RubiconMD CEO shares behavioral health insights and outlines rural health initiatives

This interview is part of a series powered by HLTH and CHIME to highlight key insights and perspectives from leading executives speaking at ViVE

Improving access to specialist care is one of the pain points in healthcare, Rubicon MD seek a solution.Company co-founder and CEO Gil Addo will ViVE Conference March 6-9 in Miami Beach.

First, he will participate in the discussion, The Next Frontier of Value-Based Care Technology: How New Population Health, Digital Health, and Next-Generation RPM and Diagnostic Technologies Accelerate Value (Courtesy of Deerfield Management).

He will also participate in panel discussions, Addressing unfair access #RuralHealthDilemma. In addition to Addo, other team members include:

To view the full agenda, Click here.

To register ViVE, Click here.

notes: This interview has been lightly edited for length and clarity

In the run-up to ViVE, Addo discussed RubiconMD’s recent behavioral and rural health initiatives, and its response to Covid-19 and Recently acquired by Oak Street Health.

How has RubiconMD evolved since 2014? What milestones have you achieved in the years leading up to the acquisition?

Gilardo

The first is really validating our needs around value-based care support. We’ve been working hard to develop the payer relationships and partnerships needed to do this. What we’ve done is more scalable access to expertise, which saves a lot of unnecessary costs from the system… From there, it’s almost entirely focused on the product and how we innovate around primary care.

We’ve developed a whole bunch of different tools and components to integrate into the primary care workflow in a more seamless way. We have developed a deep integration with the EHR so that electronic enquiries can be submitted very easily.We developed features on mobile devices [devices]. we have already [also] Features were developed to enable the clinic or other members of the care team to participate in the process.

We’ve done a lot of work from a UI/UX standpoint to make it as simple and seamless as possible in primary care.

Another big thing that happened was when we started [around] About 30 majors and sub-specialties. We determined that one of the most important things to make primary care as simple as possible is to have as many specialties as possible on the platform and be able to really answer every question. Today, we have 140 specialties and sub-specialties on the platform.This is important because we need primary care [practices] It feels like this is the tool they have for all the support and needs they need in skilled nursing. This includes everything from traditional specialties such as cardiology and dermatology to paediatric subspecialties, clinical pharmacy, genetics and more.

You start a behavioral health module. Can you provide an overview?

We are in the process of commercializing it widely. It’s about being able to provide greater holistic support for primary care.

Throughout RubiconMD’s history, we’ve been hearing things like, “Can you provide greater support in behavioral mental health?” Our value proposition is that we can reduce costs and empower primary care. But if you’re only doing it for your physical health, not your mental health, you’re not really providing comprehensive care and support.

We have to invest to actually build this.Data suggests it may not be a mental health condition per se [that’s] A high driver of cost, but patients with mental illness are 6 times more expensive for the system. Primary care is where you can capture, support and manage many patients who may not be experts. We need to create this tool to provide full support to be able to build this bridge. It has been incredibly well received.

How does this work in practice?

Patients see their primary care physician, who can use RubiconMD to get an opinion from a specialist. We have a network across the country and these comments are fed back to primary care clinicians within hours. That clinician can then use it to follow up with the patient.

Through behavioral health products, there is a group of patients identified as suitable for collaborative care. They were included in our plan, which had a care manager … who worked with the primary care clinician to manage this group of patients. We then bring virtual psychiatrists into the care team who can longitudinally support the management of these patients over time. They can engage in any number of interactions, and we have a collaborative workspace that they can use. They discuss these cases weekly with the care manager by phone. They can interact directly with primary care physicians when they have questions, and they can also interact with patients in limited ways as needed.This is bringing the psychiatrist directly to the care team and [provide] Provide support to this group of patients, primary care clinicians, and their teams to be able to better manage care.

In addition, we customized a registry to include evidence-based collaborative care tools that care managers use to manage patients.

So the big difference is that it’s both collaborative and longitudinal, and it’s around specific issues and patients compared to e-consultation, which covers almost all specialties.

What areas of specialty do primary care physicians using your platform most need e-consultation in?

Top rankings include Dermatology, Cardiology, Endocrinology, and then Hematology-Oncology as a joint specialty… Obstetrics and Gynecology, Infectious Diseases, Orthopedic Surgery. Neurology is another big discipline.

How is your platform adapting to the Covid-19 pandemic?

When the pandemic hit, virtual was the buzzword of the day. We fit in well. People don’t want to be seen unnecessarily in person – we provide a more efficient way to get the right expertise at the right time.

You have a lot of people on the front lines who are really struggling…so we have to step up in certain areas and be able to provide support…it’s just crisis mode for a lot of these clinics and organizations.

We have created a specific Covid-19 group to help people learn how to treat and manage people with [the condition], how to manage their workforce and employees.have many questions [at the start of the pandemic] This now seems to be accepted behavior and practice, but no one knew about it earlier.

We also do CME, so we offer CME through each console. We also have a webinar about it – which is actually another thing that has changed over the years. We conduct CME to help train clinicians and give them a better understanding of how to meet and manage the needs of Covid-19 patients.

Does this also relate to your work in health equity?

What we’re seeing in the pandemic… we’re seeing a lot of people relying on health equity and how to support the most vulnerable. I think at the time people really went beyond supporting disadvantaged groups, and we were first and foremost a tool that was able to provide fairer access. We see many organizations trying to figure out how to address disparities and how to better treat communities with fewer resources. We have been able to form partnerships with many community health centers, many organizations that support underserved communities. We launched a rural health initiative that we will be discussing at ViVE to be able to support people in rural areas who lack the same services.

The chronic diseases that drive health care costs are the same diseases that disproportionately affect black and brown people.So addressing systemic racism also [addresses] health care costs.

Can you talk about the rural health initiative and what it involves?

We’re already supporting large populations in rural areas – we wanted to figure out ways to better customize products and work with organizations to be able to scale faster in these rural areas. Rather than just building relationships with every clinic in every region, we wanted to figure out how we could work together broadly to be able to provide support in large regions that are not as densely populated but have the same needs. Get specialist care. It is important to us to identify scalable ways to meet this need and achieve our mission of democratizing the medical profession.

So we launched the Rural Health Initiative to find partners. We have a couple of big partners that we’ll be talking about case studies at ViVE that have allowed us to do some incredible work in Kansas, Missouri, and what we’ve done in Texas.

Which brings us back to Oak Street Health’s acquisition of RubiconMD. How did this deal come about?

Oak Street Health has been our long-term client and partner. It started as a discussion around how we can evolve from content built around behavioral health to being able to provide comprehensive collaborative care and management, and really move towards that vision around virtual professional care. Can we be the gateway to specialty care for every primary care organization, where the specialty is virtual? So to be able to do what we do in behavioral health and basically do it in every specialty and create these multidisciplinary care teams that are not just isolated in academic medical centers, but available to every primary care organization country. Over time, we think we can be the professional care operating system for any organization trying to do value-based care. This is really the vision we want to build. Oak Street Health is clearly a leader in primary care, so we came together with them. We are closer to primary care centers to be able to innovate to support our clients.

illustration: elenabs, Getty Images