Massachusetts Medical Society: Here Come the Docpreneurs

Here Come the Docpreneurs

Young, Ambitious, and Determined to Improve Health Care

BY VICKI RITTERBAND
VITAL SIGNS STAFF WRITER

DocpreneursWhen he was a medical student rotating through a local community hospital, Josh Mandel, M.D., was struck by an inefficiency he became determined to fix. Every morning, another medical student arrived at the ED at 5 a.m. to copy the vital signs of patients admitted overnight onto a piece of paper. The process would take an hour. Staff would then use those notes to conduct rounds.

“It was error-prone, time-consuming, and not a learning opportunity,” said Dr. Mandel, 33. “I ended up building a software tool that automated the work flow. I learned a little about how systems work and a lot about how to take medicine into my own hands and build better tools.”

Dr. Mandel is part of a growing cadre of young physicians doing just that. Working at the intersection of technology and medicine, these 30-something former whiz kids with undergraduate engineering or computer science degrees from top tier colleges view technology as a way to shake up health care business as usual — its high costs and inefficiencies. And they are being nurtured by a local environment that in the past several years has become a hothouse for health care entrepreneurship.

“Boston has the highest density of physicians per capita along with tremendous academic institutions,” said Omar Amirana, M.D., 51, senior vice president at Allied Minds, a science and technology development and commercialization company. “It has a never ending source of new ideas and forward thinking physicians working in an ecosystem that lends itself to entrepreneurship, especially in the life sciences.”

That ecosystem includes top notch universities and health care organizations; hackathons where ideas are spawned; business accelerators and incubators that take bright ideas one step further; and lots of venture capital hungry for promising businesses to invest in. Even institutions like Brigham and Women’s Hospital, with its two-year-old Innovation Hub, have caught the entrepreneurial bug. And the Massachusetts Biotechnology Council has seen such an explosion of interest in physician-led innovation that in 2013 it launched a chapter of the Society of Physician Entrepreneurs, which Dr. Amirana co-chairs.

Seeking Greater Impact

Many physician-entrepreneurs pursue medicine for the same reason their colleagues do: to forge healing connections with patients and ease suffering. But along the way they realize that they can have a far greater impact on medicine than that one-to-one relationship.

“Entrepreneurship is a vehicle for change, and I want to see more physicians driving that vehicle,” said Greg Goodman, 29, a first-year resident at Steward Carney Hospital, who interviews physician entrepreneurs each week for his podcast, The ModernMD (themodernmd.com). “At the end of the day, we’re physicians because we want to heal people, but it’s exciting to heal the health care system too.”

The Hackathon

In the past few years, the ground floor for many promising local health care innovations has been the hackathon, typically co-sponsored by some combination of universities, medical schools, and health care organizations. MIT Hacking Medicine and Tufts’ MedStart are two of the most well known local hacking events. Clinicians, programmers, designers, and others gather for a weekend of spontaneous creation, or “disruption,” in the parlance of innovation. Teams form around a problem or idea, then spend the next 24 to 36 hours collaboratively building the solution, which often takes the form of a mobile app. Teams present their projects to a panel of judges for recognition and prizes.

It was September 2013 when YiDing Yu, M.D., 30, walked into a Brigham and Women’s Hospital-sponsored hackathon with the germ of an idea and the confidence of a young physician who had already launched two companies by age 18. Like Dr. Mandel, Dr. Yu had seen an outdated process during her training — paramedics relaying medical information via radios to hospital EDs — and knew it was ripe for disruption.

“At the hackathon, people gravitated toward me,” said Dr. Yu, whose full-time job is as chief innovation engineer at Atrius Health. “I had a good pitch, I was a physician, and I had a solution for a pain point.” Two days later, her team of 11 people had created the first incarnation of what would become Twiage, (twiagemed.com) a HIPAA-compliant smartphone app that sends photos, video, EKGs, and GPS-tracked estimated arrival times from the ambulance to the hospital’s computer system so staff can better prepare for arriving patients.

The Twiage system is being piloted in every ambulance that serves the South Shore, with plans to expand to three additional hospitals in 2016, and was the 2013 winner of MMS’s Information Technology Award in the resident category.

A Foot in Both Worlds

Dr. Yu, like other young physician-entrepreneurs, still keeps a foot in the clinical world. In addition to her roles as chief medical officer of Twiage and chief innovation engineer at Atrius, she practices as an internist two half days a week at Harvard Vanguard Medical Associates.

That dual identity is also critical to physician-innovators like Craig Monsen, M.D., 29, the founder of symptom checker startup Symcat (www.symcat.com), which he launched during medical school. But it was while working at his current job as a resident at Brigham and Women’s that he conceived of his company’s other popular product, a cardiovascular risk calculator that determines whether a patient should be put on a statin. The mobile-friendly calculator was based on 2013 guidelines issued by the American College of Cardiology and the American Heart Association. But those guidelines were only available in a cumbersome spreadsheet that was nearly impossible to access on a cell phone.

“Without being in that clinical environment, I may have missed out on that opportunity,” said Dr. Monsen. “Being in a clinical environment continues to pay dividends in ways that are sometimes hard to define. But to be frank, it’s not always easy to juggle both Symcat and residency. I have little doubt that Symcat would be further along if I weren’t doing my residency.”

Jennifer Joe, M.D., 36, said that her job as an ER doctor for the Veterans Administration was challenging to manage while running two companies, Medstro (medstro.com), a physician social network, and MedTech Boston (medtechboston.medstro.com), a news site. Medstro has hosted several NEJM Group interactive forums for physicians and MMS members.

“When you’re in the ER, with patients coding, alarms going off and telephones ringing, you can’t hop on a conference call,” said Dr. Joe. So she has stepped away from clinical medicine for now. “But for companies involved in redesigning health care delivery, it’s hard to do unless you have the experience of delivering care in multiple settings and understanding the pain points,” she said.

Observers believe physician entrepreneurship will only grow as the popularity of college computer science classes reaches all-time highs. “You look at places like Stanford and Harvard where the introduction to computer science courses have roughly 1,000 students,” said Dr. Monsen. “There’s going to be a huge denominator of people with computer backgrounds and many of them will bring that to medicine.”

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