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.

Here are our 10 Launch! participants:

Cobalt Therapeutics has a portfolio of online cognitive behavioral health programs.

HealthSouk is an online marketplace and bazaar, of sorts, for health care services.

Kinergy Health is a private health care network for patients and caregivers to manage their communication with health care team members and facilities.

RealMealz is web and mobile application focused on teaching new and occasional cooks the skills, recipes and telling them what ingredients they need to make healthy and delicious meals.

BetterDoctor is a new doctor search tool that helps users find the best doctor for their needs in their area.

function Medicine is a wellness program based on easy to use, but complex weekly baseline health assessments.

Novi Medicine is an online dermatology service with diagnosis and treatment for skin conditions.

Thryve is an online and mobile food tracker and coach.

eTherpi is a comprehensive online behavioral health portal, video chat service, and practice management solution for therapists.

OnPulse is a secure, online platform for healthcare providers and patients to share information with each other and patients.

Editor’s Note: This post first ran May 1. After each company launched this afternoon at Health 2.0 Matchpoint Boston, audience members voted on their favorite startup. Thryve came in first place with about 20% of the votes. Congratulations!

1st - $4,000

And an invite to Health 2.0′s Spring Fling: Matchpoint Boston and athenahealth’s More Disruption Please conference.

No Sleep Kills: Poor sleep health from conditions like sleep apnea leads to increased risk of car crashes and other dangerous accidents. Almost two million drivers crash because of fatigue each year. The No Sleep Kills app creates a portal where patients/professionals can review and access data regarding sleep risks by state and compare to national averages. The application uses big data to compare sleep-related car crashes with rates of sleep apnea and related conditions like obesity. The team’s next step is to compare sleep-related accident data with sleep apnea testing expenditures on a state by state basis. No Sleep Kills showed us an application of big data to a little publicized issue that is actually a serious problem.

2nd Place – $3000

MyBetterFit: This team mined nearly one million user profiles charting effectiveness and side effects to various drugs. As a next step, they aggregated the data by user and condition, then compared effectiveness of common treatments for the users who had taken at least two drugs. There were over 100,000 such users in the case of depression, with an average of nine treatments tried per user. Treatments also included activities like journaling, exercise and therapy in addition to conventional anti-depressants. As a starting point, today MyBetterFit has discovered a number of interesting correlations regarding which drugs will be effective for a user given his or her previous reactions to other treatments.

3rd place – $1000

Brain Safe: Using normalized, age specific brainwave data from the NIH, the Brain Safe platform identifies abnormally high Beta brain waves in tested users. Incorporating a Mindwave Mobile headset to measure brain waves and an Orbotix Sphero to provide instant feedback, their interface provides an immediate way to measure potential braininjury. This platform can track and identify sports players who may have had a concussive event.

Runners Up – $500

Team Data-Driven: The “Decisions for Diminutive Descendants” tool helps families find healthy areas to live based on a series of health factors that they can rank by importance. For the prototype, Team Data-Driven focused on enabling people to compare a series of addresses. Their data source for the prototype was the 2012 County Health Rankings dataset, but many additional data sets could be integrated as well.

I’m Sick: ”I’m Sick” allows you to navigate through your social network to identify who has been sick and how long their disease lasted. This informs your decision on whether you need to seek treatment. The peer-to-peer epidemiological tool allows you to track sickness as it pertains to you.

Aavya Health: This team designed a web application that enables patients to understand their lab results in a visually attractive, intuitive manner. The application also provides concrete insights how these results affect patients’ risk of disease and how these risks can be modified by behavior change.

StayDays: StayDays is a mobile application, implemented on the Google Android platform today, that displays the probable length of stay, in days, for a hospitalization based on the diagnosis/reason for the hospitalization.

Despite the fact that more than $10,000 in cash and prizes are to be given out for the day, the money was not the primary motivator for many.

“I’m mostly interested in seeing what’s out there and what I can learn about data analysis,” said Bobby Cahill, a developer who specializes in PHP programming in a non-health care industry.

Brad Weinberg, MD, co-founder of Blueprint Health, a health incubator based in NYC, spoke about how “entrepreneurs commonly make two mistakes: Type 1 and Type 2. Type 1 mistakes are the mistakes you realize you make, while type 2 are the opportunities that you miss.”

Without doubt, the folks at the code-a-thon have become true risk takers and opportunists simply by showing up and are unlikely to make type 2 mistakes.

Code-a-thon winners are expected to be announced around 7pm EST and will be posted on Health 2.0 News later in the evening.

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.

So let’s start off with, many people probably noticed that your folks have been at Health 2.0 a couple of times and that Angie’s List, which started off doing work for contractors, plumbers, restaurants, has now goten into rating doctors and hospitals a few years back. But just give us a sense about the role of health care within your business?

Roys Laux:
Yeah, absolutely! This is a vertical that’s growing within Angie’s List, and it’s obviously very important to us, and we continue to invest there at a very high level. Of course Angie’s List’s mission is connecting consumers with the best service providers that they need for a given service at any point in time.

And so, as you say, that started with home contractors, plumbers, roofers, handymen…because these were high cost-to-failure service providers that homeowners needed to find and didn’t have good referral sources for.

It’s interesting that those kind of same member consumers also want to shop for their doctors and don’t always have a great place to get recommendations for doctors unless they are seeking a specialist and are getting a referral from another doctor.

And so Angie’s List has sort of continued to grow in this space to meet the needs of their members. And we intent to keep growing in this space, especially as online ratings across the board are beginning to change the way consumers really shop for medical professionals.

Matthew Holt:
Right. So obviously it may be a little bit unusual for those looking at your participation at Matchpoint Boston, that you are now out looking for partners to do a whole host of different settings.

You are looking for patient provided communication companies, people providing outcomes and data, people doing personal health management tools…so I assume this means that you are thinking strategically about sort of expanding other services you can offer those consumers who are interested in finding the right doctor or health care professional.

So can you talk a little about your sort of general strategy going forward?

Roys Laux:
We know that our members tend to be people who have more money than time and really want a trusted resource to help them navigate, not just sort of the things they need to maintain at home, but also other things in their lifestyle. And so Angie’s List begins to become that trusted resource for these members in the health space. If we can bring tools to these consumers that will help them manage their health, the health of their families, that will help them more easily select and communicate with health care providers or make decisions about their own health care. This is a role we believe we can continue to grow, that value added product for our members.

Now, we could certainly go out like to software development companies and try to create our own tools in this space, but we understand that Health 2.0 has a wealth of innovative resources kind of as an organization that you can tap into, and so we are excited to learn what some of those may be that could partner nicely with Angie’s List to bring more value to our consumer members.

Matthew Holt:
On that point, have you done anything similar across the board in other areas–so non-health medical–in terms of partnering with other companies and moving into other areas beyond what people want, or is this kind of the first time you will be trying that?

Roys Laux:
We are parallel passing that on other parts of Angie’s List currently. So just like we are out looking for pilots and partners in the health space, we are also looking for other value added tools we can add in the home services space, and some of that is going to be in-house innovation, but some of that is going to be partnering and bringing in new resources, or even potentially acquiring other companies as well.

Matthew Holt:
Great! And I guess in terms of the health space and particularly Matchpoint Boston, you have got a list of folks who have gone to the website and seen what different types of activities you are looking to find.

But of the various things that you have been looking for in terms of looking out at companies, what do you think you are most excited about? What would be sort of a really good nugget to uncover?

Roys Laux:
A couple of things that I think are maybe most strategically aligned with where Angie’s List is today, just generally in the business and then also as it continues to move forward, are anything in the space of eCommerce, or health eCommerce. People who may be members of Angie’s List or are familiar with Angie’s List can see that, not only are we connecting our members to service providers, but we are also helping them choose a provider that can do the job at the right price.

We have a big deal product that we offer. We have storefront products that both health providers and traditional home services providers can stand up on our website. But we don’t have a really concerted effort in this area, specifically in the health space today.

I think if there are some great eCommerce tools out there that maybe allow a consumer to basically find price compare and shop for, not just quality, but also prices on medical services, that may be of interest to us.

Answering questions for people as they are trying to choose a provider or make health decisions in sort of an online chat and Q&A portion, this is something that, yes, we have some functionality around for certain parts of our product offering today, but nothing that’s sort of in the health space, so this is something that’s of interest to us.

And of course just anything we could add that would enhance the profiles of the providers we have information on today. So whether it is outcomes data, whether it is peer clinical rankings and ratings, those things may also be attractive and just a value add for members that are selecting a provider.

Matthew Holt:
Great! So that’s a whole list of stuff, but a lot of it around sort of enhancing the experience of consumers online as they work through that and you are working to enhancing the health care experience on Angie’s List for people who are coming and looking for providers and sort of taking the next steps, so that’s fabulous.

Roys, we look forward to seeing you in Boston.

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.