The Voice of the Patient… Heard Through the Megaphone of Data

Brian Urban (00:22):

Yes, this is the Healthcare Rethink podcast. I'm your host Brian Urban, and today we have a good one. We brought in CEO, Dr. Mitesh Rao of OMNY Health to join our podcast, and we're going to be talking about exactly how OMNY Health connects data to transform lives. They are dealing within the whole healthcare ecosystem to connect providers and life science organizations to fuel partnerships that drive patient care. So without further ado, Dr. Rao, thank you for joining our podcast.

Dr. Mitesh Rao (00:54):

Brian, it's a pleasure to be here. Thanks for having me.

Brian Urban (00:57):

I'm so excited for our conversation today. We've gotten to know each other a little bit before our recording here, so this is going to be a real cheat for our listeners. So with every conversation, we love to get our audience familiar with our guests. So let's go back before the MD. Let's go back before OMNY Health. Who is Mitesh? Who is Dr. Rao? And how did your whole journey come to creating this dynamic organization? So take us through it.

Dr. Mitesh Rao (01:28):

Yeah, that's a great question. And I will say I think a lot of the work that we're doing at OMNY Health is a product of my experiences and frankly the challenges that I've lived firsthand on the healthcare side. I want to go back all the way. I'm a product of a father who's a computer science engineer and a mother who's an OB-GYN. And so I've spent most of my years straddling the technology and healthcare space in really interesting balances. Spent most of my career as a health executive. So prior to starting OMNY, I was the Chief Patient Safety Officer at Stanford Healthcare. Before that, I was one of the execs helping to lead innovation in Northwestern. And then before that, I was at Yale where I did my residency, my fellowship and was a clinical scholar at the Robert Johnson Foundation. My work's always been focused on the data that sits in the clinical environments and how we can leverage it.

(02:18):

And I think the challenge that I kept living and the frustration, frankly, was I kept seeing opportunities for the wider world of real world data to connect, provide organization like health systems and practices into these incredible opportunities where we were advancing the science, we were advancing the care practice, we were building new treatments for these rare diseases, and that data that was sitting within the clinical environment was such a powerful additive to that equation. Yet getting that data out at scale and doing it in a way that protected patients and protected providers and focused on really bringing good in that space was an inherent challenge. And I couldn't find a piece of the architecture or a platform that would enable me to do it at scale. I kept looking at our current IT stack and saying, "Well, look, there's a missing piece of the equation here. How do we create empowerment? How do we help every organization who's sitting on data step forward, not to be scared, but to think about the potential that they can drive with their hand on the steering wheel?"

(03:22):

And so I took my experiences and we raised capital, built a great team and have subsequently scaled it into a national architecture now that covers all 50 states and drives partnerships for over 56 million lives now across the country, helping large IDNs and nonprofit health systems, academic medical centers, national cancer institutes, children's hospitals, large MSOs in the specialty space into these really powerful opportunities where they're partnering hand in hand with pharma biotech companies around research data, discovery, safety and efficacy studies, social determinants of health, health equity concerns, really transforming clinical care, clinical practice in the future of healthcare all from a data-driven perspective. And that's really the focus of our business is helping empower and enable those connections.

Brian Urban (04:13):

I love that you led with OMNY Health is a product of all of your experiences, from an executive level, from an actual treating patients level. And I am so excited to see your organization continue to grow and impact lives. 56 million lives and growing, and that's across the whole ecosystem, all the different entities that you had mentioned.

Dr. Mitesh Rao (04:36):

Yeah, we'll be aiming to be more than twice that in pretty short order. So it's been growing quick and I think that's testament to the great work that we're doing, helping so many organizations now around the country build these opportunities and build these partnerships and helping them think about ways to really get the voice of the patient and engagement from their patients into these opportunities to really scale the potential.

Brian Urban (04:59):

And that's the thing is that it needs scale. It can't be these one-off things and you being able to play a key component of interconnecting the larger web across the healthcare ecosystem is really proving out its value, proving out the IT into reality now, which is about time. I want to go back to one thing that you had mentioned. In your earlier days, being a physician, that's a large part of your background, a large part of how you see the ecosystem is through that clinical lens. What's the biggest challenge that we have today with patient engagement for our healthcare providers?

Dr. Mitesh Rao (05:37):

I'd say there's almost two key challenges, and there are really two sides of a coin in my opinion. The first piece and probably the core challenge that's been there for even throughout my career on the provider side is getting access to deep, clean, meaningful data to help drive decisions. And that's such a challenge still to this day. We're still working. It's a work in progress as an industry to get healthcare into being very data-driven. I think we've made incredible strides and incredible progress, but there's still a lot more that I think we can build out there. And that inherent challenge, when you think about it from the day-to-day perspective of clinicians seeing a patient and having to make so many decisions, we always talk about... Our physicians and our nurses do heroic work and they do it in spite of the limitations of the system.

(06:28):

The system really, I think, can be enhanced and redesigned to provide a lot more support, to make their lives and their jobs easier, more focused, and help them do the good that they're dedicating their lives to on everyday basis. So that is one big key piece, and that's a core tenet of our business, is really empowering that on the provider side. The second piece is it's really aspected towards patients. A lot of the data we gather today, it's focused on clinical care, but it misses dimensions around the patient's experience, it misses dimensions on health equity, social determinants of health. And how do you really take that comprehensive view? When you look at a journey of a patient, there are so many factors and aspects, both intrinsic and extrinsic, that impact the eventual outcomes for that patient. And that is where data can really shine. And so at OMNY, we take that holistic view of data.

(07:22):

We think very deeply about not just what's coming from the clinical side, but also how do we incorporate the patient aspect, the patient voice, the patient experience so that when we talk about, say, a rare disease, we're really thinking about this from a 360 view of what's going through and what's impacting those eventual outcomes, the adverse events, and the clinical staging that these patients go through? So that's an important aspect and in my mind, those are two sides of the coin and they go hand in hand. And I think if we tackle one, we should be tackling the other simultaneously because together they make everything stronger.

Brian Urban (08:01):

Everything's stronger indeed. And I like how you were thinking about it from a tech stack perspective earlier. You were thinking about what organizations have certain technology or certain data available to them to help the decision making process. And you said a couple words that... Obviously we both share public health and clinical perspective too, which is social determinants of health data, and we need to address this. We've had racism and fractures in our healthcare society since the beginning of time, but now we've come to a point where we have great, nimble, fast organizations like yourself trying to help healthcare organizations identify high need populations. So how is OMNY Health using SDOH data to do that, to see the person and the patient?

Dr. Mitesh Rao (08:55):

Yeah, and that's a big challenge, right? It's not just the need for that data, but how do you get that data? Who has the right data to address those concerns? There's a lot we're doing right now, both in partnership with pharma and biotech as well as in partnership with our health systems and provider organizations, finding those disparities, finding and identifying when patients get diagnosed and treated, ensuring that we're capturing all those aspects. A lot of this data is not necessarily captured in traditional clinical approaches or EMRs. And so you have to really think about where else are we missing pieces of information and how do we gather those parts? Things like unstructured data, for example, tends to have a wealth of information about the patient's experience, their hurdles, their challenges. That gets documented in freeform conversation as the physician is talking, their dialogue with the patient.

(09:48):

That's not a dropdown menu in an EMR, right? And that's a key piece, thinking through how do we incorporate things like that rich unstructured information, how do we go about ensuring that we are not just searching for that information, but starting to transform how providers are interacting with patients to gather that information? And that also feeds into what's important in when you're looking at that data and the population you're looking to grab it. Diversity in the network of who you're addressing, diversity in the network of, say, the provider organizations that you're working with is really critical, right? From the academic medical centers all the way through small rural hospitals and outpatient clinics, the community health centers all over the country, we want to make sure that we're looking at data across the spectrum so that data is representative, that it touches every population, every group, every geography.

(10:35):

If you just look at data from, say, the academic medical centers, you're getting a very select approach. And if you're not looking at it from a broader perspective, you run the risk of not being inclusive. And what does that mean down the road? That means that these patients don't get included in things like opportunities for research, trials. They know their data doesn't get incorporated when we're starting to do safety and efficacy studies. If you're not ensuring drug safety with all the patient populations in mind, that's a challenge, right? So that's a big piece, is think through how do we make sure that the representation is there? How do we make sure that every population is being engaged so that we can truly do this from a national perspective?

Brian Urban (11:16):

I love how you hit on the raw unstructured side. A lot of data pools that sit outside of clinical and that aren't integrated into clinical. And there are so many and finding is it a trigger? Is it a score? Is it simply a short list that a physician is able to maybe handle downstream to a licensed clinical social worker, or is it upstream play for health plans to be able to provide interventions? Nothing is proven out yet. We are in an exciting time, but time's not on our side. We need to be able to figure this out and do things quickly. And you mentioned something really interesting, drug effectiveness.

(11:52):

So clinical trial diversity has hit the healthcare ecosystem with a huge wave in a large part because of regulation that has come through FDA saying that you need to have a diverse population through your phases of trials with bringing in new drug to market or a biosimilar to market. And you all face a lot of life science organizations. So Dr. Rao, with clinical trial diversity, it's so new and growing. How is OMNY supporting these new drugs and the diversity of the cohort that's needed and the data exchange that's needed as well? How are you all addressing this and helping this side of the ecosystem?

Dr. Mitesh Rao (12:36):

Yeah, that's a great question, Brian. And I'll tell you, it was something that we spent a lot of time thinking back when we were first forming the company, but all we had was a PowerPoint slide looking about our business plan. The biggest challenge that I saw was there were so many organizations around the country, such a large swath that was so focused on providing care to underserved communities with high risks and burdens of disease. And their access to things like research trials was just so limited. And the question is how do you democratize that? How do you ensure that the patient who's in rural Mississippi has the same access to the patient who's in downtown Manhattan? How do you ensure that they have the same access to the same level of care, same quality of care, but also the same trial opportunities, the same research opportunities?

(13:24):

And the organizations on the community health side, the organizations on the community health system side do incredible work, absolutely astounding work supporting populations and communities that rely so deeply upon them. And we want to ensure that those groups get the same levels of resourcing, that they get the same levels of access and the same opportunities. And that's a big piece. And so when we set out to build our network, we went to those groups first. We said, "Look, we're going to build what we think is the national data layer. We want it to be truly representative. We want to be truly engaging. We want it to have the voice of every part of this country. And so we're going to start with the groups that have the least voice or the least opportunity to engage their voice in the research and trial space, and let's build from there." And so now we're at a point where we've captured, I think, a great representation and have been able to bring a lot of opportunity into those communities, into those groups.

(14:21):

And now we're just focused on heads down, doing more good work, scaling that piece of the business and really thinking through how can we continue to scale these partnerships out? And our focus is always bringing the vast majority of value, benefit, anything coming out of our life census partnerships back into pride organizations, back to benefit patients. We focus very heavily on... Our decision goes completely at risk in our partnerships because we believe so strongly in the value that can come forward. And that's a shift in the ecosystem. I mean, for years, we saw a lot of organizations that were in the data space not being able to really give that back, that giving back piece to patients, to communities, to providers.

(15:01):

And we wanted to change that equation. And so that's a really different focus in how we do business and how we build partnerships is really thinking about... The rising tide raises all ships. And so how can we ensure that every organization who's part of these questions and conversations around data, who's contributing data, who's doing research on data, how do we make sure that everybody benefits? And that's I think an important aspect as we think about healthcare going into a data-driven world in the future.

Brian Urban (15:28):

Wow. Yeah, and I love how you keep going back to patient safety, patient efficacy, patient awareness too, being able to let them know, especially marginalized populations, that they have a voice and they're represented in data. And also outreach too. And you made me think of something. So Walgreens is still heavily invested into the clinical trial space and they're trying to push for a lot of initiatives, leveraging their retail locations. CVS has maybe paused, I don't know if they're completely backed out strategically, but your work, I see it directly connecting with advancing clinical trial operations for including diversity because we can't just have... And they're wonderful, huge organizations. They have great intent, but a CVS or Walgreens, it can't be just on them. It's definitely a village approach. So I can see your organization being able to puzzle fit so well with advancing what their initiatives are being required to do. So I'm really excited. If you're going to that space, I'm excited to follow up with what's going to happen there.

Dr. Mitesh Rao (16:36):

I will say Brian, too, the other bit that excites me is the way we built our network is that it's a two-way flow of communication engagement. So we keep very deep relationships directly with our health system and specialty group partners directly interacting with the leadership of the providers. So when we think about trials, we don't think about it from the standpoint of just helping to find patients across a diverse network. We think about connecting and we think about aligning that piece with... Think of it as unified data that forms a common language so that these can groups actually interact closely because we want the life sciences, the CROs, the biotech world to be able to collaboratively work together, the provider organizations, and focus in on engaging with patients. We want that partnership piece.

(17:24):

We want to do it in a way where there is the right compliance, there's the right security, there's also the right protection of patients and providers. But doing it from a perspective where it really is about collaboration, it's not just about identification because it takes a village to do a trial, honestly. And it's not just about finding the patients, it's about helping them get engaged. It's about getting the right resources around them. It's about making sure that the PIs have the right support, that you can ensure that those patients get not only aligned with the trial opportunity, but also that they can successfully be a part of those trials. And that takes true collaboration.

Brian Urban (18:01):

You're right. And they have to be pulled in. Individuals have to be pulled into this because it's not about checking a box, it's not about just identifying, but it's also about having them in the conversation and the journey because quite honestly, I think we could all say that those that are engaged in clinical trials are in some degree an early hero to drug effectiveness to their respective race, ethnicity, their particular challenges with a disease or rare disease. So I love that you took it that, it's beyond compliance, it's beyond checking a box and identifying. I love that. We could stay on this subject all day. Let's bounce to something else. I want to go back to the social and clinical profile of a person.

(18:50):

So the true longitudinal health record I think is seen in many different ways. I think a lot of physicians of traditional backgrounds say, "Oh, it's end to end everything that a person has experienced in their healthcare journey, what they've received as a service or treatment." But when we think about the social side of our existence as humans, everything's happening to our health outside of physician's office and interaction. But that's my definition of a longitudinal record. I think you could agree with it, but how far away are we from something like that, that type of lens that a physician can look at? Are we still in science fiction here? Do you think that's going to happen? Is it already happening underground and it's going to happen sooner than we think?

Dr. Mitesh Rao (19:41):

By definition, being an entrepreneur, I am an optimist, and I will say that I'm very glass half full on this one. I believe that we are getting very close to being able to actually create the true, call it, patient journey longitudinal record, because we're starting to really think about the different aspects. Practitioners are getting more data savvy. The way we're collecting data is becoming more robust. The technology systems are starting to scale effectively and starting to get to enough of a, call it, technological depth that we are able to grab all those aspects that we actually need, where before we were looking for needles in a haystack, and now it's becoming easier and easier to start to stitch those pieces together and do it in a way where we can still protect things like patient identities, provider identities, be compliant with HIPAA, right? Do that in the right way because we are not the FinTech industry, right?

(20:38):

We are not a consumer industry where there's different levels of regulation or protection. We have to be very focused on being a very highly regulated environment for very good reasons. And that's an important piece. That's where I see a lot of opportunity for partnerships between organizations, organizations like ours and FinThrive, for example. Being able to partner and really think about how do we create and translate that data and that information into evidence that's actionable and evidence that is leveraged not just at the sort of higher level of thinking through R&D, but also within the clinical practice. That's a really important piece going forward.

Brian Urban (21:17):

And you're making me want to talk more about your physician days with that comment. And definitely I love that you say... There's definitely a coopetition and a collaboration that's needed for so many organizations to be able to address the challenges that we're seeing across the ecosystem. But I keep going back to seeing you in a white coat. So I got to ask you a couple more questions in terms of where you practice. So you practiced in the northeast and then you were in the Midwest. You were supported by Robert Wood Johnson in terms of your academic scholar excellence. So you have a lot of different touch points and a lot of different populations that you had treated.

(22:00):

So when you think about those days of going through your academic adventures and then going into practicing and then transitioning into your executive world, how important is it for the next generation of medical practitioners to be trained in exercise, physiology, nutrition, medical humanities in particular, that have a direct correlation to addressing social determinants of health? Is that up to the healthcare system to retrain or is that something that needs to be woven into the actual school of medicine where they're at? Where's the 2.0 advancement play here?

Dr. Mitesh Rao (22:36):

Yeah, that's a fantastic question. And I'll tell you my whole life, it's been a learning curve. I think medical school did a great job in giving me that foundation as I went into, say, residency. And my residency training gave me great foundation and going into being an attending physician. But each step of the way, my whole world was opened up to new aspects of healthcare that I just wasn't privy to before. And even then, when I got into the administrative side, I got to see behind the curtain on how the sausage is made in running a health system, running a business where margins can often be very tight and economics can be challenging. And I got to feel those pains firsthand where when I was just a clinician, I didn't really have to pay attention to that piece. And so each aspect, I think, of my career evolution has opened my eyes to a different piece of this.

(23:22):

I don't know how we train people out of the gates on this, but I will say that for the next generation of physicians, as they come into the workforce, data and aspects of care like health equity, social determinants of health are going to be so critical to how they practice that it has to become core to their basic training. I mean, these are things that we have to actually be able to incorporate, and I'm not sure that it happens at the medical schools level. I think you have to really be within the thick of it and practicing to do it, which means residency is really the right time to start to inundate and give those experiences to the future physician attendings who are going to be coming out of training, having to fend for themselves effectively and fend for their patients by themselves. And that's an important aspect piece.

(24:07):

I think we do a great job building a lot of different aspects around our residents, but that is one piece that I think will continue to improve and will continue to be emphasized. The same way we emphasize, say, academics and research, we'll start to emphasize some of those aspects and they'll become core to our skillset.

Brian Urban (24:26):

And I hope that vision becomes true, and I hope it becomes real. And I think you're right. It's the batting practice cage that is residency before you get into attending is where a lot of this needs to be put in place and how to have these conversations, how to use data to make things a little bit more effective downstream when you're addressing social determinants of health in any setting you're in as a physician. So I love that I can go back... I can see how your father had the engineer brain and your mother a physician brain because you dabble back and forth between these worlds so eloquently. So that's what's really-

Dr. Mitesh Rao (25:06):

My mom thought she had won. When I was just a practicing emergency medicine physician and focused on clinical practice, she was so sure she had won. And now that I'm running a tech company, my dad's like, "Actually..." So it's an interesting starting to it. But honestly, those universes are colliding and they're becoming one. And the Venn diagram of what exists in technology, what exists in healthcare is overlapping so quickly and so strongly these days that it's just such a core piece of what everyone's going to be doing going forward. So I am grateful for the background that I had. For a while, I thought it was challenging and I was living in two different worlds, but now they're really one world, and I mean, this is where the future is going. So I have a lot of hope for where residency training will go. And the one piece that I will bring up, Brian, is something I really strongly believe.

(25:56):

The training we put people through, whether they're going through nursing school, residency, they're going through PA school, you teach resilience and you teach the ability to engage beyond, call it, your comfort zone. And that means that everyone who comes through in the provider space is incredibly adaptable and incredibly inquisitive. And that's really important because that makes us agents of change that are resilient and versatile. And so as this industry changes, I have absolutely no doubt in my mind that we will adapt with it quickly and we'll be able to adapt new methodologies and new modalities very fast like we always have in healthcare.

Brian Urban (26:34):

And that's the best thing about it is the adaptability, the evolution, and now it's truly an emerging place here. Two lanes, three lanes, five lanes are all coming together. And that was a beautiful analogy from what you've experienced to what's really happening in the industry. So Dr. Rao, I want to look ahead here. We've covered a good ground. I feel a part two coming on. I feel a bigger conversation coming on with a few other folks that we share the same circle with, but getting us to that, I want to look three years down the road, not too far, maybe four years down the road, what is OMNY Health's biggest impact, biggest contribution to the healthcare ecosystem?

Dr. Mitesh Rao (27:21):

Well, I'll tell you two things. One, today it takes so long to really establish even something like a clinical guideline because generating the data and the evidence takes so long and is so hard. And so speed of innovation, speed of engagement, speed of research, there are so many dimensions and aspects of that. Our lasting contribution is our core mission, which is creating a secure, compliant, common language of data across the country, a language that allow every provider, organization, regardless of whom, where, what their resourcing is, what their tech stack is, what their underlying support structure is, to be able to actually engage and be a part of that. Same with the patient side as well. Ensuring engagement, representation, and making sure that when we talk about things like research, drug discovery, safety and efficacy, clinical trials, we're truly representing the voice of everyone. That is our lasting contribution.

(28:20):

We took the road less traveled, we took the harder path in being able to bring these partnerships directly together. And the early years of it was challenging, but now we're at a stage where we're scaling quickly because we knew once we could get that model in place that it would be the right model. And so our lasting contribution is going to be building what we think is key digital infrastructure, really aligning these groups and allowing them to build these collaborations. They're going to transform healthcare for decades to come.

Brian Urban (28:49):

I love that because it's the foundation, the key architecture that is being built. You didn't say you're going to have the answer, the solution, the ultimate utopic solution. You said what you're going to do, and I think it reflects really well in where your organization started and how it's grown, is you're building a very strong foundation. You can't have a house sit on sand. It's got to sit on rock. And I love that you kind of took us that way. So I am so thankful, Dr. Rao, that we shared this time together. And for more exciting excerpts and insights, please visit us at finthrive.com. Thank you, Dr. Rao.

Dr. Mitesh Rao (29:34):

Brian, thank you to you and FinThrive. It's a pleasure to be on today.