1. Strategies for Startups to Partner with Healthcare Systems
A View from Geisinger
Gregory J. Moore, MD, PhD
Chief Emerging Technology and Informatics Officer
Director, Institute for Advanced Application
Twitter: @GJMooreMDPhD
gjmoore@geisinger.edu

2. Geisinger
Health
System
coverage
area
Revised
7-­‐25-­‐12.
Geisinger
PR
&
Marke7ng
Department

3. Geisinger Health System
• 3.5 million patients in service area
• 1,120+ physician FTEs, 700+ advanced
practitioners FTEs
• 78 community practice sites
• 7 hospitals
• 480,000+ member health plan
• Institute for Advanced Application
Center for Reengineering Healthcare
Center for Emerging Tech and Informatics
Center for Clinical Innovation
• Center for Health Research

4. GEISINGER–An Integrated Health Services Organization
Provider
Facilities
$2.3B
Physician
Practice Group
$1.2B
Managed
Care Companies
$2.5B
Geisinger Medical Center
& Geisinger Shamokin
Area Community Hospital
Geisinger Wyoming Valley
Medical Center
Geisinger Community
Medical Center
Geisinger Bloomsburg
Hospital
2 Nursing Homes
4 Surgery Centers
~80K admissions/OBS &
SORUs
1,623 licensed beds
Multispecialty group
~1,120 employed
physicians
~700 advanced
practitioners
78 primary & specialty
clinic sites
~3M clinic outpatient
visits
~420 residents & fellows
~490K members
(including ~77K
Medicare Advantage
members)
~112K Medicaid
Managed Care Projected
Membership (GHP
Family)
Diversified products
~39K contracted
providers/facilities
43 PA counties

5. Geisinger Institute for Advanced Application
3 Centers, 9 Labs, Informatics and Technology Trials Office, High Performance Computing Core
5
Organized for Synergy:
• Predictive Analytics
• Human Factors Engineering
• Diagnostics
A National Laboratory For HealthcareTransformation ($6B R&D Lab)
Leading through continual innovation
• Novel data streams and big data analytics
• Re-engineering via IsysE approach
• Emerging technology and Informatics
• Rapid clinical innovation
• Remote assessment/diagnostics/treatment
• Transforming patient care
• Engaging patients
• Improving the healthcare value
proposition
Center for Clinical
Innovation
Center for Emerging
Technology and
Informatics
Center for
Re-engineering
Healthcare

6. Data
Generation
Data
Aggregation
Performance
Measurement
Insight and
Action
Clinical
Transformation
and
Reengineering
Knowledge
Generation
• Care by-
product
• Transactional
• Required for
performance
measurement
• Establishes
current state
• Deployed as
visualization,
alerts and
reminders
• Basis for new
models of care
delivery
• “What to do in
a patient like
mine?”
Natural
Language
Processing
Data
Warehousing
Dashboards
Anticipate
and Mitigate
Automation
Machine
Learning
Enhancing the Data Value Chain

7. Six Drivers of High Cost, Poor Quality Care
• Mistakes
• Unjustified variation
• Fragmented care
• Perverse payment incentives
• Patient is a passive recipient of healthcare
• Supply-demand mismatch

8. Patient Engagement Objectives
Understand
My Health
Manage
My Visit
Control My
Condition
Patient Engagement

9. Value of Patient Engagement
Patients engaged in their health tend to
have better outcomes and potentially
lower cost
(Dentzer, 2013)
• Fairview Health Services study showed patients with a Patient
Activation Measure (PAM) of level 1 were 21% more expensive
than patients with a level 4 score (Hibbard & Greene, 2013)
• Shared decision making study of 60,000 patients showed
patients participating had 5.3% in cost savings, 12.5% less
inpatient admissions and 21% fewer heart problems (Veroff &
Wennberg, 2013)

10. Using Technology for Patient Engagement
To activate patients, you have to
meet them where they are.
(Hibbard, 2013)
“Only 1% of a person’s life is
spent with healthcare
professionals”
(Chase, 2013)

11. Empowering Patients Through Transparency:
11
Perspective
The Road toward Fully Transparent Medical Records
Jan Walker, R.N., M.B.A., Jonathan D. Darer, M.D., M.P.H., Joann G. Elmore, M.D., M.P.H., and Tom Delbanco, M.D.
December 4, 2013 DOI: 10.1056/NEJMp1310132

12. Patient Portal Access to Providers’ Progress Notes
>85% of outpatient
providers participating
• 90% of patients
understand their
health and medical
conditions better
• 84% of patients take
better care of
themselves
• 91% of patients feel
more in control of
their healthcare

13. Regular
Care
100% Care Processes and
Protocols (Digital)
Automation
Patient
Activation
Populations
Workflow
Modification
Patients and
Conditions
Population
Identification
Bundle
Development
Delegation
and
Algorithms
Low Efficiency and Reliability High
Reengineering and Disruptive Innovation

14. Healthcare Transformation: Empowering Patients
Potential Opportunities?
• Enabling Data Sharing by Patients
• Patients and Caregivers as co-writers/editors of medical
notes with healthcare providers
• Transparency in medical costs and outcomes
• Sharing Predictive Analytics with Patients How?
14

15. Health Care Systems
Choose Your Partner Type Based on Needs/Goals
• Traditional Academic
• Hybrid Integrated-Clinic Model
• Provider Only Systems
15

16. Know your Health System Partner
• Be aware of your healthcare system partner’s capital and
budget cycles
• Be aware of your partner healthcare system’s pain points
• Be able to clearly articulate in a prioritized list what
specific types of value you seek from your healthcare
system partner including “must haves” and “nice to have”
16

17. First Steps
• Getting the Opportunity-Contacts
• Getting the right people on the call/in the room
• Be Prepared-Anticipate Questions/Needs
• Be Respectful of Time
• Prompt/Relevant Follow-up
17

18. The Perfect Pitch
• Clear and compelling vision
• Convey your team’s ability to deliver
• Highly relevant management team
• Strong/credible market opportunity (size and growth)
• Product Differentiation-better mouse trap or disruptive
• The Solution-solve real pain point/must have
• Financials-credible, clear, open, defensible
18

19. Terms of Partnership - Part 1 of 2
Be clear on what value you are willing to bring to
the table at time of first discussion:
• Cash
• Non-Cash Equity Exchange
• Technology
• Services
• Preferred Licensing
• Future Royalties
• Other?
19

20. Terms of Partnership - Part 2 of 2
Be clear on your ask of the Healthcare System partner
at time of first discussion:
• Determining the Value Proposition of the Intervention
• Demonstrating Utility in a segment test-bed or “safe sandbox”
• Utilizing Healthcare System Brand/Endorsement
• Providing/Defining Market Opportunity (through Healthcare System
Dissemination Partnerships)
• Co-Development & Integration assistance (EHRs etc)
• Clinical Trial for regulatory clearance (FDA)
• Demonstration Site
• Future Customer relationship
• Cash Investment
• Other?
20

21. Questions?
Strategies for Startups to Partner with Healthcare Systems
Gregory J. Moore, MD, PhD
Chief Emerging Technology and Informatics Officer
Director, Institute for Advanced Application
Twitter: @GJMooreMDPhD
gjmoore@geisinger.edu