In this insightful episode of "Healthcare on the Rocks: Employee Benefits with a Twist," Lauren Gums, Executive Vice President of Clinic Services at Transcarent, shares her expertise on the rapidly evolving world of telehealth and virtual care. With over 20 years of healthcare leadership experience, Lauren offers valuable perspectives on how these technologies are reshaping consumer expectations and transforming healthcare delivery.
Throughout the episode, Lauren highlights the growing importance of convenience and accessibility in modern healthcare, noting that "90 percent of the U.S. population [has] smartphones, and of those smartphone users, 96 percent prefer text." She explains how telehealth platforms like Transcarent are meeting these expectations by providing "urgency and accuracy" in care delivery.
The discussion covers a wide range of topics, including the sustainability of virtual care models, the revolutionary role of AI in healthcare, and crucial factors employers should consider when evaluating telehealth programs. Lauren also addresses the critical issues of data security and privacy in virtual care solutions, emphasizing their importance in maintaining trust and compliance.
Key takeaways from the episode include:
- Telehealth usage has stabilized at about 38 percent higher than pre-pandemic levels, indicating a lasting shift in healthcare delivery preferences
- AI is playing a pivotal role in enhancing personalization, improving diagnostic accuracy, and streamlining care delivery in telehealth
- When assessing virtual care programs, employers should focus on employee engagement, health outcomes, and overall satisfaction
- Robust security measures, including HIPAA compliance and AI governance programs, are essential for protecting member data in virtual care platforms
- Virtual care platforms are seen as complementary to traditional healthcare, with Lauren advocating for "an integrated hybrid approach to delivering care"
Stay in Touch!
- Connect with Lauren Gums on LinkedIn
- Visit Transcarent
- Learn more about the Springbuk Activate Partner Marketplace and get other related resources
- Get the complete 2024 Employee Health Trends report and other related resources
- Connect with our co-hosts Brittany Hardaway and David Pittman
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Episode Transcript
[00:00:00] Brittany: Welcome to Healthcare on the Rocks, Employee Benefits with a Twist. I'm Brittany Hardaway, Director of Strategic Partnerships at Springbuk.
[00:00:09] David: And I'm David Pittman, the Vice President of Marketing at Springbuk. Today, we're diving into the world of telehealth and virtual care with an industry expert who's reshaping how healthcare is delivered.
[00:00:21] Brittany: Our guest today is Lauren Gums Executive Vice President of Clinic Services at Transcarent. Lauren brings over 20 years of healthcare leadership experience, overseeing a 24 virtual primary care and behavioral health clinic. serving 4 million members. Her background includes scaling ambulatory care at the University of Washington Medicine and leadership roles at 98.6. Lauren, welcome to the show.
[00:00:50] Lauren: you so much for having me. I'm super excited to be here today.
[00:00:54] David: We're really excited that you could join us. And I understand this is your first podcast.
[00:00:59] Lauren: This is my inaugural podcast. so bear with me.
[00:01:03] David: I'm sure you'll be great. Before we get into the main topic though, tell us a little bit about you. What are some of your interests outside of work?
[00:01:12] Lauren: Yeah, thank you. Um, love to travel. we try to travel internationally as much as we can when we get a break from work. Um, we have two kids, teenagers, one in college and one in high school, and, so love to explore. We're all foodies in this house and, um, get outside as much as possible.
[00:01:31] David: Great. Love to hear that. So before we go further, I've got to know favorite place you've gone so far and place you're most looking forward to.
[00:01:42] Lauren: Favorite place I've gone is New Zealand. It is jaw droppingly gorgeous. And, um, on our bucket list is South Africa. Just talking about it last night.
[00:01:53] David: Both great ones. Excellent. I've never been to either, so I'm assuming they're both great, but yeah, I'd like to go to both of those myself. Okay, Lauren, let's dig into it. Uh, most Americans, as we all know, have, have a smartphone and they're increasingly thinking of, um, how to use it. We interact with those devices and all the apps, the easy to use apps that we have on them.
And people are starting to wonder how their healthcare experience could be improved. So how do you see telehealth and virtual care fitting in with these evolving consumer expectations?
[00:02:28] Lauren: Yeah, that's a great question. Um, as we all know, and as you just said, David, consumers are accessing all types of resources differently due to technology. We know that there are a billion healthcare searches every day on Google. So people clearly want answers now. The convenience to accessible information is important.
And healthcare is no different. I think the difference between getting information on Google versus a platform, platform like Transcarent or any other, telehealth platform is that with, um, a telehealth platform, you're getting urgency and accuracy. Sometimes when you put in a search, uh, information into Google, what you might get back, you're unsure if it's a reliable source or not.
So with the telehealth platform, you're getting best in class, evidence based best practices. So I like to say that's urgency and accuracy. Members are increasingly becoming tech savvy, and so they're expecting this convenience, accessibility, and healthcare is no different. If they have 15 minutes while they're on a break, they want to be able to access healthcare.
If they're in line picking up their child and you're in that long line of cars and you have 5 you have 5-10 minutes, able to access healthcare on your phone, on your own time. Not on the provider's time, not based on when there might be clinic availability. And so, having that access and convenience on your phone is what consumers are expecting.
And one, um, one statistic that I like to share is that we think that may, maybe all Americans in the U. S. do not have access to phones, and that's actually incorrect. In 2023, I saw a statistic that said 90 percent of the U. S. of the U.S. population smartphones, and of those smartphone users, 96 percent prefer text.
So that's, that is how we are communicating. And again, healthcare should be no different. Um, in my, my preamble I said I have a college student and a high school student. My college My college-age student, she accesses her healthcare through her primary care provider via telehealth. Like, that is her mode of connection with her provider.
Um, I had COVID unfortunately two weeks ago, and from the minute I came in for a visit to when I actually had actually had Paxlovid in my hand, for going out and getting it, it was 42 minutes. Like I literally was counting, and so it's really just amazing, um, sort of where we've come and how technology has augmented our visibility and access into healthcare
So this is really the kind of healthcare experiences that consumers are demanding. All while driving down the cost. the cost. U.S. healthcare expected to grow on average 5. average 5.5 percent year. And by 2031, the healthcare spend in the U. S. in the U.S. is going to be $7.2 trillion. is extraordinary. So from a care delivery perspective, which I oversee and I provide leadership, I feel like it's my responsibility to assist in controlling costs.
[00:05:46] Brittany: Telehealth use skyrocketed during the pandemic as the industry sought to maintain access when in-person care was limited. While the volume has decreased, it's still significantly higher than pre-pandemic levels.
And you mentioned, Lauren, in your experience with COVID just a few weeks ago, my primary care physician, she won't even see anybody who's actually sick. In the office, that's a mandatory virtual visit. Um, so where do you see the industry going? What does the sustainable model of virtual care look like in the
[00:06:16] Lauren: Yeah, indeed, uh, the pandemic has accelerated the adoption of telehealth. There's no doubt in that. The surge has tapered off, but telehealth usage remains significantly higher than higher than pre-pandemic levels. I think, um, I read the other day that it's stabilized at about 38 percent higher than higher than pre-pandemic although it's tapered off, it's still what we believe and how people want to access telehealth and virtual care.
A sustainable model of virtual care will likely be driven by the integration of AI. I'm sure we'll get to AI somewhere in this conversation conversation, but data-driven solutions more personalized medicine and care delivery is what is going to be expected from the consumer. AI is going to help drive, um, drive down costs, reduce administrative burdens, and ultimately improve patient outcomes. That's ultimately, um, the end game here is that people get healthier, they stay healthy.
Our CEO often quotes Winston Churchill when talking about the future of telehealth and virtual care by saying, now is not the end. It's not even the beginning of the end. But it is perhaps the end of the beginning. And that just rings so true.
If we think about other industries, such as banking, digital banking, or virtual travel, those things are just common nature and that is where healthcare is. Digital health is just going to be. It's going to be the common practice.
I mean, when was the last time you walked in a bank? I, it's been years for me, uh, for sure. And so that is how we bank today. I believe that we're just scratching the surface on how technology is going to transform the delivery of health and care.
[00:08:02] David: And who knew Churchill was using virtual health?
[00:08:06] Lauren: Way way before his time.
[00:08:09] David: Well, one aspect of virtual care, and you mentioned it, Lauren, with your daughter, is text-based communication. Can providers really, truly build a relationship with their patients via text? And can virtual care through texting solve some of those persistent issues of utilization and member engagement?
[00:08:32] Lauren: Yeah, thank you. I, I believe providers indeed can build a very meaningful relationship with their patients. And there's a couple reasons. One is because immediacy and convenience to texting with your provider. So you're, you're reaching out to your provider when you need care, not in three weeks or six months when they're available.
So there's an urgency that creates immediate engagement, and that builds connection and trust. It also provides a level of privacy, so actually, I believe patients are getting increased accuracy in their diagnosis, because they're more forthcoming in what's going on with them. I think we all know and,and, if you have experienced the white coat effect, which is you get into a provider's office, and all of a sudden your blood pressure rises, and you forget about all of the symptoms and all the things you wanted to talk about with your provider.
But if you're at home, or on the bus, or um, we're not going to be texting and driving, but if we're, we're pulled over and, and we're waiting for child care pickup, you want care now. That availability to connect when you're provide, with your provider at the highest need is what creates engagement and utilization.
Another aspect, I think, of text-based care, um, that's important to call out is the webside manner. A provider needs to connect with the patient. They need to feel the authenticity and the vulnerability of the patient. And so it's their responsibility to pull the patient into the visit. And you can absolutely do that via text, via that communication mode. One question you didn't ask, but I'm going to offer is one of the things that we're seeing in this world of telehealth and virtual care is the camaraderie amongst the medical group and amongst the providers themselves. It is tremendous what kind of collaboration comes out of a virtual health practice.
I've seen physicians and nurse practitioners who have practiced with colleagues for 15 or 20 years, and they say that they know their colleagues in the telehealth business better than they did their practitioners and their colleagues in brick and mortar. And that's because when you're in a brick-and-mortar setting, you go in, especially in primary care, you're seeing 25 minimum patients a day, and then you're probably doing about three to four hours of documentation. You don't have time to, um, chat and do the water cooler conversation with your colleagues.
And in telehealth and in virtual care, you do. And in fact, you're often reaching out to your colleagues to, you ask questions? What do you think about this rash? What do you think about, this diagnosis? And so it's a very collaborative environment, almost more so than a brick and mortar setting.
[00:11:25] Brittany: I can definitely see that. Employers face a lot of pressure to build benefit programs that enable their employees to be healthy and productive. What are some of the reasons employers are investing in on-demand virtual care programs?
[00:11:40] Lauren: Yeah, I think it's very important that employers understand this. A healthy workforce really drives down costs and increases productivity. So keeping your employees healthy and satisfied and giving them the right care at the right time is actually incredibly critical for the employer to drive down costs and increase employee satisfaction, especially in primary care and mental health.
As we know, mental health and personal well-being unfortunately, um, the need has exploded globally, but certainly nationally. And so when an employee needs care, again, they need care now. Not in six months when they can get in to see a provider. So it's important to give your employees access to high-quality care that is immediate, that is convenient to the employee themselves.
It's important for an employee to think about that it's a flexible, comprehensive benefit that will boost productivity. And ultimately, if you have a happy workforce, you're going to retain top talent. And we know it's an competitive environment and competitive market right now, so it's critical that employers are retaining the top talent.
[00:12:55] David: All right, Lauren, you know that our primary clients are the employers and the advisors who help them. When this episode airs, we will be just past. Open enrollment time. Employers are already going to be looking forward to the programs that they're offering next year in 2025. So if an employer is evaluating their current virtual care program or thinking about implementing one, what might be some of the factors that you would recommend they consider when assessing the success of their program?
[00:13:30] Lauren: Yeah, that's a great question. It's really important that employers are looking at employee engagement. We just talked about that in the last question you asked, but are employees engaged? Are they accessing the benefits that employer is offering? So if they're not accessing it and they're not engaged, then you're not going to gain the benefit that you're offering your employees. So really knowing your workforce and making sure that they're engaged and they're actually utilizing the services that you're offering.
I think it's important for an employee to look at health outcomes. You can't just look at are they accessing it, the services and the point solutions or the integrated care and how engaged are they, but what is the quality that's being delivered and are your, your members, your patients or your employees getting better?
Are they staying healthy? Are the point solutions that you're offering and the platforms that you're offering, are they making a difference? And ultimately, if you're making a difference, and your employee population is staying healthy, it's going to drive down your own health care cost.
Um, we also need to look at employee satisfaction. I, I already talked about employee engagement, but what is the ease of use of the platform? How well does it integrate with the other benefits? Is it seamless across the platform to the employee? And, um, are there comprehensive care offerings? Are they integrated with other solutions?
So all these factors will help determine the efficacy of a program and in support of health, engagement, and productivity, which is ultimately what an employer is looking for.
[00:15:08] Brittany: That's very interesting. So I mean, we've seen some pretty high profile exits from the telehealth space in the last six months. So just to piggyback on what you've already mentioned, as employers evaluate these solutions, what else should they keep in mind?
[00:15:24] Lauren: Yes, I agree. Um, we've seen some high profile exits in the telehealth space, um, indeed. I think it's important that employers look at a platform or a product that is able to scale and will have an impact on the employee's health and wellness. There are a couple factors that one should consider.
Again, enhanced utilization. Are partners reporting higher utilization rates in comparison to their previous telehealth providers. We see a lot of telehealth providers out there with very low utilization. Why is that? Why are, why are the members not accessing care? Perhaps it's not convenient, perhaps it's not easy to use. So you need to look at the enhanced utilization.
One aspect, we haven't talked about today that I think is incredibly important is language inclusivity. Are the platforms supporting translation of language and making it accessible to their diverse member base? That is extremely important. We see so many employers that have, um, and support members that speak multiple languages, and we want to make sure that we're offering a service that is in the, in the, natural language of that member.
Another aspect, um, one should consider is the rapid deployment. So once you sign a contract or an employer signs a contract and they receive the eligibility file of all its members, how long does it take for the platform to go live?
What type of disruption? Hopefully minimal disruption and maximum efficiency. And then what is the proven track record of the platform or the product? I would look into, um, getting references from current clients, big businesses, health plans, large self-insured employers. So understanding the current retention rate and the client success.
[00:17:16] David: Lauren, earlier you said a phrase that got my ears tingling a little bit, AI. I'm a huge proponent of AI and it seems these days, you know, every conversation in the tech space includes at least some passing reference to AI.
So how does it factor into the delivery of telehealth and what do employers need to know about it?
[00:17:39] Lauren: Thanks, David. I, too, love this question. I love talking about AI. What we're doing at Transcarent, I think, I think, is groundbreaking, and I think it's, you know, an extremely exciting time for all of us. I don't know about in your career, but I feel like this is the most innovative space we've been in since I've been a working professional.
More so than the dot com business. So, uh, thank you for the question. I do believe that AI is playing a very key role in enhancing personalization, improving the diagnostic accuracy, and streamlining care delivery. We are implementing AI at Transcarent to not only not only deliver member satisfaction, but also for our providers.
It is decreasing clinician burnout. We have to take care of those that are taking care of us. And so what we're doing with AI is delivering to the providers exactly what they need to know at the right time to deliver high-quality care to the members. And AI can absolutely do that for not only our providers, but for our member experience.
For employers it's important to understand how AI can drive better outcomes, increase efficiency, and reduce cost in telehealth, it's crucial for evaluating the effectiveness of programs and ensuring that they meet their employees needs.
I'd love to talk about this, um, example where a patient came in from Washington state. The provider was licensed and actually practicing medicine in Washington state, and they came in with an unusual rash.
The provider asked to take a picture of the rash of the patient, and within seconds the AI digitally scans the picture that the patient sent in. And again, within seconds, and delivers and delivers probable diagnosis. So let's say in this case, it's a tick bite. So you don't see ticks in Washington state very often. The practicing provider who is in Washington state may not know what a tick bite or a rash looks like.
In a brick and mortar setting, this patient may have gone into a primary care provider and either been referred to an infectious disease doctor, referred to a dermatologist, or almost worse, been misdiagnosed. And we know with tick bites, it is extremely important to get appropriate care quickly. Otherwise, you have these chronic longitudinal symptoms that are quite debilitating.
So, in this case, the AI was assisting the provider of, I've seen this, I know what this is, this is probable tick. And then it basically serves the provider information at the right time for the patient to get the best care.
So, I, I do think that employers should be looking at how platforms and telehealth and virtual care can help support the effectiveness of quality care as well as decrease cost.
[00:20:49] David: That's a great example, thanks.
[00:20:50] Brittany: It is. That is truly amazing. So all of this talk about technology and AI, security and privacy are definitely top concerns in healthcare. What measures might employers want to ensure are in place when they're considering virtual care solutions to protect their members data?
[00:21:10] Lauren: Yeah, this is so important, um, employees trust their employers with health information and we know that cyber security threats continue and are on the rise and so it's important to ensure that virtual care partners. There are a number of um, factors that one should be considering when We all know HIPAA compliance, that's the bread and butter, it protects our personal health information.
This might seem like a no brainer, but the stakes are too high not to overlook. You have to look at the various compliance programs an employer or a platform has. Another area to look at would be security certification. does the platform offer SOP2? Are they high trust? These again, this would be just basic table stakes, but you'd be surprised at how many platforms out there are not, um, security protected or don't have the certifications.
Another aspect that's It's a little bit more new in the industry is creating an AI governance program, and the governance program really needs to be compliant with the national institute of standards and technology. Again, I'm not sure we've seen too many telehealth or virtual platforms that have an AI governance structure or they're just putting one in place, and this is critical to ensure that and I'll see you The policies that are being developed in-House do adhere to the federal and state laws, and there are a lot around and a lot changing around the regulations related to the development deployment and the use, use usage of AI systems.
So it is very important that when you're looking at a platform and that, um, employers are. Looking at solutions that they're going through all the factors to make sure that their employees health information is protected
. This is not an area to let down your guard.
[00:23:09] David: Absolutely not. Yeah. Great. Great to hear that you have all those certifications. Well, as we wrap up, Lauren, I'm curious about how you see the virtual care platforms fitting into the broader healthcare ecosystem. How do they complement traditional healthcare versus competing with it?
[00:23:28] Lauren: Yeah, that's a great question. So we started out talking about the telehealth. It just is. Virtual care just is. It's here to stay. Telehealth will continue to complement in person care. We all know that there is a time and place for in person care. There is a time and place that a patient needs to be palpated, but I do believe it's our responsibility to make sure that patients are getting the right care at the right time.
And that's not just telehealth and it's not just in person. It's really an integrated hybrid approach to delivering care. I, um, as I said, I've talked about my kids a little bit. I'm trying to schedule multiple appointments for my son that in a brick-and-mortar setting, the soonest I can get in is three weeks for one service and the longest is six months.
And that's just unnecessary. My guess is there is a lot of inappropriate care being served that's unnecessary, and that many of those patients would be better served in a virtual care or telehealth environment. So I think the, the key to sustainability here in, in driving appropriate usage, driving down costs, and making sure the patient gets the right care at the right time, truly is important.
A digital front door, telehealth as the front door, engaging the patient, pulling the patient in and allowing board certified clinicians to help direct, clinically guide the patient to the right place so they do receive the right care at the right time. One of my favorite sayings really is on the other side of complexity and healthcare is a very tangled web.
One of my favorite sayings is simplicity on the other side of complexity. And there is no other industry that should adhere to this more than healthcare. It is a complex web. So I would say in summary, it's critical to keep the person at the center of their own care and consider the consumer experience when considering the future of telehealth.
[00:25:32] Brittany: Lauren, thank you. so much for sharing your insights with us today. If our listeners want to learn more about Transcarent or connect with you, what's the best way for them to do that?
[00:25:42] Lauren: The best way to reach out to me is through LinkedIn, Lauren Gums, and to access the care experiences that we offer at Transcarent, it would be Transcarent.com. I welcome input.
[00:25:55] David: Alright, go and visit those and connect with Lauren, on LinkedIn. Lauren, thank you very much for joining us and thanks to all of our viewers and listeners for tuning in yet again to Healthcare on the Rocks: Employee Benefits with a Twist. Please don't forget to subscribe and leave us a review. It really helps others find the show and helps us know how we can improve and give you what you want to learn more about.
[00:26:20] Brittany: And for more episodes and to stay updated, visit springbuk.com/podcast. Until next time, stay healthy and stay informed.
