So why aren’t I the mayor of my favorite Thai restaurant? Because I don’t use Foursquare.

Foursquare depicts an incomplete picture of traffic for a couple of reasons:

• Not everyone participates.
• The check-in requires the manual act of checking in.

This is unlike Placeme, a free mobile app that doesn’t require check-ins. It’s continually running, continually tracking the places you visit. It’s an app that’s always capturing data without the user having to lift a finger.

That’s the direction healthcare apps are headed. Technology is getting so advanced and automated that the barrier to collecting certain types of data is becoming lower and lower.

Automated data tracking
Apps that help patients store and analyze personal data will prove to be extremely beneficial, especially to patients with chronic conditions. For example, diabetic patients manage their blood glucose levels through a careful combination of food, exercise and medication. Instead of using a paper and pen to regularly record and analyze which variables influence their levels, diabetics can now monitor blood glucose levels on mobile devices.

The iBGStar for the iPhone, which was cleared for use in the U.S. in December, can help patients give themselves and their doctors a more complete picture of their health than they could by writing it down. The small meter plugs right into the phone and records blood glucose data on the app so it can be analyzed over time. Users can then email the information to their doctor or nurse.

Wellness trackers
Diabetics aren’t the only ones who want a more detailed look at their bodies. Quantified Selfers (QS) emphasize tracking everything from exercise to productivity to spiritual well-being, all in the pursuit of better health. QSers now enjoy apps that not only digitize their personal data, but capture it Placeme-style — virtually without any effort.

• The Withings armband measures blood pressure and connects to an iOS device. The recorded systolic and diastolic blood pressure readings can be emailed to physicians and automatically synched with a personal health record.
• The Zeo sleep quality monitor is a headband that tracks sleep stages throughout the night and then wirelessly sends information to a smartphone. The app helps users to see what factors (such as an apple a day) impact their sleep. Anderson Cooper loves it.
• The FitBit personal sensor is designed to be worn 24/7 in order to track steps, distance walked or ran and sleep quality. The online application allows users to track daily progress and compare to others in their age and fitness range, and the personal profile integrates with workout and meal information on smartphones.

Future of health apps
In the future, imagine ingestible sensors that automatically transmit information on diabetics’ blood glucose levels to their smartphones. We’re not there yet, but as technology rapidly improves to help us better capture data automatically, this could be where we’re headed.

For many QS-ers, this sounds like heaven. Others range from feeling slightly to extremely creeped out by the idea.

“And yet, this ‘creepy’ model is the future,” wrote Phil Baumann, founder of Health Is Social, in a blog post. “It represents the technological and cultural arc that social software is throwing us. We can fight it (and should in order to flesh out the nuances so we can ensure safety) but in the long-run we shall have to accept the trend and work accordingly.”

Technology is getting good enough to make this kind of future possible. But how many people will opt not to be a part of it? Just like I opt not to participate in Foursquare or Placeme.

This post first appeared on mHIMSS. 

Bush often describes himself and his company by doing impersonations of various caricatures. He turned into Scrappy-Doo to explain his personal style of running the company. Bush was asked by an audience member if he’s always been so energetic, from the beginning of athena.

“You need to get attention any way you can. If you break a leg or piss someone off, it doesn’t matter,” Bush said. “And getting out in front, taking all the intellectual and emotional energy of your company, stealing it, driving it into you [allow five seconds to morph into Scrappy] … that’s really good.”

Athenahealth creates cloud-based business services for physicians. Bush co-founded the company with U.S. Chief Technology Officer Todd Park in 1997. Now, though the company is ever proactively looking for partners, it’s in the position to be approached instead of just doing the approaching.

Bush described three maxims for small startups as they look to parter:

1. Don’t bite off more than you can chew
2. You need your partner’s “id” as well as its signature
3. Culture trumps capability

On the last point, Bush described how clicking with the actual people behind the partnership makes a huge difference when making sure the joint effort is successful. He talked about one instance when he felt the click through a partnership with the Ohio State Medical Association.

“It was just hugs! Somebody who sees me for who I am. In fact, I think it’s that they see athena for who she is more than me in particular. But that feeling makes you share so much more with that person. Go so much further out of your way to make things work for them,” Bush said.

And they’ll likely return the favor.

Bush spent a lot of time talking about the company’s low points and relating the takeaways from his experiences.

He described an early relationship athena had with the Hospital Corporation of America. At one point, Bush and his coworkers were just about to run athena into the ground. HCA said it would help them out, but that it wanted to own athena.

“We almost lost the deal,” Bush said. But Bush and his co-workers stuck to their guns and didn’t give the company up.

“If you’re in one of these big deals, do not give away your company. Do not give away your code, do not do these things. Because you’ve given up the whole dream.”

An audience member asked Bush, now that athena is on the other side of the dealmaking relationship, what does athena look for?

First, he said, a potential partner might exclusively provide a service or feature that athena either doesn’t have or isn’t delivering it as well as it could.

“Our hedgehog is that we’re going to get doctors paid for for doing the right thing,” Bush said. Partners can make athena better at that.

Number two, athena looks for a company to have capabilities, meaning it’s a master at what it does. And three, the partner creates regular access to people athena wants to access.

Oh, another question someone in the audience had: What is a hedgehog?

A hedgehog isn’t a fox. A fox moves fast and keeps changing direction. (Bush physically demonstrated this on stage.) A hedgehog, on the other hand, knows right where he’s going.

Karie Rego, Sheppard Mullin
On practicing medicine across state lines

Rego talked about her daughter who has a rare disease called kawasaki’s. She said there are only two doctors in the country who treat this disease regularly ― one in San Diego, CA, in the state where Rego lives, and one in Boston, MA. When her daughter was being treated for her disease, Rego often talked on the phone with the Boston doctor. Practicing telemedicine across state lines can raise some issues.

“The first thing whenever I work with a company is deciding is there a chance that what we’re doing here is medical care? And if it is, then where does it fall into that state rubric? And oftentimes that involves taking a look at different states where you’re operating.

It might, in some cases, involve limiting your business plan to certain types of states, at least initially, so you can get a handle on it. So you’re not running into problems with respect to the practice of medicine in different states. The boards of medicine can be extremely aggressive.”

Brian French, Nixon Peabody LLP
On documentation

French was prompted by a question from an audience member who asked if there’s a standard way to document company actions. French said no, but offered this:

“The more you can do up front to show why you’re doing what you’re doing, the better off you’re going to be. So when you come up with any kind of contracts, being able to establish ahead of time here’s the need, here’s the medical need, here’s the patient need for what we’re trying to accomplish and why. And here’s why our strategy makes sense. The more you have up front and can point the government to afterwards, it’s a huge benefit to have.”

David Harlow, The Harlow Group LLC
On FDA regulation

The FDA is in charge of regulating electronic medical records and will likely start regulating many more health applications.

“They have asserted that the definition of device in their old statute includes virtually anything you can think of, and that includes electronic health records. Any time a health record moves from just a repository of information to anything that is approaching medical decision support, that is now a device, and that is something that is going to be subject to FDA regulation.

Last year, as you know, the FDA put out a draft policy on mobile health. And they basically said in that draft guidance, they’re looking at mobile platforms, mobile apps, mobile medical apps. And they define a mobile medical app as simply something that meets the definition of a device under the law. And for purposes of this guidance, they are looking at mobile medical apps as something that’s used as an accessory to a regulated medical device or that transforms a mobile platform into a regulated medical device.”

Jack Eiferman, Goulston & Storrs
On the misnomer of a kickback

“It’s a bad term because the term Kickback, I think, is a suggestion that you’re engaging in some kind of venal behavior. That’s not what’s going on. That’s not what the word tries to capture.”

“They want the decision making by health care providers to be pristine, to be uninfluenced by any of the considerations in the commercial marketplace. It’s modeled on the single family physician making decisions and having those decisions remain unsullied.”

Dan Orenstein, athenahealth
On his top tips and tactics

·Encrypt your data
·De-identify information
·Encrypt your transmissions
·Use a standard business associate agreement

For more on health 2.0 law, check out Harlow’s blog post on SeachHealthIT.com.

Indu Subaiya: You said you can’t decide if you like something until you’re good at it. I’ve used the other side of that statement in my own life which is if you love something a lot, you have to love it enough to be bad at it for a while. I like this idea of being brave enough to suck at something.

John de Souza: That’ll be right. To me, a good example is being a parent. There’s something I knew I love from the day you see the kids, but being bad is a good example. I need to learn how to be a good parent and that’s the time to go through it and trying to figure out what it means — what does it mean to do it well. And so there are some things where you naturally know that you’ll love it and you want to go through and invest as much time as it takes to get good at it, and for me that was a good experience. Education is another thing, how to invest in it.

And then there are things that for whatever reason you want to try until you’re good at it you’re not going to do. You’re not going to know what it is like to really enjoy it. And we live — often in the generation we live in, too may things I think, treatment is to have a very short attention, it’s a very good example. When the kids started playing golf, a bunch of other people started playing golf as well and they all dropped out very quickly because when you play golf you get good in a matter of hours. But in reality, it takes years to get good at.

So a lot of what we live in right now, people want that quick gratification, and if you don’t get good very quickly, people lose interest, and then I think you need that above these, I can pursue it for a long time and eventually I’ll get good.

Indu Subaiya: Alex Drane [of Eliza] gives data on how — even if you work a really hard and intense job but you find it rewarding, you don’t report negative stress on your health. But people can have an easy job, but be really unfulfilled.

John de Souza: I think that’s a great insight. If you come at my office, lots of people, surprisingly people go, well, it seems like a low stress environment. There are two things on that that have done very intentionally. One is in terms of not creating artificial stress and a lot of people who run by artificial deadlines create that. Kill that and I’ve gone all the way to kill the politics and all within it.

But the other thing I’ve done which really helps me is anytime I lose perspective, I call my mother up and then I go, this is — first, the question is, is anybody dying? I don’t even know. She is, is anybody sick? I don’t know. She says, what are you stressed about? And having gone through the [Ethiopian] revolution, she has such a phenomenal perspective on what should cause stress.

And any time I lose that perspective, I just need to call her back and get us right back and it’s allowed me to fill in people that we need to keep things in perspective. I think it helps us, obviously we need to do a lot of good things. But all the stress about unnecessary stuff is not worth it. It’s been wonderful and in turn we say, we just need to keep things in perspective. There are very few things that are so major. Most things are not.

And then you trust people to work hard, you don’t need to fire drill to look out, it’s working hard. We just need to make sure that priorities are set properly and it goes well.

Indu Subaiya: What other things have you done from a cultural standpoint at MedHelp? How do you get people to focus on the priorities?Do you have your manager set priorities? Tell a little bit about how the company is structured according to your philosophy.

John de Souza: There are a few things. One is I want major stress to end at medium/senior management. So as you look at people, some people do well at stress, some people don’t do well. But there is a very few group of those things that are — that come without stress, for example, we had a major customer decided — and this was in 2008 when we went through downturn that decided we had a million dollars due to us, they decided not to pay us, and we had that stress.

But what we sort of do here. One is, I tell — we are very transparent with the company and that’s helped a lot to the extent that it allowed them to trust us and it turned up – we were going to go through ups and downs. Just trust me that I’m going to do what we need to get through them. So I can improve them, they’ll go through and they’ll trust me and they’ll allow that stress to end on my part as opposed to meeting the stress and then causing everybody at the company to stress as well.

So I do two things, one we do have transparency and I tell them to look at allow me to — have the trust and then I’ll go through and deal with it, and then once we get through it, I do these detailed postmortems at the company so that they know exactly what happened which gives me the trust and gives me the leeway that said, look, we trust you, you know what’s happening, and that does help in a tremendous amount.

Indu Subaiya: So GE in particular is one of the partnerships we’d be talking about on stage in Boston. So tell us a little bit about how that partnership came about and kind of what it means for MedHelp right now in terms of MedHelp’s growth and strategy?

John de Souza: You know I think it would help — a scope for us is there are lots of companies that are in the health space and it’s become a priority for senior management to go through and to look at the health space. You know GE is one of those and there are a few other companies that we are working with. It is the scene where we succeeded where we can find companies that look at heath find it to be strategic importance and then we can use what we have in the platform to work with them, to realize the process that they don’t have, and they wanted to go through these.

You start off with them looking at the mobile face and they wanted to go through and initially during in the pregnancy and wanted to see, what is the effective way to go through and reach people?

Now, for them they’ve always — they have not been a consumer health company, they sell everything to hospitals doing large development, but at a high level we had the vision to realize that over time, they need to have a connection with the consumer because consumers will become more important in making those decisions even in hospitals.

So they wondered to be able to connect with them to work together and develop an app called I’m Expecting and it did exceedingly well. So they came back and said, that’s unbelievable how we do, not only reached but have an ongoing meaningful connection with through that, so we expanded and have done a full series of different types of apps for them.

 Indu Subaiya: Just sort of big picture of MedHelp going forward many years from now, do you guys leave it open-ended for discussion as to where the company is going? Any thoughts of big picture goes for the company in the future?

 John de Souza:  Before there is a company, we want to make sure we keep on thinking profitable and going. This is sort of doing down the thing what they could have learned through, haven’t gone through three different companies, lot of it depends on what’s happening with the timing and all. There’s a plenty of time going through building becoming chasing exits, you end up spinning your wheels and wasting a lot of time. So my experience has been when the things align and go through and think about it at the time the best thing you can do to measure is to always make sure that folks in the business malls make sure the companies make it possible and make sure you’re going to do that, the rest will take care of itself.

The campaign aims to reduce health spending and patient harm by encouraging both doctors and patients to carefully think about what makes a test or procedure necessary.

The ABIM Foundation and Consumer Reports put together an impressive list of partner medical organizations in addition to collaborators participating on behalf of patients. Alliance Health Networks officially joined that group today. The organization operates more than 50 condition-specific social networks made up of 1.5 million patients.

Alliance Health is going to start leveraging that reach by launching topic pages that open up the health care spending conversation within online communities. The pages will feature articles, videos and discussion boards.

Choosing Wisely argues against physicians giving patients routine tests like X-rays, stress tests and CT scans in certain situations, even though many patients are comfortable with the exams; patients feel they’re taking preventative measures just in case something might be wrong. But the problem, professor at the Dartmouth Institute for Health Policy and Clinical Practice H. Gilbert Welch explained in a recent op-ed, is that these test can lead to more and unnecessary tests and even treatments.

“‘Routine’ chest X-rays, for example, have a way of unearthing multiple abnormalities. This raises questions in physicians’ minds ― triggering CT scans, needle biopsies, bronchoscopies and even surgery in an effort to answer them,” Welch wrote.

Physicians recognize the problem, but there are a few reasons why cutting back on testing isn’t so easy. One reason is because less testing equals less pay since most physicians are paid on a fee for service basis. An unfortunately reality, but Choosing Wisely is urging doctors to move away from these practices, reminding them to “do no harm.”

But another reason physicians find it hard to abandon unnecessary testing is because their patients have come to expect it, and physicians have a hard time saying “no,” Dr. Davis Liu explained in a blog post.

 In general, it takes a doctor more time and energy to educate a patient on why an antibiotic or MRI isn’t necessary, how an individual’s personal experience is different than those of their friends and family who all got antibiotics and MRIs in the past, and to do so in a caring and compassionate way.

If we expect doctors or patients to bend the health care cost curve this way with more education, better communications, and encouraging patients to talk to their doctors about the appropriateness of care, we will fail.

That’s why Choosing Wisely’s patient education component is so important. Patients are already taking it upon themselves to be more proactive and educated about their health, and they aren’t just looking to their doctors to help them do it. On Alliance Health Networks alone there are more than one million patients seeking online health information. Choosing Wisely is off to a great start involving Alliance Health, and it’s likely to see that online word of mouth is an effective way to spread its message.

Matthew Holt: You guys have actually created a couple of new products in part by acquisition. So I want you to talk a little bit about what the product line is now and how it came to be.

Karl Zachar: I think you were referring to athenaCoordinator which was something we had on the drawing board for several years here at athena and was launched with our acquisition of ProxsysathenaCoordinator  allows a real,  economically sustainable model for patient referrals connecting hospitals with non-employed, affliated providers in the community.

So, we’re excited about athenaCoordinator because it’s a working example of Health Information Exchange.  Think of it as a “real” HIE – one with a sustainable business model.  Coordinator helps facilitate the coordination of care between “sending” providers and “receiving” providers – using athena’s terminology. Finally, we’ve created a unique model to be able to exchange information and make that information flow seamlessly and more efficiently in the transfer of a patient data from primary care physician to specialist or hospital.

Matthew Holt: And that also contributes to the bottom line, but also the physician and the hospital in terms of not only making efficiency but also some revenue transfer there as well.

Karl Zachar: So that was at the core of our thought process which ultimately led to this acquisition.  The strategic problem athena wanted to solve was: how does athena create an economically sustainable model where the sending physician (in this case, the primary care physician), the receiving physician (the specialist or the hospital), the payer, and the patient all  benefit from better care coordination?   This is driving the strategy behind athenaCoordinator.

Matthew Holt: Why don’t you sketch up sort of the general directions that you guys are going in now and then we’ll talk a little bit about what that might mean in terms of products and things you like?

Karl Zachar: Two of athena’s services have come via acquisitions: Communicator and Coordinator. So back to the question where are we looking next? There are four areas we’re are currently focused on for the next five to ten years.

First is developing tools and data to help providers thrive in the new ACO and risk-sharing reimbursement environment that will dictate the future of healthcare.  athena’s cloud based architecture is uniquely positioned to help healthcare providers have all the information and tools they need to take on the shared risk by giving them real time, relevant information at the point of care.  It’s a beautiful vision.  Imagine if your doctor had a consolidated, comprehensive record of all your health and wellness.  Then, she would have the tools at her fingertips to provide the best care and quality.  In this scenario, everyone wins.  That’s where healthcare needs to go.

The second focus is the patient.  To date, most technology solutions have done nothing to enhance the patient-physician interaction.  We are looking for solutions that enhance  intimate time between care giver and receiver.

The third area we’re focused is data.  athena’s platform – being cloud-based and a single instance of software – allows us to have very valuable, realtime data which is could be helpful to many players in the healthcare ecosystem -  whether it be payers, the government, manufacturers, pharma, employers, and others who can use the data to better our healthcare delivery system.

And then finally, we are keenly focused on large healthcare enterprises where we’re constantly finding ways to add value. Coordinator clearly was the first step into the enterprise.  Most hospitals are very interested in expanding their presence in the community expanding their ability to connect , and becoming better partners with physicians that are living in the surrounding communities but aren’t necessarily employed by the hospital.

In summary, Athena is constantly looking for creative ways to increase efficiency and productivity for providers and patients.  Athena’s “hedgehog” has always been – getting medical care givers paid for doing the right thing.

Matthew Holt: So in terms of, and that obviously gives you a large range of options in terms of things that you can plug in. There are probably two different ways of thinking about this and we’ve had some discussions with athena about both of them.

One is obviously, you can make acquisitions, plug-in, add another products on. The other you can do is, and I think Ed Park talked a little bit about this, is open up the API and have other people build into that and work in partnerships. So there’s sort of combination of things you can do to grow the ecosystem. Now you have obvious large basis of solutions you are using. Can you give a sense of where you guys are in that patent now and then I’ll also ask you a little bit more philosophical questions about how you go about this.

Karl Zachar: Athena is very interested in speaking with companies in all difference stages of their development that provide physicians the tools they need to be more efficient and more productive in doing what they do best, which is helping patients.

So, as you can see, we’ve been somewhat active on the acquisition front. But we’ve been more active, and we’re spending more of our efforts on a partnership strategy called More Disruption Please or “MDP”.  We want to partner with disruptive innovators, invite them onto athena’s MDP network so our approximately 35,000 providers can benefit from their innovation.

Over the next 12 months, I think you will see us develop many more partnerships with companies that share a similar philosophy to ours.  We’ll partner with those companies and allow them to interact our providers on the athenaNet platform.

Matthew Holt: Fantastic. Okay, very last thing. If I had Jonathan Bush  on the line with me, what would he say athenahealth would look like in 10 years time in terms of an organization or company, those areas you serve? Would you be comprehensive across all those scales or would you be still rooted in the physician market?

Karl Zachar: Despite Jonathan’s wildman appearance and athena’s terrific growth, athena has a singular, laser focus on aligning everything we do with our physicians.  Athena’s mission is to be the most trusted service and partner for this cohort.  That sharp focus singlehandedly accounts for our successful to date and has allowed us to grow faster than all our competitors.

Today, Athena serves approximately 35,000 providers.  Our tactical goal has always been to grow to serve 100,000 providers. But once we ring the bell at 100,000, I am sure we will set a higher goal.

More importantly, our strategic goal is to make athenaNet THE healthcare delivery platform for efficient and open exchange of healthcare information.  We will then invite disruptive, innovative health 2.0 type companies to partner with us and take advantage of athena’s open platform.  When we accomplish this, every stakeholder in healthcare will win.

Every athenista is working hard to see athena become THE health information backbone for all our providers rather than a product or services company. In five years, Athena will be known as an open platform company for every provider, patient, payer and stakeholder in the healthcare system. Creating this efficient information marketplace will make our physicians, our patients, our shareholders and every athenista very, very happy.

Kaiser launched its very first app, the KP Locator, back in July 2011 and followed up with its health management app for Android devices in early 2012. Now, with the iOS launch, both mobile management apps allow users to email their providers, order prescription refills and check appointments on their smartphones.

“Accessing health information and care from mobile devices is quickly becoming a new norm for care,” CEO of Kaiser Permanente George Halvorson said in a release.

In April, 15% of traffic to kp.org came from mobile users, including people on their Android phones and those accessing the mobile-optimized site. Since its release, the Android app has been downloaded more than 99,000 times.

On a Kaiser press conference call, Mom of two, Melissa Marote of Canoga Park, Calif.,  explained that she’s been using the Android app for her youngest daughter, Scarlett, since she was born. Scarlett had to go in for follow-up care after she got sick when she was five weeks old. At the same time, Marote also got sick.

“One thing that was really convenient while I was in the hospital was you could look at the after care summaries,” Marote said. “It was nice to look at all the information and not second-guess myself.”

Marote continues to use the app to keep in touch with Scarlett’s doctor. When she’s on the go, she shoots the doctor a quick email so that she doesn’t forget to communicate important information later.

“I think this has actually strengthened the relationship I have with folks,” said Colorado-based Kaiser Permanente pediatrician Mark Groshek. He said he can respond with a quick email to worried parents, giving them the reassurance they need.

Doximity, which offers a social network for providers, partnered with Stanford Medical School to create an alumni application. The app allows physicians to search a directory of published articles, lectures, clinical trials and CVs from their peers.

This week is national nurse week. To celebrate, Voalté, creator of health care communication software, is hosting a storytelling competition on Facebook so nurses can share why they chose to go into their profession.

Shareable Ink and Medical Web Technologies integrated Shareable Ink’s electronic medical record and the One Medical Passport System. Web Technologies’ passport lets patients scheduled for surgery enter their demographic, insurance and medical information online. It’s then made available to their medical facilities on an EMR.

Houston-based Memorial Hermann hospital @houstonhospital will live-tweet a brain surgery today from 7:30 a.m. to 11:30 a.m. CST. This comes after the hospital’s twitter coverage of an open-heart surgery in February.

Clinverse, Inc., a cloud-based financial management software for clinical trials, closed a $3.8 million Series B round of funding. The round was led by Hatteras Venture Partners.

Verizon partnered with TeleCommunication Systems Inc. to create a 911 texting service. Using SMS can help those who are deaf or hard of hearing to report an emergency.

Health 2.0′s Codeathon in Boston this week will focus on creating Big Data applications. Register here.

The Centers for Medicare & Medicaid Services announced a delay for data collection under the Sunshine Act. The act requires the reporting of payments or gifts to physicians. CMS said the delay will give organizations time to prepare their submissions.

The Institute for Health Technology Transformation released “A Roadmap for Provider-Based Automation in a New Era of Healthcare.” The report gives advice on how to set up health IT applications for population health management.

UnitedHealth Group, the nation’s largest insurer, brought in more than $100 billion in 2011. In recent years it’s expanded to more areas of health care by setting up 24-hour nurse hotlines and electronic medical records, and it even owns a bank that handles health savings accounts.

Matthew Holt: So Pfizer is a large pharmaceutical company that is doing a lot of work in internal strategy, but also taking part in investments and the connected health platform. Can you give me a flavor of a couple of things that you’ve been involved with over the last year or so that match those categories?

Wendy Mayer: Sure. So actually the investment area is a relatively new one for us, but we have been closely involved with some accelerator programs. I have someone on my team who has been a mentor to some of the local accelerators that we have here in New York.

We’ve been very actively involved with different venture funds to give some insight into areas that we’ve been focused on, and try to work on getting a better sense for where the environment is going and where there could be some opportunities.

So, I was having a conversation with a startup the other day that’s focused on partnering with some of the bigger physician information portals and using that as a way to kind of connect into some of Pfizer’s information. So we’re looking at those kind of opportunities and have made some direct investments in those areas.

We have an investment in an organization called Keas, which is a health and wellness gaming system that encourages and motivates people to change behavior towards more health and wellness types of activities. It utilizes a gaming methodology with points and rewards in order to incentivize that behavior.

Matthew Holt: We know them very well–they debuted Health 2.0’s San Francisco Conference in 2009. That’s great information.

Wendy Mayer: Yup! We’re using our external connections to make some direct investments from more of a strategic understanding.

Matthew Holt: Alright, I’m going to ask you easy, practical questions and then some philosophical questions.

The practical question is, if there is a small organization or technology company that might sit well with Pfizer, how do you guys approach them? What’s the best way for those organizations to somehow get in front of you? And what’s the specific thing that you’re looking for?

Wendy Mayer: Right. We’re essentially looking for alignment with our broader strategy. I think the biggest challenge that we have is that there are a lot of people with really great ideas and really great offerings, and we’re very often pitched on a number of different areas.

But the areas that we weaved and found internally, even if you can get an internal audience for an idea where teams get frustrated and hit the brick wall is if it’s not aligned from a strategic opportunity standpoint, then there just isn’t funding and support internally to move things forward.

So if you have an idea that you think will be aligned strategically, that could be an avenue in an angle to approach internally.

It is quite honestly, just about kind of knowing the people to connect with and in some ways, it’s the right person at the right time kind of situation.

But internally, we’re trying to do a better job of triaging some of these opportunities by putting the filter of strategic alignment on to many of these opportunities.

Matthew Holt: Yes, I think that’s something that Health 2.0 is actually doing with this Matchpoint process. We’re trying to figure out how you explain to a small startup, not only here’s what you need to say to these folks, but also to a large organization like the Pfizer or Enron or another, that what they’re actually looking for exists.

Wendy Mayer: Yeah. And I think quite honestly, there’s probably more of an onus on us, because if we’re expecting that we’ll be able to find some of these opportunities, then we need to be more specific and transparent about what areas of opportunity we’re focused on, because that’s where you get efficiency across the board.

We’re trying to–as best we can–be focused. The broader scattershot approach tends to not to work as well.

Matthew Holt: Let me ask you the most philosophical question, or broad strategic question, which is that Pfizer is obviously best known as a blockbuster brand. Recently, it’s biggest product has gone off patent. The organization as a whole, obviously, is going to have to do sort of more than less, and innovation is a big part of that.

But going forward five years, do you expect Pfizer to be regarded as not being a drug company but running other services that might come in through your organization? I’m trying to sort of grasp the strategic importance of your innovation-focused work to the overall business.

Wendy Mayer: Yeah, it’s an interesting question and I don’t know that I necessarily have the answer, but I will say that part of the debate that we have internally is do we need to do more with less or do we need to do less with less.

And I think that in part that’s to the question that you’re asking. So, do we need to try to be more things, because just being a drug company is not going to be sufficient, or do we need to be very targeted and focused and recognize where we could drive the greatest value within our organization and scale back on what we’re doing and focus just on that?

I will say we are very tuned to the needs of our stakeholders and the evolving health care environment. We spend a lot of time and effort to try to understand how a number of the global changes within the health care environment impact not only our business, but the business of all of our stakeholders, because that ultimately drives what they need and what they want and how we can best support them.

So to that end, we have been looking a lot at not just the drugs. I think we have a program that we just recently instituted that was actually one of our innovation platforms last year. Integrated Health is more about recognizing that there are a lot of elements that come into the management of the disease, and that drugs are just one part of that. At Pfizer we have a very good understanding of the disease states that our drugs are used to treat. So the opportunities that we have, whether it’s through a revenue generating opportunity or as a way to add greater value to the drugs that we deliver, is very much on improving outcomes.

What I don’t know is whether or not there will be things beyond those closer adjacencies that are tied to improving outcomes of particular disease areas.

And that’s an often internally debated topic as well. I think right now our stated direction and focus is on our innovative core. So that’s very much tied to the products in the disease areas that they represent.

But you’ll never know what the future will bring. This is our current position on the near-term horizon.

But what is the value in attendance? Better question, why has the event attracted more and more new attendees recently?

I’ve spent the last few years supporting private-sector healthcare innovation – especially around health IT.  What I’ve come to appreciate from those dedicated to the space – whether a two person startup or a carve-out within a large technology prime – is that success at every stage of innovative development is predicated on how quickly one can create value based on the expectations of the relevant stakeholders at that stage.

Put another way, if you are innovating in healthcare, you’ll advance to the next stage of development ONLY if you’re able to find the stakeholders you are supposed to collaborate with (a search issue) AND create innovative value based on their expectations (an execution issue).

The reason why this event has been quite successful in the past (typically filled to capacity) is because it offers a solution to the fundamental search and collaboration challenge for healthcare innovators.  In addition to keynote presentations from Todd Park and Bill Frist, there will be dozens of meet-up events and networking opportunities through the agenda and DC Health Innovation week.

If success in healthcare requires and appreciation of multiple perspectives from external, how do you have meaningful interactions with folks outside your immediate tribe? For example, if you’ve developed a prototype for your nurse-oriented mobile app, where would you find an appropriate testbed? Who would you consult with on usability and data standards issues?

This year’s Health Data Initiative registrations show quite a balance mix of innovation stakeholders – startups, developers, policymakers, investors, patients, caregivers, and educators.  The conference will be filled with a wide variety of backgrounds and talent – I would guess you would have as much chance of running into an engineering grad with the next big idea for diabetes medication adherence as you would Bertolini, Chairman and CEO of Aetna.  And while the event is centered around the health data, it is the ecosystem that has been built around the event that will be vital to those innovate.

I’ve mentioned before that innovation communities and meaningful exchanges are essential to the success of those developing health IT.  Health 2.0 and other forward looking organizations have risen to the challenge to host and encourage community building efforts – the May Boston Spring Fling is another great, upcoming example.

If you’re leading or hosting healthcare innovation community building efforts, I’d love to know about them.  Of course, if you’re able to register while space is still available, I look forward to seeing you at the June Datapalooza in DC!

Wil Yu leads nationwide healthcare innovation efforts for the U.S. through the Dept. of Health and Human Services.  He directs several innovation grant programs and created the “Investing in Innovations” program, i2, which utilizes prizes and challenge to spur early stage innovations and community building. (@HlthInnovaton)