Norm Volsky, Director of Mobile Healthcare IT had the opportunity to interview Tim Coulter, COO of PreparedHealth. Mr. Coulter shared insights about his career in healthcare, as well as the interesting initiatives PreparedHealth is taking to help people get well faster in the comfort of their own home.
Please tell us about yourself and PreparedHealth.
My name is Tim Coulter and I’m currently the COO of PreparedHealth. I’ve been working in healthcare for the last 15 years or so. PreparedHealth was founded by my good friends, Ashish Shah and David Coyle who I met at our last company, Medicity. David was also the co-founder of Medicity and Ashish was the CTO while I ran various departments in finance, professional services, and account management.
PreparedHealth is focused on helping people get well faster and stay well longer in the comfort of their home. We believe there’s a better way to coordinate care that happens outside of the hospital, a way that empowers the patient, connects personal caregivers and care providers, and enables payers to keep their members healthier, safer and happier at home. With the enTouch Network, everyone stays connected in real-time, receiving care updates as they happen, and improving the odds a patient's in-home care will be a success. From home-based providers to hospitals and health systems to health insurance plans, we’re transforming the industry by leveraging technology and data to optimize care and improve outcomes for patients.
What led you to pursue healthcare in your career?
Like most people who work in healthcare, I was motivated to pursue this career based on a number of personal experiences. I spent most of my 8th grade year in and out of hospitals due to a bacterial infection which would lead to several open-heart surgeries. I was able to make a full recovery but would spend the next several years trying to coordinate follow-up care between a variety of specialists with the inability to share medical records. Every time I showed up at a new specialist after starting college, moving for work, etc. I would have to essentially start over. This experience initially drew me to the healthcare field and ultimately led to working at Medicity to help solve this problem – I instantly connected with the idea of using my career to not only provide for my family, but also help others solve the various inefficiencies of our healthcare system.
Fast forward about 25 years from my childhood experience and I would run into another medical scenario which connected me specifically to PreparedHealth’s mission - which was my father being diagnosed with liver disease. Trying to coordinate communication between my mom, my brother, and myself was difficult enough, but then throw in the complexity of trying to coordinate with the actual doctors, nurses, home health aides, etc. along with my dad’s confusion from his condition and we had a horrible time knowing how to help. Even just getting clarity on what the actual initial diagnosis was, was extremely difficult.
The other difficulty we experienced was knowing what options were available once the diagnosis was treated and he was being discharged from the hospital. Even though I had worked in healthcare for years, most of the post-acute world was still a mystery for me. Very quickly I had to learn the differences between home health, home care, hospice, palliative care, rehab vs skilled nursing, etc. - an experience which is common to many of us when our parents arrive at this stage of life. My dad really wanted to just go home and receive care there. Which ultimately, he has been able to do, and he is recovering wonderfully right now.
PreparedHealth focuses on how to get people well faster and stay well longer in the comfort of their homes. How do you connect with this mission?
90% of people want to age at home just like my father did. PreparedHealth’s mission is to provide a platform that allows for post-acute providers and family caregivers to work together in a way that makes this desire possible. Ashish and David formed PreparedHealth based on similar personal experiences to mine and when I reconnected with them I was extremely excited to work with them again.
What are the biggest challenges you are seeing in the industry right now?
There’s a lot of noise within healthcare right now making it challenging to get our message across. The industry is inundated with constant policy updates from Washington to every vendor shouting many of the same terms - interoperability, big data, lowered readmissions, etc. Most of the discussion is focused on the hospitals and large health systems, but there aren’t a lot of people talking about the home. We believe in the power of helping people age in the home and making the transition from hospital to home as seamless as possible, helping to make sure they don’t head back to the hospital for an unnecessary reason. With this, we’re trying to reach the post-acute providers, including home health, hospice, home care, geriatricians, skilled nursing facilities, and more. This area has historically been fragmented and lacks the data that the hospitals are just now figuring out how to use. We’re excited to empower these providers by bringing more transparency and more coordinated care.
What interesting new projects are you working on?
Our main focus is building our enTouch™ network. We’re seeing some incredible results the more it grows and the more service lines that join across the post-acute spectrum. Our home health partners like BAYADA Home Health have helped lead the way for new upstream partners with skilled nursing facilities like Genesis Powerback locations and hospitals like Centegra in Illinois. As more partners join, they are completing the care continuum and making the transition from hospital to home more coordinated. At the same time, we’re investing heavily in DINA, our digital nursing assistant. She uses data-driven AI and machine learning to push proactive care recommendations so that no patient falls through the cracks. She’s also leveraging data to help our providers make evidence-based care transitions.
What strategies do you use at PreparedHealth to retain top talent?
We are a young company that is growing quickly, so it’s a balance of putting a focus on retaining our people, not just on recruitment. We are really picky about who we bring on, and not just from a talent perspective, but from a culture fit. You spend a lot of time with your team, so make sure they are kind, genuine people that want to make a difference. We also make sure that we invest in our employees, making sure that PreparedHealth is a place you can build a career.
What exciting new trends and changes do you expect to see in the industry in the next 5 years?
Healthcare is on the cusp of making some exciting changes. It’s an old, slow moving industry that is apt for change. Artificial Intelligence is going to make a big difference across the board from diagnosis and care to care management and will help put all of the data being collected by EHRs to use in interesting ways. There will be a greater transparency and communication in healthcare including caregivers and family members being a part of the conversation. Large corporations are already joining forces to make changes in how care is paid for and delivered.
But, the biggest trend will be for healthcare to move back to the home. The growing boomer population wants to age in their home and more care providers are switching to that same mentality - they just need the tools to make it efficient and transparent.
December 15, 2017
Norm Volsky, Director of Mobile HIT interviews Adam Kaufman, President and CEO of Canary Health. Mr. Kaufman shared the mission of Canary Health, interesting trend news, and a multitude of insights from his HIT career.
Please tell us about yourself and the mission of Canary Health.
I’m an Engineer and a Health Economist who came to Digital Health out of a passion for solutions and technology-enabled services that rethink approaches and improve people’s lives; and I have a real commitment to making sure that those solutions and services work. Canary Health is the perfect place to blend my first career as an engineer with my work in economics. We’re dedicated to the mission of empowering individuals to better self-manage and to understand how their health impacts their lives. It seems like an obvious thing, but for a lot of us we don’t stop to realize that our emotions, daily habits, and relationships are impacted by having one or more chronic conditions. It’s a really exciting mission to be empowering people to have the health they need for the life they want.
What is Canary Health’s key differentiator in the industry?
Our key differentiator is our focus on helping people determine what matters to them and working towards what’s important to them. I think a lot of the industry has an important, but over-reliant belief that better data and analytics are going to solve the problem. We are certainly big believers in helping people see the trends in their data and leveraging analytics, artificial intelligence and machine learning to improve our service, but there is something missing in those processes that helps someone understand what matters to them. We are differentiated by this unique approach that comes from intellectual property developed at Stanford University around how you engage someone in their own health and support their self-management. That is our foundational approach to helping them understand how to better care for themselves and drive towards improved condition management.
What inspired you to pursue a career in healthcare?
Two reasons why healthcare is the most exciting place to think about how technology can improve people’s lives: One is that it’s a great mission to know that every day we are working on impacting people’s lives in one of the most basic ways; their health and their ability to do the things they want. Second is that the healthcare industry has lagged far behind in terms of the adoption of technology and the way that technology has disrupted the traditional service patterns. It’s an exciting place to be able to work on both a great mission and to make impact given how much opportunity there is to rethink care delivery and patient engagement.
What trends do you expect to see in the HIT industry in the next 5 years?
The most talked about trend, and I certainly agree, is Healthcare’s connection to artificial intelligence, machine learning, and the ability to now leverage data to speed the processes, feedback loops and intelligence. I think that’s really interesting. What I think is less talked about, although maybe even more impactful, is how we are finally past the early adopter stage of health technology permeating the rest of our lives. I’m particularly interested in the extensions of health into other areas of our lives – like some of the innovative work with Alexa, and the rapid adoption of monitoring devices. In the normal course of how individuals buy and shop for things, or interact with technology, health is often front and center. There have been some false starts in some of the bigger consumer technology companies into healthcare but I don’t think they’re giving up. Apple is taking another stab at it and Google is very involved, so I think that hopefully in the next 3-5 years we will start to see health as an element of our life that fits into the way we think about all the other things we’re doing.
How is your company getting into AI and Machine Learning?
We think that regardless of how great the technology is, healthcare is still a human delivered service, so a large part of our service is the technology, the experience on the app, and the experience with the devices we ship, but an important part of it is also the interaction with our coaches. We have a network of almost 90 coaches who interact with participants of our services. One of the first places we are applying AI and intelligent feedback loops is into what this coaching element. We look to help them learn about the personalities and the demographics of participants, not just whether they’re male or female, but how it all rolls up into a personality type, and how we can then help them be smarter about the way they respond to questions. Clearly there’s a lot of gain in getting the right answers, but we make the connection of who the user is as we know about them through the technology and through their consumer profile with our coaches’ engagement. We think it’s a really exciting application that can make our coaching more effective and more efficient while driving towards a more tailored and custom experience.
What interesting new projects are you working on?
A big project for us, and for us it’s the whole reason we’re here, is to further embed self-management support into condition management approaches. We see that as focusing on what matters to an individual and empowering him or her to set goals to own that process. What I mean by condition management is the more clinical element of medications, physiological measures and clinical care related to a consumer’s disease. We want to connect that experience, which is primarily a disease management experience, with the self-management experience. That’s our big push and our reason for being; to humanize those programs that historically have been too clinical and not focused enough on what matters to the individual.
Have you had a mentor or mentors throughout your career?
I have had a number of mentors. I think some mentors are people who are in your life forever and some play particular roles. My first boss at my first job out of college was just an incredible mentor professionally, but also showed at that stage how you could run a business, be friendly with the people you work with and care about them, but at the same time lead your own life, have a family and be committed to them, and be committed to other elements. He was such an important mentor because he was a good example of how to make a successful professional career fit with a successful life. My advisor in grad school was incredibly important for helping me think about some of the more intellectual challenges, and the Chairman of the Board at my previous company is someone that I deeply respect and continue to look to for guidance. And in addition to bosses, a number of colleagues have been incredibly mentors. I have also had an executive coach off and on for a decade and that has been incredibly valuable as well. I think sometimes we can use the word mentor too hierarchically and would encourage a broader perspective.
What strategies do you use at Canary Health to attract and retain top talent?
The easy answer is we do what everyone else would say; we make sure compensation is competitive and work towards ensuring delight in our team’s roles. I think that’s table stakes. For us we focus on a culture and approach of real transparency; we are incredibly honest with people as we’re hiring them. We’ll openly discuss topics around our corporate trajectory and growth for example.
This, for example, has been very valuable in Digital Health to level set expectations that might be brought from consumer technology companies around the pace of growth. I have stressed with candidates that if they’re here for a quick win in terms of equity liquidation, we’re not the right place. We’ve lost some candidates to folks who are seeking more of the Silicon Valley cycle, but it has allowed us to attract great people who are aligned with our mission and aligned with our approach to focusing on impact and growth at the same time.
Participant Engagement in your program are at high levels and a 90% satisfaction rate. What do you attribute this success to?
We take design very seriously and we take the user journey very seriously. We put participants at the center to decide what they want to commit to and what matters to them. Our design philosophy is about them first. We never make a recommendation; we give tips or examples but really everything participants are doing is something they’ve committed to. It’s all about them inside of a framework of support, tools, coaching, and nudging that we know they need to be successful but they’re the ones setting the way it works. On top of that, our cultural honesty permeates the way we act with our participants. Our service is not a single transaction, so it’s about engaging folks long term. We’re honest with them about how fast we think things will happen, and honest with them about what they need to put in to get there. The participants know what to expect and that helps keep them engaged.
What do you believe are the traits and qualities of a great leader?
I think I would start by saying I don’t know if I know. I think leadership evolves. What people need evolves and different qualities are needed at different stages of a company so I don’t think there’s a single answer. It depends on the situation and depends on what was promised to the people you’re leading. It comes back to authenticity; it’s different in each setting. Leadership in a video game company would be different than if you’re a coach of a sports team, and different than in our business. Our team, extended team and participants know we believe what we are saying, and we’re clear about it. That’s really critical.
Your LinkedIn profile mentions that you are active in a number of organizations with a primary focus on defining and measuring the health and economic impact of technology. What steps are you taking to achieve this within your organization?
That passion and commitment comes from my graduate work. My PHD is in Health Economics and Health Program Evaluation. To me, it’s a commitment to rigor around evidence. We’re about building long-term sustainable impact, while also building a big company. This takes time. We could fool ourselves in the short run, but eventually it’s going to catch up to us and there’s no long-term value in that. To say we’re data driven is easy, but what is harder is building the culture data and insights that matter. Some of the ways we do this are simple – like closing not only our financials, but participant engagement milestones regularly and with rigor and holding a weekly meeting that is attended by the whole senior team and all team leaders to review, look for correlations and drive upcoming behavior. We also work with our clients to match the outcomes we have in our programs with what they’re collecting, which allows us to connect the participant experience to utilization and expense. The third thing we do is build rigorous clinical trials, often with our academic partner. For example, our colleagues at Stanford and Anthem have run a major trial in which they’re looking at clinical outcomes and utilization, and they’re doing it in a very rigorous way because they are committed to publishing the information out to the public.
What advice would you give professionals looking to break into the HIT industry?
The biggest piece of advice I would give is that it is very multidisciplinary. HIT is often, although not exclusively, not deep foundational technology, but it’s technology that needs to be utilized and integrated with clinical care. For a technologist, having some sense of the business case and use cases is helpful and for the business side to know how technology is utilized and where it goes. Just within our company we’ve got clinicians, designers, product people, and economists. Because HIT is still an emerging field, there’s no core curriculum just yet – I think we’re getting closer, so you cannot just train yourself for just that. Being open to the reality that we are still figuring out how these different disciplines fit together is going to be critical for anyone who wants to get into HIT.
November 13, 2017
Brenda Schmidt, Founder/CEO of Solera Health, recently spoke with Norm Volsky, Director of Mobile Healthcare IT about her company, goals, trends in the HIT industry, and much more as a part of our Thought Leader Interview series.
Please tell us about yourself and the company you founded, Solera Health.
I started my career in Science, receiving a Bachelor’s degree in Microbiology and a Master’s degree in Immunology, and then flipped over to Business. I worked for Baxter Healthcare for about 15 years, the last 6 of which I was responsible for the Clinical Nutrition Market in Latin America. I really wanted to break out of a large company and start something on my own, so I looked around at where the market was going in the early 2000s when health management was going high tech, high reach. I thought there was a real opportunity to impact the health of service workers who didn’t have a computer and required more of a community-based focus. I bootstrapped a company, Viridian Health Management, for about 10 years and the experiences with Viridian led me to Solera’s business model. Solera has created a new category as a preventative care benefits manager. We connect individuals to non-medical prevention, coping and support services that meet people’s unique needs and preferences, paid by their health insurance company. We have initially focused on the Diabetes Prevention Program to prove our business model.
What was your motivation to start Solera Health?
I purpose-built Solera’s business model through several experiences at Viridian that identified the need for a marketplace or integrator in healthcare for non-medical services, delivered by community organizations and digital health solutions paid through medical claims. At Viridian, we focused on employee health management for organizations that had very diverse employee populations. These employers required a creative approach to monitoring the health and productivity of their employees, primarily through program delivery by local community resources that delivered evidence-based, culturally competent programs, which was unique in the market in the early 2000s. After that, we won a large CDC population health demonstration project that leveraged community resources to deliver evidence-programs as a health management strategy for small and mid-sized employers. We then worked with a national retail pharmacy chain to manage patients with multiple chronic conditions, referred from a local accountable care organization, to keep them compliant with their care plan between their doctor visits. Based on these three experiences we realized that there was a real need and opportunity for a technology platform and business model that could connect patients, health plans, and physicians with non-medical prevention, coping and support services, delivered by digital health solutions or community organizations, that could impact cost and quality through a high-access, low cost network. That was the motivation for Solera. I pivoted the business model from Viridian Health Management and purpose-built Solera’s business model to address that market need.
What inspired you to pursue a career in healthcare?
I was always interested in Science in high school and in college, getting my degree in Microbiology. Disruptive companies in genetics and tech were starting to enter the market. I thought there would be growth in careers focused on genetics or microbiology, and I applied for a position as a microbiologist. I’m pretty outgoing and I remember the guy in the lab saying, “this job is not for you.” After that, I thought about medical school but got my Master’s degree in Immunology partly because my parents said I either needed a job or I would have to come back home. I didn’t have a job and I didn’t want to go back home, so I went to Grad school. At the end of my Master’s I realized I didn’t want to get my PhD and spend my career in research. I wanted to go out and see if I could make a difference in healthcare through product, technology and innovation. My first job out of Grad school was as a Pharmaceutical Sales Rep and that was probably much better suited for my personality. After a few years in sales, I joined Baxter Healthcare and had a variety of roles in Global Marketing, Product Management, and Quality. Those experiences in a world-class company served me well when I started my own company. From the very beginning, the vision was to create an innovative company that solved a big healthcare problem with a culture of compliance and quality as opposed to a technology – driven company that develops a product and then looks for a buyer. Solera purpose-built our business model to solve a problem with a large financial impact for payers. This has led to Solera’s quick market adoption and growth.
What are your goals for Solera Health in the next 5 years?
Five years from now I want Solera to be a global platform for integrating non-medical services into medical care at a lower cost to improve quality of care. As a first step, Solera chose to integrate the hundreds of Diabetes Prevention Program providers to prove our business model - that health plans would see the value of non-medical providers to prevent and better manage their members, and would pay for non-medical services delivered by community organizations and digital health solutions. The Diabetes Prevention Program was the first prevention program that we launched in an ecosystem that includes prevention, coping and support. Solera’s technology platform supports value-based non-medical network designed to keep people compliant with their care plan between doctor visits by connecting them to an ecosystem of community and digital providers. Solera guides each patient to the “best fit” program provider based on their unique needs and preferences. For example, a physician might tell a patient to lose a few pounds, eat healthy and exercise more and then send them out into a world where that’s not very easy. Solera can help the patient by matching them to a program, paid for by their insurance company, where they live, work, play, pray and shop and provide them the needed resources whether that’s prevention programs or social support, resilience, sleep or healthcare related social supports. All of those things have a direct positive impact on healthcare costs, but they’re not appropriate services to provide within the four walls of a clinical setting.
What trends do you expect to see in the HIT industry in the next 5 years?
A trend we are already seeing is market consolidation of digital apps. There are hundreds of apps, and individual point solutions have a difficult time gaining traction with payers and employers who are looking for single-source platforms. The other trend we’ve seen is collaboration among a wide variety of stakeholders to integrate their various technology and digital solutions into a patient-focused strategy where those things, in concert, can provide holistic care to a patient. In general, people are realizing that a single technology is not going to solve an end-to-end problem in healthcare, so collaborative partnerships and integrated technologies help streamline both the contracting process and the patient experience. Another trend is that demonstrated clinical effectiveness is becoming more and more important. Payors want proof that these things work in broad populations, and certainly, the FDA is moving in that direction around pre-certification of digital apps. Another trend is just the recognition that human interaction and accountability is an important driver of behavior change, and that digital apps that use data and even provide feedback using artificial intelligence haven’t shown that they can drive sustainable behavior change. We have seen several hybrid models where content delivery and data collection can happen digitally, but when you want to provide effective support for sustainable behavior changes, we believe that takes human interaction, accountability and motivational interviewing - which is very difficult to do with technology.
What interesting new projects are you working on?
We looked at all the reasons why our business model was successful for the Diabetes Prevention program. There were 3 key factors that drove the success of our business model. The first was a highly fragmented set of program delivery providers that required integration into a network. The second was the need for a standard set of quality metrics across a disparate group of program providers to document quality, performance and outcomes. Third, we look for programs where there could be an engagement strategy dependent on consumer choice. Even though many program providers may be delivering the same program or addressing the same problem, the intervention methodology and patient experience can be very different. Solera is like Match.com for non-medical service providers - we match people to the program provider that best meets their unique needs and preferences. The delivery modality could be telephonic, telehealth, digital, online, community, in person, group, or individual. There are several different variables that can impact a person’s success. Because behavior change is so personal, it is important to meet people where they are and provide programs and program providers for them where they feel that they’ll be most successful. As the business model has expanded beyond Diabetes Prevention to other non-medical services such as sleep, resilience, tobacco cessation, and healthcare related social support, we look more like Expedia.com when you think about a wide variety of different types of programs and services that we can bundle together. For example, if your trip includes a car, a hotel and a flight, in our world that might be diabetes prevention, stress and a food prescription as a custom bundle for each person from among our variety of programs and services that’s unique to each person. That analogy makes a lot of sense for our technology platform and the business we’re building. The next market we are launching is an integrated network of sleep and resilience program providers. There are so many different digital apps addressing sleep and stress management that deliver their programs in very different ways that there is even more of an opportunity to identify and match people with a program that meets their needs than diabetes prevention. Improved sleep and resilience also have a direct clinical correlation with obesity and chronic disease. As we’ve talked to employers, consultants, plans and even the providers and vendors in our network, most agree that our model makes sense. If Solera can identify the people that are the “best fit” for each one of our network providers, it benefits both the program provider and the patient. We have dozens of solution providers in our network. They are not competitive with each other, even when providing the same program, because they don’t want the most people using their app or program, they want the people who are going to be most successful using that app and program. If Solera can help make that match, it benefits everybody.
You are the President of the Council for Diabetes Prevention and the Board of the Arizona Bioindustry Association. What new initiatives are you accomplishing on these boards?
Each board has very different missions. Here in Arizona, there’s a recognition that Phoenix and Tucson have the assets to support and fuel an innovation economy and become a medical and technology innovation hub. The Arizona BioIndustry Association was critical in pushing the angel Investment tax credit through the legislature, paving the way for tax breaks for people investing in young entrepreneurial companies. The organization is a catalyst for bringing capital to Arizona life sciences and healthcare technology companies, and supporting technology transfer to commercialize the innovative technologies being developed at our state Universities. The group is also creating collaborative partnerships with the Arizona Technology Council and other economic development stakeholders to attract companies to Arizona, making sure that we have adequate talent and socializing the assets that can support a vibrant start-up community.
The other organization that I’m very passionate about is the Council for Diabetes Prevention, a new non-profit that was started just about a year ago at a Congressional briefing. The Council was created with the recognition that the Diabetes Prevention Program was going to become a required preventive benefit for all Medicare members. The program is delivered by highly fragmented community-based organizations and digital health solutions that didn’t have an advocacy voice in Washington. The Council provided the opportunity for these providers and other diabetes prevention stakeholders to come together, share best practices, and establish quality metrics for program delivery for the industry. They also needed an organization to advocate on behalf of non-medical providers that could deliver these evidence-based programs in a quality way without licensure, credential, or certification. We now have almost 100 Council members, an independent 5-member board. The Council is very active in advocacy and working with CMS and CDC to ensure the effective implementation and administration of the DPP. It was fun to be involved in something from the very beginning that could make a big difference in a new national benefit.
As an accomplished healthcare entrepreneur, what advice do you have for up and coming entrepreneurs?
Breaking through the noise in healthcare is really hard. There are literally hundreds of healthcare startups pitching to the same buyer. When introducing a disruptive technology or new product, it is important to focus on the problem you are solving, and the industry will look to you to solve it. Grow through thought leadership and clinical evidence as opposed to marketing. It is also important to identify and sell to the person who is financially motivated to buy your solution to solve a problem that impacts their bottom line. Health Plans and employers are very fatigued with point solutions and are looking for platforms that offer an integrated solution or end-to end patient experience. There are certainly a lot of problems to solve in healthcare but I think the other important strategy is collaboration. There isn’t a single company that has an end-to-end solution for payers. A good strategy for new market entrants is to partner with a more established company that already has clients and revenue. Find partners where your solution helps them add more value to their existing client base as a way to gain revenue and traction to avoid the very long sales cycles. This has been an effective strategy for benefit integration platforms and consumer engagement companies. Once the new company has established credibility as a partner to one of these larger organizations, it’s easier for them to sell directly to payors and scale their businesses
What drives you to succeed?
I just really want to make a difference. When I leave the house in the morning I tell my husband, “I’m going out to change the world one pre-diabetic patient at a time.” We just did a series of testimonial videos for people who have participated in the Diabetes Prevention Program that highlighted their journeys. Solera has made a difference in people’s lives even though we don’t deliver any of these programs. Sometimes I play these videos to focus on our mission because it is a privilege to have the opportunity to make a real difference in someone’s life, and it is very motivating. There is a tremendous opportunity to scale non-medical programs delivered in communities and the world can’t move fast enough for me to scale prevention and support programs and services that I believe can transform healthcare. I see such a huge opportunity to impact patients outside of clinical settings. While I am focused on innovative business models to transform healthcare to improve costs and quality, it really comes down to helping individuals improve their health. The personal stories of people struggling to improve their health and the feedback that we have made it a little easier for them drives me to do more.
What strategies do you use at Solera Health to retain top talent?
I have purpose-built a mission-driven organization with a great corporate culture. Solera benchmarks our corporate culture against industry and national benchmarks, which we exceed in all categories. We recently won the “Best Places to Work” award in Phoenix. We also hire self-driven people and then give them the freedom to excel. I have a no-jerks rule, a rule to not have stupid rules, and we really focus on mastery, autonomy and purpose in a collaborative environment. Solera is a very mission-driven organization and it’s important to me that everyone can tie their job with both the business objectives but also the purpose of the organization. Corporate culture and focusing on the importance of our culture has really helped us attract and retain top talent. People want to work here. We consistently get inbound inquiries about coming to work for us because people believe in our mission and believe that we can make a difference.
How has government regulation and policy affected your niche in the healthcare industry?
Government regulation was the driver for us selecting the Diabetes Prevention Program as our initial market and product. The Centers for Disease Control was authorized by Congress back in 2010 to scale the Diabetes Prevention Program. The CDC built an infrastructure of community organizations using non-clinical providers as trained Lifestyle Coaches who were delivering the program through grant funding. The CDC developed a standardized curriculum that was public domain and established quality and fidelity metrics for the program. That standardization and CDC oversight made it a good market for us to start because we could assure our health plan clients that we had a quality delivery network as opposed to Solera curating our own network. The Center for Disease Control has an existing infrastructure and framework. We saw a line of sight on reimbursement for two reasons, the first being that the US Preventative Services Task Force made a recommendation that the Diabetes Prevention Program was the Gold Standard to address cardiovascular risk reduction. It became a mandate for health plans to cover cardiovascular risk reduction through a 12-month intensive lifestyle program that really wasn’t applicable to deliver by higher-cost clinical providers. The second reason was the Diabetes Prevention Program was being evaluated by the Centers for Medicare and Medicaid Services Innovation Center as an expanded model. We anticipated that the Diabetes Prevention Program would become a covered Medicare preventive benefit around the 2017-2018 timeframe. Back in 2013 we knew it was an interesting market for us to enter based on regulation and prove our business model, and not have to go to health plans and ask them to cover services without documented impact and outcomes. The health plans felt that they had to cover the DPP and we provided a business model that made it very easy for them to administer and offer the program to their members and employers.
When did you feel that this business model was going to be a success and you were solving the problem you set out to solve?
A very meaningful moment for me was the day we reached out to health plan members to inform them of the Diabetes Prevention Program as a new health benefit. We could actually watch and see the statistics of people matching and enrolling in the Diabetes Prevention Program. We celebrated the number of people who may not become diabetic. We’ve enrolled more people in the Diabetes Prevention Program in 2017 than the entire industry has enrolled combined over the previous 4 years, so we have solved for consumer engagement and scale. This is tens of thousands of people who may now not get diabetes. It’s really thrilling to see our model and technology working.
October 10, 2017
Norman Volsky, Director of Mobile Healthcare IT recently had the pleasure of interviewing Justin Kahn, Founder/CEO of TruClinic for a Thought Leader Interview. Justin shares the interesting background of his career and the inspiration behind TruClinic, as well as industry insights, advice for young entrepreneurs, and more.
Please tell us about yourself.
My name is Justin Kahn, I’m 39 years old. I have had multiple careers in my life – I’ve been a Realtor, a Natural Disaster Claims Adjuster and for the past seven years, I have been the Founder and CEO of TruClinic.
Give us some background on TruClinic, why you started the company, and the mission behind it.
I joke around and say telehealth chose me, which is kind of true. When I was young I got hit in the head with a baseball bat during a softball game. I suffered a traumatic brain injury and was misdiagnosed with Post Traumatic Stress Disorder for over a decade. When I was in my late 20s, I had a seizure that scared me into seeking out the help of a neurologist who discovered, after working with her over a period of time, that I had TLE (Temporal Lobe Epilepsy). She put me on an anti-seizure medication and it changed my life almost overnight. I used to suffer from anxiety and panic attacks and those went away after I started this medication. As a side note, I grew up around the VA hospital system. My stepfather was an administrator for the VA so we lived on the grounds of different hospitals growing up as a kid. I knew what the infrastructure was like at the VA and knew some of the problems they had as it related to behavioral healthcare in particular. In 2008, I happened to read a transcript of a speech that Robert Gates had given to the graduating class of West Point and he talked about how the DOD was going to start investing billions of dollars into the PTSD epidemic that had been plaguing the branches of the military. That article resonated with me because growing up, I always wanted a doctor to see these panic and anxiety attacks I was having in real time instead of trying to explain what had happened weeks later in the doctor’s office. When I read that article and started to think about the infrastructure at the VA, I came up with an idea, really thinking about what I wanted for myself and how that might apply to the VA. My idea was to connect active duty troops with VA providers from the troops’ home state at the beginning of their service career. When the troops graduated from training, they would be deployed and assigned with a group of providers from the VA. During deployment, they would be able to meet with those providers through a secure video conference and the idea was that it would be outside of the military, but not outside of the DOD. The hope was that the troops would be comfortable engaging with the VA providers while they were deployed so when they transitioned to a veteran status, they would already have those relationships established and would continue to engage those providers, and more importantly, they would get used to the technology. The video technology piece is important because close to 40% of veterans live in rural and frontier counties in the US. I took this whole idea to the Salt Lake VA, and they liked it. The VA said if we could produce the technology we were proposing, then they would give us a grant. Less than a year later, we brought the BETA version of the technology in for a pilot in which relaxation exercises were taught to a test group of veterans using the technology. They measured the retention rate against the control group, which did not use technology, and they had phenomenal success with the test group. That led us to apply for grants with Utah Valley University and also from the Governor’s Office of Utah to finish building out the first version of the platform. We also used grants to do a couple of projects with the Goshute Native American tribe, one of the most rurally isolated tribes in the continental United States. Our success with the Goshutes led us to get the seed capital for the company, which was really the beginning of TruClinic and how we started off to the races.
As an accomplished, young entrepreneur, with several awards to back that, what advice would you give to up and coming entrepreneurs?
Don’t quit. Take criticism, feedback, advice, and learn from people who have been through the experience. Take their advice with a grain of salt and don’t be afraid to make decisions. The best piece of advice anyone ever gave me outside of my father is “the only wrong decision is indecision. You can either act, react, or do nothing, but you do it consciously.”
What drives you to succeed?
Success is an unattainable target; an ongoing goal. I love what I do because I am capable of doing it. I am always working towards the never-ending definition of what success could be. In my opinion, success can only be measured against the happiness one feels in their day to day activities.
What interesting new projects are you working on?
The stuff we are really interested in right now is machine learning. With the launch of our new version 3 platform we have much more robust capabilities around gathering and analyzing data and using that in a way that actually provides real ROI back to our customers. The first movers in telehealth as it relates to machine learning and AI are around patient triage and common symptoms, deciding whether or not individuals need to go to the doctor or if this is something that could be handled through an algorithm. This is the place to start and is one of the low-hanging fruits, but when you start really thinking about predictive analytics, clinical decision support and longitudinal data and what that means in terms of not only helping to streamline efficiency, but also to improve patient outcomes- that’s one of the things that really interests me personally as we think about how telehealth moves into the next iteration. My team and I think of that as virtual health where you’re unifying the experience between what happens inside of the four walls and outside in the real world.
What challenges do you currently see in the healthcare IT industry?
It’s the wild west in a lot of ways, but there’s also a lot of noise. As one of my mentors would say, “there’s a lot of sizzle but not a lot of sirloin.” The first wave of telehealth was the direct-to-consumer and specialist consults. The second wave was the platform play, and now there are a variety of different technologies to choose from. Video is a commodity, and now there are a lot of single use, tactile solutions out there that are limiting in how they can be applied to different use cases and workflows. Frankly, I feel bad for hospital and health systems and even the smaller mom and pop clinics and practices. The challenge they face when it comes to picking a vendor and building a strategy is that they may spend millions of dollars with a platform or provider services organization and then hit the proverbial wall with what they can do with it. What that has led to is organizations buying multiple overlapping and sometimes redundant solutions in order to fill the different use cases or work flows they’re trying to support as it relates to telehealth, and it becomes cumbersome, unruly, and unmanageable especially in large organizations. That’s why TruClinic is winning customers. We are seeing customers who have invested into those platforms and transitioned over to us, and we have also seen new customer entrants in the market coming straight to us because of the solutions and the services we provide and the partnerships we have created with our customers.
Have you had a mentor(s) throughout your career?
I collect mentors. I am only as smart as the people I surround myself with. I make it a point to engage and meet people by going out for coffee, learning, asking questions, and posing scenarios. I find that is one of the most effective ways for me to gain perspective and insight and to help me in how I think about the challenges or problems that I’m faced with.
What strategies do you use at TruClinic to retain top talent?
We are a big family here at TruClinic. Every person that I work with is someone that is part of the culture, and part of the fabric. We all support each other and we all make sure that we are helping each other in carrying the load. We all have our own domain expertise so we collaborate internally as a team as well as externally with our customers. I think that a focus on collaboration and team dynamic allows for the most constructive work program. We also use other strategies; For example, our engineers are not allowed in the corporate office unless they’re specifically here for a meeting. Otherwise they’re home, in a coffee shop or wherever their safe space is for programming. We do that because there is this component of what is called context switching – to have an engineer be in a mindset and be developing and have to switch, attend a meeting, or phone call then come back to programming, it’s difficult to do. We are an agile shop, so we decided that engineers work their own time, they have to be on certain calls or meetings for check-ins, and stay in constant communication. Everything we do is written, but I don’t care if engineers code at 2 AM or 2 in the afternoon as long as they get the work done. We have an understanding of different teams and different dynamics, and how they work and when they need to be available. We try to build the culture where, following the Netflix model, we don’t care when the work gets done as long as it gets done, and it is quality work, and on time. From a CEO perspective, the trick is to treat your team like a family, listen to the concerns and suggestions they have, and build the culture and team at the same time.
You received your B.A. in International Economics, and B.S. in Political Science and Government. What led you to pursue healthcare?
Originally, I thought I wanted to be a lawyer working on international infrastructure projects. That’s where I thought my career would go in college. Instead, my career went a different way. I came out of school, got a sales job, did some consulting and learned real estate because it was interesting to me and that was the direction my life went for the better part of a decade. I knew that being a Real Estate Agent wasn’t something I wanted to do for the rest of my life. It was more the fact that it gave me a lot of flexibility in terms of trying to figure out what I did want to do with my life. A real estate commission can be significant, so being a real estate agent and a claims adjuster gave me the ability to save money and invest it. When I made the decision that I wanted to pursue TruClinic, I self-funded the company for the first 2 years and did that based on the commissions I was making. This all led into what we, as a company have been able to do. Like I said before, I am only as smart as the people I surround myself with and everyone on this team has been an integral part of the company. Their knowledge, background, expertise and their experience have all help shape the vision and the direction and the strategy of this company.
What trade shows are you looking forward to attending in the near future?
I’ll be heading to the Gartner IT Symposium, the Conex Event in Dallas, HIMSS, ATA, AHA, SPS, and ISM. We do a decent amount of shows and speaking.
June 6, 2017
Norm Volsky, Director of Mobile HIT at DRI recently had the chance to interview Evie Jennes, President & Chief Commercial Officer, swyMed. Evie shared information about swyMed, their latest solutions, her career, and insights into the telemedicine industry.
Tell us a little bit about yourself and swyMed.
As the President and Chief Commercial Officer, I am ultimately responsible for the sales, partnerships and marketing direction at swyMed. When it comes to working with a company, I am particularly attracted to young organizations that need to grow. I also love to travel and have been working internationally for more than 20 years including 7 years in Eastern Europe and more specifically, Russia. My time there included working at a number of start-ups in that region as well as for larger multi-nationals in the early 1990’s. In terms of my career, I have spent about half of my time in Healthcare, and the other half in FMCG, VC Funding, and various manufacturing projects.
As far as swyMed goes, a major barrier for telemedicine to date has been the bandwidth, or I should say the lack thereof. More specifically, there is simply often not enough, in both rural and urban settings, to reliably conduct video encounters for real-time telemedicine outside the four walls of a hospital. At swyMed our whole business was built around solving this problem. We believe that we have addressed these issues head on with our truly unique video software which has a patented data transport protocol that overcomes latency, and our latest solution, the DOT Telemedicine Backpack, which leverages this software. Between the two technologies, we are able to deliver reliable connectivity, and a video encounter from basically anywhere which is a huge differentiator in the market.
What is swyMed’s key differentiator in the Telemedicine market?
I think what people need to realize, and they slowly are as telemedicine moves outside of the hospital, is that even if you are the most sophisticated telemedicine vendor in the marketplace, with the most robust virtual care platform, if the end user doesn’t have the bandwidth to reliably conduct video encounters outside of a hospital or clinic, the technology is limited. When we founded swyMed, we made the decision to focus specifically on providing the necessary solutions to make telemedicine possible in rural areas as well as urban areas with congested networks. Today, our patented data transport protocol allows users to get around traditional networking challenges, to deliver on-demand video telemedicine encounters in even the most rural and remote locations, where they need telemedicine the most. Day in and day out we work with our clients offering a Mobile Integrated Healthcare solution that enables them to reach places and patients where it was never before possible.
Tell us about your DOT Telemedicine Backpack.
The DOT Telemedicine Backpack is swyMed’s most recent and largest product launch to date, which we scheduled around this year’s HIMSS 2017 conference. The offering is the industry’s first lightweight, mobile telemedicine solution that truly gives care providers the ability to connect to doctors for real-time video encounters-- anytime, anywhere, even in the most remote areas, or on the go. Truly, a “Doc-on Tap.”
For example, say you live in a rural area where communications infrastructure is limited or in a city where networks get congested -- telemedicine will likely be challenging, potentially having a significant impact on the speed and quality of care and ultimately outcomes. Not to mention it is extremely frustrating not to be able to connect when we want to. We have likely all experienced this with our home internet, Skype, FaceTime, etc. But in this situation, these challenges can ultimately lead to care-givers choosing to forgo using the telemedicine technology they have, which in turn limits care.
Armed with swyMed’s DOT Telemedicine Backpack, users can now leverage even the faintest whiff of a network signal and elevate it to a level where high quality, reliable, virtual care is possible regardless of location or infrastructure challenges. And for the areas that have zero networks, we have satellite built in, thus offering a connection literally everywhere on earth. The DOT Telemedicine Backpack is an ideal solution for mobile telestroke programs, community paramedicine, remote triage, disaster response, and critical transport as it extends the reach of providers and care-givers.
What are the biggest challenges on your plate right now?
As a leader at a young company, driving visibility and sales of our software and the DOT Telemedicine Backpack will of course remain a top priority for me throughout 2017. One of the biggest challenges right now is that our prospective customers need to find a way to pay for the DOT Telemedicine Backpack. The excitement around the DOT Telemedicine Backpack is palpable in virtually every meeting we have. Our customers very quickly see the many challenges we solve, but purse strings remain tied, and budgets tight. Health systems need to change the dynamic in how they view the price for our (and other) solutions. It would be helpful if the ROI, which in our case is quite significant, was weighed against the initial investment in the DOT Telemedicine Backpack a bit more. It is being done, but not consistently as of yet. We as an industry need to continue educating our customers on how we are ultimately saving them money and improving patient outcomes.
The pace of telemedicine adoption can also be a challenge. The industry recognizes the obvious benefits and value that telehealth brings to care, but these findings need to be backed up by legislative changes that reimburse for telemedicine visits. The good news is that every day telemedicine is growing in terms of reach and impact, and with this success we do see some movement on that front. We hope to see that trend continuing.
Other than ATA, what conferences and trade shows do you attend?
Besides ATA, HIMSS is another big event for us obviously as it’s the biggest healthcare IT show of the year. We also make the EMS State of the Sciences Conference (dubbed by media as "A Gathering of Eagles") a priority as it has become one of the most progressive and important EMS conferences nationally. Given our business model, the emergency management community is a top target for us so it’s great to be able to be part of the conversation related to the most cutting-edge information and advances in EMS patient care.
In the coming year we will also focus on particular states that would be best served by our solution and attend conferences there.
How do you manage your geographically dispersed team?
We get asked this question a lot despite all the technology we have at our disposal today, many people still feel as though you should be in the same room or same building to be successful. At swyMed we challenge this belief by having a team that’s dispersed over two continents. And it works because first and foremost we have colleagues that work exceedingly well together. I have been part of many organizations and this is one of the absolute best teams, if not the best, that I have been a member of. We complement each other’s skill sets, we are completely frank with each other so there are no politics, and we genuiunely really like each other as people, which is so important. We also use our own video software platform for weekly management meetings, sales meetings, and spontaneous meetings. The technology allows us to still have the ‘watercooler chat’, but on video vs. in person. Then of course we do see each other at customer visits, conferences, etc., which is always fun, and fruitful.
On your LinkedIn page, you mention having the entrepreneurial spirit. Since this isn't something you are taught, how did you develop it within yourself?
I think that I was born with an entrepreneurial spirit and it was then encouraged by my parents, and especially my father. I was the kid with the lemonade stand, who was canvassing the neighborhood for babysitting jobs until I turned 16 and could get a ‘real’ job.
The seven years I spent in Russia and other Eastern European countries really developed my ‘entrepreneurial spirit’ as it was the ‘Wild, Wild East’. If you were not creative with problem solving, resourceful, and entrepreneurial you were not going to make it even with large multi-nationals budgets.
What are the traits or qualities of a great leader?
I managed fairly large groups of people when working for multi-nationals and this is when I developed my management skills. As a leader I had a few rules that served me well and I still follow them today. Hire people that are smarter than you are, ask good questions, and listen to the answers. Treat the people you work with, and those that work for you with respect. The people that work for you should feel and know that you have their back. Do what is ‘right’ even if in the short term it is not in your best interest.
May 8, 2017
By Norm Volsky, Director of Mobile HIT
As an executive search consultant in the Healthcare IT space, it is my job to be able to identify emerging technology companies that are poised for significant growth. Since I am specifically focused on Mobile Technology and Telehealth, I have plenty of companies from which to choose. I do research daily and during my discussions with industry thought leaders, I make it a point to ask them what companies in the space they find intriguing and unique. I feel it is my job as a member of this industry to share this knowledge/information with my network so that you could be exposed to these organizations too.
Below are companies I have had my eye on all year that I met with in person at ATA to learn more about their story and vision.
TruClinic- Cloud-based Telemedicine platform that easily connects patients and providers inside their existing workflow. Their hardware agnostic approach enables their customers to launch a telemedicine program with zero capital expense. TruClinic allows patients to schedule appointments and pay bills online to enhance the patient experience. TruClinic is also focused on improving clinician satisfaction and reduce the total cost of healthcare which is perfectly geared towards the value-based care model. Security of the platform is unparalleled being compliant with: HIPAA, HITECH, COPPA, PIPEDA & SSAE 16-II. Simply put, TruClinic helps increase accessibility to healthcare by providing a consistent patient experience regardless of the modality of care delivery, whether traditional face-to-face or virtual.
Pera Health- Clinical Surveillance solution that identifies at risk patients using predictive modeling and real time vital sign data. The founders created an algorithm called the Rothman index that uses Vital Signs, Lab Results and Nursing Assessments. Pera Health’s solution reduces Alarm Fatigue, the number of False Positives, Code Blues, unplanned ICU transfers and Sepsis Mortality. In January, the company raised $14M in funding. Pera Health helped both Houston Methodist and Yale New Haven to reduce their mortality rate 30% in nine months and twelve months respectively.
Cloudbreak- Originally a remote interpretation service company that was founded 14 years ago. Since then, they have transitioned to not only provide interpretations services in over 200+ languages but to also provide telemedicine capabilities to its over 650+ hospital customers. Cloudbreak facilitates over 70,000 interpretations monthly. This unique platform allows doctors to be able to bring in an interpreter and a specialist anywhere in the world onto a tele-consult with a patient to provide world class care.
Grand Rounds- Enables patients to get World Class second opinions by leveraging telemedicine. They have been able to attract some of the world’s top specialists on the platform by exposing them to the most complex and intellectually stimulating cases. Grand Rounds helps its customers improve employee/patient satisfaction, reduce absenteeism and improve clinical outcomes by giving their employees/patients access to the top specialists in the country. Grand Rounds now has 50 state coverage and recently just opened their Maine office.
Fitango Health- Care Management and Patient Engagement vendor helping its customers move towards value-based care. Their HIPAA compliant solution enables all the stakeholders to communicate including: Care Managers, Care Givers, Providers, Network Managers, the Patient and their family. Fitango’s approach is preventative in nature and is geared towards the post-acute setting. The goal is to reduce readmissions and improve adherence to the patient’s care plan.
Azalea Health- EHR, PM and RCM vendor that uniquely has telehealth imbedded into the EMR which solves the reimbursement issue. The solution suite includes patient portal and scheduling capabilities. Due to the fact that many of Azalea’s customers are Rural, there was a need for telehealth which gives physicians access to additional patients.
Cohero Health- Chronic Disease Management app focused on Asthma and COPD. Cohero’s mission is to transform respiratory care through smart mobile devices to enable real time monitoring and adherence. By leveraging Cohero’s devices that send patient data via the cloud, Nurses, Pharmacists and Pulmonologists can intervene when necessary when a patient is at risk. The solutions Cohero provides allow the patient and their care team to monitor the use of their inhaler (both daily use and emergency) and test for lung capacity.
Sensely- Developed a nurse avatar powered by AI named Molly that communicates with patients via their mobile device. The disruptive platform was built to improve the patient experience by focusing on empathy and clinical support. All the data collected is sent to the patient’s clinician so they can monitor risk factors and adjust clinical protocol. Sensely raised $8M in series B funding. Sensely already works with the Mayo Clinic and is launching a program with NHS in the UK.
Carena- Carena is a software-based virtual care provider for health systems. Carena started as a primary care house call service in 2000 and has since evolved into a telemedicine company. Carena works with more than 120 hospitals including Ascension, Catholic Health Initiatives, and University of Washington Medicine. They focus on helping health systems get better connected to consumers in their local markets by providing an easy and convenient way to access the health system anytime, anywhere, and navigate cases more appropriate for virtual care out of the ED and urgent care. Carena works with hospitals and health systems to supplement the services they have and resell the virtual care product to employers and health plans—not competing with the health system by taking patients away (like some telemedicine companies do that work with Health Plans and Employers).
Wellpepper- Patient Engagement platform that improves patient satisfaction, clinical outcomes and access. Wellpepper completed a Parkinson’s study at Boston University and the patients saw a 9% increase in mobility compared to a 12% reduction in the control group. They also have research studies with Harvard, Brandeis and UW Medicine. Their CEO, Anne Weiler was asked to speak at ATA on a panel for Tele-rehab for total joint replacement recovery.
Vivify Health- Remote Patient Monitoring Platform helping move the industry toward value-based care. Helping its patients manage their chronic disease, Vivify is one of the leaders in mobile population health management. In 2016, Vivify not only signed UPMC as a customer, but the health system also participated in their recent $17M Series B investment round. Vivify, along with Iron Bow Technologies were awarded a $258M telehealth contract by the VA in 2017.
Avizia- Robust end-to-end telehealth solution suite that connects any doctor to any patient at any time. Avizia as a company has made it their mission to advance healthcare by helping all patients have the ability to get top quality healthcare regardless of their location or situation. In October of 2016, Avizia wrapped up a $18M Series A funding round led by NY Presbyterian and Northwell Health.
Zipnosis- Provides its customer a significant ROI which has been proven to convert 25% of patients from the telemedicine platform to in person customers with an average spend of $3K per year. The providers that were using the Zipnosis platform met guideline adherence up to 95%. Key customers include: Baylor Scott and White, UCLA Health and Mission Health.
Medici- Created WhatsApp for healthcare with an emphasis on user experience. Medici built a business platform for providers to communicate HIPAA compliantly with their patients. While attending SXSW, they had 1500+ app downloads and 17% of people did a consult using the app which is unheard of in the telemedicine space. The text, phone and video capabilities allow for seamless communication, e-prescribing and referrals. Providers can also bill via the app which caters to patients with high deductible plans. Medici is launching in South Africa in May and is looking to expand their international footprint.
I remember going to this show three years ago in Baltimore and I am amazed at how much the industry has moved towards being software focused. The software vendors are definitely trending up as they had the largest and shiniest booths. I always come back amazed at how passionate and innovative this industry is as a whole. All of the companies above are helping drive change towards value based care and I feel so lucky to be able work in this industry every day.
Director of Mobile HIT
Direct Recruiters, Inc.