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WHERE IS THE HEALTHCARE REVOLUTION?

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JAY PARKINSON, MD, MPH


CHIEF MEDICAL OFFICER


CANADIAN-BASED


HEALTHCARE IT


HEALTHCARE SERVICES


NAT FINDLAY, CEO


VP OF CLINICAL STRATEGIES


CARDINAL HEALTH


23 EMPLOYEES


16 DEVELOPERS


PRIVATELY FUNDED


STARTING THE REVOLUTION


PEDIATRICS & PREV MED


FEW OPTIONS TO PRACTICE


NO OPTIONS TO USE TECHNOLOGY


I HAD TO STEP BACK IN TIME


10 YRS TO USE TODAY’S HEALTH IT


I AM A MILLENNIAL DOCTOR


WELL...ALMOST


I’M 32


I COMMUNICATE LIKE A MILLENNIAL


I USE MILLENNIAL TECHNOLOGY


GEN X AND MILLENNIAL PATIENTS


THEY USE MILLENNIAL TECHNOLOGY


AND THEY NEED A DOCTOR


WE USE THE NET TO COMMUNICATE


WE USE THE NET TO CONNECT


IT’S VERY EFFICIENT


IT’S VERY FUN


IT’S JUST PLAIN NORMAL


YOU CAN’T CONNECT WITH DOCTORS


I CHANGED THAT.


WORLD’S FIRST “VIRTUAL” PRACTICE


I DIDN’T HAVE AN OFFICE


I HAD A WEBSITE


AND A NEIGHBORHOOD


AND YOUR APARTMENT


I CONNECTED WITH MY PATIENTS


EMAIL, IM, SMS, VIDEO CHATS


I SAW THEM IN THEIR HOME


I HAD ALMOST NO OVERHEAD


$1500


TECHNOLOGY GAVE ME FREEDOM


WE COMMUNICATED HOW WE WANTED


AND WE DID IT EFFECTIVELY


AND EFFICIENTLY


THAT’S WHAT THE NET DOES


TELL ME THEIR SYMPTOMS ONLINE


BRANCH LOGIC QUESTIONNAIRE


LOOK AT MY GOOGLE CALENDAR


SCHEDULE THEIR OWN APPT


iPHONE ALERTS ME I HAVE AN APPT


I SEE THEM IN THEIR APARTMENT


I CHARGED A REASONABLE FEE


$100 - $150 PER HOUSE CALL


AND PEOPLE PAID ME CASH


THREE TIMES THE RATE MY PRACTICE

300 225 150

TRADITIONAL PRACTICE 75 0 SEPT

OCT

NOV

DEC


HALF WERE INSURED


STILL PAID ME CASH


I WAS ACCESSIBLE


I COMMUNICATED NORMALLY


WE HAD A RELATIONSHIP


THAT WE BOTH VALUED


CLIENTS WERE WILLING TO PAY


A REASONABLE PRICE


VALUABLE, ACCESSIBLE SERVICE


I AM A DOCTOR IN BROOKLYN


WHO HUNG UP HIS SHINGLE


VIA THE WEB


7,000,000 HITS IN 3 MONTHS


WHY?


I SAW A NEED


AND I FILLED IT


STRAIGHT TO THE CONSUMER


MEET THE NEEDS OF...


|kənˈsoōmər|


WHAT IS THAT?


TWO DEFINITIONS


1

a person who purchases goods and services for personal use


2

a person or thing that eats or uses something


WHICH APPLIES TO HEALTHCARE?


I SAY #2


AN ANALOGY


YOU NEED TO BUY CLOTHES


EVERYONE NEEDS CLOTHES


LUCKY YOU


YOUR OWN PERSONAL SHOPPER


YOU HAVE NO FASHION SENSE


YOU DESPERATELY NEED HELP


HE’LL CHOOSE YOUR CLOTHES FOR YOU


HE HAS A GRADUATE DEGREE FROM F.I.T.


HE TRAINED THERE FOR NINE YEARS


HE’S VERY OVERWORKED


BECAUSE EVERYONE NEEDS CLOTHES


YOU WAIT HOURS


HE’S THE BOTTLENECK


THE ALTERNATIVE = NAKED


ONLY THE BEST FOR YOU


YOU LOOK GOOD = HE LOOKS GOOD


COST ISN’T AN ISSUE


WHY?


HE DOESN’T KNOW, NOR DOES HE CARE


HE’S TOO BUSY FOR SUCH TRIVIALITIES


AND LUCKY YOU


YOU DON’T CARE EITHER!


SOMEONE ELSE IS PICKING UP THE TAB!


HE TAKES YOUR MEASUREMENTS


HIS TOOLS ARE SO PRECISE


TAPE MEASURE = $50,000


HE’S PARTICULAR ABOUT HOW YOU LOOK


AND IF YOU’RE NOT HAPPY...


YOU SUE HIM!


HE WRITES THE ORDER


YOU PICK UP YOUR SUIT


FROM THE MOST CONVENIENT STORE


PAY YOUR $10


AND LEAVE WITH YOUR $5000 SUIT


OBVIOUSLY CRAZY


EVEN CRAZIER THAN PRE-INTERNET


STORES COMPETED IN LOCAL PAPERS


NO EASY WAY TO COMPARE COSTS


ALONG CAME THE PRICE REVOLUTION


THE DINOSAURS WERE SCARED!!!


LITTLE DID THEY KNOW...


THIS WOULD ACTUALLY INCREASE REVENUE


CUSTOMERS = MORE, SIMPLIFIED! SELLERS = LESS, COMPLEX!


CONSUMER IGNORANCE = $


BUT IN FACT...


CONSUMER KNOWLEDGE = $$$


THEN CAME THE QUALITY REVOLUTION


THE DINOSAURS WERE SCARED!!!


SELLERS HAD TO BE ACCOUNTABLE


YOUR BUSINESS DEPENDS ON YOUR REP


PRODUCTS HAVE TO BE ACCOUNTABLE


AGAIN...


THE DINOSAURS WERE SCARED!!!


SALES DEPEND ON YOUR QUALITY


THE DINOSAURS THAT DIDN’T CHANGE


SIMPLY DIED


WAS IT A METEOR?


NO...


IT WAS AN UNCOORDINATED


SMOLDERING ATTACK


FROM A BUNCH OF GENIUS NOBODIES


THAT CHANGED BUSINESS FOREVER


THAT CHANGED THE WORLD FOREVER


WHERE IS THE HEALTHCARE REVOLUTION?

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IT’S SIMPLY NOT HAPPENING


WHY?


HEALTHCARE IS OFFLINE


NO ONLINE HEALTHCARE TRANSACTIONS


ONLY HEALTH INFORMATION


NO PROVIDER-PATIENT CONNECTIVITY


THE PAYORS ARE IN THE WAY


AGAIN...THE PAYORS ARE IN THE WAY


DOES PAYPAL GET IN THE WAY OF EBAY? NO!


PAYPAL ENHANCES EBAY


DOES VISA GET IN THE WAY OF AMAZON? NO!


VISA ENHANCES AMAZON


WHAT ARE THE NEXT STEPS?


FOLLOW THE EVOLUTION OF THE NET


START TRANSACTING ONLINE


MAKE DOCS MORE ACCOUNTABLE (SELLERS)


MAKE THEIR PRODUCTS MORE ACCOUNTABLE (DOCTOR SERVICES)


QUESTION CURRENT QUALITY PRACTICES


WHAT IS PHYSICIAN QUALITY?


THE DEGREE TO WHICH HEALTH SERVICES FOR INDIVIDUALS AND POPULATIONS INCREASE THE LIKELIHOOD OF DESIRED HEALTH OUTCOMES AND ARE CONSISTENT WITH CURRENT PROFESSIONAL KNOWLEDGE


HUH?


WHAT DOES THIS REALLY MEAN TO DOCS?


DO I DELIVER GOOD HEALTHCARE?


HOW DO I KNOW?


I LIKE TO THINK I DO


BUT DO I REALLY?


THE BMJ RECKONS THAT 50% OF THE TREATMENTS I USE IN GENERAL PRACTICE AREN’T PROVED, AND 5% ARE PRETTY HARMFUL BUT I STILL USE THEM


HOW DO I PROVE I IMPROVE OUTCOMES?


IN MY PAPER CHARTS


OMG!


I HAVEN’T DONE A CHART REVIEW


SINCE MEDICAL SCHOOL


BUT THE REAL QUESTION IS...


WHAT DOES THIS MEAN FOR PATIENTS?


DID MY DOCTOR INCREASE MY LIKELIHOOD OF FEELING BETTER?


DID SHE USE CURRENT PROFESSIONAL KNOWLEDGE TO HELP ME FEEL BETTER?


GEEZ...I HOPE SO


BUT HOW DO I KNOW?


WHERE IS THE INFO TO PROVE THIS?


IN MY PAPER CHART IN MY DOC’S OFFICE


OMG!


I CAN’T EVEN READ THE HANDWRITING!


AND WHAT DO YOU MEAN???


$100 TO FAX IT TO ME!


FOUR WEEKS FROM NOW!


HERE’S THE POINT


MEASURING INDIVIDUAL PHYSICIAN QUALITY WITH THE CURRENT INFRASTRUCTURE IS IMPOSSIBLE, UNREALISTIC, AND FAR FROM THE ACCEPTED SCIENTIFIC METHOD


HEALTHCARE DATA = PRE-EXCEL ERA


HEALTHCARE DELIVERY = 1960’s


HEALTHCARE TRANSACTIONS = PRE-EBAY


WE ARE SCIENTISTS


WE EXPECT RANDOMIZED, CONTROLLED, DOUBLE-BLINDED STUDIES


JUST LIKE MEDICATIONS


PHYSICIAN QUALITY IS AN INTERVENTION


DO YOU THINK YOUR PATIENTS ARE A RANDOMIZED, CONTROLLED, DOUBLEBLINDED STUDY?


DO YOU THINK YOU HAVE ENOUGH SIMILAR PATIENTS TO MAKE THIS DATA RELIABLE AND REPEATABLE?


MOST DOCTORS ARE AVERAGE DOCTORS


WE FOLLOW A BELL CURVE


SOME ARE REALLY GOOD MOST ARE AVERAGE SOME ARE REALLY BAD


HOW ARE YOU SUPPOSED TO KNOW??


DOCTOR RATINGS?


COME ON ALREADY!


CONSUMER INFORMATION IS FREE!


10,000 TVs = 36 RATINGS


2,000 PATIENTS = 5 RATINGS?


RELIABLE RATINGS DEPEND ON VOLUME


VOLUME DEPENDS ON INCENTIVES


THERE ARE NO INCENTIVES


BLOWING OFF SOME STEAM


TELLING STRANGERS HOW WONDERFUL YOUR DOCTOR IS


LET’S RETHINK QUALITY “RATINGS”


WHAT DO PEOPLE EXPECT FROM DOCS?


HOW DO CONSUMERS VIEW QUALITY?


THOROUGHNESS


THEIR OWN, REGULAR DOCTOR


A WARM, FRIENDLY DOCTOR


TIMELY APPOINTMENTS


APPOINTMENT OPTIONS


WHAT DOES THIS MEAN?


CONSUMERS WANT: THEIR OWN THOROUGH, FRIENDLY DOCTOR WHO WILL SEE THEM WHEN AND HOW THEY WANT TO BE SEEN


HOW CAN WE MAKE THIS HAPPEN?

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START TRANSACTING ONLINE


TAKE LESSONS FROM EBAY, AMAZON, AND KAYAK


WE NEED TO STOP PRODUCING MORE CONSUMER HEALTH INFORMATION


FOCUS ON TRANSACTIONS


USE THE NET TO CONNECT PATIENTS WITH THEIR NEIGHBORHOOD DOCTORS


FACE-TO-FACE AND ONLINE


PAID FOR BY INDIVIDUALS, NOT PAYORS


SUSANNAH FOX *former editor of US News & World Report *current Director of Pew Internet and American Life Project


RECRUIT DOCTORS. GO MOBILE. LET E-PATIENTS LEAD.


1 START RECRUITING DOCTORS


PCPs ARE GETTING RESTLESS


THEY’RE SICK OF WORKING LIKE DOGS FOR SOMEONE ELSE’S PROFITS


THEY’RE SICK OF NOT BEING ABLE TO DO THEIR JOB WELL


BECAUSE THEY GET PAID FOR VOLUME


AND THAT PAY DECREASES EVERY YEAR


SOCIAL NETWORKING

DOCTOR BLOGS


“HYPERLINKS SUBVERT HIERARCHY” -THE CLUETRAIN MANIFESTO


TAKE ADVANTAGE OF HYPERLINKS


BOTTOM UP APPROACH


TO CREATE A UNIFIED PHYSICIAN VOICE


THE INTERNET ORGANIZES GROUPS


WE HAVE TO GIVE DOCS ALTERNATIVES


OPPORTUNITIES TO BE ENTREPRENEURS


A PROFITABLE BUSINESS MODEL


TECHNOLOGY AND TOOLS TO CREATE “THE CONSUMER EXPERIENCE”


DIFFERENTIATE THEMSELVES FROM “THE COMPETITION”


COMPETITION: TRADITIONAL, OVERWORKED, UNDERPAID, INSURANCE-TAKING, TOO BUSY TO CARE DOCTORS


ADVERTISING AND MARKETING SUPPORT


BECAUSE DOCS DON’T DO THIS WELL


THIS WILL SPREAD VIRALLY WITHIN DOCTOR COMMUNITIES


WE’RE ALL LOOKING FOR A BETTER WAY


2

GO MOBILE


INTERNET COMMUNICATION IS NORMAL


SMS, IM, VIDEO, FACEBOOK, MYSPACE


IT’S HOW WE COMMUNICATE


IT’S ACCESSIBLE.


IT’S UBIQUITOUS.


IT’S EFFICIENT.


THERE IS NO DIGITAL DIVIDE


WE NEED TO CREATE FACEBOOK FOR HEALTHCARE


A WEB PLATFORM


WHERE DOCS CONNECT WITH THEIR PATIENTS


ONLINE AND IN-PERSON


TO COMMUNICATE AND COORDINATE


A MARKETPLACE BASED ON CASH


WITH ABSOLUTELY NO PAYORS


NO MIDDLEMEN


PATIENTS AND PROVIDERS CONNECTING DIRECTLY


TRANSACT ONLINE


3

LET E-PATIENTS LEAD


WHAT ARE E-PATIENTS?


e-Patients represent the new breed of informed health consumers, using the Internet to gather information about a medical condition of particular interest to them.


The term encompasses both those who seek online guidance for their own ailments and the friends and family members who go online on their behalf.


e-Patients report two effects of their online health research—better health information and services, and different (but not always better) relationships with their doctors.


CONNECT DOCTORS WITH E-PATIENTS


USE THE INTERNET AS A TOOL


TO EDUCATE PATIENTS


HAND-PICKED INFORMATION


PERSONALIZED TO YOU.


WHO ARE E-PATIENTS?


THOSE WITHOUT AN ACCESSIBLE PCP


E-PATIENT #1 THE UNINSURED WHO HAVE TO PAY CASH


WHO ARE THE UNINSURED?


47 MILLION


70% (33.4 MIL) ARE AGE 18-55


38% HAVE INCOMES > $50K


20% HAVE INCOMES > $75K


80% OF PEOPLE AGE 18-34 ARE ON FACEBOOK


YOUNG WIRED NOT POOR RELATIVELY HEALTHY PRONE TO ACUTE INJURIES PRONE TO ACUTE ILLNESSES SPEND $900 PER YEAR ON HEALTHCARE


E-PATIENT #2 THE INSURED WHO WANT INFORMATION, ACCESSIBILITY, AND COMMUNICATION, AND ARE WILLING OR HAVE TO PAY OUT-OF-POCKET FOR IT


OUT-OF-POCKET HEALTHCARE EXPENSES $250 BILLION PER YEAR


ANNUAL REVENUES: EBAY = $7.7 BILLION APPLE = $24 BILLION GOOGLE = $11.4 BILLION AMAZON = $13.5 BILLION MICROSOFT = $51.1 BILLION


OUT-OF-POCKET DOCTOR SERVICES EXPENSES: $75 BILLION PER YEAR


AND NOT A SINGLE COMPANY HAS GONE AFTER THIS MARKET


UNTIL NOW


hellohealth


CONSUMER BRAND


HEALTHCARE DELIVERY


THE MYCA WEB PLATFORM


“THE FACEBOOK OF HEALTHCARE”


CONNECT DOCTORS AND PATIENTS


BOTH ONLINE AND IN-PERSON


DOCUMENT THESE INTERACTIONS


BILL FOR THESE INTERACTIONS


NEIGHBORHOOD-BASED OFFICE


MUCH LIKE STARBUCKS IS A NEIGHBORHOOD STAPLE


NEW HEALTHCARE CONSUMERS


WHO EXPECT MORE


WHO EXPECT BETTER


IT’S ABOUT TIME


OF HEALTHCARE


FOR THE WHOLE FOODS CROWD


THEY EXPECT ACCESS


THEY EXPECT SERVICE


THEY EXPECT VALUE


THEY EXPECT THE EXPERIENCE


THEY PAY FOR “EXPERIENCE”


THEY’RE HAPPY TO IF IT’S REASONABLE AND TRANSPARENT


JUST ASK


SUCCESSFUL CONSUMER BRANDS


PEOPLE NOW INTERACT WITH BRANDS


PEOPLE EXPECT


PEOPLE EXPECT


BUT IN HEALTHCARE


THE HEALTHCARE CONSUMER EXPERIENCE


SIMPLY DOESN’T EXIST


UNTIL NOW


hellohealth


INTERACTIVE NEIGHBORHOOD-BASED CONSUMER-BRANDED HEALTHCARE DELIVERY PLATFORM AND SERVICE


VERY LOW OVERHEAD


USED TECHNOLOGY


TO STREAMLINE PROCESSES


STREAMLINE COMMUNICATION


CUT OUT THE MIDDLEMEN


PEOPLE WANT TO CONNECT


PEOPLE WANT THEIR OWN DOCTOR


PEOPLE WANT TO MAKE THEIR APPTS


BUT DOCTORS ARE INACCESSIBLE


AND TOO BUSY


TO PROVIDE THE EXPERIENCE


TECHNOLOGY NOW EXISTS


TO CONNECT PEOPLE


THE INTERNET HAS CHANGED


IT’S ALSO CHANGED EVERYTHING


IT REVOLUTIONIZED INDUSTRIES


IT REVOLUTIONIZED RELATIONSHIPS


IT REVOLUTIONIZED THE ECONOMY


IT WILL CONTINUE THE REVOLUTIONIZING


IT CREATES OPPORTUNITY


IT FOSTERS CREATIVITY


IT STREAMLINES PROCESSES


IT SAVES MONEY


IT CREATES MARKETS


IT CREATES COMPETITION


IT KEEPS US HONEST


IT KEEPS THINGS FAIR


HEALTHCARE


BUT THINGS ARE CHANGING


WE CONNECT YOU


WITH YOUR NEIGHBORHOOD DOCTOR


USING A STRONG CONSUMER BRAND


AND A CASH-BASED “ECONOMY”


hellohealth


BRANDED ADVERTISED MARKETED DESIGNED


the barbarian group


1,000,000,000 HITS


WHAT DOES EACH hellohealth LOOK LIKE?


TWO DOCTORS


TWO MID-LEVELS


TRIAGE SPECIALIST THIS PERSON MANS THE DASHBOARD


5000 PATIENTS


EACH PATIENT PAYS $25/MONTH


TO BE A MEMBER


IT’S NETFLIX-LIKE, “SO LOW I DON’T EVEN THINK ABOUT IT” MONEY


+ PER EPISODE FEES


$75 TO $150 PER IN PERSON VISIT


INTERNET COMMUNICATION


DOCS ARE PAID BY THE HOUR


ONE NEIGHBORHOOD


INITIALLY 50% HOUSE CALLS 50% OFFICE VISITS


MORPH INTO ONLY OFFICE VISITS


FIT INTO ANY NEIGHBORHOOD


ANYWHERE IN AMERICA


TECHNOLOGY REPLACES STAFF


JUST YOU AND YOUR OLD-TIME NEIGHBORHOOD DOCTOR


LOTS OF TECHNOLOGY


COMMUNICATING NORMALLY


POWERED BY MYCA


A VERY INNOVATIVE PLATFORM


FACEBOOK MIXED WITH AN EMR


MIXED WITH iGOOGLE WIDGETS


FACEBOOK AND MYSPACE


THE OS FOR SOCIAL NETWORKS


GOOGLE


THE OS FOR SEARCH AND CLOUD


THE MYCA PLATFORM


THE OS FOR PRIMARY CARE


UI IS 100% WIDGET BASED


EMR WIDGETS


HERE’S A SNAPSHOT


SCHEDULING WIDGETS


COMMUNICATION WIDGETS


EMAIL, IM, SMS, PHONE, VIDEO


FEDEX LIKE LOGISTICAL ENGINE


TO ANALYZE AND PLAN MY DAY


SO SIMPLE


COMPLETELY CUSTOMIZABLE


CHOOSE YOUR WIDGETS


FROM MYCA’S WEBSITE


ORGANIZED BY SPECIALTY


ORGANIZED BY FUNCTION


ORGANIZED BY INTERFACE


ORGANIZED BY WORKFLOW


IT’S PICK-N-CHOOSE


IT’S DRAG-N-DROP


IT’S REARRANGE


JUST ENOUGH TO MAKE YOUR UI PERFECTLY EFFICIENT


JUST FOR YOU


NOT TOO COMPLEX NOT TOO SIMPLE


JUST FOR YOUR NEEDS


STUNNINGLY BEAUTIFUL


SIMPLY iGOOGLE-LIKE INTUITIVE


THE OS OF PRIMARY CARE


hellohealth FREES DOCTORS


INCREASES THEIR REVENUE


SIGNIFICANTLY $125,000 PER MONTH OF CONSTANT REVENUE


hellohealth STREAMLINES


hellohealth IS EFFICIENT


WE GIVE CONSUMERS


THE EXPERIENCE


MOST IMPORTANTLY


WE CONNECT WITH THEM


AND MAKE GOOD MONEY DOING IT


WE DISRUPT THE OLD WORLD


WITH NEW TECHNOLOGY


STARTING WITH CASH


A STRONG CONSUMER BRAND


FOR NEW DOCTORS


AND NEW CONSUMERS


WHO SIMPLY EXPECT BETTER.


WE’RE OPENING JULY 1


WILLIAMSBURG, BROOKLYN


105 BERRY STREET


hellohealth


ANY QUESTIONS?

Profile for Jay Parkinson

Where is the Healthcare Revolution?  

Where is the Healthcare Revolution?

Where is the Healthcare Revolution?  

Where is the Healthcare Revolution?

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