One thing I’ve learned from personal experience is that our healthcare isn’t designed to proactively diagnose, let alone prevent disease. That’s why my mentor — who technically had access to great healthcare — died too early. Healthcare has a design flaw. It was designed many decades ago and evolved within that original design framework without the goal of meeting the complexity and scale of our modern healthcare needs. As a result, our drugs, doctors, hospital services and diagnostic tests cost more and we spend more on administration, regulating and managing care than any other country relative to GDP. And, all the extra money spent does not yield better outcomes.
Asa part of my interview series with leaders in healthcare, I had the pleasure to interview Justin Bellante. Justin is the founder and CEO of BioIQ, a healthcare engagement and gap closure company that is redefining the way payers, employers and consumers navigate and connect with the U.S. healthcare system. An engineer and scientist by training, Justin is using new technologies and engineering principles to build disruptive innovation in the healthcare industry and positively impact 100 million lives. Prior to founding BioIQ, he developed novel materials and testing platforms for microelectromechanical systems while pursuing his doctorate at the University of California, Santa Barbara. In early 2019, Justin relocated the company to Atlanta, Georgia, for its wealth of tech talent and proximity to BioIQ’s rapidly growing client base.
Thank you so much for doing this with us! Can you tell us a story about what brought you to this specific career path?
In2005 I was a doctoral student at the University of California, on my way to a career in Materials Science, which combines the fields of physics, chemistry and engineering. It’s a fascinating field — but everything changed in an instant when a good friend and my academic mentor suffered a fatal stroke as the result of an undiagnosed diabetic condition.
That was a game-changer to me. It really opened my eyes to the challenges and opportunities facing the U.S. healthcare system. My background as a scientist helped me realize we could find solutions. So, in 2005, I partnered with other entrepreneurs and health industry leaders to found BioIQ. Today, BioIQ is a leading healthcare engagement, gap closure and testing company (as in tests for diabetes, chronic kidney disease, colon cancer, etc.). Working with some of the nation’s largest health plans and employers, we believe our company is redefining the way payers, employers and consumers navigate and connect with the U.S. healthcare system.
Can you share the most interesting story that happened to you since you began leading your company?
Early in BioIQ’s journey, we were focused on engaging employer populations and providing health testing through at-home diagnostic test kits, a model we likened to “Netflix for healthcare.” One of our first major prospects was a large disease management company for whose patients we could vastly improve access and convenience over going to the doctor for routine testing for diabetes and heart disease. Despite months of work in the sales process, we were being blocked by a person on their procurement team who did not understand the value proposition and favored their existing approach. At that point, we called a meeting to occur in one month with all stakeholders, including the procurement specialist, to get to a go / no go decision.
On the day of the meeting, twenty people from both sides gathered in a conference room to hash it out. The meeting began with the procurement specialist walking to the front of the room to give their assessment. We expected a tough start. The specialist began by saying that he recently test-drove our solution and discovered that he had diabetes, which he confirmed with his physician. In the weeks prior to the meeting he began to actively manage his condition through diet and exercise. He proclaimed that we had helped change his life through an understanding of his health and a key health risk. Needless to say, the meeting went well and started a long, productive relationship with the company, helping tens of thousands of its patients along the way. It was a great early lesson that often people in healthcare can reject new technologies or ways of doing things on face value. However, if they see or experience the outcomes firsthand, they can take the next step towards change. In healthcare, technology can be seen as the sum of the parts, but the impact must be judged holistically.
Can you tell our readers a bit about why you are an authority in the healthcare field?
I started in healthcare as an outsider, an engineer who looked at the world through physics and thermodynamics — as a large system made up of smaller systems. Throughout the past 15 years, I have used that lens to innovate within the healthcare system, with a focus on helping millions of people more easily access and navigate the system to better understand their health and take action. Over that time frame, BioIQ has worked at the intersection of payers and venture capital / private equity along with dozens of cutting-edge business partners to use technology to impact healthcare workflows and payment in consumer, employer, health plan, government, hospital and physician settings. We continue to innovate, adding consumer analytics and AI to our solutions, to make healthcare easier for the hundreds of clients and millions of lives we serve.
What makes your company stand out? Can you share a story?
The BioIQ team is passionate and mission-driven, but we realize that even the coolest, cutting-edge solutions will never get to market at scale (to impact millions of lives) if they aren’t balanced with an understanding of how to fit into the current system. This systems-thinking approach has helped us scale from a small, direct-to-consumer testing company to a platform helping millions of employees and health plan members more easily navigate critical, often complex healthcare processes to better understand their health and get care. Through vertical integration of analytics, engagement, and human logistics, we are seeing health testing and care compliance results 2–3 times greater than what health plans have achieved with fragmented approaches to engagement and clinical adherence, despite often working with some of the most disadvantaged and challenging members of a population.
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?
BioIQ is changing healthcare by mapping routine care onto consumer behavioral preferences. We are using consumer analytics to personalize engagement and a technology platform that configures and facilitates care navigation with a focus on connecting people to emerging delivery models such as home and retail, as well as traditional care settings if there is a fit.
The U.S. healthcare system has a poor record of engaging patients and getting them to adhere to best practices in care, especially when it comes to preventive care, as evidenced by statistics around diabetes, heart disease and cancer diagnoses (i.e., lack of diagnosis). We realize that people generally don’t want to be unhealthy. They want care. They just have deep consumer behaviors and expectations built over years and decades that make it very difficult to engage the traditional health system as it stands today. Most of our healthcare system falls short of the consumer convenience, access and experience achieved by other modern industries.
BioIQ’s focus on the non-clinical aspects of healthcare, social determinants of health and consumer behavior helps ultimately achieve better clinical outcomes. In doing so, we are helping to solve major challenges in engagement, clinical adherence, and the overall consumer healthcare experience. The results are happier, healthier patients, with a better understanding of their health and the ability to take action.
What are your “5 Things I Wish Someone Told Me Before I Started” and why. (Please share a story or example for each.)
Timing is everything. We were a decade ahead of most consumer at-home testing companies and had to pivot early in our journey to working through payers. As healthcare has evolved and consumers are paying more out-of-pocket for their care, this segment has started to blossom over the past few years.
The “why” is critical. Starting a business is hard, especially in healthcare. It takes time and persistence, crossing mountains and valleys along the way. Without a spark or a deeply rooted passion driving you, it is difficult to get through the many “no’s,” the financings, and all the challenges facing a new venture.
Don’t get lost in the tech, healthcare is an applied field. We can do a lot of cool stuff with technology, but to make an impact in healthcare you have to keep an eye on scale! Early on we focused on a niche technology approach to population health testing, but it wasn’t until we embraced the challenge of integrating into broader healthcare payer workflows, payment models, and consumer preferences, that we were able to achieve impactful scale.
Someone has to pay. Healthcare is difficult because the end consumer is not always the one paying for the solution. Aligning our solution to the needs of both consumers and payers, along with the myriad of other healthcare stakeholders and regulations, while integrating into claims billing and other payment models is a key factor to success.
Don’t play to the level of your competition. It is easy to compromise design, user experience and other aesthetics to achieve price points and other values of traditional healthcare stakeholders, but that is why healthcare has traditionally suffered so much in these areas. Even when we didn’t have to, we pushed the envelope in usability testing, consumer experience and technology design in order to create better outcomes for our customers.
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?
- One thing I’ve learned from personal experience is that our healthcare isn’t designed to proactively diagnose, let alone prevent disease. That’s why my mentor — who technically had access to great healthcare — died too early. Healthcare has a design flaw. It was designed many decades ago and evolved within that original design framework without the goal of meeting the complexity and scale of our modern healthcare needs. As a result, our drugs, doctors, hospital services and diagnostic tests cost more and we spend more on administration, regulating and managing care than any other country relative to GDP. And, all the extra money spent does not yield better outcomes.
- We are a consumer nation, and healthcare is not consumer-friendly. The payer for care has been detached from the user of care. This has allowed the system to evolve based on the worst aspects of the public-private partnership. Private insurers have been built to serve the needs of shareholders, and public institutions have been too slow and bureaucratic to change. Despite that, some instances of success in this partnership have emerged, Medicare Advantage (managed Medicare) being one example, using the best aspects of those stakeholders. Public institutions have set a framework for learning and improvement and defined success with the Triple Aim, and private companies have risen to the challenge — increasing coordination, more effectively managing cost, and focusing on quality (which includes consumer experience).
- We must rid ourselves of the factory mentality to healthcare. Focusing purely on profits, clinical diseases and short-term interventions has allowed the healthcare system to scale easily. But health and people are not one-size-fits-all and cannot easily be mechanized, especially in a country as large and diverse (geographically, socially and economically) as the U.S. The root causes of poor health are more aligned to consumer behaviors, social determinants and mental illness. We have yet to fully acknowledge and address these elusive, fundamental challenges at scale, as they are more complex, less easily diagnosed, and have not historically been linked to traditional healthcare. Thankfully, the industry is starting to pay attention to these, and myriads of new solutions are emerging as investment and resources flow into the healthcare sector at record rates.
You are a “healthcare insider”. 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.
- Personalize healthcare. Use consumer analytics to configure care to fit within existing individual consumer preferences and patterns, reducing behavioral barriers to care and increasing the probability of adherence to clinical standards. For example, we can use consumer analytics to better understand patients and talk to them in a way that shows we understand them and care for them — varying the content in our communications to appeal to what motivates them as a person, the medium (text, email, phone, or mail) to connect with them on their terms, and the frequency to best guide them to take action.
- Leverage emerging delivery models. Home and retail solutions offer convenience and access — key barriers in traditional care settings — and equality, eliminating geographic and socioeconomic biases in the healthcare system. If someone needs preventive testing and we know they live within 3 miles of a grocery store or pharmacy, we should guide them to get care while they plan to do their weekly shopping.
- Scale through systems-thinking. Rather than trying to be the best at all things, bring consumers the best of healthcare solutions through interoperable ecosystems of best-in-class solutions. Some companies have built the best diagnostic for a certain condition, others have the best retail footprint in a certain geography, but no one company has the best combination of all attributes. Using platforms to connect an ecosystem of many traditional healthcare point solutions and configuring them for individual consumers, leverages the strengths of many and provides a better overall experience and outcomes for consumers.
- Give physicians more leverage so they can create value. Facilitate routine, clinical care and testing (the basis for 70% of healthcare decisions) outside of the physician office to reduce physician low-value administrative load and arm them with patient data to maximize the value created in their most important activity, the patient visit. The worst scenario for providers is when they and their patient expend all the energy and resources to get together in a room for 10 minutes only to find out that they don’t have enough clinical data to provide advice or make decisions, then sending the patient out to do more things and get more data and then come back again — a poor, low compliance, much too common experience.
- Build for adaptability. Healthcare will continue to change, as will even faster evolving consumer industries — business models and technology architectures need built-in flexibility to provide long term continuity for patients. Possessing the ability to generate and/or leverage social determinants data in care models and workflows is a key, current example of the need for adaptability.
Thank you! It’s great to suggest changes, but what specific steps would need to be taken to implement your ideas? What can individuals, corporations, communities and leaders do to help?
We can’t just bring ideology or cool innovation to healthcare and expect it to make a difference. We need to do the hard work and thinking to get innovation to work within this large, complex system — within the many workflows and amongst the many stakeholders — if we want to create change. As leaders, we have accepted that we need to change, and have begun to align around some broad, long-term concepts, such as the Triple Aim. We may not always agree on the exact “how,” but if we can start moving in the same general direction, change and progress will accelerate.
What are your favorite books, podcasts, or resources that inspire you to be a better healthcare leader? Can you explain why you like them?
“The Hard Thing About Hard Things” by Ben Horowitz and “Organizational Physics” by Lex Sisney are reminders that building a business is hard, but there is a framework or at least guiding principles for success. “Zen and the Art of Motorcycle Maintenance,” by Robert Pirsig, is a thought-provoking examination of reconciling technology with humanity, the rational and irrational, and general philosophy that has a lot of relevance to healthcare innovators.
CB Insights puts out great, data-driven research and The Health Care Blog, part of Matthew Holt’s Health 2.0 venture, has consistently created valuable perspective, content and debate.
Lastly, the Health Evolution Summit has created an intimate forum for curated discussion and debate amongst healthcare leaders along with ongoing content form industry thought leaders.
How can our readers follow you on social media? Readers can learn how BioIQ is changing healthcare by following us on twitter (@BioIQ) and LinkedIn.
Thank you so much for these insights! This was so inspiring!