HLTH_Heidi R. & Heidi A: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.
Saul Marquez:
Hey everybody! Saul Marquez with the HLTH Matters podcast. Welcome back to today’s episode with amazing health leaders. Today I have two actually that I’ll present to you, and if this is your first time visiting us, make sure you hit subscribe because we are coming out with interviews, just so much amazing content, you’re not going to want to miss it. So hit subscribe and thanks for joining us. Today I have Heidi Anderson and Dr. Heidi Riney joining us. I’m going to start with Heidi Anderson, she’s the president and chief growth officer at Nox Health. She spent more than two decades building businesses and driving major growth in emerging and mature B2B and B2C markets, especially in the healthcare industry. In her role as president and chief growth officer at Nox, a sleep healthcare and tech company founded in Iceland, Anderson helps lead the visionary team that’s reimagined sleep healthcare so that millions worldwide will have access to highly effective sleep solutions, including at-home sleep testing, sleep board-certified physician telemedicine visits, and ongoing care team support. Prior to joining Nox Health, Anderson served as senior vice president of Strategic Clients and Initiatives at ASO Strategy at Teladoc. I want to welcome her here, she’s just done an amazing job, and also has had much impact with her time at Time Warner and WebMD. She’s a pro at making things happen in the healthcare business. Alongside her, I’m hosting Dr. Heidi Riney, she’s board certified in sleep medicine and neurology by the American Board of Psychiatry and Neurology and is a member of the American Academy of Sleep Medicine, Georgia Association of Sleep Professionals, and National Sleep Foundation, where she serves on the Public Affairs Committee. She’s an incredible leader in the sleep space, and she completed a clinical neurophysiology fellowship at Emory University. And I’m excited to have her here to talk about a very important topic, sleep. Welcome to the podcast.
Heidi Riney:
Thanks for having us.
Heidi Anderson:
We’re excited. Thanks, Saul.
Saul Marquez:
Yeah, I’m super excited too. You know, there’s so many things that contribute to health and we’ve been focused for many years on sick care, but there’s so much that could happen on really the home side and wellness. We’re going to talk about sleep today and Nox Health and the things that they’re doing to revolutionize health for all of us. Before we dive into the very interesting topics with them, I want to ask both of you what inspires your work in healthcare? Dr. Riney?
Heidi Riney:
So for me, it is the prevention, I think you’re exactly correct. I think we, definitely in med school, it was very much reactive. Someone has a disease, what do we do to fix it and not what can we do to prevent that disease? And so, you know, I’m a neurologist by training. And unfortunately, with neurology, there’s a lot of diseases that we can’t cure, and often you’re seeing them at the end, so catastrophic strokes, dementia. And I looked at sleep as something that we can do to be preventive, and it’s truly something that everyone is affected by and I don’t think they realize is a disorder and something you can do something about. And truly seeing how life-changing it is to address someone’s sleep and how it helps the whole family. So it’s not a solo thing, you know, this is something where everybody’s involved in the process. Everyone’s affected by someone else who isn’t sleeping well, and then when the short term they’re doing better, they’re more productive, they say, my life has changed, and then their diseases get better. So people who have chronic diseases, to see them be able to come off medications and to say, I never thought I could do this or I can lose a weight that I haven’t, you know, I don’t know why I’m gaining this and know that their sleep is impacted or their memory. So, I mean, I can go on and on, but it’s a passion, I mean, for real to give people good sleep and educate.
Saul Marquez:
You were frustrated by the unsolvable and you uncovered sleep as that thing and now you’re just on a mission.
Heidi Riney:
It is, and I think, you know, it’s actually, my brother is an internist. And actually, I was, you know, we were talking about sleep and he was like, you know what? I never really thought about why we sleep. Like, why does it matter? I think people and I think that’s a very common theme of you just think I close my eyes and I do it, but what does it really serve? And it really serves everything. So, you know, and that is our mission, to educate why it matters, what we can do to get people healthier sleep, to let them know what that looks like, and that is our goal.
Saul Marquez:
Thank you, Dr. Reiner. Heidi?
Heidi Anderson:
Absolutely, I have been in healthcare, in and out of healthcare most of my career, and I would say the thing that interested me the most was transforming healthcare. It’s such a ripe space for disruption and transformation. And within healthcare, sleep is this foundational underpinning that really touches everything. I spent almost a decade at WebMD and Medscape creating programs that educated patients and healthcare providers and had the opportunity to join a company called Livongo, which was in the diabetes space, which was very much a disruptor or a transformer of healthcare, and I discovered Nox and it’s really this combination of scientifically backed technology-enabled human-centered care that has allowed us to disrupt the healthcare space. And to Heidi’s point, sleep is the underpinning of everything. It really is the foundation. There is tremendous correlation with all of the chronic diseases, with mental health, with depression and anxiety, with productivity and decision-making and functioning, and even safety. And so it felt like this one thing that I could, you know, jump into the mission on and really help transform healthcare in a powerful way by leaning in and becoming very passionate about this one aspect of physical and mental health.
Saul Marquez:
Thanks for sharing that, Heidi. So really, you’ve been on a mission to educate in the healthcare space for a very long time and you gravitated toward this sleep thing because of the impact it could have.
Heidi Anderson:
Absolutely, one of the things that we’ve been talking a lot about and has been surprising to large self-funded employers, which is a primary target of ours and also health plans, is that sleep is hiding in our highest cost claims. When we do an analysis and we illuminate for our clients that they’re already spending on sleep, but it’s not necessarily effective and efficient as it could be. And so we’re able to demonstrate that sleep is so correlated with diabetes and hypertension, musculoskeletal, you know, as Heidi said, all the mental health issues, behavioral health conditions. And so when we’re able to shine a light and illuminate the fact that if you solve for the sleep, which we have a proven system solution to do, all, everything really gets better. If you take care of your sleep, sleep will take care of everything, and everything will get a little bit better, both from a cost perspective and from a clinical outcomes perspective, and we’ve been able to prove that, which has been exciting.
Saul Marquez:
That’s fantastic. Thank you for that. And so I think it’s worth, you know, dialing in. Talk to us about Nox Health. How is it that you guys are deploying the solution, the platform? Help us understand that.
Heidi Anderson:
Yeah, well maybe I’ll start, it’s a wonderful story, if we were, if we try to channel some of the Icelandic founders who are not with us today. I did grow up in Minnesota, I am 70% Nordic, but I can’t say I’m from Iceland. I just, I have a team of, yeah, in Minnesota … deep affection for them. So it was a bunch of Icelandic engineers really that set out to work on technology for sleep diagnostics, and that was really how Nox was born. And our Nox medical business is thriving, we have sleep diagnostic in 50 countries across the globe. And about 15 years ago, Sigrid John Christensen, our CEO, moved to Atlanta and partnered with some of the folks from Emory Health, including Heidi Riney, and really was on a quest to help bring value-based care to the US healthcare system. He read that really incredible article from Michael Porter in the Harvard Business Review in 1991 that talked about value-based care and really putting the patient at the center and removing the friction for both the person and the healthcare provider. And so Nox has grown from a diagnostics company that originated in Reykjavik, Iceland, to a very full-service sleep specialty care, both brick and mortar and telehealth in the Southeast. Heidi practiced, she’ll tell you, for many years, and we’re now delighted, she’s our chief medical officer. And then we had a baby, those two businesses had a baby, and we created that enterprise business, and we’re really on a mission to provide that value-based care, to give access to everyone who needs good sleep care across the country in a seamless, frictionless way that’s efficient and effective and affordable and drives that behavior change and the adherence and the compliance that ultimately lead to all those obviously cost benefits and clinical outcomes. So Heidi can tell you a little bit more about the journey from brick and mortar clinic in Atlanta to a full-suite enterprise solution that we have today.
Heidi Riney:
Set that up perfectly. So one thing with sleep we were talking about a little bit earlier is that we didn’t get a lot of education with that during med school training, and it’s one field of medicine where you can actually come from a lot of different specialties and specialize in sleep medicine. So the good thing with that is that you have a lot of multidisciplinary approach to it. The troublesome thing is that sleep is often something that people dabble in or they might include part of it. And so sometimes it’s hard for people to know who to go to and then the follow-up for care can be fragmented. And so that was where fusion came from. It was, all we do is sleep, was our tagline, and that was our way to communicate to our referring physicians and our primary care physicians to say, we are here to support you, we’re here to take care of your patients. If they have any sleep concerns, bring them to us and we’ll take care of all of it, but we won’t take them away from you. We’re here to support you and to help you. And it really grew from there to say, you know, from diagnostics to treatment to care management, We want to keep them on therapy. That’s the other part of it is, it’s easy to diagnose, it’s another thing to keep them on treatment and make sure they’re doing well with the therapy. And that’s when we really see our biggest cost savings is if you keep them on, they’re going to reap the benefits and they’re going to do great. And so really, that’s where our enterprise solutions came from that model.
Heidi Anderson:
And I think that’s what’s been exciting to our partners, you know, both the large self-funded employers and the payers is realizing that this is a novel efficient, seamless way to get people measured, monitored, diagnosed, and measured and scored and then get them the appropriate treatment. One of the not-so-fun facts is that 50% of people typically fall off sleep care therapy in the first year. And with our solution at Nox, we’ve been able to keep less than 10% of people falling off therapy. And that’s really that combination of tech enablement, the mobile technology that we can meet people where they are, testing them in their home, giving them that telemedicine access anywhere they live. And then the behavior team, really our secret sauce is our behavioral healthcare team that helps them adjust to whatever therapy path is appropriate for them and encourages them and gets them over that hump to keep them on therapy, and that really is what drives long-term cost savings and clinical outcomes. One of the exciting things we’re starting to do with our clients is looking at lab data and actually looking at reduction in a1c levels and reduction in blood pressure, all the clinical benefits that come from caring for sleep. And Heidi has dozens of stories, life-changing stories of patients and how it’s changing their, good sleep is changing their lives.
Heidi Riney:
Oh, God, yeah. I mean, recently I had a gentleman who came in really just because his wife was tired of him snoring. And then he’s like, You know what? I am tired. I want to address it. And he’s in his forties with on three medications for blood pressure. And the first thing he noticed a month into therapy was that he was able to come off one of his medicines.
Saul Marquez:
Nice.
Heidi Riney:
And he was like, I didn’t even think about that correlation. And you also go to wake up to the bathroom multiple times a night and he’s like, I don’t do this anymore. But the blood pressure thing was so big, he’s like, everything else got better, but he was like, I wish I knew. You know, I didn’t question when I had another medicine added on. He’s like, I’m in my forties and I’m on three blood pressure medicines, and if I had known that this could be part of it, you know, I would have done this much sooner. And so that was, and so he was like, I’m going to become the biggest advocate. And that’s what it is, patients become the biggest advocates. And he’s like, I’m going to go to my primary care and let them know, hey, if this comes up again, please ask about their sleep. Or, you know, my favorite story is this PhD who I saw, this was probably ten years ago, and he had acute memory loss and he’s in his fifties, and he thought, you know, I think I have Alzheimer’s, and he went to a neurologist. He had MRIs and all this blood work, and he had neurocognitive testing which showed he had mild cognitive impairment. And he, they told him, why don’t you look at your sleep, which I was so happy they said that, and he did, and he had very mild sleep apnea. And at the time I said, you know what? I am a believer that sleep does everything, but I don’t know if it’s causing this. And, but we’re like, we’re going to go on therapy and see what happens. And a month later, I was just looking at this note recently, he was like, I am back to where I was. And we were like, I don’t know if this is true or not, and then he retested eight months later at the same testing, and he was 1.5 standard deviations above normal. So, and he had chronic pain too and that went away and he was like don’t even think to tell you this, and you know, it’s.
Saul Marquez:
Oh my God.
Heidi Anderson:
So we’re starting to gather the data, which is exciting. But I don’t know, you know, it’s kind of, it’s fun coffee, kind of cocktail party talk too, you will die sooner from lack of sleep than you will from not eating. Most people don’t realize that there’s a reason, it’s a torture mechanism. You know, we grew up in this sort of bravado era of we’ll sleep when we’re dead. And, you know, it’s great to be able to function on 3 hours of sleep, it’s not. Sleep heals the body and the brain, and you need good sleep duration, quality, every night to really function at our best.
Saul Marquez:
So I really want to say thanks for those thoughts. And folks, you’ve got to pause and think about this for yourself. Are you sleeping? How is your sleep? And it’s important to be honest, right? I mean, I was talking to Heidi outside of the podcast booth here at the HLTH conference, and I was like, wow, I am one of those people that needs sleep. And you’re probably one of those people, too, if you’re honest with yourself. So a question for you guys. How do we know? Like, is there a test and assessment that we can take to sort of baseline and then things we could do to improve that and then test later?
Heidi Anderson:
Absolutely, we, as part of our sleep charge program, which is our enterprise program, we have a quick sleep checkup, which generally gives you a general baseline on your duration, quality, and timing of your sleep, the three key criteria, and then we quickly pull you into a little, more of an evaluation that gives you a little deeper assessment. But Heidi can tell you more about the diagnosis. It’s quite easy, it’s quite seamless, and we’re happy to help anyone that needs good sleep.
Heidi Riney:
That’s exactly right. So after they do that evaluation, you know, we tell them, hey, you know, you may be at risk for a sleep disorder depending on how they answer the questions. And they have access to schedule a consultation with one of our board-certified sleep medicine physicians, and we have someone in all 50 states, and then from there come up with potentially what may be the sleep disorder. So there are 80 plus sleep disorders out there, and our physicians are very adept to seeing what may be going on, and our big thing again is educating the patient who comes in as to what we think may be going on and figuring out the next steps together. So be it testing, therapy, depending on what modality makes the most sense.
Saul Marquez:
That’s fantastic. So folks we’ll leave a link for you whether you’re thinking about it for yourself or if you’re thinking about it for your employees. One of the main groups that Nox Health helps is self-funded employers that are taking care of their own benefits. So as you think about the productivity of your employees or your own productivity, this is a must.
Heidi Anderson:
And Saul, it’s really a no-risk proposition, if I may, we take risk in the front end. I mentioned earlier in the podcast that we’re very committed to the value-based care model, and so we don’t actually charge an employer or health plan until someone is enrolled in the program. And that means they’ve taken a sleep checkup, they’ve done a digital evaluation, they’ve had a telehealth consult with a sleep specialty physician licensed in all 50 states, and then they’ve had an in-home sleep test, and only after they have had that diagnosis and scoring and they’ve chosen to enroll in our program, only then do we charge the employer for the patient. And so it’s really risk-free, and we hope that people will join us on this journey of helping people sleep better and understanding the power of good sleep, and recognizing that it’s really a transformative thing that you can do for yourself and your employees.
Saul Marquez:
I love it. Well, listen, I’m joining and I know Michelle over there is joining. It is critical that we all seriously consider this, so I want to thank you both for the perspective today. What closing thought would you leave the listeners with as we conclude the podcast?
Heidi Riney:
So honestly, just to think about sleep, I mean, a lot of times when we see people, they’ve probably seen four or five physicians before considering sleep being an issue, and oftentimes if you can address that first, you may not need to see those four or five doctors. So as you said, assess your sleep, know what your body needs, give yourself the appropriate time to do it. And if you’re still feeling like I don’t feel the way I should, I’m waking up a lot at night, I’m struggling to go to bed, I’m struggling in the day, I’m tired, I’m sleepy, whatever those issues are. Look at your sleep.
Saul Marquez:
Love that.
Heidi Anderson:
And I would just say, you know, there’s a lot of Type As. Here we are in Las Vegas at the HLTH conference, and we’re all trying to do more with less and probably getting less sleep than we should. I know Ludacris is going to be on stage tonight, which is going to pull a lot of people away, but I would say give yourself the gift of sleep. Learn to say no and focus on yourself and recognize how much more of an impact you can have with good sleep.
Saul Marquez:
Outstanding, and thank you both. Where can people learn more about Nox Health?
Heidi Anderson:
They can reach out to Heidi or Heidi. Heidi@NoxHealth or HRiney, R I N E Y, @NoxHealth, or they can go to NoxHealth.com and we’d love to help you.
Saul Marquez:
Amazing, pretty risk-free. Check it out, guys, now’s the time, take action. Thank you both for being here.
Heidi Riney:
Thank you for having us.
Heidi Anderson:
Thank you, Saul.
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