Healthcare has been the embodiment of the irresistible force paradox, a classic paradox formulated as “What happens when an unstoppable force meets an immovable object?” We know that technology and empowerment of the individual have been the drivers of immense change in virtually every corner of our lives…except healthcare.

There are many efforts ranging from startups to convening thought leaders at events to public and private sector initiatives meant to change this dynamic. It’s clear it will take a broad coalition of these efforts to make the change most desire in the face of immense forces to protect turf. It’s natural that organizations collectively generating trillions of dollars of revenue won’t give up without a fight. In fact, it’s entirely predictable that they’ll use every “FUD” (fear, uncertainty & doubt) tactic in the book…and already have. The key is to create the inoculation against that inevitable poison since healthcare is the single greatest threat to America.

During my detour away from healthcare, I had the opportunity to play a leading role in shifting another entrenched industry that had been largely unchanged for 50-100 years — the media business. Today, digital media now surpasses even broadcast television for ad spending — an unimaginable thought just 10 years ago. Driving that media industry transformation was their own shift from fee-for-service to fee-for-value (or what is more commonly known in media as pay-for-performance or cost-per-click). I draw from what we did to accelerate that industry shift as well as my experience in shifting a technology ecosystem within healthcare. Having said that, the scale of this transformation and the degree of FUD that will be used to slow progress is of a much greater magnitude.

To complement the aforementioned efforts, I’m doing my part to accelerate the shift to a much higher performing system. We all have levers to positively impact — these are mine. The following is a brief summary of the levers I’m contributing to and how you can help:


Health Rosetta 

This open source project is in response to the fact that purchasing healthcare unwisely leads to under-performance and using out-moded technology. In less than a year, the Health Rosetta has become a blueprint for wise healthcare purchasing that health coalitions are adopting, the investment thesis for a venture fund and the call-to-action for an upcoming film (more below) that highlights employers saving 30-50% per capita on health benefits. There is a LEED-like certification for healthcare being worked on around the Health Rosetta concept. One dimension of that borrows ideas from Fair Trade around transparency (doing beyond merely price transparency).

How you can help:

  • If you have or know anyone who has influence on health benefits, share this with them.
  • I regularly speak at companies, executive meetings and industry events to share the Health Rosetta (some organizing the entire event around the Health Rosetta). 
  • Feedback is also welcome as it will continue to evolve -- despite the momentum, it's very early and has plenty of gaps and areas to improve.


HEALTH ROSETTA PRINCIPLES for a New Health Ecosystem 

If the Health Rosetta is the “what” of the future health ecosystem, these guiding principles are the “how”. That is, Leonard Kish and I curated a set of guiding principles for the winning approaches of the future. These were curated from the leading thinkers in healthcare. The Health Rosetta Principles were inspired by a ground-breaking proclamation called the Cluetrain Manifesto that was hugely influential in the development of the Internet. Cluetrain’s 95 Theses followed the model of Martin Luther’s 95 Theses that triggered the Reformation. Clearly, healthcare needs its own Reformation given how poorly performing the status quo is.

We’re now in the process of expanding on each of the principles by having the leading thinkers bring each guiding principle to life. We’re thrilled to have contributors ranging from Susannah Fox to Eric Topol to Bill Gates to Esther Dyson to Jonathan Bush and many others.

How you can help:

  • Digest and then share the Health Rosetta Principles. Nominate whoever you believe would do the best job of writing an essay to expand on a given thesis. 
  • In the spirit of the highly influential Cluetrain Manifesto, we invite you to "steal" the principles, write about the, riff off of them, etc. We'll happily point to others' who have built off it it. 
  • I regularly speak at companies, executive meetings and industry events to explain how the Health Rosetta Principles can shape a company's future. Everyone realizes that the industry will be radically altered over the next 3-10 years. 
  • Feedback is also welcome as the Principles will continue to evolve -- you can comment on the thesis page itself or write your own piece and it will be linked to.


FILM: The BIG Heist

The film referenced above has gone from a twinkle in my eye to now having a Peabody-winning (broadcast’s “Pulitzer”) and an Academy Award nominated director/producers digging into this project (see update here). The film’s goal is to be as transformative for the public consciousness as Super Size Me, Waiting for Superman and the Inconvenient Truth were. In a smart, funny and entertaining manner the film will both take on sacred cows that create massive collateral damage as well as provide inspiring stories of what happens when the Quadruple Aim is fully achieved. The film is in the development stage. We are starting to build the grassroots organization that will use the film as a point of activation to transform the industry through a partnership between clinicians and citizens — neither can drive the necessary change on their own. The “good news” is clinicians are even more dissatisfied with the status quo than regular citizens. When they see how much more fulfilling their professional lives can be, they’ll recognize they can leave burnout and dissatisfaction behind.

How you can help:

  • As mentioned in the update, securing resources is paramount to getting this film out in time for the change of presidential administrations. Regardless of the outcome, healthcare will be a topic of discussion for the new president and congress. The stories of healthcare's dysfunction, collateral damage and the proven solutions to fix those problems transcend political labels. We want to drive a positive dialog. With the world class team combined with the stories, data and solutions we have in place, the primary risk for getting the film out by January 2017 is securing the necessary resources in time. 
  • I am working on a TED-style talk to accompany the film. If you have an event where that would be a fit, let me know. The title of the talk is "Unleashing the American Dream by Thwarting the Healthcare Heist." It's a natural for business coalition events as well as other groups who have a stake in thwarting the heist. This includes local governments, faith-based organizations, non-profit health-focused orgs (e.g., American Heart Assoc), United Ways, business coalitions, employers, social justice groups, medical societies (state/specialty/interest area), responsible government groups/foundations, PTAs and teacher unions.


Investing in the Quadruple Aim & next generation health & wellness platform

Put simply, I don’t believe the vast majority of the “changes” in healthcare are sustainable. Too many of the changes throw more technology and bureaucracy on top of an already-flawed process. It’s no wonder doctors and nurses are extremely dissatisfied (and it’s getting worse) when the 4th aim (improving the care team experience) is overlooked. Fortunately, in my study of the highest performing health plans/providers over the last several years and particularly the last several months (following leaving WebMD), I couldn’t be more optimistic about how achievable the Quadruple Aim is. So much so that I’ve created a seed stage called the “hf Quad Aim Fund” — the “hf” is short for Healthfundr. 

We are working on a reference model for the health platform that we'll publish as it takes shape. Currently, we're defining it and getting feedback from experts in the industry. It will go into the next level of detail beyond what was outlined in the new industry taxonomy that has been extremely well received. It's our belief that just as Amazon Web Services dramatically lowered the bar what resources it took to launch a startup, the winning platform(s) will make it far easier to establish a next generation health and wellness service. As you might expect, we see tremendous investment and revenue opportunities around a health platform that is focused on the totality of health -- not just the hospital-centric systems that impact a very small part of health outcomes yet consume the vast majority of resources. 

How you can help:

  • If you are a startup, read the investment thesis. Tl;dr: If your company has proven it can positively impact the Quadruple Aim as a technology or technology-enabled services company and are Pre-Series A, let's talk.
  • If you are a purchaser of technology, buy for the future and not the past.



Forbes exclusively published this report here. Like Mary Meeker’s Internet Trends report that it’s modeled after, it’s a big deck so will take some time to digest. However, at the beginning of that deck (slides 4-8) is a new industry taxonomy that stands in stark contrast to the pre-Copernican view of healthcare where hospitals/disease/technology are at the center of the healthcare universe. Rather, it is a post-Copernican view where individuals (aka patients) are at the center of the healthcare universe -- not as a cute marketing slogan but as a fundamentally different lens on healthcare. 

How you can help:

  • Digest and then share the report/taxonomy. It's already been viewed ~25,000 times so it is striking a chord. 
  • I regularly speak at companies, executive meetings and industry events to provide a lens into the future by looking at what is already happening and how the winners are organizing themselves around the new industry taxonomy. If that is a fit for your organization, let me know.
  • Feedback is also welcome as we will update the report in the future.

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Contact via Healthfundr for expertise requests or speaking engagements 

Upcoming travel/speaking schedule present opportunities to get on Dave's speaking calendar:

  • Week of September 8: Pittsburgh
  • Week of September 26: Silicon Valley
  • Week of October 13: Dallas/Chicago
  • Week of October 25: Grand Rapids
  • Week of November 1: Denver
  • Week of November 14: Chicago/New York