Month: October 2022

The macro trends driving the growth of digital health funding are still in place

Season 4: Episode #137

Podcast with Jacob Effron, Principal, Redpoint Ventures

"The macro trends driving the growth of digital health funding are still in place"

paddy Hosted by Paddy Padmanabhan
To receive regular updates 

In this episode, Jacob Effron, Principal at Redpoint Ventures, discusses the venture capital (VC) environment for digital health. Redpoint Ventures is a venture capital firm focused on investments in seed, early, and growth-stage companies and has been investing in the healthcare tech landscape for the last decade.

Jacob believes that the fundamental trends driving the growth of digital health are in place. However, later-stage companies looking to raise additional capital may experience some uncertainty in the short term. He also talks about the demand environment for Redpoint’s portfolio companies and his advice to founders looking to navigate the health system space. Take a listen.

Our Podcast Partners:

Show Notes

00:32Jacob, tell us about Redpoint Ventures and your role.
02:56 Give us your State of the Union on where we are with digital health, especially the younger companies.
05:24Have you changed focus considering what's happening in the macro environment? Are you investing more in one stage versus another?
06:52What are you hearing from the startup entrepreneurs and the founders about the demand environment, their operations, the talent etc.?
10:10What are you hearing from the market about the demand environment for digital health solutions?
11:43 You mentioned value-based care and how startups now must get creative about demonstrating value, taking on risk, and being able to put more money at risk to earn the right to a seat at the table. Tell us how that's playing out.
16:07What do you think of the policy environment? Are there things that you would like to see in the near term that could make a difference to the picture?
18:34What are some of the core attributes you seek before you begin funding one of these startups?
21:43The competitive landscape for the startups today has big tech---Amazon, Microsoft, Google, Apple---coming into the core healthcare services space. What’s your take on what this means for smaller companies?
24:04What's your take on what to expect for 2023 and what are you advising your followers?

About our guest

Jacob Effron is an investor at Redpoint Ventures specializing in digital heath. He's an operator-turned-investor, having worked as a product leader at Flatiron Health before going into VC in 2019. Jacob’s background as an operator grants him firsthand knowledge of the pain points that health techs go through. He also regularly shares his thoughts on the digital health industry and how he’s approaching his investments on his Substack, Vital Signs with >2K subscribers including many CEOs and industry veterans.

Jacob Effron is an investor at Redpoint Ventures specializing in digital heath. He's an operator-turned-investor, having worked as a product leader at Flatiron Health before going into VC in 2019. Jacob’s background as an operator grants him firsthand knowledge of the pain points that health techs go through. He also regularly shares his thoughts on the digital health industry and how he’s approaching his investments on his Substack, Vital Signs with >2K subscribers including many CEOs and industry veterans.

Q. Jacob, tell us a little about your firm and your role there. 

Jacob: I’ll start with Redpoint and then, give a bit of background on myself. Redpoint is fund, and kind of a classic Silicon Valley venture firm. We’ve been around since the late nineties and the heritage of the fund’s really on the side of enterprise software, data infrastructure, and other categories. So, think companies like Stripe, Snowflake, Twilio and HashiCorp and Ramp. But in the last decade, we’ve gone into health care in a big way so, it’s actually about a quarter of our fund, now. 

The way we think about it is really in bringing the best of enterprise software, data tools, consumer experience, fintech etc. that we’ve come to expect in every other part of our lives into health care. As a firm, we’ve invested in companies like Cityblock Health, Galileo Health, Strive Health, AcuityMD, Garner Health, and hims —a whole host of a really exciting companies. That’s where I spend my time. 

In terms of my background, I joined the health care policy side in college. Then, I started my career at McKinsey working with state Medicaid agencies, payors, providers, and pharma companies. Subsequently, I went over to Flatiron Health, which was doing Big Data for Cancer treatment to help start a new business line there. Eventually, I joined the product team and helped build workflow tools for Cancer centers we worked with. After we got acquired (by Roche), I switched over to the venture side and have been at Redpoint for the last two and a half years. 

Q. With regard to the digital health landscape, we’ve moved from celebrating the blow out funding numbers for startups here to a blowing up of some of these companies. Give us your State of the Union on where we are with digital health. 

Jacob: One of the interesting parts of being at a firm that invests in health care tech is, you get perspective on what’s happening across spaces that venture capital firms invest in. 

There are a series of later stage companies that raised rounds last year when the market was roaring and people thought good times were exclusively ahead. Now that the public markets have really corrected in every space—in software, fintech, and health care—a lot of people don’t know what these later stage health care companies are worth. 

What that means is—and I’ll bifurcate what’s happening in digital health investing right now to early stage and later stage—on the later stage side, there’s just a bit of confusion as to what these companies are worth. People are waiting to see that. With the public markets moving around so much, there aren’t that many health care companies that are public, so, there aren’t that many examples to point to that are analogous to a lot of these startups. In that environment of confusion, folks may be a little bit reticent to invest in some of those later stage health care companies. A lot of the later stage companies are then, facing a period of uncertainty. 

One has to make sure you’ve got runway to see it through to greener times. The overarching theme then, is like all the macros that are driving health care and this is really relevant to the early stage. They’re still there. None of that’s changed because of the current environment. That’s not like last year when the health care cost curve was going up a ton. This year, it’s suddenly flattened. Last year, there was a need for technology and providers, payers, pharma, and that’s suddenly changed. So, all the thematic reasons that make digital health really interesting are still there. 

However, I don’t think the market’s changed dramatically for early-stage companies and really, for strong teams, and going after interesting problems. It’s really these later stage companies where there’s just uncertainty about how they should be priced. 

Q. Have you changed focus in light of what’s happening in the macro environment? Are you investing more in one stage versus another, now? How’s your firm looking at this? 

Jacob: We’ve retained focus on the same stage, throughout. Certainly, there are opportunities across the board and the saying, “No one knows how to price some of these growth rounds” is interesting. They’re actually becoming interesting opportunities. 

There are some great later stage health care companies that are in the private markets that maybe were planning to IPO and now, isn’t really a great time to do that. There continue to be more interesting opportunities across the board but it’s just that maybe last year those deals were priced at a certain price and now they’re not pricing at that level. 

Q. What are you hearing from the entrepreneurs and the founders running these companies about the demand environment, their operations, the talent etc.? 

Jacob: There’s a lot there so maybe I’ll start with the talent side. 

There’s an interesting opportunity on the talent side for digital health where in the past, maybe large tech companies have been able to pay salaries that dwarf what any digital health company can pay. So, anytime you’ve got this inflection in the market as a whole, it’s like an interesting dislocation where it forces people to reconsider, “Oh! I thought I had all these options and I thought they were going to be worth so much money that I had golden handcuffs and I was going to stay at this, at Facebook forever.” Now, people are rethinking that. 

One trend I’ve seen across the board is that folks want to do more mission-driven work that’s meaningful to them. I talk to people all the time and they’re like, “I want to go into health care or climate.” So that’s where they want to spend time and for a while it’s actually a really interesting talent market. 

Across the board, in our portfolio companies, we’re seeing incredible engineers, product people that maybe are using this current environment as a inflection point to think about, “Okay, what do I want to do with this next stage of my career?” On the talent side, I hope to see this continued influx of folks into the digital health space, which is really interesting. 

On the customer side, I guess a classic investor thing that has always made people interested in health care is that it is in many ways countercyclical. There’s this fear in software at large right now that like all these startups sell to other startups. And the second the music stops, there aren’t as many startups out there like all these companies.

Actually, in health care, a lot of our customers and companies sell to large employers, hospital systems, or pharma companies and certainly, there’s a tightening of the belt across the board. But again, back to the original point, the problems haven’t changed. If anything, you have some companies that actually make for really interesting inflection points. For instance, we have one portfolio company, Garner Health, that focuses on helping employers lower the cost of care and improve the member experience. That’s actually even more relevant in this current environment. They have a lot of folks that are seeing the premium costs for next year and saying, “In this economic environment especially, that’s something we really want to tackle.” 

Q. With regard to the enterprises—health plans or health systems—what are you hearing from the market about the demand environment for digital health solutions? 

Jacob: It’s interesting that on the health system side, maybe if you were to bucket different kinds of solutions, there’s stuff that feels like, “Hey! This is a point solution that just does, a very specific thing or, seems cool like a cool algorithm or a cool tool.” But it doesn’t really have an ROI or that’s unclear, still TBD (to be decided). 

We’ve always been reticent to invest in some of that and in this environment, you’re really going to see a bifurcation of tools that are broad in scope, that can really be partners for systems at a much larger level, along with tools that have clinical and financial studies behind them and proof points in case studies with other systems that they work. You do find the best but in this current environment, it’s a really hard time for systems right now. 

When you approach a system to talk about specific clinical applications in one department that maybe has some clinical validity, it’s about how much time you get relative to the person that’s like, “Hey! I understand the staffing challenges you have and here’s something that we’re building around that.” Or “Let’s talk about revenue cycle.” Or “Let’s talk about patient engagement and keeping folks within your system.” Or “Let’s talk about some of these new, value-based models you may be moving into.” 

The current environment forces a prioritization. That’s always been there because it’s always hard to sell to these systems and payers if you’re not one of their top two or three priorities. 

Q. You mentioned value-based care and so let’s talk about how startups now have to get creative about demonstrating value, taking on risk, and being able to put more money at risk in order to earn the right to a seat at the table. Tell us how that’s playing out. 

Jacob: There’s an increasing trend of startups moving from a fee for service world to actually taking on risk for the services they provide. In some ways, it’s the ultimate kind of confidence in your own model to say, “We’re not just showing you a pretty slide that says this thing saves money. We’re so confident it does that we’re willing to go at risk for that.” A few trends that happened have really enabled that. 

The first is, a lot of this stuff follows government policy. There’s been a lot of government policies over the past decade and even more in the last two, three years that have created these interesting models that startups can then, opt into. A lot of times the government creates these models—first, it was ACOs, then, these kidney choice models, and now, direct contracting and easier reaching. They just announced the enhanced Oncology model. So, there’s a whole host of these different models the government introduces, but then private payers also latch on to you. All this it creates an interesting opportunity for startups to provide care in a different way. 

If you think about what a lot of these companies want to do anyway, they want to provide a higher touch, better consumer experience type care, and these payment models enable them to do that. So, there’s a lot of promise in these kinds of businesses. There are early proof points as seen through companies like Validate, Know Street that have demonstrated really interesting outcomes both, clinical and cost related. So, a lot of folks will look at those companies and at their valuations, the way that Oak Street, Agilent, and Validate Health are all valued. They’ll say, “That seems, in a way, like we can do things that are in line with how we want to provide care and also stay financially lucrative.” 

Q. Healthcare is very good at following the money and notwithstanding all the excitement about alternate payment models, value-based care, and risk based, the vast majority of health care payments still go through some model. Do these models work better perhaps for employers but maybe not as much for health systems? Is there a nuance there worth thinking about? 

Jacob: A few thoughts on that. One, as you well know, healthcare is just so massive that all these worlds can coexist and still be really big. You’ve got Oak Street, which, depending on the day is a $5-6 billion company or a ChenMed—All these things that people talk about have done a wonderful job and created a lot of enterprise value but they touch less than one percent of Medicare patients. And there are still massive businesses. 

Then, you have the systems that are more in the fee for service world. I totally agree with the point that almost all payments in the system world are on the fee for service side now. It’s obviously been slower to move to value based than maybe some of the independent physicians and groups, but both worlds can coexist and still be pretty large for the time being. 

I do think it’s a really good point that on the system side, there are a lot of people that come in and they say, “Oh! We’re going to sell value-based care and do something that really works in those models.” However, in these challenging times for systems, you can’t go into a room pitching someone and talking about something that’s not one of the top two or three things they’re thinking about. A lot of times when we talk to early-stage companies, we encourage them that they’re going to do something in the value-based world where a lot of the innovation is really happening. 

Q. What do you think of the policy environment? Are there one or two things that you would like to see or do you anticipate in the near term that could make a difference to the picture? 

Jacob: On the value-based care side, the big policy question is whether any of these models are going to be made mandatory at some point. If I think about how they’ve evolved, basically about how these benchmarks get set up, how much should it cost to take care of a population etc., it’s a median or an average. 

As you can imagine, companies are very good at saying, “Well, you’re in the top quartile of practices. So, if you don’t lift a finger or change anything, you will do better in this model than you were doing in the status quo, because it was set at the median.” So, you have a lot of practices that were in that top quartile saying, “Great, the value-based care sounds awesome.” It’s a real way for health care to move to a different payment model. 

What you’ve seen though, is some of those practices that maybe would or most need to transform. There’s no incentive or even a reason for them to opt in to some of these models. Therefore, the big question is it’s politically difficult. I don’t envy the policymakers that have to do this. But, are these models going to have a little bit of teeth in them where you start pushing people to make the transition? As long as you make it optional there will be some subset of folks that think they’ll be better off in this kind of a future world than they are today. 

Q. What are some of the core attributes you seek before you begin funding one of these startups? 

Jacob: Sometimes a fresh perspective can be helpful but obviously, one needs to have a lot of humility with the U.S. healthcare system. So, we really focus on a combination of things. 

First, if someone’s just like a learning machine—because health care is endlessly nuanced and weird, there are those that love that weirdness or find it interesting—and asks, why something is the case or the way it is. It’s really hard to successfully build in the space and we get really excited by folks that have been inventorying surgery centers for three months for example. But they’ve possibly already uncovered something in that research. They’re just more fluent in that space than just about anyone you talk to. 

Then, there’s a sort of humility like, “Hey! There’s a lot that we don’t know,” which entails bringing the right folks around the table. So, if you’re a technologist, bring in someone that’s an M.D., or someone who has a lot of experience in whatever it is you’re doing. Form that team right on. 

But the one thing that gets me super excited about a lot of the companies we invest in is they’re starting to be like this interesting second generation of founders where essentially, they were tech people, then, they moved into a first wave health care startup like Oscar or Flatiron or HIMMS or any of these companies that were really popular from 2013 to 2019. Then, they went on to form their health care startups. 

That’s just incredibly exciting because those people are great technologists. They have all the stuff you’d want in the traditional software world, but they’re not brand new to healthcare. They ran provider networks at Oscar or they did something that was in the weeds in health care but they know the space really well. That kind of archetype of entrepreneur is really exciting. The more you know and the more folks that come into digital health, the higher the chances of that kind of second wave. 

Q. The competitive landscape for the startups today has big tech—Amazon, Microsoft, Google, Apple—coming into the core healthcare services space. What’s your take on what this means for smaller companies?

Jacob: It’s not something that we spend a lot of time thinking about. The hardest part is that the health systems are hurting. How do you get your solution to matter for that health system and simultaneously, have nothing to do with the competitive landscape? Do you have a product that’s compelling enough to go through all the hurdles that are required to get something adopted? 

As I think about the role of big tech, the Lord knows the pie is big enough in health care and there is a lot of technology that needs to be introduced here so, if we just start moving toward there being more solutions, I think, there’s plenty of pie. 

But if I were to reflect on the role of big tech in health care today, there’s definitely a lot of pieces that are interesting or that folks are trying out. However, I wouldn’t say any of the big tech companies have really figured out how to have an at-scale impact on health care. Amazon One is a great example—they tried to build their own business and they ended up acquiring One Medical that had come from the startup world. In some sense, it’s always good to have more smart technologists working on the problem. 

From a startup perspective, these are potential acquirers. That’s great as they want to do more in health care. But it’s not like we don’t have companies that go head-to-head with pitching against Google, for instance. I think a lot of that problem, for both the big tech companies and the startups, is much more about figuring out. How do you figure out a product that really has resonance for the startups? If we get really good at that, we’ll get to a world in which there’s a lot of direct competition between them. 

Q. One very unique aspect about the competitive landscape is the dominance of electronic health record platforms. 

Jacob: We do think a lot about Epic. Epic is probably the most relevant to the world of selling into health systems than Google, Microsoft, or Amazon. 

Q. How about the macro environment? This year has been an interesting one—interest rates continue to rise, inflation continues to be high, and the demand environment is uncertain. What’s your advice to founders for 2023?

Jacob: I’m certainly not an economist so I will not pretend to have the kind of prescient macro take. But I would say, obviously there’s a range of things that might happen next year. The advice that we always give is, there’s many ways things could go. 

I think next year could have many of the same struggles that this year has. So, we tell our entrepreneurs that they must be ready. If the world starts booming again, great. They can always adjust, accelerate hiring, and change things around. But they may want to plan for what is somewhat a likely case, which is that things don’t get a ton better next year. 

Luckily, we worked with a lot of our companies to make sure they’re well capitalized and can navigate that because I don’t think anybody knows whether things will go down or stay flat, and you just want to be prepared for whatever those circumstances are. 

Q. What’s your firm’s outlook? 

Jacob: We’re very actively investing. We just sent two term sheets in the last few weeks. As a firm, I believe, a lot of the best companies get built in downturns. So, we’re back to where we started. None of the macro trends have changed. Yes, this is like a macro economy change for the time being, but like the things that got us excited about health care a year or three ago, if anything, they’re more exacerbated in this type of environment. The opportunities are very much still there, people just need to figure out on a later stage side, what are things actually worth. 

We hope you enjoyed this podcast. Subscribe to our podcast series at  www.thebigunlock.com and write to us atinfo@thebigunlock.com

Disclaimer: This Q&A has been derived from the podcast transcript and has been edited for readability and clarity.

About the host

Paddy is the co-author of Healthcare Digital Transformation – How Consumerism, Technology and Pandemic are Accelerating the Future (Taylor & Francis, Aug 2020), along with Edward W. Marx. Paddy is also the author of the best-selling book The Big Unlock – Harnessing Data and Growing Digital Health Businesses in a Value-based Care Era (Archway Publishing, 2017). He is the host of the highly subscribed The Big Unlock podcast on digital transformation in healthcare featuring C-level executives from the healthcare and technology sectors. He is widely published and has a by-lined column in CIO Magazine and other respected industry publications.

Digital health is about applying data in a smart way into interactive user experiences

Season 4: Episode #136

Podcast with Russ Thomas, Chief Executive Officer, Availity

"Digital health is about applying data in a smart way into interactive user experiences"

paddy Hosted by Paddy Padmanabhan
To receive regular updates 

In this episode, Russ Thomas, Chief Executive Office of Availity, discusses their core business of clinical and claims data to drive better healthcare outcomes and reduce costs. Availity optimizes information exchange between two of the most critical stakeholders in the healthcare ecosystem – health plans and providers – through a single, secure network.

Russ talks about their recent acquisition of Diameter Health to standardize the unstructured data to automate clinical workflow, make it available to the right people at the right time, create a better healthcare system, and ultimately drive better healthcare outcomes. He also offers thoughts on the digital health landscape. Take a Listen.

Our Podcast Partners:

Show Notes

00:13How would you describe the current state of digital health?
03:17 About medical data, is EHR data specifically, also part of the datasets covered?
04:53Is there a HIPAA consideration here? What would be the top considerations when it comes to exchange of data?
11:18You mentioned prior authorization as one of the biggest friction points in healthcare. What is the competitive landscape looks like for you?
12:48Can you share a couple of use cases coming out of the Diameter Health acquisition that enhances the value of your business?
17:02 What about the health outcomes? What is the role of your data set and platform?
20:27Digital transformation of healthcare data and analytics is super important in all of this. Do you work with digital health startups? How do you enable them? What should they know about you?
27:14There’s the emergence of a lot of data consortiums – Truveta, HIEs, etc. What are your thoughts on the market right now?

About our guest

Russ Thomas is the Chief Executive Officer of Availity. His vision helped to diversify Availity’s solutions and grow its customer base, creating the foundation for the expansive Availity network that exists today. Combined, the enterprise now delivers healthcare business solutions to a growing network that connects more than 1,000,000 physicians and allied care providers, 2,700 hospitals, and more than 600 technology partners with health plans nationwide. Under Thomas’s leadership, Availity is leading the charge in provider engagement and empowering health care professionals to improve results.

Russ Thomas is the Chief Executive Officer of Availity. His vision helped to diversify Availity’s solutions and grow its customer base, creating the foundation for the expansive Availity network that exists today. Combined, the enterprise now delivers healthcare business solutions to a growing network that connects more than 1,000,000 physicians and allied care providers, 2,700 hospitals, and more than 600 technology partners with health plans nationwide. Under Thomas’s leadership, Availity is leading the charge in provider engagement and empowering health care professionals to improve results.


Q. Russ, tell us a little about Availity.

Russ: The company’s been around for 21 years now, so, we’re two decades old. We have been in healthcare technology since arguably before it was termed healthcare tech.

At our core, we connect health plans and providers for their business transactions and enable data exchange so they can run their respective businesses more efficiently. What that means in practical terms is that we’ve got two million providers on one side of our two-sided network, and on the other side, we have every health plan. Between them then, we transact roughly 13 billion transactions a year, including claims.

If you look at the aggregate claims and value their network, it’d be claims around USD 2.5 trillion billed through the Availity network on an annual basis. So, there’s a lot of economic and business activity between two of the critical stakeholders in the health care ecosystem. We see a lot of things paying off now.

Q. Availity sits in the middle so neither party really gets to see the other’s data, but eventually has the ability to use the data in ways that create business value for both sides. Is that correct?

Russ: Who owns what is I guess core to that question. So, a provider would say, “When we create a claim, the work that goes into the creation of that claim is our work. So that is our data.”

We send that data through Availity to the health plans. They receive it in the form of a claim. The payer would then say, that at that point the claim becomes theirs and so does the corresponding remittance or response. But then again, when the provider gets that back in their system, now suddenly, that’s their data.

We don’t typically get into the debate around who owns what between health plans, providers. Generally speaking, I think the industry has been fairly practical about these ownership rights when it comes to business workflows. It’s been more focused on getting the workflow automated than haggling over data rights in the context of “Is it claims data? Is it medical data? Who owns it?”

Q. With regard to medical data, is EHR data specifically, also part of the datasets covered?

Russ: Historically, we’ve been moving almost purely administrative data. However, over the last several years, we’ve begun to move more and more medical data which is what we use generically for clinical data in various forms ACT, CCD and variety of formats.

A little over a month ago, we closed on the acquisition of Diameter Health, and we’re very excited about that. If people think that structured X12 data is very standardized — unless you work with it every day wherein you realize that it’s not really as standardized as previously thought – they must see one payer implementation. They’re all different when it comes to clinical data given it’s still very much the Wild West in terms of how data is facilitated, created, transacted, named, or even identified. There’s still a lot of opportunity to provide a structure around clinical data so that it can be used and automated into workflows, which is where we are. We’re very much focused on that.

Q. Is there a HIPAA consideration here? What would be one or two top considerations when it comes to this kind of exchange of data?

Russ: It plays a bit to our strategy. We’ve never sold data and we have a lot of claims data. While remittance data and a lot of very valuable data flows through our networks, we’ve always felt that it’s better to be a trusted data steward than a data broker. So, just like any firm that resembles ours, we take secure information along with security, and privacy, very seriously.

The fact that we have not been in the business of selling data has enabled us to strengthen trust with both sides of the equation — payers and providers — which we think is going to let us create some interesting use cases for data in that business workflow.

But to your specific question, you have just your core underlying concern of “Let’s make sure the data about the right person is going to the right person at the right time.” Our network, like any health care network, is constantly under some form of assault by people trying to breach it or get into it. So, we spend a small fortune on information security and privacy.

Beyond that, it’s about where you’re going. Once you move from those standard business transactions, which everybody opts into to how do you really use that clinical data to create a better health care system, then, you’ve got to be super careful about data rights, both in terms of the payer, provider, and patient who some would say ultimately, owns all the data.

Q. With regard to your recent acquisition, what does Diameter Health bring to the table?

Russ: I’ll use a few analogies to explain this. There’s considerable clinical data being mined out there in the market, many aggregators, and data collection sources as well drilling for oil so to speak, in this case, drilling for data. What we’ve noticed missing is, the ability to take that raw crude and turn it into a usable fuel.

Diameter Health is the data refinery that receives data from a variety of sources. They don’t actually have endpoints into provider systems to gather any data so are wholly dependent upon their customers to create those endpoints. That’s one synergy they have with Availity, which creates endpoints for data all day, every day.

Diameter Health pulls that data in from all these disparate sources and refines it to a particular client’s standard whether that client is a payer, an HIE, works in the government sector, etc. They have a variety of different customers with use cases for clinical data to drive better health outcomes and enable cost reductions, everything we want to see happen.

However, given how fragmented this data is, our ability to automate its flow into a utilization management system or a care management, encounters gaps making it hard to achieve the required scale. Diameter Health applies their tech to raw data and upcycles or standardizes it to create a structure by applying clinical knowledge to the data. Clinicians at Availity — nurse practitioners and Pharm Ds– work on these data structures so that when we flow it back to the end user client, it can be pushed into an automated workflow.

Q. Have you started tapping into individual data?

Russ: We’ve never had a direct-to-consumer strategy because we’re direct-to-provider and the providers ultimately source a lot of the data that the health plans need and vice versa. A direct-to-consumer strategy then, feels like a pretty big lift and one that, frankly, for the use cases that we are bringing to life, includes a lot of patterns. There are many low hanging fruit. To automate workflows like authorization, care management etc., the data required by the plans lies in the provider systems so, that’s where we’re really focused on data capture.

Q. You mention authorization and that’s one of the biggest friction points in healthcare. What is the competitive landscape like for you?

Russ: In that particular one and in others where you have the payer partnering with Epic, we serve as the gateway for the payers that have been identified. We’re big fans of automation, whether it comes in an Epic system or any other application, so we help automate data and workflows.

That said, the biggest pain point between providers and health plans today, is one that frankly has not been solved at scale. I really like what Epic’s doing with the Epic Payer Platform and driving all the automation there. That’s going to be an important source. Frankly, we’ll be a catalyst for a lot of other innovation around over the next few years.

Q. Can you share a couple of use cases coming out of the Diameter acquisition that enhances the value of your business?

Russ: Let’s start with Auth because I really have very personal reasons for wanting to solve the Auth problem. I just think it’s bad not only for business but also, for patient care. Any time a patient’s left standing at a doctor’s front desk waiting for an Auth to be approved, that is not good for patient care. That, to me, is one great example of where even though we’ve got some great tech that’s being applied to the Auth problem itself, you still have to empower data in a consistent, logical way so that it can be transacted into the payer system. One of our helpline partners is Elevance. And to that point, even they’re right. You’ve got to be able to push the data into their systems in a consistent and automated way.

One example of where we will put the Diameter technology to work is upcycling that clinical data that gets used in a Auth UM workflow both, for Auth determination as well as ultimately, the second phase of that process, which is medical necessity determination. If you can get an Auth and still not have medical necessity approved, you have got to have a way to pull that clinical data into the system so that you’re solving both problems at once. So, starting Auth is a great example of that.

I’ll bucket it under the general heading of chart retrieval, for various purposes. Today, the chart retrieval process is still a very manual process with thousands of people sitting in the bowels of health systems looking at paper records all day and scanning them into some OCR system and then, pushing them through. Ultimately, the plan is not to look for that entire medical record. They’re looking for data elements that are in that medical record to approve whatever it may be right for, whether it’s a medical necessity determination, etc. That’s another area where we think there’s just a ton of room with what we’re doing with Diameter Health to bring that data to life.

Everyone knows the data is there but it’s how you bring it to life in an automated way that needs to be seen. One of the comments I was going to make about Elevance is, there’s a lot of really smart people there, but one, in particular, who uses the term “auto adjudication” instead of just “automation.” He talks about auto adjudication in context not just of claims but everything from provider directory data. When a provider updates a piece of demographic data, how do you auto adjudicate that all the way through the planning system to clinical data? It’s a great example as well of getting clinical data and being able to then, auto adjudicate that through whatever multitude of systems the plan may need. That is where we think the real value of Diameter Health is and where you can start to really prove ROI. We know the large costs entailed when a human has to intervene in a chart review. So, that’s a couple of great examples of how we’re going to do it.

Q. What about the other side — health outcomes? What is the role of your data set and platform?

Russ: I love the idea of bringing disparate data sources to life around total care management but the one thing that frustrates me about the U.S. health care system is, it’s by and large, a reactive health care system. We treat symptoms, diseases, and specific diseases. We don’t treat real conditions of human health.

I’m personally very interested and trying to get a lot smarter around things like longevity. What can we do to prolong?

Q. Didn’t that come up with a supplement that does that anyway?

Russ: Yes, but one of the reasons that we aren’t more proactive in managing care and paying for the management of care proactively is, it’s really hard to prove returns on investment. We know all day long that if somebody has high blood pressure, then, treating it with a pharmaceutical product is going to help and if it’s high cholesterol, treat with a statin. But we don’t do anything to get at the underlying conditions which are causing that. So, I’m very excited about the notion of being able to go out and get a lot of differentiated data on people and bring it into this central repository.

We talk at Availity about one patient health record. That is not just what’s happened to you retroactive to becoming sick. For instance, I’m ill and now I’m being treated. But how do we proactively enable providers to know what they need to know about you when you come in instead of just how you may be feeling today? My doctor will be able to look at a chart and say I’ll be ok because he’s been tracking the Hemoglobin A1C, and glucose levels for the last three months so can see where the spikes are. He can then talk about my diet in ways that we can do and test things to reduce those spikes. That to me is the health care system.

The question then, is, where does Availity play? For now, at least, Availity’s play in that is in a retrospective manner, but you ultimately have to have a way to measure what value we’re getting from that and total cost of care. I think that’s the way you look at it over time. So, our ability to look at claims and then, the analytics across claims is critical. I do analytics across claims and know what’s going on with the patient but after the fact is where you get a lot of that.

Q. Let’s talk about digital health. Digital transformation of healthcare data and analytics is super important in all of this. Can you do your work with digital health startups? How do you enable them? What should they know about you?

Russ: While I’m very opinionated on this topic here’s what I think. Digital is another highly overused term, not unlike population health and interoperability and that sort of stuff. To me, digital health is about user experience and it really is that simple.

How do we apply data? How do we make data smarter and apply it into an interactive user experience that drives as a high net promoter score, user satisfaction and gives people the answers to questions they need? That is by proactively anticipating the questions that are going to be asked and answering those questions in a very logical way in workflow.

The example I always use and not a lot people can relate to it is that, I’m a pilot and I’m flying what’s called a glass panel, which means I’m looking at a screen just like I’m looking at two computer screens when I’m in the cockpit. That has evolved over decades from six different devices and instruments to one glass panel that gives you all the information you need, as you need it, even before you need it. It is thinking ahead for you and preparing you for what’s coming next. It’s answering questions intuitively, applying analytics to the data that’s coming in to give you routing information. The truth or the same reason that we did it today in health care is that, I think, we’re still very analog in the way that providers and health plans interact with each other. So, where we’re investing as a company is in two particular areas.

We’re investing in data intelligence and data analytics. We’ve just hired Gigi Yuen-Reed, who was a Principal Data Scientist for IBM Watson, and is now, our VP, Data and Analytics and we’re building a team around her. Their job is going to be to take 13 billion data points and make them smart, more intuitive, more interactive to extract insights and knowledge from all the data flowing through our network.

On the other side, we’re investing in our user experience, not just our screens, but the way that we deliver data to our end users, whether that end user is in an Availity application or in an Epic application. That’s because we sell a ton of provider business through our partnership with Epic or in a nascent digital platform that some brilliant entrepreneur has independently developed.

I’ll give you two examples of where we have a budding partnership with Rhyme, which was brought off and is now run around automating the prior authorization workflow. Leveraging tech that Rhyme has built creates what I call nodal activity – it’s not a very good term. However, the problem with the auth workflow is not a transaction but a conversation between disparate systems and health systems in a payer system. So, Rhyme has really brought intelligence to that conversation so that they can actually speak the same lines. Rhyme is a great example of a partnership where we are bringing value to a young startup digital company to help them get scale.

The other is Vin who’s a very close friend and what Vin is doing with clinical data capture at the point of care is particularly valuable in smaller EMR and EHR systems. We are now leveraging Vin as our own point solution, if you will, which we will bring to scale, to extract and deliver clinical data and insights directly on the provider’s desktop.

Where we are investing is in building an underlying architecture in an API framework so that we can very easily stand up partnerships with some of these brilliant young entrepreneurs who are building applications and sitting there having built something really cool. But question arises, “How do I get scale? Where can I get to a network where I can actually interact with health plans and providers at scale?”

We think Availity should be a logical place for them.

Q. There’s the emergence of a lot of data consortiums – Truveta, HIEs, clearing houses etc. What are your high-level thoughts on the market right now?

Russ: I’ve been involved in HIEs since 2002, so I go back a long way with them and to your point, I think there are HIEs that serve very viable purposes. They’ve figured out a commercial model and are very relevant as data aggregators and local community voices that help create trust around data exchange. We love partnering with them. We’re partnering in Michigan and California. Now with Diameter Health, we’ve got a number of other places where we’re helping bring that data to life.

There’s no lack of data but what do you do with it? We’ll continue to focus on this. We didn’t last for 21 years by not having a good, sustainable business model and I do believe that we knew that some of these disparate, nascent data elements were going to become more and more important to us. Finding ways to consolidate that data into an existing workflow is an area where I think Availity can be very relevant and start creating real value for the end user. What we do today in just transacting claims and eligibility is highly commoditized but if you do it at scale like we do, it creates a phenomenal platform that you can build around.

We hope you enjoyed this podcast. Subscribe to our podcast series at  www.thebigunlock.com and write to us at  info@thebigunlock.com

Disclaimer: This Q&A has been derived from the podcast transcript and has been edited for readability and clarity.

About the host

Paddy is the co-author of Healthcare Digital Transformation – How Consumerism, Technology and Pandemic are Accelerating the Future (Taylor & Francis, Aug 2020), along with Edward W. Marx. Paddy is also the author of the best-selling book The Big Unlock – Harnessing Data and Growing Digital Health Businesses in a Value-based Care Era (Archway Publishing, 2017). He is the host of the highly subscribed The Big Unlock podcast on digital transformation in healthcare featuring C-level executives from the healthcare and technology sectors. He is widely published and has a by-lined column in CIO Magazine and other respected industry publications.

Healthcare is now about combining the digital pieces with a personal touch

Season 4: Episode #135

Podcast with Zane Burke, Chief Executive Officer, Board Member, Quantum Health

"Healthcare is now about combining the digital pieces with a personal touch"

paddy Hosted by Paddy Padmanabhan
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In this episode, Zane Burke, CEO of Quantum Health discusses the current state of digital health and how Quantum is working towards creating a different and better healthcare experience with better financial and clinical outcomes.

Zane is a long-time veteran in the healthcare space with successful tenures in Cerner and Livongo. He notes that while there is progress with digital health, data silos and lack of integration are some of the biggest friction points in delivering better healthcare experience and outcomes. He also talks about how healthcare is intensely personal and why the connection of digital pieces and the personal touch pieces will make a huge difference.

Zane discusses a range of other topics, including digital health funding and the M&A environment, the role of big tech in the healthcare ecosystem, and the pace of digital transformation in general. Take a Listen.

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Show Notes

00:48How would you describe the current state of digital health?
02:20 How did you come to Quantum? What does Quantum Health do?
04:16 Who are your main customers today – employers, plans, or providers? Who would you consider your competition?
08:30In the context of health care, the other big competitor is, “Who pays?” Healthcare is all about following the money. Who pays for the solution as a self-insured employer?
10:42In the context of the markets and data silos, you've been a senior executive at one of the big EHR platform companies and in startups. Give us a State of the Union on interoperability. What's the unfinished business here?
15:27Digital health companies are in their own ecosystem and the consumers are somewhere in the middle with very little control over their data. If companies cannot access the data easily from an EHR system, where do you think that leaves digital health companies today?
18:15 What are your thoughts on the M&A environment of the marketplace today in light of how many digital health companies are actually struggling?
21:27What’s your take on the role of big tech in the healthcare ecosystem going forward?
26:35What is your advice to the health systems and digital health startups trying to play in this environment?

About our guest

Zane Burke is the Chief Executive Officer, Board Member at Quantum Health. An internationally recognized health IT leader, Burke has both a clear, forward-looking vision for digital healthcare and a unique understanding of the challenges in global healthcare delivery.

As healthcare gets continuously harder for people to navigate on their own, Burke’s professional passion is creating great healthcare experiences for all and addressing the imbalances in healthcare delivery. At Quantum Health, he leads the organization's goal to transform the consumer experience, with solutions that uncomplicate and innovate healthcare navigation. By continuing to reach into new end markets, the company will serve more consumers and ultimately improve more lives.

Prior to joining Quantum Health, Burke served as chief executive officer of Silicon Valley-based Livongo Health Inc., a leading software as a service (SaaS) consumer digital health company. Burke spent more than two decades at Cerner Corporation where he concluded his service there as the company’s president. He serves on several industry and not-for-profit boards of directors.

Zane Burke is the Chief Executive Officer, Board Member at Quantum Health. An internationally recognized health IT leader, Burke has both a clear, forward-looking vision for digital healthcare and a unique understanding of the challenges in global healthcare delivery.

As healthcare gets continuously harder for people to navigate on their own, Burke’s professional passion is creating great healthcare experiences for all and addressing the imbalances in healthcare delivery. At Quantum Health, he leads the organization's goal to transform the consumer experience, with solutions that uncomplicate and innovate healthcare navigation. By continuing to reach into new end markets, the company will serve more consumers and ultimately improve more lives.

Prior to joining Quantum Health, Burke served as chief executive officer of Silicon Valley-based Livongo Health Inc., a leading software as a service (SaaS) consumer digital health company. Burke spent more than two decades at Cerner Corporation where he concluded his service there as the company’s president. He serves on several industry and not-for-profit boards of directors.

Q. Zane, you’re a veteran in the healthcare tech space having been part of large enterprise class technology platform providers and startups that have had spectacular success. How would you describe the current state of digital health?

Zane: It’s a fascinating time and digital health has seen a lot of amazing innovation where people are taking on areas that may need better health care experiences and better clinical and financial outcomes. There are a number of places where there’ve been significant movements in a positive light for many disease states. That’s a real big positive.

On the other side, what we’ve seen is almost a bigger silo of data and information that’s really creating too many small pockets of information with not enough views of the larger picture and a lack of integration.

For instance, I know I like to go to concerts and drink wine. That’s what I do for my health care. I don’t do health care to do health care and I don’t think anybody does that, either. I think, they really do it to live their lives. So, it’s a missing component of what’s really occurring. We just see more and more of these little islands of information and more siloed elements and while in those individual spaces, there are better experiences and better outcomes, we’re missing this broader picture for people.

Q. How did you come to Quantum? What does Quantum Health do?

Zane: I came to Quantum Health because it’s really about creating a different and better health care experience with better financial and clinical outcomes and really looking at hard ROI within the boundaries of the medical spends, today. What really attracted me, in addition, to that core piece there, was the people and the business model. That is the only one I’ve seen, particularly in digital health, that’s really around bringing together the plan sponsor, the member, and the provider.

Those three components were what attracted me to Quantum Health because I saw this as a platform by which we could deliver what I call the connective tissue between a clicks and mortar world. It’s increasingly important for people to recognize that it’s not going to just be a digital health or virtual care world, only. It’s a connection back to that physical piece.

How do we create that singular experience for the member and simplify it? That’s what I saw in Quantum Health. That’s the opportunity as we move forward.

Q. Who are your main customers today – employers, plans, or providers? Who or what would you consider competition?

Zane: We are mostly a large self-insured employer. We scale both, up and down. But if you think of a Delta Airlines, a Target, an Allstate, a Honda, then, those are some representative clients. We’re serving over two million members today, in that space and that’s where we got our start.

Increasingly, we’re seeing that the health plans themselves are interested in navigation, although it leads directly to the competitive environment where the biggest competitors are still the health plans themselves. That’s because they think of themselves providing that customer-first experience. Unfortunately, what they’ve done is optimized around business processes.

What we are able to do around navigation is be on the journey with the member by taking all the data sources in whether it’s claims data, PBM data, or that provider information. Every single one of these interactions in health care is a health signal and is calibrated in our Artificial Intelligence to help us create the next best action. It’s really about the next best action for that member and helping them in their journey in the context of their health plan.

What benefits they can be accorded will depend on what’s in-network or out-of-network. So, how do we get them to the right side of care?

When you’re on a real health care journey, you know how difficult it is to actually navigate the health care system. Quantum really guides that person through the journey and it turns out that they’re actually doing the right thing, making the experience better, and helping people navigate to the right places. So, our Net Promoter Scores are in the mid-70s which I just haven’t seen in any other business ever and we’re getting hard ROIs as well. So, doing the right thing turns out to be really, really good for the sponsors and/or for a large self-insured employer. It’s a win, win, win across the board. However, “do nothing” still remains our biggest competitor. Stay with the payer.

Increasingly, there are more people entering into navigation. Unfortunately, it isn’t about just putting a little digital app on the front-end and doing some lightweight pieces. We’re seeing digital applications making a difference. Our front-end, for example, is great and we’ll continue to hone that but it’s really all the data science and ultimately, a personal touch that comes with it, which matters.

I often mention this in my executive meetings. Every single day, I get multiple notes from members that say “thank you for X” — either better clinical outcome, better financial outcome, or better experience — but it’s always tied to a person and what we call our health care lawyers. I’ve never got a response that said, “thank you for writing that software” and that’s what health care is. It’s intensely personal. It’s about how you connect the technical part with the personal part that makes such a huge difference.

Q. In the context of healthcare, the other big competitor is, “Who pays?” because healthcare is all about following the money. Who pays for the solution as a self-insured employer?

Zane: Sometimes, employers hire us and pay us a per member per month fee on behalf of their members so we become the front-end both, for the interactions with their members and our engagements with our providers to get paid. Literally, we created a model for a single flow for that member, the workflow for that physician’s office and that’s how we often garnered a number of those health signals. Then we also delivered value back to either the member or the provider on those signals, along the way.

That this is coming from the sponsors themselves creates great experiences for the employees — better health care experiences, better clinical and financial outcomes — and sponsors, too. We’re seeing significant ROIs then, on the amount of fees that they’re paying. That’s the thing when you talk about what the state of digital health is. If you’re not driving value, there’s just no way you’re going to be in the game in the long run.

Q. In the context of the markets and data silos, you’ve been a senior executive at one of the big EHR platform companies and in startups. Give us a State of the Union on this interoperability. Is it getting better or worse? What’s the unfinished business here?

Zane: It’s getting better but what people have to realize is, it can’t be a one-way street on data. That goes for everyone involved in the conversation. From an EHR perspective, we have to think about what’s in it for those EHR companies and the value they’re going to get back from the connections that they receive. People may look at that and say, that’s a bit of a jaundiced view. They received Dollars as part of the federal programs and incentives to go drive that. So, I do think there’s a responsibility from those EHR companies to be open.

I’ve long been a proponent of health care data. It should be mine as a person, not mine as a EHR company. You ought to own your own electronic health record and I, mine. Whether I choose to share it or turn it off, should be my prerogative and I should have the ability to do so.

EHR companies have come a long way but there’s more to do. The hold-up though is still the notion of what’s in it for them on data-sharing from these other technologies. That’s often lost in the mix. What you have seen in digital health has been more cooperation around democratizing the data and saying, “If I have data to share, I’ll share that with our partners.” If you have data or digital health from our ecosystem, you’re sharing it with us because we can provide better experiences for our members. The digital health community has done a fantastic job in data sharing. I’ve seen it at Livongo, where we’ve shared Apple data, Fitbit data, claims data, and others as part of that conversation. We have an incredibly robust ecosystem and partner program at Quantum Health where we can connect in multitudes of ways and share information which is an important part of that responsibility.

There’s a lot of work to do around the data. Your ability as an individual to be able to turn that on and off and understand where your data goes is critical. Most people don’t appreciate that once they flip the switch for their PHI to be put into an Apple health kit, for instance, then, that data is no longer your PHI anymore. It’s literally part of the Apple ecosystem. Some of those pieces are areas of importance for us to continue to track and follow through on. There’s a lot more to do from the EHR perspective. However, at the digital health level, this notion that your data, should you press a button, will be forever out there, persists.

Q. Digital health companies are in their own ecosystem and the consumers are somewhere in the middle with very little control over their data. If companies cannot access the data easily from an EHR system, what is the true value of a digital health solution?

Zane: It can be much more robust to have the EHR data in those digital health elements. I’d say that there is a ton of information in these digital health organizations that are clinically relevant for those EHR organizations and the providers, and quite frankly, I don’t think digital health has actually stepped up to the plate to embrace the provider meaningfully.

Actually, Quantum is one of the lone exceptions out there in terms of, “Hey! There’s an opportunity to give back here.” There’s a reason why our provider scores are so high and it goes beyond the understanding of the benefits paid. That’s because you actually get some feedback from the first time, from the digital health community so, I do think there’s actually more that digital health community can and should do to close the loop. It’s painful and hard work, but it needs to be done. That’s part of the responsibility of being in health care.

You can get a lot of value in those disease-specific condition states. With those digital health applications, you gain a lot through the claims data and the PBM data, etc. and it would be beneficial to have more access on the EHR side. That’ll come and I really believe that that’s on the right trajectory. Everybody in the ecosystem has to remember you have a responsibility to close the loop on behalf of the member, and that includes leading back to the providers themselves. Doing that in a way that’s useful to the provider, rather than a burden is just one more thing that we put on their plate that they have to sift through.

Q. Livongo’s successful exit may have paved the way somewhat for a few of the large, recent exits — One Medical with Amazon, Signify, CVS, and perhaps Cano Health. Can you share your thoughts on the M&A environment of the marketplace today in light of how many digital health companies are actually struggling?

Zane: The macro financial markets are very tough and challenging for fundraising for digital health solutions and while that may continue for the next 12 to 18 months, it’s going to have implications. There will be people that run out of funding and those whose business models just haven’t shown profitability in those pieces. That will have ramifications on the marketplace. Those with deep balance sheets are going to be in the best position to scoop some of those pieces up. So, you’ve got that dynamic.

You alluded to the amount of M&A activity. You’re going to see more because of the financial challenges that I spoke to start with and the Amazon One Medical and Signify CVS combinations which prove a thesis that I’ve long believed that this ultimately requires personal service. Technology is critically important. You can deliver great experiences through that, help people practice more at the top of their license, whether that’s truly a professional license or just at the top of their game. But at the end of the day, it’s the personal touch that matters. Both those combinations are big signals that it’s the delivery of care integrated into the digital aspects that people are betting on the future and thinking that it’s again back to it’s going to be a digital only world is just not how health care is delivered.

The big value is always in the cases that are the most expensive and in the top 1% driving 50% of costs. But you’ve got to know the whole phone book to be able to dial in and say, “This person is the one that’s going to be on this journey. How do we engage with this person early and often and get them the right kind of information before all the choices have been made?”

That requires the digital pieces, along with the personal touch pieces. So you’re going to see much more M&A activity for those who have deep pockets on a go-forward basis.

Q. There are big tech firms like Amazon actively getting into the core health care services space. What’s your take on the role of big tech in the healthcare ecosystem going forward?

Zane: This might be the part where I’ve been around the block for too many times and so I’m a bit cynical. I’m not a cynic by nature and those that know me well, know I’m an optimist and I’m a half full kind of a person. But I’ve seen IBM and Trident Healthcare trying to get in health care four times. I’ve seen Google try to get in at least twice. I’ve seen Microsoft in it at least three times back in the day, McDonnell Douglas, American Express, and GE.

So, there’s a lot of dead bodies on the side of the road. Health care is a humbling experience for me every day. There’re reasons why your podcast is so wonderful, because what you do is, you turn this gemstone of health care and depending on what lens you look at it through it just gets a different viewpoint every time. That’s one of the fun parts of my own personal career and that is being able to turn the gemstone and see it through a couple of different ways. I’m humbled every day as I get to learn and try to say that I want to make a difference.

There’s a role for big companies and they may be the beneficiaries of a downturn in the financial market side because they have such strong financial statements and they are able to acquire some technologies that they otherwise would not have. So, this is going to be a little different. While I’m, on the one hand, cynical because I’ve seen large companies not be successful, I’m, on the other hand, hopeful that they’ll provide the kind of capital that’s going to be necessary to see some of these technologies reach their full potential. I can be, on the one hand, pessimistic, and on the other hand, optimistic, and say that’ll happen. I look at the company I used to be associated with this arm and Oracle joining that fray and on the one hand, I’m optimistic that contemporizing in the Cerner platform and truly getting to a cloud-based environment and doing some of the things that Oracle is uniquely capable to do would be super beneficial for Cerner. But on the flip side, I’ve seen where large companies think they know it all, and the smart people have come to save the people that are unworthy. I have concerns about those kinds of scenarios.

I’m not being critical of the Oracle or others that have tried and failed. It’s too big a market to ignore 20% of GDP. We’re going to see big-tech players in this space and the ones that will be successful are the ones that say, “I know how to scale. I know how to think about technology. But I’ve got to embrace everything that is health care and understand that there’s different dynamics at play here from the payer models to, you know, the consumer models, the providers and all the elements thereof.” If you think you invented it at your shop, you’re probably wrong. That’s what I would say. Again, I say every single day, I get to learn something.

Q. This year has been a bad one for health systems financially speaking and with labor shortages. Do you think this will slow down the pace of digital transformation? What is your advice to the health systems and digital health startups trying to play in this environment?

Zane: You’re right. I sit on the largest safety net hospital in Missouri, and they’ve prudently managed through what has been a very challenging time. Many of my health system clients have had some significant challenges and a number of health system clients are utilizing Quantum’s services.

They’ve got to be focused on value received and on making their own employee base feel loved and cared for. Often, the health professionals provide the love and care and it’s really important for the health systems to return that because it’s just been an unbelievably taxing time to be a health system provider and any kind of health system worker over the last couple of years.

For me, it’s just thinking about the employee population and then the value, the places they can go to the first dollar value place. How can you, as a health organization, not be subjected to what’s going to be a downward trend around value-based care? As people come after the big spend items, they’re going to have to think about how they’re providing unique value and how they’re going after first dollar. So, it’s a tricky time if you’re in the digital health. If you’re the digital health providers, you better be delivering a heck of a lot of our hard ROI or you’re just going to be out of business.

We hope you enjoyed this podcast. Subscribe to our podcast series at  www.thebigunlock.com and write to us at  info@thebigunlock.com

Disclaimer: This Q&A has been derived from the podcast transcript and has been edited for readability and clarity.

About the host

Paddy is the co-author of Healthcare Digital Transformation – How Consumerism, Technology and Pandemic are Accelerating the Future (Taylor & Francis, Aug 2020), along with Edward W. Marx. Paddy is also the author of the best-selling book The Big Unlock – Harnessing Data and Growing Digital Health Businesses in a Value-based Care Era (Archway Publishing, 2017). He is the host of the highly subscribed The Big Unlock podcast on digital transformation in healthcare featuring C-level executives from the healthcare and technology sectors. He is widely published and has a by-lined column in CIO Magazine and other respected industry publications.

The Healthcare Digital Transformation Leader

Stay informed on the latest in digital health innovation and digital transformation.

The Healthcare Digital Transformation Leader

Stay informed on the latest in digital health innovation and digital transformation.

The Healthcare Digital Transformation Leader

Stay informed on the latest in digital health innovation and digital transformation.