Helping Hospitals Achieve CMS E-Notifications CoP Compliance with Jay Desai, Co-founder, and CEO of PatientPing: Audio automatically transcribed by Sonix

Helping Hospitals Achieve CMS E-Notifications CoP Compliance with Jay Desai, Co-founder, and CEO of PatientPing: 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:
Welcome back to the Outcomes Rocket, everyone. Saul Marquez is here, and today I have the privilege of hosting the outstanding Jay Desai. He is the CEO and co-founder of PatientPing. Jay started the company in 2013 with one goal in mind – to connect providers everywhere to seamlessly coordinated patient care. Prior to founding PatientPing, Jay worked at the CMS Innovation Center, where he helped develop ACOs, bundled payments, and other payment initiatives. Jay’s passion lies at the intersection of technology, policy, and community building. He’s got his MBA in Health Care Management from Wharton and his BA from the University of Michigan. He just feels lucky to love his work, but also loves running and all things music. And today we’re just really privileged to have him here to talk to us about the work that he’s doing at patient paying. Jay, thanks so much for joining us.

Jay Desai:
Thank you for having me.

Saul Marquez:
Absolutely, man. So just a very interesting background with your time at CMS and prior to that obviously other health care leadership roles. Talk to us a little bit about what drives your work in health care, what lights your fire, what makes you do what you do.

Jay Desai:
Yeah. So I will say that my family. My parents were health care workers. My dad was a pharmacist. We had a small pharmacy on the south side of Chicago. And my mom was a respiratory therapist. So kind of grew up in and around health care. I think out of college, I was somebody who was motivated and excited and pretty ambitious to do work. And I’d say that becoming a health care worker wasn’t really my path. It didn’t feel like that was my path. And I’d say that if I was going to go into business, which is something that I was really interested in – business and policy, that doing it in health care as opposed to say working on manufacturing parts or selling potato chips or anything like that, health care just felt more meaningful and more complicated and more interesting, you know, a space to spend my time. So that’s what brought me.

Saul Marquez:
I love it, man. Yes, it’s in the family. And you took the business route. I mean, who wants to sell potato chips?

Jay Desai:
Yeah, I mean, my parents probably wanted me to become a doctor, but so maybe it was just sort of guilt that I decided to take a different path and in health care. But here we are.

Saul Marquez:
A little slice of honesty there. I appreciate that. Yeah. You know, and so here you are. Right. I mean, you’ve got this really neat journey that you took with your career and now doing PatientPing. So her talk to us a little bit about what you’re up to and what exactly PatientPing is doing to add value to the health care ecosystem.

Jay Desai:
Yeah. So PatientPing is a care collaboration platform. So the way to really think about it is patients get care from a lot of providers. And when those providers don’t work together around any given patient, then the care is more dangerous and it’s more expensive. And the people who … Not everybody needs care coordination, but if you are young and healthy or go to the hospital because you broke your thumb, you’re probably going to get a cast, you’re gonna go home, you would be fine. You don’t need a bunch of people working around you. But it’s for those patients who are high risk, high need, and those following a number of categories. It could be frail, elderly, could be multiple comorbidities, people who are homeless or experiencing severe mental illness or substance abuse issues. Those are the people who are sending out of ERs and hospitals and they’re going to primary care doctors and social services that are supporting them. They go to post-acute care providers. And the system doesn’t really work all that well to coordinate across all the different providers. And so if you think about the way that the system works today, these providers sort of operate in their own silos. So if you’re a primary care doctor, you deal with the patient when they’re with you. You’re a hospital you deal with the patient when they’re with you. You go to rehab after surgery, they deal with you, and then they pass you off and they send you away.

Jay Desai:
And I think that that that lack of coordination across all these providers has been a big problem in our industry for a long time in this country. We are a very modern country with a lot of money that we spend on health care, but we still don’t get the types of outcomes that we could get. So patient paying, we have a number of products. They’re centered around the clinical encounter so when a patient presents in a hospital when they show up in an emergency room, we activate the full care team by notifying them. So that could be your primary care doctor who could live in New York City and you may get hospitalized in Florida. We’ll make sure that those providers know about each other and that information can kind of flow back and forth and they can work together to make sure the patient gets the best care during the particular episode that they may be having. And then also afterward, I think it’s appropriate follow-up care. So that’s kind of set at a high level what we do.

Saul Marquez:
Yeah, now that’s great. And, you know, it’s like all the effort that went into putting EMRs into place, you think that there is a way that facilitated this care through the continuum. It still remains a challenge, and so you guys are doing it in a really unique way with the different things that you do, the pings, the spotlights, the call-outs. I love what you guys have done. So help us learn a little bit more and maybe give us an example of what you guys have done to improve outcomes and the experience of a provider or a patient.

Jay Desai:
Yeah. So let’s use the example of a patient that we were supporting in Wisconsin. This is a kid who unfortunately was an orphan. So this child was adopted by a family and unfortunately was a victim of abuse within her family. He ended up in the emergency room and there were major issues with the patient and it was in the emergency room we were able to alert the community services, the state-supported social work team that the patient was in the E.R. and the department, the state-level department that supports foster children was able to detect that this was a situation of violence and the child was able to be set up in a different home. So this is a very dramatic version of how. There are services to help patients that when they end up in the emergency room, a lot of times that’s when the system has failed. So this particular child was able to work with the social services that were available to the child, and then they were able to detect that this issue was happening and again, move the patient through some transition period into the safe environment. So that sort of at the patient level is these people who are sort of falling through the cracks or sort of lost when they’re getting in and out of the hospital.

Jay Desai:
Another example could be a patient who goes to a hospital for surgery and let’s say they’re old and about a third of the country is experiencing severe social isolation. So they go to the hospital. They don’t really have caregivers. They don’t have children. They don’t have a spouse to take care of them and help them manage their care transition. So they go to the hospital and let’s say they have dementia. If the hospital then says, well, here’s your discharge instructions, here’s the nursing home that we’d like to you need to go to a nursing home. And here are some options for where you can go. And once you get there, here’s how you want to. We’re going to set you up. And and and then after that, we actually you’re probably going to need to have you send them three days a week with a home health nurse that comes to your house. If you’re a patient, you’re completely overwhelmed. You’re like, one, I don’t know how to manage my own care. I don’t have anybody to help me. And so managing all these care transitions from one place to the next can get very complicated. From the provider’s perspective, they’re in a situation where they just need to move the patient out.

Jay Desai:
They’ve got many patients that are in the hospital who need to be transitioned out of the hospital. They have a lot of pressure to clear the beds, open them up for the people who are in the E.R. so they don’t have enough time to spend with that patient to make sure that they safely get to the next destination of care that they’re trying to get to. So this is this results in a lot of problems. It’s no surprise that if you’re, again, that patient who’s elderly, who has dementia, the hospital gives you a care instruction on setting up to stay. They don’t go to rehab provided they go straight to home and they’re supposed to set up home health services. If nobody’s there to make sure that that happens, it’s not a surprise why are readmission rates in this country are so high? You’re just going to go right back to the hospital after you get home because the services didn’t come in and set up on time. You start getting scared, you start feeling sick, maybe took the medications in the wrong order. You go back to the E.R. and so our readmission rates in this country are very high. And that’s because patients don’t get the supportive care that they need is a transition into the system.

Saul Marquez:
Yeah. Now, you’ve highlighted some of the critical issues and caring for the at-risk population. Then there are the chronic conditions at the beginning of our discussion, you mentioned, hey, you know, not everybody needs that presence. If you’re young and you just you had something happen. You got it taking care of you’re good, you’re healthy otherwise. But now you’re dealing with these crazy situations on the one hand. But on the other hand, you have chronic conditions that need that consistent vigilance, the nudges. So talk to us a little bit about that. With regard to population health, I imagine that the platform could be pretty advantageous.

Jay Desai:
Yeah, so great question. I think that chronic conditions require a plan no matter. And pretty much everybody has a plan of care for really healthy, probably only do much, maybe go once a year, do to get a physical. If you have chronic conditions, you probably need to get care on a more frequent basis. You’ve got to take your medications. You have to go in for a checkup, maybe with a specialist, you maybe need to get some lab tests or other kind of monitoring done. And so if you’re trying to take care of yourself and your chronic condition, you have to sort of stay on plan. Now, what our service does is it tells you if the patient presents in the emergency room, if they present in the hospital when they go to those facilities, we allow those providers to see what the care plan is. But the thing that’s really important is if somebody has a chronic condition and they end up in the emergency room, that probably means they’re off plan. That means that probably something happened in between that wasn’t supposed to happen.

Jay Desai:
So if you have a chronic condition, unless it’s fully exacerbated, you’re towards the end of life where now you’re maintenance of that chronic condition is going to be very different if you’re in the phase. We’re trying to manage a chronic condition. Usually, there are programs in place, medications, and therapies to keep you out of the hospital. But when that set of support infrastructure, whether it’s medical or social services, falls apart, you end up back in a hospital or other provider. So right now, for those patients who are chronically ill, I’m simply alerting the doctor, their primary doctor or their care manager, the care co-ordinator. That could be the health plan that could be at that provider level that the patient has had an event and then helping that point of care providers see what’s going on with that patient who does have a chronic condition and a series of care measures that they needed to sort of adhere to allows that patient to sort of be on their path to recovery and stitch back up essentially to get back on the plan.

Saul Marquez:
For sure. And so, as you think about the patient approach, what would you say makes it unique and different than anything else that’s out there?

Jay Desai:
The biggest thing is a network. So where most care coordination products and services tend to focus on one health system and coordinating care across that health system, or maybe even one small health system. And then their handful of providers that sort of are within an immediate geographic radius of that health system, ours are regional, actually really national. So most of the value does occur regionally because care coordination happens really for the most part amongst the providers within your community. But we think very much regionally. We want to connect all of Massachusetts or we want to thank all of Connecticut or all of Texas so that all those providers can work together. But then there’s also state-to-state value because there are snowbirds who spend half the year in Arizona and then half the year in Michigan. And so there’s a lot of state-to-state value that does accrue. There are also care management organizations that are delivering care for patients nationally across multiple states. And so they want to work with one group to be able to provide this sort of coordination services across the country. But really, I think that’s a very unique part of what we do, is we think about a network, we think about a national network and connecting everybody across a region on a common platform, which is I think, a very unique and unique position that we serve.

Saul Marquez:
Yeah. Now, that’s interesting. And so how does the stuff show up? Like there’s all the backend things that you do to make connectivity, interoperability happen. But how does it show up to providers? How does it show up to case managers, to patients? What does that look like?

Jay Desai:
Yeah, so I can focus on two products. Pings is the real-time alerting service. So it’s basically saying, hey, Saul in the emergency room or Jay is in the skilled nursing facility. And then there’s a series of contextual there’s a sort of a set of contextual information on what happened, why they’re there when they got there with the care team is what may have happened prior to them showing up in that particular facility. And that is rendered in a variety of ways. That’s true. However, the provider wants to consume it. So some people may love using our application. We’re backed by Google. We’re sort of a tech-forward product-driven company. So we have a very intuitive and a Twitter-like user experience versus a constant stream feed of, hey, here’s what happened. And it’s just it’s always on. It’s always real-time. And it’s always refreshing what’s going on with your patient population. And you can get that in our application. That also has a series of notification preferences where you can send a text or email and get it within your phone or however you want to consume it. But a lot of providers don’t want to be in our application, and that’s totally fine for those providers that may exist in a population health system or a care management system or there are we have a number of integration options to push the data into their system so that it lives where they want to live and they can have sort of a native experience within their application. That’s for the providers that aren’t with the patient during a clinical episode that want to be alerted of the fact that somebody is having a clear episode.

Jay Desai:
For the point of care providers, that’s our product stories. And that says, hey, Saul is in the emergency room, what else is going on that we don’t necessarily know about? Have they been in multiple ERs recently? Have they recently had a sniff, say, or they recently in a home? Are they currently receiving home health care from a particular provider or are they part of a care program? What’s their care plan? Is there patient-level care or are there population-level instructions? What’s going on? Does the payer have case management support? Is there any information on prescriptions that we can provide? So we have access to a lot of data sources that want to work creating by threading together this longitudinal history on the patient, but also accessing other data sources to be able to feed into that kind of a workflow that information does. Most providers, whether in a clinical episode with the patient, in the hospital, in the emergency room, in a nursing home, and in a clinic, they don’t really want to go anywhere else besides their EHR to get that information. So almost always will breathe in on their EHR, we’ll be within the track board. It’s a smart on their application in many instances where they can just click through single and get to a lot more information that we’re providing so it’s really seamless, it’s within the provider’s workflow. We don’t want them to come anywhere else. But that’s what.

Saul Marquez:
That’s fantastic. That is the I mean, the Holy Grail. You know, you’re a physician. You’re taking care of a patient. You’re a patient and your physicians taking care of you. You don’t have all that information right? You don’t have the MRI from last year and all that stuff. Right. So I think it’s so great that you guys are able to stream all this data through patient stories. That’s fantastic that it shows up in the EMR. Definitely exciting to hear about the capability. So congrats on being able to put that together. I’m sure it wasn’t easy and I’m sure you continue to run into issues. So talk to us about the challenges. As entrepreneurs, we learn more through the tough stuff. So maybe you could think about one of those experiences, what you learned and why you’re better as a result.

Jay Desai:
Well, look, we’ve been at this for seven and a half years, and you’re right, it hasn’t it hasn’t been easy building a network. Providers now in our materials on our website, a number of different places. We have a number of dots on the map of all the participating providers on our network, hospitals, ER’s, physician organizations, that sort of thing. And every one of those dots on the map was not easy to learn. It just takes a lot of effort to convince providers to think about doing things slightly differently and for good reason. You know, if you’re a provider, you got patients’ lives at stake. So to change how you do things and add more complexity or in our case, hopefully, take away the complexity, it does require a change in any and every instance that requires that’s hard. It just takes time sometimes to create change. The good news is that there have been some major changes that are happening in the industry and both the reimbursement side for how providers are paid for care and incentivized to deliver care, but also on the technology side to modernize the infrastructure that we have. And so that’s been able to accelerate some of our growth by both rewarding providers to do the work of coordination.

Jay Desai:
That’s why Medicare and a number of other commercial payers have been doing incentivizing providers to invest in this kind of technology and services to deliver high quality coordinated care, but also on the technologies that our companies and a number of others kind of surrounding the ecosystem are being promoted to help drive this digital transformation that we want to see in our country. So there’s good news as far as what’s been happening. Go back to your question on what have been some of the biggest setbacks? I mean, it’s hard to count all of them because, of course, in any in any startup or kind of new business venture, there are times where you question what you’re doing. There are times where you are experiencing real complexity. And those things fall into all the categories. Customers who you thought were interested back out, customers who sign up, who then later decided to cancel, employees who make mistakes. With my own leadership, I make mistakes over the course of the years. And there’s sort of a full range of setbacks that I think any company experiences. I’m certainly no exception, but I think we’ve had an attitude as a company where a learning organization, we try to take these moments of difficulty or setbacks or failures and really treat them as learnings, as lessons, and then apply that towards how we’re doing things going forward.

Jay Desai:
And we’ve always had that approach. I often say in my company that while growth is great, revenue is great. It’s obviously very important. Our biggest our most valuable currency is knowledge. So we should keep our ears really close to the ground, learn from our customers, learn from our own employees as far as what we can be doing, both in terms of the strategy and the business and the products, but also in our own culture and how we how treat each other and how we kind of learn from each other. And I think we have a team full of learners. We have a team full of and they’re all sort of interested in self-improvement, both at an individual level, but also as a company. And it’s just the way that we’re wired as an organization. So so setbacks on the one hand can be hard, but there are obviously opportunities to continue to grow that not.

Saul Marquez:
Thanks, Jay. And sounds like you’re definitely doing a fantastic job there with the culture. It’s just such an important facet of a growing business segment like health care, where there will be constant, constant changes and learnings there. I mean, gosh, selling to a hospital right there, you’ve got to be ready for anything. So kudos to you for your leadership there, my friend, and for what you’ve done with your excellent management team. You guys are doing some really promising work. What would you say you’re most excited about today?

Jay Desai:
Yeah, I mean, one thing I say for entrepreneurs is this is threatening the last question and setbacks. And then also the question on the excitement is you kind of need to be your company’s biggest skeptic, but also your company’s biggest cheerleader. You’ve got to have both of those things in your head at the same. Because by being a skeptic, you force your company to really get sharp in making sure that what you’re doing is actually real and that people are getting real value from it. But you also need to have a huge amount of enthusiasm and belief in the future. And that’s probably where I am very, very excited. So we’ve spent seven years building this incredible network. We’re able to detect when patients are having events at various facilities across hospitals and nursing homes and virtually and home health agencies and other providers in virtually every state. So one thing I say a lot in my company is every ADT we use our notifications or mission discharge transfer notifications, one of our core services. Every AD&T is an opportunity to help. So the patient has an event. They’re admitted somewhere, they’re discharged somewhere. Any opportunity, we have to share more content and facilitate workflows to help those vulnerable patients get the right care during that clinical episode, but then also after they’re having it into their care transition is our opportunity.

Jay Desai:
And there’s just so much to be built off of this platform. For a long time has been hard to invest in the future and the new capabilities and where we’re going next, because we had a core product which was in a notification service, which just required tons of investment because it was scaling so quickly and reaching kind of this broad kind of reach. And so we didn’t have the luxury to invest in all of our future products to the extent that we’re doing it now. I’m so excited that we now have this network, this platform from which we can build additional applications, additional services to drive high-quality outcomes. I’d say that one area where I’m uniquely excited is in that period after a patient is hospitalized or has a clinical event somewhere and is discharged home actually goes to their home because there’s a lot of care and services that are offered to a patient once they leave an institutional setting and go home. Those things could be social services that the patient may need to access. It could be follow-up appointments with their primary care doctors or with specialists. It could be access to clinical programs. There are all these really cool digital health programs that are being offered now in the industry, things like chronic condition support or certain disease, specific support, virtual primary care models, all kinds of new telehealth options.

Jay Desai:
So being able to help those patients access those services, get linked into those services in a way that feels seamless to both the discharging provider but also the patient as well as the receiving provider is a really, really exciting opportunity. Care is moving home and very in a very, very large way away from the institutional setting, things like long-term acute hospitals, particularly COVID people are a little bit more shy to be in infection rich environments like skilled nursing facilities or even hospitals. And to the extent that they can get the same level of care for their particular condition in the home setting, that’s what patients prefer. If they can get it over video if they can get it over the phone if they can get it within their home. There’s a lot of news at home. There’s a new hospital home models. People and payers, Health plans, have made a huge push to the home. And a lot of payers are doing the same to support patients while they’re in the home setting. And we think we’re in a really good position to make sure that those patients who do live in an institutional setting and are in need of a variety of home-based services are going to be able to access those that care. So that’s something that I’m very, very excited about.

Saul Marquez:
Yeah. Now, for sure. That’s definitely where it’s ‘s going. And you mentioned and that is very exciting, like a couple of questions ago, you mentioned sort of the expanding network. And I, I was actually looking at your website where you actually show the years and the growth. I mean, that is just so cool to see the network kind of clustered there in Michigan and the East Coast. And then fast forward to 2020 over forty-three million patients supported five thousand plus post-acute. Eleven hundred plus hospitals. An awesome job.

Jay Desai:
A lot of sweat and tears went into those dots on the map. It wasn’t easy work to do, but we’re very proud of where we come and we’re just getting started. So I know that there’s a lot more to do.

Saul Marquez:
That’s fantastic, Jay. And the broader the network, the more useful the data and just the super exciting to know that you guys are working on this. And so as we wrap up here, well, tell us what you think we should be thinking about as a health care community of leaders. And then the best place that the listeners could get in touch with you or your team to learn more about what you guys are up to.

Jay Desai:
Yeah, I mean, I think the way that the health care industry has been shook over the past year, combined with a multi-year journey towards value-based care and digital transformation that we’ve been on for the past 10 years is creating just extraordinary room for innovation. So if you’re an innovator or you’re working within a company and you’re looking to sort of take the company to the next level or an entrepreneur and want to sort of create new products, I’d say that there’s just so much room for improvement. And the industry has woken up to the fact that they’re ready for it. We’re ready for it. So whether you’re providing services for providers, payers, lifescience companies, patients directly, there’s just so much demand and enthusiasm to try new things. And sometimes you have a market shock like this. This happens once in a lifetime to have people change their way of thinking and loosen some rigid, hardwired processes that we’re sort of there for, again, for good reason. This happens once in a lifetime. So I would say take advantage of that opportunity, create change, build things that are going to make patient care better. If a very modern country of a lot of money that we’re spending on health care, it can be better spent to get there to get to higher quality outcomes. So I would just encourage innovators to go after it would love to be in touch with anybody where we’re hiring. We’re always looking for talent in the company. And certainly, if there are health systems, payers or providers out here that are looking for help around here for our nation, we love to step in and talk to you. I am at jay@patientping.com so you can reach me there.

Saul Marquez:
Awesome. Thanks, Jay. Yeah. What a great message to close this one off with. I mean, once in a lifetime, folks, I mean, take Jay’s message home. This is the time to make a difference. And so Jay just got to say thanks, man. Awesome work that you’re up to. Thanks for sharing the insights you shared today and certainly wishing you guys an amazing, amazing year.

Jay Desai:
I appreciate it. Thanks, Saul.

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