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Medcorder & The Fight To Help Patients Understand Doctors
Episode

David Weekly, Founder and CEO at Medcorder

Medcorder & The Fight To Help Patients Understand Doctors

In this episode, we are privileged to feature the amazing David Weekly, Founder and CEO at Medcorder, the first company focused on helping patients get the most out of a consult by recording the session. David discusses how his company helps patients retain and understand doctor instructions which lead to better health. He explains the benefits of Medcorder for both patients and doctors and other possibilities for the medical speech audio which the company is currently exploring. David also talks about technology, telehealth, setbacks, and shares many other info on voice biomarkers. Medcorder is a great solution that has many possibilities. Learn more about Medcorder and its potential benefits in this interview. Please tune in!

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Medcorder & The Fight To Help Patients Understand Doctors

About David Weekly

David is a seasoned entrepreneur, currently the CEO and founder of Medcorder, the first company focused on helping patients get the most out of a consult by recording the session. Previously, he held several roles at Google, including overseeing the data center software and Verily product teams, and was also a product manager at Facebook. In addition, David is an active angel investor and founded Silicon Valley’s first seed program for Mexican-based Internet startups and also is chair and founder of Hacker Dojo and Open Community Center and hackerspace for software teams in Silicon Valley. He has visited over 40 countries, taught kids technology in Ghana, worked with the Tunisian government on connectivity, seen fiber trends in Uganda climb mountains to support hilltop community wireless and in northern India. And he’s been a reporter for the Korean press. 

Medcorder & The Fight To Help Patients Understand Doctors with David Weekly, Founder and CEO at Medcorder: Audio automatically transcribed by Sonix

Medcorder & The Fight To Help Patients Understand Doctors with David Weekly, Founder and CEO at Medcorder: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

Saul Marquez:
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Saul Marquez:
Hey everyone, welcome back to the Outcomes Rocket. Saul Marquez is here. Today, I have the privilege of hosting David Weekly on the podcast. He is a seasoned entrepreneur, currently the CEO and founder of Medcorder, the first company focused on helping patients get the most out of a consult by recording the session. Previously, he held several roles at Google, including overseeing the data center software and Verily product teams, and was also a product manager at Facebook. In addition, David is an active angel investor and founded Silicon Valley’s first seed program for Mexican-based Internet startups and also is chair and founder of Hacker Dojo and Open Community Center and hackerspace for software teams in Silicon Valley. He has visited over 40 countries, taught kids technology in Ghana, worked with the Tunisian government on connectivity, seen fiber trends in Uganda climb mountains to support hilltop community wireless and in northern India. And he’s been a reporter for the Korean press. Just a very interesting and dynamic person. I’m excited to have him here on the podcast to tell us about his venture with Medcorder and just really delighted to have him on the podcast. David, welcome.

David Weekly:
Thanks. It’s a pleasure to be here.

Saul Marquez:
I love all these interesting things that you’ve done. And I’m just curious how you find the time.

David Weekly:
I don’t, but I’m old, that’s some of the truth of it. And part of the fun of that is to get to try a lot of different things as you age and just embracing the randomness and interest in trying out new things and learning new things all the time is helps keep it fresh.

Saul Marquez:
Oh, man, it certainly does. And so we had a good conversation before the podcast and with hanging out with your kids and just the interesting things that you do, I mean, I’m impressed. And so with regard to your work and health care, obviously spent a lot of time in tech and what you’re doing now is tech enabled health care. So talk to us about why health care, what inspires your work in it?

David Weekly:
Yes, I think for a lot of people who are in health care, they get into it pretty early. I went to Stanford for my undergrad and some ridiculous percentage. I think it was like half of the incoming freshmen at Stanford declare in premed. And just all of those people, you know, even probably from junior high, had some sort of notion of, I want to be a doctor, I’m going to work really hard, and that’s going to be the path for me. That emphatically wasn’t how I got into it. There’s a kind of second group of folks who get into health care often the hard way, and not that it’s more difficult, but it’s more difficult emotionally, I guess you could say, who get pulled into it because something terrible happens. And that’s more of what happened to me, is that my background is in technology. I started programming at the age of five. My dad’s dad’s job title is Computer. So I like to joke I’m one quarter, one-quarter computer. But I never thought about getting into medicine, mostly because my area of specialty was in building computing systems and building consumer products. And I didn’t understand that there was any sort of need for that in the medical space. And then about nine years ago, my mom got lung cancer and she passed pretty quickly. And it was actually shortly after that that my brother got stage four brain cancer, glioblastoma, and he’s miraculously survived it, which is incredible. He was told by professionals in the area, that he should get his affairs in order because there’s basically no way he was going to survive more than 18 months.

David Weekly:
And here we are almost a decade later, and he’s in wonderful health and enjoying his two daughters. But then a couple of years after that, my father got a pretty aggressive form of prostate cancer and I got some good time with him. But then he did end up passing in early 2018. So kind of three times over. I got to see what the patient experience was like with the family experience was like with a loved one who was going through a complex care condition. And one of the things that really surprised me was to see how much really helpful rich information was being shared by the physician orally in the consult. And that wasn’t making it into the after-visit summary, the discharge notes, the electronic medical record notes, it just vanished. And so unless you had somebody who was with you taking extremely detailed notes or if he got permission to go on record, there was a lot of really important information in there that was just going to get dropped. And this is the information that gives nuance on literally life and death choices about what kind of surgery do you want? Do you want this chemo or that chemo, do you want to skip chemo? There is a lot of choicew that’s given to the patient about their care for a condition.

David Weekly:
And if the patient isn’t actually fully retaining everything that the physician is presenting, then they’re not going to make an informed decision. So by the time things got to my dad. He got permission from his oncologist to record the audio of his consults and he’d email that over to me. I’d listen through the whole thing and write up a summary and link out to terms I wasn’t familiar with. And I emailed the rest of the family with that, which worked great for keeping everybody in the loop. But it was a huge amount of work. And it also became clear that the vast majority of families didn’t have a workflow like that. And that’s the point at which I started thinking about Medcorder, putting together first designs and then contracted with Dev Shop to go and build the first version, released it. It was still super buggy crashing all the time, but the rudimentary aspects were there. And a few weeks after that, my Aunt Terry got multiple myeloma and she started using the app to record her consults and share the recordings with families, with her family members. And the fact that she found it useful even when the app was in as embarrassing a condition as it was really provided the signal to me to, hey, I need to take this seriously. And that’s when I decided to quit my job at Google and go full time on working on Medcorder almost exactly two years ago.

Saul Marquez:
That’s quite the story. And that’s really interesting. And I think that it’s ideas like this, David, that I think we can all benefit from. And it’s not super complex, but it’s super helpful. So really, you bring in your device then. It’s an app.

David Weekly:
Yeah. So what we have right now is an app that the patient uses to go and record the consult with the position with the permission of the physician, and we then automatically generate a medical transcript of that. In addition to recording it in high quality, we transcoding it to MP3 for easier download by other family members. We push out a notification to them that new recordings are available. We also link out any of the medical terms to authoritative definitions at WebMD, at Mayo Clinic. And we provide a full transcript of the encounter. We are only offering that does a full medical transcript of the encounter, in addition to automatically sharing it out with family and letting family discuss it there so patients can also put in upcoming appointments, questions they have for that appointment and go and review and discuss that with family members in advance of what’s going to be a critical consult. So that’s something that we’ve had on offer for two years. It’s an award-winning app and both the Apple and Android app stores. And we’ve got tens of thousands of patients across the US using it to record their consults to better understand what’s going on. What I’m excited about for this year is that we have a new solution that we are working on with physicians to get in their hands the audio so that both the provider and the patient can benefit from the clarity around the encounter.

David Weekly:
And where that starts getting super exciting is that there is an enormous amount of medical signal that is embedded within the patient’s speech. So you can analyze a patient’s speech pattern and flag early onset ALS. You can flag other forms of cognitive decline. You can flag distress, depression, anxiety. Blew my mind around two weeks ago that you can have a patient say Aaaahh as loud as they can for six seconds and tell whether or not they have coded. So there’s actually an enormous amount of information that’s embedded in the speech content, not just the transcript, but the actual waveforms themselves, the timing and the prosody, the cadence that’s used by both the patient and the clinician to extract interesting information about the encounter to help make the encounters more valuable. Another one I’m really excited about is lateral length. Some of the IP from voice call analytics for sales calls or customer support calls and use that in the medical domain to be able to flag high-risk encounters, to be able to say, OK, this was an encounter where the patient got increasingly upset and angry when interacting with the physician. And you can also pull out things like, OK, these are instances where the physician is systematically interrupted the patient. You can also use it for health equity if desired, where you could see, OK, the way that you’re interacting with different patients from different demographics is different in these objective ways.

David Weekly:
And so just being able to have that as a tool to reflect back to ensure that everybody gets high-quality care could be really important. You can also build this into a bunch of the doctors’ workflow to save them time. Doctor, spend two to three hours a day wrangling electronic medical record systems. If you can automatically pull out the ICD codes, the EMR summary, and have something effectively a note prepared that they can just review and execute that could save them a huge amount of time. Better patient clarity about what they’re being told means fewer follow-up calls means less in the way of interruptions. Hey, doc, I forget you told me something really important in our consulate yesterday, but I was a little hazy on what you walk me through that. Again, those follow-up calls are unbillable. And they’re also not very well scheduled. We’ve just found out today that the majority of overtime that’s paid to the back office is following up on patient phone calls. So if the patients are calling less because they actually understood what you said, because they have a chance to listen to that recording and review the transcript and review that with their family members, then that’s going to be a lot better for the doctor, too. I think the clarity around the encounter, it’s good for the patients, it’s good for the family members and it’s good for the physicians.

Saul Marquez:
Yeah. And what you guys are doing is really different is the sweet spot where you’re able to not only help the patient, but also help the the the physician and the amount of time that they’re spending with the patient. So talk to us about how the technology is helping improve outcomes.

David Weekly:
Yeah. So there’s been a lot that has shown that poor adherence to physician instructions, particularly medication adherence, leads to pretty bad outcomes. Right. doctors prescribe medications because the medications work. And if you don’t take the medication, the medication doesn’t work and you don’t get the help of it. Right. And so the more you are able to be compliant with physician instructions, the better outcomes that you’re going to see as a patient. Because guess what? Doctors are pretty good at the craft. And if you follow their instructions, well, you’re probably going to have better outcomes than if you don’t. In one of the leading causes for lack of adherence for noncompliance is lack of retention. Just forgetting what it is that the doctor said, as well as lack of comprehension, not understanding why it is that the doctor said what they said. And if you can not only have a recording to come back to, to give you that context, the after-visit summary is basically just going to have the bullet points of the doctor wanted you to take drug X, but it doesn’t have the nuance in the conversation about why did this matter for me? And that is going to lead to we will be able to show lower medication adherence. Furthermore, your family members that can’t accompany you to your appointments anymore because of COVID protocols, if they can actually hear what the doctor had to say to you in terms of why you should be doing certain things or not doing certain things in an outpatient recovery environment that’s going to help them help the patient.

David Weekly:
That’s really going to let them fully activate. And we’ve been learning more and more about these social determinants of health in terms of correlating positive outcomes with the degree to which you can lean on a fully activated and engaged community of your loved ones outside of the hospital. And I think to do that effectively, they need to understand what the doctor wants for for your recovery, for your convalescence at home so that they can really come on board with you and with the doctor all in one team to get to a better outcome. And then I think finally, like one of the interesting bits that we’ve come across as well is patients misremembering, not just failing to remember something, but remembering the wrong thing, remembering the doctor giving them instructions that the doctor did not give them, and then adhering to those false instructions can lead to bad outcomes, because now they’re performing certain actions because of either health that we’re not actually related to them by their doctor. They may have flipped a bit. A nerd’s would say. And remember that if the doctor said don’t do X, that they remember. No, the doctor said something about doing X and that obviously could lead to really bad outcomes. So I think making sure that the patient and their family is fully aware of what the doctor wants and can be adherent to that is going to lead to better outcomes for the patient.

Saul Marquez:
And that’s really great. And being able to have this resource is critical even. So you’re saying today you and the folks at Medcorders are actually talking to providers about doing this and then sending the recording to the patients afterward?

David Weekly:
That’s right. So we believe there should be a clear and authoritative recording of every encounter. And both the physician and the patient should be able to benefit from the clarity at that recording. So you could sort of visualize it like there’s an audio stream that’s captured that comes from a nice Internet-connected mic that’s in the exam room. And then the doctor has their whole workflow that may be customized for them. There may be different modules that they want to install for the processing of that audio and transcript that makes sense for their particular care setting. But then there’s also a whole workflow for the patient and their family that they get the benefit of that, too. And what we don’t see anyone else in the market doing is focusing on rolling out a solution that gives both sides that kind of clarity and that workflow. And even there’s a whole bunch of great companies that are in the position. Directed audio recording space, mostly focused around doing remote scribing or automated scribing. None of them close the loop with the patient to provide that audio back to the patient.

David Weekly:
And also, none of them plugin with each other that there’s basically a single shot, right. So their solution just works with what they offer, which is generally ICD coding and note summarisation, which is valuable for the provider. But there’s so much more that can be done with medical speech audio that it’s a whole developing field with cool providers like ellipses, like SOND, like winter light that are building these IP modules that can take medical speech, audio and produce these interesting and actionable findings. And so one of the other aspects of where our offering is looking to be unique is that we want to be the app store for medical voice. We really want to let those kinds of providers and plug into our architecture so that providers that have a need to, for instance, screen their patients for depression, which is actually now getting to be required at a bunch of cancer clinics, that that’s just something that they could take a box and say, yeah, I want to add that on as well.

Saul Marquez:
And I think that’s great. I love the vision and with the pandemic and everything. David, it’s interesting, you know, with telemedicine platforms, Right., I mean, how are you guys playing in that space?

David Weekly:
Yeah. So telemedicine is interesting. It’s a little complex for third-party integrators because all of the ways of doing it today are a little bit awkward if you’re coming at things from a patient-directed standpoint. Candidly, the simplest thing to do is if you’re having a telemedicine consult on your laptop, your tablet is to pull out your phone and use a second device to go and record because that’s guaranteed to work with absolutely everything. And the people sometimes worry about the quality of the recording. But once you actually try it once you’ll see that the quality is quite good. It actually can be better because you can put the microphone directly next to the speaker where the other person’s audio output is coming. And that’s actually a better recording environment than if you’re in an exam room and you’ve got your phone recording on the paper sheet, on the exam table, and the doctor is eight feet away from you, facing the opposite direction as they’re typing in their clinical notes and, you know, mumbling important things under their breath about your health. But that’s not an infrequent recording environment for an in-person dialogue.

David Weekly:
And so using a second device to record a telehealth consult, again, important in the 11 states that are two party consent with the physician’s consent. But we find that that works best. We’re definitely interested in some of the developments around participant-directed modules. And so Zoom’s got this thing they’re working on called zaps, which are a little bit confusingly different than Zoom apps, where Zoome apps are installed by a site administrator. And getting that working for medical care becomes a little bit more like an enterprise health care cell because you’re trying to get the CIO to install you for all of their providers who are in the room installation. Doing things for a patient. Directed perspective is definitely where we’re looking at coming from, and that’s where we’re interested to see what happens with these apps and how that could be a platform for recording their resume does seem like they are leading in the telemedicine space, but it’s got a huge broad tail. There’s just an enormous diversity of solutions out there for performing remote consults.

Saul Marquez:
That’s fascinating. Thanks for that, David. So as you think about kind of the build out of the business and things that you’ve encountered, what would you say is the biggest setback or challenge you’ve faced and how has that created a better Medcorder?

David Weekly:
Yeah. So earlier on we were going to providers with the message of we’ll help you get a recording and give that recording to your patients and your patients will love it. And we found that almost nobody cared. I think that was a little bit of a surprise to us because the literature around patients appreciating getting a recording from their consultant and rating the quality of care received goes back like 40 years.

David Weekly:
So it’s just like extensive evidence around this. And our assumption was that a primary motivator for doctors would be patient satisfaction, patient retention, and that just turned out to not be true. And that’s not because I think doctors are bad people, but they’re very, very busy. There’s this huge problem with physician burnout that’s happening. And a lot of that is that they’re spending two to three hours a day on wrangling their EMR so they actually get paid for the work that they’re doing, which is a pain in the butt. And they’re also having to field a bunch of these follow-up calls at random times. And so I think for us, getting that kind of humbling feedback that, hey, if you want the doctors to be excited about this, you need to frame your solution in terms of what you can do for the doctor and the stuff that they care about, the stuff that is setting their world on fire. That was really useful feedback and that really helped us craft our plan to deliver to providers something that would concretely save them time, save them money and ps lead to their patients really loving them, giving them higher ratings and ultimately getting better outcomes, but that was more of a yeah,

Saul Marquez:
That’s interesting. And it’s all about the messaging. And do you feel like the new messaging around saving time has helped?

David Weekly:
I certainly think it’s the part of the discussion that we’re having with physicians that causes them to look up like, whoa, what did you say? You can do that automatically like that? That’s pretty. I want to learn more. And so I think just again, learning for us, like, what are the aspects of what we could offer that end up exciting to them are something that we’re still learning about.

David Weekly:
So the whole bit that I mentioned about cancer care systems needing to do a good job at systematically screening their patients for depression and other signs of distress, we only learned that last month in February. And that set us certainly to thinking about ways in which we could participate in that, in helping to act as an effective screening tool by taking advantage of the time that the patient is roomed. They’re sitting there in their gown on the exam table waiting for the doctor to come in. That’s wasted time today that could be made actionable and the potential impact of making that actionable is enormous. I similarly only found out last month that 52 percent of all suicides happen within 30 days of a primary consult. My jaw hit the floor and I heard that because it’s a real clear signal that patients are looking for help. I don’t know how to ask for it. And it’s really hard for the physician to see absent some other data that’s letting them know, hey, you really should flag this and check this out. So using depression, screening voice analytics as a way in advance of the consult, when the patient is waiting for the doctor to show up, that we could make that actionable in the console. And if we can do that, we could we could save lives. And that’s really interesting to think about from a systems deployment perspective. Additionally, because some of these cancer care centers may lose their accreditation if they’re not doing a good job systematically screening their patients for depression. So that’s something that we could do for them. And it wouldn’t just be like a nice to have high five, but it actually becomes something that saves lives and B, that they’re increasingly required to do.

Saul Marquez:
And that’s fascinating. That’s that. I wasn’t aware of that and something for all of us to think about. There are different ways to really understand how we’re doing, how our health is. If you’re taking care of your patients, think about these unique approaches that David is mentioning. Voice biomarkers can be very rich and telling us about a patient’s status and depression is key. And so what would you say you’re most excited about, David?

David Weekly:
I think there’s so much to be done here to use modern machine learning techniques to help patients understand what’s going on, to help them really benefit from that extremely limited time they have with the doctor, and to give the doctors superpowers to let them see things that they might not have seen otherwise, to let them remember things and to take away a lot of the clerical burden that they are having to bear today for reporting and for billing to remove a lot of the risk from it by having these clear, authoritative captures of the encounters and consent. And so I just think there’s there are so many ways in which this could benefit medicine that it’s obvious to me that in some amount of time, say, 10 years, we’ll look back and we’ll be astonished that previously patients would leave encounters without a recording in hand. The doctors would have to wrangle four hours a day struggling to remember every last detail of what happened in the console to get appropriately compensated for the real work that they actually did. It just seems like such an obvious thing to me that this is the direction of medicine that I’m really excited and proud to be a part of the helping champion in that to benefit patients and doctors alike.

Saul Marquez:
Yeah, that’s fantastic. And it’s exciting to know that technologies like these are readily available. How do we get Medcorder?

David Weekly:
Yeah. So as a patient you can get the med quarter out just by opening up the App Store. So if you’re on Apple, open up the Apple App Store, search for mid-quarter and medicine and tap to install. If you’re on an Android device, you can open up the Google Play store and search for a similar Medcorder and tap to install. It’s a free app to use and we’d love to hear your feedback. If you’re a physician interested in incorporating speech into your practice, I would love to hear from you. My personal email address is David@Medcorder.com. That’s David@Medcorder.com. You can also find me on LinkedIn, on Twitter, pretty much everywhere across the Internet as the DWeekly.

Saul Marquez:
I love it, David. This is great. A fantastic opportunity to really consider this approach. It’s not rocket science, but, man, it’s so helpful. And you talk about some misremembering gosh, I mean, like I saw a couple of weeks ago, I got shingles and like, you know, and all good. Went to the urgent care and got my Valtrex. And they’re like, you’re right. I’m like, I couldn’t remember what the doctor told me. How often should I take this? And I had to call back. And that’s time from that that office staff. And, you know, and I just told my wife, man, you know, it’s just like there are these older people like and here I am, a younger guy and not remembering this stuff. So it happens to all of us. And so it’s a great solution, one of many ways that it can be used. But certainly worth exploring, folks, as David mentioned, Medcorder.com. And he gave you different ways to contact him, which will include in the show notes. So, David, thank you. Really appreciate the insights you’ve shared with us today.

David Weekly:
Thank you, Saul. So I appreciate it.

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Things You’ll Learn

  • There was a lot of information being shared in the consult that does not make it in the after-visit summary, discharge notes, or in the EMR notes. 
  • There’s actually an enormous amount of information that’s embedded in the speech content.
  • Poor adherence to physician instructions, particularly medication adherence, leads to pretty bad outcomes.
  • The more you are able to be compliant with physician instructions, the better outcomes that you’re going to see as a patient.

 

Resources:

Email: david@medcorder.com

Website: https://www.medcorder.com/

LinkedIn: https://www.linkedin.com/in/dweekly

Twitter: @dweekly