September 4, 2020: Meet health tech entrepreneur Lucie Ide, MD, PhD and Founder & Chief Health Innovator of Rimidi. A health tech company focused on bringing personalized management to chronic health conditions. Software for clinicians, by clinicians. She shares her sustainable business model. How do you get your best ideas? What is the market demand that you’re meeting? What's the revenue model for your product? How can you understand the pain points? From employee issues to founder issues to investor issues. And how do you handle tech debt as you mature as an organization? Step into the exciting mind of a scientist, clinician, academic and entrepreneur.
Making it Easy for Clinicians to do Right with Rimidi Founder Lucie Ide
Episode 299: Transcript - September 4, 2020
This transcription is provided by artificial intelligence. We believe in technology but understand that even the smartest robots can sometimes get speech recognition wrong.
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Welcome to This Week in Health IT. My name is Bill Russell, healthcare, CIO, coach, and creator of This Week in [00:01:00] Health It a set of podcasts, videos and collaboration events dedicated to developing the next generation of health leaders. This episode, and every episode, since we started the COVID-19 series has been sponsored by Sirius Healthcare. Now we've exited that series, but Sirius has stepped up to be a weekly sponsor of the show through the end of the year. Special thanks to Sirius for supporting the show's efforts to develop the next generation of health leaders. Right today, we are joined by Lucie Ide PhD MD. Dr. Lucie Ide, Founder and CEO of Rimidi. Good morning, Lucie. Welcome to the show.
[00:01:30] Lucie Ide: Good morning. Thanks for having me.
Bill Russell: So Rimidi. I have Rimidi down as a health tech company focused on bringing personalized management to chronic health conditions. Elaborate on that a little bit. What, what is it that you guys do?
Lucie Ide: So we are really focused on the issue of how do we help, clinicians that are using data when looking at these chronic diseases and sort of bridging from, protocols and population health type guidance to that individual patient who you're [00:02:00] taking care of. And with the enormous amount of data being thrown at clinicians in their EMR, from devices in the home, how do they make sense about and make that really evidence-based data driven decision about patient care?
Bill Russell: So you're bringing evidence-based, guidelines and those kinds of things. How do you interact? I mean, how do you interact with the, are you in the workflow of the EHR or do you have your own digital tool. How do you interact?
Lucie Ide: Yeah. So early on when I started the company, [00:02:30] EHR integration was a huge pain point in the industry, as I'm sure, very well as a former CIO and, someone luckily put a bug in my ear about FHIR, way before fire was a cool thing to talk about.
And we became very early adopters of FHIR and sort of that concept right. Of a common API and standardized way to interface with the EHRs, not just about the data, but about the actual user experience. So sort of the smart on fire piece of that and how do you basically run an [00:03:00] application like ours within the clinician's workflow?
So, from my point of view, if a clinician never really knows that Rimidi is what's delivering this great product to them, I don't care. Our goal is for them to have the data analytics and tools. They need to deliver it better for patient care all within that existing workflow.
Bill Russell: Yeah. And that's the problem.
We talked about that a lot on the show of the promise of technology fading into the background, right? So we're just enabling outcomes, enabling progress, but what kind of [00:03:30] outcomes are you guys seeing and what kind of things do you measure in terms of the success of your implementations?
Lucie Ide: So, as you mentioned, we're focused on chronic diseases like diabetes, heart failure, hypertension, obesity, et cetera.
So we look at those clinical outcomes, but sort of the, the means to the end, right? How do you get to those clinical outcomes? It's where there's been the rub in chronic disease management for years, maybe decades, right? If you spend more money getting the better outcome, [00:04:00] it becomes sort of a non-scalable, non-sustainable type intervention.
So efficiency of workflow is a big deal. and then I would say most recently with the big focus on remote patient monitoring and new reimbursement models, sort of driving that financial model with the ideal situation being, clinicians and health systems can use technology that generates new revenue streams drive more efficiency for their end users and also better patient outcomes.
Bill Russell: So when, when COVID hit, [00:04:30] did you get a lot of requests to do something different than what was your core business? Was that a common thing?
Lucie Ide: Not necessarily different from our core business, remote patient monitoring has been a part of our core business from the beginning. We've always starting with diabetes.
We've always been pulling in the blood glucose data, into the workflow, mashing it up with EMR data to help drive this evidence based decision making. But. Yeah, just like telemedicine. All of a sudden there was this explosion of [00:05:00] how do we take care of the highly vulnerable populations remotely, because we can't bring them into the clinic.
So, a lot of interest in the RPM capabilities and because of some of the reimbursement changes that have happened under the public health emergency, a lot more focus on the billing for RPM.
Bill Russell: question on this, cause I'm really. I'm curious. So, we have a lot of data moving around.
You're you're, providing, some, [00:05:30] I don't know what the best word is for this, but you're, you're providing intelligence around that data. And you're presenting that data at the, at the right time, at the point of care and whatnot. Are you doing any, anything with regard to, artificial intelligence machine learning to, either look at the data during the clinical workflow or post clinical workflow to enhance, operation performance outcomes?
Lucie Ide: In the clinical [00:06:00] workflow. Right? The, one of the challenges with remote patient monitoring is the feeling by clinicians of don't just give me more data, right? Don't dump a bunch of patient generated health data into my workflow.
Help me know what to do with that. Who do I focus on? Which patients are highest risk of having an adverse outcome or having an ER visit? so we have a lot built into our rules engine that drives our clinical decision support. Pathways that really helps clinicians optimize for that efficiency of, who are the highest [00:06:30] acuity, highest risk patients who need, attention and intervention.
And then as you said, outside of that workflow, we are certainly building, analytics and algorithms to help them understand globally what the implications are. it's, these protocols and guidelines can be incredibly complex. And they can be conflicted. If many of these patients have multiple chronic diseases that you have, diabetes guidelines, you have heart guidelines, you might have kidney guidelines.
That's difficult for human beings [00:07:00] sort of optimized for that intersection. So we're really interested in that space and sort of optimizing that individual patient's decision making in the face of complicated and sometimes conflicting, evidence.
Bill Russell: So is that so, No, you have the, what the clinician really wants from digital tools and, and digital transformation.
And what patient really wants from the tools and transformation. Is it, is it clarity of what I should be doing at this specific time? [00:07:30] given the, just the complexity of all the information and the complexity of my chronic condition, is that what they're looking for? Or, or how would you describe what the clinician and what the patient are looking for?
Lucie Ide: Yeah. I think the best way a clinician put it to me was make it really easy for me to do the right thing and make it difficult for me to do the wrong thing for this patient. And, I think we as patients, we're all patients at some time, right. That's what we want. We want to go to that trusted advisor [00:08:00] of our physician or other caregiver.
And have to make the best decision for us based on our unique circumstances and our characteristics as an individual. So I think those two are aligned.
Bill Russell: Yeah. That's fantastic. Easy to do the right thing, hard to do the wrong thing. That is, that's fantastic. Especially with all the deluge of information that's coming at them.
You have a phenomenal background. I probably should have started here, but, like to get back to it. So you have a phenomenal background, [00:08:30] PhD MD. So you are, would you classify yourself as somebody who's always wanting to learn more? That's why you ended up there or did you just went down one path and decided that there was another path?
Give us a little background, a little background on how you end up a PhD MD.
Lucie Ide: Yes. I started my career as a scientist and I would say I probably am at the root of it. The scientist at heart, is a physicist working for the government. And then went into venture capital for a bit. We can come back to [00:09:00] that and then really had a plan to transition into academic medicine.
So I did a dual MD-PhD program with the goal of, having a career in a large academic medical center and running a research lab and seeing patients and once I got into residency and really got a feel for what the actual practice of medicine is like and what actual hospital operations are.
Like, I just became fascinated by all of the opportunity to make that work better. Right. And sort of a [00:09:30] system level analysis of like, why do we do this this way? And why haven't we changed in light of evidence and sort of that endless? Why?
Bill Russell: Yeah. The, the, the PhD in you, the scientist, and you came out. You just kept looking at you, you looked at the hospital operation and you're like, this, this can be better.
So, so, I, I'm curious about, Elon Musk talks a lot about using the scientific method and is that essentially your approach? You have a hypothesis [00:10:00] you'd like we could do this better. I think if we do this, this will be better. Is that, how is that how you approach your, your, your company and your entrepreneurial efforts?
Lucie Ide: Yeah. And I think, often I get asked about being a physician and becoming an entrepreneur. And I actually think that scientific training is much more preparatory for shifting into entrepreneurship, because exactly you see a problem, you create a hypothesis of what's underlying that problem.
How could you solve that problem? And then you just start to [00:10:30] iterate on that. you try something, you gather evidence. DId that work? Did that not work? Okay. Let's. Change that little piece to see if we can get it to work better. and in our journey, when we first launched a platform, it was standalone and we had people who loved it, but said, I, I can't scale this across my organization if it's not integrated to the EMR.
So then we start down that pathway. Okay. how do you do that? What is fire? What does that mean? What's the future? So it's sort of endless peeling back layers of an onion.
Bill Russell: Yeah. when you're [00:11:00] hiring now, do you look for people who I have a, I mean, have a scientist kind of background or are you pretty broad in terms of who you hire?
Lucie Ide: I think I look for people who are curious, right? Cause at the end of the day, that's what, that's a comment train of. A lot of science is just fundamental curiosity and a willingness to explore things they may not know a lot about and to sort of continuously learn. and so certainly when people join our team, it's like, this is, [00:11:30] this is a young, nimble company and what we're doing today may be different than what we're doing three to six months and you want, you need to want to go on that journey with us.
Bill Russell: I'm curious about tech debt and when you're first starting a company out, it's beautiful because it's greenfield and, you can set things up and go in a lot of different directions but as you start to progress, you get asked your list of things that people are asking you to do gets pretty long, and then you have some legacy data, legacy systems, and those kinds of things. How do you, how do you [00:12:00] determine what you're actually going to do? I guess it's the first question. And then the second. How do you handle tech debt as you mature as a, as an organization?
Lucie Ide: Yeah, it's a tough one. And there's sort of what we call a cage fight that happens on our product roadmap session, where, everybody comes in with their list of requests from clients, the list of requests from the tech team, the strategy requests of what they want on that product roadmap. And we really do have to sort of fight it out, [00:12:30] figuratively, over what, what ends up on that roadmap.
And one of the big issues is, when do you invest the time and resources and, moving past some of that tech debt. So, we've really tried to, operate on really modern future facing architecture and stacks and having people who don't come from healthcare is very helpful. and often when we're talking to IT teams at health systems, they're sort of, crying a few tears of jealousy.
When we talk about these, [00:13:00] modern architectures that we work on. Cause it's things they don't often get to work on and their day to day life, But it's hard, right? I mean, it's the trade off. Could we build enhancement that customer right now is asking for, or do we invest, months of dev and moving to, to, updated platform and dealing with some of that tech debt. So it's just a trade off.
Bill Russell: What about the users? Do you have trade offs from time to time where you're looking at and you go, Hey, this is going to be really good for the clinician, but it might not be as good for the patient, or this might be really good for the patient, but the clinician [00:13:30] is really going to hate putting this into the workflow. Do you have those, those kinds of trade offs?
Lucie Ide: we have over time, Sort of really worked to understand the usability and those demands for the patient and the demands from the clinician. And certainly on the patient side, I truly believe none of us want our health issues to dominate our day to day life.
Right? Just like clinicians want the technology to fade into the background. The patients do too. If I have diabetes or hypertension, I don't want to spend my day thinking about that. [00:14:00] And so, we have scaled back and scale back in some ways what we try to ask a patient. You know, we love cellular enabled RPM technologies.
Just step on the scale, just take your blood pressure. The data automatically goes into our platform and you don't have to think about it. You don't have to pair to a smartphone with Bluetooth, which is frustrating. And, so that's been our approach on the patient side. It's, how do we make this accessible and available?
Our team is really committed to sort the community [00:14:30] health aspect as well of, years ago, I sort of set the expectation if we're not going to be a technology company that makes healthcare better for the 1%, I want to be a technology company that makes healthcare better for those who have the hardest time accessing healthcare.
And so that's, influences a lot of what we think about in terms of accessibility of price and technology of what we build for patients. Yeah.
Bill Russell: And the sensors are really going there. Right? I mean, the sensors, the cellular technology, I mean, with [00:15:00] five, one of the best things about 5G coming out is that 4G becomes less expensive in 3g, becomes less expensive.
So we can now get these little sensors that we put in these things. I mean, is that what you envisioned sort of the home of the future, where I sit down on a chair and it automatically takes a handful of readings and, and puts it in into some sort of, database, bad terminology, but anyway, but it brings all the data together about my health, passively, over time. Is that [00:15:30] what we're envisioning?
Lucie Ide: Yeah, I do think we need to get to the continuous passive model of monitoring. Right? And today the cutting edge is using enabled medical devices. Like accommodator, we all know that's going to go away at some point in the future. And whether it's, sensors embedded in the home, in my clothing, whether it's maybe at the next step, the sensors and smartwatches and phones, You know that's where we're going.
And in fact, we're doing some cool and exciting work around COVID with [00:16:00] continuous noninvasive monitoring and really the analytics of picking up deviation from personal baseline and flagging people who are displaying early symptoms and sort of warning signs of COVID.
Bill Russell: Now you mentioned this earlier and I've been in these meetings where the doctors were like, I don't want any more data. I mean, like here's all the data, you figure out what it be. I mean, do something to it and just present me, these three data elements. That's all I really want to see. I don't want to see every [00:16:30] time somebody sits on a chair, I don't want to see, their weight changed by 0.5 ounces.
Lucie Ide: Absolutely. They need the technology to distill it down to the actionable information for the physician. And then I think we all also have to continue to think about top of license practicing, right? What do we need physicians to do? Because only they can do it through their credentialing and their training.
What can the rest of the care team do? And I think that concept is going to be further advanced as we move more into this [00:17:00] continuous virtual model of care. And, everyone on the care team has a role to play there.
Bill Russell: How do you get your best ideas? Is it from your clients? I mean, do you have like an advisory board of clients or is it just by interacting with your clients? Is IT help desk calls? I mean, how do you determine, how do you find the next ideas for your product?
Lucie Ide: Yeah, I would say it's mostly client and clinician driven. So both clinicians who were at client sites and then sort of [00:17:30] formal and informal advisors who we have.
Bill Russell: Yeah. That would make sense. All right. So I want to go back. I don't know how I ended up where I'm at, but I want to go back to your background. So you, PhD MD, you worked in venture capital and let me, this is a question I'm asked a fair amount, when when's the right time for someone to look at venture capital PE, angel investing [00:18:00] or bootstrap, no investing at all. If you're, I mean, where do the different strategies really work the best?
Lucie Ide: I think depending on the stage to the company, what kind of product you're building if you can bootstrap a technology and start generating early revenue and fund the company through that, I think that's a great mechanism. That's hard. If you're building clinical software that needs to comply with HIPPA and a lot of other [00:18:30] regulatory burdens. It's hard to with the long healthcare sales cycles to bootstrap something, I would say. That's been my experience, but you'll see people in healthcare with more consumer facing technologies, less clinical technologies who can take that path.
Overall, I think it's just important to get alignment of the people you've raised money from. They are becoming the longterm part of your team and know that, and be aligned with them as to what your goals are, what your values are. [00:19:00] And to me that's much more important than the type of money is that you're raising money from people who are wanting to go on the same journey with you.
Bill Russell: Yeah. So you're not just taking money from somebody who's going to give you money. That is one of the problems people are like, I finally found somebody to give me money. And so when you say to them, there are all those things aligned. There's our values, objectives.
They're like, they're going to give me money. that's probably a, a path towards destruction. Isn't it?
Lucie Ide: There's going to be bumps in the road right. [00:19:30] And ups and downs and turns, and having people who are willing to go through those times with you and be supportive. Their role, isn't always to be supportive. The role is to question you and help make you better, but you want that fundamental alignment at the end of the day. What's the problem we're trying to solve. And, do we believe in the same thing?
Bill Russell: Yeah, it's interesting. Podcasts I've mentioned this before on the show, but Redox did a podcast with their VC and the two [00:20:00] founders cause they recently had to do some reductions and it was interesting to see all three of them addressing not only their company, but they addressed the entire healthcare community by putting it out on a podcast of why are we making these decisions? How are we focusing? And I think that's a great example of really good alignment between the VC and the owner.
There's not a question there, it's just sort of a comment, but you've seen a lot of pitches to VC. [00:20:30] What would you say is the mistake that you see made when people come before a venture capital firm and pitch for a partnership and money?
Lucie Ide: Yeah, I'd say probably the most common pitch mistake is having a technology looking for a problem or a solution looking for a problem to solve that. any of us, you can fall in love with the ideas we have and the technology but if you don't really understand the problem you're solving [00:21:00] . What is the market demand that I'm meeting? And what's the revenue model for a product, right? Because at the end of the day, we all have to come up with a sustainable business model that's going to support growth of a company. So in general it's hard, right? Because you're so close to it. but always being able to speak and sort of that, unit economics of, for the client, for the user, this is the problem I'm solving and this is why they must have what I'm [00:21:30] building.
Not, it's a nice to have.
So there's a sense in which I, I, you probably hear a lot if, if we build it, they will come. There's not really a good model for, Hey, here's how we're going to help them to be successful. Here's how we're going to help them write the patient outcomes. Here's the demand that's already been generated around this type of product set and those kinds of things.
So, yeah. And the, the early days of value based care, I think we're a good example of that. there are a lot of companies building solutions to help drive better outcomes for [00:22:00] early ACO and other value based care models. But the economics weren't necessarily all figured out of what would it be?
Those, models work for the health system, much alone for the supporting technologies. So there were a lot of cycles around that, of pitching better outcomes but how does that tie back to the revenue and the savings?
Bill Russell: So Lucie, why did you, so you talked a little bit about how you ended up being an option manure, and you had the VC background.
People might look at it and go, that's just the perfect fit, but there's [00:22:30] so few females health tech entrepreneurs, yeah. Give us a, an idea. Were there any obstacles you had to overcome in order to get to where you're at today and what would you say to maybe the next generation in terms of doing things today that will prepare them for that role?
Lucie Ide: Yeah. I think when I talk with sometimes clinicians or scientists who are interested in being entrepreneurs in healthcare, I [00:23:00] do think actually having the clinical experience, y'all talk to med students sometime and they'll say, Hey, should I just quit and go start a company?
And I usually advise them, no, actually go out there and really understand. What your colleagues in medicine are experiencing because the ability to be empathetic when you're building technology is incredibly important. And I think that's been very important for us as a company to really know, understand the pain points and the priority of those pain points and sort of the, schlog of the day to day medicine.
[00:23:30] Sometimes you come in and you've got 40 patients to see. And at the end of the day, you actually want to go home and have dinner with your own family. and so I'll repeat that to my team over and over. We can't build better technology that adds an hour to their day that we just can't. Nobody will use that because over time they actually want to be able to go home at night.
So I think, let me add it with that perspective of I'm going to go get them some experience that will help me be. I'm able to better relate to those end users is one approach. [00:24:00] I'm raising money. I'm okay. Pretty involved in female entrepreneurship, organizations. And, there's a big gap in terms of the amount of money that women raise as entrepreneurs versus men.
And while I had worked in venture capital, I really didn't have connections and to healthcare VCs. So that was a big obstacle to overcome for sure. And, you have to just be tenacious be okay with being told no, dozens, if not hundreds of times, and be confident in what you believe in and your [00:24:30] vision and if you're really providing value, somebody else will see that and appreciate it and support you.
Bill Russell: Yeah. Tell me, talk to me a little bit about, networking and mentorship, right? So, I hear a lot of people say, I can't find a mentor. I want a mentor, but I can't find a mentor. That's one thing. And then the, and just the value of the people that you've interacted with over the years and how they, how they help you maybe today in the role, maybe even get you into the role you're in today.
[00:25:00] Lucie Ide: Yeah, I think one area that's overlooked is peer mentorship. That has been incredibly helpful to me. One of the, actually the first sort of fund money in was from a group called Village Capital, who has this really unique peer selection process around their investment strategy, which we would luckily lucky to be selected.
But it's a group of peers who I have stayed connected with because while we may be building different companies and different technologies, we're all to some degree in living the same experience. and then later in the company, [00:25:30] we were located at Georgia Tech. It's the technology accelerator there.
And I would have lunch every Friday with the other CEOs. And that was probably the most helpful group of mentors who I have interacted with because, they could be a FinTech company, a marketing tech company, but yeah, we all have the same issues, right? Employee issues, founder issues, investor issues, and sort of knowing it's not unique to you that like, this is hard. Everybody else is going through it. They come out the other side. [00:26:00] To me was what was super helpful in sort of getting up and doing it again the next day.
Bill Russell: Yeah, those groups. yeah, it's interesting to me, there have been times where I've sat around with other CEOs and people are like, you get to talk to CEOs all the time.
I'm like, yeah, you get to hear a part of the conversation on the podcast. Invariably, the best part of the conversation is the 15 minutes after we stopped recording. Because the guard comes down and we, and they go, Oh, [00:26:30] man, this chang to the HHS database from the CDC database has sent my team into a swirl and we ended up sharing that stuff. What's your not sharing on the podcast. I don't know. We just don't do it and why they did. But yeah, it's the, it's those groups where you can be honest for, people sharing, same kind of problems. You can be honest non-competitive and just help one another out. It's phenomenal. How can, how can people get more information about, about your company and how can they follow you? [00:27:00]
Lucie Ide: So the company is rimidi.com R I M I D I.com. We are really active on Twitter, on LinkedIn. So, follow us at those two locations and you can follow me on Twitter. just my whole name at Lucienne Ide.
Bill Russell: Just out of curiosity, Rimidi, how'd you come up with the name?
Lucie Ide: One of those creative uncomfortable branding exercises, but it's a play on the word remedy, but something that we could own and sort of grow [00:27:30] into.
Bill Russell: Yeah. It's hard to name a company, isn't it? I mean, it's, it sounds like it's easy, but it's, there's so many things that go into it.
Lucie Ide: Absolutely. Yep.
Bill Russell: Lucie, thank you again for your time. I really appreciate it. And that's all for this week. Don't forget to sign up for clip notes. Send an email to clip [email protected] Special thanks to our sponsors. Our channel sponsors, VMware, StarBridge Advisors Galen Healthcare Health Lyrics Sirius Healthcare, Pro Talent Advisors and Health Next for choosing to invest in developing the next generation of health leaders.
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