HIStalk Mobile Interviews Peter Hudson, MD

Peter Hudson, MD is Co-Founder and CEO of Healthagen

Peter Hudson, MD

When did you decide that you wanted to start this company? Can you just walk us a little bit through what’s happened over the last couple of years from inception to where you are today?

Wayne Guerra and I are both ER docs, so we’ve seen 50,000 patients around the point-of-care. Over the last three or four years we just realized that patients weren’t sure where they should go. They often ask us questions: “Is this the right place? What should I be worrying about? Was this the best place for me to come for the condition that I have?”

The genesis was a Saturday morning, trying to get the kids off to soccer and I got three calls from different neighbors who not only weren’t sure what they had – they had a symptom, or their kid had a symptom or had an accident – and they weren’t sure what to worry about, and how to think about it.

Then, when they sort of settled on what they were most worried about, where should they go? What kind of facility, and then where. Exactly where – the latitude and longitude, address, and phone number. I was really surprised by that because these people had lived in our community for years and they’d probably driven near hospitals and urgent cares and things like that and they just weren’t aware of it.

We realized that there’s a real need for answering those two simple questions [what could be wrong, and where should I go], which aren’t really that simple when you realize how much content is required for the first one – which is kind of a clinical question; and how much data and location specific data is required for the second one. As mobile technology became available and the landscape for distributing software became more open, we felt that was a perfect opportunity.

At what point did your vision of an opportunity to create this valuable tool go from ‘let’s build an iPhone app’ to ‘let’s build a company that we can build a platform for providing consumer-based health information’?

We’ve been thinking about this for awhile because there’s just so little that’s known about the details of healthcare – how much does this cost; what’s the best treatment for this; who’s the specialist to take care of this condition? We felt like there was this huge information gap and inefficiency. We started thinking about that even before we realized that this product could be a good entry point for some of that.

But as we thought about our initial product, it was never about just being an iPhone app; it was about being a decision platform for people. We modeled this entire thing out with a comprehensive flow chart from start to all sorts of different finish points with every data set that we needed completed. Our product does what we modeled. I guess having provided medical care, having been patients, and having talked to so many patients, we just had a really clear view of what we saw to be some of the problems. Natural places where different data sets could really provide information to patients within a context of the decision they needed to make.

See, from my perspective, the application is a very nice application. It looks like you guys have done a great job, but there’s a lot more here than I think most people would expect. I say that because for one, the founders are a couple of long-practicing physicians. It’s not like you just started residency and then decided to start a software development business. But then, you start to uncover a little bit more, and it’s quite impressive that you guys have a fairly serious group of people behind your company and you look pretty serious about it.

We’re extremely serious about it. We think that patients deserve, really, a very robust, very connected resource at their side and it’s possible, so why not have it? We went out to a lot of the largest companies that could help us for the data needs and we shared our vision, and they partnered with us. We went to large health systems and we talked about what we were doing and they became our clients.

We rolled our software out and then asked people for stories about how they used it, and they used it in every way we designed it for and got benefit from it. In fact, we’ve had very few comments saying anything other than ‘can you add this disease or that one because I didn’t see it on there?’ Most of it has been ‘I had a problem. I now have a way to think through it because I want to be empowered. I want the information when I need it and I made a decision. I was really happy with my decision.’

It’s been extremely rewarding. As much as taking care of patients one-on-one in the hospital; now we can take care of and help people in a sort of one-to-many, or a much larger focus.

When did you first launch the first version of your application?

March 10th of last year – about a year ago.

I’m very impressed because you guys are covering a lot of ground very quickly. Where do you see yourselves, as a company, in a year?

I think we’ve tackled one of the harder parts of a consumer-facing technology for healthcare, and that’s real-time decision support with real-time access to over a million data points around the country. We will be expanding into helping people manage their health; helping people learn more about their health, and promoting different capabilities of improving their lives. You know, getting healthier.

With the knowledge that they have the value-add of thinking through an acute problem. It’s always there. Thinking through how to access the system is always there. I think that’s more of our vision of where we’ll be in a year.

Our current technology, which we call symptom-to-provider technology, we see it as a flow chart or a flow of information that goes down many different pathways, but the same kinds of pathways, the same categories of pathways. We envision it becoming more engaging on the front-end with more specificity for the patient, and better connections to our clients on the back end. So, as you access the system, we’ll become more and more integrated and valuable to both the hospital and the patient in facilitating their entry point to the healthcare system.

When it comes to building consumer-oriented solutions, like PHRs, the prevailing attitude seems to be ‘let’s build it and they will come.’ I think that’s far from true. Your application is one of the first that I’ve seen that, as a patient, as a potential consumer of this application, you’ve actually given me a compelling reason to use it. I think that’s extraordinarily unique.

The challenge is then, how do you make people like me aware that you guys exist?

That’s why we have partners. That’s why, in every market, we have clients and they promote us, but you’re absolutely right. As to the first part of your question, I think there’s something that other vendors in the chronic disease space and the personal health records space should think about:

When and how do you engage somebody? People say that if you have this cool graphing technology for your glucose on your phone, that it’s engaging. That if your glucometer connects to the rest of the world and shares your data with your doctors and they can give you feedback, it’s engaging. I think those are connecting and those are efficient. Those are good ways to collect data and connect with data, but they’re not engaging.

I think that the moment of engagement comes when somebody has something wrong. I know this personally because people come into the ER with all sorts of chronic problems, for example, perhaps they’re an alcoholic and are drinking themselves to death. Every now and then if I’m around on a shift when they sober up I’ll say, “Listen, you’ve got to stop drinking. You’re going to kill yourself.” I’m never afraid to tell people exactly what I believe to be the truth – if you keep drinking you’re going to be dead. Every now and then somebody comes back and says, “You know what? I stopped drinking, Doc, cause you told me that I needed to stop drinking; that I was going to die.” Information combined with an event that helps someone take notice. That’s engagement.

Ultimately, if you have a technology that will help people track their weight or what they eat, or their nutrition, or what their glucose is – all that is great if they want to do it, but I think they probably need some event to promote their interest in doing it and what a better chance to engage somebody than to help connect them right at the point-of-care, right at the point of need, with the right solution.

Then guess what? Some of our partners are pretty interested in the fact that we have real-time surveillance of where people are going. And, can they engage with people and help them because they see that ER visit, or they see the urgent care visit or their interest in certain conditions being a sign of worsening or a sign of exacerbation of their condition.

I guess it’s something you’re probably used to dealing with, really. But to me, the frustrating part would be that how many people will go through a crisis and not really know how to respond, or don’t adequately respond because they don’t have the tool available. It won’t be until after the fact, and maybe never, for them to know that there is such a tool available and at their disposal.

You’re right, it becomes compelling and it becomes engaging when you need it. I suspect that’s the challenge for you guys is to get out there and get people’s attention before they need it, so when the need does arise, that you’re at hand.

I think that’s one of the reasons why we love talking to you and other people who have an audience. There’s huge businesses built on moving the needle for a population one-percent. It doesn’t take a huge amount of engagement to actually make a big difference, and then it becomes something that continues to snowball when people hear about it.

What is your exit strategy? You’re an entrepreneur, you’ve built a business. You guys are tracking nicely. What’s the end game?

Our exit strategy is really to keep our head down and to continue to add more and more data, add more and more hospitals, and provide some benefit to some populations that we’re talking with. Cost and quality information, personal health record access, etc. To some degree, it could look like we’re trying to do a lot of different things, but in my mind it’s so connected and so structured that it all fits together. I think we just want to keep building the best solution and see what happens.

Ultimately, somebody will realize that 130-million patients a year go to the ER; another 60-million go to urgent cares, and something like 800-million see the doctor. In all these decisions there is inefficiency and waste, in the hundreds of billions of dollars. If all of a sudden there’s a mobile solution that really facilitates that access and helps people think about it in the right way, it’s going to be compelling for somebody. We’re quietly building it.

Is there anything that I haven’t asked, or anything specific that you would like people to know either about the application or about your company that you feel we didn’t cover?

From a CIO’s perspective, or somebody in information technology, we offer a platform to communicate certain really key hospital system variables to patients in a very simple format, and offer many pathways to further enhance the patient experience through integration. Initially, this can even be marketing data, but the other integration opportunities are very defined, simple to execute on, and can provide meaningful revenue opportunities for your organization. I think that, especially with your audience, is a key message to get across.

Thanks, David, for taking the time to talk with me.

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