Using data for health science and innovation
Episode 124
: [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] Welcome back once again to be outcomes rocket where we reach out with today’s most successful and inspiring healthcare leaders. I invite you to go to outcomesrocket.health/reviews where you could leave rating in review for today’s podcast. She is an amazing individual and an outstanding leader in healthcare. Her name is Lucia Savage. She’s the chief privacy and regulatory officer at Omada Health where they’re using data for health science and innovation. They’re doing some pretty amazing things but the beautiful thing about Lucia is that she has just a rich history of Healthcare Leadership where she spent some time as chief privacy officer at the office of the national coordinator for health I.T.. She was a senior associate general counsel at United Health Care. And she’s done all the things in different areas of health care that really give her a unique perspective across the payer mindset across different stakeholders and include government as well as private business. And so it’s super exciting to have you on the podcast today. Lucia just want to open up the mic welcome you and help you in any of the gaps of that intro.
Lucia Savage: [00:01:27] Thanks so much, Saul. I’m really happy to be here today and the only other thing I would say is that as we go to this you might find some interesting and fun facts about me and I think that the I.T. expert community the health expert community in the U.S. has got some pretty fascinating back stories and if you meet people in real life you should always ask them questions about their backstory.
Saul Marquez: [00:01:48] Nice I like that that’s a good tip and so maybe why don’t you tell us a little bit about your backstory.
Lucia Savage: [00:01:54] I guess I’ll say two things. I mean I have a real passion for what I do because I’ve been able to kind of see it in action in my own family. I’m of a generation where I take care of kids and elders and I could just figure out wave a magic wand and make it easier for all the caregivers to get the information they need to advocate for their people every day. That’s what I would start with. And it ranges from You know people are profoundly ill family members to people who just want to get an immunization record for a camp form.
Saul Marquez: [00:02:23] Yeah definitely a big topic in health care and what gets you into health care to begin with. Lucia.
Lucia Savage: [00:02:28] Well I actually was working as an attorney at the time the hippo was enacted so been doing this for a pretty long time and I was in the compliance office at Stanford University and I had a portfolio that was a mix of defined benefits and deferred comp and health care. And it was the 90s and people were trying to fix healthcare then and it was very attractive to me this mix of economics and psychology and public policy and law. And I really start off first hand through that role. A lot of the things that I thought were not working very well. Danforth was a great place to be exposed to all of that. That was in Alan Tobins. That was you know Hillary care. Alan M. Tobin if you remember back then. Oh yeah. And it just seemed like such an interesting area to work in. And I know I have colleagues who still do the deferred comp and that’s what makes them excited about work in the morning but I was very attracted to the opportunities to make some real change in health care.
Saul Marquez: [00:03:26] Yeah. And obviously you’ve had some major staying power. You’ve stuck through many years. What would your synopsis be of the last 15 20 years how we’ve come since then the improvements and then maybe the opportunity to still ahead.
Lucia Savage: [00:03:41] Sure. Well if you remember Hippo was enacted to four billing to Medicare in a digital format sort of to take advantage of the coding systems and if you’ve never had Dr. hippo on your podcast he would be somebody to dig up. But I think that we’ve really managed to bring that process to fruition because we’ve digitized so much more data in the health system and created these really great channels for both putting information where it needs to be and also how to analyze it taking advantage of advances in computing and we can have a lot of discussion about has interoperability gone far enough and many things in that space but where we’ve come from 1997 to the present is really amazing. On the other hand we have not really created information that empowers the consumer. And given the consumer a the power to use the information that’s out there. So I’ve been watching today’s trades about transparency and pricing information and we’ve made huge strides but it’s still not at a place where it’s easily usable by individuals who are now more financially responsible than ever for their own healthcare. I think transparency. We’ve got a ways to go.
Saul Marquez: [00:04:53] And a really great summary there. So thank you for that. Lucia what would you say if if you had to do a kit that included maybe three or four streams of data that would be useful for patients. What would you summarize those three or four things.
Lucia Savage: [00:05:07] Well it’s a hard question because for people who are caring for a profoundly ill individuals the data is complicated and voluminous and eat a lot more of it. So I think it really depends where it’s your average consumer who’s healthy you maybe just want what you need to manage your life and you really have to think from a policy perspective which pap are you pursuing. So for me I think the game changer would be making it easier for whichever individuals want to get their own data to do so to cause a little bit better balance between supply and demand. The supply is out there but the demand isn’t. So we need to figure out how to enable consumers or empower consumers to really make demands for their information and not be overwhelmed by the complexity of the health care system. If we’re going to empower them that I would pick the path that gave the most consumer the increased consumer demand the most.
Saul Marquez: [00:06:03] Got it. Yeah and it’s more of an opportunity for those that actually want to take advantage of it to actually have access to it and then maybe from there it’s a domino effect that’s created through just those that know can now teach and then exactly. OK very cool.
Lucia Savage: [00:06:19] If I could just add one more thing. I just think that we’re kind of on the cusp of a generational change. So I think that millennials as they become parents or become caregivers of the elders and you know the tail end of the baby boom we really have a different kind of perspective we have different levels of patience and we have less willingness to how this system operates for us. We want to be the operators of our health care. And I think that’s going to be a big game changer I used to say when I went see that at the end of the day my kids who are in their early 20s when they have children they are not going to wait 20 minutes on a phone to make an appointment.
Saul Marquez: [00:06:59] Give me the app may have a few that beginning to calm.
Lucia Savage: [00:07:05] So you also have you know most of the people running the health care system are not of that generation and maybe they’ve acquired their technical expertise sort of after the fact as opposed to growing up digital natives. I think of the digital native become leaders more in healthcare management. You’ll see things start to change.
Saul Marquez: [00:07:22] That’s super interesting. I definitely see it happening already and I think it’s duffing going to be powerful so I think that’s a really really interesting observation that you shared all the conversations that we have on the outcomes rocket Lucia. There’s leaders like you that think about these things every single day. And if it’s one little tidbit that you share that resonates with the listener. And then our mission has been fulfilled here and so on that topic. What do you think leaders today should be thinking about health care leaders. What should they be thinking about.
Lucia Savage: [00:07:51] Well I think they should be thinking about this generational difference and they should be paying attention to the way the Gen X and the millennials and whoever the people are who are teenagers now communicate and they should be becoming fast feel and comfortable with those forms of communication. And of course in healthcare we have complicated security issues and I know everyone today is thinking about their Intel chips but good health care depends on good communication between the providers and the people who are ill or their caregivers. And so we’ve got to be communicating in the way people actually communicate.
Saul Marquez: [00:08:24] And I think it’s really really interesting that now Lucia you know you sort of you practice what you preach. You know right now you’re making a move you’re going to be in the West Coast where these shifts are are happening. I had a guest on the podcast not too long ago Jonathan Kaplan. He’s a plastic surgeon and he’s snap chatting about his surgeries. And this was never done before. And he’s on the on the edge there but he’s doing it and he’s he’s resonating with the people that are coming up with these millennials.
Lucia Savage: [00:08:52] Well you know as a hipper expert I have these personal experiences all the time and right as I left and I had an opportunity to kind of field test for myself how easy it was for me to get my data out of the healthcare system and I had a dialogue with my doctors office through the portal about how could I get the notes from a visit. And I said why don’t you paste them into the portal and then I’ll just download them. And she said and I quote kippot doesn’t allow me to do that. No I don’t have the fancy business card anymore. So it’s harder for me to have that argument. OK. So I said OK why don’t you print them. Put them in an envelope and seal it and I’ll come to the office and pick them up which of course is the functional equivalent of an identity proof electronic log in. Yeah only I have to get in my car and drive. Right.
Saul Marquez: [00:09:37] And what did the doctor say.
Lucia Savage: [00:09:39] And keep it. Oh absolutely. Of course I’ll do that.
Saul Marquez: [00:09:41] Gotcha.
Lucia Savage: [00:09:42] So right. How do we get our health care professionals again sort of you know you’ve got this plastic surgeon using Snap Chat hopefully with only his patients.
Saul Marquez: [00:09:51] Absolutely only patients and signed consent.
Lucia Savage: [00:09:54] Exactly. But we have to sort of think it through and figure out how to get our providers comfortable with all of the capabilities and risks of the new digital environment.
Saul Marquez: [00:10:04] For sure. Yeah. This is a really fascinating story that you shared and I’m glad that you were able to get your information even though it was in the paper mode. But it’s an interesting story. You should blog about this. This would be an interesting blog.
Lucia Savage: [00:10:17] I actually wrote about it for the Journal of the American Health Information Management Association which is the Journal of the people who run the system document rooms.
Saul Marquez: [00:10:28] So it’s a public article.
Lucia Savage: [00:10:29] Yes and it’s up to the linkups on my LinkedIn page.
Saul Marquez: [00:10:32] Sweet. So listeners I’ll definitely be sharing that with you. Take a look at that. I mean just as these experiences and the roads that Lucia has gone down with her experience and her and her mindset I think you’ll really appreciate it. It’s one that I’ll definitely pick up because they may be a little one or two things that you pick up from her blog that you didn’t know before so thanks for sharing that Lucia.
Lucia Savage: [00:10:54] You’re welcome.
Saul Marquez: [00:10:55] So let’s talk about Omada health and maybe dive into a couple things that you guys are up to and how you guys are improving outcomes.
Lucia Savage: [00:11:03] Well sir you say your listeners know about Omada. I think a key thing for me and joining Omada was the business model it has always had which is our customers pay us only Lumi achieve certain health outcomes. So you could have a digital behavioral modifications Earth like ours and you could pay Letson or you could pay per month. But our customers pay us when our participants lose weight. And complete lesson and I truly believe in an outcomes based model I’ve been working on that in various capacities since 2003 full time and with very attractive to me to be at an organization that has really put its money where its mouth is relative to paying for value and then the other thing I think that’s important for listeners to know about a model. We use digital tools to do that. And the digital tools that tell us when we hit those value indicators. So for example a fundamental piece of equipment in the home on a program is a cellular enabled scale that each person might receive that their home that’s securely tagged to their accounts. You cannot lie about your weight and the scale weights tell us you know how your weight trajectory is doing and many other things about the data platform we have. Help us get people who need more help the help they need and people who are clearly succeeding in the program on their own because they have their own motivations. Just let them go and we don’t bug them and it really helps to customize the program. All of the electronic data we’re getting in and I think that in traditional health care partly because the systems are old and partly because the data is more complicated there’s still more opportunities for traditional health care to take up those kinds of opportunities for a dashboard that a nutritionist or somebody who has a practice extender and a physician’s office can look at every day go oh I need to reach out to this person but not that person because I can see from the data points what their health status is.
Saul Marquez: [00:12:56] Now that’s super interesting and listeners if you go to the omadahealth.com site you’ll see this front page. Welcome to the start of a life changing journey. There’s a box right at the doorstep kind of like the Amazon feel and it says your gear is here. Let’s get started. And these things that Lucia is sharing is that they don’t get paid unless they deliver results. And if you’re a provider out there looking for somebody that’s willing to do risk sharing programs like this one I think Omada is a company that you definitely have to consider in your chronic disease management as well as the taking care of patients through the continuum of care. Would you add anything to that.
Lucia Savage: [00:13:37] Well the other thing I’d say is yes the box is cool and everyone likes getting it super exciting but I think that you know obviously there are some people who really need an in person program where they go to every day and there’s 86 million diabetics so there’s plenty of people for all of us to serve. But for the people who really engage in this digital communications platform they seem to get so much out of it. We hear so much feedback about being able to communicate with their cohort we group people together how they’re communicating with their coach. The story I like to tell is if you’re learning nutrition through your Omada lessons and you’re at the grocery store and you’re not cool you’re hungry because at 6 o’clock and you just got off work and you’re not quite sure how to change your grocery list you can message your coach and your peers right there from your phone.
Saul Marquez: [00:14:24] Yeah that’s pretty cool is that the access. Yes. Yeah. Instead of calling setting up an appointment you have immediate access right there.
Lucia Savage: [00:14:32] Or waiting a week for your next and personal lesson.
Saul Marquez: [00:14:35] No I think that’s beautiful. I think that right there is is a differentiating feature and just as folks try to innovate. Oftentimes it’s stuff that’s already in place. And folks like Omada have the pathways it’s just about collaborating with the right people. And you guys have been doing a lot of building. Lucia what would you say up to this point has been maybe a setback that you guys have run into that you learned a lot from.
Saul Marquez: [00:14:59] So I think there are a couple of things so built on a clinically proven method that we turned. We have applied a digital platform to deliver the method. And so that’s kind of a key feature as well that we really had a lot of clinical science from NIH studies to other states by CNS about how effective this work I think for us. We are super enthusiastic about digital technology. And from my perspective in regulatory affairs I think we are still dislodging myths about digital technology and patient who uses it. How effective is it. Why is it different is the record keeping reliable etc. And so that’s just kind of an ongoing educational process. Yes that is I wouldn’t call it a failure. I would call it. It’s kind of like a headwind.
Saul Marquez: [00:15:47] Yeah for sure. That’s interesting. And so have you come up with any best practices from running into these headwinds.
Lucia Savage: [00:15:54] I think one of the things Amadis been doing really well is kind of creating a team that Amal brings together technologists and people who are very experienced in the healthcare system and it’s through the internal dialogue we have. We help not only identify what the headwind is but what the right tactic is to address it. How do you effectively explain to the FDA or the office of the Inspector General that CMF how your data collection system work.
Saul Marquez: [00:16:19] Now a very insightful response depending on who is to receive the response.
Lucia Savage: [00:16:24] Exactly. And again if you’re describing that to a customer you know we are a provider we provide a health care service. We do it through a digital platform. So another had when we have is trying to explain that we’re not software as a service we’re actually a healthcare provider supplying therapeutics through a digital platform.
Saul Marquez: [00:16:40] My goodness. Yeah you’re right and you don’t know what you don’t know and when you’re faced with obviously Lucia you have the background and the and the savvy to be able to understand that there’s legal legal ease that needs to be filtered through and responses need to be a certain way and we don’t know what we don’t know as leaders in healthcare. And so we’ve got to figure out the most insightful and right ways to respond so that we don’t waste time especially if you’re a company you’re running with money from a venture fund. Hey you know money is time and you can’t be doing things willy nilly. So these are some real good insights from Lucia would you agree Lucia.
Lucia Savage: [00:17:19] I would and I would just say one more thing particularly for people who have new ideas. I think health care is crying out for creativity but we can’t really break health care because it’s set up in many ways the way it is to make sure people don’t get further harm. So what you need to do is take the creativity of the idea and find a lawyer who’s just as creative who can help you use the environment we have to launch your product which is something Omada did way before I came onboard as opposed to kind of ignoring what happens in that space. If you want to create an app that intern operates with electronic health records vendors how do those rules really work and how can you take advantage of them and leverage them instead of trying to push through them.
Saul Marquez: [00:18:02] That’s so so insightful. I’ve been in situations where I’ve dealt with legal counsel and you know hey I just they tell you I just want to give you a heads up. I’m an attorney. I need your attorney here as well. And it’s amazing what happens when you have two attorneys in the room. Things happen like versus if it’s just you and an attorney it just things don’t happen and you become a third party. And yet what a great what a great insight. Absolutely. So tell us a little bit about an exciting project that you guys are working on today.
Lucia Savage: [00:18:34] Well I think probably the biggest projects we’re working on right now without getting into too many details is obviously growth is super important for us. And we had a we’ve had a really really good year in that respect. From my perspective how do we automate the data that we need to share to prove our outcomes. So obviously we have for years sent to our clients secure Excel files. But what happens when we create an API and how many clients can we leverage off of that API what can we stand up on it. So my job is you know all the legal rules in place and I see that API as a potentially security vector and just another delivery method of something that you’re allowed to are not allowed to share. But again that automate that there is an initial investment it’s actually easier for everybody. And then you have a sort of reduce the time lag. So that’s something I’ve really been working on is how do we automate all the ways that we share data whether it’s with individuals or with our customers or you know someday the government will have an API for DPP filing.
Saul Marquez: [00:19:36] Yeah that’s exciting. At the end of the day we’re measuring outcomes here and if you’re working with somebody that is getting paid based off of your results and if you don’t get them you don’t get paid automating it is really I think a really smart thing to do. And so I’m excited to see where that goes. Lucia and how valuable it will be I just imagine that it will be very valuable for your organization and your customers.
Lucia Savage: [00:20:00] Yeah I think that’s definitely true and I think that for younger startup companies this is really something that’s worth thinking about because legacy software system it’s much harder to automate those activities as opposed to a system where you have a cloud based program and your software is amenable to engineering and API. Now I’m getting a little bit out of my you know my ballpark but this is what the engineers how me and I really I love working with the engineers and I trust them but right it could be a really important differentiator for a younger company. It’s how they share data how easy they may get. And at the same time of course younger companies have to prove themselves more than mainline companies so there’s obviously balancing act there.
Saul Marquez: [00:20:42] Yeah not really powerful really really powerful message there. So if you’re a startup listen to this again rewind and listen to this again because these are some huge huge pieces of value. So thank you Lucia let’s pretend you and I are building a medical leadership course on what it takes to be successful in medicine though 101 or the ABC of Lucia Savage. And so we’ve got a syllabus right here Lucia for questions lightning round the aisles followed by a book. You’re ready.
Lucia Savage: [00:21:10] Yep. I’m ready.
Saul Marquez: [00:21:11] All right. What’s the best way to improve health care outcomes.
Lucia Savage: [00:21:14] I think it’s to listen to the patient’s needs and wants and their constraints. An example would be drugs. If you don’t know what’s paid in their formulary and you prescribe something they can’t afford because of their formulary structure for sure not going to take it.
Saul Marquez: [00:21:28] What is the biggest mistake or pitfall to avoid.
Lucia Savage: [00:21:31] I think the regulations and the health care system can be burdensome but don’t overreact to them sort of back to that idea. They mean something for a very good reason and they’ve been created with a lot of input. How can you leverage them.
Saul Marquez: [00:21:42] Insightful. How do you stay relevant as an organization. Despite constant change.
Lucia Savage: [00:21:47] So in Omada we really try to be the drivers of change which is partly my role and we have other people who also work in the advocacy role and I think that certainly try to drive change or lead change instead of wallowing in the tail of it because you’ll never keep up. If you’re in the tail.
Saul Marquez: [00:22:02] What’s the one area of focus that should drive everything else in the organization.
Lucia Savage: [00:22:07] Well I think it’s your vision right Toto model. We have a vision of we want to become ubiquitous. We want to serve 2 million Americans by 2020. That’s only two tenths of a percent of the pre diabetes population but it’s still a lot of people. So that for us is what’s your long term goal and how do you get there that should be your pollster.
Saul Marquez: [00:22:25] Yeah listeners don’t chase the change just focus on your vision and your goals. And like Lucia she’s very focused on his vision of what could be. And with that the change comes. What book would you recommend to the listeners.
Lucia Savage: [00:22:40] So I thought a lot about this and it’s actually a timely book I’m going to I’m going to recommend a pair of books so if you’ve gone to see the movie about the Washington Post you’ll see Katharine Graham being played by Meryl Streep but church has a wonderful biography called personal history which that movie is adapted from. And I would pair that with a book by Jill Ker Conway called the road from Coorain. Conway was the first president of Smith woman president of Smith College and she’s a historian. But the thing that makes them interesting is their books cover the same time period up sort of the latter half of the 20th century as a professional woman making your way career wise in America. And I think they’re full of wisdom some do interesting and just out of fun. I am a hobby hobbyist gardener and set up there. I always refer people to about vegetable gardening. It’s called How to grow more vegetables than you thought possible in less space than you thought possible and instead of writing I have a garden in my hand. And if you’re interested and you know having better nutrition in your life and getting some exercise casually fashionable gardening is 100 percent the way to go.
Saul Marquez: [00:23:47] What is your favorite vegetable.
Lucia Savage: [00:23:49] The ones I grow. It’s kind of a toss up between corn and tomatoes.
Saul Marquez: [00:23:53] Oh nice. Very nice sounds like you can make a really good corn tomato salsa.
Lucia Savage: [00:23:58] I could but I usually just eat the corn.
Saul Marquez: [00:24:01] Okay got it. Got it.
Lucia Savage: [00:24:02] Chicago land of great corn.
Saul Marquez: [00:24:05] That’s right. We got plenty of corn here baby we love to throw it on the grill and it makes for a nice. Definitely. You know just plain we love to just eat it off the grill and mix really nice. This has been a lot of fun and listeners again ask if you run into somebody with I.T. background ask them about their backstory you see Lucius so interesting you never know what you’re going to learn from your friendly friends and I.T. and legal go to outcomesrocket.health/Lucia LU C I A and you’re going to find all of the show notes as well as the syllabus that we just created for you and links to the books that she recommended Lucia. If you can just share a closing thought with the listeners and then the best place where they can get a hold of you.
Lucia Savage: [00:24:47] Well people can always follow me on Twitter savage Lusa and I have linked him profile where I post my personal thoughts and whatever I’m publishing these days. Outside of my work for Paramatta and I am happy to be approached when you see me in public. I met you at 2.0 I’m going to be some JP Morgan events next week and I’d be happy to talk to anyone.
Saul Marquez: [00:25:10] Wonderful and so listeners. The invitations there. Take a look at the links and the thoughts that Lucias sharing through her. Her writing on Linked In and Lucia again I just want to say thank you so much for spending time with us and excited to see with the new year brings for you for Omada and for all of us. Thank you.
Lucia Savage: [00:25:27] Thank you for having me, Saul.
: [00:25:33] 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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