HIStalk Interviews Ben Albert, CEO, Upfront Healthcare

Ben Albert, MBA is co-founder and CEO of Upfront Healthcare of Chicago, IL.

Tell me about yourself and the company.

I have been in healthcare for my whole career. Prior to starting Upfront, I founded a company called Care Team Connect, which was a care management platform for population health that was acquired by The Advisory Board. We did a lot of care management work through a digital platform that enabled care managers to support the high-risk patients that they were serving and supporting in a shared risk agreement.

That experience it led me to found Upfront, because every patient, not only those who are high-risk in some population health agreement, deserves to be navigated to the care that they need, and technology is required in order to scale that type of navigation for every single patient across a health system. That is the foundation of Upfront Healthcare, to help every patient get the care they need.

How do you differentiate the patient engagement and digital front door technology market?

It’s a confusing market, for sure. The digital front door is mostly tied to patient acquisition. Where Upfront focuses is on how to retain every single patient that you serve. If the digital front door is going to bring in a bunch of new patients, how do you use personalized engagement and access to optimize the experience for that patient so they stay with the system for the long term after the digital front door is activated and you engage that patient initially?

Health systems are starting to understand how to get patients into the system. Do they also study why patients leave the system?

They definitely study why patients leave the system. They look at referral patterns and if patients are leaking out. If they are being used as a retail service and the front door generates only retail visits, how can they convert that patient into an empaneled patient on the primary care side or the system of choice for that patient for the long term?

They definitely look at that conversion and understand how to keep that patient and retain them. Especially in light of all of the specialized services that are coming to market, Amazon and Oak Street Health for example, that are focused on particular types of patients, to help attract those patients to their services. Our clients, the health systems, need to focus on how to differentiate and keep their existing patients.

How do health systems engage with patients whose encounter was one-off, such as in an urgent care center or telehealth visit, and determine how much of a relationship those patients want?

They need to engage those patients through a more personalized experience to help understand the needs of those patients and then guide them to that service proactively. Patients are often left to figure that out on their own. They might get a simple text message thanking them for their visit or preparing them for a visit, but they aren’t really aware of options within the system and how to best use the system to meet their own needs.

We often talk about patients as the most underutilized resource in healthcare. How does the health system look at that initial encounter or initial event as a way to help educate the patient about all the services that are available to them in a personalized way, so that only those services that are going to be the most impactful for that patient are put in front of them?

How is that different from retailers, who are happy to sell you whatever you want to buy and hope you keep buying, when what patients want isn’t always what clinicians think they need?

The patient will make the right choice if they are given the education and the appropriate information to enable them to make that choice. Often the clinician might be communicating what the patient needs, but the patient doesn’t understand it at the time that communication is provided. It’s not as personalized in some ways as it could be.

You can give patient the alternatives in how to get that care. Let’s say it’s a flu shot for example, something very simple. You give them the alternatives of, you don’t have to go to your primary care physician because we have these different options for care for you, including our urgent care, where you can get this flu shot. We are going to help guide you and let you pick what service is most convenient for you to get that care that you need. It flips it around a little bit to give that patient choice to meet the needs that they have by availing them of the information to optimize their own care.

Is there any comparison to dental practices that message their patients effectively, albeit with list of services that is much shorter and predictable than that of a health system?

It will be as simple as that. It’s not the complexity of the system, it’s the communication of what pieces of the system meet the needs of the patient. 

There is a way — we call it care traffic control — to understand all the services that a health system can provide to a patient, and then to personalize that service and the access to those services so that the patient will know exactly where they’re supposed to go and when they’re supposed to go there. They will get that care that they need from the system and it won’t feel so complicated. It won’t feel like there are so many choices because it has been tailored for them and guides them directly to where they need to go.

So yes, it can feel like the dentist. Does it today? No, because it’s a lot of fragmented communication coming through different channels that confuses a patient as opposed to one omnichannel communication that will ultimately all be on the same page to enable that patient to get where they need to go.

How will you apply the consumer science capabilities of PatientBond, which Upfront acquired in August 2022?

We are excited about the acquisition of PatientBond. Psychographics, in combination with the behavioral analytics that we already do at Upfront, will help us understand how to best engage a person. Psychographics are a consumer capability that helps create these personas of individuals, so that we know exactly what communication pathway to take to engage that person so that we can ultimately understand how to best communicate with them.

You use the right imagery, you use the right language, you use the right time of day and super tailor and personalize the experience for that individual. You tie that in with the behavioral knowledge that the Upfront platform has and that really understands that when they go for care, where they need to go. You optimally tie those things together to have a communication pathway, then access that pathway for a patient that is unique to them and scalable. They are getting to that care 40% more than they were before because of that communication pathway.

If value-based care ever becomes significant and maintenance of health becomes more financially important to providers, will the same messaging platform support it?

Yes. From our point of view, whether it’s value-based care or not, every patient should be getting these necessary preventative services. How it gets paid for on the back end, we certainly understand the value of that. But ultimately if you take the patient-first approach, everybody should be getting that annual wellness visit who needs it and everybody should have those care gaps closed who need them, not only if they’re in some value-based care arrangement.

How do you help every single patient, regardless of what the economics are behind their care, get to the most optimal care for them? It’s informed by what type of care they need to receive and what type of model of care they’re in to make it super efficient for the health system while still enabling every patient to get the same level of care across the system. In a value-based care context it’s incredibly important, but it’s equally important in a fee-for-service context where these patients still need that same care.

How do health systems change their philosophy about consumerism and then choose systems to support it?

They all want to be more consumer centric and they’re on this journey to be so. They have built all of these services, retail-type services like urgent care, virtual care, on-demand care services, asynchronous care, and in-person services like traditional office visits. They have built all of these services to be more consumer centric, tried to increase access points, tried to make themselves more convenient.

Ultimately, though, they have not optimized that for the patient. What they are doing now in that next wave is saying, we have all these services and we can compete for access, convenience, and efficiency for the patient. How do we tie it all together and enable the patient to understand which one of those services they should be utilizing within our system to ultimately get the best experience for them and get in for care when they need it?

We see a big effort in tying that all together to make it feel seamless for the patient, even though we know that under the hood, it’s not as seamless as it probably should be in the long term from a health system point of view. You can enable the patient in a way that feels seamless and guides them across those services. That’s how they are digitally transforming right now. The first step is how to enable that consumer even if you can’t fix everything across the system on the back end right now.

Does consolidation into larger health systems change the scale and speed in moving to a more patient-focused direction and the use of technology to support it?

In theory it’s helpful, but ultimately you are now on multiple EMRs. You have to reconcile all of that data and all of those services across the system. Unless you have something that can sit beside the EMR, sit outside of that ecosystem and look across multiple EMRs to understand what services are available and guide patients, it doesn’t actually advance the cause. It can slow it down because of the focus is so heavily on the EMR itself and not on how to activate your patients and help all those patients navigate through the integration of a couple of systems coming together, which is incredibly complex for patients to navigate, but also for the system to execute on as well.

How do you see the consumerism aspect of playing out over the next few years and how will the company change in response to it?

To us, healthcare needs better personalization for every single patient. The more we can delve into truly understanding exactly what service the patient needs and enabling them proactively to get that service, the more efficient we will be at a macro level. For us, it’s continuing to enable patients through personalization, through psychographics, through behavioral data, through the right type of communication and omnichannel communication that is integrated across the system so that access and appointment booking is frictionless and easy to get to. 

I would love to say that it’s a one-year journey to be able to tie all of that together, but those of us who have been in this industry for a long time recognize the complexity of it. We will just stay with it and keep doing more of it over the next few years, and you’ll look back at the body of work and say, wow, we’ve made a big impact. More patients are getting the care they need. They are getting a personalized experience that feels much more consumer centric, and they are actually healthier as a result.