Everything that it takes for a medical innovation to gain traction requires being on the “right side of the provider.” Maya Said, president and CEO of Outcomes4me, joins the show this week to share how she grew her company’s digital health app to make it easier for breast cancer patients to know all of their treatment options. In this episode, you’ll learn how to identify the right time to start marketing a device, how to adapt partnerships to suit evolving business needs, and why provider relationships are the ultimate laboratory.
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Announcer: It’s time to think differently about healthcare, but how do we keep up? The days of yesterday’s medicine are long gone and we’re left trying to figure out where to go from here. With all the talk about politics and technology, it can be easy to forget that healthcare is still all about humans, and many of those humans have unbelievable stories to tell. Here, we leave the policy debates to the other guys and focus instead on the people and ideas that are changing the way we address our health. It’s time to navigate the new landscape of healthcare together, and here’s some amazing stories along the way. Ready for a breath of fresh air? It’s time for your paradigm shift.
Michael: Welcome to the Paradigm Shift of Healthcare, and thank you for listening. I’m Michael Roberts here today with my co-host Scott Zeitzer and Jared Johnson. On today’s episode, we’re speaking with Maya Said, she’s the Founder, President, and CEO of Outcomes4Me, the creators of a breast cancer app that makes it easier to know your treatment options. Maya, thank you so much for your time today and for coming on the show.
Maya: Thank you for having me.
Michael: Absolutely. So, if you could give us a 2-minute origin story for Outcomes4Me…
Maya: Sounds good. I’ll try to make it 2 minutes, knowing that it’s never 2 minutes to start a company. But let me just tell you why we actually started Outcomes4Me. So, partly it’s driven by a personal story, which is I come from a family of healthcare doctors generations, so, you know, I’m a baby healthcare person. And I studied biomedical engineering and pre-med. And then, my entire career, until starting the company, has been in the healthcare industry. So, throughout my life, I’ve came to believe that I actually understood patients and that, professionally, I was focused on patients, I was working in large pharmaceutical companies. Until the time I became a patient for the first time in my life, so, this is in 2006. And to make a very long story short, you know, in retrospect, it ended up not being something serious but serious enough that it needed the major operation. And in a period of 6 months, I realized that, not only I had never been a patient in my life before, but it actually humbled me as an experience.
And it had three aspects to it. First was the initial chapter of kind of realizing what this was about. And I was a bit shocked how overwhelming the experience was. I was googling and I went from, you know, “This is nothing,” to, “I could die tomorrow.” And I’m a scientist by training, I work in this industry. I could not parse out the information.
So, that was like the initial experience. Then, okay, we kind of got it diagnosed. I was living in New York City, at the time. I wanted to come to Boston and get a second opinion. So, I was being treated at NYU going to another large hospital, mass general hospital. And just being able to take my images, that I’ve taken in NYU, to MGH was an ordeal. I had to literally go and tell them, “I’m gonna pick them up tomorrow. It’s my right, as a patient, to have them. Give them to me,” and then show up the next day at MGH.
And then, the last chapter, just to keep this to 2 minutes, I had the major operation done and then, you know, I started getting healthcare bills. A major payer, Blue Cross, Blue Shield. And I’m receiving these bills, mind you, I was actually in charge of market access at the large pharma, professionally. So, payers were my customers. But I received the bill for the first time as a patient, I literally could not read it. I did not know if I owed the insurance $40,000. So, all this to say that this experience actually opened my eyes to realizing that actually patients, that alone patients going through a serious disease such as cancer, are extremely overwhelmed. And today, there is no solution that is trying to help them really navigate through their care.
Michael: With breast cancer being such a common thing, a common disease kind of like in the overall landscape of things, like I think that a lot of us that are listening or participating today have somebody that we know that’s gone through that scenario. And I think that almost every one of us can identify with that same feeling of just not knowing what to do, so, many points of just being completely overwhelmed from everything that you mentioned. And I wish that, you know, your experience was more of an outlier than the norm, but we do hear that being the norm for so many people. Can you tell us a little bit more…like you get these different points, and you talked about several different points where you’re kind of feeling overwhelmed and feeling kind of lost in the system, so to speak, like how is it that Outcomes4Me helps people in that space?
Maya: Yeah, no, excellent question. So, one of the issues in healthcare, as we all know, is that it’s a very weird industry in the sense that the consumer, us, the patients, have zero power. And the reason we have zero power is we don’t get to decide what we take, we don’t get to, ultimately, pay for what we buy. And, so, that creates kind of, you know, an industry where, with time, very little has been developed that’s specifically focused on the consumer first.
So, where we’d like to believe we’re taking a very different approach is, essentially, where it’s a patient-first company. Our user is the consumer and we wanna bring in, what we call, consumer-grade experience to healthcare. What does that mean? It’s a bit crazy today. If I wanna pick a lipstick, I have more information, as a consumer, to pick which one is good for me than if I wanna kind of pick what treatment options I have been diagnosed with breast cancer. It’s crazy but it’s true. And the reason that’s the case is because there’s the Amazons of this world that have taken consumer-grade experiences to the next level. Well, we haven’t done the same thing in healthcare.
So, what we do very differently at Outcomes4Me, and what we strive to do, is, essentially, you know, once diagnosed…and as you mentioned, we’re focused on breast cancer as a start. Once diagnosed with breast cancer, essentially, as a patient, we really have one of two questions. First is, “What are my options?” Right? I mean it’s shocking, as an experience, but I wanna know what my options are. And second, I wanna know how my life is gonna change so that I can better manage this life. In some sense, my body has betrayed me and now I wanna get back the sense of control and hope that I have lost when I’ve been diagnosed with that disease.
And to do that, what we do at Outcomes4Me is we use technology to help patients get back that sense of control and hope by bringing all that information that exists in the science and making it personal to them and actionable.
Michael: That’s definitely something where we see a lot of different disease types. So, I’ve got a chronic patient in my family, so, we have to deal with disease. And a lot of the information that we were looking at, we were definitely in that kind of overwhelmed state where we were looking at all the information but we didn’t know how to apply it to our case specifically. So, I’d love to hear more about this personalization side of it.
Maya: Yeah. I love it, I love it. So, here’s the thing. Right? So, when we’re all looking for information, the issue of that approach, whether we’re doing it, you know, by googling or we’re asking a friend, is we have two problems. One is the burden of search is on us as patients, as users. We have to know what we’re looking for to find it. If I’m talking about breast cancer, just asking kind of, you know, “Okay, I’ve just been diagnosed with breast cancer,” you know, “what are my options?” is not enough. I need to know that, you know, in the context of breast cancer, HER2 status is important, hormonal status is important. These are things that I don’t know from the get-go when I’m diagnosed. That’s number one.
The number two is exactly what you said, Michael, is kind of, you know, even if we knew exactly what we’re looking for, there’s so much information that comes back at us today. We’re not equipped to parse it out. And by parsing it out, it doesn’t only mean if it’s, you know, scientifically-valid or anecdotal, but it does also mean if this is relevant to me today, tomorrow, or in the month. And we’re not ready, we don’t have all that information at hand to know what’s relevant.
So, what we do at the Outcomes4Me is, essentially, there is no concept of search. Everything, as you mentioned, is personalization. What does that mean? Personalization means that, essentially, I’m guiding you as a patient to better understand what is your diagnosis, so that I can provide you with the information that is relevant to you at that point in time. And the way I do that is we personalize…so, you know, we do this via a mobile app because we want people to access it wherever they are in the world, we, essentially, meet people where they are and they can download the app. And then, the first thing that they experience, them is kind of, you know, “We’re trying to understand what the diagnosis is. So, we’re not asking you what is your diagnosis, we provide you with the opportunity to either, you know, personalize the experience based on your clinical data, so, your medical records, or then we ask specific questions that are very relevant and adapted to your case.” And based on that, we provide personalized evidence-based information. That’s the other element that’s very important. It’s not only personalization but we’re science-driven that, essentially, everything, the information, the guiding that you go through on the platform is evidence-based. To do that, we’ve been partnering with different healthcare organizations and guidelines to bring all that to the patients so that they can navigate through their care.
Michael: I love the approach to how you’re helping the patients. But how is the provider benefiting from this as well?
Maya: Yeah, great point. So, one thing that’s very important to understand about Outcomes4Me is we are here to help patients but we are also here to extend the relationship between the patient and the provider. Right? So, obviously, we’re not here to replace any provider, we’re here to really kind of augment that relationship. Today, as a provider, you know, providers, essentially, the reason they’re providers and they’re doctors in the healthcare industry is because they, essentially, wanna help patients. That’s what they signed up for. But, unfortunately, today they spend actually a relatively small amount of their time doing that versus everything else they have to be doing.
They’re really overwhelmed by other administrative tasks. The time they have with their patient is shrinking, not extending. So, where a platform like us comes into play is, essentially, it creates a means for shared decision making, between the provider and the patient, that allows for that contact to be, not only much more meaningful and more efficient for the provider and to have an engaged patient on the other side, that helps, essentially, lead to better outcomes. We’re really always focused on making sure that we’re not creating new workflows but, essentially, we’re really going into their workflows and reducing the administrative burden, not increasing it.
Michael: That’s something we’ve heard echoed, I think, through some of the different folks that we’ve talked to. We had a guest on that talked about physicians aren’t resistant to technology if it’s actually helping them and not creating more work for them. So, I’m sure that physicians are appreciating what you’re doing there. So, you’ve got this idea scoped out. You’ve figured out how to help patients, you’ve figured out how to help providers. And it really does seem like a win-win, the more that people can be educated and can feel confident in the process certainly helps both sides of that equation. So, when did you know it was time to start marketing this product and not just building the thing out?
Maya: It’s interesting. So, I told you the reason I started this company was driven by a personal experience. And, so, you know, I did not go through cancer, right, so, my personal experience was different from the initial product we developed in breast cancer. But, essentially, it was a hypothesis to say, if I was overwhelmed, and we all, you know, have friends, close friends that actually have gone through these experiences, you know, there’s much more need on that side that let us start with breast cancer.
So, you know, we started developing the app and one of the very very first things we wanted to do is, essentially, we wanted to bring things that people just don’t have access to today. So the initial partnership we did was with the NCCN, the National Cancer Center Network, which is, essentially, the guideline committee, the guideline authority, in the U.S. and the world, on issuing cancer guidelines. It’s a number of the top cancer institutions that issue guidelines on every cancer. So, we’ve integrated their breast-cancer clinical guidelines. And we created an experience where we were still testing it with, you know, friends that we know have gone through breast cancer. We also wanted to make sure that what we’re developing is reachable to anybody, wherever they are in the world. So, we did the small pilot where we kind of, you know, put a very small ad on Facebook, you know, kind of asking people that have been diagnosed with breast cancer to kind of participate in, essentially, testing the product.
And then what happened, which is, actually, earlier than I would have anticipated, we’re starting hearing more and more people tell us, “Oh, I wish I had this when I was first diagnosed,” or, “I wish I had this just a few months ago.” And, so, that kind of led us to actually start marketing the application perhaps earlier than I had anticipated. Because we thought more people can actually just benefit and also help us develop it. And, so, you know, we started just, you know, kind of putting through Facebook groups, through different ads, to make sure that, not only our friends and connections to our friends were…knew about it, but also the person that’s sitting…you know, like one of our earlier states was people in Alaska downloading the app. Because these are the people that benefit also the most. We’re based in Boston, I mean arguably, you know, people in Boston have access to more things than, you know, people are sitting in Alaska. So, that’s kind of what got us to actually start marketing it.
Michael: Everybody, I always appreciate that you tune in, that you’re listening to the show here, I wanted to let you know that we have set up a new newsletter that you can get to at paradigmshift.health, that’s paradigmshift.health, you can go there. And the reason that we’ve got this newsletter is that we like to send out a few extra pieces of information with the show. We also have a full transcript for every single episode that we do. And we can let you know that through email, we can let you know, also, if we have like a good quote card to be able to show for every episode, so, check that out, if you’d like, paradigmshift.health. Thanks so much.
Scott: Health tech companies rely a lot on their provider relationships to grow and scale the business. And I was kind of curious about how you connect with the local providers to get that early-stage feedback and how you work yourself into their individual processes, because everybody has a little bit different process in terms of workflow.
Maya: Absolutely. So, as I mentioned, from the get go, we felt that for this to be really, you know, transformative, if you will, as a platform, it was very very important for us to, not only be consumer-grade, so, in other words, really kind of develop it for patients and focused on…not only the patient experience, the person experience, right, like being treated as a person, not as a patient. But also, we also felt it was very very important from the get go that we develop it with the provider in mind. Why? Because, at the end, if we’re gonna improve outcomes, and this is where the name of the company comes from, you know, the provider is a major player in this. And, so, we have to make sure that, as we’re developing this, we are, quote-unquote, on the right side of the provider.
And, so, first of all, you know, my co-founder is a medical oncologist actually practicing at Dana-Farber Cancer Institute. So, from the get go, you know, we had a lot of early discussions with providers to better understand, you know, what they felt was friction points on their side of the equation. Some of it has to do with Dr. Google that they hate. Why do they hate Dr. Google, right? No provider hates the fact to actually talk to a better informed patient. Every providers wants that for their patients. What providers hate is when people are googling and coming in and they ask questions that actually have zero relevance to the case. So, when they have zero relevance to the case, that wastes precious time and it confuses the patient. That’s why providers hate Dr. Google.
So, as I mentioned, the very first partnership we did was with the NCCN, and we’ve integrated the clinical guidelines. These are the guidelines that are written for physicians. We’ve integrated them to make them patient-friendly and patient-facing. And when we’ve done that, actually, we’ve started being contacted by providers saying, “We love what you’ve done with the guidelines. This not only helps our patients but actually it helps us in the community settings because the field is advancing so fast and the guidelines get more and more complicated.”
And, so, you know, we did a number of partnerships in Boston. We worked with Mass General Hospitals. We recently announced, you know, the Vanderbilt Collaboration. And we also have worked a lot with physicians, individual physicians, throughout the way. We continue to have a lot of conversation with them to adapt things, to make sure it’s helpful to them too.
Scott: The Vanderbilt-Ingram Cancer Center. And what are you focusing on, like what problems are you solving there?
Maya: I love the way this came about because it kind of shows that, you know, once you start working on something that is relevant, you know, have a set ideas where, you know, based on what we’re doing, we see value. But then other people may come up and say, “Hey, have you thought about this?” etc. And the Vanderbilt example is a great example because, as I mentioned, we started breast cancer, we started with the clinical guidelines for breast cancer, so, initially, the experience was fundamentally focused on people that were just diagnosed with breast cancer or going through active treatment.
And then, you know, we were at actually a medical meeting, actually, at Northwestern University in Chicago, and we had actually…one of the people we were working with at Vanderbilt, Dr. Tuya Pal, who’s a geneticist and the Associate Director for Cancer Health Disparities, she saw what we did to the clinical guidelines. And, at that point, she said, “Actually, I love what you guys have done. There is huge disparities in genetic testing for those of people that are not fully aware.” If you have a predisposition to cancer, there’s a lot of things, in particular breast cancer, that you could do. If you have a BRCA1, BRCA2 gene mutation, whether you already have breast cancer or not, there are things you could do to improve outcomes. So, there’s actionable things you could do, but today people are not being tested that should be tested.
So, that initially started by saying, we told her, “Well, we have this partnership, we could easily extend it to genetic testing,” which we did and we rolled out. And part of that conversation then led to saying, “Well, actually…” you know, we got connected to another doctor Dr. Debra Friedman at Vanderbilt, so, really focused on cancer survivorship. And there she said, “Actually, I love what you guys are doing but, you know, there’s really a huge need on the survivorship side.”
And let me just explain what the need is there. Right? So, once a patient is diagnosed with breast, unless it’s metastatic breast cancer, in early-stage breast cancer, at some point, a patient goes into remission. So, in other words, the cancer is no longer detected. And that’s sometimes, you know, called “survivorship.” At that point in time, as a patient, you go from, you know, having the spirit of, you know, fighting the disease, right, and being actively treated to, essentially, going into survivorship. And, on the patient side, you go from, essentially, being a fighter to actually the ecstatic point of saying, “Okay, I’m done with treatment,” to a real void, an emotional void. Because then everything stops and you’re not being managed and you’re unable to know what you need to do.
And one thing that’s very important, I mean, you know, like I don’t know if people realize, today, in early-stage breast cancer, people are more likely to die from a heart attack than their breast cancer. But the heart attack is not because heart disease is more prevalent, it’s heart attack due to the cancer treatment, to the chemotoxicity that’s actually the toxicity that the chemotherapy has created. And that could be managed, these are called late effects of treatments that need to be managed. If they’re not managed, people will die from heart attack that is caused by their breast cancer.
Scott: So much to take in. And I do have a quick question for you. So, with COVID, so much has changed. How has your company had to adapt regarding relationships during the COVID pandemic?
Maya: Yeah, COVID has been interesting because, obviously, a lot of things have changed. And for us, we went through different waves. So, at the beginning of COVID, right, you know, like we didn’t know what it was in, obviously, you know, let’s call it the March to June time frame. And we have our, you know, patient population are people that are diagnosed with breast cancer that are typically undergoing chemotherapy or other treatments. And they are immune compromised, some of them are, because they’re taking chemotherapy. And, so, the initial wave was people were worried and they could not go see the physician. Right? It took some time for telehealth to pick up and all this. And, so, what we found ourselves in those early times, early stages of the pandemic is we ended up actually creating on the platform, it was the first time we started launching these webinars where we brought, essentially, all the top-notch breast-cancer oncologists in the conversation, live conversations, with people on the platform, addressing all their questions. And there were live conversations, we still do them, essentially, evolving as our understanding of the pandemic has evolved. So, that was like…we call it the first wave of COVID.
In the summer, that’s when people more settled, if you will, around, you know, kind of…we better understand what the pandemic is but also providers really picked up on telehealth. And, so, in that context, we started seeing also, on the provider side, a lot of interest in our platform. Because, essentially, we enable patient engagement remotely and we really bring in that high-quality personalized, you know, navigation to help patients, especially if they’re in the telehealth setting. So, that’s when, you know, we did the partnership with the MGH, the partnership with Vanderbilt. There’s other, you know, that will be announced soon. So, that’s also kind of was another wave that, you know, we benefit a lot.
And now what we see is it’s a lot about also raising awareness. I mean one of the things that it’s actually worth today is people are still…and here I’m talking about patients, not necessarily following up enough with their providers, whether it’s screening, whether it’s actually procedures, and one thing that worries a lot, on the provider side, that we’re trying to really raise awareness of it on the patient’s side is, if you end up catching cancer late, the management of it is much more complex. So, delaying screening, delaying treatment is not a good thing. And now everything is safe to be able to do it.
Interestingly, also, with the vaccine, so, this recently came up actually in a webinar, and this was something that the clinical trial for the vaccine doesn’t show because, you know, it’s not enriched for a breast cancer population. But one thing that happened, you know, in January, once the vaccine started being given is one of the side effects of the vaccine that’s short-lived is could be an enlargement of the lymph nodes. Which actually, for breast cancer, could be thought through as a recurrence when it’s not. Now there’s guidelines around it because now we understand them better. But being able to even mention it and kind of anecdotally including, whether, you know, we did that with, where they’ve been seeing it, and letting the population know was a big benefit to patients.
Jared: It’s really encouraging to us, Maya, when we hear this. It’s really helpful for us to get an inside look at what goes on behind the scenes, when we’re talking about such a useful tool for patients, for us to be aware of what goes on to bring that to market. And I love that provider partnerships are such a key of everything you’re doing, and it sounds like the road map as well. So, I love hearing that because it really does seem like that’s such a core part of any business when we’re talking about any digital-health or health-tech tool that’s out there these days. So, it’s great to hear all of that. I’m very curious, as we kind of, you know, start to wrap up this conversation, just an open-ended question for you in terms of what else is on the radar screen for you? So, you’re a founder of a health-tech company, you’re very very involved, very aware, you’re developing something so important and so useful that is so meaningful. What else is on the radar screen? I love kind of, you know, ending with something where we can really look forward to something. What are you excited about right now?
Maya: Thank you, Jared, for asking the question. I think, I mean, you know, I’m excited about a lot of things. But I have to say, I mean, you know, it gets old to say, you know, there’s no better time to be in health tech than now. But it is true, and let me tell you more specifically why. What I’m particularly excited about, especially in terms of what we do, you know, maybe one of the silver linings of COVID is that actually it created the mass education and it made us all, as people first, more aware of health and the importance of health. And, also, kind of, you know, whether it’s clinical trials, whether…you know, it made us a more educated population and more curious population and better sensitive to these issues. And this is exciting. Why? Because, you know, if you’re a cancer patient, which is, you know, you are more open to being more informed about your own care. And that’s important, you will do better if you’re more informed. So, that’s exciting.
The second thing is there is no more exciting time to be in cancer than today because the science is evolving extremely rapidly. Extremely rapidly. So, this is exciting and this is a challenge. Because, as the science moves very fast, and, in breast cancer, we’ve had…just in the last year, the number of approvals in breast cancer has been just mind…you know, the guidelines keep on updating. And that’s great. That’s great for patients, that’s great for providers, that’s great for everyone. And that’s great for companies like us, it’s how do you bring all that, meet people where they are?
And then the third thing, which is actually a bit of a challenge, but for a company like us, I’m excited because it’s a way to partner with providers and a win-win. Win-win-win, win for the provider, win for the patient, and win for us is, unfortunately, because of COVID, hospital systems are strained and their budgets are strained. Because they had to kind of delay a lot of kind of the treatments and the procedures, the elective procedures, that typically helps finance the hospital. Where a platform like us comes to play is, you know, we do clinical trial matching, we do clinical trial recruitment. We work with providers to help them be more efficient in a way that helps patients. And I think we could be part of the solution with them today in a way that’s probably much more impactful than we could have been before COVID.
Michael: We’re definitely all for anything that helps improve efficiency with healthcare. So, that’s fantastic to hear. Maya, thank you so much for coming on the show today. I really am inspired by what you’re doing here. So, thank you so much, we really appreciate it.
Maya: Thank you very much. Thank you for having me.
