Empowerment Through Informed Prescription Decisions with Trenton Kriete, Chief Data Scientist and Director of Engineering at RxRevu was automatically transcribed by Sonix with the latest audio-to-text algorithms. This transcript may contain errors. Sonix is the best audio automated transcription service in 2020. Our automated transcription algorithms works with many of the popular audio file formats.
Saul Marquez:
Hey, Outcomes Rocket listeners, Saul Marquez here. I get what a phenomenal asset a podcast could be for your business and also how frustrating it is to navigate editing and production, monetization and achieving the ROI you’re looking for. Technical busywork shouldn’t stop you from getting your genius into the world, though. You should be able to build your brand easily with the professional podcast that gets attention, a patched up podcast could ruin your business. Let us do the technical busy work behind the scenes while you share your genius on the mic and take the industry stage. Visit smooth podcasting dotcom to learn more that smooth podcasting, dotcom to learn more.
Saul Marquez:
Welcome back to the Outcomes Rocket. Today, I have the privilege of hosting Trenton Kriete. He is a chief data scientist and Director of Rngineering at RXRevu. You guys probably remember our interview with Carm Huntress, the CEO. That’s episode 430 on Transforming Prescription Decision Support. Today, we’re hosting Trenton and he’s the brain of the operations, the data science and engineering. In his role right now, he oversees the technical initiatives and teams, including software development, security, HIPAA development operations, dev ops and really analytics and reporting. Additionally, he leads advanced statistical and predictive modeling, reporting and analytics initiatives. He has over 20 years of software development experience, 15 plus years of advanced statistical and machine learning training, as well as 15 years of studying and publishing on the biological basis of human behavior. Dr. Kriete has developed a unique combination of complementary skills. Prior to joining RXRevu, he conducted research in a top computational neuroscience lab utilizing cutting edge techniques such as deep neural networks and other machine learning algorithms to help better understand the functioning of the human brain. Today, he is focusing those efforts and learnings in making medications more affordable and helping Americans and their providers do the best for them with the right choices in medications. So just such a pleasure to have you here, Trent. Thanks for joining us.
Trenton Kriete:
Yeah. Thanks so much, Saul. Really happy to be here.
Saul Marquez:
Absolutely. So before we dive into the work that goes on behind the scenes of the our review engine, I love to get more on you and what inspires your work and health care.
Trenton Kriete:
Yeah, you know, I’ve always believed that and this is going to sound a little corny, although I’ve always believed that those who have the ability to make a positive difference kind of have an imperative to do so. And if you look at my career, whether it was when I was doing autism research or others, I’ve always chosen path at least give me some opportunity to make make a real impactful difference for people. And health care is one of these great areas where, due to its complexities, sometimes it’s relatively slow to change. And just the importance of what’s happening in health care, there’s small improvements that can make really positive, large, positive impacts. So there’s just so many ways that we can make health care workers lives better, patients’ lives better. And so it kind of is a perfect place to to really have a positive impact.
Saul Marquez:
I think it’s great. I don’t think it’s corny. I think it’s awesome. And you’re right. It’s these little changes that you can make that have such tremendous impact. And, you know, speaking of medication adherence, transformation of prescription, there’s a huge opportunity there. So I’d love to maybe even recap the time with Carm tell us a little bit about our review, what the core value there is and how you’re contributing to getting to those results.
Trenton Kriete:
So I said our RXRevu for our core value is we’re trying to remove barriers from access to care for patients and making it easier for the providers to give their care, make it easier for the patients to get that care. We’re currently focused on issues that are mainly surrounding a patient access to medications. And we’re doing this through leveraging technology and leveraging transparency. RXRevu through our partnerships, we’re able to provide what’s known as benefit information in real time to the provider, to the prescriber as they’re sitting there with their patients so they can have a conversation, as does this medication makes sense for you? Can you afford it? By the way there might be a prior authorization for this. So it’s going to be a couple of weeks before we can get this to you. Is that OK? And really making that process a lot more smooth to the hopes of getting that patient the medication at the right time for the right price so that they can hopefully get on the treatment that their health care expert has suggested for them, which with them was lots of studies that show that this will increase the adherence of the patient, thereby also reduce the burden on the health care system by preventing things like readmissions and other issues that can happen with nonadherence.
Saul Marquez:
And this is good stuff and it’s real time. So on the data side and it’s a problem Right.. Three hundred and thirty billion dollars is, I guess, what was estimated in twenty sixteen for prescription drugs. Yes, it’s a big number. And so you guys are focused on real time data. Can you tell us the value of that and how that translates into potential results for patients and providers?
Trenton Kriete:
Yeah, absolutely. Um, if it’s not real time for the patient, given how quickly things can change in the prescription space, the value is greatly diminished. So by the time that the I guess, back up a little bit, there’s something called formula benefit information, which is the old way essentially of getting price information for patients. And almost by the time this was loaded into whatever system was being used to communicate this, it was nearly out of date for the patient. And so real time allows this information to be acted on immediately by the provider. This includes things like as we’ve moved into this value based system with higher deductible plans and so forth, the patient may not be all the way through the deductible. So the old way of doing it wouldn’t have accounted for that. But with real time information, you’re able to actually say something to the effect of you still need to pay off X amount of your deductible. Therefore, this medication is still going to cost you one hundred dollars. But after the next refill, it’s going to go down to 10 based on your copay. So that kind of information is really valuable to have at the point of care because it matters like dollars matter to patients for picking up their medications. If they don’t have that information, then by the time they get to the pharmacy. So suffer what’s commonly called sticker shock and abandonment can be as high as 30, 40 percent at that point.
Saul Marquez:
Abandonment. Yeah, yeah. You help the patient say, wow, this is the reality. Actually, what else do they have? Like one of my other options, Dr. Right..
Trenton Kriete:
Exactly. The conversation happens while the patient is there with the prescriber. There’s no of callback on the pharmacy to have that conversation. And really, for me, the most important thing is, is that patients just so much more likely to actually pick up that medication if they have that conversation ahead of time. There’s no surprise when they get there. Got it. I think that’s the real advantage of real time information vehicle.
Saul Marquez:
And so on the deductibles side, that’s a huge benefit. Anything else?
Trenton Kriete:
I think the other really interesting part about real time information is you can not only reduce the burden on the patient and increase the likelihood that they’re going to pick up their medication. But there’s this concept of prior authorization, which is essentially something that organizations that are at risk for ensuring the patient will use to say, OK, have you tried these other medications? Let’s make sure that you’re not jumping ahead, kind of slowing down the process a little bit for them to access higher cost specialty medications. And what’s great about flagging that information is a lot of times the provider prescriber wouldn’t have known that that was going to be a burden that the patient or the pharmacy or even their own staff was going to have to face to get that medication out. So by surfacing that information, giving them ways to sort of bypass it with possible other alternatives that don’t have that kind of coverage restriction, they can make the decision right then and there that, hey, we’re not going to go through this process because we don’t want this patient to get this medication two weeks from now. We want them to get this medication today.
Saul Marquez:
So in other words, medication that does the same thing but doesn’t have all the pre authorizations.
Trenton Kriete:
Exactly.
Saul Marquez:
That’s really cool.
Trenton Kriete:
Yeah, it’s up to the expert in the room, the prescriber, to decide if this medication, maybe they failed something else before, but showing them something that’s therapeutically equivalent that would have the same effect and giving that option is also really powerful.
Saul Marquez:
Love it. Yeah, that’s really powerful. And how about on the pharmacy side? Are you guys facing them or just getting data from the pharmacy or are you also providing value and benefits to the pharmacy?
Trenton Kriete:
We do think that we provide value to the pharmacy as far as to kind of take this rubric of reducing friction in the process. We don’t contract directly with pharmacies or anything like that, but we do by having this conversation up front about the coverage restrictions that might exist. If there’s going to be an adjustment to the quantity that would prevent this from being covered by the patient’s insurance, we can take care of that upstream so that the time it gets to the pharmacy, they don’t have to worry about calling the doctor’s office back and working through the authorization or working through those quality limits there will already be handled for them. In that way, it’s making their lives a little bit easier as well. Very cool.
Saul Marquez:
Yeah, I can see that. Thank you for that. And data is crucial and really understanding how the data can help. And in health care, if you can get real time data and you know how to use it, it’s powerful.
Trenton Kriete:
Yes, absolutely. Absolutely it is. There’s somewhat of a paucity of this in health care. So being on the forefront of getting this real time cures for real time data is really important. But I think the floodgates are getting ready to start to open as people are starting to see the benefits that we’re able to provide by giving this data in real time as opposed to at times weeks after the fact. And so that this march toward real time data, I think is only going to get better for us.
Saul Marquez:
Man, that’s awesome. I think it’s great. Now, you guys are certainly leading the way here. And so let’s talk a little bit about really the different offerings, Right.. So cost transparency is huge. You guys are providing that therapeutic alternatives is awesome. You mentioned coverage restrictions. Give us a story maybe of a customer or a patient that you guys are able to benefit. It could be an outcomes result or it could also be a business improvement result.
Trenton Kriete:
There’s been quite a few lately. So we recently did a webinar with Dr. Chelin from U.T. Health, and he was able to provide a really powerful example of an alternative that won’t remember the exact medications that that’s OK. He was able to site, but where he was using our tool with his patients. And as you prescribed medication for them, it came back with not only the price of the medication, but also some really simple alternatives. I think some of these things were as simple as switching to a 90 day supply and possibly going from a tablet to a capsule like nothing that’s really hard. Yeah, but the cost savings for the patient in this case was in the hundreds of dollars per month per. Yes.
Saul Marquez:
Which is crazy, right? I mean, this stuff adds up.
Trenton Kriete:
And it adds up and unintuitive ways Right. like who would have done that? Just simply changing the form from tablet to capsule would have had this sort of disproportionate effect on price. And there’s no way that the prescriber would know that because they’re not necessarily and they don’t have the benefit plan of every single patient that comes through memorized. And so he was able to save this patient who he described as an at risk patient who would likely not have been able to get this medication if they hadn’t had that information in real time. That was one that really struck me as if you were powerful. But I do think it is it is powerful. The idea that simple things can make such a big difference. And without that data, there’s just. Health care is just too complex. These benefit plans are too complex for to expect our providers to be able to do this on their own.
Saul Marquez:
I think it’s great. And so I think about the employers that are responsible for thousands, millions of lives, Right. and how powerful this tool could be for employers. Are you guys working with employers or mainly with providers? Something more about that.
Trenton Kriete:
Most of our let me, I guess, put it like this Saul. We work mainly with health care organizations directly. We kind of sit in the middle of this value chain between organizations that are risk, such as payers and PBMs and the health care systems themselves. As such, there are health care systems that have their own plans, are at risk themselves or possibly employer organizations that use one of our partners as someone that services their benefit. So they could possibly be leveraging our information as well, but we don’t contract directly with them.
Saul Marquez:
Got it, yeah, got it, not makes a lot of sense, you’re enabling the providers and those bearing risk, not necessarily the employers that are purchasing the insurance.
Trenton Kriete:
Exactly, exactly. That’s something that has been nice about sort of how we’re positioned in the market. As you know, we’re we’re not owned by any large organization or a privately held health care company who are most of our major investors, our health care organizations. And that lets us sit at this nice little nexus in the value chain of health care, where we can try and align incentives across the organizations that are at risk with the health care systems and with the patient. We believe that reducing this friction in access to medications and providing this information, this data and real time that will allow the patient to get the medication more quickly, more reliably. That, in turn, will help the health care organization provide better care for the patients, provide better information further prescribers, as well as reducing some of the administrative burden from some of these prior authorizations and things like that. And if you can increase the health of the patients by having them on their medications, people that are at risk for these patients are going to do better as well, because you’re going to have as many readmissions. You’re not going to have as many high cost health events as adherence goes up. And so it’s a really nice position to be in that we don’t have to consider any sort of corporate masters at this point, and we can just really concentrate on delivering value.
Saul Marquez:
Yeah, I love it. I love it. Thank you for that. And certainly valuable. And we could also think about the less fortunate populations that have trouble with access and federally qualified care centers, these populations. Is there anything being done there to help with affordability?
Trenton Kriete:
Absolutely, especially in the medical the Medicare population. But there’s a lot of federal organizations that could potentially benefit from this. Imagine someone that is on a fixed income, that is in the elderly population, that’s on Medicare. Once they get to their donut hole where the coverage kind of has a gap for a little bit. Understanding the cost of the medications and what other options they might have might be the difference between them staying on their diabetes medications or their lipids or something like that. That is vital for them, for their health and for potentially other cost events and health care that could happen if they get off of their meds. In some ways, it’s helping them budget and stay on track with their health care if they have this kind of information when they’re in that, you know, that gap that happens within Medicare.
Saul Marquez:
Yeah, that’s a great opportunity there for sure. And so, Trent, very cool. I appreciate learning more about the data side from you. And so tell us about maybe a setback that you guys experienced, what you learned from that that’s made you guys even better today?
Trenton Kriete:
You know, this is about my sixth year with RXRevu. And so I’ve seen as a starter basically from the beginning with them. I would say one of the bigger setbacks that we’ve had was one that we realized that the way we were trying to get our information to the patients and to the providers was wrong. We’ve always had the mission of helping patients get access to medication through transparency and through cost savings opportunities. But we started this path down a consumer facing route where we were trying to essentially have this conversation with the patient. We cut the prescriber out of this. We cut the health care organization out of this conversation. And we had some pretty rough times because of that initial misstep as the health care organizations, these are the people making the decisions for the medications are the ones having the conversations with their patients on what the best route of care is. And that is that we definitely had sort of a reckoning of sorts where we realized that we were completely going down the wrong path of delivery and we had to throw away, I would say, four years worth of software development, do some re organizational structure because we didn’t necessarily have the right people in the right seats anymore. And it was so painful. But we ended up finding this much better fit. We’re now we’re in the workflow working directly with the health care organizations instead of around them. And so that was a very painful thing to learn, that some people suffer because of it, unfortunately. But having learned that, knowing now the right way to get this information to people has been transformational for for us as a company.
Saul Marquez:
That’s so great. I mean, the pain and the hardship that you guys went through there was formative, but also just shows how committed you guys are to this, because at that point, when you’re like, gosh, you know, four years into it, we were doing this wrong and not necessarily wrong, but we weren’t hitting the mark the way that it was going to take off like a lot of people would have given up.
Trenton Kriete:
That’s not in our DNA, thankfully, but it was it was definitely painful, Saul I will say that. But this is common in startups, right? Where you for sure is that the way you’re running ended up being misguided for X, Y, Z. But if you’re able to take that, learn from it rather than sort of use it as an excuse, you can do what we did, which was save the company and then start adding the value that you always wanted to add to the health care system. It’s been great since we made that call.
Saul Marquez:
Man, that’s so great. I appreciate you sharing that story. It’s inspiring. And for all the folks listening, I hope you can draw some inspiration out of that as well. If you feel like you’re at a point right now where your business or your organization, for that matter, is maybe hitting a brick wall, it’s an opportunity to rethink, make a shift and keep at it. Because if you’re truly committed, you could find a way. And so now, because of that commitment, resilience Trent, Carm and the rest of the team at RXRevu are able to fulfill their mission of helping patients get affordable access to their medications. And they’re helping through the existing workflows, through the EHRs that the providers already use so fascinating and inspiring. Trent, what would you say you’re most excited about today?
Trenton Kriete:
I said the thing I’m most excited about today is starting to gather the data information that is going to be able to speak to and help us understand exactly how we’re helping patients and organizations. And what I mean by that is we’re showing the information that we’re showing the real time benefit and cost information. We know these conversations are happening with health care providers and we have the nice anecdotes of people getting medications that otherwise wouldn’t have. But I think there’s a really interesting story here. If we could do a longitudinal study, which we’re starting to work towards, to actually see and quantify how much benefit patients are getting, how are we saving health care organizations money? How are the organizations that are at risk, the exact value that we’re getting and leverage that contribute to the broader scientific community with the information? I’d say that’s something I’m really excited to get to do.
Saul Marquez:
Yeah, that’s definitely exciting. That’s certainly exciting. And once you guys get that, forget about it. I mean, you’ll be able to talk to the specifics of savings and access. So truly, truly awesome. And I want to thank you for our time today. And I’m sure your listeners are grateful as well. You guys are doing extraordinary work to make medications more affordable and help our providers have more sustainable businesses. Why don’t you leave us with the closing thought trend and the best place that the listeners could reach out and continue the conversation with you?
Trenton Kriete:
Yeah. Thanks so much for having me. So all this has been great. I’d say my last thought is something I’ve been thinking about in this world we’re living in. And the pandemic with COVID is a possible silver lining is that if you look at past pandemics and past epidemics, they’ve led to some really amazing innovations and discoveries. So during the outbreak of the plague, that’s when Shakespeare wrote King Lear, Macbeth and Cleopatra. The discovery of vaccines was really spurred by some innovation that happened during a Boston smallpox epidemic, and the Spanish flu eventually led to the first flu influenza. I’m optimistic of the kinds of things that we’re going to be able to come out of this innovation wise as a society, even though it’s really painful right now. That silver lining is something that I think we should all concentrate on sometimes.
Saul Marquez:
That’s awesome. And some great historical references there to to encourage us to keep going. Really appreciate that. And so if the listeners want to reach out and learn more or continue the conversation with you and the team, what’s the best place for them to do that?
Trenton Kriete:
I would say either hit me up on LinkedIn at Trent kriete K R I E T E. I think I’m the only kriete out there. So or you can email me at trent.kriete@rxrevu.com
Saul Marquez:
Love it. Thanks. Thanks for that. And listeners, if something resonated around data or medication adherence or lower costs, reach out to Treant. And don’t forget to also check out that interview with Carm Huntress, just extraordinary work that this leadership team and our review is doing. Trent, thanks again. This is great.
Trenton Kriete:
It was a pleasure, Saul. Thanks.
Saul Marquez:
Hey, everyone. Saul Marquez here. Have you launched your podcast already and discovered what a pain it can be to keep up with editing, production, show notes, transcripts and operations? What if you could turn over the keys to your podcast busywork while you do the fun stuff like expanding your network and taking the industry stage? Let us edit your first episode for free so you can experience the freedom visit smoothpodcasting.com to learn more. That’s smoothpodcasting.com, to learn more.
Sonix uses cutting-edge artificial intelligence to convert your mp3 files to text.
More computing power makes audio-to-text faster and more efficient. Quickly and accurately convert your audio to text with Sonix. Manual audio transcription is tedious and expensive. Here are five reasons you should transcribe your podcast with Sonix. Get the most out of your audio content with Sonix. Sometimes you don’t have super fancy audio recording equipment around; here’s how you can record better audio on your phone. Sonix has the world’s best audio transcription platform with features focused on collaboration. Automated transcription can quickly transcribe your skype calls. All of your remote meetings will be better indexed with a Sonix transcript.
Sonix is the best online audio transcription software in 2020—it’s fast, easy, and affordable.
If you are looking for a great way to convert your audio to text, try Sonix today.
