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Saul Marquez:
Hey everybody! Saul Marquez with the HLTH Matters podcast. I want to welcome you to today's episode. All of these episodes are recorded straight from the Las Vegas show floor at the HLTH event. Just amazing interviews with the leaders that attended that event, and I want to thank you for joining us to listen to it. Today, I want to welcome Ron Emerson to the podcast. He's the global healthcare lead at Zoom, and he's a former member of the board of directors of the American Telemedicine Association and chair of the Industry Council. He has more than 20 years of experience in the healthcare industry, having worked on a number of telemedicine programs in 46 countries. He's recognized as a thought leader in telehealth, having developed a variety of innovative telehealth applications and consulted on telehealth deployments worldwide. He also held the position of executive director for a large telemedicine operation in the United States, where he was responsible for the efficient provision of services to 350 sites. Mr. Emerson was the previous recipient of the American Telemedicine Association Industry Council Award for his Leadership in the advancement of telehealth. I want to welcome Ron to the podcast. Thanks, Ron, for being with us.
Ron Emerson:
No, it's great to be here. I appreciate it. Thank you.
Saul Marquez:
Absolutely, so Zoom has done incredible work. The pandemic proved to be just a fantastic opportunity that you guys seized to help deliver care. Equity is one of the things that is top of mind at this conference as well as care at the home. We're going to dig into a lot of that stuff with you. But before we do, Ron, what is it that inspires your work in healthcare?
Ron Emerson:
It's very interesting. One thing in my bio I don't put, that I was a United States Marine.
Saul Marquez:
Thank you for your service.
Ron Emerson:
For almost five years, no, I appreciate that. And then when I got out of the Marine Corps, I actually got my bachelor's degree in nursing. And I enjoyed working with individual patients, but I realized very early in my career that I was really interested in sort of system change and how can we change systems to provide better care and access to patients regardless of where they're at. And that was really inspired by one study I looked at a long time ago, from 1960 to 2010, the cost of healthcare in the United States actually increased five times of what gross domestic product was. And when I looked at that, I realized that we needed to do things differently. So it was an inspiration to say, hey, how can we change the way that care is provided?
Saul Marquez:
I love that, you're very mission-driven. So you're a marine, you're a nurse, you've worn a lot of hats, and that type of perspective really does help. Having the clinician hat on the one hand, helps understand what pains they're going through. And so talk to us a little bit about what Zoom is doing and how you guys are adding value to the healthcare ecosystem.
Ron Emerson:
Of course, what we've all been through, it's been a hard time and Zoom has learned a lot, as everyone else has, and we've learned a lot, but really two key areas, just to sort of give you an idea of the scale of what that look like. And if you look at December of 2019, Zoom had about 10 million daily meeting participants. And then, of course, COVID kicked in and within about three and a half months later, we had 300 million daily participants.
Saul Marquez:
That is just mind-blowing.
Ron Emerson:
It really is, it really is, because everyone virtualized. So the areas that we focus on, of course, is how can we sort of close that gap, and the whole premise and the whole value of what Zoom provides, and just doing it in the most frictionless manner to make it easy as possible, is that it's more efficient to move information than is people when appropriate, right? So there's really two areas we focus on. Of course, a lot of folks know Zoom, but what some people don't know is that Zoom is actually the market share leader in the US for telemedicine. More people see their clinicians over Zoom than any other platform and there's a variety of studies that show that. So we're really focused on how we as an organization can provide hybrid models and different models of care for care delivery, so change your care delivery models when virtualization is appropriate. And then of course, our other core mission is how we can help healthcare organizations, including life science, medical device, biomed, pharma, and of course the provider space, payers, how we can help them to have hybrid models of work where they can work more efficiently within their organizations. So it's really on two sides and we've had some exciting announcements lately. We just had our annual conference, … Zoomtopia.
Saul Marquez:
Oh yeah, I haven't been to those, are they pretty fun?
Ron Emerson:
They're great, you know, we have a lot of big announcements there every year and it's bringing a lot of thought leaders together and the virtualization. And, you know, this year was really special, is, it's the first time back in person. It was a virtual event as well as an in-person event, but it was really interesting, a lot of the discussion about, you know, what the future looks like with people who just deal with this every single day. And we did a couple of announcements. We're going to have Zoom Now, so we're going to have our own email and Zoom calendar, and, you know, really bringing that whole platform together and what Zoom's focusing on as being that multipurpose platform that serves healthcare organizations as your communication tool, but also as a virtual care tool as well.
Saul Marquez:
Ron, I've started to see, and I'm a Zoom user, and so I've started to see little features creep in and I'm like, wait a minute, what's going on here? Starting to get this like Slack-Teams type of feel, but in your own way, so I think it's really cool that you guys are expanding the platform to enable more care.
Ron Emerson:
We really are, and it's tricky because where Zoom really accelerates is, of course, Zoom is a full platform and an enterprise solution. A lot of people don't know, but we have a state-of-the-art phone system, it's called Zoom Phone. Of course, everyone knows about Zoom Webinar, people know about meetings, but people don't know about things like we have Zoom IQ that actually analyzes sales calls. We have Zoom events, which is just amazing for virtual events when you need to virtualize events or have hybrid model events, we're seeing that being used in health systems as a way to reach out across communities and educate them on what services are provided. We have a Zoom contact center, so you can have actually a full voice contact center, but the unique thing that Zoom does is it actually has video-enabled contact center for cueing and skill-based routing. And I think the biggest thing is when we look at costs and total ownership is, right now, healthcare organizations are going through a really hard time financially, I think we've all seen that, right? And it's not just the upfront cost of, day-one cost, but it's, what does it cost to actually manage a platform over time? And that's where Zoom as a true platform is really showing a lot of benefit and they're using it for multiple purposes, which shows the true ROI. So it's really exciting time for us, not just in the telehealth space, but also just in everyday work of how people communicate within their organizations.
Saul Marquez:
That's great, Ron. Thanks for sharing all these additional features that are in the platform. A lot of us use it for just calls and that's sort of the bread and butter for everyone, so it's good to know. And folks, in the show notes, we'll put a link here so you could go explore some of Zoom's other capabilities for your organization or for yourself, because, hey, they're there, so if you already have the platform, why not use them? Ron, your role is global. What trends do you see in the US and internationally?
Ron Emerson:
Yeah, it's been an amazing journey. I've been involved in telehealth, as you had my bio, for over 20, about 22 years, I guess. And just to see the huge transformation of the virtualization of healthcare, of course, which was inspired by a hard time for all of us, this has really changed. So I think the two kind of key things that I see globally, one is that when appropriate, we really are seeing sort of digital-first models of healthcare. And I think some great examples of that is just urgent care or how you interact with your healthcare system. If you look at banks, we've been doing that for quite some time. You interact with your bank and then the level of that interaction actually dictates if you need to be in person or not. Well, we're starting to see the same thing on the clinical side. We are seeing organizations that during COVID, some of the largest centers of excellence that we work with, 75 to 90% of their outpatient visits were virtual because they wanted to, of course, keep people away and not risk what the virus was providing. So digital first doesn't mean digital only, though, hybrid models. And what's interesting is, the three things we always look at, the patients like it. So when you look at care delivery, Zoom actually did a study. We had an organization called Qualtrics do a study, and we looked at ten different countries. And you know, when you look at the US, patients who had actually had a telemedicine visit within six months, 61% of them actually said they wanted a hybrid model of care moving forward. So we know patients like it, which is exciting. 34% said, you know what, we're okay, we'll do the in-person, which is fine, and then 4% said we wanted video. So we know that patients like it, so that, the digital-first, which means basically, in certain cases, but it really does turn out that it's kind of moving the trend that I see, it's hybrid work models and hybrid care delivery models as well, that's one. Another one that's key is just sort of the decentralization of healthcare, and we hear about this with clinical trials, and I also just see it in healthcare in general. It's like, how can we take resources and provide care where it's needed and meet the patient where they're at rather than someone have to go to their clinician or under the hospital or a center of excellence? We're distributing those resources, so if you think of healthcare as like this sort of continuum of where people are in their homes, primary care offices, taking that expertise from those centers and those clinical models and that clinical care and spread it out. And another example of that is hospital-at-home. You know, Australia is way ahead of us, and they're doing a lot of great things on that, so it's really encouraging. And first responders, I'm, work with a group in Australia that they have emergency room doctors and the paramedics have video cameras on their heads. They're actually showing a 70% treatment-in-place model. So think of the cost savings by not having to bring people out to the hospital. So those are the two big areas, digital-first, hybrid and then, of course, is sort of that decentralization.
Saul Marquez:
Wow, it's nice to hear about your global lens, Ron, because we could learn a lot from other countries and the things that they're doing, and it's great that you're infusing some of those learnings into what you guys are doing here in the United States. You mentioned care delivery models, and I think that's an area that I want to ask you, as a nurse, there's models that potentially are holding us back from adopting more care. What are your thoughts around that? Like, do we have to change the culture of how care is delivered to be able to make that next step?
Ron Emerson:
I think the first thing is we're all incentive driven, right? Everyone is incentive-driven and a large part, specifically focusing on the US here, a large part of, of course, hospitals and providers in general, they're incentivized for fee-for-service models. So that really is about the interaction that they have with a patient, they get paid, or when the patients hospitalized, so we're focused on when people are sick. So I think the first thing is, and then of course, regulatory reimbursement, the first thing is, is how do we provide that change, which we are doing, and we realize the importance of moving away from just sort of the fee for service to basically more value-based care models, which is where the provider under capitated rates, they get a certain amount of money to take care of a patient for a month, there's value. They have to show value, and so it changes behaviors, right? And if they don't have to worry about every interaction to generate revenue, it's really more about how can I reach people and provide it, provide care so I don't have exacerbations, and that's what's really, really important. And we are moving, about 40% of Americans last year were underneath some sort of alternative payment system, so we are moving in that direction, but we have a long ways to go. So that's one thing that's going to accelerate different care delivery models, is the incentivization of how we work. And then I think on top of that is, it's a little more difficult when you have payer-providers. you know, like you say, we can learn a lot from public systems because they pay and they provide, so they have more control, they have a vested interest on both sides. And we are seeing movement in public sectors that can actually be a little more agile and can move faster, of course, in the US. We are seeing some positive things. UPMC just did a report where they showed that when they actually provided care for urgent care over a video that they would track the patient for three months, and what they showed is that they actually saved $128 per patient. So when they saw the patient, it was a durable treatment, it wasn't like they saw the patient and then two days later, they end up in the emergency room. So when you looked at the whole study and everything, basically it actually was a nice cost savings from the … And then the other part of that that we need is just how good a care we provide virtually. It was exciting that Mayo just put out a clinic, they use Zoom integrated through Epic, and what they showed is that, and multispecialty when they would actually see a patient, that after they would see the patient, they saw the patient in person within three months of the video encounter. And what they found is that 86.9% of the time that the diagnosis was the same. So we have some really good data that's promising, so that change is occurring. And then, of course, you know, we're in a private system, right, just the market drivers. And just to be very, you know, Saul, if you're a hospital and I'm a hospital and I'm using telemedicine to reach out and interact with patients, the real revenue in the hospital system is when they come through the door. So if I can develop that relationship through telemedicine, through convenience and lowering the barrier, then they're going to come to my facility for MRIs, the CAT scans, the blood draw, all the other things that generate revenue.
Saul Marquez:
Yeah, that's a great call, Ron. A theme across these podcasts at the conference has been the patient experience, being able to improve that experience, those touch points, going beyond episodic care, taking care of the patient through the care journey is a great way to establish a relationship and a long term partnership with the patient, so I think you're bringing up a great point on how Zoom can be used for that. Let's talk telehealth. You have such rich experience. You were in telehealth before telehealth was actually cool and practical, so you sort of saw where the puck was going. You ran a telehealth network in your past, and we've seen change, but how do you see the future? What does it hold?
Ron Emerson:
My opinion is we will have, and sort of my view of the world is that, we will have a digital-first hybrid model of providing care. You know, in healthcare we have something called subjective data and objective data, right? Subjective is what someone says, objective is what you need to see. Like I need to look in the ear, maybe I need to do a throat culture, maybe a urinalysis, those type of things are objective data, right? And sometimes it's not appropriate for telehealth. So I think where the real benefit is how we can use telehealth and virtual tools to lower the barrier to the entry point as we look at equity of care for people to actually enter the healthcare system. And then we have these hybrid models that through increased access, we get people into the system, we decrease the chance of exacerbations and, which require more costs, and of course, we meet the consumer where they're at and where they want to be located, but we do that through these hybrid models. And I think that organizations that don't do this and countries in public systems, I think they're going to be left behind because the data is strong, it shows that there's a lot of reasons to do this, not just because it's the right thing to do, and we're providing care, but it also makes sense from a clinical perspective and a cost saver perspective as well.
Saul Marquez:
Some great insights there, Ron, really appreciate it and certainly looking forward to keeping up with Zoom and the innovations you guys are coming up with in the approaches to healthcare. So thank you for all the insights today. What closing thought would you leave our listeners with today?
Ron Emerson:
As hard as the last few years have been for all of us on a variety of levels, everything from isolation to different ways that we work, I think that sometimes we can look at the glass-half-full approach, that we've really learned a lot and let's not lose those experiences that we've learned and just go back to other ways that maybe weren't working because it was the status quo, because there's so much opportunity. On 2020, studies have shown that there were about 450 million telemedicine visits in the US alone. So this model has been proven, we know it, so let's use it when appropriate, but when appropriate, and let's do it right, and let's do it good. And I think that's the lesson, let's continue to pick up on those things that we've had success with and provide better care for the people that we're charged to take care of.
Saul Marquez:
That's awesome, Ron, thank you for that thought. And if people want to learn more about you or Zoom in the healthcare side of things, where can they go?
Ron Emerson:
Zoom.US/Healthcare and you'll be able to see all of the things that we do, and you can reach out through different channels to get to me as well, Saul, and of course, LinkedIn is always a good way to reach out as well.
Saul Marquez:
Love it. Ron, thank you so much. Folks, make sure you check out Zoomed.us/Healthcare. It's in the show notes, go explore the options. Ron, thank you so much for your time.
Ron Emerson:
Thank you, Saul. I appreciate it.
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