I dont know about EHR, but video killed the radio star

Video killed the radio star.
Pictures came and broke your heart
So put all the blame on VCR

We’ve seen it happen before, and it repeats itself – something will always replace the current best thing.

Myspace killed Six degrees (and many others); Facebook killed Myspace.

Healthcare in general has been making great advancements within itself. The infusion (and overlap) of tech advancements with healthcare have helped accelerate health IT disruption. Technology and specifically mobile devices have significantly changed how we communicate and interact.

Email killed paper mail; SMS/Text messages killed phone calls; WhatsApp killed SMS.

Mobile killed the Desktop.

The introduction of Electronic Health Documentation gave us Electronic Health Record (EHR) systems, killing paper based documentation. While many software vendors existed in the EHR space, government incentives brought on a whole set of technological initiatives and helped Health-IT become a hot space leading to mass disruption.

With the help of wearable devices, mobile devices and apps, continued government incentives and startups, innovation in Health IT is happening multidimensionally.

As more people move away from emails, phone calls and in-person discussions to Tweets, Facebook posts, WhatsApp and other quicker ways to interact with others, the reliance on mobile technology grows and becomes the preferred way to communicate.

Personally, VOIP was big for me since it allowed me to call my parents internationally without paying ridiculous land-line rates (thanks Vonage); this then transitioned to Skype where my dad would facilitate the calls for my mom since it was still slightly “technical” as you had to use a laptop. Today, my mom Skypes me with her iPhone, and while, she cant type, she sends me audio messages via WhatsApp. I send her videos and pictures of the fun things we do and she loves receiving them. Without all the innovation in technology, I’d still be paying $3 a minute to call her.

It goes without saying that the way people communicate and interact has constantly evolved over time.

Adoption of technology varies by generations/age-groups as someone below 50 is probably more included to use technology than someone over (respectfully ignoring outliers here). The doctors and nurses who preferred paper based documentation over electronic have probably retired by now (again, ignoring outliers), and if the current/next younger generation(s) are more readily going to adopt technology, how does their daily tech use influence how they want to work with technology in Health-IT?

When my kids see a Kiosk, they almost always expect it to be touch friendly, just like any device with capacitive touch, and when things don’t drag, or respond to their touches they get frustrated.

Previously I wrote a quick post on Innovating the Physicians Inbox which used a twitter look/feel to present content in a way that makes it quicker and easier to digest; with intentional drill downs to get additional details/info.

Today, “Secure” text messaging, is making it rounds in Health-IT since almost everyone has a device on them and communicating using their device is just more natural. These secure text message apps pretty much take the idea behind “WhatsApp” (message, audio, image, video, real-time chat) and wrap security around it (HIPAA) and while this accomplishment isn’t small, it’s still missing a major piece.

I remember using IRC back in the day, it was useful and fun. Several months ago, I ran into Slack and I fell in love with it. With its big and powerful integration capabilities, it was a game changer… while it may not be here to “kill” anything, it is definitely the platform to wrap everything else under. Using Slack integrated with: asana + bitbucket + crashlytics + dropbox + raygun + Jira meant that I no longer had to visit any/each of those platforms directly. I had one tool to consume them all, and best yet, was that I could collaborate with all the people I needed to, in one place, with the needed context.

And that is exactly, what is missing from these “Secure” text messaging apps – Context; specifically, Patient Context.

Without integrating with EHR systems, there is a disconnect between the context and the discussion. By integrating with other systems, Slack makes the external context, internal and the collaborative discussion becomes more meaningful.

While today’s hype is around “Secure” text messaging as a tool that helps collaboration, it really should be about collaboration as a platform (rather than a tool). While this platform wont “kill” EHR and other systems, it will integrate with them so that providers can more naturally collaborate on patient care leading to improved communication among care providers as well as communication between care providers and patients leading to a higher quality of care.

The Leadership skills you know you don’t have.

Previously I posted this on leadership skills and while I was recently reading it again, I realized that I now disagreed with something I had said earlier:

I have come to realize that some are leaders in one function (Project), others may be a mix in two (Functional and Technical); In my opinion (and conclusion), one must continue to grow their leadership by improving skills in other areas/domains that are not on-par with the rest.

People (followers) expect their (great) leaders to roll up their sleeves and get their hands dirty, so great leadership is well rounded and should be able to tackle any problem.

I now disagree and think that great leadership is not always well rounded; while its important to continue growing; there are going to be areas that one might just completely sucks at. it’s important to realize that and know what your weaknesses are and plan for them; ideally by putting others in place that can help cover them……….. or by learning how to suck less at them.

Have a plan, bring on and place great people… that’s what really counts.

The kitten and the mouse.

There was a kitten and there was a mouse.

Every evening the kitten would cry at the mouse. “Come out and play”

But the mouse would not come to play.

Yet, every night the kitten cried for it to come play.

After a long time, the mouse finally decided to come out to play – and the kitten, now a cat, killed it.

That is the reality of the cat – and the fate of the mouse

Innovating the Physicians Inbox

Remember Gmail back in 2004? How about Yahoo mail back in 1997 or Hotmail in 1996? Regardless of what you are using for email, its evolved & improved (you may or may not agree) – it has changed.

From tags, to filters, to conversation grouping (my favorite) to other tricks and hacks… all to make email more – manageable.

I entered the Healthcare industry a few years ago (I am no doctor), and while my medical and healthcare knowledge is minimal, I can certainly say that there is ample opportunity to innovate.

So why the mention about email? For me, it was interesting to see and learn that in a clinical environment there is “so much going on” and that physicians want a “systems that can give them information without overloading them”. There are definitely challenges in doing that, because what you decide to leave out for the sake of simplicity might actually be needed, by someone, somewhere.

It all starts with the “Inbox”; that’s where all their results, orders, alerts, etc show up regarding all the things going on around them: Have a look at some of the interfaces they currently use, reminds me of outlook express and outlook 2000.


google searched source | Demo Video |GE’s system

Some have tried to replace the entire Inbox, but why would you want to replace such a core functionality in the first place? The ones who use these systems day in-day out know exactly where to look for what they want, yes there is a lot of information and it can get cluttered., so why not build complimentary products that help deliver a smaller snapshot of the big picture – it’s like searching for something on google, you get a general idea of what the page might contain in the return results and you can then decide if you actually want to dig deeper.

It would be neat if you could take all this information, and funnel it into some sort of relative context that “tells you a bit about everything” and then you can funnel down to a “tell me everything relative to this one thing”… Someone must have surely done this already, maybe not for physicians/healthcare, but for some other “busy” information context; hasn’t anyone done this???

If you followed this blog post through twitter, then you are already on a platform that does just this. If you used twitter on the iPad, then you are already using a design that I used as inspiration for my idea for what a Physicians Inbox (Providers Inbox) could look like.


This is still a rough idea, there are several things to consider but it would definitely be fun to change the way physicians interact with their inbox.

eCommerce tooling: Build vs Buy

When you can’t quite find something that fits the need, don’t give in and accept “almost” or “good enough”; don’t settle.

Blank Label needed an eCommerce platform that supported several custom parameters (shirts are complicated). Several were looked at but they didn’t fit; we built our own.

We needed a user experience that allowed dynamic visual updates – theres lots of crap out there, we custom built our own.

We needed to account for manufacturing and our fulfillment, we built our own.

Analytical – several great products out there, we did not build our own 🙂

Email that went out in mass volumes – Thank you sendgrid.

We tried several customer engagement/referral reward solutions, coupon management, gift certificate generation, sales commission – stuff. They didn’t work, we built our own.

We’ve built a lot of stuff – and perfected it. We’ve also learnt a lot about our customers and the way they like to shop and be engaged. We also learnt when to buy and when to build.

There are some exciting things in the pipeline for the stuff we’ve had to build and what we would like to do with all of it.

Stay tuned!