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The Fundamental Challenge of Building a Healthcare-Provider Focused Startup

Posted on March 6, 2015 I Written By

Kyle is CoFounder and CEO of Pristine, a VC backed company based in Austin, TX that builds software for Google Glass for healthcare, life sciences, and industrial environments. Pristine has over 30 healthcare customers. Kyle blogs regularly about business, entrepreneurship, technology, and healthcare at kylesamani.com.

Over the past few years, the government imposed copious regulations on healthcare providers, most of which are supposed to reduce costs, improve access to care, and consumerize the patient experience. Prior to 2009, the federal government was far less involved in driving the national healthcare agenda, and thus provider IT budgets, innovation, and research and development agendas among healthcare IT vendors.

This is, in theory (and according to the government), a good idea. Prior to the introduction of the HITECH act in 2009, IT adoption in healthcare was abysmal. The government has most certainly succeeded in driving IT adoption in the name of the triple aim. But this has two key side effects that directly impact the rate at which innovation can be introduced into the healthcare provider community.

The first side effect of government-driven innovation is that all of the vendors are building the exact same features and functions to adhere to the government requirements. This is the exact antithesis of capitalism, which is designed to allow companies to innovate on their own terms; right now, every healthcare IT vendor is innovating on the government’s terms. This is massively inefficient at a macroeconomic level, and stifles experimentation and innovation, which is ultimately bad for providers and patients.

But the second side effect is actually much more nuanced and profound. Because the federal government is driving an aggressive health IT adoption schedule, healthcare providers aren’t experimenting as much as they otherwise would. Today, the greatest bottleneck to providers embarking on a new project is not money, brain power, or infrastructure. Rather, providers are limited in their ability to adopt new technologies by their bandwidth to absorb change. It is simply not possible to undertake more than a handful of initiatives at one time; management can’t coordinate the projects, IT can’t prepare the infrastructure, and the staff can’t adjust workflows or attend training rapidly enough while caring for patients.

As the government drives change, they are literally eating up providers’ ability to innovate on any terms other than the government’s. Prominent CIOs like John Halamka from BIDMC have articulated the challenge of keeping up with government mandates, and the need to actually set aside resources to innovate outside of government mandates.

Thus is the problem with health IT entrepreneurship today. Solving painful economic or patient-safety problems is simply not top of mind for CIOs, even if these initiatives broadly align with accountable care models. They are focused on what the government has told them to focus on, and not much else. Obviously, existing healthcare IT vendors are tackling the government mandates; it’s unlikely an under-capitalized startup without brand recognition can beat the legacy vendors when the basis of competition is so clear: do what the government tells you. Startups thrive when they can asymmetrically compete with legacy incumbents.

Google beat Microsoft by recognizing search was more important than the operating system; Apple beat Microsoft by recognizing mobile was more important than the desktop; SalesForce beat Oracle and SAP because they recognized the benefits of the cloud over on-premise deployments; Voalte is challenging Vocera because they recognized the power of the smartphone long before Vocera did. There are countless examples in and out of healthcare. Startups win when they compete on new, asymmetric terms. Startups never win by going head to head with the incumbent.

We are in an era of change in healthcare. It’s obvious that risk based models will become the dominant care delivery model, and this is creating enormous opportunity for startups to enter the space. Unfortunately, the government is largely dictating the scope and themes of risk-based care delivery, which is many ways actually stifling innovation.

Thus is the problem for health IT entrepreneurship today. Despite all of the ongoing change in healthcare, it’s actually harder than ever before to change healthcare delivery things as a startup. There is simply not enough attention of bandwidth to go around. When CIOs have strict project schedules that stretch out 18 months, how can startups break in? Startups can’t survive 18 month cycles.

Thus the is paradox of innovation: the more of it you’re told to innovate, the less you can actually innovate.

Voalté’s Connectivity Enables Hospitals to Leverage Infrastructure

Posted on April 30, 2011 I Written By

Voalté enables caregivers at the medical center to make high-definition VoIP calls, receive critical alarms and send and receive presence-based text messages on the iPhone. This unique deployment includes integrations to the hospital’s Siemens PBX, GE Dukane nurse call system, and Cerner ADT alarms through Philips’ Emergin Enterprise Service Bus over its Cisco wireless network.

Heartland Regional Medical Center’s GE, Siemens, Cisco, Philips and Cerner systems integrated to Apple iPhone

SARASOTA, Fla. April 28, 2011 – As tablets and smart phones evolve and make their way into hospitals, many health care executives are working to develop a successful mobile-integration strategy. St. Joseph, Mo.-based Heartland Regional Medical Center recently implemented Voalté’s iPhone solution, which leverages the hospital’s disparate systems onto a single communication platform.

Voalté enables caregivers at the medical center to make high-definition VoIP calls, receive critical alarms and send and receive presence-based text messages on the iPhone. This unique deployment includes integrations to the hospital’s Siemens PBX, GE Dukane nurse call system, and Cerner ADT alarms through Philips’ Emergin Enterprise Service Bus over its Cisco wireless network.

“Our nurses wanted iPhones because they can communicate faster using only one device and smart phones offer anywhere access,” said Dr. Joe Boyce, chief medical information officer at Heartland Regional Medical Center. “We evaluated handsets and voice badges and chose to implement Voalté’s iPhone solution because it works with our existing infrastructure and allows our clinical staff to provide a higher level of care. Replacing legacy phones with Voalté has been a smart decision.”

Health care organizations like Heartland Regional Medical Center need to find a communication solution that leverages their current investment and provides a platform for future expansion and functionality, according to Trey Lauderdale, vice president of innovation at Voalté.

“We are excited to have a partner like Heartland Health that is helping us drive the future of point-of-care communication,” he said.

Streamlined and simplified communications allows nurses to focus on providing care and service.

According to Julia Jacobs, a registered nurse at Heartland, texting another clinician is much easier for the nurses than roaming from room to room or having them paged overhead, which often disturbs patients who are resting.

“When I am in the room trying to comfort a patient or the patient’s family, I need to provide a peaceful environment for them,” said Jacobs.  ”It was hard to do that when my pager and phone would continue to go off.”

According to Boyce, nurses want to see the right information at the right time in the right form.

“Our nurses don’t care about all the integration that is happening behind the scenes,” said Boyce. “Voalté enables them to spend more time with their patients.”

Anything that relieves nurses of non-clinical duties frees them up for patient care, Lauderdale said.

“The time alone that we will save by being able to text message a group of people is priceless,” said Jacobs. “I love being there to hold my patient’s hand or provide support for my patient’s family. Now I have more time to do that.”

About Heartland Health

Heartland Health is a not-for-profit, fully-integrated health system serving community members of northwest Missouri, northeast Kansas, southeast Nebraska and southwest Iowa. More than 3,200 caregivers (employees, volunteers and providers) provide the best and safest care by focusing on acute illness and injury through physician and hospital care services including cardiac; women and children; primary care; oncology; surgery; orthopedics; and neurosciences. Heartland Health caregivers are dedicated to improving the health of the community, one individual at a time through the work of Community Health Improvement Solutions and the innovative initiatives of the Heartland Foundation. All entities work collaboratively to fulfill Heartland Health’s mission — to improve the health of individuals and communities located in the Heartland Health region and provide the right care, at the right time, in the right place, at the right cost with outcomes second to none. For more information on Heartland Health, please visit www.heartland-health.com <http://www.heartland-health.com> .

About Voalté
Voaltéâ provides compelling software solutions for healthcare institutions that solve communication problems at the point-of-care. Voalté products are designed to be intuitive, high value, mission critical applications running on the latest generation of touch-based smartphones.  For more information, visit www.Voalte.com