It was serendipity when Guy Hudson, MD, a pediatric specialty surgeon, met Shelley Cathrea Roy, a chiropractor, and Laureen Driscoll, a nursing administrator, for the first time at their EMBA orientation meeting in 2011. Though Guy and Laureen were both working at Swedish Medical Center at the time, neither they nor Shelley could have guessed that their EMBA experience would soon result in teaming up to lead change in pediatric services at Swedish. Pursuing a career shift, Shelley sold her practice and, leveraging her EMBA network, joined Swedish the following year as a clinic administrator. All three quickly found innovative ways to apply the business tools they were learning in the program in the hospital setting. Executives took notice, and supported their efforts to marry their growing business savvy to their professional expertise on the job. Leadership opportunities and promotions followed, with more to come.
How a UW technology becomes a startup and its developer an entrepreneur, with a little help from a lot of friends around the Foster School and beyond
It began with a problem. A glaring inefficiency of the modern hospital that is as pervasive as it is puzzling.
In this age of digitized everything, the status of virtually every patient in virtually every medical department in America is manually tracked by erasable marker on an overcrowded white board.
Such a simple, central organizational hub works great as a framing device for the bustling casts of ER, Grey’s Anatomy, and other fictional hospital dramas. But in the real ward, it makes for a shockingly outdated nerve center—error prone, incomplete, and far too taxing of staff time better spent on patient care.
Ben Andersen (TMMBA 2012) understood this completely when he took up the challenge of modernizing the tracking system in the department of surgery at Seattle’s Harborview Medical Center. Before enrolling in the Technology Management MBA Program at the Foster School of Business, Andersen was a perceptive young IT guy working on the informatics team at Harborview, a branch of the UW Medicine Health System.
Fast forward a few years and his one-off solution has become a nascent company called PatientStream with broad ambitions in the $2.5 trillion health care industry.
Andersen’s jump from developer to entrepreneur is a study in technology commercialization at the University of Washington—of an innovator who is educated, mentored, focus-grouped, funded, challenged and championed by a fabric of experts and entrepreneurial organizations around and affiliated with the UW at large and the Foster School in particular. Complementary nodes in an ever-expanding network.
When Harborview opened a second surgery site four years ago, coordinating patients and medical staff on twin white boards proved unwieldy, to say the least.
The job of finding a solution fell to Andersen. He first sought an off-the-shelf fix, but found it didn’t exist. So he offered to custom-build a solution. And his entrepreneurial manager, Peter Ghavami, gave him the green light.
Andersen immersed himself in activity around the white boards. “I wanted to capture their language, every mark they made,” he says.
His solution was deceptively simple: an electronic patient tracking and operations management system that drew and displayed information from existing hospital systems on a flat-screen television (or any networked computer). A digital white board.
It was useful. More importantly, it was usable.
“Normally when we roll out a new system, there are groans and moans and no one wants to learn it,” Andersen says. “When we implemented the digital whiteboard, after about five minutes of training they said, ‘That’s it? I can do that.’ Support calls were almost non-existent.”
The Electronic Whiteboard (EWB), as Andersen named the digital display system, worked from the start. Easy to use. Effective. Efficient. Patient waits fell markedly. Accuracy increased. Medical staff no longer had to cruise the white board all day to track their schedule. And administrators could view instant metrics on operations and performance.
Word spread quickly. Other departments began clamoring for the EWB, first at Harborview, then the UW Medical Center. Today, over 50 departments throughout the UW Medicine system are running on the EWB.
“When I began getting request after request from other departments, I realized that this is a need that’s not being met,” Andersen says. “Maybe this deserved to be in other hospitals as well.”
Andersen had founded a company before. It was the right-place-wrong-time story of a workflow management firm serving property management/landscaping companies—launched unsuccessfully at the start of a historic housing crash.
Delivering a kindred tech solution to the health care industry, he knew, would be exponentially harder.
But Andersen held a few advantages. He had an author’s knowledge of the software and a proven track record of implementations in real hospitals. And he was enrolled in the Foster School’s TMMBA Program where he added a full suite of management skills that would be essential for a software developer to make the jump to CEO.
Suresh Kotha’s technology entrepreneurship class, in particular, was pivotal to Andersen’s ambitions. The course helped discern whether the opportunity and technology were market-worthy, yielded a working business plan, and, most importantly, demystified the entrepreneurial process for Andersen, equipping him with the requisite confidence to start a business.
“I build my course around the premise that there is nothing special about entrepreneurs—they are not some superior beings,” says Kotha, the Foster School’s Olesen/Battelle Excellence Chair in Entrepreneurship. “They simply have the skill set and confidence to do it. And these can be developed.”
Andersen got one more essential from the TMMBA Program: a team. He assembled an entrepreneurial A-Team of classmates expert in each function that would be critical to developing the business: Marc Brown on sales and custom support, Jason Imani on marketing, Anoop Gupta on technology, and Glen Johnson on finance.
They called the venture Xylemed.
Andersen found the experience exhilarating from the opening investment round, a kind of entrepreneurial trade show where 36 start-up teams fast-pitch to more than 200 roving judges over four crazy hours. “The pitch we started with and the pitch we ended with were radically different,” Andersen says. “We learned to key in on the part of the story that made their eyes light up.”
In a word, traction. More than 50 installations across three medical centers, each one delivered on-demand. Andersen polished the narrative until it was irresistible. “Ben started with a very real problem, came up with an elegant and efficient solution, and demonstrated a tremendous capacity for making people understand what he was out to do,” says Connie Bourassa-Shaw, director of the Buerk Center. “He has a compelling story to tell.”
That story took Xylemed to the final four, where it won the $10,000 second prize. “The money was great,” Andersen says. “But much more valuable are the connections that we made.”
“That’s a wise assessment for an early entrepreneur to have,” says Aaron Coe (MBA 2003), one of those connections. “There’s great value in connecting with people who add knowledge, add perspective, and challenge assumptions.”
Coe, a Foster MBA grad who helped launch 2003 BPC champion Nanostring and had an even bigger success with a pharma company called Calistoga, coached Xylemed before the semifinal, then later secured them a spot at the Technology Alliance’s Innovation Showcase.
There were many others. The team’s semifinal judges included investor Greg Gottesman of Madrona Ventures and serial entrepreneur Terry Drayton of Rainier Software and HomeGrocer.com. Both opened their personal networks to Andersen. “I’ve been amazed at the caliber of people who approached me and offered their help,” he says.
It’s no surprise to Bourassa-Shaw. At the end of the day, the Buerk Center is in the connection business.
The UW Center for Commercialization (C4C) is in the licensing business. When Andersen’s digital white board first reached the inbox of Angela Loihl, associate director of technology licensing, she shopped it around to a variety of software and health care companies. It’s a common corporate strategy to cherry pick R&D out of university labs, and C4C has negotiated more than 100 licensing agreements of UW intellectual property since 2005.
Recently, Loihl says, an increasing number of faculty and staff are expressing interest in launching their own ventures around their innovations and discoveries. So the C4C has evolved into a hybrid transaction/partnership model—a kind of bus dev team for researchers and innovators.
After the digital white board found no initial takers, Andersen—by this time well into the TMMBA Program—began changing the conversation. What if he sold the software himself?
As he prepared for the Business Plan Competition, Loihl connected him with the C4C’s Entrepreneurs-In-Residence Program. He rehearsed his pitch in its New Ventures Facility. He sought advice from the Law School’s Entrepreneurial Law Clinic.
And while Loihl oversaw the negotiation to license Andersen’s software, she also served as advisor, advocate and fan. “It was obvious that Ben had been taught well at the Foster School,” she says. “He came to us prepared, asked the right questions, and knew exactly what he wanted to get out of every meeting—in the nicest possible way.”
The kind of entrepreneur you want to root for.
Today, Andersen is a recent Foster grad, a former employee of Harborview, and a full-time entrepreneur. He has rechristened his company PatientStream, a name that sounds less like a pharmaceutical and more like a software company that tracks hospital cases. He’s incorporated the business, finalizing license negotiations, developing a mobile app, seeking investors, and closing in on several key hires.
Even on his own—his TMMBA colleagues have returned to their lives and livelihoods—Andersen is still breathing the rich air of the UW’s entrepreneurial ecosystem.
Success in the Business Plan Competition earned PatientStream a spot in the Jones Milestones/Foster Accelerator, a resource that provides expert mentoring and advising, work space in the Buerk Center’s new Herbold Innovation Lab, and a chance to earn up to $25,000 in additional seed funding if Andersen can achieve several important milestones over the next few months.
He’s pitching for considerably more money from the newly instituted W Fund. The public-private partnership aims to invest nearly $20 million over the next four years in promising start-ups spinning out of the UW and other research institutions across the state.
For PatientStream, a business that needs to act fast and first, a small slice of that pie would be a veritable feast.
Time will tell whether his company’s promise is proven on the open market, in the notoriously difficult-to-crack health care industry. But Andersen has a viable technology, a running start, an ever-expanding network of powerful allies, and a robust entrepreneurial education, in and out of the classroom.
“Between the incredibly rare opportunity to develop a technology in a hospital IT department, the skills and confidence that the TMMBA Program gave me to start a company, and the networking that came out of the Business Plan Competition,” he says, “the past few years have been a perfect storm.”
Perhaps the most telling testament to Andersen’s growth was his preview presentation of PatientStream, by all reports outstanding, to the newly formed W Fund investment committee—an intimidating collection of the region’s premier entrepreneurs and investors.
“To go in front of these guys as a young IT guy and hold your own is pretty impressive,” says fund investor Dave Marver, the former CEO of Cardiac Science. “Ben wasn’t intimidated in the least.”
Does the American healthcare industry require reform or revolution?
According to Brereton “Gubby” Barlow, CEO of Premera Blue Cross, it’s going to take a radical economic disruption to stem the runaway costs of an industry that threatens to swamp the US economy.
Barlow was the keynote speaker of the inaugural Symposium on Creating a Sustainable Healthcare System, co-hosted by Premera, one of the region’s largest healthcare insurers, and the University of Washington Foster School of Business Executive MBA Program.
The event, held October 26 at Seattle’s Bell Harbor International Conference Center, approached the overarching theme of “Economic Disruption in Healthcare” from every possible angle.
And there are many angles.
Paint it black
Barlow painted the big picture, specifically the ominous rise in health care costs as a component of the United States economy. The Congressional Budget Office reports that health care accounts for 18 percent of the nation’s GDP currently, and projects that it will account for a third of the economy by 2035 and continue climbing at a hastening clip.
“If left unchecked,” Barlow said, “health care and interest are going to bankrupt the economy.”
His solution is simple in concept if difficult in practice: clarify costs and coverage, and give consumers the power and responsibility to make their own choices.
This concept has been introduced in new high-deductible health plans that offer low premiums and tax-free healthcare savings accounts, but also impose greater out-of-pocket expenses. Barlow cited a Milliman study finding 50 percent less health spending on consumers in these new plans over traditional plans.
“We need to shelter patients from financial devastation,” he said. “But we also have to get consumers to have real skin in the game. It’s worked well in every other walk of economic life, from food to cars to computers.
Barlow emphasized that the shift of decision power in healthcare from the supply side—physicians, hospitals, government, insurers—to the demand side—consumers—is both necessary and inevitable.
“In health care finance and delivery, we’re still in the mainframe era: complex, sophisticated, extremely expensive,” said Barlow, a member of the Foster School’s Advisory Board. “Yet I’m optimistic that this is going to change for one simple reason: with health care, as with computers, when consumers get directly involved, costs will come down.”
After Barlow’s keynote, the symposium program embarked on a more granular examination of the forces currently at work in the healthcare system—from Medicare to network integration to innovations in healthcare delivery—culminating in a panel focused on how to reconcile the issues.
Topics and speakers included:
“Challenges in Hospital Financing”
Edward Kim, Vice President of Goldman Sachs, Healthcare and Higher Education Group
“Economic Challenges in Biopharmaceutical R&D”
Roger M. Perlmutter, MD, Former Executive Vice President of R&D, Amgen
“Purchasing Innovation in Healthcare”
James C. Robinson, PhD, Director of the Berkeley Center for Health Technology
“Economic Impact on Provider Groups”
Lloyd David (EMBA), Executive Director/CEO, The Polyclinic
“Economic Forces in Network Integration”
Rodney F. Hochman, MD, Group President, Providence Health & Services
“New Breed Health System: Adapting Strategy to the Evolving Market Environment”
Megan Clark, Senior Consultant, Health Care Advisory Board
“Impact and Challenges of Medicare”
James C. Capretta, Fellow, Ethics and Public Policy Center
A panel attempting to reconcile these diverse issues consisted of Brian Ancell, executive vice president of Healthcare Services & Strategic Development at Premera; Don Brunell, President of the Association of Washington Business; Dan Fulton, President & CEO of Weyerhaeuser; Rod Hochman, Group President of Providence Health & Services; and Johnese Spisso, Chief Health System Officer at UW Medicine.
Founding a symposium
The symposium was devised and driven by current Foster EMBA student Dr. John Henson, a neurologist and Associate Chief Medical Director at the Swedish Neuroscience Institute. Sparked by the numerous healthcare industry questions of his EMBA classmates, Henson saw an opportunity to organize a panel rich in knowledge and experience and found a willing partner in Premera, which helped draw more than 350 participants to the symposium.
Additional sponsors were Point B Consulting, the Association of Washington Business, the Seattle Metropolitan Chamber of Commerce, Seattle City Club, the Washington Policy Center, and Providence Health & Services.
In this post, experienced entrepreneur Brian Glaister, President & CEO of Cadence Biomedical shares his 9 Principles for successful team building. We will also learn how to build your winning team with the best Leader, Culture, Teammates, and Advisors. We will finish off with Brian’s top book picks and Q&A from the session audience.
Brian came across as very genuine and humble. He definitely believes in his work that helps people with walking disabilities become more mobile.
Like many entrepreneurs, Brian hit speed bumps on his road to success. He failed two business plan competitions before winning the third. Brian enjoys sharing what he learned with others and provides coaching and mentoring to other business plan competition teams. He likes to joke “I got my PhD in mechanical engineering, but my MBA through business plan competitions.”
Winning Attributes of a Great Leader
Brian believes that a “giant chunk of success comes from how you operate together and a big chunk of that comes from the person at the top.” He referenced the book “Good to Great” by Jim Collins. In the book, eleven top companies are described as having a level 5 leader. One of those was Ken Iverson of Nucor. Ken set the corporate example by fling coach. Another example from the book was George Cain CEO of Abbot Laboratories. It took George fourteen years to get rid of nepotism in the company.
Closer to home, Brian’s wife worked at for a CEO who took time out of his day to install a broken toilette. Another local star according to Brian is Steve Dimmer, CEO of Innovative Pulmonary Solutions. Steve went twenty months without a salary, leveraged grant money to get the company going and recently raised an eight 8 million dollar venture round.
Brian believes in the four characteristics of emotional intelligence as outlined in Primal Leadership: Realizing the Power of Emotional Intelligence by Daniel Goleman. Be sure and watch the video for an expanded explanation of the attributes.
- Social awareness
- Relationship management
As part of the discussion on social awareness, Brian admitted that “there are tons of reasons why you shouldn’t start a company because it is really, really hard. You have to be able to look past [the challenges] and believe that you can get there. ”
Winning Attributes of a Great Culture
The Cadence team looked long and hard at W. L. Gore & Associates, Inc. one of the best places to work (Brian’s best friend’s Dad also works on the culture there). Brian then outlined the
9 Principles they want to follow at Cadence:
- Distribute power (to accomplish, not dominate) and opportunity widely. That creates a whole team of problem solvers vs. just one or two people.
- Maintain transparent communications (business plan and financials internally).
- Encourage an environment of trust.
- Encourage a high performance ethic and self-responsibility. The hard hat award for the hardest worker to wear for the day.
- Live by contradictions. By combining big picture view with that from those closest to the problem, you can solve the problem fast.
- Tackle the hardest problem first.
- Don’t have too many meetings.
- Work can and should be fun – “If you are going to hate your job every day, why come to work?”
- Work hard, but take breaks when needed.
Winning Attributes of Great Teammates
Brian then listed the four key attributes they look for in employees – in order.
“We have a strict no jerks allowed policy,” he said.
According to Brian, advisors are great to have, but they are not part of your company, not really motivated to help you succeed. They may provide ideas, but not a lot of help
For Brian the Board of Directors is much more important. “They have a fiduciary responsibility for your company. They are there to provide accountability and make sure you stay on task,” he said. The board also provides relevant guidance and can provide critical help executing your business plan. Brian believes that “there are thousands of great ideas, but value is built on execution.”
In case you didn’t get the message, Brian finished with an emphatic statement that “I can’t overemphasize just how important a great board of directors is.” A good board will help you avoid rookie mistakes and “keep your feet to the fire,” he said.
Brian finished with his top four books for building your team and leadership culture:
- Good to Great
- Primal Leadership: Realizing the Power of Emotional Intelligence
- Emotional Intelligence 2.0
- Patrick Lencioni Leadership Fables
Q: What happens if a jerk sneaks in? Brian was very clear that the rule is “fire fast and hire slowly”. Take the time to interview carefully to avoid mistakes.
Q: How did you find your teammates? “I hired my friends.” They are just now looking at hiring additional people outside of the core team.
Q: Sometimes you have a great team, but after a while the dynamics are not functioning. How do you fix that? “Laser tag!” Brian believes in company vacation. He emphasized that you should do team activities during work “so you don’t barge in on family time.”
Q: How do you convince people to come on board in the early stages? “We were all looking for this. We’ve all had jobs we didn’t like. We wanted our 40, 50, 60 hours per week to mean something. We are all working below market grade salaries. The purpose outweighs the risks and the hardships.”
Q: What are some of the lessons you have learned two years in? For Brian, the early struggle was “being the boss of friends. It is hard to do and still be best friends,” he admitted.
Q: what did you find was successful to ease that transition from friendship to management? Brian was lucky to have a strong mentor in the family. “I leaned on my dad a lot. He’s the COO of a billion dollar manufacturing company. There’s a bat phone signal going to Wisconsin.”
Q: what do you do when a key contributor is a jerk? Brian counseled that “problems won’t solve themselves.” There isn’t one solution for every situation. You have to face each issue individually.
Q: How democratic is the culture? “Business is not a democracy, nor is it a dictatorship,” he said. “For the most part we come to a consensus.”
Q: What do you provide for professional development? Cadence isn’t’ big enough for a HR department so they don’t have formal training. Brian indicated that they just “figure things out as they go.”
Q: When you come across a challenge with the team, whose advice do you rely on? For Brian, it is the whole team, his Dad and he “leans on the board a lot.”
Guest post by Sam Rosenbalm who fuels his passion for startups and social enterprise as a director in Microsoft’s BizSpark program and a GSEC advisory committee member and judge. Connect with Sam @rosenbalm
Guest post by Barbara W. Cosgriff, Foster School alumna
As the debate over health care reform continues to swirl inside and outside Washington, DC, policymakers and regulators at the federal, state and local levels have proposed myriad solutions to fix what many commentators describe as an inherently broken system. In this process, many solutions have been popularized and, unfortunately, politicized.
From this multitude of often controversial remedies, I would suggest distilling a viable solution with the potential for real reform. This idea posits a system that aligns disparate groups around a common goal: creating a wired health care system that empowers patients and payors alike to make informed decisions.
Imagine a world in which a central repository exists that enables a 360-degree view of every aspect of health care—including the data and results from the lab, from the health plan, from the pharmacy, from the hospital, and from the doctor or doctors—all organized around the patient. In this health care system, safeguards are in place that improve safety, raise the quality of care, increase access, and reduce waste—while delivering increased transparency to payors and patients.
This is—in short—a wired health care system.
But this is not some blue-sky theory, it is happening all over the country, today, through technology advances and leadership from the public and private sectors. Today’s “wired” health care system is based in large part on America’s longstanding pharmacy practice and a 1990 federal law enacted to wire pharmacies from end to end, nationwide—leveraging this system holds unleashed promise. Many companies today use this type of system to allow a pharmacist to cross-reference pharmacy data with medical data thereby providing more comprehensive treatment of chronic and complex conditions. The shift from the legacy health care system to a wired system that utilizes as its backbone the wired pharmacy coupled with tools and training, has proven to be effective in lowering costs, improving quality and increasing access.
All told, wiring health care creates a foundational opportunity to improve the effectiveness and efficiency of our health care system—and minimize waste that arises from treatment and management of complex and chronic disease, to personalized medicine and beyond. In fact, studies have estimated that efficiencies stemming from wiring health care could save an estimated $680 billion annually. In an overburdened system, that represents significant cost savings.
Several health care companies are already harnessing the savings, efficiencies and quality of care associated with a wired health care system that leverages the wired pharmacy backbone. Patients and payors receive the benefits associated with a wired health care system when they are confident medication compliance monitoring is the norm, cost-saving generic medications are widely available and treatment regimens comply with national standards of quality care.
Today’s reform debate would do well —especially for the average American—to move beyond fractious and narrow partisanship and seriously consider the benefits of building upon an existing wired foundation as a model for tomorrow’s health care system. America’s payors and, most importantly, patients, deserve no less.
Barbara Cosgriff is the former senior vice president of public policy and external affairs for Medco Health Solutions, Inc. Cosgriff holds a BA in Business Administration and Accounting from the UW Foster School of Business and an MBA in International Business from George Washington University.