A vascular procedure ends. The evidence keeps accumulating. A device has been implanted, a patient goes home, and the questions become harder to answer: Did the treatment last? Was another intervention needed? How did comparable patients fare elsewhere? The answers arrive across appointments, institutions, and years. Someone has to make them comparable.
- Fivos runs clinical registries and analyzes medical-device outcomes.
- Its customers include specialty societies and device manufacturers; hospitals contribute clinical records.
- The useful trick: reuse an existing evidence network for another carefully defined question.
That is the business of Fivos. Its PATHWAYS platform collects detailed clinical information and follow-up results. Medical societies use that information to examine care; manufacturers use appropriate registry data to study devices. The unglamorous part - definitions, validation, permissions, and missing records - is central to the product.
A smaller company story, by design
The corporate history initially points toward a different business. Medstreaming, founded in 2006, built software for image-intensive specialties. Its co-founders, Wael Elseaidy and Ewald de Vries, had worked at Philips. In 2016, Medstreaming acquired M2S, bringing clinical workflow software together with registry infrastructure.
The combined portfolio became Fivos in August 2021. The name refers to Apollo, the Greek deity associated with medicine and healing. There was also a practical naming consideration. Former CEO Jay Colfer explained that the company wanted to escape the old names beginning with M. Finding an available web address complicated the exercise. Even healthcare informatics has to negotiate with domain names.
Then came a consequential narrowing. Fivos dates the transition of its workflow products to late 2023; buyer Harris announced the acquisition in January 2024. The software and team would operate as Medstreaming within Picis Clinical Solutions. Today's Fivos concentrates on registry partners and real-world evidence. That distinction matters when reading older descriptions of its ultrasound, practice-management, and billing products.
The form is part of the science
A registry starts with agreement about what deserves recording. PATHWAYS supports the Society for Vascular Surgery's Vascular Quality Initiative, or VQI. Its forms, designed by vascular surgeons, capture patient characteristics, procedural details, and subsequent outcomes. Built-in checks catch out-of-range entries; help text explains individual variables; incomplete-record monitoring flags unfinished work.
The platform also supplies reports for clinicians and institutions, including benchmarking and complications. Comparisons become useful when the underlying records describe comparable things. A hospital looking at its results needs more than a count of operations. It needs enough clinical context to ask why those results differ.
Fivos names the Society of NeuroInterventional Surgery and the American Association for Thoracic Surgery among its society customers, alongside SVS. It advertises more than 1,000 participating centers. These are connected institutions with people entering, checking, and using information. Their participation is part of what a buyer is buying.
What an existing network can save
A 2020 study examined six VQI-based device studies involving four manufacturers. Their average actual cost was about $1.8 million, compared with an estimated $4.4 million for independent studies. The modeled saving was 59%. Those figures describe particular projects, compared against a counterfactual, rather than a universal discount.
2020 analysis. Rounded values. The comparison is modeled, not randomized.
The economics have a concrete explanation. Relevant records, participating sites, contracting relationships, and monitoring infrastructure already existed. Manufacturers paid for additional collection and follow-up, while the underlying registry's maintenance cost was not charged to them. Reuse made the projects cheaper; the network itself still required support.
For two completed post-approval enrollments, recruitment took 21 months against an industry estimate of 38. The transferable idea is straightforward: before building a new study apparatus, examine whether a suitable one already exists.
A device needs a longer memory
Fivos's Device Evaluation Portal, launched in late 2024, packages registry information for manufacturers. Its subscription tiers range from snapshots of usage and patient characteristics to deeper outcomes analysis. Features described in its product interview include one-year outcomes and comparisons with blinded aggregate peer data.
This gives clinical, quality, and product teams a way to investigate performance after distribution. In the company's account, evolving regulatory expectations helped motivate the portal. The product addresses a practical information gap: knowing where a device shipped tells a manufacturer little about the patient's subsequent course.
“A lot of our data sits in unstructured notes.”Jay Colfer, then Fivos CEO, in a 2021 interview
Fivos sells more than access to a dashboard. Society services include registry design, operations, contracting, and administrative support. Manufacturers can commission custom analysis and study support. In 2021, Colfer described a model in which device-data revenue was shared with the society. Fivos now says societies retain ownership and control of registry data, with Fivos acting as processor.
For a society considering a registry, this changes the buying question. A software demonstration can show a form and a report. The longer commitment involves deciding who defines each field, who resolves ambiguous entries, and who keeps institutions engaged. A functioning registry needs those responsibilities assigned long after launch day. Fivos's service offering makes that continuing work part of the commercial proposition.
The work between the records
The stubborn bottleneck is abstraction: getting the right facts out of clinical records. Colfer identified the manual burden in 2021. In December 2025, Fivos and Carta Healthcare announced a partnership combining PATHWAYS with Carta's Lighthouse technology and clinical abstractors. Their chosen approach pairs AI with clinical expertise.
Fivos operates in a market that also includes IQVIA's registry offerings and ArborMetrix's registry and analytics services. Its particular position combines specialty-society relationships, longitudinal procedural data, and services for device evaluation. The relevant comparison is how well a partner can sustain a particular evidence program, including its daily operational chores.
The approach depends on the question fitting the available records, credible comparisons, and people returning for follow-up. Observational data also require care over differences between patient groups. Fivos's useful lesson travels beyond healthcare: agree on definitions, make collection manageable, and give contributors something useful back. The next question becomes easier to answer when someone has already done the work of remembering.