How Predictive Technology Is Improving The Patient Care Experience
I had the pleasure of interviewing Griffin Myers, MD, M.B.A, co-founder and Chief Medical Officer of Oak Street Health, a primary care doctors for adults on Medicare in medically underserved areas. The Oak Street Model is a value-based model that cultivates community engagement, deploys integrated care teams and provides enhanced support services. Griffin is a BS graduate of Davidson College, has an MBA from the University of Chicago Booth School of Business, and an MD from the University of Chicago Pritzker School of Medicine. He completed his residency at the Brigham & Women’s and Massachusetts General Hospitals, affiliates of the Harvard Medical School, is a diplomate of the American Board of Emergency Medicine, and is an Adjunct Instructor of Emergency Medicine at Northwestern University’s Feinberg School of Medicine. Griffin is also a Fellow at Doximity, a Thought Leader for the New England Journal of Medicine Catalyst, and a Presidential Leadership Scholar.
But if you ask him, what he is most proud of is the team at Oak Street and their shared values for evidence-based medicine, health equity and accountability in healthcare.
Thank you so much for doing this with us! What is your “backstory”?
After receiving my bachelor’s at Davidson College, I decided to get my medical degree and pursue my passion for taking care of patients. However, when you get to medical school the medical-industrial complex ever-so-subtly tells you that unless you’re a fancy specialist, you don’t matter, you will never make money and you’ll never make a difference. This created a conflict for me that I really couldn’t handle. It was either prestige, success and money, or staying consistent to my values around health equity and community. So I left medicine after graduation and got a job at Boston Consulting Group (BCG) where I worked as a consultant building economic models of healthcare systems around the world.
On my first day at BCG, I met Mike Pykosz, who is a co-founding colleague of mine and our CEO at Oak Street Health. We became quick friends and played golf and watched football together. Mike wrote a paper arguing that healthcare providers could save a lot of money if they could reduce emergency room usage and hospitalizations. His idea was that healthcare providers could reinvest those savings in primary care, where patients ought to be treated in the first place. One day he said, “Why am I telling people to do this? We should just do this ourselves.” That was the day Oak Street Health was born. A few months before starting the company, I met Geoff Price, current COO, at Mike’s wedding. We instantly clicked and co-founded Oak Street Health together.
Before going back to do my residency, I went to business school to learn the technical parts of finance and economics to better understand healthcare models. Once I matured enough to understand that I didn’t have to listen to the “only specialists matter” mantra, I chose emergency medicine because the emergency department is where the real world meets the healthcare world. Frankly, it scared me but I loved it.
I did my residency in emergency medicine at the Brigham and Women’s Hospital and Massachusetts General Hospital. Late in my residency, I also started to build Oak Street Health with Mike and Geoff. We first opened Oak Street Health’s doors to patients in Chicago in 2013 and I became Chief Medical Officer, responsible for the excellence of health care delivery across centers, as well as building and support our patient care teams — ensuring they have what they need to deliver on our promise.
Today we’re treating more than 42,000 patients in 25 centers across Illinois, Michigan and Indiana, with 11 new centers on the way. Two of the metrics I’m most proud of, however, involve our patients; we’ve achieved a 94 percent patient retention rate and have decreased patient hospitalizations by 44 percent since 2013.
Can you share the funniest or most interesting story that happened to you since you began leading your company?
We’ve had a lot of great stories at Oak Street Health about the way our work impacts patients. I remember one patient in particular as a unique, very Oaky story.
I have the privilege of working alongside our care teams one day per week. We had one gentleman with diabetes who had been resistant to treating his condition with insulin for years. I saw him one afternoon while a colleague was away, and we started talking about his medications. He had been saying he didn’t want insulin because he was afraid of needles, but we noticed he had been getting regular lab draws.
Turns out after a nice chat, he was embarrassed about not being able to afford the copay for the insulin. Well, our Patient Relations Managers are experts in just this kind of situation. He didn’t know, but he actually qualified for a special kind of Medicare plan just for folks with diabetes, and our Patient Relations Manager was able to meet with him that same day to talk about it.
However, there was one little problem: we had a social event going on that day and it was an Anita Baker cover band concert. It was so loud we could barely hear each other back in the exam room. So, he had to wait another half hour for the concert to wrap up to meet with the PRM whose office was being used as overflow seating for the concert. Ultimately, he had that discussion and was able to find a plan that allows him get more affordable insulin. And that’s how it all has to come together — clinical services, social and benefit support services and an Anita Baker cover band to provide patients what they need to be at their best.
What do you think makes your company stand out? Can you share a story?
We deliver an entirely different model of healthcare that is based on providing value to our patients, instead of volume of services. Our physicians spend more than twice as long with each patient than a typical doctor, and each patient is assigned a team made up of a primary care physician or nurse practitioner, a medical assistant, a care manager, a registered nurse, and a clinical scribe to document notes. That team is responsible for delivering great health.
Additionally, we follow our patients’ journeys through the healthcare system, whether their care is directly from an Oak Street Health provider or not. Our model takes the full risk for our patients away from insurance providers, meaning if a patient receives any other medical treatment, like hospitalizations, rehabilitation services or specialist visits, we are accountable and will pay that bill. That enables our care model to use a preventative approach to address the needs our patients, leading to a reduction in hospital visits.
As a result, we’ve found from hundreds of stories and an incredible amount of outcomes data that our patients are happier, healthier, and stay out of the hospital due to the Oak Street care model and the terrific work of our teams.
Are you working on any new or exciting projects now?
Now that we’ve proved our model results in quality care for patients and is economically sustainable, we’re now focused on building out the platform to further improve the patient health experience and to scale so we can serve more communities. We’re investing in a variety of ways, but I’ll talk about three in particular.
First, we’re investing a lot of time and money in improving our health plan partnerships so we have more data and the ability to connect with more patients.
Second, we’re investing in some very exciting technologies to help us improve the quality and experience of care. This is stuff traditional healthcare organizations just can’t do because they don’t have the value-based model to make the economics work. We’re investing in tools that help our teams care for patients when they’re at home, in the hospital or wherever they may be. And those tools allow us to deliver evidence-based care tailored specifically to that patient.
Last, and probably most importantly, we’re investing more and more in the long list of crucial things our patients need, outside of simple primary care, to be happy, healthy, and out of the hospital. In fact, we call ourselves a “social determinants practice,” not a primary care practice, and that’s why we’re so excited about those investments in transportation and social services. We’re even exploring projects around affordable housing, high-quality foods and employment. That’s where we feel we can continue to lead in delivering the best healthcare to our patients.
What advice would you give to other executives or founders to help their employees to thrive?
We’re not only on a mission to keep our patients happy and healthy, but our employees as well. Our value-based model helps a lot; in a fee-for-service model, there’s no alignment between a provider’s values and her reward. In our model at Oak Street, we can make very real and deliberate sacrifice in the interest of our patients, whether that’s work harder, stay later, invest in personal development, etc. And it’s not every day, but when a patient needs it, we at Oak Street know our efforts reward our patients, they aren’t just some isolated financial objective.
In other words, when patients thrive, we thrive too.
Specifically when it comes to our physicians and nurse practitioners, we’ve built a program we call “Joy in Practice,” to celebrate and focus on just that: creating an environment where providers can find meaning in caring for our patients. For that reason, we’re making very meaningful and measured progress towards overcoming burnout and finding that joy. According to anonymous surveys of Oak Street Health physicians:
● 98 percent say they’re willing to put in a great deal of effort in order to help Oak Street Health succeed
● 96 percent say Oak Street Health inspires them to do their best
● 96 percent say they would recommend Oak Street Health to other clinicians as a great place to work
We’re incredibly proud of that because we think the work of primary care is heroic work. And we’re delighted to know our heroes are inspired and engaged to care for our patients.
None of us are able to achieve success without some help along the way. Is there a particular person who you are grateful towards who helped get you to where you are?
It would be impossible to pick a single individual. Oak Street is truly a team and a team sport. I am obviously very biased, but I think I had the best founding colleagues, Mike and Geoff, in the history of solving hard problems. We knew from day one we were on a mission to rebuild healthcare as it should be for our patients, and those guys never ever wavered on that. Not once. And that kind of focus and commitment has been inspiring from the hard times to today.
That being said, if you push me, I’d say my wife Diana is truly a saint, because she knew how insane this whole idea of building an entirely new healthcare system from scratch was — with personally-guaranteed loans and all — and she was 100% supportive. And not just that, she’s been encouraging and motivating. And I know the guys’ spouses are the same. There’s a lot of trust that’s enabled us to keep pushing for our patients, and now that extends to the whole Oaky team. They inspire me every day. So, like I said, it’s really a team sport at Oak Street Health.
How have you used your success to bring goodness to the world?
When our patients do well, we do well and are able to reinvest back into our patients and care teams. We are fortunate enough to be able to address the needs of adults on Medicare in medically underserved communities. Today, healthcare is not just about primary care — it is about disparities in access, providing equitable and accountable care to those who need it most and leveraging successes to reinvest back into these same patients.
Our model is about combating the issues that aren’t happening and typically presented within the walls of our offices. We provide behavioral health, social work, at home visits, help with housing and food insecurities, transportation and social opportunities. Our community rooms are home to over 10,000 events a year and are a safe and welcoming space for all community members where they can come and be warmed in the winter, cooled in the summer, and be secure and social all year round.
Something we talk about a lot at Oak Street is a data point from the New England Journal of Medicine back in 2007: 80 percent of morbidity in the U.S. is due to factors outside of the exam room and the quality of healthcare received. Yet the current healthcare model in the U.S. focuses on treating only 20 percent of the problem. It’s literally the 80/20 rule, and we’re focusing on the 20. We built Oak Street Health’s model to address some of society’s greatest needs found beyond hospitals or health systems, the social determinants of health — including social and community support, education, economic stability, neighborhood and built environment, and access to healthcare. For so many in this country and around the world, quality of these five determinants is typically very low, and access is often limited or unavailable. And we are very fortunate to be able to continue to provide care that focuses on the missing 80 percent we see in the current fee for service models of healthcare.
To say it another way: at Oak Street Health, we strive for a world where health isn’t determined by factors that people cannot control. And that’s a really meaningful objective.
Can you share the top five ways that technology is changing the experience of going to the doctor.
- Data analytics is shaping more accurate and productive patient experiences. At Oak Street we are now hosting a cloud-based enterprise data warehouse that integrates thousands of data lines, allowing data teams to apply algorithms that make it easier for care teams to deliver the right care at the right time with maximized efficiency. For example, let’s say a patient travels downstate to visit family and goes to a Walgreens to get a flu shot. When that person visits his or her primary care physician the next week and the physician asks, “Have you had your pneumococcal vaccine?” the patient may say yes, thinking that is synonymous with a flu shot. However, the data analytics system will tell the physician that person got a flu vaccine and still needs the (potentially life saving) pneumococcal vaccine.
- Predictive technology and workflow tools are mitigating hospitalizations. We at Oak Street are also building proprietary tools to guide their teams through evidence-based workflows that are shown to deliver better care. For example, predictive technology is being used today to identify cases at high risk of readmission, and workflow tools to ensure teams provide all the services that give patiences the best chance at avoiding that hospitalization. These services include ensuring they have a post-discharge visit scheduled with transportation to and from the center, that our pharmacist has reviewed and reconciled their new medication list, and that the in-home care team is scheduled for a visit.
- Video/tele-psychiatry services are early but hold promise in terms of improving access to care. Not all patients have equal access to care. We’ve built a video/tele-psychiatry service to bring board certified behavioral health to our patients and caregivers, and found dramatic reductions in hospitalization rates among our patients with behavioral health challenges. This kind of remote care won’t solve all patients’ problems, but when designed around specific patient needs and conditions, it’s a great tool with great impact.
- This one is very early, so we’ll see where it goes, but the emerging use of voice-controlled devices in healthcare may help patients and doctors take a more preventative approach to healthcare. Amazon recently announced it’s building skills for Alexa that will help people with diabetes management, care for mothers and infants, aging care and more. With these skills, patients would be able to take a preventative approach to health in the comfort of their own home. And if Amazon can work through regulations and data privacy requirements laid out by HIPAA, devices and apps would be able to share and upload health data with medical professionals and patients, creating a truly data-driven doctor visit. However, for voice to be successful in healthcare, developers of Amazon Alexa and other voice-controlled devices will need to focus on staying clinically relevant, being culturally competent, and reducing patients’ fears around privacy and abuse of their information.
- Most importantly, technology is evolving to allow providers, executives, and policymakers to identify where and how we can improve. This sounds like a small item, but just a few years ago, we didn’t have the technology in place to identify which practices were good at caring for chronic disease, which hospitals placed patients at high risk of surgical site infections or even where the sickest patients in the country lived. Today we have many of these tools, and while data feeds and statistically robust risk-adjustment methodologies aren’t as sexy as a wearable device, they are doing a lot to improve quality and equity of healthcare in the U.S. and around the world.
Can you please give us your favorite “Life Lesson Quote”?
I’m generally not in the business of unsolicited advice, but this feels solicited. For me, it’s all about values. Know what you’re values are and always make decisions and behave in a way that is consistent with those values. For me and for our team at Oak Street, our values are around evidence-based medicine, health equity and being held accountable. Knowing that means that while I’ll still always have hard decisions to make, I know the framework for making those decisions.
Some of the biggest names in Business, VC funding, Sports, and Entertainment read this column. Is there a person in the world, or in the US whom you would love to have a private breakfast or lunch with, and why? He or she might just see this :-)
That’s tough. My “dream breakfast” list pretty long, and I’m always working on it. For today, despite the fact that I’ve largely aged out of being a sports fan, I’d say LeBron James. I wouldn’t want to talk about sports. I’m inspired by how he entered into such a high profile role at 18 years old without any training and was able to accomplish what he has today. He’s made mistakes in front of the whole world, and he has not only owned and addressed those mistakes, but he’s thrived. Watching that has been incredible. He’s also had an important voice in so many conversations we’re having as a country. Agree with him or not, he tells you, and he’s right, he’s just a kid from Akron. But he’s clearly a natural leader who is not afraid of a challenge and isn’t bothered by criticism. Like him or not, you have to admire that.