Wellaho CEO Naser Partovi Presents a Prescribable App

There are thousands of wellness apps in the app store. When we asked Naser Partovi what sets Wellaho apart from the crowd, allowing it to help individuals manage chronic conditions, he had a three-part answer:

1.  It’s a prescribable app, connecting patient and clinician, sending individually-configured alerts to the clinician as appropriate.

2.  It’s been validated through numerous clinical trials.

3.  It’s personalized medicine — the app is configured to reflect an individual’s history and experience (e.g., diagnosed with diabetes 10 years ago, not taking insulin).

For conditions subject to the preventable readmission rule, Wellaho customers are the hospitals that would be on the hook financially for a readmission: the hospital is the party most interested in preventing the readmission because it will not be able to bill for the readmission if it is for a condition on the Medicare list (currently COPD, pneumonia and acute myocardial infarction). For other conditions, the customer is the insurance company covering an individual with a chronic condition.

Join Naser Partovi at Diabetes Innovation 2013, and hear more about Wellaho — and a new soon-to-be unveiled product as well.

Have a listen to our interview (press play); read the transcript after the jump.

Here is the full transcript of our conversation:

Diabetes Innovation Interview with Naser Partovi, CEO of Sanitas (Wellaho)

August 2013

David Harlow:  This is David Harlow for Diabetes Innovation, and I have with me today Naser Partovi who is the Founder and CEO of Sanitas, which has developed Wellaho.  Welcome to Diabetes Innovation, thank you for joining us.

Naser Partovi:  Thank you David, looking forward.

David Harlow:  So, to start off with, I would like to ask you to explain what is Wellaho?

Naser Partovi:  Wellaho is a chronic disease management platform that helps patients with any chronic disease to be able to take care of themselves in partnership with their family and friends as well as their medical team away from home, away from hospital and doctor’s office on a day-to-day basis.

David Harlow:  And there are a number of tools out there that promise the ability to do something like that or perhaps a piece of that and I’m wondering what are the elements of Wellaho that will allow someone to successfully manage a chronic condition?

Naser Partovi:  It’s a very good question.  There are about somewhere between 3000 and 3500 wellness and healthcare apps out there, and the big question is what’s the difference.  How do you differentiate yourself among those?  There are three main differences that we point to that we believe makes a better tool for both the patients, their family as well as the providers to better take care of the patient.  One is that most of the apps are not connected to the patients’ medical team, and patients can keep track of what’s happening to them on a daily basis, but their medical team doesn’t see it almost they print a report or email it to them separately.

Wellaho gets prescribed.  It’s a prescribed application by your doctor and as such every time you enter your data they immediately see that data and they see the trends, and if there’s anything out of line that the doctor has a specified certain threshold for various parameters — if anything is out of line they get notified immediately about your condition.  So the connection to your medical team is important and it could be multiple doctors, you know it could be your endocrinologist in one place and it could be your family care provider somewhere else and if you have diabetes, you may have heart problems, it could be your cardiologist in somewhere else.  They can all see the same sort of data.

The second one is that this tool has been tested and validated through numerous clinical trials.  We started with a heart failure trial with the heart failure patients.  Now we’re doing a 200 patient diabetes trial.  We’re doing an asthma trial.  We’re doing a weight management trial, breast cancer trial so the tool has been validated through rigorous clinical trials, and we have FDA approval for the tool so they’re not many of those 2500 tools that have FDA approvals for chronic disease management.

And the third one which is the most important is the level of personalization that Wellaho provides for each patient because we work with the doctors we download your medical records and would be using your medical record.  We personalize your education.  You could be having diabetes for 10 years or you could be very new to diabetes.  You could be having, you may have had diabetes for many years and it’s not still got to the point where you need insulin and you’re managing it well, so your education, your monitoring, your support is going to be very different than somebody who needs a lot closer care.

So that level of personalization in your education, in your monitoring and your support is provided because of the information we get from your doctors about your diagnosis and the severity of your diagnosis and where you are on the spectrum of health.

David Harlow:  So this sounds like a terrific example of personalized medicine, but it also sounds like it’s extremely labor intensive both on the physician and on the company end — are there opportunities for automation of some of these functions or is it in fact a great deal of labor intensive time spent on both ends of the equation here?

Naser Partovi:  Not really.  On the clinician side, I can give you example with 200 patients on the diabetes side.  The nurse spends about an hour a week monitoring the patients; an hour a week for 200 patients is not a lot.  And we are introducing new tools and we’ve reduced that by automating a lot of the functions that they do today. Because we generate alerts based on each patient’s conditions and each patient’s specific parameters that the nurse sets when they register them, they really don’t get alerts unless there’s something that specifically requires their action and we create actionable alerts telling them what they need to do.

On the patient side, we ask them to invest one minute a day — that’s all we ask them to do — to update their status on the cell phone or on their computer, and the reason after 12 months we still have more than 50% of the patients coming every day to update their status is good enough indication for us that the tool is actually working and they don’t find it cumbersome to use it.  Even though there are —

David Harlow:  And there are — it’s integrated with the number of what I would call more passive data collection —

Naser Partovi:  Exactly, so.

David Harlow:  — avenues for the patient as well, so you’re not relying on a minute a day from the of the patient, but that adds flavor to the whole picture I imagine.

Naser Partovi:  Absolutely — so if you have a wireless scale or wireless pedometer or wireless glucometer or wireless blood pressure all these get automatically uploaded whenever you’re using your devices, so you don’t have to enter, but there are certain information which are very, very critical for patients to specify for example mood, how are they feeling today and things like that are critical for doctors to evaluate how a patient is doing and their level of engagement all that are metrics that we keep track of and that helps.

I will give you an example: If somebody’s mood has been going down and their level of engagement with their family or friends or the medical team is going down we can send a reminder to their family that they need to call on this patient and they do.  So it’s more than the parameters that people enter — it’s the level of engagement they have and that helps us a lot in terms of altering family members when they need to intervene.

David Harlow:  So when you were starting out and studying the heart failure mode you were quoted as saying once that the focus of this tool was an inch wide and miles deep, and now you’ve expanded this to a number of other conditions.  You’ve been talking about diabetes specifically.  I’m wondering if you can give a sense of what is behind the patient interface or the clinician interface what do we have that’s miles deep on the diabetes front or in connection with one of the other chronic conditions that you’re helping people manage.

Naser Partovi:  It’s the algorithms that are disease-specific, so somebody that has diabetes most of the patients with diabetes have other chronic condition as well, and this is again somewhere where we differentiate ourselves because we’re covering other conditions we can help patients with the other conditions.  So if a patient has diabetes and heart disease which is very common 40% of diabetes patients do have heart disease then we’re monitoring them also for their heart disease and they get the information about both heart disease and diabetes in one place, and the algorithms are very different for those patients than somebody who is only diagnosed as a diabetes patient, so it’s the algorithms for education, the algorithms for monitoring, creating alerts and the patient specific education modules we have over 1800 modules and 1200 videos onsite with these diseases so its very broad right now.

And the way we have done that is we’ve had one disease at the time through clinical trials, learn from those patients, from those doctors and expanded to other diseases not simply going and adding another disease because the patient behaviors are so different and their needs are so different across each one of these diseases.

David Harlow:  So what is the revenue model?  Is this something that is purchased by a patient? I think you said earlier that this is something that can be prescribed by a clinician. Are third party payors or other sources of payment stepping to the plate here?

Naser Partovi:  Right now we’re — the reason for example we started with heart failure is because we’re helping hospitals that had high readmission rates in heart failure, heart attack and now starting with COPD and others, reduce their readmission rates so we’re basically selling the tool to the hospitals.  Meantime we’re working with the payors, third party payors, to get reimbursement for the tool so that when the hospitals deploy it for conditions like diabetes all that they can also get reimbursed for those.  We are not there yet, but we have been working for two years with various payors and we’re providing them the data they need from clinical trials to get that so we’re hoping that we’ll soon get third party payors on board, but we are not there yet.

David Harlow:  So it sounds as though the hospitals have bought in to the concept and has seen the savings in the readmissions department and see that its worth their while to use your tools — is that correct?

Naser Partovi:  That’s right.  So we’re having a lot easier time working with hospitals on the readmission side because the tool with the heart failure trial we showed that we could reduce  hospital readmissions by 77% that’s very attractive to the hospitals to be able to use the tool to help their nurses and all that to coordinate care with the patients and patients’ family.

We’re now getting into second phase where diseases like diabetes, cancer and all others — there the hospitals don’t get penalized, but they have a big incentive on improving patient experience because that’s also another element that they’re getting measured at, and we are starting our first program for breast cancer, where the only quality that we’re measuring is quality of patient, quality of life and patient experience.  And we have very high confidence we’re going to be significantly improving patient confidence and patient quality of life and that would be how we will address diabetes, cancer and some other diseases.

David Harlow:  Well, it’s very impressive that you’re able to customize the — not only the clinical content and the algorithm but the outcome measurement and the metrics that you’re using for each disease or disease states of that their appropriate measures being used and looking at the — at this as its used in different situations.  I’m wondering if you could speak a little bit to the FDA approval process and what that experience is like for you and your company?  A lot of entrepreneurs and innovators in the space are experiencing various kinds of emotions, shall we say, with respect to the FDA.  I’m wondering what you could say the folks who are looking at working in this space.

Naser Partovi:  Well first me who is coming from outside of the healthcare environment for the first time to this space.  My first reaction was why, but the more I have got into this I understand peoples health is involved, and FDA is doing an amazingly good job of trying to protect the patients lives and you can’t just throw an application out there and say this is going to help you without having any clinical evidence that it does so.

We found the process enlightening actually we got early we discussed that they haven’t a lot of that applications, so there was a part of going back and forth to get clarification on a lot of requirements, but at the end of the day we benefited from it because all the metrics they wanted about the quality measurements and quality processes and making sure that we’re not going to harm the patient and how we’re going to respond to patient complaints and so and so forth are all the things that I want to do as in the name of quality of product if this product is being used by my own children or by own family, so we found it to be very enlightening and helpful to work with them and they are asking some of the things that honestly I said why, why, why.

But there’s a reason behind it because they haven’t got a new classification for apps yet, so we are classified as a device, class II device, and we told them why those are not applicable and they listened and they accepted those.  We’re going though our second product that we’re going to announce on September 15th — FDA approval — and the same process is going through and its going back and forth for us explain what we’re doing and for them to explain what we need to show for them to approve it.

This tool is going to help millions of Americans who don’t have the slightest idea they have propensity to get diabetes or cancer or heart disease — to help them learn about their chance of getting such diseases years before.  You can even calculate if you have kids way before you have the kids what are their chances of getting diabetes.

David Harlow:  That’s tremendous.  So I look forward to learning more about this later, later in the year once this has been released.  I’m wondering — you mentioned a moment ago that you had moved into this space — that you worked in, in other arenas not in the healthcare before founding this company and I’m wondering what motivated you to move into the healthcare space.

Naser Partovi:  Because of tragic personal experience.  My wife was diagnosed with breast cancer in January 2008, and for two years I tried to save her life and didn’t succeed so she passed away in January 2010, and I was just frustrated with how much we could help other patients like her to be less discomfort, to help them manage their care when they’re so motivated to do so, and we couldn’t do it. For example, like everybody, else when she was diagnosed we both went to Dr. Google and that was a very frustrating experience trying to use Google to learn about your disease and what your options are for treatment.

And if you’re stage I breast cancer you end up reading about everything about stage IV which builds more anxiety and you think you’re going to die tomorrow and nobody is providing education for me about my disease, my level of specificity and I can’t explain everything, go and find it from my doctor, that’s why we link it to the doctor’s office — get the specific diagnosis to this level of ICD codes and use that as a way of helping patients. So it was the experience of trying to learn about the disease.  It was the experience of me building a spreadsheet trying to monitor her daily trials and tribulations, medications that you had to take.

We provide all that help online for patients today and the supports.  I don’t want to go on — with all due respect there are thousands of public blogs that I can go and learn about and try to speak in as a patient, but Harvard did a study on Facebook diabetes pages, and one out of three contributions was from a marketing person and 1 out of 10 recommendation was fatal.  If you followed it, it could kill you.  We provide a HIPAA compliant environment where you’re secure to talk to other patients and doctors who are all certified to be real patients, real doctors.  There’s no advertising, there’s nobody selling anything to you.

David Harlow:  All right.  I’m sorry for your loss.  And I know that you like so many other people come to this through personal experience and personal frustration with the system that you found before you and are looking to improve it.  I’m wondering if you could tell me what you could hope to see at the Diabetes Innovation conference this fall, what sorts of folks do you hope to meet, what sort of conversations do you hope to be having?

Naser Partovi:  I’m hoping to meet patients and understand better what they go through because every time I talk to a patient they enlighten me about things I don’t know about.  I am hoping to meet doctors and hospital administrators to see, to hear from them what it is that they want to solve and I can help them solve it with our tools, and I’m going there to learn about most of the patients things like innovation in disease treatment and diagnosis the latest needs of the care providers because everybody is in this together.  They’re trying to help patients and we’re trying to give them tools to help the patients.

David Harlow:  Well, great.  I look forward to seeing you there, and I’m very interested, we’re very interested to learn today about Wellaho.  Thank you.  This is David Harlow for Diabetes Innovation.  I’ve been speaking today with Naser Partovi of Sanitas, developer of Wellaho.  Thank you very much.

Naser Partovi:  Thank you so much.

Diabetes Innovation 2013