Q. How do you keep it fresh, how do you keep growing and keep up with the need to be disruptive?

A. Healthcare is so frustrating; it’s enough to put piss in your vinegar. I really feel if we don’t, I wonder who will. It’s been allowed to be so atrophied for so long. I don’t think there’s any problem with me remaining motivated. This is a very Gen Y employee base, and they’re looking for a cause. Religion is kind of not as important to people as it used to be. War has been professionalized – even protesting against war has been professionalized. So, there’s no great cause to throw yourself at, and athena and liberating health information and making healthcare less humiliating is a cause that resonates. I have no problem getting people excited, and staying excited myself.

Q. What keeps you up at night?

A. When I can’t sleep at night it’s the scratching sound of a doctor’s pen on a contract or old fashioned software because they bought an EMR or a Cerner system or whatever because they didn’t know they had an alternative, and they thought they had to buy something because of meaningful use or whatever else. So that’s what is terrifying – it’s that idea of doing all this work, but not getting enough market share to get network effect. And then actually dying irrelevant because we didn’t get the network built. I feel like I’m in a race against time and irrelevance and incompetence.