In this episode, Derek Streat, Founder, CEO & Chairman of DexCare, discusses unlocking capacity, growth strategies for CFOs and COOs in healthcare.
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Learn how to listen to The Hospital Finance Podcast® on your mobile device.Highlights of this episode include:
- How DexCare is uniquely positioned to help with healthcare supply and demand challenges
- What some of the biggest barriers are to expanding capacity
- How to help manage the demand for care while improving financial performance
- Success stories from health systems using DexCare’s platform
- Major trends for 2025
Kelly Wisness: Hi, this is Kelly Wisness. Welcome back to the award-winning Hospital Finance Podcast. We’re pleased to welcome Derek Streat. Derek is the founder, CEO, and Chairman of DexCare. He’s an accomplished healthcare technology entrepreneur and executive, having co-founded and/or been at the earliest stages of six venture-backed companies, including C-SATS acquired by Johnson & Johnson, Classmates acquired by United Online, Medify acquired by Alliance Health Networks, and AdReady acquired by CPXi. Prior to joining Providence as an entrepreneur in residence to commercialize the DexCare platform, Derek served as VP of Digital Solutions at Johnson & Johnson, a role he assumed after its C-SATS acquisition. Derek is also actively involved in national healthcare data transparency efforts for the improvement of patient care as a co-founder and board member of two leading data sharing organizations, PEDSnet and the Improving Renal Outcomes Collaborative, or IROC.
In this episode, we’re discussing unlocking capacity, growth strategies for CFOs, and COOs in healthcare.
Welcome, and thank you for joining us, Derek.
Derek Streat: Thanks, Kelly. Thanks for having me.
Kelly: Well, let’s go ahead and jump in then. So, Derek, how is DexCare uniquely positioned to help with healthcare supply and demand challenges like rising patient volumes and clinician burnout?
Derek: Sure. Yeah, so our organization and the product we offer was purpose-built to orchestrate demand and supply across all lines of care. We were born out of one of the leading health systems in the country, Providence Health, which owns about 50, 52 hospitals or so, I think in seven states in the western part of the U.S. And like many health systems, years ago, and even to this day, they face a situation where there’s rising demand for care. People are living longer, demographic trends, all the things we’re well aware of are driving demand for care. And yet there is a limited/reducing supply of people, humans to take care of, take care of everybody. So, capacity issues have been brewing for a while, was exacerbated during COVID, and it hasn’t let up at this point. And so we built a system that, in a nutshell, makes sense of three key data sets, patient intent and motivation, provider data sets, and then what the health system is trying to accomplish as well, which includes financial metrics for the health system, and then balances the needs of those three constituencies and what they’re trying to accomplish in taking care of patients, taking care of themselves, taking care of the health of providers as well, and not burning them out, and then matches patients with the best provider setting, service line, modality, or the intersection of those things in a way that helps everybody win in those situations.
Kelly: Wow, that is impressive. So, with an aging population and increasing demand on healthcare systems, what are some of the biggest barriers to expanding capacity, and how can they be addressed effectively?
Derek: Yeah, so I alluded to one of them earlier…biggest kind of sort of physical barrier is that there’s just not enough medical providers, licensed medical providers, to take care of all of us that have increasing health needs as we get older, as we live longer, things like that. At the same time, we know that access itself has been challenged at a patient or a consumer level as well. We know that some of the hardest things to address in healthcare access are just getting an appointment and being able to pay for an appointment. And those are very difficult things for lots and lots of people to do. And so, these barriers persist. They’ve been here for a while. The barriers seem to be getting higher for the reasons I mentioned earlier. And so, we’re at this moment, Kelly, where technology really can help out and is helping out. I think we all know those of us who’ve been in the healthcare space for quite a while is that usually the problems to be solved, particularly in access, are not technology problems to be solved. We have a large healthcare infrastructure in this country. These are very smart people working in complex environments. And so things like change management and organizational change, those things are necessary to utilize these technologies.
But once you can do that, then we are at a point where now the workload, if you will, to get that appointment, to pay for that appointment, to do those kinds of things can be distributed to other stakeholders, right? So, for most of the lifecycle of healthcare in this country, and I would say other places, everything went through the doctor from start to finish, right? But we’re in a situation now where technology has made it so that patients can do some of this work on their own. They can educate themselves about what may be going on with them. They can learn whether or not and make a decision whether or not they actually want to go and see a provider for a particular situation. They can do things like self-schedule online. They can work with their payer portal and their benefits providers to figure out whether or not something can be covered. None of this is to say it’s easy, by the way. There’s lots of problems to be solved in that space. But the point is, is we’re now in a situation where workload can be distributed and democratized to patients, to a variety of providers of different licensure as well. Not everybody needs to see a medical doctor for every situation.
Some can see sometimes a registered nurse or advanced practitioner, folks like that can take care of folks very easily as well. And then finally, there’s the different modalities. COVID definitely shone a light on other ways of delivering care. We’re now in an omnichannel world where I can get taken care of anywhere from the big expensive hospital all the way to the to the small ambulatory center in the strip mall, all the way to virtual care, which could be synchronous or asynchronous. And so, as we enter this world where technology can now make these types of care more accessible and at the same time understand the backend piece I mentioned earlier about what’s going on with providers and the health systems to do matching better. We’re now at a point where not everything needs to go through these very limited bottlenecks as they have had to for most of the history of healthcare in this country.
Kelly: Very true, yes. So, the ability to precisely orchestrate care delivery is gaining traction as a key strategy in healthcare. So, what does it really mean and how does it help manage the demand for care while improving financial performance?
Derek: Yeah, there’s two sides of the equation, right? There’s a demand side and there’s a supply side. So, when we think of demand, we break that down into a few different groups. So, there’s getting new patients into the system. That is a series of motions that are not unlike what companies and organizations and other industries do to try to make sure that their products, if you will, are discoverable and made aware to potential consumers of those products. So, in our world, we see health systems and there are main fiduciary organizations we work with. Their products, quote-unquote, “are care options,” we call them different ways they can deliver care and types of care they can deliver. And so, part of it is making those types of care more discoverable and in many ways the same way that organizations would, whether they’re promoting their different offerings, making them available through search engines online, things like that. Another side is demand management, right? So, you may be an existing patient in the health system. You may already be aware of what that health system offers, but you’re very busy, right? You may not have thought about the fact that you’ve reached an age, for example, where it’s prudent to do a particular type of screening, for example, to make sure that you stay healthy as well.
So now the technology can reach out proactively to patients to make them aware of those things as well. On the supply side of the equation, here we’re talking primarily about resources. So, they’re the providers themselves. They’re the facilities if it’s appropriate for you to come in person to a facility. All of those entities need to have– there needs to be an understanding of who does what, who’s best at doing what, or what setting is best at doing what, what kind of outcomes will they likely produce if they’re seeing certain patients? What kind of satisfaction will they likely produce? What is their true capacity, not just availability, and how efficiently can they see various patients? When you understand that underlying data about those resources and you match that with the demand upfront, what we find with the health systems we work with is that there’s on average about 40% additional capacity in the health system that’s underutilized simply because there’s not an understanding of the demand side and the supply side, those underlying data of those constituencies in a way that will allow those people, those patients to be matched up with those resources as well. And once you do that, then it’s a win for everybody because more patients are able to be seen, which is better access. Providers are seeing patients that are more appropriate to see and actually lowering the average number of patients they’re seeing if they’re already seeing too many, because now you’re balancing load across the system. And the health systems can be sustainable in that environment as well.
Kelly: Yeah, no, that makes a lot of sense, Derek. Can you share specific outcomes or success stories from health systems using DexCare’s platform that illustrate its impact on patients and providers?
Derek: Sure. So, we work with leading health systems around the country. We cover about 20% of the US population now through our partners like Kaiser, Providence, obviously. We work with organizations like Piedmont in the southeast, SSM in the Midwest, and CHN in the Midwest, organizations serving very large metros like THR in the Dallas-Fort Worth metro. We do rural care with our partners at University of Rochester and in upstate New York. So pretty wide coverage across the country. And what we found is by utilizing the kinds of systems I mentioned earlier, making their care more discoverable in the places that people may be just spending their life, right, looking for things online or calling into call centers, things like that. They’re not really spending life in call centers, but sometimes you got to call the number to get to get care, making their care more discoverable in those places, and then getting a true understanding of their resources in the back end and what their objectives are for the health system as a whole, where they’re looking to grow. We found that we can typically increase the percentage of care that’s booked online in sort of a digital digitally enabled way, about 50%. We can find that– we also find that in a virtual setting where you can really get scale, we’ve been able to increase virtual visits for some of our partners. I mentioned, particularly the ones in the Midwest, about 300%. And then on the capacity side of the equation, we found that that that increase in kind of digital enablement of even things like booking appointments for our partners that can lead to up to a 70% increase in clinic visits.
And in a virtual setting, we’ve seen numbers as high as a 4x increase, a 400% increase in virtual visits as well. All that being said, probably the stat I’m most proud of all these things is that we have a number of examples to give you Piedmont in the southeast, for example, where we’ve reduced the number of days it’s taken to it takes to be seen in a primary care appointment in that organization by 5 days. And that’s all been accomplished again by making sure patients are– so you’re seeing more patients come into the system, yet they’re being seen 28% faster. And that’s because if you understand– that’s the fact if you understand the underlying supply, which providers are burnout or not or overutilized or underutilized, etc., and match them appropriately, more people can be seen with less stress and burden across the providers and the health system as a whole. And that’s good for everybody.
Kelly: It definitely is. Thank you for sharing that with us. So, as we move into 2025, what major trends do you foresee shaping care access and care delivery for hospitals and health systems?
Derek: I think as we’re all starting to see now at this point, the ways you can either look at– you can look at one or two ways. Either the ways we’ve– and I’m going to stay focused on access because that’s the world that we’re in. The ways we’ve access care, even up to this point, even the things I just mentioned in the first part of this conversation, are starting to be broken and I think are challenged, at least. And this is a positive challenge. And/or there may be opportunities just to leapfrog ahead. And what I mean by that is I think we’re entering a phase here where we can make care more discoverable to patients. We can make it easier for you to figure out what’s covered through your payer portal. And admittedly, this is never easy to do. But now with new technology, and yes, I’ll use the Gen AI word, but I truly believe in this. We’re entering this phase where those things that we’ve been on the path of trying to make easier can now be made an order of magnitude easier than they have before. And so, an example would be we can make it easier for, like today, we can make it easier for a patient to enter their intents and motivations and be matched with and find providers and resources that are relevant and appropriate for them. Find a list, right? We’d see in a search list, find a doctor list or something like that, and then choose them and book that appointment. That’s all better than it was 10 years ago.
But I think we’re entering this phase where that may be an old construct where you actually could have an AI agent that aggregates all those data I mentioned in the back end, figures out the right match. That’s the kind of thing we do today. And then importantly, find that best appointment for you, get you scheduled in that appointment, does that work? And then if you want to change it or cancel or whatever have you, or then you can go back to the, quote-unquote, “old way” of doing things. But I think we’re entering a world where whether it’s getting a new appointment or for something that you are proactively seeking or whether it’s reactive like a wellness thing where it’s time to do this checkup or the scan or what have you, we’re in this world where agents can not only reach out to you to make something discoverable, they can actually do the work for you as well of getting you into the right setting service line modality provider, scheduling that appointment, collecting all the pre information that may need to be collected to make sure that that is an efficient visit for you as well. And it’s just incredibly exciting to think of that world where more of this care is being orchestrated by the system as opposed to kind of the world. Historically, if I had to break into the phase, I think historically and really pretty much up to this point, it’s been, “Well, my doctor’s going to orchestrate this stuff for me.” And doctors are busy. They’re in the business to take care of the field, to take care of people, having to remind you to do all this wellness stuff is really not really putting a lot of burden on them. So that was kind of the way healthcare has been done.
Now we’ve moved into this world, and this is the world that organizations like DexCare have reduced friction in, which is, let’s make it easier for people when they’re ready to get care to come and use these kind of tools and systems, kind of distribute that workload, as I mentioned, so that more people can be seen faster. And now the third wave we’re entering now is a world where it’s less reactive and I think more– and this is driven by these kinds of technologies can actually be proactive in reaching out to you. And importantly, connecting the dots and doing the work to actually make that orchestration happen. So now it’s not putting the burden really on the provider or the patient; the technology is the one that’s doing that orchestration and providing a better outcome for everybody.
Kelly: Wow, thank you for that. So, what does the future of DexCare look like, Derek?
Derek: Well, that’s exactly where we’re going. And so, we will stay true to our mission, to make it so that our mission is that no one ever has to wait for care again. We truly believe the way to do that is not to try to mint more doctors out of medical schools, although that’s needed. But it’s not enough to solve the problem. It’s also not enough, by the way, to put all the burden on the patient, right? It’s great that you can make things more discoverable, but people are busy, and so they got to do everything, that’s kind of a problem as well. And so, we’re leaning into this new world of leveraging Gen AI and a generative technology to proactively do a lot of the work that that we’ve had to. We’ve had to have our software enabled thus far, right? So, if you kind of go back to where I started, this whole thing is based on a deep understanding of patient intent motivation provider data and health system data as well. There’s a lot of work that goes into humans, software engineers, aggregating these data sources, making predictions based on it, deriving novel data for that, keeping it not only comprehensive, but timely and hygienic. We’re now leading into these technologies, the kind of technologies that can do that work much faster and more efficient than we’ve been able to do before, and then go that extra mile to helping make care more accessible by not simply just providing a list. It could be the best list, but it’s still, at the end of the day, providing a list of providers as an example for the patient to get to get care from. But instead of going that extra mile of saying, “You know what? Here is the perfect match for you. Let’s get you in to see them as fast as possible.”
And then if you want to change it and go back to a big list, you can do that. You’re certainly welcome to do that. But we’re going to try to reduce friction in the process and make this better and easier for you as a patient. And then also providers as well by making sure that you don’t have to continually go in and you have you or your clinic operator type things into boxes and databases to keep your profiles up to date. With technology right now that we’re developing to make sure that we can deduce from case histories and what providers actually deduce what they’re best at and who they can best see. Again, these are things that can be amplified and made easier for patients and providers by leveraging these kinds of technologies.
Kelly: Sounds like very exciting times for you all. Well, thank you so much for joining us today, Derek, and for sharing your insights on unlocking capacity, growth strategies for CFOs and COOs in healthcare.
Derek: Thanks for having me. I really enjoyed it, Kelly.
Kelly: And if a listener wants to learn more or contact you to discuss this topic further, how best can they do that?
Derek: You can go to our website, http://www.dexcare.com.
Kelly: Awesome. Easy enough. Well, thank you so much. And thank you all for joining us for this episode of The Hospital Finance Podcast. Until next time…
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