Heal founder Dr. Renee Dua on the future of digital health
At our What’s NEXT Live stage at CES, Heal founder Dr. Renee Dua spoke with Entrepreneur’s Jason Feifer about how her company is making healthcare more accessible by bringing doctors to the patient’s home.
Jason Feifer: Dr. Renee Dua of Heal. Heal is a On Demand doctor call service. So it’s funny, technology bringing us back how doctor visits used to be.
Dr. Renee Dua: That’s right.
Jason Feifer: Where they actually show up. And the first time I heard about this, it’s rare! Rare is it that I hear of a start up and I say “I need this right now” It’s so amazing! So let me rattle off a few numbers, you can tell me if I have properly memorized it and then we’ll go from there. So Heal has raised $52 million in funding. A doctor visit is $99. You have 70 doctors on staff and you are in California, DC, Northern Virginia, and you’re expanding further this year.
Dr. Renee Dua: That’s right.
Jason Feifer: And I’m just going to do your job for you and tell you all about your own company.
Dr. Renee Dua: I love it. I’m having a good time.
Jason Feifer: And the big news at CES which we’ll talk about afterwards, or at the end, cause I want to build up to it, is hardware for the first time they’re getting into. But to start, tell us how the idea for an on demand doctor at your house service came about.
Dr. Renee Dua: Sure. Sure. You bet. So, I want to correct one thing that you said.
Jason Feifer: Yeah and get really into that mike.
Dr. Renee Dua: Better?
Jason Feifer: Yeah.
Dr. Renee Dua: I want to correct one thing that you said.
Jason Feifer: Okay.
Dr. Renee Dua: Which is that while we want to make this services accessible, and the cash price is $99, the vast majority of our users, actually use their PPO insurance plan. So we are in-network with every major PPO plan. And that means that a doctor’s visit would be the cost of your copay. Alright, so very clearly, a house call for 30 bucks is a pretty good deal.
Jason Feifer: Yep.
Dr. Renee Dua: The idea came because my husband, who is the CEO of the company, and I had a terrible experience having our own children and navigating the health care system for our sons. And we’re lucky people. I’m a doctor, he’s a serial entrepreneur, he’s an engineer. We should know how to do stuff. We should be able to get access to care and yet, we struggled in an unimaginable way. And so, what Nick and I wanted to do, was really revisit the doctor/patient relationship, and take all the stuff in between it out of the way. And what we did do, we started in Los Angeles. We got in-network with all the major California payers. We expanded throughout.
Jason Feifer: Well, let’s just pause on that.
Dr. Renee Dua: Yeah.
Jason Feifer: Is that a hard thing to sell insurance companies on?
Dr. Renee Dua: In the beginning it was. But it’s a really cool thing when an insurance company sees that what you’re doing is great and oh by the way saves money. So when we come and do a house call, we don’t just say, “Oh hey, you have a cough, sorry for that. You don’t need antibiotics,” and leave. We say “Okay, you have a cough. Let me educate you on why you don’t need antibiotics and by the way, you haven’t done your Pap and mammogram. Let’s get that scheduled and ordered.”
Dr. Renee Dua: And payers, insurance companies love that because what they want for their patients is the same thing heal doctors want, which is comprehensive care. So every heal visit is extremely comprehensive. If we see a child, we’ll look at the vaccine schedule. We’ll look at the developmental milestones. If we see an adult, we’ll say, “You know what? Your blood pressure’s slightly high. Has anyone talked to you about this?” We take note of all the different aspects of your health and make our care as complete as possible, send that back to the insurance, and then they know more about who is using their coverage. And how they can help their patients do better as well. So we become a team. All three of us.
Jason Feifer: I think a lot of people would assume, because of the world of Ubers and Lyfts, the doctors that you have would just be kind of contractors you’re just connecting. But that’s not the case.
Dr. Renee Dua: Not at all.
Jason Feifer: Did you, at the very beginning of this, think we need the doctors on staff?
Dr. Renee Dua: Absolutely. You know, I think there is a big difference between getting a ride and delivering a pizza, and developing a responsible relationship with a professional who is advising you on your life choices. That’s somebody that you want to get to know over and over. And that’s somebody that you want to develop trust in. You may not care if you trust your Uber driver past the fact that he or she can get you to the next stop, right? So, we want to have continuity of care. We want our patients to be able to see the same doctor over and over again. And as such, we hire our doctors full time, and we request, we even demand, frankly, that hey, you’re gonna have a flexible lifestyle, but there are some things we want you to do. We want you to give us some weekend time. We want you to give us some holiday time. Because, just because it’s Christmas, doesn’t mean people don’t get sick! And you’re the doctor and we want you to be the source of truth and intelligence. Right? Instead of people going to the emergency room for a cough.
Jason Feifer: But if a doctor is spending a lot of time traveling from patient to patient, I would imagine there’s a concern that the doctor’s day isn’t as efficient as if they’re just in an office.
Dr. Renee Dua: Yea. And we use technology to solve that problem. This is very much a technology company that puts doctors in the spotlight. But, for example, in a city like Los Angeles, which is not one market. Los Angeles is six markets. It’s a humongous city. In a city like Los Angeles, we’ll run eight medical teams. And we’ll geo fence a doctor and a medical assistant in one part of Los Angeles so that hopefully, they’re not driving more than 20 minutes between visits. And hopefully, they’re on time for visits. You have a rainy day, it’s tough, but we try to make it work with as many medical teams as possible. And as many routing algorithms as possible to make sure that we’re efficient and respectful of both the doctor and patient’s time.
Jason Feifer: Let’s keep going on efficiency.
Dr. Renee Dua: Yes.
Jason Feifer: Because the way that you built this, the way that you were able to create a service that works financially, is that you had to develop a method of running a doctor’s office functionally in a far more efficient way than it’s currently run.
Dr. Renee Dua: Yes.
Jason Feifer: Walk me through what that means. What inefficiencies had you identified? How does the technology solve for that?
Dr. Renee Dua: You bet. So, imagine that if you are a doctor, in an office, you have someone at the front desk taking the insurance, checking it’s eligibility. You have someone in the back office, taking vitals, and taking the medicine reconciliation. You have an office manager paying rent and making sure you have malpractice. You have a biller trying to collect on all those claims and by the way, it’s not like we collect on every claim, right? You have other intermediaries, people who take your time. A drug rep might walk in, or another patient has questions or another form that needs to be filled out.
Dr. Renee Dua: What we did, was we built tech for each of those pieces. One of the most interesting things that we did, for example, is we built our own billing system. It recognizes a patient’s insurance eligibility live, immediately. So it can tell us, okay, you are still in your deductible. Right? So we’re not going to send you a statement, we’re going to collect the money upfront and then we will dispatch a doctor. Another thing we’ve built. We don’t need to get to your house and get all those consents that you get at a doctor’s office, we’ll have you consent before we get there. So we’re slowly rolling out all these efficiency measures so that once the doctor gets to the visit, it’s all about the doctor making eye contact with patient. And that’s what we focus on.
Jason Feifer: I wonder if you were ever tempted to just be a software company. Because you could’ve, you’ve produced this and you could have roll this out to doctor’s offices and that scales a lot easier that hiring doctors all across the country.
Dr. Renee Dua: Yes. Well, we, you know, and doctors are one part of this very important facet called healthcare. Doctors refer patients to physical therapy. Doctors refer patients to dermatologists. Doctors refer patients to the hospital. Right? There is no reason we cannot look at the house as a source for healthcare. And there’s no reason we can’t use routing algorithms and billing technologies to dispatch the same kind of care. Patients, who are dogs and cats, get the vet to come over. We’re no different. We just have to have, and we are a very highly regulated industry. We’re part of a highly regulated industry, we just have to dot all the i’s and cross all the t’s. But I think it’s a really exciting time to be able to do something like this. And I think patients and doctors are welcoming.
Jason Feifer: I’m going to seize upon you saying it’s a highly regulated industry because that is something that I often hear scares people off. You don’t want to go and try to build something new and disruptive in an industry that’s extremely regulated. It just seems extremely intense, difficult. How did you approach that? How did you think through it?
Dr. Renee Dua: You don’t want to do that until that same industry screws you over. And so it becomes very personal. For me, this company is one of my children. It’s extremely personal. And what I went through as a physician and as a mother, no one should ever have to go through. And I mean that very honestly. And so, there are days that I do this job and I think, “God, how am I gonna get out of this?” And some days when we have major wins and I think “Goodness, we’re doing something great. We’re making major progress and we’re helping people.” And that’s worth it to me.
Jason Feifer: Tell me about expansion.
Dr. Renee Dua: Yes.
Jason Feifer: What is it like to move into a new market for something like this? You’re establishing a completely different way,
Dr. Renee Dua: Yes.
Jason Feifer: For patients to interact with doctors. That cannot be an easy thing to just walk into a new city and set up.
Dr. Renee Dua: It’s not completely different though. Many times we’ll hit a city and a patient will say, “I used to have this and it was incredible. And Dr. X was the family doctor and knew all of us in town and you know, that person was our source of information.” So, I find when we launch in a new place or a new city, patients and doctors and payers are extremely excited. Because everybody is excited about doing something that is going to offer comprehensive care, offer quality, offer doctors. You know, right now, doctors are in trouble. Us doctors, we are overworked and we’re not able to keep up. And doctors are burning out left and right. Doctors are excited to join something where their needs are being managed, right? So, I find a lot of excitement actually.
Jason Feifer: Can you compare a doctor’s schedule at an office to what a doctor’s schedule is with Heal?
Dr. Renee Dua: Yes and it’s such a great question. When you look at reimbursements in an office practice, a doctor needs to see, needs to schedule 40 patients. The first 25 of whom, that doctor is not being paid for, personally. Right? That goes to pay all the bills, the staff, the insurance and so on. And so when you wonder why your doctor is spending 10 minutes with you, it’s just a numbers game. I have to get through this many patients to be able to stay afloat.
Jason Feifer: That’s the economics of their business.
Dr. Renee Dua: That’s the economics in the doctor’s office. Our economics are totally different. Right? We are using routing algorithms, and insurance eligibility and technology to say, here’s what we need to make and here’s how many patients we need that doctor to see. And it’s quite sensible. So a doctor can show up for a visit, spend 25 minutes, be very comprehensive, be very quality oriented, chart on the way to the next visit. Have a Telemedicine call on the way to the next visit. We use that doctor’s time very efficiently and effectively, as well, and still we’re not breaking the bank.
Jason Feifer: So is this an easy sell for doctors or do you have doctors that just don’t get it? Or are comfortable in the old model?
Dr. Renee Dua: I think it’s, you know, if you have an allergy to cats, you might not want to do house calls. Right? If you get carsick, maybe you don’t want to do house calls. If you want a flexible schedule and you want to be paid competitively and take great care of your patients, you’re coming over to do house calls.
Jason Feifer: So let’s talk about the vision for where Heal goes next. You have announced hardware for the first time.
Dr. Renee Dua: Yes.
Jason Feifer: So tell us about the Wellbee and what it does and what it means for the future of Heal.
Dr. Renee Dua: Yes. The Wellbee is this awesome new device that we’ve worked on creating because what we want is twofold. One, we want the patient to download the app. We want the patient to have profiles for all of his or her family. And two, we want to know more about that patient before we get there. In other words, we have to be bigger than a house call. Right? Our doctors are on the way to the visit. They have the patient’s vitals, they have the patient’s medication reconciliation, they have the plan from the last visit. So that doctor’s walking in totally informed about Mrs. Smith and children X, Y, and Z. And that’s what we want for Dr. Lisa.
Dr. Renee Dua: What the Wellbee will do is it plugs into the wall and it interfaces with 120 different devices. So, to give you an example, if you’re a person who’s been told, you are pre- hypertensive, that Wellbee is acquiring the data of your blood pressure at various times, graphing it, and sharing it with the doctor. So the doctor says, “You know what? Actually, Mrs. Smith does qualify for the diagnosis of hypertension,” and may need medication treatment.
Jason Feifer: So when you say it plugs into the wall, in other words, the patient’s home has the Wellbee. It sits there, it’s constantly collecting data.
Dr. Renee Dua: That’s right.
Jason Feifer: So now you need lots of devices to be talking to the Wellbee.
Dr. Renee Dua: Well, you may have, and you may have not. And we will recommend. Somebody, I was just at a panel, and somebody asked me, “Well, will it count the exact number of steps on your pedometer?” That’s not that interesting, right? Maybe you took 7,000, maybe you took 3,000. That has no predictive value on your health. But if you are using a blood pressure monitor, and we’re interfacing with that blood pressure monitor, that’s incredibly important to us. Another example, there are devices that check blood sugar. And blood sugar monitoring, in a diabetic, is a life or death piece of monitoring information, right? And so we use this Wellbee to say well this person is having blood sugar spikes in the middle of the night. What do we do? Is there something to do? Or this person’s blood sugar is dropping profoundly in the middle of the night. That’s actually, frankly, dangerous. So how do we manage that? And that’s how we’re using the device.
Jason Feifer: And how is that data making its way to the care provider? Which is to say, if there is something to be alarmed about in the data, are you being alerted to it?
Dr. Renee Dua: Yes. Yes we are. And again, Dr. Wong may be your physician, and while she’s on the way, she’s collecting, she’s been able to review all of this data and go in with an educated plan to say, “I’ve noticed your blood pressure is doing this,” “I’ve noticed your blood sugars are doing this and here’s the plan we;re going to take. I’m going to see you in one month” right? And really create stylized plan of care for this patient.
Jason Feifer: And Dr. Wong, who’s heading over there, might be heading over there because the data told her to head over there?
Dr. Renee Dua: You bet. Or she might say we need to schedule a Telemedicine call. Not everything requires a visit. And that’s the best part of our technology to be able to say, you don’t need to see me, but you do need to talk to me, or least you need to see me in a screen.
Jason Feifer: So what comes next for Heal.
Dr. Renee Dua: I mean I think we are working very hard to standardize the house call. We’ll drop in various states and that’s been a big goal of mine. But, you know, I look at many different things in this company that we have to do. We have to divert patients from the emergency room when they don’t have emergencies. We as a company prescribe less often, refer less often, do imaging less often, because we spend time with patients and act as clinicians. And for me, being able to be a physician who’s a clinician is an important part of bringing respect back to our entire community. And I want to see more of that. As a patient, I want to have more control of my data. The Wellbee might be collecting all this data, but it’s mine within the Heal app. And I want to be able to be able to see it. And I’ll give you an example, children get vaccinated and they used to get, in California, a yellow card with all the vaccine records. Those are gone now. So where do parents put the vaccine records? You’re required to have it for school. And we built it in the Heal app. So you literally push three buttons and have that for the school to see.
Jason Feifer: I have them in PDFs in Dropbox.
Dr. Renee Dua: There you go! Right?
Jason Feifer: That’s not a good system.
Dr. Renee Dua: That’s not a good system. Right? And you want to, of course, make sure it’s HIPPA compliant, and protected, it’s your children’s information. So, we think on all these different problems, and we try to solve them all one by one.
Jason Feifer: And what’s expansion look like? When am I, in Brooklyn, NY, going to be able to get a Heal doctor?
Dr. Renee Dua: I’m so excited about New York. New York is a big, big, exciting market for me. And so, in progress.
Jason Feifer: Great. What. Big picture question as we end this session. What does Heal say about the future of healthcare?
Dr. Renee Dua: That the most, in my mind, the most important relationship is between doctor and patient. And how much knowledge doctor has before doctor sees patient. So that each visit with a doctor is as comprehensive as possible and those patients are having the best health outcomes possible.
Jason Feifer: And how much of that can Heal do? If you’re moving into hardware, where else are you moving? How integrated can a company like this become?
Dr. Renee Dua: You know I’m already so impressed with how much we’ve done. But I think it remains to be seen. The most important part of this conversation is, are we actually doing good for the patients? Just because we provide a house call, does that mean that that patient or that family member goes on to do better? And that’s the kind of tech we’ll build.
Jason Feifer: Dr. Dua, this has been a great conversation.
Dr. Renee Dua: I really, yes.
Jason Feifer: Thank you everyone for joining us. Thank you Dr. Dua and we can’t wait to see what comes next!