The Global Entrepreneurship Forum

A Blog by Paul B. Silverman

Entrepreneurship Perspectives • New Venture Development • New Venture Financing • Management Analytics • Managing Innovation • Management Strategies • Global Entrepreneurship • Emerging Technologies • Government Entrepreneurship Policies.

NEW FACEBOOK PAGE

New Facebook Page – will focus on #entrepreneurship, #predictive analytics, #new ventures, #healthcare

More to follow. Check out http://tinyurl.com/m8t5z4g

 
Paul B. Silverman writes about entrepreneurship, healthcare, and strategy management and serves as Advisor, Speaker, Educator, and Managing Partner of the Gemini Business Group, LLC, a new venture development firm, and Adjunct Professor in the R.H. Smith School of Business at the University of Maryland.

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Music Streaming and Analytics-How Spotify is Impacting the Music Business

Excellent New Yorker article about Spotify and how music sector business models are changing- very clear here that the online music market business models are morphing quickly- check out http://tinyurl.com/lw88lkc

The article reinforces my view that analytics, not content, packaging, or other features will be the primary success driver in most of today’s markets, including the music sector. I am looking at analytics-centric healthcare, financial, and business management ventures and clear to me these ventures will reshape current sectors and create new large scale opportunities just as Spotify is doing in online music

To fully understand the possibilities here, consider the following 3 points noted in the article:

  • Note migration from early stage “collaborative filtering” analytics-using what you did before to define what you want in the future – first generation analytics here which provided a competitive edge.
  • Spotify bought Echo Nest-an analytics company and created “Truffle Pig” – result is an artificial music intelligence platform that helps Spotify dissect in detail the music elements (they now look at 50 parameters for all music products) and further tighten ability to meet users’ needs
  • Most significant, Spotify’s analytics are what I call second generation, seeking to use other external personal/ environmental data to improve their ability to meet users’ needs/improve user satisfaction (and of course not switch to iTunes or Pandora). To get a glimpse into what is meant here, check out the following from the article:

Now that the Echo Nest is part of Spotify, its team has access to the enormous amount of data generated by Spotify users which show how they consume music. Spotify knows what time of day users listen to certain songs, and in many cases their location, so programmers can infer what they are probably doing—studying, exercising, driving to work. Brian Whitman, an Echo Nest co-founder, told me that programmers also hope to learn more about listeners by factoring in data such as “what the weather is like, what your relationship status is now on Facebook.”

When I look at how analytics is shaping all market sectors, we see explosive growth of what I call second generation analytics- this will spawn many exciting new ventures, and some of these will be in new market sectors that don’t even exist today. Exciting times lie ahead here

 
Paul B. Silverman writes about entrepreneurship, healthcare, and strategy management and serves as Advisor, Speaker, Educator, and Managing Partner of the Gemini Business Group, LLC, a new venture development firm, and Adjunct Professor in the R.H. Smith School of Business at the University of Maryland.

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Comments on Business Models at “For Entrepreneurs”

Comments on Business Models at “For Entrepreneurs”

Excellent summary by David Skok on new business models we now see in the entrepreneurial arena. If you are interested in understanding the variety of business models we now see in the market this is a good place to start. I contributed comments on Data Intensity Models or “DIM” which I am looking at for new ventures- very exciting area using analytics. Check out David Skok’s site and my comments at  http://www.forentrepreneurs.com/business-models/    Copy of my comments below:

David
Excellent summary on business models – good work. Glad to
contribute here. I am focusing on a related models in the new venture arena looking at how companies create value based on their customer and ‘community of interest’ data. The Data Intensity Model (“DIM”) goes beyond lead generation models to increase revenue and looks at the value created by understanding customer needs using analytics. Mint.com is the widely quoted example here but other directions are emerging. Sounds far out but the DIM model may shape how you manage your wardrobe- check out http://paulbsilverman.com/2012… Obvious opportunities in finance arena similar to Mint.com but major opportunity I foresee is in healthcare arena. Check out my post/exchange about new business models on Accenture blog http://paulbsilverman.com/2013…. The excellent contribution you are making to educate entrepreneurs is I am sure appreciated by all.

                                                                                 Paul B. Silverman

 

 

 

 

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Pushback to My WSJ Comments “Electronic Medical Records: A Huge, Expensive Burden…”

Pushback to My WSJ Comments “Electronic Medical Records: A Huge, Expensive Burden…”

In response to WSJ article citing EMR problems, last week I posted comments taking position that a full featured EMR system is a “powerful building block improving our healthcare system. The U.S. lags Australia, Netherlands, New Zealand, Norway and the U.K-all have EMR adoption rates above 90 percent… ”

As expected, I have received some pushback to my support for today’s EMR and the outlook/vision I see here. Check out the pushback comments and my reply at WSJ   http://tinyurl.com/ksnav8e.

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Comments on WSJ Post- “EMRs: A Huge, Expensive Burden”

Electronic Medical Records (EMRs) provide the foundation to improve healthcare quality and improve cost performance. And standardized EMRs open the door to telehealth and new analytics to improve clinical decision support systems and save lives. But the transition from paper records, as we learned in the e-commerce revolution, will take time and create disruption. I posted comments on a WSJ post to share my view on the benefits we can expect to see. WSJ post and my edited comments at http://tinyurl.com/ksnav8e

Copy of my complete comments as follows:

We need a standardized, full- featured EMR system- this is powerful building block to improve today’s healthcare system. The U.S. lags Australia, the Netherlands, New Zealand, Norway and the U.K., all of which have EMR adoption rates above 90 percent. No surprise these countries have healthcare systems that lead the U.S. based on all patient outcomes/cost performance metrics. Coupled with the ACA’s new core quality measure reporting (‘eCQM’s), we are taking the right steps. But EMR also enables predictive analytics which I see as the Holy Grail here. What lies ahead- new clinical decision support systems improving outcomes; new tools to minimize adverse drug events; improving patient selection for new drug trials; improving surgical outcomes examining chronic issues; and many more. The Social Progress Index report, created by Harvard Business School’s Professor Michael E. Porter’s team, ranked 132 countries using 50 indicators. In the Health and Wellness category the United States ranks poorly at 70th, behind Mali (69th), and Nepal (68th), but, small consolation, ahead of Kuwait (71st). Keep that in mind the next time you hear a pundit say “…our healthcare system works just fine and we don’t need to change it.” These studies are based on metrics/data analysis, not hype or talking points. There will be some disruption, but a standardized EMR system will benefit both the entire healthcare community and the public.

Paul B. Silverman

 

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Failure Is Often A Key Driver for Success: Check out “Failing Forward — 3 Tips for Failing Your Way to Success”

Most entrepreneurs are familiar with the story of Thomas Edison’s invention of the light bulb. To outsiders, looks like a waste of time and effort- we see about 10,000 failures and one success. Thomas Edison saw it differently in his widely quoted views on success and failure: “I have not failed 10,000 times. I have not failed once. I have succeeded in proving that those 10,000 ways will not work. When I have eliminated the ways that will not work, I will find the way that will work.”

I agree with Thomas Edison and always define failures as “Learning Experiences” — this works for me.

I recommend checking out “Failing Forward — 3 Tips for Failing Your Way to Success” – an excellent perspective on success and failure from Marshall Graham, Managing Partner at Indian River Advisor, LLC. Excellent insights here for all entrepreneurs.

 

Paul B. Silverman writes about entrepreneurship, healthcare, and strategy management and serves as Advisor, Speaker, Educator, and Managing Partner of the Gemini Business Group, LLC, a consultancy firm, and Adjunct Professor in the R.H. Smith School of Business at the University of Maryland.

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Posted Comments -Ex-Apple CEO Invests in Telemedicine

Health telemonitoring market is moving quickly with many major players including Xerox, Medtronics, others.  Posted comments on Fierce Medical Devices article: Ex-Apple CEO investment in remote health monitoring market. Link to article and comments at http://tinyurl.com/lwchryc

Here is copy of my posted comments:

MDI, Xerox’s Healthspot investment are moving us in the right direction-using internet and telemonitoring technology to improve healthcare and create value. As example, look at one area – prenatal care and chronic conditions treatment in rural areas with 25 percent of population but only 10 percent of physicians- you realize very quickly the benefits offered by these emerging healthcare telemonitoring applications. But we can and should be doing more here. Several observations:

– We need standardized EHRs and adoption now being driven by ACA’s Meaningful Use rules. Integrating EHRs with remote monitoring and analytics, we create exciting new opportunities linking to medications for compliance, drug efficacy, adverse effect tracking, and so on. EHR adoption is over 90% in many countries and we are about 60%- we can do better here. EHRs provide the transactional data to support “big data” analytic solutions.

–No doubt telemonitoring and kiosks will improve healthcare and hopefully achieve the $6B projected healthcare savings. All players should emphasize analytics, how analytics will be used to support clinical care decisions, how patient data to personalize healthcare, develop improved treatment modalities and so on. These analytical tools exist, can make a difference, and help address the 30% of all medical errors due to misdiagnosis. Very high leverage and upside here but I do not hear these discussed- they should be

–New ACA regulations/penalties imposed to reduce readmissions are forcing institutions to establish new processes to address after discharge patient tracking- while the emphasis of these “kiosk centric” ventures has been mostly walk-in users, I see several major hospital related markets such as readmission reduction and others which I believe will be significant.

–Pharma clinical trials demand working with 1,000’s of patients and closely tracking their meds during the Phase I/II trials. Networks of remote kiosks provide an excellent vehicle to support new drug clinical trials more efficiently than done today

No question exciting times and strong growth ahead in the remote telemonitoring and medical monitoring device market – lets do what is needed here to use these new offerings to create value and improve our healthcare system

Paul B. Silverman

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Comments – NPR: Surprise Medical Bills: ER Is In Network, But Doctor Isn’t

Posted comments today on NPR story about ER billing problems using ER services in Texas. Ironic, as noted in my comments,  Texas is one of the states that has pushed back most strongly on ACA efforts to improve our healthcare system. So if you do have an emergency while traveling in Texas, on the way to the ER in the ambulance, I suggest make sure you check that you are covered for both hospital and doctor costs. Looks like “every doctor  for himself” there- what a way to run a healthcare system. We can fix this and I believe with modifications ACA is the vehicle to accomplish this objective.

You can read my comments and the NPR article at http://tinyurl.com/pfd5zwe

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WSJ – Comments on Alibaba “Singles Day” Results

WSJ – Comments on Alibaba “Singles Day” Results   Nov. 11th

On November 10th, the WSJ reviewed Alibaba results and the Gross Merchandising Volume or “GMV” metric used to measure performance of e-marketplace companies such as AliBaba and others. I find GMV and related platform business model metrics not well understood. These will be increasingly important as growth of “customer to customer” platform networks accelerate in healthcare and other sectors. Below is a full copy of my comments. Link to the WSJ article and edited comments at http://tinyurl.com/n369mha

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Reading about Alibaba’s business model, I recall the “eyeball model” driving the e-commerce explosion in the 1990’s. The premise- attract large numbers of users/customers to your site, generate value by product and service sales and, most important, generate scale to drive advertising revenue and “exponential” future earnings. Some did it well such as eBay, but the model spawned hundreds of new ventures and most failed. Why? Management, undercapitalized, poor execution strategy- these are the usual reasons most ventures fail. But there was also a fatal flaw here- the eyeball model at the time could not create a universally successful business in all sectors without careful positioning and deep pockets, not the outcome many investors expected. “Build it and they will come”- they didn’t.

Fast forward to today. Alibaba reported very impressive results on “Singles Day”, I.e., 111114, reporting 35 billion yuan ( about $5.75 billion) in the 24 hour Singles Day period. GMV or Gross Merchandise Value is their key business model metric- high GMV translates to higher revenue and presumably long term earnings growth. Following a $25 billion IPO two months ago, there is great pressure to show high GMV.

Several comments here. No question Alibaba is an outstanding success by any measure. One question is long term sustainability. Having merchants offer steep discounts ( 50 % in some cases) to create high single day sales volume looks like a “loss leader” strategy- at least one analyst also questioned whether this is sustainable long term. Remember Groupon and LivingSocial issues. Secondly, note GMV shows total value of transactions sold through Alibaba’s marketplace platform and is not a well defined standard. GMV may include shipping charges, items that will be returned, and other components for the “customer to customer” sales via Alibaba’s platform. GMV is excellent for comparing marketplace companies, but each player may use different assumptions to calculate. Finally, recognize GMV is one of several platform model metrics such as Gross Transaction Volumes or GTV which is well suited for platforms using commission-based pricing strategies. Bottom line here- Alibaba’s success will spur other “GMV” centric new ventures as did the “eyeball” model- lets understand the definitions here and standardize, ensure the proper financial accounting and reporting practices are in place, and ensure the e-marketplace sector achieves the global market growth we all foresee.

 Paul B. Silverman writes about entrepreneurship, healthcare, and strategy management. He serves as Managing Partner of the Gemini Business Group, LLC, a consultancy firm, and Adjunct Professor in the R.H. Smith School of Business at the University of Maryland.

 

 

 

 

 

 

 

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Right Answer, Wrong Question- New CIO EHR Survey

New Survey- “CIOs Say Usability, Search-Related Problems Prevalent Among EHRs”

iHealthBeat reports on new Frost and Sullivan survey focused on CIO EHR perspectives. I believe we need to refocus today’s EHR dialogue on the many benefits EHR provides- this vision seems to be missing. We are playing catch-up to many countries who have embraced EHRs. Survey highlights and summary of my comments posted on iHealthBeat http://www.ihealthbeat.org/articles/2014/10/27/cios-say-usability-search-related-problems-prevalent-among-ehrs . I see many parallels between the e-commerce revolution in the 1990’s and today’s EHR debate. Copy of my unedited comments below.

 

Right Answer, Wrong Question…

Asking CIOs how they feel about EHR’s, you would expect comments that today’s EHRs are challenging, slow, and have operational problems. That is the right answer, but in my view the wrong question. While the information gained provides insights into perceptions, the more important question to address is from the CIO perspective, what do they see as the most immediate EHR applications they need to change and/or enhance their current operations, including meeting ACA guidelines and improving their cost/performance benchmarks. What I am suggesting is let’s move the discussion to focus on specific process enhancements that EHRs will drive. My thinking is driven by what we saw in the e-commerce market evolution.

E-commerce, new electronic services that displaced paper, was a driver of the Internet revolution in the late 1990’s. Many saw the vision that cost/performance benefits, not paper or admin cost reduction was the real driver here, but we faced formidable challenges, e.g., lack of standards, privacy, multiple technology platforms, training issues, complexity compared to ‘simple’ paper forms, and others.

From my perspective, sure sounds like exactly what we are facing with today’s migration to EHR. So looking back, what did we learn and what does experience tell us about today’s EHR “revolution.” I see three key directions based on my experience.

First, e-commerce winners understood that changing process, not solely displacing paper, was the key benefit. For example, using electronic purchase orders rather than paper saved paper and admin costs and were more efficient, but they also enabled analytics to optimize supply chains and improve profitability- that could not be done with paper. This was a key point driving e-commerce revolution which myself and others reinforced, i.e., “implementing e-commerce systems will cost more, but you will achieve cost and operational efficiencies and improve your competitive position.” This was not accepted by all at the time. Key point here- today’s EHR’s may cost more but they don’t just automate paper-based record keeping- they really open the door to create new processes and dramatically reshape healthcare. That is the message we should be reinforcing backed up with solid cost- effective applications.

Secondly, new e-commerce applications emerged and many new ventures were spawned contributing to e-commerce market growth. And these were entrepreneurial ventures, targeting sectors and all value chain functions to improve operations, e.g., supply chain management, distribution channel optimization, marketing analytics, and so on. Market growth at the time was fueled by venture capital and creative entrepreneurs, not the major firms. In today’s EHR environment, expect to see many new ventures accelerate in areas of remote telemonitoring, predictive analytics, and others- healthcare is a significant target, long overdue for major cost performance step up, and EHR is the accelerator to make it happen. VCs in my view are still behind the curve here but I believe approaching a critical mass here.

 

Finally, e-commerce was a global business and, at the time, many new technologies and e-commerce structures emerged overseas. Today, recognize that many countries have EHR adoption rates greater than 90 percent, and we are playing catch-up with EHR adoption at less than 70 percent and CIO resistance based on the survey . In these overseas markets today, EHR is embraced and driving new applications, analytics, and solutions which I expect will play a role as the US market for enhanced EHR achieves what I believe will be exponential growth in the next decade.

Paul B. Silverman writes about entrepreneurship, healthcare, and strategy management. He serves as Managing Partner of the Gemini Business Group, LLC, a consultancy firm, and Adjunct Professor in the R.H. Smith School of Business at the University of Maryland. Contact: paul@paulbsilverman.com; blog www.paulbsilverman.com/blog; follow @globalbizmentor

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