As a boy, Bush watched Emergency! on television and was captivated by the romance and seeming magic of saving lives. As an adult, he found the reality of medicine to be very different: There wasn't much humanity in the way health care was actually delivered. Believing that he'd be daunted by the course work required for a medical degree, he decided to take an entrepreneurial route to improving the system. His first sense of the opportunity came while he was driving an ambulance in New Orleans one summer during college. Some patients with chronic disease who couldn't afford their medicines would repeatedly call the ambulance to take them to a hospital where they could be stabilized. What if the ambulance itself were outfitted with treatments for the five most common chronic diseases and carried EMTs who were trained to use them? Those patients could be treated in place, at a radically lower cost than what the hospital would charge. That idea didn't work out, and Bush moved on to think about a network of maternity clinics. He and Todd Park drew up a business plan at Harvard Business School--one that was "unbelievably complicated to execute and very risky." But in the process of pursuing it, they created websites for the paperwork with rules that prevented mistakes. That was the seed for athenahealth, which today supports electronic medical records and a suite of practice management and care coordination services, leaving doctors free to spend more time with their patients.
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