Innovating for Wellness

Bridging the Gap between Health System and Patient

Robert L. Longyear III

• Publisher: New Degree Press
• Year: 2020
• ISBN:
  9781641375733
• Edition: 1
• Topic: Medicine
• Subtopic: Health Care Delivery

The healthcare system has failed to achieve its purpose: supporting patients in their pursuit of better and stable health. Innovating for Wellness: Bridging the Gap between Health System and Patient explores the ways in which innovators are thinking differently about how healthcare should be provided to our nation’s sickest patients. In this book, you will discover:

• Innovative digital health technology start-ups and entrepreneurs
• The father of the Accountable Care Organization, who dedicated his life to changing how we pay for healthcare
• How healthcare is changing to fundamentally flip from reactive to proactive

Longyear explores these innovations through the lens of a patient and caregiver as his family’s tragic story reveals important insights into how healthcare must change to drive better outcomes. Healthcare is in the perfect storm for disruption as technology has accelerated and new payment models provide new incentives for change. Innovating for Wellness speaks to professionals, students, patients, caregivers, and those interested in the rapidly changing world of healthcare. If you work in healthcare, have ever been a patient, or are interested in the future of the industry, this book is for you.

PART 1

“Innovation distinguishes between a leader and a follower.”

– Steve Jobs

Introduction

“So, basically, you guys solved healthcare,” I said with a bit of disbelief in my voice.

I said these words to Taylor Justice, a man with an incredible story. He attended West Point and was later commissioned as an Infantry officer in the US Army. Within two years of his military career, he was injured and his whole world flipped upside down. “Transitioning from the military into the civilian world was tough,” Taylor reflected. “I was in survival mode at the time, but my West Point network helped me find a job at a medical device company in sales.”

So, Taylor was able to find a position where he could enter the civilian world and little did he know, at that time, he was destined to co-found one of the most innovative healthcare technology companies in the country—one that is helping drive change for the costliest and deadliest issues in America.

* * *

Before I ever spoke to Taylor, while I was still deep into my degree in healthcare management and policy at Georgetown University, I was looking for the next step in my life. I learned quickly and early in my college career, that, despite years of claiming that medical school was my end-goal, I no longer actually wanted to go to medical school. I knew I was deeply, and very personally, passionate about healthcare—but I was not quite sure what I wanted to do, or where I wanted to position myself in the vast industry. But, like many other students looking to continue exploring before specializing, I ended up very interested in healthcare consulting.

Before this, though, when I was looking for which area of healthcare I wanted to be in, I had sent a few applications for “fun” to a couple select start-up companies that had the potential to really flip healthcare on its head. I was batting a bit out of my league on these applications, but I figured it was worth a shot. I didn’t get contacted about a job at that time, but little did I know that I would find myself not only interacting with one of those companies through this book, but leading one myself. And now, as a result, I have spent six months trying to solve some of the most challenging problems faced by healthcare today, through the use of mobile technology.

One of those companies I applied to was Unite Us—a technology company that connects social service providers, or community-based organizations (CBOs, as they have come to be called in the health policy space) and healthcare providers through a shared platform to better coordinate and manage their services for people in need. As I began this book journey and desired to focus on technology, I knew that I needed to try and talk to someone at Unite Us. That’s when I sent Taylor Justice, Co-Founder and President, a hopeful LinkedIn message trying to set-up a phone call—I got lucky and Taylor was kind enough to provide me with that opportunity.

Shortly after entering the civilian workforce, Taylor volunteered with a national veterans organization and started their local chapter in Philadelphia. The organization helped veterans and military families connect with their local communities via physical fitness and social activities. Fueled by his own experience and passion for helping his fellow military brothers and sisters, he began to notice that many veterans attending these events had several co-occurring social issues that required additional support outside of what his organization could facilitate. He realized the population was fairly “heterogeneous” despite many social programs treating the people they serve as very “homogenous” when it came to social needs. Taylor began to organize and support these individuals by connecting them to organizations he knew in the community, using an Excel spreadsheet to try and manage his workflows.

During this time, Taylor found a new job with a technology company and enrolled in the Executive MBA program at Columbia Business School. That’s where he met his Co-Founder, Dan Brillman (a veteran himself), and the foundation was laid for Unite Us. Their first meeting lasted five hours—there were subsequent conversations that lasted even longer. The pair shared a knack for technology, business acumen, and a passion to connect veterans effectively to the social services they need. Seven years later (and several iterations of the platform), Unite Us is transforming the delivery of social services not only for veterans, but for all populations.

While this seems like a giant task to undertake, solutions from Unite Us are decidedly simple and intuitive. The coding, product features, and technology may be complicated, but the functionality—once you understand it—makes you hit yourself on the forehead while uttering a resounding, “Well, duh, why didn’t I think of that?” As, often, the best innovations do. Not only is this true about Unite Us’ product, but, like many truly innovative solutions, the actual solution to the problem is often very small, but with a huge effect.

The innovation process begins with the identification of a problem—this often comes from an individual’s lived or professional experience. This process doesn’t work very well. It would be so much more efficient if this happened. What if we did it like that? I think I can do this faster and better. This is so messed up. These are the types of thoughts that often preclude a successful innovation.

* * *

What Taylor and his team did may change the face of healthcare moving forward—despite first operating in the sphere of social services. To better understand what happened, we first need to walk through a brief background of social services and community-based organizations in the United States.

Let us imagine, for a moment, that we are living in a small community called Smallville. In Smallville, there are people of different demographics and socioeconomic statuses. For people who are impoverished and disadvantaged, there exist organizations to help: homeless shelters, food banks, soup kitchens, job training programs, community health centers, religious aid organizations, government social service agencies, emergency departments at hospitals, etc. These organizations do wonderful things by providing services to the people that need them.

Each of these organizations operates in their respective areas, trying to be as efficient as possible so as to provide the greatest benefit to the people they are trying to help. But, the specialization of these different services is a blind spot when it comes to meeting the needs of the people they are helping. Homeless shelters provide shelter, hospitals provide healthcare, and soup kitchens provide...soup. Taylor and his team were able to see this first when they were helping veterans.

“Veterans, like the greater population, have needs that are co-occurring,” Taylor said.

We typically associate “specialization” with increased efficiency. If you think back to any economics course, the idea of specialization in trade generates more benefit to each entity than if both tried to do everything themselves. If you are familiar with Jared Diamond’s Guns, Germs, and Steel, he speaks of the importance of specialization to enable civilizations to advance from hunter-gather societies to agricultural ones that can build advanced societies.

In today’s world, specialization is everything. In college, you major in something specific, in graduate school you specialize even further, in a company you see titles like VP of Human Resources, where specialization is indicated in the title. In business school, “specialization” for a product is taught through the lens of market segmentation—which defines the specific type of person or business that is the intended customer? Specialization is how the world works, but it has its drawbacks.

When looking from the individual’s perspective, rather than the system’s, it paints a very different picture for how individuals experience social services and the actual collection of their needs—the poorest, sickest, most in-need people are not specialized; they are diverse as a population and experience different challenges individually. Thus, they need multiple services to help them.

Taylor first recognized this phenomenon while volunteering at the veteran-support organization. An individual may be homeless, require food support, be involved in the justice system or formerly incarcerated, have multiple medical conditions, and/or be in need of job training. They may receive food from a soup kitchen, visit a food bank, see two different community health centers, and require support from a government housing agency while moving back and forth between homeless shelters. From an individual’s perspective, they have a lot of required services from many different organizations. And, the person receiving the support is the only one that knows which ones they are engaging with.

The problem with the way social support organizations operate is that these individual community-based organizations may all duplicate services, perform their own additional services, and hold their own records. This is a terribly inefficient process. They have specialized, and, therefore, isolated themselves and operate along a single social need.

So, what Taylor and Unite Us did was build a technology platform that connects these organizations, but with the needs of an individual in mind and with the ability to scale the network. They built their system around both the care coordinator and the end-user. Now, using the app, the food bank knows which homeless shelter the individual stays at; the community health centers know that this individual is receiving nutritional support from the food bank; the government social services support center sees where this individual can be contacted, and also sees that the social worker from the hospital indicated that this individual has an unmet substance abuse need and can connect them to a program supported by a different local health center. This coordinated platform all...