At Vator Splash Health on Thursday, Vator CEO Bambi Francisco sat down with Owen Tripp, co-founder and CEO of Grand Rounds, an employer-based solution that gives employees and their families better technology, information and support they need to make healthcare choices.
During their conversation, Francisco asked him how he was able to match the right physicians to the right patient.
"What were some of the minimum viable product traits that you looked at to start ranking?" she asked, as well as some of the traits that Grand Rounds discovered through the data collected.
"This is, literally, the $3 trillion question," Tripp responded.
"We think of doctors as major consumers of the economic dollars of healthcare, but the reality is they are paid less than 20 percent of the overall healthcare picture in the United States. But, they drive the remaining 80 percent. So, they are responsible for recommending devices or not, they are responsible for recommending surgeries or not, hospitalization or not, you get it. So, the match that you make with your doctor, as a patient, and to the person who is underwriting care, paying for the care, that is the most important, most profound moment in the entire journey, is that match," he said.
"It was clear to us, starting in 2013, that we needed a way to scale this to understand the practice patterns, the expertise and the outcomes, of all 770,000 doctors that practice in the United States, which is a really hard problem."
The company poured $100 million into solving that problem, so that the company can tell a patient on an insurance network, who is looking for an answer on a specific clinical thing, "we are going to match you with someone who is going to be exceptional. That they will have demonstrated outcomes, that they will have demonstrated clinical judgment, that they will be well trained, well positioned to do that."
This is a big problem since, right now: most doctor profile pages, 60 to 70 percent of the clinical interests that are listed, the doctor actually hasn't treated anyone with those conditions in years, Tripp said.
"As a patient, you are massively outgunned in that fight. You don't know that, and the doctor that was referring you probably knows enough doctors to know that this is an orthopedist, but they're not likely to know that that guy or gal is super expert in knee surgery. For a primary care doctor to maintain that graph of doctors in their head is impossible. They'd have to know the names of 1,000 doctors, and then they'd have to graph on top of it: where are they located, and are they taking new patients? And do they accept the insurance that the patient has? It's an impossible information problem."
Grand Rounds gets their information from 7.5 billion commercial claims annually that it is processing. It also uses patient medical records, while also surveying patients and other doctors. Patient loyalty, turnover rate, clinical experience and hospital readmissions are some of the other aspects the company looks at.
"We get a really crisp picture of, given a specific need, is that doctor going to deliver?"