 Over the past few months, I have been asked quite a few times about my thoughts on building a startup in the healthcare industry. It’s true that after 4 years in hardcore healthcare, I have come to a few conclusions about its dynamics, stakeholders, disruption potential (and speed at which change can happen). I feel that we’re at a crossroads and critical mass for change has been met: this time it is really different, I think. As I said before, I am at a junction right now and as I am wrapping things up, this is part two of my thoughts on healthcare and the few lessons I have learned along the way. Revolution is coming: I think we are at a moment when even all the various stakeholders themselves in the healthcare industry have understood that costs aren’t going to rise forever while outcomes remain stagnant at best without a revolt – the perfect storm is coming, it will be destructive but the realignment is necessary. As a very simple, self-experienced, example, It’s mind blowing to me that, in 2019, I can’t schedule an appointment with my ophthalmologist without having to call a number, be put on hold for 45 interminable minutes and given the run-around by front desk employees who couldn’t care less about the negative value they are bringing to the equation. The empowered customer In my personal example, I simply brought my business elsewhere: if as a provider you are not consumer-centered (read very carefully: I am using the term “consumer”, not the industry term “patient”) then you are bound to be disrupted due to two primary drivers: 1) increasing costs and 2) increasing expectations. As a business owner, your demand (the Consumer) is paying more out of their pocket than ever before. As a result of all this rising cost, individuals have now a vested interest (if not forced) to take more ownership in their healthcare decisions. This leads me to new consumer expectations: we are all increasingly looking for on-demand solutions in healthcare in the same way we use apps to order a ride, book a flight and buy food. A new kind of healthcare customer is rapidly emerging, who takes a great interest in managing their health care on a daily basis, and actively look to leverage new technologies and health information. And yes, coming back to my ophthalmologist example, we’re challenging the status quo by seeking care outside of the traditional hospital and doctor’s office. And they are already challenging the status quo by seeking care outside of a traditional hospital and doctor’s office. Changing consumer demands have created an expansion of new care delivery models centered around easier access, lower cost, and a richer experience. Already, there is a range of entirely new ways to “see your doctor”: one survey showed that 60 percent of consumers with employer-based insurance have received care in an urgent care center, 25 percent in a retail health clinic and 11 percent by video visit. New entrants capitalizing in primary care — One Medical, Forward Health, Paladina, and others — offer a range of “on-demand” online services like same day appointment booking, immediate virtual doctor visits, accessible medical records, and prescription renewals. Healthcare is already increasingly being offered at consumers’ fingertips, with consumers accessing medicine (or telemedicine) with a simple app. Tech natives are inevitably going to disrupt traditional incumbents Over the past 4 years, I have seen the fallacy of using tech to automatize inefficient and outdated care models as historically, industry incumbents are looking for ways to incorporate technology into their existing systems and workflows – resulting in poor results: this is the wrong way of looking at the problem. Successful new entrants in healthcare are increasingly being built from scratch with technology baked into the DNA of the company – and (of course!) with a consumer-centric sensibility. We are also seeing tech-natives getting into healthcare like Apple and Amazon. We’re not very far from a world were Amazon can deliver our drug prescriptions same-day via PillPack and also offer low-price telehealth services for Prime members. These new entrants are creating increased and rapidly disruptive and wide-ranging competitive pressure with an acceleration of competitive pressure on traditional providers and insurances’ margins as well as a customer base that is increasingly shopping for superior user experiences at a lower cost. Dissolving the payor/provider silo With so many different stakeholders all acting in their own silo with disconnected incentives, often not driving for value at all. But these silos are beginning to dissolve, creating a new opportunities to rethink how we deliver, pay, and experience high level care. One particular silo that is increasingly facing disruption is the payor/provider paradigm. In a traditional “fee for service” system, hospitals and clinics are incentivized for volume and not necessarily for outcomes and even less for the total cost of care. But in order to better align incentives and address the gaps and fragmentation in care, we are beginning to see the lines between payors and providers start to blur. A few weeks ago, for example, Blue Cross and Blue Shield of Texas opened ten “advanced primary care centers” in partnership with Sanitas, a global healthcare network of hospitals and clinics. This partnership creates a new value-based care delivery model that is takes a holistic approach to improving one’s health: from primary care, urgent care, lab and diagnostic imaging services, to wellness and disease management programs, these medical centers accelerate the ability to coordinate care across one patient’s journey while reducing costs and improving outcomes. Today is (finally!) a great time for healthcare As a conclusion, it seems almost certain to me that the winners of this new world order will be those who are focused on comprehensive, end-to-end solutions that win on outcomes, cost, and experience. I think we are in the middle of major shifts in our healthcare ecosystem, all of which have the potential to completely transform both the demand and supply side of the healthcare landscape. These shifts are creating a rare and powerful window for new entrants to define that landscape in the coming years. Let me know what you think! DM me @philippemora
My name's phil mora and I blog about the things I love: fitness, hacking work, tech and anything holistic. Head of Product and VP Engineering. thinker, doer, designer, coder, leader
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More creative stuff I've been working on on my way to Europe a few days ago. I thought I would share!        Let me know what you think! DM me @philippemora
My name's phil mora and I blog about the things I love: fitness, hacking work, tech and anything holistic. Head of Product and VP Engineering. thinker, doer, designer, coder, leader  1. Email makes you feel productive, but you are not. Just observe yourself when you check your email … you’ll probably realize that it’s happening when you’ve hit a “stuck” point on whatever you’re working on. You’re probably at that point in need of your micro-dopamine “hit” so you can get a false sense of achievement, and then you feel better and you go back to your original task. Rings a bell? This would be fine if it happened to you once an hour or more, but I guarantee you it’s happening to you many, many times in an hour. If you’ve got an iPhone, look at the “screen time” and see the number of your mail app “picks” per hour. This should shock you. And the result is that a task that should take you a certain amount of time does take you way longer because of your email “addiction” 2. Email is the most inefficient way of internal communication Email forces you to be reactive. Period. It starts with the first batch of emails you check and respond to at the beginning of your day, then emails beget more emails, as eventually you’ll end up encouraging useless email “conversations”, always ending emails with a question that needs an answer, rather than trying to bring an issue to a quick resolution. Most often this reaches a level of absurdity when you realize that your discussion involves two or more people that seat almost right next to each other in the same office. 3. The case for banning email from work We all agree that email stresses people out and it’s a colossal time suck. I will argue that face-to-face is still the best way of communicating efficiently: it’s the highest bandwidth form of communication and it includes visual sub cues that are essential for thorough understanding, from body language and facial expressions, leaving an impression; to bonding with coworkers. As such, any leader who wants to foster cultural shift from an individual mindset to that of a community will come to the same conclusion as I have: ban internal email! Replace with face-to-face and instant messaging. My experiments and research on those who have done it have experienced the following changes:
Sounds like a shoo-in to me! Let me know what you think! DM me @philippemora
My name's phil mora and I blog about the things I love: fitness, hacking work, tech and anything holistic. Head of Product and VP Engineering. thinker, doer, designer, coder, leader  Over the past few months, I have been asked quite a few times about two things: my thoughts on building a startup in the healthcare industry and how to approach a brand new industry from scratch. Obviously I don’t have a magic recipe however I thought I would share a little bit of my thoughts so far, after 4 years …. Why? because I feel that first, I am at a junction (I’ll elaborate in future posts) but also because
I am going to make this short: only three points. To get this started, more than ever, I am a big fan of setting clear strategies for success, in particular being absolutely intent on creating the right teams at any level, tying products to services in an efficient and value driven way and most importantly execute, execute, execute! (and be kind, compassionate and have lots of fun too). Now, here are my few points: First of all, I think healthcare SaaS will require you to build high-touch services in order to deal with extreme variability in your customer’s operational environments - for example, make sure you build across a large product surface area (if you’re “just an app” you will fail) and transactional depth (scheduling, payments) to immediately show utility, value and ROI and make a really airtight case for your risk-adverse buyers at any level. Second, about the other end of the funnel — it’s critical that the customer-facing front line is stacked not only with industry insiders who understand the culture of your users and customers, but most importantly, these insiders also must be absolutely fluent in technology and be able to understand and diagnose issues quickly and efficiently to your internal dev and product stakeholders. In other words, if your customer service folks are awesome with doctors but have no idea about the ins-and-outs of your API stack, prepare for a lot of hurt and wasted opportunities. As a result, extend your engineering and product teams to include field application engineers and run away from low quality, cheap call centers. On the engineering side, hire world class engineers and data scientists who have a deep knowledge of the latest and greatest techs but also have the patience and courage to want to deal with age-old legacy systems that you will have to — without any doubt — integrate with. And lastly, make sure you’re super specific in defining your target market segment because this will immediately define your sales and service delivery model, pricing strategy and sales team profile. But most importantly, you will have to clearly anticipate extra long sales cycles and heavy buyer education needs … As a result, you must be clear (at least in your mind) to favor and prioritize evangelist customers ahead of revenue: they will help you communicate a strong vision and having excited customers who can see the long term “end game” is super important for your survival. As a conclusion, I think that healthcare tech is not for the faint of heart … Check your hubris at the door, be humble and work hard. And most importantly, always aim at building products and services that will delight your customers and change their lives! Let me know what you think! DM me @philippemora
My name's phil mora and I blog about the things I love: fitness, hacking work, tech and anything holistic. Head of Product and VP Engineering. thinker, doer, designer, coder, leader |
i blog about the things I love: fitness, hacking work, tech, Experiences and anything holistic.
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