Episode #16 - Reshma Khilnani, Co-Founder and CEO of Medplum

Written By Omar Mousa

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Description

Reshma Khilnani is the Co-founder and CEO of Medplum, an open-source healthcare developer platform that helps build, test, and deliver healthcare products and services. With a background in big tech and a passion for solving healthcare’s most complex challenges, Reshma is at the forefront of driving innovation in the industry. Her work with Medplum spans empowering developers, advancing interoperability, and supporting the next generation of healthcare delivery models. In our conversation, Reshma shares her insights on:

  • The Origin and Vision of Medplum: Reshma shares how her experiences in building healthcare applications inspired a platform to reduce redundancy, incorporate lessons learned, and enable scalable developer solutions.

  • Challenges with Traditional EMRs: She highlights the limitations of legacy EMRs, such as feature bloat, poor modularity, and rigid designs, and how Medplum reimagines these systems with modern workflows.

  • The Power of Headless and Open-Source Architecture: Reshma explains how headless systems drive modularity and adaptability while open-source fosters transparency, collaboration, and cost efficiency.

  • Engineering-Led Product Development: Medplum thrives without formal product managers, relying on customer feedback, developer collaboration, and iterative design to solve real-world problems.

  • Go-to-Market Strategies for Open-Source Platforms: Reshma describes how Medplum targets developers, drives grassroots adoption, and converts users to enterprise clients with compliance tools and premium features.

  • The Role of Messaging and Tasking: Reshma underscores how messaging and tasking enable real-time collaboration, proactive task management, and integration into healthcare workflows.

  • Lessons from Building Zero-to-One: She reflects on challenges like navigating healthcare regulations, improving interoperability with FHIR, and addressing the health tech talent gap.

  • Opportunities for Health Tech Innovation: Reshma identifies key opportunities like reducing administrative burdens, advancing interoperability, empowering developers, and enabling virtual and hybrid care models.

In this episode of Concept to Care, Reshma provides a compelling look into how Medplum is shaping the future of healthcare technology. Her insights into product development, architectural design, and health tech innovation offer valuable lessons for developers, healthcare leaders, and entrepreneurs looking to make an impact in the industry.

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Some takeaways:

  1. The Origin Story of Medplum: Reshma described Medplum as the product of repeated experiences building healthcare applications, each time realizing developers were recreating the same systems with minor variations. She and her team saw an opportunity to break this cycle by creating a platform that reduces redundancy, incorporates hard-earned lessons from previous iterations, and demonstrates the "right way" to build healthcare apps. Medplum’s vision is to empower developers with open-source tools that ensure flexibility, scalability, and composability from the start.

  2. Why Traditional EMRs Fall Short: Reshma outlined several reasons why traditional EMRs often feel frustrating and inadequate:

    1. Feature Overload: Over decades, EMRs have become “pin cushions full of functionality,” burdened with features added to address regulatory changes and increasingly complex workflows. This accumulation has made them unwieldy.

    2. Lack of Modularity: In contrast to other industries where functionality is distributed across specialized applications, EMRs tend to bundle everything into one massive system, making them less efficient and harder to navigate.

    3. Ergonomic Failures: Many EMRs are not user-friendly for clinicians, requiring excessive typing, dictation, or clicking. Reshma highlighted that software should reduce the burden on users, allowing them to focus on face-to-face patient interactions.

    4. Rigid Design: EMRs are often designed with rigid assumptions, such as fee-for-service workflows or specific provider locations. This rigidity makes it challenging to adapt them to modern use cases, such as value-based care or multi-clinic practices.

      Medplum seeks to address these challenges by rethinking healthcare software with a headless architecture that enables modular, fit-for-purpose solutions. Its composability allows organizations to tailor their applications to specific workflows without inheriting unnecessary complexity.

  3. The Power of Headless and Open-Source Architectures: Medplum combines the strengths of headless and open-source architecture to deliver unparalleled flexibility and capability. Reshma highlighted key benefits for each approach:

    1. Why Headless Architecture Matters

      1. Enforces Abstraction: A headless system separates the backend logic from the user interface, ensuring clean, modular development. This prevents the intertwining of features and workflows, making changes easier and reducing complexity.

      2. Composability: Developers can mix and match components, creating tailored workflows and applications that meet specific needs without building unnecessary features.

      3. Adaptability: A headless system allows UI changes or backend upgrades without disrupting the other, empowering organizations to evolve at their own pace.

      4. Change Management: By enabling modifications at all layers of the system (e.g., UI, identities, access controls), headless architecture supports seamless iteration and upgrades over time.

      5. Developer Ergonomics: With APIs that handle nearly all functionalities, headless architecture simplifies integration and development, making it easier for teams to focus on core innovations.

    2. Why Open-Source Matters

      1. Transparency: Open-source platforms allow users to inspect and understand the inner workings, building trust and enabling deep customization.

      2. No End of the Road: Developers aren’t limited by proprietary constraints—they can dig into the codebase to solve complex problems or create novel solutions.

      3. Community Contributions: Open-source fosters a collaborative ecosystem where users share improvements and solutions, driving innovation and robustness. Medplum benefits from active contributions, signaling adoption in production environments.

      4. Proven Paradigms: Inspired by successful open-source tools like Postgres and Kafka, Medplum applies the same principles to healthcare software, providing developers with familiar paradigms that work.

      5. Cost Efficiency: Open-source reduces the barriers to entry for small teams and startups while offering the flexibility to scale up with enterprise-level capabilities.

    3. Together, headless and open-source architectures make Medplum uniquely positioned to transform healthcare software. It empowers developers to build faster, organizations to scale more efficiently, and healthcare ecosystems to innovate beyond the limitations of traditional systems.

  4. Challenges and Lessons in Zero-to-One Building: Reshma shared key challenges Medplum faced during its development journey and how her team overcame them:

    1. Navigating Healthcare Regulations: Building an open-source platform in a highly regulated industry required strict compliance with standards like SOC 2. Medplum addressed this by prioritizing transparency, allowing users to inspect and trust its software while ensuring it met all regulatory requirements.

    2. Bridging the Customization Gap: Organizations often struggle between building custom solutions or relying on rigid off-the-shelf products. Medplum resolved this by offering a headless, API-first platform, enabling developers to build modular applications tailored to their needs without starting from scratch.

    3. Improving Data Quality and Interoperability: Healthcare data’s lack of standardization creates barriers to integration. Medplum adopted the FHIR standard and leveraged community contributions to ensure consistent data modeling, enhancing interoperability and data quality across systems.

    4. Tackling Talent Scarcity: Finding engineers proficient in both software and healthcare is a persistent challenge. Medplum’s comprehensive documentation and intuitive platform lower the barrier for developers, empowering a broader range of contributors to build impactful applications.

  5. The Role of Product in an Engineering-Led Culture: Medplum’s engineering-first approach is a deliberate choice, reflecting the company’s mission to serve developers and technical teams. Reshma shared insights into how Medplum thrives without a formal product manager and how this decision aligns with their customer-centric philosophy:

    1. Engineering-Driven Product Development: At Medplum, product decisions emerge organically through close interactions between forward-deployed engineers and customers. These engineers gather requirements by embedding themselves with clients, listening to their needs, and reverse-engineering problems into actionable solutions.

    2. Product’s Role in Modern Health Tech: Reshma emphasized that in healthcare, product management must extend beyond traditional responsibilities to include subject matter expertise. Strong product leaders need to navigate complex requirements, prioritize what to build (and what not to build), and ensure implementations remain focused and manageable.

    3. Customer Engagement as a Substitute for Traditional Product Management: Instead of a dedicated product management team, Medplum leans heavily on customer feedback. This includes maintaining active Slack channels, Discord groups, and open-source issue trackers. These channels allow developers and users to share direct feedback, vote on priorities, and shape the roadmap collaboratively.

    4. Why This Model Works for Medplum: The company’s focus on developers as primary users aligns with an engineering-led structure. Engineers at Medplum are empowered to act as product owners, translating real-world customer use cases into technical requirements.

    5. Potential Evolution: While Medplum doesn’t currently have formal product managers, Reshma acknowledged the value of strong product leadership in scaling healthcare applications. As the company grows, there may be opportunities to integrate more traditional product management functions while preserving its engineering-driven DNA.

  6. Go-to-Market Strategy for a Developer-Focused Platform: Reshma provided insights into how Medplum’s GTM strategy is uniquely tailored to its technical, developer-first product and contrasts with traditional off-the-shelf health software approaches:

    1. Target Audience: Medplum primarily sells to developers, IT leaders, and forward-thinking healthcare organizations. By focusing on these technical users, Medplum positions itself as a tool to empower innovation rather than just a software solution.

    2. Developer-Led Adoption: The company relies on an open-source model to lower barriers to entry. Developers can freely explore and build with Medplum, integrating it into their workflows without requiring upfront buy-in from non-technical stakeholders. This strategy enables grassroots adoption.

    3. Building Credibility Through Use: By fostering a community of developers and providing extensive documentation, Medplum ensures its platform’s capabilities are showcased organically. Developers who experience its power often become internal advocates, influencing organizational decision-makers.

    4. Simplifying the Sales Process: Rather than pursuing high-touch sales cycles, Medplum uses its open-source adoption to identify users already engaged with the platform. The focus then shifts to converting these users to paid customers by offering enterprise features like compliance tools, premium support, and advanced integrations.

    5. Closing Deals: Medplum ensures enterprise clients recognize value by highlighting its scalability, flexibility, and ability to solve healthcare-specific challenges (e.g., interoperability). Success stories and developer endorsements help build trust and accelerate decision-making.

  7. Driving the Next Generation of Healthcare Software: Reshma highlighted messaging and tasking as foundational features for the future of healthcare technology, explaining their critical role in advancing care delivery and operational efficiency:

    1. Enabling Connected Workflows: The next generation of healthcare software must focus on creating seamless, connected workflows where communication and task management are embedded into clinical and operational processes. Messaging and tasking features serve as the glue that holds these workflows together, enabling timely collaboration and reducing delays in care delivery.

    2. Messaging for Real-Time Coordination: Messaging functionality allows clinicians, staff, and even patients to communicate in real-time, fostering immediate responses and collaboration. This is particularly valuable in urgent or complex care scenarios, where timely communication can directly impact outcomes.

    3. Tasking for Proactive Management: Tasking systems ensure that key actions are organized, prioritized, and tracked to completion. When tied to specific clinical events—such as lab results, referrals, or medication reviews—tasking creates accountability and prevents critical steps from being overlooked.

    4. Integration as a Must-Have: To realize their full potential, messaging and tasking must be deeply integrated into EMR/CRM ecosystems. By linking messages and tasks directly to patient data and clinical events, healthcare software can provide context-rich, actionable insights that streamline decision-making and reduce cognitive load for users.

    5. Medplum’s approach to embedding messaging and tasking into its platform exemplifies the evolution of healthcare software—shifting from siloed tools to cohesive systems that improve communication, task execution, and, ultimately, patient care.

  8. Opportunities for Innovation in Health Tech: Reshma shared her vision for where health tech is headed over the next 1–3 years and how Medplum aims to play a pivotal role in driving innovation:

    1. Streamlining Administrative Burdens: One of the biggest opportunities lies in reducing the administrative overhead for clinicians through automation and better system integration. By leveraging technologies like AI and structured data workflows, health tech can enable clinicians to focus more on patient care and less on operational tasks.

    2. Advancing Interoperability: The next wave of innovation will prioritize seamless data exchange across healthcare systems. Medplum’s commitment to FHIR standards and its dual API approach (GraphQL and REST) positions it as a key enabler of interoperability, helping organizations break down data silos.

    3. Empowering Developers: Reshma emphasized that developers are the driving force behind health tech innovation. By providing tools like Medplum, which simplify building modular, scalable applications, health tech can accelerate the creation of solutions tailored to diverse clinical and operational needs.

    4. Evolving Care Models: With the rise of virtual care and hybrid care delivery models, there’s a growing demand for platforms that can adapt to non-traditional workflows. Medplum’s headless architecture and open-source nature give it the flexibility to power these emerging models, enabling organizations to innovate without being constrained by legacy systems.

Show Notes

Where to find Reshma Khilnani

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Where to find Angela and Omar:

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Referenced:

Transcript

[00:00:00] Reshma Khilnani: Headless is really important in that it helps enforce those abstractions. Many applications are built with like a UI in mind and everything kind of propagates downwards. So if you have a headless system, you're extremely rigorous about maintaining those abstractions. For example, MedPlum is like really aggressively headless.

[00:00:20] Reshma Khilnani: If you think of the functionality that we provide, there's only a very small sliver that cannot be done via API or automation, including things like Adding identity providers to the system or like inviting users with specific access policies. 

[00:00:35] Angela Suthrave: Welcome to Concept2Care, where we hear candid stories of success and failure, discuss strategy, and dive into the details that offer advice on what to do and what not to do in health tech.

[00:00:47] Omar Mousa: Whether you're a seasoned pro, growing your career, or just starting out, our aim for this podcast is to be relevant, real world, and tactical. We're dedicated to not only entertaining you all, but also empowering you with actionable insights that can be applied beyond the podcast. One concept at a time.

[00:01:02] Angela Suthrave: This is Angela 

[00:01:03] Omar Mousa: and this is Omar. 

[00:01:04] Angela Suthrave: Welcome to concept to care. Hello. Welcome to concept to care. Today. We are thrilled to have Reshma Khilnani, CEO and co founder of MedPlum joining us. MedPlum is a headless open source platform designed to revolutionize healthcare software, and it does it by offering unparalleled flexibility and interoperability.

[00:01:25] Angela Suthrave: We are especially excited about this episode because MedPlum has been a guest favorite. In this episode, Reshma takes us behind the scenes of building MedPlum and she shares insights on why traditional EMRs fall short. She talks about the benefits of a headless architecture and how open source is reshaping healthcare technology.

[00:01:44] Angela Suthrave: We're also going to dive into MedPlum's engineering led culture, their innovative approach to product development, and the unique challenges of their go to market strategy. I really love this episode because MedPlum is empowering tech enabled healthcare services to deliver more integrated care. If you're building in health tech or want to learn more about EMRs, this is a great episode.

[00:02:05] Angela Suthrave: Enjoy.

[00:02:13] Omar Mousa: Freshman. Welcome to the show. 

[00:02:15] Reshma Khilnani: Omar Angela. Thank you for having me. 

[00:02:17] Omar Mousa: Yeah, it's a pleasure. We are excited to talk to you. You've been mentioned and spotlighted a few times on this podcast. It's a It's been very unintentional, which may speak to the nature of how great you and the team at MedPlum are. Let's start this off.

[00:02:32] Omar Mousa: Just tell the audience about yourself. 

[00:02:34] Reshma Khilnani: Sure thing. Well, first of all, both of you, thank you for having me on the podcast. It's great to be here. I'm Reshma Kilnani, co founder and CEO of MedPlum. We help people make custom medical apps. By, you know, history, I've had a crossover career, big tech, Facebook, Microsoft, I guess now Meta.

[00:02:54] Reshma Khilnani: And then about 10 years ago transitioned to be a healthcare, um, software professional founded a company called Med XT, which was acquired by Box for the same team at MedPlum who is building that built a, you know, a few systems in between and now building MedPlum, which is open source technology platform.

[00:03:15] Angela Suthrave: We've heard so much about MedPlum. We'd love it if you could go into the initial vision and how did it evolve as a product? 

[00:03:23] Reshma Khilnani: Happy to. So, you know, MedPlum is really born out of a need. Having been a developer in the healthcare software space over the years, you find yourself doing the same thing. Again, and again, you know, when we built our first startup, we built a certain system med XT.

[00:03:40] Reshma Khilnani: We actually rebuilt that same system several times, including some of the team members at med plum. We're on the one medical team as well. So similar patterns seen again and again when developing applications. And when you're a developer, you think about that a certain way you use open source tools, for example, to reduce the repetitive nature of building the same application again and again.

[00:04:05] Reshma Khilnani: And that's exactly what inspired MedPlum. We don't want to do the same thing over and over again. We want to show how to do it the right way. Incorporate the learnings that we've had over having done it a few times. In terms of evolution, I mean, software products do require like constant maintenance.

[00:04:22] Reshma Khilnani: They're always evolving. If you go to our MedPlum repository on GitHub, you know, github. com MedPlum forward slash MedPlum, you'll see that we are like. Adding to it constantly us and community members, and it is driven by people encountering specific issues in the wild when they're doing their implementation.

[00:04:41] Reshma Khilnani: So that's a lot of where the evolution comes from organic. 

[00:04:45] Omar Mousa: Reshma, it's maybe not a secret and, you know, maybe just my opinion, but it seems like. Everyone hates their EMR. Most people have not thought about why, and I think you have a really great way of articulating this. Can you speak to why EMRs are not an appropriate?

[00:05:05] Omar Mousa: Tool for like a, or a full stack application for health care. 

[00:05:09] Reshma Khilnani: So I think that, you know, electronic medical records, medical systems of different kinds, like if you think of, um, provider order entry tools or laboratory information systems, they've all accumulated a ton of functionality over time. You know, due to changes in the regulations, the increasingly complex and technical natures of workflows, you start adding more and more to applications like EMRs, and they become at some point, unwieldy, like, they're like a pin cushion full of functionality.

[00:05:42] Reshma Khilnani: If you compare to, like, what you might see in other industries. What you see in an EMR might be like four or five different apps or an app suite in another industry. So this is not that inherently this category of software has like a flaw. It's more that it's just gotten overloaded. And so that is a, you know, origin of a lot of the frustration that people EMRs.

[00:06:07] Reshma Khilnani: And I think that is part of the inspiration behind MedPlum. We think that like decomposing applications into like functional units that are fit for purpose, that are directed, and that are like really ergonomic is part of what is going to delight users and, you know, reduce their burden over time. So that's what we really hope for.

[00:06:29] Omar Mousa: I've never heard someone describe software as ergonomic. Can you tell me what you mean by that? 

[00:06:35] Reshma Khilnani: Well, in Medflim, we help people make custom medical apps, and one of the top goals that they have is that people don't have to type as much, don't have to dictate as much, don't have to click as much. That's a big, a big win for a provider who exists in helping people in a face to face interaction.

[00:06:53] Reshma Khilnani: Like, You don't really want them to have to have a lot of touch points with their software. You want it to feel natural. And so, yeah, that's a big, that's a big drop. I think if something is super ergonomic, it's not hurting your wrists. It's not like disrupting your day. It's something that is really helping you versus hindering you.

[00:07:11] Reshma Khilnani: Reshma, 

[00:07:13] Angela Suthrave: I would love for you to help us understand the modern healthcare landscape. And if you could talk through some of the problems that you identify along the landscape, I think that'd be really helpful. 

[00:07:26] Reshma Khilnani: So I 

[00:07:27] Angela Suthrave: think 

[00:07:28] Reshma Khilnani: there are many problems in health care applications in general, and specific ones have their own, each have their own set of like quirks.

[00:07:38] Reshma Khilnani: But at a high level, one of the fundamental issues with a lot of health care systems and health care IT is that All of the abstraction that there's no sense of abstraction, everything is commingled things like the data, the business logic, the clinical logic, the compliance, the identities, the user interface, they're all commingled and they're kind of smashed together as part of many applications.

[00:08:04] Reshma Khilnani: And so if, for example, you wanted to like just replace the clinical logic or just like enhance the compliance, you have to do maybe I'll use the medical analogy. I really like open heart surgery on the, on the application that is in general, hard, problematic, and high risk. So one of the, you know, ways that we think about it is crystallizing each layer into its own kind of piece.

[00:08:28] Reshma Khilnani: So. The data management is done separately from the access controls, which is done separately from the clinical logic and separately from the user interface. And so if you just want to swap out something on the user interface, or just want to upgrade the identity system, for example, you could do so. And I think one of, you know, the problems with the co co mingling can be Really like helped by providing those right abstractions.

[00:08:55] Reshma Khilnani: So it's a very developer centric perspective. I wouldn't say that like, you know, there's problems across the board for a lot of medical systems. The data in them are not semantically comparable across applications, for example. But I think this abstraction one is very fundamental. And when we experience day to day, 

[00:09:13] Omar Mousa: Med plum is often referred to, or Maybe even can be classified as a headless open source platform, right?

[00:09:20] Omar Mousa: And that's fair to say. Can you speak to one, the benefits of a headless architecture and to. Why might someone want an open source platform to build on, especially in health care? 

[00:09:31] Reshma Khilnani: I mean, headless is really important in that it helps enforce those abstractions. Uh, many applications are built with like a UI in mind and everything kind of propagates downwards.

[00:09:42] Reshma Khilnani: So if you have a headless system, you're extremely rigorous about maintaining those abstractions. For example, MedPlum is like, Really aggressively headless. If you think of the functionality that we provide, there's only a very small sliver that cannot be done via API or automation, including things like adding identity providers to the system or like inviting users with specific access policies, like those type of.

[00:10:08] Reshma Khilnani: Uh, very specific functions we support in a, in a headless manner. And that's to, you know, allow change management to happen effectively at all layers of the system. So the user interface can be changed. The identities can be, can be changed. So it's, it's, it's. It's really in service of that composability that application developers and eventually like providers, staff members, and other stakeholders need to, to build up that experience that is really going to work for them.

[00:10:38] Reshma Khilnani: So we see that as super important. That's why headless matters to us. If we're really successful, there will actually be like, yeah, less UI rather than more. And that will be a benefit for people because they'll just have like less things to navigate. So open source relates directly to that as well. So there's a lot of, if you really need to program something and you really need to make it work.

[00:11:02] Reshma Khilnani: Like open source is an incredible tool because you won't reach the end of the road. You can like see how things work and push through many hard issues. I see this at firsthand and like non medical systems, things like Postgres or, you know, Kafka, like these type of systems are incredibly useful in engineering in general.

[00:11:22] Reshma Khilnani: And we're trying to bring that same, that same process and same thought pattern to healthcare applications. 

[00:11:28] Angela Suthrave: I love that you have built. Um, med plum from a zero to one. I think that, you know, it's incredibly admirable. We would love to hear some of the biggest challenges that you faced in the build of the company and you know, how you were able to overcome such challenges.

[00:11:45] Angela Suthrave: So like I 

[00:11:47] Reshma Khilnani: mentioned, maybe at the top of the show in the background, we've built MedPlum zero to one, but it is inspired by that previous applications that we have built in the past. And it's really like maybe even a third or fourth generation of a system that we've seen the patterns for again and again.

[00:12:07] Reshma Khilnani: And this time we're, you know, open sourcing it and we're. Documenting it with an incredible zeal, like we're really trying to document to the extreme. And part of a big, you know, the big challenge of zero to one is identifying the use cases and like how people will use it and then trying to encourage people to use it.

[00:12:28] Reshma Khilnani: And we had a, the benefits of having done gone through that process a few times before. So that is part of what's helped us this time around. But the biggest challenges are always around circle around the developer, like engaging them, finding them. And then convincing them that this is like a reasonable solution to solve those.

[00:12:50] Reshma Khilnani: Thorny problems that we, we talked about building that software that's less hateable than previous versions. 

[00:12:58] Angela Suthrave: When do you remember the moment that you understood that you had product market fit? I 

[00:13:03] Reshma Khilnani: think that product market fit, you know, is on a continuum and we are always pushing, trying to push forward.

[00:13:10] Reshma Khilnani: I think one of the things that we think of as a really big milestone is when we started to get. Like meaningful contributions from those who are not MedPlum employees. And for us, that's a sign that someone is using this in production and you can just tell by the nature of what fixes they're pushing to MedPlum that, you know, they're doing something that's really meaningful, for example.

[00:13:36] Reshma Khilnani: This query is running slow. You must have millions of patients if your query, if that type of query is running slow. So you kind of, that is a very, a tell for our, for our community. And we really value the contributors and those who are like really building on the system every day. And they're for us the strongest signal of any kind of product market fit engagement.

[00:13:57] Reshma Khilnani: And we are always working to like, try and serve them as well as we can. 

[00:14:00] Omar Mousa: I want to switch gears here for a little bit. I want to talk about product development and some of the go to market motions at MedPlum. Tell us a bit more about the team at MedPlum and how you're building product. Healthcare uses product.

[00:14:15] Omar Mousa: Managers to often communicate how healthcare does business and, you know, we're talking about a developer product, but developers are never really, I wouldn't say never, but they're not normally super close to the business in a way. We'd like to. So what does the team look like? And how do you guys prioritize feature development at Med Plum?

[00:14:36] Reshma Khilnani: That is a good question. And I mean, our, our team really mirrors our customer set to date. So we are pretty much all engineers. We come in two flavors, infrastructure engineers who work on the core product and kind of a forward deployed engineers who work with customers. So those are the two kind of categories.

[00:14:56] Reshma Khilnani: I guess there's me. And then, you know, I am an engineer by training, but hands on keyboard are maybe more limited at this time in my life. But, you know, how we prioritize product development is really informed by those forward deployed folks who are working directly with the customers. We open up a shared Slack channel and we also have a Discord.

[00:15:20] Reshma Khilnani: Group with with people in it who are literally asking questions, and it's a unique skill. It's it's very product like skill to like, listen to what they're asking, try and reverse engineer what they're doing and think about how that would drive the requirements. It can be as specific as like, we see this weird encoding when this crosses the wire.

[00:15:43] Reshma Khilnani: Down to, you know, I need to implement something very business specific, like this value based care payment scheme. And we have to like trace that back to the technical requirements. So it's, it's more of a practice than a formula or anything like that, but it is really informed by up close. Touch points with the customer.

[00:16:02] Reshma Khilnani: And I think like any, you know, I have worked in product in, in other organizations as well, and a lot of touch points and customer success, or those type of functions where you're facing the customers, those are just like really ripe for finding out the insights that people need in order to advance their business and advance their use case.

[00:16:23] Reshma Khilnani: But it's always a work in progress. I mean, Healthcare is a very, it's got depth in so many axes. Like you mentioned the business requirements, like not only does the engineer sometimes like even product or business that like almost nobody can see through end to end in an organization that happens, I don't know if you have that experience as well, but 

[00:16:46] Omar Mousa: I wanted to ask two follow up questions.

[00:16:50] Omar Mousa: I'll go one at a time. Is how did, how does, so it seems like you don't have like a formal account management function, cust customer success function. It kind of, because it's a developer product. And it's developer led, you have this system in place to kind of get those customer requirements and you sit really closely with the customer.

[00:17:09] Omar Mousa: Talk to us about what that looks like in practice, like how, how the details. Yeah, 

[00:17:15] Reshma Khilnani: totally. So, I mean, maybe account management is the term we, we have that MedPlum. My co founder, Rahul Agarwal, he comes from Palantir. So he's really the expert on how to make this. It's work, but it's a combination of like, you know, hands on implementation experience and you know, first party engagement with the customers listening and then distilling that into requirements and kind of seeing the common thread throughout multiple customers.

[00:17:50] Reshma Khilnani: So we also have like good traffic on our repository, people filing issues, hitting, we run a big offering so you can see request patterns and traffic. So these are all like really rich sources and our account management is driven by those touch points. We also do, you know, have customers with who have a business relationship with, and they have specific objectives that they want to meet sometimes their business objectives.

[00:18:18] Reshma Khilnani: So that's often another, you know, source of Intel into what to build and how to build it. 

[00:18:24] Omar Mousa: I read a tweet this morning, shout out Nikhil from out of pocket, but he had mentioned Palantir's culture and like how they've done such a great job. Um, you know, building these or creating this function around individuals who are on site with the customer and how.

[00:18:43] Omar Mousa: The words coming from those individuals are pretty much gospel. Right? Like that is very much how you solve problems for customers is you kind of embed yourself in that same way. So kudos to you guys for, you know, bringing in some pound here town. My 2nd follow up question to that was you get a lot of inbound.

[00:19:01] Omar Mousa: You know, you said you have a lot of activity on the on the on the on the community, right? How do you prioritize specifically there? Like, how, how do you decide what gets done next? Because, you know, constraint is always engineers. 

[00:19:14] Reshma Khilnani: This is always a work in progress, you know, how to prioritize the customer requests.

[00:19:20] Reshma Khilnani: I think there's a few techniques that we like to employ. One is that we have a public backlog and, you know, there's people who can vote with their feet and really write. What they'd like to see, um, and, and why, and we take that seriously. We're not, you know, making this up in that respect. There's a lot of great open source companies.

[00:19:44] Reshma Khilnani: I think post hoc, super base, like these type of companies really pioneer how to do that, and we love to use them as a reference example on, on what to do. With regards to healthcare itself, we have a lot of benefits in that there's a ton of bright lines that healthcare provides. HIPAA, SOC 2, ONC certification.

[00:20:07] Reshma Khilnani: You need to support these specific, you know, NCQA or like, uh, the government outlines. And so that's also a really great framework with which to think about the, the requirements. We're very into the healthcare standards. So we're, you know, heavy users of the common ontologies like SNOMED, et cetera. Fire, HL7v2, DICOM, you know, we are very well versed in all of these standards and the dialects that come from peer systems.

[00:20:36] Reshma Khilnani: Often people just want things to work, like I want to connect system A to system B, so, uh, or I want to get this, this workflow done. So that's also kind of a lens with which to think about prioritizing, like, if we, if we think about tracing the path of where people want to go, that's part of, of what we offer.

[00:20:55] Reshma Khilnani: I think our public roadmap, Omar, is maybe something to, to think about if you wanted to weigh in ever on something that you think we should be doing. I would welcome that. 

[00:21:06] Omar Mousa: I think we're going to, we're going to probably take some of these and publish them in the show notes. I'll take a look. I, I, we're not using it, but maybe I just throw some opinions in there.

[00:21:17] Reshma Khilnani: It's like a podcast feedback probably is similar to people, you know, tweeting at you or, or writing it. 

[00:21:23] Omar Mousa: Yeah, for sure. I think our audience probably has a lot to say. 

[00:21:27] Angela Suthrave: Um, one thing that I'd love to understand is that you are building a very technical product. And so I'm sure your go to market is a little bit different than typical off the shelf healthcare software.

[00:21:40] Angela Suthrave: Could you explain a little bit about. Who you're selling to, how do you sell to them? How do you get it in the hands of the decision makers? How do you close deals? Things like that. 

[00:21:52] Reshma Khilnani: Good question, Angela. And the first thing I'll mention is we don't make it up. You know, we are open source company. And so we are also taking cues from the open source greats who are like, You know, Databricks, Confluent.

[00:22:05] Reshma Khilnani: These are enterprise software companies who use a developer for sales motion. So we are riffing off of their leadership and not, you know, making things up to NOPA. But the really, the way it works is that we have a few channels. You know, we have our Docker downloads, for example, our Discord open source community, our GitHub issues, our SaaS product, and people are constantly signing up and coming through those channels.

[00:22:35] Reshma Khilnani: We ask them if they would like to see a demo of the commercial offering and, you know, move them through that way. There's a lot of things that are kind of a natural business arrangement for people to have with MedPlum. For example, we have integrations with other software and you don't have to license it yourself or you could just, you know, buy a package and get those integrations.

[00:23:02] Reshma Khilnani: Or you want something, a certain kind of certification. That's like a natural touch point. But what we rely on, and this is common across a lot of open source companies, is that actually before the sales process, people are building and they're engaging the leadership at their organization, kind of making the case internally.

[00:23:22] Reshma Khilnani: And they come to us later in the process. So it's, it does feel very different from something like Uh, full stack SaaS solution where you go find the business stakeholder and present to them. There's kind of a big triangle of internal stakeholders, kind of the, the buyer and us as a technology provider.

[00:23:41] Reshma Khilnani: So I'm not sure if that, that helps Angela, but you know, really acquiring across the channels and engaging in community is part of what we see as really important. And I think super 

[00:23:50] Angela Suthrave: strong word of mouth. Are you all word of 

[00:23:53] Reshma Khilnani: code? 

[00:23:54] Omar Mousa: I love that. I've never heard that one before. Word of code in to double click on just like awareness.

[00:23:59] Omar Mousa: Like, is there any levers that you guys pull to drive awareness outside of the organic space? 

[00:24:04] Reshma Khilnani: That's also a work in progress. But, you know, As other open source platforms have done community events, like really having a physical presence where people can, can meet and convene those types of things are generally really effective.

[00:24:22] Reshma Khilnani: I think you need to find out where other developers are. So that is, that is a thing, but part of growing awareness is having a presence there and having like a name to a face. type of thing. We also encourage our, those who are developing on the platform to share their solutions and, you know, really, I don't know, make, make videos or show screenshots and, and people generally do.

[00:24:46] Reshma Khilnani: And that's another way to, I guess that's maybe more on the organic side, but. Um, as, as we mature, as time progresses, we'll, we'll do more of that traditional stuff. But at, at present, we're really focused on the organic channels and working with our community and in community with our customers. 

[00:25:03] Omar Mousa: Makes sense.

[00:25:04] Omar Mousa: And then to double click further on the, you know, how does one go from community To enterprise, you mentioned integrations. Is it, is it specific features or is it a usage? Like what, what's the, what's the thing that I need to, that I want or need before I become an enterprise customer? 

[00:25:22] Reshma Khilnani: Sometimes it's as simple as compliance.

[00:25:25] Reshma Khilnani: I want to use your certification, or I need to have a hosted version that's already SOC2 Type 2 compliant. That type of thing is a pretty bright line. Second is really, you know, connectivity to things like exchanges or lab ordering, medications, those, those type of use cases, having those, like. You don't have to worry about it as an app developer.

[00:25:49] Reshma Khilnani: You can just focus on your business logic. That type of thing is a, is a good touch point. I think that there's also like more advanced scenarios. For example, for an enterprise buyer, they often want to have a system that's independent of Azure GCP and AWS, they want to have like a sovereign solution. And so, you know, using a, having a commercial agreement with a vendor who could potentially operate across those is something that's useful to the enterprise or who, or they want to like, You know, high scale performance guarantees support this many transactions or this type of workloads.

[00:26:29] Reshma Khilnani: So those are, those are typically the angles. Again, we're not making this one up confluent data bricks. They all, they also have a very analogous kind of transition into. Into the offering, but we, I'll make this clear. Like we, we encourage every healthcare dev to try out MedPlum. Like, please go nuts. Like, we really think that it's important that we have an offering for everybody, you know, to try and to, to use if it's useful for you.

[00:26:59] Angela Suthrave: Okay. So Rashma, you know, one of the things that we learned from you is that MedPlum is a hundred percent engineering. There's no product people. Uh, And so we'd love your perspective on the role of product when using a platform like MedPlum. You know, do you feel like they're needed? And what value do they bring?

[00:27:19] Reshma Khilnani: Product, it plays a really critical role in these healthcare organizations. In fact, it's almost product plus a little bit of subject matter expert that you really need to deliver the solutions well. And we see it as a big sign of success. A strong, like a strong product leadership is it will really be helpful in implementation when we work with customers.

[00:27:40] Reshma Khilnani: Cause that's often, you know, a big aspect of the implementation. To have a well controlled slice of what you want to build versus building everything is just incredibly helpful. So I'd say the role of product that we see in a modern health care organization is, you know, subject matter expertise ability to navigate the complex requirements and to.

[00:28:05] Reshma Khilnani: What to build, but also what not to build, because having that focus is what will really, you know, deliver that ergonomic quickly delivered and not spiraling application implementation. 

[00:28:18] Angela Suthrave: One of the things that we've seen is that product can have a variety of different. Roles and responsibilities within an organization and so do you have guidance.

[00:28:30] Angela Suthrave: In terms of training to be a successful product person. 

[00:28:34] Reshma Khilnani: You know, I, uh, that's a really good question, Angela, and I think that it's very useful for those in product to have some base level of technical education on, like, how applications are built. I think one of the things that we think is useful to do is often make a hello world application that kind of does something very basic to, for example, display a patient message or something like that.

[00:29:03] Reshma Khilnani: To get a sense of. What your engineering team is experiencing day to day, often that just hello world can show, oh, how does the authentication system work? Like, not everyone can have the same permissions. We need to make sure we store the diffs on the data, like those basic things, which are. We have to obsess about on the engineering side that often are completely, you know, brushed under in a implementation, but are critical to make things work.

[00:29:33] Reshma Khilnani: Well, so I think that developing that or trying that out as a group, if there's like a group. We also, you know, welcome folks to read our documentation and we think that it, it has a very technical lens and could provide a precursor to that type of exercise. 

[00:29:50] Omar Mousa: Let's talk about interoperability and APIs. So given MedPlum's focus on healthcare interoperability, what are some of the biggest barriers to achieving seamless data exchange in health tech and how does MedPlum address them?

[00:30:05] Reshma Khilnani: Wow. This is a big and complex problem. So I'm going to. Answer it from the perspective of, you know, my limited vantage point, I would, I think there's many experts who I think you've had on and will bring on, on this space, but I do have, I think, a unique take in the sense that those who are using MedPlum are often authors of, you know, healthcare data.

[00:30:28] Reshma Khilnani: They're not just like slurping it in from another system or, and that, that is, Unique in many ways, we want customers to, and community members to create data that is like semantically comparable across implementations. For example, if you have like. You know, Clinic 1 and Clinic 2, what I've seen in practice, looking at other systems, ETLing them and like massaging the data and looking at it, is sometimes you can't even compare the data across.

[00:31:01] Reshma Khilnani: So what we see as part of our role is helping people create that super standards compliant data so that Clinic 1 and Clinic 2 would have, you know, data that is actually comparable, which means standards compliant, tagged with the right ontologies, has the right provenance. Where it came from, all that stuff.

[00:31:20] Reshma Khilnani: I think there's, there's a lot of barriers to getting the interop to work. Well, some of them are like, you know, a lot of legacy systems were never intended to be connected to or, For whatever reason, people don't want to connect them. I think one of the things that is rare about healthcare is that you have your EHR is mandated to have an interface if you want to be compliant.

[00:31:47] Reshma Khilnani: And you haven't ever seen that in other industries, right? It's not like this company wanted company to have to share their customer list. They don't. So it is kind of novel. I think the, the barriers are maybe. Often too big scope to discuss from a MedPlum perspective. But one thing that I'll say philosophically about us that is unique.

[00:32:09] Reshma Khilnani: MedPlum invites interoperability. Like we want people to build highly interoperable apps. We want them to make lots of connections. That is distinct from, I think, other systems, which are, you know, would like to, in some cases limit or have limited access along various lines. 

[00:32:26] Omar Mousa: Preston Pyshko, I love that MedPlum uses GraphQL.

[00:32:29] Omar Mousa: Tell me about that choice there. Like, why are you using GraphQL over technologies like REST and how does this choice? Sort of enhanced flexibility and capability in the platform, especially when you think about the kind of the end user or use case of like supporting virtual care or like a integrated health care ecosystem.

[00:32:47] Reshma Khilnani: So we do support rest and, uh, you know, we have a fire API, standard one, all works. We also do support graph QL. And one of the reasons is, you know, it's back to the ergonomics. Again, this is the ergonomics for developers though. And if you want to like develop an app quickly, you want to be able to express yourself in code quickly.

[00:33:10] Reshma Khilnani: GraphQL is a really good tool. We're, you know, very standards forward, standards compliant at, on the MedPlum side. And so we use a lot of FHIR. And fire has like resources and resources point to other resources and they can be like nasty and twisty. So having a GraphQL interface does reduce the burden for developers and helps them like wrangle the data model, which due to the nature of healthcare is complex in a more effective way.

[00:33:41] Reshma Khilnani: It's surprisingly popular. We, when we released it, we were kind of shocked at the The response to it, but we're, we're really happy that customers are taking to it. And we think that it's going to be a useful development paradigm, help people get their apps out the door quicker and higher quality and better.

[00:33:58] Angela Suthrave: We're going to talk a little bit about messaging and customer relationship management and electronic medical records integration. So you have a stance that I completely agree with, which is. The power of combining messaging and tasks within the clinical context. We'd love it if you could go a little bit deeper into that and why it's really fundamental to the next generation of healthcare software.

[00:34:24] Reshma Khilnani: This is part of the original ethos of MedPlum, which is we want, you know, composability to be part of what we offer to our customers and community. Composability really helps. With getting things to, to truly work across the board. And that's one of the main tenants of open source software. And also like we see it especially useful for this messaging and CRM case.

[00:34:51] Reshma Khilnani: One of the big use cases for MedPlum is, you know, messaging of various types. I think messaging from the user perspective, the patient to provider, provider to provider. And we also support a lot of messaging types from legacy systems like HL7 V2 messaging and, you know. Communications with DICOM, MLLP, et cetera.

[00:35:11] Reshma Khilnani: This is, this event driven kind of reach out, get a response is just very foundational, fundamental. And we think that integrated into the clinical context provides just that much more power. I think one of a big, you know, constituencies in, in the MedPlum community are, Software developers who are building healthcare software.

[00:35:37] Reshma Khilnani: So if you're building, for example, a call center application or a, you know, c like CRM or patient engagement solution, if you can't access the patient's allergies or you can't get their history of appointments, you're just in a tough spot. , you're so that, that's what we see. Like the, the value of that, having that unified model.

[00:36:00] Reshma Khilnani: I think the, it's, it. It's controversial in that, like, it's even adding more stuff to a very, a category with a lot of functionality already, but we hope that combined with the, you know, headless nature and the ability to customize the UI and the clinical logic that this will be like a compelling use case for, for people.

[00:36:21] Reshma Khilnani: Um, I, I think wrapping around versus like directly integrating, we support both patterns. I think that it's really a matter of where you come from as an organization and what. Systems and workflows you have in place, but in general, having access to the data you need at your fingertips. We see a super important.

[00:36:40] Angela Suthrave: So if I'm listening to this and I'm looking to either custom build these from scratch or take it off the shelf, you know, what, what would you say to someone like me? 

[00:36:52] Reshma Khilnani: So there really is no solution that will stand alone off the shelf and work. That's my belief. Almost everything will require some amount of programming.

[00:37:06] Reshma Khilnani: Whether the system you're using was designed to be programmed and whether it supports it natively, or you have to kind of force it, that's the difference. Just think about all the crazy workflows. Scribes, you know, automatic responders, bot responders, triage list. The use cases are immense. And for our customers, many of them are replacing a system because they can no longer, like, manipulate it the way they need to.

[00:37:36] Reshma Khilnani: So they want something that's more programmatic. So, I think, I guess, Angela, to answer your question, My belief is that there is pretty much no implementation without programming, whether you do it yourself as an organization or you find someone to do it, that's part of where the industry is. Maybe in the future, this will be solved via LLMs or something, but at present, that's where 

[00:37:57] Omar Mousa: we are.

[00:37:58] Omar Mousa: You mentioned wrapping or a CRM around EMR functionality, and there is a growing trend. I can speak personally as someone who's Currently doing things like this. Can you speak to some of the risks and benefits I think to this approach? Because I think like EMRs are really good at certain things. CRMs are really good at certain things.

[00:38:19] Omar Mousa: Yeah, and can you speak to like Why are these like MSO models or you know VBC models? Struggling to kind of build this. 

[00:38:29] Reshma Khilnani: I mean, you described you used a couple of terms in their BBC and M. S. O. which speak to the complexity of implementing these solutions. For example, if you're doing a managed service offering or or a value based care offering.

[00:38:45] Reshma Khilnani: You're often sewing together multiple practices who have like a long history of, of doing things, you know, their own way. I think that's part of the challenge. You're, you're not, you know, you're not really often building de novo. You're bringing in a bunch of providers who, who have a workflow and it needs to keep on going.

[00:39:06] Reshma Khilnani: It can't stop. So some of the complexity comes in like. Adjusting your software to the workflow and really understanding it well, that's often like a product function and then building it so that it respects what's in place and doesn't interrupt is additive versus like messing with anything that's in place.

[00:39:30] Reshma Khilnani: I think the key reason that traditional EHR struggle is because they're so rigid. They're designed for a few cases, like they have a strong sense of place. They assume that a provider is in a certain location or they have a strong sense of, you know, fee for service or some kind of specific transaction.

[00:39:52] Reshma Khilnani: And so it's hard to work around those aspects. So the rigidity is a big problem for a lot of the implementations and why people would look to find alternatives or wrap around in a, in a novel way. 

[00:40:04] Omar Mousa: Pineapples. I'm right now building the ingest and the sanitation of data that's going to go into HubSpot because HubSpot now has a PAA and it's just nasty.

[00:40:16] Omar Mousa: And it's like a whole business in itself. I, I think it's like literally the problem to solve. And Angela is now doing Angela's whole company. She ended has a job change. But yeah, Angela's working on it from an LLM perspective. I think it's a sticky problem. It's 

[00:40:34] Reshma Khilnani: sticky. It's sticky. And you know, 1000 small details.

[00:40:39] Omar Mousa: Yeah, 

[00:40:39] Angela Suthrave: totally. A lot of our listeners are builders and operators and health tech. And so we'd love to understand from you. What are some of the common pitfalls that you've seen health tech companies fall into when it comes to scaling their products? And do you have any advice on how we can avoid them?

[00:41:00] Reshma Khilnani: Ooh, hard one. So, you know, common pitfalls with scale building and scaling products are really, you know, keeping all the stakeholders aligned and doing great change management. And that is a problem that we've seen time and time again. One of the things that we find. Incredibly helpful in this regard is to like, lean on a standard versus make something up.

[00:41:28] Reshma Khilnani: I'll compare and contrast. So some people are like building out software to run a large scale multi state practice and they spin up a database and they make up their own data model and build up an app that does the functionality that they need. Eventually, they need to bring more people on or more sites on And people just don't know what the fields mean that they made in their database.

[00:41:54] Reshma Khilnani: So one of the things that we do at MedPlum is like, you know, we have a lot of tooling to help support you if your stuff doesn't fit, but in general, you should use the standard. Fire, HL7B2, LOINC. And if you have, if you lean on those standards, then at least it's look up able by someone, someone else, so that they could interpret.

[00:42:16] Reshma Khilnani: This is, this is a big deal for folks who have done implementations and very helpful. And it also helps prevent against many of the issues that, for example, you have a key personnel, you know, change in your organization. That continuity of business is to, is to. Typically tricky and you don't know like what specific what's gone specifically into an implementation and use of the standards is just so, so useful for scaling a bunch of our, you know, community members, customers, a lot of their use cases are sewing together data from multiple systems and the use of the standards again here is just helping them to a large extent for those who are doing AI implementations to, um, Um, all these LLMs understand the standards a lot better than your bespoke data model.

[00:43:03] Reshma Khilnani: So that can also help, I guess that's more on the, on the novel side. 

[00:43:08] Angela Suthrave: I also find that when you're scaling quickly, there are a lot of demands and a lot of requests coming from all sorts of stakeholders to stakeholder alignment. And so I'm curious if you all have found. A framework for how you do prioritization to make sure that as you're scaling, you're focused on the right things.

[00:43:30] Reshma Khilnani: You know, we're right back to those abstractions that we talked about at the top of the show. So we are very disciplined about keeping like the data, the identities, the event driven workflows, and the clinical logic separate. So when we get those demands that, you know, we need this workflow to work this way, at least.

[00:43:53] Reshma Khilnani: It could, you can in a more streamlined way, add resources to that project in a way that other, if you have an alternate pattern, like you wouldn't be able to, to do that. You'd need to like, you can only have one open heart surgery at a time, but you could add a few Legos in strategic places. I will not say that this is like solved, but it does really help to have a platform engineering approach when you have a lot of stakeholders and a lot of people to manage.

[00:44:23] Reshma Khilnani: Many of our community members, for example, are able to effectively use MedPlum to staff augment because our, you know, documentation and APIs are really good. And so they can parallelize some of their development or some of their use cases that their core staff might, might have a tricky time supporting.

[00:44:41] Reshma Khilnani: Um, but it is a, it is a hard one. And part of the issue with a lot of these healthcare apps is just, there's so much functionality that needs to be supported. Um, I think the parallel tracks from open source is what has helped other platforms really thrive, and we think it could be applicable here as well.

[00:45:01] Omar Mousa: Freshman, could you share a few notable MedPlum community stories that might resonate? 

[00:45:06] Reshma Khilnani: Sure thing. So first of all, if you go to MedPlum. com in the photo bar site, we have some, some case studies and folks have kindly made videos of their implementation. So I recommend. People check that out, but I think you had some team members from, from Flexpa on here before.

[00:45:21] Reshma Khilnani: They have a very cool implementation where they're, you know, pulling from the patient access APIs from the payers. And it's for those of us in interop, I was like, wow, I haven't, you know, I haven't seen something like that. So it's a emergent use case. This is not at all like an EHR or a care app. It's more of a.

[00:45:38] Reshma Khilnani: A solution to get data that was previously dark and it's very, very cool. Yeah, the team at Summer Health has a, has a cool implementation as well. And I think they're, they're very, you know, forward on the, the AI use cases and have a good solution that is very messaging centric, very patient centric, it's a pediatric care application where you can via messaging get care for your, for your child.

[00:46:06] Reshma Khilnani: So. You know, moms in the group are also excited about that one. I think both are, are cool. And we think, you know, we're, we're excited for the team and hopeful that more implementers will be inspired to, to build their solutions. I'd say that, you know, we span multiple verticals, healthcare software, care applications, provider facing, patient facing, and also in the payer sphere as well.

[00:46:33] Angela Suthrave: And can you talk a little bit about how tech enabled health care service companies are using MedPlum as a sidecar application and why that may be advantageous for them? 

[00:46:46] Reshma Khilnani: Good. That's a, that's a good question as well. So I think some of our community and customers are building full, Care applications like an electronic health record, and some already have an electronic health record or a, you know, or maybe a picture archiving system or other clinical application that they're using for their primary workflow.

[00:47:07] Reshma Khilnani: I think part of it, you know, a specific commercial models like managed service offering MSO value based care we've discussed in this previous hour. Those need functionality that EHR doesn't readily support often. Things like messaging, advanced interop, or access for partners that's controlled. For example, you want to have a partnership with another clinic.

[00:47:34] Reshma Khilnani: You don't want to share all the patient data, but you know, only some segment. And those type of flexible use cases that are often, you know, need specific access controls, need specific workflows, messaging centric, asynchronous, rely on tasking or, or other um, You know, primitives, those are really good use cases for MedPlum and we see customers building off of those.

[00:48:02] Reshma Khilnani: And one thing that's kind of interesting from the healthcare IT perspective, you know, MedPlum is a, has a FHIR G10 interface, which. Is like a fire API and other health records have it too. So there's kind of a very natural peering relationship that other EHRs have. People connect to, you know, Epic and a lot of the major platforms using this technique, plus some other techniques as well.

[00:48:29] Reshma Khilnani: You know, usually they have to do a combination method, but that natural, you know, touch point is, is something that is well suited to building a sidecar application. 

[00:48:40] Omar Mousa: Thank you, Rashma. I want to just hit lastly, before we go into the concept closing call, where do you see the biggest opportunities for innovation in health tech over the next year or three?

[00:48:51] Omar Mousa: And where do you envision MedPlum playing in that, in that sphere? 

[00:48:55] Reshma Khilnani: I'm really excited about this question because I think that we're in a great time for health technology and for healthcare. Built for purpose applications. I think the future is really bright. And the thought that I'll plant in your mind with regards to the way the future is going to go is not like more UIs or more fancy looking apps.

[00:49:17] Reshma Khilnani: It's actually less, I think that headless systems and automations, you know, the advances in AI that are happening. will make it so that a lot of stuff that is done by humans, a human workload today is actually done by machines. And I'm really kind of excited by that prospect. To take the burden off clinicians to like provide a better quality, more access.

[00:49:38] Reshma Khilnani: I think that is a really going to be something that we see as a futuristic use case.

[00:49:47] Reshma Khilnani: The idea that like a lot of the administrative work too, could be, could be automated. I'm super hopeful for that. I think we're still in early days, but you know, one to three years. Yeah. We're going to make a lot of progress and technology advances and stuff are just going to be compounding over that time period.

[00:50:04] Reshma Khilnani: All right. Reshma,

[00:50:14] Angela Suthrave: we have arrived at the very exciting portion of the podcast called the concept closing call. So we're going to ask you some questions and they're just meant to be Fun, fast paced. So the first question is, are there any frameworks, methods, or processes that you've found to be especially helpful in your work?

[00:50:33] Reshma Khilnani: The first one I'll plug here is source control. Like, you know, if you are,

[00:50:41] Reshma Khilnani: it's a process. So, You know, I write a lot of documents and I write them in source control and having that kind of change management, um, for it, I think is incredibly effective and fun and, um, can really help organizations. I also didn't make this up. The founder of, of GitLab, his name is Sid, wrote their whole handbook, you know, in, in source control online.

[00:51:08] Reshma Khilnani: And it's like an amazing resource for all founders to see. I think that's very inspiring. And we. We left that today at, at MedPlum and I think others might find it useful too. So when you're spinning up a new doc, think about source control.

[00:51:25] Omar Mousa: I think about it with SOPs for the ops teams when we're writing SOPs. It's like, it's an evolving thing. And you want to know who made the change, why we made the change, the metadata associated with the change. And I think source control is great for stuff like that. 

[00:51:40] Reshma Khilnani: And then someone like merge it and have feedback, you know, that's, that's useful.

[00:51:44] Omar Mousa: Yeah, 

[00:51:45] Reshma Khilnani: if you're in a heavily regulated industry to just so many benefits. Anyway, I digress. 

[00:51:50] Omar Mousa: Sorry. What is a tool that is highly valuable to you and that you think that others might not be using? 

[00:51:56] Reshma Khilnani: I like to use cloud to generate code and to talk to in general, maybe as a, as a sounding board for any, even, you know, a lot of decisions.

[00:52:07] Reshma Khilnani: So I think I would recommend Claude, I think it's got a lot of use cases for, for those who are just not even using it in an integrated way, just kind of for a thought buddy. 

[00:52:21] Angela Suthrave: Are there any concepts in healthcare that are really exciting to you right now? I mean, 

[00:52:25] Reshma Khilnani: I've, this may be a recurring theme, but I think the fact that healthcare regulators are leaning so hard into the open source standards.

[00:52:35] Reshma Khilnani: Like fire, like SNOMED, you know, they're even open sourcing a lot of the quality metrics and the implementations for them. I think that's a great, it's a great trend. I, There's, uh, there was a kind of maybe eight or 10 years ago, an initiative that like started this in motion and it's just starting to really become a movement now.

[00:52:59] Reshma Khilnani: And I think that is very exciting. And for those of us who are like really in the weeds trying to make the systems work, it's going to be a huge benefit. 

[00:53:08] Omar Mousa: Do you think product management is a science or an art? 

[00:53:11] Reshma Khilnani: First of all, it's definitely an art. There's a large belief that technologists are kind of tone deaf to healthcare, you know, they have a lot of just faux pas or they think very differently.

[00:53:27] Reshma Khilnani: I'd say the art here for product managers is really listening carefully to the requirements and understanding the landscape well. And in that way, I think art plays a big part. We at MedPlum are not immune from this. We also have to work really hard on it to try and stay in tune with what's needed versus the right technological solution.

[00:53:47] Angela Suthrave: And where can people get in touch with you if they want to reach out? And would also welcome any shameless plugs that you have. Maybe I can give one for you, which is to add to their community. 

[00:54:00] Reshma Khilnani: Would so appreciate that. There are three major ways to reach us. First of all, github. com forward slash MedPlum MedPlum is our core repository.

[00:54:09] Reshma Khilnani: Join us there. If you have a GitHub account. Star the repo, that is my plug. I am Reshma at medplum. com would welcome emails. We'd love to talk to anybody who's into the, into the weeds as much as we are. And, you know, we have our, our website medplum. com in the footer. There's a discord community, which would love to have folks join as well as various, you know, YouTube and stuff like that.

[00:54:36] Reshma Khilnani: If you're into watching healthcare, IT, YouTube shorts. So with all of those, we would love to have people and thank you for letting me plug those 

[00:54:46] Omar Mousa: Roshma. Thank you so much for coming on the show. This has been a delight. You were the first CEO we've had on the show and I think it's by you're an engineer by nature and or by what is it by by by 

[00:55:02] Angela Suthrave: training training.

[00:55:04] Angela Suthrave: Yeah, that's the 

[00:55:05] Omar Mousa: word. You're an engineer by training. And I think, you know, you've have builder DNA. You've been a founder, multi time founder. And so, you know, we, this has just been an incredible episode. Thank you so much. 

[00:55:16] Reshma Khilnani: Thank you so much for having me on.

[00:55:21]Omar Mousa: Hey, thanks so much for listening to the show. If you liked this episode, don't forget to leave us a rating and a review on your podcast app of choice, and make sure to click the follow button. So you never miss a new episode. This episode was produced and edited by Marvin Yue with research, help, and From Aditi Atreya, we're Angela and Omar, and you've been listening to Concept2Care.

 

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