Improving Back Pain Outcomes while Minimizing Costs
Episode 412

Lydia Zeller, Vice President of Product Strategy at Kiio Inc.

Improving Back Pain Outcomes while Minimizing Costs

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Improving Back Pain Outcomes while Minimizing Costs

Episode 412

Recommended Books:
Elizabeth George books

Best Way to Contact Lydia:
lzeller@kiio.com

Mentioned Link:
Kiio

 

Improving Back Pain Outcomes while Minimizing Costs with Lydia Zeller, Vice President of Product Strategy at Kiio Inc. transcript powered by Sonix—the best audio to text transcription service

Improving Back Pain Outcomes while Minimizing Costs with Lydia Zeller, Vice President of Product Strategy at Kiio Inc. was automatically transcribed by Sonix with the latest audio-to-text algorithms. This transcript may contain errors. Sonix is the best way to convert your audio to text in 2019.

Saul Marquez:
Welcome back to the podcast. Today, I have the privilege of hosting Lydia Zeller. She's the Vice President of Product Strategy at Kiio. Kiio is a digital therapeutics company focused on changing the paradigm for musculoskeletal care. Evidence based, personalized and consumer centric Kiio for low back pain significantly reduces pain, opioid use and medical costs, leading to improved quality of life for the individual and decreased costs for the health plan and employer. Kiio partners both with health plans and employers providing a cost effective, easy to implement solution tailored to the needs of our partners. And everybody listening here knows and understands the impact of health care costs to our bottom line. Lydia has led Kliio's digital therapeutic product line from inception and is responsible for overall product strategy. She's passion about excellence and continued innovation, combining the best in evidence based medicine, personalization and behavioral economics with state of the art technology to move the needle. Her goal is to help individuals using Kiio lead healthier, pain free lives and to drive value through effective high value solutions that reduce health care and employment. Linda started with Q but has over 20 years of diverse entrepreneurial experience and I'm super excited to dive into her experience in this podcast today. When she's not working hard on improving employers bottom lines and outcomes, she enjoys hiking, gardening, cooking and reading. So, Lydia. It's a privilege to have you here on the podcast today. Thanks for joining us.

Lydia Zeller:
Thank you so much for having me. We appreciate the opportunity.

Saul Marquez:
Yes. And so what is it that got you curious and interested in health care?

Lydia Zeller:
Well, the honest answer is that I came to kill a little bit out of pure love. I was re-entering the workforce after having taken some time off homeschooling our children. I had been working as a consultant in the wealth management area and was looking for a career change and getting back into the workforce. My husband was one of the what was one of the first software engineers at Kiio, and that's how I came to Keough. But I became passionate for two reasons. One is we have the opportunity in healthcare to very directly impact individual lives. So in our case, helping people suffering from musculoskeletal pain get back the activities they love. I have the privilege of being able to talk to our end users are participants at times and to hear them share their stories about how we have impacted their quality of life really make something more meaningful. Number two, health care is changing so rapidly and there is really tremendous opportunity to shift the economic value balance with new care delivery models and new partnerships that are creating alignment of interest between those who pay for health care to provide health care and patients because of that alignment under today's fee for service structure. It isn't always there. So right now, we're really seeing employers, health insurance companies, a small energy company playing a leading role in demanding, creating and delivering new care options, particularly for people with chronic conditions. So musculoskeletal for Kiio, but also diabetes, hypertension and other areas of chronic pain.

Saul Marquez:
Yeah, those chronic conditions are a focus area that I think a lot of employers are paying attention to and payers as well. How do we manage or how do we help our our employees manage these conditions? How do we help them stay healthier? And when we think about the approaches taken. I feel like digital therapeutics is one of those areas where people are starting to accept and the the the niche of digital therapeutics really the effect on outcomes. The bottom line and patient experience is proving to be very useful. And so I love to hear from you, Lydia and some of the success stories or an example of how your company has created results with this.

Lydia Zeller:
Absolutely. So you our first program is in kill for low back pain, target back pain and back make a big deal. It's the leading cause of opioid prescriptions, even though opioids are proven ineffectual for back pain. The leading cause of disability in this work days and really a top medical cost driver, both for employers who have not only medical cost up the employment cost and also for the health plan. Kiio for low back pain is individualized to the end user, 24/7 can be a more flexible, proven effective and will integrate with traditional care to get the right level of care to the person at the right time, and through this we're achieving outstanding clinical results for our participants as well as financial results for our partners. So for health plans and for employers, our participants are seeing significant pain reduction, significant improvement in function, personal empowerment and reduction in use of opioids and aggressive treatment. We really have to remember that aggressive treatments are not just a cost. They're also can impact quality of life. So if you have an MRI, for example, and 86 percent of MRI should consider for medical services, it's not just the cost of the MRI. The problem is also that once you have an MRI, you are significantly more likely to have back surgery and back surgery. About one third are going to have a success. About one third are going to have no impact at all on the pain and about one third are going to make the pain worse. So in my eyes, that's about a two thirds, two thirds failure rate there. So now we have to we have to remember that providing appropriate care is really, really important. And so specifically, our partners are seeing reductions in pharmaceutical use reductions and overall low back pain related medical studies and primarily driven through reduction in more aggressive treatments. So MRI injections just carry us as well as surgery.

Saul Marquez:
So, Lydia, I'm sure the listeners are probably thinking, this sounds well and dandy, but what exactly does the does the technology do? Maybe you could walk us through an example of what a patient will see and what kind of treatments they'll get as part of their care process.

Lydia Zeller:
Absolutely. So once what the participant engages with Kiio and you can engage with us 24/7 so it can be 2 o'clock in the morning on a Saturday, your back pain is unbearable. And you remember that your health plan provides yields that benefit or your employer provide you with anything and you decide to engage. The member experience begin with a short online computer adaptive screening. We're going to ask some questions about medical history, about the type of back pain. And we're really looking for four main things here. We're looking at medical risk. So how are you appropriate medically? Are there any medical red flag is appropriate for you to engage with? We're looking at behavioral health risks and we are looking at a fund. We're getting a baseline out pain, baseline on function, baseline of work impact. And then we are going to run a poll and we're looking at the type of back pain because it's very important to treat different types of back pain differently with different exercises. So you will answer this short series of questions. And as soon as you're finished answering in the background, we've run a multidimensional risk profile. But what you see is either the link to download your digital care program or for the small subset of individuals for whom we find a medical red flag or a high behavioral health risk, you're going to get immediate referral to appropriate care in that work for you. So for the vast majority, Kiio is an appropriate care program and for you, your digital care program personalized to you, download immediately to your mobile device and you can begin engaging. And there are really three main pillars to the care program. The first is exercise. We all know that exercise is the most important component of any care program for back pain. The exercises are specific to the type of back pain that we identified during training. And we use interactive digital coaching to guide you both visually and audibly through your exercise. These are progressive series of exercises, so we're going to begin you with gentle range of motion. Flexibility will move beyond what appropriate to add in support, strength building and then we'll move you on from there to work both the flexibility and the court strike. So there are three core levels of exercise and you'll be moved through those three core levels based on how you individually are responding to treatment. And this is all a I've driven. So how you answer your questions as far as we're going to be where you are in your pain requiring you and your function, requiring why your perception of how you're doing and all that going to determine how quickly you progressed through. So we're really tailoring that to you. We will offer you, you have access to this program for a full year. That's because that page has a currency rate of up to 80 percent. So we want you to be able to come back to the program when you have a flare up and we absolutely find that our participants do precisely that.

Saul Marquez:
So. Just a quick question. Yes. So, you know, I wake up with back pain. I go on an app, do the test, get some. It's not too too severe. I get my my plan. I follow that plan. Feels better, but maybe it comes back. So then you go back and you and you get your plan again. If it's not that route, then do you just put them in touch with somebody they could talk to? Or how does the more kind of severe route go?

Lydia Zeller:
Right. So we actually are appropriate for people with severe pain. So you can have pain ranging from zero through 10. And we actually are probably most effective in people who have higher levels of pain. That's partly because, of course, people with higher levels of pain are more motivated to participate. So so the severity of the pain isn't going to be a reason that we're not appropriate. So we see more medical red flags that might indicate you have a neurological condition that should be checked out by your health care provider first or you have developed really significant fears around your ability to recover, which means that you would benefit from one to one power station with a behavioral health expert in addition to the exercise. We do have an education and behavioral modification component, so that's the second core components of the program. And those materials are delivered in little bite sized pieces. So you'll get helpful tips, helpful information, really try to better understand how pain works in the body. And there's a piece in there about opioids, piece about advanced imaging, really engaging information. How we're turning to work while quickly returning to the back to activities, building activity into your lifestyle. It's going to give you the best long term outcome. And then we have support.

Saul Marquez:
Yeah. Go ahead.

Lydia Zeller:
Now, I'm just going to say the third component is support. And we're providing that full of digitally. So this is the artificial intelligence that's providing content based on your status and your participation and how you're doing. But then we are also backed by care management. So you do have the opportunity to reach out through the app and say, I want to have a one on one conversation and then you can talk to a professional care manager to answer any questions you may have or help you get that or you side of the program, or if maybe be refer you out to your health care provider. And that care management also received extension based learning. So something we detect something in training or something isn't going. It's hoped they'll be exception based of our get back into care management and care management reach out to you.

Saul Marquez:
So I really appreciate that walk through, Lydia. It helps the listeners get a better appreciation of how it works and the different phases of treatment. And so what would you say is an example of when something didn't work? And what did you guys do about it? How did you grow and get better from it?

Lydia Zeller:
That's a great question. So in our very first implementation, reconsidered our role to begin once the participant actually engaged with the digital care program. So right when you register for the program, you answer the screening question and we relied on our partner. In the first case, I helped plan to craft and deliver the messaging to make the members aware of the program, make them aware that, you know, the plan provided to you was a benefit and interested in finding out the back pain and the initial messaging written by the health plan and delivered out to their networks was very clinical in focus. It was wordy, not personal. I think the South Line was invented apps. Well, nobody cared. Some innovative that they care if it's effective. It's easy to use and it's going to help. And if it's free, right?

Saul Marquez:
Yeah.

Lydia Zeller:
So what we really learn, you know, they've got a pretty low response to that. And what we learned is that engagement really begins well before the person begins engaging with their care programs and includes that messaging awareness campaign. So we took a step back and we worked with a really consumer centric marketing firm and we designed a multi-channel multi touch dynamic awareness campaign that we use to drive awareness in either a member population of our customer. So I guess the members of the health plan were the employees and employer in that campaign, it's all focused on meeting people where they are and empowering people to take positive action to take back what they want from your life. And we've seen a tremendous to medical people engagement using that campaign.

Saul Marquez:
Wow. That's a great learning. Appreciate you sharing that. Yeah, we're gonna be mindful about how we engage with with our consumers making it friendly and speaking in terms of their interests. Right.

Lydia Zeller:
Yes, absolutely. That's a key focus for us.

Saul Marquez:
Love it. And what would you say is one of the proudest experiences that the company has experienced?

Lydia Zeller:
Well, you know, I guess from a company perspective, it was really together with Dave Grandin, our CEO, having having the courage and foresight to make a major pivot and product and market and seeing that, did it draw real results for both our participants and for our customers? So we really made a shift from our early days when we were providing solutions for physical occupational therapists use in clinics with their patients moving into that digital therapeutic realm and and providing effective, careful vision and really shifting our market focus to working with the at risk entities. So both to both the employers and health plans. And then, of course, the all important end user. Right. Lower selling need to be. There's the all important participants and engaging with them have and seeing the impact that we can have on their lives has been tremendously rewarding.

Saul Marquez:
I'm sure, you know, just kind of coming up with a solution and, you know, just thinking through why why is it not resonating and then doing a lot of listening, figuring out where it could gain some traction. And then, wow, you guys found the niche in and the and the payer space and now and the employer space. And now it's it's getting some major traction.

Lydia Zeller:
Absolutely. Absolutely. It's been really exciting to see the traction that we're getting the outcome coming in and being able to reach through partnerships with larger organizations, being able to reach more and more people, because then, you know, then you're having you're moving the needle. You're having a bigger impact.

Saul Marquez:
And so for the leaders listening, you know, if you've established a new business or an idea, you got to think broadly. If it's not working, you've got to ask yourself, where else can this resonate? And maybe I'm in the wrong vertical. Maybe I need to go elsewhere within the health care economy. And so let me as an example, here's is a great one to provide inspiration for everybody out there with a great solution. Tell us about the most exciting project that you guys are working on today.

Lydia Zeller:
Absolutely. So we are really half focused on consumerism. Right. So I think, you know, when we're thinking about topics that need to be on everybody's mind, we need it to be like we really need to remember that patient has to be viewed as consumer. Right. People with chronic conditions are not defined by their condition, but need to be views of people or consumers. And if we look at how services are produced and delivered and the whole health care lags significantly in acknowledging and embracing both consumer expectation and technological advancements that have transformed so many other industries. Right. We understand perhaps patient centricity when it comes to actual care, but I don't think as a whole health care has implemented consumer centricity in terms of immediacy, convenience, personalization, value that people expect really in every other aspect of our lives. So one of the things that's most, most exciting to me is that we are working on today is continued support and continued engagement. And we really view engagement through that lens of consumer centricity. So we are working to further personalize the experience each end user. And that's important for a couple different reasons. One, every time you increase the locus of control for that participant, for example, let them modify the program within parameters course to fit their individual needs. You empower them and when you empower them, you help make them partners in their care. And that absolutely drives outcome. Yeah. I think it's critical. Right. We really have to we are not going to get great outcome without involving people in their own care.

Saul Marquez:
Now, that's critical. That is critical. So. So I love the story here and the work that you guys are doing to improve outcomes and and help the people that are funding the health care, the employers and payers. Phenomenal work, Lydia. And folks, if you want more information on Kiio, it's kiio.com. You could find them at K I I O .com kiio.com. And so time for the Lightning Round and a book that you recommend to the listeners. You ready?

Lydia Zeller:
I'm ready.

Saul Marquez:
All right. What's the best way to improve health care outcomes?

Lydia Zeller:
Involving the patients in their care, making them a partner in their care.

Saul Marquez:
What's the biggest mistake or pitfall to avoid?

Lydia Zeller:
So I actually think it's being too cautious to try something. I think the biggest risk can be failure to take action. So if your health plan or your employer do a pilot, if you pick your partners with care, there's very little risk and there's a lot to gain. And you're really not, you know, treading way out into the weeds. This is becoming quite mainstream. If you are not trying digital, you are actually, you know, behind the curve at this point.

Saul Marquez:
Love it, how do you stay relevant as an organization despite constant change?

Lydia Zeller:
Well, you have to deliver a balancing stellar service right now, today with keeping abreast of new learning best practices in your specific area and then absolutely looking down the road and skating to where the puck is going.

Saul Marquez:
What's an area of focus that drives everything at Kiio?

Lydia Zeller:
Being good partners both to our participants. So the people engaging with our solution and to our customers and again, working to involve people more deeply in their care. Working on engagement. So, you know, I mentioned previously helping people control their own program. And another thing is to tie into individual motivators. So what motivates you is going to be different than what motivates me. So on the fly, changing images, changing actual messaging to tie into what we know about you and what motivates you.

Saul Marquez:
Love that. So what book would you recommend to the listeners? Lydia.

Lydia Zeller:
So when I am relaxing, I actually enjoy mysteries. And probably my favorite mystery author is Elizabeth George.

Saul Marquez:
And any book title that you'd recommend.

Lydia Zeller:
Oh, I really like and like all of. There are a series and I think if you read it from beginning to end, then you'll enjoy the sum of.

Saul Marquez:
Everything Elizabeth George,.

Lydia Zeller:
I enjoyed her. I love it. And hey, you know what? Sometimes solving health care problems can be mysterious. So that's the kind of work that you're doing there with your reading. Maybe get your creative juices flow and do good work like you do when you're when you're in your job.

Lydia Zeller:
Absolutely. And stick with it. You'll find a solution.

Saul Marquez:
That's great. Now, before we conclude, I love Lydia, if you could just share a closing thought and then the best place for the listeners could continue the conversation with you.

Lydia Zeller:
Absolutely. So I guess my closing thoughts would be that every opportunity is a learning opportunity. You may not move the needle all the way immediately, but you can definitely move the needle, engage in discussion. There's a lot to happen in health care, particularly in the state where I have the privilege to be on digital therapeutics and a cut credit condition. There are a lot of interesting companies doing interesting things and having great results, great impact both on member outcomes and then reducing the cost of care for the health plan or the employer. Engage in discussions. Reach out and talk to people and you will find that good partners are more than willing to work with you to do a pilot with you or to do a full implementation. Where to reach me kiio.com My email is lzeller@kiio.com But if you just go to the website, you can reach out and more than happy to engage.

Saul Marquez:
Love it, Lydia. Well, folks, there we have it. Digital therapeutics for the lower back pain. It is a great service to consider proving outcomes. Bottom line, patient experience. They all matter. And just want to give Lydia and the Kiio team a big thanks for joining us today. Thanks, Lydia.

Lydia Zeller:
Thank you so much for having me.

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