Archive for the ‘Conferences’ Category

I’m writing now from beautiful (and breezy) Charlotte, NC where I managed to convince the hotel to give me a mostly undeserving room upgrade, and so I have a rather spectacular view of downtown right now!

This is our third consecutive year showing at the AAOE Conference (it used to be called BONES). This is basically the premier conference for the administrators of Orthopedic practices around the country. There are around 500 administrators total, and at least 50 different vendors.

A simple but meaningful thing kept happening to me today: I ran into people I’d met before, or clients of ours, or people I knew, or people I didn’t know but recognized from previous years. First of all, it dawned on me that running into people you know and had fun talking to is FUN! Some kind of neurochemical is released when it happens because it just makes me feel happy to catch up with people even if we’re only mildly acquainted. There’s something wonderful about strengthening a human bond; it’s very fundamental to our existence.

The week before last we began a new project with a 3-physician pediatric group in Scottsdale, AZ. I’d met the practice manager over a year ago and she expressed a strong interest in working together. She still researched us along with two other companies, and it still took a year before she was ready to sign a contract. At the end of our first meeting — which went very well and was also fun — we had an interesting exchange:

Her: You know, I actually compared you guys to two other companies. Do you know why I chose Omedix?

Me: Charismatic personnel?

Her: Haha, well, you were still around 1 year later. Both of the others had disappeared.

How does this all tie together? The “Life Truism” I referenced in the title is that business is built on relationships, that relationships are built on trust, and that trust takes time to build and is very precious. It’s so easy to look from afar at a company and try to see why they’re business strategy made them so successful and completely miss the point that if your clients don’t actually like you and trust you, nothing will ever happen.

Initially, our company is almost always evaluated based on price, quality, and features. But I feel like whenever I have a really good personal connection with a prospective client, we wind up getting the business. I feel like I enjoy my work so much more when I have a good personal relationship with our clients. It just makes the world such a happier place.

So, here at the AAOE Conference for Year #3, it’s kind of a cool feeling because we’re not strangers here anymore. People know us. People know we were here last year, that we’re here this year, and that we’ll be here next year. That kind of thing is powerful and builds trust.

I’ll write another conference post probably by the end of the conference — talking one-on-one with so many practice managers is incredibly enlightening — but for now it’s time to get some sleep!

Information TherapyI’ll be honest. I was sort of conferenced out when I was heading to Park City, UT for the next Information Therapy Conference. I figure these conferences are only as valuable as the people I meet and the extent to which the information I learn impacts current or future behavior. “Conference Burn Out” is generally not a great foundation for conference-inspired behavior change!

Well, I’m actually really glad I went. This conference is sort of like the little gem in the industry in my opinion: it draws a lot of very forward-thinking people from some very well-known institutions and some very cutting-edge ideas are discussed.
For the uninitiated, here’s the definition of Information Therapy:

Information Therapy (n.)
Prescribing the right information at the right time to a patient so that the patient is elevated from “passive receipient of care” to ” educated and empowered active self-monitor of the care being received.”

Basically, it just means that a diabetic patient 30 years ago may have blindly gotten their A1C Test just because their doctor told them to. But his modern-day counterpart was educated by his doctor about what the A1C Test really is, why it’s so important, and what the different ranges mean. In other words, the patient is now empowered to monitor what’s happening to him in his healthcare experience.

I wasn’t too sold on the concept when I first started going to this conference a few years ago but today I take a long, savory drink of this particular Kool-Aid. It’s really game-changing stuff.

I think what’s most interesting is that it’s something very concrete, so people have used it to launch other ideas about what it means to be a patient in the “new” healthcare paradigm. Basically, there’s a growing trend toward people seeing the patient as a partner in the care process, someone who has a proactive care plan and works in partnership with his doctor to achieve his personal goals. It means the patients is educated enough to know at least generally why he’s getting the tests or treatments that he is.

It means that it’s actually possible that the patient might know more than the doctor does about her particular illness because she obsessively researched it prior to her visit. Dr. Paul Wallace, Chief Medical Officer at Kaiser Permanente and a former practicing oncologist, humbly admitted that one his more enterprising patients frankly knew more about her ovarian cancer than he did.

This isn’t a failure on his part; there’s simply too much information on every different type of cancer for him to be the world’s expert. Rather, it’s an indicator that we live in a world overflowing with more information than anyone can reasonably process. That means that the days of the doctors as the untouchable lecturer of all relevant knowledge are sort of gone, and the days of the doctor as highly-educated consultant who works together with the patient to make the best decisions are beginning to come here.

It’s funny because I sat next to a girl who was developing a wellness program for her Care Management company (for the uninitiated, Care Management Companies are hired by insurance companies to proactively call members who suffer from chronic conditions and help increase compliance to keep costs down). Anyways, I cynically told her that by the end of the conference we would have yet another “we know the healthcare system is broken and if we just close our eyes and squeeze our fists we can all change it.”

I was actually proven wrong, though. The seeds of change are already afoot. Here are a few examples from the conference:

Renaissance Heath
This is a paradigm-changing practice started by Dr. Rushika Fernandopulle, who had possibly the most difficult-to-spell name at the entire conference. Dr. Fernandopulle studied healthcare policy at Harvard and utlimately decided the current system delivers systematically “crappy” care (his word; I like it). So he created a new model of primary care, which is supported by a different kind of labor setup and a different kind of business model.

Renaissance Health charges its patients $20 – $40/month and in exchange the patient goes from “episodic care” (i.e. visit doctor when I get sick) to having a proactive medical partner who works together to manage your current health and prevent future illness.

The sense of realism is what struck me most. Dr. F talked about a patient that had 5 co-morbidities. They determined that for her to do everything that was “optimal” for each condition would have required around 3 hours per day. So instead of unrealistically saying “go do these things” and then forgetting about her, they worked together to create a “care strategy”, they prioritized the list, and then they focused on the 1 or 2 issues that mattered most to her.

Dr. F also talked about how he wanted to change the paradigm of “protect the doctor from the patient at all costs” to “strategically avail the doctor to the patient in conjunction with supporting resources.” He introduced positions in his practice like “health educator” that simply don’t exist in most other practices. Sadly, Dr. F complained, the IT they wanted was more optimized to help the doctor code for the highest possible reimbursement rather than communicate proactively with the patient.

I thought it was a phenomenal model, and I have so much respect for Dr. F for “doing” instead of just talking. I hope we’ll get the chance to work together.

medencentive.jpg

These guys actually presented at last year’s conference, but I ran into their CEO, Jeffrey Greene and we chatted a bit. I obviously can’t share the details of our conversation, but just based off their public demo last year and other “winds” I’ve heard since, here’s another potential game-changer.

MedEnctive is a pay-for-performance company (for the uninitiated, that means they help setup incentive programs so that doctors who provide higher quality care are rewarded by earning more money), except that they set up a very clever incentive scheme: the patient is incentivized financially to engage the doctor (the patient gets 30 bucks if he can get the doctor to give him an information prescription) and the doctor can earn up to 10% – 15% more income per year if he gives the patient an information prescription and gets high satisfaction ratings from the patient.

The results from their first pilot were IMPRESSIVE. Like, I’m talking 30% overall cost savings in the system. That’s crazy! Crazy good, that is.

healthvault.jpg

Finally, we have another game changer. This was the first conference I’d been to since Microsoft announced their HealthVault product last week, and their was a palpable excitement in the air. Essentially, MS has setup a Personal Health Record (that’s a medical record that patients can access and update) and set up an open, free interface for accessing it.

That’s huge. It means that Omedix systems can talk with some random EMR company we’ve never even heard of as long as both of us talk with Microsoft Healthvault. Here again we have the seeds of change being sowed.

Overall, I guess you could say I’m almost kind of euphoric. I feel like American Healthcare — in all its big, clumsy, excessively wasteful and inefficient glory — is finally beginning to lumber around to a better system. For the first time, I actually feel like there are things I can do as an entreprneur that are simultaneously fun, good for America, and profitable. Finally, capitalism works the way it’s supposed to.

It’s an exciting time in our industry…as much as I’m suffering from conference burnout, I can’t wait to go to the next one!

Health 2.0 ConferenceI’m still here in San Francisco, and yesterday (Thu, Sep 20) was the Health 2.0 Conference. The idea behind the conference was to see how the latest & greatest on the Web (“Web 2.0″) applies to Healthcare. Does it get any more relevant for what we do?

Most conferences are better for the people you meet than what you learn in the sessions. I thought the panels here were actually quite interesting (except for the insurance company one which was extremely boring and overly “health 1.0″), but the attendee list here was incredible: CEO of WebMD, Former CCHIT Head David Brailer, CEO of AllScripts, the list goes on.

During the boring insurance company panel I was joking with the woman next to me that I think someone forgot to tell them it’s a Health *Two*-point-oh conference, she laughed, we introduced ourselves and it turns out she was the head of Internet Services for all of Kaiser. Cool!

Anyways, here are what I saw as some of the key trends:

Key Trend #1 — Social Networks for Patients
Seeing some of the social networks for patients was pretty interesting. Personally, I felt the two best were:

www.DailyStrength.org — This was an online community built around different disease groups. Its core concept is basically “social network for patients” but the way it was implemented was clever and fun (I give you “Hugs Received Today”).

www.PatientsLikeMe.com — This concept was just amazing. The business model is another story, but the actual user experience is incredible. Hopefully you can see in the screenshot below, each patient joins a “disease community” (the example here is Parkinson’s) and reports their history of medication usage, symptoms, weight, etc. The brilliance is in how the data is visually shown. Trends over time and relationships between, say, medications and symptoms are clearly visible. Your data can also be compared against that of other patients. Although it’s limited to chronic diseases and moreoever to just a few diseases, the potential to connect patients throughout the country (world?) is really amazing.

patientslikeme.jpg

Key Trend #2 — Social Networks for Providers
There was also a panel on these. Sermo.com is basically the leader in terms of both visibility and number of physicians registered. Within3 was also interesting, though Sermo appears to be focused around connecting physicians to each other whereas Within3 seems to center around connecting physicians to other healthcare researchers or industry members.

Key Trend #3 — Everyone Remains Pissed Off at the Healthcare System but No One in Incentivized to Do Anything About It

Okay, so this is me ranting, but it’s just getting so frustrating. Even at a conference like this where discussions were all about the next generation of healthcare, the “the system is broken and we KNOW we can fix it someday” attitude was still quite prominent.

I agree the system’s broken — defensive medicine, perverse incentives for doctors, rising premiums, unacceptably high numbers of hospital errors, 1 out of every 6 Americans is uninsured, etc. — but the problem is after a conference like this I go back to my world and think about how I can do a better job of helping our physician practice clients use the Web to become a better practice. I help them; that helps grow our business; but does the healthcare system itself change? Sadly, I don’t think so.

It’s like my (cardiologist) Dad says: “Some things are bigger than you.” It’s a defeatist statement from someone I know to be the anti-defeatist, but it’s kind of true.

Key Trend #4 — Patients Will Soon be Presented with “Find a Doctor” Services

There are a few startups I saw that aim to help patients find doctors and dentists the way they find what movie theater they want to go to:

www.xoova.com — Patients can search their zip code for a doc and learn about which one they like the best.
xoova.jpg

www.vimo.com — Vimo is the same concept as xoova, at least for finding a doctor. But Vimo is cool because they focus mostly on letting you shop for health insurance in a nifty online “apples to apples comparison” kind of way. Simple model, simple business, easy to make successful. These are my favorite kinds of business models.
Vimo

Closing Thoughts

My first thought is that this is a reallly long blog post. I can’t believe you’re still reading this (j/k…I know it’s interesting stuff). My second thought is perhaps (*perhaps*) more profound:

It really is clear healthcare is undergoing a quiet revolution. Maybe I’m being ego-centric, but I think companies in our space have some of the greatest potential to effect change out of everyone. I mean, we help the doctors do cool things online that help them appeal to patients and become more efficient, and how do we earn revenue? The practices pay us money direct because we offer valuable services to them.

Case in point: Earlier this morning, I spoke with a wonderful client of ours who runs a 2-physician OB/GYN practice and she shared with me how they get now upwards of 5 online appointment requests PER DAY and how their website has really altered the dynamic of their practice — they get patients from search engines, patients read information about their condition before and after their visit, etc.

What if when we equip this client with our Patient Portal we linked them into “PatientsLikeMe” via some kind of cool partnership? What if we made sure that patients searching on xooma or vimo are guaranteed to find our clients for relevant searches? What if our doctors logging in get automatic access to sermo or within3?

The future is exciting and unknown. You can probably see now why I love my job so much. :o ) Thanks for reading!

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