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Episode Info: 08:49 Oh, well there's something I've learned today. So you've already done your job for the day. Excellent. Lilly: 08:56 Raising awareness. That's my big goal in life. Janet: 08:59 When you serve as a patient advocate for a company, what does that really mean? Lilly: 09:03 Yeah, it's an interesting question. It means something different depending on the company. I think there's an important distinction because there are some companies who truly embody this patient-centric mindset and I really hate the word patient-centric and I think a lot of people do in the industry but its sort of what we're stuck with. If you don't say your patient-centric then people think you're a bad company. It means that you are the person within the company who is championing the patient voice. You are working across teams to ensure that the patient voice is being infused into the work that you're doing and you are fighting at the table. You ideally at a company, you're in a leadership position as a patient advocacy person and you are fighting to ensure that business decisions that are made are what's in the best interest of patients. And so that's really the primary role of somebody who sits in a patient advocacy position. But there are also doing a number of other things. They're managing relationships with the patient advocacy organizations and patient communities and they are helping develop disease education awareness materials to educate on the different medication medicines that they might be developing or supporting, helping offer grants to different advocacy organizations. So there's a lot of different ways that a patient advocacy function within the industry. Janet: 10:31 So when you were working with Clara Health, you are working with a company that was trying to match up Pharma and clinical trial participants, is that right? Lilly: 10:41 Yes. It was a multi-sided marketplace there. We were working to, or we are working because I am still a lead patient advisor with them and love the work that Claire is doing, but we're working to connect patients directly with clinical trials and making it easy for patients to connect, which means we're helping them search for the clinical trials. We hold their hand through the process, we call the clinical trial sites on their behalf. We coordinate their travel handle, all of those administrative burdens that a patient would typically be tasked with. And then on the other side, we work with companies to help them recruit for their clinical trials and retain patients. It's in their clinical trials and we take a very patient-centric approach through that because we actually work with patient advocates to help companies think about what their clinical trial protocol looks like and actually help support like have live patients to help support other patients through the process. Janet: 11:38 All right, and then tell me about making the transition over to Savvy Cooperative. How did that come about? Lilly: 11:44 It was an incredible opportunity. I've admired Jen and Ronnie who are the co-founders for quite a while now. Jen and Ronnie are notable patient advocates in the space. Ronnie is a cystic fibrosis advocate who developed the largest online community for cystic fibrosis patients and Jen is a juvenile idiopathic arthritis patient. And she has spent her life really dedicated to patient advocacy. She works with the FDA. She got her Ph.D. in human factors research so that she could really bring her perspective and to industry. What they've created is something so special that I am really honored to be a part of because it is a patient-owned cooperative. As these advocates, they were constantly being asked by companies to give their perspective, but what they realized was that yes, we love giving our perspective and it's great that they're asking us, but you know what? We can't offer a diverse perspective. There should be more patients who are giving their perspective and just because there may be not public about their disease on social media, they're a little harder to find, but that doesn't mean that companies shouldn't be actively trying to reach out and get those diverse perspectives. And so that's why Jen and Ronnie founded Savvy Cooperative, and they made the decision to make it a cooperative model, which means that patients actually own shares in the company and share in our profits at the end of the year because they believe that the business model should benefit the patient and patient should be fairly and equitably compensated for the work that they do. And so I couldn't have imagined more of a perfect fit for me as somebody who, you know, my priority is to ensure that we are infusing the patient voice across every aspect of the industry, from Pharma to startups to health insurance. We want to make sure that that patient voice is incorporated early and often. And that's ultimately Savvy's goal. So I, I'm living the dream, getting to work with all of these different companies and, and learning about all of them, all of the incredible work that these companies are innovating on and being able to bring patient experts into to give feedback on that and so that they can iterate and make a product that truly fits an unmet need. Janet: 14:06 Oh man, that's fascinating. And sometimes I think a lot of people don't realize or I don't know, maybe we should realize that patients traditionally really don't have a lot of money. And yet these companies, Pharma companies, in particular, they're going to be making millions and billions of dollars through selling all the way through to the patient. Yes, via a provider, a physician, a nurse practitioner. But ultimately it's coming out of the patient's pocket in some way. And yet they've had very little economic say and how these businesses and medications have been developed. Lilly: 14:40 Absolutely. And I mean, and it's, it's crazy to me because in every other industry we consult the end user. If you look at consumer-facing products, they're constantly running focus groups. And I actually wrote a piece on this called challenging healthcare to engage in a Pepsi Challenge. The idea for this story came from a book I was reading called Blink by Malcolm Gladwell. And in it, there's this whole section on Pepsi and Coca Cola. And he talks about how they were really had to have, I mean they still go head to head, but how they were trying to figure out what they could do to get consumers to buy more of their product. And so coke even went to such lengths that they ended up altering their secret formula based on feedback from consumers. They have this really secret formula that they are used for years and they altered it to try to sell our product. Lilly: 15:40 And as I was reading it, and this was right around when I started at Savvy, just thought, oh my God, if we could get health care to engage patients. For the way that consumer-facing industries engage patient, engage their customers. We would be golden. I mean health care would actually be innovating in making things that matter to patients because right now part of the problem is so much money is being wasted on products that patients don't want or that aren't the right fit or that don't even end up being successful. And so not only is it really d quote unquote right thing to do when you engage patients, it's actually a really smart business decision that helps save money and earn more money because your end user is happy. They want the product. Janet: 16:38 You know, I've been involved in the startup community for a while and a lot of Startup Weekends are about young people coming in with an idea and I'll give them credit. They're thinking through challenges that people unlike themselves or having predominantly their grandparents, for instance, their Nana or their grandfather, and they've got this really cool idea that they may be figured out at Thanksgiving, I could solve this problem. The problem is I wonder if they've actually researched it and talked with not just their grandparent, other people in the industry. So how exciting it is that they seem to be getting startup funds and get support for an idea that really hasn't drawn in the patient's perspective and that generationally it hasn't really been vetted out by a true need. Lilly: 17:25 Yeah. And you bring up such a great point because the young tech entrepreneurs are, while they mean well and I think that some of them are doing it right. Okay. They are doing their research to actually really yeah, boots on the ground and talk to the patients who this matters too. And I had the opportunity now to work with a number of different companies who have made the decision to talk to patients and are actively working with them and it makes a major difference in the development of the products in a way that it's iterated on. I mean, I have to give the hats off and a shout out to Clara Health for bringing me on as their patient advocate as one of the first hires. That's really unheard of at most small health tech companies and but, but that made a big difference because I was able to come in and share my perspective and then say, Hey, you know what? Lilly: 18:20 I'm going to give you this perspective, but we need to bring in a lot more other patient perspectives. If we want to actually develop a product that's going to meet a diverse set of needs because one patient, much like in a consumer-facing industry, you can't talk to one person and build an entire product off of that. That's crazy. People would not do that. It would not be allowed. And in the consumer-facing industry, you would not get to move forward with that product. It just wouldn't be an option. How tap? Because it has not been and in healthcare in general, because it has not been the status quo to talk to the patients. Nobody's doing it and you're not expected to. And VC firms aren't forcing these companies to talk to patients because again, it's just not what's expected. And I think that it's resulting in a lot of products that are not making it to market or are startups that are failing. Janet: 19:12 And you know, there's a limited supply of cash out there and every time we see something fail, that limits the pool of cash for other maybe more on focus ideas that have maybe a little bit deeper research or a better validation. I love that everybody's trying to solve problems and I'm sure that that was a good thing they were trying to do, but really how many diabetes apps do we really need? I think it would be very cool, you know if we could figure out how to get the patients involved in doing this kind of development. Lilly: 19:43 Yeah, I mean certainly. And so really our plea at Savvy is that you get out there and, and you talk to patients and we've also made a real effort to be startup friendly. I think another big part of the problem here is that it can often feel cost restrictive to some of these small startups to be able to say, hey, we need to allocate the money to go talk to patients. And so what we've done is we've created a pricing model that does accommodate some of these smaller startups that they still have the ability to talk to patients but not break the bank because we understand that every dollar really counts when you're at that stage. And so I really encourage companies, help small tech companies to spend the money. It will be worth it. I know every dollar counts, but it's so critical that you spend that money there. Speaker 1: 20:32 You know, one of the things you mentioned is that diversity in your community is really important, but when I think about the number of conditions and disease states out there, holy cow, your community could end up being millions and millions of patients. Lilly: 20:48 Absolutely, and what's interesting about our co-op model is that we already have a very large reach. So because our patients are owners, many of them are owners and our platform rights, they own a share and again, they share in our profits at the end of the year. This means that let you know if we're recruiting for a company that really wants to talk to a thousand patients, a thousand patients in Crohn's disease, let's take Crohn's disease because that's what I have and it's an easy one to go to. And let's say we have 500 Crohn's disease patients on our platform. We could reach out to those 500 patients and they'd all find us enough to get us to that 1000 and sent the company and they would all do that because they're all highly motivated in Savvy success because when we are successful, they're successful. And so it's a really, really unique model unlike anything else that exists. And so we're able, we have this really special reach into private Facebook communities and support groups and boots on the ground because our members are, are the conduit. There are salespeople of Savvy, of spreading the good word about patient feedback and bringing their fellow patients into the fold. Janet: 22:05 Okay. So what I'm imagining is that there are a lot of groups that patients may be involved with, ones that are, say specifically about their disease state or condition where they're talking to patients. So that's not really what you're trying to do out there, but they can on your behalf, recruit more people with like conditions into your projects. Lilly: 22:28 Exactly. And that's how we get a more diverse range of folks on our platform as well. Because not every patient works with an advocacy group or shares their story on Twitter or regularly it goes out to companies. So that's sort of the low hanging fruit if you will, or the patients who are easily accessible. But there are a lot of patients who, you know, maybe live in the middle of the country and the way that they're expressing their patient journey or they're learning more about being a patient is through a local support group. And so we're able to reach those patients because we have folks on our platform who are connected everywhere, which is really, really special. And just unlike anything I've ever seen working in this industry. Janet: 23:18 You know, and that's a really big issue for hospital systems. I know for instance, in the state of North Carolina, we've had some rural hospitals close, well those patients still live in the rural parts of North Carolina where those hospitals formerly were, and they're losing all kinds of resources, not the least of which is the ability to connect to other like-minded patients. So as we look at critical clinical trials, mostly taking place in major cities or even midsize cities, there are a lot of patients that are falling through the cracks, are not getting to participate because of this limited geographic viewpoint. Lilly: 23:55 Right. On the money. I don't even have anything to add to that because that's exactly what we're always talking about. Janet: 24:02 Excellent. And I'm glad we're on the same page. So tell me about the kinds of things that as patients they can get involved with. And I'm assuming that of course, this is all going to be Phi protected health information, or are they participating in anonymously? Are there times when they would actually block their identities from being known? Lilly: 24:22 Yeah. So it all depends on the gig. So when we call them gigs, because what we like to say is we've created a gig economy for patients. So patients can log onto our platform and they can see different opportunities that are open to them and they can raise their hand if they feel there are fit. So some of them involve maybe an anonymous survey where you provide your feedback online via a survey. Some could be sharing your story via a blog post with a company, um, in which case you would be talking more publicly about your story. There are gates that allow you to stay in anonymous, but there are also games that allow you to get out there and share your story. And, and I think we certainly have a mix of patients on our platforms, some who really want to be out there and some who still want to contribute but want to do so in an anonymous way. So there are options really for everyone. Janet: 25:09 Oh, well that's excellent. And I think you're gonna find that you probably have already found that there are patients who are just tired of being in the dark and they're learning to embrace, you know, where they're coming from. And of course, we get to the question of stigma and while they might be ready in their own groups to come out and talk to other health professionals that don't necessarily always translate to their own neighborhoods or even inside their own home, you know, talking about their conditions with friends and family. Lilly: 25:38 Certainly. Yeah. And, and that's something that we're very sensitive to because we know that unfortunately there is still a stigma for patients within their kind of everyday communities and in the workplace. And some people would like to keep that private. But it is my hope that we can continue pushing to raise awareness, especially about some of these invisible illnesses where people, you know, in your workplace, they may not fully understand and you might not feel comfortable sharing with them that you living with an invisible illness. But I want it to become more commonplace, that that's what people are doing so that we can raise more awareness and people can understand that, you know, if you're living with an autoimmune disease, when you'd say you're tired, you can't come into work because you're tired. That's not a normal tire that's on a tired, that healthy person feels, that is crippling fatigue that forces you to be in bed all day. You just, you barely even feel like you can take a shower because you're so tired. And so I think that we need to actually keep pushing. And I do encourage people when they comfortable to share their stories, wherever they can with their workplace, with their family, with their friends, and with their communities to help raise that level of awareness that we can have better support services in place where people living with invisible illnesses or autoimmune diseases. Janet: 27:03 Oh, that's excellent. Probably have already found that there are patients who are just tired of being in the dark and they're learning to embrace, you know, where they're coming from. And of course they, we get to the question of stigma. And while they might be ready in their own groups to come out and talk to other health professionals that doesn't necessarily always translate to their own neighborhoods or even inside their own home. You know, talking about their conditions with friends and family. Lilly: 27:30 Certainly in it is, and you know, we'll get there. It's taken time. But if you look at cancer, cancer, something, something like the American Cancer Society, that advocacy group has been around for, I think it's over a hundred years and anybody says, you know, so and so, and my family was diagnosed with cancer. There's really this automatic empathy that strikes I think between a peep. People get it, they understand how difficult that is and if you were to communicate that at the workplace, it would be understood, oh, this so and so needs to take time off because they have to care for their family member who has cancer. We lack that same sense of empathy when we're talking about invisible illnesses, autoimmune diseases, mental health issues are another big one. And I believe the only way that we can really push forward in that is by people coming out and sharing their experiences and telling their story. Lilly: 28:29 Whether it be at companies or just at your, in your local community center is at Church, at a place of worship at the local YMCAs. It needs to be happening everywhere. It really is a grassroots movement. It's amazing what all of these patient influencers have done and the movements and changes they are helping make in shifts in mindset. But a lot of work can be done on a grassroots level as well. And so it's my hope that you know, we can continue to inspire patients to, to get out and feel comfortable to share their experiences and their stories. Janet: 29:02 Now you just got back from a conference that was very patient-focused, didn't you? Lilly: 29:07 Yes, I was at a Patients as Partners in Philadelphia and it was my first time there. I spoke with a number of folks who said, oh my gosh, you're going to love this conference. It's one of my favorites. And what's really special about it is that on almost every panel they have patient representatives who speak on behalf of patients and advocates alongside industry professionals. And that's really unique because typically at a conference you'll see a handful of panels, maybe sometimes no panels that include the patient voice. And so this is really unique in that the patient really is present throughout the entire conference. I think it makes a massive difference in the strength of the content, the value of the contents. And I only wish that we could scale it up to see this happening at more conferences, not just patient-focused ones, but really across the board and in every nook and cranny of industry. Janet: 30:09 I really challenge every single health conference, not just to make a place for patients to actively engage, but to fund their presence through scholarships because let's face it, so many patients are facing huge financial burdens. Therefore, it isn't just a question of time and even money and the hotel, it's like money for food or for care for their families at home while they're away at a conference. I'd love to see more of this happening. Lilly: 30:39 Yeah, Janet, you couldn't be more right. And, and that is something that patients face. It's like, okay, now we have a seat at the table, but what about the fact that we have to take off work to go to this conference? You know, maybe not all of us work in the industry and, and so for us to have to leave work and take time off, and find childcare, daycare and who's going to go check on elderly parents? There's just so many factors that we need to think about. And then this kind of goes back to the clinical trials as well. This idea that we need to be designing experiences around the patient's life. We can't expect patients to just plug into what we want them to plug into. That's not fair. That's not right. So I do, I challenge people to really think about how we can design around the patient instead of, you know, trying to get them to just plug into what we've already developed. Janet: 31:37 You know, you mentioned to me earlier about the administrative burden that gets put onto a patient file or in a specialty Pharma situation. Can you describe that a little bit more? Lilly: 31:47 I'll talk about it a little bit from a, from a personal point of view and something that I've been experiencing over the past couple of months and really have been quite infuriated with the burden that I has been placed on me when it comes to dealing with insurance and some of the specialty medications that I need to be on. And I'll preface this by saying I'm in medically controlled permission. So I function remarkably day to day, kind of like an average person, which is again, remarkable and, and all the credit in the world to this industry that has developed these, these life-changing medications. But there are a lot of patients who are dealing with administrative burdens on top of being incredibly sick and being so sick that, you know, as I was talking about that they can barely take shower without feeling exhausted. So keep that in mind. Lilly: 32:42 Is that, as I kind of talked through all this frustration, there are a lot of people who are dealing it with, with it while they're actively sick. And I just can't imagine that. So lack of specialty medication is something I need every two months and it costs $20,000 every two months. So it's a hefty price tag. I am very fortunate that I'd have an insurance that covers it. But for years now I have had major issues with ordering and delivering this specialty drug. I spend all of this time coordinating hours with my physician who needs to write the prior authorization, which goes to the specialty pharmacy and my insurance. And then it gets, you know, most recently I was told, oh it's, it's approved, it's approved. Okay, excellent. It's approved. Great. I get a letter in the mail saying it's approved. I called to schedule the delivery. Oh No, it's not approved. I'm not sure why. I said, well, I have a handwritten letter from, from you that says this, this medication has been approved. So, oh no, I don't know what's happened with our system. That's, that's not the case. So then it's up, got to go back to my physician who my physician then has to call the specialty pharmacy and then I call the specialty pharmacy again to check in and you get the picture. I mean this is this, it's a constant frustration and this is one time and so finally we get it all set up. The delivery is supposed to happen. We get to the day, I stay in my apartment all day. I do not leave my apartment, I do not take a shower. I did not do anything because I don't want to miss the ups truck that delivers my medication. Lilly: 34:21 And so it's 3:00 PM and I receive a notification on my phone that the medication has been delivered. And I say, well that's interesting because I'm supposed to sign for the medication and I had no bell ring. And then I pop outside. I'm like, Oh, they left this $20,000 medication outside. Somebody is in trouble, but the medication isn't even there. So now I'm left, you know, in a frenzy trying to call ups to try to figure out what's going on. I am. Nobody's being helpful. I kept, I keep getting kicked out to an international helpline. And so I go to Twitter and I started tweeting about it and I, the patient community totally rallied around me and it ends up that I get the phone number, the direct line to the San Francisco office. Then you need to speak to again on the phone with them. Lilly: 35:08 They tell me that it was delivered to the restaurant next door. Oh my gosh. So my $20,000 medication is sitting in a restaurant next door that I was supposed to sign for. So I first opened my door, run downstairs to the restaurant and they have it miraculously and they put it in refrigeration because it says perishable on it, but at, so I get the medication. But it was only because the only reason I got my medication that day was because I am on Twitter actively and how to following within the patient community. If I was kind of, you know, an everyday person who didn't really, you know, have the wherewithal to like navigate all this and put it on Twitter. And I mean, I don't think I would have had my medication. And that is upsetting to me because Twitter shouldn't be a privilege to get your medication. Lilly: 36:03 And so that's just one example. I've got a million more examples of, of instances like this that happened. And I know that this is, this is the struggle of countless patients who are on some of these specialty medications that they deal with. And so there is a massive administrative burden being placed on the patient to be coordinating appointments, to be coordinating medication, to be calling insurance and fighting insurance bills. And I, I mean, I feel like I spent half my life on the phone fighting with insurance about charges. So this is just the reality that patients are living with. And I, and, and I don't think this administrative burden is fair and I think there's a lot of work that needs to be done in that space and I'm eager to see more people come into disrupted. I'm, I'm encouraged by some of the insurance companies that I've seen coming into the space like Oscar health. They're a startup insurance company and I'm actually a member of theirs right now and I've been really impressed by air communicative nature and how easy they make everything and the on-boarding and so I'm really thrilled to see some innovation happening in this space and I hope we can continue to move the needle because it's a big issue. Janet: 37:18 You've raised so many good ideas here for startups and to inform them about issues being faced by patients, but I do want to clarify one thing. The Savvy Cooperative is not a place for patients to come and share stories with each other. Right? It's not a support forum. It's about getting the patients from a business perspective, engaged with the health care companies, the Pharma companies, people who need to better understand what the patients are going through. They need to reach those folks, which sometimes is very difficult to do. Is that right? Lilly: 37:50 Yeah, that's a great point. And I'm glad you brought that up. And, and the reason that Savvy isn't necessarily a place where patients can talk and share their stories is that there are already so many people out there who are doing that. A lot of advocacy organizations have offered that platform and we see a number of different people who have taken the initiative on that. But we really haven't seen people coming in and, and giving patients an opportunity to monetize and to really actively get connected to companies and, and transform the space. And so I, that being said, I think that Savvy really is a wonderful community of patients and a community has sort grown organically if you will be, all the patients who have been involved. And we do share the stories of some of our members, but it's not really a place for that pure peer support. It's more of a place for, hey, how can, how can I share my experiences too and get paid for doing so. Janet: 38:54 Okay. Awesome. Now you do, I know, embrace social media and I know that you have a Savvy chat on Sundays. What's that all about? Lilly: 39:02 Yeah, so Savvy chat is where we actually chat with folks for really like across the industry, which we chat with patient advocates as well, but we chat with people who are doing really cool things in the patient experience and patient innovation and patient feedback space. So we try to bring that to light so that we can spread the good word and share ideas so that we can start to see this movement happening across the industry. Janet: 39:33 Oh, that's exciting. All right folks, now you know where to go to get involved and let's direct people how to find them. Lilly: 39:39 Yes, so if you go to Savvy.co op, that is really all you need. You can go right there and our social media is there. We're on Twitter, Instagram and Facebook, and YouTube. But you can sign up very easily. You can create a profile. You also don't even have to sign up to see the gigs. You can go in just as we, because we want it to be accessible to everyone. So if you don't want to sign up, you don't have to, you can just sign up for the gigs that you're interested in. But of course we do hope you sign up and we do hope you become a cone or it costs $34 it's a one time fee to become a co-owner. And we do have financial aid available for those who are unable to afford the $34. So again, it's a very accessible platform and we're looking to bring diverse perspectives. And so patients, caregivers, healthy participants, all are welcome. Janet: 40:34 Oh well that's awesome. I hadn't thought about healthy people. Lilly: 40:37 Yes, well they're important to write for sewer and it's, and it's interesting because you know, at some point, unfortunately in our lives, most of us or all of us will become patients. And so getting actively involved in research, we certainly have a number of people on our platform who maybe are healthy participants because they've seen loved ones who have been through something and they all still want to be able to give back. Janet: 41:00 Okay, great. Well, I'm thrilled to have finally had the chance to talk with you, Lilly. And I am sure to put all of your LinkedIn and social links in the show notes for this podcast so people can find out more about the Savvy Cooperative and folks. Of course, it's Get Social Health.com if you happen to be listening on a podcast APP, you can come on over to the website and get all of this information. Lilly: 41:22 Well, thank you so much for having me, Janet. I love the work that you guys are doing. You've brought together, you really created such a vibrant community of health care professionals and I am honored to be a part of it and look forward to continued collaboration. Janet: 41:39 Thank you, Lilly. Announcer: 41:41 You've been listening to the Get Social Health podcast. This show notes are located at getsocialhealth.com to join our healthcare social media journey. Follow at, Get Social Health on Twitter and start a conversation..........
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