The Mix Tape: Ep. 4 — Reversing Chronic Disease: AndHealth’s Mission to Improve Patient Outcomes and Reduce Healthcare Costs

Intro:

Welcome to the Mix Tape.

Natalie Taylor:

I’m Natalie.

Valerie McCandlish:

And I’m Valerie. And we got more exciting news to share. I feel like we obviously have an exciting update.

Natalie Taylor:

We do.

Valerie McCandlish:

In the world of mix, but this one is probably one of the most exciting things because we have officially been recognized for the fourth year in a row as a Columbus best place to work.

Natalie Taylor:

Yay.

Valerie McCandlish:

Yay.

Natalie Taylor:

I did a little drum roll in the background, but I don’t know if you could hear that.

Valerie McCandlish:

It’s just such an honor and it’s really cool to be recognized among some of the coolest companies here. And I just think it’s a true testament to our leadership who really want us to have a great culture.

We have trusting employees and people that we just really care about each other and that is clearly evident in our survey that we take to see how we’re doing. So I’m just super excited. We get to celebrate in November and I can’t wait to see how we actually rank amongst the top 10. But it’s cool to know that we’re in the top 10 regardless.

Natalie Taylor:

Yes, it’s so exciting and especially it being the fourth year in a row. I mean, that’s a very cool recognition and it’s something we’re really proud of and we strive for every day. It is very exciting news.

Valerie McCandlish:

Four wins in four years.

Natalie Taylor:

Four wins in four years. That’s right.

And on that note, another very cool organization here in Columbus, Ohio is a company called AndHealth. And today we’re going to be talking to one of their leaders, Dr. Erica Conroy, who is the SVP of Employer Partnerships and she’s also a board chair of Bio Ohio.

She’s going to be talking with KC McAllister, who is our head of strategy here at Mix Talent, who you may recognize from a few of our other episodes. And they’re going to be having a really interesting discussion on Erica’s career path, learning a little bit more about AndHealth and their incredible mission and the work that they’re doing. But it’s just a really cool organization that I’ve learned about recently and I love what they’re doing and I love to see such interesting organizations growing here out of Columbus.I know I feel like we’ve had a few episodes that have focused on what we’ve got going on here in Columbus. So a great way to tie in by Ohio. Great way to tie in a local organization. And also really cool to have an awesome leader with Erica joining us. So with that, we’ll turn it over to KC and Erica.

K.C. McAllister:

According to a study published by the NIH website, chronic disease affects 50% of the population in the US and its care consumes more than 85% of healthcare costs. This equates to more than $3 trillion annually or almost 20% of our gross domestic profit. These numbers are staggering and only getting higher as the baby boomers get older. And our current system of healthcare focuses on treating symptoms versus root causes and overall wellness.

So what can we do about this challenge facing Americans today? Well, one way is to change our approach to chronic disease care and the incredible team at AndHealth is looking to do just that. AndHealth is a virtual center of excellence, whose mission is to help people reverse chronic disease. I am so excited today to welcome AndHealth, Senior Vice President employer Partnership, Dr. Erica Conroy, to discuss her personal story that led her to AndHealth and the great work her team is doing to benefit patients.

Erica, welcome to the Mix Tape.

Erica Conroy:

Thanks KC. It’s such a pleasure to be here. Thank you so much for inviting me.

K.C. McAllister:

So happy to have you today. So I know when we first met and I had looked at your background, I was so intrigued by this PhD in science, who was doing bench scientist work and drug development. Who ended up as an entrepreneur, raid a business leader, an advocate for change in healthcare. So, I thought we could start today if you wouldn’t mind, Erica, if you would share with our audience a bit of that journey.

Erica Conroy:

Yeah, KC, happy to. So obviously I live in Ohio today. I grew up in California in a town called Livermore. It’s where Lawrence Livermore National Laboratory is located. My dad worked there, my dad is a scientist, so was my grandmother. So, I had science in my genes. What’s interesting is, my mom was a small business owner, so she was an entrepreneur. And so she was involved in…

Her name of her company was Professional Retirement Plans. And I can tell you as a little kid, like our retirement plans, very interesting. Hopefully not now, but I was exposed to that and I didn’t really see the power of that till later. When I was in fifth grade though, my mother actually got diagnosed with cancer. She had something, she had surgery. It was a sarcoma in her leg where they removed it. She had radiation and she was cured. But it was super scary for me because it was the first time I saw my parents vulnerable and scared. And I distinctly remember her telling me and crying when she told me.

So if you fast forward to that sort of background of, I have science, mother’s entrepreneur, I ended up going to… When I went to college, I had to choose my major and my dad recommended Biochemistry of course, because he was always lobbying for science. And I thought, mm that sounds interesting, I’ll do it. I like science, but I didn’t love science. It wasn’t a big passion of mine I would say. But then when I was in school, my second year I started taking this class called Organic Chemistry, which most people say they hate.

K.C. McAllister:

They hate. Yes, the dreaded org chem. Yes.

Erica Conroy:

Right. Yeah, it’s like, wait, are you an alien? And anyway, there’s a lab portion of that and I just loved the lab. I can’t even tell you. I was just in there, I was so happy. I would show up very prepared and I don’t know, it was just like my nirvana.

And the professor said, Erica, it’s really interesting that you have a propensity for this. Why don’t you do an internship this summer? Would you be interested? And he actually recommended me to go to Pfizer and work in the medicinal chemistry department. And so when I did that, all of a sudden I connected. Okay, science to drug discovery, to creating new medications, connected to what I went through with my mom.

And I was like, I want us to develop new medications for people suffering with cancer. This is what I’m doing. So, I went back to school and my professor helped me choose different graduate school options. And one of them was Ohio State. They had a really good anti-cancer, natural product program. And so I ended up going to Ohio State made my PhD, and then I went to… Did a postdoc, so I was in school until I was 30.

K.C. McAllister:

Oh wow.

Erica Conroy:

And actually during that time, maybe my fifth year in graduate school, my mom got diagnosed with cancer again. And this time actually it was very aggressive and we lost her very quickly.

K.C. McAllister:

Oh, I’m sorry to hear that.

Erica Conroy:

So it was, yeah, it was so hard. Then you think, how do I even go on living? What do I do? And I said, thank God I’m doing something that I’m passionate about and that aligns with patient care and helping patients. But I would say that moment, the energy behind that passion just blew up in terms of, I feel like I’m still fueled with that today in terms of helping patients.

So I completed my postdoc and then I actually went to work in… So I had moved back to California, I dragged my husband from Ohio to California and I finished my postdoc. And then I got a job at a company called Vertex Pharmaceuticals. A lot of people know of them. They’re based in Boston, but they actually have their RD Center in San Diego. And at that time I worked in cystic fibrosis, so I didn’t actually work directly in Oncology, it was just kind of where I thought it would always be.

And it was interesting because it kind of opened my eyes to other areas where people are suffering. Cystic fibrosis is a genetic disease that you’re born with. And at that time, the mean age of survival was 35. And so you’d have parents coming with their little kids, going develop things to save our kids. And what we developed, and that was such an opportunity, was to develop one of the first personalized therapies meeting. We directly targeted the mutated protein that created symptoms from cystic fibrosis. So we actually went after the root cause of CF.

K.C. McAllister:

Yes.

Erica Conroy:

So it was…

K.C. McAllister:

Which has now become a whole industry in itself right? With…

Erica Conroy:

You got it.

K.C. McAllister:

Cell gene therapy, personalized medicine.

Erica Conroy:

Exactly. It was one of the first…

K.C. McAllister:

Of that, certainly.

Erica Conroy:

So that was a drug if you wanted to look it up, Kalydeco or Ivacaftor. And so that was an amazing experience. But one of the things I also noticed is after we developed the drug and it was commercialized, it was very hard for patients to get access to the meds.

K.C. McAllister:

Yes.

Erica Conroy:

It was like a $380,000 drug because there was 880 patients in the entire US that had this particular mutation. And so for me that was eye opening to say, really the job’s not done after you develop the drug, you got to get in the patient’s hands.

So I was there for five years. My husband had, like I said, moved out there and actually sold his business to move out to California with me. So it was a big sacrifice and I would say he liked California, we liked it, but he missed his friends. He missed sort of his network back in Ohio and I don’t know if he ever really found himself out there.

And so, he started working with an advertising company here called Orange Barrel Media that he had been connected to before. He started helping them expand out in California. And their owner, whose name is and CEO, Pete Scantland, asked him to move back to Ohio to take a full-time position. And he said, I would love to but I can’t. Erica’s got a good job here, she’s really happy. And so Pete was, he’s a very smart man in terms of getting what he, getting this…

K.C. McAllister:

Sales and marketing.

Erica Conroy:

Sales and marketing.

K.C. McAllister:

He knows how to pitch it.

Erica Conroy:

He knows how to pitch it. Suddenly, he has a twin brother, Matt Scantland, who had been starting, CoverMyMeds. And I knew Matt from my time actually in Ohio. He was a Biology major. And so we would always sort of nerd out over science and talk science when we were together. And I had just seen him actually at a wedding and we sort of talked business and ideas. And I had different ideas actually that I was starting to think about business ideas while I was at Vertex.

And so, coincidentally a couple days later I heard from Matt and he was interested in me coming actually to cover my meds and starting their innovation team. So a big jump, but for me I thought, okay, this aligns with my passion of helping patients get access to medications, cover my meds for those that aren’t familiar with. It was really born on automating the prior authorization. And prior authorization is, I would think of it as a permission slip of why you need a particular medication. And what happens when prior authorization’s in place is one, it delays people to get on therapy and it can also lead to abandonment. So the prior authorizations are put in place by insurance companies.

So I ended up selling our house and moving right back to Ohio and joining CoverMyMeds.

K.C. McAllister:

There you go. And that’s what I was going to ask, one of those questions. So when you look at that background working at Vertex in rare disease, with CF and then ending up at CoverMyMeds and in the prior off space, it does make sense when you refer back to that link of patients needing that coverage, right.

And now you see that with all these rare disease treatments that fortunately are starting to come out, is that payers don’t understand necessarily that value prop. And especially the curative ones hopefully that we will see more and more of.

Erica Conroy:

That’s exactly right. That’s exactly right. So it’s a whole journey just to get access.

K.C. McAllister:

So during your time at CoverMyMeds and I love the story, the personal connection there with Matt and that makes a lot of sense. We’ll get to that in a bit. But obviously that’s a thread that’s pulled through here to AndHealth.

But making that transition into that innovation and product side, what was that like having to change hats from scientists now?

Erica Conroy:

Oh my gosh.

K.C. McAllister:

To business leader and especially in a different aspect of the healthcare industry.

Erica Conroy:

It was a whirlwind, but I would say that one thing that I learned from my science background is, I learned to study and tackle complicated topics. Because in drug discovery you switch disease areas very often. So you have to become an expert in CF and then you have to become an expert in chronic pain and you have to understand all those different pathways and so forth. So one of the things I didn’t do well in my first job at Vertex is ask questions when I didn’t know the answer.

And I noticed that it completely slowed down, said insecurity of, oh well maybe people won’t think I’m smart if I don’t ask the questions.

K.C. McAllister:

Certainly.

Erica Conroy:

And I just said, when I went to CoverMyMeds, said that’s over. So I just asked, asked, asked everything. And I can remember distinctly asking what is ROI? And some kind of gave this look like, what? It’s return on investment. And I said, and I always tell people that story when they’re afraid to ask questions. Because if I ask this and I felt like I learned things so quickly in terms of onboarding was really, really, really fast.

The other thing is that in product development, it’s very similar to drug development, in some ways there’s some parallels. It’s this whole thing around build, measure, learn. And you’re going through this cycle when you’re developing products and in drug discovery, the faster you can go through that cycle and the more disciplined you are, the faster you’re developing and iterating.

And so when we applied that to software development, I found that we could develop things very quickly and make data driven decisions. And I found it to be super fun. So we ended up getting the opportunity to build some really cool products that ended up being businesses. And so I think that’s the two things is when you start that job, just ask those questions because you’re just… If someone doesn’t think you’re smart because you ask a particular question, that’s their problem and you’ll learn so much faster.

K.C. McAllister:

Just making yourself vulnerable in that way.

Erica Conroy:

Being vulnerable. Yeah, yeah.

K.C. McAllister:

So you were with CoverMyMeds when they went through the acquisition, right? The big event for Ohio really. It was like the first Columbus, the first unicorn, certainly when they were acquired by McKesson, of which they’re still a part today. So stayed there for a bit of that transition and then that led to AndHealth. So give us a bit of how that all came to be.

Erica Conroy:

So, got to be there for the transaction and that was an amazing experience.

K.C. McAllister:

Getting [inaudible 00:15:22].

Erica Conroy:

Well one, I was eight months pregnant with my second son when Matt told me we were selling the company, I needed to be at a hotel in three days with a presentation about our products. And I felt like Superwoman just pulling that off in a few days, being so pregnant. And that was just an amazing learning experience and just the ride of it all. And it was hard, it was hard.

And then after the acquisition I got to stay for a few more years and start a new business all around specialty meds of getting axe, helping patients just get access to special meds, which it goes beyond the pay. If you think about CF, going all the way back, affordability and so forth. So by doing that, I sort of got to take it full circle and get over to specialty, which I was really excited about.

Once we got that business off and running, it was going really well. Sort of like, okay, what’s the next thing I’m going to do? And Matt approached me, he had since left the company probably two years prior, and he was thinking about his next thing. Which he said his favorite hobbies is creating businesses, great opportunities and it doesn’t change even when you have a big transaction.

Matt approached me because he was interested in starting a business around chronic illness and root cause and root cause approach to chronic illness. And one of the things that I’ve learned along the way is that as opposed to we did a personalized therapy with CF Cystic fibrosis, in many of these conditions, like diabetes is a great example. There’s not going to be a single pill that someone’s going to take that cures their diabetes.

K.C. McAllister:

Certainly.

Erica Conroy:

And secondly, our healthcare system is really set up for we would say, infectious diseases and acute care. And what that really means is that it’s set up for one and done care. Meaning, if you or I have an ear infection, we have to go to the doctor, we get an antibiotic, we’re cured, we’re good to go, we don’t need to see our doctor again. That’s great. When you see your doctor once a year.

My appendix got inflamed, I went in, got it removed, cured. But when you think about diabetes, you go in for that 15 minute appointment and all you can do is prescribe symptom suppressing drugs. Your disease is still progressing when you leave that office and then you’re not seeing the doctor again for a year. So you’re going to get maybe a higher dose of meds or your disease is going to get worse.

And so for me that was really interesting to me around personalized therapy and root cause to say, hey let’s create a new healthcare model where we can, instead of letting disease progress, let’s reverse it. And let’s add the tools and the time for our doctors so that they can figure out, well why does this person have diabetes or your migraine or an autoimmune condition? And then let’s address it by helping the patient participate in their healthcare. So let’s keep them, create a model that enables people to participate in their healthcare.

K.C. McAllister:

Well that’s fascinating. And I think, I mean again, talking at the front rate of the show about the number of people living with a chronic disease or illness. The huge cost and burden on the healthcare system in this country and obviously in others, you would think intuitively that that would be where people would focus their time and energy. And really it hasn’t been for all sorts of other reasons.

Erica Conroy:

Exactly.

K.C. McAllister:

So it’s exciting to hear that that’s where AndHealth is focusing. Help us understand what are some of the tools that you guys are developing for that toolkit that could be used?

Erica Conroy:

Yeah, exactly. So to help people participate in their health, obviously we can’t say that you need going to a doctor’s office twice a year. It’s not going to provide the tools to be able to work on behavior, because you just don’t see the patient enough.

And so we said, okay, so how do we touch the patient or be part of the patient’s daily life when it comes to their treatment plan? And the only way to do that is to see them more. And so that’s when we became virtual. We said, okay well for virtual, well then we can talk to a patient every single day and now we can create continuous delivery of care. And now we also have the time to determine the root cause. So we can use labs and we can do assessments and we can understand medical history, we can review those with you and we can create now a personalized treatment plan with you.

And we can augment our care team with health coaches, so that our physicians are not only prescribing medications, we do manage medications just like physicians do, but they can also prescribe behavior objectives against that root cause. And what’s nice about that too is that that health coach can help that patient take on tiny habits to address against behavior objectives. And what we’re not doing, to be clear when we talk about behavior objectives, we’re not creating people that go to the gym seven days a week or Olympic athletes.

K.C. McAllister:

Biggest loser contestants. Right, okay.

Erica Conroy:

It’s not that, it’s like what are tiny little things that you can do? Hydration is a big thing with migraines. Talk about it in a second. It could be simple as when you’re drinking a cup of coffee, have a glass of water with, about the same time. Little things that people say, you know what, I can put this in my life and feel shine when I do it and feel success. So that’s the key. I say the tiny habits, virtual and augmenting with health coaches.

K.C. McAllister:

So that’s very interesting. So I know even just when I try to get into a doctor for an annual appointment, Erica, it can take six to eight months. I was laughing going in for my annual with my gynecologist and they said we can’t get you in for 10 months.

Erica Conroy:

You have to schedule at your last appointment.

K.C. McAllister:

Right, exactly. So when you’re talking about having that continuous care, cause even on the virtual side, right? That’s usually a one and done when you call using those programs.

Erica Conroy:

Like a tele vac or something.

K.C. McAllister:

Sure, sure. So, how are you guys creating a community of physicians of access to these health providers that can be that available to your participants?

Erica Conroy:

Yeah, exactly. Cause we’ve got to be accessible, we’ve got to be available. So one, we’re working off a protocol that we’ve developed and so we have obviously physicians but we augment them with nurses and then RNs. Then we also have health coaches that are there to talk to that patient on a daily basis.

And if there’s something that needs to go to the physician, they can bring that to the physician or bring the physician in on the communication. So that’s a big, big part of it. And our physicians are also able to reach people virtually. So that helps us too in terms of where they’re located.

K.C. McAllister:

Okay, no, that makes a lot of sense. Well good. So as you guys are starting this program, AndHealth is relatively new, what are some of the outcomes that you’re seeing with your patients?

Erica Conroy:

So we started with migraine when we first started. And the reason we start with migraine is one, there’s a severe shortage of care for migraine. There’s just like 40 million people in the assist with migraine and there’s 2000 headache specialists. So that’s literally 20,000 patients to one headache specialist. So it’s months, it can be years to get in to see a doctor. So, severe shortage of care.

Secondly, highly motivated patients. So we’re creating a company that helps people participate in their health. Where do we start? We’re going to start with folks that are just inherently motivated. And the reason that migraine patients are so motivated is, it’s so painful, right?

And we’ve actually done a study around this, it’s called the disease activation index. And we can see that migrainers are some of the most motivated. So anyway, we started with migraine, we did a study with around a hundred patients where we provided them their root cause. These are patients that had 10 or more migraines per month for the last 20 years.

K.C. McAllister:

That’s miserable.

Erica Conroy:

Talk about miserable. So these are people who have tried everything. So they came in, we helped them determine, we took them through protocols, determine their root cause. And for migraine, there’s over 250 different root causes to migraine and it can range from a neck injury or hormone balance, to an insulin dysregulation, to food allergy, distress, sleep. And it’s honestly lots of times a combination of all of these.

But when we determined their root cause and they took behavior objectives against those, in three months 60% of those individuals, if they were a brand new patient, wouldn’t get diagnosed for migraine because their frequency and severity had gone down to such a low level.

K.C. McAllister:

Wow.

Erica Conroy:

Yeah.

K.C. McAllister:

That’s incredible.

Erica Conroy:

Right? And then the remainder of 40% had lost 50% less days of work or activities and had like 30% improvement in severity too. So huge impact by just helping people understand the root cause and take baby steps towards addressing that through behavior effectives.

K.C. McAllister:

Well that’s absolutely amazing. And so with those kinds of results and outcomes which are so impressive, is it a situation where the participants, the patients, I don’t know what language you guys use to talk about your program. But are those people then continuing forward with this? Is this an ongoing, is there a graduation when you kind of completed this program? How does that work?

Erica Conroy:

Yeah, so great question. So the first part is assessment. Today the program is offered through an employer sponsored benefit. So we work with employers and they add this program onto the benefits for the healthcare for their employees. And the reason they do that is because obviously they want to care for their employees. It’s a great retention strategy, engagement strategy. But big thing is it’s very costly from a productivity perspective.

And so they’re losing, the average person that comes into our program is losing 29 hours in the last four weeks of work, but only two of those their manager knows about. 27 of that is you go to work and you just power through. And I think anyone who’s a migraine sufferer knows that if you have chronic migraine, you basically need to learn to just power through and show up to work. And so for them it’s a huge cost from a productivity perspective. And a lot of times they don’t see it because it’s not in their claims because one, there’s such a shortage of access to care but it shows up in other ways.

So anyway, what we do is we offer that as an employee sponsored benefit, people sign up for the program, they become participants as we would say.

K.C. McAllister:

Okay, there you go.

Erica Conroy:

And a participant goes through an assessment, we do labs, we understand, we determine what the root cause is. They meet with our physician and the entire care team. We put together a personalized treatment plan, that is basically three months of called reversal period where it’s pretty, I think structured I would say. So they’re meeting with their… They’re not only managing medications, they also have behavioral objectives and they’re working with their health coach on a daily basis through our app on behavior changes.

They’re also meeting with the coach every two weeks for one-on-ones. So that’s for three months, it could be longer. As I told you about our study before, as we see most folks see significant outcomes within three months.

Now after that, the participants have the option to either to continue in the program into what we call support and control. Where they continue to be part of our practice, they’re a patient of our physicians, they have access to their health coach and we can help them. They’re still going to get an occasional migraine, they still have a genetic predisposition in respect of a migraine, but it might happen when they get Covid. People have gotten Covid and got sick or they go through a major life event, death in the family, example like that.And so we’re there to help them manage through. And I would say those that are chronic, one of the biggest stressors are what do I do when my next migraine happens? So knowing that we’re there, reduces that stress for them. Now folks that are more and chronic, I should say just from terms perspective, is 15 or more migraines in a month. Those are the episodic, which is less than that. Maybe a couple migraines a year might stop the program and say I have the tools and the time to do this on my own. I know what I need to do. And I think it varies.

K.C. McAllister:

Well that’s great. So again, it can be very personalized.

Erica Conroy:

You got it.

K.C. McAllister:

Based on the need of your team, of the individual participant. What a great benefit. So to that end, obviously again, there’s certain tools that you may have access to in a current program. How is this different from the current standard of care? Or when employers are thinking about this as it relates to their workforce?

Erica Conroy:

Yeah exactly, exactly. How is it different than going to the local doctor or whatever?

K.C. McAllister:

Yes.

Erica Conroy:

So we hear from patients all the time, what do they say? And the way they describe the care is not what you would describe if you were going to your doctor’s office. Accessible, caring, empathetic, listening, nonjudgmental, available, real time, all these different things. And I think the biggest difference is that these patients, particularly migraine patients, they feel heard for the first time.

They go to their doctors now and many times the doctor, there’s no solution. They continue to get migraine and they feel like they have someone there on their team and they’re not on this journey alone. And they say, I now feel like I’m capable of being the person I can be.

Doctors are all doing the best they can. There’s amazing doctors out there and we’re all trying to do the best. But the reality is you’re restricted in terms of the time you have with the patient and how you’re meeting them to do these other kind of care models. And when you can reach a patient continuously and build that relationship, now you’re building trust and the more likely to go on that disease reversal journey with us.

K.C. McAllister:

Well that’s amazing. I know, I think I shared with you Erica, that I am a migraine sufferer. A lot of people are. Started dramatically impacting me when I was in college. Actually had to step away for more than a year in the middle of my university education, was able to fortunately go back after we got symptoms under control.

But then just as you’re talking about, as a young professional traveling a lot, not sleeping as much, you’d have more. Then I’ve had four children, so hormonal changes, you get impacted in that way. But I know even in talking about it with others that I know it’s such a challenging thing because unlike having a fever or a rash or a limp or something in terms of symptomatic display, it’s hard, especially from a work perspective.

Erica Conroy:

You got it. There’s no Biomarker.

K.C. McAllister:

Do you really? Can you really not function today? And again, having visuals or having to be in a room without sound and light can be really traumatic. Especially when you know it’s coming or it happens often.

Erica Conroy:

Oh yeah.

K.C. McAllister:

Such a great need. So obviously I appreciate the need for this, but why was migraine the first area of focus for AndHealth in this sea of chronic disease that’s so vast unfortunately, with so much opportunity?

Erica Conroy:

I think it comes back to, wasn’t good access to care and just it’s super, super painful. Super painful and if we optimize on people participating, we think we want to kind of bring in our first participants as folks that really want to participate in their own care.

We actually did a study called, looked at Share of Voice in social media and we looked at content creation, content conception and joining groups around different chronic illnesses. And then we could compare that to the prevalence of it. And so what we saw, the reason we did this is because when we first started, I was on Reddit and I couldn’t believe the conversations with people about migraine. Have you tried this? Have we tried that? Have you tried this?

And what we determined and when you order that, you actually, that’s how we created that disease activation index is the things that were there was tons of content creation and consumption and joining groups. But there was a very small prevalence where at the top, lupus is actually at the very top and the autoimmune conditions, migraines up there.

And that’s because they’re basically listed in pain order of a burden to people’s lives. And as you go to the bottom, what we saw was things like metabolic things, pre-diabetic were actually at the bottom because they weren’t painful. So they weren’t something that was impacting daily life where people were really motivated on this journey to find something different.

K.C. McAllister:

So that makes sense. So we talked a little bit, Erica about why you guys focused on migraine here initially. There’s always a lot of talk again about triggers versus root cause. Are those the same thing when you’re talking about migraine suffering?

Erica Conroy:

Yeah. Okay so that’s a really good question. So the way that we think about root cause and triggers is sort of, just bear with me, is picture a coffee cup that’s full of water. When you’re not addressing your root causes, you sort of have that full coffee cup. And so I would say triggers, let’s say you have a glass of wine or you miss sleep and you add a little bit of water to that coffee cup, it dribbles over the side, right? Cause it’s totally full.

That’s what I would think about as triggers, meaning anything, and people sort of say I was trying to figure out what triggers my migraine. Any little thing sort of sets it off. Is it chocolate? Is it wine? Is when I didn’t sleep or maybe I was stressed about that meeting. But when we address the root cause, what we can do is we can actually take that coffee cup from being so full to making it, bringing the water down.

So when you bring the water down and the coffee cup, so we’re addressing. We’re getting you eight hours of sleep regularly, we’re addressing that you maybe have a nutrient deficiency, maybe you have a food allergy. So we’re reducing some inflammation down there. What happens is the water gets more shallow. So that means when you have that glass of wine, it doesn’t overflow when you get a migraine, you know. You miss one night of sleep, you don’t get a migraine.

And so you’re not sort of… In some ways people are able to introduce things back later when you can reduce that threshold, essentially to the migraine. So think about root causes reducing your threshold and then your trigger, think about it as this little things that if you have no threshold, could create a migraine. So they’re different.

K.C. McAllister:

So that makes sense. So again, when you’re focusing on the reversal of this chronic issue, we’re not trying to just skip the glass of wine that may trigger it.

Erica Conroy:

Exactly.

K.C. McAllister:

Which again is not a bad thing to do either if you’re a migraine sufferer, but truly it’s about reducing the opportunity.

Erica Conroy:

Exactly.

K.C. McAllister:

For them to present.

Erica Conroy:

You got it, you got it. Reducing the risk and potential flare up. And really pinpointing, well what is it that’s causing that migraine and focusing there rather than being like, okay, I’m not going to do that, I’m not going to do this, I’m not going to do that.

K.C. McAllister:

Which truly, again, from a long term outcome perspective, is what’s going to make the impact.

Erica Conroy:

You got it.

K.C. McAllister:

Right. Versus that one off.

Erica Conroy:

Exactly.

K.C. McAllister:

Great. Again, you talked about very active participants as it relates to the need, the healthcare, right? Obviously I shared my story. Have you seen any particular demographic or profile that kind of rises to the top more than others as it relates to migraine sufferers?

Erica Conroy:

Yeah, yeah, absolutely. So first of all, women are disproportionately impacted two times more than men.

K.C. McAllister:

Wow.

Erica Conroy:

Yeah and actually so impacted that it’s connected to the gender wage gap.

K.C. McAllister:

Wow.

Erica Conroy:

Yeah. And the reason why, if you think about it’s like you’re suffering through, you’re going to work, you’re putting on a smile, but you’re probably not less likely to raise your hand for that promotion because you don’t want to have, like you said, less sleep, hit those triggers. And then also you may be less likely to speak up in a room.

K.C. McAllister:

Okay.

Erica Conroy:

Forth at a table table because you’re suffering from a migraine.

K.C. McAllister:

Certainly. So right, that either removal from the opportunity of what’s next and or a perception…

Erica Conroy:

You got it.

K.C. McAllister:

That you’re not engaged at the same level as somebody else.

Erica Conroy:

You got it. Exactly.

K.C. McAllister:

That makes sense.

Erica Conroy:

And interestingly, so the reason you see that too is girls tend to start getting migraines after puberty. And it starts to peak around 37, when you’re childbearing having all those kids, four kids.

K.C. McAllister:

Yes, yes.

Erica Conroy:

And then tends to go down after menopause. So that they see a correlation in terms of prevalence.

K.C. McAllister:

That’s wow.

Erica Conroy:

Yeah.

K.C. McAllister:

So an opportunity really to impact not just the patient in terms of their actual healthcare, but also potentially their life track, right?

Erica Conroy:

Right, you got it. And migraines most prevalent at the working age.

K.C. McAllister:

Right, which would makes sense.

Erica Conroy:

Which is interesting.

K.C. McAllister:

Yes. Unlike other conditions.

Erica Conroy:

Yeah, exactly. The other thing that migraine impacts is people of color. So, where higher chance of not getting the proper diagnosis for treatment too. So there’s inequity there and higher chance of having, when having migraines being chronic.

So there’s definitely a lever for employers when you think about DEI for addressing women, people of color within their population to bring better healthcare.

K.C. McAllister:

Okay. So I’m sure there’s going to be lots of listeners out there going, sign me up Erica, how do I become a part of this? So if somebody is interested in participating, how do they get access to AndHealth’s great services?

Erica Conroy:

So if you’re interested, all you need to do is go to our website, andhealth.com, www.andhealth.com.

K.C. McAllister:

All right. We’ll make sure we get that on the Mix Talent website as well.

Erica Conroy:

There you go. And what you can do is you can actually see if your employer covers yours, is a partner of ours already. And they might be, and if they are, you can sign up right away.

If they’re not, there’s a couple different options. You can actually and anonymously request the baseline offer. And what we will do is reach out to them on your behalf and say, you have employees that are suffering from migraine that are interested in having this as a covered benefit. The other thing that we can provide you is a note to bring to your HR team for you to ask them to sponsor you for the program and then you can start the program.

K.C. McAllister:

So that’s fantastic. So there’s again, a couple of ways there. One, you can check and see if your organization is already participating. Two, is that you can anonymously, I think that’s important, not everybody wants to share that yet. Anonymously recommend and AndHealth team will reach out, on your behalf to that employer. Or thirdly, you’re saying that you could actually ask to be sponsored as an individual participant…

Erica Conroy:

You got it.

K.C. McAllister:

In the program.

Erica Conroy:

You got it. Exactly.

K.C. McAllister:

Okay. And all of that is again accessible via your website andhealth.com?

Erica Conroy:

Correct.

K.C. McAllister:

Okay. Well that is very exciting, for lots of reasons.

Erica Conroy:

Yes, exactly.

K.C. McAllister:

So again, obviously getting started, migraine making a huge impact on these outcomes. What’s next for AndHealth?

Erica Conroy:

So, actually this summer it’s been very exciting. This summer we launch our autoimmune program.

K.C. McAllister:

Great.

Erica Conroy:

A lot of folks ask us, okay so why autoimmune? One, I told you that again, patients have a propensity for a lot of motivation to participate in their healthcare for these conditions. So for autoimmune, I know there’s over a hundred different autoimmune conditions. So ones we’re focusing on, are rheumatoid arthritis, psoriatic arthritis, psoriasis, ulcerative colitis and Crohn’s.

K.C. McAllister:

Okay.

Erica Conroy:

They have very much… So something that’s interesting about migraine is that it has, people with migraine have lots of other comorbidities, very much connected into autoimmune actually from a comorbidity perspective of inflammation. And so those conditions are very much addressable through a root cause approach. And what’s happening right now, is that the patients themselves are starting to take these biologics. Humira, Dulera, you can see commercials for them all the time.

It’s very difficult to get off those medications once you start taking them. And they’re very expensive to the employer. And they’re actually, as I talk to employers regularly and they’re seeing 1% of their members with an autoimmune condition making up 35% of their pharmacy costs.

K.C. McAllister:

Yeah, that’s significant.

Erica Conroy:

Wow, right? I just talked to an employer, 500 person employer, five people making up 35% of your pharmacy cost. And so for us it’s really about helping those patients and helping employers, their members, become participants in our programs and reverse their autoimmune condition to a level that they don’t need as much medication.

That we can actually, in some cases de-prescribe medication or reduce the dosing on a particular medication. So our goal really there is, and then ultimately, that saves employers quite a bit of money. Also saves the patient money because they’re also paying for these very expensive medications, that in many times they feel like they’re taking it for the rest of their lives.

K.C. McAllister:

So that makes a lot of sense. So again, on the autoimmune side, Erica, is that something similarly that people could follow that same path to engagement? Or is it more you’re looking for participants?

Erica Conroy:

Yep, absolutely.

K.C. McAllister:

Okay. So great. So again, we will make sure that all of this information gets on the Mix Talent website as well in our social feeds. We’ll link out to the team at AndHealth as well. I think there’s going to be a lot of people very interested in this really impactful healthcare.

So again, I think it’s exciting. It doesn’t surprise me when you talk about your path and the curiosity, the desire to make an impact that this is where you would be. But very exciting for all of us in the healthcare community as patients, as caregivers, to see what the work that you’re doing and the opportunity that it has to really, again, reverse chronic disease.

Erica Conroy:

Thanks KC. I know it’s a provocative statement saying reverse chronic disease, but really I think we’re at an inflection point where we need a different kind of healthcare. Like you said when you opened up. I mean, chronic cost, healthcare costs, it’s just, it’s going up and up and up and up and we’ve got to do something different.

And the reality is our healthcare was built on the discovery of antibiotics and surgery, right?

K.C. McAllister:

Yes.

Erica Conroy:

So it makes sense how it was built, but now it’s time to create a new model, if we’re really going to take down the cost and help people not be sort of seeing diseases, a life sentence.

K.C. McAllister:

Oh, absolutely. Well great. Well this has been an incredible discussion. I’m so glad to have you here today. It is, of course the Mix Tape. So we do always end with a couple of questions for all of our guests.

You knew this was coming. So the first one being, as we’re in the talent space here, what is the best interview question, Erica, that you have ever asked or been asked?

Erica Conroy:

So I’m interested if you’ve heard of this one before, you’ve probably heard every question ever. I heard this from someone one time and I just loved it.

And it is, what was your job in high school? And the reason why someone asks this is because it kind of gets that inherent grit of like, did you go out and start working? Did you just not work? What was the job you had? So did you take a job, for example, my first job was Burger King.

K.C. McAllister:

Okay.

Erica Conroy:

And then it was actually Applebee’s, Burger King and some retail job and all the same…And anyway, I just thought that was really interesting because it sort of gets at hustle and grit and it just tells you a lot about someone. And so for me, that I found that to be really interesting.

K.C. McAllister:

That is it. No, I love it. I actually listened to a serial entrepreneur, this fabulous woman a couple years ago. Similarly, she had said her favorite question was what? Tell me about the first time you made money.

Erica Conroy:

Oh, that’s good.

K.C. McAllister:

So similar idea, but not necessarily in high school. But it was like sometimes you hear it was the lemonade stand, sometimes it was, I used to hustle kids in the lunchroom, sometimes it was I worked at Burger King. But same idea. I think it does give you a lot of insight, right? Into a person’s character and where they come from.

No love that one. Yeah. Well, and again, it is the Mix Tape, so we do have our Spotify playlist. We hope everybody downloads it. But want to add a song on your behalf. What song should we add to our playlist?

Erica Conroy:

So I was trying to think of everything I listened to and when I go look at the things I’m playing all the time. So I actually, I played piano when I was little. I’m a trained classical pianist and I listen to so much classical music that that’s not really my jam as much, but I really like solo pianists and I like more modern day piano.

So, Yiruma is a pianist from South Korea and I love his music, highly recommend it. I listen to it on a plane or when I’m studying or reading or working on something, I just find it really calming. I play it when my kids are causing our chaotic at home. And one of the songs I really like is A River Flows In You. And I just… Check it out, check it out. And I would love to hear if anyone likes it.

K.C. McAllister:

Absolutely. Well that’s great. Well that’s a great addition. And I have to say, I don’t know that we have any other solo pianists on the list today, so it’ll be a great addition to that and looking forward to it, listening to it myself.

So again, thank you so much for being here today. Our guest, Dr. Erica Conroy, the Senior Vice President of Employer Partnership at AndHealth. Again, you can check out all their incredible services @andhealth.com, follow them on social media. We will look forward to your continued success and appreciate your time.

Erica Conroy:

Thank you so much, KC. It was such a pleasure being here.

Natalie Taylor:

Thank you so much to Erica and KC for that insightful discussion. I loved that episode. I think AndHealth is just such an interesting organization and I love their mission personally because I recently, well maybe a year or two ago, discovered that I have migraines, which I never knew about ever before. I don’t get them very often thankfully, but it’s a certain kind of migraine called a vestibular migraine. So I think this is really cool and I know a lot of friends and family members who suffer from intense chronic migraines.

And to know that there’s a solution out there that you can anonymously apply for your organization, is really cool. And I just think this concept is really fascinating and I think it’s a huge need for our society. I mean, to Erica’s point, talking about going to the doctor once or twice a year and not getting that follow up, not addressing the cause or the root cause of the issue, it’s a problem. So giving patients tools and support they need to improve their overall health, I think is a great improvement.

Valerie McCandlish:

I know, and I think that’s probably in my opinion, what a lot of people’s problems with our healthcare system here is, is that often because you’re only going to the doctor once a year or when you have a problem, the outcome of that session is really going to be treating the problem as it is instead of taking the time to understand what that root cause is.

So, knowing that AndHealth their mission is to provide a personalized treatment plan for this migraine program and kind of reverse this chronic disease is such a game changer. And I can’t wait to see more about what they do. And I definitely, immediately went to their website to check out what they had going on. And I can’t wait to see what comes from their work for their program for the autoimmune disease reversal as well. Because I mean, we know so many people who suffer from chronic disease and the auto autoimmune space as well.

So just really cool things coming out of AndHealth and Erica leading at the forefront. But also another takeaway that I had, obviously just really passionate about everything she had to say, but another takeaway that I loved wasn’t so much about the work that she’s doing, but something that was a big difference maker for her as she was going through her career path.

And that’s how asking questions really made a big difference for her growth. Because I think it’s hard when you’re in that middle, early stage of career development where you’ve been working for however many years. At that point you kind of know what you’re doing, but you’re still, there’s so much you don’t know, but you sometimes don’t want to seem like you don’t know what you’re talking about.

Natalie Taylor:

Absolutely.

Valerie McCandlish:

So you might be a bit apprehensive to ask questions, but great to hear the impact that had for her to be able to not be afraid to ask those questions and how she was able to learn so much. And clearly that’s been a huge impact on her ability to excel in her career.

Natalie Taylor:

I agree. I really loved when she mentioned that and I could just see that being such a helpful reminder for myself and my peers and friends. And it’s a good reminder.

And in addition to the incredible insight and knowledge that Erica shared with us today, she has also shared a new song for our Spotify playlist, which is River Flows in You. So thank you to Erica for sharing that beautiful addition. We’re so appreciative for her for joining us on the Mix Tape. As a reminder, you can find the playlist on Spotify, you can find the podcast on Spotify as well as Apple Podcast and on our website. And with that, thanks for being in the mix. We’ll see you next week.