RamaOnHealthcare August 30, 2022
Delivering Immediate Expert Orthopedic Healthcare
Today, RamaOnHealthcare talks with Dr. Alejandro Badia, who shares with us of his entrepreneurial service to provide patients with immediate expert orthopedic care.
Dr. Alejandro Badia, MD, FACS, FRCSI, OrthoNOW
RamaOnHealthcare (ROH): Welcome, Dr. Badia, to our thought leadership series. Congratulations on your company, OrthoNOW, to disrupt musculoskeletal care by giving patients direct access to a walk-in center with expertise and all imaging and treatment modalities under ONE roof and powered by an award-winning app. Let’s begin with a simple question. What are your company’s mission and game plan, and how are you aiming for success?
Alejandro Badia, MD (AB): Thank you for providing me the opportunity to share! OrthoNOW® offers patients immediate access to expert orthopedic care through a combination of brick-and-mortar specialized centers but also informs us of their intent to visit the center, allow referral, and have access to our subspecialists via our app.
Our mission is to disrupt HOW expert orthopedic healthcare is delivered… NOW. This consists of easy access to high-value specialty care, whether urgent or not, when and where patients need it. Our decade of data shows that 70% of patients seek healthcare because of pain. While not necessarily urgent, this separates us from the current protocols that send the patient to an Urgent Care Center. While often for a more urgent need, Urgent Care Centers are frequently unable to provide a definitive orthopedic diagnosis, let alone the solution.
We aim to grow this nationally and internationally via a branded system that is easily reproducible and can potentially provide a joint venture with clinicians, healthcare systems, and even large employers.
ROH: As per the media and public discourse, the current American healthcare system is complex, confusing, and very costly, soon approaching 20% of US GDP. Please outline how your plan addresses these issues with your company to focus on a major sector of healthcare: Musculoskeletal.
AB: The basic premise that while primary care is a vital component of healthcare delivery, hopefully focusing on disease prevention and close monitoring of patient conditions, the specialist is often better equipped to manage areas whether eyes, skin or bones and joints (Orthopedic).
The specialist will typically order less costly tests since the clinical gestalt is better refined for clinical presentations.
The specialist will typically order less costly tests since the clinical gestalt is better refined for clinical presentations. Eliminating the middleman leads to more rapid diagnoses, timely treatment, and decreased costs. This applies further to the insurance megalopolis, where patients are often forced to be seen in general urgent care settings, emergency rooms, or busy primary care clinicians because of outdated protocols. Seeing the correct specialist at the right time saves money and improves outcomes. OrthoNOW is poised to be that entity in every community.
Seeing the correct specialist at the right time saves money and improves outcomes.
The societal concerns of cost and inefficiency are simply not being adequately addressed. I also discuss this in my book, Healthcare from the Trenches, along with 26 contributors from varying areas of healthcare delivery, including patient testimonials. The difficulties implementing a disruptive solution, such as OrthoNOW and those of other companies, inspired me to write the book, as a clinician and reluctant healthcare entrepreneur, from the trenches.
The societal concerns of cost and inefficiency are simply not being adequately addressed.
ROH: The pandemic led the public to adopt new ways to access care and consider new, non-hospital-based solutions to healthcare delivery. How did OrthoNOW fare during this challenging period?
AB: OrthoNOW decided to encourage more of our community to adopt our telemedicine platform that was present for some years prior to Covid. While our flagship Miami Center largely remained open due to needs for imaging, casting, and handling true emergencies, we depended on our digital health solution to give patients access while not leaving the safety of their homes. We charged a nominal fee of $25 for an orthopedic-focused telemedicine appointment because we felt a free service might paradoxically not receive the engagement we hoped. The public responded, and today we do a fair number of tele-appointments as the public both embraced Zoom, and the Miami traffic became horrendous. The convenient, nearly immediate access to an orthopedic clinician is a truly novel approach to care that has amplified since the pandemic days. Two years later, schools, fitness centers, and many employers are using OrthoNOW as their first stop for musculoskeletal care, not the 2nd or 3rd step as we saw previously.
ROH: The current trend is shifting control from provider and payer to employer and consumers. How do you see OrthoNOW participating and contributing to that shift?
AB: The consumer has realized the need to research options as traditional mechanisms proved to be costly, inefficient, or simply not allowed due to restrictions. The practice of a payor trying to “practice medicine” has led to poor and wasteful decision-making. Consequently, the employer is getting involved in the employee’s healthcare decisions which can include suggesting where to seek care or perhaps incentivizing the employee to follow a particular pathway.
OrthoNOW is participating in this by offering a streamlined approach to assessing and managing pain or acute injury. The latter is particularly important in the worker’s compensation sector, where notoriously, patients, and employers, are given little choice where to access orthopedic care, which represents 93% of work comp claims nationally. Our model disrupts this by giving both employer and employee immediate access to our clinicians. The need, know-how, and talent are all in place, and our ability to grow as fast as the demand is the only limiting factor. Additionally, musculoskeletal care via a “well-being” program is also available to allow staff to keep healthy and avoid injury with many downstream benefits.
ROH: Where do you foresee the most significant potential of AI and Digital Health within healthcare in the future? Please provide a brief example.
AB: I believe we are already seeing the benefits of Digital Health across many sectors of healthcare, and our app, OrthoNOW, is making it easy to remotely access patients who are in pain or suffered acute injury, whether at home, work, or play. Communication between clinicians is also facilitated and is disrupting the incredibly wasteful period between testing and interpretation by the treating clinician. OrthoCHAT™ is a component of the OrthoNOW app and allows the onsite orthopedic clinician to present a case in real-time to the appropriate surgeon subspecialist who might be in their own office, seeing elective patients, or in the operating room scrubbing for their next case. A wide breadth of experts can be instantly connected via a variety of digital health platforms, increasing every day. The real barrier becomes awareness and then adoption. The medical world is notoriously slow at adopting change, and this is a critical component of digital health.
Also, Data continues to increase exponentially, and only AI can manage that volume of information. We will soon see diagnostic algorithms will increase accuracy, leading to treatment protocols that will be increasingly automated. All our clinical information, including our genome information, will be easily accessible and will help determine treatment protocols, drug efficacies, and interactions, as well as early detection of a broad range of ailments. Clinicians will need to work WITH this trend rather than fighting it.
ROH: Where are some of the biggest challenges in healthcare today in need of innovation and/or disruption?
AB: I firmly believe the most needed disruption is in HOW we access and deliver care. The medical and technological advances continue at breakneck speed. However, what good are scientific advances if we allow bureaucracy and barriers to hold up progress, including individual care plans? We can start by replacing the dreaded word “Authorization” with oversight- where a highly vetted clinician can practice medicine unencumbered, without barriers and hurdles every step of the way. We do need to watch for any outliers, but most clinicians are doing the right thing for their patients, and an adjustor or insurance executive only causes delay and cost increases.
I firmly believe the most needed disruption is in HOW we access and deliver care.
Perhaps a more radical approach is to gradually transform the insurance industry into a non-profit model. While there will be major initial pushback, I see no reason why the insurance C-suite should not be rewarded for creating cost-efficient models coupled with superb clinical outcomes. However, they should not be answering to Wall Street or investors but rather re-injecting profits to improve healthcare delivery. It will create a positive vicious cycle that will improve US healthcare markers while driving down costs. OrthoNOW looks forward to contributing in its own humble way to these lofty but needed goals.
I want to emphasize I will always prefer my role as a hand and upper limb surgeon but feel clinicians NEED to be involved in forging progress where we are the bigger part of healthcare decision-making.
ROH: Where do you see the market for self-insured employers headed in the coming five years?
AB: If you go back a year, the penetration of telehealth was 3 to 5 percent. In three months, we saw penetration go to almost 100 percent, and I think it will settle in between 30 to 50 percent. We saw similar gains in virtual physical therapy and more. To innovate quickly, you must offer what health consumers want. I believe we will see a dramatic change where consumer digital health will eventually just become health care and include a mix of digital and hands-on, in-person care. And no navigators at high costs, but just a system that’s easy enough for anyone to use.
About Dr. Alejandro Badia
Dr. Alejandro Badia is a Hand and Upper Limb Orthopedic Surgeon and creator and founder of the Badia Hand to Shoulder Center in the heart of Doral, Florida. OrthoNOW was inaugurated in 2010, offers a licensing program, and is actively engaging healthcare entrepreneurs and surgeons for national expansion. He is also the author of Healthcare from the Trenches.