HIMSS10 – athenahealth

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The always entertaining CEO of AthenaHealth, Jonathan Bush, talks to Dr. Eric Fishman at the HISTalk HIMSS10 party. Mr. Bush discusses the significant growth of Athena Health’s EHR in the past year. Mr. Bush also mentions AthenaHealth’s programs to help physicians finance the costs associated with EHR adoption. In closing, Dr. Fishman and Mr. Bush discuss speech recognition and Athena’s billing solutions.

Category: HIMSS10, Tradeshows
Date: March 14, 2010
Views:6,915 views

Dr. Eric Fishman: This is Dr. Eric Fishman and we're here at the HISTalk awards and we have the extreme pleasure of talking to Jonathan Bush.

Jonathan Bush: Dr. Fishman, nice to see you again.

Dr. Eric Fishman: We did this last year.

Jonathan Bush: Of course we do every year.

Dr. Eric Fishman: It's been a lot of years. There's been a couple of changes, maybe even a lot of changes and maybe you can tell us some of the things, some of the highlights. You've gotten married since last year.

Jonathan Bush: I have gotten married. I've changed my accounting which is exciting.

Dr. Eric Fishman: Okay, the accounting I guess is a big thing on your mind these days for many obvious reasons.

Jonathan Bush: That's all I can thing about. When I ask the taxi driver for my bill, I say can I have the accounting. It's interesting. I don't know where it comes from.

Dr. Eric Fishman: Let's talk about the implementations. I'll think you've had more than a couple. You were in the teens of thousands when we spoke last year.

Jonathan Bush: Still in the teens of thousands. I think we're 22,000 providers.

Dr. Eric Fishman: Neat.

Jonathan Bush: So just over the teens and in the teens of thousands of physicians. I don't know the exact number but somewhere in there.

Dr. Eric Fishman: Give us some comments about your EHR as well as your billing. How is that coming along?

Jonathan Bush: Last time we spoke, we loved our EMR like it was baby which means it was a little fat and ugly but it was ours so we loved it. Honestly, today we feel very proud of it. It's grown up, it's through puberty and we've got Cook Children's. There's 400 physicians.

Dr. Eric Fishman: Is it dating yet?

Jonathan Bush: It's dating, it's cute. It's a prom queen.

Dr. Eric Fishman: You've got 400 physicians using ((inaudible) EHR.

Jonathan Bush: A couple of thousands, yes. We signed up Christie which is 500, we signed Cook Children's and they actually went live already. It's 400 or 386 or something like and several thousand other ones. So it's actually taken off way out of proportion with our plans for it. Because we love it, we don't want to overstress it by making it do too much and it way over delivered. So we're very excited with Athena Clinicals. We have pricing we're working on where the doctor actually doesn't have to pay the full cost of Athena Clinicals.

Dr. Eric Fishman: We've had all sorts of people today are telling me that they're giving the software away and when they prove meaningful use then they'll go ahead and pay for it.

Jonathan Bush: Well, our goal is to make Athena Clinicals cost less and less and less per doctor per year every year. Meanwhile, to get the other folks who benefit from doctors using medical records to pay more and more and more. So the hospital receives an electronic virtual admission of a patient, that's a huge savings to the hospital, hundreds of dollars.

Dr. Eric Fishman: Are you getting the hospitals to pay anything yet?

Jonathan Bush: Well, that's what we're working on. We haven't yet but we've had a lot of interest and it pencils out for them to make money. It certainly is more fair for the doctor because the doctor bears currently 100 percent of the cost to be an EMR. (inaudible) and Middleton did research that said they get about 11 percent of the value.

Dr. Eric Fishman: We've heard of a lot of hospitals now paying for PHRs. Are you going in that model?

Jonathan Bush: Well, we're always available. It's like my strategy for dating cheerleaders in high school. When I was in high school I said I would refuse to date cheerleaders, however, if any cheerleader had actually wanted to date me, I might have changed my strategy. Currently, our strategy is that hospitals should not fully subsidize only one EMR. Now if any hospitals would like to, God bless you all, subsidize us, then I'll change my strategy.

Dr. Eric Fishman: That would work. That would work.

Jonathan Bush: I would love that.

Dr. Eric Fishman: You had some interesting things to say about my bread and butter, Dragon. Tell us how you really think about speech recognition.

Jonathan Bush: Well, the way this works is learning engines need some control. They need something to stay still. When Dragon goes out and sells its software a la carte, the learning curve is scattered across all the customers. What you really need is something like eScription which now is owned by Nuance.

Dr. Eric Fishman: They own it all.

Jonathan Bush: But that idea is the learning is centralized, right? So the individual users are out there in the world but the learning engine's only one. That's what we need in speech recognition and what we haven't had yet. We think we can be that. We don't have a speech recognition engine but, you know, we're available for dating.

Dr. Eric Fishman: I like that phrase. Is your wife here now?

Jonathan Bush: I'm not available for dating women.

Dr. Eric Fishman: Fair enough. Is your wife here in Atlanta?

Jonathan Bush: No, she has no interest in HIS, HIT.

Dr. Eric Fishman: What does she do?

Jonathan Bush: She's a post partum doula getting a masters in social work and she's the bravest most solid human being in the world.

Dr. Eric Fishman: She married you.

Jonathan Bush: Right, with five kids. I had five, she had none, she married me.

Dr. Eric Fishman: Good for her.

Jonathan Bush: She's a fricking saint.

Dr. Eric Fishman: So tell us about your billing for a couple of moments.

Jonathan Bush: Billing?

Dr. Eric Fishman: Yes, you do a little bit of billing.

Jonathan Bush: I do a lot of billing. I don't know if we're the largest but we're right up there.

Dr. Eric Fishman: Tell us about that.

Jonathan Bush: Oh, I don't know, we did $4 billion in physicians' collections last year.

Dr. Eric Fishman: Did the auditors agree with that number at least?

Jonathan Bush: I hereby recues myself from any of these numbers but the basic idea is we figured out that if you get all of the physicians in the country to do their billing on one network then all these esoteric rules that insurance companies throw in --

Dr. Eric Fishman: You can learn them.

Jonathan Bush: We can learn them.

Dr. Eric Fishman: That's what you said about speech recognition which is to have one entity learn all of the rules.

Jonathan Bush: Exactly, exactly. So if you take that learning and you centralize it then the incremental cost per doctor out there, of the new more educated rules engine for claims or speech recognition engine for dictation or p for p engine, for HIS, ARRA --

Dr. Eric Fishman: Okay, I've heard of that one.

Jonathan Bush: -- HITECH Act whatever, it's like a public utility. It's very expensive to set up and maintain but the incremental cost --

Dr. Eric Fishman: Incremental cost is tiny.

Jonathan Bush: -- per doctor per benefit is very small. So that's our whole philosophy. It's the exact opposite of the software companies.

Dr. Eric Fishman: That's interesting.

Jonathan Bush: But anyway, there's no trade show for people like us, so we show up here.

Dr. Eric Fishman: So here you are. You were talking about presidential packages last year if you remember that.

Jonathan Bush: I love Obama's package. He looks awesome.

Dr. Eric Fishman: So this is Dr. Eric Fishman. We've been speaking with Jonathan Bush, Founder and CEO of AthenaHealth. Thank you.

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