Latest / CareTalk: Healthcare. Unfiltered. / Michelle Davey on Reinventing Care Delivery With Virtual Care

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Michelle Davey on Reinventing Care Delivery With Virtual Care · CareTalk: Healthcare. Unfiltered.

• 0:00
  David: The US healthcare delivery system is in trouble.
• 0:03
  David: The last few years have been especially tough.
• 0:05
  David: Many physicians and nurses are seeking opportunities to keep serving patients without all the stress of traditional practice.
• 0:11
  David: Enter Michelle Davy, founder and c e o of Wheel.
• 0:14
  David: She grew up in rural Texas where she spent her childhood on a diagnostic odyssey, being shuttled from one doctor to another in search of answers and learning a lot about healthcare in the process.
• 0:25
  David: She founded Wheel in 2018 to bring virtual care to life.
• 0:29
  David: As far as we know, she didn't instigate the pandemic, but it was perfect timing to surf the virtual wave.
• 0:34
  David: Welcome to Care Talk America's home for incisive debate about healthcare, business, and policy.
• 0:38
  David: I'm David Williams, president of Health Business Group.
• 0:42
  John: And I'm John Driscoll, the president of Walgreens Health as the President of Walgreens Health.
• 0:45
  John: I can assure you, David, that Michelle had nothing to do with the pandemic, and I don't know why you should follow yet another
• 0:52
  David: conspiratorial rabbit hole.
• 0:54
  David: I only read what, I only know what I, I what I read about you in the Wall Street Journal, John, I thought that's where I saw it.
• 0:58
  David: But not just stop, stop, stop.
• 1:00
  John: Michelle, welcome and thanks for joining Care.
• 1:03
  Michelle: Thank you.
• 1:03
  Michelle: Thank you for being here.
• 1:04
  Michelle: I didn't instigate the pandemic.
• 1:07
  Michelle: I can put that on record today.
• 1:09
  Michelle: But excited to chat and talk further.
• 1:14
  David: Yeah, that sounds awesome.
• 1:14
  David: So
• 1:15
  John: Michelle, how did you get in interested in, in healthcare?
• 1:17
  John: David referred to a diagnostic journey, but a lot of folks in a diagnostic journey, the last thing they want to do, Get involved in, in, in, in healthcare.
• 1:27
  John: What, what, what, what got you interested in it and how did you, how did you end up starting a
• 1:32
  Michelle: company?
• 1:34
  Michelle: Well, I do take it back to my personal life growing up in rural Texas and maybe my diagnostic odyssey is what I think David called it.
• 1:43
  Michelle: Really trying to find the right.
• 1:45
  Michelle: At the right time.
• 1:47
  Michelle: And that was a real struggle for me and my family.
• 1:50
  Michelle: I grew up in a blue collar family.
• 1:52
  Michelle: As we all know, cost of care was rising, continues to rise, and it was oftentimes not a struggle just to find a doctor, but to be able to afford that doctor and specialist over time.
• 2:03
  Michelle: So that's where my real interest with healthcare and my experience started.
• 2:08
  Michelle: But professionally, I started my career in large.
• 2:12
  Michelle: In diagnostics.
• 2:13
  Michelle: So started at Medtronic.
• 2:14
  Michelle: I went full in thinking healthcare was really innovative.
• 2:19
  Michelle: At 22 years old I was like, oh, I'm gonna be in the innovation cycle and I'm gonna be in healthcare.
• 2:26
  Michelle: After about three years of being in large companies and large metal device as well as capital equipment companies, I quite frankly swore off healthcare.
• 2:35
  Michelle: I was like, it's not the innovation center that I was expecting.
• 2:39
  Michelle: It wasn't really.
• 2:41
  Michelle: Trying to do better by patients in many ways.
• 2:44
  Michelle: And that's when I jumped over to tech.
• 2:46
  Michelle: So spent several years at Google leading a recruiting team there.
• 2:51
  Michelle: I then went to an on demand delivery startup where I scaled it from.
• 2:56
  Michelle: 10 people to 500 people.
• 2:59
  Michelle: Thousands of users got really familiar with the future work model back in 2014.
• 3:05
  Michelle: Really passionate about alternative ways to for people to be employed or contracted and kind of make additional revenue.
• 3:14
  Michelle: And then it came all the way back around.
• 3:16
  Michelle: And I then found Healthtech.
• 3:18
  Michelle: And for me, this was 2016.
• 3:21
  Michelle: And the word telemedicine came across my desk and I was like, what is this?
• 3:26
  Michelle: And quite frankly, for me, that meant a real mash together of my personal values and what I cared about, as well as my professional background.
• 3:38
  Michelle: So I spent about a year at a telehealth startup learning that one, at that point in 2016 patient to Demand was pretty central around urgent care use cases, quite frankly.
• 3:51
  Michelle: So we saw, you know, sub 1% most times, and then, you know, surges of 3% in these back half of the year, the fall, the cold and flu season.
• 4:01
  Michelle: But really what was interesting to me was the fact that the labor pool or the clinicians that were delivering telehealth back in 2016, it was like this dirty word people didn't wanna talk about.
• 4:17
  Michelle: Being a clinician powering telehealth or providing telehealth, most of 'em removed it from the resumes altogether.
• 4:24
  Michelle: I wanted to change that, not only for the clinician.
• 4:27
  Michelle: I wanted it to be a better, so why double,
• 4:30
  John: but double click on that.
• 4:31
  John: Why would they want to hide from telehealth?
• 4:34
  John: What, what, what was the dark secret of telemedicine?
• 4:38
  John: That was, that they were.
• 4:41
  Michelle: Well, if you remember, like this was a time when people didn't think telehealth met the standard of care, and to be a clinician providing that care and then having the overhang of, is it.
• 4:55
  Michelle: Adequate care, does it meet the standard of care?
• 4:58
  Michelle: And then the third piece was, well, you just didn't see a lot of demand happening, patient demand.
• 5:05
  Michelle: And so, you know, you did during those certain times, like I talked about cold and flu season, but you didn't see it for a large subset of use cases.
• 5:14
  Michelle: It was really this urgent air world.
• 5:17
  Michelle: And if that, If that's where it was.
• 5:21
  Michelle: A lot of the clinicians who practice more chronic care, longitudinal care were not interested in the system at that time.
• 5:30
  David: And so what do you think about, you know, you talk a lot about rethinking healthcare delivery, fundamentally rethinking about how much of that is about sort of the labor model versus technology policy, how you.
• 5:40
  David: What are the key actors there?
• 5:42
  Michelle: Well, they all play a role but for us, fundamentally, it's always been about leading with the technology.
• 5:47
  Michelle: So I think what people get wrong about we all oftentimes is that we're a staffing company and, you know, labor and clinicians, we all know we have a labor shortage in this country and it's getting a lot worse, whether that be because of the pandemic or the aging population, et cetera.
• 6:06
  Michelle: But ultimately I do believe they all play a role together.
• 6:11
  Michelle: Fundamentally rethinking it means that each one of those has to come together and be changed in order to move anything forward.
• 6:19
  Michelle: And that's really the foundation of we all, from the regulatory environment, the technology, and the clinicians behind the scenes actually being the engine for that care.
• 6:30
  John: So what actually, you know, if, just backing up a second, Michelle, what exactly does Wheel do and who do you sell to?
• 6:40
  Michelle: It's a great question and sometimes people think we're a very mysterious company and I think it's because we've really come up during a time where we've been powering some of the most innovative healthcare innovators.
• 6:52
  Michelle: This last couple years.
• 6:54
  Michelle: So most people know us for powering the consumer driven healthcare of digital health and tech companies.
• 7:01
  Michelle: We still do that.
• 7:02
  Michelle: But we also use our technology and our platform, which I'll double click to in a minute to sell to traditional healthcare providers and retailers.
• 7:11
  Michelle: And really for us, it's about providing all of the underlying infrastructure, whether that's our technology.
• 7:17
  Michelle: Virtual care technology, lab technology, marketplace technology, et cetera, for companies to build multiple programs for different patient populations.
• 7:29
  Michelle: Under one singular technology.
• 7:32
  Michelle: And then also having the clinicians to be able to either provide that carefully or augment that that network that the client has.
• 7:41
  Michelle: So we've brought in definitely our approach as well as our technology, and we continue to build much more technology driven for different types of virtual care, not just te.
• 7:54
  Michelle: And we continue to double down there.
• 7:57
  David: You know, I didn't think it was a staffing company cuz I saw the you know, the tremendous amount of money you've raised and is on the balance sheet.
• 8:02
  David: It reminded me of that old expression, you know, money makes the wheel go round.
• 8:06
  David: And I wonder like, why, you know, like, how do you raise so much money and what's the, you know, why do you, why do you need that?
• 8:13
  David: ?
• 8:13
  David: Michelle: Well, we've raised about over the last couple years, and it really has been for twofold.
• 8:20
  David: One, there's a lot of broken technology that needs to be rebuilt, and that's what we're really focused on, that infrastructure layer and enabling different types of companies, whether that's digital health, innovators, payers, retailers, to build on top of that and be able to provide great patient experie.
• 8:41
  David: To their members.
• 8:43
  David: That means we have to do things like acquisition.
• 8:46
  David: So we announced our acquisition of the GoodRx Care platform and Q4 of last year and will continue to add on the capabilities of our platform over the coming years.
• 8:58
  John: So what is the GoodRx Care platform?
• 9:01
  John: Because as far as I could tell, GoodRx didn't have a care platform.
• 9:05
  John: So what did you.
• 9:07
  John: Separate from there.
• 9:07
  John: That, and what kind of care are you planning
• 9:09
  David: going to add, John?
• 9:10
  David: I dunno if that's a fair question to say she bought something that doesn't exist.
• 9:13
  David: It
• 9:13
  Michelle: definitely exists or didn't.
• 9:17
  Michelle: There's, there's multiple pieces, but.
• 9:20
  Michelle: A couple different things.
• 9:21
  Michelle: I think really where we all, since 2018, to call it 2022, had focused most of our r and d and product build was around our routing capabilities to match the right patient with the right clinicians.
• 9:35
  Michelle: So we match on over 15 different attributes in our routing algorithms to ensure that the patients get the right care at the right time, as well as all the clinical tools.
• 9:44
  Michelle: So the back.
• 9:46
  Michelle: Of the clinician kind of back office.
• 9:49
  Michelle: That's really what we built.
• 9:50
  Michelle: And Good RX is well known for their great consumer patient experience for members or patients who have come in through the Good Rx care site.
• 10:01
  Michelle: And we were really excited about that.
• 10:03
  Michelle: We had built and multiple brands in this market, including , some of the top healthcare brands like GoodRx, and we were blown away about their patient experience as well as some of their clinician experience.
• 10:17
  Michelle: And it really is top of the shelf software that enables patients to have great experiences and enables.
• 10:24
  Michelle: A single page for clinicians to take care of multiple areas of a patient's care, whether that be longitudinal or episodic.
• 10:34
  Michelle: And so right now we're focused on integrating that to all of our technology.
• 10:38
  Michelle: So our marketplace technology, we have a labs platform and really being this full platform for any type of virtual care to be delivered on.
• 10:49
  Michelle: So
• 10:49
  David: do
• 10:49
  John: you wanna replace the AM wells and the Teladocs of the
• 10:53
  Michelle: world?
• 10:55
  Michelle: I get that question a lot.
• 10:56
  Michelle: I think it depends is the right answer.
• 10:59
  Michelle: I think Amwell and Teladoc have made a really great push forward, especially over the last year around longitudinal care.
• 11:09
  Michelle: But wheel is much more than just telehealth.
• 11:11
  Michelle: And I think that's important to restate multiple times because many of our partners build unique
• 11:18
  John: programs.
• 11:18
  John: David is very, is a very slow learner, and I find I have to repeat myself a lot.
• 11:24
  David: I just listened to the podcast 10 or 12 times, Sean, so I can understand what the heck you're saying.
• 11:29
  Michelle: Yeah, so I think for us it's not about a replacement, it's about really being able to bring new types of care delivery and new types of models into more traditional areas of healthcare, whether that's the payers whether that's retailers, et cetera.
• 11:46
  Michelle: But building consumer driven healthcare experiences that we've come to power over the last several.
• 11:53
  David: So I hear you talking about longitudinal care, and I don't know if that's relative to other companies or what Wheel's doing, but I've also heard some discussion about how Wheel helps providers to be more like Uber drivers.
• 12:02
  David: And I think, I don't have a longitudinal relationship with my, my Uber driver.
• 12:06
  David: And I'm wondering, you know, on the one hand, is the becoming an Uber driver type of an approach?
• 12:11
  David: Is that the, is that the, you know, the solution for physician burnout and what does it mean for the doctor-patient relationship?
• 12:18
  Michelle: So the Uber model gets a bad rap in the sense that, yes, I think we think about our driver that picks us up and drops us off and maybe took the wrong turn a couple times.
• 12:29
  Michelle: I think for us it's really about a couple different things.
• 12:33
  Michelle: Applying the right clinician, To the right situation, right, and the right patient.
• 12:40
  Michelle: Again, going back to our routing algorithms, I kind of think about telehealth 1.0.
• 12:44
  Michelle: When we were routing patients to doctors, it really worked like that taxi company, right?
• 12:49
  Michelle: It was just who was available and the next queue, and that's who got the patient or the ride.
• 12:56
  Michelle: We really think about it, of how do we match the patient with the right clinician at the right time?
• 13:02
  Michelle: Well, we can do.
• 13:04
  Michelle: With a number of different things like algorithms, but also it comes down to the clinicians that are providing that care.
• 13:11
  Michelle: So in the episodic, urgent care or asynchronous care environment, a longitudinal relationship doesn't always have to be front and center.
• 13:21
  Michelle: With that being said, the access to the data from that patient's health record, whether that be during a virtual visit with Wheel or one of our partners, so the unique part of our wheel platform is we can actually aggregate data across all of our partners and then serve that up to the clinicians as well as bring in patient data from other sources.
• 13:46
  Michelle: And then as we've started to evolve and as.
• 13:49
  Michelle: See healthcare and virtual care really pushing into longitudinal care.
• 13:54
  Michelle: That's where we're using different models for longitudinal care, which we'll be talking more about and then coming in quarters.
• 14:02
  Michelle: Do
• 14:02
  John: you see yourself, Michelle playing more?
• 14:06
  John: Are you going upstream to.
• 14:11
  John: actually replace the doctors with your own kind of doctors you would otherwise contract with, with, with fully employed docs, a virtual medical group, if you will.
• 14:19
  John: Is that where you then would take actual risk on a, on a, on a population or a, or a set, a cat, a category of medical procedures?
• 14:30
  Michelle: It's not something we're doing today, but I think it's pretty clear kind of with the aging population the way.
• 14:37
  Michelle: The dirty word of value-based care, but as we start to actually see
• 14:42
  David: value-based care, yeah, we're not allowed to, FCC doesn't allow us to say that on the podcast, so we'll have to censor that out.
• 14:47
  Michelle: Yeah.
• 14:49
  Michelle: I believe strongly in, in the idea of value-based care, I think we haven't quite fully developed the working business model of value-based care for the future.
• 15:02
  Michelle: And in those models over time, as we evolve as well, I do see us doing different models of clinicians, whether that's kind of.
• 15:12
  Michelle: A network, mso, a virtual network manager, et cetera, to be able to provide that level of, of care for our patients.
• 15:20
  David: You know, you mentioned matching the patient with the right clinician, and I noticed that you do work with physicians, but also I believe nurse practitioners, nurses, behavioral health practitioners.
• 15:30
  David: How do you integrate and manage those non-physician clinicians?
• 15:36
  Michelle: Yeah, so we work with a.
• 15:39
  Michelle: Bunch of different types of clinical supply and clinicians, and it really depends on the types of providers as well.
• 15:46
  Michelle: So one, from a regulatory perspective, not only do we ensure that the clinician is practicing to the top of their license, but also that all of the back office.
• 15:57
  Michelle: Things like chart reviews and state level reporting, et cetera.
• 16:02
  Michelle: We take all of that on off of both the clinician and our client.
• 16:06
  Michelle: So that's a really important piece to enable our clinicians to not have to worry about providing the care that they are and not the headache that the regulatory environment across 50 states can be for our clients as well.
• 16:20
  Michelle: So, We really try and think about how do we make it easy for both clinicians and our clients to.
• 16:29
  Michelle: At the highest quality of virtual care.
• 16:32
  Michelle: And that may mean utilizing technology to do a lot of that as well as offering different services like our RN networks or our nurse practitioners as well.
• 16:43
  Michelle: Do you see
• 16:44
  John: Wheel as actually just making the current provision of healthcare more efficient or do you see the virtual care platform you're building actually extending.
• 16:55
  John: More care to more patients, basically increasing capacity as opposed to making the capacity just more
• 17:00
  Michelle: efficient.
• 17:01
  Michelle: Yeah.
• 17:02
  Michelle: I think the vision is to not just make it more efficient, it's really to increase the capacity of.
• 17:13
  Michelle: The clinician as well as the amount of patients that can be treated under healthcare.
• 17:19
  Michelle: I think I use the air quotes here because healthcare over the last several years has really been focused on sick care and chronic care over time.
• 17:30
  Michelle: We're also looking at kind of the earliest indications of care.
• 17:34
  Michelle: Some people call that wellness, but also preventative care as well.
• 17:39
  Michelle: And so thinking about that full life cycle of healthcare in bringing the capacity of what that means to patients in a more broader
• 17:49
  John: way.
• 17:49
  John: And as you get into the extending more care in more ways, do you expect to be using tools like You know, chat, G p t or some of the, the, the things that Google's working on to sort of replace the clinicians with sort of you know, sort of.
• 18:07
  John: Learning bots.
• 18:08
  Michelle: I'm a strong believer that AI doesn't replace clinicians, but it does help them in their workflow and enable them to expand their, their capacity, as well as provide really great care to patients.
• 18:23
  Michelle: So spending time on a video or a chat-based interac.
• 18:30
  Michelle: Where clinicians can use tools like chat g p T to build better kind of protocols or follow up visit treatment information that really helps the clinician not spend 20% of their time in a charting.
• 18:47
  Michelle: World while still trying to communicate with a patient.
• 18:50
  Michelle: So I believe AI is gonna be a compliment to the clinician, not a replacement.
• 18:55
  Michelle: You,
• 18:55
  David: you talked about back in 2016 with the providers not wanting to put, you know, telehealth on their, on their resume.
• 19:01
  David: And I think some of it may have had to do with online prescribing of lifestyle drugs at the time.
• 19:05
  David: If we look in the last couple years though, there's also been an
• 19:08
  John: uptake.
• 19:08
  John: David, you're not gonna talk about your own experience with lifestyle drugs.
• 19:12
  John: , David: I thought we got rid of call it emergency department.
• 19:16
  John: John, I, I have, you know, if I, I thought, listen, if I need to borrow one of those, I'll just take one from outta your little pill container.
• 19:22
  John: But I'm talking about the zoom new drugs out for for weight loss in particular.
• 19:26
  John: I'm thinking about also in behavioral health and there have been some.
• 19:30
  John: You know, there have been some companies that have been called out.
• 19:32
  John: Well, cerebral.
• 19:33
  John: Cerebral, yeah.
• 19:35
  John: Those guys are probably
• 19:35
  David: going to jail.
• 19:36
  David: Exactly.
• 19:36
  David: Who knows?
• 19:37
  David: But, but I would imagine, you know, Michelle, these, these, some of those companies that are out there, there's some that are doing the right thing, meet the standard of care, innovating, and there's some that you might not wanna be so involved with.
• 19:46
  David: How do, how do you sort of, sort that through, how do you talk to clinicians about.
• 19:52
  Michelle: Yeah, it's a great question and it's actually something we thought about since the founding.
• 19:56
  Michelle: So my co-founder is a health regulatory lawyer.
• 19:59
  Michelle: So regulation and clinical quality and regulatory environment has been.
• 20:04
  Michelle: a part of our founding since day one.
• 20:07
  Michelle: And and quite frankly, to your point this is kind of been going on for several years.
• 20:13
  Michelle: First it was the D m E providers.
• 20:15
  Michelle: Now it's, you know some of the behavioral health as well as some of the weight loss.
• 20:20
  Michelle: I think it really depends on the situation.
• 20:22
  Michelle: And for us, we do vet all of our clients on a regulatory.
• 20:28
  Michelle: Our regulatory checklist as well.
• 20:31
  Michelle: We help companies move from a place of being uncompliant to a place of compliance, and that's a really important feature of wheel.
• 20:40
  Michelle: And one of the things that we think is a core value prop of ours is really being able to help.
• 20:46
  Michelle: Our clients understand the changing regulatory environments cuz it has changed and especially now as we see some of the covid waivers rolling back.
• 20:54
  Michelle: But for us, we're always focused on not only what's right for the patient, but are our clinicians protected.
• 21:01
  Michelle: And that's how we vet our, our clients.
• 21:03
  Michelle: So we are proud not to represen.
• 21:06
  Michelle: Some of those companies as well.
• 21:08
  Michelle: So
• 21:08
  David: A, as
• 21:09
  John: you think about leveraging AI tools and building this platform out, are you more of a software business or more of a services business given your vision of Wheel going
• 21:19
  Michelle: forward?
• 21:24
  Michelle: We're a tech company at our heart, and we always have been.
• 21:27
  Michelle: I think you'll see over the next year especially over the next couple years, really our ability and our product capabilities really expand.
• 21:36
  Michelle: We're heavily investing into our platform and our.
• 21:39
  Michelle: Our added capabilities over the next couple years.
• 21:42
  Michelle: So we really lead with, we're a technology company at heart, but it doesn't take away the fact that a hundred percent of care in this country is delivered through clinicians.
• 21:53
  Michelle: So, while again, I do believe AI will be a compliment, but not a replacement, we really are focused on how do we enable the workforce to work in a whole new way for the future.
• 22:05
  Michelle: And especially as we start to see hybrid care really start to pick up steam and
• 22:10
  David: evolve.
• 22:11
  David: So Michelle, my last question for you is I saw that you are a mentor and an angel investor for women-led companies.
• 22:17
  David: And I'd like to hear a little bit about how that's going.
• 22:21
  Michelle: Yeah.
• 22:21
  Michelle: Well for me it's really important to give back to the next generation of women that are coming up and building incredible companies.
• 22:30
  Michelle: The great news is there's a lot of them.
• 22:32
  Michelle: I think.
• 22:33
  Michelle: , they historically women have been underfunded.
• 22:36
  Michelle: I think even now it's getting worse based on the recent numbers coming out.
• 22:41
  Michelle: But for me, . It really is.
• 22:44
  Michelle: And for me it was the people around me who helped me through every stage of this journey and continue to help me.
• 22:50
  Michelle: It's not like now I'm a mentor and don't ask questions.
• 22:54
  Michelle: I still have mentors.
• 22:55
  Michelle: I still reach out for questions.
• 22:57
  Michelle: I wanna be not only a place of capital for women.
• 23:01
  Michelle: But also a place for advice and known learned experiences for them.
• 23:06
  Michelle: And just sharing and giving back to the women that are building incredible companies.
• 23:11
  Michelle: And I know many of them that are, are doing so excellent.
• 23:15
  David: We hope to have some of them on as as guests, and I'll make John be nice to them and ask good questions.
• 23:20
  David: Well, that's it for yet another episode of Care Talk.
• 23:23
  David: We've been talking about virtual care and we've been rediscovering the wheel.
• 23:27
  David: CEO E and founder, Michelle Davy.
• 23:29
  David: I'm David Williams, president of Health Business Group.
• 23:32
  David: And I'm
• 23:33
  John: John Driscoll, the president of Walgreens Health.
• 23:34
  John: You like what you heard, please s you for joining.