Can Entrepreneurs “Cure” Health Care With Technology?

Today marks the beginning of the 8th annual Healthcare IT Week. Healthcare IT Week was started and continues on as a collaborative forum for public and private healthcare constituents to discuss the value of health information technology (health IT) for the U.S. healthcare system.

It is amazing to see how far health IT has come over the last 10-15 years.  It has its own week!  If, a decade ago, you told people that health IT would be a core focus of investors, entrepreneurs and everyone else in healthcare, the energy produced from the eye rolling alone could power the lights on the Las Vegas Strip for a month.  The basic sentiment back then was this: Why would anyone invest in, think about, care about health IT when the consumer Internet was rocking and companies selling online dog food could get started on Monday and sold on Friday for a bull mastiff’s weight in gold?

Today it is quite clear that healthcare IT is a hugely significant part of any success we are having and will continue to have in transforming our healthcare system from one where 30% of cost and care is wasted or the result of error to one where value reigns supreme.  We do not believe anyone rational would now argue that healthcare IT is non-essential to improving the quality, productivity, efficiency, cost and outcomes we produce in our healthcare system, although the path is not always smooth.

And it’s about time. Technology has been used to optimize and redefine virtually every key industry except healthcare. Manufacturing has gone from human assembly lines to robotics; banking has gone from tellers to home banking; travel has gone from agents with brochures to Travelocity; and yet in many ways, the fundamental practice of medicine hasn’t changed in decades.

Many of today’s most passionate entrepreneurs are trying to bring the dazzle and real promise of technology innovation to the challenges of healthcare, resulting in an explosion of companies focused on everything from wearable sensors and weight-loss apps to big data analytics and GPS-tagged hospital equipment—the “internet of things.” These emerging tools and promising technologies—which collectively comprise “digital health”—offer a promising path forward, and entrepreneurs and innovators are forging forward seeking to make a real difference in a vitally important field that is sorely in need of its own tender loving care if it is to flourish in tomorrow’s world.

The key challenge faced by would-be disruptive technologists is not only recognizing potentially useful analogs from other industries, but also understanding the ways in which health remains fundamentally different. Success in healthcare requires a nuanced understanding of the problems to be solved, since these problems are often less obvious and more personal than may be initially apparent.

Amid the clamor to disrupt healthcare, we should also take care to preserve and augment what may be right about medicine—the doctor/patient relationship for example, or the drive of inquisitive physicians, engineers and business people to continuously push and challenge the limits of what is known and what is possible.

As Hippocrates once said, “Healing is a matter of time, but it is sometimes also a matter of opportunity.” And technology—if judiciously applied—may be just the tonic to help reinvigorate the health of our healthcare industry.

We have sought to capture the impact of the technology tremors reverberating through our healthcare system in Tech Tonics: Can Passionate Entrepreneurs Heal Healthcare with Technology? This newly-released book is a distillation of our writing and thinking over the last several years and particularly our thoughts about how we got where we are today and where these fields may be headed, including a ground-level view of the technology landscape, its structural challenges, players, progress and pitfalls.

In compiling Tech Tonics, we have particularly sought to chronicle the recent trials and tribulations of digital health, capturing the energy, passion, hope, and hype, the ambition—occasionally misguided—of wildly smart technologists trying to grapple with some of the most difficult challenges of the modern era.

David Shaywitz is co-founder of the Center for Assessment Technology and Continuous Health (CATCH) in Boston.  He is a strategist at a biopharmaceutical company in South San Francisco. Lisa Suennen is a founding partner of Psilos Group Managers. She blogs at Venture Valkyrie. Their co-authored book, Tech Tonics: Can Passionate Entrepreneurs Heal Healthcare With Technology, is available from Amazon here.

25 replies »

  1. I love now that I can be reminded of my appt via my hospital’s app, as well as interact with my doctor, receive test results all over the web. I think that really lets doctors and nurses not bury themselves with paperwork and phone calls as everything can be accessed online. It’s a beautiful thing and I feel technology will continue to assist us as we age and even eventually have face to face appts with docs that way.

  2. It is important you take the proper insurance for your wants.

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  3. At the risk of being trite, I’d like to say that one of the biggest problems in medicine and just about everything else is that we’re simply too obsessed with technology and forgotten our superiority as human beings. The day my doctor is a robot or other computer I’ll be going back to quack remedies and nice people.

  4. I think that the emphasis on IT is per se wrong, or at least misleading, although I understand the underlying point of view. The technology underlying processes is a secondary factor when we consider process improvements. Let me give you an example: When we consider managing patient records efficiently,w e think of databases – and we should not. We should be thinking of systems whereby a patient’s symptoms and doctor’s diagnosis are embedded in a knowledge system that runs correlative algorithms that reference a huge medical database, travel records and so on. The system will then apply ‘expert systems’ techniques to apply further diagnosis, prognosis and possible treatments in support of the doctor concerned. This is NOT simply IT, but “Expert Systems’. IT is a tool, a part of a broader solution and we need to ask specific questions before applying it or any other tool to the task at hand. or we will be buying IT snake oil forever and a day.

  5. Tremendous discussion and appreciate the information regarding the nutrition labels Lisa. Eating healthy is one of the keys to our long term health, yet so many take the easy road by consuming fast food and avoiding food labels. It’s amazing what you find in the ingredient lists these days.

  6. It does contribute to the outcome…it slows it, inflates the cost, kills throughput.

    Definitely contributes something

  7. Agreed that the “passion” thing can be overused. Sometimes “I need a freaking job” is mistaken for passion. Fair point.

  8. I’ve heard my share of “passion” in my decade+ at Google/YouTube/Netscape/etc.

    My Recommendation: Get the book. Read the content. Enjoy.

    It’s smartly grounded, expertly informed, and crisply written.

  9. Maybe they can just get everyone to eat more healthful/nutritious foods? Costs will rise as long as the amount of unhealthy people grows…

  10. There are myriad examples in many different HC sectors. Worth noting that almost all new drugs and devices come from young venture-backed companies. HSA and value-based insurance products came first from small venture backed companies (Definity Health) and now cover a large % of Americans. Clinical analytics to apply evidence-based medicine came first from small venture-backed companies like Active Health (before being bought by Aetna); Virthually every digital health product that is now moving diagnosis and engagement towards the consumer is being created at a small company (e.g., Asthmapolis, now called Propeller Health, Theranos, etc.) On the clinical delivery front we have seen interesting innovations from all sorts of fronts, but particularly from small companies like Iora and Minute Clinic. Check out the book by Clayton Christensen called The Innovators’ Dilemma; it talks about how big companies can never be the source of the innovation because it is too hard for them to blow themselves up.

  11. Thxs for these replies. David, I’ve enjoyed many of your articles over the past year; haven’t yet read much by Lisa but am sure her commentary is astute as well.

    Will try to see if I can read some of the book, but in the meantime, would love it if either of you could provide an example or two of the small guy causing a big disruption in healthcare. Healthcare as average primary care internists know it, that is. (That’s the part of healthcare I care most about, although I have recently been futzing with sleep apps and wondering if this could help me manage insomnia in primary care.)

    The only example I can think of at this very moment (end of day and I’m tired) is Practice Fusion, which put a cheap cloud-based EMR in the hands of a lot of docs.

    Other examples?

  12. Leslie-Also, while Lisa is far too modest to point it out, our book includes a great commentary she wrote that looks directly at the HIMSS/SXSW comparison.

  13. okay, okay — I didn’t necessarily mean to come across all snarky

    If I did, sorry. I’ve read your work and know you bring real analytical rigor to your work. The passion thing just bugs me …

    All of the fist bumps, the self-referential behavior and craigslist posts (“Are you passionate about changing Android customer relationship management apps – if so let’s talk.” )

    Of course, you’re right. Passion IS the key ingredient. Or one of the top three anyway. It is unfortunately, highly fakeable.

    Why don’t you help us out? What kind of sniff test analysis do you do to gauge passion? How do you separate those who are legitimately passionate from those who just have the act down?

  14. Why can’t IT lower the cost of health care, at least where its passed on to patients? IT adds to the cost of health care. What other business would buy into IT efficiency when it would increase costs – only health care where costs are freely passed on?

  15. Leslie, I have great respect for Dan and liked his story a lot, but I don’t agree that only big players can cause change. There are so many good examples of the small guy causing the big disruption that it is very hard to generalize. While money and patience are both necessary to change, so is will. All too often that will is hard to muster in very large organizations that have done things in a more traditional way for a long time.

  16. Interesting question in the title. Does seem like this post conflates Healthcare IT (which makes me think of EMRs and big companies selling enterprise software to the medical community) with the entrepreneurial energy within a more start-up oriented digital health community. You know, kinda like HIMSS compared to Health 2.0.

    Also, curious as to what the authors think of Dan Munro’s recent Forbes piece on “the Big Disruption that Isn’t Happening in Healthcare,” esp the last section on why startups aren’t a good source for disruption. Munro quotes Francisco Dao as saying:
    “Really big paradigm shifting developments are so costly and require such a long term outlook that they essentially have to be disconnected from the profit requirement.”

    I myself haven’t given up on entrepreneurs helping to materially improve healthcare for the average (older) person & for caregivers, but it really does seem tough to make a serious dent in the state of things.

  17. Peter1, agree that IT cannot “solve for those” alone, but no doubt they can contribute to the outcome as with virtually every other facet of our lives. People are not gadgets but gadgets, when productive, can help people. Agree, however, that all technology solutions for healthcare need to be extremely mindful of and responsive to the human at the center.

  18. “Love, happiness, comfort…all unmeasurable but high on everyone’s list of important.”

    No IT can solve for those – or the delivery of health care. IT just doesn’t get it.

    People are not gadgets waiting for inputs/outputs.

  19. Bubba, Passion can be a cliche but it can also be an intrinsic quality an entrepreneur projects, hopefully to customers more than investors. I don’t care what field it is, if the leader of the parade doesn’t show commitment and dedication to the cause, they are doomed to fail in it. Great leaders win over great ideas every time. When both happen together good things can really happen. Oh, and by the way, just because we can’t measure something doesn’t mean it’s not important, in my opinion. Love, happiness, comfort…all unmeasurable but high on everyone’s list of important.

  20. What does passionate mean in this context, anyway?

    I keep hearing about this “passion”

    It appears to translate into large groups of people earnestly trying to convince investors that each is more “passionate” that the next “passionate” disruptor

    because passion is not easily quantifiable we can’t measure it — we don;t get it – can’t tell the difference between the “real” thing and the fake variety .

    how the hell did this whole stupid cycle get started anyway?

    did some idiot put out an email with a bullet list saying “oh and one more thing folks, the secret ingredient is passion …”