When you have the wrong hub, your spokes don't matter
In December, I had the pleasure of leading a Kellogg Levy Inspiration Trek to Boston with 12 of Kellogg's best and brightest to explore digital health entrepreneurship. At our closing dinner, I asked the students about key takeaways from our amazing experts and speakers. A few months later, there is one takeaway that I keep coming back to courtesy of Dr. Jeff Greenberg, co-founder of Firefly Health.
Like for many digital health companies, engaging the patient population is key to Firefly's success. As someone who spends a lot of time thinking about the behavioral science of engagement, I love hearing how others approach it. Jeff described one way they approached things differently in building Firefly, specifically around their tech stack. Rather than trying to take the traditional health care system model and bolt onto it to activate and engage their patients, Firefly flipped a key element of the tech enablement portion of the model - they put their CRM at the center of the tech hub, not the EMR.
There is no shortage of complaining about how EMRs suck - for providers and patients. Rather than replicating that pain point in the virtual care delivery model, Firefly was thoughtful about what their goals were and how they could best use technology to support them
Early stage investors anchor heavily on the team in investment decisions. That might mean the team's track record at previous start ups. It might mean unique sub sector knowledge. But it can also mean the team shows you how they intend to deliver different outcomes by making choices that reflect challenging assumptions or hypotheses about different paths to yield the desired clinical outcome.
In this case, by challenging the assumption that the EMR needs to be at the center of a clinical care tech stack, the Firefly team showed us one tangible way that they plan to execute differently to deliver different results from traditional care.
On her podcast, Stacey and I talked about what founders and leaders need to do to deliver outcomes on her podcast and how those decisions aren't always easy. In the short term, the Firefly decision makes the technical build harder, riskier and more expensive. But has the potential to deliver higher engagement and better outcomes.
We also talked about how leaders communicate KPIs (or OKRs or whatever you call them) to the team - it is a reflection of what matters. If I'm a clinical leader being told that patient engagement is our northstar and you hand me clinical and patient facing tech that sucks, I can see the disconnect. Building a tech stack that actually reflects what you say is most important to your business has the potential to increase your clinical and clinical ops employee satisfaction. I had a product consulting engagement with a virtual care company around their EHR. The clinicians hated what they had, clinical ops hated what they had, their biz dev and (B2B) client service teams didn't like it either. I asked a focus group of providers what they had used in prior roles. They offered up some names. And when I asked if they liked that alternative, no one said yes. Many of the reasons centered around the inability of the EHR (any EHR) to support the work they viewed as most critical to delivering outcomes. The outcomes their employer (current, former) told the world was their key value proposition. Clinician burnout and retention may not be THE reason to rethink where the EHR fits in your tech enabled care delivery model, but it should definitely be A reason.