Today, I want to beat the drum for Persimmon, a new offering from the healthcare veterans at Leapfrog Technology.
It was March of 2021. We were launching new vaccination management software for Signetic, a healthcare startup. The launch site, Lumen Field, the home field of NFL’s Seattle Seahawks, was transformed into the primary point-of-delivery for COVID vaccinations. Chandika and I were on site with the City of Seattle operational team, reviewing the real-time dashboard of people having registered for a vaccine, the number having checked in via iPad outside of Lumen Field, the number of vaccinations predicted at the end of the day; and, most important, an on-going tabulation of the folks having been vaccinated so far that day.
At 9:10am, as would become custom, 250 workers and patients alike applauded and cheered in unison as the first vaccination of the day was administered — the first of up to 20,000 in a day at Lumen Field. The sea of applause hyped our energy and inspiration — the type of energy and inspiration one feels as an integral part of something bigger and more important than can be accomplished alone.
Signetic is one of over 40 healthcare startups and solutions we’ve helped imagine, create, and scale. And while it’d be easy to distill Leapfrog’s mission as simply “feel more of that Lumen Field energy” from our products, the truth is that’s only one element of my motivation. Like many others inspired to work on healthcare innovation, my mission, in part, is driven by personal dismay with healthcare operations and outcomes.
For me, healthcare innovation crossed the line from business model to mission earlier this year. My wife’s grandmother, three months from her 100th birthday and stranded in relative isolation by the pandemic, was found unresponsive on the floor of her assisted living facility.
She was discovered by our Aunt Cathy, who happened to live in the same facility. As it turned out, Grandma Emily had pneumonia that had been developing for some time. Grandma didn’t make it.
At that same time, Aunt Cathy was discovered to have a high fever and a UTI, and subsequently hospitalized for a week. Frustration welled up: how did nobody at the facility “notice” these health problems? I’d crossed paths with enough RPM startups to know that even the most basic of remote monitoring and patient engagement may have prevented such a tragic outcome. At the same time, I also understood why remote monitoring wasn’t done: that much of our healthcare system is structured around treating tragic outcomes, rather than preventing them. My frustration and grief converted to heightened motivation for change.
Personal circumstance often impacts motivation. Persimmon’s Head of Product, Bimal Maharjan, documented his own healthcare challenges as a person with chronic constipation. He shared his findings as a “sample size of one” with wearables, diet journals, and diagnostics. In fact, he wrote the book on it, including his own battles with his insurance provider around diagnoses, lack of transparency, overbilling, and pass-the-buck interactions.
Through disparate experiences like these, we share a common mission: we’re committed as part of the growing force that’s fixing the American healthcare system.
Marshaling our resources, we’re helping eradicate weaknesses in the healthcare system through better use of technology. We’re doing this by supporting the healthcare heroes and like-minded innovators. We’re doing this by challenging legacy models like fee-for-service. We’re doing this because we understand that 44 percent of physicians are at risk of burning out, and at the same time, Americans get worse outcomes than peer countries.
We’re doing this for other Grandma Emilys who might otherwise die alone in assisted living facilities because basic vitals weren’t being monitored remotely. We’re doing this for the people who can’t afford health insurance and end up in the ER for easily preventable complications.
We’re doing this because it’s the right thing to do, both as personal commitments and as a business model. Too many Americans, for too long, have needlessly suffered. It’s time for change. It’s time to take responsibility for change. We take pride as a player in the change.
Over the past 10 years, we’ve been hands-on participants in building over 40 healthcare startups and solutions. And we’ve witnessed our positive impact with our partners.
Impact has come through a variety of approaches, evolving through a product design whiteboard to implementation on an iPad. Sometimes it’s “little more” than coupling behavioral nudges and care team collaboration, such as illustrated by COPD patients earning virtual rewards for self-managing their chronic disease.
We’ve also built applications directed at process: like algorithms that help hospitals get more reimbursements from payers by identifying gaps in coding and documentation for the work they do; or classifiers that match patients with psoriasis to the right treatment pathway based on genomics, thereby saving $25,000 by combining machine learning with relatively cheap lab tests.
We’ve created Persimmon by packaging top designers and engineers, sharing our collective expertise of best practices for success in healthcare. That experience — our experience — avoids pitfalls and steers innovators towards success.
1. User adoption
The graveyard of healthcare startups is littered with great technology nobody ever used. A recent study found that “though 66 of the 100 largest U.S. hospitals offer patients mHealth apps, patient usage clocks in at only 2 percent.” And that’s because, as one startup founder said, of the “bastardization” of patient engagement. The truth is that nobody wakes up every day wanting insipid engagement. Companies need to find the most organic ways of tailoring self-care, education, engagement, and monitoring into the patients’ individual needs and lifestyles; fixing healthcare through adapting applications of pedagogy-driven and user-tested behavioral nudges to encourage long-term patient impact.
2. Provider adoption
Similarly, movements like CCM billing codes were thwarted because providers didn’t have the time or incentive to look at yet another dashboard. Alert fatigue is real, with some physicians laughing when asked if they respond between visits to the 100 alerts they get in a single day. Provider experiences need to be actionable, and either organically intertwined with existing workflows such that they’re seamless or, more likely, supported by a separate “human in the loop” who can distinguish between false alarms and emergencies.
3. Data Synthesis
Data integration is table stakes for most healthcare startups, yet few do it well. The ability to gather and translate data from multiple sources (e.g. wearables, medical devices, EHRs, patient surveys, lab results, etc.), and incorporate that information into real-time decision support, is what sets companies apart. We use health analytics, expert systems, and machine learning to serve insights that support action for a patient, a provider, a scientist, or a human-in-the-loop scenario.
4. Security and Compliance
Application security, data privacy, and compliance are absolute requirements in healthcare. We’ve seen new products stumble when they don’t have secure and compliant practices in place from the outset. Such practices must be ingrained in the culture and habits of the people building the product. Simply checking the boxes is not sufficient. We have extensive experience navigating the complex waters of security and HIPAA compliance, and we walk side by side with our partners as they design their infrastructure and procedures.
We’ve seen that the perfect product plan, and the perfect team to build that product, are pipe dreams in this age of disruption within healthcare. But we believe the perfect approach does exist — an approach that is agile and iterative in terms of product and people. We bring Lean Startup and agile practices to healthcare technology, systematically validating based on user feedback and adapting as market landscapes evolve. Our breadth of expertise allows us to similarly adjust the mix of people and skills that are important at each moment in a product’s lifecycle— be it the first designs, the next sprint, the first pilot, or the 10th customer. We align with entrepreneurs who need to ideate, validate, and iteratively get to market with as much speed and quality—and as little waste—as possible.
“Persimmon” is our metaphor. We’ve chosen to rally a new brand, “Persimmon,” that embodies our spirit of innovation as a means to improving health for more people.
- Persimmon is a fruit packed with nutrients, antioxidants, and myriad health benefits.
- Persimmon needs time to ripen to reach full sweetness, which recalls the iterative process to find the sweet spot for products we work on.
- Persimmon represents longevity and good luck, and is used in Puja ceremonies celebrating the same in Nepal, where hundreds of our professional staff live and work from.
And for customers who choose to work with us, we want Persimmon to represent a promise of shared passion, focus, and unrelenting commitment to making their products, users, and patients successful.
We’re launching Persimmon for two reasons. First, we believe we’ve become good, even exceptional, at healthcare innovation. Second, the pandemic is a once in a generation event that has catalyzed an era of accelerated innovation that we are passionate about, and, accelerated progress we have been hoping for in this historically stagnant industry:
- Patients matter more
There are tectonic shifts in business models with direct-to-consumer primary care, wellness apps, and wearables. Additionally, value-based care is driving investment in chronic disease management, care collaboration, and healthcare analytics.
- Payers are beginning to cover patient-centric activities
Telehealth became mandatory during the pandemic, and continues to offer access to more patients regardless of their or their provider’s location. The time spent helping people manage or prevent conditions is now billable, and this includes remote physiological monitoring, care coordination, and, as of 2022, remote therapeutic monitoring.
- Decentralized care delivery is disrupting the industry
Historically hospital-based services are being unbundled; fire departments are being called to the forefront of COVID battles; public health initiatives and care delivery are increasingly distributed and community-based; pharmacies are becoming involved in primary care while pharmaceutical services are shifting online; and an increasing number of clinical trials are conducted remotely.
The healthcare industry is undergoing a remarkable transformation, and we want to contribute to the technology that accelerates it. We want to be a part of redefining healthcare as something that keeps people well, rather than treats them when they’re sick. And we want to do so by helping healthcare innovators succeed in bringing needed products to market to serve all people.