Health Insights from the Founder of Paypal

At the annual South by Southwest (SXSW) conference a wide range of industries and creative artists come together to explore transformation through interactive technology. It’s not just healthcare people talking to healthcare people!

One of my favorite presentations this year was by Max Levchin, one of the founders of Paypal. He began by challenging the audience to focus on big problems, Problems That Matter. (I’m presuming the job a guy I shared an Uber with told me about—managing the social media profile of a dog—wouldn’t qualify.)

Levchin highlighted four key trends in business and technology—waves the audience could ride to catalyze meaningful change. Though I was consciously stepping outside of the healthcare track, nearly half of Levchin’s points explicitly referenced opportunities in health and healthcare, while it was easy to draw relevant lessons from the ones that didn’t. Big trends include:

1. Beneficence (AKA “doing good”). Increasingly businesses are providing value and benefit to consumers, even at the expense of higher profit margins. For example, Levchin most recently launched Affirm, a lending service focused on millennials, that specializes in transparency: clearly telling consumers how much they are being charged for financial services. While competitors typically obfuscate their fees (often unbeknownst to consumers), Affirm is in the business of doing well by doing good.

Just imagine the parallel opportunities in healthcare: we could clearly convey to patients the risks and benefits of procedures, costs, or the vested financial interests many doctors and companies have in performing interventions or prescribing drugs, regardless of their efficacy… so many possibilities!

2. Human Assisted Artificial Intelligence (AI). Levchin said the future lies in “cogifying it,” pretty much whatever the “it” is. He suggested that the audience make stuff smarter by using computers that work closely with humans to leverage the strengths of each. His example: healthcare! Specifically,telemedicine. As an avid biker, Levchin sends photos of his biking cuts and bruises to his doctor via phone for evaluation. Many of us wish we also had that arrangement. By why not take it a step further and also send those pictures to multiple providers, feeding their collective wisdom into an AI engine to train it to evaluate the severity of wounds on its own? Human healthcare providers could weigh in on an as-needed basis for the borderline cases.

3. Software Eating Older Software. Per Levchin,twenty year-old software dominates the banking industry, creating slices of opportunity to replace it with something more elegant and efficient.

Fortunately there aren’t any outdated or poorly designed systems in healthcare, so I guess this one doesn’t apply. (Kidding!)

4. Regulatory Opportunities. Levchin explained how regulation creates pools of capital in the form of federal subsidies. He went on to illustrate the point with… Meaningful Use, and the opportunities it will open up for businesses in healthcare, particularly with the integration of APIs into EHRs.

Levchin didn’t get into the details: that more than $30 billion Meaningful Use dollars have already been spent, and that the money flows directly to eligible providers and hospitals only, many of whom have used it to pay well-established EHR vendors (perhaps even some offering that 20 year-old software he told us about?). Nevertheless, the point holds that Meaningful Use should create many downstream opportunities to fuel the growth of creativity, via progressive EHR companies, data analytics companies, and consumer app developers. Even more important, efforts under the ACA to shift payment to value based care will put a business emphasis on health outcomes and enable consumers to play a more active role in shaping and benefitting from the healthcare marketplace.

Levchin’s talk was one of many at SXSW that drew parallels between health and finance. There is certainly much to learn from other industries, too. Another reminder to get out of our healthcare echo chamber and collaborate with a wide range of other problem solvers.

Lygeia Ricciardi is the President of Clear Voice Consulting, which provides strategic guidance on digital health and consumer engagement to cpmapneies. She previously established and led the Office of Consumer eHealth at the Office of the National Coordinator for Health IT (ONC).

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4 replies »

  1. Thanks Lygeia. So much IT/tech ferment in healthcare these days, adapted from other areas. At long last. Some of it is saving $$$ but the available evidence is still sparse that it’s structurally restraining cost growth, as you know. There’s a desperate need to accelerate.

  2. “Levchin’s talk was one of many at SXSW that drew parallels between health and finance.”

    These “parallels” are popular among that population stratum for whom “health” means “looking good in their underwear” (to quote a health coverage dinosaur). They break down quickly when reality intrudes. So let’s just go ahead and not give that set of parallels nearly the earnest attention underwarriors would urge us to.