Is Access to Care Better with Digital Health?

Interview with Scott Snyder

CDO, EVERSANA

August 2024

WATCH THE INTERVIEW ON YOUTUBE:

• Scott Snyder Answers: Is Digital Health Improving Healthcare Provider Access?

• Scott Snyder Answers: Does Digital Health Improve Patient Access or Redistribute Provider Supply?

• Scott Snyder Answers: Will Digital Health Allow New Organizations to Become Healthcare Providers?

READ THE INTERVIEW:

Adam Kaufman: I'm really pleased and honored to be here with Scott Snyder, the Chief Digital Officer of EVERSANA. Scott, thank you so much for joining us, why don't you give us a little bit about your background about EVERSANA? 

Scott Snyder: Thanks, Adam. Great to be here with you as well.

Background-wise, I kind of live at this intersection of tech innovation and business model innovation and new ventures. I'm a little bit of a tourist through the healthcare and life science industries. I've spent time in other industries like aerospace, Fintech, and Consulting. My time in healthcare has been largely around thinking about how to apply emerging tech like digital AI to transform how care is delivered, the way products get to market, and the way patients can achieve a better experience. So pretty excited to talk about this topic,

Currently, I'm the chief digital officer at EVERSANA. And we provide end-to-end commercialization of products to benefit patients in the life science market.

Adam Kaufman: I think, you know, I'm a mathematician. So maybe simply thinking of an equation of how digital could impact access. 

1. We could think about digital as making clinicians more efficient. So with an 8-10 hour day, they could actually see more patients. We just opened up supply. 

2. We could think of digital as helping people get to the right kind of clinician. So that maybe we have fewer unproductive visits.

3. In some cases, digital tools could actually end up replacing or complementing a clinician so we actually need fewer visits. 

So let's start with the simple question, are we making access better now through digital health? 

Scott Snyder: Well, the bar is still pretty low on access, right? I think the last time I saw the statistics, about 30% of patients didn't even have a primary care physician. The wait times are still crazy long — like 26 days on average, to see a specialist. The time to diagnose most conditions is in years, not months, and it gets worse, for rare conditions and gets worse for people from underserved communities.

So there are plenty of access challenges that could be addressed. Now, can they all be addressed by digital health? Probably not. 

But I think a lot of them could be! 

I think of how we can help transform the patient experience journey as a three-legged relay race. 

1. The first leg is how do we get patients to a diagnosis faster so they understand the condition they might even have?

Through a combination of AI analytics coupled with cooperative data coming together from multiple sources including social determinants of health and clinical data, we have the opportunity to help more effectively identify patients who are undiagnosed or misdiagnosed and stuck at the top of the funnel. 

2. The second leg of the relay race is then about how do we make sure patients engage with the right kind of clinician? And have the right conversation to even get past that gate to make sure they're getting prescribed the right treatment or the right care path. In that case, it's educating both doctors and patients to be ready for that conversation. There are a lot of sensitive conditions where people don't even show up for their first appointment because they don't want to go to the doctor. They're embarrassed to talk about it, or they feel intimidated by the health system or have a lack of trust. 

So could digital health or telehealth help with that access point? Absolutely it can, and it could make a massive impact on a ton of patients. 

3. This brings us to the last hurdle, how can we make the journey from insurance approval through prescription as fast and simple as possible while also ensuring follow-up treatment and appointments are easy. Is there enough bandwidth in the system to make sure that happens, and that patients actually get on the therapy versus the doctor moving on to the next thing?

Each of these presents unique challenges. And I think we've been guilty of looking at this as a patchwork versus really organizing this ecosystem around the patient experience and journey. I think the pharmaceutical industry is starting to realize better options exist to provide a better direct-to-patient experience, which is exciting.

Not everything in the relay race is going to be solved with a digital solution, but I think many turns on the relay can be impacted and even supercharged with AI and digital solutions. 

Adam Kaufman: Do you think we're in the stage with digital where we're actually seeing those benefits? 

Scott Snyder: I do, and, I think there's some great examples out there that are chipping away at this. I'll call it classical AI and machine learning to go find these patients and identify them earlier.  There's a pretty good competency there. I think self-assessment tools like symptom checkers have all gotten better as a result of better AI and better data.

So I look at even tools like Ada or, in the dermatology space tools like VisualDx that can assist a physician to more quickly diagnose a patient. There's a lot here already that can accelerate and make things better. 

I think everybody's getting a little hyped around GenAI and the promise that patients are just going to talk to chatGPT and understand their condition better and find the right pathway.

And the reality is, just like every new technology, whether it's mobile, eCommerce, or cloud, these things take time to get wrung out, productized, and scaled in a way that especially a regulated industry like healthcare can actually use them reliably. 

But I think right now, already with classical AI and just digital self-assessment tools, things like telehealth, things like natural language processing - you look at what Abridge is doing to just make the doctor's life easier to create notes around the patient conversation.

These are real-time savings, real efficiency gains that we're seeing. And I think we're just in the early stages here. And I think we're just in the early stages here.

Adam Kaufman: That's great to hear that it's already happening in some places and yet it's still in the early stages. 

What would you say to folks who, maybe to use a bad metaphor, sort of think of what we're doing in digital as maybe rearranging the deck chairs and using virtual care or remote care as an example? It's a clinician who would have had this many appointments available in person. And so all we've done is move them online. Maybe, a cash patient could have more access, but we've actually taken them out of the community. And so we're not actually creating more access. We're just moving the way that people get.

Scott Snyder: Yeah, it's a great question. If you just take the simple example of telehealth, it actually has two modes broadly, asynchronous and synchronous. Today most doctors schedule appointments in 10 or 15-minute slots and, if they run over, that’s just how scheduling goes. Their schedules are so compact that they have little to no flexibility. 

In telehealth, it's much different, and flexibility can and is built into the process. Telehealth can allow in real-time patients to choose their slots and doctors to see in real-time when to be on and when, from anywhere. It makes the experience much more efficient and faster. Recently, I read a study from the Veteran’s Affairs office that saw a 6 percent  6 percent improvement in productivity for telehealth versus regular visits

And while this may not be a massive amount of time, the flexibility, and how that physician allocates their time, has tons of upstream benefits, including reducing burnout. Think about it, it’s so repetitive to to see 40 patients a day, but now through telehealth, you can have more flexibility, see them faster, and get back to what you want to do quicker. 

You've been a veteran of the digital health world. The other digital piece that we often over-index on is building really shiny objects, and experiences for the patient, and we forget about integrating it into physician workflow. That’s where things get clunky.

I think today we’re seeing much more thoughtful solutions. The ones that integrate with the workflow, like in Abridge, like a NeuroFlow in the mental health space, like others. They're driving real productivity gains because they start with the physician as well as the patient at the center of the experience and design backward from that.

Adam Kaufman: I think that's right. The other thing, in the early days, the innovators and entrepreneurs creating these experiences came from around healthcare, but not deeply in the provider structure. I've been really excited to see big health systems and the Pharma companies and the payers who are living in these clinician workflows investing in digital health. 

From an EVERSANA standpoint, do you think this is going to free other kinds of organizations to become providers?  And if so, is this, sort of democratization of who can see patients and how they connect into the workflow going to be helpful?

Scott Snyder: I think everybody can benefit. If you can do more upstream to get the right curated flow of patients into the funnel, that's going to benefit everybody in terms of getting more patients on the right treatments. And then downstream, I think patient support tools like remote monitoring and digital health, should be huge aids to accelerating how you interact with that patient or treat them or even allowing them to self-serve. Most patients would love to just self-serve and guide their own care journey and get the advice they need if they could, but unfortunately, we usually have to get on the phone with somebody.

I think it's something that can be a game-changer for direct-to-patient. There are enough medical deserts out there that if you could use these telehealth engagement models to fill in gaps, I think every health system would raise its hand and say, I'd love to provide more access if I could. But capacity constraints are real. 

In some ways, the insights we might get from the patients we're serving in telehealth might benefit the traditional care path.  I think there's lots of opportunities there. I think some of it's going to take a lot of collaboration and cooperation that hasn't existed in the past, but I'm excited by direct-to-patient as a new mode of delivering care.

Adam Kaufman: Switching to the chassis of healthcare. So payments have been evolving, but the bulk of payments are still for a fixed amount of time from a clinician or for a particular procedure. Do you think we can make real improvements in what we've been talking about in those 3 phases without payment reform?

Scott Snyder: I think you're hitting on something really important. That's probably why digital health was stuck to the reimbursement models that just didn't catch up fast enough. I think they're catching up in remote monitoring. There are more codes available to tap into. I think things like PDURS are interesting for pharma. If you can attach a digital health experience that shows better outcomes with therapy, that’s an exciting new development that shows a lot of promise.

I also think in general it goes back to an efficiency play that might hopefully combat burnout. Part of it is, people still want to have incentives and rewards for doing the right thing, and I think the more we can work together around that - I think that's a big deal. So we should figure out how do we make sure that these digital solutions, if they're truly driving better outcomes - like, let's say, we create a digital human for patient education that a physician can give out to their patients and we show that it's driving a better outcome - how do we make sure the physician is incented to do that? 

I look at an app like a tonic in Europe. It's a digital clipboard the physician gives to their patients so they capture the information of the patient faster and it also can be a vehicle for sharing educational information on their condition. That's saving the physician time. It's making the patient experience better. In China, you've got GoodDoctor, from Pingan, and they have a physician side to that called Ask Bob. Bob is used by hundreds of thousands of doctors in China to basically just accelerate the time to diagnosis and how they educate their patients. 

So if we can work both sides of it, it should improve efficiency. But doctors should be incentivized to want to use these digital health tools. In the end, if we all keep putting patients first and find better ways to make an impact by leveraging these tools, we’ll all win.

Adam Kaufman: Scott as always, really appreciates insight. Thank you.