The Future Is Now: “Home health monitoring that can go directly to your doctor” Girish Navani of eClinicalWorks

For the past 20 years, digitization of healthcare has been heavily focused on the provider, meaning physicians, clinics and hospitals. Now, patients are shifting almost completely to digital and are asking for products such as online visits, contactless check-in and copay, previsit questionnaires and appointment reminders via text message. And we’re providing technology to do exactly that. Today, you can purchase practically anything online and have it delivered to your doorstep. Similarly, medications and refills are now being delivered to patients’ doorsteps — prescriptions are electronic, and delivery is automatic. We are seeing a surge in wearables and trackers. I believe there is going to be an exponential increase in home monitoring such as glucometers, weighing scales, blood pressure cuffs, sleep studies and watches that monitor activity. These devices give adequate and skilled data that is sent directly to your physician. The digitization of the patient side with contactless check-in, TeleVisits, and wearables and trackers, will result in a radical shift in healthcare.

As a part of our series about cutting-edge technological breakthroughs, I had the pleasure of interviewing Girish Navani.

Girish Navani helps set the company’s vision, leading efforts to grow and expand all aspects of the business, and actively manages its Research & Development pursuits. His efforts assist in securing eClinicalWorks as both a pioneer and leader in the healthcare IT industry. He was named to Boston Business Journal’s 2014 Power50 list of most influential people in Boston, honored as a 2010 Mass High Tech All-Stars honoree and received the Ernst & Young Entrepreneur Of The Year® 2009 Award in the Healthcare Technology category in New England. Navani also was chosen for the Boston Business Journal’s 2006 40 Under 40 list of entrepreneurs and innovators.

Prior to cofounding eClinicalWorks, Navani led successful IT and business initiatives at Fidelity Investments, Aspen Technology and Teradyne. He holds a Master of Science in Manufacturing Engineering from Boston University.

Thank you so much for doing this with us! Can you tell us a story about what brought you to this specific career path?

I have been involved with information technology and software engineering since I was an undergrad. In my engineering program, I focused on the software side. During my mechanical engineering undergrad, I completed my thesis by writing a software program. Additionally, my master’s centered around robotics and software — I’ve always been intrigued by the design of creating new programs and how they can serve different industries.

After college, I ventured into a few different industries, such as semiconductor, fintech, petro and chemical big industries on the software and analytical modeling side. I have several family members that are in medicine, including my sister, brother-in-law and aunt. Healthcare has always been a significant part of my personal discussions. Coincidentally, I stumbled into healthcare software at a meeting in Switzerland. The speaker at the conference was highlighting industries that will be impacted in the future, and healthcare was among them. This gentleman spoke at length about how healthcare could transform itself with digitization, which was quite a modern discussion at the time.

I was looking for an opportunity to contribute to healthcare by utilizing technology, and I spoke with my family members in the medical field who validated this idea of healthcare digitization. I already had a desire to be an entrepreneur and work on something significant. This led to the creation of eClinicalWorks and a journey to digitize the physician’s office.

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

The most impactful stories are the ones that make you sit back and think. After one of our early Enterprise Summits, I spoke with a physician who was a user of our product. He said, “you have no idea the impact technology has on healthcare outcomes. You won’t realize it, but your software helped save four women’s lives because I screened them early for breast cancer using mammogram reminders, and we got quick results where prevention was possible. If not for the technology and automated reminders, I may have detected these cases years down the road, and the outcomes would not have been as positive as they were.”

The fact that I still remember this interaction a decade later is evidence that one can create a meaningful and long-lasting impact. Certain things we do every day are helping, serving and changing doctors’ and clinicians’ lives for the better. This encounter set the stage for a long-term business model, one that will last decades and outlast its founders, and whose cause cannot simply dissipate. We are planning the next 20 years, not just the next quarter, with the idea of creating a meaningful impact on healthcare.

Can you tell us about the “bleeding edge” technological breakthroughs that you are working on? How do you think that will help people?

In technology, breakthroughs occur every decade or so. Within those 10-year cycles, there are many more that occur incrementally and still have a seismic effect. For instance, in 1999, web and cloud computing erupted and set the path for eClinicalWorks, which was built as a cloud platform.

In 2007, mobility became a large technological asset when the smartphone was released with internet capabilities. We seized that opportunity and focused on capabilities that would allow providers to carry their phone, and eventually an iPad, and provide care anytime and anywhere. This also enabled patients to access their records and book appointments through their smartphone. A few years later, the revolution of data analysis — inference models that aid artificial intelligence or data-driven decisions — helped users gain insight and make informed decisions, which led to products such as Population Health.

This year, we have seen a confluence of mobile, video, cloud and data in revolutionary products such as telehealth. In a matter of weeks, telehealth transformed from a technology discussed, yet not considered integral, to a key advancement amid a global pandemic. People began asking, why haven’t we used this before? It’s helping patients and physicians. And, it’s enabled affordable and timely access to quality care, which is a transformative application for healthcare.

Technological frameworks, such as Kafka, allow for tremendous scalability and reliability in terms of communication with patients and doctors. Additionally, the public cloud computing platform of Microsoft Azure and AWS, for example, has resulted in faster time to market. This is an impactful innovation as it allows business flexibility to scale the cloud and, as an example, the social distancing guidelines implemented to control the pandemic resulted in exponential increase in the use of telehealth visits we were able to scale rapidly.

How do you think this might change the world?

For the past 20 years, digitization of healthcare has been heavily focused on the provider, meaning physicians, clinics and hospitals. Now, patients are shifting almost completely to digital and are asking for products such as online visits, contactless check-in and copay, previsit questionnaires and appointment reminders via text message. And we’re providing technology to do exactly that.

Today, you can purchase practically anything online and have it delivered to your doorstep. Similarly, medications and refills are now being delivered to patients’ doorsteps — prescriptions are electronic, and delivery is automatic. We are seeing a surge in wearables and trackers. I believe there is going to be an exponential increase in home monitoring such as glucometers, weighing scales, blood pressure cuffs, sleep studies and watches that monitor activity. These devices give adequate and skilled data that is sent directly to your physician. The digitization of the patient side with contactless check-in, TeleVisits, and wearables and trackers, will result in a radical shift in healthcare.

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

Primarily, I am concerned about the unethical use of data and I believe tech companies should be very cognizant in how they use it. There are too many business models in which the use of data is not clear. And those are very scary propositions for everybody, especially the consumer and the patient. Personal data should not be used for any purposes beyond the individual’s explicit knowledge and statement of use. If used for clinical trials or research studies, the individual must consent to it. Personal health data is for the individual’s care, and it should only be used for that purpose. There must be explicit consent, not implicit consent. As a result, eClinicalWorks has very clearly stated that our data belongs to our customer, meaning our doctors and patients. We will not monetize it by selling it, and we will not use it for any other purpose than the cause for which it was collected by the provider.

Furthermore, I am also concerned about uncontrolled use of what is broadly referred to as artificial intelligence (AI) and machine learning. Using a software program or AI to constitute a decision may be problematic or unethical, as computers lack empathy. Instead, physicians today speak with relatives and conduct consultations in order to make an informed treatment plan. Fortunately, I have not seen any indications that AI will replace empathy. However, we must consider the ramifications of combining AI with data and whether its decisions will always be fair, or if somebody will monetize it for purposes other than improving life and humanity — that is the big risk.

Was there a “tipping point” that led you to this breakthrough? Can you tell us that story?

There was not a tipping point — I always say that the river finds a way to the ocean as it meanders towards the right path. Similarly, our thinking, is that you meander your decision-making through years of reflection guided by a strong moral compass. It’s a series of decisions that, in the end, the relationship between a provider and a patient is enhanced with technology, not replaced by technology. You must hold your ethics higher than your business benefits.

What do you need to lead this technology to widespread adoption?

We make up 20+ percent of healthcare delivered in the United States in terms of visits in outpatient settings; that’s big. We have achieved widespread adoption by keeping the customer at the center of all our decisions, and in this case, our customers have been doctors, physicians, providers and patients. Everything we do is to serve their cause — to make it easier, better and function more effectively. This has led to higher levels of satisfaction, which becomes pervasive in how you scale your business. We do not invest heavily in marketing; instead, we invest heavily in our customer service.

What have you been doing to publicize this idea? Have you been using any innovative marketing strategies?

The most innovative marketing strategy is a satisfied customer, that’s genius marketing. That’s what companies should be focused on, having a completely delighted customer who wants to tell another individual about their good experiences, because that’s what humans do. If you have a great experience, you will tell somebody about it. If you have a bad experience, you will tell many people about it. The key is to keep your current users satisfied, which seems so straightforward, yet it gets lost in this world of targeted marketing. It is very difficult because it’s not a fad, it’s not fashion.

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?

There are different tenets to success, and you are influenced by many individuals throughout different phases of your life. Building something in your life that outlasts you, that has always been one of my foundational principles and one that I got from my father — he has been one of my greatest influences. He used to construct these large railroad bridges, and he’d always say these bridges will outlast him. So, rather than starting a company that IPOs and you quickly leave, build something that outlasts its founders.

In terms of tech mentors, though I have never met this individual, I admire Bill Gates, particularly for his foundational work for healthcare disparities and support for broader philanthropic causes beyond tech. Additionally, I’ve respected his overall way of managing technology. I aspire to be somewhat like that — managing technology while simultaneously supporting broader causes. There are several things we’ve done privately in terms of improving and addressing inequalities — particularly, we have been passionate about education for years.

And finally, not an individual, but an aspect of life that is a great joy for me is sports, both on and off the field. My dad taught me how to play cricket — a team sport. Primarily, I follow team sports, and whether it was watching or playing cricket, football, or baseball, you realize that every player has an essential role to play on the team. You can be the best pitcher, but you still need somebody to hit to score a run. You can be the best quarterback, but you still need somebody to catch your pass. A team mentality has played a large role in this idea of no titles, rather prioritizing teamwork over the individual. Daily, I learn from my peers and my colleagues; every meeting, I learn a new perspective. Listening is a big factor of success and one that you don’t get from a single person. Decisions should be made as a collaborative team versus individually.

How have you used your success to bring goodness to the world?

We have improved healthcare as a company. This is not about me, it’s about eClinicalWorks and our 5,200+ employees. Our technology has helped facilitate better outcomes, immediate and faster diagnoses, quicker treatments and effective information sharing. It’s a simple goal that is very difficult to achieve in conjunction and in coordination with physicians. This technology does not replace the individual; rather, it assists doctors in how they make decisions, how they share data with their patients and how data is shared with them. Rapid lab results allow them to make better decisions quickly. That has been our impact at eClinicalWorks: Improving healthcare together.

What are your “5 Things I Wish Someone Told Me Before I Started” and why. (Please share a story or example for each.)

There is a common expectation and belief in society that things can only be done a certain way in business. You are told this many times — you will need to raise capital, or you will need to think about an exit strategy otherwise, you will ruin your business. I am glad that we didn’t listen to those, and I wish someone had told me that on Day One — don’t bother listening if it doesn’t add up.

The one piece of advice I can give is to believe in yourself. As long as your moral compass and your ethics are pointed in the right direction, trust yourself, because what you end up doing is your creation, it is your art. The dogma or any preconceived ideas on how things should be done are not necessarily accurate. I can say that today, 20 years after having done things based on what our heart told us to do and focused on long-term success, we have served our employees, our customers and our communities well.

Several people questioned why a tech company would not go public. We would like to highlight that we have a great profit-sharing program. Our employees prefer the guaranteed long-term success and very low risk. You must be steadfast in your thinking and not allow external noise to influence you because as I look back at 20 years, it’s turned out to be true.

You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. 😊

One must have an element of fairness in every decision you make and work hard to remove inequality. Do not allow discrimination to be a factor or a part of what you influence. In fact, incite change that counters discrimination, injustice and focuses on fairness. At the end of the day, all of us want to be happy, that’s the basic tenet of human life.

I’ve always said that I have liberal social policy mind frame in a very capitalistic model. I’m very competitive when it comes to technology and software. eClinicalWorks is very competitive in the way that we want our software to be the software because it’s the best, and we will keep making it better. Yet, on the other side, we strive to create policies that speak to our social conscience, that are a lot more liberal and don’t leave people behind — it is not just the fittest that survive. Simply, have an element of fairness in whatever you do, work towards eliminating discrimination and fight for justice in every facet of conducting your business and life.

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

A.P.J Abdul Kalam explained that dreams are not the ones you see while you’re sleeping, dreams are the ones you see that don’t let you sleep. This idea has propelled me forward throughout my life.

I love what I do; I don’t work at eClinicalWorks for the financial aspect, I am truly passionate about what I do, and that’s what I call my dream. It’s a very straightforward, uncomplicated, untangled lesson I would tell others to follow, “love what you do, do what you love.”

Some very well-known VCs read this column. If you had 60 seconds to make a pitch to a VC, what would you say? He or she might just see this if we tag them 😊

We, at this stage of our company, and from the very beginning, have focused on a long-term growth business model. We are currently well positioned and not pitching to the venture capital community.

How can our readers follow you on social media?

I’m a very private person, and I don’t have a separate page for myself. Instead, follow eClinicalWorks’ Facebook and Twitter pages because whatever the company does is what I do, we’re aligned.

https://www.facebook.com/eClinicalWorks/

@eClinicalWorks

Thank you so much for joining us. This was very inspirational.