Mandate clear interoperability requirements and a simple format that all healthcare technology vendors could use to securely exchange patient information among authorized providers of care. Every healthcare organization we have worked with has to operate with a mind-boggling array of differing systems, formats, data types, and so forth. This is the byproduct of a highly siloed, specialized industry with conflicting interests and makes access to the full spectrum of needed patient information at the point of care difficult to impossible.
Ihad the pleasure to interview Adam Sabloff, CEO and Founder of VirtualHealth. Adam has worked at the forefront of healthcare transformation for more than a decade, perfecting the technologies that pioneered patient-centered care. Utilized by some of the most innovative health plans in the country, VirtualHealth’s HELIOS platform is the first comprehensive care management solution purpose-built to power the entire ecosystem of value-based care. Previously, Adam spearheaded the development of the first ever “The Ritz-Carlton Residences,” a new concept in real estate that he co-created in partnership with The Ritz-Carlton Hotel Company. Adam is a recipient of the Baltimore Business Journal’s “40 Under 40,” the Daily Record’s “Most Influential Marylanders,” and American Business Awards’ “IT Exec of the Year.” VirtualHealth has received multiple awards for its work, including #39 in Deloitte’s 2018 Technology Fast 500, Modern Healthcare’s 2018 Best Places to Work, and the 2018 TripleTree iAwards for Healthcare Engagement.
Thank you so much for doing this with us! Can you tell us a story about what brought you to this specific career path?
The genesis of VirtualHealth started with my work in the mid-2000s. I was involved in the renaissance of the Inner Harbor in Baltimore and a key part of our mission was to empower seniors moving into these new developments to have access to a great healthcare ecosystem. This was the early days of telehealth. The goal was to use connected devices to make the home an organic extension of the healthcare system through real-time monitoring of key indicators like glucose levels, weight, and blood pressure. We saw real promise in leveraging telehealth to monitor patients’ health and prevent expensive hospital visits. Most importantly, I realized that there was incredible potential for technology to bring about real change in healthcare.
Can you share the most interesting story that happened to you since you began leading your company?
One story that I like to share with other entrepreneurs happened about a year into our journey. We had bootstrapped a promising prototype, but we were struggling to get initial traction and had reached a critical juncture, financially. Right around then, I met with a very experienced healthcare VC firm that told me flat-out that our idea was never going to work. It would have been easy to give up right then and there, but we didn’t. We persevered because we believed that what we were doing was going to profoundly change people’s lives. That story inspires me every day to never stop moving forward, no matter how daunting the road may seem.
Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lesson you learned from that?
This story is both funny and informative, because it demonstrates the importance of a key tenet of healthcare — data integrity. We were working on a pilot program that, among other things, required patients to weigh themselves daily using an FDA-approved WiFi-enabled scale. Every Tuesday, a specific patient’s weight would spike by 40 pounds — a physical impossibility that would trigger alerts and send caregivers scrambling. This went on for weeks. The mystery was finally solved when we discovered that the patient’s housekeeper came every Tuesday and would use the scale to weigh herself — not realizing that it was WiFi enabled and connected to a real-time alerting system. What we learned from that is, no matter how advanced the technology, it is only as good as its users.
What do you think makes your company stand out? Can you share a story?
What makes VirtualHealth stand out is the fact that we built the first cloud-based, comprehensive solution for value-based care — and we did it in the country’s largest, most regulated and most siloed industry. I launched VirtualHealth at a time when healthcare organizations were still holding tightly to the idea that ‘the cloud’ could not be trusted and that sharing data between siloes was impossible. In our early days there was a lot of educating clients about the benefits of SaaS technology and agile innovation. Right around then I had a meeting with a very experienced healthcare VC firm. They told us flat out our idea was never going to work. I think it would have been easy to give up right then and there. But we persevered because we believed that what we were doing was going to profoundly change people’s lives.
What advice would you give to other healthcare leaders to help their team to thrive?
The advice I would give is do not be afraid to challenge the status quo. One of our core values at VirtualHealth is relentless innovation. If you believe that what you’re doing is right, then take it upon yourself to prove it to your team, to your company, to your industry, and, ultimately, to the world. But with that said, also be adaptable and be willing to listen to constructive criticism. The seed of a great idea may come in a flash of insight, but turning it into the tree of reality requires iterating diligently and listening to a lot of feedback.
Ok, thank you for that. Let’s 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?
- The first reason is a lack of clear requirements and accessible formats for sharing patient data. As a provider if all I know about a patient is what I see in my EMR, I may be missing 99% of the relevant information I need to determine the optimal plan of care. The worst part is that this information is out there, in various other systems, but I am not able to see it.
- The second reason is a lack of proper incentives that align payer, provider, and patient. Healthcare is a unique industry in that the ones who consume the services are not the ones who pay for the services. If the right incentives are not in place, we can have scenarios where what the patient, the provider, and the payer are all pulling in different directions. We have to get everyone to align on the most important goal: the best possible outcomes at the right level of cost for the entire patient population.
- The third reason is a lack of proactive care. The vast majority of health problems occur outside of the hospital or the medical office. By the time the patient shows up at the doctor’s or the ER, it is already too late. If we had a better way of monitoring patients in the home, in the community — if we could engage patients more effectively at an earlier point — we could catch a lot of health issues before they turn into health emergencies. By capturing every available piece of data about a patient, including from technologies such as wearable sensors, automatically analyzing them in real time, we can create timely action items for patient care teams. This is what our clients are able to do for their patient populations using our HELIOS platform.
You are a “healthcare insider.” If you had the power to make a change, can you share 5 changes that need to be made to improve the overall US healthcare system? Please share a story or example for each.
- Mandate clear interoperability requirements and a simple format that all healthcare technology vendors could use to securely exchange patient information among authorized providers of care. Every healthcare organization we have worked with has to operate with a mind-boggling array of differing systems, formats, data types, and so forth. This is the byproduct of a highly siloed, specialized industry with conflicting interests and makes access to the full spectrum of needed patient information at the point of care difficult to impossible.
- Create a single, simple model of care where payers, providers, and patients have aligned incentives while engaging the patient in their own care. We have seen firsthand how different regulatory regimes and provider contracts create situations that are sub-optimal for not only patients, but also payers and providers.
- Require that payers and providers consider not only clinical indicators but also social determinants of health. We have seen situations where a patient is not getting their prescribed medications because they are disabled and do not have a way to get to their pharmacy, or where a patient is not able to follow their dietary plan because they were not properly educated on their condition. We have to consider factors like financial need, nutrition, transportation, home environment, and many others to make sure we are treating the whole person. Additionally, we have to integrate community providers such as food bank, job training programs, and housing services to the healthcare ecosystem and connect patients to the services that are readily available to them.
- Reform utilization management to be more retrospective rather than prospective. We spend so many administrative dollars and effort on requesting authorizations, processing authorizations, documenting authorizations, reviewing authorizations, communicating authorization determinations, handling appeals, and so on and so forth. And yet the majority of requested services are approved. Retrospective review will help us identify and minimize any fraud, waste or abuse, but still allow providers to be proactive through cutting-edge care management, early diagnosis, risk stratification and behavioral change.
- Create a better operational triage system for healthcare. The emergency room needs to be used solely for emergencies, physicians need to be focused on treatment, and retail health, community providers and health hubs need to be first line of defense for basic issues like colds, immunizations, and burns. On the operational level, nurses need to be empowered at these front lines, be supervised by PA’s, who are supervised by physicians. All the excellent resources of our healthcare ecosystem need to be freed up to focus on what they do best in a thoughtful, scalable methodology.
Ok, its very nice to suggest changes, but what concrete steps would have to be done to actually manifest these changes? What can a) individuals, b) corporations, c) communities and d) leaders do to help?
Leaders have the opportunity to make regulatory changes that make the healthcare system simpler, more transparent, and more accessible. Healthcare corporations can embrace technologies and new models of care by transitioning their legacy systems and approaches. Communities can support retail health and local resource initiatives. And individuals can embrace greater engagement with managing their health before a potential issue turns into an emergency. Each patient should challenge their provider and payer care team to give them all the information they need and not be afraid to ask questions.
As a mental health professional myself, I’m particularly 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?
As Forbes columnist Amy Morin wrote in a June 2018 column, just like it’s important to educate people how they can take steps to stay physically healthy (diet, exercise, and sleep), we need to talk about the steps people can take to improve their mental health. We have tackled this challenge head on at VirtualHealth by providing a way for the entire care team — including both physical health and behavioral/mental health professionals — to collaborate effectively on a patient’s care in a single ecosystem. We believe that this is an effective model for organizations that are concerned about treating the whole person.
How would you define an “excellent healthcare provider”?
I once read something that really struck me and stayed with me: “Good [healthcare professionals] are good communicators. They are able to truly listen to their patients, empathize, and provide information about diagnosis and treatment in a way their patients will understand. Good [healthcare professionals] are altruistic (that is, they are always ready to put their patients’ needs first). Good [healthcare professionals] also have a strong sense of service, of wanting to help people feel better, making health care work better, and, in many cases, giving back to their communities. Above all, good [healthcare professionals] are motivated by a strong sense of professionalism — they have integrity and honor and are committed to upholding medicine’s timeless values.” (https://www.pomona.edu/administration/pre-health/prepare/characteristics)
Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?
“If you don’t quit, you win.” It’s something my father told me that I kept close as I was building VirtualHealth. The reality is that most entrepreneurs will give up at their fledgling company’s darkest hours, even though victory is right around the corner. If you hang on, if you stay in the game and keep fighting, you will succeed.
Are you working on any exciting new projects now? How do you think that will help people?
Our HELIOS platform is purpose-built to support the goals of value-based reimbursement models and is currently being used to deliver care to millions of the most vulnerable individuals nationwide. It integrates clinical, behavioral and social data streams into a single, complete patient view and then combines real-time data with intelligent and responsive workflows to empower proactive interventions. HELIOS has an incredible impact on our clients- for example, just one state-run program that we work with is able to conduct 2,000 assessments and complete nearly 5,000 interactions with patients each day.
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 have a lot of interests across mediums and I find inspiration from a variety of sources. Moneyball by Michael Lewis directly influenced my perspective in harnessing and utilizing data and metrics to create operational efficiency and provide maximum output. I’m also an avid sci-fiction reader. Sci-fi encourages us to dream big and in broad strokes, and then back into the science and facts to get us there. Preston Tucker and Howard Hughes have been inspiring figures for me in that they both brought innovation and passion and change to heavily regulated industries.
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 like to believe we are at the forefront of the most important movement going on today; improving the US healthcare system for the highest risk populations, especially the disabled, disadvantaged and the elderly.
How can our readers follow you on social media?