Thought Leaders in Healthcare IT: HealthRight CEO John Palumbo (Part 2)

John Palumbo: It’s really difficult for the average American family to get access to primary care physicians. Now, you have about 80% of the adult emergency room visits happen because there’s no access to a physician. Our members basically get access to a nurse, on an average, in about 12 seconds and are able to have a consult with a physician in under 30 minutes. That physician can help write orders, guide them to the appropriate care they should have, whether they should go to an emergency room or an in-person visit.

The interesting part is 80% of those adult visits, 47% are not emergency cases. That’s a good example of how when you have immediate access with a trusted provider, you’re able to get the kind of care when you need, how you need, and at the best price that you can get.

Sramana Mitra: Let me ask a couple of question to see if I got this right. You are running, essentially, a virtual network or call centre of nurse practitioners and physicians and these are available on-demand for a fee to either your B2C customers or customers who come in through corporations or other hospital systems. >>>

Thought Leaders in Healthcare IT: HealthRight CEO John Palumbo (Part 1)

The US Healthcare system has much to be desired. HealthRight is trying to address a portion of the challenge.

Sramana Mitra: Tell us a little bit about yourself as well as introduce us to HealthRight.

John Palumbo: My career stands almost 30 years now in healthcare. I’ve been very fortunate to have a fairly diverse career in the sense that I’ve done two startups. Both of them went public. One still remains a publicly traded company and is AllScripts, which is arguably one of the largest electronic medical record companies in the US. The other company was a company called I-Trax.

We got on the American Stock Exchange, grew it from a startup up to about $150 million. Ultimately, that company was sold to Walgreens. I also had an opportunity to work with two Fortune 100 companies in between. I have that diversity in large and small companies. In 2010 when the Affordable Care Act got passed, I was doing investment banking. >>>

Thought Leaders in Online Education: Norm Wu, CEO of i-Human Patients (Part 7)

Sramana Mitra: That’s a good thing because your contribution is in enhancing the quality of education, so the ones who don’t have that quality of education will gain more from your technology.

Norm Wu: Right. Just like with MOOCs, you can go out and find the best educators and the best content. We’ve had a major effort to build the world’s largest database of evidence-based medicine tying symptoms and diagnosis together. You can take all that and you can make it available not only to the other 90% of the US but to all the schools around the world in a very scalable way. You need nothing more than a web browser. There’s no software to download. There are no plugins.

We simulate everything in the cloud and then we push it out through just an HTML5 web browser. We’ve got a lot of technology behind that, which is why the NSF is funding us. When we think of our mission and vision, we are thinking about how we will take the best content and the best way of delivering learning through active simulation and making that scalable to the entire world. That’s what we’re excited about. >>>

Thought Leaders in Online Education: Norm Wu, CEO of i-Human Patients (Part 6)

Sramana Mitra: We know quite a bit about that segment—stuff like Concordia’s huge programs in nurse practitioner training. Do you provide the content infrastructure for them?

Norm Wu: It’s very much the same model. They can either create their own cases or they can license cases that we’ve worked with outside educators on. Our move into nurse practitioners education, which now accounts for over half of our customer base, has been more recent. Our cases, by and large, have been developed by medical school educators but they’re using them anyway.

What we’d like to do is develop a whole series of cases that are developed by nurse practitioner educators and which are more targeted towards them. As you may know, with a nursing background, you tend to think more holistically about patients. When you’re asking them questions about their medical history and symptoms, you may ask about what’s going on at home that’s causing the stress that is contributing to the illness. >>>

Thought Leaders in Online Education: Norm Wu, CEO of i-Human Patients (Part 5)

Sramana Mitra: Let me actually question a few things on the more specialized learning in the medical school process. In terms of the different specializations, how much coverage have you accomplished so far? This is a very intense body of simulation and content that you need to be able to deliver.

Norm Wu: Our company is only three years old. i-Human Patients was formed in November of 2012 but we actually absorbed the technology from a predecessor company that our founders had which made standalone clinical and physiological simulators. What we did was integrate all of these standalone simulators together into a complete interactive multimedia-intensive patient encounter. Then we overlaid on top of that an authoring system.

We don’t have nearly as many cases as we would like to have eventually, but we have way more than anybody else out there with any sort of virtual patient program. We have approximately 350 different case scenarios and about 200 different programmable avatars. We have three or four configurations of each case scenario. >>>

Thought Leaders in Online Education: Norm Wu, CEO of i-Human Patients (Part 4)

Sramana Mitra: I have a question here. This material that you’re developing and making available in a cloud-based model, do you develop the content and the whole infrastructure for delivering this content?

Norm Wu: No. We have the technology platform and we work with outside medical educators to develop the content. There are really two different models. One is the crowdsourced model where institutions take our platform and develop their own content. We have an authoring system that’s supported by a very large medical media asset repository so they can create their own cases. In that crowdsourced approach, they develop it for their own use and then make it available to others. They allow other schools to take their cases and make derivatives of those cases.

The other approach that we have is to sponsor peer-reviewed cases that are developed by experts across different institutions. We have had 86 different educators under part-time contract. Those cases are then sold to other schools. Those cases may have been funded by us or may have been funded by folks like the American Medical Association, which has been very interested in what we’re doing to transform medical education. >>>

Thought Leaders in Online Education: Norm Wu, CEO of i-Human Patients (Part 2)

Sramana Mitra: Tell us a bit more about i-Human Patients. What do you do? How do you do what you do? What are the trends that we see in play in this particular venture?

Norm Wu: We are fundamentally an online education technology company. We’re focused mainly on the healthcare professional vertical market. Specifically, we make virtual patient technology. This is a cloud-based platform to simulate life-like patient encounters all for the purpose of developing and assessing what are thought of as very difficult, critical-thinking, and cognitive competencies. These are things like, “How do you assess and diagnose patients quickly, accurately, and cost effectively so that you can treat them appropriately?” It’s what we think of as the Sherlock Holmes part of medicine.

What we are doing is really addressing two very large pain points. One is basically the quality of care. If you look at the research studies, you’ll find that anywhere from 5% to 25% of patients are misdiagnosed, and half of those misdiagnoses can actually be harmful. It results in 40,000 up to 150,000 avoidable deaths each year. It accounts for a very, very large portion of the $700 billion to $1 trillion of unnecessary healthcare that is being spent. >>>

Thought Leaders in Online Education: Norm Wu, CEO of i-Human Patients (Part 1)

There will be an acute need for trained medical professionals as healthcare becomes democratised around the world. Norm discusses what his company is doing in this very important realm using online education principles.

Sramana Mitra: Let’s start by introducing our audience to yourself as well as to i-Human Patients. What do you do? What trends are you working with?

Norm Wu: I’m a serial entrepreneur. Even in high school, I had a little bit of entrepreneurial experience. I was one of the co-founders of the campus radio station. I became very interested in technology. I started working in Silicon Valley after getting my BS and MS at Stanford. I worked on reconnaissance systems for the defense industry. This was during the Cold War when we really needed to understand what the bad guys were doing with respect to radars and missiles. >>>