• Michael Docktor, MD

Reasons for Hope: Lessons Learned as a Healthcare Startup, One Year Into a Global Pandemic



It’s hard to believe a year has passed since the world changed in front of our eyes, and we began the collective observation and experience of horrific suffering, loss, fear, and, remarkably, hope. I recall our guest lecture on March 2, 2020, with our investor, David Hornik at the Yale School of Management when I predicted it would be the last trip we’d take and the last bit of normalcy we’d see for a while; sadly, I was correct. For one year now, we have watched a lifetime of entrenched healthcare practices transform almost overnight. There were changes in care delivery, changes in care needs, the miraculous fact that we have several life-saving vaccines for SARS-CoV-2 available in less than a year, and now the fact that telemedicine has moved to a standard-of-care on par with decades of in-clinic workflows -- this ingenuity is extraordinary. We have seen the unexpected speed and flexibility of the healthcare industry that has shown an ability to remodel rapidly in the midst of an unprecedented pandemic. Healthcare as we know it has changed forever. We’ve been forced in many ways to jump off the cliff, but now must reflect, refine and sustain our progress.


A Leap Forward

I have practiced telemedicine with my pediatric gastroenterology patients for nearly a decade. I have tried dozens of fledgling technologies for a small subset of patients over the years, hindered by the reimbursement models rather than by the need, efficiency or benefits to both my patients and my practice. Within days of the pandemic shutting down healthcare as we knew it, every provider (young and old) were adopting virtual care, skyrocketing its use by nearly 5000% seemingly overnight. Thankfully, the state of technology was prepared for the timing of a global pandemic in 2020, with platforms such as Zoom, Doximity, Teladoc and AmericanWell at the ready.


Beyond simply connecting with patients virtually in place of an in-person clinic visit, suddenly the world became acutely aware of the potential digital health evangelists like me have been professing for years. We’ve only begun to scratch the surface of our ability to care for our patients in their homes with tools such as chatbots and remote patient monitoring (RPM), an arguably safer and more affordable site of care in many instances. From connected medical devices like TytoCare, screening tools like Buoy Health to entirely new models of care from companies like Dispatch Health and MedArrive, we are at the dawn of a new age of healthcare, spurred on dramatically by a global health crisis.


With this shift to alternative care models, so too has the workforce of providers shifted - moving to their kitchen tables and “home offices.” As we’ve previously declared at Dock Health, the providers are not only the doctors providing virtual consultations, but rather they are also the administrative support teams from schedulers to receptionists and care coordinators who are now part of a virtual health workforce. It will come as a surprise to no one, but this workforce has been forever transformed and will likely shift everything. From practice and hospital design to, importantly, the digital tools these essential workers use to collaborate and securely help manage patient care in the future, care will look different, and it’s a good thing.


The Progress Pendulum

In the midst of a tremendous need, the healthcare enterprise shifted technologically to the path of least resistance, a phenomenon seen in the consumer space by default, but rarely seen in healthcare. As with everything in this $4-trillion-dollar industry, the pendulum will swing and the widespread adoption of transformative tools will wane. The pandemic has forced healthcare providers to examine their business models, sustainability, and unfortunately their ability to continue to care for their patients and workforce. Some providers have found this new model of virtual-first care ideal, such as the much-needed mental health practitioners, while other types of clinicians may struggle. We have seen and will continue to see hospital mergers, private equity consuming small practices and a significant shift to value-based care. I am hopeful this will all be in an effort to provide better care to patients, with a focus on primary prevention, remote monitoring and at-home care in a more cost-effective, efficient and reliable form.


With this tectonic shift in how we provide care, virtually, financially at-risk and with a distributed workforce, the need for digital methods of collaborating as a cohesive care team becomes even more critical. This is an immediate requirement the electronic health records have not and are not prepared to serve. Unfortunately, as in other times of need, providers may take the path of least resistance, placing patient privacy and protected health information (PHI) at risk as they leverage consumer tools for patient and practice needs.


Educating the Market

As a company, we’ve learned so much in the last year. In a brief, yet unprecedented time we have built a virtual-first company, raised capital, grown our remote team and learned an incredible amount from our amazing customers. We have observed the macro environmental changes in healthcare and feel uniquely situated to support this new world of distributed clinical and administrative teams, care at home, RPM and the need for secure collaboration tools. We've also learned how naive the healthcare market is to the concept of task management. While many industries have been transformed by task and project management solutions like Trello, Asana and Jira, my informal Twitter poll (and hundreds of conversations) suggests that 80 percent of healthcare professionals have either never used or

even heard of these multi-billion dollar

companies.


We have learned the challenges of culture and why practices remain so entrenched in healthcare for decades, particularly in the enterprise. But, we have also seen the power of innovative thinking, of bringing the best of other industries into healthcare and care transformation. We have seen how powerful our platform can be for practices, providing structure, accountability, visibility and efficiency to otherwise error-prone workflows. Simple things like onboarding a new patient to a practice have proven to be particularly challenging for practices to coordinate among their team members and erode the fragile patient experience. With a collaboratively designed workflow, clarity of responsibility and visibility into the status of a process by the team, everyone is rowing in the same direction, efficiently and reliably. We have also learned the power of integration and automation and continue to work tirelessly to reduce work for providers, meet them where they are with the tools they use (electronic health records and email, for starters) and provide structure and high-reliability to inefficient and complex practices that are at risk of dropped balls (and HIPAA fines).


We are incredibly bullish about the future, from a macro perspective on healthcare that will be more nimble, virtual, digital and collaborative. And also from a public health perspective, there is new light at the end of this dark tunnel, and we are quickly approaching a next normal*, with tremendous hope and reason for scientific optimism. As a company, we are incredibly proud of what we have built and the lessons we have learned from our loyal customers. We look to the future with great anticipation as providers become wise to the need and power of secure collaboration and the clarity of purpose, accountability and high-reliability that can be gained with a shared workflow management system.


We will continue to serve all providers in these and other areas of need. We welcome the opportunity to support you, as well.


Better collaboration = better care.


*McKinsey, 2020



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