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Big Healthcare Companies Won’t Disrupt Themselves

Posted on November 7, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’ve been really interested in something Jay Walker, curator and chairman of TEDMED, told me at Xerox Healthcare event at CHIME. I’m not exactly sure how we got into the conversation, but Jay made the comment that “big companies never disrupt themselves.”

I’d love to have had a chance to dive in more to what Jay Walker was really thinking on this subject. No doubt I could tell he’d given it a lot of thought. However, the concept is incredibly intriguing to me and the more I dig into it I realize that Jay is really on to something.

There are so many reasons why a big organization won’t or can’t disrupt itself. This isn’t to say that big companies aren’t without their value. It turns out that large organizations are really really good at optimizing existing business, services and processes. They can squeeze the value out of a current business like no other. However, optimizing your current business is very different than disrupting your business and changing a market. There are just too many incentives for a large healthcare organization to not disrupt themselves.

When it comes to healthcare IT, I think we will see this same concept play out as well. We can look to the large healthcare IT organizations to see how something is going to be optimized, but we shouldn’t expect any sort of disruptive innovation to come from these larger healthcare IT companies. They have so many reasons not to disrupt themselves.

I give Jonathan Bush, CEO of athenahealth, a lot of credit when it comes to understanding this. He literally built a program at athenahealth that he calls “More Disruption Please.” My take on it is that Jonathan Bush wanted a way to spend a bunch of money on things that could disrupt the athenahealth business. This program would allow him to do just that without having to explain that spend to the public markets. When they ask why he spend millions of dollars on these disruptive companies, he can just say “That’s what I told you I was going to do. It’s called More Disruption Please for a reason!” I think it’s pure genius.

Although, even this effort which I call genius really just highlights that the disruption to healthcare is likely going to come from outside large companies. If anything, this program is a way for athenahealth to tap into that disruption so that they’re well positioned to ride that wave of disruption which will surely come.

What disruptions do you see coming to healthcare? And if you tell me it’s coming from a big company, I’ll take a look, but now you’ll know I’m skeptical. Although, I’m certainly happy to be proven wrong.

What flows through you into the world?

Posted on May 17, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

On this lovely Friday I thought I’d throw out something that I heard at TEDMED that was quite profound. One of the organizers asked the following question that had impacted his life:

What flows through you into the world?

It’s a powerful concept to consider what we’re doing of good in the world. In fact, he asked some follow up questions for those of us in healthcare.

Are you in healthcare to do good? Or just to make money? Or just to provide for your family? Or just because you have no other choice?

I remember when I first got my job in healthcare I was really empowered by the idea that maybe something I did could help save someone’s life. It’s amazing how the mundane gets in the way of that broader vision. Although, I feel pretty good about what flows through me into healthcare IT and EHR. It just can always be more. I hope you’ll join me in thinking about this idea this weekend.

Does adding all these EHR and other tech add or subtract to healthcare?

Posted on May 7, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Such a compelling and tough question to consider. Let me repeat it again so you can let it roll around in your mind for a minute:

Does adding all these EHR and other tech add or subtract to healthcare?

This was one of the off hand comments I heard someone make in their presentation at TEDMED and I think it’s a serious question that every EHR company and healthcare IT vendor should consider.

The simple answer to the question is that some companies add to healthcare and some take away from healthcare. That’s just the nature of markets. However, there’s a deeper part of the question which fundamentally asks if the shift to electronic is helping healthcare or hurting it.

As I’ve mentioned previously, at my core I believe that technology has an overall positive impact on any industry. In my heart I believe that technology has the potential to improve most things.

My fear with the above question is whether we’re implementing the right technology that will help us have a positive impact on healthcare or whether we’re currently implementing dated technology which will set us back for years to come.

I got in a heated discussion today on LinkedIn about the MUMPS database. A HUGE portion of healthcare is built on the back of MUMPS. Nothing against MUMPS (although it does sound like an STD), but is it going to be powerful enough to “add” to healthcare or will we reach a point that its limitations start subtracting from what could be possible?

I don’t necessarily want this post to become a MUMPS pros and cons post, but I think it’s a great illustration of why I’m reticent to say that the technology foundation that healthcare is building today is providing a platform for an amazing healthcare IT future.

On the other side of the spectrum is the plethora of smart phone apps and devices in healthcare. You can’t tell me that the Alivecor device or AirStrip’s work in the mobile field isn’t incredibly exciting. They’re leveraging the latest technology in a beautiful way.

One challenge we do face is the HUGE number of EMR companies and mobile health apps. With so many companies, we’re bound to have a healthcare software graveyard soon. Hopefully the companies we find in the graveyard are those who were subtracting from healthcare instead of adding to it. Unfortunately, that’s still just a hope and may not be the reality.

Many of our newer readers might not be familiar with my reference to Jabba the Hutt EHRs. The concept would seem to apply well to this post. For those not familiar with the concept, Jabba the Hutt was a really powerful individual, but it’s safe to say that he wasn’t very nimble. Does this sound a bit like some of the healthcare IT and EHR companies that dominate the market today?

Maybe I’m wrong, but the nimble innovative companies are the ones that usually add the most to healthcare versus subtracting. Luckily history is on my side. I’m just not sure we have enough Princess Leia companies that are in a position to wrap their chain around the neck of Jabba the Hutt companies.

I’ll let you decide which companies you believe add to healthcare and which ones subtract from healthcare. Although, I think we’d all benefit if every company focused on adding to healthcare.

Inspiring Multidisciplinary Collaboration to Achieve Innovation – TEDMED

Posted on April 22, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.


I was invited to attend TEDMED as a guest of Xerox and what an experience it was. If you missed my first post about the TEDMED experience, you’ll want to start with that post to provide some context to this one. The first day and a half that I describe in that post was a whirlwind experience and the second half of TEDMED was no different. However, the second day and a half had a bit of a different twist. It seemed to focus less on the technical side of medicine and more on its emotional and philosophical parts, but there were still a lot of lessons learned.

The reality of writing a TEDMED recap is that you could literally write about every speaker that participated and so you’re guaranteed to leave out some noteworthy talk. With that made clear, let me highlight some of the messages and people that struck me and would likely be useful to a healthcare IT crowd.

Close to the end of the TEDMED conference, Raghava KK took the stage with some really twisted perspectives on how to teach diversity and stretch your mind in new ways. This quote from his talk seemed to teach an important lesson for healthcare, “When you teach perspectives, you teach creativity.” In the insular healthcare environment, we could benefit from learning about outside perspectives. No doubt we see isolated examples of creativity in healthcare. Maybe the reason we don’t see more is because the healthcare industry needs more external perspectives.

Victor Wang from GeriJoy was a delightful person; I guess you’d need to be to start a virtual talking dog company. While his product is interesting in its own right, his approach is where we can all learn something valuable. Victor said, “We are leveraging the global supply of compassion and kindness.” I’m still trying to process the possibilities of that statement. Victor and GeriJoy are using people from around the world to share compassion and kindness with elderly people. I see an amazing untapped potential where technology has the power to deliver humanity. A talking dog is just the beginning.

Eli Beer‘s lifesaving flash mob, United Hatzalah, is something special. I loved his description of, “Not viral videos. Viral community building.” The power of community is often forgotten or left untapped.

There was an entire session of TEDMED on death. No doubt this applies to a large number of people in healthcare in a lot of different ways. Amanda Bennett offered a couple insights that seemed to capture some of the essence of the conversation including this gem, “Looking at death has taught me how to live.” Plus, if you’re interested in this topic, her discussion of patient denial is a great one. She even borrowed from software development to say, “Denial is not a bug, it’s a feature.”

Roni Zieger, Former Google chief health strategist, announced his new Smart Patients community at TEDMED. He called this and other similar communities a “network of micro experts.” Think of the power these micro experts have when put together in a network. He also pointed out a concept I’d never seen articulated before, “The biggest value isn’t in the data we can predict, it’s in the unexpected connections.” He even applied it to EHR software where he suggested that EHRs were pre-configured and therefore have a hard time seeing emergent trends. His solution, “We need systems that can reconfigure based on the context.”

Marleece Barber, chief medical officer at Lockheed Martin took us all to task when she asked, “If we can land a man on the moon, can we land your butt on a bike?”

Jessica Richman and her company uBiome are part of a growing concept around citizen science. She posed the inspiring question, “Can a citizen scientist win a noble prize?” She believes that if you can ask and answer questions, all you need are the right tools and anyone can be a scientist. I loved her idea of changing science from being a spectator sport on Discovery Channel to a sport that anyone can participate in.

Many of the concepts that Jessica described remind me of patients wanting to be more involved in their healthcare. The growing ePatient movement is a strong one and requires some really challenging shifts in culture. I’m sure I’ll be doing many posts on Jessica’s concepts in the future, but it seems that scientists have similar views to doctors. At the core of the issues to me is the belief that without years of schooling you’re not smart and can’t evaluate complex issues. I don’t want to understate the value of education, but we also shouldn’t understate the value of micro experts (to steal Roni Zieger’s term). They can both have a place in the process and working together they can be much more than the sum of their parts.

Two of the most heartwarming and inspiring presentations were Charity Tillemann-Dick and Sue Austin. Charity, the recipient of two double lung transplants, is a soprano opera singer who performed an aria for us. Her story of survival and drive to live is beautiful. Her message of organ donation is an important one, but her ability to inspire you to battle anything in life is priceless.

Sue is a scuba diver, but she does so in a wheel chair. Instead of trying to explain it, watch one of her other TED talks including a video of her scuba diving.

Martin Hoffman tweeted something that summed up TEDMED quite well, “Inspire multidisciplinary collaboration to achieve innovation.” I’d say that goal was accomplished for many.

Read more coverage from TEDMED from Xerox on the Real Business at Xerox Blog and follow @XeroxHealthcare.

EMR Ready: The Smartphone Physical

Posted on April 9, 2013 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Here’s the kind of thinking that makes me wish I was going to TEDMED 13 (John Lynn will be there if any other readers are attending.).  At this years’ show, a team of current and future medical professionals plan to do a complete “smartphone physical” for attendees, using a bunch of devices that appear to be compatible with an iPhone. Not only is the data immediately readable as the testing goes on, it’s EMR-ready, too, both pretty neat features.

Check out just how thorough the physical is going to be (courtesy of the TEDMED blog):

• Body analysis using an iHealth Scale.

• Blood pressure reading using a Withings BP Monitor.

• Oxygen saturation/pulse measured simultaneously with blood pressure, using an Masimo iSpO2 placed on the left ring finger.

• Visual acuity via an EyeNetra phone case.

• Optic disc visualization using a Welch Allyn iExaminer case attached to a PanOptic Ophthalmoscope.

• Ear drum visualization with a CellScope phone case.

• Lung function using a SpiroSmart Spirometer app to conduct a respirometer test.

•Heart electrophysiology using the AliveCor Heart Monitor.

•Body sounds: A digital stethoscope from ThinkLabs auscultates and amplifies the sounds of a patient’s lungs and heart.

• Carotid artery visualization using a Mobisante probe.

Participant Shiv Gagliani, a Johns Hopkins medical student, tells TEDMED that the smartphone physical can improve doctor-patient relationships, as the real-time, audible and visual results help connect patients to the tests and increase their understanding of their bodies.  Not only that, the patients can help gather the data themselves, increasing their engagement with their care.

And of course, the devices that make the smartphone checkup possible are also very portable, making it possible for doctors to take them wherever they go, be it down the street or across the globe.  What’s more, less-trained global health workers will be able to use these devices to gather baseline readings and via telemedical links, get instructions on how to treat patients. This device connectivity is part of what John suggested was needed for successful Telehealth.

To learn more about this project, visit http://www.smartphonephysical.org/. I’d definitely take a look; it seems to me that this type of mobile health technology is here to stay.