Healthcare startupVida (@JoinVida) recently launched an integrated enterprise continuous care platform for chronic health conditions, designed for the 133 million Americans — nearly 1 in 2 adults — living with at least one chronic illness.
Vida, which offers 24/7 care in a one-on-one or team-based model, helps users manage their chronic conditions with the help of health coaches for conditions like obesity, diabetes, and hyperlipidemia. The app essentially combines features like those of Yelp to match a user with health coaches, Skype videoconferencing and instant messaging with coaches, and charting blood pressure and weight with Apple HealthKit and wearable device integration.
The team has kicked off IRB-approved trials at multiple major healthcare systems. Vida will be tested at the University of Texas, MD Anderson Cancer Center for managing metabolic complications from long term high-dose steroids provided to leukemia and multiple myeloma patients. Vida will also be tested at Duke Medicine for managing cardiac rehabilitation patients.
Why is this important? Amidst the sea of fitness apps and calorie counters, chronic health conditions comprise a more difficult public health issue that start-up and healthcare technology companies tend to shy away from.
We spoke with Vida co-founder Connie Chen, MD (@ConnieEChen). Dr. Chen has had extensive experience in digital health including prior positions at Health 2.0, Stanford University’s StartX Med as Medical Director, HealthTap, and Kaiser as Digital Health & Innovation Principal. She currently practices in San Francisco.
What inspired you to create this product?
I’m a primary care physician and I see patients in San Francisco. It’s just so frustrating to see patients with chronic conditions. You see them every six months for 15 minutes, and you don’t really have that time to understand what’s going on in their lives, and what their barriers are, and what their resources are to make hard, but really important, behavior changes and lifestyle changes to really change their condition. That includes taking their medication and monitoring their data regularly
I’ve been fascinated by the research about team-based medical homes that can be powerful to provide extended multidisciplinary support for patients, but it’s hard to show a positive return-on-investment because it’s very expensive to hire so many care providers when you know reimbursements for primary care have been so low and been cut so much over the years.
What do you hope to accomplish with Vida, then?
Our vision for Vida is to power a team-based easy-to-use technology to radically reduce the cost, and offer a service that’s very patient-centered in terms of the experience.
We have over 20 specialties represented nationwide, and we dynamically match the best coach with them.
That makes sense. But don’t some health systems already have case managers that follow up with patients?
If it’s a traditional model, there may be one coach in the clinic that works with the patient.
But it’s really hard to have a single health coach that can [interpersonally] get along with the entire clinic panel. The coach is really like an expert support and mentor, and you can imagine that depending on your age or cultural background or your personality, [your interaction with such a coach is] probably dependent on finding the coach that’s the perfect counterpart for you.
With our marketplace, we can pair people with not just one assigned coach, but really the best coach for them. I think it really contributes to high engagement. We can also provide access to multiple coaches at once to cover different specialities or specific medical concerns a patient may have.
How does Vida’s technology work?
On the technology side, we built an iPhone and iPad app… [with] an Android app [slated for release in] early 2015. With mobile devices, [it’s more personal]. There traditionally have been a lot of web-based platforms over the year. We want to create something that people can’t easily ignore or pretend doesn’t exist.
We chose to build our own backend care management platform in-house. What it is [like] is Salesforce, with a population management platform, allowing our coaches to see an entire panel, and easily see how people are doing with clinical engagement, and whom to prioritize reaching out to. It’s also where you do all the texting, auditing and compliance [activities], and store clinical notes. It’s also where they can access our program library. Our patients are enrolled in something more structured, like a specific diet or a specific education program, with more oriented goal-setting with their coach. We have evidence-based clinical programs like the Diabetes Prevention Program.
This sounds like a phone bank, except smarter.
It also allows us to use a team-based approach with multiple coaches to provide a view for case managers to be able to see [their entire caseload].
It’s really a platform to use coaches and leverage them in a compassionate way. It’s like a nurse phone bank. But we are lower cost than a traditional phone bank model with much higher engagement. We really attribute this to the platform: the coach can do things that are automated, but they are required to inject personal touches into their messages, one-on-one, like a CRM (customer relationship management software).
The whole program is designed to orient people towards texting, which is so much more efficient. You maintain a daily touchpoint, but you provide precise text messages. That’s a lot more efficient than getting them on calls. In an hour, you can do 2 phone calls. But texting, that’s so much faster. And people tend to be more responsive. [Nurses] often spend 30 minutes cold-calling to get people on the phone or writing e-mails to get [their attention].
It’s a mixture of asynchronous and synchronous models. I’m a big believer that medicine should move towards asynchronous care.
Having an army of health coaches is quite a massive undertaking. Even health systems here — such as in Sacramento County — struggle to service all of their clients.
We can offer this model so cheaply, we are selling heavily directly to consumers. Some people are paying the price point, but it’s not so much more than what Weight Watchers costs, and you get so much more. And, particularly if you have risk factors like being 100 pounds overweight or [are] recovering from a heart attack, people are highly motivated to look for help and do things to improve their health.
We’ve talked a lot about coaches and patients. What about the doctor’s role in this? What can a doctor do with this? Do they count as a health coach, or do they choose modules for patients to follow?
Let me give you an example of a pilot we have in the [San Francisco] Bay Area. What happens is the doctor will see the patient, and… the patient isn’t doing super well. You see their hemoglobin A1C going up, they’re gaining weight, and they’re not managing their blood pressure. in the past, what I would have done is kind of sigh and feel like I couldn’t do much.
What [doctors] can do now [with Vida] is say, “I’d really like you to try Vida” and write it on a [prescription-like Vida] card with instructions to the patient to go to www.vida.com, get an app and get a code specific to the clinic.
In [some] cases, the patient will shoulder the costs directly. [In others,] the clinic covers part of it and the patient covers part of it.
A lot of our readers are doctors. How can they get this for their patients?
We’re interested in scaling the program. If they’re interested they should [email Vida at firstname.lastname@example.org]. We’ll send marketing materials, like the [prescription-like] postcard with Vida, and they can give it to their patients.
The great thing about Vida is that we’re launching a pre-paid program, $99 for 3 months, for weekly video calls and daily coaching and education content from the program. They get little reminders, encouraging messages, all related to what they’re working on: the DASH diet, the DPP diabetes program, or other programs.
In the next article, we talk with Dr. Chen about the behavior change principles underlying Vida, and advice from her for other budding healthcare provider entrepreneurs. To find out more about Vida, go to www.vida.com. No Android version is available but is slated for release in 2015. An iOS version is available on iTunes.