Full Resources: If your patients get comfortable with navigating synchronous telehealth, you should consider incorporating in other digital tools to enhance care quality. Most basically, you can include automated longitudinal screenings and asynchronous chat. In certain behavioral specialties, digital therapeutics and remote patient monitoring can be effectively deployed.
One of the consequences of the pandemic is the dramatic growth of Telehealth and Telemedicine. But how can doctors and providers best care for their patients when they are not physically in front of them? What do doctors wish patients knew in order to make sure they are getting the best results even though they are not actually in the office? How can Telehealth approximate and even improve upon the healthcare that traditional doctors’ visits can provide?
In this interview series, called “Telehealth Best Practices; How To Best Care For Your Patients When They Are Not Physically In Front Of You” we are talking to successful Doctors, Dentists, Psychotherapists, Counselors, and other medical and wellness professionals who share lessons and stories from their experience about the best practices in Telehealth. As a part of this series, I had the pleasure of interviewingJake Cooper.
Jake Cooper is Co-Founder and CEO of Grow Therapy, a FL-based behavioral health group helping therapists launch thriving in-network practices. He is passionate about bringing change to our unaffordable and opaque healthcare system through provider empowerment. Prior to Grow, Jake was a private equity investor at Blackstone.
Thank you so much for joining us in this interview series! Before we dive in, our readers would love to “get to know you” a bit better. Can you tell us a bit about your ‘backstory’ and how you got started?
We founded Grow because our provider friends were struggling with the complexity of starting their own practices, and our loved ones were priced out of care due to lack of in-network options. In my prior career, we expanded physician groups by negotiating insurance contracts, streamlining administration, and bringing in the latest technology. Our work at Grow is similar, except we’re proud to be working for our providers — not the other way around.
Can you share the most interesting story that happened to you since you began your career?
The greatest personal growth comes from leveraging mentors to go beyond your capabilities. In my old job, we created two companies from scratch in super niche industries — receivables factoring and commodities transportation — by leaning on mentors. Our mentors made founding Grow, and tackling the esoteric parts of healthcare, far less intimidating.
Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?
Pick the neighborhood, not the house. The specifics are less important than surrounding yourself by amazing people, picking a vertical that is going to be the future, and fully committing yourself to your goals.
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? Can you share a story about that?
My co-founders are my biggest mentors and sources of support. In the early days of Grow, I found myself temporarily living in a different state, caring for a loved one, and balancing the responsibilities of my day job. My co-founders shouldered professional responsibilities and supported me personally, helping me get through that challenging time.
Ok wonderful. Let’s now shift to the main focus of our interview. The pandemic has changed so many things about the way we behave. One of them of course, is how doctors treat their patients. Many doctors have started treating their patients remotely. Telehealth can of course be very different than working with a patient that is in front of you. This provides great opportunity because it allows more people access to medical professionals, but it can also create unique challenges. To begin, can you articulate for our readers a few of the main benefits of having a patient in front of you?
Within behavioral health, in-person visits as a modality can sometimes lead to stronger clinical relationships and deeper observations. Patients can see their providers as complete humans, subtle gestures such as passing a glass of water or tissue box are possible, and there is no possibility for technical impairments such as lag or glare. Additionally, providers can use their five senses to derive deeper observations about their patients to iterate most effectively.
On the flip side, can you articulate for our readers a few of the main challenges that arise when a patient is not in the same space as the doctor?
Telemedicine is an extremely effectively modality for behavioral health, but there are potential drawbacks. For those with spotty internet, lag and pixelization can detract from the quality of their connection. Additionally, certain patients with higher acuity should be triaged to in-person settings where providers are present and can respond to crisis situations.
Fantastic. Here is the main question of our interview. Based on your experience, what can one do to address or redress each of those challenges? What are your “5 Things You Need To Know To Best Care For Your Patients When They Are Not Physically In Front Of You ? (Please share a story or example for each.)
- Triage: For certain conditions, generally those with higher acuity, it may be best to triage to in-person care. Effective intake screening, via questionnaire, phone call, or referral is vital to making this judgement.
- Guidance: We’re over a year into the pandemic, but I know that I still run into issues on my daily Zoom meetings. Many patients experience difficulty navigating the scheduling, portals, and video apps. It is vital that directions are overcommunicated and fail safes, such as giving your number for the patient to call, are built into your process.
- Setup: Before meeting with a patient, log in a few minutes early to optimize your setup for lighting, audio, and background. Logging in early also reduces confusion that may arise from a patient not see anyone else online (am I in the right spot?)
- Human Connection: Eye contact and facial expressions are as important, if not more, for telehealth visits. It’s imperative you align your camera well, and mind your body language. In some ways, telehealth can be more effective for monitoring your body posture — use it to your advantage!
- Full Resources: If your patients get comfortable with navigating synchronous telehealth, you should consider incorporating in other digital tools to enhance care quality. Most basically, you can include automated longitudinal screenings and asynchronous chat. In certain behavioral specialties, digital therapeutics and remote patient monitoring can be effectively deployed.
Can you share a few ways that Telehealth can create opportunities or benefits that traditional in-office visits cannot provide? Can you please share a story or give an example?
Telehealth has three main benefits, which are profoundly impactful particularly in behavioral health.
- Meet patients where they are: Patients often feel more willing to open up when they are in a familiar place, such as their own home. As a practitioner, greater context into their day-to-day life can also be illuminating.
- Convenience: Telehealth is significantly lower friction than commuting to an in-person visit. We’re able to accommodate more patients through telehealth because they do not need to leave their home or office. Additionally, our telehealth no show rate is around 10% vs. +25% for in person visits
- Selection: There is a shortage of behavioral health professionals across the country and particularly in rural areas. There is a much greater shortage of in-network providers. Telehealth effectively expands patient selection to any provider in the state versus within 30 miles, giving patients far more options to find the best match from a clinical and affordability (i.e. in-network) perspective.
Let’s zoom in a bit. Many tools have been developed to help facilitate Telehealth. In your personal experiences which tools have been most effective in helping to replicate the benefits of being together in the same space?
Evolutionary tools tend to be more effective than major overhauls. Specifically, the difference between a low versus high quality video conference software, and bad lighting versus an effective ring light and stand, can meaningfully improve care quality.
If you could design the perfect Telehealth feature or system to help your patients, what would it be?
We do this at Grow! In my opinion, best features include easy scheduling, great video connection, and transparent billing. Even better features include effective asynchronous chat, systematic longitudinal screening, and clinical collaboration features to integrate a patient’s behavioral and medical care.
Are there things that you wish patients knew in order to make sure they are getting the best results even though they are not actually in the office?
I think most patients understand that we are figuring out this new normal alongside them. We’re calling from our bedrooms and living rooms; navigating the responsibilities and challenges brought about by the pandemic; and doing our best to lean into the silver linings (which telehealth is in spades).
The technology is rapidly evolving and new tools like VR, AR, and Mixed Reality are being developed to help bring people together in a shared virtual space. Is there any technology coming down the pipeline that excites you?
I am less excited by new technology than using technology in new ways. Specifically, there are a number of amazing teams tackling specific conditions through a novel combination of existing tools such as in-person care, telehealth, digital therapeutics, remote patient monitoring, and peer-to-peer groups.
Is there a part of this future vision that concerns you? Can you explain?
I believe that technology can supplement, but not replace, human care and connection. The illusion that you can get sufficient care through an app that runs on AI or super light touch (i.e. solely asynchronous texting) is naïve for most patients and conditions.
Ok wonderful. We are nearly done. Here is our last “meaty” question. 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. 🙂
I would move to further nationalize in-patient care. In U.S. healthcare, the most devastating outcomes are often financial, and they generally originate from hospital visits. Hospitals and payors have teams of billers and lawyers battling each other to determine who owes what and how much, and when they can’t come to terms, the patient can get clotheslined with a 5 to 6 figure bill that absolutely destroys their life. That is terrible. Commercial payors will argue that they are overcharged to subsidize government payors and the uninsured; physicians will argue they often treat patients without compensation and have significant costs inherent to the payors’ inefficient and onerous administration requirements. At a certain point, the cost and quality benefits of using nationalization as a means to go fully vertical will outweigh the immense friction costs of implementing changes to our reimbursement system.
How can our readers further follow your work online?
Follow us at growtherapy.com!
Thank you so much for the time you spent doing this interview. This was very inspirational, and we wish you continued success.