Understanding social determinants of health data and its impact on human health
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Welcome to the Outcomes Rocket podcast where we inspire collaborative thinking, improved outcomes, and business success, with today’s most successful and inspiring health care leaders and influencers. And now your host, Saul Marquez.
Saul Marquez: And welcome back to the podcast. Saul Marquez here today have the amazing Kara Dennis. She’s the Senior Vice President and General Manager of Life Sciences at Clarify Health Solutions. Carries a health tech leader with proven experience building mobile software businesses and teams. She’s passionate about life sciences and experience and working with product engineering services and client teams to create new health care possibilities. You’re listening to this podcast. You care about health care possibilities. Sort of dive into some of her thoughts here about what she’s doing to clarify health. She joined after leading mobile health at metadata solutions where she was responsible for the creation of a comprehensive offering in mobile health. While there she led experienced teams to create deliver and scale the offering which included technologies for patient patent engagement and also integrated wearable sensor data into clinical trials. Prior to that Kara was with McKinsey and Company’s Healthcare practice. And she’s done a mixture of different things in the corporate world for healthcare so it’s a pleasure to have you on the podcast, Kara.
Kara Dennis: Terrific. Thanks so much. Great to be here.
Saul Marquez: Absolutely. And so we’re gonna be diving into some of the things that you guys do at Clarify, some bundles, BPCI, etc. But what I want to do is sort of get your story what got you into the healthcare sector to begin with?
Kara Dennis: Yeah it’s actually so a variety of reasons but one of the interesting driver is something that didn’t even come up on that bio that you just read. My first job out of college is actually with Teach for America. And I was teaching middle school students in Harlem. So that said that maybe like an entirely different podcast but an alarmingly high percentage of the kids I taught had serious asthma so many kids actually that we had standard protocol for how to deal with asthma attacks in the classroom. I actually have one on one field trip, I had a kid having such a severe asthma attack that he collapsed. I did pick him up and put him in a taxi. Actually he threw up all over me and all of the taxi. But he had a favorite target with a specific hospital and emergency room. But they take him seriously got there and that is fine. I ended up being fine but I did observe that a number of health issues kind of related to environment and stress were very pronounced in the community that I taught in and that was a big driver for when I joined McKinsey to raise my hand to work on healthcare projects. And from then the healthcare thing just like took hold and I loved exploring new therapies and new disease area and there was so much interesting work to be done in my sciences. I also worked for healthcare provider and I was hooked. I have an escape to this day.
Saul Marquez: That’s awesome. So you see you had this experience and wait a minute this could be better and you haven’t looked back since.
Kara Dennis: Absolutely.
Saul Marquez: So now you’re here you’re doing work with clarify how. What do you think is a hot topic Kara that needs to be on health care leaders agenda today and how are you and your organization approaching it?
Kara Dennis: Yeah I think there are several but one out is there’s a lot of discussion intra exploration analysis and I expect there’ll be more on social determinants of health data and that’s actually to some extent connect with the story I just told about environmental factors, stress, demographics, and economics that is impacting human health. And we certainly I think there’s enormous potential for better understanding social determinants of health data and by that I mean I think data that we can gather associated with an individual has a medical condition but data that on lifestyle nutrition believe whether the individual lives with other people at home. Engagement with community more basic kind of socio demographic elements those kinds of Spain have real potential not only for helping understand disease and helping identify potential interventions but as artificial intelligence tools and capability they’re built up across the health care system those elements the social determinants element help with the predictive power of models that are built in as a tool that are trained. So I think that’s going to become very interesting as we think about approaches to either development of new therapies or application of new approaches within the provider setting. There’s great potential for improvement in a number of different areas that will come from the insights that we pull out as social determinants of health data.
Saul Marquez: Fascinating and and so are you guys doing any work at Clarify as it relates to implementing social determinants of health?
Kara Dennis: Very much so. Absolutely and I think one of the things I just mentioned which is the social determinants elements are very powerful in our work for risk stratification of patients. So that’s one core capability of clarified to get to very sensitive and precise assessment of the risk of patient populations or individual patients. And then also as we make predictions about a journey of care which is another key element of what we do on a daily basis they make predictions about a clinical pathway a series of steps that a patient will go through either part of course of their disease or a specific episode. And the power of our predictions is greatly strengthened with this type of data.
Saul Marquez: Fascinating. Yeah it’s there’s no doubt that the social determinants of health are affecting everyday outcomes. You know I just think of companies most recently the one that comes to mind is like lift for example. All these patients that have no way to get there they have no car. You know now they’re using technology to help bridge that gap. And as you guys build your decision making models for providers, what’s been one of the key insights you’ve made here and in this work?
Kara Dennis: Yeah it’s a great question. Just as I think about think the predictive model the so I would say on on the provider side there there’s a variety of elements. There’s some elements of it that are specific to some of our clients I’m just trying to think of the weather there for example. Actually it may be worth going through a different question and I’ll try to think of an example for you and it may be worth coming back to that answer.
Saul Marquez: Now that sounds that sounds good. Now maybe we could visit another area of focus and chat with the listeners about how you guys have created results improved outcomes by doing things differently?
Kara Dennis: Yeah. So a couple of things. One is I think that what we tried to pull together in terms of our team and the types of people that we’ve been bringing on board I think it’s quite unique in my experience of the health tech landscape. So it’s a combination of things one is a big part of our team comes from the financial services industry which is interesting and exciting for a couple of reasons. But a core engineering and product team came from a world where they built portfolio accounting software for hedge funds and large global investment banks. So they had to build a platform that was that was able to scale over the true big data platform to take in all different kinds of data structure a cleanup process and do analysis on it. So that platform which process the value of derivatives on a nightly basis was was terrifically successful and then the team wanted to turn their attention to health care for a variety of reasons. And so they joined forces with former senior partner at McKinsey our current CEO and decided to work on helping providers make the move to value-based care. So they put together similar to what they had in financial institution a big data platform that scaled quickly that pooled in data from all over the healthcare ecosystem and that’s what we have today. Same thing. Clean it manage it make sense of it and build a software platform with intuitive simple workflows that enable users to pull insights from the data and to guide decision making. And so I think that the the angle of pulling this great base of talent from an industry that may be quite a bit ahead of where healthcare is today in terms of big data processing and analysis and use of artificial intelligence. I think that was that was a terrific insight and I interpret approach. What we’ve also done is filled out the clinical expertise in a therapeutic area expertise to support it because I think anyone who works in healthcare knows that the learning curve to understand healthcare data healthcare applications to understand disease that learning curve it is real. So we had actually a large number of doctors on staff and a large number of people with deep expertise and experience and provision of care life sciences the payer say. So that to me has been the single most exciting thing about clarify is this combination of incredible talent from those two different sides of the world if you will working on these big problems in health care.
Saul Marquez: For sure. And if there were a particular niche say that you guys have seen some major strides in helping your clients what would niche would you say that is.
Kara Dennis: So the initial area of focus for the company with many of our clients. You know we have a data platform that’s quite expansive and that can address a broad range of analytical and then clinical pathway workflow challenges within a provider’s bank. But one of the initial things that made sense to work on with clients was support for bundled payment. And so one of the interesting things that some of your listeners may know others may not be familiar but Medicare has a series of I think very thoughtfully constructed initiatives to support the transition to value-based care. And they’ve done it in a very targeted way which I think is a great approach to getting healthcare providers moving in that direction. I know there’s a lot of if you step back there’s a lot of lamenting about how how healthcare is so driven by fee for service and you make more money if you do more services. How do we move to value-based care. And I do think that an enormous amount of thought and effort has been putting in to make that move in one of those areas is some of the targeted bundled payment program including the BBC programs of the AMA. So we’ve been able to support clients in understanding their performance within those those structured payment models. So as they receive a bundled payment from Medicare we help them make predictions about how much it’s likely to cost for that to treat their patient population with these payment bundle. So there is clinical and financial or operational components of the analysis and of the performance management.
Saul Marquez: That’s great. You know Kara what a great focus area because as the systems do make that transition it gets confusing and it’s easy to get lost. And so I love that you know your company’s name Clarify, it’s just very very appropriate for the work you’re doing in bundled payments. You know it’s hard to track and it’s hard to understand where it’s all going. It sounds like you guys have a great system to help folks understand that.
Kara Dennis: Yeah absolutely.
Saul Marquez: So what would you say your proudest leadership moment to date has been in healthcare?
Kara Dennis: Yeah I would say a couple of things. One is, so as you mentioned in the intro I came from Medidata Solutions which has was a fantastic journey and if I have to step in my career and I ran our mobile health team our mobile business unit and we built a number of offerings really from the ground up from an initial conversation with a client who told us I have this problem and described the problem. Then we went back and started to put together the beginnings of technology software databases that would help them address that problem. Built it out tested it with Charter fly and tore it apart when it wasn’t working and rebuilt the head and then got it up and running and clinical trials and specifically we built technology that did a couple of things it ingested data from wearable devices. So patients and trial could wear something that was fairly simple and intuitive and easy for them. And the trial investigator could be gathering data about their mobility, about their sleep, about potentially like movements throughout the course of a day. And they got some really powerful indicators about patients quality of life in you know potentially a quite seamless way. And there were so many different you know we went around and talked to companies there were so many different therapeutic areas that were key leads would tell me that they really would tell me a couple of different things. One, is that the data that they had available to them to assess the trajectory of disease or response the therapy that that data was not sufficiently objective that they were relying on subjective measures from the doctor or the patient or they would tell me that the data they had was not sufficiently continuous. There were gaps in their understanding of the patient’s progress. And so we were able to put together this more continuous more objective flow of data on how the patient was doing. So just building I think that offering from nothing to youth and in clinical trial was really exciting. And I think your question about proudest moment, I absolutely think that when we would take a look at metrics of our portfolio and the usage of our offering across a variety of different kind of a large base of clients and see actual metrics on client logging in and usage pattern that was so fulfilling. One of the most fulfilling thing I think so that I would absolutely include it as a key element of proudest moment. And I have to say the other the other thing that immediately comes to mind when you ask that question is just the teams that I’ve been able to build out and work with over the year. Because I know there’s so much this sense of fulfillment that I get out of work that comes from the health care problems and the client needs and building the software and seeing technology work its magic. But there’s also so much fulfillment that just comes from coming into work every day and working with incredible people who are smart and motivated and excited about helping patients, excited about building technology. And I’ve had such really just the honor of being able to build out teams and get people I think incredible problem to work on and working on those problems myself really hand in hand with them so that I would include it as the second thing. I’ve just always been so fulfilled by this team.
Saul Marquez: That’s outstanding. Congratulations on that. Nothing like working on a solution and we all know the cycle for innovation and health care is long. And so to see something like that. Right. And then hit the road and see it used in a way that really helps improve outcomes is great. So kudos to you and your teams. I could hear the passion in your voice as yet as you talk about them. You’re a good leader, Kara and I’m sure your team knows that. And the thing that comes to mind is hey you know behind every success there’s the obstacles that had to be overcome. Can you share one of those obstacles and and the lesson that you learned out of it?
Kara Dennis: Yeah so many and that is again an entire podcast unto itself all the failures that are all the things that yes we just had to do better. And I’m definitely a big person where I just like I used to tell my team all the time and it was easy someone else would have done it. Like there’s so many just day to day challenges of working in healthcare and there is nothing that is easy about the data or about the workflow of a clinical trial or about finding patients or anything like that. So a lot. Lots to discuss there. One of the things that stands out to me that was actually kind of interesting is back to that what I just described which was building up that platform for that ingestion and use of wearable or Internet of Things data and clinical trials. There was a lot of great use cases in momentum for that but one of the things that we learned along the way we have been assuming that the wearable and the data thrown off by the wearable was going to be good enough for use in a clinical trial. And of course this is with data cleaning and analytics and a set of tools to weed out the problematic data and that kind of thing. But we had to learn through a number of different or worked for a number of cycles of trial and error testing out wearable to work for the combination of different factors that would make a wearable viable in a clinical trial. And we did learn about what those different factors were. So for example I think in early rounds we probably didn’t fully understand how important it was to really understand that ease of use. We used wearables that had great data but if the patient wore them in the shower it would get dripping wet and then you going to take it off and not wear it for a period of time. So that was problematic or patients would take them off before they got into the shower and then they would forget to put it back on and move you move long stretches of data or we would hear you know we had no other devices again. They were terrific. We thought in terms of data quality in our initial testing but we would get feedback from patients that they were too big and clunky and too obvious and that the patient really didn’t want anyone to know that they were sick and they want to talk about why they were wearing the strange device on their arm and waiting. So the data quality for that in that case in that some of the problem that problematic features of that particular wearable. And then in other instances we would run into things that maybe weren’t a problem for a consumer grade device because the consumer might be able to tolerate gaps in data or issues where they kind of scratch their head and say that data seems problematic but whatever I’ll move on to the next day and pay attention to the data the next day whereas in a clinical trial particularly if you all could that we would want an outcome a clinical end point to come from that data, the rigor is it’s just much much higher for not being able to have missing data or not being able to have data that out of that or you know just making sure all that data transferred properly and there is a lot of those pain points that we spent extensive amount of time working through but really that that patient experience and like making sure that upfront you spend an enormous amount of time doing your testing doing your user research to make sure that that you have like a full month and end experience even starting with at a clinical site. The research coordinator really needs to be able to take something out of a box to hand it to the patient isn’t it easier to put it on easily if that whole process takes like five, ten minutes. We’ve kind of lost you’ve lost your momentum you lost the ability to get to a point where the sponsor or investigator of a trial and the site and the patient think this is a good idea. Once you start adding burden it really becomes problematic. So I think I know to answer your question that I think really putting investment up front and to researching those types of things with a big takeaway of mine and a lesson learned.
Saul Marquez: It’s a great great call out Kara, you know the other thing that comes to mind too is the importance of agility and the ability to have teams pivot on information that may have been wrong. And so what what would you say was the key to helping keep that agility high?
Kara Dennis: Yeah. One thing that does stand out is just thinking of the lessons learned not as failures but as truth like learning opportunities and getting excited about learning opportunities. So I think that having like for me as a leader of a team what I find is critical is to go into every interaction with clients and with the teams just like truly excited to learn about all the things we could be doing better. That makes all the difference because then even when you’re asking a team to redo something that they’ve done already you know they need to pivot and do it differently and think differently. Just really managing that and talking about it as an exciting thing and now we get to try a different way. That’s really important. The other thing in terms of being agile it kind of goes back to what I mentioned before just about understanding users all across the spectrum. And that’s actually another I think complex thing about healthcare is there’s only a very few solutions where there’s really only one user you know even if you’re often companies that are making something directed at a patient have someone buying the solution that’s not the patient. And so there’s just so much that goes into understanding the workflow of all parties. But I absolutely think that in order to stay agile you have to stay very very close to your client, the users, others in the workflow and really immerse yourself in that. And for your team in the path that involves spending a lot of time at trial site and just a lot of time on the ground with clients understanding like what they do on a day to day basis and what they’re trying to solve with the solution.
Saul Marquez: Great tips there. Love the approach that you guys have taken there and the success obviously speaks for itself. Let’s pretend that you and I, Kara are building a medical leadership course on what it takes to be successful in the business of healthcare. It’s the ABC’s of Kara Dennis. And so I’ve got four questions. Lightning round style followed by a book that you recommend to the listeners. You ready?
Kara Dennis: Awesome
Saul Marquez: All right. What’s the best way to improve health care outcomes?
Kara Dennis: Through deep understanding of disease including the social determinants of health that are associated with that disease.
Saul Marquez: What is the biggest mistake or pitfall to avoid?
Kara Dennis: Making assumptions that don’t have a deep foundation and the patient or the user of the health care solution.
Saul Marquez: Love it. How do you stay relevant as an organization despite constant change?
Kara Dennis: You have to embrace the change. I think change is the constant within healthcare. And so building a core capability within your company to be excited about learning and adapting to that change.
Saul Marquez: What’s one area of focus that drives everything in your organization?
Kara Dennis: Absolutely the patient and absolutely getting better care for the patient by better articulation and understanding ofpatient journey.
Saul Marquez: And what book would you recommend care to listeners as part of the syllabus?
Kara Dennis: I really do like the Emperor of All Maladies. Great overall but in particular for a health care audience that’s a fantastic one.
Love it. So listeners Kara’s given us some great pearls of wisdom here in this mini syllabus for you. The full transcript of our interview, links to their company, they’re all available on the website. Just go to outcomesrocket.health/clarify you’re gonna find everything there. This has been a ton of fun. Kara I love if before we concluded you could just share a closing thought with the listeners and then the best place where they could follow or get in touch with you.
Kara Dennis: Yeah absolutely. So you know I think clothing thigh really that this is such an exciting time to be in care. I think what I’m seeing at Clarify is the integration of best in class solutions in that platform, big data, artificial intelligence from other industries. I do feel like are at long last making their way into healthcare and that’s going to be a terrific benefit for all of us that work in health care and health tech. So that it’s just a really exciting time and I do think a very interesting inflection point for many of us. So that’s great. And you can find me LinkedIn, Twitter, email I’m kara@clarifyhealth.com maybe the best way. And thank you so much for that. It’s such a pleasure. And excited to have a foundation.
Saul Marquez: Kara it’s been a pleasure and looking forward to hearing how you guys do your amazing work moving forward. Thanks for spending time with us.
Kara Dennis: Fantastic. Take care.
Thanks for listening to the Outcomes Rocket podcast. Be sure to visit us on the web at www.outcomesrocket.com for the show notes, resources, inspiration, and so much more.
The above audio transcript of “How to Deliver more Satisfying, Higher Value Health with Kara Dennis, SVP and GM, Life Sciences at Clarify Health Solutions” was transcribed by the best audio transcription service called Sonix. If you have to convert audio to text in 2019, then you should try Sonix. Transcribing audio files is painful. Sonix makes it fast, easy, and affordable. I love using Sonix to transcribe my audio files.
