John Kim admits he had a relatively easy path to success. One day he decided to form his own software company, and eventually it went on to generate tens of millions of dollars in revenue. Or at least that’s how he remembers it now that he’s moved out of the call center space and into health care.
“I, like an idiot, looked at health care and said, ‘Oh! I’ll go into that next! Watch what I do here. This is going to be amazing,’” Kim, now the CEO of DoctorBase, said.
Though DoctorBase’s trajectory so far isn’t looking exactly like Five9’s, it doesn’t sound like Kim is any less enthusiastic about his newer venture. The doctor-patient communication platform has undergone a series of experiments, many of which have failed, resulting in several durable ideas, which have stuck. From Kim, here are three lessons learned from his experience with DoctorBase.
Get office administrators involved
DoctorBase lets patients use a portal to email their provider, who then receives the message on his iPhone or iPad. In order to work correctly, the platform requires participation from three different parties: patients, doctors, and administrators. Administrators, as well as mid-level practitioners, are key, Kim said.
They help with the division of labor so that answering numerous patients’ questions isn’t so laborious. In fact these employees are going to be the ones who answer a lot of the emails because much of what patients ask isn’t medically relevant. Many send questions about appointments or prescription refills. Administrators make sure that the medical questions are forwarded to the doctor.
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It is no secret that the current trend of rising health care costs for businesses is unsustainable. The increasing prevalence of employees with chronic lifestyle diseases, such as obesity, high cholesterol, or diabetes, is resulting in more absenteeism, less productivity and an overall increase in health care costs.
All these factors contribute to the growing need for business leaders to get proactive and bring down these costs by helping their employees to get healthier.
This is where workplace wellness programs can be of value.
Chronic lifestyle diseases are, in large part, caused by unhealthy behaviours: bad eating habits, sedentary lifestyle, etc. Thus, if wellness programs can change these unhealthy behaviours, then the costs associated with them can be prevented.
However, creating the kind of behaviour-change necessary to improve employee health-habits is a notoriously difficult thing to achieve. Merely disseminating information about what one should eat or how often one should exercise does not seem to work in the long term. People know this information, but often fail to act on it.
This is because the unhealthy habits that wellness programs are trying to change are deeply ingrained in our way of life. It is extremely easy and convenient to take the unhealthy option: unhealthy foods are always within reach, and are cheap. We drive more often than walk, and take the elevator rather than the stairs.
Mobile and online technology, as part of a comprehensive wellness program, offer a way to respond to these factors and create the kind of lasting behaviour change necessary to bring down health care costs and increase productivity. Use of these types of technology can make it just as easy and convenient to take the healthy option and eventually change habits.
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There are more excellent ideas out there than there are ideas that will succeed, according to Microsoft HealthVault‘s Chief Architect Sean Nolan. At Health:Refactored, Health 2.0′s conference for designers and developers, Nolan delivered a keynote centered around the stumbling blocks encountered during the lifetime of the average startup. In this video he discusses overcoming an early obstacle — getting over the dismay of not knowing someone who can pilot your product at their large hospital.
On an inside job, Senior Vice President at Health 2.0 Jean-Luc Neptune, MD, MBA, interviewed with us at Health Datapalooza IV. Neptune heads the developer challenge program in New York City and has carried out numerous innovation challenges over the course of his two years with Health 2.0. In this video he discusses overall attitudes toward challenges in the public and private sector, and whether or not he thinks organizations have come to understand their benefit. He also gives a rundown of the challenges going on now.
WellDoc, a health care behavioral science and technology company, launched BlueStar, an FDA approved mobile prescription therapy for Type 2 diabetes. It is the first mobile health product eligible for insurance reimbursement similar to other prescription products.
Sessions began a clinical trial of its mobile-based coaching program for inactivity and nutrition at Mayo Clinic, as reported by MobiHealthNews. Sessions is a member of Rock Health‘s Class of 2012.
Basis, maker of wrist-based health trackers, launched the mobile app for Basis Band, its flagship product. The app is currently supported by Android platforms only. Basis raised $ 11.5M in Series B funding earlier this year.
UC San Diego Health System began a pilot program at its Emergency Department to study the effectiveness of telemedicine in addressing crowding and reducing patient wait times. The study will use cameras to connect on-call doctors to patients in need who are outside of the hospital.
Scientists at the National Science Foundation developed a new smartphone app that allows 911 operators to virtually collect biometric data, remotely control the smartphone camera to view the scene of emergency, provide speech to text guidance, and send GPS coordinates to first responders.
Nuance released a new version of Dragon Medical Practice designed for smaller practices that includes voice shortcuts to aid searches for medical information and more than 90 specialized medical vocabularies.
A KLAS report on EMRs that targeted the voice of ambulatory physician leadership found that success in achieving high usability ranges from 85 percent to 55 percent. The report noted that the burden for the EMR usability gap was shared between vendors and providers.
Chemists at the University of Pittsburgh demonstrated a sensor technology that could diagnose and monitor diabetes through breath analysis alone. The team is currently working on a prototype of the sensor, with plans to test it on human breath samples soon.
England is launching a cancer database tracking all 350,000 new tumors detected each year as well as 11 million historical records going back as far as 30 years, in an attempt to advance personalized medicine. The database will be updated monthly with information from every acute NHS trust.
Stanley Healthcare launched their Hugs infant protection solution on the AeroScout Wi-Fi-based RTLS Platform. The new Hugs system works with standard Wi-Fi, and is able to track the location of babies and provide protection wherever Wi-Fi coverage exists.
Health care is slow to change. But the word “slow” is relative and means something different to each person depending on where he or she sits within the health care system. From the investors’ perspective, health information technology moves at a fast pace, at least relative to biotechnology.
“The limited partners, who are the ones who put their money into the venture funds, have lost the taste for biotech investing. Why? Because it locks their capital up for long periods of time — 10 years at least — with very uncertain outcomes,” Merv Turner, PhD, former chief strategy officer for pharmaceutical company Merck, said at a recent seminar in San Francisco.
The event was hosted by QB3, a partnership between University of California schools UC Berkeley, UC Santa Cruz, and UCSF, which promotes the quantitative biosciences. For his talk, Turner was asked to frame the state of this domain within the context of the entire health care system, a task that was very similar to what he did in his last role at Merck.
While he was in the strategy office there, Turner created Global Health Innovation, a fund that allowed Merck to invest in emerging companies. For the purpose of investing smartly, Turner was charged with identifying the up-and-coming business opportunities in health care and assessing their possible impact, for better or for worse, on the pharmaceutical industry.
It was interesting to hear which topics and developing health care themes Turner chose to highlight for an audience of biotech entrepreneurs. Overall they were incredibly similar to the ones commonly discussed by the health tech community. For example, there is the difficulty of convincing firms to invest in health care when they have their choice of technologies in a range of other less cumbersome fields.
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Artist Regina Holliday sat down at Health Datapalooza IV
to provide an update on the progress of the Walking Gallery
. Her patient advocacy mission began after her husband Frederick Allen Holliday II lost his battle with cancer. Holliday’s mission to educate others about the benefits of HIT as well as its pitfalls has taken her around the world. She’s managed to paint more than 200 jackets as part of the Walking Gallery for those she’s met along the way. Here Holliday discusses her coming plans for the project, and why she’s aiming for a second successful run on crowdfunding platform
The rapidly growing and changing technology landscape of the health care industry means that companies catering to this market are also rapidly developing and adapting. Technological advancements are happening so quickly that health care companies have to be able to move quickly in order to stay relevant and effective. This can be a challenge for large, public companies because there are a lot of moving parts that all need to be working in unison to make the vehicle run, not to mention many layers of approval to navigate. A private company can be more nimble, more customer-oriented and more experimental with the way they use technology. In an industry where “fly-by-night” companies are a regularly accepted occurrence, there is something to be said for well-established, stable and privately held companies in the health care industry and the benefits they can provide to their customers.
For example, when a company is privately held, there are no demands for quarterly increases to meet shareholder goals and no immediate pressure to introduce something revolutionary every few months. Privately held companies are able to concentrate on making sophisticated, yet user-friendly products. Of course new features and functionality continue to be introduced, but it’s done at the company’s own pace – ensuring that the end product is the best it can be — not just something that was rushed out the door to meet a deadline. Because there aren’t multiple parties to cater to, private companies can always stay true to what they really want to do — make great products. When companies are trying to please numerous entities, it can lead to poorly matched mergers, as well as the “sun-setting” of similar products within a combined company, often upsetting existing customers who are basically left hanging with a product that will not be further developed or supported.
Another privately held company in the health care industry that I’ve noticed has experienced much success and growth is venture-backed SonaCare Medical, a world leader in minimally invasive high intensity focused ultrasound technologies. Because of their ability to concentrate on creating great products in a specialty area, they have grown to be leaders in their field. More than 130 Sonablate 500 systems are installed in more than 30 countries and over 12,000 prostate cancer patients have been treated with Sonablate 500.
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For emergency department physician Graham Snyder, MD, one of the most psychologically challenging parts of losing a child to drowning is that in almost every case he knows exactly how it happened.
“Healthy, happy and young is just not supposed to die. One of the frustrations about drowning is that it’s so repetitive, and I almost hate to say it’s predictable,” he said.
Mourning parents have told him that they looked away for one second and just like that, their child was gone. But Snyder knows that’s not how it happened because drowning doesn’t occur so quickly. Which doesn’t make it any more the fault of the parents or whoever was on the lookout. The norm around the swimming pool is noise and movement — children laughing, splashing, screaming and jumping.
“Then they’re supposed to notice the one child who’s silent, who is no longer in view, and he’s not moving,” Snyder said. “They’re trying to notice the thing that’s unnoticeable.”
That’s why Snyder and a team of engineers went to work to create a monitoring device to alert lifeguards, parents and other onlookers to a potentially dangerous situation. They designed the SEAL, a waterproof device that is worn around the neck and connects back to a hub positioned near the lake or pool. If a child is under water and the SEAL band is submerged for too long, an alarm will sound.
Anyone who’s taken a tumble from a hard-hitting wave, or who has been held under water by an older brother, knows the uncomfortable feeling of being unable to breathe for too long. But there is a significant amount of time between that feeling and actually going into cardiac arrest, Snyder explained. His strategy is to take advantage of the time period between the point when a child feels that he or she is drowning and the point where cardiac arrest is imminent.
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Jan Gurley, MD practices internal medicine in San Francisco. As a physician, she’s an experienced writer, but through a patient perspective, she recently chronicled her experience receiving a cancer diagnosis in the three-part series called “Booby Traps.” Gurley delivered a talk last month at Health:Refactored, Health 2.0′s conference for designers and developers. In this post-game interview, she elaborates on her talk and explains to product designers when it’s OK to talk to patients at the fourth grade level.