The future of telehealth: Finding the sweet spot for patients, payers and providers

October 26, 2021 SmartBrief Season 1 Episode 4
The future of telehealth: Finding the sweet spot for patients, payers and providers
Show Notes Transcript

A McKinsey report found that telehealth usage in April 2020 was 78 times higher than in February 2020. Although use has moderated, it remains substantially higher than before the pandemic. In this episode Dr. Prentiss Taylor, vice president of medical affairs at Included Health, formerly known at Grand Rounds + Doctor On Demand, and Mohammad Jouni, chief technology officer at Wellframe discuss what makes a great telehealth experience and how health plans can facilitate it. They see it as not only an opportunity to address a patient’s concern, but also as a touchpoint for connecting them with resources, educating them about their benefits and identifying needs they may not even realize they have.

This episode is brought to you by Wellframe.

Melissa Turner  0:03  

Hello and welcome to touch points, a conversation about care connection and costs in US healthcare. I'm your host Melissa Turner. I'm content director for healthcare and life sciences at SmartBrief. SmartBrief is a publisher of digital newsletters for professionals and creator of this and other shows in our series of smart pod podcasts. In addition to overseeing production of SmartBrief healthcare content, I'm of course also a consumer of health care just like those of you listening. Together in each Touchpoints episode, we'll explore the issues that make health care hard for all of us, and we'll discuss how health plans, health care providers and their partners in the health care ecosystem can make it easier. Thank you for joining us.

Melissa Turner  0:55  

Touchpoints is sponsored by Wellframe. Wellframe works with health plans to reimagine member relationships. Their team believes that health plans are in the best position to lead the charge into the world of digital health management. Let Wellframe be your partner in improving member engagement and outcomes. Learn more at 

Melissa Turner  1:15  

Today our topic is telehealth and I'm pleased to welcome Dr. Prentiss Taylor, vice president of medical affairs at Grand Rounds Health and Doctor On Demand. Dr. Taylor is a health plan veteran, having previously held roles with Blue Cross Blue Shield and UnitedHealthcare. Welcome Dr. Taylor.

Prentiss Taylor  1:33  

Good morning. Good morning. Good afternoon.

Melissa Turner  1:35  

I'm also pleased to welcome  Mohammad Jouni, chief technology officer at Wellframe. Mohammad leads engineering product and data science at Wellframe and previously built eWise's financial services engineering team. Welcome Mohammad.

Mohammad Jouni  1:50  

Thank you. Thanks for having me.

Melissa Turner  1:52  

Well, really glad to have you both here today. Appreciate your time. This is a great topic. I think our listeners are well aware of the fact that telemedicine use exploded during the pandemic. A McKinsey report found that usage in April 2020, was 78 times higher than in February 2020. I don't know about either of you. But I had my first telehealth experience during the pandemic, I think there were some things that were good about it, and certainly a few things that could have been better. Just taking off your professional hats for a moment. And we can certainly leave out personal health details. What is your take on telehealth as a patient if you've experienced it? Mohammed, let's go ahead and start with you.

Mohammad Jouni  2:32  

Yeah, so it's it's been an interesting couple of years, and one of the exposures we've had at my family, personally, is we had our firstborn during the past year or so. So we navigated the entire spectrum of the delivery, the pregnancy, the delivery, and then being parents of a newborn for the first year throughout the pandemic. So it was interesting to see that pattern and our own experiences before the pandemic. And to the point of this, you hit the nail on the head, it was a mixed bag, I think some of the experiences were positive, because we were able to access more resources without actually having to physically go to certain places to see providers. But in other cases that technology was a barrier. And for multiple reasons. One of them was due to the solutions being used weren't really that strong from a member experience perspective that we interacted with. That wasn't Doctor on Demand. So I have yet to experience that, and I'm sure it's an excellent experience. But the one we experienced wasn't really that positive from a member exchange perspective. And I think the other thing was there was so much pressure on the solution itself that the waiting lines were very high, which caused an abrasion in the member experience. So we ended up not using it as much as I think we should have or could have if the overall experience was better, or if there was more supply of providers we could tap into. So I think it's a mix. But for us it was positive also to have that access through telephone and other areas. Definitely a lot of areas but it was it was interesting to see how much the technology has come through.

Melissa Turner  4:03  

Yeah, absolutely. Dr. Taylor, I'm interested to hear your experience. Of course, you are a clinician in addition to answering this question from a patient perspective, I don't know if you can kind of tease out.

Prentiss Taylor  4:13  

I can definitely tease it out and as a father for I want to say congratulations to Mohammed and his family. Yes. So what I would say without it sounding like an infomercial for our company is that there are great differences between different telehealth solutions and platforms out there. What I can say is that all of our experiences have been very positive. And I would say that's from the perspective of myself. I spend about 10 hours a week in addition to being an executive as one of our primary care frontline physicians licensed across 24 states. So I see people from coast to coast. And I would say that the experience of those people has been great and I know that because you know we average at Doctor on Demand 4.9 patient ratings. That's in other words, member satisfaction ratings for health plans on a 5.0 scale. So those ratings are very high. And if anybody wants to independently check this, I'd invite them to. Ours are the highest in the telemedicine industry. So I haven't seen any negatives around that. The other thing is that Mohammad mentioned some waiting time. So we have definitely staffed up for the pandemic. And our wait times were short anyway. But as one reliability statistic, and one of our performance guarantee statistics, people are waiting less than seven minutes, 24 hours a day, seven days a week to connect with our clinicians. And we're very proud of that. So I don't want to go on and on about that. But I would say from that experience, and I know that one of my sons has done a telemedicine visit with a Doctor On Demand clinician, and that experience was very favorable to him. So you know, we can talk about anecdotes on the one hand, and it's not for me to be negative about anybody's mixed experiences. But I think what we need to do is look at the average experiences and objective ratings that are out there in the app stores and from other reliable sources.

Melissa Turner  6:18  

Yeah, thank you for that. Dr. Taylor. And something you mentioned, I've found particularly interesting, which is that you are working the frontlines in addition to being in your leadership role. how has that influenced your work?

Prentiss Taylor  6:31  

Well, it keeps me very rooted. For example, just last night, I was on duty. I mainly work on nights and weekends because I stay fairly busy with our quality improvement and other projects during the day. And last night I was treating a lady in a southern state who has had chronic swelling of her legs, she's in her 40s and she is starting to get an infection that we call cellulitis in one of her legs. And as I spent time with her, you know, our typical visit is about 15 minutes, but our clinicians can add on extra time at no extra cost the the member, so we did a 23 minute visit where I was able to get into depth about her problems or medicines what doctor she had seen, and I realized that she had a strong family history she told me of congestive heart failure, her grandmother has had it, her mother has had it and no doctor thus far has explored whether she is evolving heart failure for why her legs are staying swollen all the time. She thought it's because she's on her feet at her retail chain store, national chain store employer long hours, but I thought it was more than that. So what I did is recommend that she connect with an excellent cardiologist -- and she's never seen one -- to get a an in depth second opinion. That said, she also had other risk factors like high blood pressure and high cholesterol that lead me as a clinician to wondering whether she is developing heart failure. And then our company has our Grand Rounds division, which is very well known for expert medical opinions and connecting to excellent specialty care. So I was able to do a handoff this morning after seeing her last night one of the medical directors over there to get them with their algorithms and their software to connect her to an extremely highly rated cost efficient, high quality cardiologist within reasonable driving distance of where she is in this state. So that's an illustration of what floats my boat is the opportunity to connect people to excellent quality medical resources to solve problems when they're not doing that. 

Melissa Turner  8:45  

Yeah, connections between sites of care, modes of care, and coordination, as we know, across the healthcare system have long been a concern. So nice to hear that it's happening the way that it should. I want to look now at some of the lessons from the early months of the public health emergency, certainly clinicians, health plans, and of course, patients, we all had to adapt to the rapid rise of telehealth quickly. So I'm interested to hear from each of you what you think worked, what didn't and then what else we may have learned from this experience.

Mohammad Jouni  9:17  

It's interesting from our perspective, and just just to make sure that the audience understands like, the way Wellframe works is we typically empower and help fix the two biggest problems in the US healthcare, which has the member experience and rising cost. And the way we do this is we provide this holistic longitudinal relationship between the payers and the members so that there's a relationship that's ongoing so that there's more touch points between the member that has a need or is going through a chronic condition with a care management and clinical team that's supported by the plan. And you can imagine why because plans are highly incentivized to take care of you for a long period of time, because that translates into better cause but also better experience and better overall health for the members that they're managing. So when we saw interestingly at the beginning of the pandemic, was the response of plans really varied based on how much adoption of digital they'd had before. So the question was, did they have channels for their members to be able to outreach and surface any challenges they were having that were emerging from the pandemic. And if you think about it, those challenges were all over. Like there wasn't something there was a playbook that people can tap into. So whether you had a channel or not dictated your readiness for response, for example, what we saw was, all of a sudden, we saw an uptick in our chat, and the communication through messaging, of people saying, like, Look, I had this procedure, it got canceled, what can I do? I was going to meet with my doctor on the X, it was cancelled. What's my alternative? What can I accomplish? and other things that are mental health questions like, Hey, I'm suffering here, what should I do? How can I do that? And what people started doing is, at least what we saw from our platform, is there was this new type of triage that was happening, where the clinicians on the other end started supporting those members and saying, Look, this is what you can do, this is what's possible, using the platform to educate members about what COVID is, what's happening, but also provide the mechanism of relief to say, look, we're here to support you, what do you need, and sometimes those conversations are purely just to let off steam and talk about the state of things. That added a lot of mental support. But also to Dr. Taylor's point, that also led to a lot of the what we call the video conferencing chat, that probably led to a lot of conversations Doctor On Demand and other platforms where when those folks triage the need, and said, Look, we know that you have this patient, you have this doctor meeting that you can't make, let me offer you the service, it could be Doctor on Demand or other that will let you talk to a doctor instead of that. And we saw this, our channel becoming a triage channel to enable more traffic coming into that, but also as a way to say like whether something needs to go there, or it could be sometimes tackled with a simple message or a chat that could resolve those. So that's what we saw, and it was really positive. But again, you had to have invested in the platform like this, so that you were ready to engage that.

Melissa Turner  12:17  

Thank you, Mohammad. Dr. Taylor, I imagine your organization also saw a variety of sort of readiness levels across health plans interested in your thoughts on this question. And on that point, in particular,

Prentiss Taylor  12:28  

well, I think Mohammed made some very, very valid points. And I'd like to layer on to those, we know that four out of 10 adults reported in national surveys, avoiding care because of COVID-19. And this was particularly true for people who had two or more chronic conditions. And so this sort of care avoidance caused concerns about potential increases in morbidity and even possibly mortality associated with chronic and acute health conditions. So it's become increasingly apparent that sort of a one size fits all approach in healthcare doesn't work in in really any setting. We need to factor in social determinants of health, people's experiences, Community Resources, Relationships, and resources. And I know these are challenges for health plans, particularly when you get into small towns or urban areas or rural areas that are part of their service area. And that's where we particularly excel in providing access to high quality health care, I want to go on to say that you know, that behavioral health has been very exacerbated as many of you read, and the mental health issues and Mohammad mentioned that briefly. In that there's been a lot of stress where people especially if they had some pre existing level of anxiety or mild depression, all of that got pumped up on steroids. And and we've seen a huge increase in behavioral health visits. We've also learned that it's immensely important to have access to integration of both the physical medical healthcare and the mental health care, chronic conditions we know are consistently associated with an increased prevalence of depression symptoms. So rather than being too long winded about this, I just would want to say that this is multifaceted. But we've found that there are many, many opportunities to help and particularly when you have great triage and systems available, like Wellframe, you know, those, those can be very helpful at all times, and especially during this time.

Melissa Turner  14:31  

Thank you, Dr. Taylor, continuing that line of conversation, I want to talk a little bit about some of the benefits of of telehealth. You know, one obvious benefit, of course, is convenience. We've alluded to this already. I'm wondering if each of you want to mention some of the maybe lesser known or less obvious benefits of telehealth and then conversely, perhaps some drawbacks, places to be careful. Dr. Taylor, you just mentioned you know, there's no solution that is one size fits all. So I think we want to have a conversation about where telehealth fits as part of the bigger picture. And so Dr. Taylor, I'll ask you to start.

Prentiss Taylor  15:05  

Well, there are a lot of things and we mentioned them just a moment ago, and I don't want to exactly repeat them. But what I would just say is that increasing access to high quality care, I know that many health plans are focusing on high value care. And I think they know very well that their provider networks segment into high performing quartiles and lower performing quartiles. And so it's been the our thrust for many years, and we've accelerated it recently with Grand Rounds to be wherever possible when we're referring to specialists as we don't generally employ specialists, we have a PCP model to be able to refer to high quality specialists, whether it's our urgent care, our behavioral health, or even our virtual primary care, which is a recent type of innovation we've done in the last couple of years, we just want to also make sure that people aren't left behind in the digital divide due to connectivity issues. And we know that the current national administration, and the Biden administration is beginning to tackle that I understand the infrastructure bill that's pending in Congress for ratification. There's a lot in there to increase broadband and other access to internet across all counties across all 50 states. And we salute those kinds of efforts. 

Melissa Turner  16:28  

Thanks, Dr. Taylor, Mohamad, what's your take?

Mohammad Jouni  16:30  

So Melissa may be just to make sure we're anchoring this from a telehealth perspective, it's so important, I think, to define how at least we think at Wellframe of telehealth and the way we see it, it's actually the whole spectrum of any way that the member engages through their care through a digital medium. And the reason why we consider it that way, because there's a lot of areas that as you engage the member, you can collect data about what they're doing and empower them, not just when they're interacting with their with their doctor, but also day to day. So for us like that includes remote patient monitoring, managing like day to day cases, managing any questions they might have, even around admin, like what's available to me, who should I talk to. So we consider that as part of the care management package for telehealth. And the reason why this is important, because if you start thinking about it that way, there's a lot of benefits that come from the new wave around what data is available to the patients, but also which data they generate. And the reason why that's important, because this creates new vectors of information that could empower clinicians like Dr. Taylor to make a better informed decision on how to treat that number. And I'll give you a concrete example when you're able to connect with the glucometer that a member is using and collect that data and make it easily available for them. But also any kind of like Apple watch that has heartrate monitors or even their weight scale, when you're able to collect that data and provided a place for the patient to have access to it. But then to be able to share it back with the clinician, then you empowering them both to have better data and better visibility over that. So that's a very strong byproduct of this. Now the challenge with this is is integration and I think that's alluded to this too is if there is no good integration of that data in a way that flows into the physician workflows. So that informed with this and they have context and they know how to interact with that, but also the privacy and consent requirements of that so that the member data is handled as best as possible, then you can actually get some negatives there because the data could be seen by the member but the physician isn't able to see it doesn't have the context. So you have to dig down there. I think between these two if you can balance them out, you can get a ton of benefits from that added data visibility and I would love to hear Dr. Taylor's perspective on this, that notion of added data that's being generated by these new integrations

Melissa Turner  18:50  

thanks Mohammed. Dr. Taylor want to weigh in?

Prentiss Taylor  18:53  

Well I think Mohammed makes a very valid point there's a lot of data and metadata that that is generated and it's a matter of you know, sifting is what's most valuable in the patient doctor doctor patient relationship and also at the level of population health and what health plans objectives are, for instance, like raising HEDIS measures and Medicare star measures, so there's a lot that goes into it and you know, we've worked with a number of health plans on these these sorts of issues and helping them solve their population health challenges, especially if they have any pain points clinically or within HEDIS, Medicare stars etc. that we can help with. So I'll leave it there but let you know a lot of this rolls up to how we can better help get better health outcomes and also raise member satisfaction with the plan you know, the NPS scores and that's something that has been very important and our work with our many health plan clients.

Melissa Turner  19:55  

Touchpoints is sponsored by Wellframe. Wellframe works with health plans to reimagine member relationships. They believe health plans have the knowledge and resources to support more people across more touch points in their healthcare journey. Wellframe's solutions for care management and advocacy empower members in health plan staff to achieve their best in the most wonderfully human way possible. Make sure your members feel confident, cared for and supported by their health plan. Don't miss this moment.  See how a digital health management strategy would benefit your plan at 

Melissa Turner  20:32  

I think before we pivot to looking at the landscape now and in the future, we might benefit from defining what is really become a household term in this country. Telehealth makes a lot of people thinking about FaceTime with their doctor, and of course, it can be that. But what other forms can telehealth take and how should they be used?

Prentiss Taylor  20:49  

We really have found in our eight years of service to the nation, that video visits are much richer in terms of being able to have consistent eye contact with patients -- see their body language, they see the doctor, the behavioral health specialists, the clinicians, the health coach's body language, and it lends to a much richer experience and also understanding the patient's environment. I can't tell you how many times I've been in a visit with patients and they've lit up a cigarette in the middle, trying to calm their nerves. And that's certainly a teachable moment. And one thing we can touch upon before the end of the visit, and if it was just a phone visit, I would have no idea. So we are aware that there are some telehealth companies that when you ask them are doing mainly phone visits, and so even though we do phone visits to we do chat based visits, we do text based interactions, our experiences and what we want to leave behind is a thought is that video visits are much richer experience that we know correlates highly with member satisfaction and better outcome.

Mohammad Jouni  21:57  

I would agree with Dr. Taylor on that, I think the way we've been looking at it, and some of the data we've seen is there's so many personalities and needs by patients that there's a specific type of interaction needed for each type of need. And some of those are video, and video cannot replace those needs. But what we also saw on top of that is there are some needs that are good questions that could be just tackled easily if you have a low friction medium, like text messaging, it doesn't mean it replaces video, it means it augments it. And some other capabilities even there. I'll maybe say a quick anecdote on this that that we found really, we find really insightful. We found a lot of times that members for example, don't know that their insurance covers that eye exams if they're diabetic. So what happens usually is that sometimes members, low income members are struggling to find money to pay for that for that visit. And when they interact with the with their clinicians through like the text chat, say like, hey, by the way, someone mentions a gap in care and says, Hey, by the way, you need to schedule this visit. And the response is usually I can't afford it. I'm waiting until I can save up some money. What we typically see is they educate the clinicians, that actually this is covered by your plan. This is available and this is a quick 30 minute conversation, then basically, the member feels empowered because now they feel like the plan is taking care of them. And it's very low, low friction, they got that. And you can imagine the number of touch points that due to that, that to your point Dr Taylor might not require the video chat to be able to deliver but you still the tackle some of the SDOHs that could be preventing those members from getting care. So that's why we're seeing it as more of a holistic engagement platform so that it's video, it's text, it's so many other things on top of it that helps the member engage the best way with their cat.

Melissa Turner  23:46  

Yeah, really making the most of any opportunity to connect with the patient. Dr. Taylor, did you want to add to that?

Prentiss Taylor  23:52  

Well, I thought Mohammed made some really interesting points that I would just add to it by saying in our experience, what our clinicians our trained to do is to be virtualists. So they are particularly trained in this, how to optimize this video medium. And what they see on their screen over on the left side is a checklist basically that fits in with objectives that are relevant to the patient. If the patient has diabetes, for example, a checklist of things like the eye exam that Mohammad mentioned, that you can dialogue with the patient about. So I don't want to say that text messaging on that point has no value. But in our experience, we found it's very rich. Once you've established that relationship, which is is deep we find as an in person relationship with a trusted physician you see over and over again. And then they persuade you to go and get that eye exam that you need every year for diabetes. And then by the way, as Mohammad said, you know it's not going to be any cost to you. So that's something that is especially with our virtual primary care product, referral coordinators routinely emphasize with patients.

Melissa Turner  25:04  

Thank you, Dr. Taylor, I want to shift us toward talking about where things are headed a little bit, but perhaps first we can kind of level set. The pandemic continues. Of course, we know the healthcare landscape has shifted substantially since those early days. The McKinsey report I mentioned earlier found that utilization has stabilized after spiking early on, it still remains 38 times higher than before the pandemic, according to that report. We know that utilization will vary according to many factors. But I'm curious what broad trends each of you are seeing now in your organizations? Dr. Taylor? 

Prentiss Taylor  25:41  

Well, I would say that the behavioral health care access has been a particular helpful point for many health plan members that they can connect with a psychologist or mid level therapist or even a psychiatrist from the privacy of their bedroom or their kitchen or even their car. Some people even connect from a quiet break room at work when nobody else is around to have a private conversation. So in all of those settings, I've been impressed by this -- just to give you an anecdote that, you know, our primary care physicians have been trained to recognize, score and treat anxiety and depression. Also, this has been the first time in my career as a primary care physician. I've had grown men call in on a video visit one guy called in from his delivery truck, let's say Think of it as UPS, FedEx, and was weeping due to his anxiety about the pandemic. Another was a pharmacist who took a break from being behind the counter at his chain pharmacy, went out to his car and did a visit with me as a primary care physician, again, to talk about his anxieties and so on, and what the medication options were, which he knew a little about bit about, as a pharmacist, that even when people don't have that knowledge, you know, we're able to guide them on the path. So that's just to illustrate that these anxieties and this stress that this pandemic has really been getting people and it's been great to be able to help with that.

Melissa Turner  27:09  

Yeah, all the more reason to improve access in whatever way we can. Mohammad?

Mohammad Jouni  27:16  

So Melissa, what's what's really emerging is, if you look at the entire market at this point, and all of the health tech solutions that are popping up to support members and plans and navigating all of this, what we're seeing is this desire to figure out how do you create a cohesive and consistent experience to the member and patient, because the challenge is sometimes you have fragmentation and those multiple experiences might not be talking to each other. So it creates patient abrasion. So what we're seeing is plans starting to think about what investments do I have to make to create a good experience for my member holistically across the board, and not just for the high risk members, but also low risk members or rising risk members, how do I engage folks early on, even when they don't have a medical need or a chronic condition, so that as things are evolving, or as they have these episodic needs, we can interact with them, and then funnel them into the best site of care. So they're starting to think better that and I think what we really, we will find very promising is they're starting to spend more investment in technology to do that. And a lot of this is around, how do they build the infrastructure to support these integrations between these different points? But also, how do they invest in the human capital and restructuring of some of their departments, so that there's someone who can navigate and guide the members and patients through this experience, and help us fix some of that abrasion abrasion in the experience? So we've been really optimistic about that. And that's not going to go away. I think that's the new reality. And it's now just figuring out how do you build that best member experience and patient experience?

Prentiss Taylor  28:53  

Melissa, if I could just build on two or three sentences to what Mohammad just shared. You know, we've innovated with chat based coaching for this very point dealing with subclinical levels of stress and concerns people have that are in the psychology and mental health realm. But people don't feel a need to see a psychologist and needed a particularly, we find addresses in a preventive way, some of the behavioral health concerns, or some of those low risk and rising risk type numbers that Mohammad mentioned. So I'm so glad that he pointed that out. And that's an area where we continue to want to innovate. And the final thing I would say, is for some plans, rather than hire new staff to do that, if they look at the value proposition, it's sometimes it's better to outsource that to a technology company, which also has hired these sorts of health coaches to support chat based coaching. So that's a new area for innovation that I would commend the plans to know more about.

Melissa Turner  29:53  

Well, we're going to move in that direction right now. As part of the conversations we host on touch points. I like to ensure that we provide listeners with some key takeaways, really a list of ideas, principles that they can act on right away as they put this thinking into practice. So we know health plans spend a lot of time talking about and working toward delivering the right care at the right time at the right cost and through the right channel for optimal outcomes. I'm wondering from both of you, what are the key considerations for healthcare leaders to keep in mind as they seek the right role for telehealth in the future? Dr. Taylor? 

Prentiss Taylor  30:29  

Well, there are many differences depending on your patient population, whether you're a Medicare Advantage plan or Medicaid plan or commercial plan, or you have all of those, and you're looking for something that you can use that that covers all of these arenas, so to speak. So, you know, those would be things that many of the telehealth companies are involved in, including ourselves. I think that one of the things that's an innovation, again, that needs to be known about is that in the exchange plans, and then the individual markets, there's a trend towards digital front doors and innovative plans, like Priority Health and Michigan have launched new virtual first health plans. We have one with Humana, Humana on Hand across multiple states. And this is certainly an area for innovation. So this is one of the things I would commend to people that this area of virtual primary care is a solution that a number of innovative plans are seriously engaging and embarking on now.

Melissa Turner  31:30  

Thanks, Dr. Taylor. Mohammad, you have alluded to a few things that probably need to be on healthcare leaders' to-do lists. What would you say to that?

Mohammad Jouni  31:38  

so building on what Dr. Taylor said, but also shifting a bit into the technology around some of the limitations for building a strong patient and member experience is the infrastructure and the data interchange for plans and these vendors. So we encourage plans to think of themselves as data integrators as much as possible, which means investing in infrastructure, and components that allows them to control the data flow between these vendors, and all of that to be able to create a seamless experience. But to give you an example for why, imagine someone calling into the call center of the plan with a need. Sometimes a lot of the clinical needs flow through the customer support line. Because there's no clear boundaries on who should I call for what, so you get these calls. So you need an infrastructure to allow people on the receiving end of that call, to know where to triage, how to send that and what to do. And make sure that that data breaks down silos between the various departments of the plan, because you might need to take that person without them to your care management departments so that they can manage them and support them. So the more plans can think of themselves there, and one of the big plugs we have for this is the FHIR standard is becoming better and better, especially with the new regulation coming out the Cures Act and all the pressure on empowering plans and members to get access to the data. If the more plans can think about how can they help lean into that interoperability, the more they can create an ecosystem for that integration for vendors, for patients, but also providers so that all three can interact to build that excellent member experience

Melissa Turner  33:21  

building on that point, are there things that stakeholders like health plans and service providers could be doing to ensure that telehealth works optimally for clinicians, in addition to patients and of course, patients themselves? Dr. Taylor?

Prentiss Taylor  33:35  

Melissa, I would say that, again, one of the big innovations that is supported by multiple studies in the brick and mortar world is that in networks is that having great access to a high quality primary care physician who can act as the quarterback for care makes such a difference, particularly to challenging members. So we know that that quarterback for achieving your goals satisfies the triple aim of increasing quality outcomes, increasing member satisfaction and NPS while decreasing costs. So multiple studies have shown that high value care and high value clinician solves all aspects of the triple aim. So I would I would leave that as a take home thought and it's something that again, the innovative health plans partnering with us value very highly this access to a very high quality primary care physician. And for us, it's backed up by the 24 hour urgent care and the behavioral health services that are fully integrated.

Melissa Turner  34:39  

Thank you, Dr. Taylor, Mohamad, what can health plans and other health care leaders be doing to make this work better?

Mohammad Jouni  34:45  

To be honest, this is one of the key questions that all of us as folks working in technology we have to answer. And the reason why is it goes back to the incentive structures set up in the US healthcare system and it's very interesting because we See those limitations sometimes as technology. But other times they're really incentives driven. And I'll give you an example by that. So one of the things we see is that to Dr. Taylor's point, the primary care physician usually carries the most weight in the advice and recommendation for the member and the the patient and can give them the best accurate advice. But what we see usually is the primary care physician doesn't have full visibility over let's say, what benefits the member might have or and this isn't a typical relationship between payer and provider, or what, what they can do or the gaps in care and all of this, it could be available. So one of the key barriers we see is that coordination between the two entities, and I think this is where both incentives, something around value based care and some of these initiatives, but also technology that helps connect both of them so that the workflow of the primary care physician is empowered with data from the payer, but also coordination with the payer to make sure that both entities are supporting the member the best way possible, think the more that the relationship can be strong, and it could be enabled with with technology and incentive, the more that the member and the patient will benefit from that joint interaction. 

Melissa Turner  36:12  

Well, looking forward. We have heard a lot about the fact that telehealth has won over patients during the pandemic, many clinicians as well, but also that there are some obstacles to optimizing utilization of telehealth after the end of the public health emergency. I'm curious to hear from both of you, what are their barriers from your perspectives and what's needed to bring them down? Let's go ahead and start with Mohammad. 

Mohammad Jouni  36:36  

it's actually that's something that Dr. Taylor has alluded to. And I really want to emphasize that and it's it's the access to internet connection that allows you to to be able to do that. And, and the funny the interesting part is the, when we live in big cities, we don't feel that disparity, when you go back out to the rural areas, things that we take for granted aren't there and the more we connect people in the rural areas to broadband internet. And we're really encouraged by a lot of the regulation initiatives happening now with FCC and more. And that's going to be really helpful. That's one part. The second part is what I alluded to around the incentives. Like we need to make sure that the incentives are in place for the payer and the providers to work together to make sure that they're building the best telehealth experience for the end member with the member at the middle of that with their needs catered for. And I think when that happens, you're going to see a high satisfaction with that, but also, we're going to see across the board and I'd love to hear Dr. Taylor thoughts on that, just like the utilization of the healthcare system will be more optimal. Optimize across the board, people who don't need to go to the ER will get better ways to do that. And preventable deaths could be prevented that will often lead to better quality of life. So those two key things will be awesome to see.

Prentiss Taylor  37:51  

Well, you know, I would say in perspective, that access the telehealth and the health plans we work with, found that it has mitigated cost trends and allowed them to achieve their MLR goals. So I would say that the legislative changes that are pending in terms of the Telehealth Modernization Act, which as I understand it would make certain telehealth flexibilities under the Medicare program permanent after the public health emergency ends. So I would commend the health plans that to the extent that you have Government Relations experts on your team and lobbyists that you work with to let your members of Congress in your districts know how important that is for the sake of your members in your service areas. So I think we are all playing on the same team and hopefully working towards the same goals of making those changes in terms of access and reimbursement for telehealth services permanent because we know that health plans like it, we know that members like it. We know that improves health outcomes. We didn't have time today to talk about the details of that. But there's data available, I'd be happy to show anybody interested for how we can bring down depression scores, bring down cholesterol levels, bring down A1C levels and diabetes, bring down blood pressure levels all through telehealth and how that has been magnificently achieved during the pandemic. So these are just a few examples that. Happy to talk about more in detail.

Unknown Speaker  39:30  

Well that's a great message to end on. And a reminder that we probably need to have this conversation again. I really appreciate your time, both of you, hope we can have you back to continue chatting about telehealth, Dr. Prentiss Taylor of Grand Rounds health and Doctor On Demand. Mohammad Jouni of Wellframe, it has been a pleasure talking with you both.

Prentiss Taylor  39:49  

It's certainly been a pleasure today to hang out with Mohammad and with you Melissa. I want to thank everybody on the team in the background that made this happen.

Mohammad Jouni  39:58  

Thank you Dr. Taylor. This was really informative from my side, too. Thank you.

Unknown Speaker  40:05  

Thank you for listening. I hope you enjoyed today's conversation and learned something too. You can check out smart briefs healthcare newsletters by going to and hitting the blue subscribe button. Be sure to spread the word and subscribe to the Touchpoints podcast. Finally, a huge shout out to our friends at the Shift.Health content network.

Unknown Speaker  40:30  

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