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Jay Parkinson at Himss Jay Parkinson at Himss Presentation Transcript

  • WHERE IS THE HEALTHCARE REVOLUTION? +
  • JAY PARKINSON, MD, MPH
  • CHIEF MEDICAL OFFICER
  • CANADIAN-BASED
  • HEALTHCARE IT
  • HEALTHCARE SERVICES
  • NAT FINDLAY, CEO
  • VP OF CLINICAL STRATEGIES
  • CARDINAL HEALTH
  • 23 EMPLOYEES
  • 16 DEVELOPERS
  • PRIVATELY FUNDED
  • STARTING THE REVOLUTION
  • PEDIATRICS & PREV MED
  • FEW OPTIONS TO PRACTICE
  • NO OPTIONS TO USE TECHNOLOGY
  • I HAD TO STEP BACK IN TIME
  • 10 YRS TO USE TODAY’S HEALTH IT
  • I AM A MILLENNIAL DOCTOR
  • WELL...ALMOST
  • I’M 32
  • I COMMUNICATE LIKE A MILLENNIAL
  • I USE MILLENNIAL TECHNOLOGY
  • GEN X AND MILLENNIAL PATIENTS
  • THEY USE MILLENNIAL TECHNOLOGY
  • AND THEY NEED A DOCTOR
  • WE USE THE NET TO COMMUNICATE
  • WE USE THE NET TO CONNECT
  • IT’S VERY EFFICIENT
  • IT’S VERY FUN
  • IT’S JUST PLAIN NORMAL
  • YOU CAN’T CONNECT WITH DOCTORS
  • I CHANGED THAT.
  • WORLD’S FIRST “VIRTUAL” PRACTICE
  • I DIDN’T HAVE AN OFFICE
  • I HAD A WEBSITE
  • AND A NEIGHBORHOOD
  • AND YOUR APARTMENT
  • I CONNECTED WITH MY PATIENTS
  • EMAIL, IM, SMS, VIDEO CHATS
  • I SAW THEM IN THEIR HOME
  • I HAD ALMOST NO OVERHEAD
  • $1500
  • TECHNOLOGY GAVE ME FREEDOM
  • WE COMMUNICATED HOW WE WANTED
  • AND WE DID IT EFFECTIVELY
  • AND EFFICIENTLY
  • THAT’S WHAT THE NET DOES
  • TELL ME THEIR SYMPTOMS ONLINE
  • BRANCH LOGIC QUESTIONNAIRE
  • LOOK AT MY GOOGLE CALENDAR
  • SCHEDULE THEIR OWN APPT
  • iPHONE ALERTS ME I HAVE AN APPT
  • I SEE THEM IN THEIR APARTMENT
  • I CHARGED A REASONABLE FEE
  • $100 - $150 PER HOUSE CALL
  • AND PEOPLE PAID ME CASH
  • THREE TIMES THE RATE 300 MY PRACTICE 225 150 TRADITIONAL PRACTICE 75 0 SEPT OCT NOV DEC
  • HALF WERE INSURED
  • STILL PAID ME CASH
  • I WAS ACCESSIBLE
  • I COMMUNICATED NORMALLY
  • WE HAD A RELATIONSHIP
  • THAT WE BOTH VALUED
  • CLIENTS WERE WILLING TO PAY
  • A REASONABLE PRICE
  • VALUABLE, ACCESSIBLE SERVICE
  • I AM A DOCTOR IN BROOKLYN
  • WHO HUNG UP HIS SHINGLE
  • VIA THE WEB
  • 7,000,000 HITS IN 3 MONTHS
  • WHY?
  • I SAW A NEED
  • AND I FILLED IT
  • STRAIGHT TO THE CONSUMER
  • MEET THE NEEDS OF...
  • |kənˈsoōmər|
  • WHAT IS THAT?
  • TWO DEFINITIONS
  • a person who purchases goods and 1 services for personal use
  • a person or thing that eats or 2 uses something
  • WHICH APPLIES TO HEALTHCARE?
  • I SAY #2
  • AN ANALOGY
  • YOU NEED TO BUY CLOTHES
  • EVERYONE NEEDS CLOTHES
  • LUCKY YOU
  • YOUR OWN PERSONAL SHOPPER
  • YOU HAVE NO FASHION SENSE
  • YOU DESPERATELY NEED HELP
  • HE’LL CHOOSE YOUR CLOTHES FOR YOU
  • HE HAS A GRADUATE DEGREE FROM F.I.T.
  • HE TRAINED THERE FOR NINE YEARS
  • HE’S VERY OVERWORKED
  • BECAUSE EVERYONE NEEDS CLOTHES
  • YOU WAIT HOURS
  • HE’S THE BOTTLENECK
  • THE ALTERNATIVE = NAKED
  • ONLY THE BEST FOR YOU
  • YOU LOOK GOOD = HE LOOKS GOOD
  • COST ISN’T AN ISSUE
  • WHY?
  • HE DOESN’T KNOW, NOR DOES HE CARE
  • HE’S TOO BUSY FOR SUCH TRIVIALITIES
  • AND LUCKY YOU
  • YOU DON’T CARE EITHER!
  • SOMEONE ELSE IS PICKING UP THE TAB!
  • HE TAKES YOUR MEASUREMENTS
  • HIS TOOLS ARE SO PRECISE
  • TAPE MEASURE = $50,000
  • HE’S PARTICULAR ABOUT HOW YOU LOOK
  • AND IF YOU’RE NOT HAPPY...
  • YOU SUE HIM!
  • HE WRITES THE ORDER
  • YOU PICK UP YOUR SUIT
  • FROM THE MOST CONVENIENT STORE
  • PAY YOUR $10
  • AND LEAVE WITH YOUR $5000 SUIT
  • OBVIOUSLY CRAZY
  • EVEN CRAZIER THAN PRE-INTERNET
  • STORES COMPETED IN LOCAL PAPERS
  • NO EASY WAY TO COMPARE COSTS
  • ALONG CAME THE PRICE REVOLUTION
  • THE DINOSAURS WERE SCARED!!!
  • LITTLE DID THEY KNOW...
  • THIS WOULD ACTUALLY INCREASE REVENUE
  • CUSTOMERS = MORE, SIMPLIFIED! SELLERS = LESS, COMPLEX!
  • CONSUMER IGNORANCE = $
  • BUT IN FACT...
  • CONSUMER KNOWLEDGE = $$$
  • THEN CAME THE QUALITY REVOLUTION
  • THE DINOSAURS WERE SCARED!!!
  • SELLERS HAD TO BE ACCOUNTABLE
  • YOUR BUSINESS DEPENDS ON YOUR REP
  • PRODUCTS HAVE TO BE ACCOUNTABLE
  • AGAIN...
  • THE DINOSAURS WERE SCARED!!!
  • SALES DEPEND ON YOUR QUALITY
  • THE DINOSAURS THAT DIDN’T CHANGE
  • SIMPLY DIED
  • WAS IT A METEOR?
  • NO...
  • IT WAS AN UNCOORDINATED
  • SMOLDERING ATTACK
  • FROM A BUNCH OF GENIUS NOBODIES
  • THAT CHANGED BUSINESS FOREVER
  • THAT CHANGED THE WORLD FOREVER
  • WHERE IS THE HEALTHCARE REVOLUTION? +
  • IT’S SIMPLY NOT HAPPENING
  • WHY?
  • HEALTHCARE IS OFFLINE
  • NO ONLINE HEALTHCARE TRANSACTIONS
  • ONLY HEALTH INFORMATION
  • NO PROVIDER-PATIENT CONNECTIVITY
  • THE PAYORS ARE IN THE WAY
  • AGAIN...THE PAYORS ARE IN THE WAY
  • DOES PAYPAL GET IN THE WAY OF EBAY? NO!
  • PAYPAL ENHANCES EBAY
  • DOES VISA GET IN THE WAY OF AMAZON? NO!
  • VISA ENHANCES AMAZON
  • WHAT ARE THE NEXT STEPS?
  • FOLLOW THE EVOLUTION OF THE NET
  • START TRANSACTING ONLINE
  • MAKE DOCS MORE ACCOUNTABLE (SELLERS)
  • MAKE THEIR PRODUCTS MORE ACCOUNTABLE (DOCTOR SERVICES)
  • QUESTION CURRENT QUALITY PRACTICES
  • WHAT IS PHYSICIAN QUALITY?
  • THE DEGREE TO WHICH HEALTH SERVICES FOR INDIVIDUALS AND POPULATIONS INCREASE THE LIKELIHOOD OF DESIRED HEALTH OUTCOMES AND ARE CONSISTENT WITH CURRENT PROFESSIONAL KNOWLEDGE
  • HUH?
  • WHAT DOES THIS REALLY MEAN TO DOCS?
  • DO I DELIVER GOOD HEALTHCARE?
  • HOW DO I KNOW?
  • I LIKE TO THINK I DO
  • BUT DO I REALLY?
  • THE BMJ RECKONS THAT 50% OF THE TREATMENTS I USE IN GENERAL PRACTICE AREN’T PROVED, AND 5% ARE PRETTY HARMFUL BUT I STILL USE THEM
  • HOW DO I PROVE I IMPROVE OUTCOMES?
  • IN MY PAPER CHARTS
  • OMG!
  • I HAVEN’T DONE A CHART REVIEW
  • SINCE MEDICAL SCHOOL
  • BUT THE REAL QUESTION IS...
  • WHAT DOES THIS MEAN FOR PATIENTS?
  • DID MY DOCTOR INCREASE MY LIKELIHOOD OF FEELING BETTER?
  • DID SHE USE CURRENT PROFESSIONAL KNOWLEDGE TO HELP ME FEEL BETTER?
  • GEEZ...I HOPE SO
  • BUT HOW DO I KNOW?
  • WHERE IS THE INFO TO PROVE THIS?
  • IN MY PAPER CHART IN MY DOC’S OFFICE
  • OMG!
  • I CAN’T EVEN READ THE HANDWRITING!
  • AND WHAT DO YOU MEAN???
  • $100 TO FAX IT TO ME!
  • FOUR WEEKS FROM NOW!
  • HERE’S THE POINT
  • MEASURING INDIVIDUAL PHYSICIAN QUALITY WITH THE CURRENT INFRASTRUCTURE IS IMPOSSIBLE, UNREALISTIC, AND FAR FROM THE ACCEPTED SCIENTIFIC METHOD
  • HEALTHCARE DATA = PRE-EXCEL ERA
  • HEALTHCARE DELIVERY = 1960’s
  • HEALTHCARE TRANSACTIONS = PRE-EBAY
  • WE ARE SCIENTISTS
  • WE EXPECT RANDOMIZED, CONTROLLED, DOUBLE-BLINDED STUDIES
  • JUST LIKE MEDICATIONS
  • PHYSICIAN QUALITY IS AN INTERVENTION
  • DO YOU THINK YOUR PATIENTS ARE A RANDOMIZED, CONTROLLED, DOUBLE- BLINDED STUDY?
  • DO YOU THINK YOU HAVE ENOUGH SIMILAR PATIENTS TO MAKE THIS DATA RELIABLE AND REPEATABLE?
  • MOST DOCTORS ARE AVERAGE DOCTORS
  • WE FOLLOW A BELL CURVE
  • SOME ARE REALLY GOOD MOST ARE AVERAGE SOME ARE REALLY BAD
  • HOW ARE YOU SUPPOSED TO KNOW??
  • DOCTOR RATINGS?
  • COME ON ALREADY!
  • CONSUMER INFORMATION IS FREE!
  • 10,000 TVs = 36 RATINGS
  • 2,000 PATIENTS = 5 RATINGS?
  • RELIABLE RATINGS DEPEND ON VOLUME
  • VOLUME DEPENDS ON INCENTIVES
  • THERE ARE NO INCENTIVES
  • BLOWING OFF SOME STEAM
  • TELLING STRANGERS HOW WONDERFUL YOUR DOCTOR IS
  • LET’S RETHINK QUALITY “RATINGS”
  • WHAT DO PEOPLE EXPECT FROM DOCS?
  • HOW DO CONSUMERS VIEW QUALITY?
  • THOROUGHNESS
  • THEIR OWN, REGULAR DOCTOR
  • A WARM, FRIENDLY DOCTOR
  • TIMELY APPOINTMENTS
  • APPOINTMENT OPTIONS
  • WHAT DOES THIS MEAN?
  • CONSUMERS WANT: THEIR OWN THOROUGH, FRIENDLY DOCTOR WHO WILL SEE THEM WHEN AND HOW THEY WANT TO BE SEEN
  • HOW CAN WE MAKE THIS HAPPEN? +
  • START TRANSACTING ONLINE
  • TAKE LESSONS FROM EBAY, AMAZON, AND KAYAK
  • WE NEED TO STOP PRODUCING MORE CONSUMER HEALTH INFORMATION
  • FOCUS ON TRANSACTIONS
  • USE THE NET TO CONNECT PATIENTS WITH THEIR NEIGHBORHOOD DOCTORS
  • FACE-TO-FACE AND ONLINE
  • PAID FOR BY INDIVIDUALS, NOT PAYORS
  • SUSANNAH FOX *former editor of US News & World Report *current Director of Pew Internet and American Life Project
  • RECRUIT DOCTORS. GO MOBILE. LET E-PATIENTS LEAD.
  • 1 START RECRUITING DOCTORS
  • PCPs ARE GETTING RESTLESS
  • THEY’RE SICK OF WORKING LIKE DOGS FOR SOMEONE ELSE’S PROFITS
  • THEY’RE SICK OF NOT BEING ABLE TO DO THEIR JOB WELL
  • BECAUSE THEY GET PAID FOR VOLUME
  • AND THAT PAY DECREASES EVERY YEAR
  • SOCIAL NETWORKING DOCTOR BLOGS
  • “HYPERLINKS SUBVERT HIERARCHY” -THE CLUETRAIN MANIFESTO
  • TAKE ADVANTAGE OF HYPERLINKS
  • BOTTOM UP APPROACH
  • TO CREATE A UNIFIED PHYSICIAN VOICE
  • THE INTERNET ORGANIZES GROUPS
  • WE HAVE TO GIVE DOCS ALTERNATIVES
  • OPPORTUNITIES TO BE ENTREPRENEURS
  • A PROFITABLE BUSINESS MODEL
  • TECHNOLOGY AND TOOLS TO CREATE “THE CONSUMER EXPERIENCE”
  • DIFFERENTIATE THEMSELVES FROM “THE COMPETITION”
  • COMPETITION: TRADITIONAL, OVERWORKED, UNDERPAID, INSURANCE-TAKING, TOO BUSY TO CARE DOCTORS
  • ADVERTISING AND MARKETING SUPPORT
  • BECAUSE DOCS DON’T DO THIS WELL
  • THIS WILL SPREAD VIRALLY WITHIN DOCTOR COMMUNITIES
  • WE’RE ALL LOOKING FOR A BETTER WAY
  • 2 GO MOBILE
  • INTERNET COMMUNICATION IS NORMAL
  • SMS, IM, VIDEO, FACEBOOK, MYSPACE
  • IT’S HOW WE COMMUNICATE
  • IT’S ACCESSIBLE.
  • IT’S UBIQUITOUS.
  • IT’S EFFICIENT.
  • THERE IS NO DIGITAL DIVIDE
  • WE NEED TO CREATE FACEBOOK FOR HEALTHCARE
  • A WEB PLATFORM
  • WHERE DOCS CONNECT WITH THEIR PATIENTS
  • ONLINE AND IN-PERSON
  • TO COMMUNICATE AND COORDINATE
  • A MARKETPLACE BASED ON CASH
  • WITH ABSOLUTELY NO PAYORS
  • NO MIDDLEMEN
  • PATIENTS AND PROVIDERS CONNECTING DIRECTLY
  • TRANSACT ONLINE
  • 3 LET E-PATIENTS LEAD
  • WHAT ARE E-PATIENTS?
  • e-Patients represent the new breed of informed health consumers, using the Internet to gather information about a medical condition of particular interest to them.
  • The term encompasses both those who seek online guidance for their own ailments and the friends and family members who go online on their behalf.
  • e-Patients report two effects of their online health research—better health information and services, and different (but not always better) relationships with their doctors.
  • CONNECT DOCTORS WITH E-PATIENTS
  • USE THE INTERNET AS A TOOL
  • TO EDUCATE PATIENTS
  • HAND-PICKED INFORMATION
  • PERSONALIZED TO YOU.
  • WHO ARE E-PATIENTS?
  • THOSE WITHOUT AN ACCESSIBLE PCP
  • E-PATIENT #1 THE UNINSURED WHO HAVE TO PAY CASH
  • WHO ARE THE UNINSURED?
  • 47 MILLION
  • 70% (33.4 MIL) ARE AGE 18-55
  • 38% HAVE INCOMES > $50K
  • 20% HAVE INCOMES > $75K
  • 80% OF PEOPLE AGE 18-34 ARE ON FACEBOOK
  • YOUNG WIRED NOT POOR RELATIVELY HEALTHY PRONE TO ACUTE INJURIES PRONE TO ACUTE ILLNESSES SPEND $900 PER YEAR ON HEALTHCARE
  • E-PATIENT #2 THE INSURED WHO WANT INFORMATION, ACCESSIBILITY, AND COMMUNICATION, AND ARE WILLING OR HAVE TO PAY OUT-OF-POCKET FOR IT
  • OUT-OF-POCKET HEALTHCARE EXPENSES $250 BILLION PER YEAR
  • ANNUAL REVENUES: EBAY = $7.7 BILLION APPLE = $24 BILLION GOOGLE = $11.4 BILLION AMAZON = $13.5 BILLION MICROSOFT = $51.1 BILLION
  • OUT-OF-POCKET DOCTOR SERVICES EXPENSES: $75 BILLION PER YEAR
  • AND NOT A SINGLE COMPANY HAS GONE AFTER THIS MARKET
  • UNTIL NOW
  • hellohealth
  • CONSUMER BRAND
  • HEALTHCARE DELIVERY
  • THE MYCA WEB PLATFORM
  • “THE FACEBOOK OF HEALTHCARE”
  • CONNECT DOCTORS AND PATIENTS
  • BOTH ONLINE AND IN-PERSON
  • DOCUMENT THESE INTERACTIONS
  • BILL FOR THESE INTERACTIONS
  • NEIGHBORHOOD-BASED OFFICE
  • MUCH LIKE STARBUCKS IS A NEIGHBORHOOD STAPLE
  • NEW HEALTHCARE CONSUMERS
  • WHO EXPECT MORE
  • WHO EXPECT BETTER
  • IT’S ABOUT TIME
  • OF HEALTHCARE
  • FOR THE WHOLE FOODS CROWD
  • THEY EXPECT ACCESS
  • THEY EXPECT SERVICE
  • THEY EXPECT VALUE
  • THEY EXPECT THE EXPERIENCE
  • THEY PAY FOR “EXPERIENCE”
  • THEY’RE HAPPY TO IF IT’S REASONABLE AND TRANSPARENT
  • JUST ASK
  • SUCCESSFUL CONSUMER BRANDS
  • PEOPLE NOW INTERACT WITH BRANDS
  • PEOPLE EXPECT
  • PEOPLE EXPECT
  • BUT IN HEALTHCARE
  • THE HEALTHCARE CONSUMER EXPERIENCE
  • SIMPLY DOESN’T EXIST
  • UNTIL NOW
  • hellohealth
  • INTERACTIVE NEIGHBORHOOD-BASED CONSUMER-BRANDED HEALTHCARE DELIVERY PLATFORM AND SERVICE
  • VERY LOW OVERHEAD
  • USED TECHNOLOGY
  • TO STREAMLINE PROCESSES
  • STREAMLINE COMMUNICATION
  • CUT OUT THE MIDDLEMEN
  • PEOPLE WANT TO CONNECT
  • PEOPLE WANT THEIR OWN DOCTOR
  • PEOPLE WANT TO MAKE THEIR APPTS
  • BUT DOCTORS ARE INACCESSIBLE
  • AND TOO BUSY
  • TO PROVIDE THE EXPERIENCE
  • TECHNOLOGY NOW EXISTS
  • TO CONNECT PEOPLE
  • THE INTERNET HAS CHANGED
  • IT’S ALSO CHANGED EVERYTHING
  • IT REVOLUTIONIZED INDUSTRIES
  • IT REVOLUTIONIZED RELATIONSHIPS
  • IT REVOLUTIONIZED THE ECONOMY
  • IT WILL CONTINUE THE REVOLUTIONIZING
  • IT CREATES OPPORTUNITY
  • IT FOSTERS CREATIVITY
  • IT STREAMLINES PROCESSES
  • IT SAVES MONEY
  • IT CREATES MARKETS
  • IT CREATES COMPETITION
  • IT KEEPS US HONEST
  • IT KEEPS THINGS FAIR
  • HEALTHCARE
  • BUT THINGS ARE CHANGING
  • WE CONNECT YOU
  • WITH YOUR NEIGHBORHOOD DOCTOR
  • USING A STRONG CONSUMER BRAND
  • AND A CASH-BASED “ECONOMY”
  • hellohealth
  • BRANDED ADVERTISED MARKETED DESIGNED
  • the barbarian group
  • 1,000,000,000 HITS
  • WHAT DOES EACH hellohealth LOOK LIKE?
  • TWO DOCTORS
  • TWO MID-LEVELS
  • TRIAGE SPECIALIST THIS PERSON MANS THE DASHBOARD
  • 5000 PATIENTS
  • EACH PATIENT PAYS $25/MONTH
  • TO BE A MEMBER
  • IT’S NETFLIX-LIKE, “SO LOW I DON’T EVEN THINK ABOUT IT” MONEY
  • + PER EPISODE FEES
  • $75 TO $150 PER IN PERSON VISIT
  • INTERNET COMMUNICATION
  • DOCS ARE PAID BY THE HOUR
  • ONE NEIGHBORHOOD
  • INITIALLY 50% HOUSE CALLS 50% OFFICE VISITS
  • MORPH INTO ONLY OFFICE VISITS
  • FIT INTO ANY NEIGHBORHOOD
  • ANYWHERE IN AMERICA
  • TECHNOLOGY REPLACES STAFF
  • JUST YOU AND YOUR OLD-TIME NEIGHBORHOOD DOCTOR
  • LOTS OF TECHNOLOGY
  • COMMUNICATING NORMALLY
  • POWERED BY MYCA
  • A VERY INNOVATIVE PLATFORM
  • FACEBOOK MIXED WITH AN EMR
  • MIXED WITH iGOOGLE WIDGETS
  • FACEBOOK AND MYSPACE
  • THE OS FOR SOCIAL NETWORKS
  • GOOGLE
  • THE OS FOR SEARCH AND CLOUD
  • THE MYCA PLATFORM
  • THE OS FOR PRIMARY CARE
  • UI IS 100% WIDGET BASED
  • EMR WIDGETS
  • HERE’S A SNAPSHOT
  • SCHEDULING WIDGETS
  • COMMUNICATION WIDGETS
  • EMAIL, IM, SMS, PHONE, VIDEO
  • FEDEX LIKE LOGISTICAL ENGINE
  • TO ANALYZE AND PLAN MY DAY
  • SO SIMPLE
  • COMPLETELY CUSTOMIZABLE
  • CHOOSE YOUR WIDGETS
  • FROM MYCA’S WEBSITE
  • ORGANIZED BY SPECIALTY
  • ORGANIZED BY FUNCTION
  • ORGANIZED BY INTERFACE
  • ORGANIZED BY WORKFLOW
  • IT’S PICK-N-CHOOSE
  • IT’S DRAG-N-DROP
  • IT’S REARRANGE
  • JUST ENOUGH TO MAKE YOUR UI PERFECTLY EFFICIENT
  • JUST FOR YOU
  • NOT TOO COMPLEX NOT TOO SIMPLE
  • JUST FOR YOUR NEEDS
  • STUNNINGLY BEAUTIFUL
  • SIMPLY iGOOGLE-LIKE INTUITIVE
  • THE OS OF PRIMARY CARE
  • hellohealth FREES DOCTORS
  • INCREASES THEIR REVENUE
  • SIGNIFICANTLY $125,000 PER MONTH OF CONSTANT REVENUE
  • hellohealth STREAMLINES
  • hellohealth IS EFFICIENT
  • WE GIVE CONSUMERS
  • THE EXPERIENCE
  • MOST IMPORTANTLY
  • WE CONNECT WITH THEM
  • AND MAKE GOOD MONEY DOING IT
  • WE DISRUPT THE OLD WORLD
  • WITH NEW TECHNOLOGY
  • STARTING WITH CASH
  • A STRONG CONSUMER BRAND
  • FOR NEW DOCTORS
  • AND NEW CONSUMERS
  • WHO SIMPLY EXPECT BETTER.
  • WE’RE OPENING JULY 1
  • WILLIAMSBURG, BROOKLYN
  • 105 BERRY STREET
  • hellohealth
  • ANY QUESTIONS?