Startup Insider: 4 questions with Kyruus CEO Dr. Graham Gardner

Kyruus, a Boston-based health IT startup, found inspiration from an unlikely source — the 2011 baseball drama Moneyball.

In Moneyball, Oakland Athletics General Manager Billy Beane uses analytics to build a better baseball team, which2016 Graham 1 ultimately finishes first in its conference and advances to the playoffs. Kyruus, inspired by the A's, runs statistical analysis to identify variation in physicians' practice styles. The startup's goal? To match a patient with the most appropriate physician for his or her needs.

"I was raised with a worldview that we are all different, that we are all beautiful in our own way and that we all have our relative strengths and weaknesses. I saw evidence of that everywhere, including how my colleagues performed as physicians in the care of their patients," explains Graham Gardner, MD, CEO and co-founder of Kyruus.

"When I saw the movie Moneyball, I realized baseball not only embraced this philosophy, but also developed a system to optimize it," he continues. "If statistics could be used to determine when to put a player up to bat, why couldn't we use data to inform when to put physicians up to bat? Why couldn't we use data to match them with the kinds of patients, cases and opportunities where they excelled?"

Becker's Hospital Review caught up with Dr. Gardner to discuss how he addresses industry challenges while fostering a workplace culture that utilizes every employee's skill set.

Editor's note: Responses have been lightly edited for length and clarity.

Question: What are some challenges to matching patients with providers?

Dr. Graham Gardner: The fundamental challenge is the lack of complete, current and reliable information about providers. Because the definition of the "right" provider for a given patient is constantly changing — based on factors such as the severity of the condition, patient preferences and network design — the ability to make an accurate referral depends on the integration of hundreds of different data points. This information about insurance, location, credentials, scope of practice, availability and more sits in dozens of different silos. The situation is further complicated by the fact there is no standardization of data: "Dr. J. Jones" might be in one database and "Jeremy Jones, MD" in another. Our technology platform's ability to synthesize this data and build the digital inventory for a health system has been essential in helping schedulers route patients to the "right" providers in their network.  

Q: What barriers do tech startups face when deploying their products in the healthcare industry?

GG: People sometimes lament that healthcare is 30 years behind other industries — admittedly, self-service scheduling came to the airline industry decades ago. Too often though, technology companies conclude the simple translation of a paradigm from banking, retail or travel can jump-start better processes and outcomes in healthcare. The reality is biology is complex, and each individual patient, physician and health system is different. Because the stakes are so high, companies need to have more than a "minimally viable product." They have to demonstrate knowledge of how this will integrate with existing processes and deliver a meaningful ROI [return on investment] that justifies any risk or change management that will be required. Furthermore, trying to improve care delivery requires buy-in from multiple stakeholders and functions across a network. Kyruus routinely engages with 20 to 30 senior decision-makers in a health system, spanning IT, marketing, clinical, operations, finance and more. This not only requires time and patience, but also deep functional expertise. This has gotten easier as we've delivered a compelling ROI at dozens of systems, but there is no quick substitute for developing a robust solution and then demonstrating its impact with clients.

Q: What are some of your goals for Kyruus in the next year?

GG: In the past, we have been fortunate to work with our clients to understand and demonstrate the operational and financial lift we can deliver to a health system by better coordinating care within their network. One of our most important priorities this year is to measure the clinical impact our solution can drive. We've worked with researchers from [Cambridge, Mass.-based] Harvard and [Hanover, N.H.-based] Dartmouth to uncover how when providers focus on specific conditions and procedures, they deliver better outcomes — in some cases even from a mortality perspective. We know our solution sharpens the focus of individual providers and are looking forward to quantifying the clinical impact that we therefore can deliver to health systems.

At the same time, we are focused on recruiting the right people and developing internal processes to enable us to scale Kyruus to meet market demand. People joke about this being a nice problem to have, but it is still a problem if you aren't thoughtful about how you drive efficiencies, while preserving culture.

Q: How would you characterize your company culture?

GG: We have adopted Moneyball as a guiding principle for our team and culture as much as we have for our product vision. We believe each employee has something special to contribute, and we foster an environment that allows them to tap into their talents. Even when I am not intimately involved in a hiring process, I still onboard every person at Kyruus, sharing stories about what makes us special and articulating our vision and mission. We also take career development seriously, borrowing from the best practices of the apprenticeship model in which I trained as a physician. It's hard — there is never enough time to do it the way you wish you could, and you are always trying to figure things out on the fly, but I try to model the reality that we all must rely on each other's skills to perform best as a team. As we start to encounter the expected strains of a rapidly-scaling organization, we've started to talk regularly about "team-liness," or striving for balance between individual and functional accountability while working collaboratively to solve problems for our clients and their patients.

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