Last Thursday, Vator and HP held the first of four events centered around the advances in healthcare. Taking place at HP Headquarters in Palo Alto, this event centered around the future of clinics, and how local clinics can become hip to a new generation.
Our second panel of the day focused on tech pioneers and healthcare incumbents, who shared with the assembled audience how they are re-shaping the clinical setting.
Led by moderators Archana Dubey (Global Medical Director, HP Health Centers, HP) and Bambi Francisco Roizen (Founder and CEO, Vator), the panelists included Patrick Carroll (Chief Medical Officer Healthcare Clinics, Walgreens), Nikki Sims (Director, Sutter Health Walk-in Care), Nico Arcino (Senior Director, Strategic Partnerships, Kaiser Permanente), Munjal Shah (CEO & Co-founder, Health IQ), Sean Duffy (Co-Founder & CEO, Omada Health), Neil Parikh (Senior Medical Director of Care Delivery, Oscar Health), Andy Kurtzig (CEO, JustAnswer)
The panel was filled half with tech pioneers and half with healthcare incumbents on purpose, Francisco said: to see if there’s some sort of synergy and match there.
“Doctor Carroll had mentioned that he wanted to get more into chronic care treatments, and so this question isn’t for you but more for Sean and to Andy: you’re offering a different service to cater to chronic illnesses. Do you see yourself working with a Sutter, working with a Walgreens, being on their digital shelves?” she said.
Duffy responded that would be interested in working with Walgreens and Sutter.
“In time, absolutely. We know Sutter as a customer, employees at Sutter are benefit eligible. We work with Kaiser in many, man regions, I think all, actually. We’re referred individuals and I think the exact same thing holds with Walgreens and retail clinics. Any moment where someone’s found to be a good candidate for program like Omada’s and they’re covered, we’d loved to take advantage of it. Now, to really create models that work, for that to happen we have to have sufficient market access and coverage in certain areas, because if there’s like a group of 1,000 people coming into a regional clinic or into a PCP that’s still largely free for service and only 100 of those would be reimbursed for Omada’s program, it makes it very difficult to influence at all prescription behavior or referral behavior. So, a lot of the mission, in the long arc of our company, to get the majority of insured Americans in the country in a place where we’re in their medical policy, and they can be reimbursed should they be clinical a fit. There’s actually a couple of states where we believe we’re just at the tipping point where we can start to explore these models. So that’s how a Walgreens and Omada can work together,” said Duffy.
“The other question, kind of related to that, and I’m going at Omada again, is we have seen the transition in physical therapy, for example. It’s a direct access model, people can self refer themselves for physical therapy. They’re going to OBGYNs and self refer themselves. Do you see Omada getting to that point in which people can self refer themselves to an Omada, which can be a digital therapeutics that they can actually buy off the shelf of Walgreens and be reimbursed? Are you going in that direction?” asked Dubey.
“We’re not pushing hard at it, but it’s conceivably possible. There’s a pretty good way through a risk screener that’s valid against the CDC diabetes data set to determine if you’re likely to have diabetes, and you need to determine if someone might be a good fit. So I think that as coverage evolves that would be possible. We are in a situation in the country where, if you look at pre-diabetes alone, 90 percent of people who, if you were to test their blood, and they would find out they had pre-diabetes, they actually don’t know. As much as you can pray that people are going to go to a primary care doctor and get screened, you have to find alternative ways to do that,” Duffy responded.
Francisco then asked Carroll if he could work with JustAnswer.
“I’d like you to respond to two statements, because I want to ask Andy, Walgreens wants to be on the front lines of access to care and you provide this slew of physicians. Is there a way, and I’m sure that they don’t have as many physicians as you have access to, so is there a way to work with them? And then Dr. Carroll, I’d like you to respond to whether you can work with both of these services,” she said.
Kurtzig and Carroll both responded that they’d be open to working with the other.
“I, like many people here, are big believers that healthcare is moving online, getting much more digital. Not everything but certainly telehealth and talking to a doctor is going to move more and more online and people are going to expect to get that digitally. It’s a tough business, the telehealth business. I’m sure you’ve seen lots of companies come and go in the space. We’ve been doing this for almost 15 years now and we’re not trying to be a billion dollar company in the healthcare field, we’re in other verticals, and that allows us to compete and to be really good at this one thing, and that one thing is connecting people with experts, and, in this case, doctors. We’re good at that and we’ve done all kinds of cool things to make that that efficient, both cost efficient as well as efficient for customers and for the doctors, who have chatbots and a bunch of cool things we can talk about. At the end of the day, we’re an ingredient for anybody who wants to have that thing plug into whatever else you’re doing and we don’t have ambitions of taking over the world in healthcare, we just want to do that one thing well. Happy to do that any number of ways, including being $30 on the shelf at Walgreen if that’s what it takes,” said Kurtzig.
“I point to one of our partners in the Pacific Northwest, Providence Healthcare, and what we’ve done with them is we’re working with Aaron and his group such that if you’re in Seattle you can go onto the Walgreens website and, if you’re looking to try to access care or questions on the Walgreens website, there will be a direct link right into the Swedish website and Swedish actually offers you a visit with price transparency to one of the retail clinics that’s located in Walgreens. You can also get an appointment for urgent care, you can get a home visit, or you can have a virtual visit. So we think that the virtual care is absolutely a big part of this healthcare ecosystem and our view is we want to partner with health systems such that in the MSAs that we’re in and partner with the health system, we want to provide that link from a Walgreens website with an app that’s been downloaded 50 million times right into that health system’s access points, including virtual health,” said Carroll.
Francisco then turned to Sims to and asker her weigh in on what applications and services Sutter offers and is looking for.
“We’re really finding now there are a lot of patients that don’t want to have a primary care physician, they just want to find care where it’s convenient for them, and that’s really difficult for health systems because how do they reach those same patients in a really convenient way? It’s moving more and more in that direction. So we’re trying to offer a really low price point. I think it’s difficult, insurance companies find it really challenging for us to know what we’re charging and we’re also diving into video visits and we want to collect as much payment up front so we don’t have to have debt down the road trying to serve these patients, but what happens is the insurance is to complicated they’re really looking for some sort of system that can help us understand what benefits are available to patients and what’s left on their deductible. The process to go into that is so tedious and we’re spending lots of time on websites or through that are just good enough but not really good, and they’re not incredible accurate. So, it’s a big void for us to collect any payments up front, so that’s one piece that we’ve really been looking for,” she said.
“Also, one of the things that’s great about being in a healthcare system is that we have all these opportunities to connect patients to specialty care and we don’t have to do it all, we just have to do what we do really well and I think we do that and we can focus on the consumer. But when we want the patients to stop going to the emergency room and come to the retail clinics or, if it’s a little above that and we want the go to an urgent care, how do we communicate that for consumers? I think it’s great there’s so much competition, but we’ve also created a lot of confusion for each other. Where you go when you have certain ailments and how can a technology help education our patients where they’re supposed to go. I think we can find some that can help with, especially a large health system, where we’re saying, ‘Ok, this patient’s coming in and they have these particular ailments.’ The first step for us was determining what we wanted to be when we grew up so I think we figured that out. You know, these are out metrics of care, this is the continuity that we want our patients to follow through and now it’s helping the patients navigate that now that we’ve determined what that looks like. And we’re still waiting for something to come up.”
