I am a doctor.  My father was a doctor.  His entire ethos and my childhood was about my father and his patients. I thought I would kick things off with a few premises.  Please either agree or disagree: What we don’t want:

• No one really wants to go to the doctor if they don’t need to
• No one wants a complication of a therapeutic intervention
• No one wants to go to the ER or hospital if they don’t need to and certainly no one wants to get re-admitted to the hospital after they’ve just left

What we do want:

• A doctor’s office that doesn’t put you on hold (and make you wait)
• A doctor that uses technology with a purpose rather that just for technology’s sake
• Access and connectedness
• To be given tools that empower us to engage

We, as patients, spend 99% of our lives out of the healthcare system – yet, when we try to engage, the friction is overwhelming.  It doesn’t have to be that way.  Daniel Pink, in his book, Drive, elucidates the long-term ineffectiveness of carrots and sticks as incentives and brings into stark relief the power of autonomy and mastery. By tapping into fundamental human motivations, he argues rather effectively, we will flourish.  How does healthcare tap into this wellspring? Well, up until now, it doesn’t.

As physicians and as a system, we have failed to empower our patients and in the process have anointed Dr. Google as the sole reference.  The problem is, Dr. Google eventually bestows upon the patient, the inglorious Internet Medical Degree.  As a practicing physician, I can tell you there are many people who truly believe that their 3 hours of research can match my 15 years of study, mistakes, pattern recognition and experience.  This is not to say that physicians are infallible, rather Dr. Google is empowering people (and people like that).  The problem is Dr. Google will always list cancer as one of the possible diagnosis…almost every time.  What, me worry?

There is no semblance of a normally functioning ecosystem.  There are protected silos of data and research, large regulatory bodies, armies of lawyers, doctors using electronic medical records (EMR) that can’t talk to each other and a myriad of middleman clocking the ‘arbitrage’ dollar and choking innovation.  Here is a thought experiment:  Imagine each entity in the healthcare system is a circle and the size of the circle represents its power.  Now imagine drawing a dark line between the entities where the money flows (like a broken etch-a-sketch). Follow me here, now draw a dotted line between the entities that have influence over one another.  (ewww, getting ugly). Now for the punch line – draw a green line between the entities that trust each other.   Perhaps it’s just my point of view, but I can only really see one bright green line…the one that connects the doctor to the patient.

There is no archetype of a doctor.  ER doctors, radiologists, oncologists, pediatricians all have a different set of critical functions and workflows that are absolutely unique to that specific specialty.  So why is it that all health information technology (HIT) vendors build silo’s?….Well, duh!  Make the switching costs high and difficult and you’ve got a long-term customer.  I believe the world of HIT should model itself after Lego’s.  Everyone can build what he or she wants with the pieces that make sense for him or her.  Let the institutions, no matter what size, roll their own.  We need to compete on value – finally, there is a marketplace for applications that can work together.  

In all the talk about ACO’s, HIT, HIE’s, gain-sharing, risk sharing, readmissions, integrated systems – we seem to be missing something…the patient!  As a profession and as a system, we have a lot to learn from our ‘customer.’ Facebook was built by engineers for users – not built by engineers for engineers.  Doctors built healthcare for doctors and has since been subsumed by hospitals and insurance companies following the mighty dollar.  We now have a marketplace where sick patients make the market bigger.  (Are you as nauseous as me?)  With sustainability as the zeitgeist of a post-recession era, healthcare needs to find it’s footing.  The good news is that Healthloop is here – we have a very big idea.

We’re not naive.  We know the road to success in healthcare is littered with the skeletons of innovation crushed by the incumbents and byzantine payment models.  The good news is that the physicians working with the HealthLoop team are seeing patients every day, and listening, while our funders and advisors are veterans with decades of battle scars. The excitement is palpable.

With funding from TomorrowVentures, Physic Ventures and FoundersFund Angel and beta, pilot sites like Henry Ford Cardiology, the SOAR Clinic in Redwood City, and a myriad of doctors ranging from urology, plastic surgery, rheumatology, GYN and internal medicine – we are hopeful. See job opportunities here.