Ann Bilyew, SVP of Health at Internet Brands and Group GM of WebMD Provider Services sits down with Niko Skievanski of Redox to discuss emerging trends in health tech and how health systems and hospitals can transform to deliver patient-centered care.

During the podcast, Niko and Ann discuss:

  • WebMD Provider Services and why it's uniquely positioned to help health systems, hospitals and care management providers deliver personalized care
  • Why scale matters to health systems as the market shifts towards consumerism 
  • How startups feed into these trends, creating alternatives for patients and putting pressure on incumbent health system providers to step up their game 



Condensed transcript

Niko: How does WebMD help consumers?

Ann: WebMD is the number one provider of information for consumers seeking information about their health, and to help them make decisions about the health of themselves or a loved one. In any given month, we have 85 million unique visitors coming to WebMD to help them find information to make good decisions. Now, rightly or wrongly, we know that folks have a health concern before their spouse, before their child, before their parents, and almost certainly before their doctor. They're coming to WebMD to do some research, they're coming to WebMD to get information, they're coming to WebMD to understand what might be happening with them. So, very early on in the patient's journey, we are developing a trusted relationship with that consumer. In terms of building on that related to how we help providers and health systems, hospitals and payers, we're starting a dialogue very early on with the patient as they're starting a care journey.


Niko: How does WebMD help health systems?

Ann: We work on behalf of health systems and providers to reach patients as they're making a decision about whether to seek care, when to seek care and with whom to seek care. We're  right in the mix where these most important decisions are being made by consumers. 

We acquired PulsePoint, a programmatic exchange, earlier this year to have the ability to reach those same consumers, making those decisions, wherever they are on the web. With access to 90% plus of the U.S. population we can identify those who are actively seeking care and begin a dialogue with them. We help advertisers identify segments of the population that they want to market to, identify where they are on the web, and serve up contextually relevant ads.

We're catching patients very early on in their journey on WebMD owned properties and now through PulsePoint, basically run-of-web. We acquired two other companies previously, called Krames and The Wellness Network that brought us right to the point of care. 

Krames is embedded in almost 2,000 hospitals, deeply embedded in their EMR with patient education and patient engagement solutions. The Wellness Network is the largest network of onsite TV solutions for hospitals. We've got access to over 300,000 TV screens in hospitals, including patient rooms and waiting rooms, and other active parts of the hospital environment.

We're very early on in the journey, we're embedded during the active course of care, and then we have a solution called Direct to Patient Active Education, our messaging solution, which enables us to reach the patient with relevant information post active episode. We’re maintaining that relationship throughout an active episode of care and following it. 

We call that our discovery to recovery platform. We've built the first unified patient experience throughout the entire journey, and it all starts with the ability to reach consumers at scale. And then we're reaching patients at scale through our Krames and our TWN networks. And then again, we're reaching patients at scale with our direct to patient solutions. So, it's all about being able to deliver content, deliver information, and engage patients at scale.


Niko: How are you thinking about tying the patient experience into all of the solutions? 

Ann: We're working to tie this together so the health system, or the hospital, is speaking with one voice to that consumer throughout their entire journey. And we're the only company that can do that. We're the only company that can put the patient at the center and be with them through the entire journey. There're providers who are point solutions for patient acquisition programs or patient education, serving up content free and post-care, but nobody's put together that whole package. Now, to support that though, and to create a truly unified experience for the patient, you need almost hyper-personalization.

You need to know what content, in what format, on what platform, at what time, in what language. There’s a hyper-personalization that's required to really deliver relevant content to the patient that's going to be impactful and influential and feel, frankly, relevant to them. And that’s all backed by massive data sources, which we’re the only company that I know of that's in a position to build.


Niko: Who in those organizations is the one that cares about the communication to the patient across the entire journey?

Ann: Increasingly, health systems are thinking about the patient journey this way. And so, they've put somebody in charge of that. Historically, you've got the head of marketing, the chief marketing officer, that's talking to us about patient acquisition, branding solutions, referral management, we also leverage our massive physician audience on Medscape for referral solutions.

And of course you have your head of clinical that's talking to us about our patient education and patient engagement solutions. That's the CNIO, or the chief nursing officer, or the CMIO-CIO to some degree. They're talking to us about our clinical solutions. Increasingly, health systems are beginning to put those things together and think about the patient experience in totality. Frankly, as most other consumer-facing industries and consumer-facing businesses do, they're putting in place a Chief Experience Officer, or somebody who's really charged with thinking about a unified patient experience, from discovery to recovery. Those are the sorts of folks we're talking to.


Niko: How are patient engagement strategies evolving and where does WebMD and your  suite of products fit into that evolution of how patients are becoming more engaged in their healthcare?

Ann: I'd say that health systems, just to pick up on one comment that you made, are becoming more sophisticated about this because they have to. They're under so much pressure in terms of massive consolidation and whatever sort of regional market they're in. But, they're also under pressure by these new, well-funded, capital backed startups that are creating new health models. They’re beginning to actively compete for patients and actively compete for patients with a digital-first mentality. These startups are starting out without the constraints that a typical health system has with its legacy system, they're starting with a digital-first mentality.

And they're well funded, increasingly public, and under a lot of pressure to grow. They're putting tremendous dollars behind their patient acquisition strategies. Then you've got the really big guys, of course, like CVS, Walmart and Walgreens, and they're saying, "Now, our future is not as a pharmacy, our future is as a patient-care solution," broadly speaking. So hospitals are under siege from a lot of different angles, not just their traditional health system competitor around the corner or down the street. So we've got to help them up their game.


Niko: Is the move towards value-based care at odds with a consumer-focused or a consumer-oriented experience in healthcare?

Ann: In my opinion, there's been two sorts of competing movements about how care was going to be paid for. You've got this value-based care concept, which has maybe made some progress. But what's made a lot of progress is consumer-driven healthcare. In terms of patients being responsible for more dollars, being responsible and accountable for making more decisions, and in charge of more of their money. We see this with HSAs and higher insurance deductibles. That's taken off a lot more, or had a bigger impact to date, than I think the value-based care concept has. Whenever you give consumers more choice, they're going to make decisions based on convenience and where they think they're going to get the best value for the dollar they know they're spending. And where they feel the most cared for in terms of having a good experience. 

Which means good information, it means easy to get an appointment, it means easy to get access to the information they need, it means being easy to pay bills. All of those things factor into how consumers are going to make decisions.


Niko: When you think about needing to complete the picture of your vision of how you want to provide services in this space, how do you think about whether you want to acquire something, or partner with an organization, or build it yourself? 

Ann: Really, there are multiple factors and every deal is unique. I think we've got six thousand employees at this point, probably between three and four thousand of them are developers. So we have tremendous capability around our own product development, our data and analytic capabilities. We can build whatever it is  we need or want to build, or we think is going to be strategic for us. But if something is going get us to market faster or give us a big chunk of a market, meaning a nice installed base, which is clearly what Krames and TWN have brought us, then that saves us time and that saves us money. 

Before I joined WebMD, I ran a company for almost 10 years. I was a partner at a private equity firm for another 10 years before that, all in healthcare. I've seen so many companies develop really great solutions. But they're far too narrow. And with the sale cycle and the complexity of most healthcare institutions, these companies end up stuck in what I call death by pilot. They get a bunch of really small pilots, proof of concept pilots at 100 hospitals, and they never get beyond that. And that's where they die.

Most tech startups get a director of IT to agree to try something out for a few months to see how it works, but scaling beyond that is really hard. Once they get into that pilot mode, it’s hard to get out because there's no reason to end the pilot. There's no reason to scale the pilot. And doing a pilot is easy. They probably only needed one or two people to be their champion in the health system. Meanwhile, the people who really write the big checks probably don't even know they're there. That's why we're so different. Because we help health systems operate at scale. If you can go in, and you can give them a solution that helps them solve a really big problem, and solve a really big problem for them quickly and easily, and at scale, that's a whole different conversation.


Niko: What’s your take on where the industry trends are going regarding enterprise health technology? 

Ann: As healthcare organizations get larger and larger, they need to deal with scale providers. Think about the administrative time and hassle of dealing with a bunch of point solutions. The question you asked earlier about how do you create a unified patient experience if you have a bunch of point solutions when, for example, your orthopedic service line is using one texting platform and your cardiac service line is using another? There's no ability to scale that and get real leverage from those capabilities.

You’ve got to have scale and you've got to have a great data platform that supports all of that and helps you get back to what I was talking about earlier, radical personalization. Really understanding that patient. Not only in terms of their interactions with you, but what their digital footprint looks like. What do they do online? How do they search for care? What are they doing on your hospital website? Putting all of that data together requires a scale solution. Then, if you really want to have an impact in your market and achieve enduring market share gains, you’ve  got to deploy those solutions at scale. Having a bunch of different disconnected point solutions isn't going to get you there.


Niko: Will investors continue to fund startups or look for opportunities to consolidate companies that can scale to meet the needs of healthcare?

Ann: I think it'll be a combination of the two. This is not the first wave of digital health funding with massive dollars flowing into digital health. You know, the late '90s and early 2000s, there was a huge wave of funding by venture capital attracted by the early internet days. There were massive dollars, huge valuations, very frothy, looks a lot like today. Maybe the fundamentals are a little better today, but what happens is, you have massive consolidation that follows and not all those startup companies survive. 

I think we have a few more innings to go in this game. There's a lot of really great things that  companies are working on. Ultimately, we're gonna have to pick some winners. Just like Epic. Epic was founded many, many years before meaningful use and was a tiny, little company for a long time. There were many EMRs that were out there, including a lot of home grown ones that  hospitals built. Eventually, winners come out in big swaths of categories. I think the winners in EMR clinical systems are fairly clear at this point. I think what's still wide open is the marketing stack, and who's gonna win with the CRMs and CDPs and patient engagement solutions and marketing activation solutions. I think that's still wide open. The winners aren’t clear there yet.


Niko: How does partnering with Redox fit into your ecosystem?

Ann: It gets back to that point I was making about radical personalization and reaching the patient where they are. To do that requires a lot of data and it requires integration, across systems and  infrastructure. We need to know a lot about the patient, about how they consume information, their demographics and their clinical history if we're really going to deliver information that's going to have the most impact.

In order to do that, we need to have those sorts of pipes in place. We could do that hospital by hospital, or we could do that at scale with a company like Redox. We're using Redox to go into our health systems and say, "Let us help you build out your digital ecosystem." You need those pipes and data for all of your patient engagement solutions. You can also use it for other things over time but we're gonna help lay that road. Use whatever analogy you want to use around infrastructure. We're gonna help you build out that digital infrastructure because you need it to continue to scale your business.

It gets back to what I said earlier. We care about speed to market and we care about scaling quickly. So anything that helps us do that is attractive to us, whether it's partnering with a company like Redox, or acquiring a company with a strong installed base, or a great content corpus. Whatever it’s going to take to get us to market at scale.


Niko: What keeps you motivated in this space, having been in it for as long as you have, and the experience and all of the stories you've seen? Why do you stay in healthcare?

Ann: The people that work in healthcare are amazing and what brings them to work every day? I'm talking about the clients we serve. What brings them to work every day is so admirable. And if we can continue to make their job easier, if we can continue to help them do their job better, which ultimately serves the patient's best interest, then that's being a force for good in the world.