GUEST POST from Arlen Meyers

Enormous amounts of patient data creates big business opportunities. In fact, some day, patient sick care might be a loss leader. Instead, the revenue model will be patients owning data and using a platform to sell it for a price. Patients will become digital health entrepreneurs.

Selling your sick care data is called an “edge opportunity”.

We are headed in that direction.

1. Blockchain technology could make it easier for patients to own their data and share it , or sell it, with anyone they choose
2. Third party data science companies will churn submissions and deliver information and actionable intelligence as a service
3. The FDA will change how it regulates software as a device, data as a service and intelligence as a service
4. Online platforms will broker the two sided market between the buyers and patient sellers of data
5. ICOs will cater to data sellers in exchange for cryptocurrencies
6. Public databases that are open to data and biomedical scientists will be open for research, much like present genomics data bases run by public agencies like the NIH and NCI
7. Data entrepreneurs will translate publically available databases to commercial products
8. Data selling and the resulting revenue will be a new employee benefit for those working for self insured corporations, unions or other entities. Patient reported outcomes will one of the data sources along with the internet of medical things.
9. Value based care intermediaries will create a new revenue model
10. The sick care data value chain will evolve and get more complicated. It will start with patient owned data and eventually be bought and sold though a series of value added steps by intermediaries. Here is what it looks like:

• Discover: In today’s digitized world, there are many sources of data that help solve business problems that are both internal and external to organizations. Data sources need to be located and evaluated for cost, coverage, and quality.
• Ingest: The ingest pipeline is fundamental to enabling the reliable operation of entire data platforms. There are diverse file formats and network connections to consider, as well as considerations around frequency and volume.
• Process: Many applications are well served by processing data immediately following the ingest stage, to transform the data into a format that facilitates its reuse or to take immediate action based on incoming events.
• Persist: Cost-effective distributed storage offers many options for persisting data. The choice of format or database technology is often influenced by the nature of other stages in the value chain, especially analysis.
• Integrate: Much of the value in big data can be found from combining a variety of data sources to find new insights. Integration is a nontrivial but valuable step in which this combination process occurs.
• Analyze: The star of the big data show—analysis—depends critically on every other step in the value chain—the so-called data janitorial work that makes up 80 percent of data science. New insights and actions are derived from data, enabled by an ever-growing and nuanced choice of tools and platforms.
• Expose: The results of analytics and data that are exposed to the organization in a way that makes them useful for value creation represents the final step in deriving value from data.

11. We will need to address the societal and ethical implications. Who rules AI? There are three basic challenges: data protection requirements, minimizing biases and transparency.

12. Silicon Valley startup Open Health Network, which develops AI-based applications for healthcare organizations like UCSF, Sanofi and Cornell University has launched a new product meant to use blockchain technology to allow patients to manage and monetize their medical data. If successful patients will be able to sell their assets on the PDX. a NASDAQ for patient data.

Of course, there will be a dark side to all of this. Every time shoppers return purchases to Best Buy Co. , they are tracked by a company which has the power to override the store’s touted policy and refuse to refund their money.

That is because the electronics giant is one of several chains that have hired a service called The Retail Equation to score customers’ shopping behavior and impose limits on the amount of merchandise they can return.

Will patients be refused services for “abusing” the system, or doctors refused payment because they take care of them? Aetna already tried that, but had to back off after the backlash.

Airlines might charge you based on your online shopping history. Will the same thing happen to your sick care insurance premiums?

Nearly one in five employees in the healthcare field said they’re willing to sell confidential data like login credentials to unauthorized parties, a new survey from Accenture claims. Nearly one quarter of the survey’s respondents said they know someone in their organization who has sold their credentials or access to an unauthorized outsider.

A bid and asked sick care data revenue model is inevitable.What would you charge for your data ? What’s in your iPhone?

 
Image Credit: Pixabay

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GUEST POST from Arlen Meyers

I’m a privileged, old white guy who won the ovary lottery. My child of immigrant, first generation to college father got advanced degrees. Consequently, I was able to grow up in the right ZIP code and take advantage of the opportunities afforded to me by sheer dumb luck. As a result, I wound up being an academic surgeon and worked at the same place for 40 years until I retired as an emeritus professor to pursue my next encore side gig, including working with several non-profits that sit at the intersection of sick care, higher education, biomedical and clinical entrepreneurship and diversity, equity and inclusion.

Like everyone else though, regardless of status, there was a lot of life collateral damage along the way.

Increasingly, my story has become a rare one. A more common commentary is getting multiple degrees with big student debt, jumping from job, or side gig or career to job or side gig or career, no retirement savings and living in your parent’s house. Just ask your Lyft driver who’s moving back in with mom and dad. Younger people are also more likely to be lonely.

Members of Generation Z, born between the mid-1990s and the early 2000s, had an overall loneliness score of 48.3. Millennials, just a little bit older, scored 45.3. By comparison, baby boomers scored 42.4. The Greatest Generation, people ages 72 and above, had a score of 38.6 on the loneliness scale.

I pursued these adjacent careers because, in part, after 40 years of taking care of 20 patients a day, I increasingly felt I was treating the societal and systemic symptoms and not the disease. They are wicked problems indeed with no simple single bullets.

The disease- opportunity, income,healthcare and education inequality- has become epidemic and all the statistics show it.

As one of the haves, I’m trying to set an example for the other haves and show why and how diversity, entrepreneurship and sick care are wicked problems requiring inter-system solutions and why it is in the best interests of old white guys like me to solve them.

Here’s are 3 reasons:

THERE ARE COMPELLING BUSINESS REASONS TO DO IT

Four key arguments make the case for diversity, equity, and inclusion:

• The moral or social justice case asserts that each person has value to contribute, and that we must address barriers and historical factors that have led to unfair conditions for marginalized populations. For example, racial equity refers to what a genuinely non-racist society would look like, where the distribution of society’s benefits and burdens would not be skewed by race, and individuals would be no more or less likely to experience them due to the color of their skin. From a moral perspective, nonprofits are created to improve society and as such they should be diverse, inclusive, and equitable.
• The economic case is based on the idea that organizations and countries that tap into diverse talent pools are stronger and more efficient. Economists see discrimination as economic inefficiency – the result of a systematic misallocation of human resources. In fact, the Center For American Progress finds that workplace discrimination against employees based on race, gender or sexual orientation costs businesses an estimated $64 billion annually. That amount represents the annual estimated cost of losing and replacing more than 2 million American workers who leave their jobs each year due to unfairness and discrimination. In this argument, organizations should become more diverse and inclusive because it makes economic sense to leverage the talent pools of different populations.
• The market case states that organizations will better serve their customers if they reflect the diversity of their market base. A dramatic demographic shift is under way in the U.S., which will be majority non-white around 2043 according to the Census Bureau. In the private sector, companies such as Deloitte recognize the buying power of minority populations and highlight that diversity is critical to growing market share and bottom line. In the nonprofit sector, clients are our customers, and they want to see themselves represented in the organizations that serve them. Donors are also customers, and organizations and their clients can benefit from the resources of different groups. What’s more, organizations with diverse leadership are more likely to understand the needs of a diverse client base.
• The results case is that diverse teams lead to better outputs. Scott Page, author of The Difference: How the Power of Diversity Creates Better Groups, Firms, Schools and Societies, uses mathematical modeling and case studies to show how diversity leads to increased productivity. His research found that diverse groups of problem solvers outperform the groups of the best individuals at solving problems. Diverse nonprofit organizations, and the diversity of perspectives within them, will lead to better solutions to social problems.

SICK CARE CANNOT BE TRANSFORMED INTO HEALTHCARE WITHOUT ADDRESSING THE SOCIAL DETERMINANTS OF ADVERSE OUTCOMES

I’ve worked for many years in “safety net” hospitals-city and county hospitals, university hospitals that take care of a disproportionate share of poor patients, VA patients who are homeless, and native American facilities located on reservations with a culture of poverty. In most instances, health success has little of nothing to do with what goes on in the examining room. Instead, the psycho-social and behavioral health context usually is a predictor of treatment success or failure. In most instances, doctors are ill-prepared to deal with those issues and live at the epicenter of medicine, the legal system, medical sociology and a very dysfunctional mental and behavioral health pseudo-system.

UNHEALTHY STUDENTS MAKE POOR LEARNERS

Here is how education affects health and the price we, as a society, are paying by ignoring the long term consequences.

Most diversity and inclusion conferences are filled with the faces of a demographic that does not reflect the faces back at the office. Most of the people in the corner offices , like in IT, financial services, law and medicine, are older white guys like me.

While demographic diversity is important, psychographic diversity is equally important when it comes to creating high performance teams.

Plus, Pew asked a nationally representative sample of white men with jobs in science, technology, math and engineering (or STEM) fields whether they thought their gender made it harder for them to succeed. Of the 14 percent who said yes, more than one in 10 said they had been affected by reverse discrimination.

Women in medicine burn out more than men. Solutions will need to address personal, professional cultural, organizational and systemic issues.

The agenda for change should be at multiple levels:

1. Personal to build resilience and action plan to confront examples of sexism, e.g. not participating in manels that are not diverse, academic glass ceilings, board representation, etc

2. Organizational to remove sexism and stereotypes through transparent policies and procedures and outcome metrics and future of work issues (job sharing, gig economy, changes in the structure of pensions and benefits, etc)

3. Medical professional cultural to recognize the differences in female physician practice styles and unique accomodations that need to be made for family and child care giving and maternity issues. particularly in medical specialties like general surgery, orthopedics and others that have female under representation.

https://www.ama-assn.org/residents-students/specialty-profiles/these-medical-specialties-have-biggest-gender-imbalances

4. Systemic to remove administrivia and non-essential care giving tasks and reimbursement rules that discriminate against specialties with high female participation

Changing that will mean those with the power will have to give it up in order to get more power. As a recent diversity and inclusion keynoter noted, be a go giver, not a go getter. Be the solution, not the problem.

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GUEST POST from Arlen Meyers

In their book, The Innovator’s DNA, the authors identified 5 parts to the secret sauce of innovative business success:

In thinking about how these skills work together, they found it useful to apply the metaphor of DNA. Associating is like the backbone structure of DNA’s double helix; four patterns of action (questioning, observing, experimenting, and networking) wind around this backbone, helping to cultivate new insights. And just as each person’s physical DNA is unique, each individual we studied had a unique innovator’s DNA for generating breakthrough business ideas.

Innovation starts with mindset. Most scientists, engineers and health professionals don’t have it. However, there are ways to develop and change the gene expression by practicing epigenetic exercises. In case you missed that biology class, epigenetics literally means “above” or “on top of” genetics. It refers to external modifications to DNA that turn genes “on” or “off.” These modifications do not change the DNA sequence, but instead, they affect how cells “read” genes.

So, if you want to unlock your innerpreneurial genes, try :

1. Associating, by realizing that sickcare USA cannot be fixed from inside.
2. Associating by practicing open innovation
3. Associating by thinking twice about thinking out of the box
4. Questioning by being a problem seeker, not a problem solver
5. Questioning why not instead of why and getting to why
6. Observing by learning to see around corners
7. Observing by looking for the clues, not the roadmap
8. Experimenting by using the business model canvas instead of writing a business plan
9. Experimenting by applying your clinical or scientific mindset
10. Networking by building robust internal and external networks
11. Networking the right way when coldLinking
12. Networking by learning how to meet up at a Meetup

Here are some more ways to sharpen your entrepreneurial skills.

Doctors have the potential to make great entrepreneurs because they have the DNA. No, they are not lousy business people. Downstream gene expression, though, is often a problem.

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GUEST POST from Arlen Meyers

Business plan. Those two words have been used a lot to kill a lot of innovative ideas. Yet, it persists in the entrepreneurial consciousness. It’s a mainstay in the manager’s tool box. Sure, it you are going to ask for money, you will in all likelihood need to write a business plan. But, so few entrepreneurs actually get to that stage, that it’s putting the cart before the horse. I’m not the only one who thinks so. There are lots of reasons why writing a business plan, or even worse, telling someone to write a business plan, is a bad idea. Here are some more:

1. Business plans are usually smoke and include financial projections that, at the most, are guesses without valid underlying assumptions on which they are based.

2. There is little evidence that business plans are related to business success.

3. Few successful businesses wind up doing what they said they would do in their initial business plan

4. Few investors or sponsors want to see a business plan first. They want a concise pitch that generates further interest.

5. As Guy Kawasaki points out in ” The Art of the Start: 2.0″, business plan competitions are really pitch competitions. It would be a whole lot easier for BP judges to watch submitted 3 minute videos than have to plow through pages of business plan submissions.

6. Business plans are used by dull managers to dissuade innovation. Have an idea that could kill our cash cow? Go write a business plan and get back to me. It’s called triage by inconvenience.

7. Most intrapreneurs don’t know how to write a business plan so it’s another way to kill ideas.

8. Planning is different from writing a business plan

9. Most of what you would put into a business plan anyway can be validated before and if you get to that stage.

10. Better to create and test a business model canvass than a business plan

Distracting you and hoping you’ll get discouraged is but one arrow the in the anti-innovative bureaucrats quiver. There are many more:

Deflection: turfing you to the death committee

Delay: Maybe some other time

Denial: We don’t have a problem

Discounting: It’s really not that big of an issue

Deception: They make up facts that discredit you

Dividing: Divide and conquer

Dulcifying or appeasing: Making meaningless concessions

Discrediting: Sniping

Destroying:Trying to ruin you and your reputation and get you to quit or retire

Dealing: Compromise and give you just enough to make you go away.

Maybe you work in a place with this org chart:

There are alternatives to writing a business plan based on :

Prototype: Sketch out your idea quickly with the Business Model Canvas and Value Proposition Canvas.

Question: Ask yourself what needs to be true for your idea to work, i.e. define the underlying hypotheses.

Test: Test the desirability (will customers want it?), feasibility (can I build it?), and viability (will it be profitable?)

Iterate: Adapt your initial rough Business Model and Value Proposition Canvas and refine with increasing evidence from testing.

Here are some more innovation killers

 Still not convinced? Try these too.

Look out for killer phrases that start with “That’s a good idea, but…”

1. It’s against company policy
2. It’s not practical
3. It’s not necessary
4. We don’t have the resources
5. It will cost too much
6. We’ve never done it that way
7. Our customers (or vendors) won’t like it
8. It needs more study
9. It’s not part of your job
10. Let’s make a survey first
11. Let’s sit on it for a while
12. That’s not our problem
13. The boss won’t go for it
14. The old timers won’t use it
15. It’s too hard to administer
16. Why hasn’t someone else suggested it before?
17. Let’s form a committee
18. We should wait until the economy improves
19. Who else has tried it?
20. Is it best practice?

More innovation killers are :

• Unconscious neglect: a tendency toward carelessness and impulsivity, such as sending work before it’s ready or rushing to send responses that come across as uncaring.
• Overprotectiveness: reserving your best work and being reluctant to share achievements for fear that your ideas will be stolen.
• Overconfidence: leaning on your ego and willpower rather than asking for help, even when you need it.
• Overexertion: pushing yourself beyond reasonable limits.
• Devaluation: taking success for granted and under-appreciating relationships and resources out of an urge to pursue “the next new thing.”

No business pllan survives the first customer, and it is definitely helpful to plan. However, writing it as the first step is another story and just discourages innovators. Stop it.

Maybe those two words will help.

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GUEST POST from Arlen Meyers

Everyone seems interested in getting the most impact out of their innovation efforts. Collaborative Innovation Networks (COINs) have mushroomed since the invention of the Internet and cheap mobile communications. Community based innovation and biomedical and health online innovation networks have the potential to speed new product development, offer alternative financing platforms for early stage ventures, provide education, information and support to those with particular diseases and help to lower the costs and speed of clinical trials. A recently announced collaboration between the FDA and PatientsLIkeMe will make it easier to do post marketing surveillance for drugs.

However, questions remain about their effectiveness in creating value, security, commercial and clinical validity, legal status and sustainability.

A important question is whether COINs, particularly in biosience and health, create lasting impact, and , if so, under what circumstances. Based on my experience co-founding a non-profit COIN and contributing to efforts to transform it into a sustainable entity that meets its mission i.e. getting biomedical and health ideas to patients, leaderpreneurs need to overcome several hurdles:

1. A relentless focus on advancing a clearly defined, easy to understand mission.

2. Creating and validating a business model that generates enough revenue to sustain the organization.

3. A marketing effort that uses state of the art social media techniques to target those most interested in supporting your mission.

4. Minimizing spending on things that don’t add user defined value.

5. Continually offering new products and services as part of the platform.

6. Telling your story in a way that it appeals to the heart, not the head of potential supporters.

7. Engaging and building the community of interest until it reaches a tipping point.

8. Transitioning from working in the COIN to working on the COIN once it has reached a critical mass.

9. Cheaply creating and killing experiments early when it is clear they won’t yield positive results

10. Expanding your influence to interface or open networks with overlapping interests. COINs need to be COPINs-collaborative open innovation networks

Building collaborative open innovation networks requires:

1. An organization with leadership to coordinate, grow and engage the community of interest
2. A compelling value proposition that meets the jobs, gains and pains of participant stakeholders
3. A communications plan that uses various message delivery channels

4. Metrics and a dashboard to measure both inputs and valid outputs

5. A viable business model

6. Leadership

7. Network engagement and advocacy

8. Innovation

9. Branding

10. A sustainable competitive advantage

Open innovation is about encouraging your teams and leaders to expand their internald external networks, make diversity and inclusion part of the corporate culture, encourage people to have outside interests and understant that your industry cannot be changed from inside only.

Collaborative, or open innovation, collaborative innovation, are “…activities organizations use to improve their rates of innovation and problem solving by more effectively leveraging the diverse ideas and insights of employees, customers and partners.” Here are some ways to measure their efficiency and effectiveness.

There are four essential steps to open innovation.

1. Obtaining innovations from external sources

2. Integrating innovations

3. Commercializing

4. Knowledge transfer programs during the interactions

Here are some tips on how to build a better sandbox.

COPINS can be as narrow or as wide as you like. For example, you can create a COPIN that links different academic entities on one campus v one that is an intercampus COPIN v one that connects different universities in the same state with other parts of regional innovation ecosystems. Or, you can create a global one.

Here are some ways to diversify your network.

Building your COPIN to make an impact is but the initial step. To reach your SMART COPIN goals, the community will need to evolve along a pathway that measures inputs, processes, outputs and outcomes, not just vanity numbers on a Linkedin group.

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GUEST POST from Arlen Meyers

Dropped medical handoffs are pervasive and a leading cause of medical errors.

Handoff errors happen for many reasons:

1. There are at least 5 participants that can break the chain: the sender, the receiver, the patient, the third party intermediary and the referral platform user interface
2. The communication is not standardized
3. The system relies on people to do what they are supposed to do instead of automating or templating the communications whenever possible to minimize workflow disruption
4. There are too many unnecessary appointments or the referral is inappropriate
5. There is no sense of urgency to fix the problem
6. The stakeholders don’t appreciate the clinical and economic costs of a dropped handoff
7. Tracking systems are poor
8. There is no global health information cyberbrain to coordinate and transmit accurate cross border information
9. Nomenclature is not standardized
10. We will never be able to aggregate the infinite expansion of medical information for a given patient. The challenge is to determine the minimal amount of information necessary to accomplish the clinical handoff goal
11. More people need to be in the conversation than there used to be. Instead of a doctor communicating with another doctor or patient, now medical care teams need to communicate with patient care communities, in some instances, on the other side of a country or an ocean.
12. Often, no one knows who is the captain of the medical team or patient care community ship and, therefore, should be the designated sender or receiver.

So, what would a whole product solution look like?

1. It starts with a global whole product information system, a cyberbrain that aggregates, coordinates and disseminates information to those who need it and are allowed to access it. Think an ATM for health information and the fintech required to allow it to exist.
2. Each of the hand off stakeholders need to understand their role in the relay race and be held accountable for performance
3. A tracking system to measure key performance indicators, outcomes and impact
4. A business model that is VAST
5. Interventions at various stages of the handoffs that change behavior that deliver results, such as those that use behavioral economic techniques, nudges or technologies, like bots.
6. Ways to address the social determinants of missed handoffs and appointments, like lack of child care or transportation.
7. Better online appointment and tracking systems that are more convenient
8. Creating handoff standards and incentives for compliance. Consider rewarding patients to show up with something they value at the time of the visit
9. Automating the requirements to complete the chain, e.g. one click templated forms for the sender and receiver derived from AI driven EMR data that would reduce unnecessary administrivia and confirm receipt by the receiver
10. Celebrating the champions and showcasing successes
11. Treat patients like students, not customers.
12. Sell, don’t tell

Success in reducing handoff errors and dropped handoffs will depend on creating a globally networked infrastructure that satisfies the QWILT SET for doctors and delivers a clear value proposition for other stakeholders.

Short of that, we will be living in a medical world where there is only one fax machine.

and Co-editor of Digital Health Entrepreneurship

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GUEST POST from Arlen Meyers

Biomedical AIntrepreneurship describes the practice of creating AI products and services to solve bioscience (drugs and devices) and clinical problems. As such, it is the pursuit of opportunity under conditions of uncertainty with the goal of creating user defined value through the design, development and deployment of biomedical innovations that use a predominantly AI backbone, platform or foundation that have a VAST business model. It is a subsegment of digital health products and services.

The use of AI in medicine is evolving rapidly. Here are some updates:

1. Educational platforms, meetings, conferences and magazines
2. Robust investment into development and M/A
3. Coherent applications combining AI, medtech and biopharma
4. Increasing concerns and attention to the ethical, societal, education, manpower development and economic impact of AI in medicine
5. How AI is contributing to the 4th industrial revolution
6. The intersection of AI and robotics
7. The intersection of AI and blockchain
8. The impact and perils of decentralized, DIY medicine
9. Cybersecurity and confidentiality concerns. If you are not worried yet, read this too.
10. Concerns and strategies to make transparent algorithms and mitigate AI bias and “eliminate black box bias”.
11. Stories and organizations about physician AIntrepreneurs.
12. Regulatory, legal and reimbursement challenges

13. Convergence of AI into medical device and biopharma Current emerging applications appear to fall into three main categories:

Management of chronic diseases – Companies are using machine learning to monitor patients using sensors and to automate the delivery of treatment using connected mobile apps (Example: Diabetes and automated insulin delivery).

Medical imaging – Companies are integrating AI-driven platforms in medical scanning devices to improve image clarity and clinical outcomes by reducing exposure to radiation (Example: GE Healthcare CT scans for liver and kidney lesions).

1. AI and Internet of Things (IoT) – Companies are integrating AI and IoT to better monitor patient adherence to treatment protocols and to improve clinical outcomes (Example: Philips Healthcare solution for continuous monitoring of patients in critical condition).

As artificial intelligence projects roll out, organizations will need to rethink the definition of the “work” that people will do. The future of work will become one of the largest agenda items for policy makers, corporate executives and social economists, says Sanjay Srivastava, chief digital officer at Genpact, a professional services firm focusing on digital transformation. Here are some of the key issues.

In addition, as part the 4th industrial revolution, AIntrepreneurs are creating a sick care environment that will challenge how we educate medical trainees and computer and data scientists to work together and figure out how to overcome the barriers to AI dissemination and implementation, the IoMT challenges and the legal, economic, societal and ethical hurdles.

The implications of the convergence of AI with other technologies in multiple industries are vast. However,the value remains to be demonstrated. What is clear is that AI is the latest shiny new object on the block and will continue to grow, and, hopefully, realize its potential to reduce costs, improve outcomes and efficiencies and the doctor and patient experience.Innovation starts with mindset and there is nothing artificial about that.

 
Image Credit: Pixabay

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GUEST POST from Arlen Meyers

US physicians are becoming more entrepreneurial to cope with the seismic shifts happening since the passage of the ACA. They are being forced to rethink business models, innovate and create value by offering new products, services, care delivery and process improvements. But, physician entrepreneurs are challenged by how to reconcile the ethos and ethics of business with the ethos and ethics of medicine. Some see practicing compassionate capitalism as the solution.

The challenge is how to resolve the conflict of purpose with profits. US Sickcare, Inc has grown to be a $3.7 T enterprise. Yet, increasingly, practitioners are finding it increasing difficult to be mission or purpose driven while having to comply with rules and regulations and increasing pressure to achieve profitable growth.

5 years ago, Stanford’s Tom Byers and Tina Seelig set up a fellowship program for master’s students at Stanford’s engineering school aimed at teaching the ethics of entrepreneurship. They enlisted veteran venture capitalist Heidi Roizen, then a partner at DFJ, to help it get off the ground.

As the record of startup meltdowns in recent years (Uber, Theranos, et al.) has shown, the need ethical training is huge. “Every entrepreneur is going to have their ethics tested, guaranteed,” Roizen said in an interview.

• It’s not just ethics that make the job hard, Roizen says. She notes that many founders naively launch a company without fully understanding how isolating the job is, how much pressure they will be under or how likely they are to fail.

President George W. Bush made the “compassionate conservatism:” a household word. Although the term dates to the late seventies, President Bush used the phrase repeatedly to describe his economic philosophy of using conservative, market driven techniques to improve the general welfare of US society. In essence, the idea was to be sure those who needed health care, housing and other social services got them by partnering with private enterprise, social and religious institutions, but that the government not be directly involved with providing them. Private institutions would thus do well by doing good.

Many physicians have been entrepreneurs for decades and have played various roles in the innovation pipeline as inventors, market perceivers, social entrepreneurs, educational entrepreneurs, business leaders or investors. They have invented new medical devices, patented drugs, improved and sold new medical processes, and have always been able to charge their patients, and their insurance companies, sufficient fees to make a good living. Now there is a convergence of forces that is forcing physicians to be even more entrepreneurial and innovative to not just serve their patients better, but to survive an increasingly turbulent landscape. Practicing state- of- the- art medicine, as difficult as it is, is simply not enough. In addition, physicians need to embrace an innovative and entrepreneurial mindset, lead , manage operations to achieve maximal effectiveness and efficiency and use digital health technologies to leverage their value and create new business models.

For example, Drs Wayne Guerra and Peter Hudson, two emergency room doctors, noted that the wrong patients where coming to the wrong places, like the emergency room for the wrong reasons. The result: iTriage, a mobile app that prompts patients for answers to medical questions and suggests the appropriate facility for care.

Medical entrepreneurship is the pursuit of opportunity in biomedicine and health with uncontrolled resources. The goal, like all entrepreneurship, is to create user/customer/patient defined value by deploying innovation using a model that creates, distributes and harvests value in return. The challenge to most physicians is to how to do that while balancing the conflicts between how business is done and how medicine is practiced. This culture clash creates tensions that, to some, are irreconcilable.

A new series of books by Laurie Bassi, et al, titled, Good Company: Business Success in the Worthiness Era, John Mackey and Raj Sisordia, titled, Conscious Capitalism, Seth Godin, titled, The Icarus Deception, and Richard Branson, titled, Screw Business As Usual, are all making the claim that it is those companies and those entrepreneurs who do good for the world who will win the game of capitalism. They will earn higher profits and last longer than other companies that have the narrow purpose of just making money. Their contributions to the world of business will grow internationally in this flat world. And, they will be purpose driven, not just money driven organizations.

Here is the case for profit-from-purpose companies, investment and philanthropy.

Physicians are uniquely positioned, and are starting to be trained, to take advantage of this trend as they are constantly improving the state of the art in their fields and now gaining MBA’s, graduate level certificates in one or more areas of biomedicine, and are reaching out to the investment community to fund the research and development, the intellectual property designations they need, the team for their companies, the strategic alliances they will need for their supply chain, and their distribution chain, as well as the marketing necessary to launch a successful biomedicine product or service.

Now, physicians in the US, with a little help from business schools, schools of entrepreneurship, and even medical schools providing entrepreneurship and business training, like the University of Colorado Denver’s Medical School, are becoming more and more proficient, and more and more interested in “monetizing” their contributions to helping people through medicine. The term “physician – businessman” will become much more popular over the next decade.

Soon more and more “B” schools will cater to physicians and consultants who will work with physicians to put physicians’ ideas into the marketplace and earn a solid return for the physician. The days of the doctor in the scrubs will be with us forever. But, the physicians will also have a new look and demeanor, with their iPADs in hand, talking to early stage investors and venture capitalists about funding their idea from the start through to international patents and business arrangements that will change the medical landscape around the world. The medical consumer, the patient, will benefit greatly from this expansion of entrepreneurism through physicians practicing compassionate capitalism.

This is all possible not just because physicians today want to become entrepreneurs. This is possible because the medical profession, and medical sector in general, will become more innovative over the next decade as it deals with two simultaneous, complex sets of events, cost cutting, and a rapid increase in the number of people receiving medical care under Obamacare. It is now inevitable that innovation will grow by leaps and bounds and it will be driven by physicians and other entrepreneurs putting their ideas to the ultimate test, the market test.

Tech and the 4th industrial revolution has its dark side.

We can think of no label better to describe this phenomenon than “Compassionate Capitalism.

Herb Rubenstein is a Lecturer, University of Colorado Denver, Graduate School of Business and Executive Director, THE LEEEGH, INC.

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GUEST POST from Arlen Meyers

If you agree, then thriving in the 4th industrial revolution will require nothing short of restructuring public education at all levels, not just k-12. Even doctors will need to change how they educate their young. How many things can you do with a paperclip?

Many not for profits are directing their efforts to provide equitable access to public education. However, putting more students in a broken, dysfunctional system won’t yield the outcomes and impact we want. Instead, the very structure and process of education will need to change if we are to provide students with the knowledge, skills, abilities and competencies they need for jobs that have yet to be created.

What’s more, unless we address the gender social and cultural stereotypes, the 4IR could make gender inequity worse, not better.

One goal should be to create entrepreneurial schools and universities, and by that I don’t mean teaching children how to start businesses. Instead, creating the entrepreneurial mindset is about the pursuit of opportunity with scarce resources with the goal of creating user defined value through the deployment of innovation. Creating a successful business in but one of many ways to do that.

If for nothing else than the future of your children, take 12 minutes to watch this:

Here are 10 different ways to encourage youth entrepreneurship. The same techniques might apply to graduate students as well.

Other learning objective and curriculum themes are emerging:

1. Encouraging private, public and academic collaboration to define market based competencies
2. Teaching horizontally, not vertically, in limiting smokestack domains
3. Developing soft skills that are in high demand
4. Experience cultural competence, diversity and inclusion
5. Alternative pathways for teacher training and development
6. Job searching techniques that are state of the art
7. Mandatory experiential learning opportunities
8. Developing and testing alternative intelligence measures
9. Replacing memorization with creative problem solving, problem seeking and divergent thinking.
10. Hiring for creativity and finding and supporting educational reform champions
11. Like sick care, recognizing and addressing the socioeconomic determinants of academic failure, like housing, illness, disability and nutrition.
12. Rehabilitating the brand image of teachers
13. Teaching STEAMpathIE and rethink STEM as BMETALS
14. Preparing students for the jobs of the future that have not yet been created.
15. Teach them how to work in and manage virtual international teams.

Here is how intrinsic motivation will have to replace extrinsic motivation: autonomy, mastery, purpose

Here is how automation will affect economies around the world.

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GUEST POST from Arlen Meyers

The Society of Physician Entrepreneurs was created as a 501 (c) 6 non profit biomedical and health innovation and entrepreneurship membership association in January, 2011. Created by 3 physicians and a medical society executive, we started with 50 people. Part of our vision was to make SoPE the home for a community of stakeholders interested in advancing biomedical and health innovation and entrepreneurship in an effort to get ideas to patients by offering education, resources, networks, mentors and experiential learning. We created a linkedin group to build the community of interest along with other social media sites on Facebook and Twitter@SoPEOfficial.

Since our founding, the membership of the site has grown substantially. Likedin groups serve many purposes, but ours was to primarily use the site to create awareness, increase membership, and create a platform for discussion, information and education. As the “owner” of the group, here’s what I’ve learned:

1. Content is king. You can almost never be overexposed or offer too much information. In addition, repetitive posting acts like a trigger that prompts new readers to engage. The information also needs to be redundant and relational to other communications platforms like websites, blogs, webinars, You Tube videos and podcasts on other sites that can leverage your reach. In fact, content is the most effective way to generate leads and, in our case, subsequent members.

2. You need to build a relationship with your audience and engage them in the conversation.

3. Controversy helps, but only to a point. There is a line and if you step over it, you loose points to say nothing of members. Be careful about using the platform to fight culture wars

4. Recruit other site managers to help with content and keeping the site uncluttered with unwanted posts or comments.

5. A Linkedin group site takes almost daily care and feeding and is a significant commitment of time and effort

6. Some other Linkedin group owners are not interested in sharing information or posts.

7. You need to be selective about who you allow to join since some are only interested in selling or finding a job. Exclusivity promotes sharing and the desire to join.

8. You need to know your audience and how a Linkedin group adds value. Cyberspace is an extremely cluttered and noisy place and users need to have a good reason to go there on a regular basis. The owner is responsible for “protecting” the site from unwanted intruders.

9. Use video, graphics and other media to supplement text.

10. Use the site as a crowdMOOC to primarily educate and inform and showcase people and their stories.

11. Most doctors are Linkedout.

12. You social media sites are just part and parcel of your overall web strategy.

Here’s how some others have created online communities that generate sustainable revenue.

Your Linkedin group should be but one part of your marketing and communications strategy to convert leads to customers or members. Other include your website, newsletters, blogs, podcasts, testimonials, and face to face meetings all orchestrated by a marketing operations platform that can coordinate and execute the different parts. Here are the 7Rs of content marketing.

When you take ownership of a Linkedin group, you accept the responsibilities of a digital engagement editor. That requires multiple skills, knowledge, abilities and competencies.

Most social media sites include mostly gawkers, about 9% talkers and 1% walkers and ours is no exception.

There is a debate about whether, for the average medical practitioner, using social media is useful or a waste of time. Factors include independent or employed status, targeting cash paying patients or those with third party insurance payers, the skills, knowledge and abilities of doctors, the impact and return on investment of social media interaction with patients, legal and regulatory issues and the cost-benefits and return on investment of using it.

Creating and building a Linkedin group takes time, commitment and writing and social media skills. When done properly, it is an extremely powerful way to build a decentralized collaborative innovation network that can drive your mission and help realize your vision.

Here are some more tips on how to build your community and encourage and reward UGC (user generated content)

Also, remember that if you want to do crowd funding, you need to start with a big enough crowd to meet your goals. Building a crowd requires that you take the necessary STEPPS: social currency, triggers, emotion,public,practical value and stories.

Building a Linkedin group is part of building a platform, not a product.

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