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Monday, October 12, 2020

Review by MD Tech magazine

Interview with Dr. Karun Philip


It will be great if you could give me a brief background about your company as to what you do and you know, what kind of value proposition do you have to deliver in the medical practice management field? If you could give me a brief background about your company, we can take from there.

 

Alright. Tranquilmoney was incorporated in 2001, based out of New York. We got new investors and we acquired a company in India that I earlier owned which did you know, back office software development and business process outsourcing work in India for US and European clients. So our strategy was not to move jobs from our company who happen to be in India. We created a platform that allows teams to work within our client's company along with teams that we provide in global locations. Our first major client was Citibank who wanted to move their loan processing to their own offices in India, Sri Lanka, Philippines from European branches. And that's when I built the software -- in 1995 -- and then used it for companies like UPS and then McKesson Corporation, Prudential securities. And then Costco Pharmacy.

Costco and Prudential Securities were our first big clients, and then McKesson Corp. Then we decided that were all *pharmacy* revenue cycle management. So we decided to focus on pharmacy revenue cycle management. Because by then developing a global workforce was commonplace and we needed to specialize in the vertical. So Costco was starting to open pharmacies in all of their stores. We had 12 stores when we started with 12 pharmacies and 12 of best stores wouldn't be started. And then now they have over 500. So that provided us a lot of our growth over the years. But at the same time, instead of becoming too dependent on one client, I started working with physician practices again, back in around 2001. And what we did in pharmacy was initially I had 250 employees in India because paper was scanned at profitable. And then we would we would put it through a double key entry process. My PhD was in intelligent character recognition using neural networks, but that doesn't give you a hundred percent. So I came to the conclusion that we already have the hardware for AI. It's, it's in human beings, it seems the brain of human beings. So I have the best hardware available at a low price anywhere in the world. I just have to develop the software to control the workflow and give them a structured work process to follow. I call it Managed Natural Intelligence. 

I have PhD in AI, which I used to recognize the heart wall and CT images and develop a finite element models so that I can figure out how much, how well a patient's heart is doing. And I got pretty good results. Well, the best in the industry at the time, but artificial intelligence will never be 100% perfect. So I couldn't go to the idea to let you know, you start with manual, then let AI help and then you manually correct. So it's a, it's you can go around that cycle as many times as you need. When, when it came to recognizing characters for financial transactions, we couldn't do with less than a hundred percent. So the old method of which IBM invented was two people see the same image and enter the same data. If it matches, it goes through. If it doesn't, it goes back to the same process. 

So when we started with paper intensive processes that the pharmacy used to handle, I made sure that we work with all of the players. So over the years, we helped convert the pharmacy system to handle both paper and electronic formats of all varieties.

I decided that since pharmacy was too small a focus area, we should take up physician practices as well. When it comes to physicians practices, there is still has a lot of paper. So right now we're doing the same thing. We back up the paper or electronic and proprietary formats and then convert it to a standardized format, which is called HL7. That's the industry standard. So and then we built the software. I got it certified as an HR product. That was also those common things like online appointment scheduling for the doctors as well as templates to help them diagnose and decide what procedure to do. And then the system will electronically or paper bill. And then when the payment comes in, we will, if it comes in electronically, we'll take the electronic data and each person's electronic data is slightly different also, although they follow a standard called the eight 37, the custom fields. So each, each pair uses it differently. So we built an expert system, which has also artificial intelligence of a different time to to put in the rules that each care uses. 

For each insurance plan, we put the contract details in our platform. But the plans have the option of changing the contract sometimes without informing the physician. So our software will capture that. And then we'll try and confirm with the insurance plan and we'll report to the physician. But the plan has changed. So if you want to renegotiate with them, then this is the documentation you need. So it's software and, and services like if I give someone, there are software providers who give the physician software and then they have to operate it. And then there are billing companies that use whatever software they have and then do the billing and follow up. Now I view it as complete business process outsourcing, including software. We give away the software for free and we charge a, either a percentage or a per claim fee depending on the state or different rules about it.

And we only get paid a small percentage of what the physician receives from the insurance companies. And say for example, I mean our, our percentage varies greatly depending on the specialty or if it's a flat fee or depending on the number of cranes, et cetera. But what we get is a small fraction of increase in collections that the physician receive. So it's not this free software. It's better than free software and services because we're, we're not focusing on getting rid of doctors, employees. We're creating a global team who can use software that will create a joint workflow using people anywhere in the world to work for that, whether it's one physician or a thousand, it doesn't matter. We can create teams of any size because this software is proprietary. We developed it ourselves and we can hire as many people as we want.

We have a formal training program. We give a certificate to people who grips. We're a training program and we have experts that will work for the doctor who know how to code in each specialty and so on. So it's not just getting rid of someone in the us and hiring someone in India. It is adding more people to the team. Your current team and the person who's going to be paying for it is eventually the insurance company will have to pay whatever they contracted to pay. We do not allow physicians to submit project and train. So the insurance companies like us too because when it comes through us, we've already collected the evidence, but the procedure actually took place. So we feel we're addressing all the, the points of gain and by converting data formats from one to the other, we start up doing it manually, but we automate it over time.

And the price doesn't change. It's the same because there is a cost to manual labor and there is a cost to developing software so it balances out. But over time, if we scale, we, if we scale up, there are a million doctors. So my goal is to serve at least a 999,999 at them. So we need to automate as much as possible so that we can scale through working with everyone. Now, some people may have their own software or some third party software and we're happy to work with that. They don't have to change anything. We will interface with whatever they have. They can, other billing companies or software companies can partner with us. And they can provide their components and use whichever of our components that they want to use. So we're totally open about partnering with other vendors in field at the same time.

It's a doctor who's been around for it took a long time, eyes on the paper documents will help them convert or whatever he has. And you be, you can continue to use paper and within 24 hours that data will be electronic. So we have a bunch of options. I mean, you can, you know, for the meaningful use, you get a benefit from either the government or the insurance companies. And so we can prove that there's meaningful use of the software. Many, many doctors today are giving up private practices and joining the hospital hospital or big group. But what happens is they say they're going to pay, you say $240,000 a year, but then there's a clause in the same that if you have collections go down, then your salary goes down. And then these hospitals, they focus on their own high dollar billing for whatever specialty you go in and say operation or some complicated procedure. And the physician would just get a hundred dollar reference fee. They don't follow up on the collections that a hundred dollars, whereas it's important because the doctor will see a thousand patients and a hundred dollars each. So he has to collect every penny to make a decent living. And so we do that just like we did in pharmacy where the average claim is $40 that is owed by third party insurance. And we started with manual and over 20 years we've made it almost a hundred percent electronic.


So how do you really create this balance when it comes to innovation and simplicity, ease of use, seamlessness? How do you really maintain this balance in inside yourself?

You're absolutely right. And there are two ways we handle that. One thing is that everything we build has a customizable user interface. So when we set up for physician, we don't show him all the options are available, but he will have a customized UI that focuses purely on things that he does most often. The second thing is that some doctors don't even look at the software. They just run monthly reports or weekly reports or daily reports and they'll get them by email in whatever format they want. So by they do not have to know that the software has so many options. 

It's a combination of those two. I mean, if they want something new, we develop that. We customize what we have already or would charge $25 an hour if it requires changing our software code and it's our code so we can modify it to anything that each doctor wants. But when we modify, if we add a feature for one doctor, it become available optionally to all the other doctors.

 

Your system provides the option for the doctors or the practices to really you know, create a seamless proposition for the data unit that pine menace that claims the skid dealing, the, you know, the custom reports, the chalk module dashboards and messaging and the patient odorless belt. So the data that's contained in these kind of features, how do you secure that data? How do you create a system which is combined to their regulator system out there? Regulatory you know you know, options out there. So it'd be great if you could talk to me about the security and the regulators. 

Yes. So we have been audited in order to get a certified EHR status. Our servers hosted professional hosting platform where to get into the server, you need a hand print access. We implement a 128 bit security. You can access it through any browser, but if you would like, we can limit it to the specific IP address that that comes from your office. We set up a virtual private network, if you'd like. But basically if you just want a little bit of security, all you need is secure web access to a secure browser and a password. You can also set up multiple more levels of security yourself. Or we will do it for you.


So can you give me an example here, a case study or a success story where you helped your clients in obtaining what they wanted. Now I completely understand that you might not be able to name the practices name, but Hey, you know, what I'm looking for is a before and after scenario, some of the challenges that your clients face before the collaborative with you. And how did you really help for the solution?

Yes. I can give you one specific example, but it's very specific to New York. New York state has a Workers' Compensation Board, which arbitrates the workers' compensation claims. So we were the first to integrate electronically with the Workers' Compensation Board. So for the doctors, we started the New York workers' compensation revenue cycle management. We built electronic interfaces to the Workers' Compensation Board and he went from getting paid next to nothing, to 99.9% collection. 

You know, people do work for compensation only because they have to, if at all. And usually they don't get paid because the insurance administrator just gives some excuse and doesn't pay. But in New York, if you file with the Workers' Compensation Board, then they act as arbitrators. What we do is we collect the whole reimbursement contract for each insurer, and find out who hasn't paid the contracted amounts. We send the physicians practice a report for each of the plan administrators, which they email or fax to each of them.

And if they still don't pay even after agreeing to pay, we have an Attorney Portal. The physicians attorneys can download the documents they need for the brief, and present it to the judge. The insurance administrator has to dispute it, or pay it, or agree on a settlement.

So the workers' compensation appeal process of New York state takes income from what was zero, to a hundred percent. And so for many other doctors in New York, we helped them take on a new line of business, which is workers' compensation. Because from getting zero dollars a claim, they can get at least as much as Medicaid pays, for instance. Another example is what is called the Major Medical insurance plans, that most of us take. The increase in collections in one case was 1000% in workers' compensation. It's 10 times of what they used to collect. 

But in Major Medical, our average increase in collections is about 40%. Sometimes they say "we didn't get the claim" or they just pay less than the contracted amount. And unless you do the accounting and reconciliation, you don't know which plan wasn't paid or which claim was paid less.

But most of them, if you do the accounting party and send them the report, they'll pay if you get, if your data is accurate. Some of them it goes to court even from major medical. But it, I mean the court, if it goes to court, it ends up in a settlement that, you know, the attorneys either side don't really want to drag it out. They'd come to a settlement and our data is 100% accurate. So 40% is the average increase of a normal physician that we provide. And again, our rate varies from 2% to 18%, but the average would be about 10%. Which is a fraction of the increase in realized revenue.


Talking about your company now, what would you say are some of the factors that differentiates your company? Puts you ahead of the competition. Of course, being in the business for so long and having copped a unique niche for yourself I believe is a strong point of differentiator, shift differentiation. And then of course the team and you have years of years of experience in this field. So I believe they experience it and they expertise are two of the major points that differentiating. But any of the point that you mentioned or maybe you wanna elaborate on kind of the experience? 

I did my PhD and then work for Tata Consultancy Services ("TCS"), which is the largest software company in India. And then I started my own business. I could afford to do these things because I'm from a family who could financially back me. And we;re one of the largest groups of family owned companies in India, I'm the only one in the family who went to the U S and became a US citizen and started a US company. But the family companies include MRF Ltd, which is the largest tire company in India, and the 12th largest in the world. 

We own the largest circulation newspaper in India. We have coffee, tea and rubber plantation, large sizes. So I could have just sat on my back and, and done nothing. But I went to the top one of the top engineering colleges in India and I'm interested in technology. 

And I decided to go to the U S and then I fell in love with the US so I wanted to stay there, and at the same time keep a connection, keep my connections in India. And so we are backed by billions of dollars of the family network of companies. I've never taken any money from my family yet. This company grew from its revenues. Our first clients were happy with our willingness to customize the software to their needs, so we became highly  recommended. So I mean that if I want, I have extra capital -- my part of those billions. So we are financially very stable.

 

One other question that I had was about the future of the company. When it comes to the next 12 to 18 months, what would be the next big step that your company would be taking? 

Well there was football culture, Notre Dame coach Lou Holtz. He said: "First be the best and then be the first." I think with physician practice management, we are now the best. And so from 2020, I started working on becoming the First. 

I've never done sales and marketing. My clients just came to me, but now we have a sales and marketing budget. We have publicity, we have people on the ground going to doctors offices. And there's 800,000 of the million doctors used, still have independent practices. They're all selling out and joining hospitals. But then they think they're going to get a $240,000 salary, but they end up earning a hundred thousand or less. And they would like to and they are allowed to by contract, continue their private practices. And over the next 12 to 18 months, I'm going to be focusing on growth. We have everything working and we took our time to get it to work correctly in property and fast. So we're cheaper, better, faster than anybody in the market, but what we haven't done with sales and marketing. So that's my goal for the next 12 to 18 months.


Wednesday, September 9, 2020

The Kitcoin Club


The Kitcoin Club

The entrepreneur is commonly seen as an innovator, a source of new ideas, goods, services, and business or procedures. In such a scenario we are with Dr. Karun Philip, who is the Chairman & CEO and a co-founder of Tranquilmoney, Inc. to tell us how to become a true leader.

1.           Which according to you is the primary rule to becoming a successful entrepreneur? How are you instilling it?

Play to your strengths. There is always a myriad of opportunities where new businesses are needed by the market. Your strength could be the business network you have, and knowledge of what problems that the end-users your market have. Your strength could be software development, or some other specific skill.

My specific skill is programming. I built a home computer from a hobby kit that an uncle of mine had brought into India in parts when he travelled to Singapore and back one time. When I finally got access to an IBM PC-compatible running DOS, I was in heaven, and wrote myriad programs myself.

The primary rule for my new entrepreneurial debut was “Keep Learning.” And keep training others in what you have learnt so that you can move to the next level. 

2.           Why do you think if physicians handle their medical billing in-house the errors will be extremely high? How are you addressing this issue?

The cost of in-house documentation of the diagnoses and procedures, structuring it in the format required by each TPA – a Third Party Administrator – and auditing the whole process daily, is extremely high. In-house Practice Managers are very highly skilled, though, but many of those who know the domain do not know enough about technology to automate it. There are over 400 Practice Management Software companies and many more Medical Billing companies that the Practice Manager can use to manage claims properly and follow up on disputed claims.

Tranquilmoney’s Practice Tracker is one company that provides both practice management software as well as medical billing services in one complete package. Our technology uses the process I helped design, of AI and domain experts in a continuous loop until rules defined in the software determine that the claim is complete and ready to submit. The input we get can be paper or a large variety of electronic formats. Claims submitted can be either electronic or paper may be required in some cases. For instance, a TPA may say that their electronic system can handle only 4 Procedure Codes, so if more than 4 procedures were used, then it must be submitted on paper. This may be due to shortcomings in the TPA’s software, or simply in their interest to delay payments while holding on to the money that they collect anyway each month from the Healthcare Insurance Plan. When a TPA pays a claim, that can also come with a paper Explanation of Benefits document of Remittance Advice document, which describes the eligible payments, and the rules of the plan that the Provider or Patient has subscribed to. Again, PracticeTracker™ uses the “AI - domain expert loop” to check whether the TPA has processed the claims correctly, applied the contracted rate for payment of each procedure, and are quoting the correct rules that apply to the particular plan that the patient has subscribed to.

independent modules, each of which comply with HIPAA and HITECH Act. For each medical specialty, we can define a screen where only the diagnoses and procedures that a Physician of that specialty needs. That forms a Library of Templates for every new Physician we take on. Each Template is them further customized to that particular Physicians business. The modular architecture allows each person to be assigned a particular role: Physician, Practice Manager, Coder, Biller, AR Follow Up Staff member, etc. All platforms are supported as long as they are capable of hosting a browser, but desktops and tablet computers are the most used now. Mobile devices will be the near future.

4.           As an entrepreneur what is store for the future?

Physicians have always complained about the amount of paperwork involved in the US Healthcare system. Now with everything going electronic, it ironically takes even more of their time. We solve it now by telling them to put their Practice Manager on the software system and continue to use paper forms until we customize their mobile or table interface so that there are just check boxes to click or touch. In the future, especially with Telehealth being made essential by the COVID-19 crisis, my coders can just sit in on the procedure as it is going on (with proper permissions, and privacy guaranteed). The complete claim with complete documentary evidence can be completed before the patient leaves the facility, and we handle the follow up and collections.

5.           How are you inspiring other entrepreneurs?

I am the author of the book Zen and the Art of Funk Capitalism It is available on Amazon and the Publisher, iUniverse, author site. The reviews of the book call it a proposal for a new kind of Libertarianism. When all people must be free, it is also every person’s responsible not to coerce any other individual. And it is a judicial system that must enforce a ban on coercion of various forms, that are specified by specific laws enacted by legislature. I call it “Libertarian Maternalism.”

The conclusion of the book is how Job Skills Training is the most important thing that is prevalent all over, but not structured on centrally accessible in any way. I have started a Social Project named ‘’The Kitcoin Club” (http://kitcoin.club) which aims to be a not-for-profit social resource for anyone who wants to increase their income.

Sunday, July 26, 2020

Dr. Ajit Yadav

Dr. Ajit Yadav Ideamensch Interview of Tranquilmoney, Inc.

Dr. Ajit Yadav

MBBS, MS (Ortho), MCH (UK)– Orthopedics

·       About Doctor

·       Hospital

·       Specialization

·       Treatment

·       Awards

·       Facilities


 

About Doctor:

Dr. Ajit Yadav is having Post Graduate MS 25 years, Post Graduate M.Ch. 22Yrs. He has been in clinical practice in Chennai from 1991. Instrumental in laying the foundation of successful Orthopedic surgery services in the erstwhile Tamilnadu Hospital and Apollo Specialty Hospital, Chennai. Dr Ajit Yadav has more than two decades of rich clinical orthopedic experience and expertise.

Expertise

·       Hip and knee arthroplasty

·       Minimally access surgery and arthroscopy

Hospital:

 Gleneagles Global Health City

Specialization:

Orthopedics

Treatments:

ACL Reconstruction,

Arthroscopy,

Bankart Repair,

Biceps Tenodesis,

Bone and Joint Malformation Surgery,

Bone Density Test,

Bone Reconstruction,

Bone Scan,

Curative and Palliative Surgical Procedures For Bone Tumors,

Ilizarov Technique for Complex Deformity Correction,

Total Hip Replacement,

Total Knee Replacement

________________________________________________________

 

Dr. Karun Philip

1995 - 2020: Chairman & CEO, Tranquilmoney, Inc. 

Home Page: https://www.tranquilmoney.com

 

   teleClinic Online Shop: https://teleclinic.tranquilmoney.com

   teleClinic Home Page: https://telepractice.tranquilmoney.com

   teleClinic Physician Practice Management: https://ehr.tranquilmoney.com

 


 

 

1995 - 2020: Chairman & CEO, MM Imagine Technologies P Liimted (a 100% subsidiary of Tranquilmoney, Inc.)

 

1993-1995: Director, MM Rubber Company Limited

 

1991-1993: Sr. Consultant, Tata Consultancy Services, AI division for practical applications of Artificial Neural Networks. Developed the Product CRANEUM (Character Recognition via Augmented Neural Methods)

 

1987-1991: Research Assistant, University of Iowa, Iowa City, IA, USA. AI pattern recognition via The Fuzzy Hough Transform to recognize myocardial walls in multi-slice, real-time cine-CT thorax images to generate a 4D Finite Element Model of each patient's heart in motion. This resulted in a non-invasive, technique for analyzing cardiac health with no dangerous cardiac stress physical workout machines.
MS: Electrical and Computer Engineering, PhD: Biomedical Engineering.

 

1983-1987: BITS Pilani, Electrical and Electronics Engineering. Joint Secretary Music Club. Founder of Annual Rock & Roll Music Festival ROCKTAVES, which is today India's most important rock competition, where winners get global music video deals and cash prizes. This has become the revenue generating machine for the BITS Pilani annual cultural festival, OASIS.

 

1974-1983: Junior, Middle and High School at Sishya School, Madras, India, and Asan Memorial School, Madras, India

Born: March 1966

 


 

Where do you live:

  • Tranquilmoney, Inc.
    461 Vose Ave
    South Orange, NJ 07079
    USA

 

Questions

1.    Where did the idea for Tranquilmoney come from?

The idea was to finance healthcare receivables, and it seemed to fit. But historically, my father’s grandfather and my mother’s grandfather both owned banks, named Travancore National Bank and Quilon Bank, in the independent State of Travancore (never a part of the British Enpire.) TRANQUIL was the code the Post Office assigned to them when they merged their banks to become the most powerful bank in non-Mughal India.

 

2.    What does your typical day look like and how do you make it productive?

I live in Manhattan, and moved my office to my co-founders’ building which also houses a day care school in South Orange, NJ. Tranquilmoney’s 100% subsidiary is MM Imagine Technologies P Ltd located in Madras, India. Almost 12 hours away.

Long before the current COVID-19 pandemic, we ran multiple 8-hour shifts. Some were combinations of two 4-hour shifts done 12 hours apart. When it became necessary for us and our Physician Practice clients to work from home, we already had the Infrastructure and Organization in place for not just me, but my entire staff and my clients and their entire staff work from home.

I wrote this little manual on working from home for everyone to be maximally productive, yet completely engaged in home life:
https://www.funk-capitalism.com/search/label/Tips%20on%20working%20from%20home

 

3.    How do you bring ideas to life?

I first test the targets’ needs. Put yourself in their shoes. A physician may not even be able to travel to his own Practice. Patients are worried about going out of their homes to see their family physician. So, I build a solution. Then, since I am not a Sales & Marketing person, I hire a handful of companies to manage the sales and marketing in various geographies and for each type of illness.

I keep the Branding function to myself.

4.    What is one trend that excites you?

The trend of people realizing that AI is fallible. Everyone knows they are not perfect and sometimes make mistakes. But it is mathematically provable (via Kurt Gödel’s 2nd Incompleteness Theorem)  that all Knowledge, whether in a human brain or an AI implementation, is incomplete. This incompleteness necessarily leads to the fallibility of both real people and Artificial Intelligence. And it will be so for all eternity.

But the solution is not for the future. It is already available from the ancient past. The solution is COLLABORATION. Even ancient societies realized that no single individual could get things done. But if you get a group of completely independent individuals, each with complete liberty to think as and when they want, then a solution can be found.

The American management specialist W. Edwards Deming taught the entire Japanese corporate world after the war how to use American Management. American management is about people and numbers. Each person manages a Total and periodically checks Line-Items that are the Totals of the people reporting to them. That was called the General Electric Way in his time. After his time, it became known as the Toyota Production System, or Total Quality Management. But the terminology caused a bit of confusion. The Way or System that Deming was training companies to follow was about the Quality of Management. Today, almost everyone outside Japan thinks that TQM is about the Management of Quality. I choose to call it Totals Management, and it is still all about the people, and being able to train any person from an IT genius to an entry-level nobody that your CEO told to hire, into becoming an American Manager.

5.    What is one habit of yours that makes you more productive as an entrepreneur?

Living in the present at all times, wherever I am.

6.    What advice would you give your younger self?

Rock and roll is fun, but do not let alcohol and drugs take over your consciousness. If it does, these are time-tested ways of taking back control of yourself, both synthetic and natural.

7.    Tell us something that is true that almost nobody agrees with you on.

All knowledge fallible. The context in which it seems true always changes.

8.    As an entrepreneur what is the one thing you do over and over and recommend everyone else do?

Develop automated training programs, but train real live trainers to use them to train others.

9.    What is one strategy that has helped you grow your business? Please explain how.

Clear Thinking. You do not have to be a genius or highly skilled in some field. Just talk to the geniuses and highly skilled people and remove the complexity of what they say to you. Keep it simple, perhaps by pretending for a while that you are a simpleton.

10.                  What is one failure you had as an entrepreneur, and how did you overcome it?

I hired a relative to handle my Sales & Marketing. He ended up stealing my largest client for my competitor. I forgave him by telling myself that it is just that he is mentally retarded. I gave my client a couple of years to notice that my competitor was losing him $150 million a year. Their COO called me and asked me to submit a proposal to come back, although he will have to wait for the six-month termination notice he signed on to give my competitor.

11.                  What is one business idea that you are willing to give away to our readers? (this should be an actual idea for a business, not business advice)

Job Skills Training

12.                  What is the best $100 you recently spent? What and why? (personal or professional)

Doubling my monthly subscription to a company that checks lists of prescription pharmaceutical drugs to ensure that there are no combinations of drugs that have an adverse impact on the patient.

13.                  What is one piece of software or a web service that helps you be productive? How do you use it?

Well, my very own custom code generator, nick-named Ava, that uses Coffee Cup Site Designer and Adobe Create Cloud, to create a beautiful UI and UX for a highly functional set of back-end modules of code, that always ran perfectly, so I have named it Avaran.
 

14.                  What is the one book that you recommend our community should read and why?





15.                  What is your favorite quote?

"Life is what happens when you're busy making other plans." -John Lennon


Key learnings: Write up 3-5 bullet points summarizing the key learnings from your interview. This information should not be written in first-person or be self-congratulatory in any way or shape. What is the most valuable information gleaned from your interview? These key learnings will go at the bottom of your interview and will be used to promote your interview via social media. Here is a good example of well-written key learnings.


The key point for the future of healthcare is that it needs to make heavy use of the latest hardware, software, and all other technology innovations such as wireless instruments for measuring patient metrics.

Healthcare Technology companies need to “get vertical.” Not every companu can learn everything about every medical specialty. We need to network with each other.


If you know someone who we should interview on IdeaMensch, let us know! Tell us who they are, what are they doing, and their email address. We will reach out to see if they want to be part of this community.

Preeti Susan Thomas (preetithomas@yahoo.com)
            Executive Vice President, Human Resources
            Sundaram Fasteners Limited
            Chennai, India.


Sunday, July 19, 2020

My bio -- life story (very long)

Personal Blog: https://funk-capitalism.com

I was born to a family that had started as peasants working for daily wages on rice farms in the southern Indian state of Kerala, then known as the Kingdom of Travancore. Travancore was never conquered by the British and remained independent throughout British Indian colonial rule. This was not due to a mightily military or superior technology, but because it was a peaceful kingdom of peasant ruled by a "Maharaja" or King and his family who were extraordinary artists, musicians, and ruled by giving grants of unutilized land to daily wage laborers so that they could own a small farm themselves and educate themselves in British-influenced schools run by local non profit institutions, including Christian Missionary Schools. All religions were allowed to practice their faiths in whatever ways they wanted, and traders were provided access to a global completely free market economy. Every individual and community had complete liberty, but in the ancient philosophical tradition of India, no individual or community was permitted to coerce any other individual or community.

My great-grandfather, Mr. KC Mammen Mappillai, grew up at a time when the family had evolved to be owner first of a rice paddy field that was below sea level, which they dammed and drained to grow rice. They evolved further into relatively prosperous traders who exchanged local commercial produce such as rubber, tea, coffee and coconuts, to Arab traders who arrived regularly at the port of Cochin, which was the local center of Judaism, and with their connections to the Middle East had become the largest port of trade in the Eastern part of the world at that time.

Mr. KC Mammen Mappillai was from a small local community of what are now called Eastern Orthodox Christians. It had been started by one of the prophets of a man they were told was named Yeshua, who was a great spiritual master from the Middle East. Mr. KC Mammen Mappillai married a woman who was directly descended from one of the four fishermen who had given refuge to the Apostle named St. Thomas (aka The Doubting Thomas).

He started a local bank with the knowledge gained from these traders from Arabia, named the Travancore National Bank. It soon became the largest bank in the local region, and then whole of Southern India, while Northern India had been invaded by tribal leaders who called themselves Mughal Emperors and followers of the Prophet Muhammed, even though none of these "Emperors" were even literate enough to have read what Mohammed had written. The northern Indian local people were soon defeated militarily by these tribals, and made a living being servants to the slaves of these Emperors, who had gained the higher social status of being a Slave to the Emperor by converting to what these Afghan tribal lords called Islam. They had no idea of the concept of banking that had been developed by the real followers of Mohammed from Persia and Arabia using the words of their prophet. 

Mr. KC Mammen Mappillai learned from the Arab traders that money, the prophet's followers decreed, could could be manufactured. Just like weapons and tools. The creation of money was done by a bank who gave it as a loan, which was nothing more than an entry in a large book now know as the double-entry book keeping Ledger.  But such loans created by private banks were for a particular project to be specified clearly by the borrower, and monitored daily by the lenders. If the project succeeded, both the borrower and the lender gained wealth and property. If it failed, they both had to share the loss.

This banking system was then stolen during during the Crusades led by zealots from Italy who called themselves Christians, but excommunicated all other Christians from churches formed all over the world by the other Apostles, and named the Roman Catholic Church as the only supreme power that represented the man was ws named Yeshua, and spelt the name as "Jesus." That the other Orthodox Churches were taught that Yeshua said there can be no Emperor or Church that can stand in between any individual and the Creator of the whole of the natural universe, the Roman Catholics simply omitted these writings at a conference that was known as the Council of Nicea, which deleted writings that made this fact known about Yeshua's words and deeds.

Mr. KC Mammen Mappillai also inherited a newspaper company from his uncle, whose son suffered from some endemic disease of he day and was not expected to live long. That newspaper, the Malayala Manorama, is today's widest read newspaper in India, larger than the New York Times.,It also has publications in several Indian languages, as well as in English with the largest circulated (as per the Audit Bureau of Circulation) weekly magazine, and is quite aptly named The Week.

Anyway, my grandfather. Mr. KM Philip, was the third youngest of the eights sons and one daughter of Mr. KC Mammen Mappillai. He moved from Kerala to Bombay to create a bank branch there, since it had become the financial capital of the region, and the concept of publicly traded joint stock companies had been incorporated into British Indian law, which the Kingdom of Travancore had promptly adopted, since their trading relationship with the British Empire was the key to their prosperity.

But the Royals of Travancore were obsessed with the ideas of Art, Justice for All, and Prosperity of All. This led them to outsource the daily administration of their Kingdom to a Governor they imported from the neighboring state of Madras. This Governor's name was Sir CP Ramaswamy Iyer, a very educated and erudite man with very good reference from the British.

When Travancore National Bank became the largest bank in non-Mughal India (northern India had become a part of the Afghan Empire, and had lost all their traditional men of wisdom of yore), Sir CP decided it wa time to bring these "uppity Christians" down a notch. he pulled out the government deposits from the bank and declared that the bank had stolen all the depositors money and loaned it surreptitiously to themselves, and then forgiven the loans. The Chairman and Board of Travancore National Bank, which had then merged with another large local bank named Quilon Bank, were thrown in jail to await a trial that took years to come to any court of any kind.

So my grandfather Mr. KM Philip and his seven brothers had to start again from nothing but their education and moral compass. He chose to remain in Bombay and import rubber and sell it to manufacturers. He also imported tea and coffee from Travancore and nearby areas to Bombay, where he had them blended into what is still some of the finest coffee in the world, sold under the name Philip's Coffee and Tea. He also started a rubber manufacturing company in the state of Madras, named Madras Rubber Factory, now known as MRF Ltd, which is the largest manufacturer of automotive tires for cars, trucks, and now even jet fighters. It's stock price on the National Stock Exchange in India is the highest nominal stock price in history, and to the current day.

When my father finished his MS in Economics from Cambridge University in the UK, he returned and asked his father whether he should help him in any of the various endeavors he had started for each of his brothers with capital raised from public investors who trusted the family, and Bombay bankers who trusted KM Philip, who was a fine businessman, a very ethical man who wanted everyone in a business deal to profit rather than just himself.

My grandfather told my father of Mr. KC Mamen Mapillai's informal business philosophy, where he said that while each of the eight brother should own every company he started equally, he must appoint only one brother to be Chief Executive of each company. He said brothers should share any and profits or losses equally, but decisions can only be made if there is only a single Boss. He had already handed over the Chief Executive role of MRF Ltd to his youngest brother, who wanted to be an artist painting scenery in the Himalayas, but came back after MRF became a viable business and my grandfather made him Chief Executive to lure him back.

So my father was sent to Madras, where he started a company making top quality 100% natural foam rubber products like mattresses, pillows, cushions, and so on unde the brand name MM Foam. This brand is still known as the finest in its industry, but 100% natural foam rubber has been all but replaced with cheaper polyurethane or coir or combination coir-foam products for the rapidly increasing Indian population, who were finding that they were becoming poorer and poorer under British Rule.

So when I was born, in March 1966, I was given the finest education, schooled on orthodox Christian moral values, and had the finest healthcare when I needed it, and was driven in a car with but the most restricted home life that anyone can imagine, where I was not given any luxury items whatsoever, and I had to live in the same way as the children of the domestic staff lived. 

At the age of 17, I finished high school and it turned out that I was in the Top 25 ranks in a nation of 1.4 billion. I applied and got into a college known as BITS Pilani, the #3 engineering college in the country.

Upon reaching this college which was in the middle of a desert in the uncivilized north of India, I suddenly realized that I was now free from the restrictions imposed on me as I was growing up!

Instead of going to classes, I spent 100% of my time building a rock and roll band and touring other top colleges around India (where rock has a very small following, and most audiences only want to hear Bollywood covers). I created an annual rock music festival named Rocktaves, where bands could come now just from one college, but any group of friends who had a band and got permission from the Students Union to offer a cash prize to the top 3 bands, as decided by a judging committee of the Union's choice, and raised sponsorships from corporate entities all over India to fund it. I raised so much money for the Students Union, that it has since been used as the primary source of cash for the annual cultural festival named Oasis at BITS Pilani which includes Bollywood music, plays, debates, and so on. I am told that winners if the competition now get prized such as a music video from MTV India and the like, and some have become famous bands, releasing albums and having sell our live concerts all over India and even outside India.

After 2.5 years of doing only music rather than studying Electrical and Electronics Engineering, I decided to get my act together and started attending classes regularly. Previously, I had only read the textbooks myself for half an hour before each test, so that I could at least maintain a B- average. 

But that was insufficient to get into Stanford, which had been my parents' plan, but my sister was at the University of Iowa, so I went there, and within 5 days I interviewed for one Research Assistant job that was posted on the board, which I was offered the next day. My parents were not permitted to send me money from India by the then laws of India, so I lived on my $800 a month, paid taxes, paid tuition, paid rent, cooked my own food, and saved a few dollars to go out for a drink with friends every Friday. Friends who were from the Heartland of America, and not at all the Americans I had seen in movies and on TV and in rock music videos and magazines. Again, I learnt a lot more than Engineering but managed to great straight A's and A+'s with just attending every class and not bothering to waste half an hour studying before each test.

I was then called back to India by my father to join the family businesses, rather than stay in the US, which was my personal preference. When I got back I asked my father whether I could make a round of the Indian software companies so that I might think about getting a couple of years work experience outside the family owned companies. He agreed, and I was offered various jobs n the largest and most high tech companies, but Mr. FC Kohli, CEO of Tata Consultancy Services, which was and remains the largest software company in India, would not let me say no. He said I could start my own division and work in any of the cities he had offices in worldwide, and address any business issue that any of his clients had, with an unlimited budget, and first choice of selecting any of his programmers for my team. I could not resist, and my grandfather was close personal friends with Mr. FC Kohli, so nobody in the family could object.

My PhD had been using Artificial Intelligence techniques to analyze multi-slice CT images of live human patients so that I could build a 3D Finite Element Model that could put each sprcific patients "virtual heart" through simlated stress tests, rather than requiring them to take strenuous cardiac stress tests, which could be dangerous in and of themselves. So for Mr. Kohli and TCS, I chose to build a neural network solution for managing the document flow in India's largest mutual fund, the Unit Trust of India, a major Indian client of his. I faced resistance from the young lady who was in charge of an elaborate but very effective solution of using the IBM double key punch operator system, where eery field of every paper form is keyed separaately by two independent data entry operators, and if there is a mismatch, that batch goes back through the process until a match occurs, or it must be marked as an exception to be taken up by more senior domain experts. I told her that I also believed that Artificial Intelligence is just a Hype-Loop technology that does not really work, and that they only way I got my cardiac wall recognition to work was to make the output of the AI go to a domain expert who manually corrected the automatically detected contours of each cardiac image layer before it was sent to be converted to a FEM model that was actually used in practice. I told her her system was conceptually the only way to get 100% accuracy, but instead of moving paper batches around, we can scan the images and use neural networks to do the first pass, but the data entry operators would remain so that they could correct the errors that I guaranteed would be present in the output of any AI technolgy -- past, present or future, for all time. SHe then warmed up to me and we agreed that the neural network was only needed for the Hype-Loop for sales anad marketing, whereas we would work on the real solution behind the scenes.

In the 2 years I spent on the project we reached 98.5% accuracy for the neural network character recognition engine on handwritten English language forms of known formats. It was better than anything academically published, but still not good enough to be put to use for India's largest mutual fund, where a single error may end up charging a customer 24,787.50 rupees instead of 2,478.75 rupees. But my colleagues at TCS's research division in Pune, India, turned out to be the best friends I have ever had and remain so. One of them was my CTO when I left TCS and started my own division of my father's market research company MM Research Corporation P Limited, and named my division Imagine Technologies. 

I just did that part time, doing the programming myself, as a sort of hobby. I tried helping my father's company modernize and automate processes and measure each employees performance according to KPI metrics that they were aware they would be reviewed about. But my father wanted things to remain the same. 

So when Citibank UK heard about what I had done at TCS, the person they met at TCS referred them to me. They came and saw my demo, where the old IBM punch card double entry system had been updated to an image based system, and I had removed AI completely since it is useless when labor costs are as low as they were in India at the time, they flew me to London First Class the next day and flew me back with a signed contract and a wire transfer confirmation of an advance to hire me to modify it for their particular need is scanning documents across their global offices, and set up a back office at one of their Indian facilities to processall loan servicing, trade receivables finance servicing, and credit card debt servicing. I gave them a fixed-time fixed cost quote and insisted on retaining the Intellectual Property rights, without which I would be just using up my time rather than investing it.

The product I built ImageCADE, used a different form of AI than neural networks. Each loan document, from origination to every payment on a schduled payment plan, with principal and interest, penalties and pre-payment charges could be either paper, or in electronic format of any kind. A "job setup" involved defining the particular processes for any organization, in Citi's case a bank, there were a very large number of very disparate processes. So I built a rule based expert system to control the dual entry process. While entering the data manually, or while importing the data electronically, the rules defined in the Job Setup would be checked instantly every time a key was punched, or one more character or numeral was imported into ImageCADE. Once inputted, another set of "bots" could be confgureded to take certain actions based on the values of the input data. Once the bots did their job in a few seconds, the result of the bots would go to the particular customer support domain expert in charge of the relationship with that customer. The domain expert would check and correct any mistakes that the bots rule-base had done incorrectly, or for cases where there was no bot rule to handle any particular case. ImageCADE would them update the bot rule-base with a custom additional rule-base applicable only to that Customer Support executive and that Client.

The result was a dynamic AI-Domain Expert loop, where both the AI and the Domain Expert were continuously learning, and continuously improving the producitivity and accuracy of each process. Training Manuals would be generated to train new Entry Level employees who were destined to grow into full-fledged Domain Expert in some set of processes defined by the Key Processes metrics of those processes. Training Manuals would be used by the Level 4 Domain Expert, who was qualified to train new Entry Level employees in to Level 2 Domain Experts, defined as thse who could manage a set of processes, but with the help of a Level 3 Domain Expert. Level 3 Domain Experts could operate autonomously, and help to improve the process rule-base further. Finally, a Level 3 Domain Expert would reach a point where they themselves, who were Entry Level employees at some time in the past, would be authorized to train new Entry Level employees. Training is the ultimate level of any employee, and would typically have the title of Vice President, or President or, Senior Cosultant, or something similar, depending on the norms of the particular industry in which the organization was doing business. 

After Citi, I got UPS for global package tracking automation. With both automation and real people involved in the process, always. No automation of any kind, including AI, can eliminate the Domain Expert. Ever. I then started using ImageCADE to get projects in the US, where I had many contacts both because my fellow BITS Pilani students had gone there because a lack of opportunities for their very high level of talent, and through my US contacts that I developed after going there initially as a student and then every quarter for business conferences and so on. In th eprocess, I got McKesson Corp, a pharmacy wholesaler, as a client. They wanted to finance retail pharmacies to buy prescription drugs from them, which other wholesalers did not offer to do.

That led to Costco Pharmacy, who remained my client from 2000, moving from just 12 pharmacies in 12 of their giant stores, to pharmacies in every one of their stores, which are now in excess of 600, and pharmacy sales accounting for over $1 billion a year. Prescription pharmacy sales are typically what is known as a "loss leader" for a corner grocery store or giant retailer. They are not there to make a profit. They are there to create "foot-fall"." Most people who have any medical condition that requires prescription drugs need to pick up supplies every week, or every month, at the least. When they go into the retail store of their choice to pick up their prescription drugs, they usually end up buying other things available at the retail store. But when I started managing Costcp Pharmacy Third Party Insurance reconciliation to enable their internal department to collect every unpad penny, they became what was probably the first "loss leader" division to make a higher profit margin than any other division of the giant corporation. So much so that the CFO finally called the Head of Pharmacy, who was my contact at the client, and told him that if everyone else is asked to make 2% contribution to corporate profit, then why is he contributing 300% of the target? My client, the Head o Costco Pharmacy was order to cut drug prices even below what the Health Insurance company would reimburse, so that their contribution to corporate profits came down to the corporate standard of 2%.

But Retail Pharmacy is dominated by giant pharmacy chains, and apart from Costco Pharmacy, I was not able to get traction with the other big players who all had in-house systems for reconciliation and would not admit that they were losing 7.49% of what they could collect. 

So I started with Physician Practices. I started with just RCM, but now offer free software-as-a-service to Physician Practices including:

- teleClinics, for Virtual Private Practices for groups of indpendent doctors who may or may not also work for large hospitals.
- PracticeTracker, for Drummond-certified EHR and Practice Management, including many add-ons such as:
  - Consulting Services.
  - AR Finance to get padi instantly  rather than waiting months ofor patients or Health Insurance companies to pay what is due for healthcare that was delivered without demanding immediate cash payment.
  - Pharmaceutical analytics to ensure that drugs that interact badly are not given to a patient, depending on their medicla history

Today, with COVID-19, teleClinic is the service that is in demand that far exceeds the supply. And ours is the only one that is free, and complete with features down to collecting or financing payments.

COVID-19 is not very different from other pandemics we have faced in the past. But there is a panic, and people are staing at home, wearing masks and gloves, and economies are generally coming to a slow halt. teleClinics can solve that today. There are already experimental prevenition strategies, such as bathing with anti-fungal soap, taking anti-malarial tablets. The only treatment for those who get it seems to be a drug known as Azihromycin, which is actually incapable of killing a virus, but is effective 100% in killing a fungus or bacterial infection. Anyway, such eperimentation may take years for governments to approve and deploy. All of us need to get back to working every day from home. teleClinics are not targeted at detecting or curing COVID-19 fungal infections that are erroneously being called a virus. It is to receive ordinary care from family physicians, or specialized care for critical conditions, all while working from home.

We believe we have been 20 years ahead of the market for 20 years, so our time perhaps has come to start a real Sales and Marketing division, which we have never really needed before.

Hence we are starting with things like Social Media Interest Groups, spending on digital advertising, and hiring training agents allover the US who teach doctors how to set up the teleClinics, and help families scan their old medical records and let us convert tham to the standardized electronic health record format that all software systems off all doctors use.

The economic danger is one that is very much more serious than the medical pandemic we are facing unless we get our act together and get back to work no matter where we are physically holed up! 



  

Review by MD Tech magazine

Interview with Dr. Karun Philip It will be great if you could give me a brief background about your company as to what you do and you know, ...