Outcomes Rocket Podcast_Tom Young: 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 Outcomes Rocket. I want to welcome you back to today’s podcast. You know, first of all, just want to say thank you for tuning into the podcast again. Today, we have a treat for you. We’ve actually had Dr. Tom Young on the podcast before, but a lot has changed since we last had him on and the pandemic of mental health continues. So really, I think there’s never been a better time than every single week for us to cover mental health. Let me just reintroduce you to him. Dr. Tom Young is chief medical officer and founder of Proem Behavioral Health. He’s a board-certified physician with over 35 years of medical experience, and he’s got the bird’s eye view into the need for greater parity between physical and mental health to ensure that patients’ overall well-being and the core role that digital healthcare plays in making an impact in overall well-being. So I’m super excited to be joined by Tom on the podcast again. Tom, really appreciate you spending some time with us.
Tom Young:
Yeah, Saul, glad to be back. It’s always, always a pleasure to talk with you. And certainly, it’s my passion around doing things better for our patients. So glad to be here.
Saul Marquez:
Yeah, no, we’re so glad you’re here. Now, for the folks that haven’t had a chance to hear about your story. I think this is a good opportunity to, for you to share with us: what is it that inspires your work in healthcare?
Tom Young:
Well, you know, I started out in this world long time ago and have gone through several iterations of sort of how do you evolve and grow. I’m a board-certified, was a board-certified family doc for way more than, actually thank you for the shortened 35 years, it makes me not be as old. But I did primary care, I taught family medicine both in Texas and here in Idaho. I have had roles for years in the oversight for Medicare so that, I was part of the group that helped make sure that the care that Medicare patients received in Washington, Idaho, and Alaska was of high quality. I was the medical director for the state Medicaid program, and in that role was lucky enough to have the opportunity to really readdress how pharmaceutical management occurred in both Washington and Oregon, I mean, Oregon and Idaho Medicaid. And then have been in the entrepreneurial world, joined and built several businesses that related to connecting people. My wife is a nurse, and asked a nurse person, and so we built a large business down in Florida several years ago that at one point in time answered the phone for half the American public every day for healthcare.
Saul Marquez:
Wow. It’s impressive.
Tom Young:
I’ve always been passionate about behavioral health. Things like suicide have affected my family. Drug and alcohol misuse has affected my family as it has so many millions of others in this country. And it affected all my patients over the years, you know, and primary care doctors are the mainstay. Primary care doctors, nurse practitioners, pediatricians, family docs are the mainstay of mental healthcare in this country. And I saw, for many, many roles as a teacher, as an oversight for a payment program in Medicaid, as well as practicing every day that we just didn’t have the right tools. It just, we were doing it all, but we just didn’t have any support. And so I started looking around to how to fix that. And that’s what was the start of what is now Proem many years ago, and it’s just doggedly worked through. And now I have a great group of people I work with at Proem to sort of begin to, we think, help assist in that connection of a really good quality care and process management that helps both the provider and the patient.
Saul Marquez:
I think that’s great. Thank you for sharing that. You know, you have such a rich history and a lot of elements of the healthcare space as a provider, as an administrator, as an entrepreneur, and you’ve worked with a lot of different populations, too. So really it makes you such a well-rounded leader, Dr. Young, I’m just so curious about the work that you’re doing at Proem. So talk to us about how the business is adding value to the healthcare ecosystem.
Tom Young:
Absolutely, what Proem brings to the table to the healthcare ecosystem is a series of tools, if you will, that bring assessments, screening tools, clinical diagnostic assistance tools to the fingertips of providers at the time they need them with the patients, and delivers them to the patients in a way that they can easily absorb them, whether that’s in the doctor’s office, whether that’s at home, whether it’s like my college students that I care for in their dorm, they have access to what they need at the time that they need it. They have a way through Proem to be able to connect with their providers when they’re not in the office. Because if you think about sort of the model healthcare, we as physicians and people see the people maybe once for half an hour, if you’re a therapist, you may see them for a 45-minute hour once a week. And then the question is always, is my daughter, who’s the therapist, so what’s going on the other 165 working hours a week that people are doing it? And then if you look well, there’s 1600 hours all week that they’re not seeing you. We have put together as an ability to not only help assess people, how to track and monitor people, and then I think the next way that we are assisting is that physicians and others, therapists, whomever they may be, the question is always what’s next, qhat’s next in what they’re doing. I’ve done a screen, what do I do next? Because in physical health, we’re well schooled. If your blood pressure is high, you do this. If you have a cardiac arrhythmia, you do this. If you have a lesion on your leg, we do this. In mental health, it’s not that clear-cut, so what Proem is attempting to do is to be the partner for both therapists, social workers, school counselors, doctors, pediatricians, to help them understand what the choice of what’s next is, and then deliver that in a format that the patients can engage with.
Saul Marquez:
That’s fantastic. Thank you, Tom. And so I understand that there’s a diagnostic component, there’s a testing component, it’s a hybrid care model where you meet people where they’re at to get them what they need. Once you get the diagnosis, like, do you help connect the dots to deliver the care? Tell me more about that.
Tom Young:
Okay, we actually start connecting the dots at the very beginning, that screening process, that initial process that, for example, we now focus through the US Public Health Services, Preventative Health Task Force on the fact that adolescents, for example, need to be screened for anxiety, they need to be screened for depression. Okay, let’s say I screened somebody. Okay, they have a positive screening result, what do I do next? Well, you know, whomever it is, let me give you the tools you need to collect the data. Once you collect the data, now you’re prepared to make the diagnosis you think is correct. We’ve given you information. We’ve made it easy for you to collect the answer to questions, for example, or to collect some biometric data, whatever that collection process is, and we’ve been able to present it in a way that allows you to make the diagnosis. Okay, now you’ve decided, Doctor, what your diagnosis is for this patient with much more data than you ever had before. And so now the question is, what do I do next? Here’s a category of things that you might choose based upon your location, based upon what you have access to, based upon the individual patient. Will this patient do well? What if I send them information and give them tools? If I give them an app that they can use to work with to get better sleep, will that help them? So we post up, as I like to, as I told the staff when we first started this journey, it’s really what’s next because that’s the question, right? For providers or therapists, Okay, what do I do next? What do I do with this patient and for this patient when they’re not in my office? So that, number one, they remain connected to their therapy. And number two, I can see if what I’m doing is actually helping, because we know, for example, if we look at physical health, if I’m treating you for high blood pressure, if I take your blood pressure and it’s not going down, something’s not working.
Saul Marquez:
Right.
Tom Young:
I do the same thing now with that same process model through Proem, I can follow and see how your symptomatology and your feelings are about, let’s say, depression. I can see how your sleep is doing as a marker of your depression. And if it’s not getting better and I can see that data, then I can talk with you, the patient about that.
Saul Marquez:
Got it, and so is there a, I guess you have an ecosystem of options for treatment, whether it’s an app or a referral management?
Tom Young:
Well, the process is really a platform that can be integrated fully into somebody’s EHR. It can be a standalone, like if you’re a therapy clinic, you can use this is a major platform for management, but it basically starts with here, here’s the starting point, here’s the program, the beginning, where the word comes from. Here’s the beginning, ask your patient simple questions. Let’s find out if this applies. If it does, here’s what you do next, gather more information. The classic medical therapy model, gather more information. Once you gather more information, and we simply make that easy to do, so rather than you having to spend as a primary care provider 30 minutes asking a bunch of questions, we can organize that and present that to the patient, they can present the data back, we can then make it visible to you easily, and then the next step, follow your patient, make sure they’re getting better, okay? And then in between that, yes, we can provide content, can stand up, for example, if groups want to use an app that will allow them to track the patient, allow them to give patient follow-up, to deal with stress, to improve resilience if they choose to want to do that as the next step. So our program basically says, here’s the clinical next steps you might want to look for, and it puts it there easily for them to just click a button, make that decision, and then execute that out to the patient, whether that’s digitally, whether that’s when they’re in your office, it’s varied. So the concept being the thing that’s missing, there’s a very, very famous person named Tom Insel, and Tom was head of the National Institutes of Mental Health, brilliant guy, founded Google Health verily, was the czar of mental health in California for many. And Tom’s, one of Tom’s things that he’s said for years and years, and I’ve known him for a while, is the problem with behavioral health, mental health in this country is there’s no process model. It’s not like physical health. If you’re a 42-year-old male and you walk into an ER in this country and you say, I’ve got chest pain and I’m nauseated, you’re going to be on a gurney, you’re going to have an EKG strapped to you, you’re going to have lab tests taken, everybody knows what to do. If you’re a 42-year-old man who walks in an ED and says, I think I’m going to shoot myself, nobody knows what to do.
Saul Marquez:
That’s fair, yeah, and you guys are focused on enabling physical care, primary care providers, the front line to be able to address some of these needs.
Tom Young:
Right, and it’s not just provider, medical providers, it’s therapists, social workers who may be working in an environment, it’s substance abuse clinic workers that are a different category, but I’m the medical director of a substance abuse clinic, and the key there is you don’t ask people why they’re an addict, you say, what is it you’re trying to treat? And the reality is they all have emotional disorders, baggage from the past, whatever it may be. So early identification, early treatment, same story in a substance abuse clinic, same story in a doctor’s office, same story to some extent by therapists and schoolteachers. So we’re here to help provide a process model for all these folks so that they have something to work from.
Saul Marquez:
Got it, thank you for that. I appreciate that. And so how do people access this? You know, and it sounds like there’s a couple, there’s a lot of people that you can help. A lot of different roles from care managers, providers to caseworkers, you name it, school nurses. How do they access what you do?
Tom Young:
Well, a lot of people access our tools from their existing systems. We’re able to work with large systems or any system and say, okay, which pieces of this fit where in your system? So as opposed to, let’s say, if I have an EHR, most EHRs have all these tools in a library, here’s this scale, … and people look at that in their eyes glaze over, which one do I use? If you simply insert our platform into your workflow inside Epic, it’s going to direct you to the first one. You don’t have to go search through this library and say, what am I supposed to do? So we can put it inside somebody’s system. They may never see that it’s Proem because we can reskin that, if you will.
Saul Marquez:
Okay.
Tom Young:
It’ll look like anybody’s system. We can drop parts of it in. We work with a lot of telehealth providers around the country that use our platform for data collection and treatment triage. So you may never see Proem if you’re a user, if you’re a small clinic. We have a lot of two and three-person clinics around the country that use our product. It’s very simple, it’s easy. We can actually set somebody up in a day to use the Internet system.
Saul Marquez:
So you could fit it into their instance of whatever EMR within a day?
Tom Young:
Right, most of those we can do that, but a lot of these simpler EMRs that don’t have a place to put this kind of thing, we can hand them our platform, it’s a very easy one-off for them to use. Unlike, say, some of my very first customers I still have from years ago, and they’re small clinics, they’re two psychiatrists or they’re three psychologists and they’re and they’ve grown with us over the years. And some of them are enormous telehealth organizations that have hundreds of providers. But so, if you’re a small clinic, my daughter’s a therapist and she has four people in her clinic, they use it. The college counseling services that we work with this and they may only have three or four counselors, but they can just drop it into their system, and then it can execute these out to the students, they can execute out to patients, and it’s very fluid. So we’re trying to make this a way for people to put process and right product, right place, right time, right person.
Saul Marquez:
That’s great.
Tom Young:
Get that individual patient what they need at the moment.
Saul Marquez:
Thank you, thank you. Dr. Young, that’s, yeah, it’s great. It sounds like you’ve made it super easy to use integratable, you know, as you’ve set out to make a difference in this space, what’s been something that you’ve found has really improved as a result of people using Proem?
Tom Young:
Well, I think we’ve learned a lot along the way in the last seven years, without question, going on eight now. I think some of the most valuable learnings for us in our development cycle was really the understanding from people that the ability to create this flexibility of what’s next so that it fit their model, it fit what they, for example, if you live in, we’ll take my state, rural Idaho, you’re not going to just say to somebody, you know, call the therapist down the street and have your patient seen, that’s not an option. So the ability to give people, providers, and patients what they need where they are through a platform that’s flexible enough. If you’re a small office, you don’t have a lot of content, well, here it’s on this platform, tou can send this out. You may not use that if you’re Intermountain hospital, you have all your own content, you’re huge, so we just link to that. So that’s how I think the learning we’ve been, we have to be flexible. We can’t just say, here’s a product, change your model, change your life.
Saul Marquez:
Fit us in.
Tom Young:
This, that’s not going to work. It’s like I started telling people the very first day if what we do bends the carpet fiber the wrong way in a doctor’s office, it’s not going to be used.
Saul Marquez:
Well said, well said. So the flexibility is built in, and as you think about what you’re most excited about today, what would you say that is?
Tom Young:
Well, I think it’s the next iteration. The thing we’re going to see in psychiatry, in mental health, that is going to be the next thing and that’s going to be biometrics. The ability to use objective data in conjunction with subjective data to begin to build a much richer diagnostic capability, a richer ability to determine, I’ll give you a perfect example: Depression. We don’t talk in this country about curing depression. You never hear somebody say, well, I’m going to cure your depression. You say, I’m going to make your symptoms better. We talk about curing heart disease. The reason we don’t talk about curing depression is because we can’t do anything but ask you a question about how you feel. Now, imagine, in the next 24 months, there will be tools out there that can say you had depression, you no longer have it because there’s no physiologic biomarker that you have depression. That’s a game changer in behavioral health. There are companies and we are working with them, and we are partnering with them, that are on the brink of that work.
Saul Marquez:
I would, just curious, so what are some of the main biomarkers you’re looking for?
Tom Young:
Okay, simply, if you look at the data, and I point over here because this is my Bible over here and psychiatric words, the DSM five, if you look at all the mental health disorders, what’s one common symptom you find in almost every single one of them, and that’s symptom is sleep, for example, that, insomnia. And if you look at that, why is that true? Well, the physiology in the brain is such that there are two nervous systems. One of them is the parasympathetic nervous system and that’s the rest and restore system in our brain. That only works when you sleep, that only rests and restores when you’re asleep. If you don’t do that and you’re unbalanced, several things happen. I change your sleep markers, you have less deep sleep, you have less REM sleep, so this rest and restore process goes down, we can measure that. Your heart rate variation, which is a marker of balance between those two systems, changes dramatically, so we can measure that. There are technologies that we’re employing that if I take on, I know we’re not on video, but if you take a phone and put your finger over the camera and push the button on the front, it will test your HRV, we’ll be adding that to some of our subjective tests so that we’re capturing a richer set of data about people. And my goal is, in my lifetime, I’d like to be able to tell people, you’re cured.
Saul Marquez:
Love that.
Tom Young:
Whether it’s bipolar disease, whether it’s ADHD, and can we use adjunctive biomarkers? And this is really going on around the world now. Miniature clinic has work going on there, Mass General, people over in Germany, it’s going on around the world, Australia, other places. So this is coming and we’re trying to stay on top of that to provide a platform which allows every doc, every patient to have access to that new kind of biometric marker.
Saul Marquez:
Thank you for that, Tom. Now, the last thing I want to touch on and I think it comes up always when you talk about delivering services, it’s reimbursement. Talk to us a little bit about that and how mental health services are now being reimbursed. Has it changed?
Tom Young:
Yeah, it’s gotten a little better. I would say that the concept of equality between physical and mental health is improving, the parity. There are codes for these things. So portions of our thing like screening, screening tests have codes that are billable and they’re paid for by the vast majority of insurers Medicare, Medicaid, and others. So from the standpoint of the provider, there are billable codes that are attached to some of this work. There are, and they come in multiple fashions, and if people are interested, we have a great group of people that can at least start you on that road of understanding that, happy to do that. But yes, so mental health parity is improving. I think it’s going to get better if you spend time talking to people in Congress. You understand that the, one of the great things of the pandemic is the recognition of the crisis in mental health. So now everybody’s eyes are open wide. So we’re going to see more attention to that. And so I’m very big on that. I think that’s a wonderful thing. So I think, yes, the payment piece is coming along. A lot of the pieces of our tools or billable services, and I think that’s important in driving adoption, obviously, for people to adopt new, new technologies, it’s got to be it’s got to fit in my time, it’s got to fit in my model, and I’ve got to get some sort of remuneration for it. So, yes, we have that attached to this and we’re going to see more and more of that.
Saul Marquez:
That’s fantastic, Tom, thank you so much for that. I know it’s always on people’s minds, we’ve got to touch that, and look, it’s exciting. You’re part of this digital transformation where we’re relying on telehealth and hybrid care models to empower primary caregivers and community members caring for people to act early, to understand where they stand as it relates to their mental health, so really appreciate you sharing all the amazing work that you’re doing at Proem. What closing thought would you leave listeners with and what’s the best place they could get in touch with you and learn more about the company?
Tom Young:
Well, you can get in touch with us at Proem Health, Proem Behavioral Health, on the web. My email is TYoung@ProemHealth.com, pretty simple, feel free to drop me an email. If you go on the go on the web, if you drop me an email, I’ll send you something back, and you don’t have my phone number, always happy to talk to people because there’s always a learning opportunity for me in every contact I make with people, so I’m very big on that. So come to Proem Health if you’re in the research world, we have a large research division that can help you and the people you work with in research around the world, whatever country you’re in, and we have our tools available in pretty much every language in the world. So if you’re a small group, if you’re in Minnesota and you have a bunch of Ukrainian people who live there, we can provide you our tools in Ukrainian, whatever language. Obviously, the Spanish, various Spanish languages, and as people from Hispanic regions know that Spanish from Venezuela is not exactly the same as Spanish from Mexico, and we have all the different versions. So get in touch with us and we’re happy to chat with them. And if they have questions, just simple questions, no question is too simple, we’re all passionate as a staff about this, and if it’s just a chat about something or you’ve got an idea that you want to share, we’d love to talk to you.
Saul Marquez:
Amazing, Dr. Young, Tom, really, really appreciate you jumping back on with us, sharing some of these amazing advancements that you’ve made. Folks, take advantage of the opportunity to leverage this platform to really tackle mental health first, and don’t let it slip. Tom, I want to thank you for your time, and looking forward to staying in touch.
Tom Young:
Great, I look forward to it, Saul. Take care. Have a great holiday season.
Sonix has many features that you’d love including automatic transcription software, advanced search, collaboration tools, secure transcription and file storage, and easily transcribe your Zoom meetings. Try Sonix for free today.
