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Interview In Action: Better Medication Management and Population Health with Weston Blakeslee

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Sarah Richardson: This episode is brought to you by Dr. First. Their AI powered solutions improve the accuracy of medication history, enhancing patient safety and reducing clinician administrative burdens.

From e prescribing to medication adherence, Doctor First Solutions integrates seamlessly with your EHR, informing clinical decisions and improving care. Visit thisweekhealth. com slash doctorfirst today to transform your medication management with Doctor First's innovative tools.

Weston Blakeslee, PH.D.: we Want to put time back into the clinician's hands so they don't become, a simple, data entry clerk. They're actually doing what they were trained to do and get back to that patient care.

Bill Russell: My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of This Week Health, where we are dedicated to transforming healthcare one connection at a time.

Now, let's jump right into the episode.

(Main) all right, here we are. It's an executive interview and today I'm talking with Weston Blakeslee with Dr. First Vice President of Population Health. Weston, welcome to the show. It's great to be here, Bill. Thanks so much for having me. Yeah, I'm looking forward to the conversation.

Before we get going, you have a rich history and tradition in this industry. But let's just focus in on what you're doing with Dr. FIRST. So tell me about your work at Dr. FIRST. What problem set are you really focused in on?

Weston Blakeslee, PH.D.: Yeah. So I've been at Dr. FIRST actually my four year anniversary was last week.

So been there for four years. And during that time I wore a lot of different hats, but. very recently, really within the past year it's been focused around our population health strategy, our interoperability data strategy and our artificial intelligence products. And so all of those teams work cohesively together on a lot of our different products and solutions.

And all of those teams now report to me. It's

Bill Russell: man, that's interesting. When I think of Dr. FIRST, I think of medication. adherence. And you're talking about population health. So help me understand where medication adherence, or maybe I should be thinking about Dr. First a little different, but help me understand where Dr.

First with population health.

Weston Blakeslee, PH.D.: Yeah. So we've been a medication management company, the 24 year existence. And that's our wheelhouse. That's what we do incredibly well. We're very well connected. In the entire United States healthcare ecosystem and some in Canada as well. But really since we have such a large data set available to us, it really helps connect a lot of those missing data gaps that you would see for population health type.

initiatives specifically around medication adherence. And, there's been a lot of innovative payment models, reimbursement models, as well as clinical outcomes studies that show really the importance of the medication management side of population health. So that's really where we focus our efforts.

Bill Russell: So it's things like errors and helping miss doses and those kinds of things.

Weston Blakeslee, PH.D.: It's all the above. It's drug interactions whether a patient needs to increase their dose or decrease their dose do they need a medication added? Do they need it subtracted? Or even getting insights to the clinicians that are measuring medication adherence before they actually meet with their patient, so they don't have to do any of these sort of fact finding missions.

They can be much more efficient. when they're guiding that medication adherence care to their patients.

Bill Russell: So when you talk population health, immediately think about the communication that's required effective medication adherence often requires seamless communication between the provider and the pharmacies and others within that chain, how does Dr.

First facilitate the communication and the integration? And what impact does it have on overall population health?

Weston Blakeslee, PH.D.: earlier in, the Dr. First ecosystem, we had focused on acute patient encounters. And so we built. a very large medication history database over the past 14 years, predominantly was focused on that acute care space for stabilizing patients when they were in the hospital.

Then we realized about three and a half years ago that we had a big opportunity to extend a lot of those efforts into the population health area. When a patient leaves the actual exam room, because both from our own internal studies and from the clinical literature itself, a lot of medication adherence decline happens in between those patient visits.

So we have both raw medication adherence data. We have our own SAS based platform that clinicians can use. And we can directly integrate our data into whichever EMR our clients are using, that'll power some of their population health type tools that they have at their fingertips.

Bill Russell: It's interesting. More and more, We're talking about clean data because AI is becoming more and more of the discussion in order to get the results out of AI that we want. We have to feed it information that's fairly clean. would imagine your data is a very good, high quality data set to look at.

Weston Blakeslee, PH.D.: Yeah, there's a big difference between a lot of data that you get from health information exchanges where, They're basically just getting disparate health systems that have different data language providers to dump all that data into one place. A lot of it can be unstructured, organized, take a lot of cleaning up to do, as you had mentioned.

To make it clinically actionable. Our artificial intelligence team has been working on this very problem for about eight years now. So it's great that we've been in the space, even before AI became a buzzword, to really clean up the data and for us, it's, Is that information going to inform a specific clinical action afterward?

That's always our target when we're using our data.

Bill Russell: So it's interesting you talked about the gaps that exist. When you're talking population health and you're working with Dr. First are the conversations you're having with the healthcare providers and the healthcare systems, or are they?

Some of the entities that live outside

Weston Blakeslee, PH.D.: of that. Yeah it's both actually. We do a lot of work directly with the care quality teams at the hospital and health system level. Those are typically they're value based care initiative teams. For med management, those are typically run by a VP of pharmacy a hospital and health system.

But a lot of the outreach for, counseling patients to take their medications falls on the nursing staff. And so they're typically called care navigators or care managers. That are the actual, boots on the ground, ears on the phone type clinicians that are performing this kind of outreach.

We also do work directly with some third party consulting companies, because some of these hospital and health systems haven't quite established their population health strategy and fully baked it. And so they consult out these types of services to chronic care management companies, for instance as third parties.

Bill Russell: So are you primarily working with Dr. FIRST customers or will you be pulled in by other entities and say, Hey we want to utilize your data to create a new solution.

Weston Blakeslee, PH.D.: Yeah it's solely Dr. First customers for who I'm working with today, I guess current and perspective as we're, building out our population health umbrella.

Bill Russell: What is the future of this? look like? we were trying to solve some of these problems way back when, and I don't know how silly some of these things sound, were looking at, medication boxes that communicate back to us that say, hey, they took their medication.

And then the problem was they could open it, but not actually take the medication. We wouldn't actually know if they, they took it. This is a real gnarly problem to try to get in front of.

Weston Blakeslee, PH.D.: Yeah. And today it's really. Predominantly based on fill data, which is really important because fill data is way better than medication list data because you have an unbiased source of an actual action that was taken to make sure that medication is in that patient's possession.

You're right. The last mile of medication adherence is determining exactly how well those medications are working for those patients. Fortunately, we've built a lot of trust with our hospital and health system networks over, a 24 year period, and even the four that I've been here, where they're willing to trust us with their outcomes data.

And we can map the usage of our platforms and our data and map them specifically to clinical outcomes. Now, can we tell if a patient actually took their medication as prescribed? Not Yet, but we do have a joint venture partnership where we're exploring using smart pill bottle caps that will basically say, if you're interacting with your pill bottle on certain times of the day, here's how much supply you have left, and if you're supposed to take one tablet by mouth twice daily, we can predict how much or how often A patient is actually taking that met as directed based on that kind of extra data that we're bringing into our platform.

Bill Russell: But the real value is, if you're getting the outcomes data and you have the front end data and you're starting to get the backend data, marrying that together. for a population becomes, really powerful. It's also really powerful data for and others. I would assume that helps in discovery and other things as well.

Weston Blakeslee, PH.D.: Yeah. The data that we use today in my team's products at Dr. First word. It's all identified at this point because there needs to be a qualifying care event in order for that data to be leveraged for, improving medication adherence. The de identification aspect is something we haven't explored yet, but certainly something that is worth mentioning and exploring in the future as it comes to how effective are all of these drugs working in tandem for a patient.

So

Bill Russell: What's the way that people engage with Dr. FIRST? do they start with a medication management solution? We've done a couple of other, One of the most powerful was just the workflow and the process improvements that you guys have created around medication management.

It's really saving thousands and thousands of clicks and the process is getting a lot more buttoned up than it was when I was there. It was a pretty arduous process and you guys have really streamlined that. It's really impressive.

Weston Blakeslee, PH.D.: Yeah, thanks. We appreciate that.

That's our artificial intelligence team that bolsters all of Dr. First products across the entire management suite. Really we focused on medication reconciliation to start, and that's where you get the, 15 to 20 different clicks and keystrokes saved per medication when you're performing a medication reconciliation and various EMRs because.

All of them have different workflows, right? You'll have, 15 clicks in one, 20 clicks in another. But being able to have confidence in those sorts of models. And really get the clinicians back to being a doctor first. That's how our CEO would say these sorts of things.

Want to put time back into the clinician's hands so they don't become, a simple, data entry clerk. They're actually doing what they were trained to do and get back to that patient care.

Bill Russell: Yeah. That's exciting. I like these narrow. AI models. trained on real high quality data.

They do a very specific thing and they do it really well. seem to be the models in healthcare that we have a high degree of trust in and are bringing significant results up front. large language models, the other thing, we'll figure those out. We are figuring those things out now. But models that have been trained on a very narrow subset of data have been really impactful.

Weston Blakeslee, PH.D.: Yeah, to that point, healthcare data can be incredibly messy, especially if you have a really broad scope. And so if you do have very narrow use cases that you're trying to solve. With really high quality data, it does make that end result much more impactful and, all of our clients that are using those tools today, they come up to us at conferences and they're basically like, thank you.

You're giving me. Hours of my week back and I can actually spend it to either rest, grab some coffee or spend more time with my patients and, decrease that cognitive load that is really unnecessary.

Bill Russell: We'll close with this. always close with a futures question. What does the future of population health look like?

What are we imagining we're going to be able do? The, obviously there's a technology component, but there's also a lot of other things that go into population health. I'm just curious, as you're looking out three, five, seven years out what does it look like to have healthier communities?

Weston Blakeslee, PH.D.: Yeah. Population health in over the past 10, 15 years was really about measuring the overall health of a population without specific actions that need to be taken to improve the overall health of that community. And if you're starting from like a 10, 000 foot view in the sky, it was really difficult.

10, 15 years ago to narrow down to that one patient, to really prioritize your clinicians to focus on them and then also zoom all the way back out. So really the next step in population health is making it more of a clinically actionable focus rather than simply measuring the problem and, hoping that a bunch of different strategies will work.

We'll have a much more targeted approach and certainly that's how we're building our solutions to really help prioritize who those highest risk patients are in ways that traditional population health metric capabilities may have missed targeting those individuals.

Bill Russell: Fantastic. Weston, I want to thank you for your time and appreciate the work that you're doing in this space.

Weston Blakeslee, PH.D.: Likewise. Pleasure to be here, Bill. Thanks for having me.

Thanks

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