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How AposHealth is Using Gait Technologies to Create a More Frictionless Healthcare System
Episode

Clifford Bleustein, Global President and CEO of AposHealth

How AposHealth is Using Gait Technologies to Create a More Frictionless Healthcare System

Could gait be the next predictor of overall health? That is one of the many things we will talk about in this interview.

For this episode, we have the privilege to host the excellent Dr. Clifford Bleustein, Global President and CEO of AposHealth, an FDA-cleared foot device designed to alleviate pain and treat gait-related conditions. Dr. Bluestein discusses how AposHealth’s shoe device leverages biomechanics to help patients get temporary relief for pain, improve function, and develop better movements. He talks of ways his company delivers better outcomes for patients’ musculoskeletal care. We also cover challenges, business models, client profiles, and more. This is a stimulating conversation about gait and its impact on our health, so be sure to tune in!

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How AposHealth is Using Gait Technologies to Create a More Frictionless Healthcare System

About Dr. Clifford Bleustein

Dr. Clifford Bleustein is the Global President and CEO of AposHealth. He is also an Adjunct Professor of Economics at the NYU Stem School of Business for the past 13 years. 

Prior to AposHealth, he was the President and CEO of Computer Task Group, where he managed more than 3400 people globally and over $340 million in revenue across health care, technology, services, energy, and financial services with operations in North America, Western Europe, and India. Dr. Bleustein also worked as the Chief Medical Officer of Dell where he had several roles before rising to become the Chief Medical Officer and Global Health Care Solutions leader with the responsibility for health and life sciences solutions globally.

How AposHealth is Using Gait Technologies to Create a More Frictionless Healthcare System with Clifford Bleustein, Global President and CEO of AposHealth: Audio automatically transcribed by Sonix

How AposHealth is Using Gait Technologies to Create a More Frictionless Healthcare System with Clifford Bleustein, Global President and CEO of AposHealth: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

Saul Marquez:
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Saul Marquez:
Welcome back to the Outcomes Rocket everyone, Saul Marquez here. Today, I have the privilege of hosting the excellent Dr. Clifford Bleustein. He is the Global President and CEO of AposHealth. Prior to AposHealth, Dr. Bleustein was President and CEO of Computer Task Group, where he managed more than thirty-four hundred people globally and over three hundred and forty million dollars in revenue across health care, technology, services, energy, and financial services with operations in North America, Western Europe, and India. Dr. Bleustein went to see from Dell, where he had several roles rising to become the Chief Medical Officer and Global Health Care Solutions leader with the responsibility for health and life sciences solutions globally. Cliffe also had a successful period as a Consultant at BWC Rising to Director with a diverse experience of projects including interim director of outpatient services, business strategy, international bio cluster development, M&A health operations, and other things. And on the ground experience in the UK, Ireland, India, South Africa, China. He’s a global health leader and today we’re going to be talking about some of his he and his team’s contributions at AposHealth, what their focus ss and why you should care. And so, Cliffe, such a privilege to have you here on the podcast with us today. Thanks for joining us.

Dr. Clifford Bleustein:
Thanks for having me on the podcast. I’m happy to be here and looking forward to the conversation.

Saul Marquez:
Same here. Same here. And one of the things that we love to dive into before getting into the operations and mechanics of the company is really about, you know, the leader of the company. What is it that inspires your work and health care?

Dr. Clifford Bleustein:
I think ever since I was a little kid, I wanted to be a physician. I was inspired by how physicians were able to help people really feel better and more importantly, to try and stay healthy. You know, when I was in high school, I worked at a health club and I was amazed at watching some of the bodybuilders there do some things that really were not even human. I mean, if you ever see a bodybuilder bench press 400 hundred pounds or deadlifts, six hundred pounds, it’s really not human. It’s kind of insane. And I was always fascinated by how in the world could the body be designed in a way that it could actually even accomplish some of those feats. And it really fascinated me to really try and learn more about that. And that curiosity around health care has really inspired me, even to this day, to try and figure out the problems which are innumerable within our health systems as a whole.

Saul Marquez:
Totally, yeah. And so you’ve done it as a physician, as a company leader in health care. And so talk to us about the work of AposHealth. What exactly are you guys doing to really add value to the consumer, to the physician? Talk to us about that.

Dr. Clifford Bleustein:
Yeah, you know, I’ve been very lucky to have many different roles in my career. And I came to… almost three and a half years ago when one of the board members was talking to me about the company. And it was funny because at the time I was running five miles a day and I had really, really bad knee pain and a little bit of hip pain. And he said, Listen, Cliff, I want you to come take a look at this really interesting company and see what you think about it. And maybe you can come on board and help us to grow this company. And I looked at the company and it was interesting in that they were a great company that was really able to design in a way to try and help people walk. But the core product looked a lot like a shoe. And I said to myself, you know, it’s really hard to believe that something that could look like a shoe could really have a huge impact on people’s gait. So I said to them, OK, fine, let me take a look. And he said, Listen, Cliff, if you tried and it works for you, although it’s not scientific, at least give us a really good shake and really good look at the company. And I tried it. And sure enough, within four to six weeks, I was off of pain medication. I was running again without pain. And it was fascinating because I had failed everything else. I had failed the physical therapy. The stopping running didn’t really help that much either. And really nothing had worked until I tried AposHealth. And I became a believer to at least take a look at the company at that point.

Dr. Clifford Bleustein:
And really, we are a company that has a device that looks similar to a shoe with these pods underneath it. How it works is pretty simple. Through pure-play biomechanics, we’re able to change the way a person’s body interacts with the ground. And by doing that, we’re able to change where your forces are impacting your muscles and your joints and in particular where it’s having pain. And we’re able to shift the force vectors away from where you’re having to pain to help alleviate It. And once we alleviate some of your pain, we’re able to help you to walk in a more normal gait cycle. And then because the pods are convex, that small amount of instability that gets created retrains your muscles so that you can have a more normal walking pattern.

Saul Marquez:
Fascinating.

Dr. Clifford Bleustein:
Yeah, we sell advice to our providers who are orthopedic surgeons, primary care doctors, physical medicine rehab, physical therapists, and they then deliver the services for our patients after a thorough evaluation.

Saul Marquez:
Fascinating. So it’s basically a shoe that has convex pads at the bottom of it. And you’re really dealing with a lot of the ailments related to the lower extremities, right? Hip, knee, maybe even some back stuff. So this is a fascinating, drug-free way to address this. Obviously, we know there’s a huge issue with the use of painkillers and the downward consequences of things like steroid shots and things like that to the back. And so you used it. You became a believer, Cliff. And now you guys are really making some inroads to really help others live pain-free lives and active lives doing the things that they love. So walk us through maybe one or two ways, Cliff, that you feel you’ve been able to deliver on that promise of better outcomes.

Dr. Clifford Bleustein:
You know, when I went into medicine a long time ago, there was an interesting report that came out in 1999 called “To Err is Human” by the Institute of Medicine, which basically predicted that roughly 96,000 people a year died of complications associated with their care and in health care. And really about 20 years ago, the Institute of Medicine came out with their report, six aims for health care, which really what they meant to say is care should be safe, effective, patient-centered, timely, equitable, and efficient. And really what we try and do at our company is fulfill all of those aims. And how we do that is, as you said, were a non-surgical non-drug treatment that’s non-invasive for patients who have chronic pain due to knee osteoarthritis. And we’re non-FDA cleared for some of the other indications that you had mentioned as well. That’s part of a healthy lifestyle. And it’s safe because it’s noninvasive unlike most of the other treatments that are out there today, we are able to improve their pain and function simply by putting on the device itself and wearing it for about an hour a day. We know that it’s effective. We have more than 60 peer-reviewed publications. We are FDA-cleared and our patients give excellent testimonials as to the improvement that they’ve had in both their pain and their function. It’s patient-centered because we’re able to deliver the services however a patient wants either in a clinic, in their homes, or via telemedicine. We have different insurance carriers that are covering it in different ways. Timely – we get most of our patients or our partner sites, get them then within a day or two. And because of that, it’s extraordinarily efficient. So if you look at the treatment of patients who have the musculoskeletal disease as a whole, there’s a lot of people who undergo unnecessary treatments, whether they’re injections or surgery and ultimately, by avoiding unnecessary treatments, we’re able to have a huge impact in musculoskeletal care in general.

Saul Marquez:
That’s interesting. I mean, you said only an hour. They don’t have to wear like the whole day. You’re talking just one hour a day.

Dr. Clifford Bleustein:
Yeah. You know, if you ever been to a gym and has seen a Bosu ball or a wobble board or even if you’re standing at a beach on the sand and you feel how your body sways around a lot due to the instability, it doesn’t really take much time on a product like that in order to exercise your muscles in a very efficient way. So you’re really getting the equivalent of thousands of repetitions in a very, very short period of time. It’s a great way to get the work without having to do the exercise.

Saul Marquez:
Totally. And, you know, as we transition very slowly, but as we transition from fee-for-service to value-based care. And really, I always go to the mindset of the employer. Right, Cliff? Because they’re the ones paying the bills for a lot of this stuff. Do you want somebody that has this pain that’s still working to try the shoe that relieves their pain? Or do you want to put them through a fifty thousand dollars surgery that may or may not be effective? When you get to those types of fork in the road questions, the question that often comes from clinicians is show me the proof. So talk to us a little bit about the data and maybe some of the things that back up the results of the shoot.

Dr. Clifford Bleustein:
Yeah, as I said, we’re peer-reviewed more than 60 publications, including one of our most recent ones in the Journal American Association Medical Association, or JAMA. We have the devices being used globally with more than one hundred thousand patients have been treated. And at the end of the day, I’m willing to put our money where our mouth is. So whether you’re talking about a full risk arrangement or a fee-for-service arrangement, we already have some contracts where we have what’s called fully at-risk. If we’re successful, we get bonus payments. If we’re unsuccessful, we have penalties. I’m willing to go at risk for the outcomes associated with our product. And many times the outcomes we care about is not only improving their pain in their function but ultimately the utilization of resources or services that are incurred by either the employer or the insurance carrier. And we look for things such as the utilization of orthopedic surgery visits or physical therapy visits, of E.R., visits of pain medications. In general, we look at outcomes associated with surgery rates, which are dramatically decreased. So we look at outcomes, all of those, and we as a company are willing to go at risk for it.

Saul Marquez:
That’s fantastic. And your willingness to do that is certainly exciting. And for many of the listeners who think, all right, Cliff and his company, they’re ready to play ball, look at this as an invitation to engage with them and see what type of results you could provide your communities of, whether it be employees or if you’re managing a population. What is it that you could do to help them up there, the care delivery strategies that you’re doing for these patients? And so really honing in a little bit more on on the business model. Nothing happens without setbacks or challenges. So I’d love to hear from you, Cliff, what you believe is one of the key challenges you guys have faced and really the learnings out of that that you believe have made you better.

Dr. Clifford Bleustein:
You know, when I started my surgery program, in training you have a weekly conference called the Morbidity and Mortality Conference. And every week what you do during this conference is you review every patient that had an outcome that was not what you had expected. What was really interesting about those morbidity and mortality conferences is that you learn very quickly that when you’re reviewing what happened, it’s very easy to say what went wrong. But the more important way to look at it is to really say, OK, given the information that I was given at the time that I had, would I have made the same decision or would I have made a different decision? And then if it would have been a different decision, what would have been the information that would have helped you to get that way or help you to get there?

Dr. Clifford Bleustein:
I think when I look at mistakes, I try, and although it sounds cliche to look at them as learning experiences because you are often making decisions with incomplete information, I think the biggest mistakes I’ve made in my career, not just that my current company has been through an aversion to take on some risk. I think at the end of the day to learn is that what is more important about making decisions is that you make them quickly and that if you choose not to make a decision, that in and of itself is a strategy and it’s usually not a good one. So my advice and what I’ve certainly learned is that it’s important to continue to experiment, especially in the early stages of the company, because many times in your startup or you’re in an early-stage growth company, you don’t have all of the solutions, you don’t have all of the answers. And because of that, it’s important to continue to test new models, continue to test your product to new situations, continue to test new partners to try and figure out what’s ultimately going to work and what ultimately isn’t going to work, and to be able to acknowledge very quickly that something isn’t working and then even ake a decision to go in a different direction or continue down that same path, but make some alterations to what you’re doing. So it’s important to be humble. It’s important to know that you don’t have all of the answers. It’s important to make choices and then live with the consequences of those and recover quickly.

Saul Marquez:
Well said. And there’s a lot of opportunities for us to really just learn. And so as you’ve built the business, who do you feel has become your best partner? Like what profile of a client would you say? Yeah, they’re the ones that we’re having the most success with, and why?

Dr. Clifford Bleustein:
We really have three different models. The first model is a fully at-risk model where we are working with large integrated physician practices that own the risk associated with the patient outcomes. They have a tendency to be wonderful partners because our product is worked into their systems as part of a care pathway. And since the physicians know where we sit within that care pathway, it’s very easy for them to refer patients that meet the right criteria so that the practice can have a good return on making sure that the right patients are treated with the right treatment at the right time. And those have a tendency to be some of our best partners. I think we work often with specialists in particular pain doctors, orthopedic surgeons, and physical medicine. And we have doctors. They often have a tendency to be partners, since they’re the ones that are often the first to see these patients because they more quickly can identify those who are absolutely required to have surgery, those who may eventually go on to have surgery, but probably aren’t appropriate yet for it. And those that have miles of a disease that could probably benefit from alternative treatments. They’re the ones who are really fit to both treat and refer patients for AposHealth in general. And those are the ones who often end up being some of our best partners overall.

Saul Marquez:
Got you. And it’s good to know and really I asked to help make the connection for those folks listening who may think this is a great opportunity for me to add value to my select patients or if it’s a population. But it seems like it’s more of the physician kind of call point where this is resonating.

Dr. Clifford Bleustein:
And it’s not just the physicians. I mean, listen, we are an amazing partner to employers. We know that musculoskeletal costs are typically one of the top three costs for every single employer. Having spoken with many of them, they tell us that there really haven’t been that many effective treatments out there for musculoskeletal disease and they’re constantly looking for new treatments. What we can tell them is that unlike many of our competitors, we actually do what they call bending the cost curve so that we actually can drop the total cost of care for individuals who have MSK disease because we a treatment modality that can be done under an hour a day while they’re either walking around work or at home because they don’t have to take our time out of the day to go to the doctor’s office, go to the therapist’s office or go to the office is more than a couple of times throughout the course of the year. We can save their employees time and having to engage with the health care system. We are very valuable to them as well.

Saul Marquez:
Very good. I appreciate you highlighting that. And Cliff, what would you say you’re most excited about today?

Dr. Clifford Bleustein:
You know, gait is going to be the next vital sign. And I say that now. And a lot of people look at me in sort of this surprised look. You’re going to hear about and learn about gait in a way that it’s going to be as ubiquitous as taking somebody’s temperature and taking their blood pressure. And I don’t know if you’re an iOs user or an Apple user, but if you go to your Apple, your Apple phone now and you check on the Health app and you go down to the browse section, you’ll see this category called mobility. And when you click on Mobility, you’re going to find all of these funky gait parameters that are currently tracked, and what is now available to people in the safety of their own home on their own phone is all of this really sophisticated gait data. We know that gait has a significant impact on people’s outcomes. So there’s a lot of studies that show that if people walk faster, they actually live longer with less morbidity and mortality. And because of that, gait is an amazing picture of overall health. In order to walk or to have a really good gait, your heart has to work, your lungs have to work, you need to have neuromuscular coordination. You have to be fit enough.

Dr. Clifford Bleustein:
It’s an amazing predictor of overall health. And because of that, I think its adoption with more readily available diagnostic techniques like people’s phones is going to make this into the next category that physicians, clinicians, and frankly, people are going to be looking at on a regular basis. So I’m really e excited about the impact that looking at gait in a whole new way is going to have. And our ability as a company to help treat patients and manage their gait going into the future is pretty exciting.

Saul Marquez:
Yeah, no, I love the perspective, Cliff. And, you know, spoken like a true visionary and seeing not only where the puck is, but where it’s going. It is exciting. And there are so many things that we probably don’t know today about gait and what certain parameters could mean. So I love the idea of gait as a vital sign. I’ll certainly be giving this more thought. And listeners, I hope you’re as stimulated as I am on that on that point that Cliff just made because it could be very promising. So we’re turning the corner here and without a doubt, I want to park on this idea of the future, what would you give us as a closing thought? What should we be thinking about here as it relates to gait and the work that you guys do?

Dr. Clifford Bleustein:
Yeah, if your activity walking gait motion, it’s important it has an impact on your life. You should be looking at it and looking to improve it. So people shouldn’t have to live with pain. People shouldn’t have to live with mobility challenges. We know that gait problem in particular function even more so than pain and limitations around it have a huge impact on quality of life. And people are desperate for solutions that work, and we hope to be one of those solutions for your listeners to turn to.

Saul Marquez:
Thank you, Cliff. That’s fantastic. And so if the listeners did want to engage, where can they go? What’s the best link or where would you send them?

Dr. Clifford Bleustein:
Yeah, www.aposhealth.com.

Saul Marquez:
outstanding. Well, there you have it, folks AposHealth. Dr. Cliff Bleustein, just incredible vision around what this could mean, this mobility perspective for all of us. So can’t thank you enough, Dr. Bleustein, for joining us.

Dr. Clifford Bleustein:
Saul, thank you for your time. I appreciate being here.

Saul Marquez:
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Things You’ll Learn

  • What is more important about making decisions is that you make them quickly and that if you choose not to make a decision, that in and of itself is a strategy and it’s usually not a good one.
  • In the early stage of the company, it’s important to experiment because you don’t have all the solutions, all the answers. Doing this will help you figure out what’s going to work and what’s not going to work, and you’ll be able to decide to go in a different direction or continue the same path you’re going but with some alterations to what you’re doing. 
  • It’s important to be humble. It’s important to know that you don’t have all of the answers. It’s important to make choices and then live with the consequences of those and recover quickly. 
  • Your activity, gait, walking, motion, it has an impact on your life. Look for ways to improve it. 
  • Gait is the next predictor of overall health. 

 

Resources

Website: https://www.aposhealth.com/

Email: information@aposhealth.com

LinkedIn: https://www.linkedin.com/company/aposhealth