The Non-Physician’s Guide to Hacking the Health Care System

Written with my friend and co-founder of Symcat, David.

We are residents and a software developers. Before starting residency, we spent time as software developers in the startup community. We were witness to tremendous enthusiasm directed at solving problems and engaging people in their health. The number of startups trying to disrupt healthcare using data and technology has grown dramatically and every day established healthcare companies appear eager to feed this frenzy through App and Design Competitions.

Continue reading The Non-Physician’s Guide to Hacking the Health Care System on THCB.

Killer Features of the Next Generation EMR

I was absent-mindedly playing with my iPhone today and took special notice of a feature I have rarely used before. If you swipe all the way to the left on the home screen, you will get a search bar to search all of your iPhone. This includes contacts, iMessages, and apps. I’ve never needed to use this before–a testament to the iPhone’s ease of use. Just prior to this, I was working on some patient notes using my hospital’s electronic medical record (EMR). In contrast, each task I performed required a highly-regimented, multi-click process to accomplish.

Criticizing EMR interfaces is a well-loved pastime among clinicians. Here, however, I am going to take an oblique approach and reflect instead on what has made good interfaces (all outside of medicine, it turns out) recognized as such.

Continue reading Killer Features of the Next Generation EMR on the THCB.

Magic Numbers for Startups

Startups are hard. There’s no book. Or are there too many books? If you’re like me, you wind up feeling like you need to learn everything for yourself. That you have to “touch the stove” to know it’s hot.

It can be time consuming to learn Everything There is to Know, so instead we gravitate towards principle, heuristics, or rules of thumb. A set of heuristics are based on specific numbers–Magic Numbers. They can be used as signposts to guide decision-making where uncertainty otherwise prevails.

Several Magic Numbers frequently come up for me: 2, 3, 5, 7, 10, and 10,000. Why are they so magical? I’ll tell you.

Continue reading Magic Numbers for Startups on the Symcat blog.

Starting a Company as a Medical Student: Part 2

Last week I included my answers to several questions I was asked as part of an interview for The Doctor’s Channel about entrepreneurship as a medical student. You can read that post at Starting a company as a medical student: Part 1.

This week I will finish the 2-part series with answers to the questions:

  1. How did your school admin respond to your request to take a year off for your start-up?
  2. How did you juggle the challenges of running a business with the rigor of being a medical student?
  3. What are some of the skills/lessons you’ve learned while running a business that a typical student would never even think of?
  4. How do you see your decision to launch a business in medical school influencing your future career (residency application, specialty choice, lifestyle, etc.)?

Continue reading Starting a Company as a Medical Student: Part 2 on the Symcat blog.

Starting a Company as a Medical Student: Part 1

We were recently asked by The Doctor’s Channel to share some of our thoughts about being an entrepreneur while in medical school and how that came about. It’s not easy to take the plunge into starting a business with so much medical training already behind you and so much to go.

Here our some of my answers the the questions we are typically asked about starting Symcat while in medical school. Since there are a lot, I’m splitting it up into a two-part series. This week I will be answering

  • Did you have prior experience in business/start-ups before launching your own?
  • Before you started medical school, did you have any feeling that you would be starting a business while still in school?
  • At what point did you start thinking your idea could be scaled from just your school to medical schools across the US?
  • Can you tell me how you made the tough decision of taking time off from school and the different pros/cons you weighed?

Continue reading Starting a Company as a Medical Student: Part 1 on the Symcat blog.

The Myth of the “A-ha” Moment

I am frequently asked about the “A-ha” moment that led to the creation of Symcat. This is frustrating because I usually have to make something up about an apple falling on my head or a dream about a snake. People generally think of ideas as spontaneous, as not existing one moment and existing the next. But Symcat has taught me that they are wrong.

About 5 years ago, I started a notebook of random ideas for products and technologies I wanted to develop further. My (rather uninspired) titles included “Website for creating prediction markets,” “computer simulation of viral news spread,” and “HUD built for smartphone.” Original, right? They were the idea du jour brought on by whatever I happened to be reading or thinking of at the moment. They were definitely not bolts of insight that immediately and obviously led to the creation of a company.

Continue reading The Myth of the “A-ha” Moment on the Symcat blog.

The Death and Rebirth of Primary Care

Much ink has already been spilled about the impending primary care crisis. Fifty years ago, 50% of physicians practiced primary care. Now, it is only 30% of them and many of those primary care physicians (PCPs) are approaching retirement. According to a recent Senate report we are short roughly 16,000 PCPs already and this number is expected to grow. Wait times have been steadily increasing and it is becoming harder and harder to access the quality PCP that we all need. It would seem that physician-provided primary care is dying.

In truth, the PCP is already dead. Step inside any PCP office for a moment and reflect on how many substantive interactions there are throughout the day. The average PCP spends less than 15 minutes with each patient, leaving 5 minutes for your history, 5 (generous) minutes for your physical, and 5 minutes for assessment / wrap-up. Somehow, these brief interactions are expected to do some of the most challenging work a physician faces: educating the patient and promoting healthy behaviors. A pediatrician I spent time with during medical school often joked that he needed roller skates to keep up with the patient volume. Something like these babies might’ve helped.

Continue reading The Death and Rebirth of Primary Care on the Symcat blog.

What Does the Massive Health Acquisition Really Mean?

If you’re like me, you’re extremely excited about the potential for design to reshape health care. I’m not talking health care system redesign (ACOs and such–though that’s great too), I’m talking about the type of design you see on Dribbble: the focus of a recent (awesome) HHS-sponsored competition.

One of the promising upstarts of health care re-design was a 2-year-old-or-so startup called Massive Health founded by ex-Mozillite Aza Raskin. Though I tend towards the skeptical, there was a part of me that thought that not only were they on to something, but they clearly had managed to aggregate real design talent. And in health care, no less! Apparently, I was not the only one as they convinced a number of investors to throw $2.25 million in to test out what they could do.

Continue reading What Does the Massive Health Acquisition Really Mean? on the Symcat blog.

The Real Problem with Physician Decision Support

Early in medical school, I was involved in the care of Ted, who could have been my grandfather. At 76 he was as spry as any of the patients on the ward and always welcomed me with a “morning, Doc!” He was admitted because he was having concerning chest pain several times a week. Opening and closing 2.8 billion times throughout his life, his heart valves had gradually become hard and inflexible preventing blood from leaving at its usual rate. Now, it was risking his life. He had several treatment options available to him: valve replacement through open-heart surgery, a new minimally-invasive procedure where they snaked a new valve through the body’s blood vessels and into the heart, or just taking medications to help with his symptoms. It was my job to help Ted figure out which option was best for him.

Continued reading The Real Problem with Physician Decision Support on the Symcat blog.

How the Big Data Trend will Support Medical Research

It is no secret that research relies critically on data collection. Whether you’re talking about pharmaceutical research, market research, or outcomes research, successful analysis can only be done with robust data that captures the metrics most relevant to the question at hand. Unfortunately, that degree of data collection can be an expensive proposition, especially when it comes to health care.

Continue reading How the Big Data Trend will Support Medical Research on the Symcat blog.