Using Technology to Improve Health Outcomes

Scheduled for: September 2nd, 2021, 12:00 pm PT / Category: Interviews

How can consumers become empowered patients?

David, a Navy Gulf-war veteran, is a seasoned technologist with more than 22 years of experience. He has participated in two IPOs and delivered more than 10 applications to market in the Salesforce eco-system. Over the last decade, Franklin has focused on cloud computing and machine learning for health care applications.

He has studied at Moody Bible Institute, Penn State, and MIT. His recent venture, knowRX, was formed after losing his father in 2018, due to a medication side-effect. Here, his desire is to help empower patients, improve conversations, health literacy and the quality of life while taking a medication.

Podcast

Transcript

Tullio:

Back to another episode of dojo.live I’m Tullio Siragusa broadcasting from Southern California. Today’s Thursday, September 2nd, 2021. This is the last show of the week and I’m joined by Kim Lantis in Hermosillo, Mexico, and Carlos Ponce, in Cuernavaca, Mexico. Hi guys. Welcome back.

Carlos:

Thank you.

Tullio:

We’ve had a great week. It’s been a lot of fun, fun shows, so let’s, you know, no pressure, David, welcome to the show. We have David Franklin, who’s the founder and CEO of KnowRX Health, and he’s joining us today. We’re talking about, how consumers can become empowered patients. The role technology can play in improving our health, a very important topic, very relevant for today. But before we go into the topic, let’s get to know David  a little bit. If you could please give us a little bit of background about yourself. Please introduce yourself, David. Welcome again.

David:

Yeah, thank you. I appreciate the opportunity of being here today. I’m David Franklin, founder and CEO of KnowRX. I’m based in Austin, Texas. I’ve been here for about 24 years. From a career standpoint before I got into technology… I’ve kind of always been in technology. I’m a U.S. Navy Gulf War veteran, and there I was in communications and from the military, after eight years in the military, I transitioned out and continued basically my technology career, navigated from the east coast back into Texas. I’m originally from St. Louis. I’m the youngest of seven kids. And really work on solution architecting […] was able to participate in a couple IPO’s and then move into consulting and then always had a desire for continuous education. So, my first program was biblical studies, [INAUDIBLE] Bible Institute. Then I went to Penn State for organizational leadership and then machine learning with MIT. And through this conversation, you will see how all of that comes together and the applications and the designs that we are building.

Tullio:

Very interesting. You know, they say that if you decode the Bible, it’s actually a big software code. So a bunch of mathematics. True. That’s what the Kabbalah is all about. Anyways, let’s continue on.

Kim:

Thank you for your service. I have to say there’s so many. I always get this idea of like Forrest Gump. We have so many guests who’ve done so much in their lives and so many different facets, it’s quite impressive. And David you’re now you’re now one of our forest Gump guests and the adventure of your life.

Tullio:

All right. Let’s get to know, KnowRX – pun intended. Tell us what gave birth to this idea and what you guys do.

David:

Yeah, so KnowRX is, is really a combination of or acronyms of two words, knowledge and prescriptions. So, it’s helping consumers, whether they’re on medication or not. So, whether they’re a patient or not understand medication management in the medications they may be on better and how it impacts their body and how they can have a better routine or less impact of that medication, better conversations with their physicians, especially is healthcare transitions into a digital technology. We have to meet the person where they’re at and that’s in the palm of their hands, on their devices. And healthcare has to meet them there without expecting them coming in. And plus we also, what’s very important to us is keeping the patient at the center of the equation. Now, KnowRX was created from a very traumatic experience. I lost my father in 2018 due to a medication induced side effects while he was in an ICU, and I would commute back and forth for six weeks between Austin and Columbia, Missouri. Only to lose my father at 72 when we went in for a lung biopsy and never did make it out. And through that experience I came up with KnowRX – knowledge about prescriptions – not only to help patients but to help physicians, nurses, pharmacists. I understand that I cannot save his life, but what I can do and what I strongly believe is that we can help improve the quality of life with everybody who’s on that patient.

Tullio:

Wow. Well, thank you for sharing that with us. We’re sorry for your loss. And it’s, it’s such an amazing gift when people use such a traumatic situation to create value for everybody else in the world. So let’s dig in and see what we can learn today. Guys. Carlos, please. Let’s kick it off.

Carlos:

Absolutely. Thank you, Tulio. And of course, thanks David for being with us today. So it seems that we’re going to be answering one question today. The question is how can consumers become empowered patients? So, for that, we’re going to be having a conversation with David today around the topic and the topic is going to be using technology to improve health outcomes. So that’s the topic as chosen by our guest today. So let’s start there. David, why did you choose this particular topic and why did you feel it was relevant for today’s day and age? Thank you.

David:

Yeah, you know, it kind of goes back to my father in, in caring for him in his final days after losing him, as his youngest son, I wanted to blame somebody. I was a technologist. I want me to fix something. And the technology’s easy, right? What’s hard is changed management and in personal lives, our discipline, our behaviors to adapt to technology, for example, but is this sudden, you know, I wanted to blame several people. The staff, his caregivers, ourselves being away, not being able to communicate with them or understand if he’s taking this medication or not, the nurses, the pharmacists, you know, there’s a whole line that has a part to play with it, but to empower a patient, what we’re here we’re talking about is being able to give you the opportunity to have better conversations, helping you be, increase your health literacy, having an accountability partner through technology and, and just taking ownership of your health and not being reliant on the system to provide health guidance and instructions to you. So this is how we empower the patient to one through those, those four areas to help identify them to be unique and not a number in a system and have a voice.

Kim:

I love that. Let’s talk about the number of voices now, as I listened to your story and the problem that you’re trying to solve, I can’t help immediately think of, you know, high profile cases. For example, Heath Ledger, I believe was a victim to mixed medications. And maybe it’s not until something like that comes up that the rest of us even think about this risk or the reality of what’s happening. What’s some statistics like, are you familiar …? I’m assuming you’re very familiar with those numbers. Like, how much of a risk is this? And how big is this problem that you and KnowRX are solving?

David:

Well, there’s, there’s a humanistic problem. And then there’s an industry norm from an industry standpoint medication adherence leads to readmissions, which is around a $300 billion a year problem solely within the United States. So, then you look at loss of work, maybe loss of school, loss of productivity, quality of life decreases. So those that’s our big impact there, right? Sometimes it seems like a simple solution to take some medication, but 50% of the people. So you look at the population of the United States, 330 million people, 50% of them do not adhere to their medication schedule on time, but they don’t complete their schedule. 44% of the people don’t even pick up their medications, right? So these are huge problems that we have in adapting in taking the medication as well. Now, in addition to that, we have to look at in 2020, just last year, 4.5 billion prescriptions were filled in in the United States. Now add onto that, that 50% and that 24%. So there’s a lot of medication being dispersed into the public ecosystem.

Carlos:

David, from the, I’d like to ask you a question from the, the let’s call it the user perspective or the layman’s perspective. I would be interested in asking you because you’re in health, a technology – and health-related technology – I would be interesting in what sort of a let’s call it changes or major, if applicable, even pivots you have witnessed in the space after last year. I, this is sort of something that we’ve discussed in other conversations we’ve had with other tech business leaders. So, I’d be interested in your particular take on in your space, how the last year, if applicable, if at all redefined your own journey.

David:

Yeah, it, it has, we’re very fortunate. We started or relaunched in 2019. And 2020 was a pivoting year. A lot of the pivot was around our messaging and how to push forward when healthcare systems and pharmaceutical companies were busy with vaccines and just treating patients. One of the biggest shifts from an industry standpoint was telehealth and being able to give access to patients in their homes remotely and extended care without putting them into an environment which could be worse for them or using those environments for those that really needed it and not more common issues. So telehealth was very big and important part of 2020. And it will continue to be there. There’s some gaps within telehealth because one thing we have to do as patients always to remember even in a tele-health ecosystem is our trusted advisor is a primary care physician who may need to build and establish a long-term relationship with. So even if there’s an inconvenience of driving and going through traffic and going over distances, that primary care physician is very key in our ownership of health, because they’re not different every time we engage with somebody from the healthcare system; we get to establish and build that relationship. And this is why digital health is going to be more concrete […] reestablishing and firming up those relationships that could have disappeared over the pandemic.

Kim:

Certainly. So what rule is KnowRX playing in this? Like, as we come into the show, my immediate association with sort of this checks and balances, the safety net to make sure that I’m not inadvertently harming myself with my medication, but what else do you do? You were mentioning, maybe I’m not even taking it appropriately. I’m not taking it on time. So what do you offer to your users?

David:

Yeah, so we have, what’s called a double-sided market. So, we sell to pharmaceutical, CROs, healthcare providers, on one side. We have a free mobile application for consumers which can be patients on the other side. Now, and this scenario for the patient we increase their health literacy by expanding approved credible information, not only from their primary care physician through institutions and just increase their level of knowledge about health. We digitize the pharmacy label. So a lot of times we take the pharmacy label, we put it in the kitchen drawer, or we dispose of it. There’s valuable information there. So what we do with that information is we digitize it, put it in machine learning algorithms and provide recommendations. ‘Cause here, what’s very important for us is understanding associated side effects that could be attributed to that medication, especially when you have compounded medications, is there a probability of a side effect increasing? So we bring your awareness around that. Then we have accountability, which is very important to us and different than some of our competitors. ‘Cause if I’m sick, I want somebody close to me who knows me that agrees to be my accountability partner, to reach out to me and say, “Hey, David, we noticed you missed your medicine or you missed it consistently. Are you having a side effect? Is something going on? We love you. We want you to be well. Please update the application”. So your positioning pharmacists will know there’s a change in the bathroom, that’s going up. So those are some simple things there. Push notifications of when to take your medicine, take it with food without food, before a meal, after a meal. How do you incorporate medicines when you change time zones, these are important factors. And then just say a performance indicator of showing me how you’re taking it. And then as we grow, we will have a wearables connected the viruses and all that come into the application as well, to give you a 360 view of the uniqueness of your health.

Tullio:

So, I’m curious. So I’m curious as it relates to helping consumers, so you help them with education. Is there a plan to also incorporate like a calendar? ‘Cause I think you mentioned about how to deal with time zone changes, but is there a way to, is there plans to perhaps integrate with, like iOS, or Android and the native calendar? So someone actually has, when they’re supposed to take their medication, the reminders built into it. That’s the first question. And the second is, there, are they plans to work with pharmacy groups where, when someone takes, gets a prescription, it automatically links up to then no, no or X application that gives them the kind of education that’s not in that pamphlet that you could barely read – that’s all-technical jargon – but it’s actually in a language people understand. What’s your thinking in terms of really meeting people where they are simplifying when to take the medication and also the partnerships that are going to be needed to potentially increase awareness and adoption. What are your thoughts there?

David:

From the notification standpoint, right now we just use nudge or push notifications, or you get a pop-up on your phone or say, your watch for example. And then we can look at potentially moving it over into a calendar device, but generally speaking, your watch or your phones near you or on your most of the time. And there’s some fun things we can do there as well. But that’s where the first notifications go and you actually have a complete schedule inside of the application as well of when you’re taking a so that’s one piece is, is we, we do have incentives and rewards in the application. So if you take your medication on time to completion, then what we’re doing from a partnership standpoint is we want to work with pharmaceutical companies or pharmacies. We want to work with payers. So you get a discount on your next prescription. You get a discount into your next healthcare provider visit where you get a discount at a local GM or local health […]  health and food establishment, all of these things are there to accomplish you around really change behavior shift of adopting a healthier lifestyle, a healthier mind, a healthier body, healthier outcomes.

Kim:

Cool. I imagine that accessibility is something that’s you really take to heart, like, with your application. I imagine that most of your users on the, the consumer side, the, the mobile app side maybe are older, maybe they’re visually impaired or even young, like if my child is diabetic or of the sort, and I need to take care of my child. So what are you doing? Like on the usability side or helping your users, you know, with that accessibility?

David:

One area we’re working on for me in [INAUDIBLE] standpoint is like with Alexa my mom, she just turned 80 last week and she has Parkinson’s. And she’s not comfortable with digital phones. She has an old flip phones with big numbers. So the application doesn’t work for her there, but through Alexa, she can, Alexa can notify her to take the medication. And then she speaks back to Alexa, which then updates the application. So when she’s in St. Louis or in her home in St. James, I can see on the application because I’m a caregiver that she’s actually taking her medication. So that’s one way, same thing for somebody younger, or like the child, you can then add in their medication schedule and you monitor that and give that to them, especially when they’re not of an age of accountability where they’re taking it themselves. Now, our, our general target audience really is around 28- to 58-year-olds. And this is the reason because they are digital. And as we age, we will come into that senior population automatically. Now seniors are on more medications, but it’s actually millennials or the younger population who don’t adhere to medication as much as they should

Kim:

Finish your antibiotics, people!

Carlos:

You mentioned tele-health, and we were discussing the … what happened last year and how it affected a lot of tech companies out there. So how did the, was this whole year, the last year that we were touching on, was it the reason why IHI was created individual health insights, or it’s just something that was, you know, went back way, way before that time. And he just, is this the year that just passed or the year that we are experiencing boost the idea or the platform?.

David:

It, it, it actually drew the requirements in sooner than expected because you’re in a tele-health setting, you have what we call objective markers. So a patient takes their own blood pressure, their postdocs monitor their heart rate, which are all counter biomarkers for COVID. Right? You have to look at the pulse-ox, the blood pressure, the heart rate, you have to look at these different things and you can’t do that from a telehealth perspective. So you have devices like we integrate with and those measures will come automatically into the application. So there’s a little bit more credibility to the numbers. And so, it can be extended out to the tele-health physician or to your physician – case in point, some of the, some of the healthcare providers did not have tele-health services, and some of them are still working on that today, so that they’ve leveraged to telehealth really coming into their own category outside of the hospital.

Carlos:

All right. Thank you. Thank you, David. Okay. Back to you guys.

Tullio:

It’s an interesting dilemma, you know, you don’t think about it some sometimes like the, to be more effective at tele-health you got to have some sort of equipment at home, right. To be able to take some measurements to give that feedback. Interesting. So how does it get delivered now? Is it an application? Is it just a note, a push notification? How does someone actually subscribe to KnowRX today. How does that work?

David:

Yeah, so currently, and I don’t think you can see it, but we do have a mobile app. It’s going through security reviews with speed for both Apple and Android. So within the coming weeks the, the first MVP or the first edition will be going live into the marketplace and we’ll be taking more feedback from consumers and patients on how to make adjustments. So, for consumer patients, it is a mobile application. For physicians, pharmacists, they have a secured web portal, and if the patient […] Alexa share information or connect and share information, then they can do that with them because they’re the ones in power. They own it. It’s their information.

Kim:

I’m curious to know your relationship with the pharmaceutical companies. Obviously you’re needing to handle and have access to a large amount of data. So what does that relationship look like? How do you determine which medications are available inside KnowRX?

David:

Okay. That’s a great question. Thank you for asking that. The pharmaceutical side is actually the buyer. So that’s who we sell to. And what we sell to them is how to op optimize their recruitment, how to retain participants is patients inside of a clinical trial and how they do their site selection. So, by having the mobile application, if you don’t know, 76% of patients that they would participate in a clinical trial if the opportunity was given to them. So, we have a wealth of people that are not participating, and we need a robust, diverse, inclusive group of people inside the clinical trials, because the outcome of those trials are medications that are given to all different types of people. So we need a very diverse group of people inside of clinical research opportunities. So, we’re able to send down information questionnaires, surveys to the patient on the mobile application, and they can decide how they want, they can speak to their physician, their trusted provider, and they can look at the opportunities to participate in clinical research which is something we have to do more of.

Tullio:

So, it’s the plan, the plan is to then also connect the user to give feedback. So let’s say someone’s learning about a medication. They just started new blood pressure medication. They get familiar with what they could expect or what they should expect etcetera, right? But maybe as the person takes it, they have some unique circumstances that triggers a different kind of side effect, right? How do they, is it going to eventually enable for the users to share their own experiences? And could that be shared with researchers or pharmaceutical companies in order for them to enhance their R&D and begin to track perhaps things that didn’t come up during the clinical trials or the FDA process, which is hard to believe because most medication takes like a decade to get approved, but still, I’m just curious if it’s also designed to eventually allow the consumer, the users, to interact and provide feedback so that there’s a bilateral cooperation in the learning and the knowledge that’s shared across people’s experiences, that’s something that’s come up or would that be very challenging?

David:

Well, no, that’s one of the things where we’re directly trying to address, we have a platform called the four pillars of therapeutic equity, and in this diagram, you have to have the right data, have to have physicians. You have to have patience and you have to have a close feedback loop, right? We have to get information from in real life, from the patient back into the healthcare providers, hands into the drug research, the manufacturer’s hands now in these scenarios. First, when you put in a side effect or putting any, you know, any symptoms you may be encountering, it will go to your primary care physician. That’s where your relationship is, right? Now, on a larger scale from a data aggregation standpoint, we will have de-identified, so nobody will know who you are, where you are where you live any of your personal PII information, but this data aggregation will be able to be researched on and looked at from that point of view. Now, going back to Kim’s earlier question, all active drugs that are released and approved by the FDA are available in our application, but also what’s important too, is over the counter (OTC) medications. So, Tylenol, Motrin, Advil, etcetera, like this Benadryl, seasonal things, we want you to able to put those in there as well.

Kim:

Wow. So real quick, before we move on to culture, not to talk about biting the hand that feeds you, but is there also an elements to offer users alternatives? Let’s say if I’m having a bad side effect with this medication, maybe this something similar, will be beneficial to me, or even if it comes down to something as simple as cost, how does that come into play?

David:

No, thank you. So, what we do this, this is kind of magical, I think. Is that [,,,]we really trigger off of side-effects. So, we know this is the medication, say it’s a semi statin, in here are known side effects or potential side effects. And what we do is we add complimentary services around nutrition, wholeness, or wellness, holistic [INAUDIBLE] Vedic, yoga, mindfulness. So in this case with a semi stand for cholesterol you may need to increase your fiber. Well, how can you naturally increase your fiber? You, you may need to walk more or do stretches, or other medications may produce more anxiety or potentially depression. So breathing and understanding meditation and mindfulness will come into play. So based off your medication schedule and their side effects will cater information to you, you will have a whole content of information, but we will sort of bring these to the top of knowing the potential side effects that you could potentially have.

Kim:

It truly is empowering.

Carlos:

Yeah. David we’re approaching the final segment of today’s conversation. And I wouldn’t want to go without asking you specifically about what’s important for you as a company. We might have viewers out there who might at some point in when I might want to come work for you, for example. So, what would you say to these folks about the company in order to reel-in the best of talent, that’s going to be aligned with your mission and the way that you feel that things should be internally?

David:

Yeah, so right now we’re just five people. We’re a small company and we’re going after funding. We’re going to open up a raise and then we need resources. But we need resources who are aligned to the mission that passionate about healthcare, about their personal health. And some of them maybe have gone through challenging circumstances as well. We are an open environment for everybody who wants to help increase health outcomes for themselves and for the people they love close to them. So that’s very important to us and it’s all driven by passion, the passion, you know, the application really is representative of my father in many ways. And it’s where I have to get it into the market to come to life. So, you know, sometimes I say, in death, I found life and I found a creation of doing something and being able to hand it off to people that appreciate that passion and that will nurture it and help it grow.

Tullio:

Amazing. Well, David, we’re up on time. It’s been great speaking with you today. Thanks for sharing your journey and thank you for doing what you’re doing. It’s so needed for everyone to just be more knowledgeable about the interactions we have with medicine and our health. So, we wish you a lot of success as you build this. We’ll definitely have to have you back maybe in a year, and just maybe hear some use cases from you. Stay with us as we go off the air in just a minute. Just want to remind everyone, Monday’s a holiday, so we will not be live for the recap show, but the team is going to be recording the recap show tomorrow. And we will air at the usual time. It will be aired at 12:00 PM Pacific on Monday, even though we’ll probably be barbecuing for labor day. So there’ll be a recap show of all the three shows we had this week, because we decided that the shows are too good not to recap them and take a day off. So that’s the plan guys, but what have we got coming up?

Kim:

[INAUDIBLE] have commitments.

Tullio:

That’s right. Commitment before you go. What’s going on with the rest of the week, Carlos, what have we got Tuesday, Wednesday, Thursday of next week?

Carlos:

Well, it’s only going to be Tuesday and Wednesday Tullio, because if you remember, tomorrow is our, our company-wide meeting and Thursday. So, we’re not going to have a show on Thursday, but the, on Tuesday, we’re going to be speaking with Airgility and the conversation will be with the Pramod Raheja. I hope I pronounced that correctly, the founder and the CEO of Airgility and also on Wednesday, we’re going to be speaking with Gary Goldberg, the founder and CEO of SquadLocker. So that’s what we have for next week. Guys, stay tuned right here on dojo.live at 12:00 PM, Pacific Tuesday and Wednesday, and a sever of course. Thanks, David, for having been with us on the show and everybody, stay safe.

Tullio:

Have a great holiday weekend, everyone.

Kim:

Thank you.

 

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