Health Tech: Anthony Brooke On How DrFirst’s Technology Can Make An Important Impact On Our Overall Wellness

Anthony Brooke is the Chief Innovation Officer at DrFirst, where he oversees a product portfolio that spans e-prescribing, integrated care collaboration, and patient-led self-care. He brings more than 30 years of innovation, software development, and a lifelong passion for learning to guide brilliant healthcare teams to deliver software that makes healthcare connected and accessible.

Thank you so much for joining us in this interview series. Before we dive in, our readers would love to learn a bit more about you. Can you tell us a bit about your childhood backstory and how you grew up?

Iwas an Army brat, born at Aberdeen Proving Ground in Maryland, which at the time was an artillery research and testing site. In that military way, we moved to different bases, first to Fort Hood, Texas, and then on to West Germany. When I was about 7, we veered from the typical path of a military family and remained in Germany through my leaving for university. Growing up as a third-culture child and traveling to dozens of countries helped me appreciate how powerful language can be in the way we understand the world. I think that is why most of my software systems over the last 30 years have been multilingual.

As a child, when I was asked what I wanted to be when I grew up, I said an inventor. Not knowing what to do with that, my family sent me to become an engineer and I specialized in manufacturing, as it covered how everything is made from concept to just-in-time delivery. I started university in Germany at the University of Maryland satellite campus in Munich, mostly so I could climb and play in the Alps every weekend. As an Eagle Scout and outdoors lover, the university’s mountaineering club helped build my technical and teamwork skills, culminating in my first successful completion of the challenging Haute Route, with additional summits along the way.

As fortune favored me, my physics professor happened to serve as a department chair at one of Germany’s National Research Institutes. He was gracious enough to secure a practicum for me, typically reserved for doctoral candidates. It was my first commercial experience writing software; I was also collecting and analyzing data for an invention, now known as a mass spectrometer. I completed my studies with a scholarship to the private engineering school Wentworth Institute of Technology in Boston, where I majored and became certified in manufacturing engineering.

Can you share the most interesting story that happened to you since you began your career?

People who work with me quickly discover that I live for meaningful projects and tend to enjoy losing myself in long hours. Early in my career, I ran a consulting firm that developed custom software. Upon delivery, I would dismiss the team to take a week off and enjoy our caffeine and adrenaline-fueled delivery bonus. On one occasion, I had an opportunity to volunteer for five weeks with Tibetan refugees in Nepal as they started a new community. I could not pass up the chance to be a part of such a unique and inspirational project. They began creating a village by constructing a monastery, a school, a care home for the elderly, and a health clinic. The village then grew as people bought vacant property and built houses and small businesses. I worked with the stakeholders to hire the right architect and plan the construction operations. While I learned much more from the project than I had to offer, two stories stick out most.

One story has to do with realizing that it really does take a village. Beyond being amazed at the thought process behind the social seeds of faith, education, elder care, and health services, I learned that inclusion is often more powerful than mechanized efficiency. While discussing how to transport tens of thousands of bricks from the truck-accessible road to the building site, I stopped the contractors as they described lines of people with baskets on their backs. Being a clever engineer, I asked why no one used a wagon, or at minimum, a wheelbarrow. The technology of a wheelbarrow would decrease the number of required people by a factor of three. The architect responded with a smile and said, “People in the surrounding villages are poor. By carrying the bricks in baskets, we have a little work for everyone who wants it. That will build better neighbors, as everyone’s family will have a story about how they helped build.”

The other story is about the transformative power of connectivity. I ended my time with the Tibetan refugees with a visit to their home in India, where the Indian government had graciously granted them land as they fled the Chinese occupation of Tibet around 1949. Generations later, they had developed established communities, and the one I visited had a small clinic staffed by two people with a little medical training. They told me of their lack of knowledge about treating more serious illnesses. Seeing a computer with a dial-up modem (this was around 1999) in the corner, I was struck by an idea. With the addition of a webcam and some volunteer physicians in Europe and the U.S., we set up a weekly ‘streaming media session’ where remote doctors provided assistance where it was needed most. I chuckle thinking about this now. In the era of the pandemic, telemedicine has gone mainstream, and video calls are the norm.

None of us are able to achieve success without some help along the way. Is there a particular person who you are grateful towards who helped get you to where you are? Can you share a story about that?

Success is a tricky one. In business, I believe we too often conflate financial gain with success. In my world view, success is the ability to deliver value. Therein, I am grateful for the many people who have given me the opportunity to attempt to provide value. For the purpose of storytelling, permit me to tell you about a partnership with Target Corp. My last startup was a scheduling, digital intake, and personalized health education company. We were about a year into existence with a functional minimum viable product (MVP) deployed at one local medical practice and struggling to get traction. Healthcare is a cautious industry that is slow to embrace the new but fast to follow the neighbor. As one of the first companies to sign a HIPAA agreement with Amazon, the prospect of ‘the cloud’ was scary for healthcare systems. At the time, Target operated 70–80 retail clinics located in their stores, and healthcare consumers loved the convenience. The call came in that Target Clinics had found us and was interested in understanding if we could help them manage walk-in and online scheduling and intake. Trying to present our sub-$300K revenue company as more stable than we were, I put on my best suit and flew to Minneapolis. I am grateful to Target Clinics and their team for a couple of things:

1. Despite being a Fortune 500 company, Target was willing to seek innovation from smaller companies they could mentor to provide the best possible experience. They guided us to deliver a three-month pilot that replaced their existing digital intake and scheduling system. Working with their team, we reduced the friction and check-in time from 6.5 minutes to an average of 1.6 minutes. After just three weeks in operation, our three-month pilot shifted to a national rollout, putting our tiny company on the map.

2. At Target, we were forbidden to use the word ‘patient.’ They wanted to recognize people as guests and not define them as patients. I thought this to be a marketing gimmick but quickly realized that by imbuing their culture with a consumer-centric approach, they were changing healthcare. The rapid expansion of the convenient care model since then has proven them right. I am humbled, still scratching my head, and just plain grateful that such a magnificently run organization was willing to give a scrappy, unproven startup an opportunity to serve and the coaching to see healthcare through the lens of delivering the best possible consumer experience. Without their belief in my starry-eyed entrepreneurial zeal, I would not likely be here today talking to you. Success is a continuous bi-directional conversation between yourself and a person or entity that is willing to give you an opportunity to deliver value. The proffered opportunity is the opening dialog; your ability to deliver value is the response.

Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?

That’s a great question and one I share with all the managers in my purview. I read, focus on, teach, and evaluate my performance as a leader against Stephen Mitchell’s translation of Verse 17 from the Tao Te Ching.

When the Master governs, the people

Are hardly aware that he exists.

Next best is a leader who is loved.

Next, one who is feared.

The worst is one who is despised.

If you don’t trust the people,

You make them untrustworthy.

The Master doesn’t talk, he acts.

When his work is done,

The people say, “Amazing:

We did it, all by ourselves!”

Part of my approach to onboarding managers is to explain that I believe titles and positions of leadership are an obligation. If the people you manage are not better at what they do because they report to you, then you are an empty title and in the way. Your job is to help provide the environment, trust, resources, clarification, and course corrections to help them deliver more value than they ever thought possible. In haiku-esque brevity, the simple lines from the Tao Te Ching summarize leadership for me.

You are a successful business leader. Which three character traits do you think were most instrumental to your success? Can you please share a story or example for each?

Keystone. I believe leaders serve as a keystone. For those familiar with a Roman arch, a keystone is a wedge-shaped stone placed in the center top of the arch or bridge. It’s the last stone to be placed and holds the structure of the arch (team) together. It does so not by carrying the heaviest load but by radiating and distributing the cumulative strength of the team. The keystone has several traits:

Focus. What you focus on, you become. As a keystone, your focus radiates through the entire team 24/7, not just while you are on stage addressing or working with them.

Awareness. For me, this is the combined ability to perceive and comprehend a given situation, be it listening to staff, customers, the market, or that little voice inside your own head. I find that most leaders have an amazing ability to see a situation in its entirety, offering them the ability to quickly chart a path forward.

Tenacity. Leadership is certainly an endurance sport and not a sprint. Great leaders need the fortitude to inspire their teams to press on, the grit to withstand opposition, and a perpetual humility to learn from their mistakes.

Ok super. Let’s now shift to the main part of our discussion about the tech tools that you are helping to create that can make a positive impact on our wellness. To begin, which particular problems are you aiming to solve and how do you think your technology can address this?

At DrFirst, we focus on uniting the Healthiverse, providing every member of a care circle (providers, prescribers, patients, families, pharmacies, and beyond) the information they need when they need it, throughout the care continuum. Our technology does this in a number of ways, helping to solve some of the most persistent problems in healthcare.

Let’s start with how we help people stay on their prescribed therapy. A quarter of all prescriptions are left at the pharmacy — just never picked up — for a variety of reasons, but most often because patients are surprised by the cost when they get to the pharmacy counter. We come at this problem from several directions. With myBenefitCheck, providers get up-to-the-minute drug coverage information specific to the patient during the care visit, including prior authorizations and out-of-pocket costs. With RxInform, patients get a secure message a few minutes after their prescription is sent to the pharmacy. In addition to reminding them to pick up the medications, the message includes their out-of-pocket expense based on their insurance, relevant educational information, and links to savings options, including coupon programs. Huddle Health, our healthcare consumer app, makes it easy to maintain and share health records, medication lists, and more. Patients and their caregivers can track their prescribed therapies and keep their providers updated. Huddle aims to help you navigate healthcare from a single smart application, leading to better outcomes and fewer hospital readmissions for individuals and their loved ones.

We also tackle the problems that get in the way of care collaboration. By integrating secure messaging and telehealth within the physician workflow, our Backline care collaboration platform connects clinicians with each other and with their patients. Patients and healthcare providers really like Backline’s virtual waiting room because it allows different members of the clinical team to meet with a patient before or after the physician’s consultation.

The very first problem we set out to solve over 20 years ago was e-prescribing for large hospital systems. And now we have a mobile app, iPrescribe, which means that doctors can have a premier prescribing tool in their pocket wherever they go, which helps patients avoid long waits for needed medications. Working together, these applications and solutions are just some of the ways DrFirst is uniting the Healthiverse.

Can you tell us the backstory about what inspired you to originally feel passionate about this cause?

Like so many leaders in healthcare, I was inspired by my experience. My wife spent three intense years as a caregiver and, ultimately, took five family members through the death process. Suicide, cancer, Parkinson’s Disease, esophageal failure, dementia, and diabetes grounded us in the experience of the U.S. health system. We are grateful to live in a time of such wonderful medical advancements; however, the struggle to navigate those advancements is very real.

Looking back, I can see how useful something like DrFirst’s Huddle Health app would have been for my wife during those challenging times. There’s so much to handle and keep track of when you are taking care of a family member with a serious illness. Huddle Health would have made it easier for her to keep up with all the healthcare appointments, prescriptions, and test results. The emotional toll can be overwhelming, so anything that makes things a bit easier and efficient can really help.

Keeping “Black Mirror” and the “Law of Unintended Consequences” in mind, can you see any potential drawbacks about this technology that people should think more deeply about?

Privacy, which is a complicated topic in healthcare, comes to mind. We suffer from siloed and nonstandard data that leads to some of the greatest gaps in care. In an ideal state, a gizmo could constantly monitor everything about your health, streaming your information 24/7 to a computer system that can detect bad changes and then escalate them to qualified medical professionals to help intervene. The level of preventative assistance this could deliver is simply amazing, but the potential for abuse is real.

Here is the main question for our discussion. Based on your experience and success, can you please share “Five things you need to know to successfully create technology that can make a positive social impact”? (Please share a story or an example, for each.)

1. Understand the context for the problem you wish to solve. Just because my family suffered a particular issue does not mean others will experience it in the same way. Use your inspiration as a cardinal direction, a hypothesis for the market and users to validate.

2. Who is experiencing that issue? Understand that most users will complain by telling you a solution, not the source of the issue. Your job is to identify the root cause and determine how various users within that topology are affected. Form must follow function. Shape solutions that meet the user where they are and through the mediums they are most comfortable with.

3. Are the users you intend to serve ready and motivated to adopt your proposed solution? One of my teams worked with the equivalent of a Kindle eBook reader twelve years ahead of Amazon’s product release. The Rocket eBook was amazing but a full decade ahead of when the average consumer would be ready to download rights-managed books, which meant it wasn’t able to make a positive impact. Form is not only how you package technology but when, as detailed in the Gartner Hype Cycle. In an ideal timing scenario, you want to launch your solution early on the slope of enlightenment.

4. Build feedback loops into your software development life cycle. You need to systematically hear from users often. Remember that every click and keystroke, or lack thereof, represents users’ feedback. Learn from both qualitative and quantitative feedback, including conversations with customers as well as hard data. Embedded analytics is nifty and can help you better understand enhancements that would improve the user experience.

5. Make user input part of your solution. Think of Google Maps; your phone’s feedback lets the application understand traffic patterns. Without user input, Google Maps would not be as effective or popular as it is today.

If you could tell other young people one thing about why they should consider making a positive impact on our environment or society, like you, what would you tell them?

For most of us, work is the thing that we focus on more hours of the day than anything else. Further, people rarely remember you as a person, but as the actions you took. So why not focus on something you find meaningful and would be proud for people to remember you for doing?

Is there a person in the world, or in the US with whom you would like to have a private breakfast or lunch, and why? He or she might just see this, especially if we tag them. 🙂

A couple of years back, I truly enjoyed Eric Topol’s “Deep Medicine: How Artificial Intelligence Can Make Healthcare Human Again.” I would be excited to chat with Dr. Topol on the future of privacy in healthcare, the latest developments in Deep Medicine, and to get his perspective on if and how value-based models are affecting how we deliver positive outcomes.

How can our readers further follow your work online?

You can find me at linkedin.com/in/anthonybrooke/ and follow us @DrFirst.com on social media.

Thank you so much for joining us. This was very inspirational, and we wish you continued success in your important work.

See interview on Medium.com.