HIStalk Practice Interviews Hill Ferguson, CEO, Doctor on Demand

Hill Ferguson is CEO of Doctor on Demand in San Francisco.

Tell me about yourself and the organization.
I came to Doctor On Demand having spent most of my career in fintech and mobile payments, most recently as CPO at PayPal. Even with the tremendous progress Doctor On Demand has made, where we are today in telemedicine is where we were 20 years ago in fintech and digital payments. Back then it was a novelty to do your banking online or send money to someone digitally. Now, it’s hard to find someone who doesn’t conduct all of their banking that way.

Let me take a step back. Lack of access to healthcare providers in the United States is a massive, growing problem. The average wait time to see a physician is three weeks. Even if you can see a doctor, it takes two to three hours every time you leave your home or office to the time you get back. It takes an average of 25 days to see a psychiatrist or psychologist. Nearly half of all patients with mental health issues go without treatment. At Doctor On Demand we provide fast, easy, and cost-effective access to some of the best physicians, psychiatrists, and psychologists in the country. Our patients can have video visits with these providers on their smartphones or computers, no matter where they are. We do this without making any sacrifices on quality. All providers are carefully screened and trained to conduct video visits and maintain more than 200 clinical protocols.

Circling back to my time in fintech, if we can make the same progress with telemedicine, we can solve some of the longstanding challenges in healthcare. By getting people high-quality healthcare, when they need it, in a setting that works best for them, Doctor On Demand is creating a new front door to healthcare.

Given your strong track record with mobile technology companies, what has surprised you most about the world of telemedicine?
Before I came to Doctor On Demand, I asked a few of my colleagues if they had seen a doctor through their smartphone or laptop, and, even among my colleagues in the tech industry, only one or two had experienced a virtual medical visit. That answer surprised me.

Telemedicine has the tremendous potential to transform healthcare, by both making people healthier and reducing healthcare costs. There are more than 160 million urgent care visits in the US each year. If telemedicine, which costs about 75 percent less than a typical urgent care visit, can replace even a portion of those, the savings would be massive.

You took over from Adam Jackson, who has remained at the company as an advisor. I understand the two of you have a bit of history together going back to your days at Vanderbilt. What has that transition been like?
I’ve known and respected Adam for many years. We’re both Vanderbilt alums, and we hired him as an intern at my first startup when he was still in school. What Doctor On Demand has accomplished in the three years since its founding would not have been possible without Adam’s skill and hard work. The company has grown rapidly. We have hundreds of enterprise customers, like Comcast, and work with dozens of major health plans, like UnitedHealthcare, Humana, and our recently launched partnership with Harvard Pilgrim. Today, millions of Americans have access to our service through their employer or health plan. Now, the company is ready for its next phase of growth, and I’m thrilled to be part of it. The whole team, including Adam, have made the transition seamless.

How do you plan to leverage your consumer-focused tech background to help Doctor On Demand move forward over the next few years?
Telemedicine — just like a lot of other innovations in digital health — can only make people healthier and save them money if people use it. What I’ve learned from PayPal and in my history with fintech is that the key to engagement is a superior customer experience. That includes things like user-friendly design, excellent customer service, innovative partnerships, and, most importantly, the highest quality healthcare. Doctor On Demand places a high priority on all of these areas, and that is what will make us successful.

Cybersecurity attacks continue to make headlines. Given the ubiquity of smart devices, how concerned is Doctor On Demand with the security of its technologies? What’s on your radar in terms of data security?It’s important that Doctor On Demand’s patients trust us not only to provide high quality healthcare, but to keep their personal information secure. Data security and privacy controls are one of our highest priorities. Doctor On Demand is the first telemedicine company to earn HITRUST CSF certified status, which is the most stringent security standard in digital health and one of the most rigorous accreditation standards in the healthcare industry.

HITRUST is an organization promoting information security in all health IT systems and exchanges. The CSF certification framework was developed with input from healthcare, business, technology, and information security leaders and includes federal and state regulations, standards, and frameworks. We believe HITRUST should be the standard across the industry.

How do you envision the telemedicine industry changing over the next five years? It seems like new companies pop up every day. Do you foresee a “bubble” that will ultimately burst?
Rather than a “bubble,” we’re at the beginning of a huge shift in the healthcare industry. We’re just on the cusp of technology’s transformation of healthcare. When realized, we will solve some of the industry’s longstanding challenges. This is the last generation that will call the doctor’s office to make an appointment when they are sick.

How does Doctor on Demand plan to stay ahead of its competitors during that timeframe?
[W]e want to not just be as good as other telemedicine providers, or even as good as brick-and-mortar healthcare. We want to provide the best access to the best healthcare at the lowest price possible. The companies that will ultimately be successful in the digital health revolution will be those that are building the future of medicine.

For telemedicine, that means leaving behind outdated technologies — like healthcare via audio telephone call — for innovations that provide better clinical quality. To ensure that, all of our visits are conducted through video so that doctors can see, hear, and examine patients. This should be the standard industry-wide. We’re also developing partnerships that will push the bounds of telemedicine. For example, we’re working with CliniCloud to incorporate connected medical devices into our video visits that can transmit real-time data to the physician.

Contacts

Jenn,  Mr. H, Lorre, Dr. Jayne, Dr. Gregg

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News 9/21/16

Top News

John Meigs, Jr. MD takes on the role of AAFP president. A family physician based in Centreville, AL, Meigs probably has a good handle on the ups and downs of the physician practice landscape, given that he was in private practice for over 30 years before merging with another medical practice affiliated with Bibb Medical Center (AL). The pros seems to outweigh the cons when it comes to moving from independent practice to employment:

“I have to go through a bureaucracy to do things and sometimes I get frustrated by the bureaucracy. And now there are a lot of committees that have to approve things. When I was private, I decided what EHR I wanted to buy, and I decided what kind of pens to write with. Now I have to put in a special request to get my pens. It’s a minor little thing, but it illustrates the point. But I still have my patients. I mean I’m still seeing the same people I’ve been seeing for almost 35 years. The best part about it is I don’t have to do the payroll and the accounts payable and all those kinds of things I did when I was in private practice. I frequently did those things at one o’clock in the morning because there wasn’t time to do it during the day.”

Meigs, who seems more in tune with healthcare technology than his peer at AMA, counts usability and interoperability as his two biggest challenges with EHRs.

HIStalk Practice Musings

This week finds me in Chicago for the Oliver Wyman Health Innovation Summit. I’ve had the opportunity thus far to gaze at Lake Michigan from my hotel window and attend an immersion tour at local primary care clinic Oak Street Health. The conference will officially kick off tomorrow, and, for reasons I still can’t remember, I signed myself up for the “Wakeup Wellness 5k” at 6 am. Look for the rundown in tomorrow’s post.

Webinars

September 27 (Tuesday) 1:00 ET. “Put MACRA in your Workflow – CDS and Evolving Payment Models.” Sponsored by Stanson Health. Presenters: Anne Wellington, chief product officer, Stanson Health; Scott Weingarten, MD, MPH, SVP and chief clinical transformation officer, Cedars-Sinai. Reimbursement models are rapidly changing, and as a result, health systems need to influence physicians to align with health system strategy. In this webinar, we will discuss how Stanson’s Clinical Decision Support can run in the background of every patient visit to help physicians execute with MACRA, CJR, et al.

October 13 (Thursday) 2:00 ET. “Glycemic Control During Therapeutic Hypothermia.” Sponsored by Monarch Medical Technologies. Presenter: Tracey Melhuish, RN, MSN, clinical practice specialist, Holy Cross Hospital (FL). Using therapeutic hypothermia (TH) as a method of care can present risks of hyperglycemia, hypoglycemia, and blood glucose variability. Maintaining safe glucose levels during the cooling and rewarming phases of TH reduces the risks of adverse events. Tracey Melhuish, author of “Linking Hypothermia and Hyperglycemia,” will share best practices for optimal glucose control during TH and the success Holy Cross Hospital sees while using a computerized glucose management software.

Contact Lorre for webinar services. View previous webinars on our HIStalk webinars YouTube channel.

Acquisitions, Funding, Business, and Stock

Englewood, CO-based startup CarnotMD, which offers provider benchmarking data and dashboard tools, joins Innosphere’s incubator program in Colorado. Founded by a group of physicians in 2013, the company is named after Nicolas Carnot, the “father of the second law of thermodynamics.”

Healthcare consulting and services company Primaris merges with care coordination and patient engagement consulting firm Digital Collaboration Solutions. DCS Founder and CEO Michael Levinger will take on the role of Primaris COO. HIStalk Practice readers may know Columbia, MO-based Primaris for its work helping Aledade stand up an ACO in Missouri – the first independent physician-led ACO in the state.

Announcements and Implementations

NextGen reseller TSI Healthcare adds OTech Group’s patient check-in kiosks to its line of technologies for rheumatologists.

People

Ellis Keitt (Radiology Associates) joins Zotec Partners as vice president.

Jennifer Nuckles (Zynga) joins Doctor on Demand as chief marketing officer.

Telemedicine

Managed care company Prime Health Services partners with technology firm Consumer Health Connections to roll out a telemedicine offering for the workers’ compensation industry.

Research and Innovation

A Physicians Foundation survey finds that 54 percent of physicians surveyed rate their morale as somewhat or very negative, with 49 percent saying they are either often or always feeling burnt out. As a patient, that greatly concerns me, especially with additional, impending MACRA hurdles (of which only 20 percent are aware). If given the chance at a career do-over, nearly a third would go into a different field. Over 60 percent are “pessimistic” about the future of the profession. Not surprisingly their biggest source of dissatisfaction stems from regulatory and paperwork burdens, and loss of clinical autonomy.

Shocking: Consumers prefer doing just about anything else (including filing taxes) to enrolling in a health plan during open enrollment, according to a UnitedHealthcare survey. To add insult to injury, most consumers don’t fully understand what they’re buying. Just 7 percent of those surveyed could define basic health insurance concepts like premiums, deductibles, co-insurance, and out-of-pocket maximums. With regard to technology, 37 percent of consumers are likely to use telemedicine. The payer launched telemedicine offerings through American Well and Doctor on Demand in late 2015.

Sponsor Updates

• Aprima will exhibit at the American Academy of Pain Management annual meeting September 22-24 in San Antonio.
• GE Healthcare will invest €150 million to establish a biopharmaceutical manufacturing campus and advanced manufacturing training center in Ireland.
• Built in Austin profiles E-MDs CTO Alan Ortego.

Blog Posts

• 3 Tips for Stopping Revenue Leaks that are Draining Your Practice Profitability (AdvancedMD)
• The Best Screening Test is the One That Gets Performed (Healthwise)

Contacts

Jenn,  Mr. H, Lorre, Dr. Jayne, Dr. Gregg

More news: HIStalk, HIStalk Connect.

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News 9/20/16

Top News

The Texas Association of Business follows up on its employer and consumer telemedicine survey with a more extensive report, presumably in an effort to convince its members and legislators to change the state’s “onerous regulatory hurdles for telemedicine technologies.” (It requires an in-person or face-to-face video conference visit with a physician prior to a virtual consult.) TAB policy recommendations include:

• Only require a patient to be examined in-person or travel to a facility when medically necessary.
• Adopt a technology-neutral definition of telemedicine that allows for patient and physician choice in selecting appropriate technology.
• Ensure that standards of practice for telemedicine and in-person care are consistent with the main goal of increasing access to quality healthcare and lower consumer cost.

Webinars

September 27 (Tuesday) 1:00 ET. “Put MACRA in your Workflow – CDS and Evolving Payment Models.” Sponsored by Stanson Health. Presenters: Anne Wellington, chief product officer, Stanson Health; Scott Weingarten, MD, MPH, SVP and chief clinical transformation officer, Cedars-Sinai. Reimbursement models are rapidly changing, and as a result, health systems need to influence physicians to align with health system strategy. In this webinar, we will discuss how Stanson’s Clinical Decision Support can run in the background of every patient visit to help physicians execute with MACRA, CJR, et al.

October 13 (Thursday) 2:00 ET. “Glycemic Control During Therapeutic Hypothermia.” Sponsored by Monarch Medical Technologies. Presenter: Tracey Melhuish, RN, MSN, clinical practice specialist, Holy Cross Hospital (FL). Using therapeutic hypothermia (TH) as a method of care can present risks of hyperglycemia, hypoglycemia, and blood glucose variability. Maintaining safe glucose levels during the cooling and rewarming phases of TH reduces the risks of adverse events. Tracey Melhuish, author of “Linking Hypothermia and Hyperglycemia,” will share best practices for optimal glucose control during TH and the success Holy Cross Hospital sees while using a computerized glucose management software.

Contact Lorre for webinar services. View previous webinars on our HIStalk webinars YouTube channel.

Acquisitions, Funding, Business, and Stock

Aprima completes its move to new headquarters in Richardson, TX. The new location, which consolidates the company’s North Texas operations into 55,000 square feet of office space, will initially house 250 employees.

Clinical trial recruitment startup EPatientFinder joins Athenahealth’s More Disruption Please program and marketplace. Based in Austin, TX, the company has raised nearly $11 million since launching in 2013.

Now it all makes sense: Bond University researchers find that nearly one in five CEOs exhibit psychopathic traits, including superficiality, insincerity, and an inability to empathize. Lead researcher Nathan Brooks says that the study’s findings “shared similarities to what we would find in a prison population.”

Announcements and Implementations

The Kansas City Care Clinic (MO) selects care coordination and patient engagement technology from BluePrint Healthcare IT to support its Community Health Worker program.

DocuTap adds text-based patient satisfaction survey technology from Calibrater Health to its EHR and PM software for urgent care facilities.

Surescripts will offer EHR vendors free access to its National Record Locator Service through 2019. The service went live earlier this year with 140 million patients and over 2 billion patient/provider interactions.

People

Carol Alter, MD (AstraZeneca) joins Mindoula Health as CMO. The Silver Spring, MD-based case management company is developing a virtual collaborative care program that will link patients with PCPs and behavioral health providers.

Government and Politics

AAP creates a wish list of action items it hopes the next administration will address. Included in the 62-page report are a number of items related to healthcare IT, including expanding pediatric functionality of EHRs. “Right now,” the AAP explains, “only 8 percent of office-based EHRs contain pediatric functionality, which creates an increased risk for errors and injuries. [ONC] should emphasize and make pediatric functionality of EHRs a driving priority in its future efforts to increase the use, effectiveness, and quality of EHRs. Eligibility for the Meaningful Use program should also be expanded to include all providers who serve Medicaid and CHIP patients, not just those who achieve a 20-percent threshold of Medicaid patients.”

Telemedicine

TreatMD offers a white-label version of its telemedicine platform. The Biscayne Bay, FL-based company officially opened for business last month.

Community Health Center (CT) and its research affiliate, The Weitzman Institute, select virtual consult technology from Safety Net Connect as part of a broader effort to bring telemedicine to school-based health centers in New Mexico. The program has been funded by a $1.1 million grant from the HRSA Telehealth Network Grant Program.

CareClix partners with Verizon to deliver telemedicine services to patients in remote areas with limited healthcare access.

Other

The local paper covers the closure of the last primary care practice in Haines, AK. Linda Keirstead, MD who has operated the practice for nine years, didn’t make the decision lightly, telling patients in a farewell letter that she looked to no avail for ways to remain open “without being consumed by the enormous and escalating administrative burden that our healthcare system has placed on us.” Colleague Leonard Feldman, MD closed his practice in Haines two years ago for similar reasons. “As a doctor, if you accept Medicare, then not only do they set the prices for you, and determine whether or not your treatment was even necessary, but they also require that you submit the billing yourself to Medicare,” he says. “Those sorts of things subtract from the time you can spend with your patients, and sort of eat away at your positive attitude, because you get these letters from Medicare saying that you’re not going to get paid.”

You and me both: Researchers conclude that the “five-second rule” isn’t real, and that “surface cross-contamination was the sixth most common contributing factor out of 32 in outbreaks of food-borne illnesses.”

Contacts

Jenn,  Mr. H, Lorre, Dr. Jayne, Dr. Gregg

More news: HIStalk, HIStalk Connect.

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News 9/19/16

Top News

As part of Prescription Opioid and Heroin Epidemic Awareness Week, the FDA launches a competition to encourage developers to build an app that will connect those in the throes of an overdose with prescription antidote Naloxone. Overdose deaths from prescription opioids have tripled to more than 165,000 since 1999. “The goal of this competition is to develop a low-cost, scalable, crowd-sourced mobile application that addresses this issue of accessibility,” said the FDA’s Peter Lurie, MD. “Mobile phone applications have been developed to educate laypersons on how to recognize an overdose and administer naloxone, and to connect bystanders with individuals in need of other medical services, such as CPR. To date, however, no application is available to connect carriers of naloxone with nearby opioid overdose victims.” Entries for the Naloxone App Competition are due October 7. The winner will receive $40,000.

In related news, the USDA announces funding for 18 distance learning and telemedicine projects in 16 states that it hopes will expand access to healthcare and substance abuse treatment.

HIStalk Practice Musings

I was pleasantly surprised to learn that my local library now offers “Checkout Wi-Fi.” The service gives library patrons access to their very own floating hotspot anywhere in the country for one week. This seems like the perfect solution for when I have a few hours to kill (and work to do) in an airport that doesn’t offer WiFi, free or otherwise.

Webinars

September 27 (Tuesday) 1:00 ET. “Put MACRA in your Workflow – CDS and Evolving Payment Models.” Sponsored by Stanson Health. Presenters: Anne Wellington, chief product officer, Stanson Health; Scott Weingarten, MD, MPH, SVP and chief clinical transformation officer, Cedars-Sinai. Reimbursement models are rapidly changing, and as a result, health systems need to influence physicians to align with health system strategy. In this webinar, we will discuss how Stanson’s Clinical Decision Support can run in the background of every patient visit to help physicians execute with MACRA, CJR, et al.

October 13 (Thursday) 2:00 ET. “Glycemic Control During Therapeutic Hypothermia.” Sponsored by Monarch Medical Technologies. Presenter: Tracey Melhuish, RN, MSN, clinical practice specialist, Holy Cross Hospital (FL). Using therapeutic hypothermia (TH) as a method of care can present risks of hyperglycemia, hypoglycemia, and blood glucose variability. Maintaining safe glucose levels during the cooling and rewarming phases of TH reduces the risks of adverse events. Tracey Melhuish, author of “Linking Hypothermia and Hyperglycemia,” will share best practices for optimal glucose control during TH and the success Holy Cross Hospital sees while using a computerized glucose management software.

Contact Lorre for webinar services. View previous webinars on our HIStalk webinars YouTube channel.

Announcements and Implementations

Coordinated Care Oklahoma, the state’s largest HIE, implements DrFirst’s Backline communication and collaboration software for secure electronic transfer of patient data in real-time.

The Compliancy Group develops an online HIPAA Help Center for covered entities and business associates.

CompuLink Business Systems develops ENT-specific EHR and PM technology.

Everseat adds insurance eligibility verification capabilities from PokitDok to its appointment-scheduling service.

People

Linda Ostach (Medsphere Systems) and Jenn Bula (Impact Advisors) join MedSys Group’s advisory services team. Tom Welch, Patricia Drew, and Aaron Spratt have been promoted to the team as well.

Telemedicine

I missed this a few weeks ago: Maven, which bills itself as “the first digital clinic for women,” (including mental health) offers a virtual consult subscription service for college students. Maven Campus offers unlimited same-day video appointments, and unlimited text messaging with physicians. The pricing, which ranges from $25 to $45 a month, seems like an absolute steal when you compare it with the typical price of an office visit to the psychiatrist or psychologist.

Walgreens adds teledermatology to its website and app through a partnership with Iagnosis and its DermatologistOnCall service. The addition is part of the company’s push to add more skin-care resources, including real-time chat with Walgreens pharmacists, to its digital resources.

IViews Imaging System launches a telemedicine imaging service that helps PCPs send images to opthalmologists at designated reading centers for quicker interpretation and referrals. The Dunedin, FL-based company has also created a cloud-based central diagnostic imaging and data repository.

Research and Innovation

A TD Bank survey of 342 physicians finds that buying or leasing new technology takes the top spot when it comes to areas of anticipated capital expenditure. Hiring staff and training and education round out the top three. Thirty-five percent across all age groups named technology as their current biggest challenge; Baby Boomers put new technology at the top of their list. Nearly half of all survey respondents believe it’s too expensive to run a practice in today’s current climate.

Other

Olympian Apolo Anton Ohno shares this picture on Instagram of a man ready to resell what looks to be at least seven iPhone 7s. “Walked by the Apple store today here in [Hong Kong] and saw a few dozen resellers of the new iPhone,” he said. “Squatting directly outside of the Apple store haha! Hustle game heavy in Asia.” The phone went on sale stateside last Friday. The larger model sold out via pre-orders last Wednesday, and while it doesn’t seem to suffer from Samsung’s exploding battery problem, several users have complained that it makes a hissing noise when “under load.”

Vince Ciotti and Elise Ames look at physician practice EHRs in the latest installment of their “Rating the Ratings” series. You can catch up on previous installments, which focus on enterprise environments, at HIStalk.com. If you enjoy this, I highly recommend you check out Vince and Frank Poggio’s webinar on “rise of the small first letter vendors,” which takes an in-depth look at leading vendors that are trying to make a go of it in the crossover EHR market.

Sponsor Updates

• Versus Technology will exhibit at Epic’s UGM September 21-23 in Verona, WI.
• Healthwise is included in Fortune’s “100 Best Workplaces for Women.”

Contacts

Jenn,  Mr. H, Lorre, Dr. Jayne, Dr. Gregg

More news: HIStalk, HIStalk Connect.

Get HIStalk Practice updates.
Contact us online.
Become a sponsor.

Population Health Management Weekly Wrap Up 9/18/16

Todd Laddusaw (Healthland) joins RedBrick Health as CFO.

Health Systems Informatics offers population health management consulting services built on a methodology that includes strategic services, assessment and prioritization, program management, and analytics build and testing.

The Garage announces that its Bridge population health management tool is now in use by 5,000 physicians across 10 states.

Vigilance Health (CA) chooses population health management technology from EQHealth Solutions for chronic care management and care coordination programs in 51 California counties.

Nebraska Medicine chooses Epic’s Healthy Planet population health management system.

Renown Health (NV) and Desert Research Institute partner with 23andMe to launch a community-based population health study that will look at health, population, and genetic information; along with environmental data. Study participants, including Governor of Nevada Brian Sandoval, will receive genetic test results at no cost. “We will begin to understand how environmental factors can help predict who may be at risk, allow for quicker diagnoses, and encourage the development of more precise treatments,” says Joseph Grzymski, DRI Applied Innovation Center senior director and principal investigator of the study. “That understanding, combined with the information we will deliver back to study participants, are the first steps toward a future where access to your personal health data will contribute to a higher overall quality of life for all Nevadans.”

Sponsor Updates

• Intelligent Medical Objects will exhibit at the Epic UGM September 21-23 in Verona, WI.
• Nordic is named one of Madison Magazine’s best places to work.
• Nvoq will exhibit at AAFP’s Family Medicine Experience September 20-24 in Orlando.
• Nordic will host an open house September 19 in Madison, WI.

Blog Posts

• Coding is about more than saving money (Intelligent Medical Objects)
• Why Can’t the Caregiver Info that Really Matters Be Part of “Discharge Instructions?” (Nvoq)

Contacts

Jenn,  Mr. H, Lorre, Dr. Jayne, Dr. Gregg

More news: HIStalk, HIStalk Connect.

Get HIStalk Practice updates.
Contact us online.
Become a sponsor.