The WHO is more important than the WHAT. While I’ve always appreciated the power of teamwork and the importance of talent, having founded and scaled several for- and not-for-profit organizations, this is a principle that has always proven to be true. I believe hiring right is the single most important role of a CEO, as the costs of hiring wrong (or having people in the wrong position) are huge.
As a part of my interview series with leaders in healthcare, I had the pleasure to interview Eric Rosow. Eric serves as CEO of Diameter Health. He has more than 25 years of experience in healthcare technology, new venture creation, and executive management. Prior to co-founding Diameter Health, Eric served as the VP and General Manager of the Patient Flow business unit for Eclipsys and Allscripts. Preceding that, Eric was the Chairman and Chief Executive Officer of Premise, a company he co-founded and led through its sale to Eclipsys. Before founding Premise, Eric was the Director of Biomedical Engineering at Hartford Hospital.
Thank you so much for doing this with us! Can you tell us a story about what brought you to this specific career path?
Asa biomedical engineer and former hospital administrator, I’ve always been fascinated by the intersection of technology and healthcare delivery.
The adoption of electronic health records (driven by Meaningful Use) has created an unprecedented opportunity to change the business model of healthcare; and while this is an extraordinarily exciting time with respect to the capabilities of advances in artificial intelligence and machine learning, the old adage, “garbage in, garbage out” still holds true. My team and I believe that to truly transform healthcare at scale, healthcare needs a middle tier of data to supplement the massive amounts of clinical data across a myriad of EHRs and other source systems. This has been a calling and serves as the vision of our company — to be the de facto technology platform for refining clinical data to fuel the healthcare ecosystem.
Can you share the most interesting story that happened to you since you began leading your company?
When we started out, we thought our opportunity was population health but soon realized that making clinical data fit for use in downstream applications was the more important challenge where technology could be brought to bear.
What makes your company stand out? Can you share a story?
What sets Diameter Health apart is our relentless focus on data quality — which may appear to be a small niche play but is the key to unlocking the productivity of clinical data in use case after use case across the spectrum of healthcare. You hear that relentless focus in the way customers describe us, such as this example from one of our customers at Health Catalyst.
Can you share with our readers about the innovations that you are bringing to and/or see in the healthcare industry? How do you envision that this might disrupt the status quo? Which “pain point” is this trying to address?
To fuel the healthcare application ecosystem by making data actionable, we standardize, normalize, deduplicate, intelligently organize, and enrich disparate data from multiple data sources, and fully automate the data cleansing process to increase analyst productivity.
To use a carbon unfriendly analogy, without a refinery to transform crude oil into fuel, internal combustion engines would run badly, if at all. Without data refinement, pumping raw clinical data into analytic applications will misfire and underperform. To borrow another analogy, a change to the status quo will create information that flows like electricity at the flick of a switch to light a room or power a Tesla.
What are your “5 Things I Wish Someone Told Me Before I Started” and why. (Please share a story or example for each.)
The road of the entrepreneur is not linear. There are many significant highs and lows throughout this journey and it’s not for the faint of heart. As I reflect on my experiences and “scar tissue” from my journey, I’ve learned not to get too exuberant nor too down about the array of planned and unplanned events that constantly unfold. I learned to hire outstanding, smart, and positive people who shared my vision and most of all, I’ve learned not to quit. Throughout this journey, the following 5 principles have served as my compass.
1. Ask for help when you need it; you don’t have to know all the answers. Nobody knows the answers to everything. Building a team (including the board and advisors) and knowing that I can lean on others when I need to is essential in creating a meritocracy culture in which the best ideas are adopted and executed.
2. The WHO is more important than the WHAT. While I’ve always appreciated the power of teamwork and the importance of talent, having founded and scaled several for- and not-for-profit organizations, this is a principle that has always proven to be true. I believe hiring right is the single most important role of a CEO, as the costs of hiring wrong (or having people in the wrong position) are huge.
3. Give hard feedback when needed. Having candid conversations can be difficult, but necessary. People (myself included) don’t always know how they can improve if you don’t tell them — hard feedback is what we all need to be pushed to do our best and to enable individuals and the organization at large to reach their potential.
4. Stay focused and make the right investments (of limited resources). As a longtime competitive rower and coach, I’ve learned that “how power is applied is more important that how much power is applied.” The importance of focusing on the right strategies and applying limited and valuable resources efficiently is essential. I’m extremely proud of how my team and I have been able to scale our company in a capital efficient manner, but this wouldn’t have been possible without working with such progressive clients and partners who share our vision.
5. Never lose sight of the WHY. Mission matters. Culture matters. Vision matters. Talented people have a myriad of choices with respect to their professional careers and while compensation, mission, and culture are certainly important components of why people join a company, in my experience, mission and culture are reasons that they stay. Balancing “context” versus “control” can at times be challenging, but empowering people and teams to creatively contribute to a shared vision is how the best ideas and solutions are realized. As the French aviator and writer Antoine de Saint-Exupéry, once said, “If you want to build a ship, don’t drum up people together to collect wood and don’t assign them tasks and work, but rather teach them to long for the endless immensity of the sea.”
Let’s jump to the main focus of our interview. According to this study cited by Newsweek, the US healthcare system is ranked as the worst among high income nations. This seems shocking. Can you share with us 3–5 reasons why you think the US is ranked so poorly?
1. Under-resourced primary care/public health
2. Administrative inefficiency — 1/3 of healthcare is wasted, but I recognize the challenges of change because what’s waste to one constituent is another’s revenue and profit
3. Lack of insurance coverage
You are a “healthcare insider”. Can you share 5 changes that need to be made to improve the overall US healthcare system? Please share a story or example for each.
1. Transition to value-based care — but this can’t be fully achieved unless and until payers can effectively integrate disparate clinical data at scale.
As an example, accurate Quality measurement, a requirement for value-based care, would include a complete view of the patient across encounters, not just the encounters within one electronic health record (EHR); otherwise, a patient’s quality score might be compliant across all encounters, but non-compliant in one system and not eligible in another. Trapping patient data in silos inhibits effective value-based care arrangements.
2. Transition to digitized, semantically interoperable clinical data
As just one example, the vast majority of prior authorizations for care are still obtained by phone or fax; transitioning to electronic methods would improve care and reduce cost across the system.
3. Greater role for public health in improving wellness (weight, diet, activity, smoking cessation, etc.) before health problems get expensive
In 2018, the New York Times reported that, from 1900 to 1999, life expectancy increased from 47 to 77 years. Of that, 25 years were attributed to improvements in public health, such as vaccination programs. Even greater efficiency of public health programs can be gained by improved targeting of population health programs. Interoperability of healthcare data will drive these improvements.
4. A rationalized health insurance system
Lack of price transparency for employers, their employees and individuals, as well as the symbiotic relationship between insurers and providers that create disincentives for reducing costs underlie this Journal of the American Medical Association study that estimated the cost of waste in the U.S. healthcare system at roughly $800 million (not including outright fraud and abuse), or about 25% of total healthcare spending. Identifying and saving that money will not be easy, but without effective digitization of healthcare data for analytics it will be like looking for a needle in a haystack.
5. More family conversations about end of life care wishes
Only 32% of those surveyed have talked to their loved ones about their wishes for end of life care, while only 18% have talked to their doctor.
Thank you! It’s great to suggest changes, but what specific steps would need to be taken to implement your ideas? What can individuals, corporations, communities and leaders do to help?
- Globally: Like Google does with the Internet, implement a “middle tier” of clinical data which normalizes and standardizes the content so it can be put to productive use
- Locally: Have the conversation about end of life care — as discussed above, only 32% of people say they’ve talked to family members about their wishes (Conversation Project)
What are your favorite books, podcasts, or resources that inspire you to be a better healthcare leader? Can you explain why you like them?
- “The Boys in the Boat” by Daniel James Brown
- “Measure What Matters” by John Doerr
- “Principles” by Ray Dalio
- “Reality Check” by Guy Kawasaki
- “It Shouldn’t Be This Hard to Serve Your Country: Our Broken Government and the Plight of Veterans” by David Shulkin, MD
- “Start with Why” by Simon Sinek
- “The Go-Giver” by Bob Burg and John David Mann
- How I Built This with Guy Raz
- A Healthy Dose
- The Way I Heard It by Mike Rowe
- The Tim Ferriss Show
How can our readers follow you on social media?
Thank you so much for these insights! This was so inspiring!