David: This is David E. Williams, co-founder of MedPharma Partners and author of the Health Business Blog. I’m speaking today with Dr. Jay Parkinson, is co-founder of Hello Health and Chief Concept Officer of Myca.
Jay, thanks for your time today.
Jay: Sure, no problem.
David: Jay, tell me a little bit about how you started your medical practice. What were you thinking at the time? It’s kind of an unusual practice.
Jay: Well, I got started because I have training in clinical medicine and preventive medicine and when I finished my second residency, it sort of alerted me to the fact that, fundamentally the health care system was pretty massively screwed up. I didn’t feel like becoming part of that system would actually help push that system to be better.
I’m a photographer as well and I have a lot of friends who are photographers. When you’re a starving artist you don’t have access to health care very well. They would always send me e-mails or IM’s with pictures of something – and ask ‘what’s going on?’. I would answer them and they were appreciative. So you know what? I thought that I could probably do that within the community, not just amongst my close circle of friends. In order to do that I just created a very low overhead practice that mixed house calls with Internet consultation.
David: I saw the announcement at the time you started. It said that you were using essentially public services that were out there like Google calendar, e-mail, and IM. I’m wondering: is it feasible to run a practice like that or do you need a more specialized platform, either specialized towards health care or to address some of the privacy and security issues?
Jay: You definitely need a platform and that was one of the main reasons I stopped practicing. A lot of the stuff is within your Gmail, and it gets mixed up with everything else in your life and it’s difficult to organize everything and you often have four or five different log-in’s to try to do the same thing that we’ve done with just one log-in.
David: So it sounds like you got introduced somewhere along the way to Myca or maybe you were involved in starting it up. Tell me a little about that and what their role is and how it’s evolving?
Jay: Great story with Myca. It began about November 24th of 2008 whenever I was on the front page of Yahoo; they did a video story on me and I was getting about 200 e-mails an hour from people all across America, from people just saying: “Thank you. My doctor doesn’t communicate with me at all.” Just stuff like that. One of those e-mails was from Nat Findlay who is this great guy who has this software company up in Canada. He sent me e-mail saying, “I’m going to fly out the next day and meet you.” So we really hit it off and ever since then it’s just been a great opportunity for both of us to build out our dreams.
David: Somewhere on your website he’s referred to as the ‘friendly Canadian,’ which probably describes a fair percentage of Canadians, but I’m curious about whether there is a Canadian take on this. In other words, their system is a bit different. Was there something about being in Canada that would enable him to see this opportunity more easily? Is it a drawback in any way?
Jay: In my journeys since starting my first practice, I’ve gone to Spain. I’ve gone to Britain. I’ve definitely gone to Canada and met the leaders of the health care systems. It’s interested that everybody suffers from the same problems. The only difference between Canada and the UK and the US is that Canada and the UK have a single payer that pays for the delivery of health care. Paying for health care is only one component of health care. The other component is delivering that health care, so nobody across the world actually is innovating on what it means to visit the doctor/receive health care. In Canada, for example, it’s not routine use to fire off an e-mail to your doctor. Of course it’s routine to fire off an e-mail to your co-workers. Everywhere people suffer from the same problems. Consumers absolutely want this. Consumers are used to service. Why isn’t health care pleasant? I don’t know. It’s not pleasant anywhere in the world and I think that’s just because there is a lack of innovative thought that we can actually, as health care providers, do things differently.
David: It’s interesting that you mentioned the UK because there is a difference there, which is the amount of investment and spending that’s gone into building the health IT infrastructure there. Also they tend to have a little bit more of a role there for nurses and other kinds of extenders in practice. Did you notice any difference because of that investment?
Jay: I have yet to see any health IT that goes beyond the look and feel of Windows 95. It’s not health IT that’s going to solve the problem. If you put in front of everyone a Commodore 64, it wouldn’t solve the problem of delivering health care better. To me, the main problem with health IT is that it addresses only one problem, which is how can we communicate as providers to insurance companies the proper information so I can maximize reimbursement. Well that doesn’t lead to a lot of great feasibility of that IT and it sure doesn’t change the concept of that IT from something that’s transaction driven to communication driven.
Now there’s a lot of talk about patients accessing their own health information. Health information is literally billing codes that probably 80% of the time are actually not reality and also not consumer speak. Why would anybody want access to this information?
David: Explain what Hello Health is and how it relates to Myca.
Jay: Hello Health is just a company of Myca. Myca, I like to describe as Intel inside and Hello Health is the consumer facing brand that’s powered by Intel. My role in Hello Health is to work with a team and storyboard and work with our designer teams in New York City as well as Quebec to build a platform for health.
David: Is the idea to sign up physicians to work on this platform or how does somebody who wants to be involved in Hello Health go about doing that?
Jay: Absolutely. That is exactly the case. Hello Health is a special network and that facilitates a transaction between the receiver of health care and the deliverers of health care. The deliverer of health care can be anyone from a primary care physician to a specialist or a nutritionist or a psychologist. We’re sort of using a trading a system where the interface is dependent upon the role that you play in the health care system. So yeah, a doctor who wants to be powered by Hello Health would create a profile and serve patients that way. We have tools to document and get paid and communicate.
David: Is this an opportunity where a doctor or nutritionist can dip their toe in the water or do they have to switch over completely to the Hello Health model?
Jay: They can do whatever they like. It’s all about freedom for the professional at this point. In the future the plan is to reduce the barriers as much as possible for physicians and other health care providers to sign up so that they can just jump in and try it out and if they like it they stay and if not, well, we didn’t do our job well. I think much of our job is to create technology that actually helps people be better doctors, not just maximizing billing. I think you’re going to see a lot of interesting tools that meet the needs of doctors who just want to be better doctors.
David: So just to follow up on the question: I understand they can do what they please. They don’t necessarily have to make a wholesale change, but just from a workflow standpoint, would it make sense to have, let’s say 20% of one’s practice on Hello Health that perhaps matched up with particular patients they have and then to handle the rest in a traditional fashion? Or would it be something where you would essentially expect a full transition at some point?
Jay: No. Again, it’s just the freedom of leaving it up to the doctors. So yeah, you could theoretically practice one day a week if you like or practice full time or never.
David: What you’ve laid out sounds like a good model for somebody who is going into practice, but I don’t see a lot of people necessarily moving in this direction. What’s holding providers to the traditional way of doing things? Why aren’t more people doing a Hello Health style of practice today?
Jay: First of all it’s not accessible to physicians or health care providers right now. We’re very close to launching, but after that, it’s game on. We really don’t know how many doctors are going to want to use this sort of method of health care. We have a strong feeling, though. We’ve had a couple thousand doctors asking for more information and I think primary care doctors are really getting stretched at the moment by decreasing salaries and increasing frustration. It’s not really working out for anyone, patients or doctors. I think patients want a better experience and I think doctors want a better experience. We are just creating the tools to enable that.
David: I’m interested on what you find on the patient side. Certainly some of the articles that you’ve been featured in have focused a lot on the invincibles, the younger folks who are rarely sick and don’t tend to carry insurance. I wonder if there is a role for other patients, older patients, those who are perhaps a little less tech savvy than your typical photographer friends or those that have chronic care issues and the folks that really consume most of the health care resources today.
Jay: The latest evidence from the American Life Project says that 41% of people age 65 and over are online nearly every day, so this method of communication and consuming information is pretty much spread across all demographics in our country right now. We also have to keep in mind that 41% of people age 65 are online, while only about 20% of doctors use computers. So there’s almost double the amount of older people using computers versus doctors. The problem isn’t so much the consumer being tech savvy, it’s giving doctors tools that make their jobs easier and that are affordable. That’s something that we’re trying to solve and I think we’re well on our way to doing that. You also have to realize that health insurance does not equal health access. Having health insurance has done an extremely poor job of health care delivery. So our position is to say that we provide health access. Maybe in the future if we have partnerships with insurance companies who are willing to work with us in a very streamlined, simple, hostile free manner that pays doctors appropriately, we will do that. But for now working with insurance companies would not be financially viable for a practice using Hello Health.
David: What about for a patient that has a high deductible health plan? Is there a fit with that kind of insurance today or are you saying that even that kind of a plan wouldn’t be compatible with what you’re doing?
Jay: Well no, it’s absolutely perfect. The chance of someone spending more than their deductible for a relatively healthy person is pretty low. So we sort of manage your deductible, help you spend a proper amount until you hit your deductible and then we essentially can’t do much for the patient because it’s sort of the big hairball messy health care industry problem.August 14, 2009