Alicia Jackson of Evernow: “We can tackle the most difficult cases that might be overlooked elsewhere”

It’s important to recognize that the US has the best healthcare in the world. We can tackle the most difficult cases that might be overlooked elsewhere. The problem is that it’s not accessible. Part of this is due to the complexity of our insurance system and the confusion and disparity that comes with this. For […]

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It’s important to recognize that the US has the best healthcare in the world. We can tackle the most difficult cases that might be overlooked elsewhere. The problem is that it’s not accessible. Part of this is due to the complexity of our insurance system and the confusion and disparity that comes with this. For instance, drugs are priced extremely high based on the understanding that insurance coverage will bring the price down — but there’s no predictability or consistency to how this works for patients.

As a part of our interview series called “5 Things We Must Do To Improve the US Healthcare System”, I had the pleasure to interview Alicia Jackson.

Dr. Alicia Jackson is currently CEO and founder of Evernow — a next-gen telemedicine company focused on menopause. Dr. Jackson has a long track record of bringing to life technological advances to solve pressing challenges facing people across the globe. She is a PhD graduate of MIT, served as a policy staffer for the US Senate Energy Committee, and was the Deputy Director of the Biological Technologies Office at DARPA, the Pentagon’s principal engine for disruptive innovation.

Thank you so much for joining us in this interview series! Before we dive into our interview, our readers would like to get to know you a bit. Can you tell us a story about what brought you to this specific career path?

Today I’m the founder and CEO of Evernow, a company that’s building the future of healthcare for women, beginning with menopause. In terms of how I got here, I have a PhD from MIT and also spent much of my career in Washington before transitioning to the startup world.

As for launching Evernow, given my deep science background, I originally thought I was going to start a fertility company. But as I learned more about hormones and how they change over time, I quickly came to understand that menopause represented a critical moment in a woman’s health span. This is the first generation of women who will live more of their lives in menopause than not. Between the drop in estrogen, the increase in the diseases of aging, and how unaddressed and overlooked it all is — so many women told me about the frustration of feeling like their bodies were going haywire. They were shocked by the changes and by not being able to get the clear, up-to-date information, care, and treatments that they needed.

I had been thinking about telemedicine around this time. It seemed like the perfect way to connect women to expert medical practitioners who care deeply about menopause and have expertise in it. It also felt like an opportunity to focus on a new way of delivering care that was centered around the woman, her biology, her needs, her life. I thought, bingo, this is the company I’m going to build. We began formulating the company, raised money for it, and then launched it. The response from our members has been amazing — we are filling a void in healthcare. That’s how I got to where I am today.

Can you share the most interesting story that happened to you since you began your career?

I’ve been lucky enough to have had a bunch of interesting experiences doing meaningful work — among them, working for the Senate on energy policy, working at DARPA managing a 300MM dollars biotech investment portfolio, and working at MIT discovering new fundamentals of the world in nanotech. But honestly starting and building Evernow has really been a peak moment. Imagine if there was one key factor that would greatly affect your lifespan and yet nobody ever told you. That’s the situation for women facing menopause. It’s fully intertwined with all aspects of health — from metabolic health to brain health to cardiovascular health. Yet until recently it seemed like nobody was talking about it because it was too complex and those health effects aren’t immediate.

Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?

Always seek to understand (rather than simply assume to know). It’s one thing to assume you know what’s going on, but when you start trying to understand it as well, so much more information and learning opens up.

How would you define an “excellent healthcare provider”?

They need to be someone you can connect with and whom you feel you can speak openly to. You’re essentially hiring a CEO for your body, and if you can’t have a great conversation with them, then they’re not for you. They also need to be available. If you’re hiring somebody to take care of you, you have to be able to reach them when you have important questions. Lastly, they need to be up to date on the latest medical research. Our understanding of diseases, treatments, efficacy, and safety changes over time, so what a provider might have learned in medical school may no longer apply. This is especially important in women’s health because it’s lagged behind men’s health and only recently have we begun to truly dig into how things manifest differently in the female body.

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 Peter Attia’s podcast. It dives deep into the latest scientific knowledge around important health topics, and I appreciate that he manages to make these meaty topics accessible while still going deep into the scientific literature around them. In addition, two recent reads that I really appreciated were Catastrophic Care, which really pushes you to rethink your assumptions around healthcare, and Organizational Physics, which explores the science of growing a business. Lastly, this may sound funny, but I’m a big advocate for staying close to whatever spiritual document you ascribe to from a perspective of taking the time to think about the bigger picture. I enjoy that because it helps you to periodically reevaluate your life and your actions and think about the larger goals.

Are you working on any exciting new projects now? How do you think that will help people?

At Evernow, we recently released a study of over 40,000 women experiencing menopause and perimenopause. Our goal was to guide women and the larger medical community on how to better treat the symptoms and health impacts of menopause, and to develop a deeper understanding of the impact of menopause on women’s bodies. Many of our findings have been eye-opening. For example, brain fog is more severe and prevalent in perimenopause than menopause. So often we think about menopause as something that happens in our ovaries, but its impacts on our brains are just as large and often more noticeable. Further, over 95% of respondents rated at least 3 symptoms a 3 or 4 on a severity scale of 0–4. We strongly believe that recognizing symptoms and understanding their severity is a crucial step toward getting treatment and finding relief.

Ok, thank you for that. Let’s now 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?

First, it’s important to recognize that the US has the best healthcare in the world. We can tackle the most difficult cases that might be overlooked elsewhere. The problem is that it’s not accessible. Part of this is due to the complexity of our insurance system and the confusion and disparity that comes with this. For instance, drugs are priced extremely high based on the understanding that insurance coverage will bring the price down — but there’s no predictability or consistency to how this works for patients. There’s also the fact that outdated and cumbersome regulations written decades ago, prevent physicians from practicing across state lines, which creates a captive market, limits knowledge transfer, and worsens shortage problems. And lastly, there’s often a lack of connectivity across providers and care resulting in no one having the complete picture, and critical information not being passed on.

As a “healthcare insider”, If you had the power to make a change, can you share some changes that need to be made to improve the overall US healthcare system? Please share a story or example for each.

Beginning with the insurance question, bringing more transparency to costs is one starting point. Currently, there’s so much opaqueness around the costs of care and how healthcare activities are reimbursed that many of the incentives that would lead to better practices and outcomes for patients are lost. Government and industry are both drivers of the current environment. Changing this status quo will require changes in government policy and regulation, coupled with innovation from industry. We’ve seen with COVID how fast both government and industry can move in implementing (or getting rid of) policies to enable shifts and innovation in care delivery. For example, with one fell swoop, video televists could happen over Zoom, medical providers could (temporarily) practice across state lines, and telehealth visits could be reimbursed at the same rates as in-person visits.

As for the licensure question, enabling doctors and nurses to practice across state lines post-pandemic without being individually licensed in each state would be game-changing. Over this past year, we’ve seen what’s possible with democratizing access to care through telehealth, but the biggest barrier remains the regulations. In addition to the licensure issue, many states also require an initial video visit (versus a voice or text-based encounter), which can be challenging for those who don’t have high speed internet. Consumers can do a lot in this area by demanding that their state regulators change these rules.

Finally, when it comes to connectivity, moving toward value based care is a step in that direction in that it begins to take into account how services ranging from behavioral health to direct-to-consumer care (like what we offer at Evernow) can fit into long-term health.

The COVID-19 pandemic has put intense pressure on the American healthcare system, leaving some hospital systems at a complete loss as to how to handle this crisis. Can you share with us examples of where we’ve seen the U.S. healthcare system struggle? How do you think we can correct these issues moving forward?

During the pandemic, people weren’t getting their routine exams done, so they fell a year behind on things like mammograms, colonoscopies, and Pap smears. For some populations, these can be critical tests because doctors are looking for changes over time. Moving forward, we can do a better job of implementing and communicating safety procedures early. In many cases, getting these tests was much safer than the routine tasks that patients still engaged in — like going to the grocery store — but we didn’t do enough soon enough to counteract the stigma around care settings during the pandemic.

How do you think we can address the problem of physician shortages?

Telehealth is essential to addressing this problem because it makes the best use of physicians wherever they are. Further, it can help with burnout because of the flexible hours it offers. Physicians have lives and family responsibilities, too, and creating virtual workspaces powered by technology abstracts away all of the busywork they once had to do, so they can stay focused on the core functions that they trained for. That alone is a game-changer.

I’m 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?

Mental health is also physical health. They’re deeply intertwined. At Evernow, we have many women coming in suffering from depression and anxiety. The causes can be manifold, but in patients undergoing menopause and perimenopause they include real hormonal changes. As a provider, if you don’t understand these kinds of interactions between body and mind you may treat the issue differently and ultimately less effectively.

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. 🙂

Reflecting on everything that we learned through our study and what I’m seeing elsewhere, I think there’s going to be a big shift in how we collect, synthesize, and learn from health information moving forward — and more importantly, how it impacts treatment. Thanks to telehealth and machine learning technologies, we can not only collect a lot of data, but also develop new insights based on this data. That, in turn, can change how we study treatments and treatment protocols. This is particularly important at the individual level when we need to decide what treatment is best for you and your health history. In menopause, for example, we know that its health effects manifest differently in different ethnicities, so we can begin to study what treatments and protocols work best for which groups and when.

How can our readers further follow your work online?

Thank you so much for these insights! This was very inspirational and we wish you continued success in your great work.

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