Expanding Access to “Medical Intelligence”

We talked to Barry Finette of THINKMD on how everyone should have access to quality health care, and this is what he had to say.

First of all, how are you and your family doing in these COVID-19 times? 

Barry Finette: We are “pandemic” surviving – like everybody else. We live in Vermont, which has one of the lowest prevalence rates in the whole of the country by a long shot. We are lucky, much luckier than others.

Tell us about you, your career, how you founded THINKMD?

Barry Finette: I started my career out as a research scientist. I received a Ph.D. in Microbiology and Molecular Genetics. From there, I went to medical school and residency to become a board-certified pediatrician. At that point, I merged the two careers. I became a classic physician-scientist. I am an attending physician in emergency medicine and critical care, developed an extensive research program, and taught at the University of Vermont College of Medicine. I have been there for close to 32 years, and currently, I am still a Professor of Pediatrics, Microbiology, and Molecular Genetics.

Founding THINKMD came about when I decided to take a sabbatical and re-train myself and gain global health and humanitarian assistance experience. I received a Diploma of Tropical Medicine & Hygiene at the London School of Hygiene and Tropical Medicine and an International Diploma in Humanitarian Assistance from the UN Colleges and Fordham University. I spent a lot of time doing clinical healthcare capacity-building, research capacity-building, disaster assessments, and, eventually, leading disaster relief missions initially in various countries, including Bhutan, Uganda, Ethiopia, Republic of Congo, Cameroon, Togo, Benin, Jamaica, and Peru.

During this experience, a need that seemed to be universal was the fact that in low-income countries (LMICs) – and also a growing issue in high-income countries (HICs) – there is an exponential increasing shortage of professional healthcare providers, mainly doctors and quality nurses that will only be getting worse with global population growth. In most LMICs, there is only one physician to every 2 000 to 50 000 people. I was often the only physician they would ever see in their lifetime and most certainly the only pediatric specialist their children ever saw in my working areas. This was problematic and one of the main reasons that the under-five mortality in the world mainly occurs in LMICs: 99% of children under five who die are in LMICs. Often, those who are sick and require interventions are not identified appropriately because of the lack of skillsets. They do not have access to trained people who can do an integrated clinical examination, make appropriate recommendations, and follow the child’s care.

The other thing that struck me was the fact that the cell phone is universally accepted. Only a few things were widely accepted in the places I worked in: shelter, food, and cell phones. The cell phone has enormous potential for delivering information. I became fascinated with the prospect of transferring how I “think” and do clinical assessments onto a phone, making it simple to use so that anybody could use it. I realized that this could dramatically increase healthcare capacity because integrated, clinical assessments are needed to determine if somebody is sick and what treatments they may need. 

I decided to build this new logic and technology because I could not find any other person or group. All other technologies focus on case management or electronic health records (EHR) rather than clinical assessments, based on paper-based guidelines that are very complex. Other technologies are based on “binary decision trees” – a yes/no symptom algorithm, but doctors do not think this way. I wanted to transform the complicated way that physicians believe and put that onto a mobile device, using a straightforward platform for the end-user, so that anybody could do it. This is how THINKMD came about. 

How does THINKMD innovate?

Barry Finette: We look at new ways to address challenges. The core challenge that we were looking to address is how do we put into the hands of those who are not physicians physician-quality logic that they can use. And we ultimately did that, building a new sense that has never been made before, in a novel way. We tested and validated it and proved that it works well.

How the coronavirus pandemic affects your business, and how are you coping?

Barry Finette: We work in healthcare delivery, building technology to be used by healthcare implementers in primary healthcare delivery systems. Those systems were thrown into complete disarray with the coronavirus. Healthcare implementers’ ability to even think about using new technology was frozen, as the entire world faced uncertainty, and the healthcare delivery system was thrown into complete chaos. All interests and needs, appropriately so, have gone into addressing the COVID-19 pandemic. THINKMD responded by building a COVID-19-assessment tool that uses our technology, which we believe is highly effective, and delivering it to the customers that needed it.

Did you have to make difficult choices, and what are the lessons learned?

Barry Finette: Yes, we had to make tough choices, right from the beginning. One of those was considering if THINKMD needed to reduce staff to ensure that we could survive the COVID-19 pandemic while not knowing what lay ahead. We also had to decide if we wanted to commit resources to develop a COVID-19 tool without any known customers – and we decided to provide it for free, if anybody needed it, as a humanitarian offering. We had to weigh the consequences of that. We also had to make tough decisions, looking at partnerships, to push our technology out in a way that could have the most impact. 

How do you deal with stress and anxiety? How do you project yourself and THINKMD in the future?

Barry Finette: My whole career has been in a stressful and anxiety-provoking field when you look at emergency medicine and critical care of children. Compartmentalization is something that physicians learn; how to separate themselves from things. You have to be able to let things go the best you can. You also have to do things that decrease stress: get a fair amount of sleep, exercise, and eat well – those are all things that I make sure I do. And it would be best if you looked for different types of communication outlets. It also helps to stay laser-focused on the problem that you are working on so that the stress becomes secondary.

We try to plan and think about what the landscape will look like during the pandemic and after the pandemic regarding company protection. In February and March, we were already working on a strategic plan, anticipating the pandemic and how it would potentially affect us to address that.

The most challenging thing from a company perspective is everybody being separated. With a technology innovation team, closely working together is essential, but now everybody is divided, all with different stressors. Some people are separated and isolated, while others are dealing with children-related responsibilities all day while trying to work. So the separation and communication are challenging. I try to make sure that people are communicating appropriately. I also encourage people to have their videos on during calls to see each other rather than speaking to blank screens. It is also essential for the team to take breaks to not be on their computers and in “tele-meetings” all the time. 

Who are your competitors? And how do you plan to stay in the game?

Barry Finette: Some groups have been identified as competitors of ours, but I rarely agree with the comparisons. When you develop technology that addresses an issue that other people haven’t yet addressed, you don’t have competitors. There is EHR management software out there, and there is symptom checker software out there – we are neither of those, even though we are associated with them. THINKMD has developed a unique clinical “medical intelligence” platform. 

Your website? 

www.THINKMD.org