Flatiron Health: Finding the Cure for Cancer

Odds are you know someone who was diagnosed with cancer. Learn more about one start-up taking on this deadly disease. Flatiron Health is a healthcare IT company using data to find the cure for cancer.

What is Flatiron Health?

In the US, cancer affects 1 of every 2 men and 1 of every 3 women [i]. Odds are we all know someone who has been at the very least diagnosed. One company looking to reduce these dire numbers is Flatiron Health, a Series B healthcare IT company headquartered in New York City and founded in 2012. Flatiron’s mission is to fight cancer by organizing data, and with $130M from Google Ventures in its latest 2014 raise, it is well on its way [ii].


In the oncology space, data has traditionally been dispersed and fragmented. Only 4% of cancer patients are captured in clinical trials, a limited sample to draw from when considering the complexities of the disease [iii]. The remaining 96% of patients have medical information that are tangled up in disconnected, unorganized medical records and doctors’ notes. Much of this information is unstructured. This is where Flatiron comes in. Flatiron helps providers organize, structure, and consolidate its cancer information onto one platform called OncologyCloud to transform the delivery of patient care [iv].

OncologyCloud is a software suite that includes:

  • OncoEMR: An electronic medical record platform to aggregate all patient data
  • OncoAnalytics: An analytics tool to draw insights from this clinical and operational data (eg, alerting clinicians if a patient is eligible for a particular clinical trial)
  • OncoBilling: A billing software to help streamline the claims process with payers on the back-end
  • SeeYourChart: A patient portal to enable patients to be informed and engaged with their care

As of 2014, approximately 2,000 clinicians and administrators were using Flatiron’s platform [v]. Since then, Flatiron has grown in customers, employee count, and VC funding and thus far appears to be on an upward trajectory.

How Flatiron’s Business and Operating Models Align

Flatiron’s business model involves offering a software platform to providers to input cancer patient data. This product enables Flatiron to build up a centralized database, organizing the cancer data, and conduct analytics to draw key insights and better improve health outcomes. With this rich dataset, Flatiron is able to work with life science companies to inform drug research and development and find a potential cure for cancer.

While this process of creating a centralized oncology database and drawing out key insights may be daunting, I believe Flatiron is a winner. Its business model aligns with its operating model, where the data and insights sourced from the OncologyCloud software suite serves as the basis of Flatiron’s value creation. These models support one another, where moving more providers onto this software platform establishes a network effect that enables Flatiron’s database to grow larger and even more valuable. As providers become increasingly reliant on Flatiron’s offerings, it becomes even more challenging for competitors to enter the space. Although individual cancer institutes like Sloan Kettering and Mt. Sinai’s Icahn Institute have attempted to utilize their own datasets in a similar fashion, the value of Flatiron is that it is able to act as a third party platform to consolidate across a diverse set of providers [v]. Not to mention, Flatiron’s push to acquire and partner with various players in the oncology space, including Altos Solutions, Varian Medical Systems, and Foundation Medicine, has enabled it to have a strong established position of credibility and support [vi].

Internally, Flatiron has dedicated client teams for the provider and life sciences sides of the business, each of which partners with the data science, engineering, and clinical oncology teams to effectively meet the needs of their provider and life science customers. It is a complex operating model, requiring much cross-functional team collaboration and clear lines of communication [vii].

What remains to be seen is what will happen for Flatiron longer-term. Will they be able to effectively draw actionable insights from their database to find a cure for cancer? Will they remain an information technology company or could they move into other parts of the value chain? How will they continue to build out their provider and life science businesses? Time will tell, but in the meantime, I say hats off to Flatiron Health for tackling a challenging problem that affects so many of us.


  • [i] http://www.cancer.org/acs/groups/content/@editorial/documents/document/acspc-044552.pdf
  • [ii] http://techcrunch.com/2014/05/07/google-ventures-leads-130m-series-b-in-cancer-data-startup-flatiron-health/
  • [iii] http://blogs.wsj.com/venturecapital/2014/05/07/google-ventures-leads-130m-round-for-big-data-medical-software-company-flatiron-health/
  • [iv] http://www.flatiron.com/
  • [v] http://fortune.com/2014/06/12/flatiron-healths-bold-proposition-to-fight-cancer-with-big-data/; http://fortune.com/2014/07/24/can-big-data-cure-cancer/
  • [vi] http://www.businesswire.com/news/home/20140509005386/en/Altos-Solutions-Acquired-Big-Data-Leader-Flatiron; http://investors.varian.com/2015-05-26-Varian-Medical-Systems-and-Flatiron-Health-to-Develop-Next-Generation-of-Cloud-based-Oncology-Software; http://investors.foundationmedicine.com/releasedetail.cfm?releaseid=885539
  • [vii] Flatiron Health conversation.


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Student comments on Flatiron Health: Finding the Cure for Cancer

  1. Great choice for the TOM Challenge – Flatiron is tackling something really important in healthcare. Beyond the most important work Flatiron takes on, does the OncologyCloud platform have applications to other parts of an oncologist’s practice beyond trial-related data collection, organization, and synthesis? You highlighted OncoBilling above; I wonder if there are ways that these tools can also assist with understanding more about patient costs, drug, and treatment reimbursements – maybe even identify trends between certain kinds of cancer treatments and “lost costs” for individual practices?

    1. Great question– the OncoAnalytics software within OncologyCloud provides business-oriented insights in addition to guidance on matching patients to appropriate clinical trials, etc. These recommendations include flagging billing discrepancies, improving administrative operations, etc. You raise a really interesting point on whether there’s also a focus on streamlining costs by cancer treatment types. Flatiron is able to track drug utilization to help support patient treatment decisions. I think they could also use this data for cost-related purposes, especially as the healthcare world moves toward value-based care.

  2. Really enjoyed learning more about a valuable healthcare service – data aggregation and compilation is so critical to managing healthcare outcomes. The healthcare industry has a tendency sometimes to adopt technology more slowly than other industries, and some providers have pushed back against EMRs because of confidentiality concerns. How do you think Flatiron can effectively communicate the risk-reward tradeoff for those who may be more reticent adopters? How can they incent providers and health systems to “get on board”?

    1. I’d say the cancer centers Flatiron targets are more incentivized than traditional hospital systems (that are often closed off with Epic and are traditionally not incentivized to openly share their patient data). The value proposition Flatiron offers these cancer centers includes an ability to match their patients to trials, keep them up-to-speed with the latest cancer research, and help them improve their business operations and billing processes. I think because cancer is such a black box where everyone is trying to ‘find the answer,’ Flatiron is in a great position to serve as this central data aggregator. Time will tell though if they end up losing steam should customers begin to raise confidentiality concerns.

  3. Great read. Flatiron is definitely moving the needle in how technology is leveraged in healthcare for better outcomes. Most current IT systems used in healthcare delivery are archaic – with non-user friendly interface, low integration across clinics, low ability to do data analysis to develop predictive trends and finally next to zero capability to provide medical insights for clinician take to better decisions for better patient outcomes. Flatiron seems to tackle all these issues by completely reinventing the interface bottoms-up (much like IDEO’s design-thinking method). Another impressive company doing similar work on Lab-Data integration is Medivo (http://www.medivo.com/). Check it out!

    1. Thanks for pointing me to Medivo, Saumya! Looks like they’re doing great work.

  4. Flatiron Health has a really interesting product and seems to be making strides towards effective data collection and analysis. However, I would be very concerned about the confidentiality point raised by Laura above. Adoption of many Health IT solutions has been stagnant due to concerns about how the data will be used, and this is even just with Electronic Health Records that have no direct plans for use in analytics. A significant aspect of Flatiron’s value-add is their utilization of the oncology data they collect but I foresee there being significant resistance from patients and physicians that are concerned about data being leaked or sold.

    1. Great point. I think because Flatiron is targeting cancer centers (vs. large hospital systems) that are all searching for a clinical solution, this confidentiality point has not been as large of a concern as it often is. The value each oncologist using Flatiron gets from this aggregated network is meaningful– e.g., now being able to have a large pool of patients to learn from across the Flatiron network vs. only one’s patients can help inform treatment decisions, etc. However, it is a valid point that this could become a larger issue as Flatiron seeks to scale.

  5. Very cool post. How in the world to they manage to extract the data from such disparate systems? Data cleanup must also be an issue, but I agree with you – the potential is enormous and the approach super interesting. I truly hope this becomes the norm. I can’t wait for more digital transformation in medicine.

    1. Thanks for your comment!

      Re: Data extraction from disparate systems– one of Flatiron’s acquisitions (Altos Solutions in 2014) had its own cloud-based EMR. With their own platform (now called OncoEMR), Flatiron was able to boost their starting position as a central database hub. They are now using OncoEMR to build in functionality and promote interoperability to best serve their customers (OncoEMR is certified for meaningful use, ICD-10 codes are available, ability to ePrescribe, etc).

      Re: data cleanup– that is spot on. Data cleaning across these different functions is a huge challenge for Flatiron, and the biggest hurdle I see is: Can Flatiron clean up all this data in a way that they will be able to effectively conduct analyses to drive toward actionable insights? I believe that while it’s a huge challenge, they have the means to do so. They have been hiring large numbers of “Oncology Abstractors” & “Oncology Data Specialists” who have the skills to help interpret and add structure to the data. From my understanding (and as expected), it is largely a manual, time-consuming process though there are opportunities to build in automation.

      I’m looking forward to seeing what happens next for Flatiron and other companies in the space!

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