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Students vs. Startups Episode 45: Revolutionizing Prenatal Care In The U.S.

Students vs. Startups Episode 45: Revolutionizing Prenatal Care In The U.S.


Featuring Babyscripts

Read Time: 15 minutes

Welcome to Episode 45 of Students vs. Startups. This week, moderator John Gilroy talks with the Co-Founder and President of Babyscripts, Juan Pablo Segura. Babyscripts is the first mobile, clinical tool to allow OB/GYNs to remotely monitor their pregnant patients’ progress and health. Listen below to hear how Babyscripts is improving the status quo of prenatal care!

[audio src="https://easternfoundry.files.wordpress.com/2017/11/students_vs_startups_podcast_episode_45-final.mp3"][/audio]

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John Gilroy: Welcome to Students versus Startups Showdown at the Potomac. My name is John Gilroy; I will be your moderator today. Let's have a big round of applause for show number 45.

Well if you're a regular listener, you know we're sitting in the offices of the Eastern Foundry. We've taken over a conference room, we have a big table here. One side of the table here we have students, the other side of the table we have a startup. We have a twenty-six minute conversation and we all walk out of here fast friends. And that's what we do every week here.

On one side of the table we have our student, our student tonight is Christen Hill. Christen, tell us about your background please.

Christen Hill : Well hello everyone. I am a journalism graduate student from Georgetown University. I worked a lot in television media and I love to do video and podcasts.

John Gilroy: Well, good, good, good. And on the other side of the table we have a startup, kind of an interesting startup today. I teach on the technology management section at Georgetown and most of my students are maybe technical and like to bring in different types of startups and we get a way different one today.

Our startup guest today is Juan Pablo Segura, and he's a co-founder of a company called Babyscripts. My, my, my, your LinkedIn profile says you're an entrepreneur, you went to Notre Dame, this is a wild background, and kind of an interesting company here. Tell us about your background and your company please, Juan Pablo.

Juan Pablo: Well, thanks for having me on the show, it's a pleasure to be with you guys. Yeah in terms of just a background, I grew up here in the D.C. area, so I'm a DMV native. Like John said I went to Notre Dame, graduated with an Accounting and Chinese major, so nothing to do with healthcare at all. I think that goes to show that there's a lot of opportunities in healthcare if a Chinese major can somehow impact it. But I actually went into a traditional consulting role working at a large firm called the Deloitte. I was never really happy with the experience there and also through a couple very personal experiences I started to understand some of the big problems in healthcare, and also some of the big opportunities that technology could bring in democratizing care, engaging patients, making empowering patients to make decisions for themselves, and to own their care. Until about three years ago, I left my consulting job at Deloitte to start what ended becoming Babyscripts, and what we do is we're a new model for prenatal care that uses both mobile apps and internet-enabled medical devices to better manage patients in between appointments with their doctor.

John Gilroy: Now wait a minute, this is Washington, D.C. We have JavaScript, we have all kinds of scripts, but Babyscripts has nothing to do with our coders and our software developers, huh?

Juan Pablo: There's a lot behind the scripts. Not to de-legitimize JavaScript, because we use a lot of it.

John Gilroy: So the question is, so what business problem does your company solve?

Juan Pablo: So we're really at the heart of ... And I mentioned a new model of care because we believe that pregnancy care in this country is falling very antiquated way of management, from a clinical perspective, so from a doctor's perspective. If you look at the model of pregnancy in the United States, basically every pregnancy is treated the same. The pregnancy is treated as a disease, when in reality, pregnancy is not a disease it's a natural part of life. It's a condition that's managed, but in whether you are low risk or you're high risk you essentially get the same care. We think that patients that are high risk should get more care and that technology can empower all patients to be able to control their care through technology. We're really focused on making prenatal care risk-specific, and generating about 30 to 40 times the amount of data possible through the current traditional means to better detect problems and improve outcomes in this country.

IMG_2310.JPG Juan Pablo Segura, Co-Founder and President of Babyscripts

John Gilroy: I am glad we have a woman in the room today to ask these questions-

Juan Pablo: (laughs) Very important.

John Gilroy: Because it's kind of an important part of the subject. Christen I'll let you jump in here and have at it! (laughs)

Christen Hill : Okay, but was that in Chinese? Or English? (laughs)

Juan Pablo: (laughs) Yeah I can do both. I can do four languages-

Christen Hill : So tell me exactly, what can I expect, say for instance, the baby Christen Jr.-

Juan Pablo: Are you expecting? Or...

Christen Hill : No I'm not. Not right now. (laughs) Christen Jr. gets conceived and I say ''You know what, I wanna be a good mom and I think I'm gonna download or get a Babyscript service.'' How does it work practically?

Juan Pablo: Well, a couple important things. So pregnancy is an app category, it's the second most downloaded category in the health space.

Juan Pablo: So yeah, pregnant women are very engaged when it comes to obviously consuming information. When you think of what's possible you can go out and download a variety of apps today, but the big issue and something that we saw is that most of the apps don't connect you to your physician, and when you think about how you manage your pregnancy, and who the gatekeeper of information in your pregnancy is, it's your doctor. Our approach is very unique in that you could download our app right now but you actually wouldn't have access to it. And so you have to be onboard it and invited on the Baby Scripts from your physician. That clinical pathway, that clinical channel, is actually part of a very core thesis of Babyscripts, the company that we have, which is digital mobile health, all these apps aren't going to be effective unless the doctor is a crucial part of the conversation.

Christen Hill : So say, ''Hey doc! My breath smells weird, is that a part of me being pregnant?'' And so he's gonna reply back, ''No, it's just your breath.''

IMG_2325.JPG Christen Hill

Juan Pablo: Well no, so the way our program works is if you work with Babyscripts, right so ... Not every doctor in the United States works with us yet, that's very important. At some point, very quickly, that will change, but if you do go to a physician or physician group that does work with Babyscripts, they will actually automatically enroll you into our app the second that you show up for your first appointment when you're pregnant. And experience has two sides to it. The first is very educational in nature where you get tasks that essentially answer frequently asked questions that you might have and all the information in the app is actually approved by your doctor, so there isn't any misinformation in your pregnancy and all of it is also tied to what's called evidence based information, so things have been researched, published, confirmed by the professional association NIH, CDC, ACOG, etc. You interact with Babyscripts through the app and you will get access to resources, tasks, basically every answer to every question that you might have in your pregnancy.

John Gilroy: I'm just gonna jump in here, three thousand trade associations in town, everyone has an acronym HCOE, ACOG is one of them, you might as well have to list-

Juan Pablo: Oh yeah, ACOG is the professional association for OBGYN's, so it's very important. So we tie it very much to clinical care, and then the second part ... Oh yeah and then NIH and CDC I think are pretty popular ones but the Center for Disease Control and the National Institutes for Health right? Yeah so we really have taken confirmed information and put that in our app. The second piece in what really makes this very different is not only do we give expecting mothers an app, but we also ship them these kits, or these packages.

Christen Hill : Great, food!

Juan Pablo: No, not food. We actually ship them a package that has internet-enabled medical devices inside.

Christen Hill : Internet-enabled medical devices? What does that mean?

Juan Pablo: Really good question. Internet-enabled medical devices is essentially a medical device that's connected to the internet through Bluetooth, Wi-Fi or cellular technology. So it can be a blood pressure cuff that has a Bluetooth chip inside, it can be a weight scale, it can be blood glucometer-

Christen Hill : And you can send it to your doctor?

Juan Pablo: The thought is, instead of you having to physically send something ... To not just take your measurement at home but also to do several additional steps to get that information back to your doctor. Automatically the second a measurement is taken, it goes directly to your physician. So there's no intermediary, there's no additional step, all it takes is stepping on the scale, taking your blood pressure. What we do, really what we're not known for, is we aggregate all that data and we communicate it to your physician in real time, so if something's off, or something's wrong, they can intervene and obviously have you come in for an emergency visit, or send you to the hospital if something's off.

IMG_2326.JPG Juan Pablo Segura, Co-Founder and President of Babyscripts

I don't know how much you know about the space, but, if for example blood pressure related illnesses account for about 15 to 20 percent of maternal deaths ... 15 to 20 percent of maternal deaths are blood pressure related. So when you think of the kinds of interventions that you can do through these kinds of tools and devices, it's pretty powerful, and so that's really what we're focused on which is a concept called virtual care, and delivering care anywhere, which is another issue in this space, which is a lot of women don't have good access to care. So if you can use devices to supplement or extend care, all of a sudden you're looking at new ways of interacting with patients.

John Gilroy: So what's the business model? So the insurance company pays for this, or the physician or what's the business model?

Juan Pablo: Right now, the physician pays and a lot of what we do and the value we bring is, number one, obviously, improving the delivery of care, making care more available, more immediate to the patients, so engaging the patient. We also, on the physician side, we're able to automate certain parts of care so that the clinic can run in a more efficient manner. For example, there's like a typical visit schedule for normal to low risk patients that see the doctor, and what's very important in prenatal care is doctors get paid a lumpsum payment for managing the pregnancy. They're not paid per appointment, they're paid for an episode of care. If you can eliminate or essentially space some visits out by ... And replacing those visits with the data collection that we do in between appointments, all of a sudden the physician has a little bit more time that they can spend seeing high-risk patients, or other kinds of procedures and they can use time that would've been spent on a routine 5 minute appointment on something that they obviously can charge another code or another procedure for.

Christen Hill : Alright, alright, alright, alright, alright. I'm just thinking. There's so many things that are going through my head right now. First of all-

Juan Pablo: I'd like to say mind blown, when people talk about Babyscripts. It's crazy-

Christen Hill : I'm like internet-enabled medical devices, virtual care and all I could think about is we're having our pregnancies, which we've had literally since the beginning of time, now be virtually cared for. Is sex gonna start being virtually cared for after this? (laughs)

But I'm wondering ... There's two things, you bring up a very good point: emergency visits. I recently had a friend who lost a child because their heartbeat stopped beating and the baby failed late in the pregnancy. Her husband is a physician, and that seems to be the best possible scenario for them, is to have a ... They're both doctors, and they thought they were doing everything right. For a person who likes to be very old-school, I wanna go to the doctors, see them, make sure everything is okay. I'm not a doctor, maybe I'll marry a doctor, but I don't know. Something like this seems extremely ... It seems dangerous, for me, as a person who would like to have children biologically. It seems as though if something goes wrong there won't be enough time to catch it because I will be taking my own blood pressure through a medical device that's working through the internet. I'm concerned as to how you're going to convince a patient who wants that care, who wants that one on one contact with their physician to do something, and if this is more of a benefit for them. If it's not more of a benefit then I'd like to go in and see my physician.

Juan Pablo: Yeah I think you have to look at a couple different things right?

So, number one, we're not saying, ''Eliminate prenatal care altogether.'' We're saying that makes certain parts a little bit more convenient for the patient, and more efficient for the provider. You have to also look at what happens at each of the visits to then be able to think about, ''Okay well what can you make more convenient for patients, and the flip side for the provider?'' And so what happens at every single visit during prenatal care is three things happen. Number one, weight is taken. Number two, blood pressure's taken, and number three, questions are answered. Now in certain visits, a little bit more happens, right? You can get an ultrasound at one of the visits. There can be genetic testing. There can be diabetes and pregnancy testing, called gestational diabetes.

Not all of those things always happen every visit. What we say is, okay, we can't replace an ultrasound, we can't replace a gestational diabetes test, obviously we're not gonna impact that because we want women to have safe pregnancies, but we can actually generate not one blood pressure reading or weight reading, or answering one question or something that you remember to ask to your doctor when you go in, we can generate ten times the amount of the same information that you would be getting in the clinic, in at home through the devices that we send moms. That's really what we focus on which is the data and the appointments that are routine in nature. Where nothing else is happening, how about this, mom who is probably working, or probably has to take four or five hours off of work to drive to the hospital, takes 30 minutes to pay for parking, to wait in the waiting room for an hour and a half, and then to sit in the waiting room, and to sit in with the doctor for 5 to 10 minutes just to get questions answered, we think there's a better way, and I think that there's a better way of engaging the consumer of healthcare, which is the patient.

So kind of our big philosophy is let's generate 10 to 30 times the amount of data possible through our program, obviously leave the crucial prenatal care items still happening in the office, they still need to happen in the office, but we think that there's a lot more that can happen through these devices. Just to make sure we touch on satisfaction, which is important, that definitely is always a concern right? Will patients be more satisfied, less satisfied if they're coming in less often? We actually did a controlled study at George Washington University Hospital where we looked at 50 patients without RUM or monitoring on a typical visit schedule, which is fourteen visits, and we looked at 50 patients on Babyscripts going in eight times with RUM of monitoring, and we saw that patients actually felt more connected to their doctor in our group, in the Babyscripts group, because they were interacting with the system three or four times a week instead of once every four weeks, which is the typical model because you're going back to see the doctor every four weeks. It's a pretty important kind of concept-

John Gilroy: So are they notified to take measurements for at least every Wednesday they have to send them in, or how do they-

Juan Pablo: Yeah, they're prompted to take a measurement every week, but what ends up happening is patients step on the scale between 2 to 2.5 times a week and take their blood pressure between 1.5 and 2 times a week. We're also sitting on one of the most massive data bases on blood pressure and weight gain in pregnancy where we can start to answer really important questions that no one knows how to answer right now, which is what causes pre-eclampsia? We were talking about that earlier. No one knows, it's like this massive black box. Well guess what? We have thirty times the amount of data that's being captured in pregnancy than anyone else, and so maybe you can start looking at certain trends when certain things occur or when certain diagnoses happen, correlate them, connect them and all of a sudden we might have an answer for why pre-eclampsia happens. That's what we're very excited about as well.

Christen Hill : Okay so, I have a two-part question. What if my doctor is lazy? Or what if my doctor gets backed up and they can't look at my Baby Scripts profile? Second question is, why did you start this company? (laughs)

IMG_2320.JPG Christen Hill

Juan Pablo: I'm a bachelor starter pregnancy company. A couple of important concepts, number one, so the way that we deploy Babyscripts, we're actually more of an exception management system. The assumption is you're gonna be alright, your data points are gonna be fine, so what we care about is what happens when something is abnormal. We make sure that there's a hand off that occurs between our system and the doctor, so that everything's followed up on. That's a pretty important concept because you can't have data points that are just hanging out there and no one looking at them right? That's important.

Regarding why I'm in this space, and why, knowing nothing about pregnancy, we're probably redefining pregnancy ... So I come from a big Hispanic Catholic family, six kids, and something that really hit me really hard growing up ... My mom actually had three miscarriages, and I think a lot about the pain and suffering that she went through, and she's the most amazing woman ... I think we'll all say this about all of our mothers right? ... But I think of the defenselessness of what she went through, where she had no idea why it happened, what she did wrong, what went wrong and I think about the amount of information that we're able to capture through these devices, and they're simple things. These are commodity technologies. I think there's other things that are important, and where we come in, filtering the data, managing the data's great, but I think the possibility of these devices, I think is gonna unlock the next phase of healthcare. I think that's the why I'm in this space, and no one's doing what we're doing, so we're really excited about it.

John Gilroy: In your linkedIn profile you were talking about HIMSS, she presented HIMSS, healthcare and informatics. This is where the number crunches are and they look very carefully. How is your product received there?

Juan Pablo: It's received really well. I think ... Because we're very unique in that we have actually a really sustainable business model, a lot of healthcare technology is actually seen in a pretty negative light because it's always thought of as an add-on, not an essential service that allows doctors to do more with less, so the fact that we operate within a lumpsum payment model, we make care more convenient for patients while also doing certain quality RUM or monitoring things, the industry's received it very well.

I think the biggest challenge is the struggle that most doctors, most health systems have with dealing with their electronic medical records. When you look at a lot of the trade associations, always the top concern is not the new care models, it's what to do with the 500 million dollar electronic medical record that I just purchased. I didn't have an option to purchase, because if I don't purchase it, at some point pretty soon, either I'm gonna get penalties from the government because they're forcing folks to ... Which is, I mean I don't think it's a negative thing in terms of encouraging people to adopt technology but a lot of healthcare systems and your doctor are, I mean whoever's listening, your doctor's incredibly stressed about electronic medical records. I think the big concern is how to deal with all of that frustration and that's what most people talk about unfortunately, instead of talking about cool new care models like what we're doing.  

IMG_2319.JPG Juan Pablo Segura, Co-Founder and President of Babyscripts

John Gilroy: One of my students is Wes Louis, we all know Wes, he specializes in UIUX. So what about your app? Is it easy to use I mean, you must test it out and how it's received.

Juan Pablo: Oh yeah 100 percent. A lot of what we look at is engagement, so how do you evaluate UIUX? I think the ultimate measure is whether actually someone uses it right? When we look at how we evaluate our app, patients take their weight, their blood pressure, and use our app more than 93 percent of the time every week. We have incredible amounts of compliance, engagement, and obviously we're looking to get that number to 100 percent. I'm a perfectionist, but also a realist, because if I was a perfectionist I would've quit being an entrepreneur years ago, because after the first pitch that failed miserably I would've quit, but no I think UIUX is the key to this being sustainable because people aren't gonna pay for something that nobody uses right? So it's very important to what we do, it's crucial.

Christen Hill : I see this is a very, extremely valuable asset, but I also see it as somewhat of a privilege asset as well, and you mentioned there are a lot of people who don't have access to healthcare. If you're gonna have access to Baby Scripts, it means that you're gonna have access to a doctor who is under your umbrella, you're also gonna have access to technology that allows you to put whatever to internet at home, you're gonna have access to a cellphone or maybe a smartphone that's gonna allow you to talk to your provider. Is there kind of way that you're gonna, say for instance, you want this to be worldwide, or you just at least want this to be in impoverished communities in the United States, how are you gonna reach people who can't afford to live the life that requires this type of platform, however it can also really serve that population? Do you understand?

Juan Pablo: No, no, it's a good question. A couple things, I think patients that have socioeconomic challenges, whether in this country, well it can start in this country and make way somewhere else right?

Number one is, in this country I think patients that obviously have challenges in access to care for example, are the ones that benefit the most from something like this. Because, for example, when you look at the numbers, more than 90 percent of patients that receive Medicaid, and are pregnant have a smartphone. Whether there's limited data plans, etc., that's a challenge of course, but when you think of the conduits that are available to these kinds of patients, they're actually perfectly positioned to receive some kind of virtual, digital experience that, for example, allows them to do more care at home, so that they don't have to take time off of work. We actually built Medicaid specific product with one of our customers looking at how do you do more care at home so that patients don't have to, which typically in this population are either hourly wage earners, have to take several buses, or they have transportation issues, but most have cellphones.

When you think of, okay, if there are barriers to care, let's see how technology can overcome some of those more infrastructure related barriers. We're continuing to think about, okay, how do we make this more accessible, more accessible at some point I think that Medicaid will pay for this because we're doing such good work in the interventions we have, the benefits we're bringing, but right now, I think we have overcome probably about 50 percent of the barriers in that population. I think we still have some work to do.

John Gilroy: Great job Christen. Juan Pablo, if people wanna learn more about your company where should they go?

Juan Pablo: They should go to www.getbabyscripts.com. That sounded like a 1990s commercial or something. Or follow us on Twitter, we actually do a lot of thought leadership, we post a lot if you wanna just learn about what's happening with the future of women's care, maternal care, we're very opinionated, so we'd love to continue conversation.

John Gilroy: Well that's great. Well we're running out of time here unfortunately. If you'd like show notes, links or transcript, you can visit theoakmontgroupllc.com.

I’d like to thank our sponsor, The Radiant Group. If you are interested in getting involved in geo-spacial projects, contact The Radiant Group.

We are hosted by Eastern Foundry, a community of government contractors who are bringing innovative solutions to the government marketplace. For more information, go to Eastern-Foundry.com.

If you would like to participate as a student or a startup, contact me, JohnGilroy@theoakmontgroupllc.com, and thanks for listening to Students vs. Startups showdown in the Potomac.