Health Tech: Dr Ronald Dixon On How CareHive’s Technology Can Make An Important Impact On Our Overall Wellness
You always have to look to the clinical and social outcomes first and understand what the pain points are, prior to trying to solve for the technology side. So we like to call all it ‘clinical pull’, as opposed to ‘technology push’. The world has enough widgets that are based in new tech for the sake of new tech. It’s vital to look at the desired outcomes and problems that need solving as a first step. For me and my team with our healthcare, clinical, and audience-first backgrounds, this is a natural direction to take.
In recent years, Big Tech has gotten a bad rep. But of course many tech companies are doing important work making monumental positive changes to society, health, and the environment. To highlight these, we started a new interview series about “Technology Making An Important Positive Social Impact”. We are interviewing leaders of tech companies who are creating or have created a tech product that is helping to make a positive change in people’s lives or the environment. As a part of this series, I had the pleasure of interviewing Dr. Ronald Dixon
Dr. Ronald Dixon, the CEO of CareHive, is a pioneer and innovator in the health tech industry. Throughout his career, he has viewed the opportunity to improve and optimize healthcare with laser focus and clarity. For example, he developed telemedicine booths 20+ years ago to allow communities to visit with their doctors without traveling to the office, while leveraging the value of data to improve healthcare outcomes.
Thank you so much for joining us in this interview series. Before we dive in, our readers would love to learn a bit more about you. Can you tell us a bit about your childhood backstory and how you grew up?
I grew up in a very middle-class family in Montreal, Canada, and my parents were Jamaican immigrants. My father was a high school biology teacher and my mother was an administrative assistant for Canadian National Railways. I have a sister who is five years younger than me and is also a physician and an entrepreneur.
We were all a very musical family. I started playing the piano at age two and continue to play to this day. And I started playing ice hockey when I was 5 years old.
The entrepreneurial streak started fairly young with me. My sister likes to say I would lend her money and charge her interest that would increase on a very rapid schedule. She thought I was a mercenary. And I also had a paper route that I was able to franchise. I amalgamated a whole bunch of paper routes and got other kids to deliver the papers for me. But I would do the collection, so I would take a margin and that started at age 12!
I went to McGill University for my undergraduate studies where I majored in biology and psychology. Then I went to State University of New York (SUNY) in Buffalo for graduate school. I was lucky enough to get a presidential scholarship to study clinical neuropsychology there. I did that for two years and then went to medical school at Dartmouth, followed by Harvard for residency. After that, I did a health policy administrative fellowship at Massachusetts General.
Can you share the most interesting story that happened to you since you began your career?
There are two interesting stories that put me on this career trajectory. One of them surrounds my father’s illness. My father developed a kind of a bone marrow cancer called myeloma while I was a resident. He required multiple in-person visits with doctors during a time when he was severely immunocompromised. This led me to start thinking about ways to access the system without needing to physically be at the doctor’s office. So that was a big precursor to really focusing on telehealth and then capturing important data.
A second interesting story was with a patient who I diagnosed with stage four lung cancer, unfortunately. And in his last few weeks of life, we used Skype. It’s important to note that this was back in 2005 when Skype was relatively new. I used the platform to manage him and his end-of-life care at home. He was too weak to travel to the office, but I was able to do video conferencing with him and he was very grateful.
It was those two experiences that really helped formulate what I thought was needed from a healthcare delivery system — both this concept of accessing virtually, and then data capture to provide evaluation and management, despite the patient not being in front of you.
None of us are able to achieve success without some help along the way. Is there a particular person who you are grateful towards who helped get you to where you are? Can you share a story about that?
I think the one person that comes to mind all the time is a clinical nurse named Penny Ford Carlton. She was a brilliant nurse innovator. She became a clinical lead for an organization called CIMIT in the Mass General Boston ecosystem, which was a conglomerate of various institutions, including Mass General Hospital, MIT, and Boston University. A group of innovators from these institutions would gather together to exchange ideas. And then if there were synergies, you could potentially start a pilot project. Penny was the person who really believed in what I was saying at the time [about telemedicine’s potential], And I had this strong belief that telemedicine should be integrated into care delivery — it was about continuum of care.
The person who was running the telemedicine effort wanted me to come work for him in a different capacity, and I said that I wanted telemedicine in my office with my colleagues and my patients as a part of our offering and that it shouldn’t be outside of clinical care. And that caused some consternation because I was a very young faculty member and I was refusing to go work for an older mentor. And Penny was incredible. She supported me and helped me write a grant application that gave me my initial funding for creating the telemedicine platform. She then helped get me support from CIMIT. So without her, I wouldn’t be where I am today. She’s phenomenal.
Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?
My favorite life lesson quote is from my mom and she used to say it to me all the time when I was playing the piano: ‘If at first you don’t succeed, try, try again’. When I was playing the piano, I would make mistakes and get so angry, and she would come down and tell me to calm down and say, ‘you just have to keep trying’. She would sing it to me all the time — I still hear it in my head.
And that quote applies to being an entrepreneur innovator. You can find yourself banging your head against the wall because of rejection but you have to keep persisting and figure out a way around the obstacles. And it exists even today. You go and start a company, you may fail, you start another one, you have moderate success, then you may fail again. So it’s all about persisting through failure and seeing failure as a life lesson. And so that concept is always in my mind.
You are a successful business leader. Which three character traits do you think were most instrumental to your success? Can you please share a story or example for each?
Persistence is the first character trait. If you look at where this all started, it was a pilot project while I was a young physician at Mass General. Now look at where we are today. It’s all been about persistence. And I think the greatest block that we had to persist through was while I was at Mass General was this fork in the road when Epic, which is an EMR (Electronic Medical Record) came along. We had some really tremendous success with the telemedicine platform that I had built. The company that I started called Healthcare 360 had scaled all throughout the Mass General ecosystem and the North Shore Health Center ecosystem. So it was very popular, but when Epic came, they said, ‘oh yeah, I know you’re doing tens of thousands of encounters on this system, but we’re now going to use Epic.
And that’s really what led me to leave and start another venture. And Epic did try to be the 360 replacement, but after they launched it, the doctors refused to use it. So what we built had persisted, and it’s still there today!
In 2020 I received a call during the pandemic from an acquaintance from a venture capital fund. We had met five years earlier and he remembered what I was doing and thought it would be of value to CareHive. And because Healthcare 360 was still in use Mass General, I was able to call the team and ask them to help me export it. And because that relationship was still very much intact, we were able to leverage the IP and that’s helping what we’re doing today. So I think persistence is a really important part of where I am.
I think another key character trait is really being ‘people first’ or being people oriented. When you put people first, especially when you’re trying to innovate, you end up building a network and all of the people in that network, at some point, are helping each other. If you try to do it on your own, I think the barriers can be insurmountable. But if you are building it with other people and you have this people-first mentality, they will be the ones that help remove those barriers for you and help make things happen. And that has definitely been the case throughout my career.
This includes my connections that led to meeting Sante Ventures, CareHive’s primary investor, which were from networking. There is significant power in networking and having a people and relationship orientation which really goes a long way.
I like the idea that to be successful, you have to put people and relationships almost first. So you have a core idea and a problem you’re trying to solve, but the only way you get there is with a people orientation, from a collaboration perspective, a partner perspective, and an employee perspective. And that’s a key part to being successful.
Ok super. Let’s now shift to the main part of our discussion about the tech tools that you are helping to create that can make a positive impact on our wellness. To begin, which particular problems are you aiming to solve?
The problem that we’re aiming to solve is the challenge of access to healthcare for patients, and then navigating the healthcare system, which is obviously a very fragmented system, when they need it and specifically being proactive about chronic disease, instead of reactive.
How do you think your technology can address this?
Our technology addresses access to healthcare in our very fragmented system by amalgamating the concept of data. And that means data on the front end. Data allows you to understand the problem that you’re trying to solve in a population of patients. And then you need a tool to intervene with that population. Our tool is called CareHive360. And then finally, on the back end, you need to prove the benefit of the technology, both from a return-on-investment perspective, to who’s paying, and then to the patient from a diagnosis and a clinical end standpoint. And while doing that, you are collecting data and learning so that the next time you go through that process of navigating the patient in this way, you’re a little bit smarter because you’ve learned from the prior interaction.
We’re doing more than just looking at single disease states to solve a problem. We’re looking at the bigger picture: 86% of healthcare spending goes toward chronic disease. The only way that you can manage chronic disease appropriately is to stratify the level of chronic disease within a population and then match the level of care within that stratification. So if you’re stratified as a higher-risk patient with a chronic disease, then you’re likely going to need more intense care to prevent a downstream exacerbation. But that care doesn’t need to wait for a doctor visit — it can be handled through synchronous or asynchronous technology. For those that are less tech savvy, then you might need a navigator to help you. Then you have a proactive approach to reaching out and touching the patient with the chronic disease, collecting that information, and then navigating them to the appropriate level of care. If you’re a middle range type person, you could imagine that the data shows that you’re medium risk and that you might simply need asynchronous question sets and check-ins, as opposed to an escalation to a physician visit.
What we’re also providing in addition to this concept of escalation, is navigating to the optimal site of the escalation or the site of the service. It can be virtual or it can be bricks and mortar. And if it’s bricks and mortar, we work to differentiate between sites that might be more value oriented. This would actually save the system dollars and still provide the same outcome for that patient. And if that’s the case, then you’re creating value. So it’s really important to tie the data to the destination of the patient, and then give the patient access and a great experience that is frictionless and repeatable. All the while we’re creating a learning system so that over time, as more patients move through with the different chronic diseases, you learn where they need to be navigated to, and you get smarter and better, and the experience improves.
Can you tell us the backstory about what inspired you to originally feel passionate about this cause?
My father’s illness is what put me on this career trajectory. He developed a kind of a bone marrow cancer called myeloma while I was a resident. He required multiple in-person visits with doctors during a time when he was severely immunocompromised. This led me to start thinking about ways to access the system without needing to physically be at the doctor’s office. So that was a big precursor to really focusing on telehealth and then capturing important data.
How do you think this might change the world?
If you approach this with a data-first strategy and you maintain the privacy and security of the data while you are amalgamating it in a way that allows for this smart routing and navigation, you should be able to change the trajectory of all chronic diseases. I’m not just talking about doing this for one particular disease. It’s looking at a population of patients, understanding what the disease burden is, having pathways for all of these different disease states, and then knowing the optimal navigation options. You might need to escalate to a higher specialist. But the majority of the time, you’re simply going to need to check in to ensure that somebody’s taking a medicine vs. scheduling an in-person appointment, it’s not required. So this idea of using the information that you can gather to make the patient experience better and save the system money across a multitude of conditions, I believe has the opportunity to really impact every person with chronic disease on the planet.
Of course, that’s going to take time and it requires a change in the reimbursement model that is fairly common in healthcare, which is what we call ‘fee for service’ (pay for what you do). And in this case, you’re now moving towards pay for the outcome, or ‘value-based care’. And that requires a very different insurance strategy. The nice thing about what we’re doing at CareHive is that we have engaged some insurance plans who are more interested on that risk side, who believe that there is the opportunity both for better outcomes as well as savings, and in some cases revenue, when utilizing data towards asynchronous clinical navigation technology.
Keeping “Black Mirror” and the “Law of Unintended Consequences” in mind, can you see any potential drawbacks about this technology that people should think more deeply about?
I do think that there are some valid concerns about privacy and security of information. But as long as you are maintaining integrity and security, I do think that there is an opportunity to leverage larger sets of data, to help inform these navigation pathways and make them smarter. And as long as we are using what you call de-identified data to form these pathways and have a secure platform, then I think we minimize the capacity of the data being used in the wrong way. I do think that there may have been overreach with HIPAA in that it does hinder some of this data sharing capacity. And I think that the only way you’re going to advance, especially with chronic disease care, is through using both retrospective of retroactive data, and then collecting prospective data to help navigate patients appropriately.
Here is the main question for our discussion. Based on your experience and success, can you please share “Five things you need to know to successfully create technology that can make a positive social impact”? (Please share a story or an example, for each.)
(1) You always have to look to the clinical and social outcomes first and understand what the pain points are, prior to trying to solve for the technology side. So we like to call all it ‘clinical pull’, as opposed to ‘technology push’. The world has enough widgets that are based in new tech for the sake of new tech. It’s vital to look at the desired outcomes and problems that need solving as a first step. For me and my team with our healthcare, clinical, and audience-first backgrounds, this is a natural direction to take.
(2) Similarly, when you philosophically commit to clinical pull, then you need to invest in conversations and learning with constituents before you build your product model. You’re going to be talking with patients, families, and clinicians to understand what the potential impact of your proposed technology will be. Is your idea going to improve outcomes, improve the process, reduce inefficiencies, and help cost effectiveness. We also can’t forget the providers — healthcare innovation that also makes the system easier for clinical teams will obviously have a better chance of adoption.
(3) Following on, then you need to have user-oriented design sessions with those constituents, with your proposed product in mind. Preferably, regular touchpoints are created with your key audiences to ensure needs are being met. There is of course danger in too much reliance here — customers can’t always see the vision and social impacts you have in mind — but certainly from a UX standpoint it is important to not assume you know everything, especially when your audience has a wide demographic spread.
(4) Then you can go and bring technologists in to confirm that your vision and objectives are possible. You need to understand what the potential impact on the constituents are and know if you can you build something according to specifications designed by these constituents that have been interviewed by product team. You must first go to the users and constituents and then work backwards. Admittedly, in many cases the solution was already somewhat in focus at the start of the process so validating the details becomes important as development begins.
(5) Finally, you develop your product and solutions. You’ve discovered the key pain points, determined what the problem areas were, and you design with the confidence of the full user experience in mind, starting with what they need most from your product or service. This is truly engineering success and doing so from the worthy standpoint of clinical and social outcomes.
If you could tell other young people one thing about why they should consider making a positive impact on our environment or society, like you, what would you tell them?
You have to follow your own passion and discover what that passion is through life experiences. And then see that passion’s effect on other people’s lives that you’re hoping to impact. If you have that lens, you have the opportunity to create something that scales and is impactful. You may not be able to see it just from your perspective. You have to collect a whole host of perspectives and then find some common denominator that will allow you to build something that has the most possible impact.
Is there a person in the world, or in the US with whom you would like to have a private breakfast or lunch, and why? He or she might just see this, especially if we tag them. 🙂
It would definitely be Barack Obama. I know many others would cite various reasons for choosing Barack, but I’d love to sit down with him because he’s funny. I think that he’s been through incredible trials and tribulations and he’s come out the other side… and can laugh about it! I’m very impressed by people who have that perspective. And I’d want to know about the things that made him laugh the hardest, especially the times where he couldn’t laugh, but wanted to! I find myself in those situations all the time… so that’s what I would want to talk to him about.
How can our readers further follow your work online?
Readers can follow the impact we’re having on our current healthcare landscape by visiting our website, following CareHive on LinkedIn or following me on LinkedIn.
Thank you so much for joining us. This was very inspirational, and we wish you continued success in your important work.
Health Tech: Dr Ronald Dixon On How CareHive’s Technology Can Make An Important Impact On Our… was originally published in Authority Magazine on Medium, where people are continuing the conversation by highlighting and responding to this story.