Rebuilding a Fragmented System
PublishedNovember 29, 2021
Andrew Le, MD: Tell us about why you cofounded Wheel. What gets you excited about coming to work every day?
Michelle Davey: I grew up in a rural part of Texas. I was sick as a child, so I spent a lot of time traveling to doctors' offices. Healthcare wasn’t very accessible to me because of my geographic location.
I wanted to improve the system. In my 20s I joined Google as a recruiter and fell in love with connecting people to their purpose. I also fell in love with the rapid pace of innovation in the world of tech. I'm a builder at heart.
In 2016, I discovered the world of telehealth. My professional and personal life collided. Here was the promise of true access to care! I joined a telehealth startup as the head of global talent and shared services. I had hired tens of thousands of people in my career and thought it would be easy to hire doctors. But I was completely humbled. Because of the regulatory environment and the antiquated processes behind credentialing and training programs, it was very complicated.
I became close friends with my general counsel at the time because I sat next to him every day trying to understand the landscape. Why couldn’t a nurse practitioner see those types of patients in some states but not others? Peers in the industry noticed the same thing. The clinician supply was inhibiting growth and scale. And we weren't forecasting demand, which is hard to do in healthcare because we don't know when people get sick.
That’s when Griffin Mulcahey, who is now my co-founder, and I had a light-bulb moment. Everybody else was building silos of care. We wanted to connect clinicians with the right populations of patients. So, we started Enzyme, which became Wheel, as a two-sided matching marketplace using telemedicine.
We quickly evolved because clinicians and the companies they worked for wanted more. Clinicians asked us where to get licensed and how to vet the companies they were matched with. Companies asked us to manage their credentialing and scheduling. Wheel now handles the development of clinical infrastructure and clinical services that allow people to scale telehealth and virtual care affordably and efficiently.
"Everybody else was building silos of care. We wanted to connect clinicians with the right populations of patients."
Andrew: What a story. Congratulations on your success.
Michelle: Thank you. We are grateful for the help of a lot of people. It's been incredible learning how recruiting and technology meet regulation in healthcare — especially how to scale virtual care without getting stuck in the same potholes as in-person care.
Andrew: As we roll out of this pandemic and telehealth has had its boom moment, what keeps you up at night?
Michelle: I wonder if we can keep the promise of virtual care. During the pandemic, clinicians saw 50 to 175 times the number of patients virtually than they had before. Regulations and reimbursement evolved to accommodate virtual care. It is a perfect storm of innovation, but we’re in early innings. How do we seize and expand on this moment?
We're seeing so many different use cases for virtual first care. It’s telehealth plus diagnostics, plus monitoring. Without connectivity between all those things, we're just going to re-fragment the system. We are trying to build a system that's connecting all those areas — not only for the patients but for the clinicians as well.
Wheel's platform functionally integrates patients and clinicians for end-to-end virtual care. Image courtesy of Wheel.
Andrew: I love that answer. Help me understand the clinician’s view of telemedicine. What are some of the unique challenges about the clinician’s life in a virtual-first world?
Michelle: From the clinician’s perspective, there has been a lot of distrust in telemedicine. It didn't seem like a viable career opportunity because clinicians didn’t feel comfortable putting their licensure and livelihood on the line.
Now, for many clinicians, virtual care is the next evolution of their career. But it feels like the wild, wild west. Which companies are the best to work with from a regulatory and clinical quality perspective? Who has strong patient demand? A lot of that information is not shared with clinicians. And unfortunately, we’ve seen some bad actors. That perpetuates a certain amount of distrust from the clinician perspective.
A core tenet of Wheel is establishing that trust between the clinician and the telehealth system. We vet every single partner we work with from a regulatory and a clinical perspective. We also help clinicians get training and education they need as their careers evolve. Healthcare is now a hybrid system. It’s not in-person or virtual care; it’s both.
"Healthcare is now a hybrid system. It’s not in-person or virtual care; it’s both."
Andrew: It's interesting to hear you talk about the evolution of telemedicine. How do you think EMRs are affecting physician connectivity?
Michelle: Whether you’re a hospital system, a retailer like Walmart, a pharmacy, or a digital health company, the EMR you choose can be a competitive advantage. Many clinicians choose to work with companies because of the technology they built or partnered with.
Clinicians prefer companies with integrated, streamlined EMRs. They don’t want to spend most of their time inside the EMR, trying to type notes, navigate to the next page, switch between tabs, all while trying to serve patients. We need APIs. We must have push and pull data. Your organization wants to hire the best clinicians. You don’t want to force people to another company because of the technology that you've chosen.
Andrew: When you think about serving both clinicians and patients, where is the most friction?
Michelle: A lot of digital health companies are trying to bring a cohesive consumer experience to patients. But not many people are talking about the fact that a cohesive experience for the patient also must be cohesive for the clinician.
So, we’re building infrastructure for both patients and clinicians. That includes everything from the virtual front door that enables clinicians to have the data they need to treat and diagnose their patients. It includes ensuring that patients get their prescriptions at the pharmacy and adhere to their medication schedule. And if virtual care isn't the best option, how are we navigating patients to in-person care?
Those are very different systems. Connecting them for the clinician is a big undertaking. One of the biggest pain points — and the biggest opportunities — is connecting the companies that are building in digital health now. We are establishing a new standard of care for clinicians and patients in virtual care. It’s difficult, but it’s where we see the most opportunity for innovation. And it’s what we most excited about tackling.
About the participants:
Michelle Davey is CEO and cofounder of Wheel, the industry’s first model for delivering high-quality virtual care at scale by empowering clinicians and providing new efficiencies for healthcare companies.
Dr. Andrew Le, MD, is CEO and cofounder of Buoy Health.