The Reverse Mullet Healthcare Podcast
Ellen Brown, Justin Politi, and Dave Pavlik bring their 90 collective years of healthcare experience to BP2 Health where they're on a mission to effect real change in the industry. Connect with BP2 Health Here: https://bp2health.com/contact/
The Reverse Mullet Healthcare Podcast
Let’s Just Blow It Up – Designing Care Delivery for Patients with Dr. Jamie Colbert, Chief Medical Officer of Memora Health
Ever thought about what it takes to create a healthcare system that truly puts patients first? Join us on the Reverse Mullet Healthcare Podcast as we sit down with Dr. Jamie Colbert, Chief Medical Officer of Memora Health, to explore just that. With an impressive background at Harvard, Stanford, and contributions to Blue Cross Blue Shield and the Brookings Institution, Jamie's journey through value-based care and population health provides invaluable insights. Jamie reveals the complexities and potential solutions to making a patient-centered health delivery system a reality, while sharing a glimpse of his life outside of the office.
In a fascinating discussion, Jamie addresses the pervasive inefficiencies in the current healthcare system and the monumental role AI technology can play in overcoming these challenges. We discuss how Memora Health's AI-powered solutions are designed to minimize administrative burdens, enhance clinician efficiency, and provide comprehensive patient education. Jamie's firsthand experiences shed light on how these innovations can transform care pathways and improve both patient and clinician satisfaction, making healthcare more effective and efficient.
Lastly, we dissect the core principles of patient-centered care and the strategies needed to redesign the healthcare system to meet these ideals. We dive into the importance of aligning healthcare with patient goals, ensuring collaborative and accessible care, and the need for timely information sharing. Listen as we highlight personal stories and practical examples that underscore the urgency of addressing emotional and end-of-life planning challenges.
Welcome to the Reverse Mullet Healthcare Podcast from BP2 Health. Today we're talking with Jamie Colbert, chief Medical Officer of Memora Health. But first, who are we, why are we here and, more importantly, why do we name our show the Reverse Mullet Healthcare Podcast?
Justin:Well, I think we know we want to be relevant, informative and creative, but we also want to be entertaining and have fun. So it's party in the front and business in the back, like a mullet only reversed Yep.
Dave:We are your hosts Dave Pavlik, justin Politi and Ellen Brown. We are passionate, innovative and collaborative and are committed to solving our industry's most important issues together with our clients. We have a combined 90 years experience it makes us sound really, really old like really old in each episode we'll dig into a hot health care topic and dig into each other be gentle on me please yes and let's not. No, let's not take any digs on Dr Colbert, it's not nice. No.
Ellen:No, we're like siblings, so we can only do that with each other. We will never do that to our guests, don't worry.
Justin:So we're excited to have Dr Jamie Colbert on the show to talk about a topic near and dear to my heart creating a truly patient-centered health delivery system.
Ellen:All right. So before we get too far, let me share with everyone Jamie's impressive background, and I also want to thank you for coming on the show, jamie. We really appreciate it. We're excited for this conversation. As we shared earlier, you are the chief medical officer at Memorial Health Memora Health. You're also an attending physician at Newton Wellesley Hospital, which is huge that you continue to still practice.
Ellen:Prior to your current role, you were the Senior Medical Director for Delivery System Innovation and Analytics at Blue Cross, blue Shield of Massachusetts, and beyond that, your background centers around value-based care, which is very much near and dear to our hearts. Even before I would say even when I looked at your background, even before, many conceded that it was more than a catchy acronym. You were the vice president of population health at Benevera Health, senior medical director for population health at Beresk Health, and you also served as a core faculty member of Brookings Institution, a learning network. Ten years ago, you were the lead author of a 2014 Brookings Institution report entitled Adopting Accountable Care an Implementation Guide for Physician Practices, and when I saw this in your bio, I thought I bet we all looked at that report, because we've always looked at Brookings as a resource. I think everybody in the industry for ACOs and I thought, wow, we met you, we knew of you before we even met you. Because I'm certain that back in those days, when a lot of folks were still very much stumbling with ACOs right.
Ellen:You also received your bachelor's degrees from a place that maybe a few people have heard of Harvard and, equally as impressive, you are a medical degree from yet another place that some may have heard of Stanford University. You completed a primary care internal medicine residency at Brigham and Women's Hospital, as well as a fellowship in medical research and health policy at the New England Journal of Medicine, which is interesting because I'm going to cite something from them later on in our episode. So you maintain an active clinical practice and hold faculty appointments at Brigham and Women's Hospital, Harvard Medical School and Ariane Bay Labs, and I'm sorry if I said that wrong. In 2015, you were selected by MedTech Boston as one of 40 healthcare innovators younger than 40. So, without further ado, Do you sleep ever?
Jamie:Do you have any? Yeah, I don't like to hear that list of accomplishments because I feel like there's so much more I wish I could do. You know it's need to be to be delivering care that truly is meeting the needs of our patients and doing so in a way that also is sustainable for our workforce. So you know, I'm glad that I've had some success along the way, but at the same time, you know, I don't want to rest on whatever small accomplishments I have achieved so far. But yeah, ellen, dave, justin, really excited to be here today. You know I've been a listener of your podcast. You know I've really enjoyed learning from some of the healthcare leaders who you've had on some of the other episodes and so just really excited to have this conversation today. Happy to talk a bit about my background, the work that I do at Momora, and then maybe more broadly just kind of talk about some of the opportunities here in healthcare to truly move towards more patient-centered care.
Justin:Yeah, absolutely Looking forward to it. But first we're going to talk Boston. Hey, go Celtics up 3-0 after last night.
Ellen:We knew Justin wasn't on a call. For those listening, justin was not on a call earlier, dave and Jamie and I were on to make sure that all the technology was working at a time. Justin was not there and we were just talking about that. Justin was like we know that Justin's going to talk about the Celtics.
Justin:Absolutely it's about time, right, I mean you don't want to count your chickens before they hatch being up 3-0 is certainly a great place to be right.
Jamie:We're excited in Boston and it's been a number of years with the Celtics getting close. We're hoping that this can be the year for our Celtics.
Dave:I think that I've got my.
Justin:Celtics banner flying down here in Sarasota.
Jamie:Don't jinx it.
Justin:It's been there throughout the whole playoff, so it's not going anywhere. Got it?
Dave:I heard that Justin can't watch the Celtics games with his family anymore. He's too intense and his family doesn't want to have anything to do with it. Is that right? Isn't that right, Justin?
Justin:Some of them, but we text each other still along the way. So it's you know, I've got my own rituals, just like we all do, when it comes to watching the game.
Jamie:So yeah, but moving past that, and then I was just going to add you know, I think Boston fans in general are certainly used to suffering. I mean, I grew up in Massachusetts as a Red Sox fan. I think I was more a baseball fan than any other sport when I was younger, you know, and it was year after year after year that they would lose to the Yankees or they would kind of get close and just never, never, finally make it. And then 2004 finally came around and that was just magical right. Coming back from three games down, I mean it was amazing, and I was in Boston at the time. It was actually the year I was applying to medical school and so it was kind of a fun break for me between studying for the MCATs and all of the other. Preparation with the interviews was just kind of getting out and being around all of that celebration.
Justin:It was an amazing time and it's bringing me back because my son was born in 04. And I got I have pictures of him on my shoulder and it was like this cathartic moment because, like you, I was a huge Red Sox fan. But I go in the Yankee stadium and you know I have to cover up because every year it was something you know.
Dave:But that is a gentleman. Welcome to sports talk from BG2 Health.
Justin:This is WEEI, but no another sport scheme is one of your and your family's favorite pastimes. What's your favorite place to go in New Hampshire?
Jamie:You know, we kind of mix it up. So we got the Indy Pass this year, which is actually great because it includes a lot of the smaller independent mountains. So, unlike the bigger passes that are taking you to all the Vail resorts or some of the other resorts that are owned by these larger corporations, you get to go to the smaller mom and pop ski areas that just still have that old-timey feel. So for us I have a four-year-old and a seven-year-old you know we don't need to be, uh, you know, going down 2 000 foot vertical runs. For us it's just, you know, not an accomplishment if we can get the kids up a chairlift and down, uh, back to the chairlift, right, you know, without falling down or without any crying.
Jamie:So you know, now with the kids where they are. Uh, that's been actually great. I mean, we've gone to some of the smaller places up in New Hampshire like Pat's Peak, uh, whaleback Mountain, those, those are kind of two uh two classics, that really probably have not changed at all in over you know, 40 or 50 years.
Justin:Another one is ragged. Uh, we, yeah, that's. You know that we would. You know it looks exactly the same as it did. And then I was.
Jamie:We had season passes at gunstock for a long time, so oh yeah yeah, yeah, and I grew up in western mass in the berkshire, so we would go to berkshire east uh, which also, you know, is still very, very similar, and that's where, uh, in middle school, I would go on the bus every afternoon after classes got out and we would be going down the slalom course and I ended up doing some ski racing for a number of years, uh, up through high school so you know it's, it's been a fun pastime for me.
Jamie:Um, I've enjoyed getting my kids on skis, and it's something that has that name seems to bring in a different, a different vibe.
Ellen:But, um, yeah, so I I actually love, um, back country, ski, mountaineering and, uh, and also I also love, you know, side side country and also even just getting up the mountain in the mornings. But skiing is something that like it's like my uphill skinning is my absolute favorite thing to do in the world. It tops running, it tops mountain biking. And so you guys are speaking. You can talk basketball all day long and it'll just go right over my head, but if you start talking skiing, then my it's all of it's over my head.
Dave:I don't do skiing or basketball.
Ellen:Yeah. Yeah so last thing before we move on to the task at hand, the talking healthcare because I want to be respectful of time, though is that you also have a big level of travel, which is something that I love much too. I think Dave and Justin's chagrin I travel as much as I possibly Dave's laughing. I absolutely love to travel. I'm crying. We're traveling as we travel as a family now and have done amazing adventures, so um. So I understand you love to travel as well yeah, absolutely.
Jamie:Do you have any big travel plans coming up, ellen?
Ellen:no, last year was our bucket list year, so we knocked off the Mdives um where we did surfing and diving. We found we went down to the southern atolls to be able to do both. And then we also knocked off singapore and we knocked off uh japan and then we went to see the northern lights in norway over christmas that's quite a year.
Justin:Yeah, it's a year of life. It's every single year, single year. And then she'll tell you I never get to do travel Right. And it's just not true. It's fake news.
Dave:I went to Ocean City, maryland, last year a couple of times.
Ellen:And I just got back from going up the Oregon coast in an RV and then went on an Alaskan cruise with my family.
Dave:Wait, there's more.
Ellen:Yeah. So I guess my point is Jamie, I don't at this juncture, unless I could squeeze in the only thing I would say might, oh no, you know what I'm looking forward to. And then I want to hear about any travel you have coming up. Or even if it's further out, because I know your kids are really young and my kids are much older now we are seriously looking at Patagonia, doing a trek in Patagonia over the holidays, at Christmas time.
Ellen:So I will say that is a bucket list potential item, but we're getting to bucket lists that I'm not interested in, like my son wants to go to. Russia. It's not a good time to go to Russia, right, and my son wants to go to Dubai and I'm like we need to get some, so let's do Patagonia. So yeah, how about you?
Jamie:No, that sounds great.
Jamie:I mean, I I've always been really into the outdoors, so skiing obviously is a great activity in the winter, but then in the summer, you know, just love being outside, hiking, camping.
Jamie:And before I had kids, my wife and I would do big trips, uh often out West, go to, uh, wyoming, montana, spend four or five nights doing backcountry camping, just kind of getting off the grid and really exploring some of those spectacular mountain ranges that we have in the United States and also doing some of the similar things in Europe. So my wife and I have had some great trips to Italy and Switzerland and Austria and France to really just get outdoors and explore. So this summer actually we're taking a bit of a gamble with the kids being still somewhat young, but we are doing a big trip. In just a few weeks We'll be taking the kids to Paris for a couple days they really want to see the Eiffel Tower and then we're going to Sardinia for a week and we'll be exploring the island and going to some of the beaches and doing some hikes and, you know, really just kind of exposing the kids to some new culture.
Jamie:So it's definitely a bucket list kind of trip for us that's amazing, you know?
Ellen:yeah, and as you know, jamie, I went to sardinia two summers ago and I love corsican sardinia. I could not recommend it more, although now I'm like kicking myself that I'm saying that on this podcast. Luckily we're not viral, like we don't have millions of listeners, but if we did.
Jamie:I'd be like I should, because yeah, so anyways yeah, so all right all right, justin's going to take us where we need to go.
Justin:Yeah, let's get down to the topic at hand. But first let's get down to the topic at hand, but first, a quick word from our sponsor, bp2 health.
Dave:It's not boston celtics. No, our sponsor is not the boston celtics. That's true, we'll do this right. Wait, gross back in. Yeah, so that's right. A live advertisement by our own company, bp2 health, is your best chance for real change. We work with hospitals and health systems, insurers and providers to solve some of the industry's most pressing problems. It's a big job, one more suited for a special operations team than an army.
Ellen:It's like the Indy Pass team we are your special ops team.
Dave:I would hire us. That's a good ad.
Ellen:You would, if you heard that you would, I would hire us All right just okay, okay, justin uses the scooby van analogy that we drive around solving um health care's mysteries.
Justin:Drive around in a van solving health care mysteries.
Jamie:Yep, so you know that's a good idea for a podcast, right yes do some live live podcasts from the van right, some narration turn by turn yeah.
Justin:Back to our episode, jamie. When we asked you what you think could affect real change and that change is real, is in caps uh, you had a great answer that we are looking forward to discussing today creating and offering a truly patient-centric health care delivery system absolutely.
Jamie:Yeah, I mean I, you. I've obviously experienced this firsthand as a physician, and I've been practicing medicine for over 15 years, and it's just incredible how we've ended up with this system that just has so much complexity and is so unintuitive to all of the players Right. So, as a physician, I find it frustrating to all of the players right. So, as a physician, I find it frustrating the nurses I work with. They also are frustrated. The patients are frustrated. The caregivers, the family members of those patients are frustrated. No one's happy, right. And why is that right? It's because the system has kind of evolved to where it is today.
Jamie:It wasn't planned to be this way. Nobody would have designed a healthcare system that is as insanely complicated as we've ended up with. If you look at how much administrative overhead there is, how many of the healthcare dollars that we spend are actually going towards delivering real care and providing services that matter to patients, versus all of the other kind of padding that's on top of that. And so you know, for me as a provider, I want to figure out what are ways that I can do to help move the system in the right direction, and it's obviously a tall order. It's not like I can kind of turn a switch and all of a sudden kind of wave, a magic wand, and healthcare is better, right, but I think that's how I've structured my own career in really understanding health policy and working with Brookings Institution early on on, advancing the models around accountable care and helping other providers to be more familiar with how to provide care that truly does meet the needs of patients, that is providing better quality, that is doing so in a way that's more efficient, so we're not wasting healthcare dollars. And then doing that through some of the organizations I work with, most recently at Blue Cross, blue Shield of Massachusetts, which really has been a pioneer in advancing value-based care and partnering with the provider systems in Massachusetts to help promote better quality.
Jamie:And the results are there.
Jamie:I mean there were a number of New England Journal studies published looking at some of the work that Blue Cross, blue Shield of Massachusetts did with what they call the AQC, which is their kind of alternative quality contract and that was kind of their terminology for the accountable care contracts that they put in front of the providers in Massachusetts, because the cost of healthcare in Massachusetts was just, you know, increasing year over year 10% or more, right, and that's not sustainable, not to working families.
Jamie:So it's been really exciting to see that we are making some progress, but there's still so far to go. For me, that led me to where I am today, at Memorial Health, where I wanted to join a health tech startup, because that would allow me to kind of break free of some of the bureaucracy and just some of the challenges that you face when you're part of a very large organization. So that's been what's exciting for me over the last two years at Momara is really trying to build something new and just the excitement of seeing the traction that we're getting and seeing the impact that we're able to make.
Ellen:That's fantastic. I mean, you know the financial alignment, right. I love that you come from a background of value-based care, because that is something that still remains, I would say, when it's done correctly is still a dirty word to a lot of people. Right, like, I'm not talking about dipping your toe in it. I understand you got to start somewhere and I'm not saying that that doesn't happen, but that that real like what you're talking about with Blue Cross, blue Shield, massachusetts, where you really are aligning everybody financially and I. That's one of the biggest missing links that we work on regularly because it without it, it will, it won't happen. So, all right. So you've laid this out and Dave and Justin will know exactly where I'm going to go, and if you've listened to some of our episodes Jamie will probably guess where I'm going to go as well, which is I have to find a definition Patient centric.
Ellen:What does that even mean? And the new England journal of medicine actually did an article on this and and has paper and it's it's defined. So it defined it and then there were seven elements. I'm just going to stick with the definition for a minute. It's when an individual's specific health needs and desired health outcomes are the driving force behind all healthcare decisions and quality measurements. Patients are partners with their health care providers, and providers treat patients not only from a clinical perspective, but also from an emotional, mental, spiritual, social and financial perspective. Easy, right, easy peasy.
Ellen:So how do we make this happen, especially given how far the pendulum has swung in terms of inundating physicians with data?
Jamie:Yeah, I think it's a great question and I don't think there's one answer, but I think that it's about, you know, trying out some of the different solutions that you know have not yet necessarily gotten the full adoption from the physician community, and one of the reasons is because physicians feel like they've been burned in the past, right, you know, we've had, you know, the latest, greatest thing come around probably every few years, and we've asked physicians to adopt some new method of how they interact with patients, a new technology that they're supposed to use, a new EMR, a new kind of billing tool, right?
Jamie:And so physicians are definitely skeptical of whether or not, you know, there really is possibility of change, and I think that's a big thing that we have to overcome is that, you know, there's no question that the status quo is not meeting our needs as providers, as well as the needs of our patients, but there's also some resistance to trying things that are different, because we haven't necessarily cracked the egg fully.
Jamie:Well, maura, I spent a lot of time talking to clinical leaders and understanding, you know, what are some of the challenges that they're facing in their day to day. Why is it so challenging for them to even find the time to have in-person, meaningful conversations with patients, and it's because there still are just so many administrative tasks that they are just dealing with on a day-to-day basis, and that's where there's just so much opportunity to use automation, to leverage AI, to think about what really is best for patients and how do we get our providers to a place where they have the time to spend with patients such that patients are really getting the need that they need, that they want.
Dave:And isn't it true that some of those you know here's the like you said the latest and greatest thing is being pushed on us? Isn't it the case that sometimes they go full circle and it's like version 2.0 of the same thing and there's probably more of a kind of a reluctance to accept that more so, right.
Jamie:Yeah, and I think in many cases, what's being pushed on whether it's providers and patients is not necessarily being driven through the lens of what's patient-centric right. It's being driven through the lens of what's best for the healthcare system, what's best for the CFOs, what's going to optimize revenue or billing or things like that, rather than really taking the time to think through, okay, what would actually be the way to best deliver care, whether that's how to support someone during their pregnancy, whether it's somebody who has cancer and needs to have connections with providers who can really help to answer their questions, whether it's someone with diabetes. Right, in all of these cases, we're not necessarily designing the system in ways that are, you know, front and center, making things easier for patients. We're designing things in ways that are easier for the hospital systems and for maximizing revenue.
Dave:Yeah, you mentioned buy-in and unnecessary or overwhelming administrative burdens. Are there other barriers that you're facing that are affecting, that are causing you not to achieve true patient-centric care or affecting real change overall?
Jamie:Yeah, I mean I think that there are many, many challenges right, and we're in a place right now where there are really just a couple of electronic health records that are being used by the vast majority of US large hospital systems and they also play the role of gatekeeper. So there's a push on the federal level for more interoperability to try to really open up these EHRs and open up data such that we can truly get to a place where data is transferable from one entity to another so that patients have access to their data, Even providers have more access to data, and without it costing a fortune.
Jamie:Exactly right. And so those gatekeepers, I think, really are, you know, still not necessarily fully on board with the future that we need to get to, and so that is a challenge that, you know, I'd like to see us overcome.
Ellen:Well, you have the same idea in mind as Lee Bowers, who's the president of Blue Cross, Blue Shield, of Medicare for Florida, and we were just listening to his episode, so we're gonna put it out.
Ellen:And we did a little mini episode of Vive with him and he was asked how would you spend a billion dollars if you had a billion dollars? And he said a universal EMR. So you're not alone in the EMR being a big, a big point of friction, and I think you know you've summed up the industry like this is. This is where we are and when we talk about like EMRs used to be a shiny object, AI is now a shiny object, and so we've debated AI a lot and shiny objects in general at our firm and on the podcast, and I think what we've come to the determination of is it makes the most sense right now for AI to be the most effective use is to deploy it really to reduce administrative burden, to reduce staff burnout and enable clinicians to operate at the top of their license. That seems to be where everybody coalescence and feels most comfortable.
Jamie:Yeah, right, and that's kind of firmly where Memora sits. So yeah, so can you tell us.
Ellen:Can you tell us more about that? I mean, that's, I feel like that's where you can just really explain where Memora fits and tell us more about Memora at large.
Jamie:Absolutely I would love to. So you know, obviously there's skepticism of you know, ai or chat GPT replacing doctors, right? So we're not ready for that. You know, chat GPT is still hallucinating some of the time and even if it's able to pass the medical licensing exam, that doesn't mean that, you know, it really understands some of the complexities of each individual patient.
Jamie:But where Momora fits in is that Momora is able to deploy AI and large language models in a way that helps to automate many of those more administrative algorithmic tasks that are taking up a lot of the time of physicians, of nurses, of schedulers, of others who are helping to support patients in their clinical care.
Jamie:And so, as the clinical leader at Memora, my team has built out dozens of automated care pathways to help provide the necessary education, instructions, guidance for patients such that they can more successfully navigate their care journeys.
Jamie:And by doing so, memora is taking off the plate of those clinical team members some of those more administrative tasks. So, whether that's just calling patients on the phone to remind them to take their medications, calling them about scheduling an appointment, whether it's providing them instructions about their upcoming surgery, or even educating them around what to do when you get home from the hospital after delivering a new baby. So we're working with leading health systems. We work with Penn Medicine, we work with Virtua Health, suny, downstate Intermountain Health, boston Medical Center, amongst many others, and they're using Memora from pregnancy care to oncology care, to procedural care, to managing chronic diseases. So it's not that we are one of these point solutions that's only able to help support patients who have a particular cardiac condition, but we really can be an enterprise offering that is, automating that support for patients on their clinical care journeys, no matter kind of which area of the spectrum those patients are falling into.
Justin:Do you experience a lot of resistance from patients like to, or you know, within adoption overall or within adoption overall?
Jamie:Yeah, that's a great question and I really think about Memora as the last mile solution to get to patients in ways that the electronic medical record is not able to today. So Memora works over SMS text and the majority of the interactions that patients have with their virtual assistant comes just through a text message. So it's just so incredibly easy for patients to interact over text. They don't have to have a password, they don't have to log in to an application, they don't have to download anything onto their phone, such that we're routinely seeing engagement rates of over 90% and we're seeing patient satisfaction rates that are through the roof. So I was just reviewing some of the data from a couple of our programs with NPS scores of higher than 90, right, I mean, that is unheard of in the healthcare industry in particular. Right, there are kind of other consumer companies that maybe are getting NPS scores of 80 or above. But the fact that you know our virtual assistant is able to help provide that level of delight to patients indicates that we're really filling a need. It's amazing.
Jamie:You know, and on the other side, right, what are the actual outcomes that we're then achieving, right? So in oncology care we're seeing that a sizable percentage of patient symptoms can be managed through our virtual assistant not all of them, because some of these are sick patients and we're not replacing the doctor. We're just helping to provide the support in that first layer of education so that if patients have a common symptom, then Memorial is able to help educate them to reassure them. And that's deflecting, so that if patients have a common symptom, then Memorial is able to help educate them to reassure them. And that's deflecting, so that not as many patients need to call their provider or need to send a message that then has to be responded to after that provider has finished their busy clinic day.
Ellen:But then I think what's fantastic about that is to be able to give people access to a means of communication that they use in their day-to-day life as their typical means.
Ellen:We all sort of jest that the sad state that we've moved from conversation like we're having right now which is part of why we created the podcast because there's not enough conversation like this, because we all text right, we just it's like this immediate thing. So to be able to engage with your healthcare provider in the way that you engage with the majority of other people in your life, like no wonder you have such a high NPS score, I mean, it's it, you know, it makes. It makes all the sense in the world, have you? So I'm just curious and then, of course, dave and Justin, I'm sure I'm gonna have a bunch of questions as well but have you then gone in and and sort of reversed it to say, not just the patient satisfaction with the doctor, um, but is there also evidence that, um, that the the doctor is feeling less overwhelmed, that they're you're helping with some of that burnout, like? Have you been able to get to that impact as well?
Jamie:absolutely right. So so we don't just survey the patients to get their experience, but we do collect nps from the providers, and we're seeing provider nps scores that are around 70, right, right, so also very, very high. And then, more than that, right, we're actually spending time understanding. You know what are the workflows of those providers pre-Memora, and then what does it look like post-Memora? So where are their phone calls that they're making today, which is still just so manual? And you know how many of you answer the phone when you get a phone call from a number that you don't recognize?
Jamie:I certainly don't, right, and so it is still usually regret it when I do right great I mean it's insane that it's still the predominant means of communication in healthcare is to try to connect with patients over the phone, right, you know, there are all these care management interventions where teams are hiring in in some cases hundreds of care managers to call patients on the phone, and a care manager may be successful if they reach five or six patients in one day. Right, if you think about that, how much money you're spending on that nurse's salary when the nurse is only able to connect with five or six patients per day, versus using text messaging, using automation, to be able to reach hundreds of patients during that same timeframe? Right, I mean, that's the opportunity there. And you know, what's really astounding is that, you know, we're just not leveraging some of these technologies that we know patients are adopting. Right, because it's just it's slow to change how people operate in the healthcare ecosystem.
Dave:Is there a degradation in the adoption as the population is older? Have you noticed through the texting?
Jamie:That's a good question. So we've actually looked at this and we have not seen a degradation as the population gets older. So we've actually done quite a bit of work in the Medicare population with those who were 65 and over and, you know, still have seen engagement rates that are pushing 90%. So you know, I think it's just the case that text messaging is still more convenient than going into a portal, right?
Dave:Or trying to remember your password, especially my parents. Exactly, I mean my parents text yeah, almost all of the technology that is being developed is in some ways difficult for somebody to come up with. Something that's that easy is a win, right.
Jamie:Right, and that's the thing.
Jamie:It's not always about what's the shiniest and what's the most complex technology we can use.
Jamie:It's what's going to be the most impactful, what's going to have the broadest reach, and that's where I'm very passionate about breaking down some of the SDOH barriers that we know are impacting health outcomes for some of the more marginalized populations in our country, and with Memorial, we're seeing that Medicaid populations, african-american populations, immigrant populations are engaging at very high rates, and in a couple examples we've actually studied this and we've gotten the data to see that African American patients were more satisfied with their interaction on Memora than non African American patients.
Jamie:Right, and so this is actually helping to bridge some of that digital divide that we talked about, where, you know, there are just thousands and thousands of apps out there, but they're mostly catering to the more educated, the more literate members of the population, versus those who would benefit the most from many of those healthcare apps that are out there aren't even downloading those apps to begin with, right, and so that's why, at memora, we're focusing on sms text, because we know that's the way to reach the broadest populations as well as those who really need the help the most that's outstanding.
Justin:You're a solution for health equity plans. You know yes actually during all this talking like a, but yeah yeah, well. Well, I know you're kind of moving along here, so I want to make sure we get to.
Dave:Well, let's go back to the New England Journal of Medicine definition of patient-centered care and talk about the seven elements in the definition. But first a word from our sponsor.
BP2 HEALTH:It's pretty simple. We're three friends who love working together. We're like a special ops team of healthcare and we stay true to our mission and to ourselves.
Justin:Seven years ago, we decided that we wanted to form our own firm. We wanted to do our own thing. We were passionate about delivering it together, and we've been very successful.
Dave:So we started BP2 because we wanted to get our hands dirty and affect real change not lose sight of people and be really proud of the work we do.
Justin:We're BP2. Brown, pavlik Politi. We get our hands dirty, we do the work. We are passionate about delivering for our clients.
BP2 HEALTH:We are the reverse mullet of health care Little party. In the front, plenty of business. In the back, plenty of business in the back.
Dave:Okay, so let's dive into the seven elements of patient-centered care. So health care system, mission and values aligned with patient-centered goals that's one yep care is collaborative, coordinated and accessible okay, two care focuses on physical comfort as well as emotional well-being okay, so we're talking mental and physical here, which? Is important because a lot of times we miss those that differentiation. And next, also important patient and family preferences, values, cultural traditions, socioeconomic conditions um are respected.
Ellen:Anybody sdOH anybody, okay.
Dave:next, patient and family always included in decisions.
Ellen:Okay, I got one right. I said caregivers. Okay, next.
Dave:The presence of family members in the care setting is encouraged and facilitated.
Ellen:So that's something that's woefully missing.
Dave:I think so.
Ellen:Because when I show up with my parents at a doctor's appointment, you'd think that like this, like epiphany has happened.
Dave:Doctors are like, wow, you've come in force you can't come out here yeah, exactly, so okay next and finally, information is shared fully and in a timely manner, so that patients and their family members can make informed decisions justin's nodding.
Ellen:No, he's like. This does not happen.
Justin:That is that stuff that, like that is like. No, no way, that's happening oh, the information sharing yeah, no, no, it's like it's know we've had so many episodes just on this and the whole breakdown of that component alone everywhere.
Ellen:Right. So if that is, absolutely, yeah, aspirational, that'd be great.
Justin:Yes.
Ellen:So, Jamie, you're a physician, not just an executive of Lemora.
Jamie:So I mean, obviously, I think the list is a great list, right, and I think that there are so many things to unpack with each of these bullets on the list.
Jamie:I mean just starting with the information sharing.
Jamie:I think that was something that we touched on a little bit earlier on in our conversation, where you know I can say that there's been small progress, but we still have a long ways to go as a industry, and I do appreciate CMS and the federal government really stepping in here and pushing for interoperability and more information sharing.
Jamie:So I am optimistic that we're moving in that direction, but we still have some barriers that we need to overcome In terms of the patient and family being included in decisions.
Jamie:I really like that one a lot and I can just look back on my own practice, where I actually spend most of my time caring for hospitalized patients who tend to be older, and in many cases there are family members their son, their daughter who are present in the hospital helping us to think through, you know, what is the best way to move forward with caring for somebody who, in many cases, is kind of getting towards the end of their life. And you know, one of the sad realities of our healthcare system is that we don't do enough to plan for the end of life early enough, such that I'm in many cases having these conversations with the patient, their family, as they're there in the hospital, right, and that's something that should have been discussed many years before, when that person was still in optimal health and still was much more able to really be thoughtful and think about okay, what do they want for themselves, what is a kind of graceful like, what even is considered their, the last remaining years?
Ellen:said a different way. Do they even want to live? We work as a health system to keep people alive yeah we don't. We don't work as a health system. I don't think to respect having people live the life. It's that health span versus lifespan and, um, yeah, I, I have a you don't talk about mortality.
Dave:We know it's taboo.
Justin:It's put off to the side and it's very culturally specific too
Dave:but I have a very relevant uh story and I'll only take two minutes, I promise I want to get dr colbert's opinion on this. I volunteer at a hospice, so the story is as follows Patient is on palliative care, right there in the last hours of life. Patient has a pacemaker and that was the only thing keeping them alive and there was no discussion up front about that, and so there was this long drawn out process to deal with that. When all of these emotions are happening and I don't know the details of how it turned out. But my question is are there checklists and things that would? That would Seems to me something like that should be on a list that says pacemaker needs to be shut off? Um, you know, at some point not not when the, not when the family is distraught and wondering you know when's this going to end?
Jamie:Yeah, that's a great, great uh example and yeah, it's not something that you necessarily want the family to have to deal with and make a decision on, kind of at that 11th hour right. It's much better to have those conversations earlier on, because nobody wants to feel like they pulled the plug on their family member right, it was their decision right that ultimately kind of ended up leading to that outcome. So you know, that's where making sure that people are making their own decisions early enough in their life. They're really involved in that decision-making.
Dave:Yeah, sorry, I brought us down.
Ellen:No, no, I'm not going to do this, but I actually have a really relevant story as well, dave that happened this week.
Dave:So anyways, Justin, you bring us to take us in for a landing and we have two more questions, so we're going to do these quickly.
Justin:Yeah, so we always ask our guests what they're by the world of Coke, right? Or if pigs could fly, idea for health healthcare would be. So just throwing that out there, what would yours be?
Jamie:Yeah, I think those are great questions and I do like the idea of thinking about even these seven kind of aspects of patient-centered care and really looking at where are we as a healthcare system and why aren't we able to deliver those seven attributes today, those seven attributes today? And I think it's because the system is not designed for patients, right, the system is designed because we have these hospitals that are already there and we need to fill beds. So we're doing things, we're making decisions based on that reality and the finances behind that, versus let's just blow it up, right. You know, if we could start again, what would it look like? And I think that the hospital would play a much, much smaller part in the overall healthcare experience. I think that we would see hospitals really as places for patients who need intensive care, who very much are close to the end of their life or have had something catastrophic happen.
Jamie:And the reality is that a vast majority of care that happens in hospitals today doesn't need to happen in a hospital. It just does happen in a hospital because the system has been designed that way. But that's not patient-centric, that's not what patients even want, it's just that's what they're accustomed to. That's where the care is delivered and so they have to go there, versus how do we design a system that is actually coming to patients and meeting their needs? So I think a great example actually just happened. Yesterday, as we were preparing for this podcast, it happened that I didn't have the dongle to connect my microphone to my computer, and so I told Ellen about this and she said oh, no, worries, I'll just get you a new one on Amazon Same day. It was delivered just a few hours later right.
Jamie:I mean, just think about how customer centric that is, how seamless and frictionless that experience was, and it solved our problem with just taking two seconds to go onto Amazon click two buttons problem solved. When you have had a surgery and you've just come home from the hospital and you're having a new symptom, how easy is it for you to get the answer that you need right? In many cases you're trying to figure out who do I call? What's the right phone number? You call, you don't get through. Someone takes a message. You're waiting very anxiously for someone to call you back.
Jamie:When they do call you back, it may end up being somebody else who wasn't actually the surgeon who did your surgery right, so they don't even know your full story. You have to start from the beginning and tell them what happened right, and that's where you know. I think that we have an opportunity to really take a step back and think about how do we design a system that is meeting the needs of patients, that is getting them the answers that they want when they want them. That is not putting the burden on patients to navigate the system, but is actually putting the burden on the system to deliver the care that is meeting the needs of those patients in ways that is reducing friction right and that is making it easier for patients to navigate and have the outcomes that they want.
Ellen:They'll have the experience that they want.
Jamie:Well said.
BP2 HEALTH:Well, we really enjoyed our time with you.
Ellen:And we of course have more questions, and we can keep going on and on, so we'll have to maybe have a part two down the road, but we really appreciate you joining us today, jamie, and taking the time out of your day and thanks again, we do Thanks again.
BP2 HEALTH:I'm Dave Pavlik. Thanks for having me Thanks again.
Dave:I'm Dave Pavlik.
Ellen:I'm Ellen Brown.
Justin:And I'm Justin Fleury. We are the partners of BP2 Health, your best chance for real change. As you can tell, we could talk all day about health care. Drop us a line through our website, bp2.