We need to find a better way to manage chronic conditions, such as heart disease, stroke, diabetes and arthritis, which account for more than 75% of all healthcare costs. Chronic conditions need continuous attention. Clinicians need a way to know what’s going on with patients the 8,516 hours per year that they aren’t engaging with the healthcare system, versus the four hours they may be with their doctor. With a rise in Bluetooth and cellular connected medical devices, this goal is extremely achievable from a technological perspective, but so far, healthcare providers have struggled to create a process to make implementing and scaling these new innovations possible.
Asa part of my interview series with leaders in healthcare, I had the pleasure to interview Joshua Claman, CEO of Rimidi. Rimidi is a cloud-based software platform that enables personalized management of chronic cardiometabolic conditions across populations. Josh has 30 years of experience leading technology businesses in Asia, Europe and the Americas. His industry experiences span his time in Dell in several senior executive positions, including the founding and development of Dell’s European Healthcare business, to his role as president of ReachLocal, one of the largest advertising technology companies in the U.S., and serving as the chief business officer of Stratasys, a leader in 3D printing in the medical field. Josh is a strong advocate for the promise of technology.
Thank you so much for doing this with us! Can you tell us a story about what brought you to this specific career path?
Ihave been involved in technology business for 30 years, periodically leading companies within the healthcare sector. I have always been fascinated by this industry, and quite frankly, frustrated with the pace of adoption of technology in healthcare vs. the potential. With the right technology in place, we can have more of a direct impact on the lives of patients and the productivity and satisfaction of clinicians. That’s why I decided to join Rimidi in 2018. Rimidi’s focus on addressing both clinical decision support and patient engagement in one platform while seamlessly integrating with the EHR and the workflow is the right approach. I became a natural advocate of this perspective.
Can you share the most interesting story that happened to you since you began leading your company?
I find each and every correspondence with a potential customer to be interesting. Since joining Rimidi, I have always enjoyed getting to show them our technology and how it can aid in enhancing patient care. Several technologies in our industry are focused on billing and claims capture, and the clinical teams and the patients follow as a distant priority. That’s how we’re different, and is probably why it is always interesting to me to see clinicians react to our software Seeing their eyes light up when we demo our platform, showing them what their world could look like is extremely gratifying. One clinician summed up what we did after a demo by saying, “you make it really easy to do the right thing for patients, and hard to do the wrong thing.”
What makes your company stand out? Can you share a story?
Rimidi stands out for two key reasons: our people and our product. We are unique in that we have a team of experts who have experience in both software and healthcare, some who have worked at major EHR companies (and understand their strengths and weaknesses), and others who have worked on the front lines of care, interacting daily with patients. We are a team of problem solvers with a spot-on understanding of our industry’s top challenges.
In fact, our founder has a background in both technology and medicine and actually left clinical practice because of workflow inefficiencies that got in the way of patient care. As such, we put major emphasis on building our solutions with clinician feedback, and ultimately, patient care, in mind. Everything we do is designed around creating a more efficient model of care that will improve patient outcomes, lower costs, increase patient satisfaction and let clinicians really practice at the top of their license. We’ve built our platform to be configurable and quickly deployable for each of our clients’ unique needs, while working seamlessly within their existing EHR workflow.
Can you share with our readers about the innovations that you are bringing to and/or see in the healthcare industry? How do you envision that this might disrupt the status quo? Which “pain point” is this trying to address?
Cost of care is a problem for many providers, payers, governments, employers, and especially patients. According to a recent study, a quarter of our healthcare spending currently is waste, due in large part to inefficiencies such as poor care coordination or administrative complexities. While the industry is trying to move away from fee-for-service to value-based care, these value-based initiatives can’t take hold until we address the way care is fundamentally delivered. In terms of managing some of the costliest chronic conditions, we need to shift from reactive, episodic, in-clinic care to proactive, continuous, virtual care. And we need to do it in a way that doesn’t add burden to the existing clinical workflow, considering the social determinants of health that may affect patient outcomes.
What are your “5 Things I Wish Someone Told Me Before I Started”.
Specific to my current journey in healthcare:
- The beneficiary of a solution is rarely the same party that pays for the solution.
- Even if all parties in a health system want a given solution, procurement processes may be undefined and disorganized.
- Value-based-care incentives do not always cascade to the clinical staff, creating confusion around the drive for new programs.
- Most of the discussion within healthcare is completely removed from the patient.
- It is rare that anyone in the healthcare ecosystem has a holistic view of the patient.
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?
I think this goes back to the fundamental way healthcare has been delivered in the US, and the way doctors have been incentivized.
- Stubborn fee-for-service payment models. For nearly a decade, healthcare has slowly been switching from a fee-for-service or “volume-based” system, to value-based, or quality-based care. Essentially, the US had been operating a “sick care” system, rather than a healthcare system, where providers are paid to treat sick people and have no incentives to prevent them from getting sick in the first place. The switch to value-based care is picking up, as 48 U.S. states and territories now have value-based programs, and the Centers for Medicaid and Medicare Services (CMS) continues to boost incentives for providers to focus on quality. However, while value-based incentives at the organization-level are starting to gain steam, there needs to be significant compensation plan changes at the individual physician level for value-based care to truly take hold.
- Episodic (rather than continuous) care for patients with chronic disease. We need to find a better way to manage chronic conditions, such as heart disease, stroke, diabetes and arthritis, which account for more than 75% of all healthcare costs. Chronic conditions need continuous attention. Clinicians need a way to know what’s going on with patients the 8,516 hours per year that they aren’t engaging with the healthcare system, versus the four hours they may be with their doctor. With a rise in Bluetooth and cellular connected medical devices, this goal is extremely achievable from a technological perspective, but so far, healthcare providers have struggled to create a process to make implementing and scaling these new innovations possible.
- Misaligned incentives creates siloed patient care. While healthcare providers are slower to fully embrace quality-based care, healthcare payers and employers have a vested interest in improving outcomes and taking proactive measures. Healthier patients’ equal lower cost. As such, payers and employers have adopted a number of innovations to improve outcomes and drive down costs — from remote patient monitoring to health coaches and care coordinators. The problem is that these patient touch points exist outside of the existing patient-provider relationship, which can create confusion and frustration for the patient, and often, fragmented, suboptimal care.
You are a “healthcare insider”. Can you share 5 changes that need to be made to improve the overall US healthcare system?
- Healthcare providers should increase value-based incentives for individual physicians.
- Healthcare needs to move from in-clinic, episodic care to virtual, continuous care.
- The ecosystem needs to drive toward a holistic view of the patient. Disparate data sets need to be reconciled, combined and then refined.
- Data interoperability needs to become a reality, without each party involved trying to monetize the same data.
- EHR vendors need to embrace partner communities openly and view these partners as mechanisms to further improve their value propositions.
What are your favorite books, podcasts, or resources that inspire you to be a better healthcare leader? Can you explain why you like them?
- Freakonomics. I like to see how data so often dispels common preconceptions.
- Fresh Air. Getting a more in-depth view of how people live, work and create is always informative and often inspiring.
How can our readers follow you on social media?