There are many companies that are competing to be the “operating system” for small businesses. The theory is that with the advent of the cloud in the digital age, small businesses can leverage a suite of services from a technology vendor to manage all aspects of their work – from payments to record-keeping to marketing to customer communications. Among those competing for this vision are PayPal/eBay, Square and Groupon, with each struggling to pull together pieces of the equation and, importantly, reach the small business in a cost-efficient manner at scale.
One company in Watertown, Massachusetts has been executing on this vision for over a decade with a winning approach for one vertical slice of the small business market: physicians. Although this is not typically how athenahealth is described, it is one way to describe what they are doing that mainstream members of the technology community might understand. I have found it pretty amazing that so few people in the tech community know their story or understand the scale and scope of what they have achieved. That is why I’ve chosen athenahealth for the third in my series on scaling (following Akamai and TripAdvisor).
Founding Story: A Pivot
Athenahealth version 1.0 was a complete failure. The company was originally founded in 1997 by Jonathan Bush (1st cousin of George W.) and Todd Park, a pair of Booz Allen consultants, as a physician practice management company for obstetrics.
There is a corner of the health care industry where rancor is rare, the chance to banish illness beckons just a few mouse clicks away and talk revolves around venture deals, not voluminous budget deficits.
Welcome to the realm of Internet-enabled health apps. Politicians and profit-seeking entrepreneurs alike enthuse about the benefits of “liberating data” – the catch-phrase of U.S. Chief Technology Officer Todd Park – to enable it to move from government databases to consumer-friendly uses. The potential for better information to promote better care is clear. The question that remains unanswered, however, is what role these consumer applications can play in prompting fundamental health system change.
Michael W. Painter, a physician, attorney and senior program officer at the Robert Wood Johnson Foundation, is optimistic. “We think that by harnessing this data and getting it into the hands of developers, entrepreneurs, established businesses, consumers and academia, we will unleash tremendous creativity,” Painter said. “The result will be improved and more cost efficient care, more engaged patients and discoveries that can help drive the next generation of care.”
The foundation is backing up that belief with an open checkbook. RWJF recently awarded $100,000 to Symcat, a multi-functional symptom checker for web and mobile platforms. Developed by two Johns Hopkins University medical students, the app determines a possible diagnosis far more precisely than is possible by just typing in symptoms as a list of words to be searched by “Dr. Google.” Symcat also links to quality information on different providers and can even direct users to nearby emergency care and provide an estimate of the cost.
In its wisdom, the Supreme Court of the United States may decide to overturn the Obama administration’s health reform legislation.
The Supreme Court of the United States may decide not to.
Mitt Romney may unseat Barrack Obama and wrest the Presidency away from the Democrats. Or he may not.
In a way, these things may not actually matter.
There may be uncertainty on Wall Street and in the media about the fate of the Affordable Care Act (ACA) and the upcoming presidential election, but the mood in the crowd gathered at the 9th session of the World Health Care Congress last week in Washington was curiously upbeat.
There was a sense that health care is making progress.
And that is a good thing.
Innovations like accountable care organizations (ACOs), scientific management principles like cost containment and quality improvement and the movement for better health information technology will make their presence felt, regardless of what happens in the courts and on Election Day.
Unlike TEDMED, which brought together official Washington, the tech industry, entertainment and medicine — at the Kennedy Center last week, the World Health Care Congress is a meeting pretty much limited to health care industry insiders at larger firms.
As is generally the case, the speakers list read like a who’s who of very important healthcare names. Kaiser Permanente CEO George Halvorson, Intermountain CEO Charles Sorensen, Aetna CEO Mark Bertolini, Economists Ezekiel Emanuel and Jonathan Gruber, former OMB Director Peter Orzag,TEDMED curator (Priceline.com) Jay Walker talked about the power of the Internet to fundamentally rewire the way people think. Verizon CEO and NantWorks Founder Patrick Soon-Shiong were on hand to talk up a new collaboration. Xerox CEO Ursula Barnes introed the tech giant’s push into healthcare. Journos like Health Affairs Editor Susan Dentzer and NBC correspondent Nancy Snyderman provided media star power.
In March of 2005, I staffed an interview between Todd Park and Steve Lohr of The New York Times in the cafeteria of the old New York offices of the “Grey Lady.” At the time, Park was heading a very small web-based start-up company that was trying to convince medical groups – and on that day, a leading national technology business reporter – that web-based “cloud” technologies would become mainstream in the healthcare IT industry and were the only logical means to get the hundreds of thousands of independent U.S. doctors and their small offices to go digital.
At the time, Lohr, one of the foremost technology reporters in the country covering IT giants like Microsoft, IBM and Intel, had just started covering Health IT upon the appointment of Dr. David Brailer as the nation’s first National Health Information Coordinator (or, as many called him back then, the “Health Information Czar”). In fact, Lohr had just gotten back from attending the annual HIMSS Conference in Dallas where he met with CEOs of “legacy” healthcare IT behemoths like IDX (now GE), Siemens, Cerner, Allscripts, McKesson and Epic.
In his first article addressing Health IT adoption in the U.S., Lohr touched on what he felt was the core challenge to achieving widespread EHR adoption: getting small medical practices to adopt and actually use these systems – something that had eluded the industry and those legacy IT vendors for many years. On the topic of getting small practices to adopt EHRs and the potential harm to the industry and the Bush Administration’s efforts if they didn’t, Dr. Brailer told Lohr, “The elephant in the living room in what we’re trying to do is the small physician practices. That’s the hardest problem, and it will bring this effort to its knees if we fail.”
Last week President Obama appointed Todd Park as the new Assistant to the President and U.S. Chief Technology Officer, with the responsibility to ensure the adoption of innovative technologies to support the Administration’s priorities including affordable health care. This got me to thinking.
Since taking office, President Obama has made some strong moves to champion the adoption of EHRs through the passing of the HITECH Act. This act, combined with the existing relaxation to the existing Stark anti-kickback laws, has actually enabled a spike in adoption of EHRs due to medical groups’ efforts to qualify for Meaningful Use dollars. But it has also had some unintended consequences that Mr. Park may now find himself in a unique position to rectify if he stays true to his support of cloud computing.Continue reading…
It’s a phenomenal time to be an innovator at the intersection of data and health care improvement. I’m incredibly excited by the rising tide of innovations we’re seeing – new products, services and features being invented by entrepreneurs across the country, fueled by open health data.
And coming soon is the latest opportunity to showcase and learn about many of those innovations: the 2012 Health Data Initiative Forum– aka the Health Datapalooza — being held in DC at the Washington Convention Center on June 5-6, 2012.
For all of you who have been creating value from health and health care data – this is your opportunity to showcase your brilliance for the nation to see! Led by the amazingly talented folks at Health 2.0, the Health Data Consortium is sponsoring a national competition for the best new apps and services created using health and health care-related data. Entry applications for the competition are due March 30th.
Innovators will then go through an “American Idol”-style process in which panels of consumers, health care professionals, and community leaders will judge innovations submitted. The innovations that best demonstrate benefit and value for health and care improvement will be featured and demoed at the June Datapalooza.
So if you’ve built or are building something terrific with the aid of health data, throw your hat into the ring! Submit your entry form by March 30th, and may the best innovations win!
Todd Park is the CTO of HHS and has just been appointed CTO of the Federal Government.
(Full disclosure: as is obvious from the article Health 2.0 which is a sister company to THCB is involved as a sub-contractor helping with Health Datapalooza 2012)
This week the Health 2.0 team will be at Health Innovation Week DC, and the biggest event there will be the Health Data Initiative Forum. One day, 50 demos, mixing more government and private data than you can imagine. We’ve been helping at the periphery of the Health data Initiative and we’ll be be having a special session talking more about the Health 2.0 Challenge, including our upcoming work running Challenges for ONC. We’re incredibly excited and enthusiastic, but no one is as enthusiastic as Todd Park! Here’s the CTO of HHS telling you about his brainchild, Health Data Palooza–Matthew Holt
Almost exactly one year ago, we launched a vital new HHS Open Government effort: The Health Data Initiative (HDI). The Initiative was publicly launched by HHS Secretary Kathleen Sebelius, Deputy Secretary Bill Corr, Institute of Medicine (IoM) President Harvey Fineberg, and White House CTO Aneesh Chopra at a forum held at the National Academy of Sciences.
The Health Data Initiative is an incredibly exciting public-private collaboration that is encouraging innovators to utilize data made publicly available by HHS and others to help fuel applications and services that can help improve health and health care. Over the past year HHS has been working very hard to make our data ever more accessible to the public – both publishing brand new data and making more of our existing data machine-readable, downloadable, accessible via application programming interfaces (APIs), free, and vastly easier to find. We’ve launched major new data and information websites (the HealthData.gov community, the Health Indicators Warehouse; and HealthCare.gov).
Equally importantly, we’ve been energetically publicizing our data, through challenges, code-a-thons, and many sessions with innovators of all kinds – educating folks around the country about what data we’ve made available and its potential to help power health improvement. Innovators from across America are taking our data and are using it to build and power an amazing and rapidly growing array of applications in creative and powerful ways to help advance health. This movement has included entrepreneurs and change makers from all sectors: startups, major businesses, nonprofits, public health, health care delivery system, federal and local government, and academia.