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Startup and Technology News
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    Healthcare is expensive, and it's increasingly suffering from overinflation. It seems that, while what we pay for consumer goods has tended to increase at a normal rate, healthcare costs have sky-rocketed in comparison. Quite a few startups have popped up of late that are attempting to bring disruptive vision to healthcare costs in the U.S., like the National Surgery Network, a sort of Hotwire for access to top surgical facilities, and MedLion , a group of doctors in Silicon Valley providing cheap primary to uninsured and insured patients alike, to name a few. Avado, a startup launching at Disrupt NYC today, is partnering with healthcare businesses like the two mentioned above to provide a "Patient Relationship Management" platform, in an attempt to create a more communicative relationship between patient and doctor by way of "Connected Health Records".

    rempson8Screen shot 2011-05-23 at 2.21.47 AMtcdisrupt_web-001-1362rempson8Screen shot 2011-05-23 at 2.21.47 AMtcdisrupt_web-001-1362

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    There are many local, regional and global startup competitions that startups can compete in. I’m a big believer in the value of these startup competitions for two big reasons—they are a great forcing function to ship your product and refine your ability to pitch your business. Even if you have no plans to raise money, you will have to pitch your business to achieve your goals. My startup (Avado) is a Patient Relationship Management platform for health and wellness providers such as doctors, physical therapists, nurse practitioners, health coaches, physician assistants and personal trainers. We decided to pursue the opportunity to compete in the TechCrunch Disrupt startup competition. Each startup competition has its own selection process. In the case of TechCrunch Disrupt, a triumvirate of Erick Schonfeld (Co-editor of TechCrunch), Heather Harde (CEO) and Michael Arrington (Founder) evaluates the companies after they have winnowed down the first list of companies. My understanding is that two out of the three of them need to greenlight a company to be a finalist. During the course of the TechCrunch Disrupt event, Michael referred a couple times to Erick Schonfeld veto’ing a company. It wasn’t clear whether that was a joke or not, but he appeared to be serious.


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    Imagine something so insidious that it leads to the following: over 750,000 personal bankruptcies per year. In Bill Gates’ recent TED talk, he described it as the factor that is devastating education budgets and is leading to a pitting of old versus young; it impairs U.S.-based automakers by adding a $2000 “tax” on all of their vehicles; many believe it is the primary driver of the jobless recovery. Despite corporate profits being at record levels, many corporations simply aren’t hiring as a result. In the startup arena, it can keep people from moving to a startup. What is it? Healthcare hyperinflation. It won’t be long before $1 out of every $5 in the U.S. economy is spent on healthcare despite the U.S. ranking 31st in the world in terms of health outcomes. Founded by Dr. Samir Qamar in Monterey, MedLion recently opened a clinic in the heart of Silicon Valley with a model that is revolutionizing how primary and urgent care are delivered (Disclosure: MedLion may become a customer of my company,, which is why I am so familiar with it.) Their breakthrough model is enabled by disintermediating insurance companies from their encumbrance of day-to-day healthcare. This allows them to dramatically reduce the cost of day-to-day healthcare.


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    medical dollar sign As reported on TechCrunch, Google shut down its medical records and health data platform. Since then, there's been a lot of bits spilled offering explanations, but they all missed the most critical item. Money. Or in the language of healthcare - Reimbursement. I explain more below regarding why Google Health was doomed to fail in light of the legacy reimbursement model. First, let's recap some of the explanations offered up so far. These are all valid but miss the biggest point. Adam Bosworth, who originally ran Google Health gave one reason - It's Not Social. That's true if one wants to create a weight management program or is simply interested in fitness-minded folks. Clearly that is important given the obesity epidemic, however there's vast swaths of healthcare where being "social" isn't appropriate or applicable in a doctor-patient relationship. In other words, being social is necessary but not sufficient to transform healthcare.

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    The scale of the Do-it-Yourself (DIY) Health Reform movement is dramatically bigger than I realized when writing about how that movement could affect the Talent Wars taking place in the tech community. So much so that I'm convinced we're on the cusp of the third, and by far the biggest, major wave of Health IT. The first wave was the introduction of mainframe/minicomputer based departmental solutions. The second wave was characterized by client-server systems and a greater degree of integration across the healthcare enterprise, though still limited between healthcare organizations. Neither of the first two waves dramatically altered the landscape for healthcare. In contrast, the third wave will fundamentally alter the competitive landscape. Healthcare's hyperinflation has ignited the DIY Health Reformers to declare what amounts to a Declaration of Insurance Independence. While the reformers recognize insurance plays a vital role for managing high risk events (house fire, car accident, cancer), the fee-for-service model underlying insurance in day-to-day healthcare has created what translates into a 40% "insurance bureaucrat tax" that they want freedom from.

    tcbucketWriting Declaration of IndependencetcbucketWriting Declaration of Independence

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    avado_logo_mediumBack in May, Avado was chosen as a finalist at TechCrunch Disrupt in NYC. The startup's ambition was, said in reductive terms, to become the of personal health records. (You can read our initial coverage here.) In other words, like Salesforce's "customer relationship management" (CRM), Avado is building a "patient relationship management" (PRM) platform in an attempt to create a more fluid and communicative relationship between patients and doctors -- by way of connected health records. Since Disrupt, Avado has been working on building out that robust communication platform for care providers and their patients, and, today, Avado is officially coming out of beta to launch its service to the public.

    avado_logo_mediumrempson8Broadcast - Provider sideBroadcast - Patient sideavado_logo_mediumrempson8Broadcast - Provider sideBroadcast - Patient side

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    DIYIn several of my past pieces, I have written about the importance of a disruptive model of care and payment called Direct Primary Care (DPC) such as The Most Important Organization In Silicon Valley That No One Has Heard About. As the DPC models scale, they become a great option for individuals and small business. However, larger organizations have another option at their disposal that I'm as excited about as the DPC models. Employers fed up with the annual "get less for more" health story when they get annual health plan updates have taken matters into their own hands. This has created one of the hottest sectors of the economy -- onsite clinic providers. These are companies providing corporations with primary care onsite at employer workplaces. Each of the onsite clinic provider CEOs (e.g., Concentra, CareHere) I have spoken with have shared that their business is growing 100% annually. Reportedly 20% of employers with over 500 employees are implementing onsite clinic programs.

    DIYSun ValleyDIYSun Valley

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    ReservoirA group of women is re-entering the workforce today and reshaping how products are made across key tech sectors like health & wellness, commerce and social products. Not only do they have the experience of raising families, but they've been business and technology leaders earlier in life. They're becoming founders and leaders at startups and in the very companies they've been buying products and services from. Not only do women make most of a family's health decisions but 48% of graduating physicians are women and women compose 73% of medical and health services managers. As a healthtech startup, we think heavily about the importance of what I call the Family Chief Health & Wellness Officer (aka "Mom"). Avado is not unlike many startups in that we have two male co-founders. We'd be fools to not figure out ways to bring the female perspective into our business.

    ReservoirSun ValleyReservoirSun Valley

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    Screen Shot 2013-10-29 at 6.31.13 PM Seventeen years after its inception, WebMD remains one of the go-to resources for basic health and diagnostic information (and hypochondria enablement) on the Web. Born at the height of the Dot-com Boom, WebMD is on a very short list of companies that were able to not only endure the ensuing crash, but go on to achieve profitability, a billion-dollar market cap and maintain their position as a… Read More

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