Latest / CareTalk: Healthcare. Unfiltered. / The Missing Piece in Healthcare: Reliability in Care Delivery w/Lumeon CEO & Founder, Robbie Hughes | HealthBiz Briefs

Transcript

The Missing Piece in Healthcare: Reliability in Care Delivery w/Lumeon CEO & Founder, Robbie Hughes | HealthBiz Briefs · CareTalk: Healthcare. Unfiltered.

• 0:00
  Healthcare is chaotic and wasteful and care coordination itself is often uncoordinated.
• 0:06
  So can technology and automation streamline the workflow and improve patient outcomes?
• 0:14
  Welcome to Health Biz Briefs.
• 0:18
  I'm David Williams, president of Health Business Group here with Robbie Hughes, founder and CEO of Lumion, which promises to unlock the potential of your care team with clinical automation.
• 0:28
  Welcome, Robbie.
• 0:29
  Nice to be here.
• 0:30
  Thank you for having me.
• 0:31
  Well, what is clinical automation and why is it valuable?
• 0:35
  So for us, clinical automation is the ability to calculate the flight path of a patient.
• 0:41
  based on a subset of their data, do it reliably and do it in real time.
• 0:46
  And then from that, to be able to inform, communicate, and ultimately automate the things that need to happen next personalized to the patient.
• 0:53
  That sounds good.
• 0:53
  And what makes that so valuable?
• 0:56
  What makes it valuable is it brings this incredibly boring thing called reliability to care delivery.
• 1:01
  And for us, we think it's the single most important thing that's missing from the industry today.
• 1:05
  Just the safe knowledge that the right things are going to happen for every patient, every time.
• 1:11
  And the way that tends to manifest from an economics point of view is it means care teams have less to do because they're only focused on doing the right things.
• 1:18
  Patients have a better experience because again, the care is delivered specifically to their individualized need.
• 1:24
  And at a macro level, healthcare costs less because we're not filling it with errors and waste.
• 1:31
  You know, when you talk about reliability, it's not a term I've heard associated with healthcare perhaps ever, maybe with some devices, but not with the sort of healthcare process.
• 1:39
  Whereas if I think about having a car, reliability, it's not the most exciting things, but a lot of times that's what people want.
• 1:44
  You know, I'm going to get from point A to B, I'm driving, whatever.
• 1:48
  Is reliability not in people don't bring it up just because they don't think they can attain it or because they're looking for something else like a cure in healthcare?
• 1:56
  I think the industry has had a mixed track record in defining what reliability is or could be.
• 2:06
  And I think that in many places people are so grateful to get the wisdom and perspective and frankly time with the care team.
• 2:19
  The downstream processes and the kind of consequential actions and insight that comes from that are often set to one side.
• 2:30
  People tend to think of their healthcare experience as their time with their doctor.
• 2:35
  But actually that only has a very small part to do with it.
• 2:39
  And, you know, to me, I would challenge someone around reliability.
• 2:43
  If you have a situation where a doctor can prescribe a course of action that requires this incredibly elaborate choreography that is almost impossible to deliver, but it will work, but it will deliver a perfect outcome, but only for 1 % of patients.
• 3:04
  who are capable of following that choreography or you've got another out, you've got another course of action that is incredibly simple, can be followed by 100 % of patients, but mainly maybe only delivers 80 % of the outcome, which is the better course of treatment.
• 3:20
  And I think people kind of wrestle with that.
• 3:23
  They say, well, you know, I want the very, very best, but they forget that unless it's perfectly realized and delivered, then maybe it's not quite as valuable as it could otherwise be.
• 3:36
  So I think it's an important question.
• 3:38
  I think we have a lot of work to do as an industry in addressing it.
• 3:42
  That's a great point.
• 3:43
  I mean, I think you could look at a kind of population level outcome and say you want to do something that's more reliable, even if it's like less efficacious for those that follow it the most.
• 3:52
  I personally had the experience of going to like these, you know, super specialized places in Boston with family members.
• 4:00
  and have actually seen them do more of the reliable thing.
• 4:02
  And they're sort of testing, you know, I present like, I can actually handle this regimen or my, you know, dependent that I'm working with can do it.
• 4:09
  And we've actually managed to do that.
• 4:11
  And I also realized that's like a 1 % of the population kind of a thing.
• 4:15
  So it's very interesting.
• 4:16
  Well, along those lines, you know, you work in both the U S and the UK and they have very different health systems and different cultures.
• 4:26
  And I wonder if you could comment on, you know, what's the same and what's different?
• 4:29
  Mike, why are you able to work in both?
• 4:31
  Well, I think that at a core level, they're very, very similar.
• 4:37
  You know, care teams are overworked.
• 4:39
  There are too many patients.
• 4:40
  There's not enough money to do all the things that we want to be able to do.
• 4:45
  And both systems have the same common issue, which things get missed.
• 4:51
  Things don't happen in the way that we would like.
• 4:53
  And a lot of...
• 4:55
  care teams time is focused on what I might describe as remedial action, rather than the things that that a lot of clinicians got into the industry in the first place.
• 5:04
  So to solve, my wife is a PCP.
• 5:08
  And I could describe her day in the UK.
• 5:11
  And it's, it's broadly the same as my PCP friends in the in the US.
• 5:15
  You know, she has too many touch points, too many encounters too much spent too much time spent documenting and chasing too many follow ups.
• 5:24
  She leaves the house at seven in the morning gets home at 10 at night Yeah, you know, that's that is the job and it's frankly an unenviable one From my perspective, but it is fixable We talk a lot these days about data and analytics And certainly important for things that you do like personalization How do you leverage data and analytics, you know sort of what's specific to Lumion compared to how we might generally see it?
• 5:49
  So the data that we're really interested in at a fundamental level is process and compliance data.
• 5:56
  So I'll give you an example.
• 5:59
  An EMR will store a lot of clinical data, it'll store orders, it'll store potentially SDOH data, financial data.
• 6:06
  But the way in which those decisions were reached and the way in which they were documented and the way in which those outcomes were then finally realized doesn't really have a place in the EMR.
• 6:20
  So...
• 6:21
  The data that I find interesting is not just the patient presented with this, to the extent that's even documented actually to a large extent today, but, and then these are the diagnoses and this is what we ordered.
• 6:35
  That's kind of the bread and butter data that's collected.
• 6:40
  But then how do we know that the process by which that information was collected, the way those decisions were made, and then the outcome finally delivered?
• 6:47
  How do we know that that process was done in a consistent way?
• 6:51
  And I think what we've seen is that people do similar things in different ways and that there is a huge amount of innovation to be had in taking potentially similar activities, but delivering them in a different way.
• 7:10
  So I'll give you an example.
• 7:12
  One of our earlier customers was working in ophthalmology and they had a situation where...
• 7:20
  they were screening patients with glaucoma and they were using physicians to have that interaction and that that that consultation.
• 7:28
  And they were collecting a lot of information and doing now I'm not an ophthalmologist, I'm going to get the terms wrong, but they were doing the I exams, etc.
• 7:37
  And what they said was actually, you know, we don't need a physician to do that.
• 7:42
  That's fundamentally a data collection exercise.
• 7:44
  So let's move the data collection exercise to a tech, for example.
• 7:49
  Let's front load that in the consultation and then let's put it into a system such that the patient comes in, instead of for like three hours of consultations, they come in for 20 minutes of data collection through the machines.
• 8:00
  And then let's run it to a virtual ophthalmologist who can then review the information and then have a conversation to the extent it's needed.
• 8:09
  And by doing that, they eliminated 80 % of the physician contact time whilst improving access, reducing the cost of the process and substantially improving.
• 8:18
  patient experience.
• 8:21
  Now, clinically, what they've done is the same thing.
• 8:24
  But what they've added in is a level of reliability because they've got two sets of eyes on the clinical data.
• 8:31
  They've brought in consistency for how it's done.
• 8:33
  So every patient is measured and decisions are made in a consistent, repeatable way.
• 8:38
  And they've wrapped around follow -up processes such that when patients come back for screening, they're always screened at the right time.
• 8:44
  And all of that previously would have been done somewhat haphazardly.
• 8:47
  Maybe each different physician had a different opinion around whether they wanted the patient to come back in three months or six months, depending on the severity of their diagnosis.
• 8:58
  So the process by which they've delivered this care is the stuff that is of interest to us.
• 9:08
  And in their case, it was a highly differentiated set of IP, if you like.
• 9:13
  about how to deliver fundamentally better care for less and at much, much greater scale.
• 9:19
  And what we see, kind of to wrap this up, is different people do things in different ways.
• 9:25
  So our job is to eliminate the internal variation such that you're doing whatever it is you do in a consistent way.
• 9:30
  And then what we're able to do is benchmark and compare that against other people doing similar things.
• 9:36
  And so we can then say for a given cost or for a given presentation, these are the steps.
• 9:42
  executed in this way that are likely to yield the best result.
• 9:46
  And then that's a really, really interesting conversation to have because it opens up questions around operating models, around scalability, ultimately around how you drive efficiency and quality in these processes.
• 10:02
  So yes, we leverage data and analytics, but we use it in a very, very specific way.
• 10:08
  Well, that's it for the latest HealthViz Brief.
• 10:10
  If you like what you hear, check out my HealthViz podcast for a full -length interview with Ravi about his life and career.
• 10:16
  Ravi Hughes, founder and CEO of Lumion, thanks for joining me on HealthViz Briefs.
• 10:20
  Thank you for having me, Daniel.