Bio: Michael Loesel, director, strategic marketing, is responsible for managing and growing deep, productive relationships on behalf of Allscripts with industry analysts including The Advisory Board, Gartner, KLAS, IDC, and others. Michael also oversees market research functions, with the goal of delivering actionable insight to the organization. Michael’s team provides the market perspectives to senior management and the board in support of annual strategic planning. Prior to Allscripts, Michael worked at GE Healthcare and started its Analyst Relations function. Prior to joining GE Healthcare, Michael worked as a marketing strategy consultant helping clients such as SBC, Allstate, Whirlpool, and Grainger grow through marketing and innovation investments.
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New York City’s famous Times Square seems an unlikely place to find inspiration for Health IT folks. But it’s where we find a great example of a different kind of Open – building architecture.
A recent TEDxTimesSquare video features architect Guy Geier discussing some of the projects his firm designed on Times Square, including The New York Times Building. I recognized that Open building architecture has distinct parallels to an Open approach to Health IT software.
“Open architecture, like in software design, is approachable, understandable, and comprehendable (sic) by the people that are engaged with the building,” said Geier.
That’s exactly what UNITY and Allscripts Open Application Programming Interface (API) does for developers. It helps make our Electronic Health Record (EHR) systems become more approachable, understandable and comprehensible. They can more easily integrate and add value for our clients
Open spaces, Open views
Geier points out the many ways in which The New York Times Building design is Open. For example, the stairwells are transparent, which Geier said encourages communication and movement.
In parallel, Allscripts Open API has more than 300 calls or “stairs” available to developers. These calls are ways to communicate with EHR systems. That means getting information out, as well as putting information back in. Stairs aren’t as useful if you can only use them for one direction.
The floors of The New York Times Building are wide open, too. Geier made a point of talking about how editors and writers sit together, making it easier to collaborate than when they were closed off from one another.
This collaboration is what we strive for through initiatives like the Open App Challenge and the Allscripts Developer Program. We’re in the same room with innovative developers, exchanging ideas and nurturing theirs.
Another of Geier’s firm’s buildings is at Eleven Times Square. He explained that sweeping views of the city encouraged an open frame of mind, calling it “a new view of the world, beyond from the building itself.”
We believe that an Open business model helps Allscripts stay better connected to what’s going on outside the company. We recognize that “not all smart people work for you” as Bill Joy from Sun Microsystems once said.
It’s important to pay attention and participate in the most advanced, innovative work happening in the Health IT industry. Open is the only way to make that happen.
Allscripts is enthusiastic about sharing ideas with clients, partners and each other. We get the power of Radical Openness.
For a jolt of adrenaline on the topic of new ideas, watch this video from TED 2012.
What an awesome testament to the evolutionary power of ideas. Some of the sources of innovation in healthcare are the startups and small companies that push the boundaries of what’s possible.
These ideas are accelerating quickly.Q1 2013 was a record-breaking quarter with almost a half billion of capital flowing into healthcare IT. That is twice the amount invested in the same quarter just one year ago.
There are a lot of people working to fix healthcare by introducing new ideas and applications. Are your people, processes and technology aligned to capture the power of Radical Openness?
Last week the Advisory Board Company held its second colloquium for Fellows in Washington D.C. with the topic being ‘The Health Care Ecosystem’. As just one of two vendor participants asked to join this fellowship with distinguished healthcare provider leaders, I was interested to hear the challenges and opportunities facing these organizations first hand.
A central theme last week was the concept of developing resilience for healthcare systems. The framework suggests resilience increases when healthcare systems can simultaneously exert control and adapt to external forces of public policy, economics, demographics and technology. One of the directors for the Advisory Board summed it up by saying “Our aspiration for you is to be leaders that can see up and around the bend.”
What happens when industries are not resilient
To illustrate the importance of this concept the Fellowship reviewed the Harvard Business School case on U.S. Steel. In the 1970s, the U.S. steel industry faced a steep decline, forcing more than 30 companies into bankruptcy by the year 2000.
Companies grappled with competition from foreign companies and substitute materials. So called ‘mini-mills’ completely changed the landscape and cost structure for the industry. To wrap the case the facilitator read excerpts from Fortune Magazine’s ‘Autopsy’ of Bethlehem Steel where the real cause of death was leadership’s lack of understanding that they needed to adapt and change.
A comment from a Fellow brought the discussion back to the implications for healthcare:
“In health care we’re great at protecting ourselves from what’s going on in other industries…we tell ourselves that what works in other industries won’t work here or for some reason we’re different.”
Exerting control and adapting in health care
At some point, every industry faces a monumental shift that requires resilience. Rather than delineate the differences between health care and other industries, it’s time to learn from them.
What actions have other industries taken to exert control and adapt to the forces of public policy, economics, demographics and technology that CAN work in health care?
I’m a big fan of Clayton Christensen. In fact, I just got done reading his latest book, How Will You Measure Your Life. I’m concerned, however, with how people might interpret his opinion piece about Accountable Care Organizations (ACOs), recently published in The Wall Street Journal. Some might read it and think that ACOs are a complete waste or because success isn’t guaranteed, the new approach isn’t worth trying.
Some ACOs will fail, some will succeed
I agree with a lot of the challenges that Christensen points out. However, Pioneer ACOs were launched with the intent that they would start from a more advanced position than other providers and teach the industry what works and what doesn’t in moving to the next phase of technology application – not that they would all be 100% successful. The CMS Medicare Shared Saving Program and private payers wanted to find new ways to provide the same or better quality care at a lower cost. To do that, they provided some basic outlines and let innovators go try different things.
Christensen himself once said, “Innovation almost always is not successful the first time out.” The same is true in the healthcare industry. Some ACOs, or perhaps many, will fail. But some will also succeed. And that’s the point: to identify what works so others can learn and replicate it. (We already have several insights from ACO Pioneers.)
No guarantees of success in any industry
After I read this article I remembered an important lesson I learned early in my career as a consultant advising clients on marketing and growth strategy. Many clients would often challenge data analysis and conclusions, asking if there was “99% confidence.” The implication was that they only wanted to adopt a new strategy or program if they were 99% sure it would succeed.
A more experienced mentor of mine, now leading analytics work at Google, helped me and clients understand why that perspective was too restrictive. A business that is successful with 80% of its programs and investments is doing very well*. If businesses and leaders will only try new things when they’re 99% certain they’ll succeed, we’ll never get anywhere.
So, back to ACOs. Chistensen is right that a good portion of ACOs will likely fail. But that’s okay, and it shouldn’t stop people from trying. Because if a few do succeed — and it’s likely to be those that incorporate some of the things Christensen mentions like pushing more care to low-cost venues — then we’ll have successful models to replicate.
Please don’t wait until you are 99% certain of success to try new innovative things.
What have you learned from the ACO journey, whether you are actively participating or are just interested in the future of healthcare?
*Note: I’m talking here about business strategies and investments, not patient care or clinical research. Higher thresholds and confidence obviously play a critical role when lives and patient well-being are at stake.
As I shared in my post What’s Motivating Healthcare Innovators?, I’m encouraged by my conversations with Allscripts Open App Challenge developers. Solving healthcare problems is not about financial gain for them; it’s a mission to help others.
It’s about transforming healthcare. To make this happen, all of healthcare IT has to work together – and so do our solutions. Interoperability is key to unlocking the potential that technology has to offer. The Open App Challenge holds promise beyond any one vendor or company. By fostering innovation and collaboration, we have a much better chance to solve problems we once thought were unsolvable.
Phase One of the challenge is underway.
We’ll likely have far more high-quality applications than we can recognize. I wish I were one of the judges that will review fascinating ideas from inspiring innovators.
Consider Dr. Phillip Lisagor, a retired cardio-thoracic surgeon. His mission is to help physicians and patients have the tough conversations needed to plan for end of life. Dr. Lisagor envisions “Rest Of Your Life” or “ROYL” champions in healthcare.
Then there is Dr. Tashfeen Ekram. After having difficulty rescheduling a dentist appointment for himself, he recognized a need for better scheduling options for patients in his own practice. He’s working towards a solution that will notify patients who are willing to be seen sooner of recent cancellations.
Declan Frye has a mission, too. He is creating tools for social workers and hospital discharge planners to quickly identify safety net facilities – such as nursing homes, mental health or substance abuse facilities. Access to this information can improve care coordination for patients as they move from one provider to another.
These are just a few examples from the surge of innovations happening today in healthcare. We’ll share more news from the Open App Challenge as it progresses.
Editor’s Note: This blog post was inspired by an invitation to participate in HIMSS13 Blog Carnival, where health IT community can discuss the most-pressing industry trends. It also appeared as a guest post on Intel Healthcare Community.
In preparation for an upcoming talk on how Open is driving innovation in healthcare, I contacted a number of applicants to Allscripts Open App Challenge. Over the course of just a couple of days, I was able to video chat with CEOs and Founders of HappyHealth.me, SampleRx, Purple Binder, ROYL, Chiron Data Systems, mHealthCoach and more.
My main reason for contacting them wasn’t so much to understand what their companies do. Rather, I wanted to understand WHY they had started a healthcare company. I was inspired to learn more after hearing the story of Samuel Pierpont Langley in this amazing Ted Talk by Simon Sinek, one of the most famous Ted Talks ever.
A couple of takeaways from my interactions with these innovators: First, these innovators have extremely deep understandings of their domains within healthcare. Whether that’s making it easier for case managers to find social services when discharging patients or specialist surgeons having tough conversations with patients, these innovators know the problems they are seeking to solve and all the issues that surround them. Why’s that so important? Because there are a LOT of complex problems in healthcare, and it will require many innovators with focus and expertise to solve them.
Second, not one of the innovators I spoke with mentioned money, notoriety, or anything like that in their motivation and future aspirations. Nobody even mentioned important business goals like revenue, growth or profits. All of the innovators I spoke with had personal stories of why they had started their companies and how they wanted to make a difference in healthcare. Some of them had failed and started again. I came away from these conversations heartened to find healthcare innovators following the Wright Brothers’ path, not Samuel Pierpont Langley’s (watch the Ted Talk).
Last I heard, more than 150 companies have registered to participate in the Allscripts Open App Challenge. While nobody mentioned business objectives as a central motivation, many did mention their desire to reach the greatest possible number of patients and physicians where applicable. I couldn’t help getting excited about making that possible for these innovators by having them join the Allscripts Developer Program and reach thousands of Allscripts clients.
There’s a lot of work to do in healthcare. Fortunately, innovation has proven successful solving big problems in other industries. My discussions with these innovators lead me to believe there’s an army of innovators out there with deep expertise and the right intentions to fix healthcare.
The question is this: Is the healthcare market truly open to innovation? What do you think?
Curious about industry trends? Partner Mary Meeker from venture firm Kleiner Perkins gave a presentation entitled ‘Internet Trends’ at Stanford Monday night that provides a broad commentary on technology, society, and the economy. If you get excited about what’s possible at the intersection of technology, culture, and human behavior, check it out.
A couple of takeaways and considerations:
Mobility will take over—Just a few years ago many thought of mobile computing—smartphones & tablets—as something complimentary to desktops. Mary’s data and trends suggest a future where mobile computing is the primary platform. What’s most exciting to consider is the potential applications in healthcare—not cramming today’s applications onto a new device, but instead rethinking, reinventing work and information flows.
iOS and Android the platforms of the future—The data show significant growth and share that Apple and Android devices are taking from Wintel. In healthcare many have cited the early lead that Apple products have, especially on the tablet side. These data suggest that in the overall market Android is outpacing Apple significantly…which may spill over into healthcare.
Open coming to healthcare—Mark Zuckerberg suggests that open (vs. closed) leads to better products, businesses, and economies. Anybody that is aware of the Health Data Initiative or has attended the annual forum, Health Datapalooza, has seen this firsthand. Open standards, open data, and collaboration are creating an explosion of new technologies and applications in healthcare.
What grabs your attention from the presentation? Leave your thoughts below.