TEDMED — further thoughts

There was no way I could keep up with the stream of incoming thoughts and people that I experienced at TEDMED.   Plus TEDMED had their own blog — which provides better coverage than I can do — so here is the official blog…which is worth a scan.

I learned a lot from TEDMED — I was particularly interested to learn about my microbiome.   The speaker — Jonathan Eisen — suggested it should be considered an organ, just like our skin.    His blog on the topic is here.

There were many thought-provoking questions:

  • the real impact of bias in the way data is published and shared from clinical trials.
  • the evolutionary future challenge of drug resistant bacteria — and whether it should impact treatment today and how
  • using gaming/crowdsourcing to figure out the right structure for a protein (go U of Washington)

One observation — which is further exemplified by the 20 grand challenges selected out of over 40 choices — is that there are SO MANY worth causes (diseases, fixing science in so many ways, engaging consumers etc) that real progress is on core issues (my definition — like getting a value driven, consumer centered health delivery system) is diminished as folks push their worthy agenda.    As Mike Leavitt said while Sec. of HHS — it is not that we lack political will – it is that there is too much political will that stops progress.

I was also struck by the many ‘chance’ encounters I ended up having with thoughtful, motivated and energized folks.  That is one of the great benefits of working in the health sector — the breadth and depth of the talent tackling the problems.     I hope the community really makes some progress in the coming year.

TEDMED 2012 — first thoughts

I’m attending TEDMED 2012 in Washington DC and I will try to add thoughts/insights each night.     The goal of TEDMED is awesome — to unlock imagination to inspire innovation.    It brings together folks from all sorts of different disciplines who care about improving the health of our society — an ambitious goal!    Jay Walker, who is now the owner/driver of TEDMED says he wants to build a community and a place for that community to come together.

Even though I’ve only listened to one session so far — I’m already convinced the conference will open my mind to both new ideas and new challenges — which is great.     There was a compelling talk by Rebecca Onie about the genesis of Health Leads — which basically unleashes the capabilities of college kids to support the basic health needs of underserved folks in the health delivery system (getting heat, appropriate food and other basic needs) which are the foundation for healthy living.    It accomplished its goal of being an inspirational talk.

I ran into a number of folks from the industry I already know – -but I also met a bunch of new folks doing interesting things or just trying to learn.   They all want to make a positive difference.   Here is one worth learning about — http://www.artandhealing.org/

Thoughts from HIMSS 2012

I am not normally a big fan of large trade shows –with all the hustle and bustle, it is hard to generate real insights or have meaningful interactions. This year, I got off to a good start because of two keynote speakers at CHIME – Ken Blanchard on leadership and change and Lowell Catlett on economics and consumerism. Blanchard helped crystallize some concepts around leadership styles and behavioral paradigms that will be very valuable in my new role as advisor to growth companies in the private equity world and Caradigm. Catlett — who ironically made a strong impression on me as the keynote speaker at my first CHIME a few years ago —  made a compelling case for “why this is a great time to be in healthcare and technology in America”. He is totally right and his basic logic is:

  • Wealth – cost of housing, food, transportation as a percent of disposable income is the lowest – ever!
  • Demographics – percent of the population entering the higher demand care years is large,  growing significantly, and has the money to pay for their preferences
  • Big data – there is so much room to understand what works, design new solutions, improve outcomes and lower cost, it is unbelievable.   
  • Consumerism – consumers/patients clearly want different experiences than available today – and innovators will combine big data, feedback loops, preferences and rearrange how services are delivered to meet this new demand.

Amid the noise on the HIMSS floor, overabundant influence of the regulatory machine and increasing downward cost pressures of our macro-economic reality, I remain very optimistic about the ability of innovators and entrepreneurs to build successful, sustainable and scalable businesses that improve health outcomes, reduce costs and deliver better consumer experiences. I have learned over the years that real change is harder and slower than I would like it to be – but it is clearly happening. As I have written before, policy makers could do many things to improve the focus on real ‘value’ in health delivery by getting the incentive systems right. What I confirmed through many interactions with health system executives and vendors alike – is that they are driving focus on delivering improved ‘value’ in preparation for however the payment system evolves. The consequence of focusing on ‘driving value’ is a clear demand for having a data strategy that goes beyond installing an EMR.  The organization needs to be able to have a ‘data fabric’ that connects many activities within the institution, with other delivery orgs, with payers and enables them to sustainably drive metrics, derive insights and improve workflows and then connect back into the EMR/ERP transaction systems.  This creates a number of opportunities for technology, content and services companies.  While many organizations are stuck in the weeds certifying Meaningful Use, many are ready to focus on the next stage and, hence, there is buyer bandwith to support the opportunity.

Given that it is a “great time to be in healthcare and technology”, this is an exciting time to be part of health focused, growth private equity fund to pursue change and opportunity.    There is nothing like exposure to interesting businesses across the supply chain spectrum – payments, revenue cycle, training, comparative analytics and more to begin rationalizing key components for value creation and the variety of approaches to assembling them to scale.  The ability to look across the breadth of pain points and innovation and connect it to investment theses around the impact of meaningful data sets and consumerism is where true value will be derived.

Sustainably innovating in health is different than other industries, due to the lack of many market signals (price transparency, consumer preferences, supply side flexibility).  There is an interesting discussion here.  The real challenge for entrepreneurs is how to find ‘beachheads’ to begin driving ‘value and innovation’ within today’s framework that will evolve and scale as the incentives change.