What Makes Healthcare Providers Buy? A Conversation with Michael Millenson

Michael Millenson started off his Health 2.0 Keynote by explaining how Harvard-trained surgeon Dr. Ernest Amory Codman had the bold idea of giving individual hospital outcomes information to consumers back in 1913. Unfortunately, he was quickly ostracized from the community, but Codman’s tenacious advocacy laid the groundwork for the outcomes-based approaches we are developing today.

Millenson Informal Photo

The Health 2.0 Fall Conference is a place where you can bump into the superstars of healthcare innovation and discover how approachable most of them are. I was so fortunate to chat with  Michael, a guy whose unique efforts caused National Public Radio to call him “in the vanguard of the movement” to measure and improve American medicine.

Michael is the author of the critically acclaimed book, “Demanding Medical Excellence: Doctors and Accountability in the Information Age,” and is an adjunct associate professor of medicine at Northwestern University’s Feinberg School of Medicine. He is also President of Health Quality Advisors.

Despite his accomplishments, Michael surprised me with his willingness to share his knowledge and ideas about healthcare technology. Instead of going to a session as he had intended, Michael graciously shared his time and thoughts while we had coffee and fresh fruits on the outside terrace on a crisp, sunny morning in Santa Clara.

Omar Shaker: What are some of the important criteria an entrepreneur should think of when developing or deploying technology for a provider?

Michael Millenson: I’ve worked with many providers before, and I think the number one thing they say is, “Don’t mess my workflow, don’t make my life worse!”

This wasn’t the case with adoption of electronic medical records (EMRs), because the whole health care system was changing and there were millions of dollars being paid by the government but generally speaking, interfering with workflow is a deal killer.

The app that a vendor brings in to me today is different. It’s probably giving me the capability to do something I don’t absolutely have to do, and so first thing is doing no harm to my workflow or my organization’s workflow that could negatively impact morale and revenue.

If you build on that, on “first do no harm,” then how does your product integrate into my EMR? Who has to use it? How do I use your dashboard and what do I do with that information?

OS: So how can an organization assess if it does, in fact, need that information?

MM: Illinois Hospital Association chief health officer Dr. Jay Bhatt’s example we heard in this morning’s session was perfect, talking about using data to track down cases of lead poisoning in Chicago. He he didn’t just tell you as a provider where the lead poisoning cases were and how he found them, but that there was a law in Chicago where kids had to be tested for lead poisoning. So that tells me if I am a provider, having the ability to generate this data fills a specific need for me.

The lesson here is to examine whether your product fulfills a regulatory need or can make use of data that comes from regulation. Then one level further is, “Does this product have an ROI (return on investment)? And what level of priority does it have for my potential customers?

If you were to sell a solution that would help hospitals reduce their readmissions a decade ago, no one would have bought it! Now that there are regulations and a direct ROI, every institution has made reducing readmissions a high priority.

OS: How do providers choose between all the different, ever-expanding list of digital health vendors?

MM : There are 2 things to think about here: Does the digital health product really perform the way that’s promised? And then, does the solution scale? Will it work for different patient populations, doctors and complicated cases?

At the end of the day, patients are different and are complex. There are all sorts of social, adherence and financial issues that get in the way. And so the 40-year-old married secretary who works for a Fortune 500 company in Chicago may not react the same way as the single mother in Reno, Nevada.

OS: If you’re a provider choosing a solution, how can you know if it will work well for you?

MM: Proof of concept data, pilot projects and white papers are all important, but I think the most critical way to assess a technology is to simply talk to the people who have used it before. Digital health solutions aren’t new drugs, and you don’t need a randomized control trial.

I’m very big on site visits and talking to people. I think nothing can replace that, but, at the same time, something may work in one environment and not work in another. “Know theyself.”

OS: You are one of the veterans on this nascent industry, how do you think it has changed and where do you think it is going?

MM: I would say 80% of the apps we’ve seen this year at Health 2.0 sound and look really great. The interface and ease of use really count. However, some solutions that look great don’t work as well when you kick the tires.

Unfortunately, some solutions have not gone beyond the “great screenshot” concepts of the early 90’s. Having said that, the industry has matured and become more sophisticated and realistic. I am very encouraged by what I see.

Today’s digital health vendors are trying to solve critical problems, and are involving those who understand those problems, including patients, patients’ families and physicians. They are more sensitive to workflow issues.

The industry is maturing, and I think as the technology evolves, our expectations for reliability, scalability and effectiveness will evolve, as well.






Omar is a physician, writer and data analyst. After realizing the potential of exponential technologies to reshape the inefficiencies of healthcare, he left medicine and moved to San Francisco to immerse himself within the network of entrepreneurs in Silicon Valley, while working on technology projects of his own. Omar frequently writes for Health 2.0 News while consulting major organizations with the Healthcare Practice of Clarity Solution Group. View all posts by OMAR SHAKER →

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