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Steve Shreeve decided to answer that question, and wrote to the VA to ask for copy of
the Vista software under the Freedom of Information Act. He eventually received a
CD in the mail, and that was the start of Medsphere. Shreeve raised $1.7 million in
angel money from some doctor friends and proceeded to port the software from its
old Digital Equipment VAX VMS platform to Linux. He also recruited some key
people from the VA who shared the vision, and raised a further $4 million in Around
money from Wasatch Ventures and Thomas Weisel Venture Partners. Now the
company has two hospital customers, in Oklahoma and Texas, with a total of about
1400 beds. Augustin plans to build out the sales and support teams and grow a big
business, he says. “Only 5 to 10 percent of hospitals can ever afford a high-end proprietary
system, he says. We want to serve the remaining 90 percent.”
But he’s well aware of the challenges. “My deepest experience with medicine is with
my father who was in intensive care after a stroke. I now have a stack of papers two
feet high. It’s the bills and reports and it’s completely incomprehensible. I don’t
know why they send them to me. I’m supposed to have some clue that what I’m
being billed for is correct, but the whole system is completely broken and incomprehensible.
Health care is one of few cases where people don’t make cost-benefit tradeoffs.
The whole industry is deathly afraid of benchmarking itself on quality.”
He continues, “At Medsphere we want baselines in order to show improvements in
ROI and quality based on our installations. But can you imagine finding a customer
who’s willing to have us say, ‘Last year you killed 39 people and this year it was only
10’? Yet you can’t reduce something unless you are willing to measure and report it.”
Carol Diamond, Markle Foundation: The power to transform
For Carol Diamond, medical school and internship were “a harsh cold shower. I discovered
that the system was really really broken. This kind of medicine was not what
you saw on TV. I had the bug to make it better, and somehow I knew it had something
to do with information systems. Right now in health care, you’re flying blind.
You don’t know who else your patients have been seeing, you have no information
about their prior care, yet you have to make major decisions about treatment.
Beyond that, the way you are trained is often somewhat tribal: The specific practices
can be different in each medical center.”
Yes, she continues, “We are trained to make decisions based on what we know, but
there’s a lot of unknowns in health care. Physicians aren’t trained to discuss this with
patients and it’s not easy just to say ‘I don’t know.’ It’s not just vanity or bravado:
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