By Andrew Nusca
Posting in Architecture
Bostech CEO Brad Bostic wants to bring cloud computing and CRM software to the healthcare business. It could be a matter of life or death.
Founder of the people-powered search engine ChaCha, Bostic is now flexing his cloud-based intelligence muscle in a newer company, Bostech. This time, he promises to bring answers to exacting, overworked lab technicians -- not just curious consumers.
We spoke with him about how cloud computing can help the U.S. healthcare system function more accurately, and how his company's hc1.com CRM product fits into the picture.
SmartPlanet: You say your business is about "healthcare relationship management." What's the problem out there? What are you trying to solve?
BB: There's a lot of talk about the healthcare crisis. If you look at the overall environment we have for providing care, it's made up of lots of separate professional entities that deliver these services. All of these different proprietors have generally been focused on internal clinical process, like electronic medical records. That's geared to achieving a level of satisfaction inside your own four walls, but these different professional entities are really not effective at managing relationships with each other.
Five percent of Medicare beneficiaries consume 44 percent of Medicare payments. Those five percent see, on average, 14 doctors per year. Those doctors really aren't coordinated.
Relationship management is the number one biggest disaster in healthcare that must be remedied. It needs to be fixed for purposes of quality of care, of cost, and fulfilling the mandate of moving from a quantity-based environment to quality-based environment.
Roughly 6.5 billion lab tests are performed every year in the U.S. alone, by about 215,000 labs. Those results drive 80 percent of all diagnostic decisions. Our initial focus is really on facilitating this relationship between the lab and the healthcare provider. We're allowing all the people in that cycle to have the intelligence they need.
Healthcare providers have historically been able to get paid for every procedure they do. They never really had incentive to scrutinize the data. To use an example: a hospital-acquired infection. Let's say they do a test on a person with pneumonia and nothing else shows up, then three days later they come back with a raging [bloodstream] infection. Historically, hospitals would be reimbursed for treating that. With quality-based care, they'll have to swallow that cost. We now have to absorb $40,000 to treat one of those.
If I can, in real time, see all of the different infections occurring across my health system, I can instantly take action to prevent something. Today, these folks have 90 days in arrears data tabulated manually by somebody.
SP: What's driving the shift? Policy?
BB: Macroeconomic environments with policy-based drivers is huge. When healthcare providers feel pressure, their vendors feel pressure. They need more than a result. They need intelligence. That's why we call it "healthcare relationship management" -- we've actually trademarked the term.
SP: And hc1.com is your answer.
BB: It's cloud-based and flexible and enables these different entities [to better communicate]. The first major component to hc1.com is healthcare-specific CRM capabilities. For a horizontal CRM that's trying to address it generally, healthcare and labs are an afterthought. You can try to force them into that [general] model, but there's a lot of nuance in lab panels and diagnostic codes.
The second major component is dashboards and alerts. This is driven by the underlying information -- diagnosis code, order numbers, number of critical values -- in an easy-to-view environment.
The third is secure communication and collaboration. If there's insufficient quantity in a sample or specimen of a test, that's instantly sent back to the provider -- versus having it sit around for a week.
The fourth component is a configurable, extensible platform in which you can plug other capabilities into the service. That's coming later this year.
We debuted the actual hc1.com service last May. We have seen stratospherically fast adoption -- over 25 contracts signed, including some of the largest labs in the world, as well as regional labs and health systems across the country. We're already processing tens of millions of healthcare transactions. It's absolutely explosive -- unlike anything I've ever been around, especially in a B2B sense.
Let me give you a specific example that's pretty cool. There's a really cool molecular biology lab called Know Error that provides a specialty test that, when you give a biopsy, it verifies that it's your tissue. It seems obvious, but three out of 100 times you could be getting back a result on tissue that's not even yours. What Know Error needed was a highly-scalable solution that's flexible to accommodate all of the pieces of their process.
The visibility it gives you -- it's actually matching at the DNA level your result and your tissue. When your biopsy is taken, the doctor takes a swab of your cheek and sends it along, where it gets barcoded and sent back. Know Error does the science, hc1.com does all the information and intelligence.
Also, think about the alerts related to something like a switching error: there might be a guy going in to get a prostatectomy; you'd better figure that out before he goes in.
You've got all these doctors and all these patients with biopsy results. You have organizations and contacts of all kinds. When I say healthcare CRM, that's a pretty deep thing. When you get into healthcare, if you don't have the specialization accommodating for this, you don't have the ability to deliver.
Hc1.com enables every lab to differentiate themselves among the competition. They need ways to step up their game. It's no longer good enough to take an order and send a result. It's mind-blowing how antiquated the system is today. The analogy that we're taking it from horse-and-buggy to warp speed is not an exaggeration.
SP: Where do you see cloud computing fit into the future of healthcare? It's a particularly dicey environment for information exchange, given steep privacy regulations.
BB: The big shift in healthcare will be the move from massive, monolithic investments in technology and gear to services. It's unfortunate that the status quo is having legions of IT people descend upon your building and in two years, it's outdated. Healthcare is ripe for the cloud.
There are no absolutes where there would be no on-premise anything. There's no big bang required, but there are a massive base of silos with data that's gold and being squandered. The bottom line is, you've got to unlock the data and turn it into intelligence so it can improve our healthcare benefits.
What cloud services provide is dramatically more secure than what currently exists. Think about the story of a doctor whose laptop is stolen out of his car with 15,000 patients' data on it. You also have facilities in places like Florida where there is a high-degree of natural disaster risk -- and they've got their datacenter down the hall.
With the right kind of architecture, it can be bulletproof.
SP: Sounds great, but we all know that change doesn't come that easily. You're out convincing potential clients to buy your product -- what challenges do you face?
BB: Your issues never go away; they shift. We have a very solid handle on what we need to do, we just need to do it. As we talk to people, we spend more time focusing on how to amplify what's working than what's not working.
The biggest challenge is to get people to move as quickly as this allows them to. People are used to an old way of thinking, and they're trapped in the mindset of big projects, and we have to get them to realize we can have them up and running in four weeks, or eight weeks in the worst case. They need to stop thinking about IT and think about a bunch of services that doesn't require them to buy a bunch of gear.
It's like when you used to have to produce heat for your home: you had to get a stove and go through the pain and work [of lighting a fire] to get heat. Then you had AC power, and you could just plug something in and generate heat -- you wouldn't have to worry about how it's doing it, it just is.
That's how I describe cloud. You don't have to worry about IT and cables, just the end result.
Feb 8, 2012