Interview with Dr. Mohammad Al-Ubaydli, Founder & CEO of Patients Know Best

Mohammad is founder and CEO of Patients Know Best. He has over 15 years of experience in medical software. He trained as a physician at the University of Cambridge, worked as a staff scientist at the National Institutes of Health and was a management consultant to US hospitals at The Advisory Board Company. He is the author of seven books, including Personal health records: A guide for clinicians and Streamlining Hospital-Patient Communication: Developing High Impact Patient Portals. He is also an honorary senior research associate at UCL medical school for his research on patient-controlled medical records.

Patients Know Best (PKB) created the world’s first patient-controlled medical records system. It is an award- winning company whose first customers include Great Ormond Street Hospital, the UK’s largest children’s Hospital); UCL Hospital (developing the national asthma personal health plan); St Mark’s Hospital (the UK’s top gastroenterology specialist centre); Novartis (to conduct clinical trials); and Torbay Hospital (to integrate records across primary, secondary and social care in South Devon). Its investors include Channel 4, the UK’s third-largest television station, and Seedcamp, who chose it out of 1,500 companies as one of the top 6 high technology start-ups in Europe. PKB has been recognized as a social enterprise by UnLtd, the Young Foundation and Ashoka UK because of its focus on patient care.

 February 2012

Well many of my family are in business, so I was always surrounded by business-minded influences. Then, when I was aged 10, we moved to Cambridge, so I grew up near ARM.  My teachers told me that when you’re in Cambridge, the thing to do is start a company. So the seed was sown from a very early stage.

How did you get started?

I learnt to programme and then, while at medical School, I’d take a programming job every summer. On the wards during clinical training I found that IT in healthcare was a mess. So I started experimenting, making software that could solve some of the issues. After medical school I spent 6 months writing healthcare software before taking up my clinical posts. At the same time I co-founded medical futures as CTO for Andy Goldberg, an orthopaedic surgeon in London.

During that first clinical post, I was constantly spotting problems that could be solved with IT. I wrote some handover software for palm pilots  and my colleagues began buying their own palm pilots so they could start using it.

So really, I took a bottom-up approach, working directly with the people doing the work and in need of the software. I just got on with it. I then started writing books, and when it was hard to get my first book published, I started a publishing company and got on with selling it. Wiley then bought the rights and translated it into 3 foreign languages and I’ve gone on to write several more books since then, including Personal Health Records: A Guide for Clinicians, Handheld Computers for Doctors and The Doctor’s PDA and Smartphone Handbook.

Following house officer jobs, I spent some time in management consulting to improve my business knowledge and skills. Then, after some time doing research with the National Library of Medicine in the US, I moved back to the UK with the aim of starting my own company, Patients Know Best.

Why did you start Patients Know Best and what gave you the belief that you could make it work?

I wrote a book in 2006/2007 based on my research with 2,700 hospitals in the USA. The book taught CIOs how to share hospital data with patients online. It was really important to me that the book’s advice be adopted because, as a patient with a rare condition myself, I wanted to get a copy of my medical data. But few people did so, and I spent about a year sulking about this.

Then I decided that I was one of the most knowledgeable people in the world about this topic, so if I wanted this to happen, I had to do it myself. Furthermore, the UK government, Microsoft and Google, were all doing it wrong, so I had to do it right with Patients Know Best. Most importantly, the best country in the world to start giving patients their data was not the USA – in fact that was one of the worst places to start, as Google and Microsoft eventually found out. Instead, the place to start was the UK and with the NHS.

So I left the USA and went back to Cambridge to start Patients Know Best. Our aim was to integrate with the NHS first, and then to spread the innovation to other countries after that.

What are you doing with Patients Know Best now?

We now provide a service for many different stakeholders within the healthcare system. Hospital patients using the PKB website can send and receive messages securely with their clinicians (e.g. to ask questions about the use of insulin), send data to their clinicians (e.g. daily blood sugar results) and access their own medical records. Patients like our tools because the typical patients gets no more than 60 minutes with their specialist every year. Secure messaging allows patients to ask questions outside of these minutes. Clinicians like our tools as they save them time and money. We improve care quality, reduce costly clinical encounters and offer additional revenues from premium services.  Research institutions like our tools because they can attract more patients to their studies. Drug companies use the tools for research trials. Insurance companies commission the tools for their private patients. So we now have multiple stakeholders to whom we provide multiple benefits.

What has been the biggest challenge in starting and running a healthcare company?

Keeping the company going and continuing to grow during the first two years, when purchasers are being slow and nobody believes in you. As a small company, even if you have a great product, it’s hard to get healthcare purchasers on board. At the same time, securing funding is also difficult early on, meaning it takes a long time to recruit great people. You have to be extremely capital efficient and lean to survive those early days. Despite that you do still need to attract the best people and develop excellent procedures – quite a challenge!

What are the best things about what you do?

The best thing is the people you get to work with, from entrepreneurs to collaborators and patients. I’ve had the opportunity to work alongside top professors – absolute world leaders in their specialties  – who have spent time teaching me about their field so we can develop our product to best help them and their patients. They’ve then introduced me to their patients, so I can learn directly from them about their conditions, their experiences and how our system helps them. That’s really a great privilege.

Would you recommend the entrepreneurial life to other medics? 

Yes. Too few pursue it. You have the opportunity to make an impact more quickly and you get to do extraordinarily interesting things.

You do need to pick up some new skills. For example, I now know far more about accounting than perhaps I would have hoped. However that knowledge was really key during the early days of the business, when it was down to me to keep an eye on the cashflow. There are certainly boring bits, like in any job – pretty much everything falls to you early on, whether that’s doing the accounting or dealing with with lawyers and suppliers. However, it’s well worth it and I’d absolutely recommend it to anyone keen to give it a shot.

What advice would you give to doctors who want to do something entrepreneurial? 

Firstly, don’t be scared to slow down in your career. Take time to learn and experience other areas and types of work, rather than racing ahead on a one-track path. I’d also say that it’s best to join someone else at first, who already has entrepreneurial experience, and learn from working with them. Also – you must learn how to sell. This isn’t something that comes naturally to most doctors, but it’s necessary for success. That said, as doctors, we do actually have more experience in this art than we realise. We all have to communicate with patients on a daily basis, including ‘difficult patients’. Often if you take the time to find out what those ‘difficult’ patients really want and what would make them happy, you’ll find they have a very reasonable request. If you can find out what they want, and solve the thing that’s bothering them, they stop being difficult. A satisfied customer. That is how to sell. So, to do well in business you need to understand people. Take the trouble to understand people and to solve their problems.

What steps can doctors take to help them work out if entrepreneurship is right for them?

Do something cheap and fast. Don’t quit your job and go salary free. Instead do something on the side whilst you’re at medical school or working. Try to sell it. See if you can do it. You will learn so much in that experiment, about what does and doesn’t work, even if you fail.

Follow Mohammad on Twitter: @idiopathic

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