Sramana Mitra: I experienced this with my grandmother about five years ago. This was in India. She was in a coma essentially and she was not responding. It was about 18 days. We would have been happy to let her go but no one would let us do that. She was 87 years old.
Girish Navani: I won’t say it’s easier, but some of them are more rational. I don’t know about this one because I have actually struggled with it internally. I like to tout the idea of health and wellness and I have somehow tried to avoid such situations. Maybe the person inside me doesn’t know how to react when faced with a decision like this myself. I would always say that if it’s better for the patient in terms of pain and outcomes, then it’s an easier one. If it is not, then which way do you go?
Sramana Mitra: It’s a tricky one.
Girish Navani: If you look at why we get two X-rays done for the same tooth when we visit two different dentists, one for our initial and one for the oral surgery, you’re costing the system twice and you’re getting no better outcomes.
Sramana Mitra: Those are unnecessary.
Girish Navani: Those are unnecessary. Those should go.
Sramana Mitra: There’s a tremendous amount of optimization to be done just in the system that would dramatically cut down cost just by moving things properly, quickly, and efficiently.
Girish Navani: With better drug trials leveraging this health technology to try and see which meds have better appeal, I think technology can create that big change that it needs. You and I can still come back to end-of-life and deal with it.
Sramana Mitra: Take the low-hanging fruit.
Girish Navani: Let’s take the person who’s living healthy and try and have them live healthier.
Sramana Mitra: The trend lines are all very good. This is encouraging. There are all sorts of bad things happening in the world—ISIS and nonsense like that, but this is a very good trend line that there is actually technology adoption and cost reduction. All these things that need to happen in the healthcare system are all happening.
Girish Navani: Since you brought up international, we have an interesting customer that has signed up with us. They’re based in Israel, but they are healthcare providers in the US. They allow international patients to seek second opinions online and they’re going to use eClinicalWorks technology for it. This is amazing. You get a specialist in US who is probably the thought leader in that space and knows a lot about that domain being able to provide an online second consult to somebody else in the world. It’s fascinating.
Sramana Mitra: What is the business model?
Girish Navani: The patient pays for getting their second consult.
Sramana Mitra: It’s a private consult.
Girish Navani: Yes, but nonetheless it is something that creates value. There are intriguing models coming up like this and will be fascinating to have someday. I hope we can cross state lines in terms of healthcare delivery regulation. I don’t understand. If you can be a doctor in Connecticut, why can’t you be a doctor in Massachusetts?
Sramana Mitra: Yes, then there are other possibilities of course because if everything is possible digitally then you can train your software to be able to take that data, analyze that data, and come up with diagnosis and all kinds of things. The doctor can do it, then the software can do it.
Girish Navani: I’d get into trouble for saying that. I’ll say this, technology can definitely assist healthcare.
Sramana Mitra: Come on! We’re computer scientists. Doctors memorize and learn what the algorithm and the heuristics are.
Girish Navani: So technology is helping physicians with better decision-making. We start giving them some understanding of outcomes based on prior historical data, which can be computed a lot more quickly.
Sramana Mitra: This is not in the 5 to 10 year-timeframe but it’s definitely in the 50-year time frame. There is a much bigger role that software plays in the diagnosis process.
Girish Navani: According to Harvard Business Review, robots are going to be helping in surgeries a lot faster. Actually, my neighbor sells into this space. He believes that robotic surgery is evolving very fast.
Sramana Mitra: That was a great discussion. Thank you very much for your time.