Health-e Law Podcast Ep. 3
Digital Health to the Rescue: Improving Access to Specialized Care with Viveka Rydell-Anderson of Pacific Vision Foundation
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Listen to the podcast released December 7, 2023 here: https://www.sheppard.com/multimedia-538
Welcome to Health-e Law, Sheppard Mullin's podcast addressing the fascinating health-tech topics and trends of the day. Our digital health legal team, alongside brilliant experts and thought leaders, share how innovations can solve some of healthcare’s (and maybe the world’s) biggest problems…if properly navigated. In this episode, Viveka Rydell-Anderson, CEO of Pacific Vision Foundation, joins us to discuss the critical need for specialized care and how emerging digital technologies can help overcome access challenges.
About Viveka Rydell-Anderson
With over 20 years of experience as a lawyer, healthcare executive, and innovator, Viveka Rydell-Anderson is a passionate trailblazer in the realm of healthcare equity and access.
Viveka is the CEO of Pacific Vision Foundation and the president of the HIMSS Northern California Chapter. She has deep experience in FemTech and specialized care spaces, among her many other impressive achievements, including holding a Master of Science in Clinical Informatics Management from Stanford University School of Medicine in addition to her law degree from UC Berkeley.
Before taking on her current role, Viveka spent 14 years as CEO of PDI Surgery Center, a nonprofit Ambulatory Surgery Center providing specialty dental care to children and special needs patients in 30+ California counties. She then co-founded two MedTech startups: ImageChain.ai and Mamsen Health.
About Sara Shanti
A partner in the Corporate and Securities Practice Group in the Sheppard Mullin's Chicago office and co-chair of its Digital Health Team, Sara’s practice sits at the forefront of healthcare technology by providing practical counsel on novel innovation and complex data privacy matters. Using her medical research background and HHS experience, Sara advises providers, payors, start-ups, technology companies, and their investors and stakeholders on digital healthcare and regulatory compliance matters, including artificial intelligence (AI), augmented and virtual reality (AR/VR), gamification, implantable and wearable devices, and telehealth.
At the cutting-edge of advising on "data as an asset" programming, Sara's practice supports investment in innovation and access to care initiatives, including mergers and acquisitions involving crucial, high-stakes and sensitive data, medical and wellness devices, and web-based applications and care.
About Phil Kim
A partner in the Corporate and Securities Practice Group in Sheppard Mullin's Dallas office and co-chair of its Digital Health Team, Phil Kim has a number of clients in digital health. He has assisted multinational technology companies entering the digital health space with various service and collaboration agreements for their wearable technology, along with global digital health companies bolstering their platform in the behavioral health space. He also assists public medical device, biotechnology, and pharmaceutical companies, as well as the investment banks that serve as underwriters in public securities offerings for those companies.
Phil also assists various healthcare companies on transactional and regulatory matters. He counsels healthcare systems, hospitals, ambulatory surgery centers, physician groups, home health providers, and other healthcare companies on the buy- and sell-side of mergers and acquisitions, joint ventures, and operational matters, which include regulatory, licensure, contractual, and administrative issues.
Phil regularly advises clients on matters related to healthcare compliance, including liability exposure, the Stark law, anti-kickback statutes, and HIPAA/HITECH privacy issues. He also provides counsel on state and federal laws, business structuring formation, employment issues, and involving government agencies, including state and federal agencies.
Transcript:
Phil Kim:
Today's episode of Health-e Law is on specialized care, including femtech.
Sara Shanti:
I'm Sara.
Phil Kim:
And I'm Phil.
Sara Shanti:
We're your hosts today and we want to thank you all for joining us.
Phil Kim:
We're pleased to have Viveka Rydell-Anderson with us today, and she is the Chief Executive Officer of Pacific Vision Foundation. Viveka is a lawyer, healthcare executive, and an innovator with years of experience in the digital healthcare space. She holds a master's science degree in clinical informatics management from Stanford University School of Medicine, as well as a Juris Doctorate from UC Berkeley School of Law. She's also the president of the Northern California chapter of HIMSS. She works in the healthcare space, the particular interest and experience in femtech and specialized care. Thank you so much for joining us, Viveka.
Viveka Rydell-Anderson:
Thank you for having me. I'm pleased to be here.
Sara Shanti:
Yes, we're thrilled to have you with us, Viveka. And as we noted, we're going to be chatting about specialized care today. So just tee us off with your experience and expertise. Can you talk a little bit about what is specialized care generally?
Viveka Rydell-Anderson:
Absolutely. So specialized care would be something that's kind of harder to access than kind of your primary care physician or your first instance of when you go to your doctor with a cough if you're lucky to go to your doctor's office or a federally qualified health center or what have you. So something for example would be if you need a referral for behavior health, maybe you're having mental health challenges, you need support around that. Maybe you have been to your optometrist to get your glasses, but they find something on your eye and they realize that you need to talk to a specialist, maybe an ophthalmologist, and maybe you need cataract surgery. Also, elder care, that could be another care where you would like to have some additional help, maybe some monitoring in your home.
Phil Kim:
How are you seeing new and emerging technology used in specialized care?
Viveka Rydell-Anderson:
So what I see is, first of all, I think we should acknowledge just the slog that it was before the pandemic in terms of getting payers to pay for telehealth. I have been working with rural populations since 2006, and it was always very hard to get any kind of help or payment. For example, there were not enough dentists in rural areas of the United States and a lot of efforts were taken to try to get dentists to be allowed to be Zoomed in remotely to see patients in rural areas. But because the payment wasn't there nor the will from the providers, it was really hard to do. Well, the pandemic came and as we know, all that kind broke up all the gateways. And so that is a huge acknowledgement of just the power of a crisis to let us just leap forward in a way that bureaucratic and legal and all the regulatory, all those things that we couldn't get past for years and years and years.
Now because of the crisis of the pandemic, telehealth has seen amazing increases in use. In 2016, the percentage of physicians using televisits or virtual visits grew from 14% in 2016 to 80% in 2022, while the percentage of physicians using remote monitoring devices grew from 12% in 2016 to 30% plus in 2022. So again, I just want you all to realize that the world we had before the pandemic was one in which physicians did not feel comfortable in big numbers to use digital health tools. But we have now seen a lot more physicians, clinicians, and anyone else really working with patient interaction, being more comfortable with it. So it's a huge leap forward
Sara Shanti:
Yeah. And we've seen that access to healthcare, specialized care are just huge topics of the day. So can you describe a little bit about where we are today with access? You just mentioned telehealth and remote monitoring, which has had a huge uptick. Are you also seeing that there's an uptick in need for specialty care because it's more accessible now or is it still the same issue, a lot of people don't know that they have this access because of where technology is at the moment?
Viveka Rydell-Anderson:
Sure, there's some more tracking of it, but there's always been a huge unmet need in the United States for healthcare overall, but even more so in specialized care because there's just more hoops to jump through. And of course, we've also seen that if patients don't have Wi-Fi where they live or broadband, then it's hard for them to use telehealth. So we still haven't gotten past where there's still a lot of inequities in terms of who has access to these solutions.
Phil Kim:
So Viveka, do you want to help us understand how digital health can help promote access to specialized care? So what have you seen in terms of patient response to using new technologies that have come into play, not only during COVID, but since then?
Viveka Rydell-Anderson:
So I think there's a couple of themes to think about. One is that if it was hard for you in the past to access care because of transportation issues or you weren't close to an academic center, now it's easier for you to navigate the tools online. Also, a lot more patients have gotten more digitally savvy, so they know how to access the care, whether or not it's using their phone or their iPad or a computer. And so what I see is this movement or a trend, of course, that we want, instead of something just being episodic when you go into the office, you might have a device at home now that is tracking you continuously. Which for example, if we're just going to heart care for people who might have AFib or other things with their heart, it's much better if the physician can see you over a longer time rather than just those few times that you make it to a doctor.
So I think it's, again, I want to make sure we share with the audience the larger movements underfoot that can happen with digital health is that you go from sick care, to healthcare, and you actually do more prevention. And one of the ways to do that is to use digital health and remote monitoring devices to have continuous monitoring of patients, which gives the doctor a lot more data, and also allows them to see how they might prevent bad incidents from happening. And again, transitioning from that physical space to the virtual, there is a lot more access for the patients to reach a support team in the hospital. And that's a good thing. That helps get a lot more access to them.
Phil Kim:
Yeah, that's great. We see providers embracing this and the benefits ultimately for the patient. And so do you see patients embracing this technology?
Viveka Rydell-Anderson:
Absolutely. I think there has been a huge uptick. The patient experience has been one where they don't want to have any of the clunkiness. So I know a lot of new products that come on the market, they have to make sure that it's not a burden, including the process to download the app, that it’s kind of instant, there's fewer kind of passwords or click throughs they have to do to access the app. But of course, they also have to be very cognizant of making sure that there's enhanced security and privacy measures. We see that as an emerging kind of field. Of course that's always been important, but one of the trends that we're seeing is definitely enhanced security and privacy.
Sara Shanti:
So I think that's really important because we've seen that and are hearing a lot of that feedback where there's some great innovations, really exciting, but they're not as user-friendly for the patient to navigate. So unless you have the usability and the buy-in, are you seeing that, that it sounds great on paper, but are you seeing where there is a little bit of a disconnect with what patients actually need? And can you speak to either developers out there, innovators out there of what they should maybe be thinking about to have a really marketable product to meet these needs?
Viveka Rydell-Anderson:
Absolutely. What we see is, if they're using up too much memory space or if there's some technical problems, of course then the users are going to fall off. But if the team that's coming with a new solution, if they don't do their research and really plan out for the process execution and for bringing on those new consumers, they're just going to fall off. So any little thing in the middle there, users will just be turned off and then they won't adopt it. And of course, that's what the systems will look at. Well, how much is it being used? And if you're not on top of that, you're not going to have good outcomes.
Sara Shanti:
And what about providers then? So we've talked a little bit about what patients want and what developers need to consider. We of course are all hearing about provider burnout and specialty care is of course really important to have the right specialty professionals in those roles. What are you hearing and seeing from what providers want to support them?
Viveka Rydell-Anderson:
We learned many years ago from the implementation of the electronic health records in the systems, clinicians do not want to have to click through another screen or another box. And during the pandemic, they did not have to do that. We now have a lot more natural language that's being used, the augmented intelligence that we have. If you ask patients, "Can we record this interaction?" Then we're actually going to have things that are transcribed for the physicians and so they don't have to spend all those hours taking notes after they've met with the patient. They can also then make recommendations to the patient using words that the patient uses so the patient also feels more seen and heard in their own language.
And so what we really want to do is make sure that artificial intelligence and all these other digital health applications and natural language recognition tools are being used so that they augment the clinicians, whether or not it's a nurse or a medical assistant or it's the doctor, so that they can do what they're good at and really pay attention and look at the patient either on a telehealth visit or when they're in the office and don't have to be turned around and clicking through very burdensome interfaces on their computer. So it has to be easy to use and all that data, again, talking to the patient in the kind of language that they were using rather than scary language that doesn't make them connect. So if it's going to be useful for everyone, we might make sure that there's inclusive language and we talk in layman's terms to patients about their wellness journey.
Sara Shanti:
So we know that you are a jetsetter and you get a lot of exposure to some really cool ideas and innovators and the thought leaders out there. Anything that you can share with us, and you don't have to name names, but of some really cool technology or themes of technology that you think are going to make a big difference?
Viveka Rydell-Anderson:
Well, absolutely. I'm going to say there's really cool things that if we think of technologies as a tool, things that can scan the retina and find if you have diabetes, they can find it much earlier on. The next level then is to say, well, we need to make sure that in every rural area around the country, also in underserved areas, that there is actually someone who can read that information. So it's not just a matter of getting those devices into all the places in our country, but also to make sure that the technology is so smart that it also provides a diagnosis that says, "This person needs to be sent to a specialist." And if we don't do that, then we have shiny toys, but nobody will know how to read them because there's a provider shortage.
I think digital health solutions that can also solve for how we are going to meet the clinician shortage. So that's a very important piece. The other piece is those technologies that can really hit the nail on the head, and I see some of those without mentioning names, but those that can really support the clinician so that they avoid burnout and be a partner for them, they are also going to do well. I think in the femtech space, and that's the female technology space, a lot of people might think of that mostly as efforts for fertility management, but of course there's also tools for prenatal management, whether or not that's for the physical body or for mental health, making sure that people are flagged early on if they're going to have postpartum depression, things like that. OB-GYN in general. Also, menopause. There's a lot of those technologies in femtech that haven’t been talked about because so much of the medical research for so long was really more on the male body than the female body.
I think there are a lot of taboos around things that can be solved. I also think for the men, I think things around prostate cancer and support for those needs, I see a lot of exciting things there. So I think that some of those taboos almost make it easier for people to access care when they don't have to meet in person with somebody. But it's also because it's a telehealth visit which makes it easier for them to talk about hard things, whether or not it's around sexuality or mental health. But also if there's an app that they can use in between visits and that also allows them to learn a lot more about themselves. So I think it's also a tool, as they allow tracking and seeing in numbers how they're doing on certain metrics. I find those to be really exciting out there.
Phil Kim:
So we know you wear a lot of hats, as we mentioned in our intro of you. You're a lawyer, you're a healthcare executive, you're an innovator. And so if you were to put on your lawyer hat, where do you see this all headed? How do you see businesses having to adapt? Are they having to navigate all the different myriad of laws that they have ahead of them?
Viveka Rydell-Anderson:
Well, absolutely. I think it's just we're going away from the one size fits all and we have to get to the personalized and you have to adapt to that. And so you have to make sure also that in... It's almost like the billable hours. The fee for service system for healthcare has been around for such a long time, it's going to have to become fee for outcome. It's going to have to be the evidence-based medicine, and focus on whether are we actually making people well instead of are we treating and are we just getting paid for the sick care that we're providing. Or are we actually on a larger scale, getting a healthier population? And if we're not doing that, then we're misspending our money. So I think those pressures will come also from the payers, that it has to be evidence-based, and they want to see good outcomes. The system just won't allow for it anymore, where it's fee for service on the healthcare space.
Phil Kim:
Thank you so much, Viveka. We really appreciate your time. And that's it for us here on this episode of Health-e Law. We will see you all next time.
Contact Info:
Phil Kim
Digital Health Attorneys | Sheppard
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