Why We Must Bring More Awareness To Precision Prenatal Care with Anish Sebastian, Co-founder and CEO at Babyscripts

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: Welcome back once again to the outcomes rocket podcast where we chat with today’s most successful and inspiring health leaders. I really thank you again for tuning in to the podcast. We have amazing guests every single day five days a week and this day. Today we have an amazing guest for you. A great contributor to Health Care. His name is Anish Sebastian. He’s an entrepreneur CEO head of product and healthcare transformation. He’s the co-founder and CEO at baby scripts. They’re focused and successful in their niche and I’m excited to dive into the things that they’re up to there. Anish was part of the healthcare transformer at startup Health where he and his team are able to build the company and now are one of the more established company as part of that. But prior to that he was also very much involved in organizations with managing risk and also contributing to health. So I wanted to open up the microphone to Neish to help him widen that introduction. Maybe I missed something Amish but welcome to the podcast, fill in the gaps.

: Perfect perfect thank you Saul for that very kind introduction. I think I think you captured a lot of that. I’ve been working on baby scripts now for a little more than four years prior to which a lot of my sort of interest was in the Quantified Self space and I got involved in the Apple community. Now it’s sort of you know all things baby scripts. Yeah.

: That’s awesome brother and I definitely am excited to dive into some of the things that you guys are up to at baby scripts and to begin. Why did you decide to get into health care to begin.

: Yeah it’s it’s a good question. In fact the beginning of my career was not in health care at all. I was working for a pretty large consulting company focusing on the financial services industry. But while I was doing that as a little too little bit I was very much involved in health tracking it’s on the quantified self movement which might be worth Merabet star. Cisco started to spread toward the East Coast and Washington DC is as a laggard started to get involved in that a little bit. That’s when I started to and I started doing the whole Fitbit thing before that became cool and you know genomic testing and profiling and all that kind of thing all with kind of this passion to really just improve my own health. Right. You know while going through that whole process you know obviously everyone has a story. But I also saw someone very close to me my own mom. You know just interact with the healthcare system through some with the disease that she was managing and that point every now and then and in life. You kind of get to a moment and you see haze is there calling for yourself right. And that was clear to me and that’s when I sort of put up my my consultant hat and left the financial services industry and I remember someone telling me that hey like it’s often people from an outside perspective can get in it and try and change stuff so you that’s when I jump straight in. And from that point on it’s been it’s been quite the right.

: That’s so awesome. Thanks for that story. Sounds like you definitely were introduced to it and it never looked back and now you’re pretty deep into it. Maybe you could talk to us a little bit about what you believe. One of the hot topics that should be on every health leaders agenda.

: Yeah I mean it’s interesting actually right so when I talk to heads of hospital systems insurance companies MCO payers where it might be oftentimes a lot of times one of the top items on their list is value based care which is OK well how are we doing it. What’s the process of getting there. What type of risk agreements are we interested in. You know patient coordination all the stuff. Then I go a step below you know the CEO and I started really examining what the pain points are at their service line level. And oftentimes one of the things I found it’s often not that at all it comes down to really what I think is true of healthcare in America which is so far behind every other industry that they’re just trying to catch up. So whether it’s something as simple as well not a simple but something that’s core is interoperability or practice automation or operational efficiency or just using little bits of technology here and there as a basic patient engagement tool. So one of the things that I’m quickly starting to realize is that while the leaders of the organizations especially at the CEO level and the strategy level tend to be focused on value based care what else they can do on it at the operational level oftentimes what we’ve seen is focus and to be hey I need to I need to run the practice run it smarter and more efficiently and make sure I’m happy patient straight. So it’s an interesting balance it’s an interesting sort of kind of needle that you have to thread. But yeah that’s been the development we’ve seen over the last 12 months or so.

: That’s a good call out and Anish you know one of the things that I think a lot of organizations struggle is value based care. You know what does it mean. How do I get implemented and well I get away from something that I’ve been doing for so long which is fee for service and it definitely very cool that you guys are focused on moving the needle there. Let’s take it a step deeper. How are you guys doing it. And give us an example of some outcomes improvement that you’ve helped your clients achieve.

: Sure yeah yeah. So obviously our product is focused on a very very specific episode of care which is pregnancy. We get involved as soon as the mom goes into their Ob-gyn or midwife office and says Hey doctor I think I’m pregnant and we’re kind of done after they deliver the baby about six to 10 weeks postpartum and they move on to the next sort of phase or Castroville which puts us in a pretty unique position because we can actually very very very squarely hone in on the targeted set of things that will improve outcome. And we define outcome in a very specific manner which is improve maternal and fetal outcomes which that focus then flows out through the company. So our mission and our moonshot in many ways is to focus on preterm birth in America. And by the year 2027 we want to make make a dent. Right. So everything that we do as a company as product engineering marketing sales is very much focused on that. So you start kind of backing track off of that and saying well that’s that’s what you want to achieve by 2027. What can you start to attack ad to get there and the way we have thought about attacking it is in a very specific manner it’s by creating a new model of care delivery that we called precision prenatal care which basically translates to when a mom comes in to get care. You essentially don’t give them the standard model that happens today. What you do is you give them a risk based care delivery protocol and they are just as needed. And we leverage mobile digital IoT tools to empower them. And I’ll give you an example of a model that we are afraid so one of the products that we have is something called the schedule optimization module. It’s intended actually for low risk uncomplicated pregnancies. These might be the second time moms that are very low risk that are don’t have any prior history of any complications sort of thing. For those type of patients we’re able to deploy some remote monitoring tools like blood pressure constant scales and one of these we’ve demonstrated is that for those patients they don’t need to come in as often to receive need any care Holmwood Elbel because we’re collecting so much data remotely. And if any of these offtrack obviously at that point they get elevated care. But for those patients they see their practice and their doctor a little less often interact with them more in a much more digital efficient manner. So that’s an example of you know this race stratified model being deployed now on the other end of it we also have a diabetes module which is very much targeted to pregnant mothers that are gestational diabetic. You need a much more heightened kind of targeted approach and we’re able to collect data on a much more real time manner from home trigger messages as needed manage that they’re obviously seeing some specialists they’re seeing their obstetrician and were able to balance that so they get they get a little bit more attention right than the low risk mom. But at the same time it’s much more risk appropriate. So what happens is at the end of this full kind of full processes as a healthcare system as a provider I go in I’m thinking about a good 30 appointments today I do go on thinking about my patients who are here today. Right. So again it has a pretty narrow focus and has a narrow niche focus on pregnancy obstetric care but we’re able to sort of really delve into that and do a good job on.

: That’s pretty great. And some of the things that come to mind are when you look at health across the nation you have areas that are safe for example rural areas or even urban areas where people don’t have transportation right. Oftentimes we don’t think about the difficulties of getting in to see a provider. And on top of that you’re pregnant so it’s harder for you to move around right. I think this is a really cool solution especially in those niches where where you have folks that are struggling to get in due to either social determinants of health or the region that they live in. Do you find that this tends to be one of the key areas that you guys are making a big impact on.

: Yeah. Absolutely. And there’s conferences on of the spectrum there. Right. You have a lot of areas in America where you have this rural care that where access is a true issue in North Carolina for example when this market shut down of L and D departments at hospitals and a lot of difficulty for patients to get care. You know they have to take two buses and plane just to get to a clinic. So for those patients ruin monitoring this is a big deal. They might not have an obstetric clinic nearby but they’ll have a smartphone right. So we’re deafly able to leverage that there have an American connection so they’re able to leverage that also. So for those patients we are literally just getting something as simple as blood pressure on a routine relevant manner. Is a big deal. Well without that not commercially and the other side of the spectrum you have very urbanise situations where you know for example were deployed now at a teen pregnancy clinic in Washington D.C. where this patient population has a much different profile than the other population I was talking about the issues there much tend to be much more related to social determinants. These patients typically have difficulty in getting time off work or accessing the proper transportation modalities to get to the clinic to get care. So we’re also able to deploy the manner right so we’re through a module that we have public your navigation aid. So it’s interesting to see access being an issue and two entirely different context. But either way that’s absolutely true. We’re we’re it’s a big problem and one I’ll be remiss if I didn’t say one of the things that is rising very interestingly is maternal morbidity and mortality in the United States.

: It’s rising.

: It is. Yup yup Texas is the worst in the US Why?

: You know why?

: The top two reasons one of the reasons is postpartum hemorrhage and the other one is called pre-eclampsia. Now if you start like breaking it down as to what causes those two things to happen. One of the things is just a better good control for hypertensive and lack of access to care. There was a documentary done recently in rural Georgia where patients just don’t have access to care and then now they get pre-eclamptic all kinds of complications come up and then it’s an issue. And interestingly now pregnancy is one of those areas where a bad outcome even if it happens rarely is a big deal because it’s not supposed to happen right. So unlike cancer or elderly care where you mean you’re dealing with a lot of complicated stuff in pregnancy. Now the mom is really not supposed to high rates. So that’s a trend that that’s not good. Right. And we’re obviously trying to like her and to be fair there. Various reasons sure but we think that one of the problems is access to care. And one of the ways you can improve access is by leveraging technology the smart way and we’re helping with that.

: That’s pretty cool Anish and thanks for bringing these issues to light because I feel like a lot of times as health leaders we can assume things that aren’t really the case. And so I had no idea that that these complications were rising in the U.S. And frankly it’s unacceptable. So I love that you and your team have taken the bull by the horns and hyperfocus and not you’re not afraid of saying hey you know what. This is our area. This is our spaces is where we’re going to play. And I think that’s the reason why you guys have experienced the success you have and you’ll continue to experience that so keep staying focused my friend. I think it’s great work that you guys are up to.

: Yeah I know. Thanks for that. You know obviously we’re not good at a lot of things but we think that we get a couple of things for. One of which is this whole you know maternal health area. And that’s always going to be a focus. That’s what we love doing. You know one of the leaders in our space Dr. Neil Shah is our Harvard. He says something that I find very interesting. Obviously in the recent like four to six months or actually of the last year or so there’s been a tremendous amount of focus on mental health and substance abuse and opioid abuse and that type of thing. If you look at the data on maternal health there should be a similar kind of uproar in the public consciousness which hasn’t happened yet. So a lot of what I try to do is to your point is to bring attention to these issues and to highlight you know how there are some major things going on and hopefully we can we can fix it. Obviously we’re very very small part of it but at the same time you know it does require a national movement. In many ways to improve outcomes here.

: Well and that’s so great Anish there’s no reason why that movement can’t be started by you. So I’m excited to be able to at least be a part of that. Getting your voice out there Anish what you and your and your team are doing because absolutely it’s just unacceptable and if we’re not measuring and if we’re not holding each other accountable for the health of women in this space and we’re failing them. And so I think it’s awesome that you’re up up to that and I’m excited to publish this podcast so that the leaders listening to this are aware and they can also join now. I usually ask later but just for the sake of this conversation like where can people reach out to you where can they get more information. Do you have a centralized place where you put your thoughts out as a company or as an individual.

: Yeah I mean obviously a great place to go would be just our website get getbabyscripts.com. We have a dedicated place there where we will talk about some of the work we’re doing at relates to the overall industry and some of the work that we’re now hoping to highlight and that type of saying one thing that is will also be on our on our Web site if you go there is we’re actually holding a summit this year in Austin and a few weeks actually coming up so nice also called the future of obstetrics and it’s unusual for a startup of our size to do something like this which is we’re bringing together all the thought leaders in this space and really thinking through how technology can improve care primarily. Just talking about stuff that we already talked about and it’s going along with the the major conference in all things will be ion which is called a cog a annual conference. Since we’re throwing shot out so I’ll throw our shout out to our future of obstetrics and you can go to our website to find more info on.

: I love it. That’s great. And for the listeners when you think about the things that Anish has been talking about here all that stuff you could find it on their Web site. So what is the website Anish.

: Its getbabyscrips.com

: getbabyscripts.com. So you’ll be able to find that as well. If you’re driving don’t worry about writing it down just go to outcomesrocket.health/babyscripts. You’re going to find that link there. But if not just right getbabyscripts.com. That’s easy enough Anish super super insightful. You guys haven’t always had it figured out and obviously you still are working on building your platform. But take us to a time when you had a setback and what you learned from that setback and what you do now as a result of that.

: Yeah I mean how much time we got.

: Exactly.

: I mean I think obviously as you grow in a company you’re constantly faced with a ton of challenges. I think from our standpoint in the early early days with baby scripts you know I think we didn’t quite have our business model figured out figuring out which of course in the service versus value care thing is like this crazy kind of back and forth trade because you’re always trying to build a product that’s ready for value based care. But at the same time you also have to provide value to. And then I mean I think I’m sure you see this to a lot of early stage companies fly into that challenge. So for us it was really about just listening to a customer and listening to users paying very close attention to them. What makes sense what doesn’t make sense. One of two things you found out through that exploration was that the particular way obstetrics was reimbursed through something called a global fee which ended up being a capitated professional fee for setting providers as to how they would manage a particular patient. So in other words doesn’t matter eyes and will be GeoEye and if I saw a patient 10 times 14 times 30 times I typically get the same professional fee. So you then kind of took that translated that into our remote monitoring program and said Hey you could still deliver the same quality of care if not better and still manage your practice in a much more efficient way. So that was like an interesting sort of tipping point or refinement in our strategy. The other thing that I will point to is you know we sell to providers of care really it’s OBGyns leadership within maternal health service lines rate of large Hospital systems in MDI by their very nature tend to be very skeptical of products that get thrown their way. Now they’re they’re trained to be very data driven insight and almost scientific in their approach. They are and scientists in many ways. So one of the things we did very early on which proved to be extremely fruitful was we invested in doing academic research with our product. So now when I walk into a practice meeting or commercial meet and walk in with a couple of published papers in my hand that document some of the results that we have made. We took a very sort of academically rigorous approach in fact we didn’t really have much of any sales for the first year of the company. We were still a trial basically figure out the best model. But B also collecting that data publishing those results that would help us. So I know both of those were kind of strategic kind of things that we did not. Which now has been helpful but initially it was kind of a struggle to figure that out.

: That’s pretty cool. Thanks for sharing that. And yeah it’s interesting that you guys take this approach right and you got your data first you put together your studies and now you guys are definitely starting to get traction and serving a great cause. Take us to a time when you actually were like wow I’m doing this. I’m doing the right thing some time when you were most proud in your medical leadership experience.

: I think it’s easy to say when we got like a big customer or when we got a big deal or made major product release as like a moment of pride. But the more I think about it and the more I have matured in my thinking. I think the moments of pride that I have is is when my team or team really is able to accomplish right. So it really comes down to building that model and that core team that can really help you grow. So hiring and they can through kind of the right profile of people making sure that team working and making sure this organizational process to kind of around communication and all the steps that make a company grow is so so important. No. Gone are the days where myself and Juan Pablo my co-founder could just stay up all night and you know get something done right. We’re a little past there now so so much of what we do right now is making sure that our team is prepped and all of the bottlenecks that could exist are removed. We have a really solid team we put together. So my job right now is to empower them and make sure they are the most successful as they can be ultimately. Now we’re only going to be successful as our team and our leadership as a company is able to accomplish great. So sort of like more to my thinking on that in some ways putting a lot more time now into making sure the organization has the fuel that it needs to really grow.

: That’s awesome Anish. Yeah absolutely. Totally feel that. So congratulations on unbuilding out that team of yours. I’m excited to see where you guys will be five years from now.

: Well for world domination.

: ‘Hey let’s turn the problem around and I think you will be achieving world domination.

: And you go there you go.

: Anish you guys are focused on specifically this space what within your focus is an exciting project that you’re working on.

: Yeah more than on a whole bunch of things. One of the areas of care in sort of our area is that I think it’s super interesting is what happens to mom after they deliver this postpartum period. Yes we see things like postpartum depression and postpartum recovery. Ends up getting a lot of attention but it’s very clear to me that the postpartum areas is probably one of the most underdelivered areas of care across the pregnancy episode. In addition to my mental health obviously the big focus there’s also issues around transitions of care. There’s also issues around proper contraceptive care issues around breastfeeding and lactation issues around. If you had some kind of complication like hypertension or diabetes making sure that’s being handled. So we think if that area is not done correctly for the mom you end up setting up a lot of sort of risks over the next five to 10 years. Right. So we’re now looking at the postpartum area and actually a lot of this minor organizations across across the country are also looking at postpartum area as a key point of making investment in the mom and making sure that once the baby is born you’re not just shipping her off to be around from hospital but you’re making sure that the first 10 12 18 weeks after the baby is born there’s proper care. So yes that’s actually partnering up with some some thought leaders here to really think through what postpartum care would look like and what that could morph into. So that’s an exciting project that we’re taking on so it should be a lot of fun.

: That’s both beautiful and exciting my friend. You know having had a baby you know my son. We were chatting before this he’s one. And you know my wife and I went through the wall she went through the pregnancy. I was there with her. But you know you’re right that period after they get home. It’s tough. And there’s very little support. The hospital does give you some resources but that’s very very minimal and so I think it’s pretty cool what you guys are doing. And the impact I think will definitely lead to a ripple effect of positive outcomes so stay strong brother. I think what you’re doing is really great.

: Yeah. No I mean you obviously you’ve been through this. Are you kind of concerned that that a little bit. No I mean I totally agree with you. Thank you for your kind words.

: Hey to the extent that we my wife and I hired a sleep consultant we hired a lactation consultant. I mean because we were last man like we had no idea what we were doing so I think what you’re doing will resonate with the listeners and also the world of that is in the process of having babies so keep up the great work.

: Yeah. I mean you know I can tell you I mean how many times have I heard that that we were lost. So you might be lost but you certainly not alone now. So yeah we’re trying to talk about highlighting issue. This is another one that that’s one of my list on my list to get to a lot of lot of challenges and this space for sure.

: Awesome brother. So let’s pretend here that you and I are building a medical leadership course and what it takes to be successful in medicine. It is the one one of Anish. And so Mr. SEBASTIAN I got four questions for you lightning round style followed by a book and a podcast that you recommend to the listeners. You ready.

: Yep, let’s do this.

: Alright. What’s the best way to improve health care outcomes.

: Focus on incremental improvement over the course of a long period of time as opposed to going after a silver bullet. Little little things across though a large spectrum makes a big difference.

: What’s the biggest mistake or pitfall to avoid.

: Gosh there are so many. Listen to the customer. I know it sounds super cliche but it’s so so important. Listen to your specific use case and specific customer and make sure you are solving that problem.

: How do you stay relevant as an organization. Despite constant change.

: I think as a leader you have to hook yourself on the core principles of what makes you different. Right now for us it’s a provider of focus and improving care but you also have to be very very attuned to the market as to what will make those principles the most amplified. Right. So that means whether it’s looking at changes like AI and data science. And so it’s bouncing. What’s true to your principles but also listening to where the market’s going and making sure that product market fits there.

: What’s one area of focus that drives all else in your company.

Patient provider relationship as it relates to improving outcomes. Every time we have any any issues we go back to what improve that.

: And finally Naish what book and what podcast would you recommend to the listeners on the syllabus.

: So as far as podcasts is concerned there’s a podcast called The Pitch which I think is pretty cool. It has sort of a long form way of essentially what’s a short circuit. It’s like a wind farm where all of our time here. And as far as as far as books go. One of the first books I read and healthcare and one of the best ones is one called complications Gawande. His book is good authors books for good. The balance is a good one.

: Love it. Great recommendations to go one day and the pitch listeners don’t worry about writing it down. Just go to outcomesrocket.health/babyscripts and you’re going to find all of the things that I need shared with us a transcript, show notes, links to his company links to the books, links to the podcasts you recommended. Everything’s going to be there. So visit outcomesrocket.health/babyscripts and you’ll find it there. Aneesh this has been a ton of fun. I love if you could just share a closing thought. And then the best place for the listeners can get ahold of you.

: Yeah I mean obviously I think that you know one of the things that is really important is building a community rates of stuff that you’re doing this is exactly I think what we need to do to transform health care over the next decade. So yeah I mean I’m all about finding forces that can come together to make that happen and the best place to get to me is really our website is a great place to get to. But since we’re talking about just shout outs also reference my Twitter a@sebastion87 you can put the show notes too so we can get to meet so.

: Outstanding. Anish this has been awesome. Appreciate all the things that you and your team are doing and all the things that you shared with us today and listeners. I recommend that you reach out to him. Check out what they’re doing and get involved. Don’t just listen. Get involved with the movement that Anish and his team are doing because the cause is great and great things will follow. So without further ado brother I just want to say thank you so much for spending time with us today.

: Saul this has been great. Thank you so much for your time.

Thanks for tuning into the outcomes rocket podcast if you want the show notes, inspiration, transcripts and everything that we talked about on this episode. Just go to outcomesrocket.health. And again don’t forget to check out the amazing Healthcare Thinkathon where we could get together took form the blueprint for the future of healthcare. You can find more information on that and how to get involved in our theme which is implementation is innovation. Just go to outcomesrocket.health/conference that’s outcomesrocket.health/conference be one of the 200 that will participate. Looking forward to seeing you there.

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