Event Recap: Under the Boughs with Rajeev Singh - Part 2

The May 30 edition of Under the Boughs featured a compelling conversation between host Lee Huntsman and his guest Rajeev Singh, CEO of Accolade. Singh shared hard-won insights into the challenges facing disruptors in the sector, while also hitting some key notes around the opportunities that exist in the face of those challenges. You can find Part 1 of the recap here.

Accolade’s Reception in the Marketplace

Huntsman’s question about how Accolade is navigating the incredibly complex matrix of stakeholders in the industry was revealing. Singh said that from discussions about who “owns” the customer, to conversations with employers about what they want, to discussions with payers and providers who disrupt even at the expense of their core business, the companies that represent the best potential partners or customers are those that want to adapt. “This is the nature of innovation […] We have to be cozy, and everybody in this room has to be cozy, [but] if we want to make this better, some people have to get uncomfortable.”

“If what we really want to do is just make sure everyone’s happy, then we’re going to get the same too expensive, poorer outcome system that we have today. […] We’re less concerned about those who will resist.”

Concluding Thoughts

Singh highlighted the importance of developing relationships toward the end of the conversation with Huntsman.

“[Health care] is not a space that’s always welcoming of newcomers or innovations that want to push on things,” Singh said.

“Technology alone will not solve this problem,” he added, saying a human relationship must be engaged and that families need help making decisions because it’s so complicated.

“People don’t identify as their condition. That’s not a diabetic over there, that’s a father of two, who wants to go to soccer games, who doesn’t identify as a diabetic, and, by the way, has the following comorbidities, and so if what you do is exactly the right thing for any diabetic, you might be doing the wrong thing for that person.”

“A lot of what we’re doing from a machine learning perspective, is saying ‘How can I identify, with all the context that we collect in our conversations, things that allow us to create cohorts that are richer and more complex than just the claims data, or just the EHR data might be able to provide you. We’re finding incredible value in those conversations.”

Q&A

Singh and Huntsman spent nearly 45 minutes answering audience questions on a range of topics. Below are some highlights of Singh’s responses.

On integrating other solutions into their platform – “The idea has to be, take your data set, surround it with open web services […] As long as the [customer says] it’s ok for that data to be out there with [service providers], we’ll link [service providers] to it, securely, so that they can deliver a better service in a more seamless way.”

On user research – “One of the hardest problems we face right now […] is how to capture the richness of the interaction. We’ve built a lot of software from the ground up. […] If you don’t instrument your software to collect everything you don’t have everything and you can’t learn from everything.”

On Medicare for All – “If the U.S. government decided they were going to cover everyone with a system that felt a lot like Medicare […] I think what would end up happening is a whole bunch of private entities would have to figure out how they were going to deliver that at scale across 330 million people. […] [In that model] there’s a role for everybody who exists in this ecosystem right now, as long as they want to get on that bus.”

On “good” metrics – “Our [employer] customers are saying, ‘I want trend line to improve and I want happy people. I want their lives to be better and want engagement with our solutions [to be] higher.’”

On self-insured employers demanding change – “Every other part of the business [at Concur, a self-insured employer] we really drove cost, we were crazy focused on being disciplined, and in that [health care] space I would just say ‘It’s going to be my benefits meeting. […] There’s nothing we can do about it.’ […] I let that happen year after year after year. We have to change that.

On open platforms and interoperability  – "Given the consumers consent, which we would get, we could absolutely share information with a doc. To do that today, I have to do an integration with an electronic medical records system, or I have to get the doc to agree to use a portal that I provide. […] There’s the complication. […] We don’t have industry cooperation."

Given the buzz surrounding Accolade, it was an honor to be able to host the conversation between Huntsman and Singh. The clarity of vision into the challenges facing health care innovators gave attendees much to think about over the summer break, as they await the next edition of the series in the fall.

Want to hear a lightly edited version of the whole conversation, including Q&A? Please use the player below:

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