COVID, Hospitals’ ‘No Visitors’ Policies, Family Involvement and Medifies with Nate Pagel, CEO at Medifies was automatically transcribed by Sonix with the latest audio-to-text algorithms. This transcript may contain errors. Sonix is the best audio automated transcription service in 2020. Our automated transcription algorithms works with many of the popular audio file formats.
Saul Marquez:
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Saul Marquez:
Welcome back to the Outcomes Rocket, Saul Marquez here. Today, I have the privilege of hosting Nate Pagel. He is the CEO of Medifies and the co-founder of Vidlet based out of San Francisco, California. They’re doing a ton of great work. Pagel is a serial entrepreneur and new media artist. He’s been part of four startup exits in the Bay Area, Austin, and New York. And he has a video show and media artwork in over 20 countries. His experience includes product management, software development, design, branding, banking. He’s got a wealth of knowledge in business. Pagel has managed award-winning digital media web and interactive marketing projects for many Fortune 500 companies, including Apple, Microsoft, AMD, and more. He is doing some outstanding work in health care now, and I’m excited to be hosting him here today to talk to us a little bit more about what they’re doing in the space. So, such a pleasure to have you here, Nate. And thank you for joining us here.
Nate Pagel:
Sure Thanks. So, yeah, and please do call me Nate and excited to be here as well and talk about in this interesting time what’s happening with Medifies, in other words.
Saul Marquez:
Yeah. So before we dig into Medifies Nate, tell us a little bit about what inspires your work and health care.
Nate Pagel:
Well, so this is my first health care startup. Everybody else on the team and board of advisors, et cetera, has had 10 – 20 plus years of experience in health care. So they helped me figure that out. The reason to get into health care is I kind of made a decision, as I’ve been through a variety of startups, to only do stuff that made the world a better place from now on, as opposed to advertising, which I did. And so health care interested me. My co-founder and I went to grade school and high school together, so I’ve known each other most of our lives. He is the chief of surgery and a cardiothoracic surgeon for coming up twenty years now, California as well. And he had an issue. So I’d been interested in health care and philanthropic organizations, things like that. But he had an issue with his surgeons that he thought could be helped and really help everybody in health care. And by everybody, I mean the doctors, the clinicians, the staff, but also the patients and also their family, most importantly. And so I was interested in taking that head-on. That was like a challenge. And so I thought I’d do something different, do something in health care and see if I could bring some of my experience and other verticals into health care and help out a little bit.
Saul Marquez:
Wow, that’s awesome, man. Well, and you’ve had success outside of health care. And the reality is we in health care can benefit from the external influences around us, whether it be technology, consumer insights. There’s an opportunity to apply those things. And the area where a lot of entrepreneurs get stuck or fail is that they make a lot of assumptions. You are surrounded by people that are health care experts. So it’s a nice combination. So talk to us about Medifies and what you guys are doing to add value to the health care ecosystem.
Nate Pagel:
Sure. So how we got started was that my co-founder recognized a need not only his need but all of his surgeons and every surgeon he knows to facilitate communication with the family of patients. So patients are job one, health care, care for that person, etc. But there’s really no protocol around talking to family and keeping them up to date and helping them feel satisfied, secure, and less anxious. And so we started with surgery based products. So let’s say my dad is having heart surgery in Dallas, Texas. What he does is he signs up the rest of us, me, his wife, my brother, etc., to get updates that are already happening in the hospital, in the hospital, they have to track all this stuff they track in the EMR systems, et cetera. But the family gets no benefit from any of that information. And so in order to better that relationship and save time for himself, he wanted to have a provider, health care provider to a family communication tool that worked on the smartphones that are in everybody’s pockets, that worked inside outside of the hospital and across the United States to let them know what was going on on a quarter-hour to hour basis all the time. So they didn’t have to make phone calls. They didn’t have to go up and ask somebody. It Was just there on the phone and they could go down to the cafeteria, get something to eat. And also, very importantly, when a surgeon and this is true in every hospital in America and a surgeon goes out to talk to the family post-procedure, which they can no longer do with covered, by the way. So I’ll give you an update there. They missed the family fifty percent of the time.
Nate Pagel:
So that is fifteen to twenty minutes of a surgeon’s time. And he’s walking around the hallway. My co-founder sends a nurse into the bathroom and a volunteer down to the cafeteria to look for them. If you can’t find them in twenty minutes, he goes and starts and scrubs in and does his next procedure. That’s him not being happy. A waste of free person’s time, their family not being happy. That’s gets communicated back to the patient and really impacts Hcaps scores which affect Medicare reimbursement. So it’s a bigger deal and it would seem it’s at its surface to make that family happy to know when they are when you want to go talk to them. And really to make the experience better both for surgeons and staff, but also for patients and family. So we started there and then taking a look at the space side, people at the Texas Medical Center come up to me and radiology, labor and delivery, chemotherapy, other practice areas where they also had problems with a family that had to pick up somebody during discharge or pick up a child at the Texas Children’s Hospital or whatever, in which, again, the family was secondary because patients should be primary. And so we discovered other practice areas, the treatment types, procedure types during which we could also update the family members. So now we do it within our platform. It’s a family engagement SAAS platform that verifies that we can update folks with dialysis, elder care, hospice, chemotherapy, labor, and delivery. And we now have a COVID-specific product for COVID cases that we offer to free for all health care providers so that products free. The rest of them will work with folks. It’s a tough time for providers, so we’ll work with folks on pricing.
Nate Pagel:
Very cool. Very cool. Yeah. You know, I never realized that 50 percent of the time the surgeon can’t find the family. I mean, that’s frustrating.
Nate Pagel:
That’s yeah. That’s bad that use of the time. Literally, they are looking in bathrooms,
Saul Marquez:
Man, crazy stuff. And so it’s these problems that are out there that often go unaddressed then and then it becomes a bigger problem. But when they’re identified and we could do something about it, it’s a great opportunity, Number One to help Hcap scores. But overall outcomes have patients and families feel less stress because these moments are stressful, right?
Nate Pagel:
Yeah, yeah. My thesis was going back to the statement. It takes a village to raise a child. Health care is progress such that we live longer, we live with diseases longer, etc. So if it takes a village to raise a child, it takes a village to take care of a 90-year-old with comorbidities and chronic conditions. It takes a village to take care of somebody with chronic conditions earlier in life as well. And to enable that is to bring the family, friends, contacts, loved ones, whatever, whoever the patient wants into that care continuum so that when they’re not in front of the doctor, which let’s face it the minority at the time, everybody else is looking out for them and helping them here because that lack of adherence to a physician’s instructions got them there in the first place. So and people that love them have a huge incentive to help them out. And so let’s make that electronic. Let’s track it. And to your point, in terms of outcomes, we have reduced readmission rates in some cases by twenty-five percent because the families there and that is not bringing them back to the hospital and we can update them. So that positively impacts outcomes because if they’re readmitted, the prognosis is generally not as good. So we’re trying to look at track everything. I’m a data guy. I’m a data junkie, given my startup experience. So I try to look at every data point and try to figure out where we’re working, where we’re not, and how we can improve.
Saul Marquez:
Nate and everybody listening. I mean, we all know that the touchpoints with patients are far like they’re too far apart and there are too few of them. And whether it be managing a patient and their chronic conditions or postoperatively, the touchpoint is lost. But what you’re telling me is Medifies will help keep that communication consistent.
Nate Pagel:
Exactly. And it’s standardized messaging that goes out. We also don’t use personally identifiable, protected health information. You get a number and you as a family member know who it is on your phone. You don’t have a lot of people in surgery that day, so you make the mental connection. And that way we can send out standardized updates that are true for all procedures, stuff like that. Patients in the or. Anesthesia has started on your loved ones and make them more comfortable during the procedure. That’s true for heart surgery. So it’s super easy to use but feels personalized to the family. And it’s because they really care about that person right there that day. And I’m talking about surgery. But this is true for cases at nursing homes. People need to get updates.
Nate Pagel:
And now I think is a good time to start talking about the elephant in the room, which is COVID. And so no startup, particularly one in health care, can say much without talking about it and how it’s affected them. And to do that and to say kind of how things have changed for Medifies and for the hospitals and health care providers in general. A couple of things. Number one, financials are kind of unknown here in this environment. Hospitals, elective cases have gone down, which is how they make their profits. So they’re getting some money from the government, but they’re worried about future income, as it should be. So that makes it more difficult for us to get in there and get stuff live and pilot stuff and things like that. Having said that, there is a no or restricted visitor policy at every health care provider type that I just mentioned.
Nate Pagel:
Dialysis. You can no longer go in with your loved ones. Same with chemo. Nursing homes do not accept visitors. So if you have a mother in the nursing home, you have not seen her for four months unless you use zoom or FaceTime or whatever. And at a time when COVID cases of the number of deaths, etc., especially in the United States, are something to be afraid of for a lot of people, especially the elderly, especially those with comorbidities or otherwise compromised health, et cetera. So these folks can’t see their loved ones, whether it’s a COVID case or otherwise, they can’t be in there. And so Medifies is a solution that makes even more sense. If you haven’t seen your mother in four months and you reading all these news items about cold cases and nursing homes, you’re worried every morning. You don’t know if her doctor, her orderly, whatever, got COVID last weekend. So in order to be able to update families on a daily basis if they want it, you can sign in for different types of adaptations. But I’d want it for my mother. I want to wake up in the morning and see no cases, zero staff cases, zero new inpatient cases, and COVID today. Your mother’s taking her medicine. She’s walking around. She seems to be in good spirits. Just that that’s all I need once a day. And I’m feeling much better that day than I would otherwise. So there’s there are a lot of areas that are very strange that we positively affect our very nature. So it’s good and bad for health care that covers around. It’s bad for people for sure. But in health care at least, it’s moving the needle in terms of telehealth, in terms of technology adoption, in terms of looking for new and innovative solutions that help today as opposed to, hey, let’s try this and see what happens three years from now. So it’s a laser-focused and uncertain time for health care, given this, and Medifies is certainly part of that interesting moment in history.
Saul Marquez:
Nate, I really appreciate you sharing really how you guys are adding value specifically around COVID. I mean, there’s nothing worse than not knowing. And that uncertainty, especially around these times and with your example about somebody’s mother in a home that you can’t see, those daily updates would be huge and then scale it to the OR anywhere else right. It’s a powerful platform.
Nate Pagel:
Thank you.
Saul Marquez:
So lots are going on to really improve health care and it’s not easy. And so what would you say is one of the biggest setbacks you’ve experienced and what was the key learning out of that so far?
Nate Pagel:
Well, I’m going to pass on COVID right now because that’s the biggest setback that all of us have experienced. I just talked about that and talk about something that’s a little bit more endemic to health care in general. And it’s a known quantity. Little aside is that when my current co-founder of Medifies and I sat down, he kind of pitched me on this idea and said Nate, can we create software that will help with this problem? And my response is, yeah, we can for sure is like, do you want to start a company to do this? I said, no way. It’s health care. And here I am four years later and firmly ensconced in health care. And part of that reason was knowing what I know now going in, but discovering it firsthand is not the same thing as knowing that it might occur, which is sales cycles. So sales cycles are known to be long. In most of the businesses that I’ve been in before, they move pretty quickly. In order might be advertising to move the most quickly and to try out things. In e-commerce similarly, they’ll have to be careful. Now going down the list. Finance is slow. Government is known to be very, very slow, and health care is somewhere between the two, if not as bad as the government in terms of and as bad as what. I don’t mean to cast aspersions because you want to be careful. The history of health care is treating patients and you change something you could do some harm and you don’t want to do any harm for sure. So it is the status quo that works. You keep it that way.
Nate Pagel:
I understand that. And I understand that, that the DNA of health care, especially having gone through EMR implementations, which haven’t been quite rosy for the systems or the doctors and clinicians using them, they are a little bit gun shy in software. They’re naturally gunshy new stuff because of the nature of health care. And so the biggest setback that we’ve experienced is long sales cycles. So the key to learning there is to be very, very flexible as a startup software provider to be very clear and make it simple to implement and launch and train. We’ve done the latter quite well. What we’ve been is flexible on, starting with folks, whether that is a pilot. My training in San Francisco in doing software is never to do pilots. In health care, I’ve softened that to do any pilot that anybody offers. The reason that you don’t do pilots is that the investors think that if we put a zero dollar value or lower dollar value on your software, that’s actually what you’re worth. And so don’t do anything for free. Health care, hospitals, et cetera, are used to doing stuff, having people do stuff for free to have a larger opportunity. So we’ve been my learning there is do whatever it takes to let people use the software, real-world environment, have metrics around what success looks like, be agreed by both parties and track it backward and forwards to make sure you’re hitting those metrics. If you’re not doing it as a startup, you’re not doing your job. You’re not providing a good enough product. If other things get in the way, covid revenue, you name it, you’ve got to be flexible enough to move around that.
Nate Pagel:
And so that’s the biggest setback other than COVID. And the key learning is to be very flexible and get the data. And actually, one of the things specifically in digital health is how you structure contracts matters a lot. So, for example, if you do a pilot, do a three-month pilot as part of a 15-month contract in which it rolls into a paid engagement so that they have to cancel it in order to change that. That’s just structurally set you up and sets their expectations in a way that that should be positive for the company. So that was definitely key learning in health care for me.
Saul Marquez:
Well, that’s great. And it certainly shows your commitment to making this work, and especially when you’re integrating into the EMR and things like that definitely could take a lot longer. But sounds like you guys are figuring out ways to get the product in people’s hands and get them to see the value upfront to get them to go for it.
Nate Pagel:
Yeah, exactly. And the need has to be there. And again, because no visitor policy, what I’m finding is folks are we definitely get their ear, if not their pocketbook, which is a little empty these days. So setting the stage for future growth is always part of any sales funnel or really startup product planning process.
Saul Marquez:
Totally, yeah. And so as you think about the landscape, Nate, what would you say you’re most excited about today?
Nate Pagel:
Well, a couple of things. So first off, internally, in the company I’m a product guy. I’m a design guy, amongst other things. But so I’m always excited about doing something new, adding something that’s necessary and fulfilling our customers’ needs and desires, whether that’s a paying customer, like a health care provider or a user that just gets free benefit out of the system, which would be the patients’ families and their other contacts. So in terms of product innovation, being able to tap into newer markets for us, which include the elder care, nursing homes, hospice, dialysis, et cetera, it all plugs into our platform, similar database structure to comply and all the rest of that stuff. So I’m excited about developing those with partners out there in the industry. And so, for example, with nursing homes, were chatting with Birkdale, which is one of the largest providers in hospice. We’re talking with Vytas, which is one of the largest hospice providers in the states and dialysis. We’re chatting with some folks at DeVita, which is big in that space, obviously so excited, innovate new things around opportunities that we have that we’ve been identifying since day one. But really, given covid has accelerated our efforts to get into those markets. And I got to tell you, out of all of them, I’m most excited about nursing homes because you’ve got a million people in the United States that need social reinforcement and can’t get face to face with their family. What a bummer is that for them, it negatively impacts for sure. What a bummer is that for the tens of permutation of families that are involved. And so to talk with those folks and solve some of their problems in a practical way that makes our collective consciousness better in a time of struggle and stress is something I’m very excited about.
Saul Marquez:
Good for you guys. And I love the approach right. There’s a lot of different niches within health care, not just the hospitals, those acute care centers where you could apply this. And so it is exciting to know that you guys are working your way into the system to provide this. Really, it’s about knowing right? I mean, it’s about knowing how your family is doing.
Nate Pagel:
Right. But it’s the comfort of that. The worst thing in the world is sitting in a waiting room, which you can’t even do with COVID these charts and looking at a clock with no updates, looking at tick by. We all knew that from junior high school Right. waiting for the bell to ring, to go home. At the end of the day, we’re used to this and the stress around that and the excitement around the case. But, you know, so if you’ve got something on your phone that, you know, is the latest information the doctors have that the nurses have, that the caretakers have it at facilities, your comfort level just goes way up and allows you to do your normal stuff every day without worrying as much. And that stuff can be automated. That stuff can be based upon your stress level as well. We have some light A.I. artificial intelligence around to send you updates when you’re stressed out and you want something. And so that’s one of the things that we’re really excited about as well, is going to make the world a better place. And that going back to my thesis, it takes a village to take care of really sick people. And so let’s get that village involved because it actually helps treatment options, prognosis, and outcomes.
Saul Marquez:
Love it. Nate, this is great work and certainly exciting to hear the progress you guys are making before we conclude. I love if you could just leave us with the closing thought and then the best place that the listeners if something today resonated with them and they wanted to explore an option with you guys or continue the conversation where they could reach you.
Nate Pagel:
Yeah, sure. The closing thought is this. We are all in this together. Literally, we were before COVID. We may especially be now the states and cities are doing this in different manners, our government is doing it differently from others. But the providers have one goal in mind, and that is to make people better and metaphase wants to help out with that, as do us all and you the listener. And so how can we best do that? Medifies is cutting off a piece of that, which is certainly relevant these days.
Nate Pagel:
But I think it’s always relevant and so engaging the family in the journey of health care that we will all have to go through at some point in our lives and we’ll all be in a hospital someday. We may all be in a nursing home or something like that. And so to get this digital technology where it needs to be our smartphones, where they need to be to be able to take advantage of that now means that we’ve all got a better future. So we’re all in this together. How to get in touch with me, folks, if you want to, please do reach out. I’m Nate@medifies.com. If you have a general question, you could be info at medifies.com. And you’re welcome to give us a call at 510 838 0672. We’re located in the Bay Area, but we’ve got presences in Miami, Houston, and Nashville as well. So happy to chat with you. Happy to meet up local and please fire off any questions as well as if we’d like to see the software.
Nate Pagel:
I love it. Thank you so much. And folks, take them up on the offer to connect. He offered various ways to do it. And why not explore this awesome option today? See what you could create for your patients. And maybe you’re a partner that is already working with health systems and they could integrate with what you’re doing. The options are now. And so I encourage you to chat with Nate if that’s of interest. And I want to thank you for sharing what you guys are up to with all of us. It’s been a really insightful conversation.
Nate Pagel:
Great, Saul. Appreciate it. Thanks. Have a great day.
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