By JESSICA DaMASSA, WTF HEALTH

Jamey Edwards, CEO of one of the larger in-hospital B2B telehealth startups in the US, Cloudbreak Health, is already seeing changes in the way hospitals are using his company’s telemedicine services in the wake of COVID-19.

From a noted rise in the rate of infectious disease consults, to “quarantine rooms” where telemedicine equipment is cleverly deployed to practice “clinical distancing” to minimize risk to front-line healthcare workers (and also preserve PPE), Jamey talks about what he’s seeing among hospital clinicians and what they seem to need most right now from telehealth providers amid the COVID-19 outbreak.

With changes to licensing regulations, HIPAA policies, and reimbursement changing the very infrastructure around telehealth, will we finally see virtual care become a true part of the healthcare system at-scale?

“One of the hardest things to do in our healthcare system is match cost to acuity,” says Jamey. “I’m not going to say we’ve overvalued the in-person encounter, but we certainly have been very hesitant to step away from it.”

“The fact of the matter is that that’s a bias. And so it’s up to us to look at these biases and say, ‘Well, no. What is the right way to do this?’”

Read the interview transcript here:

Jessica:

Hey, it’s Jessica DaMassa with WTF Health, What’s The Future of Health? We are doing a special series on the COVID-19 response of different health tech companies. And so joining me right now, I have Jamey Edwards. He is the CEO of Cloudbreak Health, which is a telehealth company. So Jamey, it’s great to have you with us.

Jamey:

Thank you. It’s great to be here, Jess, as always.

Jessica:

All right, great. So telehealth right now, having its moment. Even Trump said so.

Jamey:

Yes.

Jessica:

So if it got to him, here we are, right?

Jamey:

It was true validation for the entire industry, Jess, as I’m sure you can imagine.

Jessica:

The entire industry, waiting for that for years. So you guys have been around for a long time in your business. I mean you’re deployed, you have a pretty massive footprint in hospitals. I think it was 10,000 different end points last time I talked to you. And you guys got into start providing language translation services. So, I guess, give me real quick an update on what you guys are doing now. How have you sprung into action here? Using the agility of a startup that’s just raised $10 million to provide some support to the healthcare system virtually.

Jamey:

Yeah. Thank god we closed that round when we did, huh Jess? That was fortuitous timing, certainly. We had no idea what was coming and we are currently well-capitalized to go after and really contribute to helping solve or flatten the curve. And more than even a telemedicine company, we consider ourselves to be a healthcare disparity solutions business. And we do that by delivering telemedicine solutions.

Jamey:

So the first solution that we provided was helping limited English proficient, deaf, and hard of hearing patients achieve the same standard of care as our English speaking counterparts. But we realize now, we’re like, “Well, 1200 hospitals, 85,000 encounters a month, 10,000 video endpoints, what else could we do with this installed infrastructure?” And so we started rolling out new use cases in telestroke and tele-psychiatry. And it just so happened now that we are incredibly well positioned to help our hospitals deal with this COVID-19 crisis and pandemic.

Jamey:

And the first way that we did that was by allowing hospitals to basically effectuate their own quarantine rooms using our platform. They could roll the iPad into the room and then using the new app that we just released a few weeks back when COVID hit, they can now mitigate the distance between the doctor and the patients and help minimize their risk by taking those calls from outside the room and routing them. Yeah.

Jamey:

And so that’s one of the big deals is how do we protect our nation’s front-line healthcare workers. And so the first solution that we used was to put that into market. And then last week, we recently launched an at-home health solution. And that’s an effort to help keep people out of the hospital, which by the way, based on the numbers are looking, people are staying home and staying away from facilities.

Jessica:

Yeah. So, on that first part, I think that’s so smart. I always forget that telehealth, it doesn’t necessarily have to go direct to consumer in order to be impactful in the healthcare system. I always forget that. That it can go B2B within the health system’s walls and help prevent people from having to actually take the risk of going into the room with somebody. That’s really smart. What kind of response have you guys received from some of the providers who are using it this way?

Jamey:

Yeah, we have a ton of clients who are interested in getting it rolled out. We’ve already rolled it out at a few clients. The response has been very, very positive. And as you can imagine, Jess, you said something that was a very astute observation in my way to compliment the interviewer here, which was that you really recognize it.

Jamey:

B2B is a huge telemedicine market and people normally talk about telehealth in our country and they assume it’s a direct to consumer type of model. Clearly important here in the COVID use case, but even more important is making sure that they’re infectious disease consults available. Making sure that, again, we’re practicing social and what we call clinical distancing even within the healthcare facility to ensure that those front-line healthcare workers don’t get infected and they’re protected.

Jamey:

So, that B2B market is actually, I would tell you it’s probably bigger now than the direct to consumer one. But given what’s happening now, direct to consumer is on the rise in a pretty big way. And I think the interesting thing to watch is as this all settles down, Jess, are people finally going to understand that this virtual care is the right way to go as a first line of defense in our healthcare system?

Jessica:

I feel like we’ve been saying this for a long time. We’ve been recognizing how overburdened healthcare providers are and how you have these opportunities to kind of enter the system at some of these points where they’re the least expensive way to get in, it’s greater access to people. Everybody’s walking around with a phone so hopefully this is it. Pandora’s box has been opened for virtual care.

Jessica:

And I’d love to pick your brain on that, too. We’ve seen a lot in the last week or so with changing regulations, allow clinicians to practice overs state lines, which is huge. I know the industry has been asking for that for years. Also, some really aggressive reimbursement changes in policies so that things are being reimbursed at the same rate at parity as an in-office visit.

Jessica:

So Jamey, talk to me, I guess, a little bit about that side of things. Do you think that once… We’ve got these things instituted now in this time of crisis, but do you think that they’re going to stick, some of these changes?

Jamey:

I think it’s pretty hard to put… What’s the phrase? The whatever back in the bag.

Jessica:

The cat? Is it a cat?

Jamey:

Is it the cat?

Jessica:

I don’t know.

Jamey:

Is it a cat? I don’t know. I was going to say put the cat back in the bag but I was like, “Who carries a cat around in a bag?”

Jessica:

Someone [inaudible 00:05:29].

Jamey:

But anyway. Whatever needs to go back in the bag is not going to go back in the bag afterwards. I’m pretty convinced of that. I think we’re going to realize that telemedicine and virtual health is… Look, it’s another modality that makes sense to insert into how doctors practice care on a daily basis.

Jamey:

And I think we’ve, I’m not going to say we’ve overvalued the in-person encounter, but we certainly have been very hesitant to step away from it. And there’s a ton of stuff going on on social media and LinkedIn and there’ve been studies that have shown patients are more honest with AI. Patients are more honest with a little bit of distance from telemedicine. And there are a lot of doctors who are out there who are saying, “Well no, nothing’s going to replace the in-person visit.”

Jamey:

But the fact of the matter is, is that that’s a bias. And so it’s up to us in the industry to look at these biases and say, “Well no, what is the right way to do this?” And doctors, the thing I love about healthcare is, doctors are intrinsically evidence-based animals. And so if you can show them evidence-

Jessica:

I think they’re also intrinsically-based entrepreneurs. I feel like doctors are very entrepreneurial and they’re all gadgety-type people. They all really love technology-

Jamey:

Early adopters-

Jessica:

Yeah, early adopters. Absolutely, yeah. So I think-

Jamey:

… Which I think is a difficult thing to be in healthcare because we’re a risk averse industry on the whole. But I think one of the great things that the government has done, I’ll give credit where the credit is due, is say, “You know what? We’re going to take some of that risk out of the market right now and we’re going to let the market kind of rise to the occasion of good practice principles and we’re going to increase access to this technology in a way that can really help solve legitimate problems.” And so once that’s out there and I think enough people get the muscle memory of using telemedicine, I think they’re going to be really excited with the future of what that looks like.

Jamey:

And one are the hardest things to do in our healthcare system, Jess, is match cost to acuity. Why should someone with an earache go into an emergency department? I think we’re going to start to realize that there’s almost like a funnel, like there is in a typical sales company where it’s like, “Well, we’ve got the people who are at the top of the funnel and we need to get them down at the bottom of the funnel.” And the bottom of the funnel is going to be the hospital. It’s almost like an acuity funnel. Can we do that? Did we just coin something new?

Jessica:

Oh my god, hashtag acuity funnel.

Jamey:

Yeah. So it’s going to be the acuity funnel. And at the top, we’re going to have these really low acuity use cases and what’s the best way to do that? Well, it might be telephone and video. And then we’re going to say, urgent care. Well, what’s the best way to do that? Well that might be telemedicine and then in-person visit. Just going all the way down to that bottom part of the funnel, which is the highest acuity, highest cost. But also, that’s going to be the hospital-based acute care health system.

Jessica:

And I know there was a lot, not a lot, but there was some rumbling starting that just, I had heard even before COVID came around where people were talking about Virtual First health plans and really kind of figuring out, to go along with your acuity funnel, how do you match up the payment systems so that it goes along with that. So that people are encouraged or incentivized, more or less, to use those lower costs entry points for lower acuity things. And then save the real serious stuff for the hospitals.

Jessica:

So, and Jamey, I’m curious, too, on the language side of things. Just thinking ahead, even with COVID, if things get really dicey as they’re predicting that they will, paint a picture for me, I guess, about some of the things that you’re going to be able to offset as far as language is concerned and helping people understand what’s going on.

Jessica:

I would think one of the scariest things would be to be in an emergency situation dealing with healthcare information, which even if you are a native English speaker, oftentimes doesn’t feel like English coming at you. And you don’t speak the language. So, I guess talk a little bit more about those language services and how you see this filling a role as the virus outbreak, as more people get sick.

Jamey:

Well, we’ve built a core competency as a business about helping people who typically are in a scary situation, who don’t understand what’s happening around them, empowering them to take control of their care. So, that’s one side of the equation.

Jamey:

The other side is the physician side. So on the physician side, if a doctor doesn’t speak the language of the patient, it’s all the medical follies happen after that. You order a bunch of defensive medicine. You’re trying to diagnose with tests instead of with communication because communication is the number one diagnose… I think I say this in every interview. Communication is the number one diagnostic tool that a doctor has. And the number one patient empowerment tool. And so, one in five patients in the United States speak a language other than English in their home primarily. And that number is growing. And we have a lot of tourism in this country as well.

Jamey:

And so the need for language services is becoming more and more important. And if we think about how COVID spread, coming from China to this country, et cetera, and spreading throughout Europe like this, this ability to communicate and collaborate in a unified way is becoming even more critically important.

Jamey:

And so what we’ve seen, if you take a look at our volumes, our hospital volumes have actually been ticking down a little bit. So everyone talked about our health system being overwhelmed. But I think the general public has gotten the notice.

Jessica:

Yeah.

Jamey:

I think the general public has gotten the notice that, “Hey, we shouldn’t go to hospitals unless we have to.” And so what we’ve seen is, those ambulatory, I’m showing up to the ER visits that we would normally get over the platform are now migrating to all of our interoperable telemedicine platform partners-

Jessica:

Oh okay, cool.

Jamey:

… Right? So the folks who could be out there like American Well or like MDLive or whoever it might be. Where there’s going to be more and more visits that are migrated that way. And so we, as a company, have said, “Hey, from a language services standpoint, those companies need to take advantage of our interoperability to bring interpreters to the point of care for their patients.”

Jessica:

All right, so if a healthcare system still needs you, Jamey, is it too late to roll you out or are you easy to plug in at this point? Is it all virtual [crosstalk 00:11:05]-

Jamey:

So easy to plug in, Jess, so easy to plug in.

Jessica:

All right. I’m asking legitimately. Because we know how slow things usually move and so it’s like if somebody is sitting there in a hospital, especially I would think that may need the language services or not ,but maybe a rural hospital that’s hanging on for dear life or ready financially that really wants to plug in and have access to that B2B in-hospital to in-hospital telehealth to talk to an expert someplace in their regional healthcare center. Great. And so it’s not too late to plug that in?

Jamey:

No. And in fact we were one of the first people in the country to actually launch a free app that allow these hospitals to take advantage of using the Cloudbreak platform. And look, it’s not going to be free forever but it’s free during the crisis because we’re just trying to contribute and, quite frankly, it’s a new use case for us and we’re learning along with everybody and we’re just trying to be a good collaborative partner.

Jamey:

So we actually, I believe it’s cloudbreak.us/COVID19 and you can actually go, fill out the form, and we’ll just issue you the ability to download the app and a user ID and you can just get going. And for these rural hospitals, you’re absolutely right.

Jamey:

Look, HIPAA’s been thrown out the window to a certain degree. State licensing has been thrown out the window. Let’s throw out the contracts, too. We’re trying to make it as easy as possible for people to sign on and just get access. And we realized that as part of our mission to humanize healthcare, offering this platform for free now is exactly the right thing that we should be doing and we’re going to continue to take a leadership position there.

Jessica:

All right, Jamey, well thank you so much for chatting with us. Any last… I know you are in Los Angeles, you have been on lockdown for a week now. Any good chill in place advice you’d like to pass along to those in the rest of the country who are just new to this?

Jamey:

Yeah, I guess my mantra has been, don’t be silly, don’t expose people unnecessarily. Being home is definitely tough. Being home with a family, that’s a tough thing. Kids are being all homeschooled right now. I think it’s been pretty amazing to actually see how LAUSD and everyone has adapted to everyone making Zoom calls for their educational purposes.

Jamey:

But I think we need to realize that from an exposure standpoint, and I’ll be honest, I personally view coronavirus as something very flu-like. And it’s just kind of in its stages of getting out there and getting more exposed in terms of people catching it in public. But let’s make sure that we don’t expose our elderly. Let’s not… I was shocked to see down in Florida, people all partying on the beach and everything that was happening there only because, as much of a challenge it is to stay at home and be on lockdown, it’s not like people are saying, “Don’t leave your house.” You can still take walks. Just be responsible, stay six feet apart. Let’s not hug, let’s use our elbows. Let’s air hug.

Jamey:

But let’s remember that we have grandparents. And that realization of, “Well, if I get sick and I don’t know I have symptoms for two weeks and I go see my grandmother because I want to check in on her, I could potentially be doing her harm.” So those are the types of things. People just need to be conscientious and realize that we’re all part of being the global citizen instead of just thinking about yourself as a single citizen.

Jessica:

Jamey, thank you so much. Pleasure to talk with you. For those of you who are out there watching, don’t forget to check out the other COVID-19 type interviews that I’ve done in this series. They’re all up on my YouTube channel, youtube.com/wtfhealth. I’m Jessica DaMassa, Jamey Edwards from Cloudbreak Health. Pleasure to have you with us. Thanks for joining us.

Jamey:

Thank you very much. Thank you for having us and thank you for spreading the word, Jess. You’re doing great work.

Jessica:

Ah, thanks Jamey.