The Role of Digital Health In Elevating Patient Experience with Dr. Byron Crowe, Chief Medical Officer at Solera Health

[00:00:08] Hey everybody, Saul Marquez with the Health Matters podcast. I want to welcome you back

[00:00:13] to another episode recorded here at Health 2023 in Las Vegas. Today I have the privilege

[00:00:19] of hosting Dr. Byron Crow. He's the Chief Medical Officer at Solera Health, a practicing

[00:00:25] internist at Beth Israel Deaconess Medical Center in Boston and faculty member at Harvard

[00:00:30] Medical School. As an expert in digital health innovation and human-centered design,

[00:00:34] the overseas clinical program development for Solera's suite of physical, mental and

[00:00:39] social health solutions available to millions of patients nationwide. Dr. Crow, welcome.

[00:00:44] Saul, it's great to be here. Thanks so much for having me.

[00:00:47] It's a pleasure to have you here and look to begin with I want to just start off by

[00:00:50] helping the listeners get to know you a little bit better. What is it that inspires

[00:00:54] your work in healthcare?

[00:00:56] Many years ago when I was an undergrad, a pre-med undergrad, I was wondering what

[00:01:01] a career in medicine would look like and I read a great book called The Checklist Manifesto

[00:01:06] which many folks have read.

[00:01:07] A Tugelani's famous book.

[00:01:09] Awesome.

[00:01:10] And that book and a few other great mentors in college pushed me to think more about

[00:01:15] my this deep feeling I had that I wanted to work on health systems, not take care

[00:01:20] of patients, yes absolutely, and work on improving how we do care at scale. And

[00:01:25] that's been a theme for me for the last decade and a half. And it's taken me

[00:01:30] to all kinds of different avenues of healthcare from quality and safety to

[00:01:34] high value care and now into digital health transformation. But it's really anchored

[00:01:38] in this idea that we can improve health systems at scale and if we do, we can

[00:01:42] make a tremendous impact on people, on society at large. And I think that's

[00:01:47] been a really centering theme for me in my career.

[00:01:51] Yeah, that's a really strong driving force. And Byron, when you say health

[00:01:54] systems, do you mean like health care systems or health systems in general?

[00:02:00] Right. Yeah, so I'm talking about systems of care. Systems of care. You think about

[00:02:03] all the different systems and processes that have to take place for us to get

[00:02:08] anything done in healthcare. And at every step of the way there's something

[00:02:11] we probably could be doing a little better or even a lot better. And digging

[00:02:15] in and figuring out where we can make things run more efficiently, run

[00:02:18] smoothly, be more patient-centered, be more provider-centered. There's

[00:02:23] almost like endless opportunities to make change.

[00:02:25] Awesome. Thank you for that. I just wanted to make sure we're looking at the systems

[00:02:29] that really connect care. Exactly, exactly. Yeah, the delivery of care,

[00:02:34] patient experience, everything. Exactly. That large ecosystem.

[00:02:38] That's fantastic. So question for you. As a medical doctor, what makes

[00:02:42] chronic health conditions a space that's in need for further innovation?

[00:02:46] Chronic conditions affect six out of 10 US adults. And even more are affected

[00:02:54] by multiple chronic conditions where things get really complicated. Someone

[00:02:58] comes to us with three or four things that we as physicians need to manage

[00:03:03] longitudinally for years or decades at a time. You start to get into a lot

[00:03:07] of burden of keeping track of everything, both from the provider side

[00:03:11] for sure and then from the patient side. So it's hard to manage

[00:03:14] chronic conditions. If you manage them well, though, it can make a big impact

[00:03:18] on someone's long-term trajectory. If we can get someone's blood pressure

[00:03:21] under control, we know we're going to prevent strokes and heart attacks

[00:03:24] down the road. If we can get their chronic pain to a lower level,

[00:03:27] we know that we can get them more active living a higher quality life.

[00:03:32] There's a lot of chronic condition management out in the world.

[00:03:35] A lot of folks who need help with that, it's not easy.

[00:03:39] And we've for so long done it pretty much the same way.

[00:03:44] You go talk to your doctor, they evaluate you, they write your prescriptions.

[00:03:49] You get those prescriptions are filled or you go see a sub specialist

[00:03:52] and it's all on paper in person. I think we have a huge opportunity

[00:03:57] to reimagine how we actually make an impact on chronic disease

[00:04:00] through all of the other parts of our toolkit that have emerged

[00:04:03] in the last decade from the growing digital health toolkit.

[00:04:07] Now with new contemporary AI models and large language models,

[00:04:11] the toolkit's grown.

[00:04:12] And if we can start to move away from the legacy model,

[00:04:15] there's a lot of creativity that we can layer on top of what we already do

[00:04:19] to actually help people really manage their chronic condition

[00:04:22] effectively and without as much friction as we have today.

[00:04:26] Yeah, I appreciate that, Byron.

[00:04:28] And just want to get an opportunity here to understand

[00:04:32] the value Solera offers, Solera Health offers to the health care ecosystem.

[00:04:36] How do you guys play a role in all of this?

[00:04:38] We have a new platform called Halo,

[00:04:42] which is our next generation omnicondition management platform

[00:04:46] bringing together our own curated network of digital health solutions

[00:04:50] with third party contracted solutions all under one place.

[00:04:55] What that means is we can take the entire digital health ecosystem

[00:04:58] that a payer or an employer has and put it onto a single platform

[00:05:03] for a unified member experience at it

[00:05:06] and a unified experience from the payer side in terms of managing

[00:05:10] operations, managing reporting, having transparency into outcomes.

[00:05:15] We put it all in one place so that this is the theme of Halo.

[00:05:18] We're starting to take all these previously disparate parts of the system

[00:05:23] and wrap around and hook into all of them deeply integrating into them

[00:05:27] and then bringing all that data and that entire experience into one place.

[00:05:31] So we're making linkages between the digital health ecosystem,

[00:05:34] linkages between the in-person system,

[00:05:36] linkages between payer and employer systems all together so that

[00:05:41] it just gives us tremendous opportunity to now that these things are all together

[00:05:46] to really coordinate that care journey in a much more refined way than we could previously.

[00:05:50] Yeah, thanks for that. I really appreciate better understanding.

[00:05:53] A lot of these solutions are point solutions.

[00:05:55] They're disjointed.

[00:05:57] It's a huge pain point for so many organizations.

[00:06:00] Yes. You want to make it work, put it all together.

[00:06:03] And it sounds like that's exactly what you guys have here.

[00:06:06] It's exactly what we've done in response to the needs of our payer and employer

[00:06:10] partners who have been dealing with this point solution fatigue now for years.

[00:06:14] But it's gotten so much more demanding even in the last couple of years after Covid

[00:06:18] with the growth of the number of solutions, the complexity of managing

[00:06:21] multiple solutions.

[00:06:22] It's gotten overwhelming for them.

[00:06:24] And I don't think this is their burden to bear.

[00:06:28] I think they have tried their best to be innovators and move quickly in the space.

[00:06:32] But they need help.

[00:06:33] And that's where the Halo platform comes in, providing that technology solution

[00:06:37] to make it really easy for them to get their hands around this growing ecosystem,

[00:06:41] which isn't going away.

[00:06:42] That's going to it's going to stay.

[00:06:43] And so if we can have something that we can continue to build an innovative

[00:06:48] upon, you can get the most of this system rather than having it

[00:06:51] having digital health stagnate in kind of this in the ether

[00:06:55] but never really come into its own.

[00:06:57] Yeah. And what I really love about what you just highlighted, Byron,

[00:07:00] is that you're taking a look at this not only from a care provider perspective,

[00:07:06] getting patients what they need, but you're also looking at it from an operations

[00:07:10] lens and an economics lens to really bring forth a solution that could help

[00:07:14] with the business of health care, but also the providing of care side of health care.

[00:07:18] Absolutely. Our platform helps patients.

[00:07:22] It helps providers.

[00:07:23] It helps payers all in a slightly different angle.

[00:07:26] Obviously, when we can provide evidence based solutions to patients,

[00:07:30] that's a big win for everyone.

[00:07:32] Right? We're helping people improve their health.

[00:07:33] We're making them feel better.

[00:07:35] There's that's all very intuitive to everybody.

[00:07:37] But on the back end, when you can

[00:07:39] make it easier to run these programs, make it easier to manage them,

[00:07:42] make it easier to see what's working, what's not.

[00:07:44] We actually have a ton of impact on quality of care indirectly.

[00:07:48] If you make it really easy to manage these programs,

[00:07:50] you can manage more. That means you can offer more who make it really

[00:07:54] easy to see what's working and what's not.

[00:07:55] You could do more experimentation, do more rapid cycle tests of change

[00:07:58] on your programs until you refine them to a point where

[00:08:02] they might have been performing well before, but now they're performing

[00:08:05] really well or as good as you think you can get it.

[00:08:07] So we can actually use some of these things that may not be so apparent

[00:08:12] like operations reporting to actually drive downstream quality impact,

[00:08:16] which I think is going to be a really important thing in the next few years.

[00:08:19] Yeah. That's the end game.

[00:08:21] That's the end game. Yeah.

[00:08:22] I love that. And so let's zoom in a little bit to the payers.

[00:08:25] Can you help me understand sort of the value add for payers

[00:08:28] with this? Yeah. So from a payer perspective, they want a few things.

[00:08:32] So one is their employer clients really want to be able to offer

[00:08:37] often a more customized experience for members or for employees rather.

[00:08:43] So if you're a large employer,

[00:08:45] you might have contracted with five or ten of these solutions.

[00:08:48] You picked the ones that you really like.

[00:08:50] And some you may still like, some you may not.

[00:08:53] But either way, you want to have your customized network.

[00:08:57] And if you imagine trying to do a customized digital health network

[00:09:01] for hundreds of employers, it becomes totally impossible for a major payer to handle.

[00:09:06] What we've done with Halo is create the infrastructure to do that at scale.

[00:09:09] So being able to customize the network, we can bring our own.

[00:09:12] So if you want to bring in one of our curated networks,

[00:09:16] which we're all which we're very proud of and it's a turnkey solution,

[00:09:21] you can stand it up pretty quickly.

[00:09:22] That's great.

[00:09:23] We'll put one of our curated networks in place.

[00:09:24] If you have your own contracted solutions, we can layer that on and customize

[00:09:28] the experience for your employers.

[00:09:30] So that's how we help payers work with their employer clients.

[00:09:34] And then in the fully insured book, we can work with payers to figure out

[00:09:38] how to curate the network so that it's making the best,

[00:09:41] the most impact in their fully insured book of business.

[00:09:43] They're appropriately payers are

[00:09:46] appropriately rigorous when evaluating solutions to go into their fully insured

[00:09:49] book. And not only do they want to know what the clinical ROI is going to be,

[00:09:53] but then be able to have transparency into that out those outcomes downstream

[00:09:57] and know that it's making a difference.

[00:09:58] So we do both parts of that.

[00:10:00] We do the upfront analysis on the expected clinical ROI.

[00:10:02] And then once the solution is live, we provide outcomes, analysis and reporting

[00:10:06] back at the individual level because of how deeply we integrate with our network partners.

[00:10:11] That's fantastic.

[00:10:12] Thanks for highlighting those areas.

[00:10:14] On the one hand, you offer scalability.

[00:10:16] On the other hand, reporting to make sure that everything's working.

[00:10:19] And that's such a seamless experience.

[00:10:21] How do you see Solera directly impacting your patients?

[00:10:26] The first thing that we can do is just bring our network at scale to patients.

[00:10:31] It's about it goes back to that point I was making earlier,

[00:10:34] when it's easy to do the right thing, it's easy to do the right thing.

[00:10:37] We can turn these networks on.

[00:10:38] We can get these solutions into the hands of people who need them faster.

[00:10:41] And then we can see the impact every day when we look at our outcomes.

[00:10:45] We're integrating deeply with our partners.

[00:10:47] We're measuring for clinically important improvements in health.

[00:10:51] So these are evidence based, biometric and psychometric measures of improvement.

[00:10:54] Things like, hey, if you have a musculoskeletal condition,

[00:10:57] did your pain score improve by 30 percent?

[00:10:59] Which the clinical literature says, hey, that's a meaningful improvement

[00:11:01] if you get 30 percent or more.

[00:11:03] So we're measuring those outcomes at the individual level.

[00:11:06] And then we can see that.

[00:11:08] Oh, great.

[00:11:09] This from this population, this percentage of folks got better.

[00:11:13] And it's very black and white and objective rather than numbers

[00:11:16] that might be too hard to interpret.

[00:11:18] That's great.

[00:11:19] I appreciate you sharing that for sure.

[00:11:21] It's a very clear way that it impacts patients.

[00:11:24] And Byron, last question here.

[00:11:27] What is your call to action for the listeners?

[00:11:29] Right. This has been a fantastic conversation.

[00:11:32] And at the end of the day, health matters and matters when you take action.

[00:11:37] So what call to action would you have people take?

[00:11:39] I think that for someone listening in, try and expand your idea

[00:11:45] of what's possible with digital health.

[00:11:46] So these programs are still very new.

[00:11:48] And we have a lot more to learn and a lot more to innovate,

[00:11:51] whether it's which programs to deploy, when, which populations to target

[00:11:57] and how to link these programs more intentionally with in-person care.

[00:12:01] The next decade, I think is going to be a tremendous learning

[00:12:04] opportunity for people who are invested in these solutions and using them

[00:12:08] and working with them every day.

[00:12:11] And for those who don't and say, you know what, we have

[00:12:15] a handful of these and we're good.

[00:12:16] They're going to miss out on all that learning and miss out on all that value

[00:12:19] creation down the road.

[00:12:20] So my call to action is

[00:12:23] think about how you can be using these digital health solutions and growing with

[00:12:27] them over the next decade.

[00:12:28] Love it. That long term, folks, is where your minds must be.

[00:12:32] And with solutions like Solera Health and the work of Dr.

[00:12:36] Byron Crow and his team, the future's bright.

[00:12:38] So Byron, can't thank you enough for being with us today.

[00:12:41] Hey, saw my pleasure. Thanks again.