Bush: Healthcare innovation must start off slow

By: Aditi Pai | Oct 9, 2013        

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Jon.Bush_headshotJonathan Bush, CEO and cofounder of athenahealth, wants to build a healthcare internet.

Bush spoke about the barriers to healthcare innovation in a lively conversation with MIT Technology Review Editor in Chief Jason Pontin at the EmTech event in Cambridge, Massachusetts.

Bush described athenahealth, provider of cloud-based EHR and practice management software, as the “water boy” for the health industry that will do work that doctors don’t want to do. Their business model, he explains, is as the doctors do better work, the company will see a monetary gain. Still, Bush said the company aims to do a lot more.

“What we secretly think we’re doing — we think we’re building the healthcare internet,” Bush said. “What we think we’re doing is creating the conditions where there can be innovations in healthcare. Healthcare does experience innovation with caring and love and sponsorship and places like MIT that invest in it, but the conditions are not there. The conditions are to build a better internet, the conditions for innovation are not there.”

He believes his company can help provide a better setting in which to innovate, and yet, the road to success could still be rocky because of security concerns such as HIPAA compliance.

“The key to healthcare internet is that it’s got a fiduciary, you know the thing that kills us is you have to first do no harm,” Bush said. “Well in every other entrepreneurial venue companies explode and splatter over the wall all the time, and that’s where you say ‘oh, look at that guy, those guts actually would be really delicious, we can add that to my company.’ You can’t really do that when people’s lives and safety are at stake, so the healthcare internet is going to go slower and be lamer than ‘the dating internet’ or ‘the shopping for products internet’ but can we create a playground that’s safe enough to allow at least some of that shopping to go on, some of that that rising and falling.”

This kind of slow growth was apparent this year. In January, athenahealth bought mobile medical app provider Epocrates for $293 million, but it was only last week at the Health 2.0 event in Santa Clara, California, that the companies launched their first joint product, a free mobile app called Epocrates Bugs + Drugs that uses big data to address “superbugs” or drug-resistant bacteria. The app was launched at a strategic time — just after the announcement of iOS 7 and CDC’s recent study on superbugs.

athenahealth already has five offerings, an electronic health record, practice management software, patient communication services, care coordination services and financial and population analytics. Still, Bush believes his “healthcare internet” will take a while to blossom.

“You can’t have a healthcare internet if you have to keep typing stuff into it,” he said. “The point of the internet is to look up and it’s already been typed somewhere else.”

So far athenahealth has added only 16 companies to its app store, Bush said, because each company must go through a regulated process to get cleared.

“We’ve one by one moved them through it, it’s depressing,” he said. “I wish there was 800 already.”

He acknowledged that many companies have expressed interest, but to actually succeed, a company must be careful to go through the right steps and stay within all the regulations of the space so as not to get caught doing something wrong.

“We don’t in these early days [want to have] a Hindenberg where we blow up somebody’s privacy or in some way humiliate or embarrass someone and then everyone shuts down and backs away and then regulation comes in a reprieves it,” Bush said. “So our goal is to over-comply with regulation, and to require these poor little startups that don’t have the money to do it, to do so, with subsidized health from us, to get these products going.”