Adam Bosworth

September 17, 2008

Within the last week I’ve become quite enamored with Adam Bosworth, Founder, President and CEO of Keas. First, his background is impressive. He was one of the originators of XML and he joined Google to start Google Health. Second, he left Google Health just before its launch to start Keas, his own health company. These two factors alone make Adam interesting and someone who should be watched, but for us at PointOne he’s interesting because Adam is speaking our language.

Everything Adam talks about, whether its Matthew Holt’s interview of Adam, his blog, the Keas website, or even Adam’s old lecture on how to develop a business around a technology by meeting the needs of the customer first, Adam is tracking the same ideas we’re incorporating at PointOne and the foundation of our ClearSense product. Here’s what Adam recognizes and, more importantly, understands:

1. All the moving pieces in healthcare and how they affect each other (insurance, reimbursement, doctor workloads, hospital economics, government regulation, psychology, etc.),

2. No one oversees health, wellness and recovery (you have to have a problem to get care),

3. Success depends on constantly listening to customers and evolving as needs change and customers react (Adam refers to it as “intelligent reaction”), and

4. Combined with listening to customers, a truly innovative business must put forward a revolutionary idea, not otherwise considered by the customer, thus changing paradigms (Adam uses the ATM analogy).

Given these factors, the thoughtful pace Adam’s taking, his personality, his ability to explain complex concepts clearly, his team and his contacts, Adam is bound to reveal something extraordinary when he’s ready.

I am very interested in what Adam has up his sleeve. If we’re thinking the same way will we come up with similar solutions? How comprehensive will it be? How will it change people’s health habits, the basis of any health resolution? Who will Keas partner with and who will they compete against? How will the system change and what opportunities does that open for others? There are a lot of questions.

But, according to Adam, we’ll just have to wait.

ClearSense

August 11, 2008

This week PointOne will launch its Health and Wellness Program website, ClearSense. ClearSense will go live on Thursday, August 14, 2008 and be free as a “closed beta” website. That means it will be up and running but users must first register and we will pre-approve all users. This closed beta will last until September 30, 2008 when we will open up the website for free until 2009.

Here are some screen shots of the website:

ClearSense will have the following functionality:

Health Risk Assessments
Various Other Health Reports
Family Health History Collection Tool
Format to Collect Basic Health Data
E-mail Reports to Others
Chart Health Data Over Time
Automatic Alerts & Reminders
“Mom” Account
Sourcing data from various Personal Health Records (PHRs)

In addition, the following reports will be available or are planned to be available (* indicates 2009 availability):

ClearSense is a way for individuals to take control of their own health by tracking their health data, whether they get it from the doctor’s office, the blood donation center or the blood pressure kiosk at the pharmacy. In addition, individuals can get health risk assessments and important guidance and feedback on their own health, providing a way to track and improve one’s own health. Finally, the real power of the reporting capability will come when it is linked to a PHR and the data can be pulled from that source. ClearSense is built to support various PHR formats and promotes the concept of PHRs for individuals. ClearSense is not designed to become the ultimate repository of information. We leave that to the PHRs.

We look forward to growing ClearSense as it utilizes PointOne’s RedBox Technology to analyze individual health data. If you’d like to participate in the ClearSense closed beta process, please apply at www.ClearSense.com.

Refining Your Startup Standup Act

August 1, 2008

If you ever listen to comedians describe their careers and all the small, dive bars and clubs they had to endure before making it big you soon learn that comedians are not born, they are made. The life of a comedian is hard work. It’s a lot of travel, repetition, hecklers, bad performances, feeling like the world is against you and I’m sure filled with self doubt and thoughts of quitting. But, the good comedians keep on going. They hold on to the good nights, the great performances, the crowds they’re able to win over and their basic belief that there isn’t anything they’d rather be doing more. In fact, you often hear stories of famous comedians who show up and practice their standup act at small clubs as they continue to hone their craft. Even Jay Leno still performs at the Comedy & Magic Club in Hermosa Beach, California every Sunday night.

I see many parallels between comedians trying to develop their careers and my own experience as the CEO of a startup. I have explained our business, vision and strategy so many times I feel like a comedian hitting as many stages as possible and refining my act. And every time I do it I get better. The presentation I gave yesterday to a VC firm is much better than the presentation I gave a month ago. And I’m sure I’ll say the same thing a month from now. However, part of the journey has been some real disasters.

One of my meetings a couple of months ago was with a partner of a VC firm out West who started and sold an internet company a few years ago. He graduated from a prestigious school in engineering and was now independently wealthy but working in a VC firm trying to find investment opportunities. I arranged a meeting, not so much to pitch my business but to get his thoughts on our direction and strategy. It did not take long to realize I was in over my head with this guy. I do not have an engineering or programming background and this guy’s questions where all about the technology and how we compared to others. We have some people at PointOne who could have answered his questions, or at a minimum understood the questions, but I was lost. Despite my complete despondence following our meeting it really was a kick in the butt as to how much I needed to learn and do to have any hope of formulating and launching a successful strategy.

I would encourage all new CEOs working on startup businesses to get out and talk to as many people as possible. You may feel unprepared or with not enough material or just out of your league. That’s ok. The more presentations you give the better you get. The more questions, issues and objections you hear the more you’ll understand about your own business. The VCs are smart, they know the right questions and they help refine your message and your business. Customers know what they want and if you aren’t talking with them, listening to them and incorporating what they say you’re done. Practice your presentations on your employees, your vendors, even your family. You get to practice and they get to understand what it is you’re trying to do.

Simply put, find as many stages on which to practice, even if that stage is around your own kitchen table.

Hospital Insights

July 21, 2008

Last week I started reading Julie Salamon’s book Hospital. I highly recommend it. Hospital is the true story of Ms. Salamon’s year at the Maimonides Medical Center (MMC) in Brooklyn, NY. The MMC’s original focus was to serve the Orthodox Jewish population in the area but as a community hospital it serves a diverse group, requiring the hospital to translate 67 different languages. Ms. Salamon’s unique perspective highlights the human drama associated with the clash of cultures, money and healthcare.

MMC, one of the 4,936 hospitals in the U.S., is a perfect setting to highlight many of the issues, dynamics and economics going on in the US healthcare system. In 2003 MMC had 38,667 patients, 127,319 people served through its out-patient clinic and 81,190 in its ER. MMC was ranked as one of the 100 Most Wired Hospitals and Health Systems by Hospitals & Health Networks, a journal of the American Hospital Association. The setting, Ms. Salamon’s brilliant insights and writing style, and the tensions inherent in the healthcare system make this a great read, whether you’re in the healthcare industry or not.

Ms. Salamon’s book reminded me of a recent visit I had with the head of a major ER Department. He contacted me to find out if PointOne could provide an analytical system in his ER that would allow him to better identify patients who need special assistance and those who do not. In the ER doctors rank patients by need on a scale from 1 to 5 – “5” being someone ready to die and “1” being someone looking for aspirin. The ER Director wanted a system that would help him with the “3”s and “4”s, those who either could be sent home and directed to their primary care physician or those who needed to be admitted for more tests.

PointOne could provide such an analytical tool but as we talked the barriers of providing such a tool became obvious. First, the cost to implement the tool into their hospital’s unique IT system would cost hundreds of thousands of dollars. Second, given the cost, we would have to get it past the hospital’s Capital Committee. Third, even if the Capital Committee approved the system, it would have to be approved and implemented in conjunction with the IT Department, a huge barrier to the addition of any IT system. That entire process could take 18 to 24 months. However, and this was the death knell, it was clear the Capital Committee would never approve an expensive system that in essence reduced revenues, even if it was more efficient for patients.

The proposed analytics system worked counter to the hospital’s economics. A person deemed a “4” gets admitted and requires more tests – both of which provide more revenue to the hospital. A “3” gets sent home, thus reducing potential revenue. As Ms. Salamon points out in her book, “admissions were how the hospital made money.” The analytical tool this ER Director wanted would increase the likelihood of sending people home rather than admitting them because the current practice was to play it conservatively – admit a “3” if there are any questions, thus protecting the hospital and increasing revenue. Why would the hospital approve an analytical tool that reduced revenue and didn’t show any cost savings?

In order to have any hope at being successful in the healthcare industry you have to understand hospital economics, processes and dynamics. Hospital is a book that provides that type of insight.

Fixing Problems People Don’t Know Exist

July 15, 2008

A VC partner recently asked me to describe the problem PointOne is trying to address. This is a key question amongst VCs. You have to show how you’re solving a problem differently than others. My answer was that the problem is people do not feel in control of their own health. PointOne is trying to change that by providing reports that allow people to monitor and manage their own health. The VC partner was not satisfied with my answer – too vague, too theoretical. “Anyway”, he said “people aren’t clamoring to take control of their own health”. He argued, “People still eat too much, smoke, drink and don’t exercise. Clearly they aren’t interested in taking control of their own health.”

I think the difficulty with this standard VC question is it’s not always obvious there is a problem until people see what could be — a vision for what could be different. Then people see the problem. I’m sure if there had been a market survey in the late ‘70s about whether people wanted a personal computer or what kind of personal computer they wanted the surveyor would get a lot of strange stares and no reliable results. Who had even thought about having a PC? Why would we need such a thing? Computers were for corporations, universities, NASA or scientists. They weren’t for individuals. So what problem did Apple or IBM or Microsoft solve with the introduction of the personal computer? No market survey could have anticipated we needed PCs because we had no idea what was possible.

There are many products we can’t live without today that if we’d been asked about them before they were introduced we wouldn’t have had enough understanding of what was possible to even answer a question about whether the new technology would solve a problem we didn’t even know existed. The same is true in healthcare. People have relied for so long on doctors and hospitals to solve their healthcare issues, retain their records and provide health guidance that they may not see a problem. The system is built to keep things that way. PointOne, however, is determined to break that mold, show what is possible and solve a problem most people don’t realize they have – namely, the need to take control of their own health.