By JESSICA DaMASSA, WTF HEALTH
“What’s happening in COVID is those of us living with these chronic conditions are at highest risk — not to contract the disease, but highest risk for outcomes. Our unique ability to be able to see what’s happening in that population and deliver that care remotely is incredibly valuable always, but, particularly, in this strained time.”
Livongo Health has always been committed to helping its members (people with diabetes, heart disease, and other chronic conditions) manage their health “where they are.” Collecting loads of patient data along the way. As the traditional health system grapples with caring for those infected with COVID-19, what changes? What role will digital health companies like Livongo play as they continue to provide front-line, day-to-day care to their members and customers amidst the challenging environment of this pandemic?
Dr. Jennifer Schneider, Livongo’s President, stops by to chat about what’s happening at Livongo now as the country looks to virtual care solutions to help shore up capacity for the traditional health system. As the spotlight is turned to digital health, we get Jenny’s perspective on what it will take for health tech companies like hers to continue to prove their value to healthcare incumbents and to patients who have a growing need for their help managing their everyday health.
Read the interview transcript here:
Jessica: Hey, it’s Jessica DaMassa with WTF Health, What’s The Future of Health? I am doing a special series on how health tech companies are handling Covid-19, so who better to ask than the President of Livongo, Dr. Jenny Schneider. So Jenny, it’s a pleasure to have you with me today.
Jennifer: Thank you, Jess. Great to see you again.
Jessica: Great to see you too. I know we are both sheltered in place in California, so it’s a pleasure to talk to you. I’m like, I’m dying over here myself actually.
Jennifer: I know for extroverts like you it must be hard and I need you. I miss you. My hair is missing you. Usually you comb me down before we do these.
Jessica: Yeah. Right? Thanks. So I want to jump right in, Jenny and just talk to you I guess about what’s going on at Livongo. So it’s been really interesting tracking all of the news about Covid-19 and about how there’s a lot of concern about the overburdened health system, increased traffic, patients waiting in waiting rooms and people not getting care. This is something in health tech people are worried about for a long time and trying to solve for. But I’m curious, as far as the Livongo’s concerned, the type of care solution that you guys have built, how do you see your role in all this in terms of helping offload the burden of the traditional healthcare system, especially as those hospitals start to reach and exceed capacity with people who are sick?
Jennifer: Yeah, it’s a great question. So as you know, our mission at Livongo is really about empowering people with chronic conditions to live better and healthier lives and the approach we’ve always taken is to meet our members where they are in their own life. So we’ve built an ecosystem, a solution where we can collect their data very passively and give recommendations right back to them without having them swerve out, without having them go to the doctor’s office. So meeting them in their home, in their car, on the sports field, wherever they are. So in this ecosystem, one of the things that we continue to do is be incredibly focused on our members and delivering care. Our very unique abilities, understanding people with chronic conditions, diabetes, hypertension, we can actually understand and see their data to give recommendations. We’ve been able to do that all along.
Jennifer: It’s incredibly important for those vulnerable populations in this time that we keep them outside of exposure areas and to be able to deliver care. If you look at sort of what’s happening in Covid, it’s those of us living with these chronic conditions are at highest risk not to contract the disease, but highest risk for outcomes. We’re all equally likely to be infected, but those of us with vulnerable populations of chronic conditions are more impacted in terms of the outcomes. So our unique ability to be able to see what’s happening in that population and deliver that care remotely is incredibly valuable always, but particularly in this strained time.
Jessica: All right, I want to go back. I want to go back on two things. The first thing I want to go back on here is the data. So I know you guys have your AI, AI engine and you’re collecting all of this different biometric data from your members and you’re feeding it back to them in real time. So I guess are you able now during this time, are you guys watching the data of your members to see if there are any unusual blips or things that might indicate illness? How are you guys handling that now? I’m curious.
Jennifer: Yeah, it’s a really great question. So one of the things that we can do is we can track trends and patterns in people. So if we start to see someone who’s been very well controlled with their diabetes in an endemic area or a high concentration area and we start to see AB normal or abnormal blood glucose readings, it’s an indicator that there may be signs of infection. So we know that in people with diabetes, when they have infections, virus and otherwise, blood glucose levels tenderize. We also know that the support in the setting of Covid-19 or in any other virus or illness for people with diabetes and for hypertension is to help with supportive measurement.
Jennifer: So this is again looking at medications, looking at foods, giving recommendations for fluid intake, exercise, rest. That’s something that we’ve been able to do and been set up to do both through our digital components as well as our certified diabetes educators and other coaches who can also provide that coaching real time to our members in the setting of the data. I think, again, this underlying component of the setting of the data is really important to be able to provide specific recommendations.
Jessica: Okay, onto that data. So in all of this, we had those HHS interoperability rules yet passed and whatever, but we are so far from having that implemented. So the Livongo member that has all of this rich data that you guys have been collecting, can you take that as a member and bring that into a different healthcare settings? So say heaven forbid somebody does get sick, what are they able to actually take with them from the data that they’ve got managing their chronic conditions with Livongo? What are they able to take into the hospital setting or to their doctor’s office with them?
Jennifer: Yeah, it’s a great question. So I think one of the most valuable assets of our solution is again, all of our data, whether that’s blood pressure, weight or blood glucose for the different solutions is all captured through a cellular enablement. So you don’t have to pair Bluetooth, you never have to write anything down, and we give that data in a summary report directly back to the member. We can do that in a variety of different mechanisms. We’ve also integrated those data reports into electronic health records, a number of electronic health records so that the providers can see that.
Jennifer: But we’ve made it incredibly seamless for any individual member to share that data with whomever is on their care team. It may be their parent. It may be a nutritionist. It may be their doctor. But we have that study in the data sharing. We put the member at the center to give that to other people. So it’s been very seamless and a great tracking mechanism. We often hear stories of members who have something new come up and the doctor will ask, “Well, have you been recording?” And they say, “Actually, here’s all the data,” and it’s just seamlessly there in a report.
Jessica: That’s perfect. And on the virtual care side of this, lots of excitement in our industry about how quickly some of the regulations have eased up to allow different practitioners to practice across state lines now. We saw Blue Cross Blue Shield of North Carolina issued this press release saying they’re going to start reimbursing telehealth services and virtual care services at parody with in-office visits. So as far as all that goes, you guys have a virtual care and telehealth component [inaudible 00:06:43] kind of in two different ways I as I understand it, right? So there’s the coach that can kind of come in and talk you through things, that’s provided virtually, and then you guys can refer out. Is that right? So tell me a little bit-
Jennifer: Yes, both are-
Jessica: Yeah, so tell me a little bit I guess how you guys are positioned here because you’re in a unique spot, right? You’re not like a traditional virtual care like a telehealth provider, like a Teladoc or an MD Live or something like that. But you’re kind of in the middle section and you’re focusing on such a niche population in terms of helping them manage their chronic disease every day. So tell me I guess how you see this all fitting in and what you see your role being as things start to get a little bit more serious here in terms of the number of people who are presenting with Covid-19.
Jennifer: It’s a great question. So I’m going to start with saying I think that the world has been shifting toward more and more virtual care over time. I think the tipping point of Covid-19 has made that very apparent to people that the time is now and the benefits of remote monitoring and telehealth services are very, very high. We are positioned to care for people with chronic conditions. Remember there’s 140 million of us living in the United States with a chronic condition. Our value proposition is to collect that data seamlessly so we can deeply understand where anybody is and where they’re tracking, give them some nudges digitally and then pair that with a coach, a live person when they need it.
Jennifer: We’ve also partnered with MD Live and Doctor On Demand to escalate when they need a provider. Now the difference is tele-health doesn’t have access to all of those underlying data, so it’s harder to make a recommendation. So the partnerships that we’ve formed are really a win-win across the ecosystem and predominantly for the members where we remain hyper-focused. Again, this is the setting of Covid-19 I think has accelerated the attention in this area and I believe that we’re at a tipping point that the value proposition above and beyond Covid-19 is now being more fully understand and that the ecosystem, healthcare education, otherwise will start to shift. Zoom interviews, maybe we’ll do more of these.
Jennifer: Which will be a little sad for me, right? But I think that there’s some realization more broadly around the technology and the ability to reach people and fit things in that are here to stay. And that’s a very positive thing for us.
Jessica: All right, let’s have some good news here and take that a little bit further for me, Jenny, because I’m curious, this is the tipping point you say and I think a lot of people are looking at that. If you go on Twitter and just have a look at any of our health tech friends, it’s just like as far as virtual care is concerned, people are like, “The genie is out of the bottle. This is it.” So paint a picture for me. I think longterm, best case scenario, we all get past this.
Jessica: What does this do for companies like Livongo companies that are digital health company or health technology companies as far as the way that we interact with the traditional healthcare system? Do you think this was our moment to prove ourselves? We’re going to step up and we’re going to nail it and so we’re all going to be in a different place down the road? I know I’m asking you to kind of look into your crystal ball, but from your perspective as you’re looking ahead to what we’re going to get through this just fine, what does the other side of this look like?
Jennifer: Yeah. I think of the broad picture of what value are we offering to our members, all of us in the healthcare ecosystem? So if we can create an ecosystem whereby we can keep specialists performing knee surgeries and back surgeries and making sure that the flow through is matched with the demand and we’re not overwhelming that and we allow people to practice where they’re best, we’re going to deliver the best healthcare system. In that ecosystem our ability to continue to deliver messaging and behavioral change and deliver outcomes for people with chronic conditions who don’t live in the hospital walls, don’t live in the provider offices is really high value. I think connecting as we’re doing back into the ecosystem when they need to go to the hospital and when they need to see the provider is going to have incredible amounts of value. So I do think it’s not a hospital versus digital.
Jennifer: It is how does the whole ecosystem work together? I think one of the things we’re all acutely experiencing now is that the hospital brick and mortar in surge times cannot handle the capacity, right? So it’s again making sure that in surge times but also in regular times is the capacity right? Are we managing people where they are and meeting them where their healthcare needs are? And I do feel very proud of the ecosystem, the digital ecosystem, around the efforts that we’ve all been driving toward and making to make that better reality and make that happen for people. So again, I think the ecosystem will become out stronger because in this setting of inpatient and digital, we’ll have a better optimal experience for members. It’s not either-or. It’s a combination and getting that balance right for the combination.
Jessica: I have to say to you, I’m really impressed with how agile the incumbents have been in front of this. I really think that they’ve kind of stepped up. Like, okay, let’s do this. Let’s look at the way they’re reimbursing. Let’s make this fair. Let’s try what we can. Onto that point, as far as folks who have maybe not integrated Livongo into their healthcare plan or are providing Livongo to their employees, is it too late to talk to you guys at this point? Let’s say somebody’s watching this and they’re like, “Oh my gosh, really this would be great for our population to have, our folks who are managing chronic conditions kind of have this helper little niche to go into to have their data collected just in case.” If somebody wanted to deploy Livongo at this point, are you guys able to take on a bunch of new customers? Can you guys turn this on remotely? Can you act quickly in a disaster situation here?
Jennifer: Yes and yes. We are set up to be able to do this remotely. That’s not an issue or a problem. We have maintained incredible focus for our own employees, ensuring that our employees are healthy, happy and productive and so we’re ready. So we understand that the value add that we have in this ecosystem, particularly in this time, is an opportunity and an obligation that we have to ensure that people in the United States are receiving the proper care that they can. So the answer is yes, we’re ready. Yes, our employees are continuing to work. We’ve not slowed down. In fact, we’re actually in an acceleration period because we have both an opportunity and an obligation to make that happen.
Jessica: Awesome. Well, Jenny, it’s crazy times and there’s a lot to be concerned about, but I mean there’s a lot to be excited about in terms and, and proud of really I think with how the industry has been responding to this so far. So thank you so much for stopping by. Hey, last thing for you, do you have any shelter in place tips you want to share with anybody? How are you getting through this? I understand you’re homeschooling children. Oh my gosh, Jenny.
Jennifer: Yes. So what I would say is I have a seven-year-old, a nine-year-old and an 11-year-old, all of whom are at school, first, third and fifth grade. I’m learning lots of United States geography that I have forgotten over the years as well as how to divide fractions. I hadn’t done that in a while. But my tips are actually that human nature is human nature so bribery works very, very well for young children. It’s actually why it’s quiet right now. So thanks for this opportunity to have some quiet in my own house. So thanks, Jessica.
Jessica: I love it. No problem. Jenny, thank you so much for joining us. Best of luck with everything as you guys continue to help the health system, traditional health system, take care of all these folks out there who are sick. We’ll talk to you soon, hopefully in better circumstances than this. Thanks so much, Jenny.
Jennifer: Sounds great. Stay safe.
Jessica: I’m Jessica DaMassa with WTF Health.
Jennifer: Thank you.
Jessica: Thanks so much for joining us.