: [00:00:01] Welcome to the Outcomes Rocket podcast where we inspire collaborative thinking improved outcomes and business success with today’s most successful and inspiring healthcare leaders and influencers. And now your host, Saul Marquez
Saul Marquez: [00:00:19] Outcomes rocket listeners welcome back once again to the Outcomes Rocket podcast for we chat with today’s most successful and inspiring healthcare leaders. Hey I want to invite you to visit outcomesrocket.health/reviews. Let us know what you thought about today’s episode and we truly thankful for you listening and even more thankful for your feedback. It’s what allows us to be better. Get you what you need to improve outcomes and reduce inefficiencies. Without further ado I want to introduce to you our outstanding guest. His name is Todd Johnson. He’s the chief executive officer at HealthLoop Incorporated. They are an exciting new comer to the patient engagement space led by physicians HealthLoop has created a powerful platform which enables a meaningful partnership between physicians and their patients to ensure optimal outcomes and minimal health costs. HealthLoop promotes to be an impactful vendor and their risk bearing health entities including health plans a CEO’s IPA as he has done some pretty amazing things he’s put together an outstanding group of people over a loop. But besides that he’s had quite a bit of experience as a leader across several other businesses. But what I want to do is open up the microphones attached to fall in any other gaps in the intro. Todd welcome to the podcast.
Todd Johnson: [00:01:36] Thank you for having me. SAUL Yeah let me just briefly introduce HealthLoop in in our journey here and we can get into it. You know I’ve been in the healthcare space now for 20 years and have seen first hand the development of technology into the healthcare delivery system and so much of that technology is either focused on new interventions that we think about MRI machinery but also the electronic medical record which I think Boley is here to help the provider organizations become a little bit more efficient organize their data and operate it in a more sophisticated way. And you know our belief here at healthloop is if you really really want to drive meaningful outcomes you don’t treat the patient as a product and most people think about their healthcare incredibly transactional is often difficult to get into see your doctor or if you have to get into a hospital there’s a lot of logistics there and many health care providers can do a wonderful job when you’re sitting with them in the room about diagnosing you or understanding what the right treatment options are and sending you on your way. But once you leave the four walls of the clinic providers sort of generally rely on hope as the strategy to get that outcome. They hope you know what to do. They hope you know how to do it. They hope that you do it well and they hope that if things aren’t going well that the patient kind of reaches back out right to get the assistance they need. And the truth is in a value based world. Hope is not a strategy for success and clearly all of us as individuals have seen the profound impact in technology in our daily lives. We’re all addicted to our smartphones. We’re online all the time and you know the primary mode that we’re using those technologies for communicating. If you look at the top apps on your phone is it the phone it’s an sms, email is ways to communicate between us as individuals and as patients we get very limited communication. We have a very sort of a brick wall between us and our and our doctors. So healthloop as a company really tries to eliminate those barriers and engage patients throughout an episode of care and the basic sort of fundamental building blocks of Health is that if you’re going through an acute episode of care. So if you’ve been newly diagnosed with a with the difficulty disease are you require surgery that the health of a patient gets the proactive automated push notifications from their doctor before coming in and after discharged from the hospital to deliver to patients the right information at the right time is exactly what you need to know today. And how are you doing today. And then we’ll carefully assess using complete autonomy. How are you doing today. And it’s helped with the tasks that you were discharged from the hospital five days ago after an exacerbation of heart failure and today you’re starting to show some signs of weight gain or new shortness of breath. Those are those early signs of treatment failure rather than hope that the patient does something. What health food does as we notify the clinical team. Here’s a patient that needs your help now. And the punchline here is we’ve gotten the company to a fairly significant scale and are seeing real outcomes and decided to share some of the recent news here as we as we’ve further discussed. So any question, Saul, had a good place to start from.
Saul Marquez: [00:04:57] That is a wonderful place to start. Todd and now what a beautiful way of laying out the context of what you and your company are doing to improve healthcare. Really appreciate that. Thank you Todd. It’s really interesting. It’s a two way communication not just one way that healthloop is doing. And I want to dig a little deeper. On the personal side what got you into medicine to begin with.
Todd Johnson: [00:05:21] So my entry to medicine was somewhat accidental. The year was 1999. I was a computer science graduate. There was a time in history where I think all the computer science engineers were scrambling to the first wave of com to figure out how they could build a company. And the truth is I sat around with a few buddies and we couldn’t come up with any great Internet ideas. We started reaching out to the people we knew and we just so happened to me a few positions that Johns Hopkins Medicine in Baltimore who wanted to solve some real problems and set us off. It turns out in medicine there is no shortage of problems. The technology offer a wonderful efficiency gain. And so I spent the first 12 years of my career really focusing on using technology to address both local issues and healthcare delivery systems here in the United States. And then we did the public health work in subsaharan Africa but all centered around delivery higher quality more efficient patient care.
Saul Marquez: [00:06:23] Love it. A great story and it’s cool that you could look back to those days and you’ve stayed the course. So it’s definitely something that is striking you in a way that you feel it’s purposeful and now you’re here with health loupe which is pretty exciting. What do you think every leader in healthcare today should have at the top of their mind.
Todd Johnson: [00:06:43] Well I think the longer you spend in health care the greater risk you are of thinking about things in terms of quality measures and numerators and denominators and Arby use. And we sort of sanitize the business of medicine from the real work on the ground. And I think all of us need to spend some time back in the clinic or back in the hospital sort of getting that first hand appreciation that patients aren’t just revenue sources. Right. Our cost center health plan they’re going through scary moments in their lives and I think all of us that have been in health care often get these unique moment to reflect on the system and that’s when we’re sick or family members in that sort of anchors us back to why we’re doing what we’re doing and I think all of us need to be frequently reminded of the human impact of our work. And then I think I’m a bit of a cynic when it comes to the health care delivery system. You know when you look at the exorbitant amount of money that we spend in the United States on health care every year. You know I think that there’s good actors and there’s bad actors and those exist in every vertical segment of the industry and having a vigilant focus I think on how can we truly improve outcomes and drive down costs. Every cost reduction is somebody’s revenue though there is interest. And I think that the hard questions are for those business leaders that the big corporations that are consuming a big chunk of that health care and you know at the end of the day it’s not an easy decision to think about how can you actually reduce costs that are cannibalistic. You’re having a difficult decision or leaders debate.
Saul Marquez: [00:08:25] That that’s for sure. The patient aliment listeners don’t forget this is why we’re in health care and the challenges that you mentioned Todd it just you know yeah if you’re looking to take costs out of the system you’re looking to take the profits or the revenue of the system of key players so as you think of that what are you doing to strike a balance. And so you mentioned that there is maybe a little bit of news. I’m kind of intrigued so maybe you want to share it.
Todd Johnson: [00:08:54] Yeah. So on the surface I think this notion that if you can provide continuous guidance to patients throughout a scary episode in their lives we carefully monitor them. You ought to get better outcome. And as a business we have a strong commitment to research. And we’ve done a number of studies over the years that have proven things like well the price. If you’re continuously delivering the right information at the right time patients have a better comprehension of what they need to do to get better. It turns out that if you’re continuously connected to your patients and make it really really easy for them to reach out to you when they have questions or concerns that they have a much greater level of satisfaction with their service. However just two weeks ago at a hip and knee Society conference in Dallas two fairly groundbreaking studies were presented regarding health issues. The first study was with doctors defining being a Brown University California Stanford. He’s an orthopedic surgeon and they’ve been using healthloop on their patients for quite some time now. They’ve got a significant amount of the data in looking at their data what they have discovered is that they are seeing a significant reduction in complication. So if a patient is discharged from their hospital after surgery they’re seeing fewer surgical site infections fewer blood clots fewer adverse event right because patients are better in they’re doing what they need to do and they’re seeing as a result of that a very significant reduction in hospital readmission though the patients that are discharged much less frequently end up back in the hospital within 30 days. The second study which is equally as interesting is this with one of the nation’s largest health plans though an insurance company would withdraw. And they look at across the multi facility multi provider or you’re a clinical study. Probably the largest in the patient engagement they base certainly the most credible and it comes to the similar conclusion. Dr. Beany study that question have better outcomes they get fewer hospitalizations fewer E.R. visits. You were a complication. But what’s interesting about the health insurance companies they know the cost of everything. And so they are really looking at you know does enrolling patients can help to reduce the total cost of care and what they’ve found for these surgical episodes was about a 660 dollar per case cost reduction when patients are enrolled. So the fact that we can use digital technology to not only improve quality improve the patient experience but ultimately squeeze out cost in the healthcare delivery system we think is relatively profound. And then I think to me I lived very much in that space. The solutions are both obvious and inevitable and we’re sort of impatient. I believe every patient in the country deserves a health that if I may get them my family members loved ones have to go through a complex medical episode. I want them on health so I want them to get the best care they can.
Saul Marquez: [00:11:51] Well congratulations to you and your team for the studies and the results right. You know the studies are one thing. The results are what matters. And from a provider perspective as well as from a pear perspective sounds like the RAII as there now. What about on the privacy part. You know I know sometimes oftentimes the hip issues arise with technology and you know patient data. How do you guys deal with that. How do you keep it protected.
Todd Johnson: [00:12:19] Yeah I think that protecting health information is an important and necessary bar for every company in that space and honoring preserving the privacy of our patients is something that you just have to do period. I often think about I had a cardiac condition and had surgery earlier in my life and I was at the dentist office and you know how you have to go the past medical history forms. Here I put on the dentist’s office that I had this heart surgery and heart condition. The receptionist who is a really lovely lady and I was a 28 year old healthy male is like Oh my goodness. Had you had a heart surgery. And of course there’s a dozen other people in the waiting room that said this comes over slapped on the hand that the reach of ph. Yeah. Right. And of course I didn’t care you know didn’t matter to me. You know I think the risk with companies like health and other large companies is that you get so much data consolidated that you know one breach can expose more than that one person in the waiting room to have some friends or others in the waiting room maybe not friends but that you could have millions and millions of records leached out. So I think having the appropriate protection around those is essential. And I think we’ve seen some unfortunate events of the last year. And you know I think what 85 million patient records are seeing these things happen and my guess is there’s an economy based on really health information that companies need to be really vigilant. I think the flipside to that though is that patients in general really really want the best outcome every time and they are willing to make their information available to others that they think it’s going to help. And we’re seeing sort of a trend of patients increasingly donating their data science or participating in online forums that help them get greater information and so that he had the best outcome possible.
Saul Marquez: [00:14:12] Yeah it’s interesting you bring up some good points there Todd. You know if you’re a company much like a digital company like care loop you make sure that your information secure. But don’t hold yourself back. There are some solutions that can be provided patients are now more than ever willing to provide their information to improve their care. They’ve had it. And so it’s time to really look beyond that limitation and just dare to create solutions for them. Tad what would you say one of your biggest challenges or setbacks that you’ve had and what did you learn from it.
Todd Johnson: [00:14:44] Yeah so I think that distributing health care innovations throughout the healthcare system is hard. You’ve got big corporations and particularly on the providers side when their product is high quality outcomes and you’re talking about patient safety really needs to be paramount on their agenda. If you get a relatively risk averse customer base and so innovating is hard. I think on top of that there’s actually a great article this morning in the New York Times just the level of uncertainty in how our health care economics are playing out in a very broad sense. If you look back to the last 80 years we’ve built the healthcare delivery system that’s been buying and selling transactions. The doctor’s office want to see as many patients today as the hospital wants to fill as many as many operating are also very transactional throughput. Orient them and that is bring bankrupting the country. We know that there have been efforts over the last six or seven years to really focus on what is called value based healthcare which is instead of paying for every individual transaction to pay for an outcome and I want the health care provider to do what is right to do that at a reasonable cost. And that trajectory has was still continuously marching forward with the change up in Washington D.C. there’s just uncertainty around how quickly the healthcare economics will change how swiftly and severely they will be implemented. The Obama administration was marching very quickly to transforming the payment system. And things have sort of stalled out. And so I think with that how do you navigate the uncertainty. It’s not an easy thing to do. So you know I think the lessons learned are actually quite simple. At least for our business. Always focused on higher quality lower cost care. We believe is always the right answer is the right answer that should be rewarded. It’s the one that will be rewarded and we focus on working with the providers that are ready to do that today. And you know for a hospital for instance doesn’t want to reduce their readmission rate because that means reducing revenue of patients coming back. That’s not the right partner for us today. That’s a hard thing to do some time.
Saul Marquez: [00:17:05] For sure. It’s a good message Todd and listeners take that into consideration. Policies are always changing but the tried and true is that if you provide quality at low cost it’s always going to be the right answer. So thanks Todd for that reminder.
Todd Johnson: [00:17:21] For your listeners. One of the challenging things. It’s hard to understand who’s providing health care at higher quality lower cost than no place to go. Right. We typically learn about our doctors from our friends and family right or from our primary care physician. There’s no easy place to go see who’s the best doctor. And so increasingly we’re seeing new tools come on the market that can help patients do that.
Saul Marquez: [00:17:45] Yeah and not for the listeners you’ve probably already listened to my interview with Shakil, Shakil has put together a sort of like credit report for health providers grading them on outcomes. So go back to that episode with Shakil if you go to outcomesrocket/shakil you’ll be able to find that. And like Todd said more and more people are developing these resources. It’s only going to get better as time moves on. Todd, take us into one of your most exciting projects today. Oh I see. I know you guys had a lot of them.
Todd Johnson: [00:18:19] So yeah I think that we’ve done a lot of work sort of with individual medical groups and provider organization and just to look the last week we launched with a partner called Naveh health that is basically partnering with hospitals around the country saying that we as an organization can help you manage acute discharges so these are things like patients that had a heart attack or failure and ended up somehow manage those at scale. And so just last week we launched programs across 25 hospitals with them to focus really on the sickest patient and health group is able to reach out and you know do literally you know thousands of patient assessments every day which previously they had nurses on telephones trying to hunt down patients. And so we’re really seeing some of the solutions come to scale. It’s really exciting it’s fun.
Saul Marquez: [00:19:13] That’s a really cool application. Do you do crack conditions only or do you lump in also like traumas that that come in in the dark.
Todd Johnson: [00:19:20] Now our belief is that health care providers are going to need to manage all patients with this level of intimate support and service. And I think the state of the industry today is hospitals will focus their energy where it costs them the most. Which means they’re going to focus on these really really high cost patients right. Which leaves 80 or 90 percent of their patients without this additional support. That’s right. And so we’ve we’ve made investments to have these Bishil care pathways across most of the acute care medicine which is 50 percent surgery. So trauma orthopedics cardiovascular surgery ear nose and throat Obi GYN programs as well as the high cost chronic patients. I think our DNA has been more from the surgical episode of care is actually where we got started things like orthopedics and cardiac surgery sort of moving up the ladder towards some of the more complex poly chronic patients.
Saul Marquez: [00:20:16] I love it. And you know the cool thing Todd that you guys are up to is is just that you’ve targeted these to begin with. It sounds like you’ve gone broader now but these areas of care that include the bundled payments or are where you get readmission penalties you’re targeting those where the financial incentives are and if you’re a company trying to build a solution you’ve got to be thoughtful about your approach like Todd and his team have. I mean you’re not going to get the needle to move if you don’t follow the financial trail. I mean that’s sad but true right.
Todd Johnson: [00:20:49] Absolutely. And the truth is there’s a lot of money that we can worry out of the health care delivery system in some cases. It’s actually not as hard as you think it is but being really targeted focusing on the patients where you can move the needle and actually again our belief is that all patients deserve health care. But we’ve been really thoughtful about exposing capabilities where you might have more sort of advanced communication capabilities for the patients that are likely to have adverse event. But you can still have a meaningful experience for other patients where their risk of additional cost is extremely low.
Saul Marquez: [00:21:24] Yeah, some really good insights. Todd this is awesome. Let’s pretend you and I are building a medical leadership course on what it takes to be successful in medicine today. It’s the 101 or the ABC of Todd Johnson. We’re going to build a syllabus here and it’s a lightning round style four questions followed by a book that you recommend to the listeners. You ready.
Todd Johnson: [00:21:44] Yeah.
Saul Marquez: [00:21:45] Awesome. What is the best way to improve health care outcomes.
Todd Johnson: [00:21:48] So I think focusing in the United States on the 330 million people that have the most to gain. Right. Every patient wants better outcomes at lower cost. If we can bring them into the fold and get them to be active participants in their health care is a tremendous resource that is free and they want that and they want to help. So engaging patients I think is the number one bestseller.
Saul Marquez: [00:22:11] Love it. What is the biggest mistake or a pitfall to avoid.
Todd Johnson: [00:22:15] I think if focusing on areas where the industry doesn’t yet want to change or isn’t ready to change to truly understanding where is their economic alignment with the goals of better outcome and starting there.
Saul Marquez: [00:22:31] How do you stay relevant as an organization. Despite constant change.
Todd Johnson: [00:22:35] Yeah so I think they need to track the teams and be on top of it. But B I think this coming back to higher quality lower cost care is always the right answer. If you just continue to focus on delivering exceptional quality and at a sort of an economic advantage you will stay relevant and you will win.
Saul Marquez: [00:22:57] And finally Todd What is one area of focus that should drive everything else in your organization.
Todd Johnson: [00:23:02] Yeah I think it’s about helping healthcare providers implement the necessary change to be successful. The industry needs to be taught how to move how to move quickly how to implement the change that’s necessary to get the outcomes that they need.
Saul Marquez: [00:23:18] Well said and what book would you recommend to the listeners.
Todd Johnson: [00:23:22] Yeah so if you want a great education on the dysfunction of healthcare economics and the accretion of what we call an ecosystem but if it goes to the healthcare there’s a great book by Dan Monroe called Justino health care. Sort the story of how we got here and some of the tragic mistakes in designing our health care economics that have led us to where we are today a.
Saul Marquez: [00:23:45] Phenomenal recommendation. Todd and I literally just finished reading it. It was awesome. Listeners take this one down. Write it part of the syllabus. You’re going to get so much value out of this book. Promise you and it is definitely a great way to really dive deeper into this. Don’t worry about writing it down. Just go to outcomesrocket.health/toddj that’s TODD J. And you’re going to be able to find all of the show notes as well as links to healthLoop and this amazing book that just recommended you. Before I conclude I would just love to ask you to share one closing thought to the listeners. And then the best place where they can get hold of you.
Todd Johnson: [00:24:26] Yeah. So I think for your listeners if you have the unfortunate life event that requires you to to reach out to the health care delivery system or have a family member that challenged the doctors the hospitals that you that there are innovations out there they should be pushing the needle and ask them you know what they’re doing to improve quality. And don’t be shy when engaging with your healthcare providers. You owe it to yourself.
Saul Marquez: [00:24:51] Great advice Todd and what is the best place that the listeners could follow or get a hold of you.
Todd Johnson: [00:24:57] Yep you can find us on Twitter and you can find all of our details at healthloop.com. Find us there. And if anybody has any particularly interesting anecdotes that they’d love to share with me always looking to hear patients stories they can e-mail me directly email@example.com.
Saul Marquez: [00:25:13] Love it so there you have it listeners. Todd shared his e-mail as well as ways to contact Todd. Really appreciate the time you spent with us today. And I’m so excited to keep up with the amazing things that you guys are up to.
Todd Johnson: [00:25:25] Thank you for your time. We appreciate it.
: [00:25:30] Thanks for listening to the Outcomes Rocket podcast. Be sure to visit us on the web at www.outcomesrocket.health for the show notes, resources, inspiration and so much more.
The Best Way To Contact Todd: