5 Things We Must Do To Improve the US Healthcare System —An Interview with Limor Weinstein & Rick Halton, VP Marketing and Product, Lumeon
“Studies show that there is a strong correlation between those with mental health issues and severity of physical illness. The cost of managing people with health conditions who also have mental health issues is exponential. One way to address this is to capture mental health information early and adapt patient care plans accordingly.”
I had the pleasure to interview Rick Halton, the Vice President of Product and Marketing for Lumeon. Rick has extensive experience in both the U.S. and European healthcare markets and was previously co-founder and VP of Sales and Marketing at Chicago-headquartered Apervita, the leading platform and marketplace for health analytics and data. For more than 10 years, Rick has been involved in management teams at innovative start-ups and global corporates helping them accelerate their revenue streams through product innovation and engaging marketing, with a particular focus on the healthcare and mobile telecoms sectors. He has also held executive positions at Fortune 100 companies, including Vice President of Marketing at Hewlett Packard, and senior roles at Vodafone and Openwave.
Thank you so much for doing this with us! Can you tell us a story about what brought you to this specific career path?
Starting my career at the dawn of the digital mobile age, I worked through many waves of innovation that have taken us from brick-style cell phones with simple voice applications, through to the launch of the mobile Internet with the almost infinite number of applications — yep, the ones our eyes are glued to everyday.
My career took a sharp turn from telecommunications and into healthcare in the year 2010, when I co-founded my first health startup in Chicago. Our premise was based on the frustration that doctors and care teams experience every day as the clinical guidelines they use are only available in paper or PDF documents. Remember the old days when you navigated in your car using paper-based maps? Well, it’s still the same kind of thing in healthcare today. Due to these old ways of working, care teams end up taking different routes or missing steps, often leading to inconsistent, costly care and variable patient outcomes.
With arguably even greater need, healthcare is now on the verge of this digital revolution. It’s unfortunate, but healthcare has traditionally been a slow starter in adopting digital technology. During the last 10 years, the industry has started catching up. Most health systems have adopted Electronic Health Record systems (EHRs), so now patient data is routinely available in digital form rather than paper. But, while EHRs are great, patients really haven’t noticed any change — they still fill out endless forms, have to see the doctor in person, and are essentially forgotten about once they leave the four walls of the clinic.
I’m passionate about creating opportunities to help healthcare leverage technologies from other industries so people can live better, longer lives. That’s why I made my career move.
Can you share the most interesting story that happened to you since you began leading your company?
One interesting thing that stands out to me is when we were selected by the Cedars-Sinai Medical Center in Los Angeles to participate in their business accelerator program. This program was powered by TechStars, a seed business accelerator that works across industries.
One of the unique aspects of this program is that they make a commitment to provide rapid access to over 300 of their executives and clinicians. As a result, Cedars-Sinai identified 15 different applications for Lumeon’s Care Pathway Management platform. We decided to focus initially on one application called Pre-operative Readiness, which we developed with their perioperative care team. Not only did this solution better prepare patients for surgery, but Cedars-Sinai also built a business case identifying over $3.6 million in savings annually.
The accelerator has been the spring-board for Lumeon’s growth in the U.S. Not only did it allow the company to close its Series C funding, but it also put Lumeon on track to double its total global revenue in just one year.
Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lesson you learned from that?
I was once chatting to a member of my team in the elevator and we got on the topic of birthdays. The following week, I sat at my desk, and I saw an envelope on the table with my name on it. On opening it, I saw a birthday card for me that had been signed by pretty much everyone in the office. Completely befuddled as it wasn’t my birthday, I suddenly realized that in the elevator we’d been talking about my looming birthday when I was to turn yet another decade older. I must have given the wrong impression. In fact, my birthday wasn’t for another four months. My takeaway from this slightly uncomfortable moment was that good communication, however fleeting it may be, is definitely something I needed to improve on.
What do you think makes your company stand out? Can you share a story?
Lumeon is one of the few companies that is helping health providers use modern technology to break away from delivering care within the four walls of their facilities, to delivering care from start to finish. In other words: from referral to recovery. This is a fundamental shift happening right now in healthcare. It is being accelerated by two major forces. First, payer reimbursement is transitioning from a fee-for-service to a value-based care payment model. Second, ever increasing costs of staffing and care operations are also placing a squeeze on provider profitability, something we’ve never seen before to this extent.
Lumeon’s software platform enables providers to digitize and automate care delivery, while bringing the care team and patient together into one journey. It is personalized to each individual’s risks and preferences from initial assessment, through to triage, lifestyle coaching and outcome monitoring. The Lumeon approach allows providers to get costs under control while helping guide care teams to deliver more predictable patient outcomes.
We recently worked with the maternity unit of one large hospital system that was using whiteboards and manual processes to manage postnatal care and discharge readiness. This was causing delayed discharge and poor patient experience — with uncertainty for new mothers and their families around when they’d be able to go home with their baby.
The Lumeon team worked hand-in-hand with the hospital staff — from executives to volunteers to streamline and digitize the postnatal care pathway. As a result women and their babies can go home as soon as it is safe to do so, and patient flow from labor and delivery is efficient and coordinated. It is so special to be able to have a real impact on the healthcare experience of people at such an important moment in their lives.
What advice would you give to other healthcare leaders to help their team to thrive?
Focus, focus, focus. My advice is to regularly question what you should not do. Ask yourself which things really make a difference and then drop, delegate or de-prioritize on the rest. We all have tremendous pressures on our time and live in a world where our work / life balance is precariously balanced. Don’t let yourself get batted off course by the changing priorities of daily business and lose sight of important goals and objectives. For me, this is one of the top reasons why teams with great, single-minded leaders can often make superhuman achievements.
Ok, thank you for that. Let’s jump to the main focus of our interview. According to this study cited by Newsweek, the US healthcare system is ranked as the worst among high income nations. This seems shocking. Can you share with us 3–5 reasons why you think the US is ranked so poorly?
In healthcare we talk about outlier patients — these patients are so-called ‘frequent flyers’ who typically have severe health issues. In global terms, the U.S. as a whole is an outlier, spending almost 18 percent of annual GDP on healthcare at $10,739 per person per year. Whichever way you look at it, other high-income nations across the globe spend less than half this amount per person. What is even more staggering is that these same countries not only spend much less, but people in those countries will live on average four years longer. This seems paradoxical, but clearly greater health spend does not equal better outcomes.
Perhaps the fundamental reason for this is that many other high-income nations have a large component of socialized medicine. Even though around 50 percent of care in the U.S. is funded by CMS, in other countries, health services are both paid by the government and also delivered by the government. Socialized care is free, or very low-cost, at the point of care to patients, and clinicians working in that system naturally focus on minimizing activity and doing what is in the best interest for the patient. On the flip side, private healthcare businesses in these countries must compete with free at the point of care services, so they need to be keenly efficient.
I am not advocating for socialized medicine, but what is important is that the U.S. healthcare system looks under the hood at its care operations and expenses to handle more patients at a lower cost.
Another major reason is lifestyle choices. It is been demonstrated time and time again that those who live in ZIP codes where there is a greater access to better education, food, and lifestyle choices have a lower prevalence of chronic disease, illness and a longer life expectancy. Helping people change their lifestyle to healthier ways is one of the biggest opportunities ahead of us.
You are a “healthcare insider”. If you had the power to make a change, can you share 5 changes that need to be made to improve the overall US healthcare system? Please share a story or example for each.
1) Shift to a patient-centric care model. Today, no one person actually cares for your whole health, other than you, your family and your friends. Instead, we experience healthcare where many different health professionals are involved in different parts of your care, usually when you are already sick. Moreover, these care professionals too often don’t coordinate with each other, their systems don’t communicate, and there is nobody proactively managing all of a patient’s overall care activities. Patient-centric care would change all this by orchestrating different care team members and activities that revolve around the patients’ needs.
2) Encourage greater automation. Today, even the simplest things are still carried out by nurses, whether requesting orders, chasing a physician for an approval, checking to see if a bed is available, or sending the patient some instructions. Digital automation is going to be a major breakthrough in healthcare to assist care teams, help assess patients, triage patients, personalize care plans, and assist in lifestyle coaching and patient outcome monitoring. Like the airline industry, perhaps one day healthcare will have an auto-pilot switch for automated care delivery.
3) Incorporate more personalization. Healthcare usually has a ‘one size fits all’ approach to care plans. Greater care plan personalization will help ensure we fast-track those patients who are self-sufficient, have low acuity, and are more complaint. Frequent flyers who have multiple morbidities can comparatively receive greater attention to manage their risks. Even simple things like adapting care to personal goals and preferences can make the health provider’s brand stand out from the crowd.
4) Embrace advancements in virtualization. Millennials and Generation Z are accustomed to always being behind their mobile devices and receiving everything on-demand. By virtualizing care delivery through virtual assistants, artificial intelligence (AI) enabled chat, apps and mobile web services, health providers can extend their brands well beyond the reaches of their clinics. Not only does this drive greater patient engagement, but it also improves the patient care delivery experience.
5) Prioritize convenience. The Internet provides an almost infinite choice in shopping, but with Amazon, Jeff Bezos has dominated the retail market through a single-minded focus on ‘convenience.’ Providing an immediate, consistently high quality, digital care experience is going to be essential to survive and thrive as health becomes more frequently experienced through bits and bytes rather than in person. Patients will naturally gravitate towards providers that make it easy to access care and give continuity in experience.
Ok, it’s very nice to suggest changes, but what concrete steps would have to be done to actually manifest these changes? What can a) individuals, b) corporations, c) communities and d) leaders do to help?
Reimbursement by health payers is actually a major force of change. The Medicare merit-based incentive payment system (MIPS) is already offering adjustments to payments based on the overall efficiency and outcomes of care. In 2019, these merit incentives, or penalties, are at +/- four percent of payment, but quickly rising to +/- nine percent by the year 2022. Other health payers are also introducing changes, such as risk-based contracts, outcome-based contracts and bundled flat fees that oblige providers to focus on patient-recovery, not just billing for activity.
One of the difficulties of achieving this shift is in our ability to measure true outcomes, as opposed to measuring tasks or processes completed. With the introduction of automated patient-reported outcome monitoring systems (PROMs), we can now gather real world outcome data. Further, by associating this outcome data with automated clinical pathways, we can learn which pathways produce the best results for different patients. This is truly the holy grail in healthcare, as it allows us to continuously learn how to achieve better outcomes faster and at lower cost.
As a mental health professional myself, I’m particularly interested in the interplay between the general healthcare system and the mental health system. Right now we have two parallel tracks mental/behavioral health and general health. What are your thoughts about this status quo? What would you suggest to improve this?
Studies show that there is a strong correlation between those with mental health issues and severity of physical illness. The cost of managing people with health conditions who also have mental health issues is exponential. One way to address this is to capture mental health information early and adapt patient care plans accordingly. Knowing this, we can better coordinate care between general health and mental health professionals — providing a more holistic care plan — or perhaps refer patients for mental health assessments and treatment as part of their disease management. We can also adapt the care plan to place a higher emphasis on care task compliance because a person with mental health issues may struggle to be motivated to do the right thing or understand care instructions. If required, we can also bring in a care giver, perhaps a nominated family member or a friend, who acts as a guide helping patients course correct.
Mental health care is recognized as chronically underfunded. By taking a holistic integrated approach to patient care, there will be more focus on preventative care, including an understanding of the impact of mental health conditions on general health.
How would you define an “excellent healthcare provider”?
It really depends on your perspective. One way to think about it is that the ultimate goal in healthcare is to help people live longer, happier and healthier lives. To achieve excellence as a provider likely means that you are in the top decile of those achieving these goals — and this is an entirely different experience to the one we have today.
Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?
An ex-manager of mine, who went on to be the founder and CEO of Waze, always told me to “keep it simple.” Any idiot can come up with a complex solution. In my experience, smart people often have a sixth sense for finding simple, practical solutions to seemingly complex, multi-dimensional problems. This lesson deeply resonated with me and helped become much better at finding simple solutions to major business challenges that would also get buy-in from others.
Are you working on any exciting new projects now? How do you think that will help people?
Innovation is what Lumeon is about, so we are always working on new exciting projects.
Lumeon has recently seen through real-world customer experience that appointment experience automation solution can decrease appointment no-shows by up to two-thirds compared to legacy vendors. We’re seeing that with our automation solution, an average-sized health system can recover over $10 million in lost revenue annually.
Secondly, Lumeon is launching a new catalog of automated, evidence-based clinical pathways covering everything from disease screening, patient experience, prep for surgery, discharge readiness, disease monitoring and outcome reporting (PROMs). These clinical pathways will enable providers to quickly automate parts of their care delivery and achieve big returns. I’m looking forward to sharing more news about this soon.
What are your favorite books, podcasts, or resources that inspire you to be a better healthcare leader? Can you explain why you like them?
I love listening to podcasts while walking my dog, and I’m a big fan of personality profiling: understanding what motivates people, psychology, and mediation. If you have an interest in these areas, I would definitely recommend you read books from Alan Wilson Watts, a great British-American philosopher, or listen to podcasts from Shrink Tank, Tara Brach, Gil Fronsdal from the Insight Medication Center, Personality Hacker, and find out about other related topics like Natural Language Programming (NLP).
You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. :-)
One of the core challenges we have today is tackling unhealthy lifestyles and overcoming stress and anxiety. When we look at countries that have the longest life expectancy in the world, we see they have a healthier lifestyle and lower anxiety levels, such as Japan, the Mediterranean and Nordic countries. Many of us are doing the wrong things out of ignorance, poor habits, or a lack of motivation to pacify addictions or to distract us from our anxieties.
Being able to find the right chemistry of programs that will change our belief systems and motivate people to break old, bad habits — such as addiction to unhealthy foods, binge drinking, lack of physical exercise and poor sleep habits — is a science we have yet to learn or be successful at.
How can our readers follow you on social media?
Feel free to follow me on Linkedin at https://www.linkedin.com/in/rickhalton or Lumeon on Twitter at @Lumeon
About the Author:
Originally from Israel, Limor Weinstein has been anorexic and bulimic, a “nanny spy” to the rich and famous and a Commander in the Israeli Army. Her personal recovery from an eating disorder led her to commit herself to a life of helping others, and along the way she picked up two Master’s Degrees in Psychology from Columbia University and City College as well as a Post-Graduate Certificate in Eating Disorder Treatment from the Institute for Contemporary Psychotherapy.
Upon settling in New York, Limor quickly became known as the “go to” person for families struggling with mental health issues, in part because her openness about her own mental health challenges paved the way for open exchanges. She understood the difficulties many have in finding the right treatment, as well as the stigma that remains so prevalent towards those who are struggling with mental health issues. She realized that most families are quietly struggling with a problem they’re not comfortable talking about, and that discomfort makes it much less likely that they will get the help they need for their loved ones. She discovered that being open and honest about her own mental health challenges took the fear out of the conversations. Her mission became to research and guide those families to the highest-quality treatment available. Helping others became part of her DNA, as has a commitment to supporting and assisting organizations that perform research and treatment in the mental health arena.
After years of helping families by helping connect them to the right treatment and wellness services, Limor realized that the only way to ensure that they are receiving appropriate, coordinated and evidence-based care would be to stay in control of the entire treatment process. That realization led her to create Bespoke Wellness Partners, which employs over 100 of the best clinicians and wellness providers in New York and provides confidential treatment and wellness services throughout the city. Bespoke has built its reputation on strong relationships, personalized, confidential service and a commitment to ensuring that all clients find the right treatment for their particular issues.
In addition to her role at Bespoke Wellness Partners, Limor is the Co-Chair of the Academy of Eating Disorders. She lives with her husband, three daughters and their dog Rex in Manhattan.
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