It’s like Uber for Healthcare

Day 89: Wednesday

Morning, Tim!

Though not feeling poetic today, I love when I have enough energy and mental capacity to thoroughly enjoy my work.

I’ve been working on Non-Emergency Medical Transportation (NEMT) solutions recently.

A bit of background, followed by why I’m interested:

NEMT has traditionally been provided by an array of parties — ranging from taxis to shuttle buses, volunteers to high-priced ambulances. These services are needed not only for patients but for health systems, insurers, and tax-payers. Because transportation to and from an appointment can be a binary limiter on whether someone is able to receive care, the patient certainly has a stake. Importantly, though, because the patient’s health might otherwise deteriorate, health systems and insurers should also care, as handling sickness before it worsens is in almost every case less costly — even if it means multiple visits. Surgeries, scans, lab tests — they are all more expensive than a simple office visit to ensure someone maintains health. Tax-payers in turn should care, as their dollars are going to providing services and care for substantive portions of the population, both young and old.

The challenge of providing transportation fascinates me. Not only because I can throw out tons of transportation puns, getting on a good roll before someone tells me to put on the brakes because they can’t handle it and I have to stop (That derailed quickly). And not just because everyone in my line of work is talking about ‘the next Uber for healthcare’ when in fact, Uber could be the next Uber for healthcare. No, it’s in part because there are substantive operational considerations (i.e. if a patient is late to an appointment and backs up everyone else; if a patient is sitting in a bed waiting to be discharged but doesn’t yet have a ride, and so the hospital cannot use that bed; etc.). Yet the above stakeholders could also be interested for numerous other reasons — perhaps brand (look at how convenient we are!), patient experience (no one likes to wait around), or to better keep a broad population healthy and happy (taking patients to the pharmacy, community center, or beauty salon). It can be not only an issue of ‘sexy’, new solutions like Uber to make headlines to further a health system’s reputation, but also applying that same technology to address the social issues arising as barriers for those who often need care the most.

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There are tons of companies flooding the space, and it’s an exciting time to be looking at this work. I think it’s most exciting because of it is so broadly applicable, with the ability to interest so many.

Until tomorrow,
Zak

Rye bread

Day 87: Monday

Morning, Tim!

My apologies for being a bum correspondent last week! A better week ahead.

There were times when I would get stressed growing up. My mom was very kind about it, reminding me that I only had one day to get through that day. In fact, I couldn’t do anything about those past, nor solve for those ahead. If I put my head down and pushed through doing the right thing today, I’d be set.

Coming from my mom, I used to think this was fantastic advice for those times. I used it throughout college to push through weeks where school and work teamed up to overload my schedule. What would otherwise be overwhelming wasn’t so bad if I focused on today alone.

I have come to learn that it’s a pretty good idea to simply focus on today each day, not just in times of stress or pressure. While certainly good to learn from the past, and countless wisdom literature discusses the need to plan accordingly for the future, it seems today has its own challenges. In times of stress, it may simply be getting through the work. In times of relaxation, perhaps choosing to spend the time in a meaningful way for the benefit of others, not just self. There are opportunities to run astray — to eat the cake; to watch all of the episodes of that season, not just one; to slip into complacency when others could drastically use your help. Each day we have a lot to do, and most days we don’t get it all right.

Give us this day our daily bread

There is a recognition of asking for help, an element of taking it day by day, and a reminder that sustenance in bread is perhaps more realistic than sustenance through cake.

Until tomorrow,
Zak

Anti-Mustachioed

Day 85: Friday

Morning, Tim!

The Pope is visiting you tomorrow — how exciting!

I’ve been pondering your chances of becoming Pope. What with your ability to speak languages and translate — somehow, miraculously, English included! — perhaps you have a shot. Now, you may remember that there were betting sites on who would become pope, with demonstrable odds. But that was back when there was a Pope opening…so we’ll have to factor that in. Here’s what I’ve found.

First, there’s a simple 14 step guide, so it seems pretty easy. There’s even a step about going back and talking to your high school guidance counselor!

But that seems perhaps too straight forward. Ultimately, what I’ve found in reading, is that you must be 1) Catholic and 2) Male.

So you’re fairly close, I suppose.

But that’s only on technicality. There’s also the piece around for the most part having to be a Cardinal (because that’s who decides…). So what are those requirements?

Well, you have to be a priest, then a bishop…so you’ll need education (Which you’re rocking now!…wait…I guess composition doesn’t count..). And some years of experience.

Ultimately I like this post’s description best:

So that’s the career path: be born into the right half of the population, become one of a billion catholics, then one of 400,000 priests, then one of 5,000 bishops, then one of 200 cardinals, wait for the current pope to die or retire, and convince 2/3rds of your fellow cardinals to select you as the one, the only pope.

But let’s be honest, Tim. This is a boring analysis because it’s already been done. Let’s think of other factors that may limit you…

  1. Handlebar mustache. To date, scrolling through the 266 Popes, I found that none had a handlebar mustache. Being the first mustachioed Pope would be impressive, but also may be a limiting factor if they weigh that and discriminate against your kind.

Well…perhaps that’s it. I’ve sat and thought of other factors. For example, age; but, while you’d be young, you’re apparently older than the youngest ever pope. I also considered height and weight, ownership of birds, an ability to ride a unicycle, sense of humor, etc., but surprisingly there aren’t readily available datasets on those…that seems like a good blog idea. If we start to run out of topics here we can go start that one.

In fact, Pope facts generally aren’t readily available, I think an oversight the internet has made! So rather than an unusual use of a spoon, I’ll offer the fact that made me chuckle the most:

There are about 5.9 Popes per square mile in Vatican City

…pretty crazy.

Until Monday,

Zak

p.s. Do you think the pope gave up something really important to him for Lent? Perhaps his new year’s resolutions…

Passionately Curious

Day 81: Monday

Morning, Tim!

At work, we have this commitment to “being curious over right”. The idea here is that, rather than being committed (with ego) to a position or idea, to take on the lens of curiosity and understand why people might be coming to a different conclusion, how their background and experiences contribute to their understanding of the thought at hand.

In your last post:

You could present the most pointless and ridiculous ideas to him, and he would always dive right into them with you head first.  There wouldn’t be even a moment of hesitation to ask how worthwhile something really was.

I think there are hints of that theory in your professor’s actions. There seems to be a passionate commitment to curiosity, a keen desire to explore in order to better understand patterns, connections, ideas.

It’s curious that we have a commitment to being right. Certainly, the spot of dopamine the brain receives when being right helps. But put up mechanisms to fight our own ignorance, as if we don’t want to even explore the possibility that we aren’t right. What causes this blindness?

First, we love putting on the lens of confirmation bias. I’ve linked to the below comic before, but it’s one of my favorites so here it is again.C4C4E4A9-363E-4112-97D0-11964D9AC29F.jpg

The idea here is that we seek information that confirms what we already believe. Rather than take an objective lens, we put on blinders to information that is contrary to our existing beliefs.

Second, we don’t want our ego to be hurt. The way this pans out is our unwillingness to challenge others. We accept as fact or highly researched opinion others points of view, failing to challenge for fear of embarrassing others. Too often someone will state their point of view, perhaps more confidently than what they could otherwise back up if someone continuously asked “why”. But societal norms suggest we don’t do that to others — and likely because we would have a hard time handling that being done to us.

Third, there are elements of peer reinforcement. We fall prey to group think, choosing to go along with the crowd to balance the need for relationships and/or not have to do the hard work of thinking ourselves.

I like the idea of being curious. It’s something I look for in those I hire — people that are passionately curious to learn more, to understand how things work and why others think the way they do. I’m glad you’ve enjoyed that too. I hope we can continue to be curious.

Until tomorrow,

Zak

Alive

Day 79: Thursday

Morning, Tim!

I have a new mentor of sorts at work. He’s a pretty amusing guy – wise in how he approaches situations, doesn’t take himself too seriously. He’s retired from a great job, and I think he does the work with my company largely because it’s intellectually engaging and he can make a difference – but he doesn’t ever (seem) to let it overwhelm him. I admire that. When we get on the phone and I ask how he is, he has always responded ‘alive!’

Not that there couldn’t be more, but it’s enough to move along the conversation and, at least honest.

I’ve been a bum of a correspondent recently. Lots going on. Unlike Bob, I have allowed myself to become overwhelmed. I hope to dig out soon.

Until then…I’m alive.

Until tomorrow,

Zak

Ps here are a few pictures of all the new geese exhibits they had at the zoo! Remarkable.


Also one close up of the sleepy bear…

Overwhelmed – thanks a lot, healthcare…

Day 68: Friday

Morning, Tim!

So I obviously missed my Wednesday post. Not that I didn’t write it — it was scribbled through tired eyes while on a plane home. Unfortunately, without internet, I was unable to actually post it.

If you’d like to torture yourself, it seems the zoom on this image allows you to read the handwriting. For less torture, please see below for what, upon reflection, is exhausted stream of consciousness.

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Morning, Tim!

Obviously this is quite late. I’m on a flight back to Chicago right now, and all of my electronics are out of battery. That might seem weird since you are seeing this online — it was first written in very poor handwriting while experiencing turbulence, though.

I just spent 3 days at a healthcare IT conference. Quite the spectacle, some 40 thousand people convene to discuss how technology both new and old play a role in advancing care delivery. There were companies that helped patients schedule appointments, nurses communicate with one another, physicians dictate their notes. Still others provided security around the information, connected devices to the cloud to share data and enable care delivery in the patient’s home.

I love technology. It allows me to communicate with you seamlessly and empowers smarter, faster decisions to be made all the time. in healthcare, this translates to better patient care and opportunities to save lives. Getting to work in healthcare tech is even better than tech generally — not only is there ample room for healthcare to catch up to other industries, the passion healthcare entrepreneurs bring to helping others is truly inspiring. So I love technology.

I also hate technology.

Phones and tablets abound, alerts all over the place. An amazing amount of opportunity — yet as with everything that comes to mind, the greatest of strengths can also be the greatest of weaknesses. The ability to connect anyone at any time allows a a father to video chat and say goodnight to his kids — so too does it enable a man to get caught up in work, unable to de-tether while home as that same child yearns for attention, guidance, and love. Technology enables the spread of information, empowering scientists to collaborate on wonderful breakthroughs — so too does it enable groups to congregate and self-reinforce radical beliefs that bring harm to others. Technology can help focus, it can be the largest distraction. It can educate or inundate, facilitate encouragement or discrimination. But it doesn’t do any of this itself. It is a tool, used by people, often exacerbating the existing intuitions — booth virtues and vices.

I hope to have kids someday. I’m not sure what to do with technology. TO disallow is to deny the world these kids will be born into, disadvantage them in a world where these skills will be table-stakes. Yet, there seems a certain sadness that comes with this, a weariness weighing on a heavy heart and off-put mind. What about play and creativity, about bodily movement? We are physical beings — is using only our minds a hindrance to what our development might otherwise be? How can they use these tools for good — to help others — and not be addicted and lose themselves?

How do I do that?

Until tomorrow,
Zak

Until Monday,

Zak

Costing a leg

Day 54: Thursday

Morning, Tim!

Silly Josephine…

Tim as you well know I work in healthcare. Thinking about healthcare as a business feels kind of grimy at times — you are making money off of those who desperately need help, many times in order to live. That said, having worked with a lot of Catholic hospital systems, the usual saying goes “No margin no mission”. In order to operate, in order to help all of those people, they need to have the financial backing to do so. They certainly have a lot of write-offs each year, essentially donating care back to communities; but it’s no news that in the U.S., healthcare is expensive, and many people are paying all they can afford in medical bills.

I’m not sure how I’m supposed to think about making money off of others’ misfortune. In one hand, I’m helping them extend life; in the other, the cost of that extension is often a poor quality of life, constantly fretting about bills and work.

I recently came across some articles about financially backing legal cases. I asked a friend of mine with a law degree to explain in a bit more detail, but the gist is that there are many wrongs done to people – e.g. abuse, discrimination, etc. – done by a corporation that has quite a bit of money. If the individual were to sue, there are legal ways for the corporation to spend those dollars quickly prolonging and “drowning” the individual, making it effectively impossible to sue in many cases. There are some lawyers who will work on a contingency basis, not getting paid until the individual does — but they typically have caps far smaller than would be necessary to take on a corporation.

The linked article discusses financially backing some of these cases. Now I certainly don’t have enough money to bankroll anyone’s legal case, but the idea still intrigues me. If real harm was done, shouldn’t there be some recompense paid? The same problem we saw above begins to arise, though – in order to operate like this, the financial backer would need some form of compensation, thus taking a portion of what would go to the individual. There’s this feeling of doing good while simultaneously lessening the good done.

I’m not sure there’s any way around it within healthcare. Hopefully make it cheaper to deliver care, I suppose. It’s just unfortunate that there’s a cost to doing good.

Until tomorrow,

Zak