S1E20: Mitigating the Risk of Innovation (ft. Pothik Chatterjee, Lifebridge Health)

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Pothik Chatterjee (Guest)
Yeah, absolutely. I thank you Jordan, for for that great question. So the importance of peer provider collaboration around data exchange cannot be overemphasized because some of the biggest issues in our healthcare system are related to these manual processes and inefficiencies that currently exist. So more than 1/3 of U.S. healthcare costs today go towards this managing this bureaucracy.

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Pothik Chatterjee (Guest)
US insurers and providers spend more than $800 billion in 2017 on administration, or nearly $2500 per person. That’s more than four times the per capita administrative cost in Canada, which has a single pair system. So the those statistics really illustrate how much overspending we have because of these manual processes and the back and forth between health systems.

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Jordan Cooper
Many more.

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Pothik Chatterjee (Guest)
On the provider side and the insurance companies on the payer side and we’ve seen in other industries outside of healthcare, the use of automation, the use of predictive analytics and artificial intelligence to make that data exchange much more faster, streamlined and ultimately that translates into reduced expenses as well. There’s a number of ways that are.

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Pothik Chatterjee (Guest)
Health systems and our pairs have been working together through programs like 1501 health, which as you mentioned, is an incubator and investment program in digital health solutions.

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Pothik Chatterjee (Guest)
One of those examples is a company called Parity Team, which are PAIR, which is the first end to end provider enablement solution for Medicaid. So pair team is a startup and they provide wrap around technology of care team and EMR embedded support tools to coordinate patient care and automate value based care operations. So parity team came out of San Francisco.

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Pothik Chatterjee (Guest)
Out of why Combinator, which is a very well known incubator for technology startups, and they provide a remote team and AI to automate workflow, provide infrastructure to improve medical practices, particularly efficiencies around billing, so that these independent primary care clinics or FQ FQHC’s.

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Pothik Chatterjee (Guest)
That can use the pair team technology to improve efficiency. They can triple the rate of annual Wellness visits and increase revenues as per team has demonstrated from many clinics around the country over the last few years.

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Jordan Cooper
So many of our listeners pothik to healthy data podcast are CIOs of large healthcare delivery systems or their counterparts. These large healthcare delivery organizations sometimes do have their own accelerators or incubators and have partnered with startups, but others are more reluctant to take on perceived risk with perceived unproven models associated with startups. Can you speak to some extent about how life bridge or any other healthcare delivery organization with whom you’ve partnered with?

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Jordan Cooper
Has worked with these startups in order to facilitate faster data exchange, particularly between payers and providers, to help them access that clinical data.

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Pothik Chatterjee (Guest)
Yeah, absolutely. So I’ve been in the innovation and digital health space now for eight years, almost for a decade between Life Bridge Health, which is in the community health space here in Baltimore, MD, as well as with Brigham and Women’s Hospital in Boston, which is a well known academic Medical Center. And what I’ve found is, as you mentioned, that health systems do.

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Pothik Chatterjee (Guest)
Uh, perceive that there is some risk in either partnering or investing in technology startups because startups inherently have risk associated with them due to their early stage, and there’s a number of ways that help systems can mitigate that risk. The first one is through pilot programs where they can partner with the startup to implement.

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Pothik Chatterjee (Guest)
The technology in a clinical setting through our phased pilot program that can last anywhere from six months to a year and basically these pilot programs give the startup an opportunity to prove the value of their technology, whether that’s a mobile application for patient communication, post discharge like get while loop, which is something that we have scaled at Life bridge health across all five hospitals across the system.

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Pothik Chatterjee (Guest)
Or if it’s an EI diagnostic tool that can be used by radiology providers to help find any issues that the human eye may have missed to really compliment and support the the clinical diagnostic these pilot programs give the startups and the health system a chance to see whether or not the technology is actually effective in improving outcomes or improving provider or patient experience.

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Pothik Chatterjee (Guest)
And typically the health system will have either an innovation department or they will have a clinical champion within the service line that can set up KPI or key performance indicators that the startup will have to meet in order to show success. And then at the end of the pilot program, if the startup is successful, then they can negotiate a bigger contract for implementation and utilization.

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Pothik Chatterjee (Guest)
On a larger scale, and there has been a lot of criticism about pilots in the industry because startups will say that healthcare systems are slow moving and sometimes the pilots are not effective or even if the pilot is effective, that after the pilot, that’s when there’s sometimes a challenge in scaling the adoption of the technology. But based on my experience, if you set up the pilot in an effective way and identify the.

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Pothik Chatterjee (Guest)
Key performance indicators that are meaningful to the health system and you have a buy in from a clinical champion and an administrative champion that can be a really effective way to develop that relationship and grow the use of the technology in the health system. The 2nd way that I found to be a really helpful risk mitigants for health systems that are trying to figure out how to work or invest in.

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Pothik Chatterjee (Guest)
Health tech startups is to partner with a peer, and that’s exactly what we did with Life, Bridge, health and health works. That investment and innovation arm of care. First Blue Cross Blue shield in Maryland.

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Pothik Chatterjee (Guest)
There is a number of reasons why that worked really well. The first is that both the provider and the pair have common aims of reducing expenses through the implementation of innovative technologies. The second is that there’s very similar goals that the innovation groups of both the hospital and the insurance side have, which is in setting up these pilot programs and operationalizing them.

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Pothik Chatterjee (Guest)
In some cases, there might be common aims around commercializing technologies that have been coming out of the organizations and they’re looking to scale it and sell it to other hospitals and other health insurance networks across the country. So for that reason, the life bridge, health and Health works partnership very organically gave birth to 1501 health and I think that’s a model that could really benefit.

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Pothik Chatterjee (Guest)
Health systems across the nation, Maryland has some really inherent advantages to it. As a state with our regulatory environment, where we are incentivized to control costs by the state of Maryland. By the way, that the health rates are set across the system.

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Pothik Chatterjee (Guest)
Uh, so that was another advantage for the creation of 1501 health. But I do think that there’s value in other hospitals across the country to look to their health pares and see if there’s collaborative programs that they could start.

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Jordan Cooper
To Pothik, you did mention just now get well loop. Previously you have published study of how Life Bridge is customized automated digital patient engagement application. Get well looped has been correlated with the prevention of 30 day revisits after home discharge from an emergency department or hospital inpatient setting that you mentioned that this is also relevant to the all patient, all payer rate setting system in Maryland. Question is what are some of your lessons learned with the development and rollout?

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Jordan Cooper
Of get well loop.

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Pothik Chatterjee (Guest)
Yeah. Thank you for that question. We had a lot of really valuable lessons that we learned since 2016 when we first rolled out, get well loop with our orthopedic service line. So the reason that we started in that particular service line is because when our patients were coming in for various orthopedic surgeries like knee surgery or back surgery when they were being discharged after the surgery, they were given large stacks of paper with manual instructions.

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Pothik Chatterjee (Guest)
On what their care needs to look like after their discharge. In some cases the patients might need rehab services after knee surgery, or they might have a long list of medications they might have follow up appointments that they need to take, and oftentimes patients felt overwhelmed and confused by what exactly they need to do and what cadence they need to follow. For all of these different instructions, we found the biggest lesson learned was that.

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Pothik Chatterjee (Guest)
The use of an automated technology tool simplified the instructions and the information for our patients, so it’s significantly improved patient experience because they were getting automated reminders on their mobile app through get well loop about the medications they need to take follow up appointment reminders. And it was a two way communication platform. So they could also send any questions to their life bridge health provider team.

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Pothik Chatterjee (Guest)
So that they could get clarification about the discharge instructions. What also benefited us at Life Bridge health with this implementation and rollout was that Life Bridge Health has its own call center that manage these electronic messages through the gate well loop mobile app. So that call center was able to either respond to the messages or if needed escalated to the care team. So a big lesson learned in.

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Pothik Chatterjee (Guest)
That roll out was the value of having that call center to and that call center is also becoming increasingly important with COVID and the pandemic happening in the sense that we saw a huge spike in our telemedicine volume. So that call center was able to manage the messages and alerts from different types of telemedicine services and remote patient monitoring services as well.

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Pothik Chatterjee (Guest)
Uh. Another big lesson for us. I was at the language and the the way that we were communicating through the different gap well loop. So the loops are designed as finite.

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Pothik Chatterjee (Guest)
Uhm, communication model. So depending on the service line, depending on the patient experience it can be anywhere from 5 to 10 days long after the patient is discharged. And we learned a lot through patient surveys and patient feedback about the simplicity of language that is needed. Having different language options available for our diverse patient population like Spanish or Russian.

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Pothik Chatterjee (Guest)
For our Jewish patient population and many of our Orthodox Jewish patients had Russian as their first language. So we worked with Chatwell network to make sure that we had simple clear language available in multiple languages to really engage the patients. And then the third biggest lesson that you alluded to was that even beyond the improvement of patient experience and patient engagement, there was a clinical benefit.

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Pothik Chatterjee (Guest)
And a financial benefit to the implementation of get well loop because when you have patients that are more engaged around their care and taking the correct medications and getting to their follow up appointments, they’re less likely to go back into the emergency department for follow up care because it’s not escalating to that level because they’re already getting their key needs met. So by doing that study, we found that there was a reduction in the 30 day revisit to our EDT.

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Pothik Chatterjee (Guest)
And what was really great about that particular study that we did?

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Pothik Chatterjee (Guest)
Is that we were able to track the patients not only when they were going to life bridge health emergency departments, but we were able to see visits to any other edu’s in the state of Maryland as well. And that’s because of a really helpful data tool that we have in Maryland called the crisp which is the Chesapeake Regional Information System Portal that allows us to track our patients journeys outside of our own health systems as well. And that’s a HIE health information exchange.

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Pothik Chatterjee (Guest)
Your husband set up in different states in the country as well.

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Jordan Cooper
Thanks Pothik for telling our listeners about some of the lessons learned, what that particular rollout of the startup I continuing on the theme of accelerators, some of our listeners are likewise running health tech accelerators or are thinking of doing so. How would you characterize the value proposition a developing radically or incrementally disruptive products or services that Lifebridge has realized through 1501 health and the Life Bridge, Health, bio incubator?

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Pothik Chatterjee (Guest)
Yeah, I would think the value proposition of 1501 health as an incubator and investment program is up in a couple of different areas. The first is 1501 Health offers $125,000 in capital directly to the startup and it’s a fairly competitive process. In past years, we have had 100 to 150 startups from across the nation and in some cases outside of the United States as well.

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Pothik Chatterjee (Guest)
Apply to the program for select positions and and the program has grown over the last couple of years from 5 startups in the first year to 7 in 2022 and last year, so it’s a fairly competitive program, but even outside of the capital investment, the value proposition of 1501 health also lies in the customized program that is put together over the 12 months of incubation where each startup.

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Jordan Cooper
Hopi.

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Pothik Chatterjee (Guest)
Is matched with mentors and advisors that are really subject matter experts from the healthcare system side and from the insurance side. And the reason that’s so unique is that there’s very few pair provider incubators like this in the nation 1501 health, to my knowledge is one of the first true pay vider incubators. And the reason that is so important.

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Pothik Chatterjee (Guest)
Is because the startups are able to go to health systems to try to find clinical champions on their own. It does take time and effort, but what’s difficult is.

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Pothik Chatterjee (Guest)
Figuring out what the business model is going to look like. How is the startup going to get paid for the technology that they’re building? Is it going to get paid in the fee for service model or is there going to be a value based care arrangement where the startup will get paid based on the actual clinical value that they deliver in a value based care contract arrangement and for those types of decisions, it’s really valuable for the entrepreneur to be able to speak directly with.

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Pothik Chatterjee (Guest)
UMA, healthcare insurance expert from a.

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Jordan Cooper
So pothik you, you’re you’re you’re well addressing the value to the biotech startup entrepreneurs. However, that’s not the listener base here. I’m wondering if you were able to capture the actual ROI to the healthcare delivery system. So to what extent would you say Life Bridge was able to actualize returns, was able to quantify the amount of cost saved, it was able to generate new revenues or new business through these different startups?

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Pothik Chatterjee (Guest)
Yeah, no, absolutely. The value proposition goes both ways for the, for the health system as well.

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Jordan Cooper
Mm-hmm.

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Pothik Chatterjee (Guest)
I would say there’s two main ways that like Bridge Health, was able to capture the value from investing and partnering with startups through 1501 health. The first is through the capital investment itself. We are able to see appreciation of our investment in the startups through market appreciation.

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Pothik Chatterjee (Guest)
In the current environment, I would say it’s a little bit challenging to see a lot of IPO’s from startups because of the the market challenges and the market downturn that we saw towards the end of 2022. But it’s really important to take a medium to long term view when you’re investing in these startups because it typically takes between three to five years for the startups to have either an IPO.

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Pothik Chatterjee (Guest)
Or an acquisition that would lead to the capital appreciation. But we did see appreciation in the market value through further investments from venture capital investors after we made our original 1501 health investment. The second important way that our health system at Lifebridge Health was able to see value was by.

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Pothik Chatterjee (Guest)
Offering new services to our patients that didn’t exist before and in some cases seeing incremental revenue through remote patient monitoring or offering virtual services to chronic patients like type 2 diabetic patients. I’ll give you one or two examples. The first example is with baby live advice, which is from our first cohort. They are a telemedicine platform for maternal.

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Pothik Chatterjee (Guest)
Care and infant care. So we partnered at Life Bridge Health with baby life advice to offer lactation coaching and new parent education to our OB patients at Sinai Hospital, which is our largest hospital within Life Bridge Health. And we offered these courses in person in a smaller capacity before we partnered with Baby Live advice. But having the telemedicine access and 24/7.

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Pothik Chatterjee (Guest)
A coverage from baby live advice really helped us expand the the coverage that we were able to offer to our patients.

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Pothik Chatterjee (Guest)
The second example is live chair health, which is also from our first cohort of 1501 health. This is a really unique startup that we invested in where they are focusing on the Barber shop setting as a way to engage black men around chronic patient chronic care management. Typically for a diabetes and high blood pressure and in some cases obesity as well. So life share health was developed as a mobile app.

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Pothik Chatterjee (Guest)
For customers to book their barbershop appointments. But they realized that the customers were having conversations with their barbers around chronic conditions. So they reached out to life Bridge health in 1501. Health to see if we might be able to train the barbers to take blood pressure measurements directly in the barbershop setting and include information about life, bridge, health, primary care providers through the life chair mobile app. So we partnered with this company.

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Pothik Chatterjee (Guest)
And we found that there were additional patients within our hospital geographies that had not seen their primary care providers for over a year. And we found that by doing the pilot program in the barbershop setting with live chair, we were able to see a 30% conversion for their customers that translated into booking PCP appointments. So there was significant ROI.

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Pothik Chatterjee (Guest)
Through about live share partnership by adding new patients into our PCP offices and also engaging our patients around chronic care, which again allowed them to manage their condition better and avoid escalation when not when it was not necessary.

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Jordan Cooper
And just a quick follow up, did life bridge experience any exits from the startups? I’ve gone through the platform and get an infusion of capital.

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Pothik Chatterjee (Guest)
Uh, we have not had exits from 1501 health because it’s only in its third year, but get well loop is a great example of a company that we had partnered with when it was at the Pre acquisition stage. It was called health loop. It was a startup out of California and three years after we partnered in them through the pilot program, they were acquired by a larger technology company called Get Well Network in Bethesda, MD.

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Jordan Cooper
And that and and I guess that acquisition ended up leading to an infusion of capital to life bridge in exchange for the equity, is that right?

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Pothik Chatterjee (Guest)
Not in the case of health loop, but it was that experience of partnering with health loop through that journey that gave us the impetus to launch 1501 health as an investment program because we saw how much you value we were giving from the hospital system by helping to customize their program, offering clinical feedback that that’s what gave us the inspiration to actually start taking an equity position in future startups.

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Jordan Cooper
Excellent. Well, pothik, I’d like to thank you for joining us today. As the former head of Innovation at Life Bridge Health. So thank you.

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Pothik Chatterjee (Guest)
Thank you very much. It was a pleasure speaking with you.

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