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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GUEST POST from Arlen Meyers

Intrapreneurs are employed people trying to act like entrepreneurs. Some call them rebels at work, others disruptive physicians and most refer them as troublemakers, a pain in the neck or former employees. All are trying to create change and survive the process. Intrapreneurship is harder than entrepreneurship because intrapreneurs have to fight a two front war: one against the obstacles to new product or project development and launch and the other against the corporate immune system. Academic intrapreneurship is, in several ways, harder than non-academic physician intrapreneurship because of the culture, politics, motivations and multisided missions.

However, intrapreneurs can’t be successful alone.

In many instances, rocking the boat will sink you because your boss gets seasick.

When it comes to a “how to do it” , though, there are few resources for physician intrapreneurs, despite the fact that their numbers are growing. Here’s what the table of contents of the Textbook of Physician Intrapreneurship should include:

Chapter 1: Assessing your organization’s innovation readiness

Chapter 2: How to manage your boss

Chapter 3: Survival strategies

Chapter 4: Communications and Corporate Politics

Chapter 5: Negotiation and Persuasion

Chapter 6: Conflict Resolution Strategies

Chapter 7: Managing People Who Fear You

Chapter 8: Finding scarce and uncontrolled resources

Chapter 9: Leaderpreneurship

Chapter 10: Exit strategies

Chapter 11: The politics of innovation

Chapter 12: Status, power, influence and sponsors

Here are some other chapters:

Intrapreneur Survival Skills

10 Opportunities for Patient Experience Intrapreneurs 

Raise Your Innovation Bar

Why you should hire physician intrapreneurs…and what to do with them

There are four psychological reasons for intrapreneurial failure:

Physician intrapreneurs wage guerrilla warfare against a formidable foe-bureaucrats and members of the C-site protecting the status quo. You need a tactical operations manual that changes almost every day and turns you into a good rebel.

There are four models of intrapreneurial innovation

Try to avoid these 5 intrapreneurial rookie mistakes:

You fail to prioritize your ideas.

You go solo.

You flunk the pitch meeting. 

You give up too soon.

You ignore personal danger signals.

But, at least The Textbook of Physician Intrapreneurship is a start that you can read prior to your deployment.

and Co-editor of Digital Health Entrepreneurship

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GUEST POST from Arlen Meyers

In high schools across the U.S., a quiet movement is underway to better prepare students for a hazy new future of work in which graduates will vie for fast-changing jobs being transformed by increasingly capable machines.

Many universities are calling themselves “entrepreneurial”. Most, however, are just putting old wine in a new bottle. For them, the goal is to graduate students who can create a viable and sustainable business.

Very few medical and graduate schools could be considered entrepreneurial.

Some, like Thomas Jefferson University in Philadelphia, my alma mater, have created “tracks” and putting a toe in the business of medicine.

Here is an update on medical schools teaching innovation and entrepreneurship.

Creating a diverse talent pipeline from high school to graduate school of graduates with an entrepreneurial mindset is a key pillar of transforming sick care to healthcare and delivering value. Others are 1)changing the toxic culture of innovation, 2) eliminating the barriers to open innovation with BIG PHARMA, BIG DEVICE and BIG DIGITAL, 3) changing the behavior of doctors and patients, and 4)creating an evolving cyber nervous system to respond to environmental change and coordinate information.

Creating a business is but one way to deliver user defined value and limits the scope of entrepreneurial education and training. For medical schools and graduate training programs, the goal should be to graduate students with an entrepreneurial mindset who can create user-defined value in whatever form they decide to do it, including starting or running a business with a viable business model. It could be a process innovation. It could be a user-experience innovation. It could be an analytics tool that substantially lowers cost and improves outcomes.

AI and robotics are changing how work gets done and who does it, including doctors. One author notes that “as machines do more of what was once human, companies and people who thrive will not be those who guess correctly at the next narrow skillsets, but who cultivate the capacity of their workers to learn faster. This is true both for “on balance sheet” workers and the gig economy. As the half-life of specific skills diminishes, and machines become proficient at tasks including even decision-making, then fundamentally human capabilities become more important: empathy, curiosity, creativity, imagination, emotional and social intelligence, leadership, and the development of other people.” In other words, doctors will have to have an entrepreneurial mindset to thrive.

For most academic medical centers, innovation is described and measured by technology transfer metrics, like patents, licensing revenues and spin outs. Unfortunately, innovative universities described in these terms are not necessarily entrepreneurial universities. Some are beginning to realize that and are rethinking how they do the business of science and medicine.

University of Michigan researchers interviewed and surveyed representatives at 59 Innovation and Economic Prosperity Universities, as designated by the Association of Public and Land-grant Universities, and together they identified the following best practices for technology commercialization:

• A university with a strong cultural emphasis on innovation has leadership that promotes its value both internally to the university and its faculty, as well as externally to the surrounding community.
• Strong technology ecosystems are dependent upon champions—experienced professionals with industry and commercialization backgrounds—assisting in the maturation of a technology through expert guidance and mentorship.
• Research career incentives are vital to motivate and reward new ideas, while resources provide the necessary environment for continued growth.
• Cross-organization collaborations are necessary throughout the process to foster ideas and improve outcomes.

Here is why it is so hard to create entrepreneurial medical schools and find leaders for them.

Entrepreneurial universities have several key features: (i) top-down vision, strategy and leadership, (ii) clearly defined entrepreneurship learning objectives that drive the curriculum, (iii) robust internal and external networks, (iv) a culture of innovation, and (v) experiential learning and knowledge transfer opportunities.

Here are 10 things universities should do to transform themselves:

1. Fix their technology transfer offices or outsource the function.

2. Give faculty promotion and tenure recognition for innovative and entrepreneurial accomplishments.

3. Eliminate practice plan taxes and policies that discourage faculty-industry collaboration.

4. Create an internal seed stage fund.

5. Hold every student accountable for demonstrating an entrepreneurial mindset.

6. Hire, develop, and promote for innovation.

7. Lead innovators, don’t manage innovation

8. Celebrate innovation champions and mentor those who are interested in emulating them.

9. Transform donations into investments

10. Hire outsiders who think convergently

11. Streamline academic-industry collaborations.

In addition, medical students should be treated and tracked like customers, measuring their net promoter score during and at the completion of their education and training.

Medical educators are grappling with how to create the 21st Century workforce. To ensure that physicians-in-training around the world get the education they need to provide the best care for patients, the World Medical Association is calling on national medical associations to encourage medical schools to develop quality assurance programs and support accreditation systems that set medical education standards that align with the needs of patients.

Entrepreneurial universities and medical schools should not just be about graduating students who will create businesses. Instead, every graduate should be trained to create user defined value. After all, that’s how they are, more and more, being paid. More importantly, being an entrepreneur makes you a better doctor and patients benefit. Also, supporting faculty entrepreneurs might increase industry support for research, development and commercialization. Where are you on this list of percentage of industry supported academic research?

Companies and universities are slowly learning how to play nice with each other. However, before there can be significant rapprochement, we need to create entrepreneurial medical and graduate schools.

The fact that doctors don’t know how to deliver value is part of the reason it is so hard to kill fee for service medicine. Instead an entrepreneurial society should create entrepreneurial universities that create entrepreneurial medical schools. To do that they need means, motive and opportunity.

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GUEST POST from Arlen Meyers

Creating a new venture, championing a new process or offering a new course or program is exciting. However, statistically, it is more likely you will fail than succeed and there is a fine line between determination and pig-headed optimism. You might not have the skills to do what you love. At some point, you will have to consider quitting and moving on.

Even the big boys fail often.Microsoft will shutter its Health Dashboard site and remove its Band applications from the Microsoft Store, Google Play and Apple App store on May 31, 2019, according to an FAQ page on its website.

Quitting is not a value in the entrepreneurial lexicon. We are all encouraged to follow our dreams, no matter the cost. It is a myth. “Winners quit all the time. They just quit the right stuff at the right time.” Some, given stress and burnout levels, would rather see you keep trying, even if it kills you. Don’t let it.

You should keep a failure resume. What’s the point of such self-flagellation?

Because you learn much more from failure than success, and honestly analyzing one’s failures can lead to the type of introspection that helps us grow — as well as show that the path to success isn’t a straight line.

Your failure resume would include:

1. Schools that didn’t accept you
2. Papers that were rejected
3. Places where you faced disciplinary action or were fired
4. Companies or projects you started that were a bust
5. Grants you applied for but never received
6. Lack of promotions or failure to get tenure
7. Failure to get a salary increase you requested
8. Lousy job assessments or online reviews
9. Personal failings
10. Poor teaching, student or audience assessments of your performance
11. You have limited emotional intelligence or lack entrepreneurial competencies
12. You have a significant personality disorder or pyschopathology

You should not include burnout as a personal failure.

Perseverance has received lots of support in recent years from a variety of schools of research. One is from psychologists studying grit. In fact, there’s a large body of work showing that perseverance may have a harmful downside. 

Here are some signs that it might be time to hang up your cleats and move on:

1. It is not fun any more

2. It is making you sick

3. The people you work for or with are unethical

4. You realize that the window of opportunity has permanently closed

5. Your innerpreneurial instincts are telling you that you are doing what you are doing for the wrong reasons.

6. You are willing to take personal responsibility for your failure and apply the lessons to your next initiative

7. You have shown that your business model is fundamentally flawed and that you don’t have the time, resources or interest in fixing it

8. You have changed your priorities

9. Your life is out of balance and practicing entrepreneurship is further tipping the scales

10. You believe the fates are working against you. Truth be TOLD, sometimes they are.

There is a difference between quitting a project and quitting on yourself. Sh$t happens and learning from mistakes and how you adapted to the inevitable slings and arrows of misfortune shapes us all, if we let it. It will discourage and destroy us if we don’t.

Here is a list of common failures and coping pitfalls.

Being innovative isn’t just about what you start — it’s about what you stop. “You don’t have the capacity – the time, resources or energy – to do the new things because you are busy maintaining the old ones,” explains innovation expert Jeff DeGraff. Don’t get caught in this trap: Figure out what practices or ideas are no longer serving you and make room for new ones.

“Stopping things is hard. It’s full of feelings of loss, disappointment and failure. It takes more than creativity. It takes courage to stop what you’ve been doing to make room for the things your organization wants to start doing now.”

The history of business and innovation proves that some of the biggest winners have been the biggest quitters at some point in their career. The important point, is that, after quitting, they continued to move forward, not sideways or backwards, with their next idea.

Here’s Why You Should Seek Rejection Instead of Avoiding It

Along the way, tidying up is a good idea. Let go of the banana and don’t slip on the skin.

 
Image Credit: Pixabay

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GUEST POST from Arlen Meyers

Trinidad ,Colorado, located in the Southern part of the state on the Colorado side of Raton Pass, was, until recently, the “sex change capital of the world”. More sex reassignment surgeries were done there than any other city, until the surgeon left to take a job in San Francisco. Here is the story about Dr. Biber.

Trinidad , pop 7300, has a long, illustrious history. It grew up as a trading post along the Santa Fe Trail, one of the 3 primary “trails” in early 1800 America, that connected ST. Louis to Independence and Westport, Missouri with Sante Fe, then part of Mexico and was a major trade route. It came into its own after Mexico won its independence from Spain in 1821 and ended when the railroads made it obsolete (are you getting the lesson here?)

The Trail provided entrepreneurs with two ways to make money. The first was by providing a way for people to do business or mine coal. The second was to sell things to the people who were doing the business or mining coal.

Colorado recently legalized the sale of recreational marijuana. People is the cannabusiness fall into two categories-those that touch the leaves and those that don’t.

The traffic along the trail attracted Jewish merchants from the East Coast and Europe who saw a business opportunity providing goods, tools and supplies to Sante Fe Trail users. In 1889, they built Temple Aaron, now the oldest synagogue in continuous use in the state . The geneological connection to prominent Denverites exists to this day.

The architects, the Rapp Brothers, created the Sante Fe style and designed La Fonda in Sante Fe. Colorado Preservation Inc has declared it an endangered building there is a major effort to save this cultural heritage and architectural gem.

Different people define business models different ways and it has evolved over the years. Fundamentally, a business model is a set of hypotheses that describes how a firm intends to do what they do at a profit. In other words, it describes how a firm creates, deploys and harvests value. It is different from a business strategy which describes where and how a firm plans to play and win in the competitive marketplace.

If you are looking for an opportunity, consider selling the tools to make the product, not the product itself. For example, there is tremendous interest in companies producing high speed automated DNA sequencers that will be able to deliver the $1 genome and provide an important tool to drive the personalized medicine revolution. Another company, Sharklet(http://www.sharklet.com) is using a shark-skin like material that is bacterial resistent to coat medical devices, and, interestingly, the bottom of US Navy ships to prevent the accumulation of barnacles and other organisms that create drag on the hull. Ironically, the pick and shovel business has returned to the old Sante Fe trail in the form of marijuana. There are two kinds of businesses: the distinction is simple – either the company “touches the leaf” or it doesn’t. Companies that directly deal with marijuana or its byproducts face legal and regulatory risks that ancillary businesses do not. We define ancillary businesses as those that serve or support the cannabis industry, but don’t directly deal in cannabis products.

For all the hype, we are in the early days of artificial intelligence. It’s still hard to know what the most valuable applications will be, or what will come first. But while everyone’s trying to find those answers, those companies that provide the shovels for this gold rush are likely to profit.

A recent paper analyzed possible shifts in sick care profit pools and proposed three scenarios:

Supply-driven. The “supply-driven” scenario assumes that providers have the biggest impact in reshaping the healthcare system, through more integrated and coordinated care. Payors and providers continue to consolidate in order to manage populations and offer more coordinated, integrated care while also capturing scale efficiencies. A smaller number of players increase their market share and retain greater pricing power. Risk shifts from payors to providers, the pharmaceuticals industry gains (primarily due to better adherence driven by coordinated care), and payor margins shrink. In our analysis, the supply-driven scenario creates roughly $360 billion in value, primarily by reducing costs from today’s levels. More than 90 percent of current profits will accrue to a few integrated players.

Demand-driven. The “demand-driven” scenario assumes that changes on the patient side will dominate. As consumerization prevails, patients take a more direct role in their own care, and pay a larger share of costs out of pocket. As a result, they increasingly seek out efficient new solutions, and they rely on technology to manage their care more directly, along with alternative care settings and other tools. The solutions with the biggest impact come from areas outside the traditional healthcare industry, such as software, telecom, retail, and apparel companies. Utilization improves, but intense competition leads to lower prices and reduced margins among incumbent providers. Those incumbents also lose ground to startups that can create better consumer experiences and incentives for consumers to manage their own health. Non-acute care moves out of traditional settings and into retail environments. And an increased government share of health spending puts downward pressure on pharma prices. The demand-driven scenario unlocks roughly $480 billion in new value by 2025 — again by reducing costs from current spending levels. Notably, the demand-driven scenario creates roughly 35 percent more value than the supply-driven scenario.

Equilibrium. Both the supply- and demand-driven scenarios are hypotheticals that assume one model will dominate. And both are ultimately unsustainable, because neither would lead to a stable, end-state market. The supply-driven scenario would fail to slow increases in healthcare costs — because a smaller number of players would retain greater control over access and pricing — and would likely trigger the next revolution of reform and restructuring to make healthcare more sustainable. And the demand-driven scenario would erode profit margins for providers beyond sustainable levels, likely causing key participants to exit the market.

In any of these scenarios, entrepreneurs can touch the patients, providing face to face care, or not touch the patients, providing the eCare tools, business processes and systems required to streamline workflow and create value. To identify who does what, start with a clinical care pathway for a patient with a given disease.

Biomedical and clinical business models are constantly changing in medtech, biopharma, clinical care, care organization and business processes.

Wars create fortunes. Be the guy who sells the bullets, not the soldier fighting the war. Of course, a little prayer at Temple Aaron can’t hurt either. In fact, maybe Divine guidance had something to do with the legalization of marijuana in Colorado. Las Animas county sells the most ganja per capita in the state.

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