Understanding that size does matter: Kareo

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Free: What has been the largest misconception by vendors when dealing with smaller practices?

Pickell: It’s really about building something that’s relatively easy-to-use and intuitive. You cannot require a small practice to create a staff of experts to operate your solution. What many do not understand is that you get a lot of leverage out of the technology, but only if you understand the specific, and sometimes special, needs of the practices you are partnering with.

Small practices don’t want to deal with a lot of vendors to serve their needs. Ultimately, what we’ve learned is that they want to be in a position where they have a single, trusted technology provider that can serves the vast majority of their needs. Our mission is to become that trusted provider.

Free: What do you attribute to our indsutry’s preoccupation with greater scale? Why are so many conversations centered upon the larger health organizations?

Pickell: What we see happening in healthcare, which we fundamentally disagree with, is that there is an enormous push toward bigger being better, particularly among many government programs. Within this environment, obviously, the large vendors will supply more of the enterprise market and dictate what many see as common practice. That is going to be a natural orientation for larger vendors, but it misses the mark for smaller practices.

 Interestingly, in almost every other industry segment because of technology, bigger is no longer better and things are moving toward smaller being better. You can almost compete in any industry as a much smaller business today by leveraging technology and, in a way, that was not available to you 20 years ago. In almost every industry the government, interestingly, has been a real advocate of that trend, right? If you think about even how industries are talked about in other spaces: big auto, big oil, big finance. That’s a pejorative. In healthcare, for some reason, that’s not a pejorative which is interesting because there is no industry that’s more personal than healthcare and, ultimately, I think most people would acknowledge that your experience in dealing with your healthcare provider is going to tend to be more personalized in a smaller environment than in a large one.

Free: One healthcare IT trend that has been focused upon larger organizations is the use of the cloud. Now, smaller practices are in a position to leverage cloud capabilities. How do you see the cloud impacting small practices in the near future?

Pickell: If you think about the cloud from an application standpoint, the value is that simply having an Internet connection and very simple hardware, you can access software capabilities that previously would not have been in your reach – talking specifically about small practices. Not only would they have not been within your reach just because of the cost of the deployment and management, but probably the equally important value of the cloud is that those solutions continually improve. Again, if you’re running an enterprise-class application and you have unlimited budget, you’re probably constantly investing in upgrading your software and buying every release that comes from your supplier. In the cloud world, each and every month the solution continues to evolve and accrues.  That’s why the cloud will stay competitive.

If you think about a small practice’s ability to simply have a laptop, or even iPad, and not have any other technology, aside from what you used to deliver care, to run an entire practice is really transformational. Where we are seeing the evolution is that trend is that it’s all cloud-based. That being said, but it is not staying still. It’s moving from a small practice accessing the cloud on its desktop to accessing the cloud on a phone or an iPad. That’s probably the next big transition.

 If a doctor can have an iPad mini in his or her pocket and manage their care delivery, their clinical engagement, as well as the business aspects of their practice from that $300 device in their pocket, how amazing is that, if you think about it? And, that’s what’s happening right now. I think that trend that has very long legs before whatever replaces it comes next. I absolutely don’t think that will be in sourcing, acquiring the hardware and software again and managing it on-site.