Steve Cashman wanted to reinvent the retail health clinic – and eventually put one in your living room. His company, Healthspot, was taking strong strides in that direction as it dropped turnkey telemedicine pods into major drug store chains across the nation.
And then, without warning, they closed up shop.
Last year, before there was any hint of trouble in the media, we interviewed Cashman and asked him to share his perspective on the future of pharmacies, chronic care and healthcare’s telemedicine revolution. Here's what he had to say while the glass was still half full.
Interview by Bill Gordon
Why are you succeeding where others may have failed?
Steve Cashman: I think we’ve developed a unique model that fits the clinical standards that are out there. And with those clinical standards, we’ve been able to garner a business model that’s built around reimbursement and the way healthcare works, versus trying to recreate the whole enchilada and argue about clinical standards. I think uniquely we have done something that is close to what happens in a traditional office or urgent care. We’ve just done it with technology.
From a services perspective, tell me why HealthSpot is unique.
Cashman: What makes us unique is that we’ve really given the doctor a new tool to do his job. We’ve replicated a full exam in an office setting with an existing doctor, with an existing payer relationship. We’ve just done that in a retail pharmacy using tele- medicine. And so we’ve really just kind of built the same standards and the same thing they look for into a telemedicine model. That’s given us the ability to really eliminate the overhead from the retail pharmacy that they would have in a traditional convenient care retail clinic. And it’s given the providers reach into a segment of consumerism without them having to get outside of the box in business model and other things. It’s the patient seeing them with the standard billable office rate. They’re examining them. They’re treating them just like they would in their office, but yet they’ve been able to use all this technology.
Where do you see the most potential growth for your company?
Cashman: We’re aimed at reinventing the retail clinic. So the 62,000 U.S. pharmacies is where you’re going to find HealthSpot for the near future. Why that is so significant is because when we look at chronic disease folks, they’re in retail pharmacies 20-plus times a year and they’re in their doctor’s office three times a year. As we try to do population health management, we need to take the care to where they are and not try to bring them to where we put care. That’s a fundamental shift.
The other thing is you saw we had an announcement with Samsung last week, we’re adding other services to the HealthSpot station, such as system-on-chip-blood testing. We’re going to allow the medical community to do more and more remotely by the integrated technology that we have within the footprint there. That neighborhood pharmacy is going to become a fully integrated extension in the local medical community and remain a consumer destination that now has other services in it because of our technology
What else do you have on the horizon? Who else have you partnered with?
Cashman: We’ve done a partnership with Rite-Aid. We opened up stores in Ohio in May and that’s been a big deal to give us a national player that we can grow with. The other partnerships that we are forming range from health systems to payers; but really just building an entire converged network, where the value is built around reinventing this care delivery.
Cox is a partner as well through the Vivre Health piece, which is an entity they’ve built around how we move healthcare into the living room. They’re the third-largest cable provider in the country. HealthSpot’s unique in that we’re really a software company. What we do with our software platform in managing doctors, records, claims, remote devices and then obviously all the care delivery video and audio and other things, the support that goes with that; our vision is to make that ubiquitous. As we look down the road, the same way we’ve created a rich telemedicine visit in a pharmacy in a kiosk, ultimately we want to use that technology to build a rich patient experience in the living room of everyone’s home.
How does your approach to creating a connected care network differ from other telemedicine companies?
Cashman: I think the majority of the telemedicine guys that are out there are just doing video. They have no biometric data, they have no way to help impact HEDIS and STAR measures. They have really no way to overall report on people’s total
health because they’re just getting a snapshot of a chief complaint that’s episodic.
Whereas what we’re doing in the model we’re building out is to really create a platform for population health management, where all the stakeholders: your payer, your doctor, your pharmacy where you get your script are all ultimately integrated and the consumer’s driving that. And so we’re really trying to build converged networks. All the way down to when we do a rollout, we go look at the payer data and say: Okay, where are the people that are disconnected from health care and are going to the ER? Where’s the nearest pharmacy to that ER? Who is the right doctor that we can get them into and really try to converge that?
What are the biggest stumbling blocks to making that happen?
Cashman: I think largely doing this at scale is the only way to try to create that convergence, right? With the amount of work that it takes to converge the data and educate the consumer and achieve the scale necessary such that I can walk into any store and get my doctor – and for that service to be ubiquitous near my work and home – we have to build large networks. It’s no different than what telecom went through when it wanted to launch wireless phones, right? They had to put up a bunch of towers so that you could actually make calls in your car. If it was point-to-point communication, it wouldn’t have worked. So we have to build large networks of providers and large networks of locations and work with the payers to then form large networks of consumers to where this becomes a standard level of care in what they do today.
What's the future of HealthSpot? Give me your prediction for 3 years, 5 years down the road.
Cashman: Five years from now HealthSpot will be in about ten to 15,000 pharmacies across the country. It will be as ubiquitous as getting a DVD from a Redbox, or cash out of an ATM. The things that you will be able to do in those pharmacies will far exceed what most people’s current expectation is, and that’ll largely be around things like the Samsung device. Things today that are expensive and inconvenient and require multiple days will instantly be turned into consumer satisfaction without the pain and wait, and with a ton of cost savings.
What we see is a network across the country that we can wander into, see the medical group that we’re affiliated with and quickly get diagnosis for basic things. As we look towards total population health, we’re going to walk in there and our payer is going to be able to flag: “Hey, we want to grab your blood pressure and your weight and a few other things,” just because we’re trying to keep track of overall health trends. And we’re going to reward you for improvements in these health trends.
What is HealthSpot going to look like when it’s fully baked, when it’s a huge company generating hundreds of millions of dollars in revenue?
Cashman: I think we’re starting to become more like our core, which is a software company. The combination of everybody’s data is going to help us know what care we need today, and where it should be provided. That may be right on your Smartphone. It may be in the living room of your home or it may be coming to a pharmacy to do more advanced diagnostics. Or it may be even going into a medical facility. HealthSpot will be the ubiquitous application that’s helping deliver that; reinventing the patient experience to what is the right care at the right place at the right time, based on what you have going on, what we know about you and what sensors we need to ultimately determine what the root problem is. We will become something that is ubiquitous to the consumer where they work, where they travel, where they live and where they shop.
And we’re on our way. In our first 90 days at roughly 25 Rite Aids, we saw nearly 10,000 people. That’s a lot of biometric data; a lot of people and consumers that we now have a relationship with and that’s in a short window of time.