OR – Michael Perretta: this mp4 video file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.
Saul Marquez:
Alright, everybody. Hey, this is Saul Marquez with the Outcomes Rocket. I want to welcome you back to another episode. Today, I’ve got an awesome guest. He’s no stranger to the podcast. We had Mike Perretta on three years ago and want to welcome him back. Mike, welcome back to the podcast. So grateful you could make it back.
Michael Perretta:
Hey, thanks so much for having me, Saul.
Saul Marquez:
It’s a pleasure. Yeah, yeah, and look for, for the people that haven’t had a chance to listen to Mike’s episode, let me give you a little intro on him. Mike is the creator of Docket. Docket is a first-place winner of ONC’s 2016-2017 Move Health Data Forward challenge. Docket Health partners with public health agencies to expand consumer access to immunization records and improve adherence to routine vaccinations. We’ve seen a lot with COVID, data has been more mobilized, a lot has changed since our last discussion. So I’m really excited to have Michael on with us today to talk to us about the expansion to the various different states that they’ve made since our last conversation. Mike, excited to have you back on.
Michael Perretta:
Hey, thanks so much, Saul.
Saul Marquez:
Yeah. So look, give us sort of like, the catch-up, on sort of what’s happened since you and I spoke three years ago.
Michael Perretta:
Yeah, absolutely. So all of the work that we’ve been doing at Docket ever since 2018 has been focused on immunizations, specifically connecting consumers directly to state-run immunization information systems or IIS. This goes back before the pandemic, right around early 2020, we were starting to roll out our application with the state of Utah. So, fortuitously, that was around the time of, or, of course, with COVID, so there was a built-in urgency for this technology that helped us expand our footprint pretty rapidly. Ever since we rolled this out in Utah, we’ve been growing at a clip of about two states per year. Today, we’re alive with just about 3 million active users across Alaska, Idaho, Minnesota, New Jersey, Utah, and Wyoming, with a couple more states in the pipeline this upcoming year. What was great with, for us during the pandemic was having this urgency to grow our business. But with the pandemic in the rearview mirror, of course, COVID is having a resurgence right now, but we’re excited to get back to the basics of routine vaccination. So this is really a technology, a solution for parents and families or individuals tracking their ACIP recommended immunizations, things like hepatitis, tetanus, those kinds of things, where we see big upticks right before fall and spring semesters, which is exactly what we want to see out of the business, and we’ve been really excited with this work.
Saul Marquez:
Michael, that’s great. Congratulations on all of this. Six states, 3 million lives. Like, Mike, that’s huge. So, you know, just want to pause there and say congrats, kudos. And it sounds like going from reactive with the pandemic to now back to proactive, which was the original intent. I know for anybody listening, like, you’re probably like me, and you have a dusty card with all of your ancient vaccinations from when you were a kid. And, you know, why? Why do we do this to ourselves when you could be more modern with technologies like Mike’s, right, Mike?
Michael Perretta:
Yeah. So part of the benefit of working with government, so actually, it’s always a double-edged sword because on one hand, it’s a lot more, it takes a lot longer to roll something out, but on the flip side, specifically with the use case for immunization records, we’re not only getting a more comprehensive view of an individual’s immunization history, but also the clinical insights that come with the state immunization forecasting. So, what that, so early on, our focus really was about expanding the footprint and making this available to a wider audience, focusing on accessibility. This year, we rolled out a web version of Docket for folks without a smartphone or who don’t, individuals who don’t want to download another app, making this available to the widest audience as possible. And then, this year, it’s been more about how to engage users, about recommending being more proactive, about recommending vaccines based on ACIP immunization schedules, things like that.
Saul Marquez:
That’s great. Hey, and as you, as you’ve sort of, you know, as the business has evolved, you know, what’s, what would you say is one of the things that stands out, like a learning in business that, that people could maybe appreciate or take from you?
Michael Perretta:
Oh, I’m really bad at giving business advice, I will say. I try to just make things happen. And we are a small team, well, we grew by 50% this year. So, we used to be a two-man company, we hired a third employee, so we’re growing, but I take what I can get. I actually dropped out of business school early on the pandemic to focus on Docket. And I’ve learned a lot working with different states, and all states operate differently in terms of procurement, bidding, and then the specific legalities around it, vaccination records within each jurisdiction, and then also the technology that, the data infrastructure behind it for each state is different too, as well as each state’s specific implementation of HL7v2.5.1. So we’re using old, old technologies, … runs on SOAP, same data standard, but it’s all different. So there’s just a lot of being flexible and just trying to make things happen. I tend to have like, I take what I can get approach to business. Of course, we, we’re really selective with the agreements that we pursue to make sure that it’s sustainable for us, but also for our public health partners. Since this is, if you follow the news with, this year with the debt ceiling bill, trying to stay, trying to make our business … foolproof as possible so that, you know, we’re not in the way of things like taking back on COVID funds, that kind of thing.
Saul Marquez:
Yeah, no, I think that’s great. And look, kudos, right? I mean, you, you expand it to six states with a two-man operation. Like, that’s huge, you get something to be proud of. Yeah, you know, on the not finishing the MBA, like, dude, that’s awesome. Like, you know, each one of those states is like a different MBA. There’s no way, like, an MBA could teach you what you went through for each of those states. So I think it’s great, you know, and really staying focused, being laser, laser-focused and not giving up, especially during something like the pandemic, that in itself, right, is a lesson we could all learn from your actions. As you think about, you know, healthcare trends and technology, Mike, like, what would you say a trend or technology that’s going to change healthcare as we know it is?
Michael Perretta:
Yeah, I mean, I think there are a couple obvious ones that people have been talking about, consolidation between different healthcare organizations, of course, that’s, you know, probably outside the public health sector, and then, of course, everyone’s talking about AI. A couple of years ago, it was all blockchain… I try to not get so caught up in healthcare trends and just staying the course for us. I figured if we keep focusing on what other people are doing, we lose sight of what we’re trying to do. So we just want to stay focused on doing what we do well and trying to expand. What I found about healthcare, in general, is that it’s such an exciting industry to be in, because even in the very specific niches, there’s just so much opportunity, and healthcare affects everybody. So as something as simple as consumer access to immunization records, we’re able to just do so much on there. So, you know, you see it with what we’re doing with the reminder-recall. So, step one is we’re still giving people access to records. Step two, enabling forecasting alerts. Step three is for proactively sending reminders. Step four is that we’re tracking the reminders to see if folks are getting vaccine, getting their vaccinations based on those reminders, and tracking the, or measuring the effectiveness of that intervention. Maybe that tracking is not the right word here. We’re really, I mean, this is all at a population level. And then, the next would be to start guiding folks to nearby immunization services based on the types of reminders that are getting for a specific vaccine series, to clinics that, or pharmacies that have stock of those vaccines, or dispatching mobile clinics to rural areas and doing route optimization. Say, hey, you know, we have a critical mass of folks in this county who are all becoming due for the same vaccination. Can we work with mobile clinics to get vaccines in out there? So, I take it back, just, you know, as something as specific as consumer access we think has such a limitless roadmap. So we’re, maybe this is not so much talking about the trends of healthcare, but we just want to keep doubling down and seeing how far we can take this thing. No one’s telling me to go, so we’re just going to try to make the most amount of good as possible.
Saul Marquez:
… Yeah, you know, and what you shared is really good. It’s like, hey guys, if you’re really focused on the trends and the, and sort of where everybody’s running to, you might be missing out on the opportunity of where you’ve been and not staying focused. There’s a lot to be said for that. And then, this whole thing of healthcare. Yeah, you know, like I had a guest, Mike, just say, you know, it’s not a vertical, it’s a horizontal. Because healthcare takes care, like, it touches every vertical, so it’s a horizontal. And yeah, the opportunity is huge at, you know, 20% of our GDP, 4.3 trillion in the US. Like, it’s massive. So focus on an area and make a difference like Mike has, and you’ll see that you start finding those nuances, those niches that could help you contribute in a big way. Michael, I always appreciate talking to you. I love the success you guys have had. For those listening, if they’re part of government or maybe they’re a payer or provider, they’re thinking maybe there’s a way I could work with Mike and his team. What’s the best place they could get in touch with you? And then, what should they be thinking about? As they, as we close this podcast, what call to action would you leave them with?
Michael Perretta:
Oh, shoot, that’s a lot of pressure. I’m not sure that I have a call to action. I think, you know, I’ve heard it said at HIMSS this past year by some folks from HHS who work in the space, in the world of immunization records, and the advice was to not, to not lose the momentum from the pandemic. So the, of course, the pandemic made everything faster. Government procurement was faster, innovation was faster. It was really responding to this need. One big innovation that came out of the pandemic was Smart Health Cards, and that was the QR codes with the Vaccine Information Code onto the image of the QR code itself. Well, for the past year, we’ve been working with Microsoft, the Commons project, Apple, and other industry partners on developing and honing a new data standard that’s the successor to Smart Health Cards called Smart Health Links. It actually went live on Docket in select jurisdictions this past week, enabling a user to securely share their vaccine records in the form of a URL with the preset expiration date and a passcode, so that somebody with a access to URL and the passcode can have a copy of an individual’s immunization record that would self-update whenever their Docket app is updated. So we think that’s a great application for students going to school who want to share their immunization records one time and then have it self-update, or folks who are participating in research that want to share their records with a research organization and in a way that will not result in additional calls to the state’s immunization registry or new integrations. So this is in the spirit of consumer media, consumer media exchange, and user-managed access. We also are seeing a lot of other organizations find applications for this new technology, Smart Health Links. We, for example, insurance companies are using it for insurance cards. Washington State is looking to it for international patient summary. Other jurisdictions like, that, are looking to also support it for immunization records. … is looking to it as a promising technology for vital records. So, you know, I would say the call to action is to not lose momentum, to not rest on your laurels, and to keep innovating. Folks can find us on, sorry, and to the answer to your first question, Saul.
Saul Marquez:
Yeah, yeah. No, please go ahead. Where can folks find you?
Michael Perretta:
If anyone has any questions or want to chat some more, you can always reach me at michael.perretta@dockethealth.com, and I’m sure that we’ll make that available online as well.
Saul Marquez:
Yeah, we’ll put that in the show notes, Mike. So Michael.Perretta. We’ll leave it in the show notes. @healthdocket.com? Is that what it is?
Michael Perretta:
dockethealth.com.
Saul Marquez:
dockethealth.com. Guys, just go to the show notes. It’s all in there. We’ll make it easy for you because Perretta has two R’s and two T’s, so you’re going to want to just go to the show notes and get his email if something today resonated with you. And as I’ve always shared with you guys, do not stop at listening. If you want to take off on the rocket, you need to take action. So if something today resonated with you, please reach out to Mike, check him out, get more familiar with his work. I think you’ll be surprised and impressed with what they’ve done so far. Mike, thanks for joining us today, and I really appreciate you being with us.
Michael Perretta:
Hey, Saul, thanks for giving us a shot.
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