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The Key to Reversing America’s Chronic Disease Epidemic Lies in Continuous Remote Care
Episode

Jeff Stanley, Medical Director at Virta Health

The Key to Reversing America’s Chronic Disease Epidemic Lies in Continuous Remote Care

Today, our guest is licensed to practice medicine in all 50 U.S. states, an expert in continuous virtual care delivery, and specializes in helping patients with Type 2 diabetes and metabolic syndrome restore metabolic health while safely removing the need for prescription medications.

Dr. Jeff Stanley is the Medical Director at Virta Health. In this interview, he discusses how his company provides clinically-proven treatment to safely and sustainably reverse type 2 diabetes without medications or surgery. He also talks about the difference between traditional health care settings and the model Virta offers, the company’s goal of reversing type 2 diabetes in 100 million people by 2025, and the incredible value Virta provides in terms of standard of care and support. Dr. Stanley shares excellent insights into the care continuum, virtual care, and overcoming business challenges, so please stay tuned!

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The Key to Reversing America’s Chronic Disease Epidemic Lies in Continuous Remote Care

About Jeff Stanley

Jeff is the Medical Director at Virta Health. He previously worked as a primary care physician and hospitalist at Kaiser Permanente in Portland, Oregon. An expert in continuous virtual care delivery, Dr. Stanley is licensed to practice medicine in all U.S.50 states. He is board-certified in internal medicine and a diplomat of the American Board of Obesity Medicine. He holds degrees from the University of California, Berkeley, and the Keck School of Medicine at the University of Southern California. In his free time, Dr. Stanley spends time with his wife, two sons, and daughter, and with the morsels of time left over, you’ll find him running and playing soccer in the Portland area.

 

The Key to Reversing America’s Chronic Disease Epidemic Lies in Continuous Remote Care with Jeff Stanley, Medical Director at Virta Health transcript powered by Sonix—easily convert your audio to text with Sonix.

The Key to Reversing America’s Chronic Disease Epidemic Lies in Continuous Remote Care with Jeff Stanley, Medical Director at Virta Health was automatically transcribed by Sonix with the latest audio-to-text algorithms. This transcript may contain errors. Sonix is the best audio automated transcription service in 2020. Our automated transcription algorithms works with many of the popular audio file formats.

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Saul Marquez:
Welcome back to the Outcomes Rocket, Saul Marquez here, and today I have the privilege of hosting Dr. Jeff Stanley. He’s a medical director and practicing physician with Virta Health, which provides proven treatment to safely and sustainably reverse Type two diabetes without surgery. Dr. Stanley previously worked as a primary care physician and hospitalist at Kaiser Permanente in Portland, Oregon, focusing on treating obesity and Type two diabetes. This experience fueled his passion for helping patients not just manage but regain their health and eventually brought Dr. Stanley to Virta. At Virta he specializes in helping patients with Type two diabetes and metabolic syndrome restore metabolic health while safely removing the need for prescription medications. An expert in continuous virtual care delivery, Dr. Stanley is licensed to practice medicine in all U.S.50 states. Very impressive. He is board-certified in internal medicine and a diplomat of the American Board of Obesity Medicine and holds degrees from the University of California, Berkeley, and the Keck School of Medicine at the University of Southern California. In his free time, Dr. Stanley spends time with his wife, two sons, and daughter, and with the morsels of time left over, you’ll find him running and playing soccer in the Portland area. Just an amazing individual. And Jeff, so privileged to have you here with us today.

Dr. Jeff Stanley:
Thanks so much for having me on, Saul. So I’m excited.

Saul Marquez:
Absolutely. So you guys are doing some really extraordinary things at Virta. Before we dive into exactly what you guys are doing and how you’re doing it, I love if you could just share a little bit more about your inspiration to work in health care.

Dr. Jeff Stanley:
Yeah, absolutely. So my inspiration to work in health care has really come from the ability and the opportunity to help empower patients to regain control of their health. So since I’ve become a physician, I’ve always really looked for and enjoyed using the doctor-patient relationship to be able to meet patients where they are, help them to navigate the health care system, and help them to make some positive lifestyle changes. And what I’ve seen is that for conditions like Type two diabetes, they can often feel a little bit like a life sentence to a lot of patients. And so being able to help my patients to normalize their blood glucose, to get off of medications, and to do it through their lifestyle changes, it’s really rewarding. And obviously, its patients are incredibly proud to be able to achieve that. And so one of the things that I think one of the big obstacles that I encountered in the traditional health care settings, so my prior work as a primary care doctor was to try to make these connections and try to help people make these lifestyle changes during what was oftentimes a very limited time window.

Dr. Jeff Stanley:
So a 10 or 15-minute visit, maybe every three to six months with a patient where you’re addressing a whole host of other issues, concerns, conditions. And so that was something where I felt a little bit hamstrung in terms of being able to work as closely as possible with my patients and to help them change their life. So, I mean, one of the things that’s kind of an interesting contrast to from that work to what I’m doing with Virta is that in the years that I worked as a primary care physician, there was probably a handful or less of patients that I was able to take off of insulin. And in a sort of a particularly busy and rewarding afternoon last week, I took six patients off of insulin in the course of an hour. So it’s something that I can say selfishly as a physician, it makes me feel wonderful. And it’s honestly, oftentimes some of the best news that someone has gotten in quite a while and I get to deliver it on a regular basis.

Saul Marquez:
That’s awesome. And the passion that you have is contagious and also impressive. I mean, when passion translates into action, I mean, number one, you could count on a very short list, the number of physicians that are licensed to practice in all 50 states. I mean, that’s pretty amazing. How long did that take you to do?

Dr. Jeff Stanley:
It’s probably even more boring than it sounds, but it was a several-year ordeal. Luckily, we had some folks on our team to help with some of the paperwork and whatnot. But at this point, our medical system requires a separate license in every state, oftentimes requires slightly different continuing medical education based on one state to the next. And oftentimes that education doesn’t carry across from one state to another. So I did a two-hour-long module on child abuse reporting, I think six different times for four different states, which is obviously a pretty depressing thing to watch over and over again. And then, in addition, they still require fingerprints. And ink fingerprints for the majority of these states. So I actually became pretty good friends with the fingerprinter at the local stationery store. And I always joke that I couldn’t become a cat burglar anywhere because I think I’m on the in the system and every single case.

Saul Marquez:
That is too funny. Well, kudos to you. And, you know, the focus that you have there. And again, you know, it’s an obstacle. And we’re all hopeful that with what we’re going through with COVID, that those types of restrictions become less burdensome. But, you know, a testament to those that want to make a difference, they find a way. And Jeff, you’re certainly doing that. So help us understand more about Virta. What exactly are you guys doing to add value to the health care ecosystem?

Dr. Jeff Stanley:
Yeah, so for just kind of a very brief overview. So our mission in Virta is to reverse type two diabetes in one hundred million people by the year twenty, twenty-five. So obviously a pretty audacious goal. But really what we’ve done over the years is to sort of establish a foundation to make that possible. And so the foundation from the early days was really to publish peer-reviewed literature. So we have an ongoing prospective clinical trial running in Indiana showing initially that something like diabetes reversal is possible. And then over time, the trials going out to five years to show that it is also sustainable. And then in addition to that, there’s the infrastructure in terms of our continuous remote care model. So we’re having physician supervision, supervising patients at all times, helping them make the necessary lifestyle changes, but also the medication changes that might be needed and then using health coaching to be able to, again, really work individually with patients, meet them where they are, and help them to follow basically a personalized low carbohydrate approach to nutrition, which is incredibly powerful to help people improve their diabetes.

Dr. Jeff Stanley:
So we have kind of all these components that are working together. And then the underlying structure, again, is sort of a technology company built by folks of scale, large companies before and being able to treat people in all 50 states, treat people. They can’t make it in for a visit to their doctor because either they live very rurally or because of covid or avoiding in-person visits. So it’s something that we can really with this sort of foundation that we’ve built there and the focus on working with patients to reverse their type two diabetes. And just definitely what this means is getting people to normal blood glucose or hemoglobin A1C which is basically like an average three-month window of blood glucose. And it’s doing that while simultaneously taking people off of their diabetes medications. So the two of those go hand in hand. And when those work together again, you’re getting some quick results of people’s glucose is getting better. They’re also getting the feedback of being able to reduce and eliminate medications.

Saul Marquez:
Well, it’s certainly a big goal. You said one hundred million people by 2025.

Dr. Jeff Stanley:
Correct.

Saul Marquez:
Wow, that’s amazing. And I think about the number of people, it’s over 50 percent of adults in the US have diabetes. So, hey.

Dr. Jeff Stanley:
Yeah, diabetes or pre or pre-diabetes and you know. Yeah. And so we’re seeing that metabolic disease is just skyrocketing over time, year over year, and is expected to only increase with time. And then obviously, it’s also, unfortunately, a worldwide epidemic. So there’s definitely no lack of people who need the help. And, you know, what we’re really focused on is helping those folks that desperately need it.

Saul Marquez:
Yeah. And, Jeff, you know, the point of continuous monitoring, you know, this is, I think, the difficult but simple innovation right. So talk to us about what you guys do that’s different and better than what’s available today.

Dr. Jeff Stanley:
Yeah. So, I mean, I think when you think about standard care for most people now for Type two diabetes or really for any condition, you know, what you’re thinking about is is typically sort of standard episodic care. So like I mentioned in my days as a primary care physician, you expect that you see the doctor in person for maybe 10 or 15 minutes every few months, if you’re lucky. And then you have kind of a list of things to do, like add this medication, see the dietitian and try to maybe make some diet changes. The dietitian gives you a handout and wishes you well. And so in between those episodes of care, people are really kind of on their own right. So they’re trying to fend for themselves or trying to figure out what to eat on a daily basis when to take their meds, all of that. And so what we really, I think, do differently is that we’re able to work with a patient on a daily basis, really to be able to implement these changes. And so when someone enrolls with our team. They’re assigned a personal health coach and this health coach is working with them closely on what do I eat, what do I do when I go out to a restaurant? What can I do to avoid those doughnuts in the break room at work? Or during COVID it’s more, you know, what foods can I stock up on or other things during this tough time? And so people are getting that kind of support on a daily basis.

Dr. Jeff Stanley:
They’re text messaging, their coach questions that pop into their mind rather than waiting for that 10-minute visit with the doc where you got to ask everything or that’s your window and you’ve lost it. And then you’ve got the support from the coach. But then in addition, as I mentioned, because people are rapidly improving their glucose, you need to have medical supervision to be able to safely remove medications when needed. So if somebody all of a sudden isn’t eating a whole bunch of sugar, their blood glucose is going to go down. And if they’re still taking insulin, you have to have a doctor there to reduce or remove the insulin or they could have dangerously low blood sugar. So we’re monitoring at all times. People are logging their values. We’re looking at the trajectory of those changes. And then again, sort of proactively working to say, OK, well, your glucose is looking great today. It’s 120 today. It was 240 yesterday. Let’s go ahead and cut your insulin from 30 units to 20 units. And so that kind of feedback, again, is great for patients. They see that their hard work pays off pretty quickly. And then it also allows us to intervene when they might be struggling or if some sort of a life event comes up or just does anything that might get in the way of their long term success. But they don’t have to wait for that six-month visit to backslide and then try to restart again.

Saul Marquez:
Yeah, that’s excellent. And, you know, this continuous care with the coach seems really interesting. And so is there are also layered accountability where they have to share what they’re eating and quantities and all that stuff. Can you highlight more there?

Dr. Jeff Stanley:
Yeah. So again, we give people a sort of an overarching plan of personalized carbohydrate restriction. So we know that reducing the amount of carbohydrates that someone eats, they have diabetes, is really beneficial for their blood sugar. So people are given some kind of general guidance around avoid these foods. Don’t drink a Coke, maybe try this instead. And then they’re logging their markers. So they’re testing their blood, sending those values to us. And then we’re using those values to help troubleshoot. So people aren’t having to do an exhaustive food journal of everything they eat in a day because we’re seeing actually what the numbers do. Now, if someone is struggling, sometimes we will really dive in and have them do an in-depth food journal or start to dive into things like sleep or stress or exercise or things like that. But one of the things that’s pretty nice for our patients is that they’re not so laser-focused on every calorie or every piece of food they’re eating. It’s more of this kind of framework that they’re using. And then again, the results help us to dial in what they might need to change.

Saul Marquez:
Love it. And you’re really affecting these numbers, really. You’re looking at an A1C right? Bringing it down to a point where diabetes eventually goes away.

Dr. Jeff Stanley:
Exactly. Yeah. I mean, and so in our clinical trial, and then we’ve also released some of our data from our commercial partners. And what we see in general is usually about 60 percent of patients that are working with our team are in that diabetes reversal category. So they basically bring their A1C below 6.5 below that diabetes threshold. And in addition, they’re no longer on the diabetes medications. And look at sort of averages across the population. It’s usually about a one to 1.3 point drop in the hemoglobin they want to see. But again, what the interesting thing is that that’s happening with, on average, about a 50 to 60 percent reduction in the meds that they’re on. So that’s great for the patients, obviously. Also great for the payers because those meds can be pretty expensive.

Saul Marquez:
Oh, my gosh. Yeah, it’s a huge cost to people, to the payer, to the society. And so, I mean, just incredible work. And something like this doesn’t just get put together without any issues or, you know, setbacks. And we tend to learn more from those. What would you say, Jeff, is one of the key setbacks you guys had that you learned so much from that’s made you guys better.

Dr. Jeff Stanley:
Right. and having listened to the podcast, I share probably with a lot of your guests, and not surprisingly, that COVID has been a big, big change and initially a really big setback. So basically, at the time before COVID hit, our company was really poised for rapid growth, hiring a bunch of people, planning on rapid expansions, and more patient volume. And then when it became very clear that that COVID was going to be a serious situation, everything kind of paused. So our deal is that we’re in contracting and just about to be signed, basically went dormant or folks stopped responding. New sales deals in terms of talking to H.R. leaders or talking to chief medical officers, everybody basically said, we’re hunkering down. We have to figure things out before we’re going to expand or take on any sort of a new diabetes solution for our patients. So that was a big disruption to what we were expecting and what we were preparing for. But the interesting thing we saw is that and really kind of the thing we learned and the opportunity is that you know, it became very clear over time that diabetes was, in fact, a really big concern with COVID.

Dr. Jeff Stanley:
So there are several papers that were published showing a much higher mortality rate in people with poorly controlled diabetes, some higher complications, higher hospitalization, really just a group of people that were affected by COVID pretty badly. And so we started to see once people kind of got, you know, got their feet under them. There was actually a big explosion in terms of interest in working with us. And obviously, there’s been a big interest in telemedicine. And the continuous remote care is really enticing to people because folks are having trouble getting in to see their doc or they don’t feel comfortable doing an in-person visit. So, you know, what originally was looked pretty devastating to our business at least, has actually been an opportunity and something, where we’re seeing the demand is there. And also it’s really rewarding because we get to help people with diabetes during a super difficult time for them.

Saul Marquez:
That’s so interesting. And you’re right, during the pandemic, the folks with comorbidities and chronic conditions such as diabetes are the ones that are suffering the most. So it’s sort of just elevated, even more, the importance of what you guys do.

Dr. Jeff Stanley:
Exactly. Yeah. I mean and interestingly, I mean, what we saw with our clients our payers actually was kind of weird a little bit with our patients. And that, you know, initially when they said people didn’t know, like, I’m not sure if I can change my lifestyle or my diet or I don’t know if I’m ready to sign up for it, because this seems like too much for me to deal with right now. And then after a month or two, we started seeing people say, well, this is actually the perfect time. I have to do this because I’ve been reading the news every day about how dangerous it is with diabetes. And I’ve been kicking the can down the road a little bit in terms of doing something proactive about diabetes. And this was like the impetus that they needed to finally do something and sign up.

Saul Marquez:
Wow, that’s awesome. Well, congrats. I mean, you know, it’s a challenge right. I mean, you guys were doing a lot and got slowed down, but here we are again and things are picking up again. So what do you think is most exciting today for Virta and patients and stakeholders you guys are working with?

Dr. Jeff Stanley:
Yeah, I mean, I think this kind of dovetails in with the concerns with COVID that I was discussing. But what I’m really most excited about is that we’re sort of back on this rapid growth trajectory. And really, I think and most importantly, again, the opportunity to help more and more people to reverse Type two diabetes know we know that there are millions of people out there that we can help to be free from needing to inject insulin multiple times per day or from some of the horrific complications like amputation or blindness or kidney failure. So, I mean, what gets me excited and jumping out of bed in the morning is really that that opportunity to help those folks and to just be there for them and also to give them that satisfaction of doing it themselves is not something like a magic pill or a surgery like this is something where they’re changes and they’re hard work and their perseverance that’s allowing them to achieve things.

Saul Marquez:
I think that’s wonderful. And folks, if you have not visited Virta, check out their website. It’s Virna Health dot com. You’ll find a lot of the work that they’re doing on there. They’ve got a lot of compelling work and studies that they’re working on. And really research backs work to back up what they’re doing in practice. So whether another COVID surge comes again or not, they’re tackling it hard. And with the remote patient continuous monitoring, there’s an opportunity to continue working through whatever pandemic might come again. And so really great resilience story there. Jeff, I appreciate you coming on and sharing the insights with all of us. Why don’t you go ahead and leave us with the closing thought and then the best place for the listeners can reach out to you or the Verta team?

Dr. Jeff Stanley:
Yeah. So, I mean, what I have become, I think increasingly more certain of is that that really this approach of continuous remote care, of being paid for outcomes and not just engagement and of looking at disease. So rather than disease management, I think all of those things are really hopefully where the future of health care is heading and I’m just super excited to be a part of it and feel really fortunate. And hopefully, I can make a small dent in this really exciting area. And then in terms of getting a hold of me, you can reach me on Twitter. Jeff Standley, M.D., or feel free to email me at jeffstanley@virtahealth.com.

Saul Marquez:
Outstanding. There you have it, folks. Dr. Jeff Stanley, medical director at Virta Health. Just an extraordinary individual and great work being done by the company. Make sure you check out the Show notes as well. Outcomes Rocket. health. Type in Virta Health in the search bar. That’s where you’ll find the entire transcript, links to Virta health dot come, and more. Jeff, just want to say thank you again. This has been really great.

Dr. Jeff Stanley:
Yeah, I really enjoyed it, Saul. So thank you so much.

Saul Marquez:
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Things You’ll Learn

  • How to help patients with type 2 diabetes.
  • How to add value to the health space.
  • How continuous care setting is more effective in helping patients with diabetes.

 

Resources
https://www.virtahealth.com/
jeffstanley@virtahealth.com