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Forging the Future of Integrated Care: A conversation with Randhir Vieira, SVP of Product

The impact that increasing digital adoption is having on consumer behavior is being felt in sectors across our economy––and healthcare is no exception. In response, companies like Omada Health continue to meet the moment and prove that integrated, virtual-first care has the ability to help organizations improve the health and wellbeing of their populations.

But how did virtual-first care arrive at this moment? And where is it heading? We figured Randhir Vieira, Omada’s Senior VP of Product Management would have some answers. A leading expert with over 25 years of experience heading up product management for companies like Headspace Inc. and Yahoo, Randhir sat down with us to discuss the ascension of virtual-first care, its implications on the broader healthcare ecosystem, the flaws in traditional healthcare it resolves, and much more. 

Q: What are the biggest adjustments in healthcare over the last decade?

Randhir Vieira: The first wave was focused on replicating in-person care digitally. This certainly has value. It's usually more accessible, more convenient and has lower costs.  Examples of this include telehealth apps on your phone that make it more convenient to talk to a doctor at any point, instead of going to the urgent care. The next wave was re-imagining what is only possible in the digital realm. Continuous monitoring devices, smart nudges and longitudinal care are examples of this. But care is still fragmented and there's a lot of opportunity to make it a much better member experience.

Q: Speaking of cultivating a “better member experience,” do you think that virtual care is meant to complement or eventually replace in-person care?

RV: At Omada, we understand that there are many things that still require people to deal with in-person, such as an eye or foot exam. Those kinds of things are still happening in-person at a health care provider’s facility. The other piece that we see a lot in all of our conversations with our members is that they have a very strong relationship with their PCP (primary care provider); and we want to leverage that, not compete with it. We see ourselves as complementing the care plans that our members develop with their PCP. We want to focus on the personalized behavior change pieces that we excel at, that our members value and that PCPs don’t usually have the time and resources to fully support.

Q: You mentioned earlier that healthcare is still fragmented. What do you feel would be the resolution for this?

RV: It’s challenging for members because they have to coordinate and share information across different solutions. It also makes it challenging for buyers to manage a growing list of providers. At Omada, we’re expanding our program offerings across conditions. We offer weight management across most of our programs. We're providing behavioral health support across all of our programs. We're providing integrated diabetes prevention, diabetes management, hypertension and musculoskeletal solutions because we see a high overlap there. This helps our members get integrated care with a single care team and allows our buyers to have fewer companies to deal with. 

Q: Are there any other resolutions that need to be considered? 

RV: The other part of it is making a much more concerted attempt to integrate with the rest of the healthcare ecosystem. That way providers can see what’s happening and provide a comprehensive, unified plan for the member rather than just doing things in a silo. The more recent trend in healthcare, and digital health in particular, is not just replicating what we were doing in-person. We’re now trying to reimagine things that can only be done in a virtual or digital-first world. That includes trends around remote, continuous monitoring, being able to provide affordable feedback, and coaching that's available at the members’ convenience almost 24 hours a day, no matter where they live. That means being able to bring in things that provide better care, not just things that are easier or cheaper.

Q: You touched on integrating with the rest of the healthcare ecosystem. Would the entirety of the healthcare industry be receptive and supportive of an integrated care model like the one Omada is starting to implement?

RV: I think conceptually, yes because it provides better care and better member outcomes. But sometimes the financial incentives are not in line with that. In a model where the provider is being paid on a fee-for-service model, it's challenging for them to do things that they may believe are the right things to do, which is to respond to people on email or text without having them come into the office. Now, there are organizations operating on a capitated model or value-based contract where they get paid for managing the health of a population, not on an individual fee-for-service visit. Those incentives are more in line with making sure that we're supporting the health of our members at their convenience and at their pace, not just encouraging them to come into the office for a visit.

Q: In the healthcare industry, are there organizations who are leading the way and demonstrating prime examples of providing fully integrated care?

RV: We've got some amazing models of integrated care in the real world with in-person clinics. You have integrated health systems like Geisinger, Intermountain Health, and Kaiser.  You've got clinics like the Mayo Clinic, which have just done a fantastic job over the last several decades of building amazing multi-condition and interdisciplinary practices. We have evidence of what works when that is well-executed. The challenge with the in-person models is that they're not accessible by geography to everybody. They're either not convenient or too expensive. Our goal is to build on what we know works from the in-person world and add things that are possible only with digital technology so that we can make these best practices available to a much wider population, scale that and do it affordably. 

Q: If Omada’s goal is to build on what’s working in the in-person models you mentioned, what are some examples of that happening and trying to improve coordinated care in the Omada context? 

RV: Our members typically have a health coach that is working with them on their behavioral change program. That health coach is the primary person at Omada who's helping coordinate their care. When they have behavioral health needs, the health coach is trained to help with some of their behavioral health needs and the health coach will consult with an experienced behavioral health specialist, as needed, to make the coaching more effective. Similarly, if this person has diabetes they're bringing in a diabetes specialist, or a hypertension specialist. But there's always this consistency of care with the health coach and the member. So those are the kind of approaches that we are bringing into our programs to help with that coordinated experience across these different conditions that we treat.