Breadcrumb
AMCP Podcast Series — Listen Up: Scott Whittle on Digital Therapeutics
Show Notes
Health care expert Fred Goldstein, host of the AMCP Podcast Series — Listen Up!, sits down with Dr. Scott Whittle, Medical Director of Meridian Outcomes, to discuss the pathway to bring app-based solutions to healthcare. With skyrocketing rates of mental health issues facing us, the management of all health-related issues has grown increasingly complex. At the same time, we face massive shortages in health care providers trained to help us navigate the healthcare system. Is proven tech part of the solution?
Transcript
[SPEAKERS: Fred Goldstein, Scott Whittle]
Fred Goldstein 00:01
Hello, and welcome to the AMCP Podcast Series Listen up. As we take a deep dive into the challenges, trends, and opportunities in managed care pharmacy, follow the show's social hashtag #AMCPListenUp. And to learn more about AMCP, visit amcp.org. I'm your host, Fred Goldstein. On today's show, my guest is Dr. Scott Whittle, Medical Director of Meridian Outcomes. We'll be discussing pathways to bring app-based solutions to healthcare. Welcome, Scott.
Scott Whittle 00:32
Thank you. I'm really happy to be here. Fred.
Fred Goldstein 00:34
It's a pleasure to get you on. So why don't we start out with just an initial overview of how you're looking at apps and their use in behavioral health and other areas?
Scott Whittle 00:43
Yeah, that's a great question. I think you can view apps and technology-based solutions from a few different perspectives. But I think the one that's most compelling is probably an engagement strategy to fill in some of the gaps that the human resource elements, the docs, the therapists, the care managers, you know, all of the all of us out there working for solutions, we struggled to fill, we struggled to fill a whole lot of space, where patients need that engagement. There's information to be gathered, there's connections to be made, there's a whole lot of therapeutic work that can be done, that the people working in healthcare really struggled to accomplish, the way our healthcare system is built today.
Fred Goldstein 01:32
And when you're thinking about it, you mentioned something interesting, which was filling in those gaps. Are you looking at that from sort of an engagement piece, you mentioned a bit about engagement, as well as perhaps a clinical piece or a therapeutic component as well.
Scott Whittle 01:47
You know, it's really kind of an all of the above thing where the engagement piece is, is one gap in healthcare that we all struggle to, to overcome, it's a massive gap. But within that space, there's all of the tasks that are, you know, quite honestly, pretty redundant. You know, there's the gathering of data, there's the bringing together of data, there's the turning that into something can help healthcare providers make better decisions faster, to provide better care for individuals, when we rely upon Doc's primarily, who are an incredibly expensive tool in the toolbox. And then frankly, anybody else the consistency of the tech really makes them a fairly ideal solution. And on the positive side, they come in at a great price point, you know, having an app solve for that, you know, an analogy I like to do I apologize, go on on this. But the analogy I like to use is banking apps, can you imagine today, trying to use humans to solve every single banking task that you're trying to solve for? It just doesn't make any sense? Intuitively?
Fred Goldstein 02:55
Yeah, that's an interesting comparison. Now, obviously, everybody's out there now banking off their phones and doing things. And we also talk on why do we need these to navigate healthcare? How can they help in that area?
Scott Whittle 03:07
If healthcare is at its most simple form, you know, going in for an ear infection is pretty easy to navigate. But the second it gets complicated. The second you put one, two or three chronic conditions on top of each other, or, you know, heaven forbid, because the outcomes end up being so poor, you put on a behavioral health issue, like a depression or an anxiety, you know, that's 70 to 80% of the healthcare population. And the second you have that complexity, bringing all the pieces of a care plan or a treatment plan together, becomes so complex that for any individual, it's almost the unicorn of medicine, to have well-coordinated care.
Fred Goldstein 03:50
So the app would help them navigate and get to the right people, you're talking about things like that?
Scott Whittle 03:57
Well, that's one piece of it. I mean, the beautiful thing about these apps is they not only connect the care providers, as a piece of what they do, they also fill in the gaps in terms of gathering data by inquiring from people how they're doing. They pull in data that the healthcare providers are getting from laboratory studies from what have you, and then they know how to distribute that information out to the different health care providers. So we speak a lot to having healthcare providers working at the top of their license. I don't know that anybody is working at the top of their license if they're taking data visually and entering it into a computer with a keyboard. It just doesn't make sense today to be doing that. And, you know, there's a couple of factors coming together that make solving this problem with tech so compelling. We have the increase in behavioral health issues and medical conditions that seem to be insurmountable. Frankly, I mean, it's like a tsunami coming at us. And on the other side, we have a Human Resource, I don't know if any way to describe it but an emergency in terms of healthcare providers available to solve the solution. And the idea that we wouldn't use tech to try and solve that, for me as a provider and kind of a healthcare executive for the last 20 25 years has just been confusing.
Fred Goldstein 05:19
So you've really laid out the viewpoint of why now is the right time to do this. We've got the tech, it works, people use it, and it's able to link up these systems and improve efficiencies, I guess, is how you would look at that.
Scott Whittle 05:32
Yeah, absolutely. And just to add to that, one of the things I find really interesting is that the threshold we're asking tech to cross is that using the tech shows that your healthcare condition improves, similar to taking a medicine like an antibiotic? And for me, I don't I don't mind that threshold. I think it's, it's fair to ask the question, but I also think it's in many ways the wrong question. I think the right question is, I mean, that's like asking your waiting room. It's a tool, it's like asking the vehicle that transports you to the hospital to meet a threshold similar to an antibiotic. But that's not what transportation is, what it does is it facilitates healthcare. And I think we need to be seeing tech as a facilitator of healthcare instead of a medicine. And I know prescription digital therapeutics are being viewed through something of a lens like medicine, because I think that's useful in one form. If I use this app and am treating a healthcare condition like diabetes, do my outcomes improve? Good question. I think it's a good question. But I think the real question is a bit more broad. The real question is, can I treat more patients, more effectively, at a better price point with better outcomes. And, you know, I think singularly important is a better healthcare experience.
Fred Goldstein 06:58
So you're really looking at this more as a system enabler than as a digital therapeutic? In a sense, we should be looking at these as a tool to use to enable a more efficient healthcare system in many ways.
Scott Whittle 07:10
Absolutely, absolutely. A big piece of the health care plan. You know, recently in the state of Utah, we took a good look at the state of our healthcare system, health care delivery. And we recognize that the base, you know, if healthcare is a pyramid, with the top of the pyramid being the specialists who provide very intricate care, but the base of the pyramid being the facilitators. The idea that we're not using a base of technology to facilitate health care, in the face of having, you know, a near historic human resource crisis around providing services at the base of the pyramid of health care providers. It's very compelling. It's a compelling argument to say anything tech can do to build a foundation to support good health care on top of just makes sense. And I think that prescription digital therapeutic strategy, the way to view it as a prescription is useful. I think it's incredibly useful. I certainly don't mean to attack that at all. But I want to say, if you view it from a more nuanced lens, I think you're getting a better view of what tech can actually do to solve our healthcare problems.
Fred Goldstein 08:23
Right. So let's sort of go that other way now and look at this from a prescription digital therapeutics approach. What are you seeing out there that interests you or that you think is going to have some real potential as we move into this, particularly in the area of behavioral health?
Scott Whittle 08:38
That's really where they shine, I think, I mean, they are a facilitator and engager, but they really shine in the sense of filling in the gaps, where having a human fill in those gaps is going to be a bad use of resource. And, you know, I'm an adult psychiatrist, neurologist, child psychiatrist, by training, I did a lot of therapy in my career. But I'll, I'll just be honest, if a computer can take over 80%, of what it does to teach somebody about the principles of cognitive behavioral therapy, trauma-informed therapy, if it can teach those basics, then I can work at a level that not only is more interesting to me, which is the human piece, solving the problems that happen when therapy isn't working the way it should be. That's always the interesting stuff. You know, any teacher would tell you if there's a video that can teach the multiplication tables, and a child can learn the multiplication tables. The teacher's job is then to help the child knock off those rough edges of education where for whatever reason, is not working for them. And I think that's the way we need to be viewing these tech solutions from a prescription digital therapeutic point of view. They carry the bulk of the weight and, I I or my psychologist or You know, any member of my team has the chance to then be the human engagement piece to help individuals in healthcare get over those difficult spots they face when, you know, the tech, frankly, isn't positioned to play that role.
Fred Goldstein 10:14
So as you think about that sort of approach, what can the patients expect to see over the next couple of years in this area, from digital therapeutics and prescription digital therapeutics?
Scott Whittle 10:25
Yeah, I think you know, of the list of people that are set to benefit from prescription digital therapeutics, I think patients are at the top of the list, I think what they could expect is a similar transformation. You know, we were talking before about using a banking app, I think a similar transformation is absolutely possible, where when you're engaging, you know, you have a recent new diagnosis of, say, diabetes, and you now have the app for diabetes in your palm. And when you want to know something about insulin, you don't have to sit in your living room, anxious about the list of questions, you have to squeeze into the relatively brief encounter you're going to have with your Doc, no matter how wonderful that Doc is, having an app in your hand that has doctor-approved information that you can sit and listen to, is much more compelling than the anxiety of wondering if you'll be able to get your questions answered in your next appointment. And so, and one other point, in my kind of corner of medicine, most of my patients have their most challenging times between about 10 o'clock at night and two o'clock in the morning. Those times when you're having difficulty falling asleep, and the challenges you're facing are, I think plaguing you even worse than in the daytime hours. There is no good healthcare system available to help those individuals at that time. It just doesn't, you know, the health care system doesn't work that way. There's the emergency department. And I don't think any of us think that's the ideal solution for individuals who are struggling with a relatively solvable chronic condition, I think turning to an app and having that engagement and having, knowing that you'll be able to engage with your healthcare providers in a communication strategy that you're holding in the palm of your hand, I can set that the app down after I've answered some of my questions after I've expressed some of my concerns, and then I can go to bed.
Fred Goldstein 12:26
You've obviously touched upon how, how much this can benefit the patient, using these digital therapeutics, there's been some question about uptake by providers and using it and prescribing for these things. What would you say to them?
Scott Whittle 12:41
Yeah, you know, on the end, you know, obviously, I'm a provider, use these apps. I think of the individuals who are set to benefit from these technologies. The doctor's role is the most complicated, because, frankly, the way my colleagues view these solutions, is there’s another thing to have to learn. I understand that perspective, everybody feels a little overburdened right now. And adding another thing to do is really unwelcome. I think that has to be overcome. And the discussions I've had with manufacturers that prescription digital therapeutics, I think they're beginning to recognize that it's not just educating and engaging, that the tools are needed, and that they're high quality. I think they also have to work with systems of health care, to provide the support for the physicians to find the time and find the support needed to use these tools without having them feel like an uncompensated burden. I don't know that we've yet solved that problem. But I think people recognize that we have to.
Fred Goldstein 13:45
Yeah, I think it's fascinating. Going back to your banking analogy, and thinking, how much more efficient that makes everything for every player in the system, me, the banker et cetera, the person who had to figure out the checks or whatever, if we could make it easier for the physicians and the others who practice I think that would be the key.
Scott Whittle 14:04
No, exactly. Right. And, you know, that's one of the issues is, I really think we get to that point, but the challenge is having a doctor, do you have enough experience with it, they feel that improvement is a pretty big hurdle to get over. And I think we'll get there. But I have to sign up 100 patients to use an app to solve one of my chronic conditions before I can say, hey, this is actually making my workflow easier.
Fred Goldstein 14:29
Well, I really want to thank you for coming on this week. It's been a fantastic discussion. Thanks, Dr. Whittle,
Scott Whittle 14:35
Absolute pleasure of mine. Thank you, Fred. I love your podcast.
Fred Goldstein 14:40
And thank you for joining us today. If you liked the show, you can find all our episodes at amcp.org/podcasts on our show page at HealthcareNOWradio.com or on your favorite listening platform by searching Healthcare NOW Radio. You can follow our shows social hashtag at #AMCPListenUp. And don't forget to share, like, and follow @AMCPorg on LinkedIn, Twitter, Instagram, and Facebook. I'm Fred Goldstein for AMCP. Until next time.
About the Hosts
Fred Goldstein is the founder and president of Accountable Health, LLC, a healthcare consulting firm focused on population health, health system redesign, new technologies and analytics. He has over 30 years of experience in population health, disease management, HMO, and hospital operations. Fred is an Instructor at the John D. Bower School of Population Health at the University of Mississippi Medical Center and the editorial Board of the journal Population Health Management.
Connect:
Never miss an episode! Subscribe today.
Interested in sponsoring a podcast episode? Get in touch.