Episode 20 of The Value-Based Healthcare is out now. Our guest for episode 20 is Jean Drouin, founder and CEO of Clarify Health Solutions. Jean discusses adjusting to the work from home model, bringing analytical models to healthcare, emerging trends and more!
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Podcast transcription:
Jay Ackerman:
Hello, I'm Jay Ackerman, CEO of Reveleer. A software company committed to providing health plans with innovative technologies, to maximize their return from quality, risk adjustment, and compliance initiatives.
We're back again with yet another installment of the Value-Based Healthcare Podcast, where we engage with thought-leaders and visionaries working across the healthcare ecosystem. Through our podcast, we aim to widen the visibility and voice of people working to change how healthcare is provided and the impact it has on all those who participate in the care delivery chain. And I'm thrilled today to be joined by Jean Drouin.
Jean is the founder, CEO at Clarify Health, which enables health systems and payers to deliver more efficient care through advanced analytics, machine learning and digital care optimization solutions. Jean is a leader with over 25 years of experience in healthcare management, tech ops, finance and culture change. As CEO and co-founder of Clarify Health, Jean sets the company vision strategy and is responsible for ensuring the company's overall success.
Prior to founding Clarify, he was also senior partner at McKinsey, where he led the healthcare digital and IT practice. Jean also built and served as the founding head of McKinsey's Advanced Healthcare Analytics practice, which provides services and products on healthcare reform, consumer analytics, new payment, and pricing models and risk adjustment. Jean, welcome to our podcast.
Jean Drouin:
Thank you. It's a pleasure to join you and thank you for the invitation.
Jay Ackerman:
Yeah, we're delighted to have you today. I'm really excited to hear about your career, your thoughts on healthcare and tech. Be hard to kind of dive into this podcast without first talking about how it's going for you and your team and the work from home model. So how about sharing a minute or two on what it's like for you, operating in this pandemic?
Jean Drouin:
Thanks for the question, Jay. For us, I think as for many others, it was cold turkey from an environment, where we really valued and prize being in the office, to the next day, okay, we're all working in discovering Zoom for the first time. And I have to give a shout-out here to our employees for being incredibly resilient and trusting and optimistic.
We've discovered that in many ways, we're a far more effective and efficient working in this model. The huge surprise for me was that we've been able to continue to be successful in sales, despite not being on planes all the time, which is what we were doing before. The thing though that we're grappling with now, and in fact, I was with one of our teams yesterday, because what we've tried to do on Zoom to create connections, is have periodic ‘meet with the senior leadership sessions.’
And one of our team members said, "Yeah, it's getting a little weary to be living at work." The implication being that home has become work. And one of the things that they were seeing hearing from their friends at other companies that people really appreciate is, designating full days off for the entire company, so that there's not a sense that if a message comes in on a day that you might have taken off, that you still have to deal with it.
So overall, I think we surprised ourselves. But there's an indication though that there's some weariness setting in and people would like to have the option to see their colleagues and friends again.
Jay Ackerman:
Yeah. I can say that we're hearing that inside our company. Anything that you can share about what you've learned regarding yourself during this period?
Jean Drouin:
Great question. I think as a leader, it's been important to accelerate the process for me of something that was already having to occur, which is when you move from a 10 or 20 person startup, where it's roll up your sleeves and if the photocopier is not working, you fix the photocopier yourself, to more along the lines of 100 or more folks, and you bring on terrific leaders alongside yourself.
It's a bit of a process to learn to let go. And interestingly, I think during COVID, it's been really important to lean in and double down on trusting that your colleagues will just get it done, even though you're not with each other day in, day out. And it's been eye opening for me because it's been great to experience the freedom that comes with giving others more autonomy. And then having this time created where I can now focus on the things where presumably, I can make a bigger difference.
It hasn't been an easy process though, to learn to do that. So, I would never wish the COVID period on any of us, but I do think there are things that has forced us to experience and do, that will be positives on the other end.
Jay Ackerman:
Yeah. That's a great insight and thanks for sharing that. That's a difficult part of the entrepreneurial journey, right? As you bring on skilled executives underneath you.
Jean Drouin:
Absolutely.
Jay Ackerman:
Yeah. So, let's talk a little bit about Clarify and how the company came to be. So, can you share how you entered medicine and then bring us to what prompted you to start Clarify Health?
Jean Drouin:
Sure. So for me, going into medicine was an interesting thought process. My great grandfather was a GP. My grandfather was a cardiologist, my dad's an immunologist. So there was an element of, ‘those were the role models.’ And yet at the same time, I always had a great curiosity for what's going on in the broader world. And there was a part of me as I was growing up, that thought for sure that I might go into environmental law, international relations and/or politics.
And in fact, when I was an undergrad, I was not pre-med. I ended up working for McKinsey post-undergrad for the Mandela government in South Africa, bringing electricity to the townships, and realized, "Wait a second. I don't at least initially, want to go to either do an MBA or law school," which lots of other friends were doing. "I actually really want to go to medical school." So, I had to go back while I was working and take the MCATs. And when I entered medical school, I was 50-50 as to whether I would go on to practice.
I loved medical school would absolutely do it again. It was an incredible experience, great friendships formed during that time. And seeing how a hospital environment worked up close and personal, had a really big impact, all the way through to Clarify today. Ultimately what happened is, I decided to go to business school and into the business world because the tug of that interest in what's going on elsewhere abroad, et cetera, was stronger than the, "Okay. I want to do one particular area of medicine for the rest of my life."
It's been interesting though. I guess sometimes serendipity helps guide your career. I thought I was going to be at McKinsey for two years, ended up being for 15. But it was because I ended up in a place where I got to work on health system reform with the Blair government in the UK, and then was asked to help set up the London health region that oversaw all of London's healthcare.
And that's what ultimately laid the track towards Clarify. Which is, when I sat in that seat in London, we had the power to essentially order anything we might want to happen in the health system. And predictably what happened, because there wasn't good information on the frontline, is the change that we were ordering from the top didn't happen.
And in retrospect, it's not a great surprise, right? I think clinicians, patients, administrators, they don't come out each day wanting to make bad decisions or decisions that are inefficient. But if they don't have actionable information at their disposal to make a better decision, how can we expect them to change?
And so the initial idea for Clarify, which is, could we bring to healthcare the same precision, trust and ultimately actionability of information to the hands of those making decisions, that you see in financial services or a consumer? That was the nugget. The issue though in 2010 is, particularly in the UK, is there wasn't a way to bring those data sets required together.
So I came back to the US and was sitting, waiting for the environment to change. And around 2015, I said, "Wait a second. What Patrick Conway, Niall Brennan and others were doing in government to the Qualified Entity Program to make data available, the value-based payment models to cause people to want to invest in improvement." I said, "Wow, this might be the moment where it's worth taking a risk."
And so I left McKinsey, had the great fortune of being introduced to my co-founder Todd Gottula, who had been leading a team that built the platforms that do analytics for Goldman, JP Morgan, et cetera. And we said, "Wow, if we could combine know-how from healthcare with the data, with the know-how for how analytics has done in financial services, could that finally give us a platform that would deliver the enterprise analytics that hospitals, payers and life sciences companies would use moving forward?"
And the world that we see coming is a world where, instead of individual actors in healthcare, buying tons of expensive data and struggling with it with SQL queries, that just as in other industries, you have platforms like the Bloomberg Terminal, you would get the same thing in healthcare now.
Jay Ackerman:
That's a great analogy. Kind of easy to visualize what you're talking about. You commented on data and value-based care, highlighting the moment where you saw an opportunity to launch. So now let's talk about what industry trends that you see that are beneficial right now to healthcare orgs. And hopefully, I think as a result of that, are also momentum builders for your own company.
Jean Drouin:
Sure. Probably the biggest force that I believe holds all of us in the healthcare system to account, is that there is still vast unmet need, in terms of loved ones, friends, family members, needing care, or to improve their health, and a sense that we're not always optimizing helping people get where they need to be.
And what we've seen as the most positive or helpful trends in the last four or five years, is one, the realization that creating both the governance and the technical wherewithal to bring data together in a secure way, so that those who need to can make better decisions, that's been a huge shift. Five years ago, the thought that you could have data on 300 million individuals and make that accessible so that you can better match a patient to the right physician or specialist, that you can bring the kind of analytics they do in baseball to assess players and do the same thing for physicians, that would have been unthinkable five years ago, and it's now completely in the realm of the doable and possible.
A second one is, while we are still in mostly a fee for service system, the sense is that people feel that slowly but surely we're going to, particularly with the transparency we get from these analytics, move to more value-based arrangements. And that as a result of it, there's going to be more of a need to be willing to look at and interpret data, to see where to improve.
And then the third might be more of a cultural shift. I would say 5 or 10 years ago, by the way, quite rightly, many folks in the system would say, "Listen, it's unfair to measure me because the measurements are unfair.” And they don't properly account for the fact that I'm the physician that deals with the more complex folks. Our ability to provide much fair ways of assessing what's done, hopefully creates the substrate for a more trusting and therefore helpful conversation about what is the right thing to do, and how do we all work together to get patients and loved ones the care they need.
Jay Ackerman:
Say, just following on with that, what do you see as the biggest challenge that you continuously encounter in healthcare?
Jean Drouin:
From a strict startup perspective, I would say if I asked that question to most startups CEOs, they'll say, "Wow, the sales cycle is brutal." Obviously, it depends here and there. There is more of a sense for me, at least in healthcare versus what I've observed in other industries, that we often tend to have to make decisions by extreme consensus, which is at some point, 12, 15, people need to be brought into a room to agree. And maybe because culturally, healthcare is and wants to be a very collaborative team-based thing. And yet what I see in other industries, where if you don't improve or compete fast enough, you might become obsolete, is more comfort with one or a few individuals sticking their head above the parapet, making a decision and others appreciating that they're not going to get it right all the time. But in general, moving quickly has an importance. And sometimes moving quickly is more important than getting everybody lined up. But I think the perception in healthcare is that if you don't line everybody up, then you're exposing yourself to undue risk for the future of your career.
So the challenge of the pace of innovation in healthcare, where I think the stat is something like it takes 17 years for an innovation that comes out well published in a journal like the New England Journal to spread itself across the system. I think when the sales cycle is slow sometimes, it's just a symptom of a kind of culture and getting more comfort with taking risks and those risks not unduly affecting people's careers would unlock faster innovation in healthcare.
Jay Ackerman:
What you're trying to do in the way you're trying to use advanced analytics, to allow providers and those in kind of the care delivery chain, make better decisions. The challenge you just talked about with these consensus-based models, extreme consensus building. How do you tackle that to drive change and accelerate adoption?
Jean Drouin:
Great question. I would say all ultimately, it's all about trust. Having the courage and confidence to come in with complete authenticity, understand the lay of the land at the customer, figure out who can and want to be your champions, and then not be afraid to ask the questions that one should ask, right? Who are the decision makers? Is there a budget? On what timeline do you have the intention to buy? And then giving permission for someone to say, no.
The great phrase that we were introduced to, was having the courage to say, "Hey, the second-best answer that I can get as a startup is a clear no early on, because we have limited resources." And while it might sting in the moment, it's important that we can focus our resources elsewhere. It gives permission to the individual to say, no. Now, interestingly, if they say yes, it raises the bar on them to get to a successful outcome with you. So, it's the courage to be authentic and not be afraid to get the transparency to know whether you are going to get to a yes or no.
Jay Ackerman:
No, that's great. I'll link into a future Zoom call with my sales team. I think it would be good to reinforce some of those niceties.
Jean Drouin:
Very happy to, and to be fair, I catch myself frequently not having that courage in the moment, because it is hard to ask for rejection.
Jay Ackerman:
Yeah. No, it's true. All right. So zooming out a little bit and talking about innovation across healthcare, what do you see emerging in healthcare that you believe will have a significant impact across the industry?
Jean Drouin:
Well, obviously we're very bullish on the prospect of data and the greater precision transparency it can bring, but moving beyond that, a couple of things. We are, and maybe one that we hear a little bit less in our fields of healthcare IT, I am very bullish about the technological innovation that's going to come on the therapeutic side from biotech. CRISPR is a game changing technology, and we're only seeing the beginnings of what's coming through the clinic for that. And obviously, it can have a massive impact in areas like rare disease.
So, I think important to realize that on the therapeutic side, we will have continued innovation. On the services side, I think we're finally learning what technology can do to accelerate the change in delivery models that we want to see. So telemedicine is a great example. It was obviously helped and accelerated by COVID, but it's causing people to be willing to work in different ways that are more effective and efficient for the consumer, and mean that you can access care in an easier way.
The bit that I'm intrigued about to see whether we can crack the nut sooner than later, is around stand-alone digital engagement, where I think we've had a lot of promise, but perhaps not as much impact as we might all have liked to see. So where do we go with consumerism in healthcare, right? That feels like it's been more of a laggard in terms of its ability to have impact.
Jay Ackerman:
We're going to shift and talk about two groups in healthcare and actually really interested in your thoughts on this as someone who spent a career in healthcare, but has also worked across healthcare globally. So what advice might you have for kind of health care executives? You can take it from the plan side or maybe from the health system side, in navigating our industry during these rapidly changing times.
Jean Drouin:
What's interesting for me in healthcare is the pace of change, one. And then two, maybe one of the biggest lessons I've learned in the different situations I've been, is it's really important in healthcare to understand how the dollars flow and what the incentives are for various folks, in terms of their call on that flow of dollars.
Healthcare, maybe more than any other sector, I think exhibits the statement that you overestimate what you can get done in a couple of years, but you vastly underestimate what you might be able to do in 10 or 20 years. So if I look back for example, 10 years to 2010 and say, "All right, who had the vision then, and where are they now?" Folks who had the vision to get into telemedicine, the first few years were tough, but wow, are they in a great spot now. On the health system side, folks who said, "I get that there's going to be all this value-based pressure, but fundamentally, we're still going to be largely a fee for service system." Well, it is where we're at right now, right?
So my advice would be, be clear what it is that brings in the margin today and make selected bets on where you think the future is going to go, so that as the future moves that way, you're well positioned to take advantage of it.
And then this is the other thing, there's a big difference between what do you do if you're already an established player, if you're already an integrated delivery system, if you're already a payer? That's very different than, "Hey, I'm an upstart physician practice going after a niche," so One Medical, ChenMed, et cetera. And in that niche, I can do very well and grow quickly, right? So that's also possible and important that we get that kind of innovation. But the playbook for that is very different than the playbook for a large established institution that has to deal with existing realities.
Jay Ackerman:
Yeah. Great insights. Kind of equally as interested in your thoughts on this next one, is a third generation doctor and again, someone who's been in healthcare for your career and across the globe, what recommendations would you have for the public, for the individual member regarding their empowerment and ownership of their wellbeing?
Jean Drouin:
I would encourage folks to nurture the relationships that can give them the information and the access that they need, so that they're matched to the set of interventions that are best suited to them to get them from, "I have a health problem or a wellness issue," to, "I get to as good as I can get back to." Because what I mean by that is unfortunately, we're still a ways from a having a Google-type environment, where you can just type in what you've got ...
So let's use an analogy. If you're trying to get a credit card today, you don't fill in a massive application anymore. You put in a bit of information and a questionnaire and out spits the answer, relatively quickly. And wouldn't it be awesome if in healthcare, you could just put in a few things and out would come the answer. "Here's the best cardiologist for you. Oh, for this, you don't need to go to the emergency." We're a ways from being able to have that.
So we're still reliant in healthcare as an individual in, "What can I find on the web? But equally, do I have a primary care physician who I trust? Now, I might be accessing that person through telemedicine now, but what does that person do to guide me? And then what do my friends think?"
To this point about, can I envision a world in 20 years where there will be a lot more information available by just typing things into a questionnaire and putting on a bracelet and that's going to feed into something? Absolutely. But right now, I would encourage individuals to shop around for their care, just as much as they would for another big purchase in their lives, like a car or a house, that kind of thing, and not just rely on one source.
Jay Ackerman:
Yeah. Yeah. You don't do that to purchase a car. You don't do that in purchasing a home. But yeah, we so often do that with our care, right?
Jean Drouin:
Well, we do, because I think we're in a moment of weakness where we want an immediate solution. And it's funny, I find myself doing this too, even though I went to medical school and I can call up friends, et cetera. You often take the first thing as opposed to maybe seeking out all the information that you might need.
Jay Ackerman:
Yeah, this has been great. Appreciate your insight on all the questions that we've been talking through. So why don't we start to bring it to a close with five quick questions and no right answer. Really just interested in kind of how you think about these things and how you spend your time. So, what keeps you up at night?
Jean Drouin:
So right now, it's that everyone who wants to vote can get to vote and that vote can get counted.
Jay Ackerman:
Yeah. Beautiful.
Jean Drouin:
Right? I'm a natural optimist. I feel that we'll start the rest of it.
Jay Ackerman:
Yeah. Well, it's encouraging. I think I read yesterday that if I get my number right, over 40 million votes have already been recorded, so we're on the right path there.
All right. So, when you're restless, what book might you grab from your night stand and why are you reading it?
Jean Drouin:
Yeah. I love the question. So, one of the things I've found in the COVID period, is that if I stayed glued to Zoom after Zoom, after Zoom, my brain is exhausted at the end of the day. So, a couple of things I've said, "Okay, I need to get at least 15,000 steps." Some of that is I'll take calls walking, but the other is I've discovered Audible, so I'll listen to books.
And so the latest one is a book by Winston Churchill. I had no idea that he had won the Nobel Prize for literature of all things. They're short stories of important world leaders at the turn of the 20th century. And I love history, so it's gets my mind off of the day-to-day of healthcare. And in this case right now, the narrator's got this great British accent. So, I feel like I'm getting to travel, even though I'm stuck at home.
Jay Ackerman:
That's great. I'll have to check that one out. What's the favorite app on your mobile device?
Jean Drouin:
Well, so other than audible, I just signed up for TRX, got the straps you put on the door, and it's helping me not get locked into the shape of what I am when I'm sitting in the chair.
Jay Ackerman:
Yeah. I use my TRX like four times a week.
Jean Drouin:
Oh, awesome.
Jay Ackerman:
Love it.
Jean Drouin:
For me, it's been a revelation, actually.
Jay Ackerman:
Yeah. It's a tremendous product. In my travel heavy days when I was traveling to a location where I couldn't get to a gym, I would throw my straps in my bag.
Jean Drouin:
Well, I'm hoping for the day where, you know, that's a possibility again, because I might do the same thing. I'll take that tip from you.
Jay Ackerman:
Yeah. Well I think you've already shared a little bit on this one, but I'll throw it out there nonetheless. How do you invest in yourself?
Jean Drouin:
Okay. So obviously, yeah, so there's what I've shared. My way to de-stress is the outdoors. So, love cycling and hiking in the summer. And then look, I'm Canadian originally, so I love the winter sports and all types of skiing. So, in fact, one of the things I'm doing this weekend is I need new boots to be able to scan up the mountain if we can't get the chairlifts to go this winter. So I'm looking forward to that.
Jay Ackerman:
Fantastic. All right. Last one, what's the most creative thing you've done during this kind of work from home period?
Jean Drouin:
So this one, I'll give a shout out to our employees for their creativity in almost overnight, getting us to figure out how to work in this new way. And then as inspiration, I was talking to one yesterday who sent me a picture that he built. He got into woodworking and he built an entire climbing wall in his backyard. Yeah. And I was like, "Wow, your neighbors." He goes, "Yeah, my neighbors are a little worried about this 12-foot-high contraption." I was like, "Wow, that's way better than my saying that I've learned how to cook salmon in the oven."
Jay Ackerman:
That's great.
Jean Drouin:
Yeah.
Jay Ackerman:
Well, Jean, thanks again for your time and your openness. It's been a great podcast.
Jean Drouin:
And thank you, Jay. I really, really appreciate it, and terrific that you're doing this. I wish you well over the next few months.
Jay Ackerman:
Thank you. You as well.
Thank you for joining us today. Listen to more episodes at reveleer.com or find us through your favorite podcast platform. For episode updates, follow Reveleer on Twitter, LinkedIn or Facebook.
