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Saul Marquez:
Hey everybody! Saul Marquez with the HLTH Matters podcast. I want to welcome you back. Today, I have the privilege of spending some time with Dr. Jean Drouin. He’s the founder and chief executive officer at Clarify. Jean’s a leader with over 25 years of experience in healthcare management, technology, operations, finance, and cultural change. As CEO, he focuses on creating the environment that allows Clarify to deliver on its mission by delighting customers and growing a great team. Jean leads the executive leadership team, which sets apart the company by their vision and their strategy, and he’s responsible for ensuring the company’s overall success. Jean believes that healthcare has been held back by a lack of actionable insights and that by integrating innovative analytics and incentives, we can power better health and outcomes. I’m excited to have him here on the podcast and welcome him to our time together. So Jean, thank you for joining us.
Jean Drouin:
Saul, great to be back.
Saul Marquez:
Hey, it’s great to see you again. And the work that’s happening today, these next few days, and at HLTH is really game-changing. Clarify Health is doing an extraordinary job on the data and intelligence side of things, but it’s all connected. It’s all connected. So I’m excited to have that chat with you. Before we begin there, I want to ask you what inspires your work in healthcare?
Jean Drouin:
Oh, great question. You know, I come from a family of doctors, so my great-grandfather was a GP in the logging camps north of Quebec and then grandfather was a cardiologist. My dad’s an immunologist, so I grew up around physicians and it just seemed to be the thing in the family to want to help. The thing for me is I also had a curiosity for what drives systems and organizations, and so always had a curiosity as a kid around what’s going on in the world. And in fact, the best gift I ever got was this wall-sized map of the world that was wallpapered, right? And then as I grew older, if you put an economist in front of me when I was in med school or a New England Journal, I’d always want to read The Economist cover to cover first. So I decided early on in med school that much as I loved dealing with patients, that I would want to do something that had impact more at system level. It just took me a while through a very, full of learning 15-year detour at McKinsey to figure out exactly what that was going to be, and then, light bulb went on about seven years ago where I said, wait a second, fundamentally, what’s broken in healthcare in my mind is two things. One is the way in which we stitch together patient journeys. The second is how we pay clinicians for the work that they do. And so fundamentally we said, okay, with Clarify, let’s get really, really good at understanding and optimizing patient journeys. And then more recently, let’s make it possible to pay in a way that will reward not 12 or 18 months later, but now for doing the right things to get those journeys to harmonize.
Saul Marquez:
Well said, and thank you for sharing that about your family history, all the physicians, and sort of your curiosity to do more at a systems level. We have an opportunity today. The system is sort of in a trying time, and oftentimes it’s the trying times that allow us to make the difference. You talk about stitching together patient journeys, it’s not episodic care. We’ve got to be able to capture that patient’s care journey throughout the whole perspective. And when we talk about value-based care, payment models need to catch up. Talk to us a little bit about that and how Clarify is helping solve for this issue.
Jean Drouin:
Sure, so, you know, maybe one little aside here, I spent a lot of time before starting Clarify, working in health systems in other parts of the world England, Australia, Singapore, etc. and they would say, oh, at least here we have, not in the US, right, equity and we think about social determinants and whatnot. What’s interesting to me is the only system in the world right now that has the granularity of information to really understand patient journeys in the way we’d like to is the US, because we have fundamentally a claims-based system and most of our institutions are in EMRs now. So we have a really unique opportunity to make positive change here, despite all of the issues that we’ve got right now. We have said, and you know, you’re familiar with this, for the last, what, 20, 25 years, that we need to move to some version of payment that’s better than fee-for-service. I have now come full circle and my thought is that what we need to do is to keep fee-for-service, it’s just we need to make it value-oriented, value-driven. And the reason for that is I believe the reason value-based payments haven’t scaled in the way we wanted them to is docs just aren’t going to get excited about something that says, hey, in 12 to 18 months we’re retrospectively going to look back and maybe you’ll get something or you won’t, and we won’t quite be able to explain to you why. Like, why would you sign up for that?
Saul Marquez:
I definitely would not.
Jean Drouin:
Right? As opposed to, hey, orthopedic surgeon, you in the last month made the following decisions, you decided to do a surgery in your ambulatory surgery center instead of the more expensive hospital, you decided to use one implant or another, etc, and based on those choices, which were good choices, here’s what you’re getting. Well, then you’re appealing to somebody as a human being in behavioral economics and micro incentives. And the funny thing is, is you can do that on top of a fee-for-service system. So why rip that out if it’s so difficult to rip out?
Saul Marquez:
You know, Jean, I love that idea. And we’ve always had this or that, not like, hey, you could do it with the existing fee-for-service model that we have. And it’s about knowing what behaviors provide the health system with what results, right? And then getting rewarded for those very clearly.
Jean Drouin:
100%, and coming back to that question of data that you started with, why do we talk about data? Well, ultimately, we’re actually trying to drive better decisions, behavior change, and so for that, we need to go data to insight, to workflow, to incentives, and then we might get the better decision. And look, this is no knock on all the folks who, and I was one of those, right? I thought that retrospective look back value-based payment models were rational, that they made sense, except it doesn’t make sense for the individuals who are actually doing the work, and they’re quite clearly saying it’s not exciting to get paid in that way. So, okay, let’s, what’s different now versus five years ago is we have enough data to, for example, for primary care physicians, we can say, hey, here’s your panel of 1000 patients based on how you have been caring for them. It is possible for us to pay you prospectively, right? The analytics allow us to do that the other night. See? They didn’t allow us to do that before, so that’s what’s different.
Saul Marquez:
Well, it’s the power of having these insights. And so what’s the secret sauce? What allows you guys at Clarify Health to be able to deliver on this?
Jean Drouin:
What’s happened in about the last five years is we’ve had the rise of tokenization technology and companies like Data Von Health, Verdi, and others, and they have made it possible to aggregate lots of information, as you said earlier, claim social determinants, lab, EMR, etc, data. And so we’re now in a place where, with all of that data, we can see most of the care that’s delivered in the country each year. And so let’s say your question is, is this the right doctor for me? Is this the right therapy? It’s now possible to see, for example, the 1500 patients that a cardiologist saw and to say, hey, you know what, that cardiologist is really good at congestive heart failure. We weren’t able to see that five, six years ago. Maybe you could have seen it in some of the Medicare data, but that was it. And so we’re fundamentally able to ask a different set of questions than we were able to ask even a few years ago. And it enables an ability to bring those insights to making decisions such as who should be in or out of network, where should I refer, which drugs should I prescribe? We just have much better data on that. Now, one area, by the way, where this also has promise is in clinical trials, because the issue today with clinical trials is, appropriately, the FDA has this incredibly high standard around the data that’s collected for a trial, and that’s why it takes long to recruit patients, and the trials cost hundreds of millions. But imagine that you could say, hey, I can interrogate 300 million lives and go and find the 500,000 that had CHF and how they’ve done and use part of that as my control arm, right? You might be able to have the number of folks that are in a trial. So it’s not just in the care setting, it’s also on the drug discovery, etc., end of things that we can really make a big difference now.
Saul Marquez:
That’s great, it’s about data aggregation and being able to sort of structure the data in a way that you could ask it questions that could inform strategy decision payments.
Jean Drouin:
100%, and what’s really interesting about it, too, is I’ve learned so much, and this is where I won’t go much deeper than this, because then you’d need a technologist here, but the way we think about bringing this to life is, think of it as a layer cake with candles on top, and the three layers of the cake are data, intelligence, and workflow. So the questions people ask at the day layer are, what data do you have? Are you able to clean it? Healthcare data is incredibly dirty. Interestingly, machine learning and AI can be incredibly helpful in automating the pipelines to bring in all of that data and effectively cook it into the cleanest possible analytics fuel, and that’s what you’d look for at the data layer. At the intelligence layer, you want to be able to turn that data into an insight so that it then lands in the workflow. And the question there is, is in banking, they have ledgers, right? In healthcare, we call that groupers. Does somebody have a grouper, right? Ultimately, though, if a doc isn’t getting the insight in an easy way in the EMR or in a PDF that their administrator can print for them to see and then they can make a better decision with the patient, it’s all for naught, right? So and I think that’s a big part of the challenge is a lot of us out there have said, hey, we can do all this fancy stuff. And folks are like, hey, it’s awesome you can do the fancy stuff. What’s it like for me day to day when I still have 8 to 12 minutes in front of a patient and I just do not have time to have more information overload?
Saul Marquez:
Yeah, Jean, so when customers deploy Clarify Health, let’s just use a provider example, the data on specific things like prescriptions will pop up in the EMR so it integrates into the EMR and their workflow? How does that work?
Jean Drouin:
So it depends on the use case. If it’s, for example, referral optimization, where the chief strategy officer at a hospital says, hey, I’d like to ensure we’re making the right referrals, and they’re also saying, hey, I’d like them to be made to the home team, they can do it in one of two ways. What tends to happen today is they have analysts who do an analytics, produce reports, and go have conversations with the docs. You’re absolutely right that from a vision point of view where you would love to go is a user experience where the doctor says, take a general practitioner, I need to make a referral to a cardiologist and out pops the list of the top 3 to 5 based on that patient’s plan. And it would say to the doctor, this is from a quality and cost perspective, the best one, and maybe from a co-pay point of view for the patient and not just, okay, here’s a name on a piece of paper and you deal with calling them, but immediately the available appointments would show up and they could pick and say to the patient, I have booked your appointment at 3 p.m. next Tuesday.
Saul Marquez:
Is that possible?
Jean Drouin:
So we are so close to that, not just as Clarify, but if Clarify, say, partnered with somebody who has appointment booking capability.
Saul Marquez:
Yes, yes.
Jean Drouin:
Imagine flowing Clarify’s scores on the appropriateness of, or which clinicians are most effective and efficient with the ability to book immediately, and that’s the kind of experience we need to enable moving forward.
Saul Marquez:
Stitching patient journeys together.
Jean Drouin:
Bingo.
Saul Marquez:
And in a sense, as well as helping clinicians, empowering them with the tools that they need to keep their patient satisfaction high. And the patient experience is something that’s been coming up a lot in our conversations, Jean. Like today with consumer companies like Google and Apple entering into the traditional healthcare space, we’ve got to be focused on experience. Can you talk about how Clarify Health can help the patient experience?
Jean Drouin:
We specifically are B2B analytics player, so we are not ultimately the ones engaging with the patient. That said, just like in the example I just went through around enabling and in the moment, best selection of who you should be referred to, that’s where we play and that is providing the intelligence on which choices to make in the moment. We also have payers, for example, who use the scores we have on either facilities or clinicians to expose those to their members on their websites, for example. So that’s how we end up on that front. Look, I think ultimately you use this word earlier, which is how do we integrate all of this data into actionable insights? And if I think about the things that will make the biggest difference for the patient experience, and I’ll make it less about Clarify right now, what’s really intriguing to me here is, it really does appear that we are getting closer to a world where Apple, for example, might be the place where we, as autonomous individuals, bring all of our healthcare data together, and then it’s going to be, well, who’s able to then take that from us as we’re permissioning it ourselves to then enable these cases? Like who should I be referred to? Is this the right therapy for me? Etc, etc. I give it a 5 to 10-year horizon and things could look really different.
Saul Marquez:
Got it, and it’s clear, right? You guys are enabling providers, payers, life sciences companies, to make actionable insights based off of the data that they have, and by way of that, the consumer experience is impacted. All of these players care deeply about that.
Jean Drouin:
Yeah, the other thing I would say is the physician or the clinician experience will also be impacted because, you know, burnout is such an issue right now. And I think the notion of rewarding clinicians much more directly for the amazing work that they do can be quite a powerful one as well, because sadly, it just feels like we’ve gotten into a place where the way in which we pay clinicians has gotten more and more transactional and how do we get to a place that feels more collaborative and more team-based?
Saul Marquez:
You know, the thing that I love about you, Jean, is that you are a physician. You came from a family of physicians and you have the physicians’ best interests in mind. And so these physicians are crying, shouting for help, and I am so excited that you and your team are creating these tools that are going to help them. So, folks, the call to action here is, for a long time we’ve been leaving the physician out of the room and that’s got to stop. If value-based care is going to work, if we’re going to be able to make strides in healthcare, physicians need to be in the room.
Jean Drouin:
Incredibly well said.
Saul Marquez:
Thank you, Jean, and you guys are making it happen. So, look, I’m thrilled to be here with you. If you were to leave the listeners with a closing thought, what would that be?
Jean Drouin:
We have it in us to create the health system that we want, and we finally have the ability to pull the information together, and to your point on patient experience, give people the autonomy to make the choices that we should empower them to make. It’s not going to be easy, there’s never going to be enough money because we all want to live forever, but we can do this.
Saul Marquez:
I love that. Jean, I trust that you’ll continue to make strides in the business as well as the value you’re providing to healthcare systems, payers, and everyone out there. Thank you so much for spending time with me today.
Jean Drouin:
Likewise, really appreciate it. Thank you.
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