Q. There are literally thousands of solutions to pick from once you’ve designed the experience. Right from the native EHR system and nimble young startups to enterprise class tech firms and everything in between. How do you make that choice?
Tarun: Especially given that the frothiness of the investment market has normalized for now, I can certainly give you a framework. We look at different things that are important for us — not everything can be transformational — and incrementalism is not necessarily a bad thing.
So, we go, “Hey! Listen, we just need to get a little bit better at this.” We need to constantly iterate and I would think of something like order sets. You have to make orders better. I’ve got to make some of my other functionality within my EMR better. That’s incremental and important. You can’t stop that. That’s not where our sharp focus is. We try to focus on five or six major transformational things and we have to stay so.
One of the problems we had and one of the mistakes we made early on is we didn’t say “No” enough. I am trying to say “No” a lot. If you really want to do this as an operational owner, you have to prove to me what you’re prepared to do, to do this. I can’t make the change for you btu I will make the change with you. It’s how we think about it.
When we look at technology, I think we look at it as “Is this a problem that one of our existing solutions can either solve today or in the next 18 months? Somewhere in that window?” It’s a little bit different depending on the problem.
If it can be solved today with an existing solution, then, to go outside of that world, you really need to have a really good explanation for why someone would want to go with a tool outside of that.
If it can be solved but not today; and if one of our existing tools has a good road map to get there in the next 18 months, then, it’s a decision around the severity of market need. What’s the market demand on that one?
Then if you say no, we feel pretty confident it’s not on the roadmap or two years out. Then, we’re open to go looking with a startup or a partner. We’re trying to answer this question that states very transparently that we don’t sign ten-year contracts.
You have to constantly keep proving yourself because the reality is, one of those native systems that we had on our native platforms eventually is going to catch up. It’s probably been on offer for a fraction of the cost of what the startup is. For example, video visits. We were paying hundreds of thousands of dollars for video visit solutions. Now we’re paying $0.28 for one video visit. Purely click as you go.
So as the commoditization happens, the startups have to continue to say, “What is the problem I am trying to solve?” You may have a good contract right now but you have to work out the assumption in three years. That’s a problem someone else may have solved for cheaper. It’s been commoditized. However, take the learnings you’ve had by partnering with the health system to say, “Okay, what are the problems? I’m going to help you solve that.” That’s an approach that I think of when we look to partner with folks.