A New Approach To Healthcare Beyond Clinics And Telemedicine with Karthik Ganesh, CEO of OnMed

[00:00:01] This podcast is produced by Outcomes Rocket, your healthcare exclusive digital marketing agency. Outcomes Rocket exists to help healthcare organizations like yours to maximize their impact and accelerate growth. Visit outcomesrocket.com or text us at 312-224-9945.

[00:00:29] Hey everyone, welcome back to the Outcomes Rocket. Such a pleasure to have you joining us again. I've got the privilege of hosting Karthik Ganesh on the podcast. He is the CEO of OnMed, just an incredible individual that has done a lot of super interesting work with technology and healthcare, making things a lot better for our healthcare ecosystem. Karthik, welcome to the podcast. It's been a while and so I'm glad to have you back. Saul, glad to be here.

[00:00:58] Hey look, so to get right into it, it's been a while since we've talked, but give the folks a little bit of background on you. 25 years in healthcare, I'd like to think I've touched healthcare from all the angles there are to touch it from. I've done payer, provider, sponsored, I've run health plans, I've run a PBM, I've done healthcare consulting, built and led, value-based. I've really touched it from all possible angles. I think that's part of my brand.

[00:01:24] The fact that you take this healthcare journey over 25 years, you realize two things. One, you've got more lessons learned than best practices. But two, you also realize that we get so siloed. We have incredible leadership across the healthcare spectrum, but so much of it is so siloed. So people get into health plans, they stay with health plans. And as a result, they keep churning on health plan problems, even though those problems have been solved in other aspects of healthcare. We need more cross-pollination. And what excites me about my journey has been that it's given me a ton of ability

[00:01:53] to cross-pollinate what has worked, while also taking lessons learned and doing things differently the next time around. Well, Karthik, I love that. And there's no doubt your background has prepared you to offer value in a system that's fixed and has a lot of issues. So talk to us a little bit about your newest venture here on Med. What's your business? What do you guys do? How is it different? And why does it matter? Yeah, the problem we are solving is healthcare access. And let me set the stage with that.

[00:02:24] When we think about healthcare policy as a country, 60, 70 years, it's been about two things. It's been about cost and it's been about access. Cost, unfortunately, continues to have a very solid peanut gallery to it. Because, you know, you look at the cost end of the spectrum, you could keep reducing costs, but costs keep increasing the same vein, right? Access is binary. You either have it or you don't. And here are the facts. 84 million Americans have no viable access to healthcare.

[00:02:51] 80% of US counties have no viable access to healthcare. That's the here and now. You look at the compounding factors from a healthcare standpoint at large. We have 11,000 people aging into Medicare every single day. According to the WHO, three out of four Americans is either overweight or clinically obese. Just in the last three years, we've seen a 32% spike in Medicaid enrollment. So as a country, we are getting older, heavier, and poorer.

[00:03:18] While that is a dramatic statement, you think about it purely from a healthcare standpoint, it continues to expand and create additional risk. It also creates additional demand for access. We already have a huge access problem, and we've got a demand that continues to skyrocket on our watch. You look at the only two modalities of care that exist in our country today. Pre-COVID, all of us thought of it from the standpoint of a clinic. We like the comprehensive nature of a clinic. You go into the doctor's office, you do your thing.

[00:03:48] Clinics have two fundamental problems. Brick-and-mortar clinics have two fundamental problems. One, extremely expensive to stand up and administer. It's over $2 million to stand up and over three quarters of a million dollars to run this every year. That's one. Second, if we were serving the people who needed to be served, we needed 200,000 more physicians as of three years ago. As of 2021, we're producing 18,000 a year, and about 50% of everyone who's practicing medicine today is either a pre-retiree

[00:04:16] or has candidly stated they're burnt out coming out of COVID. We have a demand, we have a humongous supply problem as it pertains to just trying to grow the traditional way we've thought about access to care. We've hit a ceiling and there is no viable answer to lift that ceiling. You look at telemedicine at the other end of the spectrum, we all got excited about this as we went through COVID. Those of us who have the luxury, who are not a part of the 84 million or the 80%

[00:04:44] who wear wearables, we think, well, telemedicine's pretty cool. It's not. And here are the reasons for it. No disrespect to the telemedicine industry. It has its advantages, but here are the clear challenges. 42 million Americans have absolutely no access to broadband. That is an extremely understated number because when you start adding in people who have very less access to viable broadband, one, two, three, MBPS gets you nothing. That number starts pushing up to over 70 million. That's one.

[00:05:12] Second, telemedicine is great for a quick call. I got a sniffle. What do I do? It doesn't have vitals. It doesn't have scans. It doesn't have biometrics. It isn't a true comprehensive clinical experience. Yeah. Those are the only two modalities of care we know. From a supply standpoint, for a demand that is just exponentially growing as a country, if most things in life come back to health or wealth, we are completely comfortable doing everything wealth related on our phones. We can't do that with health.

[00:05:39] We are fundamentally compromising our productivity, our success as a country because we have no access to care. That's where OnMed comes in. OnMed's product is a care station. Think of it as an eight and a half by 11 kiosk. You walk in, the door closes, the glass fogs up. It can essentially be deployed anywhere. It has a 65 inch screen with a clinician on it. So you feel like you're talking to a real clinician up front live. It has devices. It has thermal scans.

[00:06:08] It's got all the things that you would expect in a primary care slash urgent care setting. About 80% of people who walk into the care station don't need a referral out of there. The 20% of folks who have got chronic conditions. We've now deployed this across most of rural West Alabama. We've deployed this inside of homeless shelters. We've deployed this inside of a prison. We've deployed this outside of health systems. It's been deployed. It's going to go into its first airport in the next month and a half.

[00:06:36] Essentially, our mantra is healthcare anywhere. Anywhere where you can plug this thing in. It is going to bring the psychological comfort of a clinic with the rapid scalability of telemedicine. The next, what I will leave you with is the next pandemic is not an if, it's a when. We need a better access mousetrap as a part of our public health infrastructure. The two modalities in place right now aren't cutting it.

[00:07:01] If hit a ceiling, we've got to take the best of what worked for them and do something different. Yeah, I love that, Karthik. The stats you mentioned are all pretty miserable stats, but it's the reality of our health structure today. We need things that will scale. Hybrid care is the way to go, but you need the devices, right? To supplement telemedicine. Telemedicine. So I love that you focus there. A lot of this seems like a combination of public health.

[00:07:30] I'm thinking maybe Medicaid, but maybe it's commercial as well. Talk to us about who your end customer is in the healthcare ecosystem. It is anyone who's looking to fix an access to care problem. And that access to care problem comes in a multitude of different trends, right? So one, health systems are a huge customer of ours from a multitude of standpoints. One, 75% of everyone who shows up in the ER shows up for non-emergent reasons.

[00:07:57] Health systems are motivated to figure out how to get the folks who are non-emergent to a more optimal site of care. So that folks who truly have emergencies, those folks aren't choked up at the folks ahead of them. Let me put it simply, right? So that's one. Second, for a lot of health systems, they want to do the right thing. They want to get their footprint out into the more rural communities, into the more underserved communities around them. They don't have the money to stand up clinics. They don't have the clinicians to staff these clinics.

[00:08:25] So we've been deploying care stations on behalf of health systems with their brand wrapped around us. In some cases, the health systems are the clinicians from the home office. In some cases, we're providing care, but it's allowing them to get their footprint out broader. So health systems, payers have the same challenge. Their challenge is a combination of star ratings, caps, things that really make it important for them to provide an incredible experience in the communities they serve.

[00:08:52] And an incredible experience is an improbable one if there is no access to care. You have to provide access to begin with, and then you have to supplement it with an incredible experience. So we are actively partnering with payers across the country. Universities, we've now deployed this at a multitude of universities because the only option they have is their health center, which is an extremely expensive one to run and administer. It takes away from their core focus, which is education.

[00:09:19] This now being placed in their student center, in their dorms, now adds a different flavor to it. We're seeing local, state, federal government activity at a very heightened pace. A combination of Tampa General and in Tampa, as well as the local charity with the mayor of Tampa, this went into a homeless shelter. The first of its kind in a homeless shelter. When a homeless person has a medical emergency or a medical need of any kind, they call 911.

[00:09:47] In two months of placing it in a homeless shelter in Tampa, the largest homeless shelter in Tampa, we saw a 50% reduction in 911 calls. In partnering with the payer, we've deployed this inside of prison. Each time an inmate needs to leave the prison, says they're sick and they want to leave the prison, one, it is a, it is just fundamentally a risk because they could decide that's the time to vote. But two deputies have to accompany them every single time they leave because one person has to back up the other. Costly. It's very costly.

[00:10:17] It is a drain on the productivity of the corrections facility. Putting this in, basically, we've got inmates tapping out saying, I'm not feeling that sick because if I'm going to go here, no one's going to show up with me. I'm not getting any win out of this whole situation. It's a huge productivity implement for them. We've deployed this with employers. So we've got employers, local, state, federal government, payers, providers, the second largest home builder in the country. We've just got a multitude of sponsors who fundamentally understand that one, providing better care now adds to the value prop.

[00:10:47] Two, absenteeism, productivity, cost savings, ER optimization. All of these are very important factors as we think about being financially more astute. And three, healthier communities are wealthier communities. There's nothing refuting that. No, 100%. That's been the motivator. Love it. No, thanks for clarifying that for us. And cost factor wise, I mean, look, you look at an organization like Walmart, for example. They shut down their whole operation.

[00:11:15] They didn't realize that primary care for a very long time was a referral source for specialty care. Does this present an opportunity for the grocers out there that maybe it's a more scalable way to deliver primary care? 100%. So it offers an incredible way of doing it. It heightens their brand because it now tethers them more closely to the communities that they're a part of. Two, it provides them.

[00:11:41] I would look at this as we call it everyday care because this is a combination of primary, urgent and post-acute. We have a lot of post-acute cases coming in that are completely taken care of via the care station. This is the medical home in a lot of the communities we've put this in right now, right? So you're exactly right. Brand equity for the grocers, it allows them to bring care in tandem where people are already going. So they add more value to the community.

[00:12:06] And three, it allows them to showcase that they don't just have to be the local grocer. They could be the local healthcare solution as well. So from an adjacency standpoint, it is a very clear plug-in. And you're right, right? I mean, it's not just the Walmart. This has been the notion of a brick and mortar construct, expensive to run, expensive to stand up, expensive to maintain, tough to find clinicians. And how do I get the right bang for the buck out of it has been a challenge for Walmart.

[00:12:36] It's been a challenge for Walgreens with Village MD. It's been a challenge for, quite frankly, an Amazon with One Medical. Everyone has struggled. CBS, everyone. Everybody's struggling with it. It is time to stop doing the same thing over and over and over again. Let's move the damn needle already. I love it. Well, there you go. You guys know who you are. Karthik mentioned you to check him out. We'll leave it in the show notes so you can get in touch. What would you say is one thing most people don't know about the problem you solve?

[00:13:06] One thing that most people don't know is we get so excited about AI. We get so excited about wearables. They all have a place. There is. Here's what most people don't know. The American consumer and the American patient, even though they might be the same person, we behave in an extremely bipolar manner. The American consumer is liberated. The American patient is claustrophobic. They are burdened by a system that isn't working for them. They are burdened by costs that aren't working in their favor.

[00:13:36] They are burdened by access issues that are not allowing them to see docs timely or anywhere close to them. We have to fundamentally start changing the dynamic. It is time to stop treating the American patient as a patient and to start treating the American patient as a consumer. The on-net care station and what we are looking to do is looking to bring consumerism into healthcare access. That's fantastic. Thank you for that. And I agree with you 100%.

[00:14:02] We could also talk about education and some of the issues there, but hey, we'll leave that for another podcast. We'll leave that for another day. Yeah. Look, we like to learn from successful people. And I wanted to ask you on that front, what's a favorite business resource or business hack that you'd recommend to the other entrepreneurs and leaders looking to be successful in business? I would say, one, I read exhaustively. I am constantly reading. I have no rearview mirror.

[00:14:27] It is vital when you're building a business, when you're looking to build a high-growth business, that you don't have a rearview mirror. You drive forward looking in the rearview mirror, you are bound to have an accident. Focus on the now. Don't get paranoid about tomorrow. Be passionate about what you're doing. Don't get caught up in whether you're planning for an exit or not. You build an incredible company. You focus on building an incredible company. Everything else takes care of itself. Focus on the problem. Focus on a solution to the problem. Be pragmatic about the problem. Solve.

[00:14:57] Things take care of themselves. That's awesome. Yeah. And what book rises to the top for you now? I know I read a lot too. So, like, it shifts. I'm going to tell you, my best business book of all time, which has fundamentally framed the way I think about leadership, is The Alchemist. And it has nothing to do with business. Yeah, yeah, yeah. Tell me what you like about it. The notion of focusing on the journey and letting the outcome take care of itself. Hmm. Yeah, that's so good.

[00:15:25] And, you know, I would say, too, one of my favorites, the other thing that I love about it is that there's so much value and wealth here now. And from a marketing perspective, I always tell our clients, like, you are swimming in leads and you don't even realize it. That's right. So I love it, Karthik, man. This is so good. Thank you for those recommendations. Folks, a lot for us to think about, both from a healthcare perspective as well as entrepreneurs. Take these home, but actually take some time to reflect on them.

[00:15:54] That's how these things can turn into valuable output for you and your customers. Look, I'd love to get more people to know about you. Tell us where they could reach out to you to learn more about you and also OnNet. www.onnet.com. It is an incredibly intuitive website. It gives you a really great feel for what we're looking to solve, what our purpose is as a company and what our product is and what it does in the market.

[00:16:19] We've got incredible testimonials from our clients, both urban America and rural America, because underserved is underserved. And the best way to reach me is through OnMed.com. Love it, Karthik. Always great to connect with you. And for the folks tuning in, make sure you check out the show notes, as I previously said, where you could find all the ways to get in touch with Karthik and his OnMed team and all the short notes so you could do a quick breeze of what we just covered. Healthcare has to change. We need solutions like OnMeds.

[00:16:48] And that's why, Karthik, we're so glad you were with us today. Thank you. All right, Sal. You have a good day, man. You too. This podcast is produced by Outcomes Rocket, your healthcare-exclusive digital marketing agency.

[00:17:13] Outcomes Rocket exists to help healthcare organizations like yours to maximize their impact and accelerate growth. Visit outcomesrocket.com or text us at 312-224-9945.