Nick Adkins, the kilt-wearing, pink socks-touting co-founder of ReelDX shares how asynchronous video is gaining traction, how health IT has changed in the year since debuting his company’s medical video API, how clinicians can give input on digital health tools, and the significance of #einpower — the power of working together across all areas of health care.
Air Date: February 17, 2016
Guest: Nick Adkins
“Health care and the evolution of where it’s going today — not some far off 5-year timeline, but what’s happening today — is succeeding because we’re all in this together. The archaic days of old silos and domains and kingdoms and fiefdoms — those days are over. That’s gone, OK? We all have to work together. It’s a collaborative effort. The days of secrets and not sharing information … it’s gone. We have to be working together to pull this off for all of us.”
|0:36||From #HITMC tweet chat: native advertising and content marketing|
|2:51||Introducing Nick Adkins|
|5:30||Video, of course!|
|10:13||Where asynchronous video is gaining traction|
|12:37||How is health IT different from a year ago? How will it be different a year from now?|
|14:14||How important is clinical input in developing digital health tools?|
|17:45||#Einpower = the power of one|
|20:43||Clinicians may be surprised at what digital health tools their patients recommend|
|21:20||UPMC, Kaiser, Intermountain Health, and Phillips are leaders in rolling out digital health tech tools|
|22:57||Find the conversations where you can contribute|
|24:36||Bonus question: If you could join a rock band or music artist for a day, who would it be?|
About Nick Adkins
Nick Adkins is co-founder of ReelDX, providers of HIPAA-compliant asynchronous video services that are gaining rapid traction in telemedicine and other fast-growing areas of health care. He is a speaker and regular contributor to online health communities. You will know him by his kilt and pink socks, which might clue you in to the passion he has for innovation in digital health.
You can reach him on Twitter at @nickisnpdx.
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Jared Johnson: Hello once again, my friends, and welcome to the Health IT Marketer podcast, the podcast for the heartbeat of healthcare. I’m your host, Jared Johnson of Ultera Digital. This is the first and only podcast dedicated to the health IT marketing community. Welcome aboard.
This week I’m hopping from one lively discussion to the next. There’s so much chatter going on in health IT right now, and I love it. We can thank a busy conference season for that, with HIMSS and HITMC both on the horizon here.
One of those conversations was actually the February HITMC or H-I-T-M-C tweet chat in which we discuss native advertising and content marketing. At one point, I was asked if I thought native advertising was considered to be content marketing, and my comment was that I don’t think the format always determines whether something is content marketing or not.
And I also didn’t think that content ought to push a product in any way, shape or form, to which Patty Dickerson had a great point in return that sometimes content actually can effectively push a product.
And Patty, if you’re listening, thanks for that response, because it really made me think, well, wait, is that true? Is what I’m saying true? And it led me to clarify that I think there’s a difference between pushing your product and content that generates leads that may mention your product.
So you might mention it, but you want to do that strategically. So some of you may disagree with me on this. I’d love to hear your thoughts on this. But suppose you produce a whitepaper about one of your customer pain points. This is actually a real case that happened with one of my clients.
Suppose there’s a white paper that’s produced about one of your customers pain points, and you go into depth with the research or statistics about that pain point, and in that section, after all of that explanation of, “Hey. We understand this pain point,” what if you then add this language of, “Hey. By the way, our product is awesome at solving that pain point,” and then you go into your standard marketing speak of features and benefits?
So for me, I try to steer clear of that. I would prefer to continue in an objective language and in an objective tone, and not turn into sales language at that point. I feel like it’s a more effective way to have a call-to-action perhaps at the end of the white paper, in this case saying something like, “Do you want to learn more?”
So I’d love to hear what you think about that. It goes against some of our traditional marketing DNA, but I venture to say that that’s more effective at winning a lead and ultimately actually building your audience.
So let me know what you think about that. You can Tweet me at JaredPiano. That’s J-A-R-E-D, Piano, P-I-A-N-O. Let me know if you think it’s more effective to include a hard sell in your content, and if so, are there better ways to do that? Or do you just try to stay completely clear of language about your product?
All right. Well, my guest this week on the program is Nick Adkins from ReelDx. He’s a cofounder, the COO and stuff, as he says, of ReelDx. So I want to welcome him to the program. Nick, how are you doing today?
Nick Adkins: Jared, I’m great. Thank you for having me.
Jared Johnson: I know that “and stuff” in the identifier there lets you do other things that have to do with all sorts of aspects of the business. Do you want to tell us a little bit more about your background and where you are now and what you’re doing? What does that “stuff” involve?
Nick Adkins: Sure. Yeah. A lot of entrepreneurs can relate to that. There are so many hats you have to wear in the startup life when you’re trying to get a company up and going. I don’t want to take myself too serious either. Sometimes you put a title on a business card or whatever, and all of a sudden you sound like a grown-up. So that kind of helps just keep it real for me.
I’m in Portland, Oregon. I moved here four years ago from Nashville, Tennessee. I was in the healthcare business in Nashville and sold a company, moved out here, met one of the other cofounders, Bill Kelly, who back in the day started a company called Sapient Health Network, which became WebMD. We met out here and decided to get together on this project, ReelDx. ReelDx started as a pure med-ed play, real patients, real doctors, real cases, using video as a learning tool.
And the interesting thing there was, wow, that’s a really cool use case of how to use video in healthcare, but what if we could create an open API that was a platform that any developer, any software that wanted to use HIPAA compliance, secure video in their flow would have a place to do that.
And so we created this thing that we call the Med Video, medvid.io API, which is exactly that. It’s an open API that developers can plug into their apps, their software, behind the scenes, to enable that feature set of secure record-and-share video, whether it’s video messaging. Whether it’s discharge instructions, whether it’s pharma, patients in clinical trials, self-journaling, the use cases are just kind of endless.
We wanted to be able to enable that feature set inside of software, and so we launched Med Video, the API, last April at HIMSS in Chicago, and today we have 180-something. I don’t know exactly what the number is, north of 185 companies, different tech companies from around the world that are using the API in their software, so it’s been very exciting.
Jared Johnson: That’s amazing. That’s impressive for just one year of growth. And we’re sitting here in 2016 saying, “Of course, video, that makes sense,” but you’re saying this was several years ago when this idea kind of took fruition. So how did you land on video as that component that could really take healthcare to a different level?
Nick Adkins: Right. Well, like I was saying, when I met Bill, he was working with our other cofounder, Dr. David Spiro, who’s our chief medical officer. It was David, really, who had the idea of using video as a teaching tool, and that’s kind of what was happening. ReelDx was building up a library of curated cases for teaching purposes.
I looked at that and I said, wow. That’s awesome. Right? That’s a really cool doughnut, but I see a box of doughnuts, and the box of doughnuts says, if we can enable anybody that wants to have video on there flow . . . I mean, you and I know, we look at everything that’s happening in the digital health conferences and out there and what’s coming on the horizon, and telemedicine is such a major, major thing that’s on everybody’s mind. Right?
And so my real passion for getting involved is, like I say, I moved here from Nashville. My mother lives in a little town in North Alabama. She lives by herself, and so I’m trying to help manage her care from 2500 miles away, and having to call, talk to her doctor’s on the phone and trying to relay messages back and forth between the doctor and the nurse and me and just trying to get all of us on the same page, it’s is kind of a nightmare. Right?
So I said, “I’m going to buy my mom an iPhone, and I’m going to show her how to use the video button. I’m going to go in with her doctor the next time I go see her, and I’m going to obviously take some paperwork so he can put in the chart, giving me permission to do this.”
But I said, “If you can record what you tell my mom, it will really help a lot of us. We’ll all be on the same page. I promise you I’ll never call your office again and say, ‘Hey. How did my mom’s visit go? What did you tell her?’ so I can make sure I’m getting the right information. This will just be seamless for all of us. She’ll be more adherent to the treatment path and plan that you’re giving her. It’s just all going to be good here. She’s going to be more engaged. All of the things that you want in that experience or that relationship between the doctor and the patient and the care team, family members.”
And so I thought, wow, let’s build an API that can enable this in any software, because there are a lot of super-cool mobile health apps out right now, and a lot of those can use secure video in their flow. And there’s a lot of people like me who want to know how their mom or dad is doing or how their husband or wife or how their kids visit went. They just need to have that information retained. There’s nothing more contextually rich than a video artifact of the encounter.
I mean, you can give me all the patient education literature you want to. I can go look up everything you want me to look up online at Google or Mayo or WebMD, but there’s nothing that’s any better than my actual encounter, my doctor. It’s my personal, unique experience, and what he or she told me. And I want to be able to watch this again and again so I can help take care of myself, and I want to share it with my family and other people in my care team who are helping take care of me.
So there’s all kinds of ways to plug this thing in, whether it’s just a telemedicine service like an American Well or Doctor On Demand, MDLIVE, etc., Teladoc, all of those live, what we call “synchronous” telemedicine solutions. Well, the way they’re going to scale that is with asynchronous video. So it’s like when Al Gore invented the Internet. We then had the ability to communicate via email asynchronously. So now we can communicate at scale, globally. Asynchronous allows us to do things that are more convenient.
So when we’re on Twitter, that’s an asynchronous form of communication. Facebook, LinkedIn, etc. It allows us to do more things in one day, doing them asynchronously. The one-to-one ratio that the normal synchronous, face-to-face visit has . . . you can’t create more time in the day. Right? So asynchronous communication allows us to create more in a limited amount of time.
And my belief, our belief here at ReelDx and the Med Video API, is the way to scale telehealth is through asynchronous. And so that’s the long story there of why I got in this and why I’m passionate about it and believe strongly that we’re in the right space at the right time.
Jared Johnson: And where are you seeing the most traction out of those you mentioned? How many different applications are you going to have that tie in, that pull this API into their flow? Where are you seeing them most traction right now?
Nick Adkins: Yeah. Obviously, the telemedicine space is probably our number-one bucket, and there’s a lot of cool stuff happening on the legislative side around reimbursement for telemedicine, and several states are already including asynchronous language in those bills for reimbursement parity, so that’s exciting. So we think we’re just probably just a little early on that, but we’re in the right place, I think, at the right time to be a part of that market as it explodes.
Another thing we’re seeing, really, is use case in the bucket, if you will, is discharge instructions. That’s kind of almost a no-brainer. You’ve been discharged from the hospital. You’ve had surgery. There’s some event, head trauma. You’ve been anesthetized. You’re sedated. You know, you’re ready to get out of the hospital. There’s no way you’re going to retain that information. And so hospitals are wanting to lower their readmission rates, improve their patients’ sat scores, and most importantly have the patient adherence to the treatment plan.
And so what better way than recording your discharge instructions for you and your family to review when you get home? So we’re seeing a lot of early adoption and movement on it from the facility side, the hospital side, on using discharge instructions as kind of their test case, use case, if you will.
Another place we’re seeing it pretty big is in pharma clinical trials. So right now, if a patient is in a clinical trial, they either have to come into a clinic and a nurse has to watch them take their medicine, or somebody has to come out to their house and watch them take their medicine. And that’s just not realistic. Since we have the technology today to say, “Look. This could be monitored remotely, this can be viewed virtually through an algorithm, and let technology do what technology does.”
And so, I’d say telemedicine, discharge instructions, clinical pharma trials, population management, those are kind of the, of those 180-something companies, I’d say those are the three or four buckets that I would put most of those use cases in.
Jared Johnson: Nice. Well, let’s wind the clock back here just a little bit to when you were talking about watching this API at HIMSS last year. So a lot has changed in health IT in the last year. Some things haven’t, and some things haven’t gone as quickly as we’d like. But from your standpoint, what’s different in health IT from a year ago, and then how do you think it’ll be different a year from now?
Nick Adkins: Oh, wow. Yeah. I think the big thing that I felt in the past year, the 12 months, has been, really, the mantra last year at HIMSS, a lot of stuff there you hear on Twitter and social media was all about patient engagement and how there’s not enough, and the patient voice isn’t being heard enough, and whether it’s in the design process from the very beginning or anywhere through the workflow. I think that’s changed.
And so, I think that this year we’re going to have more of a focus on companies and facilities and projects that are actually including the patient voice. That mantra of patient engagement, I think, that drum is not going to be beat so loudly this year, because I think we’re seeing that patients are being involved now, which is super good news, and to keep the patient at the center of design. I really love what CancerGeek’s doing with My Ideal Patient Experience and that team.
So yeah, I think that’s going to be, for me, the big noticeable thing going into this HIMSS that wasn’t there last year.
Jared Johnson: That is a big change, isn’t that?
Nick Adkins: Yep.
Jared Johnson: Another voice we hear a lot lately, especially in the last year, is about having clinical input, just like you said, having the patient voice when developing these new innovations, new technologies. But also having a clinical voice in there so that we understand what that workflow is, because otherwise we build all these tools, and then we get them, and we start testing and we realize it has nothing to do with an actual clinical workflow.
How important was that in the developmental stage at ReelDx to say, “Hey, we need to have some clinical input while we developed this thing and test it”?
Nick Adkins: Right. It’s very important, and the first version of the company, if you will, ReelDx, which we now call ReelDx Education, was strictly focused on the relationship between a clinician, a provider and his or her patient and that unique experience that they were sharing in a moment. So it was totally surrounded around clinicians being the content providers.
I mean, these were docs who were in hospital rooms, exam rooms, offices, shooting video with their own cameras, with their own phones. I mean, this wasn’t highly-produced, high-production-value stuff that was being shot by a camera crew. This was the doctor, the nurse, paramedic, EMT, having their phone out, having the camera on, whether it’s a GoPro or Glass or anything, and saying, “Look. I’m going to record this,” and it was real.
And ReelDx education product is still a standing product. We have lots of medical schools and nursing schools from around the country that subscribe to that, use it as a teaching tool, and it has the clinician and the patient at the center of the experience. That’s what it’s all about. It’s very important to us.
Jared Johnson: So do you have any advice for any other health IT companies that are trying to develop any product that should be used by clinicians in any way? Any advice you’d give them when they’re developing a product?
Nick Adkins: Yeah, absolutely. I say you better have a patient, a nurse, a doctor, anybody else in the workflow chain, you should have them all sitting at the table, looking at the whiteboard, each have a marker in their hand so they can go up and write stuff on the board that have input on the design process.
I mean, unfortunately what happens a lot of times is a doctor has a great idea, or a business guy has a great idea. They don’t really talk well together, and so one says, “Oh. This is all going to be clinical, clinical, clinical,” and sometimes the business guy says, “No. This is the business thing. It’s all business, business, business,” and both of those scenarios, it’s not about involving everyone.
And involving everyone is everyone it’s going to touch this thing and use this thing, from the doctor, the patient, to the nurse, the lab tech, to the patient’s mom and dad, the brother and sister and the pharmacist and everyone that may need to use this. Everyone needs to be involved in the very, very beginning of this thing, in the design process.
Jared Johnson: I think it’s important that you mentioned more than just patients and physicians. You mentioned nurses. You mentioned the family members. You mentioned everyone that might touch this thing at one point or another. And I think it’s the bigger thought, this realization that healthcare isn’t just during a particular point in time, that it really is this spectrum that’s going on all the time, and it’s not just physicians.
There are many others that fall into that clinician bucket that are involved, one way or the other, and they would all have something to do with a lot of products like this.
Nick Adkins: Yeah. I mean, you routinely see me tweet the hashtag EinPower, and I’ll get a hat tip out to nxtstop1, to Bernadette, for throwing that out in the Twitter sphere for the first time. EinPower, Ein is the name of our data dog, and “Ein” is also the German word for “one.” So it’s the power of one. And when I hashtag something that says “EinPower,” it’s meaning “We’re all in this together,” and that’s how this is. It’s like Twitter, “We’re all in this together,” a lot of design process, “We’re all in this together.”
I mean, healthcare and the evolution of where it’s going today, not some far-off, five-year timeline, but what’s happening today, it’s succeeding because of “We’re all in this together.” I mean, the days of, the archaic days of old silos and domains and kingdoms and fiefdoms, those days are over. I mean, it’s gone. Okay? We all have to work together. It’s a collaborative effort. The days of secrets and not sharing information, it’s gone. It’s just gone. So we have to be working together to pull this off for all of us.
Jared Johnson: Absolutely. Could not have said that better. I’ve not heard that said better by anyone. I know one part of that is once that mindset, as that has been shifting, we do see clinicians more willing to adopt digital health tools like this, like asynchronous video. So for those who are willing but not sure where to start, what advice would you give them?
Nick Adkins: Well, first of all, I say if you were going to get into the healthcare business, my first advice is run. Don’t do it. But if you’re going to stick with this and actually be in healthcare, my advice is be ready for some realistic timelines, and nothing ever happens as fast as you want it to happen. In fact, in healthcare, it moves quantifiably slower than it should.
And that’s also a legacy issue as well that I think we’re going to start seeing dissolve over the next, maybe, 18 to 36 months. It’s almost like healthcare is finally catching up with itself. So now that the technology has moved so fast and is so awesome, and the consumers are wanting it like now, I think once the awareness is out there, that what’s available, I think consumer demand is going to push this so fast that some of those lagging timelines in healthcare are going to get a jet pack in the next year or two.
Jared Johnson: Well, I would like to see that. I hope that does happen. And what about the clinician, specifically, what would you tell them if they’re kind of at that starting point too, but just not sure where to start?
Nick Adkins: Well, I’d say where to start is . . . you know, you’d be surprised what your patients are going to tell you. You’re going to start seeing more consumers walking into their doctors saying, showing their doctors really cool new apps that the doctors weren’t even aware of. So I’d say, listen to what your patients are showing you and what apps they have on their phones that they want to use.
I think a lot of the big facilities have some super-cool apps that they’ve already spun up and rolled out and are rolling out right now as we speak. Some of the front runners that come to mind would be UPMC in Pittsburgh. I think they’re probably one of the most innovative health systems in the country as far as tech and rolling out new design.
Kaiser obviously is another big one. The Intermountain Health System has got some awesome tech they’re rolling out as well. So I think clinicians, providers, who are in those big IBNs, those guys who’ve got great tech teams wrapped around them, that have vetted a lot of really good stuff.
And so, I would show up and participate and get my voice and involvement and being part of that review process at those facilities if I were a provider. I would not sit back and be passive. I’d be actively involved in wanting to know what the facility is rolling out, from a tech standpoint, to get in my hands to use and facilitate effective communication with my patients.
So I can’t give enough kudos to those three orgs I just rolled out. They’re doing some really good stuff, as well as some other. Obviously plenty, I don’t want to leave anybody out, but those three kind of routinely come across my feed as people who are winning right now.
And I’d also like to give a hat tip to Phillips. The work that Phillips is doing is fantastic, so I think when we see them at HIMSS, let’s definitely try to migrate over toward their pavilion and see all the good work they’re doing. They’re actually doing it today, so I’m looking forward to seeing them.
Jared Johnson: Fantastic. Fantastic. Well, let’s put our marketing hats here on for a second and think about . . . I’d love to hear how you prefer to do your marketing. Are there tactics or channels out there in marketing that you find to be more effective for what you’re doing? You’re trying to get the name out there, for sure, but you are involved in a lot of different ways, as a thought leader, and so you’re not just simply out there saying, “Hey, here’s how awesome our product is.” So what are those marketing tactics that you’re finding are most effective?
Nick Adkins: Yeah. I really try to avoid actually talking too much about what we do. I know you gave me an opportunity here at the beginning to tell you a little bit of our story. But routinely on social media, or even a person, I prefer not to talk so much about what we’re doing. And this kind of gets back to that EinPower. It’s more important that we all support each other.
Like on Twitter, people come to me and they say, “Hey. What’s your advice on how to Tweet?” I say, “Well, number one, don’t talk about yourself, because you don’t want to be sales pitching your stuff. And number two, just always say nice stuff about other people. Don’t get on there and be ugly.” If you look for the good in other people and other places, you’ll find it, and that’s what we all want to see.
I want to see the good stuff that Jared has found. I want to see the good stuff that CancerGeeks found. I want to see the great stuff that WT Bunting found. Right? So you guys, we all share this in this community.
I love Twitter. I kind of do it all the time. I don’t do that much stuff on LinkedIn. I probably should. I think blogging is great. I don’t too many blogs, but I follow a lot of really good people that do some good blogging and good work on LinkedIn. So I think between Twitter and LinkedIn, those are probably the two best social media tools.
Jared Johnson: Yeah. Well, for what it’s worth, that follows the conventional wisdom in content marketing right now, is to actually narrow down the channels that you’re putting stuff out there, and focus on those, and make those amazing. And then see if you’re able to, expand that out there.
Especially marketing, we’ve come from this world of, “Oh my gosh. I’ve got to be everywhere. I’ve got to establish a presence everywhere,” and so we all end up dabbling in so many different channels. That’s how Joe Pulizzi has put it, we’re all dabblers by heart.
Nick Adkins: Right.
Jared Johnson: We want to see what that new platform is, and then we might find out, okay, that’s actually not really the right way to accomplish what I’m trying to do here. So you’re falling right in line with that conventional wisdom right now.
Nick Adkins: Yeah. When I jumped on Twitter, and I’ve only been on Twitter for, I don’t know, just a little over year, maybe two years, and I said, “Okay. I’m going to do this thing. I’m going to play to win, and I’m going to try to identify certain aspects of the industry that I think I can contribute to.” I didn’t want to just be making noise. So telehealth, obviously telemedicine, digital health, mobile health, HIPAA, I can answer that conversation any day. So somehow, magically on Twitter, I’ve become known for those topics, and I stay focused on those topics.
So I don’t go off-topic very much. I don’t try to contribute to topics I don’t know much about. Sometimes we have these different Tweet chats that come on every week, like Healthcare Leader. I try to attend that one every Tuesday. Sometimes the topics are . . . I can’t really contribute to the topic. So I’ll show up, but I won’t really say much, because if I don’t have anything to say, if I don’t have anything to add to the conversation, then I just sit back and use it as a learning process.
Jared Johnson: You’re doing it right. I mean, it’s making a name out there for you in those areas, like you said, and it’s working. So kudos there.
Nick Adkins: Thank you.
Jared Johnson: Well, as we wrap up, I always love asking this question. It’s, if you could join any rock band or music artist for a day, who would that be?
Nick Adkins: Yeah. When I read that, I didn’t know. Were we talking living or dead, if we could go back?
Jared Johnson: Anyone. You can go back.
Nick Adkins: Anyone. Yeah. I’m still going to stick with who I thought. So the way I read the question is, “If I could hang out with this one rock star for a day, who would it be?” and I’m going to go with Bono. There are so many good ones to choose from, but I thought, who would I really think that I would enjoy hanging out with a day, just as a bronie, just chilling? And I think it would be Bono.
Jared Johnson: Well, you’re a man after the same direction I am, because U2 would’ve been my answer there. I think Colin Hung has given the same answer. Not that I’m keeping track or anything.
Nick Adkins: That was a tossup. I mean, if Bono is busy, I probably want to hang out with Sting.
Jared Johnson: Oh. Okay. We’ve got to talk more, because, yeah, oh my gosh. Good stuff. Good stuff. Yeah, we could go on and on. It’s like we’re dipping out of the same music bucket here. Awesome.
Well, as we’re wrapping up, anything else you’d like to share with our listeners before we go?
Nick Adkins: Well, I hope I see you at HIMSS in Vegas. If I’m around, please come up and say hi. I’m a hugger, so if you want to hug, please get a hug, and we’ll look for you in Vegas.
Jared Johnson: Yeah, definitely look forward to seeing you in real person. So that would be great. Yeah. We’ll schedule something.
Nick Adkins: Awesome. Sounds great.
Jared Johnson: All right. Yeah. Thanks for being on the program again, Nick. We appreciate it.
Nick Adkins: All right. Thank you.
Jared Johnson: Well, that wraps up this week’s program. Let me know what you thought about it by tweeting me at Jared Piano. You can leave a review and subscribe on iTunes. You can listen on Stitcher Radio. You can subscribe on Podbean or on any other favorite podcasting app.
Due to your feedback, I’m adding transcripts of several of our most popular episodes, including from Joe Pulizzi and TheDocSmitty, Dr. Justin Smith, and I will be adding more in the coming days and weeks for some of our more recent guests. So you can check those out at UlteraBlog.com.
Ladies and gentlemen, it has been real. Until next time, I’m Jared Johnson, and you’ve been listening to the Health IT Marketer podcast. This program is sponsored by Ultera Digital Marketing Consulting. Take your content further. For full archive, go to HealthITMarketer.com. That’s HealthITMarketer.com. Thanks for tuning in, and I’ll talk to you next week.