In the News: Iora Health CEO Says To Scale Primary Care "By Doing It"

The Upshot column in today’s New York Times focuses on the efforts of Dr. Rushika Fernandopulle and the team at Iora Health to scale primary care medicine services nationally. The article, “Company Thinks It Has Answer for Lower Health Costs: Customer Service,” details the Iora Health mission to improve quality of care and reduce costs by focusing on prevention and using a personalized, team-based approach. In an earlier post, we covered Iora’s impact on patient satisfaction and clinical outcomes. Below is an excerpt from the New York Times article on getting to scale – a challenge faced by many innovative healthcare startups:

[A Seattle practice] is one of five that Iora Health opened in just a few months last year. The company now has 140 employees in 11 practices, and it plans to open at least 10 more in 2015. It just raised $28 million in its third round of venture capital financing to help it expand. The ultimate goal is hundreds of practices across the country, a kind of Starbucks for health care. (The company recruited one executive whose last job was opening Au Bon Pain franchises.)

Dr. Rushika Fernandopulle, who is one of the company’s founders and serves as its chief executive, said: “Building one good practice is mildly interesting, because a few people have done that. But how do you scale that across the country? That’s much harder.”

There is plenty of innovation in health care delivery, and Dr. Fernandopulle is far from the only physician who thinks he has a better idea about how to keep patients healthier for less money.

But his idea is intriguing because it offers the possibility of mass replication of quality care, which might affect the way medicine is practiced beyond his company. Few health care innovators now expand beyond their original location. A team of Stanford researchers recently looked around the country to find what they considered to be the very best primary care practices: All 11 had either one location or just a handful of sites.

“Most doctors have no business skills, and they don’t understand what venture investors and private investors do,” said Dr. Arnold Milstein, a professor of medicine and an author of the study, who directs the Stanford Clinical Excellence Research Center.

Dr. Fernandopulle’s goal is to “transform health care.” And his strategy is to take something small and effective and reproduce it in office after office. But as Professor Milstein points out, running one unconventional practice and keeping it great is very different from running 100….

If scale in customer service businesses is difficult, then national scale in primary care medicine is unprecedented in the United States. Dr. Fernandopulle is confident, but he also knows the next few years will be telling

“You don’t learn about this reading about it or talking about it in conferences,” he said. “You learn this by doing it.”