#DOCSF18 – Meet Archana Dubey, MD: Global Medical Director for HP & HPE, expert in corporate health insurance and population health, teacher, and advisor to digital health startups. Breanna Cunningham of CODE Technology sits down with Dr. Dubey to talk about the benefits of corporate population health care, how digital health impacts her role at HP & HPE, physcian burnout, and more.
Breanna Cunningham: Hi there, Bre Cunningham here at DOCSF, and I’m so excited to talk with Dr. Archana Dubey today. Her roles and what she is doing is so vast that I’m going to let her make sure the titles are correct. But for her main day job, one of the many, she has a huge role as the Global Medical Director of HP and HPE. In addition to that, she teaches and she advises companies, and I’ll let you talk a little bit more about those role.
Dr. Archana Dubey: Absolutely. So as a trained physician and a practicing physician, my biggest passion is to provide medical care and also have a population health strategy for the two companies that I advise, HP and HPE. I also, the other passion that I have is to teach and impact medical students early on before bad habits happen. And then the third passion is to advise new and upcoming companies to make them more viable and scalable. So, that’s my daily job.
Breanna Cunningham: So how did you become the guru of population health?
Dr. Dubey: Well after working 20 some years in clinical practice, I figured that you cannot do care just one patient at a time, you have to have a bigger view of healthcare in general. And working at Stanford-
Breanna Cunningham: [inaudible 00:01:23]. What’s your specialty?
Dr. Dubey: General practice, internist and family medicine. So I’m trained as an internist and family medicine, and I realized that one patient at a time does not move the healthcare of the population at large. And so while working at Stanford, I became the first ambassador at Google at their onsite health center, and I realized that the corporations that are self insured are the key stakeholders in providing care for this larger population, and have polices and resources that they can build that would help drive their health in the right direction.
As I was … I actually took a leap of faith in going full-time in corporate health. In that way I could influence clinical decisions into benefit design of the larger patient population, which is the employee and their dependents. So if, for example, if you see for a large corporation that is self insured, if their population is starting to see trends in, whether it’s pre-diabetes or weight management or cancer risk, they can, you know … At HP for example, we offer programs like The Power of Prevention, in which we can drive, across the world, free cancer screening, and so whether it’s breast cancer or skin cancer screening, and in that way detect patients a lot early and impact their medical outcome. In that way, our employee population and their dependents not only get aware in prevention of these conditions, but also take care of this a lot more proactively.
Breanna Cunningham: What is the application of things like AI and AR and VR that we’re talking about, say, in these conferences, how does that impact your world and what you do in your role?
Dr. Dubey: It makes my job easier. So what happens is, everyone is building their solutions in a silo, and it all meets right in front of my table. Like right on my table, so it’s everybody, hospital systems, value-based systems, healthcare providers, patients, caregivers, they’ve all built amazing solutions but they are not talking to each other. And then of course, me, as a self insured employer, is a pair of this. So we are sitting in a silo, too. So, the artificial intelligence can help us integrate all of this data sources and then build the deep learning or machine learning technology into giving me more intelligent and actionable solution for my larger population that’s sitting throughout the world.
So it could be somebody who is sitting in Bangalore in India and they have the unique issues, and intelligence tells me what I can do for them. Whereas somebody who is sitting in Japan who has unique issues related to, maybe, liver issues for example, in India it could be prediabetes because we know from medical knowledge that these are higher incidence conditions. So we, as a corporation, can build a lot meaningful solutions and benefit design for our employees.
Breanna Cunningham: That is mind blowing and so exciting to actually see that practical implication of how this data’s being used to actually touch the patient and in advanced care. That’s so exciting.
So another theme that emerges this morning was regarding physicians being at the table. And there’s policy makers and also physician burnout, so how important do you think that it is for people like you who have this background where you feel it, you know, right? You’re a provider who really cares and wants to do better for your patients, and finding the time to be able to be at the table.
Dr. Dubey: So there are two questions in that. One is, the physicians do have a seat at the table. And the second is, how can you prevent a physician burnout? So the first question is really key. When I joined corporate health, I realized that most of the decisions who are benefit solutions for employees and larger number of employees were happening from folks who were trained through MBA or from technology or HR business partners, and they largely had a financial background and they did not have the clinical insights.
So they were going into the healthcare marketplace where things were being sold to them that looked great on paper but they did not have a direct impact on the clinical outcome. So when I joined the team, I was able to ask hard questions in which, why are we paying for this? How much is the engagement? Is it truly impacting the outcome? And so not only that we are able to trim down the cost of providing care for employees, because we care for and take care of and want the longevity and productivity and their spouses and kids to be taken well care of, so asking those harder questions, we were able to trim down costs [inaudible 00:06:26], but use that cost saving to use it in other more meaningful programs that we could offer for our employees. So, having that seat on the table enabled me to use my clinical knowledge and expertise to rule out certain programs.
How do we protect providers to burn out? So I think as we move towards value-based healthcare, if we as a health system start evaluating the outcome of the patients and securing time of the provider with the patient, we will actually be able to secure the happiness and the joy of medicine. What happened is because we became a very fee-for-service and a billing based healthcare system, we have put a screen in between the patient and the provider, and we have timed the number of patients the provider is seeing and that is causing all these providers to burnout. Because that’s not why they came to medicine, they came to medicine as to provide care to their patients and see them getting better. And that’s something all of our technology that we are doing, whether it’s artificial intelligence or learning the behaviors of the patients or the outcome, has to be driving and securing that human connection that happened between the patient and the provider. Once you’ve secured that, you would actually stop the burnout of the providers.
Breanna Cunningham: I couldn’t agree with you more. I think that that concept is absolutely [inaudible 00:07:56] in truth. But the barriers are so real because there’s so many … Right now we are in this vicious cycle of documenting, documenting, documenting, and then we introduce a new technology that is helpful, right, like helps you do your job. But it’s the resistance of, ugh, another new app, another new tool, another new report. What do you say to your students about that concept? And, you know, your younger self?
Dr. Dubey: Yes, my younger self are my students, yes. So I do definitely tell them to be part of the design and have a design thinking. You are part of the solution. And you have to ask the question, “But, why? Why are we doing this?” And don’t conform to the crookedness, or crooked corners of medicine, but actually break them down and make it work for you. And I do see that movement. I mean today we are meeting in this conference because more and more providers are saying, “This not working out for me, and I want to make things better for myself and for my patients, most importantly.” So more and more of the medical students, hopefully I’m inspiring them, but both at Stanford and at the Stanford [inaudible 00:09:08], to start thinking of solutions that will empower their connection to their patients and make technology as seamless as possible. It has to become invisible, and that’s the key for any technology. I mean, you know, things what you do on Facebook and how it is, Facebook being a popular engine of you know, there’s a lot of things they they do which is invisible to you. And that’s how medicine needs to be. The magic happens when it becomes invisible. It shouldn’t be a clunky utensil sitting on the table and everybody is looking at them, that’s not a great experience to look out
Breanna Cunningham: Yeah, and our company code, we believe that if you give physicians data and they’re empowered by it in real time, they’re going to use it to make the right decision.
Dr. Dubey: Which is very true. So, you know, at Kaiser Permanente, which is like the gold standard for using technology and driving efficiency, they notice that the more they shared the patient survey results and the outcome results with the providers, the better the provider’s outcome got. So I think that data is really key to share with the population, and the sooner you do it in the medical school level, the better the physicians will come out of the medical school.
Breanna Cunningham: So last question I have for you, out of all the things that you heard today and the technologies that are coming out, what makes you the most excited?
Dr. Dubey: Wow. Hard to say. I definitely loved [Dr. Emmert’s 00:10:40] VR democratization of VR education of surgeons. I think that was mind blowing. That’s almost like breaking the boundaries and thinking outside the box. It’s fresh in my mind so I can think of that first, but I’m also seeing a lot of automation of care coordination. Some of the new companies that I saw I was on a panel for, I think they are looking at the pinpoints for the patient and seeing where they can make things efficient and decrease the cost, and thereby the outcome, for the patients.
Breanna Cunningham: Exciting stuff, right?
Dr. Dubey: Yes, it’s fantastic.
Breanna Cunningham: Well it has been fantastic talking with you. Thank you so very much. It’s very nice to put that population management and the self employed, self insured, self employed insurement … Sorry, cat got my tongue there.
Dr. Dubey: Well, the self insured employers who care for and care about their employees.
Breanna Cunningham: There you go. Is really, really making huge strides in how we care for patients globally.
Dr. Dubey: Yes.
Breanna Cunningham: It’s amazing.
Dr. Dubey: Absolutely.
Breanna Cunningham: So, thank you very much. And continue that great work and energy, girl. I don’t know how you do all that.
Dr. Dubey: Well, I’m passionate about it.
Breanna Cunningham: You can tell, it definitely drives you.
Dr. Dubey: Thank you, thank you.