society of physician entrepreneurs

Introduction to Healthcare Entrepreneurship

Healthcare entrepreneurship is the pursuit of opportunity under volatile, uncertain, complex and ambiguous conditions with the goal of creating stakeholder defined value through the deployment of innovation using a valid, automatic,scaleable and time sensistive business model

The changing healthcare landscape

Biomedical and health entrepreneurship is a major driver of the US and global economy. While the two vary in significant ways, they are both part of a continuum of delivering value to patients, entrepreneurs and their investors, the local and regional economy and US global competitiveness. Biomedical and health entrepreneurs are on the front lines of the battle against disease and disability and we are seeing the results of their efforts every day.

Healthcare entrepreneurship is the pursuit of opportunity under volatile, uncertain, complex and ambiguous (VUCA) conditions with the goal of creating user/patient/stakeholder defined value through the creation, development, deployment and harvesting of health innovation using a VAST business model..


Why healthcare entrepreneurship?

The drivers of physician international entrepreneurship include:

  1. Fear: Doctors are afraid they will suffer the professional, personal and economic consequences if they don't adapt to change
  2. Greed: Physician incomes are threatened by innovation and new business models
  3. Necessity: Most doctors in industrialized countries have a relatively high standard of living. They did not bother themselves with innovation or entrepreneurship because they didn't have to.
  4. The innovation imperative: The pace of change has accelerated and markets and employers are demanding more with less
  5. Generational demands: Medical students and residents are questioning their career decisions and demanding that schools provide them with the innovation and entrepreneurship education and training knowledge, skills and attitudes they need to thrive after graduation and throughout their careers
  6. The shifting doctor-patient relationship: Technology and DIY medicine is disintermediating doctors and fundamentally altering the doctor-patient relationship
  7. Resources: The internet, local ecosystems, accelerators and access to early stage capital has made it easier to start a business or develop an idea. People are connecting to the global economy.   
  8. Portfolio careers: The sick care gig economy is growing and the future of work is changing. Fewer are committing to one lifetime career or job, including clinical medicine
  9. Opportunities: With change, comes opportunities and those few doctors with an entrepreneurial mindset are actively pursuing them.The opportunities in health entrepreneurship are sizable and physician entrepreneurs are increasing well positioned to capitalize on them.    
  10. Culture: The culture of medicine is changing and encouraging creativity and innovation 
  11. Politics: Access to quality care at an affordable price is in high demand as middle classes grow in developing countries. Not providing it leads to social upheaval and political instability.
  12. Budget deficits: The demand for care is almost infinite. However, the supply is limited. Consequently, policy makers and markets are looking for ways to improve outcomes at a lower cost through the deployment of innovation.
  13. Youth unemployment: Restless unemployed, educated citizens are demanding jobs and ways to use their talents.
  14. Economic development: Innovation and entrepreneurship is fuel that that feeds the engines of economic development in emerging economies. like Africa.
  15. Globalization: People, money and technology go where they are treated best, regardless of location.
  16. Psychology: Entrepreneurs are intrinsically motivated, driven, or some cases, obsessed with treating internal pain, be it family, a technical issue, psychological, emotional or social. It does the job they want it to do and is a socially acceptable analgesic and anodyne.

But, most do it because they make it personal but don't take it personally. As such, physician entrepreneurs want to:

  1. Create mastery, autonomy and purpose in their lives
  2. Overcome the barriers to global health outcomes
  3. Satisfy personal psychic needs
  4. Improve the dismal failure rates of new products
  5. Make money
  6. Meet the almost infinite international demand for care with finite resources
  7. Eliminate waste
  8. Save the planet
  9. Exercise their entrepreneurial psychopathologies in socially acceptable ways
  10. Protect their families
  11. Help patients other than seeing them face to face
  12. They are burned out and tired of clinical medicine or they can no longer see patients because of disability, some disciplinary action or their inability to practice because of licensure prohibitions.

Who is the customer?

In most instances, there are multiple curriculum innovation, design and administration stakeholders including students, faculty, department chairs, deans, administrators, IT support, and others who might be friend or foe to new proposals. Consequently, you need to be comfortable with the principles and practice of intrapreneurship, in general, and edupreneurship, specifically, if you want to create and scale new educational programs.

For example, a frequently asked question is, "How will we fit all this into an already crowded curriculum, given the ever increasing body of knowledge, and what will be the revenue model for a new course or program?"

There are five customer segments:

  1. Graduate students who are interested in careers in the biotechnology or medtech/digital health industries, like this one.
  2. Sickcare professional school students, like medicine, nursing, dentistry, pharmacy and public health, who are interested in supplementing their professional education with entrepreneurial competencies, including entrepreneurial activities as part of their promotion and tenure portfolio, or using them to pursue a side gig or career, like this one.
  3. Sickcare administration undergraduate and graduate students who are interested in how to create a culture of innovation, lead innovators and digital transformation and build or buy solutions to integrate and deploy into their organization, like this one.
  4. Undergraduate and graduate business students who are interested in not just career development, but, in many instances, adding value to their graduate professional school applications, like medical school, to increase their competitive standing or have Plan B if they are not accepted. The hottest jobs in sickare for non-sickcare professionals are in data science and cybersecurity. Here is an example.
  5. Practitioner continuing education who want to stay abreast of trends and best practices, like this one.

Goals and objectives

The 5 pillars of healthcare entrepreneurship are:

1.The pursuit of opportunity

Be a problem seeker, not a problem solver

Pick your spot

Innovation starts with the right mindset

The entrepreneurial mindset

The clinical v the entrepreneurial mindset

Make it personal but don't take it personally

2.Dealing with VUCA conditions

Overcome the the barriers to physician entrepreneurship

Study VUCAnology

3. Achieving the goal of creating multiples of stakeholder defined value when compared to the competitive offerings or the status quo

How to recognize innovation when you create it

How to define and measure value

Do you have an innovation to market plan?

Creating startup legitimacy

4. Designing, developing, deploying and disseminating innovation

How to overcome the barriers to dissemination and implementation

The steps along the digital health innovation roadmap

Fundamentals of medtech biodesign

Opportunities in primary care entrepreneurship

Fundamentals of edupreneurship

Problem seeking 101

5. Using a VAST business model

Valid, Automatic, Scaleable, Timely

The 7 Ms of Physician Social Entrepreneurship

Healthcare innovation is different than biomedical innovation. Biomedical entrepreneurship refers to commercializing drugs, devices, biologics, vaccines, diagnostics or combined products. Healthcare entrepreneurship is about creating value in digital health products or services, care delivery innovation, business process innovation, services or platforms.


Other forms of healthcare entrepreneurship are intrapreneurship, social entrepreneurship and edupreneurship.

There are significant differences between the innovation pathways involved for each.

1. Intellectual property protection usually is of more importance in biomedical entrepreneurship.

2. Regulatory approval can be a long, expensive and risky process for drugs and devices.

3. Reimbursement and payment for biomedical innovations are often dependent on getting the appropriate codes and third party payments at high enough amounts to generate a profit.

4. Business models differ and are constantly changing.

5. The amount of capital necessary to get a drug or device to market is frequently higher than health innovation by several orders of magnitude.

6. The FDA may not have jurisdiction over many health innovations, for example a digital health app that is not deemed to be a medical device but rather something that provides information and education to users.

7. The customers vary depending on whether you are deploying a biomedical or health product.

8. Validating your business model using lean startup methodologies will vary and can be more challenging for biomedical innovators.

9. Biomedical entrepreneurship often requires a different skill set than health entrepreneurship.

10. Biomedical entrepreneurship is riskier.

Healthcare innovation drivers

There are many new exciting business opportunities for innovators to develop and commercialize their new products and services.

However, the commercialization process is risky, expensive, and time-consuming. To be successful, bioentrepreneurs—whether healthcare professionals, scientists, engineers, investors, or service providers—need to work as a team and/or with their organizations to overcome the multiple hurdles taking their ideas to the market and patients.

The process is neither linear nor predictable and outcomes are never guaranteed. In addition, because of global macroeconomic conditions, investors are unwilling to gamble on unproven technologies in a more hostile regulatory and legal environment. Consequently, commercializing bioscience discoveries is becoming more and more difficult. However, innovators still thrive.

Where are some of these exciting business opportunities for bioentrepreneurs?

An initial understanding of the changes happening in US healthcare is the first step in identifying potential market opportunities.

1. Major and continual health care policy reforms

2. Migration away from fee-for-service payment

3. Consumerization, commoditization, internationalization, customization, and digitization of care

4. Changing from a sick care system to a preventive and wellness system

5. Defined benefit to defined contribution health insurance coverage

6. Rightsizing the health care workforce

7. Do-it-yourself medicine (DIY)

8. Mobile and digical (physical and digital) care delivery models

9. The growth of employed physicians

10. Innovation management systems and increasing attention to health entrepreneurship

11. Increasing demand for high-touch care

12. Increasing discontinuity of care

The global health care and biomedical research and development landscape is changing quickly. All of these changes present biomedical and health care entrepreneurs opportunities to create new products, services, models, and platforms. Patients are taking more control of funding and contributing to basic and clinical research using the Internet and social media, and the Internet and social media continues to play a bigger and bigger role in health care marketing and delivery.

The opportunities in health entrepreneurship are sizeable and physician entrepreneurs are increasing well positioned to capitalize on them.

Modules and learning objectives

Here are the modules and learning objectives for a course in healthcare entrepreneurship:

1. Introduction to healthcare entrepreneurship

LO: Understand and apply the fundamentals and practice of entrepreneurship

For discussion: 5 Types of Entrepreneurship With Real-World Examples | The Blueprint (fool.com)

Resource: The 5 pillars of physician entrepreneurship

What is physician entrepreneurship?

Barriers to physician entrepreneurship

2. Overview of healthcare information and communication technologies, their intended uses and outcomes

LO: Understand ICT applications and ecosystems

For discussion: Top 20 Medical Technology Advances: Medicine in the Future (medicalfuturist.com)

Resource: The anatomy and physiology of the cybernervous system

The digital health commandments

Fundamentals of digital health entrepreneurship

3. The healthcare innovation roadmap

LO: Create a healthcare innovation design, development and deployment roadmap

For discussion: 6 Steps on the Health Innovation Roadmap | LinkedIn

Resources: The life science innovation roadmap curriculum

Fundamentals of medtech biodesign and commercialization

Digital biopharma 2.0

4. Legal and ethical issues

LO: Create a legal risk management plan and apply ethical guidelines

For discussion: AI Ethics | IBM

Resources: Digitial health ethics

Compassionate capitalism

Barriers to the dissemination and implementation of artificial intelligence

5. Regulatory Issues

LO: Create a healthcare product regulatory affairs plan

For discussion: Software as a Medical Device (SaMD) | FDA

Resources: IoMT challenges

Think of MMAs and EMRs as medical devices

We need digital health package inserts

6. Financing healthcare entrepreneurial ventures

LO; Create a capital plan

For discussion: Startup Financing: 5 Key Funding Options For Your Company (forbes.com)

Resources: How to fund your biomedical or digital health idea

How to bootstrap your life science idea

What is your pickup line?

7. Scaling healthcare entrepreneurial initiatives

LO: Scale a startup digital health entrepreneurial venture

For discussion: How to scale a startup | MIT Sloan

Resources: How to go from a startup to a scaleup to a grown up

Are you lost in the culture scaling wilderness?

Fail it, nail it, scale it, sale it

8. Barriers to adoption and penetration and how to overcome them

LO: Overcome the barriers to dissemination and implementation

For discussion:Dissemination and Implementation Science for Public Health Professionals: An Overview and Call to Action (cdc.gov)

Resouces: What you should know about dissemination and implementation

D & I informs D & I

What Sales Navigtor won't tell you

9. Building healthcare innovation ecosystems

LO: Integrate into a local or regional innovation ecosystem

For discussion: How Can An Innovation Ecosystem be Developed and Sustained in Healthcare? | Colleaga

Resources: Are innovation clusters dying?

How to measure innovation ecosystem impact?

How to build rural innovation ecosystems

10. Healthcare technology transfer

LO: Be able to transfer and monetize digital health technology from an academic or commercial setting

For discussion: What Is Technology Transfer? | US Department of Transportation

Resources: How do you do innovation and technology transfer?

The future of academic technology transfer

We need entrepreneurial medical schools

11. Reimbursement and business models

LO: Create a sustainable and scalable revenue model

For discussion: Duane Morris LLP - mHealth Revenue Models: Finding the Right One for the Right App

For discussion: https://fuentitech.com/zoom-ceo-objected-to-selling-ads-until-he-didnt-info/352275/

Resources: The elusive medical business model

Bioscience as a social enterprise

Build a VAST business model

12. Customer discovery and development

LO: Understand and apply design thinking and lean startup methods

For discussion: Design thinking, explained | MIT Sloan

Resources: Problem seeking 101

Why doctors are not early evangelists

Don'ts focus on focus groups

13. Healthcare technology design, verification and validation

LO: Create technical, commercial and clinical validation

For discussion: Difference between Process Validation and Product Validation : Pharmaceutical Guidelines (pharmaguideline.com)

Resources: Where is clinical validation on the digital health business model canvas?

Is digital health snake oil?

The perils of DIY medicine and skimpflation

14. Cybersecurity

LO: Create a cybersecurity risk analysis and mitigation plan

For discussion: Cybersecurity in Healthcare | HIMSS

Resources: We need mandatory HCP cybersecurity education and training


15. Intellectual property

LO: Know how to protect and monetize intellectual property

For discussion: Software Intellectual Property: What It Is & How to Protect It (thalesgroup.com)

Resources: How is your IP IQ?

Having a patent is not freedom to operate

I have an idea. What do I do next?

16. Sales and marketing

LO: Know how to get, keep and grow customers

For discussion: Top Healthcare Sales Strategies for Fast Growth - LeadSquared

For discussion: https://www.wsj.com/articles/how-companies-raise-prices-without-raising-prices-11637490602

Resources: Things physician entrepreneurs don't get about sales and marketing

How to sell your digital health solution

What is your digital care marketing strategy?

17. Entrepreneur personal and professional development

LO: Obtain the mindset, skills, knowledge, abilities and competencies to practice heathcare entrepreneurship.

For discussion: Entrepreneurial Mindset: How to Think Like an Entrepreneur (hacktheentrepreneur.com)

Resources: Innovation starts with the right mindset

The lean PPD plan

The AREA under your network curve

18. Healthcare intrapreneurship

LO: Lead and launch corporate entrepreneurial ventures

For discussion: (2) Intrapreneurship: The Good, The Bad & The Ugly (6 Intrapreneurs Sharing their Story) | LinkedIn

Resources: The textbook of physician intrapreneurship

Intrapreneurship land mines

Why hire physician intrapreneurs and what to do with them after you do?

Intrapreneur survival skills

19. Digital health entrepreneurship

LO: Design, develop and deploy a digital health venture

For discussion: 10 Reasons why Google Health failed | MobiHealthNews

Resources: The digital health and entrepreneurship curriculum

Digital health gaposis

The stops on the digital health innovation roadmap

20. Medical education entrepreneurship

LO: Design, develop and deploy a medical education venture

For discussion: How Has COVID-19 Changed Education? | EU Business School (euruni.edu)

Resources: Fundamentals of edupreneurship

Recent advances in edupreneurship

Welcome to SoPE School

21. Medical social entrepreneurship

LO: Create, deploy and scale a medical social entrepreneurship venture

For discussion: Take Action for the Sustainable Development Goals – United Nations Sustainable Development

Resources: Physician social entrepreneurship

The 7Ms of physician social entrepreneurship

Social entrepreneurship and the mission driven business model

22. Healthcare innovation strategic planning and thinking

LO; Design and deploy a strategic plan and lead under VUCA conditions

For discussion: What is the difference between strategic thinking & strategic planning? (talentedge.com)

Resources: How do you bridge the now and the new?

The physician entrepreneur's guide to strategic thinking

Are you being hired for strategy or execution, doctor?

23. Entrepreneurial competencies

LO: Practice and develop entrepreneurial competencies

For discussion: Entrepreneurial-Competencies.pdf (eajournals.org)

Resources: How to get started as a sickcare entrepreneur

Entrepreneurial virtues v competencies

The entrepreneurial v the clinical mindset

24. Entrepreneurial challenges and coping skills

LO: Maintain financial ,physical, mental and emotional health

For discussion: Understanding Entrepreneurial Burnout (And How To Deal With It)

Resources: How to be a happy innovator

Prune

Let go of the banana

25. Exit strategies

LO: Harvest venture value

For discussion: What are the best exit strategies for startups and investors? (startupxplore.com)

Resources: 10 intrapreneurial exit strategies

What is your exit strategy?

The problem with legacy leaving

26. Analytics and data literacy

LO: Use and interpret data

For discussion: https://vatraining.remote-learner.net/mod/page/view.php?id=18438

Resources: We need to teach health professionals data literacy and data dexterity

Data competency is the new black

Data, data everywhere: the solutions

27. Diversity, equity and inclusion

LO: Overcome the barriers to innovation DEI

For discussion: https://hbr.org/2006/05/why-innovation-in-health-care-is-so-hard

Resources: The business case for diversity

Global Minded meets sickcare

The case for diversity: The old white guy perspective

28. Leaderpreneurship and high performance teams

LO; Lead innovators and high performance teams

For discussion: https://media.neliti.com/media/publications/76941-EN-a-leaderpreneurship-training-model-for-e.pdf

Resources: Where are all the sick care leaderpreneurs?

Physician leaderpreneurs lead innovators, not manage knowledge technicians

Top leaderpreneur development mistakes

29. Career strategy

LO: Planning and development

For discussion: Paradigm Shift of Healthcare: Non-Clinical Roles for Physician Entrepreneurs with Dr. Arlen Meyers

Resources: The physician entrepreneur's guide to non-clinical careers

Physician side gig gaffes

How to create medical CMOs and advisors

30. Healthcare entrepreneurship education and training

LO: Create internal or external healthcare entrepreneurship education and training programs

For discussion: 15 Valuable Entrepreneur Training Courses That You Can Take Online

Resources: Bioentrepreneurship education at the University of Colorado

We need interprofessional entrepreneurship

Lessons learned teaching entrepreneurship to first year medical students

Arlen Meyers, MD, MBA is the President and CEO of the Society of Physician Entrepreneurs and a Professor at the University of Colorado School of Medicine and University of Colorado-Denver Business School.