HIStalk Connect Interviews Jonathan Baran, Co-Founder and CEO, healthfinch

12-17-2012 6-03-29 PM

Tell me about yourself and the company.

I’m the co-founder and CEO of healthfinch, an EHR app company headquartered on the outskirts of the Epic empire of Madison, WI.

Unlike pretty much everyone else in Madison, I actually never worked for Epic. I studied biomedical engineering at the University of Wisconsin-Madison and continued as a graduate student studying human factors engineering. However, I became a PhD dropout when I co-founded healthfinch in 2011.

In the work I was doing, I could see there was a big future in building apps that would make EHRs easier to use, and there was an especially untapped area around how to make providers more efficient. The only problem was that because I’m not a doctor, I was not an expert on physician workflow and efficiencies. But around this time, I met Dr. Lyle Berkowitz at the Mayo Innovation conference and healthfinch was born.

Today, we have evolved to focus on answering one question. How do we make life in healthcare easier for everyone? That led us to build a cloud-based, team decision support system which supports our first product, RefillWizard.


12-17-2012 6-15-15 PM

What are the problems with prescription refills that RefillWizard solves?

RefillWizard decreases the amount of time physicians and staff have to spend dealing with the prescription refill requests clogging up their inbox. Most providers will tell you that they are spending 30-60 minutes each day on refills. If providers are already using protocols, their staff will take about four minutes to process a single request. When the average PCP gets 15 of these per day, you can begin to see how this might add up.

RefillWizard allows providers to build out electronic protocols for prescription refill requests. Then every time a request is received in the EHR, it is automatically processed using the protocol and sent to the appropriate party for final fulfillment. Today physicians using RefillWizard are saving 15-30 minutes every day while being ensured that all requests are being processed in a consistent and well-documented manner.


How do you integrate RefillWizard with EHRs?

Very carefully. I’m tempted to stop there, but I will continue.

In our case, integrating with the EHR is a necessity. Being that we automate a process that lives within the EHR, we had no choice but to integrate it very well. I would venture to say that we are one of the first vendors to actually embrace integration. Most vendors don’t integrate, they interface. 

I really do mean integrate. We don’t actually have our own user interface. Everything happens within the EHR. Of course, this is not easy to do, but fortunately there are some vendors that make this very easy, like Allscripts.


What’s the cost and effort involved for the practice to use RefillWizard?

Cost is very straightforward. We charge for PCPs as they are the ones getting overwhelmed by prescription refills. Today  — don’t hold this to me in the future — we charge $600 per PCP per year. All other providers are included in that price. We want the entire organization on a single workflow.

Regarding effort, when we first started working on RefillWizard, we noticed one major thing — everyone in healthcare is overwhelmed. Obviously the care providers have gotten the most press, but administrators are facing unprecedented pressure and IT staff are 150 percent overbooked for their time as well. 

We realized if there was any way for us to make a dent in this problem, we were going to have to make it very easy for everyone. That’s why we made the decision to integrate the product in a way that would not disrupt workflow, would require no training, or would not require users to learn any new screens.

12-17-2012 6-04-09 PM

The toughest chore for companies going after practices is often getting the message in front of the right person while keeping sales costs down. How are you doing it?

When I started healthfinch, I knew no one. Starting healthfinch right out of school meant I had zero connections in the industry. I’ve made a concerted effort — and continue to — to surround myself with people who do have those relationships. From Dr. Lyle to our investors to our advisory board, all of it has been built up to surround our company with relationships. Relationships are, whether you like it or not, the lifeblood of our industry.


What prevents EHR vendors from adding similar functionality to their existing products and squeezing you out?

Three things: Meaningful Use, content, and focus. Meaningful Use is pretty obvious. Most vendors are 150 percent booked through 2015 to meet MU timelines. 

Content is another reason. We have built out a whole bunch of best practice and evidence-based refill protocols. Historically, clinical decision support and clinical content has been an area that vendors do not touch. 

Finally, focus. Prescription refills are a very small niche of the ambulatory workflow. It would be very difficult for them to devote the same level of attention that we have to this workflow.


Steve Lieber of HIMSS is a company advisor. How did you make that happen?

As I said above it’s all about relationships. Steve came into the fold through one of our investors, Eric Langshur. He recognized that small, innovative companies like ours are very important to the future of healthcare IT.


Quite a few healthcare IT incubators and startup support groups have been formed recently. What’s good and bad about what they do?

When it is working at its best, incubators can be great to get young companies off the ground by providing them access to relationships and a support group. I’m a very big believer in support groups. We have a very strong one in Madison, where 10-20 local HIT companies meet on a regular basis and talk through problems that we are having. I honestly, could say that without them, we would not be where we are today.

Timing is the biggest aspect of the incubator model that I would change. Traditional IT incubators were created to give a team the resources  — like time and attention — that they needed to make meaningful progress over a three-month period. Then an investor can see the hopefully huge progress made and agree to throw some real cash into the business.

Unfortunately, it is very difficult to make a meaningful dent with most HIT companies in just a three-month period since healthcare moves too slow. I think that HIT incubators may want to consider a longer-term focus in the future.


What’s the climate for innovation in healthcare IT?

The climate is great for innovation because of the combination of rapidly changing payment models, huge demand for services, and an HIT infrastructure that has created a platform upon which other companies can build.

Of course, healthcare is still a conservative business, which means it is much easier to pitch evolution than revolution right now. That’s why are building out products to work within the EHRs being used, not to replace them. That concept is represented in our name healthfinch, which is based on the evolutionary bird of Darwin fame. Of course, I think bigger innovations will be born from something that solves problems today, but later can evolve into something else — hint, hint.


Is this your first involvement with a startup? What do you wish you’d known or done when you started out?

I had spent a year doing HIT consulting on the side before starting healthfinch, but yes, it is my first true startup. It was very difficult in the beginning immersing myself in the industry and workflows, so the first piece of advice would be to get some experience in an industry before jumping into it full time. I see the ex-Epic guys coming out and starting a company and they certainly had a leg up on me when I was starting.


Where does the company go from here?

Prescription refills are just the beginning. We are attacking all the routine, repeatable work in the provider’s day. We have plans to expand the functionality of RefillWizard in some pretty cool ways and are already starting work on product #2 – dealing with the burden of lab reports.

Our ultimate goal is to get the physician’s inbox as close to zero as possible.

  • Go Jon – Proud to be working with you!

  • Dan

    I dig the infographic/conversion tool. Makes your point quite clearly.

    Could you elaborate a bit on your approach to improving lab workflows? I feel like the road to fixing the lab report process is strewn with dead companies everywhere (mostly trying to improve things for the pt). It definitely needs an overhaul, but curious for your take on the best way to do so.

  • Agreed. Most “lab companies” are concerned with that patient. We’re going to gear towards the provider.

    Labs are similar to refills in that they are going to take 30+ minutes daily with the majority of the time being in gathering data (what were the last values, is the value ‘normal’ for this patient, etc.), interpretation (why might this patient’s results be elevated) and action (tell nurse to communicate with patient, reorder test in 3 months, change med, etc.).

    Most of the time, labs are going to be straight-forward and in those cases we are going to automate data gathering, interpretation, and action and allow the doctor to quickly sign-off and get on with their day. In the abnormal cases, we are going to be make sure they have all the information they need to make a quick decision.

    80/20 rule – the majority of healthcare innovations focus wrongly on the 20% of cases which are complex. Instead, we focus on the 80% of cases which are normal allowing the docs to spend more time on the complex cases when they come along.

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