Charlie Lougheed: There’s a mix of different vendors in the space. There are those that are pure play technology vendors—the IBMs and the Oracles of the world that often purchase technology and then configure and deploy it to run, oftentimes, behind the firewalls within these organizations. Another component from the competitor standpoint is actually some of the payers themselves. They form or acquire technology companies so that they can offer these services to the providers—usually in a cloud form, which is somewhat similar to what we do.
Then there are folks like Explorys that focus almost entirely on providing these types of cloud-based services, data assets for better intelligence, and the ability to form clinically integrated networks across different providers and deliver that care.
Sramana Mitra: Whom do you see in deals when you’re trying to sell to medical groups?
Charlie Lougheed: Optum is a good example. Optum is a subsidiary of United Healthcare. The more pure plays are IBM and Oracle. In some cases, we partner with some of these organizations. In other cases, we compete. Another one would be the Advisory Board. They have a product called Crimson, which we compete against.
Sramana Mitra: I’m going to ask you some industry trend questions. Given your vantage point into the healthcare ecosystem, what trends do you see?
Charlie Lougheed: One trend is in who bears the risk and who manages the risk. That’s a big one. The evolution from fee-for-service to value-based care means that healthcare organizations have to become masters of the data and masters of risk. As they do more and more of that, it begins to beg the question of where does the traditional arrangement fit in all that. Traditionally, payers are using data that’s very wide-reaching to determine actuarial factors to price premiums such that they can ultimately make a profit. Healthcare organizations have never had to do that before. Now, they are.
Another trend is that healthcare organizations are beginning to think differently about their customers. When you say customer to a physician, they don’t usually think of a patient. It’s a little different relationship, but the fact of the matter is that the economic relationship is shifting and changing. Just look at organizations like Castlight that help individuals, particularly those that pay for some of their care. All of a sudden, it matters how much you pay for an MRI machine. That’s a big change in the space. That’s clearly another area of shift in evolution.
I think that evidence-based medicine is one of those things that was difficult to do at scale. In addition to that, often, when a physician was told, “You’re outside the norm.” That physician was easy and sometimes fair to make the argument, “My patients are sicker. I’m different.” But if you have enough data to look at, a lot of that normalizes out. It makes it easier to be able to help these organizations and people within them see where they could begin to behave or apply their skills differently.