In this sponsored episode, Griffin Jones and co-founder of EngagedMD Jeff Issner discuss the unique ways the company provides added value for practice owners, employees, and their patients. How informed is your informed consent? Does your practice unknowingly carry added risk? EngagedMD’s education and informed consent solutions help to increase provable informed consent, reduce practice risk, increase and personalize provider-to-patient face time, increase patient education, save time, add to practices’ bottom lines, and ultimately increase access to care.
Tune in to hear:
Jeff and Griffin discuss ever-present nurse burnout, and what EngagedMD does to take some of the weight off of nurses’ shoulders.
Griffin question how EngagedMD’s program roll-out can be successful with varying practice size and demographics.
Griffin question how business advantage and patient standard of care can both be bolstered by partnering with EngagedMD.
Staggering statistics on the EngagedMD analysis of ROI on just a two-practitioner clinic, and how these results increase patient access to care.
Jeff’s information:
LinkedIn profile: https://www.linkedin.com/in/jeff-issner-0620a912/
Website: https://engaged-md.com/
Facebook: https://www.facebook.com/engagedmd
Jeff Issner 00:04
If somebody blindly signs off on something, and then an issue happens, if you can't demonstrate that the informed part of informed consent occurred, it's not helpful. It's not very valid. So all of these things are, of course, litigated through the courts. And but it's very clear that just signing a piece of paper is not informed consent, you need to ensure that patients are informed and actually understand before consenting, fertility, nursing, burnout, Rei, productivity, fertility, patient satisfaction, the standard of care, revenue, these are just a couple of things that I talked about with my guest, Jeff Fisher, he's the co founder of EngagedMD, and you've heard of them, because they're a sponsor of this show. And you've heard of them. This happens, all fertility clinics in North America are using them. And you've heard of them, because so many people have come on the show and at conferences and other places and been talking about how amazing they are. It is a sponsored episode. And so you'll hear me sing their praises, because I legitimately don't. I don't have anything to counter with, it's been the most lopsidedly Positive reported company that I know of, in the fertility field. And
Griffin Jones 01:14
but I still tried to make it more about things than EngagedMD in the scene. So that's what Jeff talks about. On the show, he talks about areas of nursing burnout, and what clinics are doing to solve that. He talks about areas where physician productivity is limiting or, or the hindrances to it are limiting access to care what they did to improve access to care, we talked about what the bridge is between business, like a business advantage versus now is integral for the patient experience and for the standard of care that patients receive. And we talk about the risk that practices face in informed consents, and the hindrances, that that can lead to people moving on to treatment and practices being liable. So all of these things we cover in this episode today. And if you want to engage MD to take a look at your workflows, if the examples that Jeff talks about in this episode are interesting to you, he is somebody who will look at your work and they'll do a free assessment. If you go to engage them d.com/grip. And they'll do that assessment for you for free. They'll point some of these things out to you. It's a free eye opener for you from a third party that works with more than 200 fertility clinics. And if for no other reason, it is nice to say that you heard about them on the show that you heard about them from me, because that helps us create more free content for you. So I really enjoyed this conversation with Jeff, I liked hearing about what EngagedMD is going to do next. And the case studies that Jeff refers to and the problems that clinics are facing, I think will be of interest to you too. So please enjoy this episode with Jeff Isner, co-founder of engaging Mr. Listener. Jeff, Welcome back to Inside reproductive health. Yeah, thanks, Griff. Glad to be here. You're the first person to ever do a sponsored episode of EngagedMD and I get a lot of messages from companies, what can we sponsor the show? Can we be a sponsor? And I'm gonna work it out, you know, we're gonna work out inside reproductive health, eventually to where I would say eventually, because I'm still working on this, you know, fertility bridge Client Services stuff. But inside reproductive health is getting big enough to the point where we can start to work out things that aren't an endorsement, but because right now, it's been the podcast, it's been my voice. It's almost like there's no way there hasn't been a way for me to do a sponsorship, that isn't an endorsement. And I have to be really careful about what that is, like when people say, You're a shill for this company or a show for that. It's like, the only sponsor that I have is EngagedMD and I tell all of you that and it's because I've known Jeff and Taylor since 2015. And more than half of our clients have used it and all of the things that people tell me about EnagedMD so I've only even had the sponsorship conversation like the opportunity to be a sponsor with like three companies. And ultimately, so far you are only the only one there was a good fit for at this like endorsement type level. And it is because you hear me on the show Jeff puts out a challenge every week where I'm like, Okay, if if you're the person that's gonna tell me the for There's a bad thing about EngagedMD, send me the email. I'm not saying the email will never come. I suspect that one day it has to write like one day it has to come where somebody's like EngagedMD do. No one ever has no one ever has up to this point. It's all been like glowing reviews. And so I just like for the three people that are living under a rock, what is the EngagedMD from the owners perspective? And what's the value that you sought to bring in the marketplace to begin with?
Jeff Issner 05:31
Sure, sure. First of all, thanks again, for having me. We appreciate what you do, in terms of the podcasts and all this amazing information that you share with this community. And we're not perfect, enga EgagedMD is not perfect, but we work really hard to create amazing experiences for our users and ultimately for patients.
Griffin Jones 05:47
Jeff Issner 05:48
So to answer your question, now, the way I like to explain engaged MD is through the story of how we actually got started. And about in 2015, when we met, our medical director really felt this problem day in and day out and his practice. And he was explaining the same things over and over and over and over again to patients and their partners. And making sure people understood what the process looks like for fertility, treatment, the risks, the alternatives, and medications, all these really important things that patients need to understand in order to make good informed decisions. And he realized, well, I'm repeating myself over and over again, and I'm probably only covering maybe 60, or 70%, of what I ideally like to and I've got all these kind of external factors that are pressuring what I can cover, whether it's the time I have for the appointments, or what else is going on in my life, or in my day. And he realized, well, I'm doing it this way. And every provider in my clinic is doing it a little bit differently. And ultimately, the patients are on the other side of my desk trying to just drink from the fire hose and absorb all of this very complex medical information for the first time. And so when patients go home, they try and remember everything that they had just been told, whether it be from their doctor or their nurse, or medical assistants or any other staff, it's too much. It's just too much. It's a ton of information that we're jamming into these appointments. And so they go online, they look for answers, they end up calling their nurses and their medical teams to try and get those answers. The nurses are picking up the brunt of this. They're doing IVF classes, med teach classes, really trying to fill in the gaps again, so that patients can make those good informed decisions. And they make those decisions historically on pen and paper. So documents are being printed, they're being given to patients, they've got to take them home, they're getting notarized, they're getting filled out incorrectly, and they're getting lost before, hopefully they get scanned back. And so we looked at this problem and said, Wow, it's so much time and energy that everybody is putting into this. And it's a suboptimal patient experience, clinic experience. There are all sorts of risks that are introduced. And so there's just got to be a better way to go about what we viewed originally as just informed consent, making sure that people are educated and consent to the right things in the way that aligns with their behaviors and what they want to do with their treatment and their goals. So we EnagedMD. And that was kind of the impetus for the platform and the company. And we have two primary product lines. The first one is Elon, so a library of educational modules that we've developed, that cover everything from COVID-19 protocols and fertility one on one, all the way through all the different types of treatment that patients may be pursuing, through the very end of the patient journey, what to do with extra gametes or embryos that you may have that OurCrowd preserved that. And these modules can be pushed to patients so that they can watch this content on their own time. They can rewatch it as many times as they want answer questions, demonstrating that they actually understood everything and then come back into their next appointment, and have a much more effective, much more efficient discussion with their medical team that's focused on the nuances of their care. Let's talk a little bit about that informed consent part for a little bit. Because anytime you talk about informed consent, you have to say, I'm not a lawyer, talk to a lawyer, get legal advice. Don't get it from me, because I'm not giving it to you because I'm not qualified to give it to you. But when I ask attorneys in our field, and
Griffin Jones 09:18
I'm chairing this session that you're actually speaking at SRM and I asked people about like, just like, what's the standard for informed consent? They'll just engage them D A N, like, What do you mean by and so what do they mean by that?
Jeff Issner 09:36
Yeah, well, ultimately, it's a non delegable duty for the provider to provide informed consent and it's making sure that patients understand everything that they need to know all of the process the risks, the alternatives, in order to and also they comprehend everything, not just or being told everything but they actually understand everything that they need to know in order to make a good decision a shared this vision with their medical team about their care.
Griffin Jones 10:03
So I didn't really think of it in this way until I was on one of Dr. Katz's webinars and the viewer, you may have also been speaking on it. And and, and this may have been in the beginning of the pandemic, when people like the people that hadn't figured it out already kind of like had to figure out their the E signature, and people were asking about informed consent. And it and Dr. Katz said, What what's, what's greater evidence of informed consent, a stack of papers, that it's that like, there's a signature and at the end, and a couple initials throughout that, like 10 point font of language that people have never heard before, or a series of videos where they have to sign off at where they have to complete each module where they have to take a quiz, demonstrating that they that they did and then a a trackable digital signature at the end. So Ken, like you talk about that level of informed consent.
Jeff Issner 11:16
Yeah. And it's the way that you're talking about it. It's kind of how we break up our product lines, I've always related the informed part to our elearning product line and the consent part to our esign product line. But consenting is much more than just signatures on paper, if somebody blindly signs off on something, and then an issue happens, if you can't demonstrate that the informed part of informed consent occurred, it's not helpful, it's not very valid. So all of these things are, of course, litigated through the courts. And but it's very clear that just signing a piece of paper is not informed consent, you need to ensure that patients are informed and actually understand before consenting,
Griffin Jones 11:55
and it's pretty easy to me, it happens a lot you can ask your turn, how often is somebody able to argue that they weren't informed and in cuts out just went through, you know, just got married not too long ago, and then, you know, talking about just family law and in figuring things out like that, and, and they don't even let people do pretty, you know, they don't even honor prenups that are within like, oh, let's say a week or two, because or I should say many courts, many courts will not honor that prenup set or within like a week or two because it's like, well, it can't really be informed consent, many courts will throw out prenups that don't have where the other person isn't represented by counsel. Many courts will throw out them where they were represented by counsel, but there isn't the documentation that they were properly informed. I think that's how Eduardo Saverne successfully sued Facebook to get back his stake. And that, I think it is because he signed everything. But he said that he wasn't properly informed. And I think he won't, and that's why his name is back on the Facebook mass that is co founder. So is that like,
Jeff Issner 13:09
it's all of these components. And Dr. Letteri from Seattle reproductive, wrote a great paper a few years back about the primary components of various litigation that has occurred over a certain period. And even if informed consent, isn't the primary reason for the case, is very often a supporting issue around the case
Griffin Jones 13:29
that it was that Was that intentional from the beginning? Or was that just kind of like a happy byproduct? Like originally, you're trying to inform patients to help with client workflow or just help with clinic workflow to help with the patient experience so that they're better informed? And oh, yeah, well, we'll include the e-signing. At the end was, was it a byproduct of this being used for informed consent in this way? Or like, like, which came first? Was it the patient experience focus, kind of workflow experience? Or was it the informed consent?
Jeff Issner 14:09
Yeah, so it was very purposeful about informed consent at the beginning. But that's not our primary value proposition anymore in terms of how we talk about the product. So when we originally developed EngagedMD, we started with the elearning modules, and really started with IVF and IUI. And it was all about ensuring that every single time people were consistently and comprehensively informed and understood what they were just being informed about. And we realized we had that informed part. And we needed the, what I'm calling the consent part, the digital signing part. So we built out our esign engine that helps digitize all of the consenting signature workflows. And it was only once we really started getting traction in the market. And one of our primary demos is to listen really closely to our customers to determine what we develop next. And what we're hearing is informed consent is super important. This is great. It's very helpful. Bye To the real benefits that we try and the real problems that we try and create benefits around our saving time, improving patient experience, reducing risk where we can, and going paperless. So it was only after we launched it, we realized, wow, this is much bigger than we originally thought. It's not just legal informed consent. This is creating these other benefits that are much bigger than what we had originally intended.
Griffin Jones 15:23
I want to talk about that, because I saw the benefit immediately, like as soon as I figured out what you guys did, and it probably took me a little bit to be fair that I probably don't know what half of the people in ASM do. But it didn't take me too long. Like as soon as I met you guys, and we talked and I was probably 2015. And I thought, Oh, these guys are nice. I kind of, you know, I have an idea of what they're doing. But it wasn't probably until I started people, I started hearing people say, this is what we're using. This is how we're using it. I'm like, oh, light bulb, I need to pay attention to what this is. And very early on, I saw the I saw the value and but I could also see what the potential objection would be. And I could almost immediately also know how to address that objection. And that objection was, well, you know, people expect personal care from us, they want to be able to talk to a nurse, and they want to be able to talk to a provider and you know, they're paying all this money for care, they shouldn't be at home and, and watch a video and and I just immediately thought like, yeah, they're paying all this money for care. And is this stressful to go through this process? They shouldn't, they shouldn't get the least amount of value out of their time with you that they can, they should be getting the most amount of value with you that they possibly can. And if they can only remember 30% of what you told them. If they're asking you questions that are completely generalized questions as opposed to specific to their case, then that is not the highest amount of value. So did you all have to work on that positioning it for? How do you help clinics position it the right way.
Jeff Issner 17:20
And it was my biggest concern, when we launched to, quite honestly, was this just going to be homework for patients when they're paying 10s of 1000s of dollars for care, and a few things to know. One is what you call about, we are trying to make that in person time more valuable, so that patients can come in with that baseline knowledge and actually have a good interaction. That's two ways that really focus to their personalized care, not the basics of how the menstrual cycle works. And what stimulation is, we want to focus on your specific issue when we've got that really valuable in time, that time together in person. So that's kind of like the core reason why this improves those interactions is you're giving that baseline info at home. But we study this obsessively. We are extremely data oriented at our company. And we measure every single step along the way, both from the patient experience and the clinical experience where I'm just wrapping up a case study right now with Seattle reproductive medicine. And this aligns with the rest of our data points where we surveyed patients and clinics but 98% of patients that the videos were helpful addition to their consultations with their medical team, and 89% agreed or strongly agreed that engage them D actually made them more satisfied with their care. So we've got to meet patients where they are, I know personally and patients who would agree based on our survey results, that people want to do things on their own time at their convenience, and they want to use that time together with their care team as effectively as possible.
Griffin Jones 18:55
That's, that's, that's huge buddy. If anybody had a nine or a close to a 10 on a net promoter score, that would be through the roof, you know, almost almost unheard of, and and SRM is not a little practice. I don't know how many Doc's they're up to now at least 12. Maybe they might even have more than that at this point. They at least two abs and they're really great group that serves a diverse patient population from all over the Northwest. So to have something like to have people say that I'm jealous of you. And and if I can go on a little tangent of why I'm jealous as a business owner of EngagedMD. I was watching I was on LinkedIn and one of my favorite marketers was talking about he was making fun of a lot of b2b marketing companies and he was saying we make blank easy. And he's and then he's like this is this is the value prop that most b2b marketers put forth, he's like, how about you just take blank off my plate entirely. And there's so much that you guys are able to take off the plate that as a client services firm, it's like I am always trying to develop to develop further develop what we can take off people's plate, but you guys just you take off so much of people's plate that they can actually provide that level of care that the patient needs.
Jeff Issner 20:29
Yeah, we're, again, we're obsessive about the data. But we're really, really obsessive about listening to our market and listening to our customers. And every single new interaction that we have with a fertility clinic, we start with a needs analysis, we really want to listen, what is your current workflow? What is the current patient journey? Where are you spending time that is manual redundant, that you don't need to be spending so that you can operate at the top of your license. So we're just absolutely obsessive about finding those pain points and helping support clinics to get better about them and to improve on upon them, whether it's using engaging DEA or not, but we're trying to develop all of our products around those issues that we hear directly from our market and our customer base,
Griffin Jones 21:13
I want to talk about those pain points, because they're not getting less painful. There's a lot of things that people could or, or more might do to improve their business that would be beneficial for their best business. But it's not necessarily. It's not painful enough. It's the adage of the old man on the porch with the dog and the motorist stops by and he's visiting the old man. And while he's having the conversation with the old man, that dog keeps whining. And finally, he asks the old man, what what is he whining about? And the old man says he's sitting on a tech, is it? Why doesn't he just get out? Why isn't it quiet? Why isn't he get up, and he has heard some bad enough to whine it doesn't hurt him bad enough to get on. And, and, and in your space? I think that there's it with the pain that your company is addressing. There's a lot where it's the point where the dog has to get up and maybe even, you know, prior to two years ago, maybe they could have sat on the tack longer. But nurses are so burnt out and embryologists are burnt out if people can't get enough staff, but you can't get an even get enough people to answer the phone. And so you need to make what you have with people, the time that you have with people as productive as possible. So we've talked about a couple of these problems, like I want to talk about the nurse time savings. I know, like there's examples of people everywhere, but they just talked to me about you know, what nurses, you know, like the time savings, and and yet, otherwise having to deal with appointments, that has been a pain for them and and how you've helped to solve that.
Jeff Issner 23:01
Yeah, to your point, the pandemic definitely accelerated a lot of these problems. And the the nursing shortage that we're facing right now is certainly exacerbating the issues that we're trying to help support. So I think it's it's pretty well agreed upon that nurses take on a huge brands of patient education and patient support throughout the entire patient journey. And that forms in IVF consults or IUI costs, whatever treatment starts before that, honestly, even through diagnostic testing, and talking through all the different things that you may want to consider prior to starting treatment and determining your treatment plan. And then throughout treatment, as well. As you're getting ready, you've got your Med teach. So I think that's a great example of an area where we heard that things we actually partnered with SNP pharmacy on this. Together, we heard that this issue of really non personalized injection, teach classes where everyone is coming in sometimes one on one, spending an hour with a nurse learning how to inject themselves through with all these different types of medications. And you've got to go home and you've got you know, videos that you can find on YouTube that you can try and search down that aren't particular to how your clinic does it or particular to your plan. So we built med ready together, which is a very personalized approach to injection training. So together with SMP, we built all this content, it's all done through motion graphics so that we can keep it up to date. And we can keep on modifying it and customizing it so that it makes sense for the clinic's protocols and their approach and how they use their medications. And when you assign these modules, you're assigning a module that is specific to the medications that the patient will be using. And this really engaging 3d Motion Graphics manners, that patients can go back and watch it over and over again, and not only understand how to use the medications, but understand why they're using each medication as it relates to the protocol. So I'll use an example from our friends at RTI, Ohio. and they were having 45 to an hour minute or 45 to 60 minute long consultations with patients just for injection training, and those were with every single patient and couple. And they adopted our med Ready program. And you know, I think, as most people are a little bit hesitant to reduce the time with patients, but they realize that this was actually able to completely replace their injection training classes for the majority of their patients. So the patients who didn't need that extra time, again, very specific questions about their injections, the majority of things are answered through the module. So they're saving four to five hours per day of nursing time by just using one of our module components. So you can apply that kind of math and apply that logic to all these different stages where you have the redundant conversation happening again and again. So that you're focusing keep on saying this nursing time, physician time, and that's provider time, they're operating at the top of their license really focused on the personalized issues, not the general things that can be repeated through a video series.
Griffin Jones 26:05
I'm just picturing the nursing managers that listen to this show here that like four to five hours per day of nursing time. And if they're one of the few clinics that aren't working with engagement, busting into the practice owners door right now with their iPhone in their hand playing this piece of the podcast, we get what for? And a lot of people can think that are listening, but what would you do if you had four to five hours of nursing time? Back like, you know what, that four to five hours is being wasted on right now that you're not getting to where your where your nurses are burnt out where they're where they're saving calls for the next day, because they just can't get to any more else, they're never going to leave the office, and then the patient's pissed off about that, because they aren't getting the answer back that day that they they were hoping to because the nurse is answering some other question or doing something else. So I think that's it. I think that's incredibly useful, no matter what employment market we're in. But especially with people being so short on nurses, it's just like a necessity now.
Jeff Issner 27:22
Yeah. And you know, you're looking at that. And so we're, we're starting with this kind of base level, ensuring comprehensive, consistent education occurs. And then it builds on that and you're actually improving the patient experience and the clinical the nursing provider experience. But when you start taking that problem a level higher, from a business perspective, you have more time to see more patients. So ultimately, you're generating more revenue, you're helping more patients access better care, and you're able to generate more revenue as a business. So it's really a win win win. And that those layers of value proposition continue to build on each other.
Griffin Jones 28:00
Let's talk about maybe the consent side, too. And at some point, I want to talk about of just like, of like how this impacts of weightless or rather what you can do during long wait periods, because that I would say the average is eight weeks now and some are 1216. And so but let's talk about consent for a little bit like what of the the issues been for clinics pre gauge MD? What are they struggling with?
Jeff Issner 28:37
Yeah, so it goes back to just the issues of paper. And, you know, it's 2022, and things have gone completely digital. But in the fertility world, this paper is really important, you've got to make sure that the right person is signing the right thing at the right time, you're authentic, getting all of that in song, the right workflows. And with paper, you're not really fully sure what's going on outside of the office. So you give people this information, they have to read it. It's an incredibly complex medical legal format, they've got to make their decisions on it. Oftentimes, they need to go to a notary to get that authentication done. And then they have to bring it back in or ship it back in or scan it back in. And if anything goes wrong along the way, you got to redo that whole process, right. So if somebody fills out the wrong thing or signs in the wrong place, notaries aren't trained to fertility treatment and what people should be doing with their decisions. You've got to go back and do that whole process again. And then if it comes back and you actually do collect it correctly, it's got to get back into the medical record so it can get lost, they can get caught up on a doctor's desk or somebody's desk, ultimately needs to get scanned and to have that proof that you've got the official informed consent. And so there's a lot of costs and a lot of time and a lot of again, suboptimal experiences in corporate added in that workflow. So with our esign engine, we're really just trying to make sure that all of that can be handled through your inbox. So you can digitize all of your documents we'll work through with our customers, for anything, not just consent, anything from patient intake through financial documents to test requisition forms, we have the ability to create those workflows digitally. Ensure you can track all the education and all the documentation in one place. So things are never getting lost. They're following these digital workflows that make it really hard to choose the wrong thing or to make errors on the consent, you're never going to miss a signature and nobody's ever going to get skipped in the signature process. And you can always go back to engage them data, see that digital copy are never going to be searching for the paper version that might have gotten shuffled somewhere.
Griffin Jones 30:48
Which that in and of itself of how long that can take people and like the anxiety when you can't find it because it is in that one file that it's supposed to be in. Yeah, it's just amazing how people use paper for for anything, at this point,
Jeff Issner 31:07
nothing worse than somebody getting ready to start their cycle or even worse, somebody's getting ready for retrieval and say, Oh, no. Where's that consent? That's the that anxiety that we're trying to completely eliminate?
Griffin Jones 31:20
Well, it was. It's funny, you should say that, because when I did my talk at PCRs, it was originally supposed to be about like, like bizdev. And then they gave me the talk to the nurses, the nursing track, they gave me the the last talk of the of the week, it was like the 11am Saturday talk. And he gave it to it was to the nurses. I was like, great, like the people who couldn't give two craps about business development. And this is what I do. So how am I going to make my talk relevant to them. And it was it had to do with branding, it had to do with creative and I had to tailor it to how to get patients to want to engage with your practices, processes. And I was just asking nurses ahead of time. Like, like, what's the biggest thing that when you tell like, you could tell patients 100 times, but you still feel like you're struggling with this problem with them. And consent was at the top of the list, like having their consents ready having their paperwork done ready to go before it started protocol?
Jeff Issner 32:30
Yeah, it's, um, nobody likes paperwork, right? I think we can say unanimously, nobody likes chasing down paperwork. But it's critical. It's really important. And so what we're trying to do is build that into the workflow, throw that in as part of, you know, these engaging videos that you're watching, tie it into a bigger part of the journey, make it digital, make it engaging, exciting, make it so that people want to do it, at least more than they would want to do it. If it was just trying to go find a notary and sign some things on paper.
Griffin Jones 32:59
You guys are right at this junction point of something that I've wrestled with since I've been in the field, which is I could just tell it like that eventually, something that might be a business plus, it first, eventually becomes part of the standard of care or elevating the standard of care. And, you know, 10 years ago, probably having a digital module would have been a business plus, it would have been Yeah, a nice little advantage to have. But now, it's like, man, you're dealing with the biggest stress in your life as a patient and a top five, and you're usually spending a lot of money. And you're, you're doing this all at a time when you like, you have to keep track of all these different things that add all this different times. And you guys are kind of like almost a little. I'm not saying the same way. But like how when you sign up for Airbnb, like it's a lot to list a property on Airbnb like to go through everything, but they break it up. So you know, you're not filling out 100 question form. It's like, what kind of house do you have? And then next, and I'm not saying that everything that you do is like that is like that, but you break things up in a way for the patient that I do feel that it is the state like that's the standard of care that's necessary for improving the standard of care now, it's not just a business plus anymore.
Jeff Issner 34:38
Yeah, I think there's a few things that you just call out there. We'll start with the standard of care. You know, we're, we're operating with about 60% of the US fertility market. We've got a very large market share and Canada, UK and Europe as well. And so, I would say that it's becoming the standard of care, especially in terms of informed consent. We're really proud of how widely adopted, this has become, and it's really become the way to educate and to consent. So really proud of those statistics. But the the other thing that you called out is the way that we're breaking things up. And we're taking experts and adult learning and elearning. And we're taking all of the best practices that are constantly evolving. I mean, we're in the world of Instagram, and Tiktok, and video, education and video. You know, absorption is definitely the standard. And we're taking all those best practices, and applying them within our platform, so that people are getting the right information at the right time, that is unique to their journey. So we're really, really focused on making sure that that overall journey, we're pushing the right information and nice chunk size bits, so that people get the right amount at the right time to properly absorb it properly make the right next decision.
Griffin Jones 35:58
For the listener, just imagine, imagine going through something as legally intense, and as outside of your expertise that requires deep expertise that you can think of like you're going through a, you know, some some very detailed estate planning. Or even more, maybe you're going through, like the you're building your dream house, and you've never built a house before you just you've been a good Rei. And now you can afford it. Now you're building your dream house, do you want to get it all in one huge sum? Like, here's the dot, like, here's the here's this stack of papers, and you got this limited amount of time to talk to me? Or do you want to have an extremely thorough module that you can go through piece by piece on your time, go back and make sure that you understand, and then use your time with the expert to be able to ask any any question I, I think if people think about it, if if they had that same opportunity, in other realms, it becomes even more heir apparent of of how useful it is. Yeah, it's
Jeff Issner 37:12
hard. And you know, we're all biased because we live in this industry. And so some of it is it becomes second nature to us. But it's so hard learning about fertility. For the first time, I remember when I first started working in the industry, all the acronyms of the, you know, different ideologies of infertility, all the different treatments and medications, there's just so much to comprehend. So I think we take that for granted sometimes that this is second nature to us. And people who are exploring treatment for the first time, it's all completely brand new, down to the vocabulary,
Griffin Jones 37:49
we're talking about improving workflow, which means improving productivity, which means potentially improving revenue, and that is flush with the topic that we cover on the show a lot. It is a business show. And we talk about private equity, we talk about venture capital, and one of the one of the claims that private equity has, and one of the gripes against them has to do with increasing productivity. And so I say on every episode that I talk about private equity, I don't have a dog in that fight. I don't I don't know I don't feel qualified to analyze the standard of care that private equity either improves or, or worsens. I just bring people on and I try to challenge them. But the the argument for private equity is that they increase efficiencies. And the argument against private equity is that ultimately, whatever those efficiencies are just means like squeezing more cases out of the provider. And so it's like, okay, we could squeeze more cases out of the provider by making them work more by packing in patients by by taking away time that they actually need to see the patient. Or we could do things that legitimately improve the experience for the patient and allow the provider to not do things that are redundant or lost, because the patient is a deer in headlights. So can you talk about? I mean, have you done any kind of analysis for return on investment?
Jeff Issner 39:35
Yeah, definitely. And just to kind of address the goals of private equity. I mean, I think process optimization is clearly one of those in order to generate a more efficient business. And if you can do that, while creating better care, that's amazing. And if you can do that, creating better care and also improve access to care by creating more time and more efficiencies in that whole process, you're helping more people ultimately have a child. So I think that's a really positive thing I know there's many different angles to private equity and with all things, there's pros and cons. But to take it this on a much smaller scale of how we look at ROI, again, going back to that initial needs analysis and workflow analysis that we do with every clinic, every clinic has unique problems, they all kind of revolve around the value propositions that we talk about. But one example that I'll give them a needs analysis that we recently completed and completed the ROI analysis for this company, they were to provider clinic. And they had 45 minute new patient consults, and 45 minute IVF consults. And we did all the math with them in terms of how much time you had save, what you could be doing with that time, how many more patients you'd be able to see with that time your margins on that. And we came out with an ROI of over $100,000 per year just on a to provider clinic, saving those 15 minutes on each of those consults, where you're able to accomplish by just spending your time more effectively, more efficiently, ultimately helping more patients access care.
Griffin Jones 41:12
That, to me, seems huge for the places that just can't get another Rei. And in a two provider clinic, there's a lot of those in your smaller cities. And, and it's the smaller cities that really struggle to get new Docs, it seems to me like 80% of the docs go to 20 cities in the US. And it seems to me, I still don't have any data. But it just seems that every anecdote that I can think of supports that that the only time that you see someone from an REI go to a Buffalo, New York, where I'm from, or a Youngstown, Ohio or Lincoln, Nebraska, is when they are their spouse are from within a few hours of their it's just so hard to get Doc's and so the alternatives like what we're just not going to, we're just not going to provide care to these people that are here. And so I often think of like EngagedMD, like being useful for ROI for for for bigger groups, because you know, they're the ones that kind of have their their eye on the p&l, but more but is there's not really separating the Pro and revenue from the from the increase in access to care is there.
Jeff Issner 42:37
Yeah, I think so. I think so. And people who really embrace that are where we see the most success. And even with, you know, the smaller local clinics, you can still make this your own right. And I think the fear sometimes as well, I don't want to be like everybody else. The people that really embrace this and start customizing the video modules and produce their own content to have as part of the patient journey and make it branded and talk about their practice and talk about their locations. That's that just warms my heart to see because they're really taking this technology and making it their clinics and making it using all those kind of efficiencies of what's being built as a baseline, but really customizing it so that it meets their needs. It really does give that boutique feel to each of their patients that come through the door.
Griffin Jones 43:32
How have you seen engage them the influence patient behavior, have you?
Jeff Issner 43:39
Yeah, that's a great, really great question. We've been doing a lot of research on EngagedMD. So we've been very fortunate to have third parties say, Oh, this is interesting. Let me get a study going. And we've had a couple of papers published. And we've got a great one that Dr. Meg sacks from University of Cincinnati. She's an REI fellow there is presenting at ASRM. So this is an example of how we've seen patient behaviors and outcomes change. And we're just starting to explore this because I think, anecdotally, it makes sense, and it happens, but we want to prove it with data. So let me give the example that she's been studying. We've been really focused on carrier screening. So just to give some background on what carrier screening is and why it's so important, from my perspective, we can prevent genetic conditions from being passed down if patients do pursue carrier screening. And it's one of a bajillion different things that has to be explained to patients as part of that initial console diagnostic testing phase. So like everything else that can be kind of shortcut, and patients may not have the right information in order to make an informed decision about actually pursuing or declining carrier screening. And not only is that kind of a workflow issue, but it's also a risk issue. We've seen massive lawsuits in the space of a patient's who feel that they weren't properly informed and ultimately had a child and Fortunately, that was affected by a genetic condition, because they declined
Griffin Jones 45:03
carrier screening because they didn't. And they didn't feel they were informed
Jeff Issner 45:08
correctly, they didn't understand the impacts of not pursuing carrier screening, informed declination is what we would call it, and didn't realize that they could go through PG TM and prevent this genetic condition from being passed down. So that information is important from, you know, population health perspective, it's important from a risk mitigation perspective. And also, it's just one of the like I said, bajillion things that has to be covered with every patient. So we developed a module on carrier screening in a workflow to allow patients to learn about what carrier screening is at home, just like the rest of our elearning modules. And then they can flow directly into making their decision about either moving forward or not moving forward. And what we saw when comparing the patient cohort that went through the EngagedMD workflow, versus the cohort that went through the traditional provider console, is nearly double the amount of patients who went through EngagedMD in deep decided to pursue carrier screening, which is just gonna let that sit for a second, that's massive, that's a huge impact that we can create.
Griffin Jones 46:09
Do you know the sample size off the top of your head, I don't know
Jeff Issner 46:13
off the top of my head, but we replicated it at a completely different clinic with a completely different group and completely different researchers kind of creating the study and is nearly identical results. And that was at a very large group that we had a ton of volume going through, but Dr. Sacks will be presenting SRM quick plug for her. She's got the poster is gonna be
Griffin Jones 46:34
on this podcast. I'm actually recording recording that episode with her and two other Rei fellows later today. So I don't know if their episode will come out before yours or yours will come out before there's I don't know how we have it scheduled right now. But yeah, little little shout out to her.
Jeff Issner 46:50
Yeah. And I think this is just the tip of the iceberg. We're really motivated to figure out what drives these patient behaviors? And how can we create really positive outcomes and health outcomes, not just patient behaviors, like positive health outcomes from using this tool, and providing great education and great patient journey management? Every single step along the way?
Griffin Jones 47:12
So yeah, maybe people should let that there's a couple of things that need to sink in people's minds from from this conversation so far. One is four to five extra nursing hours per day, what would you do if you had four to five extra hours for your nurses per day? Another one is, what would the quality of care be like for your patients? If double the normal number were going through carrier screening? But how do you make sure that engagement is actually rolled out successfully, because people have asked me to build software before and the first reason I declined is because I'm not a build. It's just not my core competency. I'm a creative I'm a salesman and building out that is what I'm good at. And, and even a CRM is too far away from that, that core competency, but the other thing is just like until it until it talks to everything. In many cases of software, it's just one more damn thing for for staffs. And, and people very often aren't even using the same EMR for scheduling as they are for billing as they are for the actual medical records. And, and then much more like, yeah, there's some people that use HubSpot and and Salesforce, I've never seen somebody like really use it like really, really, at best. I've seen a sort of rudimentary use of, of CRMs. And that's true for Yeah, like project management software that I've seen workflow software, I've seen kind of shoes. So how the hell have you been able to be like, how do you actually get people to, to roll it out? Because it's obviously being rolled out? You're at least half of clinics are using it. Everybody's telling me they like it. And and you have these surveys from both patients and staff that give you the glowing reviews. But how do you actually make sure that the rollout gets you to that place?
Jeff Issner 49:18
Yeah, well, no one likes change, right. I think that's people humans in general don't like change so that the
Griffin Jones 49:25
it's because it comes at a cost, right? It's because there's Eduardo Harrington, Dr. Harrington sent me a book. Oh, and the name is escaping me. So I'll put it in the in the show notes. But he was a Harvard professor. And and he talked about this very dynamic of like, of why companies especially don't change because the cost to change can be so disruptive to what it is that they're working on that very often when there is a disruptor in the marketplace. It is the new To company because they don't have the current obligations that the established companies have to serve us. So it's hard to implement change.
Jeff Issner 50:12
Yeah. And I think it goes back to having a big enough pen, the problem has got to be big enough, and we have to understand it well enough. So the that needs analysis that we start with, that turns into a workflow analysis, and really understanding the problems that we are trying to solve together, that are big enough to introduce this change. That's where it all begins. So we are, while there's best practices that we've learned with the about 200 clinics that we've launched at, each one uses it slightly uniquely, to solve their specific problems. So we need to understand we need to really intimately understand those problems, so that we can introduce a workflow and associated training for staff that aligns to solve their problems so that they're able to feel those efficiencies. With this has been a, an area that I've focused on from day one in town, I've really made a priority. The first person we hired as a customer as a Customer Success lead, we want to make sure that people are supported through that onboarding, that implementation, so that they start to feel and see that value. And then on top of that, we going back to being obsessive about data, we create dashboards, we're monitoring every step along the way to make sure that people are being successful. And we provide that data and those dashboards back to our clinics so that they can see which of my staff members are being compliant, which are not being compliant. How are things being received by patients? Where can we tweak and modify the workflows. So a really great example that the customer success team shared with me SEMA over at SCRC, has created a dashboard that we provide all the data into, and she actually creates competitions about who can send the most modules and forms and who can follow these workflows, the best to really encourage that compliance. So I thought that was a fun way to kind of leverage that data to make sure you're creating that optimal outcome. So it starts with really understanding the problems we're trying to solve. It ends with really closely monitoring and supporting our clinics to ensure that that change curve is overcome so that people can really see and feel the value. Talk to me a little bit
Griffin Jones 52:19
more about what your customer success leads do, like how do they help people implement? Yeah, so
Jeff Issner 52:26
we've got a number of people who are focused on this, the customer journey, I'll call off the customer buying journey. So starting with our sales team, who's really kind of understanding the problems that we're trying to solve. We have a professional services team, who's doing all of the digitization, helping with the workflow analysis, and ensuring that the right training takes place. So really making sure that the the workflow and the needs that we understand are translated appropriately into solutions within EngagedMD. And then as we launch, our customer success team is there on an ongoing basis to check in to make sure that things are going successfully to compare across benchmarks, and to listen to things that change because we all are clinics or businesses are going to evolve, whether it be through legislation or through growth, or whatever it might be. So we're here to listen and to introduce other ways that you can keep on tweaking your workflows, tweaking the platform, growing within introducing other modules, customizing your modules, changing your consent, workflows, whatever it might be to ensure that ongoing success.
Griffin Jones 53:31
What about at the financial piece of the journey in the fertility bridge, fertility patient marketing journey, it appears in the third column, there's four columns, the third is conversion from a pointment to treatment. So they become they be they've gone through their first konsult They have not yet gone on to treatment there's some drop off their finances one of those pieces so we we like to make videos about finance, we like to we like to create more content ahead of time we'd like to insert some of the content that people get before they meet with the financial counselor so that again, it's not a deer in the headlights thing and that they just it's not like their Sally down the hall go talk to her now like they they have a little bit of familiarity with with Sally there, if not looking forward to seeing Sally that they know who Sally is what they're going to talk about with her in a way that doesn't try to answer their questions that can't be answered before. It's actually one to one specific to that person. So what do you all do you all help with that? That part of the journey at all and how?
Jeff Issner 54:53
Yeah, we're really starting to make great headway just recently in this area of the patient journey and So the way that the majority of our products have been developed is by hearing our customers say, Yeah, we started using engaging D to do this. And it was like, Whoa, I hadn't even thought about that. How did we not? How do we not think of that, let's try and develop more of a productize solution for that issue. So Shady Grove, as a great example of the financial area, their financial counselor started using our esign engine to get financial documents squared away. And as we dug in a little bit deeper to that, we started learning about all the things that people are saying over and over again, very similar to a US an IVF patient as an example, the way that nurses and providers are explaining the medical process to financial counselors, we're explaining the same financial programs, how to navigate your insurance, what to be looking for what to be thinking about. And so we've just started building modules, that helps support that financial decision making just like the medical decision making. So this is allowed Shady Grove to help support their financial concepts, they've got a massive financial counseling team to help ensure that patients can make those good financial decisions. And this allows their team to not have to repeat things about their payment programs and their financial programs, instead have a much more impactful, much more efficient discussion with patients about what their options are and how to move forward. So we're starting to, you know, as EngagedMD continues to grow and to look to other areas, we want to be exploring other places the patient journey, other places of the clinic journey, and other types of users within the clinic who are looking to save time looking to improve the patient experience looking to reduce risk, we're looking to go paperless, that's how we want to keep on growing is finding ways that we can help support them best those issues best, so that the practices can keep growing and seeing more patients and we can keep growing as business as well.
Griffin Jones 56:57
I think that people often just stop at the financial challenge and think like, well, either patients can afford it or not. It's like, that's that that's not as far too simplistic of a conclusion. There is a range within there. And sometimes that there's no financial option to where a patient could feasibly pay for treatment. And that's, that's very sad. There's often a range of people that if they could, if they understood what the options were for them, then that's what household budgeting is. It's all a calculus, and the things that win are the things that one seems higher priority, but to that you understand that you understand how you're going to, you're going to pay for something and it isn't just simply a question of, well, they can afford it or they can't.
Jeff Issner 57:51
Totally totally. And it's that kind of plethora of topics that need to be explained. And as a staff member at a clinic, you have to prioritize your time and what's going to help people the most to make decisions, and it's impossible to cover everything. As you know, a consumer of healthcare is I think all humans will be at some point, navigating insurance is super hard. It's really complicated. And I work in healthcare, and I understand the space very well. And it is so complex to navigate insurance. It is so complex to navigate out, taking out loans to look through these different types of shared risk type programs. There's a lot to comprehend there. So we're trying to serve hacking away at that. Everything down to what is the deductible and what does that mean? And what does it copay through loan terms? And how do you actually navigate these different financial programs many clinics offer,
Griffin Jones 58:48
I want to ask you about the future of EngagedMD, but I want you to give me something that I can like, talk crap on you at because yeah, it's a sponsored episode and you guys pay me but you don't pay me well enough that I wouldn't bring that I wouldn't jab you with a thorn. If I had it. I just kind of love doing that. And like I do it with every guy I tried to. But I also hate it when I watch the news. And I feel like they're trying to get somebody to a specific conclusion. I just like playing with each side of an argument. And I just don't have anything for the argument against you and I don't have anything. I appreciate
Jeff Issner 59:33
that. But we are not perfect and we are trying to become more and more perfect every day our team is growing. Our processes are growing. Our product is growing. It's evolving, because you have to keep on evolving. And we do run into issues with any technology as any business does. And we're really just trying to be the best selling cannon. Our ultimate mission is to make life easier for everybody so that we can improve patient access to care. And so we're trying to center on that. And we're trying to be really thoughtful about the solutions that we bring to market and the way that we support our customers. As with any company, there's growing pains that come along with that. But we're working really hard to add value to the industry to really be a positive light as an industry player who can help support clinicians, staff, members, embryologist, patients, their partners, really all the players that take part in an episode of care,
Griffin Jones 1:00:31
will tell me a little bit about some of those things like, give me some of the earnest struggle that you're having and one of ours has been in that, like that third phase of the patient, or because we're never going to be pure operations consultants, that's not us. But you get to a point where sales and marketing can say, well, it's out of our hands, now it's in it's in our hands. And to me, that just always seemed like a dereliction of responsibility. Like, at the end of the day, someone is hiring a marketer because they want more revenue, they're not, there are some other things that they hire that person for, but a marketer needs to be able to set up the sale. And, you also should be able to set up a sale, that is delighted. And so I've had challenges with my team. And if you've made some personnel changes in the last year, because we couldn't get on the same page of what that is. But an example is, you know, we're talking about reputation management, like we help with reputation management, like the online reviews, and, and we know how to get people more positive reviews to a point. And then we might reach a point where it's like, okay, they're still getting these types of complaints. And, and what I want to be able to do is give people clients, the procedure of this is exactly what's broken. This is how you fix or this is exactly how you implement this into your EMR, I don't want to just give people something that could have been written in a blog post. And because I agree with Rita Gruber, when she says marketing throws the ball, it's the practice's job to catch it. But the practice doesn't care if you're Tom Brady, and you throw the perfect spiral. If they can't catch it, I want to make the ball land into their hands. That's the idea. And so, and that takes a ton of work. It takes discipline. And you have to be able to say like we don't, we don't totally have this yet. Because every marketer just wants to say they're the, they're the cat's pajamas. And the only reason why other people suck is because they're not as good as it No, it's it, it is connecting all of these dots, that's what it is, you're supposed to connect all of the dots. And, and so that's what, you know, that Fertility Bridges are in a struggle, what's EngagedMD?
Jeff Issner 1:03:00
Yeah, you know, I kind of go back to all the ways that people have stretched the platform in ways that we didn't fully expect. And it's great. They've created these workarounds. And sometimes there's things that people want to stretch the platform and do things that intuitively make sense in the vein of education and documentation and patient journey management, that when they even on the expense, it's like, oh, yeah, I wish we could do that today. But we, you know, we're building out a platform that needs to be scalable, it needs to be secure, it needs to be well managed, it can't break down. So we were just constantly trying to build out things in a very thoughtful way to meet these kinds of workaround methods and workflows that people have put together on our platform. And I wish we could do it as fast as possible because what it ultimately creates is people might run into a bug or they might run into an issue where they can't complete the workflow. And that's not the experience that we want people to have and our support team has helped people through that come up with other workarounds. So we're constantly trying to build the platform out again, in that scalable, secure way. So that your data is safe, your patients are safe, you're safe. And we're working really hard on that we've got a give a little bit of teaser to the next generation of EngagedMD they're getting ready to launch that will help ensure that scalability and more flexibility so that all those crazy use cases that our customers come up with will be able to better support them and continue to build upon at a faster clip to help make sure that we're supporting people even better so. It's not perfect, I think we're doing a really good job of creating as many workarounds as possible and supporting people but that would that would be the area that kind of keeps me hungry and keeps me you know, Taylor and me working really hard and growing the team and growing our resources so that we can support more of these things that really should feel fall within our wheelhouse education documentation patient journey manage met, we want to keep on growing the functionality so that there's nothing this will never be the case, of course, but we want it to be as close as nothing that we can't help solve for.
Griffin Jones 1:05:10
As the challenge with the business owner, right, you're, you're steering the ship. And it's either the iceberg that you want to avoid, or the part of the water that you want to turn towards. You can see it like you can see, it's like, can you turn fast enough for that is the challenge of a business owner. When Marc Andreessen says that software is going to eat the world? One, I believe him too. I think he's talking about EngagedMD, as you're as you're just is, as you're competently absorbing each of these spheres as you expand. So let's conclude with what do you, what can you tell us about your your roadmap, where, where, as specific as you feel comfortable going on public record, what can you share with the audience?
Jeff Issner 1:05:58
Yeah, so I mentioned we have a new version of our platform coming out, that's going to continue to expand upon the ways that we help support patients through their ultimate journey. So while some aspects of our platform right now are very much like, here's where you are, here's what you get, we're trying to create a more cohesive patient journey that's easier to manage, from soup to nuts to create a very consistent, comprehensive experience for all of the different patient journeys that you can have, and then track and manage. We're also to that point, expanding into other areas of the patient journey. So like the financial counseling journey, we'll call it, we want to keep on building out products, content, things that can help support patients through all those different stages, and we don't currently do right now. And then the last thing is just introducing more industry partners and working with more industry partners that can benefit from having this interaction with both patients and clinics to help, you know, support through things like the medication management processes, or the genetic testing processes or whatever it might be, we want to make sure that we're plugging everybody together to create, again, a great patient journey. So software contents, the people to help support it. That's where we're growing so that we can keep on helping more and more people access that amazing care.
Griffin Jones 1:07:21
Yeah, fastener it has been a pleasure having you on we're going to link to engage MD obviously, in the show notes and tag you in social but people can actually go to engage md.com/grip, and they can get a workflow assessment where EngagedMD looks at a lot of the things that Jeff talked about today. So if you want to see how your clinic stacks up, they will look at that for you. And they'll do it for free if you go to engage md.com/griffin first sponsor I ever had, because of how many people have just been blown away by your company. And I know that my own company isn't at that same echelon. Yeah, I can, I can save that. And so I admire that you've been able to do that because I'm really really trying and I know how hard it is. So thanks for sharing that on the show.
Jeff Issner 1:08:18
I really appreciate the kind words, appreciate your support and really excited to continue growing with you and growing with the industry. And so thanks again for having me. Can't wait for the next one.
1:08:30
You've been listening to the inside reproductive health podcast with Griffin Jones. If you're ready to take action to make sure that your practice thrives beyond the revolutionary changes that are happening in our field and in society. Visit fertility bridge.com To begin the first piece of the fertility marketing system, the goal and competitive diagnostic. Thank you for listening to inside reproductive health