If you’ve been keeping up with our blog series, you may recently have read a blog by Bryant Castleton, Holon’s CEO, titled Learning from the past; empowering the future. In it he writes, “clinicians are experiencing burn-out at unprecedented rates due to excessive stress, financial strains, regulatory burdens and more.” For us at Holon, thinking up ideas to deliver first-to-market healthcare technologies to remove burden from providers is a core focus. We firmly believe that technology done well is invisible to the end user.
Upon reading Bryant’s blog, you’ll immediately begin to get a sense for how just one family may have so many touch points in healthcare with many different providers. But think about the providers themselves. What if you multiply what a single family goes through by the number of families and care team partners each provider interacts with? To keep up with the statistics on physician burn-out, I recently read this article:
In January 2018, Medscape published a study revealing:
- Nearly two-thirds of U.S. physicians report feeling burned out (42%), depressed (15%) or both (14%), according to a survey of 15,000 practicing physicians.
- In addition, 33% of respondents stated these depressive feelings impact their relations with patients.
- To alleviate burnout, 56% of respondents suggested fewer bureaucratic tasks and 39% suggested fewer hours spent working. About one-third of physicians suggested more money and a more manageable work schedule.
The unfortunate fact of the matter is that the report doesn’t reveal much of what isn’t already widely known. The surge in long working hours exacerbated by out of band monotonous bureaucratic activities are two of the primary driving forces that led to Holon’s commitment to the market in the first place. A commitment of tapping providers on the shoulder to bring them interactive insights so they can make informed decisions at the point of care without leaving their workflow is what we promise – and what we have delivered. When providers no longer have to leave their workflow to make informed decisions about what’s best for an ACO member or no longer have to spend additional time after hours scouring portals, everybody wins. The real challenge is: How do we do it at scale?
Scaling up via innovative technology
One thing’s for sure, the world’s most successful companies have not become successful overnight, or by coincidence. Of course, one may argue there’s a lot of luck that plays into it. The reality is there are only a few common denominators separating the most successful “solvers of problems” and everyone else. That’s an innovative product (in our case innovative technology) and scalability.
I was once told the path to success isn’t about growth – it’s about scale. And there is a difference. For one, you don’t always need to add more employees (growth) to accomplish a market reaching goal or to expand your sphere of influence more broadly (scale). Think of Google or Amazon. What’s unique about them? They’re huge. They’ve learned how to create business models that easily scale from the very beginning without adding massive costs and resources along the way. They understand that there is a force that is fundamental to scaling a business exponentially all while adding resources incrementally as opposed to adding a fixed amount of resources at the same time a deliverable comes due.
Laszlo Bock, Senior Vice President of People Operations at Google, once suggested a book titled Scaling Up Excellence which describes building a business as a ground war, not just an air war. You have to sometimes go slower to scale faster (and better) later. In the book, there is great insight into why oversized teams are among the biggest impediments to effective scaling and that scaling depends on “connecting people and cascading excellence”. Of course, I believe the same theory applies to technology advancements that are designed and built from the ground up to amplify one’s ability to scale in the first place.
Another great book on this topic is The Mythical Man Month, written by Fred Brooks. In it, he further demonstrates that adding more human resources to any given project counterintuitively delays the project even further, and that the most successful companies are the ones who can remain lean enough to meet their objectives while keeping focused on their near term and long-term goals while scaling up. For me, this was a life lesson I would soon appreciate first-hand.
Scalability through transparency, teamwork, and talent
I first got a glimpse of this phenomenon in 2007 while at Novo, where we solved results distribution problems for ambulatory practices. At the time, we had only 16 resources on our team, managing 40 unique IDN enterprise contracts representing ~600 hospital facilities and countless ambulatory physician practices across the US. What may have looked like an extremely daunting technology task from the outside was a tremendously well-oiled machine on the inside.
Many companies seem to reach an inevitable tipping point where the sheer number of active implementations outpaces an organization’s ability to size up accordingly. At the same time, in many cases it is very difficult for most people to link their daily actions to their organization’s long-term scaling goals. This became our risk one year later when we were tasked with bringing live one of the largest IDNs in the country, taking our footprint to over 1,000 unique hospital facilities at that time. After some short-term martyrdom, we did prove out the success of our tried and true approach:
- Establish a vision, and clearly share that with all stakeholders (especially employees)
- Keep the team lean to keep the interaction and coordination simple (scale up excellence)
- Manage scale through efficient process, smart automation, and a foundation that empowers the rest of the team to run full steam ahead
- Work with only the best and most brilliant people in the industry
Scaling to meet the demand – owning the provider’s desktop
Fast forward to today at Holon. Our bold goal is to underpin the US healthcare IT infrastructure with Holon’s break-through technology to allow us to “own the provider’s desktop”, shielding them from avoidable workflows. Our patent pending technology takes advantage of the patient in context in an EHR and can surface interactive insights to the right people at the right time. With such a bold goal, we are focused on empowering our partners with simplistic user interface designs focused on improving the physician experience, access to education, and training via online video tutorials, and infusing automation whenever and wherever possible.
With that as our foundation, for every product design that has come forth, we have instituted a theory of product design that takes into account a pre-defined scalability strategy. While initially setting out to build a platform that would meet a business need, we’ve created an “automated workflow multiplier”, that offers a direct reduction in physician burnout:
- Simplify their work pathways by allowing them to stay within their EMR
- Eliminate redundant tasks like logins and patient searches in different systems
- Correlate needed data specific to a patient, even as they manage a cohort of patients
There are more examples, but what we’ve come to realize is that in solving problems with scalability in mind, we’ve in turn created something better with CollaborNet. Simply being aware of the implicit reach a solution such as this has, acknowledging the burden that is already levied upon providers, and accounting for that up front has been paramount to our success. In addition to our three core solutions: Insights, Connect, and Referrals, we now have the ability to launch third-party application experiences into the workflow of the provider, taking advantage of our patent pending contextual awareness and giving us the ability to own the provider’s desktop.
Always be innovating
Today, I’ve decided to change my opinion on what the true path to success is for a company. In my mind, it’s knowing how to read the signs that a wave is on the horizon and when you see it, growing just enough slightly ahead of time to account for it, all while keeping the team lean and methods of product design and execution crisp. When you look back months from where you are now, if you constantly create new scalable technologies to solve ever evolving complex problems, you’ll surprise yourself with how far you’ll have come.
I will be presenting on healthsystemcio.com’s upcoming webinar, along with one of our customers, David Coe, from Banner Health. You can register here . Take a look at what we’ve been up to at Holon Solutions and let us know how we can help you.
Robert leads strategic planning, product design and direction for Holon with a primary focus on incorporating market needs between our customers with the product we deliver. Prior to joining Holon, Robert co-founded Carematics, a SaaS based mobile care transitions company. Early in his career, Robert was part of a small team that built the Novo Grid, a Medicity acquired technology that still serves thousands of healthcare entities today. From there, he played an instrumental role in growing the Medicity business ahead of its acquisition by Aetna in 2011. While at Aetna, Robert served as vice president of international business development and solutions architecture representing far east interests. Later, he organized the team that invented Medicity’s patented Notify product line. Before moving to the healthcare industry, Robert served as principal architect with the MERLOT African Network for connecting international computer science professors to doctoral Ph.D. candidates at Addis Ababa University in Addis Ababa, Ethiopia.