Next week is my 37th birthday.  The gray hairs are coming in fast and furious.

Birthdays always remind me to call my internist for an annual check-up.  This year, I was told that the next available appointment would be almost 3 months away.
I go to a regular medical practice in the Bay Area and have refused to go the concierge medicine route to date.

This absurd delay at the practice that sees me coupled with the fact that 32 million more people could  be in the “system” over the next several years creates opportunities.

There are 3 themes that I am focused on right now:

1.    CRM for Physician Practices – Why is it that every other category of small business in the country has figured out CRM other than physician practices? I’m talking about electronic scheduling, reminders for visits, etc.  Really basic convenience oriented items that make a huge difference to patients/consumers.  Old school “practice management systems” don’t really seem to cut it.   If restaurants can do it, then doctors offices must be able to do it in 2010.

2.    Practice Profitability Tools – continuing the theme from above: the small to mid-sized medical practice is a small business – yet most practices have no idea what it costs them to deliver a unit of service.  I am on the lookout for tools and services that will help docs and other providers measure the profitability of each customer.  I understand that profit and medicine don’t mix well for some but many small practices are at the breaking point now and with declining Medicare and Medicaid reimbursement, they may be in deep deep trouble.

3.    Expert Systems Focused on Chronic Disease Management – Study after study keeps showing that simpler is better when it comes to medical treatments for chronic dieases and that we are a nation of over-utilizers.  3 cent /pill lasix is better for hypertension tan the new fancy $5/pill branded drug.  There are dozens of examples like this from recent studies in cardiology, diabetes, hypertension.

People have spoken about bedside decision support and evidence based medicine for ages. I believe that the next 5-10 years will finally usher the era of guidelines driven medicine at the grassroots level.  Otherwise, the combination of reform and no cost-cutting or payment changes  will mean that the healthcare system really will be bankrupt.

The government (AHRQ and USPSTF) has given a boost to this idea and now industry needs to step in with easy to deploy systems that fit into workflow.  Again, the road is littered with many broken decision support vendors using traditional enterprise models.  I think it’s the next generation companies that will succeed in this space.

In all of these cases, I’m particularly focused on companies with products in the market and revenue traction and especially on those with efficient sales models.    Email me (bijan at hcp dot com) if you are an entrepreneur in the space.