Viewing entries tagged

Are health start-ups creating cooler cultures than the hospitals they serve?

I’ve written before about my concerns about work environment in many hospitals. I looked at culture when applauding Evernote’s employe-centric policies and again recently when exploring the Bossless Office. Writing for the Washington Post’s Wonk Blog, Sarah Kliff looks at the trend of hospitals forming their own insurance plans. Us healthcare nerds call these risk-bearing entities, and it’s not a particularly new idea. Why be beholden to a third-party insurance company if you could cut them, and the associated overhead, out? That’s been a key component of Geisinger’s Proven Care program for years.

When I speak to hospital administrators about innovation, what I often hear about is new, experimental models for paying for healthcare.

I’m not sure that’s what the rest of the world thinks of when they hear the world innovation. I think many picture iPhones, Virgin America planes and Tesla sports cars. And when we think about those things, we imagine fun people in jeans gathered in glass-walled rooms imagineering (whatever that means).

What caught my eye in Kilff’s article was her descriptions of the third party company, Evolent, which helps large health systems set up their payor plans.

From the article:

… Evolent Health could be a movie set for a Silicon Valley start-up — the kind that starts with millions in venture capital funding, not in a founder’s grungy garage. An immaculate micro-kitchen, stocked with sodas and fruit, opens to a lounge with a plush white couch and big-screen TV. Two treadmill desks nearby are decked out with laptop workstations. [On a Wednesday morning, though, no employees were using any of these amenities. …[employes] were working, many with headphones on, at long rows of gleaming metal desks. Evolent has no offices, not even for its top executives. Glass conference-room walls are covered in scribbles from red, blue and green markers. “We wanted a sort of Steve Jobs feel,” Evolent co-founder and president Seth Blackley said, explaining the open landscape.

I’m admittedly mixed about what I see as a trend: the innovative, cool places to work aren’t hospitals but rather the companies who support them. On one hand, its nice to know there are places in healthcare to attract a workforce of engaged, creative and modern workers. On the other, will hospitals be left in the dust by millennials and others who desire a less conservative environment?

its not fair to expect a 60 year-old building to look like the inside of an Apple store. Really, space is really a proxy for the culture and nature of work in a given space. Inherent in my thinking is the idea that workplace culture, employee talent mix and innovative strategies are all tied together. I certainly don’t mean to suggest treadmill desks alone will produce the hospital equivalent of Virgin America planes. But is it reasonable to connect environment to talent attraction and thinking?

CancerGeek points out, on twitter, some hospitals do offer modern work environments. But its still pretty limited.

Will more join the fold, or will we see a brain-drain towards smaller, start-up style third-party players?


Here’s the original tweet from TEDMED to Kliff’s article:


HIPAA: The greatest red herring the world has ever seen

In 60s FERPA law opened up access for students to see their records. Why do we still not have same in healthcare #tedmed

Ryan Panschadsaram at TEDMED 2013

At TEDMED this year, White House advisor Ryan Panchadsaram spoke about patient rights. He spoke about how all of us have the right to view our health records and take control of the content. Specifically he called out our rights to:

  • View our records
  • Correct mistakes
  • Decide who sees them
  • Request a copy

Panchadsaram said we’re all already afforded these rights under HIPAA.


HIPAA? The Dread Pirate Roberts of laws? The none shall pass of policies? The Great Wall of HCSM?

Yes, that HIPAA.

The Health Insurance Portability and Accountability Act has been manifest into the greatest red herring the world has ever seen.

For years we’ve all —me included —blamed HIPAA for various reasons our eHealth, mHealth, and HCSM dreams have failed to take flight. Oh, doctors can’t engage with patients online because if HIPAA (Actually, to fairly represent most of the objections, I should probably misspell it HIPPA).

Panchadsaram’s point is spot on. HIPAA is not a limiter, it’s an empowerment tool.

And if we, as digital and social health advocates, are going to make headway, we’re going to have to reframe our arguments, or drop them all together.

If we stop thinking about HIPAA as the the barrier, what then? We might also think differently about the whole problem.

How might we reframe our thinking?

Maybe it’s not about getting your doctor to tweet with you. Maybe instead its about helping the traditional medical establishment (ah-hum, I count myself in that lot) understand that these tools exist, and patients use them to discover expertise and new connections.

Maybe we shouldn’t expect hospital Facebook pages to reply to every patient by saying: thank you, come see us again soon. Instead we should be driving them to post how someone who sees Panchadsaram’s video can get easy online access to their own records.

Wherever we do, let’s stop blaming and start solving. Action conquers fear!

You can watch Ryan Panchadsaram’s talk below or on the TEDMED site. Ryan is also on Twitter. Here is the Office of Civial Rights letter he mentions in the talk.