Darshan
Hey everyone, welcome to another episode of DarshanTalks. I'm your host Darshan Kulkarni. It's my mission to help patients trust the products they depend on. And as part of doing the trusting, it's really important to meet patients where they are. And our guest for today is an expert in that field because he is currently doing a 50 page analysis, our 50 page review of how do you actually monitor patients from where they are. So we'll talk a little bit about that. I'm really excited about that. As you may know, I'm an I'm an attorney, I'm a pharmacist, and I advise companies with FDA regulated products. So if you think about drugs, worried about devices, consider health, or obsess over pharmacy. This is a podcast for you. I do have a special specify that both my guests and I are attorney so nothing we say on here is legal advice and should not be construed as such. I do this podcast because there are a lot of fun and hopefully because I get to talk to really fun, interesting people like our guest today. So if you like what you're listening to please like subscribe, please leave a comment. And if you know someone who would enjoy this because I know I'm going to enjoy this. Please help. Please share this, this link this and share this podcast. If you need to reach me, you can reach me on twitter at DarshanTalks, or just go to our website at DarshanTalks calm. Our podcast and our podcast today is with the general counsel for carrion and we're going to talk a little bit more about carrion before we get further into it. He is a beast in the conversation I've known for a few years at this point, but I want to keep it tight to where we are. But he just came back from vacation and he is a very active father. whether or not he wants to be as active as he is right now. So so you should care about today's discussion. Because if you are in the world where you're looking at decentralized clinical trials, if you're in the world where you're talking about healthcare, but where the patient is not where you want the patient to be. This is the conversation for you, our guest today the General Counsel of Matt Fisher, maca, why are you
Matthew
doing well, thanks for the intro Darshan, and I love that tagline where you're saying it's trying to under better understand where the patient fits into the system. Because it you know, for us a carrier that is really one of our grounding principles and kind of the one of the principal drives from when the company was founded, it's, you know, a lot of the dev work on our platform has focused on making the experience for the patient as good as it possibly can. And I know our engineering team take a lot takes a lot of pride in the fact that it is really easy to use. And once people get the platform, we actually have really high ongoing engagement rates, which is pretty cool to see.
Darshan
So let's talk a little bit about that. I know we had like a whole bunch of topics that we talked about it like three minutes before, but sounds like that topics already out the window, because we're gonna talk about this a little bit. Things that popped in my head is when we talked about meeting the patient, where they should be, one of the big things people thought about was Uber. And what they were trying to do is we'll meet patients where they should be in the hospital, I'll send you an Uber Come on over. But that's not what Kerry was doing. Carrie was switching that that process around, can you talk a little bit about the success rate of the given take associated with meeting patients in their homes, versus bringing them to the hospitals?
Matthew
It certainly so it's kind of our the focus for our platform is very much on remote monitoring, whether it be you know, traditional remote patient monitoring programs hospital at home, really any type of tracking, where the care team is trying to get a better understanding of what's happening with patients or individuals in their daily lives. So for so when our customers use our platform, they tell the patient about it, and then the patient can sign up either or sign up for it. But then they can access it through either a web interface or mobile app. And it's you know, you take information that's being collected from a wearable, whether it be like an Apple Watch, or a Fitbit, or depending on the use case, you know, like we do a bunch of kind of post cardiac surgery recovery. So you might need a blood pressure cuff or a scale. That is the information that gets generated from that gets automatically transmitted into the app and then the care team can see it and not only appear to you can the care team see it, but the patient can see it. So the patient can themselves understand how they're tracking against their goals or be able to see trends over time. And it can be that can be the spur for the patient, and it's always reaching out to their care team and, you know, at raising and concern because maybe, you know, maybe they're having a not so great day in the recovery and they're worried Do I need to go to the emergency room or do I need to go do something they can interact with a clinician and be told Nope, this is all normal. Like Don't worry about it, or maybe this is something that's starting to show some concern come in. So you know And which I think goes directly to the point you were saying of, you know, how do we provide the probably the most efficient and the highest quality care without just telling people Oh, come in for a visit, you know, so it's kind of that type of interaction, which is pretty cool to see. And then, and then it's, you know, so that's, I think, one particular use case. But it's also, you know, we also have one client, that's not even the traditional health care sphere, it's actually a gym, and the gym is using us to replace, you know, it's a pretty, I'll call it high end. And just by high end, I mean, they have very, you know, skilled coaches and trainers there who develop pretty comprehensive plans for the people who are there, and then they can, you know, they're tracking their food intake, they're tracking their exercise, like all this different, all these different measures that that their trainer can see, and then kind of customize their plan. So, you know, but again, it's people who are motivated, or people who are breaking into it and want to improve their health can start to see what's happening within their daily lives. And that, you know, it starts to create this self fulfilling feedback loop where you see it, you get invested in it, and all sudden it becomes habit, or, you know, or just kind of gives you that visual, that's, you know, I think something that we're not used to being able to have ready access to. And it really does make an impact on you know, on overall health and well being in the daily life.
Darshan
So, as you started talking, I was taking notes, I like nine different points of places I can go through with that. But let's start with the beginnings, which is one of the things you will I worried about, with with the use of wearables has always been this idea of garbage in garbage out, and how do you sift through the garbage? And what I mean by that is, I can trust Fitbit to give me the accurate number of steps I took today, how do I trust it? To give me a readout on my EKG? Having said that, I know for example, I just read this article where I think an apple I watch save someone because they found out that they were having a heart attack or something off there I watch. So obviously, some work, others don't. But it's just inconsistent. So how do you tell and how do you sift through the garbage?
Matthew
Yeah, I think to some degree, it depends on the particular use case that we're talking about. So it's you know, if it's the more I'll call it, the more clinical ones where it's, you know, that post cardiac surgery or we do weight management, or nutrition might not be the best example because there's someone's actually logging the particular meal that they're eating, but then that gets vetted against the database that we subscribe to, that gives the actual nutritional content for the food. But let's use the the weight management or the the cardiac in those cases, we're not relying on a consumer wearable. In that case, it's a, you know, an actual medical grade blood pressure cough or scale where they're the clinical team, the clinical customer that we're working with, trust that particular device that we're using, so you have a better comfort with that particular device and the data that's coming in, not to say that there couldn't be some concerns within and we've actually seen some of the devices that we've used, like the manufacturers experience issues, and then we push them on it, because you know, your employee, we want to make sure that accurate data is being presented not just to the patients, but to the care teams, you know, but you know, kind of with all that said, there are still some cases where you know, like an apple watch or a Fitbit, or, you know, we've got a new use case that we're working with a client on around sleep apnea, where we're actually pulling sleep cycle data from a Garmin device. And based on what the clinician is telling us the information that's coming in from that on sleep cycles is sufficient for the use case that this particular physician is trying to do, and, you know, doesn't necessarily need the fingertip pulse oximeter that would be, it would kind of be the type of device that be used if you go into a sleep center. So, you know, I think it's kind of everyone's kind of feeling it out and figuring out, you know, how accurate are the data and how reliable are the data, and it seems like on the whole, the clinician, the care teams and the clinicians that we're working with, feel that it's close if you're either fully accurate or close enough, where they are able to, you know, identify what's happening. And, you know, if necessary, bring someone in or do a, you know, a telehealth style interaction or some type of intervention where, you know, they've got, you know, or they can get people on back onto the right track. So it's, you know, I think, but, you know, ultimately I do think all of that is going to keep refining because I think the devices are just gonna keep improving it's, you know, if we're thinking about the, the consumer ones, you know, I would say in the grand scheme, they're still relatively early on within, you know, the development but yeah, I mean, the, the accuracy does leave something to be desired. It's, you know, but it also depends on how you're using it. So, you know, I would give an example like my son, you know, regular you know, young kid has a Garmin Jr. Or Garmin, some type of Garmin device, because he used his own money, birthday money to buy it and you want to because you want them to track his steps, and it's like, we'll be doing the same types of And his steps will be way higher than mine. But it's like if we're playing basketball, I think it's tracking him dribbling whereas my Apple Watch it, I have to pick which wrist I'm wearing it on. So you know, I wear it on my left wrist, even though I'm left handed, but I tell it, I'm left handed. So I think it filters out, if I'm dribbling a basketball, so it's you, I think the sophistication in that regard is going to get better. And then you know, but I think you also need to kind of think about who's using it, and you know, and kind of what the, the goal is, might be with that particular individual, you know, just thinking about increasing activity for the most part, you know, you might not be seeing people had a high baseline activity anyway, because then maybe that wouldn't be something that you're trying to track for improvement, unless you're talking about an elite athlete, and then you're probably got a million other devices in there. So it's Yeah, I think it with all that being said, it's kind of said, the devices are getting better. But at the same time, you have to kind of have a good appreciation, understanding of why you're tracking and tracking a particular metric.
Darshan
So I think it's, it's, I think it's fascinating, the part that I think is, first of all, it really stood out to me, was the fact that you got competitive with your kid. He has more steps than me, this is not fair. I thought that was awesome. Just Just the numbers and how we operate as an individual. So I think that's awesome in so many different ways. But But I think that the part that also stood out for me, was this idea that I'm re emphasizing what I think you just said, which is this act as a initial filter, if you will, and that the data you get is not conclusive. It's not intended to be conclusive right now. It's intended to be a baseline that is good enough to go, Okay, come in for an additional visit, because we think you're showing some symptoms, or some data that suggests that you need further review, as opposed to being a one off, we trust the data as it stands. Is that fair?
Matthew
Yeah, no, I think that's a pretty accurate synthesis. And it's kind of also part of what you're saying, when you summarize there is it's, it's giving a more complete picture of individuals, because it's not, you know, as you said, not we're not trying to say we're trusting this, and it's the final picture of things, it's, we're starting to actually get more insight into what's happening to people in their daily lives. Because, you know, go back 10 years, all you had was, you know, if it was a healthy person, like you or me, you'd be in there, you'd see your doctor maybe once a year, if not less frequently. And even if you had, you know, a chronic illness or something, or some other condition where you had to be coming in more frequently, maybe you're in there, like four to six times a year, you know, so now you're getting a lot more data points. But you know, kind of going back to the question you raised earlier, is it just garbage in garbage out? It's, you know, we're, you're applying some type of analytics to it. So you're not just getting all the raw data, you're getting it charted out, you can kind of see trends. So if something, you know, one particular reading, let's use blood pressure is example of one particular reading is completely out of whack. You can say, okay, maybe we should record rerecord that and figure out is there actually something happening here? Or was it something just happened at that particular time? Like was, did you have trouble using the device malfunction? Or had you just been doing something right before taking the reading. So it provides that opportunity for more I'd say real time analysis and real time feedback. And in the long run, it's kind of what we're seeing is it's helping to reduce the need to come in because you can catch things earlier on and prevent a larger issue from occurring. You know, it's we actually unsolicited received feedback from a patient who is using our service like this, this patient in this we've actually published the story, but like the patient reached out to our, the chair of our board, who's one of the co founders through LinkedIn, and said, Did you actually found carry on and he's had gas, and he's like, I want to tell you my experience with it. And he, you know, this patient was talking about how valuable for him it was to be able to see the track the trending of his of his data over time. You know, he happened to have a post cardiac or cardiac procedure early on in COVID. So a nurse was supposed to be coming to his house a lot to be taken blood pressure and other readings. And he's like, I didn't want anyone coming in, because who knows what risk is being created with that. So now with the connected devices and the app, he could do record all of it, interact with his care team. And he's had a couple of times like, he had questions and he was able to get feedback either through a chat or a quick video visit that prevented him from having to go either to the ED or to an office visit. And not only that, then he said, You know, like, as he kept going through his journey, and he finished the one segment, then why didn't I think like physical therapy, and could show the physical, the physical therapy team all the data from the app because they didn't have it because it was healthcare, so he was in a different silo at that point, even though I think he said it was all the same system. You know, but it was able to show, okay, you know, you just took my blood pressure here and it looks a little high. But here look at this chart from the past like three months. And it shows that he actually was trending in a good direction that it was remaining stable. And, you know, maybe it was that typical reading in the office where it got elevated. So it's, you know, that type, those types of interactions are pretty powerful. And we'd love to hear about them.
Darshan
That's so fascinating. But let me ask you this question, though. I'm, I tried talking to my doctor at one point, like, I have all this data I can I can give to you, because I have a Fitbit, and I do all this stuff. And the doctors reaction was basically I get too much data, I don't want this much data. How do you battle? Or how do you educate healthcare practitioners who go, I have all the data I want, I don't want your data.
Matthew
Yeah, I think to some degree, it's one, the people who are signing up with us are already thinking of how can I, you know, how can I use this data? You know, how can I better interact with patients, or not better interact? I think that's probably not the right word characterize. But, you know, how can I, you know, how can we shift our practicing and wreck, you know, try to harness what's available there? Because it's, you know, I think a lot of people do you have devices, so I think, you know, part of winning that battle and saying, okay, we're not just randomly collecting information, we're not just telling people, okay, you've got, you know, a Fitbit, or all these other wearables, just dump your data on us, it's here, here's a particular goal that we're focusing on, you know, so it's, you've got a use case in mind. So, you know, kind of going back to it, it's, a lot of times, especially if we're working with like a physician practice, physician practice, we're doing remote patient monitoring, which is a specific under men, and I'll use Medicare as the kind of guiding light here, you know, that is a defined program, there are four defined CPT or billing codes for remote patient monitoring. And it can, it's designed to address either a chronic or acute condition. So it's, you're not just saying, okay, you're healthy, and I want to see all this baseline data, it's, you're actually trying to set your set of care planning, you're trying to advance a particular goal. So you've you're not also just collecting all the potential data you're identifying, maybe it's activity counts, and like steps, or maybe it's weight, or blood pressure is a specific actual data points that you're looking at. And then again, as I said, at least through us, it's not just the raw data flowing through, although that's accessible, if they want it, it's, you know, you can chart it out, you can sort it, you can, you know, look at it through all these different filters, so you can actually get to what you're trying to see. So it's, you know, I think the the concern about being flooded with that is definitely a just a justifiable one and a valid one, because there is so much being created all the time, you have to be able to have analytic, some degree of analytics applied to it. So that way you get information that you can act upon, as opposed to, you know, having something where now you're trying to sort through it and figure out what to do on top of an already busy day, and likely an already overwhelmed plate. So it's, again, it's it, I think, it goes back to the presentation of it.
Darshan
So So I carry him, do you guys find yourself creating custom dashboards, depending on the audience,
Matthew
to some degree, we'll have some custom dashboards, you know, dependent, you know, especially if it's a new use case that we're getting into. But, you know, because of all that work, we've also now developed a lot of templates and just a lot of fit within the dashboard, you know, within the care, team side of dashboard, you know, a lot of filters that they can apply. So it's, you know, kind of, I'd say, it's a little bit of both. But there's, you know, probably not as much customization happening at this point as there might have been in the past.
Darshan
Okay, the only because I found the idea that the use case you gave earlier, I thought was fascinating, where you said, gym owners are actually reaching out going, I want to track my, the individuals working with me, and I'm, on one hand, I kind of go, that's awesome. The second that my second reaction is getting all this data, are they actually? Are my trainers actually using it? Or is it something they tell them that you have access to? No one ever ever actually looks at it? It's I mean, obviously makes for a really good use case. And just excellent data. But But my third question would be, who owns the data?
Matthew
So for us, it's the patient. And that has been that has been the and frankly, has actually, you know, I think we're it's kind of talked about this in the prep that, you know, we got a question recently from a potential customer saying, Can you explain our contract to us and so, you know, which caused me to go back to our template, so I can prepare a quick summary of it. But you know, we have a data section and in our master subscription agreement, it says client, you know, there we have the client. So that would be the person you know, that the entities signing up for us. So that if they enter belongs to them, but then it also refers to our basic terms of views which say, individually users own their data and you know, it You know, kind of, in the early days, this shifted a little bit, but kind of one of the early conceptions was even thinking, you know, say you or I sign up for it, and then your physician is using it, we would have had to select to have our physician have access to our data. Now we kind of make it a little bit more seamless, just because I don't think anyone want to have to deal with it. But at the end of the day, we also do remind our customers like the page, you'll get a copy of it, because you know, by us providing a service to say a physician practice where their business associates under HIPAA, the debt, the pH I, or the patient information, protected health information that we're collecting, just by those regulations is being collected on behalf of the physician's practice. But at the same time, we're basically saying there's a dual copy of the data that still belongs to the patient, and they're always going to have access to that. And in fact, you know, if someone happens to not continue with our service, but we'll turn off their access, but the patient can keep using it essentially, in a direct to consumer, just with no care team attached to it, it's bit you know, so in essence, it becomes almost a personal health record for them. But they could continue to use it. So it's, you know, again, a very long roundabout, or not roundabout, but just a long, detailed way of saying, from our perspective, we view it as the patient owns their own data.
Darshan
And how long do you hold it, though.
Matthew
So as long as someone is active, so actually, what kind of put into a few different buckets, you know, we'll always maintain a copy of it as long as that our customer is a customer, because again, we're maintaining a copy, that's theirs. If someone if a someone asked to delete their account, then we turn off their account, but we, you know, because if their customer they're associated with is still active, we need to, we need to maintain the pH I for their benefit. But what if all of that is a that they're associated individual is no longer associated with a customer? And it's just them? If they asked him for a deletion? we'll delete it. You know, so it's kind of it, it all depends on kind of our regulatory I'd say, it depends on our regulatory obligations. But if it you know, all if all else being equal, and it's the the individual is able to have that final say, we will delete?
Darshan
No, but I didn't know if, for example, the customer you had with, with them is, as sort of left carry him, the patient didn't doesn't access the data. Is there like a drop off point? I'm making this up, like two years after the last week out? or? Yeah,
Matthew
it's a one, I'll say what probably one answer to it is we haven't had to have that experience yet. So you know, but, you know, I think what would would probably end up happening is a trigger to say, okay, you know, you've been active for X amount of time do you want to are you gonna want to reengage, especially if it's that they're no longer associated with, you know, it's a system, customer practice customer, and if they're not, then you know, kind of have that indication of, okay, you know, if you're not, if you're done using it, then, you know, both deactivate your account, and we can, we can delete it, you know, but be able to present those types of options, you know, but again, you know, that that's in the case for a patient, we call it a patient user is not is disconnected, and is essentially a direct to consumer user at that point. But, you know, so long as someone's associated with an active client, that's a system or a practice, the data is going to be maintained just because we have that obligation to that particular customer through our, through our frankly, both our probably contractual and our regulatory obligations.
Darshan
Now, the reason I asked that question in my case is because, as you know, I negotiate a lot of clinical trial agreements. And in those cases, the clinical trial agreements, I, at this moment happen to be working with the clinical trial site, so doctor's office, or a hospital or the light. And in those cases, most pharmacy companies go and you'll start data for the rest for the rest of time, basically. And you're kind of going, Yeah, happy to store the data for the rest of the time if you pay for it. But what what time do I need to Am I allowed to turn off that faucet is a question that I've always sort of battled with. There are some FDA requirements, but should you go beyond what those are? And what is the healthcare standard is really what I was trying to get get a feeling for? And what it sounds like, is it there's no standard? There really just depends on where you are, and regulatory standards and all that good stuff.
Matthew
Yeah, I think it's from that standard perspective, because when we're working with like a system, say, the hospital system or physician practice where the business associate, you know, technically the record retention requirements don't apply to us. You know, I think it's, I think, from that, from that perspective, it's probably different from the clinical trial world. You know, I think kind of the general rule I usually hear is like physicians, if they're an independent practice, I think it's usually probably like a six to 10 year retention time period, depending on the state and then hospitals can be, you know, 20 plus years, again, depending on the state so, you know, so yeah, I just happen to know that like, I'm in Massachusetts, like I remember at one point hot here, I think hospitals were 50 years and then that got shortened. Sometime in the not too distant past, you know, but it's just kind of thinking about that it's, you know, so if a customer were to terminate with us, you know, we would say, you know, we would offer to basically do a data dump to them. So they would get a copy of all the information, you know, in a mutually agreed format, but it's, you know, so that way we can help that, you know, help that cost the customer fulfill its obligation without us having to maintain the copy, although, from what I hear from more technical folks, frankly, that data storage cost is at this point in time pretty minimal. You know, because it's you can get terror petabytes, or, you know, pick your unit of measurement for relatively low cost.
Darshan
Yeah, I mean, our exabytes is something right now. So it's ridiculous.
Matthew
Yeah, no, that that goes beyond me that that's when I, that's when I start asking my engineering team too many questions. And they pretend like they've got something better, which is probably the case.
Darshan
So So let me ask you this other component, which is, you talked, we talked a little bit about data ownership. And we talked a little bit about, which I thought you guys had a great answer was the patient owns the data, because you rarely see people sort of officially go, that's where we are, which is awesome. Um, but let's, let's flip that around. I'm actually referring back to a link you posted on LinkedIn the last couple of days, which was cyber security, and how we're dealing with hacking, has that been an issue? Carry him sort of keeps at the top of its mind? And how do you deal with it as a business and as a, as an attorney, to keep sort of keep those issues? front of front of front of mind, if you will?
Matthew
Yeah. Security and cyber security very, thankfully, have been another one of the overriding principles from day one, you know, kind of, and I think I talked about this with my CEO not too long ago to it, you know, because we talked about security quite a bit. You know, but it's one of the extreme benefits that I think we have is, you know, the founders and the engineering team are very experienced, you know, it's not kind of the the prototypical startup that you see in the headlines of, you know, people who are relatively young in their careers, you know, the group that was the co founder of the company, and have been working on it, mostly, from day one, they've actually been through multiple companies together, and have come from a diversity of background, it's health, healthcare is not their traditional background, they're actually in telecom before, you know, so they actually, they've won seen the evolution of technology. But, you know, have also been building for a long time. So they had a very solid understanding and drive to want to have the security very much baked into the product from the beginning. Yeah, so it actually, when I first started working with the company in which was Frank, actually, I only, in retrospect, found this out, but I ended up meeting them, I think, within a month or two of the company being founded, you know, but right from the start as that early, really early stage startup I got, started interacting with them and representing them, or representing us because they wanted to know, HIPAA, and they want them to make sure they're doing things correctly from that perspective, understanding that they were already going well above and beyond any, any requirements that the regs would call for. So that and that is definitely still carried through. And it's, you know, it's actually pretty amazing, you know, because I'll have people, you know, we use slack a lot for internal communication, I'll have people send me questions saying, Is this okay, should we? Is it okay? If we do this, you know, or thinking about adding a new component in it's like, how is this going to impact our security posture isn't going to be okay, under HIPAA. So it's from me, you know, from the legal perspective, it's really fascinating and really cool to see people that invested in it, you know, and then it's, you know, whenever we, especially when working with bigger health systems, or, you know, other vendors that are trying to add a component that we can bring, you know, we go through pretty detailed security questionnaires and analyses, and people are always very impressed with, with how we stand. And in fact, we're also now going through a sock two phase, or type two, audit, you know, and in our Readiness Review, the our auditor actually said, you know, you're one of the best prepared startups that we've ever worked with, in terms of, you know, what was already there, because, you know, they were telling us, you don't actually have to make any material changes, you just have to document a few things better, because you're doing it, you've you're doing everything that you should be, you know, and then you know, and kind of one another example that is right from the start. They've been, we've been using an outside pen tester. And we do that twice a year. And the last time we went through that there was, I think, six low risk findings now, and I think five of them were things that we had just made an operational decision that we could live with it, usually focused around and user types of things, but you're not going to make an end user change their password like every 30 days because I don't think anyone will use a product If they had to do that, you know, but it's those types of things where it's, you know, we I think that's one of those areas where we can show a distinction with, you know, how much attention has been paid to it, and how consistently, it's being considered on a daily basis. So again, as I said, it's been very gratifying to not have to be preaching and trying to convince people that think about this stuff, but sometimes it's, you know, saying, you know, just marveling at what's happening, and sometimes we've been so you know, I think following some of the guidelines where other people are a couple steps behind, so we have to explain why we're not doing it, why they the way that it's, they think we should be doing a poor explaining now this is the most like current iteration of NIST guidance, for example, and this is how we, this is what we're complying with.
Darshan
I love that your current standard is my competitors are doing it wrong, or at least not as not as fresh or as up to date as they should be. So that's probably the best place you can be. Um, Matt, I usually try to keep this for about 1520 minutes, you're already well ahead, because it's just a great conversation. So thank you. A couple questions before we, we sort of close up? Is there a question like to ask the audience based on what we discussed?
Matthew
Today question that I'd like to ask the audience? Yeah, yeah. Yeah. So I probably the question I posed to people is, you know, what are you doing to kind of interact with the patients in your practice? And your, how are you trying to establish a higher and better overall baseline of health, because it's, I think, as we know, medicine can oftentimes be very reactive in terms of how the system traditionally drove focus. But now we're getting into more value based care and thinking about, you know, keeping people keeping people healthy, as opposed to getting them back to health. So my question is, how are you doing that?
Darshan
I love that question. Because you're right, I hadn't thought of, I'd always thought of remote patient monitoring, or I thought about telehealth as really just an adjunct to the care we already have. But what you're really pointing out is the role it now plays in preventative health, which, which is the bigger role to play anyways? And we've been talking about that for 20 years, 30 years, but how we should be helping with being healthy. So no, I love the question. So I'd be curious, but they said two other questions. One is, what's something you learned in the last month that you didn't expect?
Matthew
I don't know. Maybe this isn't necessarily so expect, unexpected, but, you know, one of the things I've been doing is just trying to it's been doing a deep dive into Medicaid coverage of rpm. And it's, you know, one of the things that's been surprising me is sometimes how difficult it is to find what the reimbursement rate actually is, you know, even when there's a fee schedule, there might not be using the same codes or, or a consistent set of codes, even if the right you know, like, in a couple of states, I've seen the regulations say RPM is covered, and you have to cover it in this way. But then the codes I expect aren't there yet. So I'm just, you know, you and I are probably very informed of in terms of how regulations work and kind of how the industry works. And, you know, when, when you have difficulty, like with that type of understanding and knowledge of finding answers, you know, you kind of scratch your head of how is anyone else going to find it? Who doesn't have that one the time or even the beginning, the inklings of where to
Darshan
go? Yeah, yeah, no, I, that's a really interesting answer. The bureaucracy of government getting ahead of itself. Simple question. Third question, if you will. What made you happy in the last week
Matthew
and the last week, seeing my son play baseball, you know, he's doing his summer all star and so, you know, he's been doing very well. So it's, you know, just seeing how much fun he has with it. And then, along with that, just all of the crazy random stuff that my daughter will say she, she can be very deadpan without intending to, but it's usually very accurate and funny when she does
Darshan
it. It sounds like Aubrey Plaza, kind of take on it. Do you know who that is? Yep. Okay. Yeah.
Matthew
I would love to say I watched all of Parks and Rec but when I convinced my wife to start watching it, over her objections, she started fight. She liked it so much that she then burned through all of it and I got to see maybe a 10th of the show.
Darshan
We'll have a whole different discussion on that because I'm having the exact same problem with my girlfriend but yes, I refuse to introduce her to shows because I know she's gonna burn through it, then I'm left with not watching it, because I don't want to see again with her. But last question. You sort of made a really interesting pitch for Carrie I'm especially and I'm still obsessing over this, but I think it's such a great use case with the gym piece because I've just never seen that done. It's awesome. How can people reach you if they have questions? or How can people reach carrying their questions?
Matthew
So if you want to learn more about curium, you can go to our website, which is go carry m.com. You know, for me, I'm Matt Fisher at Carey m.com. So that's email or you can find me on Twitter at Matt, underscore, r underscore Fisher. And even though I can, hopefully it's on the screen, maybe, but if people are listening to it, Fisher is FIA sh er,
Darshan
but it right now. So Matt, underscore, whoops. Our underscore, f is ch er at,
Matthew
nope, no See?
Darshan
No seeds? Yeah, I'm glad I asked. If I sh er [email protected]. Is that right?
Matthew
No. So the mat underscore, r underscore Fisher is my Twitter handle. And then email is just mat dot Fisher to many different ways.
Darshan
This is why we're asking these questions that people can follow. And Is that good? Yes. So that's your Twitter handle? Yeah. And then we have Matt doc Fisher. ephi sH [email protected].
Matthew
Yeah, good. Yep. And then and then people can also find me on LinkedIn just by searching for me. And that's
Darshan
my Fisher. Yeah. Great. Matt. This was awesome having you thank you so much for coming on. Oh, by the way, one more thing. Mac you have your own podcast.
Matthew
Yeah, how about that one? Yeah, so it's called healthcare to yurei so the two women who came up with that love to do some wordplay so playing off illegal terms but it's on the health care now radio network and you get to interview great folks so you often return the favor and have you on soon be able to talk about pharmacy and law and all any fun thing that you want to do but it's kind of like you I get to have a lot of really cool discussions and you know, just learn learn from my guests, which is the best thing in the world.
Darshan
Right. Matt again, what's the what is it called again? healthcare,
Matthew
healthcare data era.
Darshan
Okay, you're gonna I'm gonna wait for you to put that in. I'm gonna copy that. Oh, oh, is that how it's pronounced? I've been calling but now
Matthew
we actually call actually they call it healthcare to Georgia because they want to because they the main focus is picking up on hot topics of the day so pronounce it as if you're speaking French to health care of the day, but when with the day yurei for the legal term, which I can never remember what it actually means because I'm a bad lawyer. Don't do it.
Darshan
I love it. Awesome. having you on my Thank you so much.
Matthew
Yeah, no, thank you very much and it always pleasure to talk with you. Pleasure.
Matt
This is the DarshanTalks podcast, regulatory guy, irregular podcast with host Darshan Kulkarni. You can find the show on twitter at DarshanTalks, or the show's website at DarshanTalks.com
