Rx_Jamie Colbert: Audio automatically transcribed by Sonix

Rx_Jamie Colbert: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

John Shufeldt:
Hello everybody, and welcome to another edition of Entrepreneur Rx, where we help healthcare professionals own their future.

John Shufeldt:
Hey everybody, and welcome back to another episode of Entrepreneur Rx. Today, I have the great pleasure of interviewing Dr. Jamie Colbert. Jamie is a physician leader and an innovator with an expertise in value-based care, population health management, and health informatics. He is currently Senior Vice President of Care Delivery at Memora Health, which is a leading technology platform for virtual care delivery and complex care management. Jamie, welcome.

Jamie Colbert:
Thank you so much, John, really, pleasure to be here.

John Shufeldt:
Thanks, so you've got a really cool background. Go if we can, you're one of those smart dudes, go back and go back to your, kind of, high school, college days, and how you ended up in medicine.

Jamie Colbert:
Yeah, actually, it's all too common story. My father was a primary care doctor, and I grew up in a small town where he had his own primary care practice. And we kind of knew a lot of folks in town, and we'd go out to restaurants and people would see him and he'd be the doctor. So it was kind of a more old-fashioned type of medicine that you just don't see as much these days where you just have a level of respect in your community, as a physician, that my father had. And I really thought that was amazing and I could see kind of the impact he had on his patients. And many of his patients were teachers that I had in school and coaches that I had and folks in our small community who really looked up to him as someone who had helped them a lot. So I kind of knew from a young age that going into medicine was a way to choose a career where you could make a difference. But I definitely took a kind of more circuitous route where when I was in college, I for a while was thinking about doing something that was a little bit different. I initially was interested in teaching and spent a year as a teacher after school and then kind of was reevaluating after that first year as a teacher where it just wasn't kind of what I wanted. It was too much classroom management and discipline and it didn't allow me to really use some of the creativity and more of the science kind of focus that I was hoping to use. And so I got a job actually as a research assistant on a cancer program over at Mass General Hospital. And through that, I really loved academic medicine and the fact that all of these physician-scientists that I was working with were spending their time-solving problems, helping patients, thinking about how to advance the field of medicine. And so kind of seeing them really excited me about becoming a physician. And I thought that I kind of carved my own path in medicine to do something a little different from what my father had done as a primary care doc. So I really kind of went into medicine with the idea of doing things that would change the field of medicine and being more of an innovator and a researcher, perhaps. And then by the time I got out of my medical school and went to residency, the Affordable Care Act had just passed and it was really an exciting time with just so much transformation going on in healthcare that I decided to, now think about how could I apply my interest in fixing healthcare and pushing the boundary in healthcare with all of these opportunities that were now being unleashed by the Affordable Care Act and the push for us to think about how to deliver care more efficiently, improve quality for patients and better control costs. And so that was kind of really what led me down the path that ultimately took me to Memora.

John Shufeldt:
So backing up a bit, so you went to Harvard undergrad and then that year teaching, where and how old were they?

Jamie Colbert:
So I actually was a third-grade teacher in Mexico of all places. So I just, you know, I wanted a different experience and I felt like I had always wanted to travel and study abroad, and I never got a chance when I was at Harvard to study abroad, there was just too much that I had to kind of get through to finish my studies. And so after graduation, I decided, okay, this is my chance. So I got a job as an English teacher at a school in southern Mexico and was teaching third graders for the year, which was just wild. I mean, it was an amazing opportunity to be immersed in speaking Spanish and to get to know the culture in Mexico, and I got to travel around, and it was a fantastic experience.

John Shufeldt:
That's so cool. So then you're there, now, but you were at Harvard, you did all the pre-medical classes. What was your undergrad degree in?

Jamie Colbert:
It was in history, actually. So I did history of science because I loved science and medicine, but at the same time, I wasn't at that point committed to a career in medicine. So I chose to do history of science because I could still kind of focus on understanding how did we get to where we are, both in medicine and in kind of more generally understanding biology, chemistry, physics, and kind of what we thought of as science today and how that had changed over time. I mean, it was really fun. They have a whole History of Science Department at Harvard, where I spent a lot of my time as an undergrad.

John Shufeldt:
You know, it's cool with what you're doing now and we'll get to it, but what you're doing now, you're kind of continuing on that path of the history of science, at least the history of healthcare, like kind of standing on the shoulders of giants, sort of, methodology because you can have the, you've had the opportunity to look backwards where we've been, and now you can help create the vision for looking forward. So, okay, so you're in Mexico, you're teaching third graders and you're like, alright, this may not be my life's calling. So you apply to medical school and you go to Stanford Medical School. I mean, at least you're shooting low. I mean, I like that.

Jamie Colbert:
Yeah, well, yeah, I mean, I came back and I actually, I was living on some friend's couches for about three or four months after getting back from Mexico. Because I went to Harvard, my friends were in Boston, and that's where I found a job at Mass General. So that's kind of what I did while I was applying to medical school was do some cancer research at Mass General, get a little bit more experience, solidify that I definitely wanted to go to medical school. Then I did the applications, ended up getting into Stanford and I figured, well, I grew up in Massachusetts, why not try something different? And so I went out to the West Coast for four years at Stanford, and then when I graduated, just the fact that my family is all on the East Coast, it kind of pulled me back. So that's why I came for my residency to come back to Boston.

John Shufeldt:
So you did a three-year IM residency?

Jamie Colbert:
That's right, yeah. I was at Brigham and Women's Hospital.

John Shufeldt:
Okay, so three years IM, And then when you got out of there, what you got out of that? I mean, while you were there, did you look at the healthcare system and say, it's broken, I want to fix it?

Jamie Colbert:
I did, I mean, I was frustrated because I had a primary care clinic during residency and I had these patients who were from the lowest rungs on the socioeconomic spectrum, and there was no one advocating for them. They were unfortunately stuck with me as a primary care doctor, someone who was still in training. And, you know, they were just struggling to manage their diabetes, to manage their COPD, and it was overwhelming for them. And I just felt like there has to be a better way, there have to be things that we can do to help these patients along their journeys and to offer them support and guidance when they're not in the clinic with me. And so that was kind of one of the first tastes I got of kind of what we need to do better in healthcare was just seeing how much patients really were struggling, how much it was just about whether you could advocate for yourself. And so those who had the resources, those who had the connections, it was much easier for them to make appointments with providers or find specialists for their conditions. And those who didn't know how to advocate were often those who got left behind, and they ended up in the emergency department, and they were hospitalized. And I was also taking care of them on the other end in the hospital and saying, you know, this is such a shame that you have a chronic condition like diabetes, where if you had had more effective care as an outpatient, you wouldn't have ended up here in the hospital to begin with.

John Shufeldt:
Yeah, I just had a patient working on one of the reservations who had not been on his insulin for two years. And, you know, of course, his kidney function still wasn't awful yet. But I like, you know, I was kind of harassing like dude, what the, what happened here? And he was well, you know, with COVID, I just didn't really get into the clinic and then I had to have a device to connect to it virtually. And there's you know, there's no real connectivity on the reservation. I mean, it was just, it was one fixable problem after another that basically forecloses possibility for getting insulin. Now, if it was somewhere else, someone may have been able to help him, but there he was just left to figure it out on his own. And I've had recent experiences with healthcare that bud for connections, I don't know how folks will find their way through this process because, you know, you make an appointment with somebody and it's six months away, which is fine, I get it that they're busy, but some of these things, breast masses, for example, you don't want to wait six months before you get your needle biopsy. So yeah, you're exactly right.

Jamie Colbert:
Yeah, and so I would say by the time I finished residency, I had a decision to make. Do I go into full-time clinical practice or not? And I chose not to. So I did spend a year doing a health policy fellowship after finishing residency. And when that finished, I looked around, I didn't find the right job for me, and so I decided to take a risk. And I said, No, I'm going to take a 50% clinical job to pay the bills, and then I'm going to find something interesting to do for the other 50% of my time. But I didn't know what it was. So I had a lot of conversations with folks in the startup world, folks who were doing just interesting things in healthcare, to embrace value-based care models and think about how could we improve care delivery? And eventually, I ended up getting connected with Accountable Care Learning Collaborative, that was sponsored by the Brookings Institution. And so they ended up taking me on to be their physician lead to convene providers from around the country who were experimenting with value-based payment models. And they needed a physician who could kind of help to bring together these learning collaboratives so that physicians could share best practices about what was working as they were trying to manage populations of patients, rather than just do the old fee-for-service model that just wasn't working. And so I spent about two years doing that, which was a ton of fun. I got a chance to travel around the country and meet with physicians who were practicing in these value-based payment arrangements and thinking about how to transform their practices so that it was really all about managing panels of patients and managing chronic disease, rather than just focusing on how many patients can I bring into my clinic each day and make sure I'm maximizing my fee-for-service revenue? So it was very illuminating to kind of have that experience. And I'd say kind of everything else I've done afterwards has been kind of a result of what I learned from those conversations I had during those years.

John Shufeldt:
Is that what led to Blue Cross Blue Shield?

Jamie Colbert:
Yeah, there were a couple of steps along the way. So the next step actually for me was to join a healthcare analytics company because I saw that all of these provider groups were struggling with how to manage healthcare data, how do they get the insights that they need to make data-driven decisions about managing patients? And so I spent two years working at Verisk Health, which is a healthcare analytics company that's now part of Cotiviti. At the time, it was a separate company, so I worked there as a senior medical director. I oversaw their population health analytics work, and I did a lot of consulting with providers, health plans, employer groups who were all interested in the same thing, which was how do we better manage populations of patients to achieve better outcomes and better manage costs?

John Shufeldt:
What were some of the takeaways that you gathered from there? Because it sounds like you've kind of just learned along the way on best practices. What are some of the best practices you've learned, I guess, throughout your, even through today?

Jamie Colbert:
Yeah. I mean, I would say that there are just so many opportunities to make sure that you're taking a step back. If you're a physician or any provider who's managing patients, to make sure you're reviewing all of the information you have about patients and populations of patients, such that you can provide more longitudinal care in an effective way versus, I would say that the majority of providers that I had interacted with, kind of, earlier on in my career who were just doing fee-for-service medicine, you know, they were just waiting till the patient came into their clinic, looking at their chart, addressing whatever problem the patient brought up, and then once the patient left their office, it was out of mind for them and they weren't thinking about them anymore. And so it takes a different mindset to be much more proactive about following through on, Ok, I know I saw Mrs. Smith two weeks ago in clinic, but, you know, let's figure out what's going on with her. Is her blood pressure actually in control now that we started a new blood pressure drug? And is it her responsibility to call me if she's having side effects or if her blood pressure is not in control? No, it's not on her. It should be on me and my team to figure out how do I reach out to her, how do I check-in and make sure that she's doing okay? And so I think that's the biggest lesson that I've learned is you have to put in place systems to more longitudinally manage patients when they're not in front of providers in the clinic.

John Shufeldt:
It seems like with AI and electronic health records that should be much easier now because it should be just almost on a cue. Hey, this patient hasn't had a colonoscopy in ten years. We've got to get that. But all these things can be very data-driven, and then using AI, I think, I mean, it should, sounds like it's should be easy. I know it's not, but it should be.

Jamie Colbert:
Yeah, you would think it would be easy. I mean, I would say there are a couple of challenges that we see. And really what brought me to Memora Health, where I work today, is the fact that we're not where we should be in terms of leveraging technology to care for patients. I would say that A, physicians, in general, are fearful of technology. I think part of it is that they were promised something with EHRs that never delivered, and many physicians feel that EHRs have only created more headaches and hurdles for them such that it's harder for them to do their jobs and they're not seeing the benefits of technology to actually enable them to do their jobs more efficiently and to make sure that patients are actually better connected with their care teams. And those are things that Memora really can offer. And that was what attracted me to Memora, is that the EHRs don't solve for some of these problems and we need new solutions that really can make technology much stickier, such that patients are able to much, much more seamlessly connect with their care teams, and providers are able to communicate and guide patients in ways that they really want to, but often don't feel that they have time to do so.

John Shufeldt:
So let's talk about that a little bit. So Memora, it sounds like, I mean, you kind of have this path from what I can, what I've ascertained of all the steps you've taken have led you to Memora because you have this now perfect background for it. How did you end up there and tell us about Memora and kind of what your plan is there?

Jamie Colbert:
Yeah, and as I was saying kind of about my career, I was at Verisk Health, I was doing healthcare analytics. I was wooed away by Blue Cross Blue Shield of Massachusetts to lead provider analytics and performance there for the past five years. And then I decided to get my MBA. I actually felt like I wanted to do something that was more entrepreneurial. I wanted to be at a smaller company where I could really make more of a difference on patients and do something that was more exciting. And so as I was finishing up my executive MBA, I started to do more networking with other physicians who were doing entrepreneurial work, and through that I got connected with some folks in the VC community, and through there I was connected with Manav Sevak, who is the CEO of Memora, and he had my background from one of the VC friends that I had, and he reached out to me and after a series of conversations, he really helped me to see how Memora was in some ways kind of the culmination of the journey I've been on to help deliver patients much better guidance and connectivity with their care teams through technology and thinking about how care teams can actually use technology to make their lives easier such that they can get done the work that they need to get done. But they can also offload a lot of routine tasks to technology and automation, and then they can spend their time actually spending those hours with patients who need their help rather than spending time answering routine phone calls or responding to very routine messages.

John Shufeldt:
I just, when I was, you know, when I worked up on reservation lands, they generally share the same EHR, and it's so incredibly click-intensive. Literally, it will spend 10 minutes with a patient in 30 minutes documenting. And it's so, so unnecessary, and so I know it's one of the problems Memora is trying to solve just on the follow-up connectivity part of it, but there's a lot of room for improvement certainly. And as you mentioned, the promise of the EHR has not made our lives easier.

Jamie Colbert:
Absolutely, yeah.

John Shufeldt:
So where is Memora headed, and where are you headed in Memora?

Jamie Colbert:
Yeah, so I was hired to lead the care delivery function at Memora. So I have a clinical team underneath me and what we're doing is we're digitizing and automating journeys for patients. And so what that means is we take many of the most common clinical conditions that are out there, right? Now we know that for many health systems that means patients with CHF, COPD, diabetes, hypertension, chronic kidney disease, that makes up a fairly large percentage of the patient population that is going to see providers in the office, that are being seen in the emergency department, that are going to the hospital, and we create care programs that automate a lot of the more manual tasks right now that are being done by not just physicians, but by medical assistance and other nurses and members of the care team. So it means that patients are kind of getting messages on their phones and they're being educated, they're being reminded to do what they should be doing. It helps them to adhere to their care plan. We're collecting data so that providers know what's going on with patients, whether that's someone with hypertension, where their blood pressure is now being recorded and sent to their provider, such that the provider has more insight into whether their blood pressure is in goal or not. For patients with cancer, we're helping to manage their symptoms of chemotherapy, provide them guidance, and let them know kind of what's normal and what's not normal so that they're not going to be calling into the office with a symptom that's very much expected and is something that's going to resolve on its own, right? So it's all about figuring out how do we automate some of the things right now that are requiring a lot of time of care team members and allowing those providers to then focus on actually caring for those patients who have complications or who have deviations from the care plan where you really need somebody to intervene and have a one-on-one conversation with you.

John Shufeldt:
Yeah, it's amazing how many people I see that it could have been prevented by a simple phone call having somebody say, no, and that's actually kind of what you should be expecting. Or conversely, they come in and they said, Well, you know, I've had this for three days, and I thought it was fine. I'm like, Yeah, now we probably needed to see that three days ago, but we'll obviously do our best now, but three days it would have been the time to come in. Now, I don't say that obviously to patients when they're in the thick of things, but it's, a lot of times care is a simple phone call away.

Jamie Colbert:
For sure.

John Shufeldt:
They just don't know who to call.

Jamie Colbert:
But one of the problems is I find a lot of patients, they try to call their doctor and they're put on hold for 45 minutes or they leave a voicemail and nobody calls them back until the next day. And so what Memora offers is a text-based platform that uses AI and natural language processing. So if you're a patient, you have a concern, you text in to your provider, and if it's a common concern, you'll get an automated message right back using the natural language processing where Memora already knows, kind of based on what that question was, what the right guidance is to answer the patient's concern, and the patient feels more satisfied and more connected with their care team. And now you don't have someone in the care team who has to respond to a voicemail and call someone back.

John Shufeldt:
Yeah, it's funny, I was calling in a prescription yesterday. I had to call it in three times because they would lose the voicemail. Then I had to wait for the pharmacist. I'm like, Oh my God, there has got to be a better way to do this. I know there's a better way to do this, Walgreens doesn't seem to know it, but there's just so many things that we could so simplify and things that I've done in healthcare, I've been trying to, just for that, you know, starting urgent cares and starting the telehealth companies have all been trying to minimize this need for the emergency department and need to go in and see somebody when they when it was appropriate. So I applaud what you're doing.

Jamie Colbert:
Yeah, and we've seen such great success. I mean, the patients who use our platform have engagement rates that are much, much higher than some of the traditional outreach methods where we know that patients don't want to log in to a patient portal, so we use a text-based platform where you can just text. It's the same way that you would text your friend or text your family, so you don't have to remember a password, you don't have to log in to anything. As a patient, there is no friction, so it just makes it that much easier for the patient to get in touch with their care team.

John Shufeldt:
So, Jamie, if somebody wants to kind of follow your path, what advice would you have for them? Because you have a little bit, as you know, an atypical path with what you're doing. But I think it's a path that more and more of us are gravitating towards. So what advice do you have for us?

Jamie Colbert:
Yeah, I think that's a great question, and I would say when I look back at myself in medical school, I never would have envisioned that I'd be where I am today. It's just kind of, my career just took some turns along the way and led me to where I am and I'm super happy with the work that I'm doing and it's kind of even more fulfilling than I ever imagined. But really my advice to young physicians would be to really make sure that you're following what you're passionate about and to not be afraid to take a risk. For me, that meant initially, after I finished my residency training, I took a 50% clinical job and I didn't know what I was going to do the other 50% of my time, and I spent some time exploring and having conversations and really looking at what was out there until I found something that grabbed me and was exciting, and kind of from there, I kind of moved from one thing to another. And, you know, it's really just been about being opportunistic and looking for that next adventure and challenge. I would say that if you don't feel like you're still learning, no matter what you're doing, then it's probably time for a change. And that mantra has served me well along my career.

John Shufeldt:
Yeah, it has served me well also, it's, you know, it's the wise man knows he knows nothing sort of mentality. And, you know, hearing you describe that, I don't know if you ever heard of, you're probably at Stanford for this, but Steve Jobs commencement address about connecting the dots backwards rarely makes sense looking forward, but listening to you like it makes total sense. Connecting the dots backwards, why you are where you are.

Jamie Colbert:
Yeah, I actually listened to that speech as part of my MBA program, actually. They played it for all of us at the end of our program. It's a great speech.

John Shufeldt:
Yeah, it's something, one of my favorites. Well, Jamie, this has been awesome. In our Show Notes we'll put up all your contact information and how people can get ahold of you on LinkedIn and how people can learn more about Memora Health. So I really appreciate you taking the time to do this. God knows I'm sure you're busy.

Jamie Colbert:
Oh, thank you so much, John. Really been a pleasure to speak with you and talk about my journey. And I really enjoy mentorship. I think it's just such an honor to be able to work with younger physicians who are kind of finding their own way. And so I'm always happy to have conversations and provide mentorship to those who are trying to find their own path.

John Shufeldt:
That's awesome, thank you very much for that. Well, folks, thank you for listening to another edition of Entrepreneurs Rx, brought to you by Xcellerant Ventures, a healthcare venture fund focused on health tech and biotech. With that, I'll see you soon. Jamie, thanks again.

Jamie Colbert:
Thank you, John.

John Shufeldt:
Thanks for listening to another great edition of Entrepreneur Rx. To find out how to start a business and help secure your future, go to JohnShufeldtMD.com. Thanks for listening.

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