Empowering a New View of Mental Health and Wellness with Tom Young, Founder and Chief Medical Officer of nView Health: Audio automatically transcribed by Sonix

Empowering a New View of Mental Health and Wellness with Tom Young, Founder and Chief Medical Officer of nView Health: 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, welcome back to the Outcomes Rocket. Saul Marquez here. Today I have the privilege of hosting Dr. Tom Young. He is the Chief Medical Officer and founder of nView. He’s a board certified family physician with more than thirty five years of medical experience. He’s responsible for working with the nView team of software technology experts, the customers and partners to ensure clinical best practices are incorporated into everything they do. Tom is a recognized thought leader in consumer directed health care and population health management and can be often found speaking at behavioral health industry events. Tom lives in Boise, Idaho, with his wife, and he’s just doing incredible things, as he has in his very impressive health care career. Tom’s such a privilege to have you here on the podcast today.

Dr. Tom Young:
It’s great to be on and looking forward to it.

Saul Marquez:
Likewise, likewise. And so before we jump into nView and the you in the work that you guys do in advancing behavioral health solutions for providers, talk to us a little bit about what has inspired your work and your journey in health care.

Dr. Tom Young:
Well, I think like most people, I began my journey in health care with the idea of doing good things for people, traveled a few roads, went into family medicine and began to enjoy a lot of learning about people and became really more interested in people than disease. And I think that was kind of an interesting turn for me. So over the years, beginning to understand how people think, how they feel, not just what’s their disease, but more who they are and their response to that process. I think that’s been the inspiring part for me in getting into behavioral health, learning that people have problems. And I think probably the most inspiring thing for now that’s kept me going in the last 20 plus years is I had a son who died of suicide and about twenty two years ago now. And so that really focused me intently on how people think and how people feel and beginning to see what I could do to improve that particular disorder, if you will.

Saul Marquez:
Yeah and we really appreciate you sharing that time. I mean, it’s a very real thing, and I feel like it’s become more front and center and acceptable to talk about mental health. And hey, it’s a chronic condition like diabetes. So why do we shy away from it? And I think we’ve evolved thankfully, but we still have a long way to go. Talk to us a little bit about nView. What exactly are you guys doing? How are you adding value to the ecosystem with it?

Dr. Tom Young:
Great question. nView really began out of a focus that I had that said that primary care doctors are writing about eighty five percent of the prescriptions for mental health drugs. They make about 80 plus percent of all the diagnoses of mental health disorders in our country. They’re really the backbone for the mental health care system in the U.S. as primary care providers, and they struggle to get the correct diagnosis. They don’t have the tools that they have for other disorders. They don’t have the assistance. There is no MRI for emotions. And so I became aware of some things that were going on. nView really came out of the pure research world and had been around for 25 years in assisting researchers and getting the correct diagnoses for research studies. And I said to the gentleman, Dr. David Sheehan, who had written all that, I want that. Primary care docs need that. Yeah, so out of that was born the building back, starting back in 2016 of its view to bring quality diagnostic tools into the space for primary care providers. And we’ve expanded beyond Dr. Sheehan’s tools to other what we call world class gold standard assessment tools in diseases like body dysmorphic disorder and OCD and anxiety, and other specific disorders to help primary care docs get it right.

Saul Marquez:
Yeah, well, you know, fascinating statistics, Tom. So eighty five percent of diagnoses in mental health come from primary care, the scripts too, right? And what are we doing to empower them? This is fascinating. The alignment, too, right? Like there’s also a misalignment in reimbursement.

Dr. Tom Young:
Very, very true. There is a significant misalignment in reimbursement in this country. The reimbursement structure is based upon sort of skills. What do you do procedures? It’s not based on thoughts. It’s not based on intellectual activity. It’s not based on intellectual action, if you will. So I’m not incented as a primary care provider provider to ask you, So how does that make you feel? How you feel it? Yeah, I don’t really have time. I don’t really know what to do with the information in primary care. Unfortunately, it’s become how many people are you seeing in a day? I remember back to my primary care days of actually practicing, and even back then, back in the eighties and nineties, I could make more doing a procedure in an hour in my office that I could make all day seeing patients with diabetes or high blood pressure or depression. So there are some misalignment. You’re absolutely right,

Saul Marquez:
Yeah, and so we’re figuring this out, right, and we got to figure it out together. It starts with diagnosis, figuring out that the problem’s there. And so a lot of times these afflictions go undiagnosed, and so that is an even bigger problem. So I think it’s a huge opportunity that you guys are uncovering here. So if you think about what makes nView unique or different than what’s out there, what would you say that is?

Dr. Tom Young:
I think there’s two things. The first is we’re focused on what’s called measurement based care. That is a way to ensure quality. It’s a way to ensure improved outcomes. So measurement based care is critical in all phases. And then secondarily, the few tools that are out there really focused on conglomerates of symptoms. Our focus is on helping primary care doctors get the right diagnosis, helping them with the information they need to make a correct diagnosis and from correct diagnosis comes better treatment and from better treatment comes better outcomes. So we see ourselves as kind of the tip of the spear, a good screener that helps the doctor say, Hey, this patient may have OCD, and now I’ve got some interview tools in my hands to be able to ask the right questions to confirm that diagnosis. And then I’ve got some really good tools to see how they’re doing over time. And it’s what I’m doing helping them. So that measurement based care, combined with diagnostic focus is really the uniqueness for us.

Saul Marquez:
I love it, and you said something around the lines of like gold standard, and I love that, right? Having these a good like, data based way to do the work that you’re doing consistently. I think that’s so important.

Dr. Tom Young:
Right. it is. And I think it gives primary care doctors a leg up in being able to do that efficiently. Many of our tools literally can be sent to their clients. Their patients in advance, completed in advance doesn’t take up office time doctor has in front of him or her or nurse practitioner or PA. They have the information when the patient comes in and they can focus on it right now, makes everybody more efficient, makes everybody more accurate. And to some extent, I think it opens up the concept that it’s OK to talk about these issues. You and I have shared it’s kind of developing trust around issues. And the other interesting factor and I bring this in is about forty five percent of all people who successfully commit suicide in the United States today saw their primary care doctor in the previous 30 days, which says to me, I need to help my primary care brethren find that.

Saul Marquez:
Yeah

Dr. Tom Young:
They need to see that. They need to know how to see that coming, if you will, because really, that’s one of the key issues. And then secondarily, for people working in the behavioral health space, giving them tools to manage people post suicide attempt because those are difficult patients, they scare a lot of people in the sense of I don’t want to take the risk because again, philosophically, health care providers are the biggest enemy they have is death. That’s what they fight against. And unfortunately, people who are suicidal scare people. So hopefully giving them tools that they can follow and track and manage people who are post suicide will again help us reduce that particular disorder around the country and around the world. It’s a significant problem around the world. It’s not just the U.S.

Saul Marquez:
Yeah, it is. It’s a big, big issue and and view helps folks diagnose, helps primary care physicians diagnose, and then provides tools to help the patients that have tried and failed suicide. You know, how about the middle section there where you take them through the questions and you identify, you know, OCD or something right. depression? Whatever it might be, referral pathways have been a challenge. You know, what do we give people like? How do you manage them? Like if you want to help your patients, what do you do?

Dr. Tom Young:
Well, that’s a great question, because that’s often the question I get. Ok, I understand all this. I can do this. What do I do with them when I find them?

Dr. Tom Young:
Yeah, because access is is a huge issue in the U.S. and you certainly focused on that. I think we’re seeing a lot more of things like what’s called computer assisted cognitive behavioral therapy. These are computer based programs that people can use and a number of studies, particularly here, as well as places like Australia that use a lot of computer based solutions in their mental health work can really help people without needing to have that face to face contact with a therapist or a physician or even need a medication. So I think we suggest those things. We interweave our program with some apps that can provide somebody screens positive for depression. We can immediately provide them some psycho educational material, provide them some support, some encouragement to seek the next step in therapy. So there are a lot of work is going into how do we use technology to improve access we work with on our research side. Right now four companies, many of whom if I said their name, everybody in America would know, that are working to develop these kind of computer based, cloud based treatment outcome measures and treatments. So that’s part of what we do is hook our physicians up with solutions, hook them up with telehealth companies. We have several telehealth companies that we work with. So we’re trying to not only improve diagnostic and assessment, but also improve the outcome and give physicians around the country better options.

Saul Marquez:
Love it. Yeah, I think that’s critical. Filling that gap. Virtual is going to have to be, at least for the start of it. An option sounds like you’re leading the physicians you work with to some virtual options because the numbers are totally off, right? I mean, there’s like very few mental health practitioners to the need.

Dr. Tom Young:
Correct. And it’s gotten it’s gotten a lot worse, obviously through the pandemic. And I think one of the things that’s been highlighted to the pandemic is the issue of pediatric mental health disorders. Children with anxiety, children with depression, children with undiagnosed OCD, children with other disorders that are not readily apparent or easy to get in touch with. Helping parents to understand some of those Disorders. And we’re certainly seeing that now as sort of the second wave, the big tsunami, if you will, from the pandemic. And I think one of the things, if we can say anything has done a couple of things. It really has focused our country on the need for behavioral health solutions. And it really has helped us focus on the on the access issue by essentially immediately saying telehealth. We’ve got to get help for people on a nationwide basis. And so I think those two things are both good things that may have come out of this pandemic.

Saul Marquez:
Yeah, I agree, Tom. And you know, the unique thing when you talk about like pediatrics is also like, where do you capture it? So there’s the gateway of the school. Are there any efforts around accessing it at the school?

Dr. Tom Young:
There are, and we’ve been working with some folks over the last couple of years around that. We actually have programs now that we’ve taken into colleges and universities because again, that’s that’s an area where you see significant behavioral health issues. I practice part time at a college and so I see that on a daily basis at the school based health care. Yes, schools are starting to focus on their certain programs are now being brought in. A lot of schools are looking at the ability to capture this information, be able to refer people. And like I often say to some of my patients and some of my students where I still teach is children are explorers into the wonderful world of psychotherapy for their families. And so often it’s the reflective behavior in a family, in a child, inside a family that brings the family together around mental health issues. So it’s schooling the schools to be able to recognize that. And yes, we are working with some school based programs. We have the only really validated worldwide psychiatric interview for children, and so we can break that up and give those diagnostic modules to schools to use.

Saul Marquez:
Fascinating. Well, look, I think the opportunity is great. The tools and resources that your company is providing, Tom are are outstanding. Now I’m going to switch hats for a second. And I know that during the pandemic, many physician practices have had tremendous headwinds, you know, revenue losses and everything like that. So as providers look to supplement that revenue and find different ways to earn, I think these screenings can be a way too.. I mean, if you’re doing the right thing and you’re getting paid For it and you deserve it, right, if you’re adding value, you deserve to get paid. I’m a firm believer in that. So do these diagnostic tests, do they have CBT attached to them? Are there ways for for physicians to get paid?

Dr. Tom Young:
Actually, there are a couple of ways, and yes, they do. The more and more payers are now looking at this measurement based care process and understanding that measurement based care not only improves outcomes but reduces total cost. So they’re paying for things like appropriate screening tools. They’re paying for tracking tools, things that are monitoring people’s outcome. So earlier recognition of non improvement saves money for the payer. So yes, payers are now paying for these tools. The ability for primary care, one of the things that limits primary care docs from what’s called ENM codes is the ability to have the right documentation. Our tools provide all the documentation. So now When they want to build for a psychiatric visit for based on really focusing on the patient’s depression, focusing on their anxiety, whatever it may be, we provide them the necessary tools to support that in code. By having our data inside their system, they now can support that code to the payer and get paid more for that visit, which is appropriate. And as we talked about earlier, thinking and thought often doesn’t get paid as much as cutting and sewing, but here there is code, if I can provide you the right data and right information, now you can go for that code. So we’re trying to bring that that issue of doing the right thing, measuring the care that you give and documenting what you do can result in a higher revenue return.

Saul Marquez:
Yeah. Thank you for that time. And it’s important to note this because oftentimes people say, Oh, you’re trying to you’re trying to increase your RV, you’re trying to get more revenue. But the reality is, if there’s no reimbursement pathway, people are very less likely to do the work. And so I love that there’s an opportunity here with the ENM. And what is the ENM stand for?

Dr. Tom Young:
Evaluation and management.

Saul Marquez:
Oh, yeah, perfect. And it goes back to this idea of chronic condition. It’s got to be evaluated, it’s got to be managed. And eighty five percent, you mentioned, is the number of diagnoses that happen for mental health. So I’m grateful that you shared this pathway. And do you think there’s a lot of physicians and physician practices that don’t know this?

Dr. Tom Young:
I think they understand that they can often get paid a little bit for screening. But I think the biggest problem is really is understanding the full depth and breadth of what’s out there to help them. And so that’s been as we started the business and moved from our pure research background into the space of doing what I built the company for originally, which is giving primary care docs the opportunity to get the right information, get it quickly, easily and effectively. And now we’re getting that word out and all kinds of different ways. People are starting to look at measurement based care, and we are kind of the top of the heap for that with all of the tools from all the different psychologists and psychiatrists that we represent on our platform. And so we’re getting there, and I think we’ve got some really good back wins, tailwinds if you’re a sailor. And so our sales are getting full and the Spinnaker is out and we’re moving forward with some haste and hopefully making some change, cutting some waves.

Saul Marquez:
I love it. Yeah, this is fantastic, Tom. And as you reflect on the steps that you’ve taken to build the company, what would you say is one of the biggest setbacks you’ve experienced and a key learning that has made you guys even better?

Dr. Tom Young:
I think number one, changing our focus just a bit. We started in the research world. I started out talking to individual physicians about it and that some physicians could grasp it could get it into their workflow that others couldn’t. And at one point I finally said, I think the turn has to be I have to be able to provide an entire solution that people can take and integrate fully right into their existing platforms. And so moving from a standalone software product to a product that could literally bolt onto anybody’s already existing workflow because one of the things and you alluded to it earlier that learning came when I realized that if you’re trying to do something that bends the carpet fiber of a doctor’s office the wrong way, it’s not going to work. So that was the shift in number one. And that shift really resulted in how did we actually build the product? So we had to move from our original platform and say, my goal now is how do I, how do I bring this to them and put it where they live, which is in their EHR? So and Like now we have Opportunities with some of the largest EHRs to be able to put our tools into their EHR, which then spreads that out to a larger group of physicians for use for physicians, nurse practitioners, PTAs that are already using one of the major EHRs. If our stuff is built in now, I can use it now it fits. Now I can put it to work for me. So that’s one of the things that we’ve had to shift our thinking about.

Saul Marquez:
Wow. And so, yeah, you get to this access portal of the EHR. It really opens up the market for you.

Dr. Tom Young:
Right, exactly. Wow.

Saul Marquez:
Fascinating. So kudos to you and your team, Tom, for doing the heavy lift because that type of shift is never light. It’s a lot of red tape. It’s coding, it’s aligning and making sure that the connections are correct and that it’s seamless. So kudos to you. You come to this with a very personal mission, and I think it’s those leaders that have that fire within them to make these types of shifts and changes work and stay long term instead of disrupting. It’s transforming, and I really believe that what you’re doing is going to create change that stays. And so I’m excited that you guys are working on this. What are you most excited about right now?

Dr. Tom Young:
I’m really excited about the team that we’ve been able to bring together over the, particularly over the last 24 months to really, as you point out, make these sort of cataclysmic shifts some really, really bright driven folks and our ability to really grow through through all the crises and difficulties that our country has had over the last 12 to eighteen months. So that For me is the exciting part. And seeing our tools get into people’s hands and getting back to Gee, this is great. You know, kinds of statements that we get and having people interested in the conversation around behavioral health as a fully integrated component of regular health care. And I think that’s really the big piece is that wedge that says you need to have behavioral health fully integrated with physical health. And so our our ability to help do that has been exciting.

Saul Marquez:
Yeah, that’s that is exciting. The future is bright as a lot of efforts in integrating mental and physical health are underway. You’re creating that pathway, that necessary pathway for physicians to act on it. And I think it’s invaluable. So Tom, this has been fantastic. We really appreciate you sharing it, folks. You could go to nView. That’s the letter nview.com to learn more about Tom’s company and the work that they’re doing on advancing behavioral health for all of us. Tom, leave us with the closing thought and also share with us the best way that folks could reach out to you if they want to engage and learn more.

Dr. Tom Young:
Well, you’ll reach me at it’s really simple tyoung@nview.com. Happy to take any and all messages and share with you. I think what I’m excited about and what I’m looking forward to is this continued journey of realization in our country of the importance of people’s their mental well-being as part of their physical well-being, not keeping them separate, but looking at sort of the three hundred and sixty degree view of people. For me, that’s the most exciting change that we had in nView could help facilitate is the sudden realization that your mental health, your mental well-being is just as important as your physical well-being and that providers become comfortable with those conversations.

Saul Marquez:
Well said. Well said. Well, Tom, we appreciate it. And folks, I hope you enjoyed this interview with Dr. Young. The work being done by him and his team is paving the way to what we need to receive the care for mental health. And so really appreciate your time here, Doctor Young and looking forward to staying in touch.

Dr. Tom Young:
All right, thanks, Saul. I’ll look forward to it. Have a wonderful day.

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