Zen Pramod Menon

Should you sell your practice to a VC-Backed MSO Startup? tldr: - new VC-backed startups are forming MSOs to roll up independent practices - The pitch is physicians receive early liquidity from the roll up and are granted ESOP shares that can be used for retirement - Problem is the use of ESOPs with independent practices is not a new concept and has been used with large group practices since the 70's - ESOPs do not grant full ownership and in order for the shares to be valuable for retirement, the practice needs to run the same if not better post roll up - With VC-backed startups being primarily operated by non-physicians with zero clinical or medical practice experience, the likelihood of this happening is extremely low making the entire concept high risk However, there is a viable path for continued ownership + liquidity for independent practices. Check out the article to learn more. ⤵ https://lnkd.in/gmGvTYwP

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The US Physician Workforce will be decimated by the boomer doctor retirement cliff between now and 2030. A disturbing pattern in recent study findings makes this issue much more urgent - and the timeline to impact much shorter - than the government predictions. Let me show you why. The new statistics, the references ... everything The dots will all line up when you watch this short video and I'm happy to have the chance to show them to you. If you are a physician leader, this video is a Must-Watch because the mainstream media is not covering this phenomenon. Employers are only focused on short-term results: the numbers at the end of this second quarter, or the end of 2024.  They don't see this long-term trend. I also strongly recommend you share these videos with your C-suite - especially if your organization does not have a Corporate Wellness Strategy in place at this time. Learn what to watch out for - and what you must start doing now - to implement a Physician Wellness Strategy while there's still time. This trend will play out over the next three or four years. It's inevitable. You can't fight father time and nobody's getting any younger. Every doctor needs to know what is coming. Watch these short outtakes from this week's Wellness Champion Summit Webinar https://lnkd.in/gFYckWS4 **You will learn** 👉 What is the Boomer Doc retirement cliff? 👉🏽 How bad is it? 👉🏿 Recent changes in female physician and medical student behavior make things much worse. 👉 How the answer to this one question to your CMO doubles the projected physician shortage of 2030. 👉 Does AI at the same time make things better or worse? 👉🏿 What your organization must do now to prepare. 👉🏽 Why I'm predicting a brief window of opportunity for a corporate Physician Wellness Strategy - but you must act now!

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Revolutionizing Telemedicine: How We Beat the Odds and Built Teladoc Discover the incredible journey of Teladoc, a telemedicine pioneer, and how we overcame obstacles to transform healthcare. Follow us on Substack: https://lnkd.in/e49bGQUR Learn how our fearless team fought for change and built an engine that revolutionized the industry. #TelemedicineRevolution #HealthcareInnovation #DigitalHealth #TelehealthSuccess #HealthcareDisruption #EntrepreneurshipJourney #BuildingTechStartups #InnovativeHealthcare #MedicalTechnology #HealthcareTransformation

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A whirlwind of activity last week at the America's Physician Groups conference. Lots of solid insights shared by health system leaders. Some notable thoughts: +++ Artificial intelligence is intelligent in different ways: By now, we all know ai has a diverse set of use cases, incorporated in different applications and tools. But there are fundamental differences in how the intelligence itself is brought to life. Examples include: - Predictive AI, used to forecast future outcomes by leveraging historical data. Shout out to UCLA’s CKD/ESRD early intervention protocol (Joycee Berin) and Diagnostic Robotics’ intelligence care post-dicharge journeys (Kira Radinsky) - Protocolized AI, used to automating a user’s administrative load by using a set of detailed, pre-defined rule sets. Thanks to ARC for sharing their experience using Elaborate 's automated outpatient lab summaries (Manish Naik) - Generative AI, used to create new content. Great overview of ambient documentation at MGB as well as Cedars’ Sinai talking through its medical ontology model powering acute triage (Caroline Goldzweig) Across system leaders and experts, there was clear agreement that the first step to implementing intelligence intelligently is defining the ‘jobs to be done’. That way, internal and external stakeholders are clear on what they're solving for when they architect the solution.  +++ Scaling AI takes time and rigorous observation: Market leaders describe a phased pilot approach that allows clinicians to build confidence and system leaders to measure ROI before deploying systemwide. Loved hearing Rebecca Mishuris outline MGB’s novel approach of piloting two solutions against one another, to pressure test implementation, workflow, and value creation. +++ Proving ROI continues to be challenging: Lots of vendors using lots of different metrics to prove value, but the majority of leaders agreed that estimating the ROI of these new tools today is part science, part art. Demonstrating the ROI of the “soft” metrics around provider burnout and retention seemed to be a big opportunity, especially for investment in more efficient primary care and PCP wellbeing. After all, PCPs drive referrals to specialty-level care (and higher reimbursements) for health systems. Appreciated Anurang Revri's overview of how working team setup can also impact ROI estimates. +++ Value-based care = tools + humanity: VBC will require not only implementing tools to support clinical documentation, risk capture, upcoding, etc, but also humanizing interactions to engage patients. Countless examples, but one that made me smile was a depression focused chat bot responding in the following interaction: - Context: post-discharge check in Bot: Hi Freida, how are you feeling today after your surgery?  Patient: I’m having a tough time, am in a lot of pain.  Bot: Well, it can’t be that bad, I’m sure it will get better with a positive mindset!    🤣 🤣 🤣 Can't wait for next go-around!

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Investing in companies that fill needs for health systems is a growth opportunity for both delivery organizations and start ups. Some systems are jumping in on their own, while others are partnering with like minded systems or with established VC firms. While this is a relatively new trend for systems, health plans have been making similar bets for many years. The benefits of becoming a health system portfolio company can be significant. Data, access to beta populations and real world coaching can be extremely beneficial. Start ups get mentoring and systems have to ability to leverage outside resources to solve relevant business problems. I predict a booming business!

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The Morisky Medication Adherence Scale-8 (MMAS-8) is an ideal barometric measure for assessing medication adherence among patients due to its reliability and consistency over time. Connect with me for more information and if you want to integrate this tool within your own EHR or digital platform for RPM, telehealth or DTx. Your patients deserve to know their adherence score and an opportunity to improve it over time. 1. Validity and Reliability: The MMAS-8 has been extensively validated in various patient populations and healthcare settings, demonstrating strong psychometric properties. Its reliability makes it a dependable tool for consistently measuring medication adherence among patients over time. Healthcare providers can trust the accuracy and consistency of MMAS-8 scores when assessing adherence levels. 2. Comprehensive Assessment: The MMAS-8 assesses multiple dimensions of medication adherence, including forgetfulness, carelessness, and intentional non-adherence. By capturing these various aspects of adherence behavior, the scale provides a comprehensive understanding of patients' medication-taking patterns. This comprehensive assessment enables healthcare providers to identify specific barriers to adherence and tailor interventions accordingly. 3. Easy Administration and Interpretation: The MMAS-8 is very easy to administer and interpret, making it practical for use in clinical practice. The scale consists of eight simple questions that patients can quickly respond to, minimizing burden on both patients and healthcare professionals. Scoring and interpreting MMAS-8 results are straightforward, allowing for efficient assessment of medication adherence during routine clinical visits. 4. Longitudinal Monitoring: Due to its reliability over time, the MMAS-8 can be used for longitudinal monitoring of medication adherence among patients with chronic conditions. By administering the scale at multiple time points, healthcare providers can track changes in adherence behavior, evaluate the effectiveness of adherence interventions, and identify trends or patterns that may require intervention adjustment. This longitudinal approach facilitates proactive management of adherence-related issues and supports continuity of care. 5. Predictive Value: Research has shown that MMAS-8 scores are predictive of various clinical outcomes, including treatment response, disease progression, and healthcare utilization. Patients with high MMAS-8 scores (indicating good adherence) are more likely to achieve therapeutic goals and experience positive health outcomes compared to those with low scores. By using the MMAS-8 as a barometric measure, healthcare providers can identify patients at risk of poor outcomes early on and intervene to improve adherence and prevent complications.

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Hey everyone! I’m excited to share our latest HIT Perspectives article, AI in Healthcare: Understanding Its Position on the Gartner Hype Cycle. We dive deep into how AI is transforming the healthcare industry and its place on the Gartner Hype Cycle. Right now, AI is making a difference in reducing administrative burdens, especially in clinical documentation. In many ways, this has been a game-changer in alleviating clinician burnout. However, while these advancements are promising, broader clinical applications of AI still face significant technical and ethical challenges, which means widespread adoption is on a slower track. Here are a few key takeaways: - What's Working Well: AI is making a big impact in administrative tasks, easing the load on healthcare providers. - Areas of Caution: Clinical decision-making applications still face hurdles. - Ethical Considerations: Issues like data privacy and AI bias need careful attention. At POCP, we’re doing more to help our clients understand how AI can fit into their technology roadmaps. We’re also focused on navigating the risks and current policy requirements related to AI. There are no silver bullets, but AI has a lot of potential to help reduce burdens in healthcare. If your organization is struggling with where to use AI and perhaps where to hold off, reach out to me. I'd love to set up time with one of subject matter experts to see if we can help. #HealthcareAI #GartnerHypeCycle #AIinHealthcare #TechInMedicine #ClinicalAI #EthicalAI https://hubs.li/Q02Gb82N0

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We need to highlight more bootstrapped healthcare companies. I rarely see founders of these small businesses profiled at conferences or in the media. The chances of building a $100M+ revenue healthcare company are very slim. But that’s the expectation once you accept VC funding (especially Series A and beyond). Let me remind you, most healthcare companies do lower revenue than total capital raised. And you can build a wonderful life and help your community with much lower revenue / growth, if you take minimal or no funding. And believe it or not, most VC-backed founders are fascinated by founders and business models that didn’t require external capital. Do you agree? Or would you prefer media and “influencers” to focus on venture-backed and publicly traded companies? Sometimes I feel like I’m shouting out into the void. Because majority of content is focused on the unicorn chasers. Would love to hear from founders of bootstrapped companies in the comments?

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Thoughts on AI automating healthcare jobs— Most industries have come around to looking at technology first to solve problems, then to people. Healthcare isn’t there yet. Clinics are really good at staffing—many hire thousands of employees every year—so hiring to solve problems is natural. We think AI accelerates the “normalization” of healthcare towards other industries. But as an assistant, rather than automation. Early signs are there. For example, every clinic has a vendor management team in charge of reconciling invoices and remitting payments. Tech companies mostly centralize that to 1 person who uses automated bill pay tools like Ramp and Rippling to leverage themselves. The 1 person is still needed for one-off issues & sanity checks. But most of the time consuming work is offloaded to tech. So—will providers, QA staff, billing teammates, and coders all lose their jobs to AI in the next 5 years? Unlikely. But will there be less manual work to go around, meaning less people needed at each company? Yes. The good news—tech makes it much easier & cheaper to start new businesses. Instead of an entrepreneur needing to put together $250k to start a new clinic, technology lets them now use cheaper leasing, legal, practice management, and billing tools to start for significantly less. So, while a medium-size clinic might not need 10 employees in their billing department anymore, we think 10 startup clinics each needing 1 billing person will pop up in their place. That person will do more interesting, higher-leverage, and higher-paid work. With tech & AI as their assistant.

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I believe that telemedicine plays a crucial role in managing ADHD medication management, but it's essential to strike a balance. While telemedicine is vital for chronic conditions, the need for occasional in-person visits for controlled substances is undeniable. Regular physical exams and blood pressure monitoring are crucial for safe prescribing practices. However, Done was incentivizing doctors to avoid telemedicine visits and promoting automatic refills. Encouraging prescriptions solely for financial gain not only compromises patient care but also led to regulatory intervention by the DOJ. Finding the right balance between telemedicine convenience and in-person care is key to ensuring quality healthcare practices. #Telemedicine #ADHD #Healthcare #PatientCare #InnovativeXCare

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We're underestimating how physicians will build and access software in the future and we're 100% underestimating how this will impact independent practice. By now I'm sure you've seen the Claude 3.5 Sonnet demos and all of the use cases or application non technical folks are building with 1-3 line prompts. Even Jensen Huang, CEO of Nvidia made a controversial comment on the future of coding, “It is our job to create computing technology such that nobody has to program. And that the programming language is human, everybody in the world is now a programmer. This is the miracle of artificial intelligence,” This is absolutely true, and if there's one area where this will have the biggest impact on society, it will be healthcare. The reason for that is that physicians and clinicians have NOT been included in the design of healthcare technology over the last 20ish years, leaving them to practice in systems designed by non-clinical people. Claude 3.5 offers a glimpse into the future of independent practice. Physicians will be able to design, build, and launch AI applications as needed without requiring developer support. In the future, I envision independent practices hiring their own AI Agent developers who can not only build these applications, but also integrate them into their practice operations infrastructure to create the ultimate practice management system. What application would you build if this were possible today? ----- Hi, I'm Dr. Mario Amaro, Founder and CEO Ease, and I talk about all things starting, running, and growing a private practice with AI. Follow me, if you are planning to start one or are currently figuring out creative ways to grow one. #PrivatePractice #SelfEmployment #HealthcareOnLinkedin #HeyEase #IndependentTogether #Fintech #Infrastructure #AIinHealthcare #CareDelivery

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The most successful network & relationship-builders master this skill: 👇 It changes the ENTIRE game. 💥 Learn to master patient cultivation. Lemme tell you why: I met Shea Taylor last October at the Venture Atlanta Conference. We had a pretty engaging dialogue -- that was the spark. 🗣️ Then things got busy with holidays, and it wouldn't be until late Jan. that we could sync up on zoom. Fast forward to a great lunch yesterday where we had an exciting convo about the Atlanta entrepreneurship economy. I relished hearing more about what J.P. Morgan is doing in the small business sphere and how The Zero to One Networker can collaborate on that broader mission. 🚀 Here's the point: It took TIME for schedules to align correctly to have that valuable dialogue. ⏳ (The same is true with other great people I met at Venture Atlanta who are now good friends: Nathan A. Stuck, MBA, Caleb Kitchings, Mirtha Donastorg, Benjamin C. Andrews III, etc.) Building relationships isn't going to be a quarterly-based goal. You grow a relationship like you grow a garden: 🌻 Patiently, with constant engagement. It usually takes ~6 months MINIMUM to build that dialogue. This is why a lot of people give up -- it's not quick. Do. Not. Give. Up. 👏 Keep showing up and looking for mutually beneficial arrangements. Create value for others in the community. Believe me, people notice. This is what makes some people absolutely MAGNETIC networkers. 🧲⚡ ➡️ Follow The Zero to One Networker to learn some of my KEY strategies in building huge networks. 📈 #networking #finance #business #entrepreneurship 🚀 #ZeroToOneNetworker 😎 #LookForTheOrangeSunglasses

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We're witnessing the next wave of leading companies being within healthcare services & being more "involved" than just writing good code. 🌊 I fundamentally believe it's equally important, understanding on the highest granularity, how healthcare is delivered at the core (in the clinics, hospitals & with doctors). A couple years ago there was a massive focus on digital health, this has shifted to healthcare services, experiencing exponential growth atm, due to the following. 📈 1. Operating within the very heterogenous market of healthcare (in particular primary care) requires to understand and interpret operational nuances (those closest to the problem/market will win) and solve for those very operational topics 🩸 2. Pain to innovate is highest amongst those delivering care, as there is no "continuing as before" (patients jump between services/providers based on availability, that's why digital health only takes off v slowly), doctors can't transition away but are "stuck" with their daily operational problems 😵‍💫 3. Willingness to pay is present, (see point 2.) and doctors can afford to pay for these services (shift from paying for "non-available" staff to software) and lastly it's the largest market (DACH €+550B primary care spend) with everyone being a user at one point, opening up multiple cross revenue streams 💸 4. No payor/insurance fights but a "simple" B2B customer (non of the DTx/reimbursement complexities) and a market with unparalleled retention rates (check CompuGroup revenues over the past 10 years, €1.2B in 2023) ⚔️ 5. Less regulation and increasing emphasis/relaxation on data usage (check Patient Data Protection Act or European Health Data Space) as well as enforced digitalisation throughout the upcoming years (every restaurant needs a modern POS, whilst doctors can still operate pen & paper...) ⚖️ Personally I am very bullish, that within the next 5 years, we'll see the N26/Revolut transformation happening in European healthcare - no flying cars - just better operations, services & experiences on top of existing core medical services. 💯 Thanks for the Eterno Health mention Thomas Hagemeijer - V cool overview! 🙌🏽

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In the realm of healthcare, patients often face significant challenges in post-hospital recovery and managing chronic conditions. Traditional rehabilitation methods, while effective, sometimes fall short of providing comprehensive care that addresses both physical and psychological needs. Enter hydrotherapy. At Sukino, we've introduced hydrotherapy services at our Bannerghatta centre in Bengaluru to bridge this gap. Hydrotherapy, or aqua therapy, harnesses the unique properties of water to facilitate rehabilitation and enhance overall well-being. It's especially effective for neurological and musculoskeletal conditions, enabling patients to practice coordinated and balanced movements in a supportive environment. The benefits are immense: pain relief, improved circulation, relaxation, enhanced flexibility, and faster recovery from injuries or surgeries. Additionally, it promotes psychological well-being by reducing stress and anxiety. We are happy to introduce hydrotherapy services as part of our continuum of care setup to deliver holistic healthcare solutions. Hydrotherapy has been recognised for its numerous health benefits, and we are excited to offer this innovative treatment option to our patients. It plays a crucial role in post-hospital or post-surgery rehabilitation by promoting faster recovery, reducing pain and inflammation, improving joint mobility, and restoring muscle strength. With services ranging from neurorehabilitation to palliative care, Sukino ensures that our patients receive all necessary medical aid during their recuperative journey. We're pushing boundaries to make sure no patient has to go elsewhere for their medical needs. Want to learn more about our innovative hydrotherapy services? Visit our website and see how we are transforming healthcare in India: https://zurl.co/gxd1 #SukinoHealthcare #Hydrotherapy #ContinuumCare #Rehabilitation #HolisticCare #InnovativeHealthcare #WellnessJourney

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Here’s your recap of last week’s health IT news 🗞️ 👇 🥼AI Clinician Assistant • Suki : The AI scribe announced an SDK and APIs enabling developers to integrate ambient documentation into their applications. • Apricot: The gen AI pre-seed startup focused on reducing documentation overhead for home health nurses launched. • Tampa General Hospital + Palantir Technologies: The health system and the software platform are partnering to develop an AI care coordination and decision support platform. ☎️ AI Contact Center • Mediktor + Sensely: The AI symptom triage solution acquired the conversational member engagement platform. 📋  Patient Administration • Oracle (Cerner) + Loyal: The EHR now offers integration with the patient engagement solution through its Healthcare Marketplace. • HubSpot: The CRM and marketing platform announced it will now offer HIPAA support and sensitive data tools. 🏥 Provider and Practice Administration • LeanTaaS: The AI-enabled facility management solution released updates including: mobile-first live view of OR schedule, predictive staffing automation, and a gen AI solution allowing decision-makers to glean staffing and scheduling insights. ⚕️ Clinical Operations • Keragon: The HIPAA-compliant automation platform launched out of stealth with a $3M funding round. 🧑‍💻 Virtual and At-Home Care • AvaSure + CLEW: The virtual care platform is partnering with the AI-powered remote patient monitoring and analytics company to improve patient outcomes. 🍎 VBC • Evolent + Machinify, Inc.: The VBC org acquired AI Authorization assets from the AI operating system platform.    • ProgenyHealth, LLC + Wildflower Health: The maternity and NICU case management solution is partnering with the women’s health VBC enabler to “help health plans fill gaps, collapse silos and integrate into existing clinical and operational workflows.”    • Health Catalyst + Carevīve: The population health data and analytics company has completed acquisition of the cancer care management solution. 🧠 Food for Thought: • This article provided an interesting look at Nebraska Medicine’s efforts to design a next-generation hospital room, including the four technologies they’ve selected to anchor their work. https://lnkd.in/em-u-a5v    • McKinsey released a survey of 200 global health system executives on their investment priorities. Among the notable findings, 88% listed AI as an area of high potential impact, yet only 40% have implemented any solution thus far and over 20% don’t have plans to invest in the next two years. https://lnkd.in/eK3CeqQ2

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