Lyle Berkowitz, CEO of KeyCare, on the VatorNews podcast

4:43 - Inefficiencies in primary care: Population health is taking a population and risk stratifying it and making sure the right people get the right type of care. The classic way to do that is a pyramid with high, medium, and low risk patients, with the upper 5% of patients representing 50% of the cost of healthcare. That's where the health systems should be focusing their time and attention, making sure those patients have quick, easy access, and have long enough periods of time with their doctors to get the care that they need without having emergencies. The medium risks are the ones who need some level of chronic care, follow up monitoring, etc. and the low risk, 50% of patients represent 5% to 10% of the cost, but they gum up the system. The idea is to automate and delegate as much of that routine work as possible because the issue is not about how to make a doctor a little more efficient in doing their current job, but instead ask what job they should be doing. 

8:27 - Virtualists: A primary care doctor in the office seeing patients is very different from a hospitalist who see patients in the hospital. Now we have a new crop of doctors, the virtualists, who can and should be seeing a high volume of patients over a period of time. The doctor in the office seeing the top of the pyramid should be seeing 10, 12, 15 patients a day at most, and they should have 30 to 45 minutes with each patient and give them the time they need to solve their complex issues, stabilize them, and hand them off to the virtualist team. The virtualist team should be able to ensure patients are getting the care they need in a hyper efficient manner. In that case, you're using automation delegation much more aggressively in coordination with a doctor in the office. So, the virtualist might take care of 20, 30, 50, or 100 patients a day by using some combination of automation and delegation. 

13:17 - KeyCare’s role: The company has its own medical group that it works with, which is focused on primary and urgent care; in some cases, it will partner with other specialty groups that also will work on its EPIC instance to provide care for these patients via the health system. A lot of what KeyCare does is help rethink how primary care can be practiced, helping health systems with access, as they have way too much demand and not enough supply. Hospitals also need to do a better job of opening up their digital front door and providing immediate access to help triage and/or treat a patient. KeyCare also transforms how they manage a population by pairing up a virtual care team with a doctor, allowing that doctor to share the care with a team.

17:41 - Barriers to offering virtual care: Doctors may offer occasional virtual care, some are building up some of their own virtual offices, but they use KeyCare because they are an asset light organization, with no physical space, overhead, or extra bureaucracy. The company is able to do it much more cost effectively than they can themselves because it's doing it at scale while health systems would need to hire people, doctors, managers, staff, and house them in some way, lots of overhead. 

32:04 - building on EPIC: EPIC has over 60% of all health systems and 75% of all ambulatory healthcare, so it puts KeyCare into the space that it wants to be. It's also the only EHR that's really set up to do what the company wants to do with an interoperability network called Care Everywhere, meaning that any patient KeyCare sees it is able to access information from any other EPIC site and vice versa. The other part of that technology is they have created a pretty mature telehealth system that allows for on demand and scheduled video visits. 

38:44 - ROI:  For an on demand urgent care visit, most patients are getting seen in under 20 minutes thanks to KeyCare. Right now, most health systems will have a multi-week wait to get in with a doctor. That decreases leakage because and decreases inappropriate ER use, so there's a benefit to the health system, because they hate leakage: they don't want patients to go anywhere else and they don't want inappropriately ER use, which is a waste of resources. It also creates loyalty and a good feeling.