Offering a platform that automates care delivery
Recommended Book:
Best Way to Contact Ray:
info@bright.md
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Saul Marquez:
Welcome back to the podcast. Today I have the pleasure of introducing Dr. Ray Costantini. He’s the CEO and co-founder at Bright.md. Ray is a pioneering health care business leader, innovative physician, and seasoned entrepreneur who’s passionate about health care. Prior to founding Bright.md, He led the design, build, deployment and operations of three groundbreaking telehealth and digital health products at one of the largest health systems in the country. He also previously founded three successful companies and is a national speaker on health care innovation, telehealth and patient engagement. These topics are all core to the operations and outcomes improvement efforts that many of you are listening to at Bright.md, he oversees marketing sales, partners success, engineering and clinical content. It’s a true privilege to have Ray on the podcast today. Ray, welcome.
Ray Costantini:
Thank you, Saul. Looking forward to talking with you.
Saul Marquez:
Likewise. So did I miss anything in the intro that you want to highlight for the listeners before we continue?
Ray Costantini:
I suspect there’s more interesting things to talk about than my background. But I guess the the things that always stood out to me were that it was a combination that you really had on and I’ve been on both sides of the rail – bed rail. I’ve been both a physician and a patient and the family member of patients and I’ve been privileged to be on both sides of the business table both on the health system side and that as a solution provider. And I think that combination of perspectives has really helped me look at things differently and hopefully be a better partner to the delivery system that we work with and the patients and providers that we help.
Saul Marquez:
Now this is a really great, great point to bring up the lens to be able to see it from from all those angles is important. What would you say got you into the medical sector to begin with?
Ray Costantini:
It was definitely a passion for health care and for doing good in the world. I started much earlier in my career as an entrepreneur. I come from a long line of entrepreneurs. It was one of those funny things. My dad was an entrepreneur and my grandfather was an entrepreneur and I started down that path very early as well. It was in a very different industry. It did well but I didn’t didn’t love what I was doing and did well enough so I could kind of play the field and look for something that was less of a job and more of a vocation or a calling and healthcare was definitely that it was actually a funny thing I told my dad that I was going to go to med school and he said why. He end up, he was very supportive but it was interesting to start from a different perspective. So that’s definitely been the right choice for me.
Saul Marquez:
That’s cool, Ray. It sounds like you started on the entrepreneurial road wanting to find more meaning. Did the bedside. And now you’re you’re back at it. But now with this new specialty given their experience in health care.
Ray Costantini:
Yeah. It was I had a bad experience when my mom had multiple sclerosis and I was very early on as a child and my dad had struggled with health care issues and so I think the best part of where that passion and calling came from, passion comes from personal experience and I think they continue to build. We all experience health care.
Saul Marquez:
Now totally true. Now tell me a little bit more about Bryan M.D. and what you feel hot topic that needs to be on every health leaders agenda today.
Ray Costantini:
Gosh you know I think the the thing that we found is that it’s easy to focus on some of the hot topics out there the ones that people are really aware of those consumerization of health care or provider burnout or patient access or transition to a value based care. A lot of really important things are happening in health care right now. I have found that the most interesting and valuable problems to solve are often not those ones that people are the most aware of but the ones that are underlying those issues and people are aware of the ones that are so the problems that are so big and ubiquitous that people almost forget that they’re there and they see the symptoms rather than the disease. And for me I mean what I’ve seen is you know there’s this terrible supply demand mismatch that we’re struggling with in health care where we’ve got 30 percent less capacity to deliver care than there is patients demand and that’s getting worse every single year because of a whole lot of reasons both because of the increased needs from patients as they get older and our population grows but also because of the provider burnout. The fact that providers are actually leaving health care and then we start layering on these other challenges of unlike every other industry as we’ve brought I.T. to bear in healthcare unlike every other industry where it’s actually made things more efficient. We’ve actually seen a reduction in productivity and efficiency from I.T. and healthcare. And that’s contributing to all those things as well. So fixing that you know we had this huge ocean of provider capacity that’s really on tap to hold these all this time that providers are spending doing things way below top of license practice. Providers are spending even conservatively 60 plus percent of their time on low level administrative work and that’s not what clinicians spent more than a decade going to school for. And it’s not the best way to be able to use their time. And that’s really the core issue that we’re trying to help with this. We want to make access to care cost of care provider burnout quality of care all better by tapping into that ocean of capacity that’s really being underutilized with clinicians.
Saul Marquez:
Great great topic to focus on. Tell us a little bit about what you guys are doing at Bright.md, maybe some examples of how you’re creating results or making things better.
Ray Costantini:
So what we do and we often get lumped into the telehealth category which is not unfair and that we help enable care to be delivered remotely but more importantly what we do is something very different. It is terror automation. So we built a platform that really automates that care delivery process. It supports providers must then deliver that care not only remotely which is great for patients really convenience and lower costs but we’re letting providers deliver care much more efficiently instead of spending all their time on administrative work. We actually we interviewed the patient for the provider. We gather information from the EMR system and incorporate that into that interview process. We write the chart note for the provider. That’s a third provider time is just typing up these notes that they have after every single interview and we do that for them. We do all the order entry. We do all the prescription writing we’ll do we’ll tee up the downstream referrals to any specialty services that are needed or diagnostics finished the billing files. So by doing all of those things for the provider what we do is we let them focus all of their time and attention where it should be which is on patient care it’s on providing diagnosis and treatment. And that means that they’re able to do that in about two minutes a provider time as compared to the 20 that they’re spending on all of the things that they shouldn’t have to. And that means that care is less expensive. It means that providers are spending time where they want to and it means the patients are able to get that more affordable care more affordably and much more quickly and in a more delightful way. And the other thing that’s really neat as a clinician I hear care in two minutes and the first place my head goes as well but what kind of quality gets delivered and what we’re seeing is actually better adherence to evidence based best practices because we’re not time constrained we can actually be more thorough in the interview of the patient. So we’re actually seeing better outcomes through the smart exam platform than you see in person or via video because we remove those time constraints and we’ve been able to be more consistent and more thorough in that care delivery process than we’ve allowed our providers to be in those other settings.
Saul Marquez:
Fascinating. Ray tell me a little bit more about who your customer is. Are you working with provider organizations are you working with individual, physicians? Tell us a little bit more about that.
Ray Costantini:
Yeah we’re primarily at this point focused on health systems, larger health systems. We work across the gambit with. We’re working with three of the five largest health systems in the country. The not for profit health systems. We are also working with the integrated delivery networks that are as small as a single hospital and we’re working with some large independent position ambulatory practices. So we were able to do that whole gambit and our focus is primarily on those ideas – the hospital plus ambulatory practice groups. We get some breath in there as well.
Saul Marquez:
Love it. Yeah. There’s no doubt. Every week you see posts and articles and information about physician burnout. The quadruple aim. Yeah sounds like the work you’re doing is very much targeted toward that. But going to the core of it right I mean and oftentimes the core is not necessarily sexy. You got to get them there and it’s beautiful that you guys are focused on the problem not the symptoms. I love to hear as you’ve built the company and you’ve rolled out implementations. What’s an example of a setback you’ve had and what you learned from that to make you better?
Ray Costantini:
Yeah well I suppose I would think about two different ways. The direct answer. I mean like a setback that I’ve personally had as we’ve continued to grow and be successful as a company. It’s been a challenge to let go of things. It’s interesting to go from being the founder and one of the small handful of people who are the company to a really talented team of executives who are each better at their area of expertise than I am. And that process of letting go is definitely been as I call it a setback but certainly a challenge. And then in terms of an industry it’s interesting we’re by our nature and our DNA is that innovation. So I think some of the biggest setbacks that we run into are when we’re we’re outpacing the healthcare industry’s capacity for that. So you know we are out there we’re constantly pushing the envelope into different areas of care and helping people think about care and the care delivery process differently. And sometimes we step a little further than people are comfortable with. So I would say that’s the most common setback that we run into and that’s what I found is that it’s important to be able to recognize those and then take that step back. Keep that thing that was pushing further than people were ready for in the hopper that helped people move along that path at a pace that’s only a little bit uncomfortable but that they’re ready for.
Saul Marquez:
Yeah. Now I’d say that’s a really good problem, Ray.
Ray Costantini:
Yes it is a…
Saul Marquez:
Some people struggle to be at.
Ray Costantini:
A high class problem to have in the spectrum of things. I’m not really complaining but but it’s still the interesting thing about high class problems that there’s still problems. And yeah I’ll do something about it.
Saul Marquez:
So without a doubt. Right. You see what it could be. However there’s definitely some as you call that you know capacity to implement challenges. And yeah you just get to play with the market and the appetite.
Ray Costantini:
Yeah I think that’s exactly right. And the other thing I found is understanding people’s incentives are they built around. And in healthcare we start talking about this a little bit beforehand but that it’s a complex space and those incentives can be they can be less transparent than people would like them to be building a product that actually helps people do what they’re looking for makes a big difference. I mean if you if I went in and told clinicians we’ve got this great product that will help you deliver higher quality care for the 2 percent of patients that are really complex and you don’t know what’s going on with them but it’s going to cost you 1 percent of efficiency on all of your other visits. That’s a tough sell as a well it means. It could make things better for some people. The fact of matter is we’re still humans. Clinicians are human and so that’s not the way that we’ve built our industry to date. Now it’ll be interesting to keep an eye on that but understanding what people are looking to be able to get done and helping them do that. I think it’s a continuous challenge in building great products.
Saul Marquez:
It’s a great insight. So how about the other side of the coin Ray. What would you say one of your proud medical leadership experience is has been to date?
Ray Costantini:
Some ways it’s harder to talk about the things you’re proud of and things that you’ll learn from. I suppose you know I think it’s I feel a lot of pride when I see clinician reaction to what what we’ve built now we’ll show them what writing we can do actually first we’ll tell them that you know we have this exciting new AI platform that helps them deliver high quality care in less than two minutes of time and you can see the skepticism set in and they’re like sure. Then we show them what we’ve built and how it works and not only do we get these audible wows but it actually is catalyzing a change in how they’re thinking about how health care can be delivered. You know we’ve taken away all of the discussed part of their job. We’ve made it so instead of spending 32 clicks to order a flu shot you can actually deliver care in three and not only do they get excited about what we’re doing. They start to get excited about what we can do together. And I think that’s that moment where I feel closest to our our mission of transforming health care. It also increases my risk of doing the same thing we were talking about earlier innovating ahead of where folks are ready to go especially when they get enthusiastic clinicians who are like oh my gosh there’s so much more we can do. And that plays into my natural weakness of wanting to do more faster.
Saul Marquez:
Now that’s really great. That’s a great example and definitely I think something that a lot of product development folks as well as entrepreneurs business leaders are always looking for is that aha moment that.
Ray Costantini:
Yeah.
Saul Marquez:
You know user sees the value and this is the best feedback yet.
Ray Costantini:
Yes. And to me I think it’s one step more than that. Honestly it’s even more than that they see the value of what we’ve done is that they’ve gone from being a skeptic to being a collaborator. They want to help us do more. And that’s when you’re not just you know just it’s just pride of ownership and what we feel like it feels like we’re catalyzing a change and that that even more so. I mean that’s that’s my passionate enthusiasm for making health care better. It really lights a fire under that, wthen I see that that moment of shift for sure.
Saul Marquez:
So Ray, tell me about an exciting project that you guys are working on today.
Ray Costantini:
I feel like we’re doing that every day. You know we’re continuing to build out Bright.md so that more health systems can serve more of their patients were now accessible to 8 million patients, thirty thousand providers and we’re letting them get that high quality affordable, accessible, efficient care for almost 60 percent of primary care. I suppose the exciting part of this now we are we’re now growing into these adjacent spaces. So we started out in episodic care. So conditions that happen and need care but are time limited. But we’ve now grown into some of these adjacent spaces. And that’s really exciting. We just launched our low back pain module and that’s you know it gets patients timely access to care for a condition that can be really debilitating and difficult. And it not only helps them get a diagnosis and get treatment but it connects them with the resources that they need to better manage their low back pain. And in fact even helps combat some of the challenges that we’re facing on the opioid crisis you know and rather than getting somebody’s pills we get them connected with skills. And I suppose on a given you referred downstream into physical therapy get connected with what they need. And then on a very related note you know we’re now also we just launched our first mental health condition coverage. So we’re now supporting care for depression and anxiety and PTSD and adjustment disorder. These are things that underlie not only are they important in and of themselves because this is stuff that people really struggle with. And in fact struggle to get access to get care huge numbers of people are either either struggle under the stigma of mental health or they’re not comfortable coming in and talking about it with their provider. They struggle with the lack of capacity. We don’t have enough providers to get them the care that they need. So I love that we’re helping on both of those fronts but that same thing connecting patients with skills not just pills. It’s important. Anti-depressants are an important part of supporting care and we enable that but we’re also connecting them with both digital and traditional human downstream services to improve their management of their mental health as well. And since that has is both an ongoing condition and underlying a lot of the challenges that we see in chronic disease management of other areas. I’m really excited about us being there and helping to support that. That’s a really exciting area for us to be getting into.
Saul Marquez:
Definitely exciting Ray. So folks if you guys are wanting to learn more about what Bright.md is up to Rael definitely provide you with a great way to access their work the Web site here at the at the end of the podcast. Getting to the lightning round of our show Ray and then we’ll conclude this section we’re going to build a mini syllabus for the listeners. I’ve got a couple of questions for you. I’ll ask, these are brief answers followed by a book that you recommend to the listeners. You ready?
Ray Costantini:
I think so. Lightning Rounds always make me nervous. Let me see what we can do.
Saul Marquez:
All right. What’s the best way to improve health care outcomes?
Ray Costantini:
I think it comes back with that same thing of recognizing the underlying issue and then building tools that help actually address that rather than taking solutions and going looking for problems. So I think that’s a critical.
Saul Marquez:
Love it. What’s the biggest mistake or pitfall to avoid?
Ray Costantini:
So for health care as a whole rather than myself like an integrated talking about that one I think it’s I see a lot of health care continuing to think that our industry can move slowly into consumer digital and not be disrupted. And Sun Microsystems and Kodak and Blockbuster and Sears all argue otherwise and I think health systems are starting to recognize that. I’m seeing at tonal shift then but it’s a mistake or pitfall that I think people have to be figure in this one out.
Saul Marquez:
How do you stay relevant despite constant change.
Ray Costantini:
Read a lot and listen a lot and listen for those underlying needs not the answers. Hire really bright, talented, open minded, passionate people and build a culture of innovation where ideas and insights are valuable, where failures are embraced, where nobody needs to be right that everybody is responsible for ensuring that we do the right thing. That’s a hard question to answer. Probably longer one than deserves for a lightning round.
Saul Marquez:
No, it’s perfect. To the point I love it. What’s the one area of focus that drives everything in your organization?
Ray Costantini:
Our mission, our mission to transform health care, to empower providers to deliver better care for patients and their values. The values that we as a company aspire to constantly. I suppose it’s two but hopefully that. Hopefully that works.
Saul Marquez:
It does. It does though it does a job, Ray And the last two here. A little more on the personal note. What is your number one health habit?
Ray Costantini:
I have most relatively recently like in the last year taken up pretty actively meditation and I think that it comes back to one of those challenges that I had mentioned earlier in the interview. As I’m aspiring to let go of things and left my really talented team move them forward better than I could have. Being self reflective taking that time to just sit has been a very powerful habit and a new one for me.
Saul Marquez:
That’s great, Ray. And what is your number one success habit?
Ray Costantini:
Knowing what you’re aiming for. Being very clear about what the end points are in what matters and then letting go of the things that don’t. Being disciplined about the process of.. my dad used to say life is a series of stacked rankings and knowing what’s most important and putting your energy towards what you can make the most impact towards and recognizing that the best way to make an impact.
Saul Marquez:
I love it. Great message. And what book would you recommend to the listeners?
Ray Costantini:
You caught me. I meant reading a lot. I could go through a litany of them. I do read a lot. Health care specific.
Saul Marquez:
Anything in general I mean whatever pops up in your mind first.
Ray Costantini:
So yeah The Healing of America is fabulous primer on the different ways that health care can happen. Just read a great book called Switch about how to drive change when change is hard. Really excellent framework around that we’ve been using is a classic but lengthy on a slide dysfunction the team brought that went back out. Recently I’ve been working with just a funny thing to say about your executive team but if you read the book it’s less about dysfunction and more about how to be more functional. Actually my wife got me back into science fiction recently. It’s always passing to read science fiction and realize how many ideas that we have now that we take for granted came from the creative mind of science fiction writers.
Saul Marquez:
It’s pretty amazing. I agree. Yeah.
Ray Costantini:
It’s stunning.
Saul Marquez:
It’s stunning.
Ray Costantini:
Oh my God there’s something with me. Interesting ideas. How do they. It’s the creativity. It’s cool. It’s really.
Saul Marquez:
Yeah it’s like. This book is written in the 60s and this thing just came out in 2019.
Ray Costantini:
Yeah yeah it’s it’s wild, it’s really wild. So yeah there was not one book I suppose but it is. It would be hard for it’d be like trying to pick my favorite music or favorite song. Depends on depends on what I’m trying to do or with depends. That’s a quick answer.
Saul Marquez:
Can be an example folks there’s a collection of readings from ray Costantini. Take a listen. Check those out. You could check out all of these links as well as a full transcript of our discussion and a short version go to outcomesrocket.health in the search bar type in Ray Costantini or type in Bright.md and you’ll find the show notes there. Before we conclude Ray, I’d love if you could just share a closing thought and then the best place the listeners could learn more about you and your company.
Ray Costantini:
I really enjoyed talking with you it was fun. I hope there’s hoping in a little bit of what we what we get to talk about was impactful for folks and helps continue to drive velocity of outcomes in healthcare. So thank you I appreciate your time, Saul.
Saul Marquez:
Absolutely, Ray. And if the listeners want to check you out the website for you.
Ray Costantini:
Yeah, our website is bright.md. Or they could email us at info@bright.md
Saul Marquez:
Outstanding, Ray. Thanks again for your time. Really appreciate you carving it out for us and sharing your insights.
Ray Costantini:
A pleasure. Thanks again, Saul.
Thanks for listening to the Outcomes Rocket podcast. Be sure to visit us on the web at www.outcomesrocket.health for the show notes, resources, inspiration and so much more.
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