Coming up for air at Keas

Building Keas has been more than a full time job for the last 9 months; exciting, rewarding, occasionally difficult, and overall enormously fun. Mostly, as we have hunkered down to build Keas, I have avoided giving speeches or anything else not required to get the product launched.

But I did agree to give a talk at TEPR and I gave it this week. I gave it because we’re at an extraordinary point in our history. We have a new administration who actually wants change and can see that the current health care system needs to change.  The basic thesis of the speech is that our health care system is broken and on track to get worse, and that the only way to fix this is to get truly participatory health care between the doctors and the patients and their other health coaches. Surprisingly, as I point out in the talk, we can make a major dent in our current $2.3 Trillion of costs by covering every single American who has health issues for $50 Billion or just over 2% of the cost. Of this money, only $3.6 billion would actually go to the people building the Health IT systems. The rest, as is called out in the talk, would go to provide incentives to consumers and health providers alike to work collaboratively on their health and, in particular, for consumers to be able to be the stewards of their own health with online and ongoing support from the health care community.

Other than that, this is an exciting moment at Keas. We raised a bunch of money in December so we’re well funded (although we’re carefully husbanding our cash). We are just about to launch our first pilots. We have an amazing team but we are still looking for 2 good programmers including one who is really gifted at user interface, Javascript, CSS, HTML, etc. In addition, we’re looking for one totally can-do doctor, passionate about improving the health system, collaborative health care, and online patient support and willing to do whatever it takes to make that happen at a startup’s salary.

9 Responses to Coming up for air at Keas

  1. healthitgirl says:

    I enjoyed your presentation at TEPR this week.
    So much so that I wrote a post about it:
    When I was flying home, I came across an article about virtual reality and its effect on fitness; thought you might like it:
    Best of luck with Keas.

  2. Sean Gresh says:

    Adam, I saw your charts and was impressed with the story you painted using broad brushstrokes. Is there any way I could actually hear your remarks.


    Sean Gresh

  3. I like this.

    How do you overcome that drug, healthcare, food, etc. companies really have no incentive to get people healthy — and they control Washington?

    Even the HMOs seem to be motivated to retain the status quo (more people w/ problems->more revenue.)

  4. It’s a shame I don’t live closer.

  5. Actual Consumer says:

    Ahh yes if only we could get the consumer to buy .. mmm I mean invest in their own health.. Magically people with cancer, heart disease and diabetes and major depression would suddenly no longer need expensive care and testing. Couple of quick observations.

    70% of the health care costs are from the 15% who already have chronic conditions so in the short term your plan would cost us more not save us anything.

    1) Data Liquidity doesn’t change behavior. Smokers have had the “data” they needed for over 20 years and that didn’t change their behavior. Most diabetics know their numbers and aren’t “cured”. The classic is obesity. Everyone knows exactly how much they weigh. Data alone won’t do it. 3 simple things account for the largest consistent weight loss. eat breakfast, weigh yourself daily and I forgot the third.

    2) Coaching – necessary but why should this be the governments job? Could it be because that is what your business model is based on? We refer to that as the parasite model. Besides Most health insurance has pretty robust access to nutrionists and many include discounts to gyms.

    Most companies that implement wellness programs actually see their health care costs go up not down in the first five years or so. The same thing is happening in Mass.. More people have coverage and so want testing. Who is going to stop back docs from ordering useless MRI’s (one of the main drivers in health care costs are high tech tests). or tell cardiac surgeons to stop putting in stents and tell their patients to get a health coach instead?

    Obviously we need people to be responsible for their own health but it isn’t the role of the government to pay for online social networks and online coaches is it? Recent studies (some flawed) have shown us that preventive care results in higher costs over your lifespan not lower. (due to the longer lifespan).

    We all love your passion adam and I personally support the model of simply pushing RX’s, labs, imaging back to doctors over a national ISP but you can’t argue for consumer empowerment at the same time you advocate for 50 billion (a year?) from the government

    • adambosworth says:

      Great comment. I couple of comments back 🙂
      I agree that data liquidity per se doesn’t change behavior. But it can be used to drive intelligent programs which have been shown to change behavior. And while most people know how much they weigh, most people aren’t aware of what this means for them in my experience. I agree that coaching shouldn’t be the government’s job with one major caveat. They are essentially moving towards paying for $1 Trillion in health care just for the aged (Medicare, increasing insurance) with a huge part of that cost due to poor lifestyle decisions so they are paying and much more. That being said, I’d like the money to flow through the consumers to the health care experts and flow primarily in exchange for proven improvement and arguably that will save the government a lot. I think that the longer lifespan argument is somewhat bogus. As I showed in some slides at Connected Health, people with no risk factors don’t have the huge spike in their health care costs late in life and average $2000 per year versus the $6,000 to $8,000 for people with 3 or 4 risk factors and the huge spike (amplified by the baby boom).

      Anyway great comment and keep them coming.

  6. Belinda Humphrey says:

    Hello Adam and all,

    Having spent my entire career in healthcare, first as a nurse for ten years, then working in the industry for companies such as Siemens Medical Systems in the early 90s, I have a passion for healthcare and grieve what I perceive will be the death of the finest and most innovative healthcare system the world has ever know. At that time Siemens and many other companies thought electronic charting and the electronic communication of healthcare information such as x-rays via PACs and other devices would make for a paperless system well before the year 2000. And although much of this has caught on to some degree, it has not been to the level that anyone predicted.

    Although the electronic transformation of the healthcare system should and will occur, I struggle to understand how any of that will lower healthcare cost or make it more available. Although it’s great to pull up an x-ray on the computer in the ICU, I haven’t really seen that it has driven down cost. Also providing information to consumers is terrific, in fact they are inundated with it, but one still has to consume the information. So I tend to agree with the gentleman above that preventative care is not all its cracked up to be; since people already know it’s unhealthy to be fat or smoke.

    If our initial goal is to first drive down cost, it seems to me that first attempting to reduce the billions of dollars wasted because of Medicare fraud would be a better area to focus. I also believe if the free market was allowed to work, rather than the semi-nationalized system we currently have, that eventually cost would come down or equalize. Right now Medicare dictates payments for physician services, all healthcare procedures, drugs and use and or purchase of medical equipment. Since insurance companies follow suit, basing their reimbursements on the governments, hospitals and doctors are under reimbursed for their services leading them to increase charges in other areas or reductions in pay for staff to stay afloat. (Perhaps the reduction or simplification in Medicare and Insurance paperwork would be a way in which healthcare electronics could cause a revolution).

    Although reducing health care cost is essential, a swing too far to that mind set, will no doubt decrease incentive to develop new lifesaving advances in health care and medicine, which is the hallmark of our system and makes us the envy of the world… i.e. when is the last time you heard of someone going to Canada or Great Britain for a healthcare procedure. It will also result in rationing, which will mostly affect the elderly.

    My suggestions on ways to improve access is to have the government spend our tax dollars on building and funding low-cost health care clinics to service those that do not have insurance through private means or through Medicare and Medicaid. Then insist or motivate those that aren’t covered by private care (especially those under the age of 30) to at least get catastrophic care insurance (which most people should be able to get for less than $100 a month, about the cost of cell phone service). Another suggestion is to stop demanding and passing laws that make private insurance companies force insurance options on consumers. We should use a Chinese menu so people can pick and choose the type and amount of healthcare they want. If I don’t need prenatal and postnatal care or psychiatric care don’t’ make me buy it. That way more people could afford basic insurance. Also cut out these ridiculous low cost $10 co-pays. Make people pay more for visits and less for monthly charges. As it is now people that do have insurance overuse it because its so cheap and also fail to see the value in what they have……making everyone expect something for nothing.

    I thank you for your time. And must be honest and admit that some of my concern for preserving some of our current system is self-serving as I make my living by offering a vital service to the medical device and pharmaceutical industry. My company provides executive search services; we recruit Chief Medical Officers as well as other physicians/product developers as well as CEO’s and other executives for this industry. I know how much these people care for our country and their passion for developing the best products and drugs possible to improve people’s lives. Yes they make a good living doing this, but it means more to them than just a paycheck. Let’s hope what ever changes we come up with don’t result in throwing the baby out with the bath water.

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