Category Archives: Entrepreneurs

GetWellNetwork CEO speaks about patient engagement

Michael O'Neil, CEO of GetWellNetwork

Michael O’Neil, CEO of GetWellNetwork


Michael O’Neil had the misfortune to contract non-hodgkin’s lymphoma while in graduate school. His medical outcome was good but his experience as a patient was not. He founded GetWellNetwork (GWN) to provide an interactive patient engagement solution to help patients move from dependence to independence in the course of their care. The company’s solutions are found in 200 hospitals and are credited with lowering readmissions, increasing staff responsiveness, and increasing patient satisfaction with pain control.

I caught up with Michael at #HIMSS14 in Orlando and asked him to tell his story.

By healthcare consultant David E. Williams of the Health Business Group

Castlight Health: Early interviews

#Castlight Health has had a very successful initial public offering today and so a lot of people will be hearing about the company for the first time. If you want a little bit of perspective on how the company has evolved, you might want to read interviews I conducted from 2010 to 2013 with the company’s executives.

By healthcare business consultant David E. Williams of the Health Business Group.

My #HIMSS14 exhibit hall photo tour

Today was the day to catch up with old colleagues and meet a few new ones on the massive floor of the #HIMSS14 exhibit hall in Orlando. Here are a few highlights —

 

With PatientKeeper CEO Paul Brient

With PatientKeeper CEO Paul Brient

Paul Brient at PatientKeeper is making great traction with CPOE tools for hospitals. See my earlier podcast on their outstanding rating by KLAS.

With GetWellNetwork CEO Michael O'Neil, Jr.

With GetWellNetwork CEO Michael O’Neil, Jr.

I was impressed with Michael’s story of how his own battle with cancer led to the creation of GetWellNetwork, a patient engagement company.

With Atrilogy Chief Castle Officer Cinderella

With Atrilogy Chief Castle Officer Cinderella

Cinderella showed me the “prince pose” at the Atrilogy booth. Can you tell by these photos that I’m more comfortable with the health care exec types?

With Alere Connect CEO Kent Dicks

With Alere Connect CEO Kent Dicks

I first met Kent Dicks when he was running start-up MedApps, which was acquired by Alere and  has now grown into a much broader and grander remote health monitoring offering.

with Noridian Healthcare Chief Medical Officer Sandeep Wadhwa

with Noridian Healthcare Chief Medical Officer Sandeep Wadhwa

Sandeep Wadhwa and I go way back to college days, when he was president of our senior class at Wesleyan. We’re getting ready for our 25th reunion and trying to decide whether it’s better to be bald or grey. Meanwhile, he’s making things happen at Noridian, a leading Medicare administrator.

Health care business consultant David E. Williams, president of Health Business Group at HIMSS 2014 in Orlando with Ken Tarkoff, General Manager of RelayHealth

With RelayHealth General Manager Ken Tarkoff

Ken Tarkoff runs clinical solutions at RelayHealth, a very dynamic division of McKesson.

By health care business consultant David E. Williams, president of the Health Business Group.

#HIMSS14 first impressions

The exhibit hall at the Health Information Management and Systems Society (HIMSS) 2014 conference is pretty humungous. Even with tens of thousands of people milling around there’s still plenty of elbow room. The central part of the floor is dominated by the huge booths (some with two levels) of the industry giants. Those booths are pretty informative and impressive.

Yet I enjoy starting off by exploring the outskirts of the hall where the small booths reside. This is an admittedly hit or miss approach, but there are some real gems among the exhibitors. It’s always a learning experience for me.

A few of the interesting companies I met today for the first time are:

  • PatientSafe Solutions (booth 3983) a point-of-care mobile solution that integrates positive patient identification workflows into existing EHRs by using a modified iPhone
  • Applied Pathways (booth 3989), which offers a cloud-based platform to enable clinicians and business analysts to develop and curate clinical rules and to implement custom workflows without IT support
  • Condusiv Technologies (booth 3392) whose software improves hardware performance, e.g., by optimizing input/output processes– thus reducing the need to add expensive new gear
  • IMAT Solutions (booth 3792), an advanced data aggregation, analysis and reporting company

I’m sure there are many more interesting companies I haven’t met yet. I look forward to finding some of them over the next couple days.

By health care business consultant David E. Williams, president of the Health Business Group.

Center for Health Care Innovation: Podcast interview with Independence Blue Cross


IBC Center for Health Care Innovation

IBC Center for Health Care Innovation

Independence Blue Cross (IBC) is opening a Center for Health Care Innovation with the intention of helping Philadelphia become the “Silicon Valley of Medical Science.” In this podcast interview, Terry Booker, VP of Corporate Development and Innovation at IBC discusses the new center, how it ties in to existing IBC innovation programs like the Dreamit accelerator, how it’s funded, and how success will be assessed.

Photo credit: Independence Blue Cross

By David E. Williams of the Health Business Group.

Health insurance exchange for employers: Interview with ConnectedHealth (transcript)

This is the transcript of my recent podcast interview with Joe Donlan, co-founder and president of ConnectedHealth.

Joe Donlan, co-founder and president of ConnectedHealth

Joe Donlan, co-founder and president of ConnectedHealth

 

David E. Williams: This is David Williams, president of the Health Business Group. I’m speaking today with Joe Donlan. He is president and co-founder of ConnectedHealth. Joe, thanks for joining me.

Joe Donlan: Glad to be here. Thanks, David.

Williams: Joe, what is ConnectedHealth? What’s the idea behind it?

Donlan: ConnectedHealth is a private health insurance exchange. We’re focused on helping employers grow their business by offering a compelling and competitive benefits package to help acquire and retain key talent. The idea is that by offering this type of defined contribution solution, we can get employees thinking about their health and financial security, thinking much more holistically about how they spend and allocate their benefit dollars across benefit options. We know that if an employee is healthy and financially secure, they tend to be more productive in the workplace and can focus on growing the business.

Williams: Joe, there are a number of private health insurance exchanges around. Some focus on specific areas. For example, some work more with retired employees, those that are Medicare-eligible. Does ConnectedHealth have a particular focus?

Donlan: Absolutely. Most of our focus has been on the commercial, under 65 market. We offer capabilities on a group basis as well as offering capabilities for individuals, while always going through the employer. We can help solve employer problems and provide competitive benefits packages both in an individual and group world to those employees.

A good example of what we’re seeing in the marketplace is employers that have both group-eligible populations as well as a lot of 1099 or part-time employees that might not be eligible for those group benefits but could benefit by having easy access to individual health insurance plans.

Our approach has been going to those employers and being able to solve for each and every single one of their employees, given their diverse employee population.

Williams: It’s interesting what you’re describing. From a health care policy perspective and with all the noise regarding the Affordable Care Act, you hear a lot about the employer mandate being a problem for employers. You’re coming at in the other way, which is to say an employer might want to offer benefits even to employees who wouldn’t typically be eligible, in order enhance their attractiveness as an employer.

Donlan: That’s exactly correct. The ACA and health reform really has accelerated much of our business. Our business was never predicated on health reform at all. It was predicated on the fact that employers still need competitive benefit solutions and given their size and challenges, those needs may vary. So, an employer that has fewer than 50 employees might have a different benefit strategy and approach than an employer that has 500 or 1000 employees. We try to solve for those different situations by leveraging our e-commerce shopping platform and oftentimes using a defined contribution approach in the process.

Williams: The idea of a shopping or a customer-oriented approach to selecting health insurance is a new one. It’s getting a lot of attention now because of the Affordable Care Act. But can you describe what the experience would be like for a user? And is it more like what they would do in a typical kind of insurance purchase or is it more similar to Amazon or some other kind of consumer e-commerce website?

Donlan: It’s a great question; Amazon often comes up in this type of discussion. And really, it’s pretty different from Amazon. When you go to Amazon, you tend to know what you want. You know what products you’re looking for and you’ve already done some research, and you go there and you type in that particular product and you buy it and take advantage of Prime and all the other great services that Amazon offers.

Our approach is that people in benefits don’t necessarily know what they want. I’ve been part of organizations that have been developing consumer-oriented health care decision support tools for the past 13 years. And so there have been a lot of lessons learned in terms of what works and what doesn’t work when presenting very difficult information or, said differently, providing solutions or answers to complicated health care questions. So we spend a lot of time thinking about behavioral economics and spend a lot of time thinking about how you establish frameworks and put decisions in context to make the decisions easier for the end user and consumer. We always start with the consumer in mind, and then work backwards in understanding the key factors that influence those decisions.

Health insurance and other related benefits are very complicated and can be very confusing. And when we start talking about an exchange or a marketplace environment, oftentimes we’re talking about creating more choice. But choice doesn’t necessarily ensure satisfaction. The approach we’ve taken is looking at the key factors and the influences: What are the attitudes? What are the behaviors that we can ask someone in order to provide a smart and intelligent recommendation about a particular product? And so, we ask things such as, what is your risk tolerance?

Certainly we don’t literally ask ‘What is your tolerance?’ We ask it in a way that helps people understand how they would balance their dollars so that they realize that if they pay less in premium they could end up spending a heck of a lot more money when they need care.

And that is a concept that, with the way we address the question and the graphics we use, makes it very intuitive for someone to understand. We also ask them how they typically use health care over the course of the year for themselves and their family members. We ask how many times they typically see a doctor and how many times they typically take prescriptions, et cetera. We then apply a proprietary algorithm to that data and information and, factor in their demographic information to all the different benefit plans that are available to them.

And we provide a recommendation from top to bottom depending upon how many choices they have. We don’t say, ‘Here’s your co-pay, co-insurance, deductible, premium.’ It’s ‘Here’s your premium, here’s how much we think you’re going to pay, an estimated out-of-pocket cost.’ So we provide premium plus cost of care, and then the maximum out-of-pocket cost; the total financial exposure.

The approach we’ve taken has been pretty been fascinating. We have been giving people peace of mind in their benefit decision because very simply, the way we display the benefit recommendations, they can see the total financial impact of their decision. They know their baseline of what they’re going to pay in premium and they know their worst-case scenario.

What people don’t typically know is that middle figure. We take the mystery out of it and present it in a way that the user can start to think about what trade-off they may want to make. So if they spend a little bit more money in premium, they can see what the total impact might be and the decrease in estimated out-of-pocket cost or total maximum out-of-pocket cost.

Williams: So, when people think about shopping on these exchanges or marketplaces, there are many barriers, especially for those who don’t make their living like you and I do, thinking about this sort of thing every day. You just went through co-pay, co-insurance deductible, premium. But of course there are other sorts of things to consider – PPO, HMO, POS, narrow networks – all sorts of things that someone may have to deal with. And even the just the notion of it, is it a marketplace or an exchange, it’s pretty hard.

I don’t want to put words in your mouth but to get to the point of making the sort of trade-offs that you’re describing, does the user have to understand all that terminology?

Donlan: They really don’t. Since we keep this focused on essentially the financials, they see what the impact is on those three levers – the premium, estimated out-of-pocket cost and maximum out-of-pocket cost. We provide filters and using sliders, just as someone might use when they’re shopping for an airline ticket at Kayak.com. You can very easily start to understand what the impact might be of your risk. So you have your ability and your tolerance for risk.

It’s very easy to say that, ok, if I’m willing to pay a little bit more every month, what might the decrease in cost be and how might it change the total financial exposure? These are the things that keep the stories off of the New York Times and the Wall Street Journal. We avoid a situation where a family chooses a plan without realizing that the maximum out-of-pocket was $30,000 and then, all of a sudden, they’re bankrupt. We are very clear and upfront about what that total cost is for the health plans so there’s level of transparency. What we’re finding with our clients is that it has given people a lot of peace of mind in order to buy.

We’ve seen with one of our grow their business based on number of applications submitted by over 130 percent. At the same time, they decreased their call center calls by nearly 40 percent. That tells us that people are coming to the shopping platform, they’re navigating it in a way that they would with any contemporary shopping/e-commerce site, and they’re transacting and making the purchase.

We’re seeing a lot of really positive results by taking this approach; it took us a long time to get here. We are applying the lessons that we have acquired over these 10-plus years; understanding the decision points and understanding the complexities of these decisions and figuring out how to make it simple.

On the backend, the way I like to describe it is it’s kind of like an iPhone. The shopping platform is very easy to use, very easy. All the magic essentially happens behind the scenes. We do the hard work behind the scenes so that the user can have a more enjoyable and seamless experience when they’re navigating the site.

Williams: I know you’ve been at this for quite awhile. But for most people, they’re just getting exposure to the kind of shopping experience that you’re describing. I’d like you to push fast forward and think about where we get to in five years. Once it’s kind of routine to use this sort of platform, what kind of extensions might there be on it? What’s next for an employer, beyond trying to get people to buy and use the platform? Where does it go from here?

Donlan: I think we’re just scratching the surface right now, David. And what’s going to be really fun to watch in the market is how levels of personalization continue to get enhanced just like you’ve seen in many other industries. So we spend a lot of time looking at the financial services industry as an example, and think that there are a lot of parallels into what we’re doing in the benefits world.

So the concept of someone thinking about their overall benefits portfolio and how an individual may want to allocate dollars across that benefits portfolio from a health and financial protection standpoint is pretty exciting to me. And in order to make that successful, data and information are going to be key to drive personalization. You can envision a world just as if someone was sitting down with their financial advisor and they’re saying that they want to have a child and they want to retire in 40 years and they want to have a house in Florida when they retire, etcetera. And that financial adviser answers, “OK, here’s what your portfolio needs to look like.”

But that portfolio may change once you have children and maybe multiple children. Maybe you choose to send one of your children to a private school instead of public school. I think the same will hold true when someone looks at this holistic benefits portfolio and how they allocate dollars. Having a child is a good example. You may adjust your benefits portfolio and start allocating more dollars towards life insurance than you would have when you didn’t have children.

So, that’s where the really exciting times are ahead of us is. It’s getting people to take ownership of their health and financial security portfolio.

Williams: I’ve been speaking today with Joe Donlan, president and co-founder of ConnectedHealth. We’ve been talking about private health insurance exchanges. Joe, thanks so much for your time.

Donlan: Thank you, David. I really appreciate talking to you today.

Health insurance exchange for employers: Interview with ConnectedHealth


Joe Donlan, co-founder and president of ConnectedHealth

Joe Donlan, co-founder and president of ConnectedHealth

With all the fighting over ObamaCare and the botched launch of the federal exchange, it’s easy to lose track of the fact that online insurance marketplaces are an efficient and effective way to compare and select coverage. Exchanges are catching on in the private sector and I expect their growth rate to increase as people get used to them.

ConnectedHealth provides an exchange platform for active employees (as opposed to retirees). They focus on helping employees understand what’s available to them and the full financial consequences of their decisions. Their platform is designed to serve companies who may have a mix of employees: group eligible (i.e., full time, permanent workers), part-time employees, and 1099 independent contractors. Employers are offering the platform in order to attract and retain employees and to help those employees make the most of their benefits and avoid surprises.

In this podcast interview, ConnectedHealth co-founder and president, Joe Donlan explains how it works.

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By David E. Williams of the Health Business Group.

DocASAP: multi-channel platform for booking doctor appointments (podcast)


DocASAP CEO Puneet Maheshwari

DocASAP CEO Puneet Maheshwari

DocASAP provides an online platform that enables consumers to book appointments with health care providers through multiple channels, including insurance company websites, consumer health sites, and providers’ own websites. It also smooths the specialist referral process by allowing physician offices to book appointments on behalf of their patients.

In this podcast interview, founder and CEO Puneet Maheshwari describes how DocASAP is differentiated from other offerings, discusses the company’s strategic partnership with MultiPlan, and speculates about the uses for the transaction data generated by the platform.

By David E. Williams of the Health Business Group.

Will work for dental care. Not a bad idea

There’s a big gap in coverage for dental care. It’s not considered part of core health care benefits and so many people –even those with commercial health insurance or Medicaid– lack coverage. The Affordable Care Act addresses only a small part of the gap. That’s a problem because dental health is a key component of overall health care and not something that should be optional.

That’s why I like the looks of an innovative program in Calhoun County, Michigan where uninsured patients can earn credit for dental visits by doing volunteer work such as working in a food bank. Dentists generally volunteer their time and I can understand why:

Kip Etheridge, a dentist who sees patients from the program in his office a few hours a month, said the volunteer work makes [patients] more vested in their care and reduces the number of people who don’t show up for the program’s dental appointments.

“It’s not free care, they work for it and that aspect is what has encouraged dentists to participate,” Etheridge said.

The program rewards volunteers with $100 in dental care per four hours of work. Patients must also go to an oral health class and see a hygienist (paid for by local fundraising) first. Visits to the local emergency room for dental problems have dropped dramatically since the program went into effect.

This is a very nice example of what can be achieved at the local level when people of goodwill collaborate in a pragmatic, creative and non-ideological way. Already the program is being expanded to include chiropractic care and orthodontics.

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By David E. Williams of the Health Business Group.

Harnessing patient activation to reduce readmissions: Interview with Insignia


Hospitals are getting serious about reducing avoidable readmissions now that there are financial incentives to do so. Patients who score high on “patient activation” based on their knowledge, skill, and confidence are much less likely to be readmitted according to research by Judy Hibbard, a professor of health policy at the University of Oregon.

In this podcast interview, Chris Delaney, CEO of Insignia Health explains how his company has commercialized the Patient Activation Measure (PAM) to address the readmission issue.

By David E. Williams of the Health Business Group.