Physicians have a reputation for resisting technology, preferring clipboards and paper charts to electronic medical records. But Dr. James Madara, CEO of the American Medical Association (AMA), says it’s an unfair characterization. After all, when the first iPhone launched, physicians recognized the potential for accessing medical data and made up one of the largest groups of early adopters. 

The problem is when that newfangled technology lacks an understanding of how healthcare actually functions. Too often, devices and software meant to make the physician’s office more efficient turn out to be cumbersome and time consuming. Electronic medical records are supposed to make it easier to review a patient’s complete medical history, but a 2013 study from the American Journal of Emergency Medicine showed that the average emergency department physician spends 44 percent of a 10-hour shift entering data – about 4,000 clicks a day. It can take 16 clicks just to navigate all the drop down menus to order aspirin. Those time-consuming systems are good for billing and risk mitigation, Madara says, but often take doctors’ focus away from providing care.

To create products and systems that worked for its members, the AMA realized it had to get its physicians in on the ground floor of developing medical products. The association found that opportunity in MATTER, a Chicago-based healthcare incubator that provides mentorship, networking and shared resources for entrepreneurial companies in the medical industry.

Forming a Relationship

AMA was interested in partnering with MATTER from the organization’s conceptualization. “The fundamental reason is that sometimes we think of healthcare as a linear manufacturing process when it’s not at all,” Madara says. “It’s more a systems engineering process.” When a company develops a product without understanding how the user’s systems interconnect, that product might solve the original problem but have unanticipated effects on other nodes in the system. There is often a gulf between the theoretical understanding of manufacturers  and the granular knowledge doctors possess, Madara explains. “Practice and theory often don’t align.”

When MATTER CEO Steve Collens was developing a blueprint for the organization he wanted to address the key challenge entrepreneurs face in building healthcare products. A former employee of Abbott, vice president at Pritzker Group and founder of a company that coordinated healthcare data, Collens understood how complex the healthcare industry was for device and systems makers. How decisions are made, the products available and the way money flows between insurer and provider all play into the healthcare system. 

“You need to have more than a high level of understanding of how those pieces work in order to build a business that is not only going to ultimately look at an interesting problem, but solve a problem that is highly relevant to stakeholders in the industry and can be used by hospitals and physicians throughout the industry,” Collens says.

If a product gets too far along in development without the input from end-users – such as physicians – Collens warns that it can be impossible to go back and make changes when a fault or complication is found. MATTER is providing companies access to those physicians through its relationship with the AMA. Both organizations are benefitting from the collaboration: AMA members can guide product development to better suite their needs and MATTER companies can learn from knowledgeable users who understand the finer details of the healthcare system, making the end product more likely to be used.

The partnership began in February 2015, the same month MATTER started. “The AMA was an important part of launching MATTER,” Collens says. MATTER’s organization now includes 117 startup healthcare companies and 70 corporate and institutional partners.

Care Transition

Over the past few decades, the disease burden in the American medical industry has moved from caring for acute disease to chronic conditions. Patients with chronic diseases accounted for 86 percent of the country’s $3 trillion in spending in 2010, according to the Centers for Disease Control and Prevention. 

Despite those figures, Madara says the United States is still primarily set up in an acute care fashion. “What’s emerging now is because of this, care has moved from dominantly in-patient to dominantly outpatient,” he says. “Now it’s moving from dominantly outpatient to care-in-home.”

The process of moving to in-home care is leaving gaps in the healthcare process that need to be filled, Madara says. Companies have tried to provide solutions. There are now more than 165,000 health-related apps but only a few dozen generate actionable data, according to a 2015 study by the IMS Institute for Healthcare Informatics. Madara says that shows the medical product industry needs guidance on forming that information and how it can be effectively used in health systems. Physicians can fill that role, he adds.

“You need that real-world knowledge and insight in order to build something that’s useful,” Collens says. The industry’s transition to managing chronic conditions requires tools that make it possible to engage with patients in a continuous and real-time way, he adds. The existing healthcare system is built for episodic interactions. People go to the doctor or hospital, data is collected, and the information-gathering process ends until the next visit. Now, with continuous data collection, wireless capabilities and analytics, Collens says new technologies are coming that will help doctors make better decisions about what care to provide and when. 

“That process is not going to happen in an effective way unless physicians are part of the technology that is going to make all that possible,” he explains.

Creating Interactions

The AMA Interaction Studio at MATTER is where the theory of medical entrepreneurs and the real-world knowledge of physicians meet. The 450-square-foot room at MATTER’s headquarters in Chicago’s Merchandise Mart has video conferencing capabilities and can simulate the back room, waiting area or exam room of a physician’s office. “We brought the framework of a physician’s officer into MATTER itself,” Collens says.

The room can be arranged in multiple layouts, allowing developers to see how their products will function in the various doctor’s office styles found throughout the country. Madara says developers can forget to design with adaptability in mind. “There is a wide variance that needs to be understood and processed as you’re making a product,” he says. “This is a nuance that is often underappreciated.”

The relationship between AMA and MATTER is only a year old and the Interaction Studio only opened in November, but both Madara and Collens say it’s already resulting in a better development process. “We’re often surprised by the value add of someone that is close to healthcare and understands the variance of care,” Madara explains.

With the rapid changes occurring in healthcare, the partnership with MATTER is enabling AMA to continue achieving its mission of promoting art and science in medicine to the betterment of public health. MATTER, meanwhile, has been pleased with the involvement from doctors. Collens says at first he wasn’t sure if physicians would be willing to participate in a studio where there was no short-term benefit, but there has been no shortage of interest. 

The entire healthcare industry is thinking about how the practice of medicine will look in five years, and Collens is pleased that MATTER is facilitating that process. “The fact that this is a place where that conversation is actually happening is interesting and engaging to a broader range of the industry than I would have expected,” he says. 

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