Can Smarter Scheduling Increase Clinician Satisfaction?
An interview with Tal Eidelberg, Founder and CEO of Intrigma Inc., an award-winning physician and nurse scheduling company.
Healthcare thought leaders have started discussing the "quadruple aim", adding clinician satisfaction as a fourth leg to the traditional cost, quality and access equation. To that end, Tal Eidelberg founded Intrigma Inc. in an attempt to maximize operational performance and employee satisfaction.
Pulse: What issue does Intrigma solve?
Eidelberg: Intrigma deploys the time of health care providers in a way that is optimized for their wellbeing (i.e. minimizing employee burnout) and maximizes operational efficiency. You see, sixty cents on every dollar spent in the hospital is on labor, making it the single biggest line item to price. We therefore have a responsibility to deploy labor efficiently, but hospitals are terrible at this because it is a very complicated problem.
For example, if patients are stuck in the Emergency Department waiting room too long, they Leave Without Treatment (LWOT). For an ED that sees 50,000 patients annually, even a 1% LWOT rate results in huge lost revenues. While they can capture this by increasing their staffing, they run a high risk of overstaffing, which can result in a hospital hemorrhaging money very quickly. Unfortunately, there is no good mechanism for staffing up in tandem with demand that does not excessively burden the staff.
What Intrigma does is take each physician’s individual requirements (e.g. academic, teaching, family responsibilities), correlate them with patient medical needs, and generate a staffing schedule with a 90% likelihood to meet direct hospital demand without burning out the providers. We are therefore addressing a complex issue by deciding
- The number of staff required to treat the patient population, and
- Who specifically should be staffed, taking into account their expertise, vacation days, and other responsibilities.
And that’s very important. If you can’t look beyond the numbers and see the human, the most you have is an overly-simplified theoretical plan. We present an elegant solution.
Pulse: How was Intrigma created?
Eidelberg: Before college, I had an entrepreneurial experience in the military setting. It was extremely complicated to schedule staff to accomplish the tremendous number of administrative tasks around the Air Force base effectively. I decided to work on this, got a lot of early exposure to project management, and created a successful internal scheduling product.
Later, in college, I presented my product to my computer science class, and the guy sitting next to me commented that his wife was a doctor who frequently complained about the hospital’s scheduling issues. So at age 22, I just walked in and talked to the medical director regarding physician scheduling, which turned out to be more complex than military scheduling.
I initially worked with a student team, later with a partner, and eventually I was working alone for some time. I was losing money each day. I did some consulting work to fund our company modestly and continued to program on nights and weekends. Within a few years, I had a clunky prototype that was more complete than competing solutions. In 2007, I won a National Science Foundation grant, and was finally able to complete the product. We began sales at the beginning of 2008 as the economy was tanking, but we managed to grow the company organically by selling to one hospital at a time.
Pulse: What is your business model?
Eidelberg: We have a B2B model, selling subscriptions to our services to hospitals.
Pulse: How are you dealing with competitors in this space?
Eidelberg: Our biggest competitors are Kronos, API Healthcare, and McKesson. However, they tend to specialize in scheduling for retail models, so they do not account for the unique challenges we face in health care. For example, in retail, every client who comes into the store has the same need (e.g. coffee, clothes, etc.). In health care, clients have a radically different set of needs (pulmonary issues vs renal issues). There cannot be a cookie cutter approach when part of the battle is figuring out what the client needs. To make things more complicated, the hospital market is a bit conservative and does not embrace innovation, so nurses don’t end up using many of these solutions long term. So ultimately, there is no good existing solution for this problem.
However, we have a product that incorporates both physician and patient needs, and we are small enough to innovate faster than larger corporations. Because of this, we have closed deals with Columbia University Medical Center, Montefiore Medical Center, Kaiser Permanente, and Legacy Health System. We are rapidly gaining recognition in this space, having received a near-perfect score from KLAS, based on customer and user feedback.
Pulse: What do you wish you had known before creating this company?
Eidelberg: There are probably two key things I wish I had known.
I wish I knew how to network better. Back then, nobody cared about health care and health care did not care about operational efficiency….only patient churn. I wish I got connected with more of the right people who could help earlier on in the company.
I also wished I had known how long it would take to actually realize revenues and profits. B2B models, especially in the health care space, have such long sell cycles. I might have a hospital that is very interested in our service, but we may still take 1-1.5 years to close a deal… It was long and grueling to wait on this. Health care change is hard, so you need to preach it for years until a few innovative folks are brave enough to try it out. Had I known this, I might have designed a more consumer-facing business, which has faster sell cycles. If you explained this situation to the 22-year-old me, he would not have pushed forward with this company.
Fortunately, it all worked out. We are now doing well, the health care industry is hot from every perspective, and people want to make a difference. I’m very excited for the future.