Rock Health Summit Masterclass: Making the Medical Practice of the Future a Reality by Daniel Kivatinos Today’s modern medical practices are moving from outdated software to using mobile devices such as the iPad to collaborate and manage patient data efficiently. The time for change in healthcare is now and today’s tech companies are continually finding ways to help doctors save time and better communicate with their patients with better technology. Many practices are investing in healthcare technology, such as AI and machine learning, telemedicine, and payments applications. Also, the rapid adoption of consumer facing tech like Apple Health will change the way we think about our health, making us all more aware and accountable for our own care. Daniel will review in this presentation the challenges that the medical industry is facing to adopt new technologies, the solutions that are available and illustrate through real-world examples how the medical practice of the future can become a reality. Full video of this presentation here: https://www.youtube.com/watch?v=nyBBXO-sfMk https://www.rockhealthsummit.com/

1. www.rockhealthsummit.com

2. www.rockhealthsummit.com

3. Making the Medical Practice of the Future a Reality
Rock Health Masterclass

4. Daniel Kivatinos
COO & Cofounder
@danielkivatinos

5. ABOUT THIS MASTERCLASS
We believe today’s modern medical practices are
moving from outdated software to using mobile
devices such as iPad to collaborate & manage
patient data.
Companies are finding ways to help doctors save
time and better communicate with patients.
Practices are investing in healthcare technology,
such as AI/machine learning, telemedicine, and
payments applications.
Also, the rapid adoption of consumer facing tech will
change the way we think about our health, making
us all more aware and accountable for our own care.
Explore the challenges that the medical industry is facing to
adopt new technologies, the solutions that are available
and illustrate through real-world examples how the medical
practice of the future can become a reality.
OUR GOAL TODAY

6. MED TECH TODAY
THE FUTURE
DATA INSIGHTS

9. DATA
SILO
DATA
SILO
DATA
SILO
DATA
SILO

11. HOW DO WE FIX THIS PROBLEM?
Your medical record

12. What is most important?
Time + Care

18. WHAT IS A COW?

21. COW.
Computer on
wheels.

24. We all experience this.

25. LETS KILL THE COW

26. Secure message from my doctor.

27. MANY PEOPLE HAVE
LEARNED HELPLESSNESS
IN HEALTHCARE

28. LETS CHANGE & EMPOWER
PATIENTS & DOCTORS

29. +

31. TECH SHOULD
SERVE HEALTHCARE.
NOT THE OTHER
WAY AROUND.

32. HOW DO WE FIX THIS PROBLEM?

33. S-curve Phases

34. S-curves

35. S-curves

36. S-curves

37. S-curves

38. S-curves

39. S-curve

40. S-curve

41. THE CLOUD

42. DIGITAL HEALTH RECORDS

43. THE HISTORY OF MY COMPANY

44. Stony Brook University
Founders Daniel & Michael met in college.

45. 2002
Michael and I met in college.

46. I wanted medical records
that worked to care for
my parents.

47. OUR STORY
Founded 2009

48. Our first paying user.

50. 2 Physicians in New York City
Dr. Zina Kroner, DO
Internal Medicine
Dr. Edward Goldberg MD
Gastroenterologist
Looking to Move Off Paper

51. MISSION
is enabling the clinic of the
future through technology

52. PRACTICES ALL SIZES
EVERY SPECIALTY
OUR FOCUS

53. API
EHR Billing & RCM
API & AppsPatients

54. Niche EHR
IMPACT THE WORLD
ALL DOCTORS NEED A PLATFORM. WE WANT TO MAKE AN IMPACT.
Niche EHR Specialty EHRSpecialty EHRSpecialty EHRSpecialty EHRSpecialty EHRNiche EHR Niche EHR

55. On iPhone

57. USER EXPERIENCE
patient check-in care billing

58. patient check-in care billing
USER EXPERIENCE

59. WWDC 2016
in Apples’ MPP Mobile Partner Program

60. Statistics

61. PATIENTS IN PLATFORM
May 2019
17,776,176
TODAY

62. ____________________________________________________
327.7MILLION U.S. POPULATION
17,776,176 PATIENTS
= ?
May 2018

63. POPULATION IN PLATFORM
May 2019
Over 5%
of the U.S.
TODAY

64. HOW MANY PATIENT VISITS
IN ?

65. VISITS
booked per month
VISITS
booked per year
VISITS
booked ever
1.7M 20.5M68.9M
May 2019
TODAY

66. __________________________________________________________
883.7MU.S. POPULATION APPOINTMENTS PER YEAR
20.5MAPPOINTMENTS IN PLATFORM PER YEAR
= ?
May 2019

67. booked in yearly
2.32%
VISITS IN U.S.
May 2019

68. MEDICAL CLAIMS PROCESSED PER YEAR
May 2019
$4,896,000,000
TODAY

69. MEDICAL CLAIMS PROCESSED ALL TIME
$11,000,000,000
May 2019

72. Kaizen.
What does this word mean?
Change. Good.
Kai. Zen.

73. Japanese word for "improvement".
In business, kaizen refers to activities that continuously improve all
functions & involve all employees from executives to workers.

74. 2018 2019
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOME COMPANIES DO
YEARLY
SOFTWARE RELEASES

75. 2018 2019
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOME COMPANIES DO
MONTHLY
SOFTWARE RELEASES

76. 2018 2019
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOME COMPANIES DO
WEEKLY
SOFTWARE RELEASES

77. 2018 2019
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOME COMPANIES DO
DAILY
SOFTWARE RELEASES
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE

78. 2018 2019
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOME COMPANIES DO
SEVERAL DAILY
SOFTWARE RELEASES

79. 2018 2019
CONTINUOUS INTEGRATION
SOME COMPANIES DO
SEVERAL DAILY
SOFTWARE RELEASES
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE

80. 2018 2019
COMPOUND CODING
SOME COMPANIES DO
SEVERAL DAILY
SOFTWARE RELEASES
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE

81. 2018 2019
the power of compound interest the most powerful
force in the universe.“ Albert Einstein
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE

82. 2018 2019
the power of _______________ the most powerful
force in ___________________.“
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE

83. 2018 2019
the power of compound coding the most powerful
force in software development.“
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE
SOFTWARE
RELEASE

84. The speed of development of software is accelerating.

85. “You can’t compete with the
incumbent EHRs.”
They said.

86. This is wrong.
“You can’t compete with the
incumbent EHRs.”

87. There are NO examples of larger
companies going down market.
SAP and Oracle failed at moving down market.

88. Companies going UP market have
successfully done it.
Microsoft moved up market. Salesforce moved up market.

89. Private practice physicians don’t have
the money to buy or implement a large
EHR install.

90. Multibillion dollar markets will always
get disrupted.

91. INNOVATION IS HAPPENING
FASTER AND FASTER
ON PREMISE MEDICAL SOFTWARE USE

92. INNOVATION IS HAPPENING
FASTER AND FASTER
CLOUD MEDICAL SOFTWARE USE
ON PREMISE MEDICAL SOFTWARE USE

93. INNOVATION IS HAPPENING
FASTER AND FASTER
CLOUD MEDICAL SOFTWARE USE
ON PREMISE MEDICAL SOFTWARE USE
A bridge to full cloud is hybrid cloud solution

94. INNOVATION IS HAPPENING
FASTER AND FASTER
CLOUD MEDICAL SOFTWARE USE
ON PREMISE MEDICAL SOFTWARE USE
IT IS A MATTER OF WHEN MOVING TO FULL CLOUD

95. RETHINK DESIGN

96. RETHINK DESIGN

97. RETHINK DESIGN

98. RETHINK DESIGN

99. MED TECH TODAY
THE FUTURE
DATA INSIGHTS

100. What is
Gross Domestic Product (GDP)

101. Gross domestic product is the best way to measure a
country's economy. GDP is the total value of everything
produced by all the people and companies in the country.
DEFINITION

102. What is the GDP of the United States?
United States 15.01% of world economy
Source: worldbank.org & statista.com
$19,480,000,000,000
trillion

103. How much in United States GDP
spent on healthcare?
17.9% of Gross Domestic Product (GDP) is spent on healthcare
Source: cms.gov
$3,500,000,000,000
trillion

104. U.S. NATIONAL HEALTH EXPENDITURE Source: CMSas a percent of GDP 1960 to 2019
17.9%+ GDP
SPEND ON HEALTH TODAY

105. TOTAL NUMBER OF DOCTORS
Sources American Medical Association; US Department of Health & Human Services
in the U.S. from 1949 to 2015
Medical doctors, excluding non M.D.’s eg. Nurses
1,000,000 MDs

106. TOTAL NUMBER ACTIVE DOCTORS
Sources American Medical Association; US Department of Health & Human Services
Medical doctors, excluding non M.D.’s eg. Nurses
870,900 MDs
Working

107. 54.5%
PATIENT VISITS IN THE U.S.
with primary care physicians
May 2019Source: CDC

108. UNITED STATES POPULATION
327.7 MILLION
Source: US Census Bureau's population clock May 2019

109. 883.7 MILLION
PATIENT VISITS IN THE U.S.
from CDC
May 2019

110. Source: Medscape Physician Compensation Report 2018, page 32, April 2018
0%
5%
10%
15%
20%
25%
5%
11%
Less the 9 minutes 9-12 minutes 13-16 minutes 17-24 minutes 25 or more minutes
30%
35%
22%
29%
33%
U.S. PRIMARY CARE PHYSICIANS TIME SPENT WITH EACH PATIENT

111. U.S. spends $3.5+ trillion in healthcare
$1.5+ trillion is on medicare & medicaid
$ 33.41 billion-dollar Health Record Market
$ 11.11 billion-dollar Practice Management Market
$ 7 billion-dollar Patient Portal Market
$ 73.2 billion-dollar Revenue Cycle Market
$ 0.3 billion-dollar Healthcare API Market
$ 113.1 billion-dollar Telemedicine Market
$ 11.1 billion-dollar Messaging Security Market
$ 30.0 billion-dollar A.I. Machine Learning Healthcare Market_____________________________________________________________________________________________
$279.2 billion-dollar Addressable Markets just here!
Data from statista and CMS, other future addressable markets not displayed. Above are projected market sizes.Updated: 2019-09-16

112. MED TECH TODAY
THE FUTURE
DATA INSIGHTS

113. Our Future in
Healthcare

114. Our Future in
Healthcare

116. VIDEO

117. MED TECH TODAY
THE FUTURE
DATA INSIGHTS
APIs

118. It is an internet world
Our future will driven by APIs
APIs are URLs
We are building an API + URL health data
world

119. All companies philosophy should be "data open" to developers
through APIs.

120. Most medical record software are Walled Gardens

122. WWDC 2016
WWDC 2016
With Obama's dogs Bo and Sunny

123. WWDC 2016
WWDC 2016
Judith Faulkner, CEO & Founder
Epic Systems

124. Healthcare needs to be open.

125. Restful
FHIR
C-CDA
SFTP
HL7
Flat Files
APIs

127. Autofill
Cancellations
QueueDr

130. Launching App Directory
OutComeMD

131. Launching App Directory

132. INTEGRATE LAB & IMAGING CENTERS

133. Clinical Trials in Real Time

135. MED TECH TODAY
THE FUTURE
DATA INSIGHTS
MACHINE LEARNING

136. + + Machine Learning
Annual pay entry-level radiologist $100 per hour.
Experienced radiologists make $470,000+
Source: U.S. Bureau of Labor Statistics in May 2016

137. + + Machine LearningDeepScribe
A scribe makes about $20 per hour.

138. What can be done with Machine Learning
with Coding and Billing?
A medical biller and medical coder will cost around $18.83 per hour.
Source: BLS, 2017

139. 151
9.1 Trillion Dollar Market
6.6 Trillion in Productivity Gains
30 Billion in Healthcare
AI, Machine Learning
* Source: Fast Company

140. As to diseases, make a habit of
two things - to help, or at least,
to do no harm.”
― Hippocrates.