“Our regimen designer plays an integral part in our platform. For example, when it comes to agents used in the cancer treatment, we have professional information and patient related information. In this blog I am going to write about how we deliver patient pertinent details  through our oncology specific patient portal. Patient engagement is very critical in the cancer world. A good patient portal will help in engaging patients to provide an effective treatment and contain costs.”

The following screen shot taken from our oncology specific patient portal shows list of regimens assigned to a patient. Just by a click of button, patient can see many useful aspects about his/her regimen. Providing ultimate UX (user experience) is a very deliberate design in every part of our application.

patient portal blog

Here when patient expands the regimen to see more details, there is an option to see list of agents. Next to the names of these agents, there is a document icon. When use clicks on this icon, they will be presented with the patient centric information about that regimen. You may be wondering how this agent information gets into the platform. That is where our regimen designer comes into picture.

In our platform, we are digitizing all the content related to cancer. It lets us deliver this content in many scenarios, including this particular scenario in patient portal. Regimen designer is the tool which will let you manage this digital content.

If we are able to provide such a rich experience in patient portal, you can imagine how much more information is made available in our provider facing solutions. At the point of care, we cannot have enough information to make a good judgment call. We present all the information you need without compromising the UX (user experience).

In order for the treatment to be effective, patient adherence is critical. In our patient portal, we provide rich calendaring options. We can deliver reminders (optional) through email and/or text.

patient portal - calendar

This screen shot taken from our oncology specific patient portal, shows scheduled events for this patient.

It is important to deliver clinical information in a patient friendly manner. The following screen shot shows how we deliver lab information to patients through our oncology specific patient portal.

patient portal - lab information

ignorance and confidence

“All you need is ignorance and confidence and the success is sure”

                                                                                         Mark Twain


I hope there is some element of truth in this quote from Mark Twain.

On one hand we have companies like McKesson, ABC(ABSG), Altos, FlatIron and Varian, who have team of super talented people building cancer related solutions. Besides talented people, they are big, have long history and credibility in the industry (not to mention the access to cash to make anything happen).

On the other hand, we have my tiny company trying to build the cancer related solutions and compete in the same market place. As you can tell, I have plenty of ignorance and confidence. Going by Mark Twain’s quote, I do have chance for success Smile

Kidding aside, what we have in our product PIIKER (www.piiker.com) is really amazing. In order to build a comprehensive cancer solution many things have to be place (agent management, cancer site and ICD 9 & 10 management, side effects, ability to manage regimens, EMR, chemo therapy administration, scheduling, security, user management, scalability, multi-tenancy, performance, patient portal and plenty other factors). How do you architect a product which has seem less integration of these factors yet very simple to use and provides best UX (user experience)? We have done it, it is hosted in Microsoft Cloud (Azure).


Before iPhone, we had BlackBerry and PocketPc as smartphone options. I used to own PocketPc. Microsoft did manage to shrink the whole OS onto this small device. Then came the iPhone, they took subset of what was there and focused on simplicity, UX and ease of use. Rest is history.

Similar things are going to happen in the oncology solutions. Cancer regimen is complicated. How do provide all the important information to the decision maker at the point of care? How can we do this  an effective and simpler way? How can we still maintain a great user experience?


Like BlackBerry and Pocket, we have had some great solutions from McKesson, Varian and Altos. There is no end for innovation. People are seeking to make things better. Recent news of Varian and FlatIron  collaborating to build oncology solution is a big step in that direction.

We (www.piiker.com) are a very small company compared these companies I have mentioned above. But, we are not short on innovation. The way we present the regimen information at the point of care, the kind of UX we are providing is awesome.

Cancer world needs better tools and solutions. I am glad to be part of the innovation driving this.



Logic will get you from A to B. Imagination will take you everywhere.

Albert Einstein


Back in the early 1980’s, if you did any “design” or “drafting” work, you were most likely working on a physical drawing board and tracing your ideas out on Vellum, Paper, or Mylar sheets using various kinds of mechanical pencil materials or maybe a Rapidograph ink applicator.  Maybe you used templates and lettering guides, or shape tracers or flexible curves.In the mid-1980’s came the first real significant influx of computerized design technologies.They were collectively termed “CAD” for Computer Aided Design.  If they were connected to manufacturing machinery, they were called “CAD/CAM” for CAD + “Computer Aided Manufacturing”. They were magical for their time. These technologies changed the landscape of designing and manufacturing.

Let us talk about oncology. Cancer is one of the major diseases of our times. Regimen used to treat this disease are very complex in nature. For some unknown reasons, there is no easy way to “design” a chemotherapy regimen (protocol). Four years ago, I told myself, “this has to change”. Here we are, after four years (so many ups and downs) we have one of the world’s finest regimen designer. We want to make a difference in the world of cancer treatment. We want to provide better tools to fight this disease.

What started as a small creative imagination four years ago is becoming a reality.

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“I’m convinced that about half of what separates successful entrepreneurs from the non-successful ones is pure perseverance.” – Steve Jobs


I was working for a fortune 25 company, had a decent position/responsibilities. It was closer to home. More than four years ago, decided to quit to pursue a product idea. Idea was to create a very comprehensive cancer solution. It was very clear in my head, I wanted this solution to cover “Design to Delivery”. I wanted to start from “regimen design” and provide everything needed to “deliver chemotherapy”. Also, more than 50% of the cancer cases involves combination therapies. Most of the existing tools treat chemo, radiation and surgery as three different silos.

I executed the plan very well & fairly quickly. Demonstrated the solution to few players in the industry. Everybody who looked at liked the idea/product but nothing happened. I had many excuses to simply abandon the idea and take up a fulltime position somewhere. But, I strongly believed in the vision and what this product could do in the cancer treatment process.

After more than four long years, I am seeing some light at the end of the tunnel. One of the well know oncologists has seen the value in this vision/product. We have identified few clearly defined use cases.

It was not an easy journey. Perseverance is a virtue. Tried so many things in between, but never took my eye off the final target.This product WILL go into beta soon. I want to make an impact in the cancer treatment space and I am not too far from it….


Unlike before, we have access to better technology to build better solutions. Our oncology solution brings everything (Regimen Designer, EMR, User Management, Administration, Analytics and chemotherapy administration) together.

In this blog I am writing about staging. When clinician is staging, some information has to be made readily available.


Sometime ago, I wrote about how our regimen designer provides an easy and powerful way of configuring stages for different cancers.

In this blog, I am writing about how clinician uses that information in EMR while staging patient’s disease.


If Clinician wants to see more details, he just has to expand the appropriate sections. See the screenshot below. Clinician can easily look at tumor sizes, Biopsy reports, Imaging reports and blood tests.


Collaborative Inventory, Dispense & Payment


Most of the Rheumatology practices manage their drug inventory and dispensing information on paper. Current breed of EMR/EHR solutions do not have very good support to help with this workflow.

Our product Koduq is designed from ground up to help these medical practices to be more productive and reduce errors.


Track drugs entering your practice from the time it is placed into inventory, through dispensing, the billing cycle, until full payment is received. Eliminate unbilled, misfiled or misplaced drugs. If your practice is currently managing drug inventory with spreadsheets or paper then use the best product in the industry to modernize your practice. With KoduQ you will instantly save valuable staff time and cost.




Mobile Access


When information is easily accessible, stake holders can take timely actions to make their businesses run smoothly and cost effectively. Our solution has rich support for mobile access to information. Users can access information from their computer browsers, iPhone and iPad. To enhance the practice workflow for dispensing, native iPad application is provided to manage daily dispenses.







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Key Benefits



Add a given drug shipment into inventory and track the usage. Manage thresholds for drugs and be notified when inventory goes below threshold.


Schedule infusion patient and know what drug & quantity is required. Make sure that, when patient arrives for infusion, you have the drug in the inventory.


Record drug dispensed for a patient in just few clicks. Electronically capture clinical and financial information. It virtually takes same amount of time as your current paper based process.


Determine if a drug has been accurately billed based on actual dispense. Current paper based process will not let the stakeholder access this information easily. 


Eliminate staff hours spent tracking drug doses. Know when to order and what to order easily.


No more manual recordings on paper which is error prone. Record who did the inventory and dispense operations for auditing purposes.


Powerful Reports for Inventory, Dispense and Billing. Find Current Available Counts, Dispensed Counts, Historical Counts (Monthly, Yearly, Daily).


Configure alerts for low inventory, Expiring Drugs, Unbilled Doses.


Identify LOTs that have been dispensed or in current inventory.



Our platform is built using latest industry standard protocols. This will enable us to integrate with various EMR, BILLING and other software systems. Our system also supports importing of EDI ASN files, so that medical practices don’t have to manually key in inventory information when drugs are received.


You can access information from mobile devices from anywhere and anytime. In order to help the physician office workflow for dispensing, a convenient iPad solution is provided.


It is normal practice that when medical practices buy drugs, payment to drug supplier is made through practice account. However, at the tax time, profit-loss should consider who used what drugs (and how many). Our software makes this process very simple. By click of a button, required reports can be generated and sent to CPA for tax purposes.


We do not expect you to sign any binding contracts. If you don’t realize ROI, you can cancel anytime. There is no contract obligation.


Our solution is securely hosted in cloud. There is no need to install any additional software in your practice.


Our system and software are hosted in secure Microsoft Cloud Datacenter. Information is made available only to the authorized users in a given practice.





Staging is an important aspect in cancer diagnosis & treatment. It drives the treatment options. How do you take this complex information and visualize in a user friendly way?

All stages are not created equal. For example, Stage II of breast cancer may not mean the same combination of TNM as that of colon cancer Stage II. In our software, we provide a very user friendly way to configure these staging information for a given type of cancer.

I am attaching one of the screen shots from our software below. At Palisha, we are trying to build one of the very best oncology solutions. The following diagram is the showing various stages of Breast cancer.

cancer site staging group

Besides this friendly UI, our platform lets you control who can make these changes. This UI looks just like this on all the major browsers (including the ones on iPad, Android and Surface).


In our cancer solution we are trying to visualize the cancer details in a meaningful way to aid the treatment process. Following is one of the screens where we want to present the tumor response details to the user (clinician).

Along with the Tumor response information, I am deciding to show the tumor size (those orange bars at the top represent the tumor size over a period of time. Tumor size is represented in centimeters)




7 Years ago, I was responsible for delivering a BI solution in which we had to slice and dice the oncology clinical and financial data/information.

Very quickly I realized, if we model the regimen details differently , all the systems down stream (designing the regimen, delivering chemo therapy, cost estimation of a regimen, adherence etc.) could benefit tremendously.

We  have built a powerful system to make this vision a reality. I will be blogging about the system in next few episodes.



Everything a starts with a regimen (which tells how a given type of cancer has to be treated). A typical chemotherapy regimen is quite complicated. It has to take lot of things in to consideration.

We have seen some complex civil structures (bridges, multi-story buildings, roads etc.) being  built. Civil engineers use tools such as AutoCAD to design and model this. Why don’t we provide a similar designer tool to oncologists? Theoretically it is possible to model a given regimen where a clinician can express the details of the regimen. This includes things such as numbers of cycles and length of each cycle, what agents are given on what day in a cycle, if the agents need supportive drugs (to increase the white blood cells, to stop patient from getting anemic etc.).

Well, we took that vision and built a cool designer (think of this a AutoCAD version for Oncologists). For example, the following screen shows a scenario where a clinician is designing a regimen (Happens to be ACT Version 4.0) and modeling the fact that this regimen could be used to treat set of breast cancers









Chemotherapy administration is a very collaborative task. Lot of people have to co-ordinate to deliver chemo agents. Our solution shines in this aspect also.



So much could be done in the area of cancer research and treatment. We are doing our part. Innovations/Improvements will make us productive and reduce errors.

More detail in upcoming posts….