Improving interoperability. We’ve seen real movement on this in 2018 and 2019 with the first normative version of Fast Healthcare Interoperability Resources (FHIR) being released, as well as the Meaningful Use program being renamed to “Promoting Interoperability.” However, there is still a lot of friction in the business models supporting data exchange with the major EMR vendors. This will need to be resolved to see interoperability take hold at scale.
As a part of my interview series with leaders in healthcare, I had the pleasure to interview Lucienne Marie Ide, M.D., PH.D.. Lucie is the Founder & Chair at Rimidi, a cloud-based software solution that enables personalized management of chronic cardiometabolic conditions across populations, with specific platforms for diabetes, heart failure, and fatty liver disease. Lucie brings her diverse experiences in medicine, science, venture capital and technology to bear in leading Rimidi’s strategy and vision. Motivated by the belief that we can do so much better as individuals, an industry and society, Lucie left clinical medicine to join the ranks of healthcare entrepreneurs who are trying to revolutionize an industry.
Thank you so much for doing this with us! Can you tell us a story about what brought you to this specific career path?
I’ve had a wandering career path that led me to healthcare entrepreneurship, but every move was rooted in a mission-driven aspect. I got my undergrad degree in physics and went on to work at the National Security Administration and then the Central Intelligence Agency, which is where I fell in love with data. I started thinking to myself, “How can we turn data into information and insights that can be used to truly make an impact?” So I left my career in intelligence to work in venture capital and invest in communications technologies.
I loved the innovative, new company aspect of venture capital, but missed the science and working directly with data. That drive led me to Emory University where I got an M.D. and a Ph.D. in pharmacology. In graduate school, I worked on gene therapy for a couple of years then went to University Pittsburgh Medical Center to do my training in OBGYN. At UPMC, I was really baffled by some seemingly solvable problems in the healthcare system. I left clinical practice with an idea to invest in better healthcare technologies. However, a lot of the technologies were being developed by outsiders. The empathy, the ability to really understand the front-line aspect of healthcare, the special relationship between a clinician and a patient was just missing. I decided to step into the world of entrepreneurship to try to solve these underlining issues and healthcare. And here I am today.
What do you think makes your company stand out? Can you share a story?
When I was in residency, I loved the patient care aspect. Having trust and a relationship with patients is invaluable. But, at the same time, I was really frustrated by other aspects of healthcare. For example, I was in residency during the time that most systems went to electronic medical records (EMRs). While being able to capture all of that data was a major step, the lack of end-user input in the design of these systems was evident. These systems were designed from a business optimization standpoint, not a clinical workflow or patient-centric perspective.
Rimidi was developed with a physician’s lens and continuously seeks input and validation from our clinician clients. In healthcare, we talk about the goal of lowering costs, improving patient outcomes and improving patient satisfaction — the “triple aim.” At Rimidi, we like to stress the importance of taking that to the next step — “the quadruple aim.” We strongly emphasize the addition of improving provider satisfaction, too. We want our product to work for clinicians so they can make better clinical decisions and drive better patient outcomes.
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?
Absolutely. This is the main reason I got into healthcare entrepreneurship, because I know we can do better as a nation, an industry and as individuals.
- Misalignment of incentives. As long as we are in a fee-for-service model, everything, even the technology, is going to drive toward optimizing that revenue model.
- Siloed data. Healthcare is highly personal and highly local. Both require the use of data, yet the data is locked up in closed systems that don’t easily communicate with each other.
- Total disregard for patient experience. Somewhere we lost our way from the days of the community physician who would make house calls to today’s overcrowded waiting rooms and the inability for patients to have easy access to their own medical records.
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.
Our healthcare system is designed to get the results it gets, meaning it was designed (for the most part) under a fee-for-service model. There are several changes that should be made as we shift to value-based care. Thankfully, some of them are already underway, and Rimidi hopes to close the gaps on others.
- Incentive/Reimbursement changes. In general, only five percent of physician pay is tied to performance. That is not enough to drive behavior change. We need to see at least 25 percent of individual MD compensation tied to outcomes to drive real change in care delivery.
- Accelerating adoption of new effective therapeutics. There’s an Institute of Medicine study that showed it takes on average 17 years for new evidence to make its way into general practice. That’s totally unacceptable. We need to accelerate that pace through clinical decision support tools, presenting clinicians with the latest and greatest guidelines, traditional therapeutics and digital therapeutics while working within their existing workflow.
- Improving interoperability. We’ve seen real movement on this in 2018 and 2019 with the first normative version of Fast Healthcare Interoperability Resources (FHIR) being released, as well as the Meaningful Use program being renamed to “Promoting Interoperability.” However, there is still a lot of friction in the business models supporting data exchange with the major EMR vendors. This will need to be resolved to see interoperability take hold at scale.
- Utilizing patient-generated health data in clinical settings. If a patient is using a connected glucometer or continuous glucose monitor that isn’t connected to their clinician/embedded into the workflow, then we are not maximizing the impact of that data and potential for that technology. The ‘connectivity’ part of connected health is still in its infancy.
- Empowering clinicians, especially primary care physicians (PCPs), with technology. As we put more responsibility on PCPs to quarterback patient care, we need to support them with technology that drive efficiencies and gives quantitative support to the qualitative care physicians provide.
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?
While it’s great that individuals are starting to take charge of their own health with connected devices, fitness and nutrition apps, they should also make sure they are communicating with their physicians more regularly.
Companies are starting to play a larger role in managing their employees’ health as well, which is important. It’s especially important to make sure employer health and wellness programs are tied to existing patient-doctor relationships. I’m a big fan of corporations contracting directly with a value-based health system in their community for employee health programs.
We need to structure programs to support and feed into the existing patient-doctor relationship and address communities with limited access to PCPs through novel primary care models, like retail pharmacy. Communities have done a great job implementing creative resources, such as farmer’s markets, meal delivery, and lifestyle intervention programs. However, similarly to employer wellness programs, we should be thinking how to incorporate these into existing healthcare models rather than working in parallel.
Lastly, we need leaders to enact policy changes to facilitate expanding roles of non-physicians, such as pharmacists and nurse practitioners, as well as non-traditional delivery models like remote monitoring and telehealth.
Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?
I’ve centered my career on a piece of advice I got from my dad a long time ago. “Work hard on something important beyond yourself, and everything else will work out.”
Are you working on any exciting new projects now? How do you think that will help people?
We are always working on exciting new projects! Recently, we’ve added a view to our platform to support clinicians in diagnosing patients with Nonalcoholic Fatty Liver Disease (NAFLD) and intervening early with guideline-based management. NAFLD is gaining more awareness as a growing health crisis in the U.S., with estimates that at least 35 percent of the population has the condition. If left untreated, NAFLD will eventually progress to Nonalcoholic Steatohepatitis, or NASH, which will progress to cirrhosis of the liver, resulting in the need for a liver transplant. NASH is already the leading cause of liver transplants in women and will soon overtake Hepatitis C as the leading cause in men. Adding NAFLD/NASH to our platform was a natural step, as our goal is to proactively manage cardiometabolic conditions by helping clinicians identify at-risk patients and guide them to the right level of intervention.
Second, we are beginning a pilot program with CVS Pharmacy in a medically underserved Atlanta-area community. Community pharmacists are in a unique position to manage better patient outcomes, especially in areas where there are significant barriers to care. During our pilot, patients with Type 2 Diabetes will receive a free biometric screening at the CVS store, measuring they’re A1C (blood glucose levels over time), blood pressure, BMI and cholesterol. Patients will get to take home free test strips and lancets and a connected glucometer, which will feed blood-glucose data directly into the Rimidi platform so the pharmacist can monitor patient progress and adjust medications, if necessary. Patients will also be enrolled in Rimidi’s digital diabetes education and self-management platform and will have access to a certified diabetes educator at the CVS store. We’re excited to prove how valuable community pharmacists are as part of the care team, and how technology — specifically the ability to remotely monitor a patient — can lead to better health outcomes.
How can our readers follow you on social media?
Readers can follow me directly on Twitter at @lucienneide. For the best company news and updates from our team, check us out at @jointherimidi.
Thank you so much for these insights! This was so inspiring!