@jayparkinson

51

I’m obviously quite excited about this. Sherpaa started in February of 2012 with one client, tumblr. A little over two years later:

  • We take care of more than 100 companies
  • We’re 18 employees and hiring
  • Our monthly revenue covers our monthly burn
  • We’re now in California and in the process of expanding to 10 other major cities by the end of the year
  • We solve 70% of medical problems without referring you to see a doctor in person…think about that…that means 70% of doctor visits don’t need to happen
  • Our insurance experts recoup money on a daily basis for you from insurance companies and doctors’ billing mistakes
  • Employees absolutely love the service with 98% rating the experience as exceptional
  • Companies are offering this exceptionally-rated service and saving money 

Healthcare absolutely can be better and we’re proof. I’ve seen a lot of healthcare companies come and go and raise too much or too little money. My goal is to create a sustainable service that people absolutely need and love powered by an intelligent business and investment strategy based on a career of studying what works and what doesn’t in healthcare. In the beginning of my career, back in 2007, I often blogged about what’s wrong with healthcare. Around 2011, I decided to stop bitching, and start building something better. Sherpaa is a dream come true, enabled by a good idea and passionate investors who want to change a very important, yet broken, industry and fundamentally make it better. Without our investors’ passion and talents, Sherpaa would be nowhere. Along with the investors in our seed round (O’Reilly Alpha Tech Ventures, First Round Capital, and Collaborative Fund) who followed on in this Series A, Josh Guttman at Softbank led this investment along with David Karp, the CEO and founder of tumblr. I’m thrilled to have such a rock star group of investors enabling Sherpaa to grow bigger and better.

The WSJ article alludes to something I strongly believe. If you haven’t noticed, our investors are not healthcare investors. Their main focus is consumer technology. I’m a huge believer that change in healthcare cannot come from within the confines of traditional healthcare thinking. It must come from fresh-eyed partners and investors outside of the healthcare box who find healthcare way too frustrating and backwards. 

So cheers to the finest team of doctors, sales people, engineers, account experience directors, and insurance experts that power Sherpaa and make a better version of healthcare as awesome as it can be. Cheers to the companies who entrust us to make healthcare better for their company. And cheers to Phase Two of Sherpaa, making it bigger, better, and quickly coming to a city near you.

35
Exciting news: Sherpaa is expanding. We’re currently working with over 100 companies here in NYC and many of them have offices in other major cities in America. We’re building the nation’s first nationwide group of forward-thinking, exceptionally trained health professionals. Sure, there are massive lists of doctors out there you can find on your insurer’s website. But, nobody is curating that confusing, generic list of doctors to find exquisitely trained, mission-driven health professionals who believe healthcare can and should be a wonderful experience for patients. These doctors are rare, but they’re the secret to creating markedly better healthcare.
As Sherpaa expands to other cities, we understand that healthcare is hyperlocal— when you need to be seen by a doctor, you want one located in an office not too far away from you. Fortunately, with Sherpaa, we solve 70% of medical issues in house and online never needing to refer you to a doctor to be seen in person. But, for the other 30%, that means we rely on this tribe of forward-thinking health professionals in other major cities. If you are a health professional and you want to join the Sherpaa team of specialists we refer to, you can make that happen right here.

Exciting news: Sherpaa is expanding. We’re currently working with over 100 companies here in NYC and many of them have offices in other major cities in America. We’re building the nation’s first nationwide group of forward-thinking, exceptionally trained health professionals. Sure, there are massive lists of doctors out there you can find on your insurer’s website. But, nobody is curating that confusing, generic list of doctors to find exquisitely trained, mission-driven health professionals who believe healthcare can and should be a wonderful experience for patients. These doctors are rare, but they’re the secret to creating markedly better healthcare.

As Sherpaa expands to other cities, we understand that healthcare is hyperlocal— when you need to be seen by a doctor, you want one located in an office not too far away from you. Fortunately, with Sherpaa, we solve 70% of medical issues in house and online never needing to refer you to a doctor to be seen in person. But, for the other 30%, that means we rely on this tribe of forward-thinking health professionals in other major cities. If you are a health professional and you want to join the Sherpaa team of specialists we refer to, you can make that happen right here.

16
sherpaa:

At Sherpaa, we always tell our clients that our Doctors and Insurance Guides should be their first point of contact for all things health… and by “all” we mean any health question or concern they may have, even if they aren’t necessarily sick at the moment.
Today we released a fun new feature in our app that calls attention to the many ways to use Sherpaa. If you’ve ever had a question about your health or insurance but you were too embarrassed to ask, now’s your chance. Log in and ask Sherpaa. It’s like having a doctor in the family.

sherpaa:

At Sherpaa, we always tell our clients that our Doctors and Insurance Guides should be their first point of contact for all things health… and by “all” we mean any health question or concern they may have, even if they aren’t necessarily sick at the moment.

Today we released a fun new feature in our app that calls attention to the many ways to use Sherpaa. If you’ve ever had a question about your health or insurance but you were too embarrassed to ask, now’s your chance. Log in and ask Sherpaa. It’s like having a doctor in the family.

57
I recently spent the weekend upstate at a beautiful old house built in 1898. It was surrounded by trees and just a hundred yards away from a gorgeous, crystal clear lake. It had a lovely massive porch in front that looked absolutely perfect for sipping lemonade, reading, and, brace yourself, giving birth. The owner of the house showed me photos taken almost four years ago of her sister giving birth to a lovely little girl out on the porch, surrounded by family and friends. I’m sure it looked very similar to that very first birth in the house over a hundred years ago. 

When I was doing my pediatric residency in the West Village, the birthing center just a few blocks away was the bane of my existence. So were all the trendy West Village home births. Our hospital was where all the home births and birthing center births gone bad came to to get resuscitated. I remember the baby that was accidentally dropped in the birthing pool and took its first breaths of bloody bath water. The water was too soiled to find the baby quickly and it supposedly was under for 10 or 15 seconds as they searched for the little girl. I saw too many bad outcomes and became convinced that the hospital was the only safe place to give birth. 

But then The Lancet, one of the most respected medical journals of all time, published a study this week that found: 

"The United States is one of just eight countries in the world where deaths related to pregnancy and childbirth rose between 2003 and 2013, a new report says. That puts it in the company of countries such as Afghanistan, Belize and El Salvador."

This falls right in line with the other wide scale studies reporting the abysmal performance of our nation’s healthcare system. The most popular one being the World Health Organization ranking the US healthcare system 37th in performance. 

But why would our maternal mortality increase be on par with Afghanistan’s increase? Could it be that women have just as difficult a time accessing high quality care in America as women in Afghanistan? That’s one possibility. But I think the far more likely reason is that American women have too much access to an increasingly unsafe healthcare industry marred by an addiction to unnatural and brutal c-section births (ever seen one?) in environments teeming with a high risk of hospital-acquired infections. 

It’s been 14 years since the Institute of Medicine released their startling report finding that roughly 100,000 people die every year because of contact with the United States Healthcare Industry. Since that report was released, those numbers haven’t changed. Our nation’s healthcare industry is responsible for 100,000 deaths and our nation’s highways are responsible for roughly 34,000. 

I have 3 years of personal anecdotes from real life situations of home births gone bad. But, as a doctor on the front lines working in a pediatric ER or neonatal intensive care unit, you see a disproportionate amount of bad things. It’s the nature of our business. Sick people come to us and it colors our world because we tend to forget about all the health and all the good out there in the world. For every botched home birth, there are many more that go marvelously well safe from the world of hospital-acquired infections and unpleasant high tech machines designed to pick up the first sign of an excuse to c-section. 

So now I’m in a bind. I’ve got my experience that says natural pregnancies and births are unsafe for mom and baby. But now we’ve got legitimate, believable hard data saying that our healthcare system is increasingly unsafe for mothers. I don’t practice medicine anymore, but I’m still asked for advice. As a good doctor, I should point others to reliable, evidence-based information. Going forward, I’m afraid I’m going to have to point expectant mothers toward this study. It’s an important one and hopefully sparks a conversation where expectant mothers and fathers demand safer, cleaner, and less risky environments to bring babies into this lovely world.

I recently spent the weekend upstate at a beautiful old house built in 1898. It was surrounded by trees and just a hundred yards away from a gorgeous, crystal clear lake. It had a lovely massive porch in front that looked absolutely perfect for sipping lemonade, reading, and, brace yourself, giving birth. The owner of the house showed me photos taken almost four years ago of her sister giving birth to a lovely little girl out on the porch, surrounded by family and friends. I’m sure it looked very similar to that very first birth in the house over a hundred years ago.

When I was doing my pediatric residency in the West Village, the birthing center just a few blocks away was the bane of my existence. So were all the trendy West Village home births. Our hospital was where all the home births and birthing center births gone bad came to to get resuscitated. I remember the baby that was accidentally dropped in the birthing pool and took its first breaths of bloody bath water. The water was too soiled to find the baby quickly and it supposedly was under for 10 or 15 seconds as they searched for the little girl. I saw too many bad outcomes and became convinced that the hospital was the only safe place to give birth.

But then The Lancet, one of the most respected medical journals of all time, published a study this week that found:

"The United States is one of just eight countries in the world where deaths related to pregnancy and childbirth rose between 2003 and 2013, a new report says. That puts it in the company of countries such as Afghanistan, Belize and El Salvador."

This falls right in line with the other wide scale studies reporting the abysmal performance of our nation’s healthcare system. The most popular one being the World Health Organization ranking the US healthcare system 37th in performance.

But why would our maternal mortality increase be on par with Afghanistan’s increase? Could it be that women have just as difficult a time accessing high quality care in America as women in Afghanistan? That’s one possibility. But I think the far more likely reason is that American women have too much access to an increasingly unsafe healthcare industry marred by an addiction to unnatural and brutal c-section births (ever seen one?) in environments teeming with a high risk of hospital-acquired infections.

It’s been 14 years since the Institute of Medicine released their startling report finding that roughly 100,000 people die every year because of contact with the United States Healthcare Industry. Since that report was released, those numbers haven’t changed. Our nation’s healthcare industry is responsible for 100,000 deaths and our nation’s highways are responsible for roughly 34,000.

I have 3 years of personal anecdotes from real life situations of home births gone bad. But, as a doctor on the front lines working in a pediatric ER or neonatal intensive care unit, you see a disproportionate amount of bad things. It’s the nature of our business. Sick people come to us and it colors our world because we tend to forget about all the health and all the good out there in the world. For every botched home birth, there are many more that go marvelously well safe from the world of hospital-acquired infections and unpleasant high tech machines designed to pick up the first sign of an excuse to c-section.

So now I’m in a bind. I’ve got my experience that says natural pregnancies and births are unsafe for mom and baby. But now we’ve got legitimate, believable hard data saying that our healthcare system is increasingly unsafe for mothers. I don’t practice medicine anymore, but I’m still asked for advice. As a good doctor, I should point others to reliable, evidence-based information. Going forward, I’m afraid I’m going to have to point expectant mothers toward this study. It’s an important one and hopefully sparks a conversation where expectant mothers and fathers demand safer, cleaner, and less risky environments to bring babies into this lovely world.

45
I just set up Ducksboard for Sherpaa. It’s essentially a dashboard for your company and allows you to see the real-time status of all things happening in your company. Here are a few of the things that I can now see:
How many people reached out to Sherpaa in the last 24 hours
The types of cases people are creating (sick, hurt, insurance questions, mental health, etc.)
How our sales team is doing and what their pipeline looks like
How many phone calls our physicians got this month
Percentage of cases our docs are solving without referring you to be seen in person
Ratings for Sherpaa and for the specialists we refer to
Growth in patients and companies
Real-time revenue
Our social footprint (twitter mentions, LinkedIn followers, etc.)
All of this is extremely insightful. Data-driven healthcare is a dream of mine. However, there’s a number we’re tracking that I think is fascinating. It’s an estimate of how much money our doctors are saving all of the employees of companies we cover. It’s a number that currently has little to do with our bottom line, but it has everything to do with our mission— we want to deliver care more effectively and less expensively. We want to be a service that people absolutely love and need, one that people rave about, but also one that saves our folks money. That’s hard to do. 
Prior to setting up this dashboard, I had no idea that every month our doctors are saving our patients almost exactly Sherpaa’s monthly revenue. Without going into details, Sherpaa is kicking ass in terms of revenue. But to think that we’re saving this much money is proving out my theory that served as the reason to start Sherpaa— we absolutely can create a better healthcare experience that people love that makes healthcare less expensive. 

I just set up Ducksboard for Sherpaa. It’s essentially a dashboard for your company and allows you to see the real-time status of all things happening in your company. Here are a few of the things that I can now see:

  • How many people reached out to Sherpaa in the last 24 hours
  • The types of cases people are creating (sick, hurt, insurance questions, mental health, etc.)
  • How our sales team is doing and what their pipeline looks like
  • How many phone calls our physicians got this month
  • Percentage of cases our docs are solving without referring you to be seen in person
  • Ratings for Sherpaa and for the specialists we refer to
  • Growth in patients and companies
  • Real-time revenue
  • Our social footprint (twitter mentions, LinkedIn followers, etc.)

All of this is extremely insightful. Data-driven healthcare is a dream of mine. However, there’s a number we’re tracking that I think is fascinating. It’s an estimate of how much money our doctors are saving all of the employees of companies we cover. It’s a number that currently has little to do with our bottom line, but it has everything to do with our mission— we want to deliver care more effectively and less expensively. We want to be a service that people absolutely love and need, one that people rave about, but also one that saves our folks money. That’s hard to do. 

Prior to setting up this dashboard, I had no idea that every month our doctors are saving our patients almost exactly Sherpaa’s monthly revenue. Without going into details, Sherpaa is kicking ass in terms of revenue. But to think that we’re saving this much money is proving out my theory that served as the reason to start Sherpaa— we absolutely can create a better healthcare experience that people love that makes healthcare less expensive. 

40
Sherpaa purchased 1600 polio vaccines this week.
When we sign up a company, our goal is for 100% of employees to register with Sherpaa. We’ve been experimenting with various ways to accomplish this goal, and, this week, we implemented a new strategy. If you sign up within 24 hours of receiving the registration invitation from Sherpaa, we purchase polio vaccines on your behalf to help fight the good fight of eradicating polio worldwide.
This map shows how health professionals throughout the world have backed polio into a corner. Just as we eradicated smallpox from the world, we’re very close to eradicating polio. We’re doing our part to make that happen. 1600 kids are no longer going to get polio. This Friday feels really good. 

Sherpaa purchased 1600 polio vaccines this week.

When we sign up a company, our goal is for 100% of employees to register with Sherpaa. We’ve been experimenting with various ways to accomplish this goal, and, this week, we implemented a new strategy. If you sign up within 24 hours of receiving the registration invitation from Sherpaa, we purchase polio vaccines on your behalf to help fight the good fight of eradicating polio worldwide.

This map shows how health professionals throughout the world have backed polio into a corner. Just as we eradicated smallpox from the world, we’re very close to eradicating polio. We’re doing our part to make that happen. 1600 kids are no longer going to get polio. This Friday feels really good. 

61
I’m pretty excited to announce that Sherpaa has teamed up with Johns Hopkins Bloomberg School of Public Health to offer their preventive medicine physicians in training the opportunity to do a rotation at Sherpaa to learn about health technology, startups & entrepreneurship, the optimal patient experience, service design, and the business of healthcare.
I did two residencies, one in pediatrics and the second was in Preventive Medicine at Johns Hopkins where, as part of the residency, you also get your masters in public health (MPH). I absolutely loved it and it really did give me the experiences and connections I needed to do what I’m doing today. I’m pretty excited to be a part of helping the Hopkins preventive medicine residents train to gain the skills necessary to be effective leaders in health promotion and disease prevention and to enable maximum health and quality of life for patients. I wouldn’t be where I am today without Hopkins and I’m just super excited to pay it forward with Hopkins residents working with us here at Sherpaa.

I’m pretty excited to announce that Sherpaa has teamed up with Johns Hopkins Bloomberg School of Public Health to offer their preventive medicine physicians in training the opportunity to do a rotation at Sherpaa to learn about health technology, startups & entrepreneurship, the optimal patient experience, service design, and the business of healthcare.

I did two residencies, one in pediatrics and the second was in Preventive Medicine at Johns Hopkins where, as part of the residency, you also get your masters in public health (MPH). I absolutely loved it and it really did give me the experiences and connections I needed to do what I’m doing today. I’m pretty excited to be a part of helping the Hopkins preventive medicine residents train to gain the skills necessary to be effective leaders in health promotion and disease prevention and to enable maximum health and quality of life for patients. I wouldn’t be where I am today without Hopkins and I’m just super excited to pay it forward with Hopkins residents working with us here at Sherpaa.

41
About a month ago, I got some new glasses, as shown in this grab from my Monday’s appearance on Bloomberg (quite possibly the most unprepared professional TV hosts of all time, but that’s another story). I bought them from this boutique in Soho and got the lenses from my local shop in Williamsburg. I knew I’d have to pay for them up front and then get reimbursed by VSP, the vision insurer that covers all Sherpaa employees. So I logged in to my Sherpaa account, created an insurance case, snapped a photo of the separate receipts for my frames and lenses, and submitted them to our insurance experts to file the claim and get me reimbursed. All went just fine. Then I got some snail mail from VSP saying they denied my claim. I logged back in to Sherpaa, snapped a photo of the denial and asked our insurance experts, “What gives?” Our experts sleuthed, discovered the “problem,” fixed it, and I was just notified that the check is in the mail. This took me a total of about 2 or 3 minutes. If I didn’t have Sherpaa, this probably would have taken me at least an hour, if not more. I probably would have just put the entire thing off, because I’m too busy with work, and would have let this company screw me out of a few hundred bucks, because it’s just too time-consuming and annoying to deal with them.
We launched Sherpaa with just medical inquiries powered by doctors. But we quickly realized that people were asking us insurance questions, so we launched a service that tackles health insurance nightmares like this, powered by health insurance experts. And today, about a third of all inquiries in Sherpaa are insurance questions like this. Sometimes our doctors have to work together with the insurance experts to solve problems. Our goal is to be the intelligent go-to service that sits on top of the healthcare industry, that takes these problems off your hands and turns this annoying, confusing mess into something painless. 

About a month ago, I got some new glasses, as shown in this grab from my Monday’s appearance on Bloomberg (quite possibly the most unprepared professional TV hosts of all time, but that’s another story). I bought them from this boutique in Soho and got the lenses from my local shop in Williamsburg. I knew I’d have to pay for them up front and then get reimbursed by VSP, the vision insurer that covers all Sherpaa employees. So I logged in to my Sherpaa account, created an insurance case, snapped a photo of the separate receipts for my frames and lenses, and submitted them to our insurance experts to file the claim and get me reimbursed. All went just fine. Then I got some snail mail from VSP saying they denied my claim. I logged back in to Sherpaa, snapped a photo of the denial and asked our insurance experts, “What gives?” Our experts sleuthed, discovered the “problem,” fixed it, and I was just notified that the check is in the mail. This took me a total of about 2 or 3 minutes. If I didn’t have Sherpaa, this probably would have taken me at least an hour, if not more. I probably would have just put the entire thing off, because I’m too busy with work, and would have let this company screw me out of a few hundred bucks, because it’s just too time-consuming and annoying to deal with them.

We launched Sherpaa with just medical inquiries powered by doctors. But we quickly realized that people were asking us insurance questions, so we launched a service that tackles health insurance nightmares like this, powered by health insurance experts. And today, about a third of all inquiries in Sherpaa are insurance questions like this. Sometimes our doctors have to work together with the insurance experts to solve problems. Our goal is to be the intelligent go-to service that sits on top of the healthcare industry, that takes these problems off your hands and turns this annoying, confusing mess into something painless. 

18

Although having a doctor accessible 24/7 via app or phone is a wonderful and remarkably helpful experience, truly letting people connect in a deep way with those doctors over the internet is a challenge. As a user, you can tell our doctors are experienced, knowledgeable, and exceptional doctors…but you can’t grasp their wonderful personalities via a message. So, we created these videos of our doctors to let you meet the person on the other end. I’m so proud of our team of doctors. They are all simply outstanding.

This is Dr. Ida Santana. Also, meet Dr. Susan Gonnella and Dr. Ezra Feinberg. These are the people that make Sherpaa great.

869
From 1988 to 2014, watch the battle to eradicate polio unfold.
Red means the country still has cases of wild polio, yellow means the country is in a region that still has cases of wild polio, and white means that the disease has been eradicated.

unicef

From 1988 to 2014, watch the battle to eradicate polio unfold.

Red means the country still has cases of wild polio, yellow means the country is in a region that still has cases of wild polio, and white means that the disease has been eradicated.

unicef

59
Not too long ago, the Robert Wood Johnson Foundation invited me to speak to their entire organization about Sherpaa, re-imagining healthcare, and designing a better way of doing things. The Robert Wood Johson Foundation is the United States largest philanthropy devoted solely to the nation’s public health and they do absolutely wonderful work. 
After I spoke, they asked me to write a piece for them. Here’s what I wrote:

Everything great comes from an elegantly designed process. Just think of all of the experiences we love and use on a daily basis. Consider the iPhone. Apple re-imagined what a phone, or rather, a tiny computer in your pocket, could be and created a revolutionary device. Steve Jobs designed not only the interface that changed computing forever, but Tim Cook designed the manufacturing and material sourcing processes that enabled them to produce a remarkably complicated device at a relatively inexpensive price. They understood that, in order to deliver an exceptional user experience, they had to design the entire process, from the interface to the factory.
Health care was never designed. It just happened, revolving mostly around doctors’ needs and wants, in a culture that strongly believed “doctor knows best.” But our culture changed with the democratization of health information and other industries quickly evolved, raising consumers’ expectations of what health care could and should be.


Comparing the Apple Genius Bar with today’s average health care experience is laughable.
So how can health care catch up? Design an elegant health care process that enables intelligent health care delivery. Don’t only design that process, but implement it. Essentially, combine the elegance and creativity of Steve Jobs with the process-driven business savvy of Tim Cook. That’s what we do every day here in my company, Sherpaa. Here’s how it works:
Our salaried, full-time doctors have one mission: communicate via phone or web and creatively solve our patients’ health problems, all day, every day.
When patients have health problems, they log in and tell us their story.
Our doctors then, online, ask the right questions and get a careful history, prompting them to either order lab or imaging tests, treat with a medication, watch and wait, or refer for an in-person evaluation to a doctor in the patient’s neighborhood.
70% of the time, our doctors treat or solve the issue without having to refer to an in-person doctor. When we do refer, it’s always to the exact specialist the patient needs.
Does that really mean that 70% of primary care, specialist, and ER visits don’t need to happen? Does that really mean that 70% of those insurance claims should never happen? Yes, exactly. If you give patients accessible doctors at the right time to skillfully decide how best to use health care, health care is used intelligently with very little waste. In this system, everything that’s done actually needs to happen.
All of this is the result of an elegantly designed health care delivery process. But elegant processes aren’t free. So, in conjunction with this process, you must have an equally innovative business model to pay for this new process. There’s a hard fact floating around companies saddled with health care costs—health insurance premiums double every seven and a half years. Employers have a vested interest in taming those costs. And with roughly 70% of health care costs in America fronted by employers, they are the perfect innovation partner. Employers pay us to innovate their way out of rising costs through intelligent health care delivery.
This is all very interesting for the early adopters—the innovative and creative companies looking to make health care awesome for their employees. But what about the rest? What about the unions, those folks on Medicaid, and companies with minimum wage workers? Well, it’s called trickle-down technology. When the iPhone came out, few people could afford it. Over time, we now have cheaper versions of iPhones and, most importantly, Google’s Android smartphones. There’s even a $25 Android smartphone soon to be released. Now, almost everyone can afford this fancy “new” technology. This will also happen with health care. Start with the innovators who can’t stand frustrating experiences and who are dying to pay for something better. Work with those folks to refine your process and make it even more elegant, build an even bigger business, and watch competitors arise. And in the not too distant future, we’ll all wake up one day to see health care transformed by a little combination of dreamers, designers, and businesspeople who couldn’t stand seeing something broken without doing something about it.

Not too long ago, the Robert Wood Johnson Foundation invited me to speak to their entire organization about Sherpaa, re-imagining healthcare, and designing a better way of doing things. The Robert Wood Johson Foundation is the United States largest philanthropy devoted solely to the nation’s public health and they do absolutely wonderful work. 

After I spoke, they asked me to write a piece for them. Here’s what I wrote:

Everything great comes from an elegantly designed process. Just think of all of the experiences we love and use on a daily basis. Consider the iPhone. Apple re-imagined what a phone, or rather, a tiny computer in your pocket, could be and created a revolutionary device. Steve Jobs designed not only the interface that changed computing forever, but Tim Cook designed the manufacturing and material sourcing processes that enabled them to produce a remarkably complicated device at a relatively inexpensive price. They understood that, in order to deliver an exceptional user experience, they had to design the entire process, from the interface to the factory.

Health care was never designed. It just happened, revolving mostly around doctors’ needs and wants, in a culture that strongly believed “doctor knows best.” But our culture changed with the democratization of health information and other industries quickly evolved, raising consumers’ expectations of what health care could and should be.

Comparing the Apple Genius Bar with today’s average health care experience is laughable.

So how can health care catch up? Design an elegant health care process that enables intelligent health care delivery. Don’t only design that process, but implement it. Essentially, combine the elegance and creativity of Steve Jobs with the process-driven business savvy of Tim Cook. That’s what we do every day here in my company, Sherpaa. Here’s how it works:

  • Our salaried, full-time doctors have one mission: communicate via phone or web and creatively solve our patients’ health problems, all day, every day.
  • When patients have health problems, they log in and tell us their story.
  • Our doctors then, online, ask the right questions and get a careful history, prompting them to either order lab or imaging tests, treat with a medication, watch and wait, or refer for an in-person evaluation to a doctor in the patient’s neighborhood.
  • 70% of the time, our doctors treat or solve the issue without having to refer to an in-person doctor. When we do refer, it’s always to the exact specialist the patient needs.

Does that really mean that 70% of primary care, specialist, and ER visits don’t need to happen? Does that really mean that 70% of those insurance claims should never happen? Yes, exactly. If you give patients accessible doctors at the right time to skillfully decide how best to use health care, health care is used intelligently with very little waste. In this system, everything that’s done actually needs to happen.

All of this is the result of an elegantly designed health care delivery process. But elegant processes aren’t free. So, in conjunction with this process, you must have an equally innovative business model to pay for this new process. There’s a hard fact floating around companies saddled with health care costs—health insurance premiums double every seven and a half years. Employers have a vested interest in taming those costs. And with roughly 70% of health care costs in America fronted by employers, they are the perfect innovation partner. Employers pay us to innovate their way out of rising costs through intelligent health care delivery.

This is all very interesting for the early adopters—the innovative and creative companies looking to make health care awesome for their employees. But what about the rest? What about the unions, those folks on Medicaid, and companies with minimum wage workers? Well, it’s called trickle-down technology. When the iPhone came out, few people could afford it. Over time, we now have cheaper versions of iPhones and, most importantly, Google’s Android smartphones. There’s even a $25 Android smartphone soon to be released. Now, almost everyone can afford this fancy “new” technology. This will also happen with health care. Start with the innovators who can’t stand frustrating experiences and who are dying to pay for something better. Work with those folks to refine your process and make it even more elegant, build an even bigger business, and watch competitors arise. And in the not too distant future, we’ll all wake up one day to see health care transformed by a little combination of dreamers, designers, and businesspeople who couldn’t stand seeing something broken without doing something about it.

68
Tumblr Founder David Karp Invests in Medical-Treatment Startup Sherpaa — WSJ
78
conscientious:

W. Eugene Smith – Dr. Ceriani, 1948
Smack out of the golden age of the photojournalistic essay, Dr. Ceriani manages to maintain its power even removed from the framing of the magazine it was published in, the words around it gone. I want to think that what makes this photograph so poignant is that it essentially is a self portrait. Not in the absolutely literal way – Smith obviously was not a medical doctor, but in a somewhat metaphorical one. The concern on the doctor’s face mirrors the concern the photographer brought to his subjects, as does the closeness to the subject matter (for the doctor the injured child, for the photographer the doctor taking care of the injured child).
As a doctor you cannot help but be that immersed if you want to treat, possibly rescue, your patient. As a photographer, you could step back, but if you can’t help yourself you get close (Robert Capa’s dictum about picture quality corresponding to closeness to subject matter is mere machismo, though: Capa’s photographs always have a whiff of having been taken for effect in them, something Smith deftly managed to avoid almost all the time).
And if you want to be this close, you have go to be this good. The framing around the doctor is perfect (or expertly cropped – we have no way of knowing from the print alone), following the rules of the thirds closely. The helping hands at the bottom right corner of the frame are there, but they’re slightly out of focus. It’s all about the doctor and what he is doing.

Another one of the reasons why I think of this photograph as a self portrait is because the doctor’s attention is not on the child, at least not as far as his gaze is concerned. It’s not quite so clear what the doctor is focusing on, but whatever it is, it’s outside of the frame. We don’t know. We’re not shown. In much the same way, Smith’s photographs are as much about what they show as what they imply, what they don’t show, what’s outside those frames. There always is a balance going on (just like here): The photographic facts in the frames work with – hint at – all those facts, assertions, and ideas outside of the frame, often implicating the viewer in something: If you, dear viewer, could just get as engaged in this, we wouldn’t be in this situation, and the world would be a better place.

W. Eugene Smith was a true believer in what you could do with photographs and what it took to do that well. For that alone, he’s still missed (especially in a day and age where so much photojournalism is done for style and/or effect).
(this is one of the 100 pieces I wrote about each of the pictures in John Szarkowski’s Looking at Photographs)

Well written Jörg. Here’s the rest of the 40 or so photographs included in this photographic essay from 1948, Country Doctor. 
The last project I ever did at my previous company, The Future Well, was ideate and design the most popular iPad app for physicians, Omnio. When I was pitching the client the concept, I used this essay in our pitch deck as an emotional hook to argue that doctors no longer need a physical doctor bag, they need a virtual doctor bag in the form of an app. The clients bought into the idea, we got the job, designed the app, and now it’s a wild success. Amazing how a photograph can tell a story in so many different contexts.

conscientious:

W. Eugene Smith – Dr. Ceriani, 1948

Smack out of the golden age of the photojournalistic essay, Dr. Ceriani manages to maintain its power even removed from the framing of the magazine it was published in, the words around it gone. I want to think that what makes this photograph so poignant is that it essentially is a self portrait. Not in the absolutely literal way – Smith obviously was not a medical doctor, but in a somewhat metaphorical one. The concern on the doctor’s face mirrors the concern the photographer brought to his subjects, as does the closeness to the subject matter (for the doctor the injured child, for the photographer the doctor taking care of the injured child).

As a doctor you cannot help but be that immersed if you want to treat, possibly rescue, your patient. As a photographer, you could step back, but if you can’t help yourself you get close (Robert Capa’s dictum about picture quality corresponding to closeness to subject matter is mere machismo, though: Capa’s photographs always have a whiff of having been taken for effect in them, something Smith deftly managed to avoid almost all the time).

And if you want to be this close, you have go to be this good. The framing around the doctor is perfect (or expertly cropped – we have no way of knowing from the print alone), following the rules of the thirds closely. The helping hands at the bottom right corner of the frame are there, but they’re slightly out of focus. It’s all about the doctor and what he is doing.

Another one of the reasons why I think of this photograph as a self portrait is because the doctor’s attention is not on the child, at least not as far as his gaze is concerned. It’s not quite so clear what the doctor is focusing on, but whatever it is, it’s outside of the frame. We don’t know. We’re not shown. In much the same way, Smith’s photographs are as much about what they show as what they imply, what they don’t show, what’s outside those frames. There always is a balance going on (just like here): The photographic facts in the frames work with – hint at – all those facts, assertions, and ideas outside of the frame, often implicating the viewer in something: If you, dear viewer, could just get as engaged in this, we wouldn’t be in this situation, and the world would be a better place.

W. Eugene Smith was a true believer in what you could do with photographs and what it took to do that well. For that alone, he’s still missed (especially in a day and age where so much photojournalism is done for style and/or effect).

(this is one of the 100 pieces I wrote about each of the pictures in John Szarkowski’s Looking at Photographs)

Well written Jörg. Here’s the rest of the 40 or so photographs included in this photographic essay from 1948, Country Doctor. 

The last project I ever did at my previous company, The Future Well, was ideate and design the most popular iPad app for physicians, Omnio. When I was pitching the client the concept, I used this essay in our pitch deck as an emotional hook to argue that doctors no longer need a physical doctor bag, they need a virtual doctor bag in the form of an app. The clients bought into the idea, we got the job, designed the app, and now it’s a wild success. Amazing how a photograph can tell a story in so many different contexts.

84
Prices for tests and procedures in healthcare are literally all over the map, as told so wonderfully by Time in their groundbreaking article, The Bitter Pill. For example, if you get a brain MRI at one institution versus another, this may be the difference between you paying $500 vs. $2500 out of your deductible. That’s the difference between you going on vacation to Rio, buying that new MacBook Pro, or doing whatever your little heart desires with a cool extra $2,000 in your pocket. The obvious next question is, “Well I can only assume that if I get the test done at the $2500 place, it’s going to be $2,000 worth of higher quality and value, right?” Wrong. Healthcare costs are in no way correlated with quality and value. The same goes for procedures too. If you need an inguinal hernia repair, you’re going to quickly blow through your $10,000 deductible if you get it at one institution vs. another. But what if you can negotiate with a general surgeon for a better price? Instead of spending $10,000 of your deductible in a hospital center, you could spend $4,000 to have the procedure done in a beautiful outpatient surgical center. Now that’s $6,000 of real money you just saved.
That’s why I’m ridiculously happy to announce that Sherpaa just released a new feature in our app to help you save a potentially ridiculous amount of money when you need an expensive test or procedure. You can now tell us your story and what you need, and our doctors and insurance guides will collaborate and find you the highest quality place to get these at the best price.
I’m so damn proud of this. A resource that can save you literally thousands of dollars can make a huge difference in your life. So if you’re a Sherpaa client, give it a try and instead of throwing money blindly at an opaque, unfair system, go on that much needed vacation. You deserve it. Prices for tests and procedures in healthcare are literally all over the map, as told so wonderfully by Time in their groundbreaking article, The Bitter Pill. For example, if you get a brain MRI at one institution versus another, this may be the difference between you paying $500 vs. $2500 out of your deductible. That’s the difference between you going on vacation to Rio, buying that new MacBook Pro, or doing whatever your little heart desires with a cool extra $2,000 in your pocket. The obvious next question is, “Well I can only assume that if I get the test done at the $2500 place, it’s going to be $2,000 worth of higher quality and value, right?” Wrong. Healthcare costs are in no way correlated with quality and value. The same goes for procedures too. If you need an inguinal hernia repair, you’re going to quickly blow through your $10,000 deductible if you get it at one institution vs. another. But what if you can negotiate with a general surgeon for a better price? Instead of spending $10,000 of your deductible in a hospital center, you could spend $4,000 to have the procedure done in a beautiful outpatient surgical center. Now that’s $6,000 of real money you just saved.
That’s why I’m ridiculously happy to announce that Sherpaa just released a new feature in our app to help you save a potentially ridiculous amount of money when you need an expensive test or procedure. You can now tell us your story and what you need, and our doctors and insurance guides will collaborate and find you the highest quality place to get these at the best price.
I’m so damn proud of this. A resource that can save you literally thousands of dollars can make a huge difference in your life. So if you’re a Sherpaa client, give it a try and instead of throwing money blindly at an opaque, unfair system, go on that much needed vacation. You deserve it.

Prices for tests and procedures in healthcare are literally all over the map, as told so wonderfully by Time in their groundbreaking article, The Bitter Pill. For example, if you get a brain MRI at one institution versus another, this may be the difference between you paying $500 vs. $2500 out of your deductible. That’s the difference between you going on vacation to Rio, buying that new MacBook Pro, or doing whatever your little heart desires with a cool extra $2,000 in your pocket. The obvious next question is, “Well I can only assume that if I get the test done at the $2500 place, it’s going to be $2,000 worth of higher quality and value, right?” Wrong. Healthcare costs are in no way correlated with quality and value. The same goes for procedures too. If you need an inguinal hernia repair, you’re going to quickly blow through your $10,000 deductible if you get it at one institution vs. another. But what if you can negotiate with a general surgeon for a better price? Instead of spending $10,000 of your deductible in a hospital center, you could spend $4,000 to have the procedure done in a beautiful outpatient surgical center. Now that’s $6,000 of real money you just saved.

That’s why I’m ridiculously happy to announce that Sherpaa just released a new feature in our app to help you save a potentially ridiculous amount of money when you need an expensive test or procedure. You can now tell us your story and what you need, and our doctors and insurance guides will collaborate and find you the highest quality place to get these at the best price.

I’m so damn proud of this. A resource that can save you literally thousands of dollars can make a huge difference in your life. So if you’re a Sherpaa client, give it a try and instead of throwing money blindly at an opaque, unfair system, go on that much needed vacation. You deserve it.