Dr. Omar Manejwala From Dario | Supporting Behavior Change Between Visits To Improve Health Outcomes

Christine: [00:00:00] Welcome back to another episode of the HR Scoop. I’m Christine Muldoon, your host, and my guest is Dr. Omar, the Chief Medical Officer for Dario. And today we’re diving into the role of comprehensive support and how it plays an important connection in health needs to long-term success by helping people build healthier behaviors.

If you ever have cared for someone managing one or more chronic conditions, then you know it’s not just about the doctor’s visits, it’s the day-to-day support in between that often becomes the biggest challenge. Omar is one of the world’s leading experts on behavior change, focusing on behavior change, specifically in chronic disease.

As Chief Medical Officer at darrio, Dr. Omar is responsible for clinical solutions and provides visible external and internal leadership. [00:01:00] In his role, he focuses heavily on the clinical aspects, conducting clinical research, vetting partnerships, and setting the clinical product and sales strategies to drive both clinical and financial outcomes.

He has an MBA from the University of Virginia’s Darden School of Business, an MD from the University of Maryland School of Medicine, and served as Executive chief resident in psychiatry at Duke University. Dr. Omar is a distinguished fellow of the American Psychiatric Association, is a fellow of the American Society of Addiction Medicine and is board certified in psychiatry, addiction, medicine and medical management.

He is also the recipient of numerous awards and the author of several publications, including the bestselling book. Craving why we can’t seem to get enough. Wow. Dr. Omar, welcome to the HR [00:02:00] Scoop.

Omar: It’s great to be on the podcast with you, Christine, and I will say this next time, I promise we’ve gotta cut that introduction by like 80% so we can get to the meat of it.

Christine: No, it’s fantastic. You have quite a background and I think very relevant to the conversation we’re gonna have today and what our audience would certainly be interested in. So we have so much to cover and so I wanna dive right in.

Omar: Sure

Christine: Care without Proximity. This is a strategic initiative by Dario aimed at managing chronic conditions by providing continuous behavior driven support in the moments between clinical appointments.

Sounds really interesting. Can you explain what that means and why benefit leaders should care about this?

Omar: Yeah. So what, what really are removing these, these blind spots between, between care? So, um. You know, we’ve noted for a long time, we’ve noticed that employers are [00:03:00] really, um, you know, spending most of their dollars on decisions that happen outside the clinical setting.

Not in it, you know, as a doctor spent many years, um, offering suggestions, guidance, listening, working with people to try to help them change the things they do, not inside the room, but outside the clinical setting. Um. And, and most, most benefit strategies seem to be built around access. So like eligibility or like what network you go to or visits, but all the stuff that happens outside this, the, the adherence, the behavior change, all the follow through, the hard stuff, if you will.

Um, those are the things that actually drive cost. And all those things happen outside the visit. And so when that outside the visit period doesn’t have any kind of support or management, then the outcomes drift. Uh, the costs really compound. So at Dario, this initiative we’re talking about the product.

The way, the way that we’ve evolved the product is really built and [00:04:00] designed for that space. The space outside. Of the clinician visit using things like, uh, connected devices and, uh, coaching support that’s offered continuously, um, what we call adaptive personalization or personalization that is really tuned to your unique characteristics and interests.

Um. We use all of that to influence the decisions you make every day to support you so that when it’s super hard, like you’re, maybe you’re sitting on the couch and you’re watching Netflix and it autoplays to the next episode, you know, how can, what is the level of support you can get to, you know, get up and go for a walk or make a different decision when you’re in the grocery store?

All the different. Times when, um, choices impact health and impact, deterioration of health and, and impact costs. So the reason that it matters, to distill all that down, the reason that it matters is super simple. If you’re not managing what happens between visits, then, you know, I would say, and we would say at Dario that you’re not managing the cost of care.

You’re not doing it. [00:05:00]

Christine: So it’s kind of like that idea that when we go to see our physician, we say, oh yeah, I’m doing it all. I’m doing all the things you told me to do. But then when we go home, those things between visits, maybe we forget or maybe we’re not doing as well as we should be doing. So is that kind of like.

Same idea.

Omar: And I would say if we’re honest, I could tell you if I, if I were honest in my doctor, I try to be honest in my doctor’s office, it would be, I’m not doing all the things that you’ve asked me to do and it’s super hard to do all the things because, you know, maybe I cook and my family wants to eat.

Differently, or it’s super hard to, maybe it’s separate situation, it’s shoot super hard to shop for one. Or, you know, cravings hit at all different hours, or I’m under a lot of stress, I’m not sleeping well. Uh, all the things that get in the way of habit formation. Um, and so if we’re honest with our doctors, then it’s like it’s, I’m not able to do the things that you’re asking me to do.

Mm-hmm. It’s super hard. I need [00:06:00] support and I don’t know where to get it. That that’s if we’re able to see it. And then a lot of times it doesn’t even reach that point because, you know, doctor’s visits are super short. Yes. Um, often they’re highly, um, over-engineered. And it can be, it can be really. ’cause there’s lots of requirements and so yeah, getting, getting the stuff that matters is super hard.

That’s how I would say it. Yeah.

Christine: Okay. Makes sense. Yeah. So let’s talk about Omar’s personal aha moment as I, we, I shared your background. You spent your career studying behavior change. We talked about addiction medicine to chronic disease. Mm-hmm. So was there a specific moment or maybe a patient story that made you realize the biggest risk to outcomes wasn’t necessarily happening inside a clinic or a doctor’s office?

Omar: There was a moment, um, when I was treating addiction where, because in addiction medicine, the highest risk moment isn’t during treatment. It’s, it’s after discharge and, um. [00:07:00] I can think of many, many cases, but one, that, one that comes to mind is someone that was doing really well. Um, and, and then goes home to the, to the quote unquote real world.

And, um, someone had, someone had spilled talcum powder on a mirrored coffee table, and it looked like cocaine. And that person basically, the, the trigger was just too powerful. Um, and that person ended up relapsing and, and, um. All sorts of negative consequences after that. And I, it, it, it did sort of wake me up to this idea that you can do everything right in the clinic or in the rehab or in whatever setting you’re in.

Um, but people’s lives are not lived in clinics. They’re lived in the world and, you know, what kind of support could be offered to help somebody outside of there. So, um, environment takes over, you know, and I saw the same pattern in chronic diseases. Uh, I think. Nobody would be against education, right?

We’re all for education. [00:08:00] That’s great. But I don’t think the primary problem is that the person who is struggling with diabetes doesn’t know whether or not to eat pie. Right? I think we all know, generally speaking, I mean, there’s some nuance and there’s some tuning, but generally we, we have a sense or we can quickly get a sense of the ways that, uh, we eat that would be maybe better than the way that we’re currently eating for our own personal health goals.

Um. It’s more a, so it’s less a question of education. It’s not, not a question of education, but it’s less a question of education. It’s more a question of how do I adjust my habits? How do I form habits that support my own goals? Um, so the clinical encounter becomes a real small fracture of the journey.

Um, and most of the systems are built around the clinical encounter. Um, so for me, the aha moment was really more of a series of moments where I’ve. Began to become aware that not only is the primary problem outside the doctor’s visit, but the entire system is sort of engineered [00:09:00] around the doctor’s visit and not around life outside the doctor’s visit, which is why the entire structure of how we reimburse care, how we deliver all that stuff is really narrowly focused on something that is surely important, but is not the most important thing.

Christine: So you talk about this idea of. When you’re outside the clinic visit or the clinician’s visit, the environment takes over. And so we actually need tools or resources or techniques or habits when we go home and we’re in these situations. Yeah. And we need And that, yeah. Go ahead.

Omar: Yeah, I was, I was just gonna say, and, and we need, like, it’s one thing to say we need habits of, and of course we do, but a lot of us don’t really know how habits get formed.

What makes them easier? What makes them harder? What tends to undermine success? And there are natural. I’ll just put it like natural features of the way we think of the way we look at the world, of the way we make [00:10:00] decisions that interfere with our ability to form habits. Our brains are really designed, uh, in such a way that we sometimes sacrifice, um, reality for edi.

Um, and so because that’s how our brains process information, um, and make decisions, a lot of times the natural way that we engage the world actually makes it harder for us to form habits. So even just a little bit of support or education guidance or prac. Around the kinds of things that make habits easier, like smart goals and breaking off smaller chunks and adjusting your environment to support you and telling others about it, uh, about the goals that you’re setting.

I’ll give you a very small example. There’s a lot of research that shows that people will change when they believe they’re being observed. By someone who cares about them.

Christine: Mm-hmm.

Omar: So when we think about a habit, like let’s say I wanna do a habit where I’m exercising more, um, is someone observing me? Is someone I love, like checking in, uh, or someone who I know [00:11:00] cares about me.

Um, checking in and, and, and sort of seeing how I’m doing and, and, uh, paying attention to that. And so those are just, that’s just one of many examples of how we can alter our environment to make the habit more likely to stick.

Christine: That’s great. Yeah. So I think that leads into, um, this concept that you’ve talked about, which is what happens on a Tuesday night, three weeks after a visit when motivation dips and routines might break down.

So what’s going on in someone’s brain at that particular moment and what, what role does an employer play and what they can do about that?

Omar: Right. And I think that’s, that is the question because it’s in those moments that, and, and this is the connection I wanna make, it’s in those moments. It’s, it’s a series of those moments that determine whether that person’s gonna end up in the er, whether they’re gonna end up hospitalized, whether their blood sugar’s gonna be, or blood pressure is gonna be outta control.

It’s [00:12:00] in those moments built up. Where the ultimate, um, deterioration of health, uh, ends up, um, being built. It’s built in those moments. So, you know, three weeks after a visit, the care plan that’s logged in the, in the doctor’s office, um, hasn’t changed, but the person has changed motivation has dropped side effects, maybe show up.

Life starts to take over. There’s stress, um, uh, there’s unexpected, you know, the unexpected, let’s just call ’em like the vicissitudes of life or whatever. So that’s when adherence ends up breaking. And most programs that are out there are not really structured to, to predict. Or respond to that moment, they sort of activate it, diagnosis, then they step back and they measure activity.

Um, but what works in real time is to identify and respond to risks. So at Daria, when we see signals, so people are, are [00:13:00] engaging often on a, a daily basis. If they need that, sometimes even more often, um, there’s data coming from signals from the devices. Um, and you know, when we see like an out of range reading or something trending in the wrong direction, then the system adapts and responds and maybe sends a message or some supportive area or tool.

The way we’ve designed the flow and the North Star for product at Dario is that what matters to people. Is generally far more important than what’s the matter with people? So like what’s important to you, what’s relevant in your life? And by paying attention to that, we can drive better engagement over time.

And look, it won’t always be perfect, like sometimes the decision will still happen, but in the aggregate, if you’re influencing and supporting these moments between care, and most importantly, if the person who’s participating believes, Hey, this is helping me, this is a supportive thing. This is affecting the things that are relevant in my life that are important to [00:14:00] me.

Uh, those ki, that kind of support can really make a difference in those moments between care, so personalization and really provi and predicting risk and responding to risk, which can’t, you know, I know it sounds like a broken record, but it can never happen in the doctor’s office. It has to happen to the world.

In fact, everybody who’s in the doctor’s office, myself included for many years, knows that it has to happen out there.

Christine: Well, I like that you said the word personalization, because that’s sort of what came to mind when you were talking about this is I could know that I, I have to manage my diabetes, but also there are things that are important to me, what I want to focus on, and we’ve kind of, kind of create that balance between the two things.

So you talk a lot about, um, digital health tools that may push or focus on high enrollment numbers and things like. Um, app logins, let’s say. Sure. But for HR leaders, we, we have to sort of define the difference between [00:15:00] a vendor that’s changing behavior, actually making an impact, right? And then one that’s really just sort of generating, generating the numbers, ah, you know, so and so registered, they, they engaged.

So sort of, how do we talk about those, those two different. Types of reporting, I would say.

Omar: Yeah. The, uh, and I think this brings up like an elephant in the room kind of moment because, um, when digital health came on the scene, um, I, I, my belief, and I’ve heard this from a lot of buyers, a lot of HR leaders and others, in fact I’ve, I’ve heard this over and over again.

Um, that, uh, you know, there was a kind of a poisoning of the, well because people were billing on, I mean, we had. One very famous case, without naming any names, where a vendor was billing basically in six month increments on any engagement. So if somebody did anything like opened an email, they would get six month they were engaged and it was a [00:16:00] six month billing block.

So that means you could have D And this is real, like I, I actually signed up for this service just to see if it was real and um. What could happen is you could basically check an email twice. You could have diabetes, check an email twice and be billed for a year of service from this vendor. And there was a lot of that, not, not that was the most egregious example I found.

Um, but there were many sort of adjacencies to that, which I would describe as a kind of engagement theater or performative engagement. Um, where, and all of that was, you know, basically poison the wells. So now, um. Employers and others have become much more savvy in asking the right questions, which they should have.

Um, but it also puts digital health vendors on a lot of scrutiny, which we need to be under. Um, and it creates a deep skepticism as well because of that poisoning of the well. But what we’ve seen in evolution over, I would say like five to maybe seven years, so post [00:17:00] pandemic is we’ve seen an evolution from.

Employers who are buying in some ways more like health plans with more economic, more rigid analysis and of economic outcomes and more demand for proof. And that’s a good thing. Um, because, you know, the, the dollars were, I hate to say it, but they were wasted at many times on this type of, of, um. Poisoning of a well.

So the, basically, at the end of the day, there’s three things that matter, right? The first is, does your intervention show up in claims? Like is there a reduction in utilization? Is there a reduction in cost? And how can I be confident of that? How do I know that? Uh, in the case of Drio, and there are others that are doing this well, but in the case of dio, we’ve published data.

Others have published data studying drio outcomes, third parties, um, showing over $5,000 in savings. This is very rigid difference in difference design, uh, matched pair kinds of studies. Very [00:18:00] rigorous against treatment as usual. Great outcomes that were done by third parties, not done by Dario. Um, I was not an author on those.

We weren’t authors. We didn’t even pay for them. They were just done third party. Um, the second are, um, do your outcomes, um, occur in the right time horizon? Because it turns out people don’t wanna save money. They wanna save their money, and they wanna save their money quickly. So if you can’t save, if you can’t produce savings in year.

Then it’s gonna be very hard for, for you to have an impact. And then the third is, you know, is this engagement real and sustained? Like are people actually active? Are they doing something active, not just opening an email? Or are they checking their blood sugar? Are they checking their weight? Are they talking to a coach?

Are they. Doing something for quote unquote real engagement. And employers have learned to ask these questions because they have been burned. Um, but at the end of the day, if, if engagement isn’t tied to outcomes, then it’s just reporting it’s theater and we’re just gonna have more waste. We can’t do that anymore.

The whole, the whole system is, [00:19:00] is breaking. Uh, we have to fix that problem.

Christine: We probably could have a whole conversation on those three elements alone. Uh, but I wanna move on because I feel like. This wouldn’t be a proper conversation around behavior change if we didn’t talk about the GLP one. Oh yeah.

Probably the question that everybody is asking. So we know that GLP ones are dominating probably every conversation when it relates to behavior change, employers, healthcare costs. It is the hot question right now, or hot topic. So. When we think about people that are going on GLP ones, um, you know, many of them may be not, may not be able to sustain staying on those GLP ones for a number of reasons.

So

Omar: right

Christine: happens to an employee who stops taking it and then kind of linking it back to how does that [00:20:00] care without proximity approach actually change that outcome.

Omar: Yeah. An interesting, I, I’m gonna answer this question. I also want your audience to consider an interesting thought experiment for another day.

Okay. But just think about this. How would your view of GLP ones change if they cost $1?

Christine: Hmm.

Omar: Would you think about them differently? Would you use them differently? So that’s just a thought experiment, but, but to answer your question specifically, um, the issue with GLP is not starting the GP. It’s kinda like what happens afterwards.

So there’s several large studies, very large PBM studies. Um. That show that most people who initiate these discontinue within a year. Now there’s many reasons for that. It could be coverage side effects. It’s hard to take medicines on a weekly basis. It’s actually easier to take medicines on a daily basis because of habit and behavior and all sorts of things.

Um, but without that kind of support, you know, the outcomes will reverse. The cost remain. If you think about this, it’s the worst case scenario is the auto delivery of GLP [00:21:00] ones to the. Employee’s home, it goes in the refrigerator drawer, it doesn’t get used. It’s accumulating in the fridge, and the costs are accumulating and the person is, it’s not even entering the body.

Or you’ve got someone who uses it for a period of time and then, uh, stops using it. And you’ve spent whatever, let’s say, you know, a couple thousand dollars on an experiment that didn’t produce any long-term results. So. It’s important to really understand providing the support, whether you’re taking the GLP ones or even afterwards.

So, you know, in a structured program like ours, uh, people who discontinue GLP ones were able to maintain their weight and glycemic outcomes six months, uh, afterwards without ongoing drug spend. So we presented those data and that turns GLP ones from a permanent cost center for some people. For some people into a phase of care, but that only works if there’s support after discontinuation.

Otherwise it’s just a cliff. And so this whole idea is people are different. Some people will need to take these meds forever. We, we probably know [00:22:00] that now at this point, enough has come out about that. Um, some will want to stop. Uh, and the question is how do we support everybody so that the investments are efficient and produce improved outcomes?

Clinical outcomes and improved financial outcomes, and that requires special support. Um, and the truth is, most of the people receiving GLP ones are not getting that support.

Christine: Who’s responsible for providing that special support?

Omar: Exactly. Uh, I would say like, it’s like anything else. You know, if I buy a car, I am responsible for the maintenance.

So if I’m paying for the GLP ones and I want to get the most out of that investment, um, then I should be doing the things that maximize that investment. So providing that kind of support. Now that’s a, it’s a complicated decision, but at the end of the day, it’s the person who’s at risk. Uh, who basically needs to be responsible and the entity that’s at risk.

So if you, you know, think about the alternative. The alternative. If you don’t provide [00:23:00] this kind of support, but you do provide coverage of GLP ones, then what you’re really doing is, um, burning money and clinical outcomes, is the way I would look at it. Yeah.

Christine: Interesting.

Omar: Yeah.

Christine: Yeah, that’s probably another conversation that we could just have a whole podcast.

Omar: Let’s have it. I I, I, I would love to talk to you again. Yeah, that’s great.

Christine: There’s a lot of things with GLP ones, so Yeah,

Omar: for sure. For sure. Um,

Christine: I won’t go there anyhow.

Omar: Not today. Not today.

Christine: We talked about you are a. Certified psychiatrists and addiction, medi medicine, um, specialists. So I wanna tie in the mental aspects to physical health and kind of thinking about this in between stage as well.

So if we think about this, how does mental health and chronic conditions, and you could pick any chronic condition, diabetes, whatever it may be, interact between visits, and then why do, why do most benefit [00:24:00] designs? Really treat them as completely separate problems when we know that they are very tightly connected.

Omar: Yeah. And this could be also its own podcast, so I’ll, I’ll keep it kind of short, but this is our fault. This is the fault of medicine. Um, and, and, and, you know, the payers and everything will, it’s, it’s, we created this problem because there really isn’t a difference. You know, me, mental health is health.

Physical health is health. I mean, if there’s not really a. Fundamental difference here. We created that difference, you know, in the, in the seventies when we had had people start to flip over their card for mental health and we started covering it differently and we started thinking about this dental mental problem, which was sort of a fake problem with this idea of like, Hey, if, if we provide coverage for these things, then it’ll break the bank because everyone will go get it.

Then we started to provide the coverage and we found no people were not getting the mental health care they needed and that was actually a, just a false. Um, assumption about this. And we built parallel non interacting, uh, architected [00:25:00] systems that manage p and l for mental different than physical and look at these things differently.

And so then in a lot of health plans for many years, the incentives inside were structured such that. People, uh, there was no incentive to reduce the, uh, to, to provide mental healthcare, to reduce the physical healthcare because there were separate p and l leaders and only if you went above the bifurcation could you make an argument.

So we built it parallel. Then we, then we delivered it parallel with, you know, mental health clinics separate from physical. We, we built this fragmentation into the system and now we’re paying the cost associated with it. But they’re not separate problems. They really show up in the same moment. Stress affects blood glucose.

Just to use your example, sleep affects. Blood pressure, depression effects, adherence to treatments for chronic disease. It’s all massively interconnected. It’s not even interconnected. It’s the same thing.

Christine: Yes.

Omar: Yeah. Uh, and so, but benefit design, your, your question is a really good one. ’cause benefit design does separate them into di different vendors, but I don’t blame benefit design.

Benefit design is reflecting, um, the entire system of care, which has fragmented, [00:26:00] nobody gets to see the full picture in that case. Um, so at Dario we made a different decision. We said we’re, we’re just gonna ignore that distinction. Entirely and connect the system signals within one system so that when behavior or risk shifts, the response should reflect the full context, not just one condition.

So that’s how you influence outcomes in real life, not just in, in theory, you, you have to really understand them, not even as related, but as essentially the same thing. Physical health and mental health. Mental health is health and, and to look at it in that very plain way to understand any more than like depression affects blood sugar and eating habits affect blood sugar.

They both do. They both require intervention. It’s all for factors that just simply should be in an intermixed list of things that affect your blood sugar that should be addressed not as a separate category, if you will.

Christine: Uh, I could not agree more with what you’ve said. Mental health is health. [00:27:00] Um, we, we sort of tell this story at Web Dy Health Services that, uh, life isn’t one dimensional.

Wellbeing can’t be one dimensional either. And, um, when one dimension is impacted. Physical, mental, social, financial, you name it, it absolutely has a ripple effect on the others. And we have so many, um, individual participant testimonials that talk about, you know, I was doing all the right things. I was exercising every day.

But when you look at what that person was eating and then not having enough sleep, yes, and it was having a huge impact on their blood pressure. So you have to look at someone holistically. And to your point, um, we did design the system this way and it is, is broken in that respect. And I always say that if there is one, possibly, very possibly good thing that came out of the [00:28:00] pandemic, it’s really bringing mental health to the forefront because that is, now we’re talking about it and now we are probably even from an employer perspective, realizing how related.

Mental health. Mental health is health, as you said.

Omar: Yeah, and awareness is the first step. My, my cons, and I agree with you. That is, you know, that’s the silver lining, if you will. Um, at the same time, you know, we’re still managing it largely with like different vendors. So even if you have a front door, and even if you connect these things digitally, and if you integrate at the technical layer, the probability that you’re really integrating these in a whole health way at the clinical layer, it’s almost zero.

Anybody will tell you that. So like the, the vendor that’s managing the blood pressure does not really know what’s going on with the vendor that’s managing the depression or anxiety. But if that, if those insights were actually not just shared, not just data, but the intelligence were both shared and used.

Mm-hmm. Which even if they’re shared, they’re not gonna be used, um, then we could really make a difference. So the awareness is super important, [00:29:00] but we’re still seeing that most people aren’t managing it in a whole health way. Yeah.

Christine: Sure. Um, I think that’s a little bit of the role that our health coaches provide, but, um, it, it, you know, it is, it is a good reminder that you really have to go behind, go beyond just, uh, digital integration and really supporting that individual and all the things.

That’s right.

Omar: And that’s what’s different, I think about the, the WebMD approach. Yeah. I, I do think that’s the case. Absolutely. Yeah.

Christine: So, um. Let’s talk about from the employer perspective. Uh, we know that. Usually one of the biggest hurdles to either bringing in a new program or changing a program is of course making the case to who?

The CFO. Yes. So, um, you know, hr, I would say HR benefits leaders, they, they truly understand and get the concept, but then when they have to justify it financially, uh, that becomes probably one of the, the [00:30:00] big challenges. And so, is there a. A data point or a story that you suggest that, you know, these leaders bring to their CFO to truly make the case about specifically investing in, I guess, what happens between visits and bends, the cost curve?

Omar: Yes. So that’s a great question and I’ll just start with a very brief story, which is I’ve talked to hundreds of CFOs over the years, right? And, uh, but my, I, but one conversation stands out as my absolute favorite. I was in the room, we were having lunch. This was the CFO of a, one of the largest regional health plans in America.

Okay. Health Plan CFO. And he said to me, and this was, I was with a previous company, and he said to me, Omar, I can’t afford to save any more money. And I thought, what an interesting thing to say. And when I dug into it, what he was saying is that all these vendors were promising savings for which this health plan had to expend [00:31:00] costs to do.

And everybody wanted to take credit for the same reductions. And if everybody’s taking credit and the savings may or may not be real, it was gonna, you know, bankrupted, you can’t afford to save any more money. And so the case to the CFO is really a. Cost control conversation. It’s not an engagement con.

It’s a question of are we reducing avoidable in year spending? That’s it. The strongest proof will always come from claims reduction in hospitalizations, ER visits, total cost of care, and it will always be subject to the problem of, just to put it in plain language, would these costs have come down anyway or did the intervention do it?

In other words, was there a causal effect? Like we all talk about correlation, not causation. Um, and so how do you get to that? How do you structure studies? So you have to remove bias. So one of the biggest biases is that companies study themselves. And they publish their own. We do that, right? But it’s super important to have somebody else independent look at [00:32:00] it.

And that’s one way to get to it. Another way to get to it is to make sure you’ve structured your study in the right way. Are there controls? Is there matched pair? Are you using, uh, techniques that help to address the types of biases that exist, um, in, in cost types of studies. And so at Dara, we’ve done that.

Um. And so the, the primary angle is around reducing that kind of avoidable utilization that I described. There’s also a pharmacy angle, um, because if people can maintain outcomes after, just like we were talking about after coming off GLP once, then there’s a savings opportunity there too for one of the fastest growing cost categories.

Um, and then the third area where I would say you could make the case to the CFO is, um, you know, there’s costs associated with managing multiple vendors and simplifying that down and replacing multiple point solutions with a, a unique kind of, uh, engagement point. Then the financial case becomes a lot more straightforward when there’s curation, if you will, of these kinds of [00:33:00] solutions, which I think is what you guys do super well.

Christine: That’s right. Thanks. So let’s talk a little bit more about what employers actually might get wrong about digital health vendors. Um, so if you could wave a magic wand and fix probably one misconception that employers have about their digital health investments. What would it be?

Omar: Yeah. Okay. So, um, it’s hard, it’s hard to distill to one, but I will.

Um, and I would say, um, it really comes down to accountability, right? If, if, um, if digital health solutions came with a black box warning, that black box warning would likely say, caution, you are not likely to use this product. Because many of the things out there work really well on paper, but nobody uses them.

So often what happens is that a lot of employers and, and these vendors will pre present kind [00:34:00] of like just enrollment data or flashy like theater, as I said, performative kind of data. Um. Back to the employers and, and then the employers may assume, Hey, people are actually using these things. Um, so I would say the, the one thing that they get wrong maybe is, is not realizing that the real challenge is getting people to engage and use things.

Um, and so I would say insist on that if you’re out there and insist on reporting that shows that it’s happening. Hold vendors accountable for that. And, and then, you know, there’s gonna be winners and losers. And I believe that’s, that’s how innovation occurs. And, and the best solution should stay standing and the others should fold or, or move in or, or be acquired for technology.

Um, but we shouldn’t be scaling things that are broken.

Christine: And I’ll just add to that because obviously, uh, as WebMD Health Services, we have been. Solely focused on wellbeing for over 25 years. Yes. And [00:35:00] what we see is, of course, we have a, a set of best practices. So, you know, adding to what you’re talking about, it certainly means that you have to do a little work on your end too.

Right? So you have to focus on. Communicating and communicating often. Yes. And thinking about reaching each person no matter where they are. And that also means if you have field workers, maybe mobile access versus desktop, things like that. And then there’s also understanding. Do you have a culture of wellbeing?

Is it foundational? Yes. In wellbeing? Um, does your leadership support it? Do you provide the opportunity to, for employees to focus on wellbeing during the workday? And there’s so many elements and, and we look at it a little bit more like you also have to be committed for the long haul. Um, we do have, you know, 89% of our clients see changes in health risks.

That’s important. Huge. We have clients that [00:36:00] see a return on their investment. So, um, you have to think big picture about what you’re looking to achieve when it comes to any of these types of programs and very much to your point, um, you know, accountability, engagement, those are all pretty, I would say, foundational and essential to, um, having that magic wand and, and making sure that, you know, you are getting the most out of your digital health investment.

Omar: I’m glad. What I’m glad about what you said about, and I agree, those are things that WebMD does like. It’s known, you guys are known for doing those things well, and especially, I like what you said about a culture of wellbeing because I think at the end of the day, there will always be bumps in the road.

There’ll always be data elements and, and insights that don’t seem quite right. And, and it’s easy to abandon ship at that moment or to ask why and to tune and adjust and, and the energy to ask why or to tune, or to adjust or to get it right comes from culture. It comes from a long-term commitment.

Christine: So we have covered.[00:37:00]

So much today, Dr. Omar. They have, and

Omar: we have,

Christine: and because it is a Monday morning,

Omar: yes.

Christine: Uh, one thing to do on a Monday morning. So for the HR leader, the benefits leader that is maybe listening to this particular episode on their commute, uh, maybe they’re feeling a little overwhelmed by everything that we shared.

So what would be one practical thing that you would say they could do this week to start closing that blind spot between visits?

Omar: Yeah. I would say, look at my entire list of, of vendors and, and with each one ask myself the question, how do I know based on what they’re telling me? And show me how do I know that the people they’re serving are changing, are doing something different between the visits?

How do I know. Where can I see those data and what’s the proof that there’s actually changes that are occurring? If no one can [00:38:00] answer that question clearly, then you, you should be asking yourself, is this the right partner? I, I really think it comes down to, do I get to see what’s happening?

Christine: Fantastic.

Omar: Yeah.

Christine: And then of course I’m gonna go back to how would you v view a GLP one if it costs $1? Think about that too.

Omar: Exactly.

Christine: Okay. Well this has been a fantastic conversation. I do, however, have one more question for you, Dr. Omar, and Okay, this is a question I ask all guests, so no right or wrong answer. But what’s one small shift, Omar, that you personally or professionally have taken that has made the biggest difference in your own personal wellbeing?

Omar: Yeah. And you, yeah. These are hard questions and you asked me to distill the one, there’s so many, but, but in the interest of time, uh, I would say the one thing would be, um, you know, as I go through my day, [00:39:00] I try to ask myself did and everyone who interacted with me was their day better because they bumped into Omar Monal.

Like, was it just a little bit like 2% better? Was it a smile? Was it a helpful thing? Compliment, whatever, but like, how can I live my life such that every single person I interact with is like just a little bit better because of the fact that they bumped into me and I have, and I’m, by the way, I’m not good at it.

Um, but I have found that the more I do that, the better everything gets. And I, I often wish that more folks did that, and I wish that I did it better.

Christine: Well, I have to say Dr. Omar, that, um, my day is 100% better for having had this conversation with you. You know, I started out a little stressful this morning with computer issues, but I really thank you because this conversation was fantastic.

It was enlightening, and I really enjoyed it. So thank you so much. I did

Omar: too. You’re welcome. I did too, and I’m so grateful for the work [00:40:00] that you and you all do over at WebMD.

Christine: Thank you. Thank you for being my guest today on the HR Scoop, and thanks to everyone for listening to this episode of the HR Scoop.

Have a great day.

 

From “care without proximity” and digital behavior support to the pitfalls of engagement theater in digital health, this conversation highlights why access alone is not enough; and why employers need to think differently about how health support is delivered. 

As chronic conditions are largely managed in the moments between visits, but often without support, organizations may have a greater role to play than they realize. 

“If you’re not managing what happens between visits, you’re not managing the cost of care.” 

This conversation covers: 

• • How behavior changes happen outside the clinical encounter, and why daily support, personalization and habit formation are essential to improving outcomes.
  • What employers should understand ab out GLP-1s, discontinuation support and why medication alone may not sustain long-term outcomes without behavioral support.
  • Why mental health and physical health cannot be treated as separate issues and how integrated, whole-person support may outperform fragmented benefit models.