Health Evolution | April 26, 2021
Sajid Ahmed founded WISE Healthcare to address inequities with a particular focus on underserved populations, prisons, and safety nets with virtual-care-as-a-service offerings.
Today, the startup works across all units of the California Department of Corrections and Rehabilitation, Inland Empire Health Plan, and with others.
Health Evolution interviewed Ahmed about the company’s virtual care as a service, workflow engineers, scaling from one to 34 sites is less than six weeks for a client, why he doesn’t use the phrase telehealth, and more.
What is WISE Healthcare’s origin story? Or the inspiration that fuels you as CEO?
The best way to describe why the company was started is that I wanted to build a mission-driven organization by taking everything we’ve learned about what it means to provide health care services to an underserved population, including all the lessons learned from my career on the provider side as CIO of Martin Luther King Jr. Healthcare Corporation and being one of the folks to launch telehealth at LA Care Health Plan. On the public health side, the expectation is that the underserved populations get access to high-quality specialty care in a timely manner. Health plans contract with us because we represent a network adequacy solution for them. So, the purpose is to provide health care services, virtual care specifically, and to focus on underserved populations because the availability of quality care is disproportionately low there. In addition to underserved communities, we work with prisons, safety net providers, and dual-eligible Medicare-Medicaid populations. That’s why “A Force of New” is our intentional tagline because we want to be a force for improving access to quality care for these populations utilizing our singular focus on virtual care.
How does the technology underlying virtual-care-as-a-service work? What should CEOs understand about it?
Our business model is virtual-care-as-a-service and that includes three components that give us an advantage. We have our own providers, HubMD. Our chief medical officer is CEO of that medical group in the state of California. This isn’t just any old medical group. We have 161 board certified, personally invited, trained and curated specialists. It’s a multi-specialty virtual medical group. We bring that along with our own virtual care technology platform augmented with AI. And the secret sauce is our workflow engineers. WISE, in fact, is an acronym for Workflow, Innovation, Science and Engineering. We are made up of providers, technologists and professional services specialists who serve as workflow engineers. This means that we don’t just launch the service and move on, we stick around to support our clients for a year.
We combine those three components and that has been the core of our success. That can be seen in our work with Inland Empire Health Plan, which engaged WISE as a sole source for implementation of a virtual care platform throughout their network. IEHP specifically wanted the workflow engineers to handhold the implementation process to ensure it did not ultimately fail as is common with many other implementations whether it’s implementation of an EHR or a telehealth program. We don’t simply drop the technology in place and go. We are here to provide a service. Our providers and workflow engineers work very closely with the primary care providers, PAs, NPs and their staff, and we stay with that practice or organization for a year.
Workflow engineer is a role that some CEOs may not be familiar with so can you describe the discipline in more detail?
We began the company with workflow engineers and designed their role by combining lean processes with design thinking. Workflow engineers work on site with our client’s medical clinics, assessing their individual workflows and showing providers and staff how our virtual care technology will fit into their processes. After the initial implementation, workflow engineers follow up to ensure each clinic’s workflow transitions are going smoothly. That was the impetus of providing virtual-care-as-a-service to make telehealth programs successful. We also have our own medical group of specialists similar to Teladoc or Amwell. But unlike a Teladoc or Amwell, all of our physicians are board-certified specialists and focused on underserved populations. We also innovate with our clients on how we contract, credential, and get paid by our clients, pushing to get away from just submitting claims because we want a direct service that can leverage our model.
Sajid Ahmed , WISE Healthcare
How has COVID-19 impacted your enterprise strategy?
I have to tell you we have been extremely lucky and blessed. We were already doing virtual care prior to the pandemic. Almost immediately after COVID-19 hit, we got a lot of interest about what we do, and our business grew by more 100 hundred percent. We had 38 physicians in February of 2020 and we’re now at 161 physicians. Our specialist staff was eight or nine and we now have 24. Before the pandemic, we had a “pilot” at one site with the California Department of Corrections and Rehabilitation. By the end of March 2020, CDCR asked us to expand to all 34 of its sites. When they asked if we could scale, as of course you can imagine, we said “Yes.” But we also said that we have the experience implementing tools, technologies, policies and procedures so we only want to expand if CDCR will go all in with us as the sole player, which they did. Then, we onboarded 200 primary care providers in less than six weeks. We’ve been providing service for the entire state since then. We also expanded with our existing clients increasing our monthly telehealth visits from around 1,000 a month to an average of about 5,000 by the end of the year. So right now, our biggest challenge is onboarding staff and training them, familiarizing them into our model and transitioning them out into the field with our customers.
Which would appear to be a good problem to have, especially in 2021. Looking to the future a bit what should existing and prospective clients expect from WISE in the next 18-24 months?
It’s a good problem to have, and I would not want it any other way. We have six clients launched as of December and three others that we’re now in final contract negotiations with. We’re relatively small, but we’re operating like a big company by hiring and training more workflow engineers. We have the new technology we launched last year. But even though we have technology, we’re not merely a tech company. Our offered services are broader than that. We’re about the hand holding and helping our customers through each step of the program. In short, we are basically a concierge service to our customers. We’ve launched to over 100 clinic sites at IEHP. Its customers don’t know we’re WISE because our team goes into the field working as IEHP agents. We have IEHP badges and IEPH emails. We’re about being the client, not being a vendor or consultant to the client’s network and providers. This approach greatly improves our reception and success with individual clinics and providers. Finally, since I’ve been an executive at LA Care and MLK Hospital, I’ve been in the shoes of our clients which helps me to understand our client’s budgets, and their concerns about managing their provider network and improving care to their patients. This understanding allows WISE to truly satisfy the needs of our clients since we have such a thorough understanding of things on their side.
What is the hardest challenge or challenges you have overcome as a CEO and founder?
The hardest challenge is one we are still in the middle of overcoming. It’s scaling and meeting the demand while not giving up the culture. An essential part of this culture is the concierge model of helping clinics go-live with our technology but putting in 80 percent of our efforts after this initial go-live. So, it’s scaling, and everything related to scale, such as hiring, onboarding, training, figuring how to market our services.
In addition to those challenges, there was developing the technology to enable our services during the COVID-19 pandemic last year. We took all the lessons learned over the last 10-12 years of implementing telehealth and created the best application to support the virtual care workflow of the future. At this point I try not to refer to it as telehealth — the transitional term is “virtual care,” but eventually it will be just “care” provided through these modalities. Our technology is driven by workflow and not merely creating a real time video platform. During COVID, there was a rush to get telehealth platforms that provided video. Experience has shown that was not what doctors and patients needed. What was needed was a convenient way for patients to talk with their doctors that didn’t require scheduling a visit and waiting in a virtual waiting room; that’s just emulating existing workflows and not planning for the future. And unfortunately, that is the direction many companies went during the pandemic. Rather than just emulating existing workflows using video, the future is text messaging and real time voice communication between patients and doctors and reimbursing doctors for these communications.
2020 was obviously a tumultuous year, but what are you expecting for 2021 and beyond?
We need to let 2020 go, but we need to learn its lessons before we forget. My only real concern about the future is with regulators, specifically federal and state lawmakers and policy makers. Perhaps the one thing the previous administration did well was implementing policy changes to enable virtual care in ways that previously had been restricted. I hope this renaissance of virtual care isn’t changed because of the new administration.
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