Many innovators find themselves wearing blinders on either the business side or the clinical side, without catering to the overlaps between the two. But this often results in big issues, like spending unnecessary resources — or worse, building an innovation that clinicians don’t actually need or want.
In this episode, independent healthcare consultant Dr. Erkan Hassan explains 3 critical challenges that innovators need to balance:
- The business challenge of making sure you’re a commercial success
- Ensuring that you have clinical validation to prove that your innovation does what you say it does (without biting off more than you can chew)
- After the sale, making sure that you adapt to the health system’s workflows for long-term success
We talk about staying solution-focused vs. product-focused, the massive importance of using a patient context lens to present your clinical outcomes, how to make sure you have just the right amount of evidence, and more.
As an independent healthcare consultant, Dr. Erkan Hassan couples clinical expertise and business skills to help health systems and startups. He works to identify the clinical challenges these companies face, then use evidence-based clinical data to create innovative, intelligent solutions that drive patient-centered quality outcomes.
Formally trained as clinical pharmacist, Dr. Hassan spent the first half of his career working in academic medical centers to help manage drug therapy for ICU patients. After taking the academic route and working as an associate professor, he switched gears to become the Director of Clinical affairs for an ICU telemedicine startup.
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Speaker 1: Welcome back COIQ listeners on today's episode, I have Dr. Hassan who has been in the healthcare industry for many decades. I know I'm telling your age a little bit, but you've been in healthcare for a long time. Um, and is an independent healthcare consultant. Welcome to the show. Hello everyone. So before we get started, I always like to just kind of level set and have you do a little bit of an introduction about your background and what you do to kind of give our audience some context.
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Speaker 2: Yeah, sure. That's great. I, uh, am formally trained as a clinical pharmacist. I got my pharmacy degree and my doctor pharmacy degree and went to work at academic medical centers. Sprit. Spent the first half of my career at academic medical centers, primarily working in the ICU, working with the intensivists and critical care nurses to, uh, manage the drug therapy of these very critically unstable patients. Um, and went the academic route, got promoted to associate professor, the whole scholarly activities, the, the, um, professional service that T teaching. And then, uh, switch gears and was employee number 17 at visit, which was a startup company for um, telemedicine for the ICU, trying to leverage a limited resource and was there, we built that company. I was employee number 17. We built up the, uh, the product that solution, the, the, uh, the, the number of beds would cover about 7,000 ICU beds, uh, all adult patients in the ICU in the U S and my most recent title there was director of clinical affairs where I was responsible for identifying, prioritizing, launching, and growing the clinical informatics strategy.
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And so, and, and again, most recent shift as an independent consultant, what I do is I try to identify the clinical challenges that health systems and startup companies face, using evidence based clinical data to sort of create innovative, intelligent solutions to really drive, um, patient-centered quality outcomes. And it's really coupling my clinical expertise with business skills that I've learned over time. I think the best way to describe this is, you know, my, my fire in the belly, my, my goal of really what I want to do when I grow up is, is I really want to build or create a quality solution that really impacts the quality of care for the patient in the bed. That's, that's sort of my driving fire in the belly.
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Speaker 1: awesome. Somebody's got to do it. Oh, you know, so it's interesting because there's so many factors or things to consider when you're bringing an innovation to market, but that, but healthcare is so unique and, and I think that one of those things that makes it unique is that the clinical evidence is like a critical factor in, in being able to be successful, whereas other industries don't have to, um, you know, pay attention to that. So our show is all about helping health innovators, um, you know, go from an idea to full market adoption. And so I wanted to ask you, as you scan the landscape, what are some of the biggest challenges that you've identified? Um, when you're looking through the clinical outcomes lens?
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Speaker 2: So that's a really good question. Oxy, and if I may, let me step back for just a go a little bit real, a level higher with that. I mean there's actually three, three parts to this problem in my view, and I'm not sure if they're independent pillars are overlapping Venn diagrams, but the three parts that I see, number one is obviously the business challenge that a company wants to be a commercial success. And I think that you spend, uh, you know, a good part of your book on, on the challenges and, and we can talk, we'll talk more about that in a minute, but, but it's the business challenge of becoming a commercial success. And it's either an offshoot of that or separate pillars, a part of that because I think the other two parts are, number one, are the clinical outcomes. You said that, and you know David Nash, who's the founding Dean of the Jefferson college of population health, he just retired as the founding Dean of that has this great quote.
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I give him full credit for it, but I steal it all the time. No outcome knowing them. And again, we'll come back to, I want to list the three things that we'll come back and talk about each one of these in a little bit more detail I think. And then the third factor I think really is health system workflows and really defining the roles and responsibilities of healthcare, identifying the challenges that healthcare faces and, and how do, how do all these three interlace and really how do you take these in terms of clinical and business skills and bridge them together. So that's kind of how I see it from the business challenge. You know, let's talk about the business challenge aspect of this. So there's three parts. I don't know if it's pillars or overlapping Venn diagrams, but to be a commercial success, you know, you and I both know there are companies out there that build solutions looking for a problem and that's really not the best way to do it.
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And so that's one issue with the business challenged to become commercial success. The second area I think is in in terms of co-development and I've seen many companies where they build their solution or their product sort of in isolation and I think one of the things you need to, it's a mind shift with healthcare because you really have to build it the way clinicians think don't have that that way clinicians think to overlap it with the clinical presentation. Again, you're going to fall short and you need to be concerned about that. And then finally is the clinical validation. So again that part of the Venn diagram that we need to go talk about the Venn diagram and I think one of the best way to sum it up as I see it in terms of the business challenge is that a lot of companies, we'll think of it as a product out there and I think that's a mistake when it comes to healthcare because what health care is looking for is not a product.
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They're looking for a solution. Anything with a product that's not solving that may not be solving my problem. I really need, there is a proven solution of how do I incorporate this into my system. So that's the one business challenge piece. Let's talk about the clinical outcomes piece of this. The clinical validation piece is very critical, no outcome, no income. And I think a lot of companies are surprised that, Oh, we have this great widget, let's go sell it and without the very first question you're going to get is show me the data because think about it, if you're a new company trying to get traction, no one is going to take a risk on you without clinical data. And you know, I don't mean that it needs to be a large 2000 patient randomized clinical trial, but you do need to show a pilot to demonstrate that what you're offering really does what you say it's going to do.
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But that does entail a number of things. It entails writing the study protocol, getting IRB going through the IRB. It does not mean you need, you may or may not need to get informed consent based on what you're really trying to demonstrate with it. But having that at RB piece of paper I think is very important. Getting the data, analyzing the data, having go no go decisions, identifying the metrics you're going to measure and, and, and assess for success or failure is important. And again, this does not have to be a two year study. I think some of these can be done in very short periods of time, 90 days of once you start enrolling in, uh, getting data. So let's pause for just a moment and talk about that. Like, when does an innovator need to develop this?
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Speaker 1: Um, and, and how much is it, you know, a kind of a progressive thing. So you're kinda touching on this. Um, but I, I want to just pause and kind of drill a little bit deeper into it because I hear this question all the time. Um, you know, how much evidence and clinical validation do I have to have before I go to market? How much of it can be a little bit more ambiguous? Um, when I'm approaching someone maybe as a partner and the way I'm going to get that evidence is going to be through that pilot program. So, so let's kinda just talk about when and then what does that look like? Because I think you're doing a great job for our listeners, kind of framing that is this is what you might need before you go to market. And, and it would in this context, right? We talk about sample size and the type of type of study, um, and then what you would need maybe in a pilot or in some of your first customers.
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Speaker 2: My personal opinion is, um, if you're going to sell the health systems and you're going to go to health systems and do this, unless you're going to partner with them, um, you need the data upfront. Nope. You know, especially if you're a small startup company that, uh, you're trying to get risk takers, uh, early adopters or just what you're doing. You have to have some clinical data and to show the, and so for example, I think it really depends on what the solution really is. So, um, for example, if you have a predictive algorithm that says, I can predict length of stay in the hospital or in the ICU, then and I can, I can, this algorithm will predict length of stay. Well then I need to go to a hospital and say, will you partner with us to pilot this so that I can, and I, and let me back up.
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So I, I built this algorithm, I pulled back 2000 patients, I analyzed their data and I had some engineers build this algorithm. I know what the key components are. I validated it. I developed it and validated it in house. Yeah, no outside data before you go to a site, you're going to have the first, if you go to a site to sell this algorithm, they're going to say, where's your data? Show me that what you actually built has been validated, that it actually works. And so I think that has to happen before you make any sales.
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Speaker 1: The, the, the structure of that, does it need to be a certain population, a certain sample size? Um, is there some specific metrics? Are markers? Um, because I think that this is also a really important discussion because there's a lot of pitfalls with this. Um, because you know, most of the people that are the health innovators are not the clinicians. Um, they're not thinking the way you are and you're, you know, in the, in what you're talking about in your experience, they're thinking of more of the tech. And so the last thing you want is them to do these studies but be missing some key parts of the data to where it was wasted time, wasted money because it's incomplete or it's not what that those potential customers are looking for to actually give them assurance of, you know, patient's safety and efficacy,
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Speaker 2: you know, excellent points. I think that is right on the Mark and one of the biggest problems they see is biting off more than you should chew. And I think the first step is this is what we say it does. This is how, this is how we're going to validate that it does what we say it does. Period. That's all you're trying to do.
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Speaker 1: Yeah.
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Speaker 2: I think the other part, don't worry about the other populations that's growth down the road. Yep. You know, I think how large of a sample size, that's simple to figure out how much of a sample size you really need that that's biostatisticians can tell you that the sample size you need for that but don't, don't get to the point. So I'll give you a good example. I was recently working with a company that has an algorithm that can predict interventions, interventions somewhere between four to six hours before the intervention of the clinical intervention actually occurs. They need to do a clinical validation and they're like, well how do we show that we avoided all these interventions and the first step, cause they have not done any clinical validation yet. My response was, you don't need to yet. What you need to do is show when your algorithm goes off, six hours later there actually is an intervention and if you're living with them does not go off six hours later. There is no intervention. That's the first step. And I go in armed with that to say, look, Mr. and Ms. health system, this is what we say our algorithm does. This is the data showing that 90 95% of the time it actually did identify these patients. Now what we do with it. And that gets to the workflows piece, which is the third pillar we'll get.
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Speaker 1: Yeah, yeah, yeah, it does. Absolutely. But you know, it makes me think of another question. Um, you know, so what you're touching on in my mind is, you know, kind of around this MVP and I know people have different perspectives. You know, they say, Oh, you can't do MVP in healthcare because you know, patient's lives are at risk. And I think it depends on how you're defining MVP. And, and so I think what you touched on is, you know, for health innovators, you don't have to, if you're thinking about a product or a solution, you know, maybe you go to market with a minimal feature set and then you do your studies and your validation on those minimal features. And that helps you with the timing and the financial cost of that and being able to go to market rather than having, you know, 20 or 50 because you think that's going to make it seem more attractive, but then it takes you longer and it costs you more money and then you don't have any money to go to market.
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Speaker 2: You don't have to boil the ocean back to, it gets back to what problem are you trying to solve? And I need validation that what you say your algorithm does or your product does. Yeah, that's it. Yeah. And so you don't need to boil the ocean, especially the first, first leg out there is maybe my experience. After you do the pilot study, you end up with a bunch more questions than you started with
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Speaker 1: and that's okay. Right? Like give our audience permission that that is okay. It's okay.
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Speaker 2: Does you know what you need to survive to be able to address those questions are ties them and then figure out which ones really make the best business sense and workflow sense to really go to.
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Speaker 1: So a lot of folks um, you know, sell a technology solution to a health system and walk away. What are some of the biggest challenges, um, that an innovator might have after a sale?
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Speaker 2: So that's the third pillar. Okay. The third pillar is the health system workflow.
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Speaker 1: We can talk about that, but I've got some old stuff on the second pillar still. Okay. All right, well let's do it. We can go to either one. Listen, you're my guest. Your show lets you decide
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Speaker 2: one of the other in, in terms of the clinical outcome, in the clinical validation piece, I think one of the things as you address what problem am I really trying to identify? Um, one of you have to ask what are the problems faced by healthcare systems? Yeah. And one of the biggest problems is assimilation and managing clinical presentation. Okay, let's talk more because data, it's scattered throughout various sources. There's no one place that pulls it out together. In fact, there may be key data elements that are missing. So, so I've got to gather data from all these disparate systems gathered from a variety of scattered systems. How do I bring it all together, incorporating my solution that it makes sense to solve the clinician's problem and take care of that patient. Again, my fire in the belly, how do I improve the care of that patient laying in the bed?
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I'm thinking of the patient laying in the bed. And a lot of times the data presentation lacks patient context. I'll give you a good example of that. And a lot of CPOs systems, there's drug drug interactions, right? As a drug guy they do, they do the drug drug interactions, right? And, and a clinician will get a notification of a drug drug interaction. I read a recent paper, they looked at 3 million drug drug interaction notifications. Okay. 2.8 million of them. 91% were overwritten. Why? Several reasons. One, uh, alert fatigue, I get these things just keep popping up. Could be, could be because um, because the chart is not updated. So in other words, if the patient had renal disease that would pop up the drug notification, the acute renal failure has resolved itself, but it was never taken off the problem list. So the computer is still seizes the active and pops it up.
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A variety of reasons. So the question becomes how do you fix this? And I think, in my opinion, my opinion, but one way is to provide patient context to it. So if you have a patient you're on warfarin and I'm adding trimethoprim, sulfamethoxazole is an antibiotic and I get a notification that this drug interaction increases your INR bleeding tendency. Okay, I got it. And, and it's interesting the studies that have looked at dismissals of drug drug interactions, a lot of them have got to put in a reason why you're dismissing it. The most common reason that the clinicians dismissed drug drug interaction notifications is, yes, I'm aware of it. I got it. Click done.
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Well what if as a clinician you see on the notification, Roxy has a warfarin, trimethoprim sulfa drug interaction, it's going to increase her INR. And her most recent INR from three hours ago was 2.8 and, and, and in that same script. So now it gives me patient context. I now I don't have to go someplace else to look for it. Right. All right there and what if on the same screen I can then say, okay, cancel that order I want to use, I want to order something else. All from that same patient context screen. So, so my point is data presentation. I think as you build your innovative solution, you need to consider data presentation and it gets into the whole risk stratification, which we can talk about later. But what I call the ten second rule looking, I'm looking at a screen of, and I don't care if it's 20 patients, 200 patients or 2000 patients, and you're notifying me that these 20 patients are all red alerts, right?
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Well within 10 seconds I need to be able, as a clinician, what I want to know is who's the number one patient? I want to look at it. I have to look at where do I need to look and what am I supposed to look for. So if I don't know, if I see a screen of 50 patients, 20 patients, whatever it may be, patient, 35 maybe the number one patient I want, I have to sign to go to patient one, two, they're all red. But how do I know where the priority is? And if it doesn't meet that ten second rule,
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Speaker 1: it doesn't work in my mind. So do you see this as something that is um, an affecting the health innovator in their product development phase to make sure that they're taking that into consideration? Or do you see that as something that is really important after the sale and making sure they have an understanding of the environment to make sure that they're getting the outcomes that they hope to get from their solution or both?
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Speaker 2: Um, the short answer is it's pre, I think you go out the door with it. I think if you go out, I S so let me make let, now let me give you the long answer. The ten second rule. I have not seen anybody that meets the ten second rule. I have not seen any company out there that and small, medium, large companies that meets the ten second rule. And so that's a huge advantage if you can walk into a place and say this is how we restratify and I can show you who the top person you need to look at this and who to look at, where to look and what to look, look at. That's the ten second rule triad. Um, to me going in after the fact because it goes into our third pillar, which is the health health system workflow. And you have to have that as part of it.
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So with health system workflow, and it gets back to the question you asked earlier, if I have a technology, so I've built, I'm a healthcare innovator company, I've built this, this thing and I have my clinical validation. I show that I can predict length of stay in these patients. Right? Here you go, Roxie is as head of a five hospital health system. I would like you to buy this and you say, yes, I'd like to buy it and we install it in all your five hospitals. The outcomes, the clinical outcomes do not automatically transfer from one program to the other. Simply by adding on technology. It does not happen by simply installing and turning on a switch. You may be more, um, you may be more efficient, but you're not going to be more effective and no one, no one pays you to be efficient at doing the wrong thing.
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Speaker 1: Right? Right, right.
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Speaker 2: So even though you have strong leadership acceptance, even though you have a strong project team and even though you have clinical buy-in, these are all good starting points, but alone will not guarantee success without going back to the topic of the pillar, which is health system workflows, how do I, how do I improve the workflow? How do I streamline it? One of the biggest problems in healthcare is those frontline clinicians are very busy, very, very and adding more things for them to do without taking stuff away is not going to help. It's only going to hinder. So I think the, or has to think about what, and again, I've seen this happen with companies that say, and it's the difference between having a product and having a solution because the solution is going to encompass all of these things that all three pillars that we've been talking about. Yeah. It's going to say this is how you use it. And it may vary from site to site, right? We may have to customize it a little bit, but if you get it right, the customization should be little tweaks, not major configuration changes.
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Speaker 1: Right, right. Which is a huge pitfall. But yes,
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Speaker 2: right? And so, and even within a hospital, the fifth floor may do it differently from the third floor, from the ER, from the date. Right. But it might be a little bit differently. But aligning those people and process that, that what I call the clinical transformation change, that's what you really need to have to have it adopted and show the frontline clinician how it's going to make their job easier. Not worse. And so simply going to a site, in my opinion, going to a site and say, here's the technology, turn it on and boom, you're going to fail. You will fail. Okay?
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Speaker 1: Yeah, absolutely. And you know, it's so critical these, you know, the health innovators, you know, put their heart and soul in their solution, their innovation, and they're going to market. And it's, it's such a, a win that needs to be celebrated when you get these new customers. Um, but the fact remains is that if those new customers, those early adopters don't become raving fans, they will not help you move through the adoption curve to get the future customers. So you might have one, a few, but if that account is not managed and through the lens that you're talking about, then you're not going to have raving fans. You might have sold a solution that's not being used, you know, call, call six months and find out like, yeah, well nobody's using it. It's all installed. Or they may be using, you know, a 10th of what the capabilities are. And, and so what do you suggest to health innovators? You know, what do they need to prepare for both financially, like what resources that they need to plan for both finances and people to be able to after the sale support that implementation and execution all the way to gaining the clinical validation to where it can be a successful case study for future business.
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Speaker 2: Yeah, so I think you're right. I mean you want these initial sites to be your reference sites and you want to be able to take prospects there and say here, call up st Joe's, talk to talk to dr Roxy and ask her what she thinks of the system of our solution, right? Yup. I think you have to have the clinical validation piece before you do that, before you go out. And the other piece that we haven't talked about, which I think is part of this as an, and again, so the clinical validation piece, the data presentation piece, the ten second role. But the other piece of this that I think is also important is the reporting piece and going out without reporting I think is an error as well. Now I realize I'm dumping a lot of stuff of stuff you have to have before you walk out the door. Again, you don't have to boil the ocean. Right? Right. But I think reporting to be able to assess what, um, that what you say your solution is doing is actually doing. And part of the reporting is also part of your clinical validation. The metrics that you've identified. And I think of metrics in four big buckets. There's clinical metrics, there's financial metrics, there's operational metrics of how well does it operate within the system and then their staff and patient satisfaction metrics.
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Speaker 1: Yeah. quadruple aim. I
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Speaker 2: think the question as you're building your clinical validation, you asked, you have to go through each one of those and, and have your list and generate a list of all the possible metrics under each one of those four categories. And there will be duplication, right? Yeah. There'll be one metric that will transcend multiple categories and then there will be, again, don't boil the ocean. You want, you got to have your MVP metrics that are really gonna get back to this is the problem. I'm trying to solve that I've identified and these metrics are key to showing that not not the rest of them. So you need to identify that up front and go out there. Now as you build the solution, one of the questions if a health system is going to want is an output reporting. How well are we doing? What's our assessment of this?
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Not only initially but over time longitudinally. And we all know what happens when a new project starts. You and we also know what happens. There's a lot of enthusiasm. There's especially with positive results, a lot of encouragement. Roll it out everywhere. Let's go. But we also know what happens when you take your foot off the accelerator. And so not having the reporting and be able to assess what happens longitudinally with your program, uh, to see that it's still working is also important as long as we're talking about reporting. Let's talk about some other things. What most people think about when we say reporting assessment of outcomes is reporting to the C-Suite, the buyers. That this is the results of our solution and our, our collaboration with you. Because it does have to be a partnership and a collaboration, right? But these are the results to the C suite.
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But what I submit is don't forget the frontline clinicians. So you want to report for lack of a better term, upstream and downstream and often times we forget to circle back to the people that are actually doing the work at the front line and say this is the impact you're having with this solution. And we're going to show you this. The third part of it, there's, there's four parts. The third part is I as a health system have bought your solution. Now I want to be able to compare my hospital a to hospital B to hospital C the hospital D, right? I want to compare how, where is my problem area if I get overall I'm at 80% compliance with whatever system I'm in. That doesn't tell me that hospital D is at 40% and counteracting the 90% hospital a is at. So I need to find where my problem is and, and, and then in addition, I want to know how does my health system compare?
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How do my community hospitals compare to other community house with my other competitors in my area? How does my academic sites compare to other academic sites? How does my 300 bed hospital compare to other 300 bed houses? I don't want to compare myself to an 800 bed hospital. And how do I compare geographically from the Northeast to the Southwest? How does that compare? None of that happens without a reporting mechanism over time that you need to, to consider. And the final area is, I think the reporting that you build into this helps helps in terms of identifying areas for improvement areas you're not doing well in for whatever reason, but areas to focus on in the future to improve compliance.
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Speaker 1: Yeah. Yeah, absolutely. I mean, and that's just really that, that's a fundamental practice, I think for anything that we do today. Right? You know, design, build, test measure, and just for continuous improvement. Um, and, and so it's interesting to even think about it from the, the outcomes piece and how important that is.
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Speaker 2: I don't know what your experience has been, but mine is, a lot of times innovative companies forget about the reporting piece and they're like, Oh yeah, we'll have some reporting at the, but don't really think about what are the elements I really need to put into it.
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Speaker 1: Yeah. I, it's definitely, um, an afterthought in many cases or it's really lean a little too lean and in not, I think what you're describing is something that's really important to think about even in the development process, right? Planning for that type of, um, data collection and its segmentation and, um, you know, presentation to customers as well as to, you know, yourself as the innovator to be able to see how successful it's going. I think that, you know, as an L health innovator, you know, when you're in this startup, you know, you typically have limited resources and right. And, and, and you've got this window of up, of opportunity that you're kind of up against. And so you're kind of thinking of what is it that I have to have, what do I need to spend my money on? And I think the conversation that we are having today very often too often gets part of the down the road and, and, and I think that it becomes a pitfall for success.
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Speaker 2: I agree with you completely. And, and you know, if MVP is a dirty word, I'm sorry, but it's part of MVP and,
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Speaker 1: right, right, right, right, right. Exactly. Uh, um, so, you know, as we wrap up here, you know, there's so many people that are, that are listening today that are innovators that are in the trenches or hospital systems that may be innovating within, that are still even internally experiencing a lot of the same challenges that we talked about, or they're on the receiving side of this health innovator bringing a solution to them. Is there any other advice that you have for them? Um, before we wrap up?
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Speaker 2: Wow. Uh, uh, to throw more, more, uh, killing on the fire to stoke it even further early on, uh, when we, when we first started doing the telemedicine for the ICU solution, we could, that would sell solely on clinical outcomes. You can do it just on clinical outcomes. That environment no longer exists. And I think everyone hopefully is aware that you have to sell it on clinical and financial outcomes and you have to include the financial component to any project that you do with this. So yeah, if you're not looking at that, I think that would be my last piece of advice. In fact, I just recently saw an article of, you know, the big thing in the news these days are how drug companies price their new innovative drugs and can absorb it and price for these, well I just read an article and there are some countries in Europe that price it big price, their new pharmaceuticals based on quality, quality, life years gained solution. So the, the pricing of the drug is based on what impact on quality life years will it impact the patients taking the drug. So things that have are more lifestyle changes to improve, you know, um, we'll probably have less costs if based on that versus something that's a huge life lifesaver kind of thing. There's, there's, and, and obviously the FDA is looking at ROI and cost analysis in, in anything that they consider, especially with the drug aspect of it. So that would be my last piece of advice.
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Speaker 1: Awesome. Well, thank you so much for sharing your wisdom with our listeners today. Um, how can folks get ahold of you if they want to reach out with, reach out to you to do any type of follow-up conversations?
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Speaker 2: Thank you for that. I think the easiest way is on my LinkedIn profile. I'm ERCOT Hassan on my LinkedIn. They, uh, will have access to my webpage. I also, if you look at my activities, I post a lot of articles. I have a monthly blog newsletter, the, they're all posted on LinkedIn that you can download, read, throw away or subscribe to the, uh, to my monthly blog with that as well.
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Speaker 1: Or kind of thank you so much. I feel like, you know, we could just have this conversation for days. Um, so we'll have to schedule another episode. There's so much to talk about.
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Thank you so much. Thank you.