If you ever have a chance to hear Guy Kawasaki, take it. Guy keyed off the first ever one-day HealthTech Next Generation 2011 conference Aug 12th in Burlingame, CA. We usually cover life science conferences, but this one, which brought together leaders of the healthcare and IT industries, seemed too cool to miss. The organizers did a great job making the conference more lively and fun with Kawasaki leading out and a magician act during lunch, as well as bringing together experts to venture into the future. I’ve not heard Kawasaiki before, so I was not immune to his charisma and excitement for entrepreneurship and innovation. Guy worked twice for Apple, Inc. and once turned down a job as president of an unknown start-up in the mid-90’s by the strange name of Yahoo, a fact which Kawasaki used during his one-hour speech titled ‘Innovation in 10 Steps.’ One of Kawasaki’s steps is ‘Don’t listen to the Bozos’--those folks who say you can’t do it. Regarding the offer for Yahoo, Kawasaki said famously, “it’s too far to commute from my house, and I don’t see why anyone would use the service.” Kawasaki estimates that his stock in Yahoo would be worth $2 billion today as he contemplates the short distance from San Francisco to Menlo Park. In addition to listing himself as a Bozo, he also had the former CEO of IBM up on the slide for saying there was maybe a market for 10 computers in the world.
How else do we innovate? How about “Don’t worry be crappy,” step 5. Don’t wait til the product is perfect. Get it out there. Then work like crazy to update, going from 1.0 to 1.1, 1.2 and so on. And when something is working that your customers like, go with it, even if it’s not your main intention. Kawasaki calls this step 6 or “Letting 100 flowers blossom”--a line from Mao Tse Tung. Relating personal stories to emphasize all of his major points, Kawasaki told of the fact that Apple wanted desperately to put out a great word processor and spreadsheet in the beginning. But the customers liked Apple’s desktop publisher instead. It took a while, he remembered, but finally the folks at Apple said, “hey, let’s go with desktop publishing and stop trying to be Microsoft.” We all know what happened next.
HITECH Act Stimulus Dollars
With the passing of the HITECH Act, healthcare organizations can received stimulus incentives to use EMR’s. This is spawning new companies like Dr Chrono, epion, and new life for companies such as RedSpin.
Dr Chrono is a start-up based in Mountain View, California (surprise) and sells an EMR app by the same name. Not in the Expo hall of this conference, Dr Chrono was brought to my attention last week by a friend who just began working there. Using the all-popular iPad, Dr Chrono replaces paper records, providing physicians a way to complete everyday tasks and access information. This can be done through the Dr Chrono app but also is available from any Web browser, iPhone, or Android. Physicians can use the app for scheduling appointments, writing e-prescriptions (can be sent to any pharmacy), paperless billing, taking notes, transcription, and drug interaction tests. X-rays, EKG’s, or lab results can be uploaded to the app.
The app is free on one iPad, but more devices require subscriptions ranging from $99 to $199 a month. Most importantly perhaps is that using Dr Chrono qualifies medical practitioners for $44,000 in economic stimulus incentives provided through the HITECH Act which set aside $19.2 billion to persuade doctors to transition from paper to digital.
Another new company, Epion Health, is using the electronic tablet (they make they’re own) to target “low health literacy.” According to the company’s website, poor knowledge of health is costing the U.S. healthcare system $200 billion annually. The idea is for the tablet to educate patients while they wait outside (and inside) the doctor’s office. The content is peer reviewed and coming from the Mayo Clinic, who, according to the company, has entered into a partnership with Epion to provide exclusive content. Epion will provide the tablet free to physicians and relies on sponsors for revenue.
In order for physicians and clinics to qualify for federal stimulus incentives, they must have an IT security audit. No one could be more pleased with this requirement than RedSpin. The company specializes in testing whether an organizations is vulnerable to threats to their IT system. Not just about preventing hackers from accessing patient records, the company tests things like whether internal passwords are strong or used at all and whether backups are in place. RedSpin is focuses on the healthcare industry but also serves banking and financial services, retail, energy, technology, hospitality and casinos.
Taking place for just one day, the conference teased with fantastic titles including ‘Data Privacy and Security - Are we safe?’, ‘Meaningful Use of EHR - Hit the Ground Running!’, and ‘Future of Healthcare Systems - Innovate or Else.’ I attended ‘Adoption of mHealth - Got iPads?’ which included a panel of experts, including physicians and an electrical engineer. Focusing mostly on ‘tele-health,’ this discussion began with stories about using technology, mostly mobile phones, to aid in the treatment of victims in the recent Haiti and Katrina disasters. Dr. Enoch Choi from the Palo Alto Medical Foundation (PAMF) gave an account of his experience setting up a triage in Haiti pretty much all from his mobile phone which had excellent service while there was no power or internet.
Dr. Choi’s employer has been an early adopter of mobile technology, using their own App to connect with their patients. If you see a doctor at Palo Alto Medical Foundation, you can submit a request over your mobile and expect to hear from your doctor within 2 hours, a great example of how technology is changing medicine. (When I think of how hard it is to reach my doctor outside of scheduling an appointment, Dr. Choi’s advertisement for interconnectedness made me feel somewhat left behind.) Upon a comment from the audience about challenging problems for tele-health such as the fact that “there is no good reimbursement model for tele-visits (doctors charge much less for a visit over the phone, yet it takes the same amount of time), Dr. Choi replied, “it’s not a matter of whether to do it, we have to do it.” The planners at PAMF consider connecting with their customers over mobiles as the entry for service. Kaiser is offering services like answering medical questions over the phone for free. In order to compete, a healthcare organization must interact with their customers in new ways just to have them as patients, Dr. Choi emphasized.
It’s true, their are major challenges in addition to reimbursement including liability issues, malpractice concerns, working over state lines, and health fraud (is the person at the other end of the line even a doctor?).
According to Dr. Sara Rushinek, a professor at the University of Miami, tele-health can be used as incentives for advertisers as well as employers. She told of doctors using the X-Box to communicate with their patients. In this case a doctor “can talk to extended family as well which rarely happens in the office setting.” Perhaps the spiciest moment of the conference came not from Kawasaki but from Dr. Rushinek. As expected, someone voiced concern that something is lacking in a video conference with a doctor. The physician is unable to touch the patient and therefore somewhat handicapped. In many cases this kind of touch contact is not needed for follow up visits, Dr. Rushinek replied. “Think of porn,” she ventured, “it may be coming over the TV but you’re still having the sex experience.”
Health in the 21st century--where are we headed?