I consider myself a fairly fearless person. The normal slate of phobias (snakes, heights, small spaces, close encounters with large mammals in wild scenarios) have never been issues. There is only one thing that makes me quake in my heels; a completely irrational fear of needles. From blood draws to yellow fever shots, my life is littered with fainting spells, which feel increasingly ridiculous as an adult. As such, one of my missives for 2012 is to suck it up and cure my trypanophobia.

Officially recognized in 1994, Trypanophobia (fear of needles and injections) affects over 10% of people in this country–and those are just reported cases. There is a whole population for whom the fear is so great that they avoid medical procedures entirely. A side effect of trypanophobia is vasovagal syncope, which is a fancy way of saying your body goes into fight and flight simultaneously, leading to the aforementioned fainting.

As you can imagine, even considering my new year’s resolution, there is very little in life that I dread more than going within strike distance of a needle. So it goes without saying that the attraction would have to be great (exotic trip, threat of rabies, medical miracle) for me to even consider a voluntary blood draw. But when the opportunity to achieve two new year’s resolutions in one fell swoop arose (stop being a wimp and attempt to completely quantify myself*), I took it.

WellnessFX is a startup here in San Francisco that helps to uncover detailed health measurements and deliver individualized recommendations to improve overall well being. Through a single blood draw, they measure 50 different markers, hormone levels and lipids that reveal a great deal about our health. Since my ulcerative colitis diagnosis, I’ve been on a one woman mission to find possible causes and new ways to treat it. Personalized medicine is also becoming an area of increasing interest for me, and the rest of the Rock Healthers, so when I met their super smart team and started looking into the product, especially their inflammation tests, I had to do it–blood draw or not. After filling out the requisite medical history, I chose my date with destiny and waited for the magic to start. And it did, as soon as I received the kit in the mail. Along with the blood capture supplies, there was a thoughtful post-draw reward wrapped in cheerful blue tissue paper.

After about a week of mild to moderate anxiety that I’d pass out in front of everyone at work, the big day was upon me, ironically on Valentine’s Day. As with any medical test, you can’t eat for 12 hours pre-draw, or exercise/imbibe alcohol for 24 hours, so all of my usual coping mechanisms were out. But I loved that instead of being forced to go to a sterile medical facility, the draw came to me–far more convenient and comfortable. The friendly phlebotomist came into the Rock Health office, we ducked into a breakout room, replete with couch so I could do it lying down (trypanophobia pro tip #1: getting blood drawn while horizontal is far better than sitting up) and with Clare there to chat (trypanophobia pro tip #2: human distraction is your best ally), I was eating a celebratory cupcake** before I had time to think about what was happening. Non-fainting success!

And now, with a mixture of anticipation and impatience, I wait. Similar to 23andMe, the results are released a few weeks later and accessible online. A key difference, however, is the required professional consult with a doctor who will explain precisely what the results mean as well as areas for improvement or concern.

So for all you trypanophobes out there: let me be the proof that with the right environmental circumstances, motivation and a little distraction, you too can be well on your way to getting the vaccines, flu shots, and every other immunization you’ve been avoiding. Or, you know, learn something life altering that leads to better health, as this formerly needle-averse gal is hoping.

*Suggestions? Comments? Ideas or something new to try? Email me: qs@rockhealth.org.

**Special thanks to Geoff Clapp for our Vday baked delights!

Did you know that the United States has passed the 8 million patent mark? For entrepreneurs, patenting can seem overwhelming. In order to help our start-ups navigate through this vast world, we brought in Jeffrey Schox, of Schox Patent Group, to discuss what every startup should know about patent law.

Jeff began by addressing some of the most common misconceptions as to why start-ups should file, namely: to enforce against a competitor, prevent the patenting by somebody else, and to generate licensing revenues. Jeff believes that these are terrible reasons for entrepreneurs to file for a patent, as these reasons are generally too expensive, and unworthy of the start-ups time.

Instead, Jeff laid out three smart reasons that start-ups should file for a patent:

1. Stimulate investment or acquisition.  Acquiring a patent proves exclusivity of your technology, while validating the novelty of your invention.  These dramatically increase your value to a possible investor, making the hunt for funding that much easier.
2. Deter patent infringement lawsuit. While this happens silently, a patent discourages any outside company from imposing an expensive lawsuit, since your technology is protected under the patent.
3. Increase leverage over a partner. Owning a patent ensures you a “spot at the table” in future negotiations with partners brought on in later stages. In effect, a powerful partner cannot leave you in the dust, as you own the rights to the technology.

So now that we know the smart reasons to file a patent, lets get into the basics of how patent law actually works.  One of the biggest misunderstandings of patent law is the relationship between the patentability of an invention and the infringement of another patent.  In order to get a basic grasp for how these work, we will employ the case of the frosted lightbulb.  Thomas Edison created the lightbulb and is credited with the pioneering invention.  However, a man named Pipkin decided to frost the lightbulb, allowing for the ambient and cool light we have become accustomed to today.  Pipkin’s creation is known as an improvement invention.  So the question is, who can make the frosted lightbulb?

And the answer is, no one.  Neither Edison nor Pipkin would be able to produce the frosted lightbulb without infringing on the patents of the other.  The correct answer would be someone who licenses both the lightbulb and the frosting; this is known as cross licensing.

So, you think you have an idea worth patenting?  You are probably wondering when you have to file for a patent?

The United States is transitioning from “first-to-invent” to a “first-to-file” practice.  Under the current, “first-to-invent,” practice there is a loss of patent rights if the invention was: one, described in a printed publication; or two, in public use or on sale in the US, more than one year before the filing of a patent application.  Therefore, it may be smart to publish the idea of your invention, say in a white paper, before spending the vast amount of money filing for a patent.  Be sure you are committed to your complete invention before committing to the patent process.

However, under the coming “first-to-file” practice, the first person to file for patent protection would have the rights to that invention, regardless of who actually invented it first.  This will lead to more inventors applying for provisional patents earlier and more often.  These provisional patents provide 12 months of protection before requiring filling.  These provisional patents are much less expensive, and require little effort to file; therefore, Jeff recommends filling for these as soon as you have your invention nailed down.  To read more about provisional patents click here.

Now that you are equipped with the basics of patent law, you may feel the pressure to look through the 8 million patents in the US, finding any overlaps to your invention.  Don’t!  According to Jeff, in the beginning stages of your start-up, all you need to do is discover your top 5 competitors in the field, and understand the patents that they hold.  At this point in your company, your only concern should be convincing your investors that you can handle your biggest competitors, not every single patent owner in the United States.

So are you ready to file a patent?  It’s time to find the right patent attorney. Find a lawyer who has experience working with start-ups, understands your business strategy, and has the technical background to understand what it is exactly you want to patent. When you have found the right fit for your start-up, you are ready to file.  Good luck!

2011 was a big year for the healthcare start-up community and as we move swiftly into 2012, that momentum continues to skyrocket. One need look no further than Cake Health, HealthTap and Doximity to see that momentum in action from both a clinical and consumer perspective.

As an active participant in the health IT space, I wanted to take some time to provide insight into the largest health IT show around – HIMSS 2012 (HIMSS12). The show kicks off on February 20 in Las Vegas and, over the years, has grown to embody health IT innovation in action. If you’re attending HIMSS for the first time, consider these tips.

1. GOAL
Be clear and concise in what you want and need to get out of HIMSS12 in advance of landing in Vegas. It’s a big show and there’s going to be a lot of distractions, good (cool technology that might not necessarily be 100% applicable in your world but that’s thought provoking nonetheless) and bad (uh, gambling). Stay focused and map out who you want to connect with at the show and, when feasible, reach out ahead of February 20 to see if you can schedule partner, potential customer and/or mentorship meetings before the show kicks-off. Worst case, leverage Twitter to see what those points of contact are talking about so you can potentially communicate with them directly in real-time or, at the very least, stalk them in a friendly way while on site.

2. Before, during and after
Leading up to HIMSS, your best bet is to use social platforms for all their worth. For example, HIMSS has a pretty active LinkedIn page that provides a comprehensive list of folks who will be in attendance and the #HIMSS12 Twitter hashtag is also in full swing. But that’s just step one.

While at the show, look for opportunities to engage with folks in a less formal, more interactive atmosphere like the following:

• Health IT Exchange Tweet ‘n Meet hosted by @SearchHealthIT and @HITexchange
• Histalkapalooza hosted by @HIStalk
• New Media Meetup hosted by EMRandHIPPA.com
• HERSS meetup

Step three, following the show, take the time to thank those you met and connect again – you guessed it, via social. Look up points of contact on Twitter and LinkedIn so as to continue to build those relationships coming out of HIMSS12. Trust me, you’re going to meet a ton of people, but stay focused on why you came to the show in the first place. Devote time and energy to forming a mutually beneficial relationship with key individuals that map back to your aforementioned goals. You’ll want (and need) to leverage these contacts in the coming months and beyond, so “water” your new relationships immediately following HIMSS12.

3. Be smart and strategic with social
It’s easy to get completely overwhelmed with social media. Should you be leveraging Google+, Facebook, Twitter, LinkedIn, Quora AND Focus? That’s an easy one – not unless you have an endless supply of resources and time to throw around. Wait, you don’t have that? Me either.

Instead, create a targeted list of influencers – say 10 to 15 – people that you feel can help drive your business forward. These might be core trade media experts, like @GovHIT, or bloggers who’ve made a name for themselves, like @ahier, or maybe socially savvy doctors like @jhalamka (note, not 100% sure he’ll be at HIMSS. Still, he’s undoubtedly a thought leader in the health IT space so engaging with him is worth your time). Whoever they are, the key is to keep the list targeted and the communication personal so as to avoid “machine gun” communications. And look for social events that your key resources may already be participating in like the #HITsm Twitter chat that takes place every Friday at noon CT. Again, it all comes back to identifying who can help drive your mission forward and creating a symbiotic relationship with those resources.

4. Come equipped with insight into the key compliance and regulatory issues and how they play into your company/product
You’ve got to be able to walk the walk and talk the talk. Don’t come to HIMSS without complete confidence that you have a solid understanding of the major issues the healthcare industry is dealing with from a regulatory and compliance perspective. Some key topics you should have a handle on are listed below, and don’t forget to have a good grasp on related timelines and/or deadlines:

• ACOs
• FDA Mobile Medical App Regulations
• ICD-10
• Interoperability
• Meaningful Use

And lastly, if your start-up is tangential to any of these topics, make sure you do a deep dive on the related HIMSS12 sessions. For example, if you dabble in interoperability, you’ll definitely want to book some solid hours at the HIMSS12 Interoperability Showcase.

5. Map out your must-see’s (no really, get a map of the booths at the show and create a plan of attack!)
It goes without saying that you should probably check out Nuance’s booth #3523 if for nothing other than a friendly face, to see the latest in voice recognition and language technologies in action, and for some hands-on touchscreen technology. In all seriousness, make sure you have reliable access to a digital map or at least a printout version. It’s an expansive space and in addition to having a mapped out plan of attack, you’ll need to wear solid shoes that are kind on the feet. Save your special shoes for the “Inga Loves My Shoes Contest” at HIStalkapalooza.

6. What do you want to be remembered for?
Before you head to HIMSS12, you’ll want to determine how best to spread knowledge of your company, its capabilities and, well, yourself. HIMSS is “paperless” so as you pull together a potential press packet and/or any type of leave behind, remember proper protocol is to go digital whenever possible. One alternative to the paper press packet is to save all of your key content onto thumb drives. Just make sure you map the content back to the audience you’re handing it off to. In other words, potential partners probably don’t need a glossy headshot of you on that USB – media on the other hand definitely do.

7. Pass the torch
You can be sure that we’ll be sharing key insights and thoughts after the show via our blog, For the Health of IT. We recommend you follow suit. Don’t have a blog? No sweat. Look for other reputable bloggers in the space and pitch yourself as a subject matter expert. You’ll need to take a stance on something(s) at HIMSS that got you excited. Keep in mind, the more controversial that “something” is, the better. In addition to positioning yourself as a thought leader whether via your blog or another expert’s, this also affords you an opportunity to share insight from HIMSS with those who may not have been able to attend the event this year. In other words, share lessons learned and pay it forward.

Although here in Chinatown it’s technically the year of the dragon, 2012 is my personal year of quantified self. After several well-intentioned but poorly executed attempts to understand my food intake, sleep, exercise, etc, I’m committing to a steady diet of apps, devices, scales, wristbands, tests and tools for the year. The goal? To first get a baseline of my physiology and overall health, then find small easy changes (think BJ Fogg’s 3 Tiny Habits) and continue to ferret out amazing new companies. Note: this is NOT about short term weight loss or fads (as those who know me can attest, I’m pretty healthy in general) but rather an attempt to find meaningful, long term small tweaks to live a healthier life.

For those of you not yet privy to the quantified self movement, it’s all about self tracking through numbers, then (optionally) sharing what you’ve deduced from this glut of data. While there are an increasingly large number of products designed to help, I’m especially interested in tools with the ability to export data, those with an iPhone and/or web app component, completely passive tracking (sensors are tip top) and anything else with a major cool factor or life-changing potential.

Although I’m just getting started, here are a few things I have tested or am currently testing now:

• 23andMe (personal genomics)
• MyPlate (food diary)
• Sleep Cycle (sleep patterns)
• Heart Rate
• Stress Doctor
• Runkeeper (outdoor exercise tracking)
• Pedometer
• Zeo Sleep System

My first big commitment for 2012? Throwing aside my fear of needles (gulp!) for WellnessFX‘s panel of 50+ diagnostic tests. Details forthcoming, but it’s an amazing product thus far.

Suggestions? Comments? Ideas or something new to try? Email me: qs@rockhealth.org.

Last Thursday, Rock Health hosted HIPAA specialist Stefano Quintini, of Fenwick & West, to help our entrepreneurs maneuver through the sticky issues associated with HIPAA. When and how HIPAA applies to health-tech companies is complex and confusing, and often full of stereotypes. Stefano tackled these difficult gray areas by first outlining what HIPAA actually applies to: covered entities and business associates.

Covered Entities (CE): health plans, healthcare providers, and healthcare clearing houses
Business Associates (BA): anyone who performs functions on behalf of covered entities that involves personal health information

So, now that we know who may be liable under HIPAA, let’s look at what is covered.

Protected Health Information (PHI): Any information that relates to the individual’s health or condition, information on the provision of healthcare to the individual, or information regarding the payment for the provision of healthcare to the individual.
Personally Identifiable Info (PII): Data such as name, address, social security number, etc.

In order for HIPAA to be applicable, both PHI and PII must be present, in conjunction with a CE. Here are a few case studies:

Case 1: An application that provides personal fitness data to the user
In this situation, a vast amount of PII exists; however, no PHI exists (only fitness data, which is provided solely to the user) and therefore, this is not covered by HIPAA.

Case 2: An application that takes their users healthcare data, and provides it to physicians in aggregate form
Under this case, there is no PHI or PII, since no single user can be identified from the aggregated data, and therefore, HIPAA once again does not apply.

Case 3: A monitoring application that reminds patients to take their medications in a timely manner
In this situation, there is PII and PHI; however, since there is no covered entity involved, and the information’s final destination is the user, HIPAA has no reign.

Case 4: A monitoring application prescribed by a physician, or an application that provides data to the physician
Under these conditions, there is PII and PHI, which is provided to covered entities; and therefore HIPPA applies.

So what if you have an application enforceable under HIPAA? There are a few strict rules that must be followed in order to be HIPAA-compliant.

Privacy Rule:
Applicable to all CEs, the use of PHI other than for treatment, payment, or healthcare operations is strictly forbidden unless written authorization is obtained. For more detailed information on the Privacy Rule, look here.

Security Rule:
This rule, pertinent to all CEs, covers the standard safeguards related to health data. This rule deals with the administration, physical, and technical aspects underlying healthcare data. For example, how the data is stored, how the administration documents the data, and how the data is encrypted. While there are many required aspects to this rule, the standards are flexible; and it is important to understand the required versus addressable standards. Finally, it is very important to notify the HHS in the event of a breach of security. Read more here.

These obligations apply to all CEs. But you may be wondering how the BA fits into HIPAA policies. According to Stefano, there is one golden rule that all BAs should follow: the BA can’t cause the CE to breach its HIPAA obligations.

BA obligations:
Required to enter into business associate agreement with CE.
After the HITECH Act:
Comply with HIPAA’s business associate safeguards on use restrictions
Comply with Security Rule
Notify CE in case of breach

Read more information on BA obligations, in addition to sample BA contracts, here.

HIPAA is a complex subject that’s impossible to completely cover in an hour’s time. However, we hope this introduction will lead our start-ups (and yours) to the path of successful compliance.

Last year marked a four-year low for Americans covered by employer-based health insurance, and a four-year high for those that are uninsured. Gallup notes two reasons for this: “either some workers can no longer afford the rising cost of the health insurance the employer offers or the employer is simply not offering health insurance any longer”.  There are also an increasing number of part-time workers, who are typically ineligible for employer-based health insurance.

Healthcare costs continue to rise, and a 2011 Kaiser Family Foundation survey found that annual premiums for employer-sponsored family health coverage increased to $15,073 in 2011, up 9 percent from 2010.

But fret not!  There are a handful of smart startups in this space, to help you and your employer reign in costs:

• Bloom Health helps employers control their health care spending & helps employees spend their benefit dollars wisely
• Cake Health is a central place for all your healthcare plans online
• Castlight Health enables employers  lower the costs & provides individuals with unbiased pricing and quality information
• Change:Healthcare helps you analyze claims data
• My Health and Money makes shopping for health care easier by centralizing financial information
• Simplee helps with tracking medical expenses & managing health care costs

Your question has multiple parts: identifying the right physicians, “getting to” them, and then selling them on your idea and convincing them to want to be a part of it.

The good news here is that doctors — even very renowned ones — are often as excited as you are about new technologies to help patients, and might be more interested in meeting with you than you initially may assume. However, do note that a lot of traditional medical device and pharma companies (both startups and major players) approach them often, so physicians have become accustomed to a certain level of attention and professionalism (with some variation depending on the specialty). Be sure you’re buttoned-up before approaching anyone; it’s worth the investment ahead of time. You’ll find the forethought to be more challenging than the actual tactics of reaching out.

I’ll start with a few strategic / planning considerations, and then add to Halle’s and Daniel’s great input with a couple of experiences of my own in reaching out to physicians. Not knowing how early of a startup you are, I’ll try to give as much of a “straight down the middle” answer as I can.

Decide what you want from a partner physician(s). I’ve found some technical founders want access to a doctor in order to get the product in front of patients and to verify functional accuracy, but keep in mind that that may not make the best use of his/her time, and not serve your long-term interests. I’ll outline 3 of the more significant roles a physician can add to your startup:

The Evangelist
This role is important when you consider the “flow” of information in medicine. Most doctors, overwhelmed with the work of seeing patients and managing a practice, look to certain “thought leaders” for their input on new technologies. The annual conferences where thought leaders debate their opinions are where these technologies often begin traction. A good thought leader can write an article for publication in a journal, give a great presentation at a conference, and is well-connected to get peers to buy in to your product. But this takes time, so don’t underestimate its value early in your startup. Accessing the physician market is not going to happen solely (or even primarily) through social media or the usual tech publications.

The Clinical Leader
You need someone who can give good input on the product’s usability, design, and fit within the doctor’s workflow. But keep in mind that the thought leader, described in (1) above, may not be the best fit for this role. Thought leaders, while excellent at what they do, have sometimes taken a career path where they give a lot of talks at conferences, publish articles, etc., and don’t see as many patients as they used to. Find someone for this role who sees a lot of patients in the current environment. Also, if you need to do a clinical study, this person will likely be able to enroll people quickly.

The Reimbursement Expert
This may seem like it’s a ways out, but the last time I went through this, it never felt like we could start early enough. A physician familiar with the byzantine rules of Medicare can be a great help to you at the annual Medicare Town Hall Meeting in Bethesda, at which s/he can present on key clinical measures s/he knows that CMS will want to see. Likewise (depending on your product/market), you might want someone with a knowledge of the private payer system to do the same. (Note that this role doesn’t apply for something like an EMR, but would apply for many technologies that impact clinical decision-making, such as remote diagnostic testing.)

Decide how many physicians you want on your board
If you wish to create a physician “Advisory Board”, consider how many you want on the Board. If you just have one person, you won’t get any diversity of opinion. But too many people are difficult logistically. For a small startup, I’d recommend 3, perhaps in the roles I’d mention above. Each can specialize in one of the categories, realizing that they will probably be able to give some degree of input about the other domains, too.

Consider geography
I realize that it’s just logistically easier to have all the doctors on your Board right in your area. But keep in mind that local doctors may not represent the market well. Be sure not to select only people who share your interests or love technology as much as you do. You’ll get better feedback.

Don’t underestimate the value of the ease of working with someone. At the end of the day, be sure to select Board members with whom you think you’d enjoy working. Not only will you have more fun, it’s those people who are easy to work with who come through in the clutch, are passionate about what you do, and are there for you when the chips are down.

On finding physicians, I have a couple of additional recommendations to Halle’s and Daniel’s:

Identify physicians in the relevant specialty to your product, and see if they’ve published a paper or written an editorial
Better yet — find someone who’s written about something directly relevant to the health care problem you’re trying to solve with your technology. Then, write the physician an email saying something to the effect of, “Doctor, I read your editorial in the Annals of Cardiovascular Medicine with great interest, as we at XYZ are developing a smartphone technology to remotely monitor patients with this condition. Would you like to meet to discuss?” This makes your call less “cold” by providing a logical reason for the call. And the doctor will be impressed you read up on him/her.

Attend the relevant medical society conferences
Try to attend the relevant annual medical society conference to your technology; this is worth several times the airfare you pay to get there, because everyone you want to talk to is in one place. If you don’t have budget for the registration fee to get into the exhibit floor and scientific sessions, book coffee/lunch appointments with as many physicians as you can find who are going to the conference, and ask if they can introduce you to their peers who are also there. If no one responds to your requests to meet, hang out in the main hotel lobby of the convention hotel, and strike up conversation with physicians there. The convention hall always has a coffee shop with a huge line outside of it, with your entire market just standing there. I know this seems a little like stalking, (and no, you don’t want to harass anyone!) but you might be surprised at how many are willing to talk to you when they’re just standing there waiting for coffee. Besides, you’re not looking to sign up everyone; you’re just looking for a few of the right ones. And if you can afford the registration, do go to as many of the sessions as you can. Remember, your technology is there to solve a problem related to healthcare. So…learn about the problems the doctors in your market have and are trying to solve. Not only will doctors be impressed that you took the time to learn, you’ll have a deeper understanding of the challenges and be more informed.

When meeting with a physician, consider the following:

Attire
At risk of coming off as paternal, I include this point so you can understand the expectation that’s been set. At conferences and at the hospital, physicians wear suits, and you should, too. Overdress, and at least you’ve shown respect. But losing a would-be supporter just because your appearance didn’t give a good impression? What a shame.

Don’t count on having all the time you were promised with the doctor
Plan on the possibility that you may wait in a doctor’s office for an hour and then have 5 minutes with him/her. It’s not personal, it’s just how a doctor’s day goes. But be ready with the short pitch: (1) What is the problem you’re trying to solve? (2) How does your technology solve it? (i.e., what’s the product?), and (3) State clearly what you want from the doctor (i.e., “we’d be excited to have your leadership in a study of our product”). This final one is important, and be sure to understand the extent of the commitment the physician can give and if that is going to work out mutually.

What if the doctor says no?
First, don’t freak out. Ask if there’s someone else s/he could recommend who might be interested. And thoughtfully ask what his/her concerns are. If s/he doesn’t believe in your idea, ask for feedback. At the very least, you may learn something. And once in awhile, the physician is not reacting to your idea inasmuch as s/he may be venting about approaches others have taken. More than once, I’ve won someone over by patiently listening to concerns. Selling someone on your idea is at least as much about how you listen inasmuch as about how you talk.

Compensation
Keep in mind that many physicians consult to startups in exchange for equity and or compensation. In turn, they have an obligation to make known that they are being compensated when they present about your company in public. Without going into details here, I’ll just say that compensation is a delicate issue, and you should be sure to get educated on regulatory and legal issues ahead of time. It’s well worth your time in a rapidly changing environment to spend the money to talk with a regulatory attorney. It may seem like your technology is innocuous enough, but remember that for very good reasons, medical technologies — and not just implants or invasive devices — undergo a lot of oversight. It’s not worth your reputation or that of your company to be anything less than informed.

Cultivating Admiration in Brands: The Dragonfly Effect
Jennifer Aaker, Professor at Stanford Graduate School of Business

Using a very emotional case study to illustrate the “Dragonfly Effect”, Aaker showed the power of a focused effort to save two lives, that in the end saved almost 300 others. Her advice in cultivating admiration: Act nimbly. Be human centered. Foster a culture of optimism. Design for stories. And since all of us are in the business of building long term relationships, it’s best to ask ourselves which ones matter most? What can we build right now, and how can we continue to be nimble in a way that helps us recover when we make mistakes?

CEO Challenges: Reimbursement, Regulation, Research Collaboration
Dr. Sam Ho, Chief Medical Officer, United Healthcare
Simmi Singh, Head of Department of Health & Human Services
Teri Melese, Business Strategy & Development, School of Medicine, UCSF
Ed Yu, Principal in the Health Industries practice at PwC

With varied perspectives ranging from payer to government to provider, themes ranged from incentive alignment to data management to working within the constraints of this complicated system.

Dr. Sam Ho quoted Tom Nolan, PhD:

“The root of the problem in health care is that the business models of almost all us health care organizations depend on keeping these three aims [Improve the individual experience. Improve population health. Control inflation of per capita cost.] separate. society on the other hand needs these three aims optimized (given appopriate weighting on the components) simultaneously.” – Tom Nolan, PhD

Funding Mechanisms for Digital Health Startups
Rowan Chapman, Partner at Mohr Davidow Ventures
Anne DeGheest, Co-Founder & Managing Director, HealthTech Capital
Zina Moukheiber Contributing Editor, Forbes
Jennifer Shieh, Science & Technology Policy Fellow at NIH
Halle Tecco Co-Founder & CEO, Rock Health

Our women-led panel talked about everything from filling the gap between the incubator and VC funding, the lack of exits in HealthIT, and even the FDA. Key for everyone developing products: The physicians are no longer the ones controlling health products. And the panel left us with a few questions for entrepreneurs to ponder: How do you make money, who is going to acquire it, how much money do you need, and can you get a 10x return?

Creative Disruptions: How to Thrive in the Coming BioRevolution
David Ewing Duncan, Best-selling author of Experimental Man

David talked personalized medicine and genetic markers, via his project, the Experimental Man. With testing grounds as diverse as caffeine and mercury, he dove into the effects of each on the body, to scary result. Example: he tested his mercury levels before and after two meals involving fish. The result? The levels skyrocketed. His new project is Ecoeos, whose first focus is personalized mercury testing. So what else is needed? A revolution in interpretive tools as well as a new ecosystem to wrestle down data and make sense of it.

Moneyball for Medicine – Health Business Models
Linda Avey, Founder of 23andMe, Curious
Dave Chase, Co-Founder & CEO, Avado
Ron Gutman, Founder & CEO, HealthTap
Jennifer Wong, Founder & CEO, Alt 12 Apps

Business models, business models, business models. From revenue sharing to payers to consumer subscription, no stone went unturned. Dave set up with a great overview of the perceptions of the market as well as entrepreneur perspectives on who pays for their products and services. Through the research we did in an earlier Rock Report, we discovered that where investment dollars are going and the monetization models that entrepreneurs are building are almost completely reversed.

Innovation Showcase
We were thrilled to feature demos from 5 disruptive startups (Docphin, Habit Labs, LUMOback, mscripts, Pipette) in the innovation showcase. Each startup pitched to investors and media, so look out for coverage and check out these exciting new companies.

Hot & Hiring
And speaking of exciting startups who have been around a bit longer and are also growing quickly, the following startups are scaling quickly and need talented developers, designers, marketers to join their teams. See below for links if you’d like to throw your name into the hat.
Azumio
GreenGoose
HealthTap
Lumoback
mscripts
Proteus
Skimble
WellnessFX

And of course, as any good conference does, we ended with a happy hour celebration.  Thanks for coming, we’ll see you next year!

Anti-Disciplinary Innovation at the MIT Media Laboratory
Ian Eslick spoke to us about he disappearance of disciplines.  The only requirement of the MIT lab: Do something different. It is about the diversity of thoughts and perspectives.  “Diversity will be your saving grace.”

Designing to Make Technology Invisible
Arna Ionescu, Director of Product Development &  UX at Proteus Biomedical, challenged us to consider efficacy versus effectiveness.  Healthcare is after efficacy, but the problem is that the molecule might not be effective in the real world.  She left us with this question: “How do we design products that evoke positive emotions in the healthcare space?”

Design for Emotion: Love and Hate is Better than Indifference
Enrique Allen, founder of the Designer’s Fund, talked to us about leading with emotion.  Form follows emotion.  Without emotion, our decision-making ability would be impaired.  Visceral Design is key. How are you going to make an impression on people?

From Idea to Execution: Designing for Success
22% don’t finish their antibiotics. Who’s at fault — the patient or the intervention?  Aza Raskin, Co-founder & CPO of Massive Health, spoke about designing for behavior change and the power of feedback loops.  Humans struggle with the symptoms of delayed gratification and time discounting.

Form Reform: Data Entry for Humans
Jackson Wilkinson, Co-founder of WeSprout, gave attendees practical advice for data entry.   Data is an important part of the healthcare equation, but input design is blocking progress.  Quick take-aways: Don’t ask for anything you don’t need; whatever you request, return the favor in spades; make it fast, accurate, and simple.  And don’t forget: The best form is the one you never have to fill out.

Strategies for Creating Healthcare Tools that People will Actually Use
Maggie Breslin, Healthcare Designer & Researcher at the Mayo Clinic Center for Innovation, gave us insight into designing within the system.  It is important to remember that there are no “bad people” in healthcare. It is a place where we have really good people caught in a really bad system.

Patient-Centered Design
Sean Ahrens, Founder, Crohnology
Amy Tenderich, Founder, DiabetesMine.com
Julie Wilner, Director of Product, Basis
Stefan Klocek, Principal Designer, Cooper

• Patient needs are complex, they have a strong base desire for knowledge and social connection
• The industry spent decades ignoring patients. Let patients help! It is about people.
• Focus on three things: improving lives, being ethical, and involving patients every step of the way
• There is no uniform description of the patient, but universally everyone wants to be better

We ended the day with the Redesign Challenge, where 10 groups were given an aspect of healthcare to redesign in 90 minutes.  From the waiting room to the car, groups came up with creative plans to build better system. Judged by experts from Qualcomm, Health & Human Services, the California HealthCare Foundation and the Stanford Persuasive Tech Lab, they rewarded the teams who presented the clearest ideas and goals, that had team cohesion, and mentioned some sort of specific behavior change. And the teams got very decent prizes–signed copies of design books from our friends at Cooper. Congrats to the winners!

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