Health tech rabble-rouser, Jonathan Bush, marked his return to digital health with an appearance on the Health 2.0 stage, and quick chat with WTF Health about his new role as Executive Chairman at Firefly Health. As if conquering EMRs wasn’t enough, JB’s planning on disrupting primary care for his second act. With $10.8M series A funding and a huge addressable market, this may not be such a crazy idea after all. So, what made us miss this guy so much during his year-long hiatus from health tech? Just watch. This interview goes from the “Kabuki theater of the doctor’s office visit” to “Marie Kondo-ing” healthcare to Machiavelli and universal healthcare’s impact on the health tech market. Welcome back, JB.
Filmed at the Health 2.0 Conference in Santa Clara, CA in September 2019.
Jess and I are at Health 2.0 for Episode 95 of Health in 2 Point 00! To wrap up the conference, Jess and I talk about Jonathan Bush’s reappearance in health care on the stage at Health 2.0, with Firefly Health, with echoes of this direction in primary care by Tony Miller on the insurance panel. We talk about all the winners at Health 2.0, including the RWJF Challenge winners, Ooney with Prehab Pal and Social AI Impact Lab, and Omny who won Launch. My favorites from the conference were Indu Subaiya’s Unacceptables panel with two amazing speakers, Melissa Hanna, CEO of Mahmee & Joia Crear Perry, Founder and President of the National Birth Equity Collaborative. Catch highlights from Jess’s panel on social movements in health care as well! —Matthew Holt
Jessica DaMassa asks me about Jonathan Bush’s exit and the future of Athenahealth, celebrity suicide and the future of mental health apps, and who Amazon/Buffet/Chase should choose to be their CEO — Matthew Holt
In this edition of Health in 2 point 00 the tables are turned! Jessica DaMassa is at the upstart HLTH conference, which will make those of you with long memories of the first ehealth bubble laugh. So today I’m asking Jessica the questions, including whether Jonathan Bush likes the buyout idea, what Alex Drane (Walmart’s most extraordinary cashier) said, and whether there was anything about sex at HLTH or whether that was just at YTHLive!–Matthew Holt
Hello THCB Readers, I’m Jessica DaMassa. At Health 2.0’s Fall Conference, Matthew Holt and Indu Subaiya set me up with a camera crew and open access to the influencers, leaders, investors, and startups who graced the stage at this November’s meeting in Santa Clara. Over the course of two days, I asked more than 60 different interviewees from across the health continuum to share their point-of-view on the future of healthcare. Our goal was to capture the “state-of-play” in health innovation and contribute as many answers as possible to that elusive question: What’s going to be disrupted next?
All 60+ interviews are available for your guilty binge-watching pleasure on Health 2.0 TV, or you can stay tuned to THCB as we share some of the best-of-the-best. If you have any recommendations for future interviews (live or online), or want me to talk to you, I’ll be starting a longer series of interviews including showing tech demos. So please get in touch via @jessdamassa on Twitter. Thanks for watching! —Jessica DaMassa
Jonathan Bush, CEO of AthenaHealth, spoke at Health 2.0’s Fall Conference about the potential of networked medicine as a way to transform both the way healthcare is delivered and consumed. After his panel discussion, we got his take on where we can expect the next big disruption in healthcare. Here’s a hint (and a Jonathan Bush-ism to look out for): “ACO’s are kind of a training bra for becoming your own insurance company…”
Since 2011, over $13 billion in venture funding has flooded into digital health. 2015 alone saw well over 200 digital health companies raise more than $2 million each. From personal DNA tests to on-demand doctor’s visits, startups are taking a page from technology giants (Google, Apple, Amazon) and digital unicorns (Uber, Slack) to bring health care into the internet age.
The consumerization of health care is en fuego(!), and rightfully so. With the rise of high-deductible plans, we as patients have been forced to take on greater financial responsibility for our own health. Adding fuel to the flame, the widespread adoption of internet and mobile tech has evolved patients from passive recipients of care into active managers of care. Health care’s consumerization wildfire is thrilling, and it’s created a perfect breeding ground not only for new models of care delivery to take root, but for entrepreneurs to introduce new tools and apps for the patient and provider alike.
John Gage, Sun Microsystem’s fifth employee and its former chief researcher, famously said “the network is the computer.” The majority of us experience this every day through interactions with a wide variety of highly-intelligent, super-connected networks including Facebook, which remembers our friends’ birthdays better than we do; ATM networks, which know instantly if we have the cash that matches our request; and the complex, yet seemingly simple interweaving of phone networks, which allows us to communicate smartphone-to-smartphone regardless of carrier. Sadly, healthcare struggles to grasp this important concept.
Earlier this month, I flew to Utah for a conference hosted by KLAS, a major healthcare research outfit, about interoperability. Interoperability is a clunky word that’s talked about endlessly in healthcare, but at its root is an important notion: health care information needs to flow freely. Interoperability means that important information isn’t stuck in proprietary enterprise software that a hospital spent millions of dollars buying years ago. Having this information in the right place at the right time equates to reduced risk of medical errors and makes the delivery of health services more efficient and less costly. I’m convinced more than ever the only way to free information from the silos where it’s currently stranded is for the industry to embrace connectedness by switching to cloud-based, open networks.
The goal is clear. Yet healthcare IT executives and those buying their products remain stuck in the old ways of thinking. In their minds, software is still the computer, and sunk costs keep it so. As such, health information is largely trapped on technology islands that are maintained at great expense onsite at hospitals across our country versus flowing across the care continuum via a universally available information network. Just how bad is the data jam? An Epocrates’ survey earlier this year of nearly 3,000 physicians found that only 14 percent of physicians can access usable electronic health information across all care delivery sites and six out of 10 doctors, even when in the same organization, aren’t effectively sharing information.Continue reading…
It might have been the best of times. It could have been the worst of times. But 2014 turned out to be the most mediocre of times. Here’s a recap.
Why did Sebelius resign?
Never make a promise to your kids that you can’t keep. And never project the number of people who will sign up for the exchanges and change your mind, unless you are the CBO. If you have read about the problem of uninsured in the US you might have considered CBO’s original projection that seven million people will sign up on the exchanges within six months of open enrollment a tad conservative. Weren’t there millions and millions, forty million apparently, gagging for healthcare coverage?
The CBO revised the projection to six million in February with the projection date of March 31st coming tantalizingly close. Towards the end of March you could hear the cheers of “roll baby, enroll” getting louder.
On April Fools’ Day, the ACA remained intact, the country had not descended in to civil war and some eight million had signed up for Obamacare.
Many observers have lamented the lack of a true market in health care, and tomes have been written about the rampant distortions in the system. Large provider networks battle large insurers in a game of chicken to set prices. Patients don’t have enough information to make good choices. Costs are hidden from patients by a cascade of employer, insurer, and provider policies. And the US government ultimately provides most of the money.
One of the most prominent advocates for a health care market is Jonathan Bush, a regular speaker at health conferences and author of the recent book Where Does It Hurt? To achieve the potent mix he envisions of innovative entrepreneurship, rich data sets, and long-term care for chronic conditions, he calls for a light regulatory hand and for smashing the current oligopoly in health care.
I WAS NOW the CEO of a rising medical data company.We built automated systems to handle the administrative chores for thousands of medical practices. They didn’t buy anything from us. Instead, they subscribed to a service on the Internet.
This was what would later be called a cloud-based service, but in these early days of Internet era, we were still searching for a name for it. My partner Todd used to say in speeches that he would give Polynesian fruit baskets for life to anyone who came up with a single name for the combination of software, knowledge and work that we were selling. We had moved back east and had a new headquarters in a historic brick armory building along the Charles River near Boston.
Our future looked fabulous, except for one problem: My cousin, the 43rd president of the United States, was about to sign a bill that could destroy us.
This bill, like so many governments initiatives, stemmed from the best of intentions. The idea was to encourage the migration of the health care industry from cumbersome binders full of paper to electronic records. How was this to be accomplished? Well, hospitals and doctors were forbidden by so-called anti-kickback laws from exchanging services, information or products of value with each other. (It’s a law that infuriates me, for reasons I’ll go into later.) The bill before Congress in 2004 offered a regulatory safe harbor for hospitals to provide doctors with all the digital technology the bureaucrats could think of: servers, software licences, and training. That was absolutely the right answer . . . for 1982. The long and short was that hospitals could buy all the old stuff from our competitors, but none of the new still-to-be-named services from us. As often happens, the technology was advancing much faster than the law.
I caught the shuttle down to Washington and commenced lobbying with the fervor of a man with a gun to his head. I raced up and down the marble halls Congress, looking for someone, anyone, who would take the time to learn why this bill was so very wrong, so backward, so devastating, so lethal—at least to athenahealth.
But let me tell you, if you walk into Congressional offices sputtering about a clause in a bill that practically no one has read, something that has to do with hardware and software and online services, people tend to hurry away, or point you toward the door. I could find no one to pay attention. And as I grew more frantic, I started talking louder and faster. That didn’t help things.
Some might find my frustration strange, considering that during this drama my cousin was sitting a mile away, in the Oval Office. Wouldn’t a Bush, facing legislative trouble in Washington, contact someone in the White House entourage? The answer is no. Placing a call to him was not even a remote possibility. For starters, it’s unethical. It is also politically foolish. It would place him, me, and my company in scandal and bring shame upon our family. I would be much more willing to climb the steeple of the tallest church and bungee jump naked in the middle of the night than to call my cousin. And even if I were dumb enough to make the call, I trust George would have the good sense to tell me to get lost.