: [00:00:01] Welcome to the Outcomes Rocket podcast where we inspire collaborative thinking, improved outcomes and business success with today’s most successful and inspiring healthcare leaders and influencers. And now your host, Saul Marquez
Saul Marquez: [00:00:18] Outcomes Rocket listeners welcome back once again to the outcomes rocket podcast where we chat with today’s most successful and inspiring healthcare leaders. You know really want to thank you for tuning in again. It’s awesome to hear the feedback for the show. It really makes our day when we hear it. Invite you to visit outcomesrocket.health/reviews. That is our Apple podcast page where you could leave a rating and review what you want about today’s show because he is an outstanding guest. His name is Brendan Levy. Dr Brendan Levy. He’s a co-founder and chief medical officer at HeyDoctor. He’s got quite the resume with experience as a board certified family medicine is physician from the Georgetown University in D.C. and he’s got just a wonderful experience in health care not only as a provider but also as an entrepreneur. And so without further ado I just want to open up the mic to Brendan for him to fill any of the gaps in that intro. Brendan, welcome to the podcast.
Brendan Levy: [00:01:22] Saul thanks. Having me. It is a pleasure to be here. Thank you for that glowing introduction.
Saul Marquez: [00:01:27] Absolutely my friend. And you know I just wanted to ask you you’ve been in it for a while. What got you in the medicine to begin with.
Brendan Levy: [00:01:33] I think that nosal the sound of it cheesy English I apologize but I think it’s interesting to find out what people care about what makes them tick and find out ways that you can be either adviser and be there to kind of help them understand the science and how they can live their best lives. And Oprah speak.
Saul Marquez: [00:01:49] Love it man. Now I think it’s great that I don’t think it’s cheesy at all. You know I think it gets to the heart of why you decided to be a practitioner. And I think it’s pretty cool so much easy man. It’s good. What would you say. Brendan actually before we get into that I want to ask just for the audience so that they know a little bit more about HeyDoctor I don’t want to make any assumptions. Tell us a little bit about what you guys are focused on at HeyDoctor.
Brendan Levy: [00:02:14] Yes and the idea is there’s a lot of reasons that people go to the doctor where you know they kind of know that a doctor is just going ask them a couple of minutes of quick questions and the question is kind of what’s the point of some of these visits could you not find a better way to do them more efficiently so that you both save the patient time and you also save the Doctor time. So for some you know classic examples to be like hey I need to refill my birth control or I’m a woman I have a urinary tract infection both of which are extremely common needs. Or maybe you’re traveling you need malaria medicine. So instead of going into the doctor’s office wasting a couple hours or instead of even doing on video we say let’s just ask you the questions and then if your case is simple that will say you know yes no or what the appropriate treatment is for cases that are more complex than we can spend more time with them. What kind of is very unfortunate about the current healthcare system is that as a doctor I’m spending the same 15 minutes with patients that have a cold as have a new diagnosis of cancer say is let’s have doctors focus on the complicated cases. That way we can do other cases kind of very efficiently in a very high quality way.
Saul Marquez: [00:03:17] I think that’s so cool and so are things picking up for you guys starting to get some traction on the app.
Brendan Levy: [00:03:23] Yeah we’re actually seeing quite a few more patients than we expected. Thanks. Just a few kind of pickups and tweets out there and some advertising. We also power some other providers as a software solution. So so far so good.
Saul Marquez: [00:03:37] Man that’s awesome. I think it’s worthwhile the efforts that you’re making here. You know you probably know better than most. As a as a provider the pain that goes into you know these visits for the patients as well as a provider you know we feel like we’ve got to take into consideration as we work to improve outcomes the quadruple aim. And I think your efforts here are not only tailored to better the lives of patients but also the practitioners. Can you give us an example of how you guys have done that for either or both.
Brendan Levy: [00:04:07] Yeah. And give good example. You know I actually just got off the phone with a patient. I’m not really happy here but some of that had migraines or which are contraindication to certain types of birth control. Now she’s been getting birth control for years but nobody had asked her that I’m sure because you know these doctors are in a huge hurry. Get a lot of paperwork to do so with this format. It’s nice because we can kind of take ask questions of the patient as we want or we need to. But then you can also just put all that information right up in front of a doctor and they don’t have to do any paperwork. They can just make the right clinical decision as additionally guided by software to help them kind of know what is the latest best evidence for that decision.
Saul Marquez: [00:04:45] I think that’s really awesome. I’m getting through this book called principles by Ray Dalio and he kind of walk through some of the things that he did to have success. And in light of that he attributes to not only just his decision making as a person but that decision support that he is able to get through algorithms and computers and what you’re doing here you and your company is really just targeted at that and just using computers as decision support.
Brendan Levy: [00:05:13] Exactly. I mean I think you know the question is really how do you surface the the inputs that are going to make a decision on in a way that’s efficient in a way that lets you just never get to make a decision make it quickly and make it safely. So that’s difficult we’re trying to do. Also I definitely do read the book because they’re about the fifth person Joe recommended to me. Right.
Saul Marquez: [00:05:32] There you go. That’s a must. And it’s also an audio so you could also listen to it which is what I’m doing and it’s just. Yeah. About one fourth of the way through and an outstanding one. So listeners if you have not read that principles by Ray Dalio it’s one to pick up. If you’re looking to make serious moves in health care even though he’s a finance guy it really applies to all areas of the achievements. Ok Brendan.
Brendan Levy: [00:05:58] Actually I’;l try to pause you there for one second. Sure on the topic of finance I think that there’s a lot we can learn in medicine from other sectors. You know if you look at the average EMR if I want to find out about something as basic as some one’s day birth oftentimes it’s five clicks away when we are making the software we have designers and doctors in the room so that you know are kind of trying to emulate is like a stockbroker screen or something we see all the information you need on one screen. Don’t have a high don’t go digging for it. Show me what I need to know to make decisions I’m trying to make to help the station.
Saul Marquez: [00:06:31] You know what a great point. I really think that’s such a great point Brendan and totally so. And it’s cool that you guys are trying to emulate that and why not be able to implement in such a way as finance into healthcare so very very appropriate. Man thanks for calling that out for very well. And so I love these conversations because they’re all targeted toward improvement right. Like we improve our businesses we improve patient interactions and outcomes. Give us an example Brendan of a time when something didn’t go your way. It could be while you were practicing it could be with HeyDoctor a setback. And what you learn from that.
Brendan Levy: [00:07:09] Yeah this is. First of all are great behavioral interview question and one that I always struggled with because certainly many things have not gotten my way. But it’s always hard to call them out for probably some repressed slightly but I say hey doctor you know some of the biggest challenges are how you get people to understand what this model is because I think that many people have had experiences with Stadio telemedicine and that you know frankly I gigaton as income translates a lot of the same problems that you see in the doctor’s office. It’s a little awkward and is kind of inefficient for both the doctor and the patient. So I think one kind of step back I’ve had is definitely a great learning experience is how do you explain what you’re trying to do when it is significantly different from the status quo. And partly I’ve just learned that by kind of hearing doing my best in forums such as this to explain what we’re doing and why we’re doing it and then hearing kind of how people understand that and kind of parroting that back yeah.
Saul Marquez: [00:07:59] And so during that process what would you say was learning and maybe an improvement that you made.
Brendan Levy: [00:08:06] Yeah it’s partly learning how people I think think doctors think and I think that patients maybe. I think about this but something like a huge eye for example is a type of condition or a woman’s urinary tract infections extremely common thing and it can be expressed very simply in a one page algorithm like do you have this symptom. Yes or no. Do you have that symptom. Yes or no. I think that explaining to patients that oftentimes we as physicians are just walking you through these kind of decision trees. And so what we want is for you to provide information that helps us recommend that outcome is something I’ve learned to explain. That is kind of how I come from times thinking so that people understand what types of inputs are what steps data they need to provide for us to help provide the best advice for them. Second I’m asking you this question. The reason is because I want to know make sure recommend this antibiotic or this other antibiotic.
Saul Marquez: [00:08:55] No it makes a lot of sense. And so you know listeners think about that. You’ve got to put yourself in the shoes of the people that you’re communicating with to get an idea out. And oftentimes we make assumptions. You know we make assumptions that the people that we’re speaking to know what we know and we got to bring it down a couple notches and walk them through to help them understand and this is a great example that you bring up Brendan you know like there’s a lot of acronyms in healthcare. Let’s not assume that patients or people know the acronyms let’s use the actual words. And you did that right. You said. And then you followed through with the actual urinary tract infection. Just a simple example but yeah I think it’s a beautiful call out. And so you had that you’ve been cleaning up the game here. And so now you’re getting some traction with the app. What would you say one of the proudest experiences you’ve had to date with it is.
Brendan Levy: [00:09:50] I will say that some of the proudest experience I have are just hearing I’ll say it is a real joy getting the feedback. You know it is something that originally I thought I had missed when I was leaving my primary job is kind of an office based clinician but having this kind of ongoing text conversation with patients in some way is even more satisfying because instead of just writing the prescriptions and that’s the last time I see this person for six months now I can get a message the next day about how they’re doing it’s going well great. I can answer solid question over tax which obviously is a much more convenient modality if the patient is really in some ways kind of deep in debt because you know it’s kind of like you’re texting your friends oftentimes the other contacts and using texting. So now that same way your position can be available to answer questions for you. So finding that that does work for people has been incredibly rewarding.
Saul Marquez: [00:10:39] That’s pretty cool. Are you guys finding that there is a particular demographic or age group that gravitates toward this or is it pretty broad.
Brendan Levy: [00:10:47] Currently you know I think it is pretty broad but currently I would say women kind of 20 to 35 as our chief demographic and I think largely because they’re comfortable with the technology. Some houses were used or kind of Scheifele useful for that population. We definitely hope to broaden into a kind of primary care writ large because I really think like something approaching half of the visits you will go into the doctor for are just kind of quick checklist visits even things where it’s like you got diagnosed with high blood pressure six months ago and now you’re going to come back into all they’re going to do is measure blood pressure and ask you how you’re feeling. What is the point of going in for that type of visit when really you can just gather all the day at home with a smart blood pressure cuff for example.
Saul Marquez: [00:11:29] Or you could just go to CBS or Walgreens check it out. Glad didn’t there. Yeah yeah. All LA you go get you know a Starbucks right across the street. Exactly. That hopefully in the long term we’re saving the health care system money. Hope you’re getting somebody healthy at Starbucks and then maybe you can spend more money on things that I think really matter of society like healthy eating and other things that would help prevent these problems from ever occur.
Saul Marquez: [00:11:50] Yeah for sure. It makes a lot of sense. And so within the system. Brendan are you actually is a health care provider either practitioner or solo practitioner or a system. Are they able to to develop codes and bill for things on here or is this all being done. Like who builds for these visits these digital visits.
Brendan Levy: [00:12:13] Yeah that’s a great question. So currently because we can do it so efficient we just say you know we’re not going to buy insurance we just say you know birth control refills ten dollars to have a visit is 20. So we keep kind of all it visits very low cost but being very efficient. Ultimately I think there’s a lot of case to be made for you know a large I think really an insurer ultimately where you can say hey you know instead of someone going into urgent care which costs two hundred dollars. The average cost a thousand dollars. Why not solve their problem at home which is more Kimveer for them. It saves the payer money. I think fundamentally could kind of alter the way the system is actually run.
Saul Marquez: [00:12:48] That’s pretty cool. Can somebody use a health care savings account.
Brendan Levy: [00:12:52] Not yet but that is something we’re actively working on. Oh and I should say actually in answer to your last question our other vision would be you know a lot of health systems tend to move slowly from a technological standpoint for a lot of reasons but we certainly are talking to about potentially just white labeling this app so they could then attach it to their own records. I love you both follow ups and visits.
Saul Marquez: [00:13:14] I think that’s awesome. And then develop the seat CPT codes lower your cost. And hey that’s a way to get the job done. Make it can mean for patients and increase your profitability while you’re at it.
Brendan Levy: [00:13:26] Exactly. Hit a few aims.
Saul Marquez: [00:13:27] I love it man. I love it. I think that’s pretty cool. And so you know just thinking through the possibilities with this it’s exciting. And with patient deductables gone through the roof listeners. You’re a patient I’m a patient. Before anything were people and now with deductibles being so high options like Hey doctor are becoming a real deal. So something to think about as you explore your healthcare options don’t box yourself into your employer sponsored program. Look outside of that because right now the innovations that Brendan and his team and others are building are aiming toward keeping you healthy before you get sick at less money. So pretty cool stuff that you’re doing up around and for sure.
Brendan Levy: [00:14:10] Thank you very much.
Saul Marquez: [00:14:10] All right. So let’s focus on one of the current innovations that you’re working on something that you’re excited about today. Maybe within Health Doctor maybe within something else but something that you’re excited about today. Brendan.
Brendan Levy: [00:14:22] Yeah what I’m most excited about is taking this to what I think is the next logical step where you say okay let’s process first just 10000 patients have doctors look at it evaluate it based on existing clinical algorithms now take out all those people did you know for example see if that urinary tract infection got better. See what lab outcomes we got through our partners class or lab or feed that data back and then say what questions should we have asked that would have gotten us to the diagnosis faster for example or that would have led to even better outcomes. So we’re actually pursuing both how do we integrate machine learning into this technology so that you’re actively highlighting in ways that leverage technology which patients deserve the most or not deserve which patients could benefit most from additional attention and then potentially rolling down into an academic study to find what are just better treatment algorithms that the whole community can use.
Saul Marquez: [00:15:13] That’s exciting. Taken at the next step.
Brendan Levy: [00:15:15] Yeah, I’m excited. It requires a good deal of work but I think we’re getting there. Step by step.
Saul Marquez: [00:15:20] That’s awesome and you know what the pool of patients that you have going through this and once you get to that number that you’re aiming you’ll have a really nice sample size to start making those distinctions so that’s pretty exciting man.
Brendan Levy: [00:15:30] Thank you.
Saul Marquez: [00:15:31] All right. So Brendan I think this is really cool and I think the listeners could learn a lot from you. So what I want to do is let’s pretend you and I are building medical leadership course on what it takes to be successful in medicine today. It’s a 101 or the ABC of Dr Brendan okay. And so I’ve got four questions for you. There are going to be lightning round style so I’ll ask you the questions you give me some lightning round answers and then we finish up with a book that you recommend for the listeners. You ready.
Brendan Levy: [00:16:00] I’ll do my damndest.
Saul Marquez: [00:16:02] What’s the best way to improve health care outcomes.
Brendan Levy: [00:16:05] I think it is by examining the data from the patient’s perspective examining both what are the patients actually trying to get care for and what are the outcomes that they actually care.
Saul Marquez: [00:16:14] What is the biggest mistake or pitfall to avoid.
Brendan Levy: [00:16:17] Doing things the way that health care has done initially and not find a way to escape at least some of the constraints and are heavily regulated industry.
Saul Marquez: [00:16:26] How do you stay relevant as an organisation. Despite constant change.
Brendan Levy: [00:16:30] I would say that you must embrace the constant change. I wish I had a better answer for that but I think that’s the simple truth.
Saul Marquez: [00:16:36] Good let’s run with it and what is one area of focus that drives everything else in your organization.
Brendan Levy: [00:16:42] Is how can you use the gains that we’ve made in technology to make medicines better in a way that goes beyond clicks and other kind of superficial changes to our practice.
Saul Marquez: [00:16:52] Finally Brendan what book would you recommend to the listeners as part of the syllabus.
Brendan Levy: [00:16:56] This is a bit outside of medicine but I will say that I just finished the book Hamilton which is both a fascinating and fabulous read. I think a great learning story of someone that broke a lot of boundaries and set up some very interesting systems great learners for healthcare.
Saul Marquez: [00:17:09] I think that’s cool and a great parallel there. Another one. Brendan you’re just constantly taken us out of healthcare, Finance and theatre. But I think that’s what we need to be doing so great recommendation. So listeners don’t worry about writing any of this down go to outcomesrocket.healthcom/heydoctor you are going to find all of the show notes as well as links to the resources that Brendan put here together for you along with the syllabus that we just created. So time flies when you’re having fun friends. Brendan before we conclude I would love to just hear you share one closing thought with the listeners and then the best place where they can get a hold of you
Brendan Levy: [00:17:53] One cause thought would just be anyone involved in medicine to continue to challenge the existing status quo. Our field is a slow moving one but to explore new options that they’re popping up all the time given the chance. And if you need to get hold of Hey doctor heydoctor.co is the website. Download the app and let us know how it goes.
Saul Marquez: [00:18:12] Outstanding. Brendan hey I’m going to download this app because I’m really curious now and hope listeners do to think outside the box. This is one way to do it and just want to say thank you again Brendan for taking the time for being on the show really appreciate it.
Brendan Levy: [00:18:27] Thank you so much for having me it was wonderful.
: [00:18:32] Thanks for listening to the Outcomes Rocket podcast. Be sure to visit us on the web at www.outcomesrocket.health for the show notes, resources ,inspiration and so much more.
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