Outcomes Rocket Podcast Tom Stanis: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.
Saul Marquez:
Hey everybody, Saul Marquez with the Outcomes Rocket. Thanks for tuning back in. Today I’m privileged to host the amazing Tom Stanis. He is the chief executive officer of Story Health, a health technology startup bringing together virtual care and artificial intelligence to revolutionize care for people with heart failure and other complex medical conditions by extending the reach of specialist care into the home. In the aftermath of his father’s stroke, Tom saw the threatening gaps in the treatment of experience, that was experienced by high acuity patients, and he became motivated to build the solutions that would enable a better healthcare system. With his co-founders, Nikhil Roy, a product expert, Dr. Ashul Govil, a clinical leader, and passion to transform severe care delivery, Story Health was born. It’s the work that Tom has done is inspiring. His time as head of software at Verily Life Sciences, which, by the way, he was also the co-founder, that’s Alphabet’s healthcare Division, where he oversaw the development of software products, including med-devices, care systems. He’s done so much, he aided the company in raising 1.8 billion in external funding and grew the software engineering, data science, and user experience teams from 30 to over 300. Before Verily, Tom was at Google for over a decade as a principal engineer building core systems inside of Google’s highly successful AdWords system. Such a privilege to have you here, Tom, I don’t know how you’ve done so much at such a young age, but excited to dive in, welcome.
Tom Stanis:
Thank you, I appreciate it.
Saul Marquez:
So, Tom, you too have a story, right?
Tom Stanis:
That’s right.
Saul Marquez:
I think it’s great to start things off. One of the things we love to learn is what inspires your work in healthcare?
Tom Stanis:
Yeah, my inspiration is very personal, and I kind of experienced this very firsthand. Ten years ago I wasn’t, I was still just an engineer at Google working on ads and payments and things like that. And I was actually riding my bike in Palo Alto, I got hit by a car. I don’t remember any of this because I had a concussion, and waking up in the ED at Stanford, and they said to me, we’re going to put you into a CT scan, see if you have any broken bones. I had no idea what was going on and came out and they said, okay, well, good news on the CT scan, we found that you don’t have any broken bones. However, there’s this mass in your kidney, and it turns out that I had stage-one kidney cancer. And there’s no way of knowing that you have this kind of stage-one cancer, it’s, there’s no symptoms. By the time there are symptoms, it’s usually too late. The chance of survival changes just dramatically from 95% chance of survival at stage one to less than 5% chance of stage four. So I really think that I like to say getting hit by a car saved my life. It’s pretty literally true, right? And that, that, that moment, not only was it a very transformational for me, my body, but also it makes you step back and think, especially the period between when you’re diagnosed, when you have treatment, am I spending my time on the earth on the most important thing that I could do? Is helping people click on ads and buy apps the most valuable thing that I could do? And I realized, no, what I wanted to do is actually give people the experience I had, where some technology, and in my case a CT scan like drastically change where your health was headed, right? So that’s what inspired me to work on healthcare, and it’s been on, I’ve been on a mission ever since. This is very personal to me that I want to do that. So that’s kind of the beginnings of it. But also, as most of us are dealing with these days, like I’ve watched my parents start to get older and struggle with that. And I’ve, as you mentioned in the intro, my dad, in particular, had great life-saving care that he got when he had a stroke about four or five years ago. But then I saw the experience that he went with when he left the hospital.
Saul Marquez:
Yeah.
Tom Stanis:
And just the number of different medications that he was on, he had severe side effects from, and getting those optimized, trying new things like, it took us over two years to actually get him in a much better place. And I thought that was a place where, hey, technology really needs to get onto this care delivery side, not just the kind of the research, the new inventions, but like just the delivery of care really could be optimized. So the specialist that’s seeing so many patients actually has the tools to be able to care for people like my dad.
Saul Marquez:
Yeah, the opportunity in that space is huge Tom, and by the way, appreciate you sharing your story. Just incredible that you went through that. Actually, you had shared that with me prior to this, and I was actually sharing that with my wife and she’s just like, oh, my God. Like, how lucky can you be, right? For something like that to happen? So you got hit and like you just woke up in the hospital, like you didn’t even, it was a really bad hit.
Tom Stanis:
Yeah, I can’t remember, even today, I can’t actually recall the actual accident. I know that it happened, but, but I don’t know exactly what happened.
Saul Marquez:
Wow, that’s insane. You still ride your bike around?
Tom Stanis:
So I only ride off the road now. I don’t actually ride on the road anymore because, yes, yes. I do remember also, like when I got the call, actually, that it was confirmed that it was cancer. My first thought, my wife keeps telling me that I said this, but my first thought was, how lucky am I? Which is a strange thing to think of when you first when you’ve been diagnosed with cancer. Like, how lucky am I, right? But, that’s kind of the only way I’ve been able to cope, I think, personally, is to have that kind of attitude. Otherwise, it’s just too overwhelming and too to think about.
Saul Marquez:
Man, well, Tom, thank you for that. And then your dad went through it and you realized, there’s an opportunity here, right? Let me put my thinking cap and my skills to good use. So that’s a great transition point to talk about your company. So tell us about Story Health. What exactly are you guys doing to add value to the healthcare ecosystem?
Tom Stanis:
Yeah, so as I mentioned, most people that have significant illnesses that are in and out of a hospital, you know, you get great care in the hospital and the clinic, but it’s very difficult to manage in between, especially if you think about the cardiologists like, getting an appointment is just really, by itself can take months, and then you have to deal with all these kind of follow-up tests that you are responsible for. And then you have all the medications that are complex and dealing with the side effects you’re going to be feeling. And it’s no surprise that most Americans actually struggle to navigate these systems and don’t necessarily get the best care available because of that, so, and it’s not the fault of the clinicians. They’re actually trying to do the best they can with the system they have, right? What they need is tools to be able to project their care out of the clinic. How can they be able to care for this entire flock of patients at once rather than having to wait, for just dealing with who happens to be on the schedule today? And so that’s what we’ve been building at Story Health, is tools to enable specialists to be able to care for people at home and optimize things on a daily basis.
Saul Marquez:
That’s great, Tom, and so let’s unpack that a little bit more, right? So behind the technologies and things that you guys do, because I understand there’s also a coaching component to this. Tell us about what makes you guys different and better than what’s out there today.
Tom Stanis:
Yeah, so a couple of things that I think are particularly differentiating. One is we integrate directily with what we call the electronic health record, right? So over the last 20, 30 years, we’ve started to build up computer systems that know what your health history is. But that data is kind of a mess, frankly, and it doesn’t get used much, right? So we built an AI system that can actually go through all that data and build a true picture of where you are and your disease process, and what the best treatment is possible based on what the latest science is. So mapping those together with our AI system, that’s one of the big things that we’ve built that’s really differentiated. And then being able to bring that to the clinician, have them understand and be able to quickly understand where you are, build a plan, and then actually be able to guide you through it at home, right? So connecting the patient, so they have an idea of where they’re headed towards and can get moment by moment guidance towards how they should be, actually manage their care, whether that’s measuring vital signs, getting labs done, taking medications, all those different things, that’s kind of the big differentiator. And then finally, I’ll bring on this just briefly is, technology is great, but most of us struggle with these things and especially our parents or older are going to struggle to use technology. So we bring in kind of a human side of this. So we have these health coaches that are there to guide the patients through all the logistical barriers that they may run into. So we see things like patients show up at the pharmacy and they say it’s going to be $900 dollars for your medication. All the health coaches, they can help with that, they can figure out why was it that price? Is there a coupon card somewhere that you should have gotten on, or is there another program that can help you afford your medication, or is it an issue of your insurance just hasn’t processed it yet? So all those sorts of things are the things that health coaches can help for, because we know that a lot of these barriers are not just medical, a lot of them are logistical, and we need to help us with that.
Saul Marquez:
Yeah, and Tom, I think it’s so great that you guys are focusing on that because these logistical barriers, like the price stuff, that happens so often, it is the difference between taking a medication and not.
Tom Stanis:
Yep.
Saul Marquez:
Right? Like labs, and you mentioned labs and meds. This is one area where stuff goes downhill quickly.
Tom Stanis:
Yep, absolutely, right? Labs is I think another thing where like just getting in a lab appointment can be really difficult. Or imagine that you can’t drive if you’re an older person, how are you going to get to the lab? You’re going to wait for your daughter to come and take you to the lab. So for a percentage of our patients, we actually will send somebody to your home to draw because that’s the way to make it happen, right?
Saul Marquez:
Amazing, and these are the things that are making a difference. So talk to us about some of the outcomes that you guys have seen as a result of the work that you and your team does.
Tom Stanis:
Yeah, so we really have tried to take a very scientific approach to this. We want to make sure that we’re really moving the needle on care. And that means looking at, first of all, are our patients engaging with the program? Are they actually active? And 85% of our patients are actually engaged with the program on a daily basis, it’s an incredibly high number. A lot of that’s because they’re very sick. They like the feeling being on Story Health that like, someone’s actually watching out for me, that there’s almost a guardian angel there that’s watching out and seeing that things are going right, it’s a very great experience for our patients. The other outcome that we talk about is how do we compare against the national registries in terms of getting people on the right therapy? There’s a great study that was done called CHAMP-HF looking at particular heart failure patients, how well are they doing on getting guideline-directed therapy? And it’s actually just shocking the numbers. Less than 25% of patients in the country are on guideline-directed therapy and less than 1% are actually on a maximum dose of all guideline-directed therapy. With our patients, we were actually able to fee 60% of our patients actually get maximum tolerated dose, which is a drastically major change in the way that care can be delivered. And that translates into big numbers in terms of both avoiding the hospital and staying alive. So to give you an idea, the average heart failure patient is going to be admitted, if they’re on minimal therapy, a chance of one in four, every year, you’re going to be admitted to the hospital for exacerbation. With us and getting onto the maximal therapy, we can drop that down to less than 10%, right? So it’s a big change in the hospitalization, and we can also drop the chance of dying by 50%, right, in one year, so these medications work. The science is there, it’s just a question of getting people adapted to them and making sure we have the right regimen that works for you.
Saul Marquez:
That’s amazing, and, you know, gosh, you mix in a lot of this evidence-based care and technology with, I mean, genomics, I think, and then you insert value-based care. We’re in a healthcare future that is so much more promising.
Tom Stanis:
Oh, yeah. Yeah, it’s really neat to see this moment in healthcare transformation going on, where we’re starting to think about not just what more can we do to patients, but also like how can we make sure that we’re solving the problem from all angles, right? As you said, value-based care now is incentivizing us to think about all of these things, not just what we’re paid for, really exciting movement. And you’re starting to see it being, 40% of Medicare patients are now in a value-based arrangement, some sort, right? So it’s not a rare thing now, it’s becoming very much the norm over time.
Saul Marquez:
Yeah, for sure. So, Tom, you know, these innovations don’t come without struggle. Talk to us about one of the biggest setbacks you’ve experienced and a key learning that came out of it.
Tom Stanis:
Yeah, I think that there’s definitely struggles with this. One of the things that I think that we’ve always dealt with is more connection and more data, it can be really overwhelming, right? And we’ve definitely seen that ourselves where there are some patients where it actually creates anxiety, it creates this feeling of, oh my gosh, I just can’t have heart failure every single day like, I want a vacation from this disease, right? And we’ve had to actually adapt the program and be a little bit more kind of smart and, I think empathetic as to what patients are going for that way, right? We want to make sure we’re asking the questions at the right moment, not just all the time, right?
Saul Marquez:
Yeah.
Tom Stanis:
You have normal life to live. Let’s let you live that life rather than reminding you of your disease every moment.
Saul Marquez:
That’s great. Hey, how many of us know that feeling, right? Like, just look at your inbox, you’ll get that feeling, and we don’t want patients to feel that way. So I think it’s great that you’ve inserted some adaptive technologies in there, to present more, and I love the word, empathetically to help with the effectiveness of it. So what are you most excited about today, Tom?
Tom Stanis:
So I’m excited about like this whole movement that we’re starting to see in medicine towards caring for the patient across all the different barriers, right? So one of the really hot terms right now is this notion of what’s called social determinants. And there’s this understanding that your outcomes in healthcare are much more determined by like your zip code and how, your income level, than they are by anything else, right? So I think addressing those issues is really something I’m very excited about and I’m also very excited that the entire industry really is like laser-focused on this now. So it really feels like we’re getting to the heart of the matter rather than inventing yet more devices and potions that no one can afford, which has been the trend for the last 20, 30 years.
Saul Marquez:
Yeah, that’s a really great call-out Tom. And so access is key, Story Health, you guys are getting into the doors of both affluent but also safety-net hospitals, I understand.
Tom Stanis:
That’s right, yeah. So to give you an idea, like one of the places where we’ve been live with for a while is in Wilmington, Delaware, which is a, you know, a difficult community. Frankly, it’s people coming from all walks of life and we deal with people of, that are struggling, right? These are people that don’t have access to the best care. And so being able to bring that to those, that population, is even a bigger difference you can make. And you can imagine, there’s even small things that you don’t even think about, right? Where if, say, you’re working an hourly job where you have shifts that you have to get and then you have to go see the cardiologist every two weeks to change your medications and get that time off. And then you get, you take half a day off to go see the cardiologist, you get there and they say, oh, actually, we had to move your appointment to next week because there was an emergency or something like that. Oh my gosh, what are you going to do? Like that alone is like a social barrier that we don’t even realize we’ve created in medicine, that being able to just move that whole setting of care so that it’s asynchronous and doesn’t actually require a visit is incredibly valuable to patients in those situations.
Saul Marquez:
It’s huge. Well, folks, that’s just the tip of the iceberg. And there’s opportunities to do more, to speak with Tom more. If you’re interested in the work that he and his team are doing at Story Health, make sure you reach out to him, make sure you learn more. Tom where can people do that? You know, what’s the website and what’s the best place to get in touch with you?
Tom Stanis:
Yeah, so you can visit our website storyhealth.com. Email us at info@storyhealth.com and we’ll talk to you about, we’ll be able to have a conversation about that. I look forward to it.
Saul Marquez:
I love it. Listen, the work you guys are doing is impactful. Any last thoughts? Any closing thoughts you’d like to leave us with?
Tom Stanis:
Yeah, I really just want to bring this back to the patient. Like, imagine what it’s like for somebody that’s discharged from the hospital, that’s dealing with a new life-threatening disease, sitting there not knowing what’s going to happen next and having to figure out all these different things. Just have some empathy for that moment and think about what it could be like versus what that might feel like if you were in that situation.
Saul Marquez:
I love that, and that’s something that I’ll be reflecting on. And no matter what seat you’re sitting in, whether it’s a provider seat, payer seat, think about it, or a solution business, think about that. Tom, really appreciate that reflection you’ve given us both through your stories and also the work that you’re doing. I appreciate you.
Tom Stanis:
Thank you Saul, nice to meet you and nice to be on the show.
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