Shlain: Healthcare is a people business, not a technology business

BOSTON—“Healthcare is a people business in need of technology, not a technology business in need of people,” Jordan Shlain, MD and CEO of HealthLoop told an audience at the Digital Healthcare Innovation Summit on Nov. 4.

“People are trying to make money off of data, but you have got to remember the person behind it,” he said. All data are not created equal, and that there are many types of data—fixed, stable data, dynamic data and analog data (data based on human elements, like trust)—that need to be factored into new innovative technology products and services.

Harnessing these data should take place within a continuous learning clinical operating system. “Think of it like of it like a Hollywood scrip.” A diagnosis and treatment plan is part of Act 1, with a supporting cast of clinicians, family members and others that guide the patient along his or her care path. As a physician, “I’ve seen all variations of movies. I know when the movie is going to be a bad movie versus a good movie.”

To make it a good movie, engaging patients in their treatment is crucial. Failure of an individual to engage should be treated like a disease or pathology. To engage patients, he said it’s important to give patients agency in their outcomes and treat every patient as the most important person.

Shlain’s company, HealthLoop, works to achieve these ends. It enables patients to share medical and activity data directly with their physicians using their smartphones. The app automates check-ins and monitors patients to improve adherence with supportive communication. HealthLoop also reduces clinical risks by detecting and managing at-risk patients, reducing malpractice exposure and minimizing cancellation rates. 

“We’ve had 57,000 check-ins in the last six months,” Shlain said. When prompted, 78 percent of the patients check in 100 percent of the time, leading to an 87 percent reduction in unnecessary utilization and a 60 percent reduction in inbound phone calls. Shlain noted that it typically takes seven minutes to resolve a phone call in a doctor's office, but with Healthloop, physicians and practices have been able to adjudicate 14 people in seven minutes.

“It’s not trivial,” he said. “Telephones’ function has long outlasted their usefulness.”

The practice of seeing a patient once per year is “arbitrary” and derives from an outdated fee-for-service mentality. If data are collected in real-time, “it doesn’t degrade,” he said, adding that this information would require filtering to avoid information overload.

“We think the world is moving in a direction where people will start to have places to put information in,” Shlain said. “As a physician, I’m interested in how we can get information we can act with.” When he meets with patients, he reaches one of three conclusions: Do nothing; Do something; or Need more information. “I’d like these information wrapped into context so I know what to do.”

Shlain said it’s critical that physicians are at the center of technology used to improve care. Incentives can help. For example, HealthLoop is working with a large malpractice carrier in California which is offering financial incentive to physicians to check in with patients following hip surgery (30 times over 90 days). “Physicians get to collect funding if the patient checked in more than 50 percent of the time,” he said.

Another physician incentive of HealthLoop is patient satisfaction. “Our numbers are through the roof,” he said. One physician who had nine reviews in 10 years, with 3.4 stars, on Yelp saw five new patients enter positive feedback during the first month using the technology. “Five patients gave him five star reviews.”

For patients with positive experiences, the app prompts the ability to review on sites. But if patients are not satisfied, the app allows them to send anonymous feedback to physicians on how to improve care. “Now they are getting data they didn’t get before.” While physicians can opt out of this service, he said, “everyone wants it on.”