This week, Steve Rooks, COO of The Fertility Partners, and Griffin discuss how entities like EngagedMD and the Lean system work to reduce employee burnout and improve the patient experience. But can programs like Lean fit into the fertility space? Is the EngagedMD approach of automation helpful to the patient, or does it cut down on valuable patient face-to-face interaction? Listen to learn more.
Listen to hear:
Griffin question the one-size-fits-all approach to Lean’s operations solution, and whether or not it works in the fertility space.
Steve Rooks explain how it is possible to add patient value and reduce operational volume at the same time through automation with programs like EngagedMD.
Griffin question the viability of pre-packaged patient education in a virtual format vs. face-to-face physician conversation.
Griffin and Steve discuss the importance of patient engagement during their (long) initial waiting period.
Steve Rooks:
Company name: The Fertility Partners
LinkedIn Handle: https://www.linkedin.com/in/stephenrooks/
Website URL: https://www.thefertilitypartners.com/
Inside Reproductive Health is sponsored by EngagedMD. For technology that educates your patients with true informed consent, visit engagedmd.com/IRH for 25% off your implementation fee.
Transcript
[00:00:55] Griffin Jones: Legal liability nightmares, losing nurses because of burnout really disappointing patients because of how long they have to be seen. These are some things we try to talk about avoiding in today's episode with Steve Rooks. He's the chief operating officer of The Fertility Partners in Canada and now in the United States as well.
And it's an EngagedMD sponsor episode. I brought Steve on to talk from that lens because there's a lot of business people coming into the fertility field. You don't trust a lot of them. You don't like a lot of them and maybe you like some people that I don't and vice versa, but I want to present Steve to you because he has the heart of a teacher.
And whenever I'm assessing, can I trust someone? What are they like? I look to see if they have the heart of a teacher. I hope I do, but I think Steve does definitely does because he also has the heart of a student. He started at IBM, his career decades ago. He has a mechanical engineering degree. And then he later he got his MBA.
He's worked for places like Verizon in Bell Canada and private equity portfolio that has served a lot of funds in their portfolio. And he comes to the fertility with the lean method of management to add value, to increase efficiency, to reduce the burnout and the burden on staff. And we talk about how he used EnagedMD as a part of that.
And we've had so many people on the podcast talk about EnagedMD long before they were ever a sponsor. And I wanted to unpack more of why, like, why is this so resoundingly positive. Why is it sort of disproportionately positive? And so I thought Steve was a good person for that, as well as educating you on a lot of different ways of looking at your practice to improve systems and avoid losing any more staff than you have to and avoid taking off any more patients than you have to.
I hope you enjoy this episode with Steve Rooks, from the fertility partners.
Mr. Rooks, Steve, welcome to Inside Reproductive Health.
[00:03:03] Steve Rooks: Thanks very much Griffin really excited to be here. As I mentioned before, I've learned so much from your podcasts, that my being on here is a real pleasure.
[00:03:12] Griffin Jones: I was saying to Stephanie from EnagedMD at I think it was PCRS. I got to have Steve on the podcast because he's been such a sponge in the fertility field.
I don't know if it's been about a year or so for you have just been these sponge. I see you in all places, just really learning a lot of people come into the field and they're like, oh yeah, I want to learn. And, but often they're just coming with their own agenda and just kind of tailoring it to that and you really seem to be learning everything.
So tell us a bit about your background. What are you coming into the field with?
[00:03:46] Steve Rooks: Sure. It's been a background that as I've been more about learning a lot, being challenged, but more importantly, supporting the success of others starting, as an engineer, by education and then going on to do my MBA and then working as a management consultant where I worked across multiple industries, helping executives improve their business in a wide range of situations, both top line and bottom line.
And then taking that experience into the corporate world doing some work that had a very customer focused transforming the customer journey and the equivalent of Verizon in Canada called Bell Canada. And then from there going into private equity. So I spent real last 15 years working on the portfolio side of private equity for the likes of TPG capital, sun capital, Ontario teachers' pension plan and a number of others.
And from that, it was about working with the, the portfolio executive management and helping them again, really improve the, their business with a focus on value creation on improving customer value prop, but for me as a person going in there, I had to learn very quickly , a wide range of industries and get up to speed, to establish credibility, to help them.
So that's kind of in the basis. And that's why Dr. Andrew Michael our CEO and founder of Fertility Partners. I had a recommendation of the private equity company that invested in this. Called me up and said, Hey, would you like to try something different? So I was at that time at a private equity company and he laid out the opportunity to come to the fertility partners and really scale a platform to support the clinics, be that much better.
And to me, looking for my last gig, as I would say, my last real role before I look to semi-retirement, this was a fantastic opportunity. And got me excited was as part of that process, I spent some time talking with three of the REI's at our leading clinic, all the fertility in Vancouver and their passion and their excitement and their desire actually to improve further, even though they're already that the best one of the best clinics in Canada really motivated me to want to come on board and support them in becoming even better.
[00:06:05] Griffin Jones: And that's why they want a systems thinker. And you're clearly a systems thinker from your engineering first, then managerial consulting. And then getting your MBA. You're very much, a lot of people have the chief operating officer title because it's the title that was maybe available to some kind of senior executive.
It seems to me that actually a chief operating officer, you really an operator. And so at what point did you come across the Lean Method and will you give lean management an intro for the audience that might not be familiar with it?
[00:06:37] Steve Rooks: Sure. My very first exposure in, in a, in a really serious way, was it drew my first exposure to private equity at TPG capital. TPG is a big believer in lean, and we initially were using it in was in an orthopedic manufacturing environment.
And in the course of seeing how hips and joints knees were made, I also saw how it was applied in orthopedic surgery environment with one of the orthopedic surgeons would use Lean in his offering Belgium and I was really amazed. And then I was asked by TPG surprised me to implement lean at the Caesars and Harrah's casino operations, post global financial crisis, where all of a sudden they had to , look at ways to reduce costs.
But the beauty of Lean is it's not as hard. It's not really a cost reduction exercise. It's about starting with a view of what's value-add to the customer or in our case, it's here in fertility, the patients. And those steps in a process that aren't adding value for the patient in terms of their willingness to pay that is creating value for them are just steps that are adding time and costs to their journey.
And therefore the lean toolkit is about taking out those non-value-added steps and finding ways of working with the team so that I had to implement lean working with a team across 22 properties over nine months. And we applied Lean in every single process in the casinos and the beauty of that as I could see the impact across a wide range of processes, more important.
The other aspect of Lean that I really like is the bottoms-up process. That is you actually engage the people who work and work with the patients, work with the customers. They're the ones actually stepping back and, and with support from facilitator, looking at the process, looking at the wastes, non-value-added steps and finding ways to take it out. And then by the end of the week, cause it's typically a week long exercise, they then have a very clear action plan of what needs to be improved. They've established at least five KPIs that will measure their success and their progress. And then they have an approach going forward that will drive continuous improvement.
Most important, I can't tell you the number of times at the end of one of those weeks, hearing people so motivated where they said, look, this is the first time I felt like I was a part of the process to improve my area. I had real ownership and a stake in it, and that was really gratifying. So that was my, since that moment, literally 15 years ago, I've been a big believer in Lean and seen it have impact across a wide range of industries, service, manufacturing, distribution, et cetera.
[00:09:20] Griffin Jones: So how does that translate into a field where there's emotions, where there's a standard of patient care? I could see it, working on a Toyota manufacturing line, but when you have so many variables of one, there's just so many different kinds of cases to treat and different kinds of patient populations.
And then you have the human element, emotions, relations, human. And how does this Lean method translate to fertility?
[00:09:49] Steve Rooks: Great, great question. And again, it starts with the view of let's really focus on what's value at patients and how can we enhance that value add? So whether you apply it to the intake process to cycle monitoring, even in the lab, for example it is stepping back and saying, okay, we mapped out this journey from a patient perspective.
Let's map out all the times that they wait, let's map out all the times that they are dealing with issues from a payment standpoint, from a testing standpoint, et cetera. And let's find ways to speed up that journey and remove any constraints or irritants that they experience in a way that again, adds value while still ensuring quality and more effective outcomes, et cetera.
So we hadn't in the clinics that we've applied this, now we've done it in at least two, but we have another three lining up to do it. And we did it in the best clinic and we did it in one plant that needs a little more improvement. And in both cases, it starts with mapping out the entire value stream in this case the IVF journey for a patient. And he actually starts at learning that they're pregnant and moving back through the journey to the intake point from the referral point. And in that process, we identify all the areas that are constraints or issues or bottlenecks. Or pain points for the patient and for the participants that add value in the process, and you bring together a team of REI, of nurses, of an admin of lab, a tax, et cetera.
So that they're all aware wanted the great strengths is just understanding that where the constraints are from end-to-end. And so we'd have REI saying, wow, I didn't realize that my asking for this caused this issue downstream. And through that process, then we identify all the years to improve. And as an example, an intake from referral to first consult, we, the lean exercise on that really focused on how we could improve our capture information and to get to the patient, to the consult earlier, more fully educated with all the testing done, et cetera.
So they can have a much more effective first console. So through that process, I think everybody involved from the REI, two nurses through the intake coordinators, et cetera, they all realize the value of doing this. And they all end up at a, at an endpoint design of a new process that they all feel really good about, that they feel is gonna be more value add for the patient.
And we've established the KPIs and how do we measure success going forward? So that's that, that kind of outcome really drives a desire to apply it to the next area that could be improved, like cycle monitoring or the lab, et cetera.
[00:12:30] Griffin Jones: Then how did EnagedMD pass this value test for you? Because it seems like this type of system would be, and I'll say that EnagedMD is, this is a sponsored episode for EnagedMD, but you were at the association of reproductive man, where you at, you were at the RM meeting.
[00:12:46] Steve Rooks: Yes.
[00:12:46] Griffin Jones: Right. And it, like people just started getting up and it was like, oh, you are going to be sponsoring me or is he sponsoring all of these guys? Because it was, it turned into like an EnagedMD commercial from everybody just standing up and talking about the value, but I see a system like this is often like about eliminating things and you go through we don't need that software.
We don't need that bell or whistle. And and with this process, it seems like you added in EnagedMD. So how did they pass this value test?
[00:13:16] Steve Rooks: Well, I hate to sound like a commercial, but the first time I heard about EnagedMD was on one of your podcasts. And I immediately thought, wow, that makes a lot of sense.
And as part of the process, we're in particular, we looked at intake and saw that for some clinics the education process. So the value-add for the patient of really understand their journey, understanding their options, and being able to have a very good discussion with the REI in the first consult about their options.
That to me was an area that was it a challenge to do well for most clinics that weren't, didn't have a, a more effective approach. And in addition, the informed consent component as, as my good friend, Dr. Steven Katz would tell us many times is not typically done well. And so when I saw EnagedMD, I saw it as a big end.
Both really did a phenomenal job in educating the patient, tee them up for the consult, ensuring effective, true informed consent. And it added productivity because it reduced the amount of time that the conditions had to spend with the patient because the patient can now do it themselves at their own pace.
And we can ensure they understand it going into the first consult with the REI or after if that's the process flow. So to me, EnagedMD was a clear value add for the patient, but it also helped improve productivity and effectiveness of that task of educating the patient patient, ensure that you have proper informed consent from them.
[00:14:48] Griffin Jones: Well, , let's talk about that clinician piece for a second. That piece of them having to spend less time with the patient on a particular topic. Some people are concerned about that. They're like, well, I want to spend my time with my patient or our patients are coming to me for a reason.
And I want to give them that time with me as opposed to a module. How has that played out for you all?
[00:15:12] Steve Rooks: Well, the beauty of this approach is that those steps that are very common for all patients. So in this case, educating about the basics of the fertility journey or even the details around PGT or other value added services within the journey those are common steps for all patients.
So how do you EnagedMD where you can offload that common engagement with but then spend your time on the specialized, personalized engagement with the patient. So you can focus on their particular issues that frees up your time. And that's the same thing with the REI consult or the nurse coordinator engaging with the patient.
The common stuff is handled offline with the patient via the EnagedMD module, but then the personalized discussion about what does this mean for you? What do we have to do for your specific that gives the REI and the clinicians more time to really focus on the personalized aspect of each patient's journey and less on the common aspects?
[00:16:17] Griffin Jones: Yeah. Because otherwise the clinician is doing the job of the module, right? Like the clinician is simply a replicable recording. If they're doing the, A, B, C, D E checklist. But if the module is doing that, then the clinician said, oh, you didn't really understand. See, let me talk to you a little bit more. Oh, there's a bit more of D in your case.
Why don't we spend some time talking about that?
[00:16:41] Steve Rooks: That's the beauty of EngagedMD with their knowledge checkpoints through the education modules, the commissions have an opportunity to understand where a patient was having issues and therefore just focus on those areas. Whether that's, again, it's in PGT or in stimulation, et cetera.
It allows them to focus on where the patient themselves have had some challenges and understanding the journey. So it really allows that focus in that value, and where it's needed.
[00:17:08] Griffin Jones: I can't stress it. I do it in our own sales process and how much it helps. I don't do it as efficiently, is in EnagedMD where they've got like a whole module.
But I do have, we have a system for when people come in through the goal diagnostic, I have some articles and some pages on my site that I send them. So that by the time I talk to them and they're, they're filling out some information for me. So by the time I talked to them, it is not just that, what do you do? Who else have you guys work with? What, like, what are the types of strategies you work on? We're focusing on, this is what you all need to do. And so it's like, they're still getting my time, but it's far more tailored to them. It's far more valuable than me serving something that a webpage could do. And it seems to me like EnagedMD does that for patients really well, especially.
[00:17:58] Steve Rooks: And actually we started the process of really innovating in our intake process that, and this came out of Lean as well as some additional work that I was doing with Dr. Dan and Gary Tokuda at all, it was really trying to make the intake process more efficient, where we're doing initial triage with GPs as an example, we're nearing on a digital platform to help really improve the process for the patient. But the key thing is in that initial triage, before they hit the first consult, we have the ability to understand at least to some degree what their journey may entail though. The REI will confirm it in the first consult, but what we can do that is where we have some unique challenges for a given patient.
We can tee up the EnagedMD module. That's most pertinent to them. Many clinics are using EnagedMD might wait until after the first console to do the education. We feel it's important to tee up those unique aspects ahead of time so that when they have the conversation with the REI they're ready had some pre-education. So it's a much, again, it's a much more fluid. Value-added conversation rather than the REI having to do the education aspect first. So that's an important distinction that, many clinics haven't necessarily optimized, EnagedMD. Cause they look at the costs and say, well, we should do it after when we know that they're definitely a patient as part of the conversion process, we feel though it's me and more value-add head of the first console.
If you have a sense that, okay, this patient may need PGT as an example, and we can provide that ahead of time.
[00:19:31] Griffin Jones: I wonder if some guys are thinking, well, I have a contrarian point of view on many things. I think if you have a contrarian point of view, it's even more important to have a baseline because otherwise, if the patient's just deer in headlights, they don't even know what you're being concerned about it.
And they don't even know like other than, like, oh, that sounds good. And then they Google something else anyway. But if there's a baseline and you can say, what, on this specific point. I take this approach and I feel like if you're a contrarian, it's all the more important.
And I've just heard, at that our meeting, you started sounding off on EnagedMD and everybody else just kind of started doing the same thing that I know I'm biased because they're a sponsor for us. So everybody knows my bias. They're a sponsor for us though, because I've known them for seven years and I've talked to them about being a sponsor way before I talked to anybody else, because I just keep hearing positive things. And I'm not saying that there's nobody with negative things to say about EnagedMD I'm just saying I haven't heard it yet. So if you actually have negative things to say about EnagedMD email me. Email me.
No, not you. I mean, the listener like email me because if you exist, let me know you exist. Otherwise I don't have any evidence that they exist. I just keep hearing these really good things, but.
[00:20:51] Steve Rooks: If I can add something there, one great thing that they've done for us as a true partner, because they definitely have a mission for properly educating patients as a true partner, we needed, of course in Canada to also have Quebec, French versions of the module done. And that could have been a very expensive proposition, but they partnered with us and they were very transparent and basically just past. The pure cost of having it done properly by a third party, with a French, with a French Canadian group that helped us get these, these modules up and running for our Quebec patients.
And that made a huge difference. Furthermore for some of the more unique languages that we have in Canada, like Punjabi or say Mandarin, et cetera they have been very quick to say, Hey, the fastest track is to put subtype. For those languages and all our videos, and they've been very supportive to do that quickly in a very inexpensive way.
So I'd say now in Canada, in our clinics, we have the ability to support all of our patient base, irrespective of their language with this, these education modules, which makes a huge difference for them.
[00:21:59] Griffin Jones: We've been talking about the value-add for the patient, but I think the real. Golden, the, the silver lining or the golden bonus, whatever you want to call it is what it does for the staff right now.
Because if you're listening, like how many of your nurses are just sitting on their hands? Like not one of you and not one person listening has a nurse that's just got excess capacity and And nurses are leaving and they're burnt out and they're going per diem other places. And they're going to other parts of women's health or other parts of health care.
Some of them are leaving healthcare altogether and you can't replace them fast enough. You're already trying, I'm talking to you, being the, everyone, all of us are trying to recruit as fast as we possibly can that to exceed retention, we're all in this boat across the marketplace in the workforce, especially with nursing and healthcare.
And you can't replace them fast enough anyway, and you need to get stuff off of their plate that they shouldn't be doing. Can you talk about like that at all? Like with the reduction of burden to the staff?
[00:23:09] Steve Rooks: Exactly. I mean, that's part of our mission on our innovation that we're trying to bring to the platform.
So looking at as we look at the workflows through the Lean exercises and looking at opportunity again, if it's, non-value add a it's not patient facing, then we're looking at ways where we could automate steps and really improve the flow. So it's not just nurses, even the admin. A lot of our admin still are faced with the issue, for example, of transcribing fax referrals the EMR and that's a huge pain because of lack of integration. So, we're looking at an EMR that that would allow us, for example, to take he faxes and leverage some of the online services that can transcribe. With a strong focus on, on medical faxes transcribed and put them into the EMR.
So that's a step that typically takes 20 to 30 minutes of MOS time, medical office assistants time and typically results in errors. So our goal is to automate a lot of those things, reduce the errors and ensure that all of that is fully captured. On the backend many of our EMRs aren't properly integrated with our billing and, and accounts payable system.
So again, that's a lot of manual work that we are targeting to handle with our EMR. So throughout the value stream we're finding ways to augment all of the players in, in the, the value stream in terms of their roles. So they can focus on patient facing value added steps, for example. And I want to refer, for example, to another thing I heard that Dr. Sable once mentioned, and I think Eduardo as well around, the future of AI. So looking at our new EMR system as a way, for example, of across our clinic network being able to augment the REI by saying, Hey, for this type of patient, with these hormone levels, here are the top five protocols that have resulted in the best results. Now that's still up to the REI to make a decision about what needs to be done. But it's a way of augmenting their capability and bringing value to help speed up the decision-making around a given patient for example.
[00:25:15] Griffin Jones: So you mentioned informed consent as one of these areas that patients are getting true informed consent.
Yeah. I'm not leaving counsel, neither Steve. So we have to give that obligatory, disclaimer, that always talk with legal counsel, but when you're looking at informed consent, it's like, okay, did this person really have informed consent? If it's a stack of papers, maybe they don't speak the language that, well, maybe it was rushed.
Versus they had an online module where they watched every single one, they took a quiz, they had it in their language. What holds up as, as better as informed consent and Dr. Katz says, it's obviously the video obvious and so but that kind of talks to the effectiveness, but is there any efficiencies?
And if there isn't then talk about that, but is there any efficiency saved with EnagedMD the, in the video module or excuse me, in the informed consent part of well now you're not tracking down people for, if did they.
[00:26:15] Steve Rooks: Oh yeah, I can tell you that before EnagedMD to do it properly at least to the level that, Dr. Katz would bless us. Okay. That's sufficient informed consent. We would have nurses spend 45 minutes to an hour sitting down and working through the informed consent forms, ensuring that the patient was fully understood each clause, et cetera. And then to get them to sign. And so, again, when I stepped back, you would say the informed consent is important, but it's not necessarily value add per se for the patient in terms of getting pregnant.
It's an important legal requirement to ensure that they understand what they're going through, but that's a step where if you can have something in place, like EnagedMD, be that ensures that the patient went through has the knowledge check points and then ties it into the specific portion of the informed consent form in their language, because that's the other great thing about a EnagedMD, not only the modules, but the actual forms themselves can be there, their language.
Then you truly know you have informed consent and you have an audit trail that you can demonstrate if a bad case scenario happens and the patient comes back and tries to claim, lack of informed consent, you have that audit trail to be able to prove otherwise, now you hope that never happens, but that stuff does happen every now and then.
And you want to be able to have that audit trail. But not spend the time that was required before yet something to EnagedMD to do.
[00:27:47] Griffin Jones: So that's so much time for the nurses saved. I just like anything that we can get off. The nurses, the mid-levels the providers plates. I want to get off their plate.
If you just look at, when you think of like the cost, say like when you compare the cost of like how much time you're saving for your providers, how much you'd be saving on recruitment by not having to hire recruiters or how much are you saving on retention to me? Like the cost benefit seems there now I think more than half of clinics in north America are using EnagedMD. So we're beyond the tipping point for those that, that aren't yet. I suspect that it's just because like, it's just one more thing that we want to think about. And so for, for them, They might be at a point where it's like, okay, is the juice worth the squeeze?
Is it like how much implementation is going to be there? So can you talk about how many clinics did you unroll EnagedMD for and how did you go about enrolling at?
[00:28:48] Steve Rooks: Oh, as soon as I learned about EnagedMD, I literally teed this up within a month, now of course, as with the fertility part, we can't tell a clinic what to implement.
We have to sell it to them. So I became Jeff and Stephanie's best sales rep working with all our clinics. I liked the value now fortunately, we already had our largest clinic, all of using it for a while and they were able to point to the value in terms of true informed consent. All the savings from a nursing time standpoint, admin time standpoint, but also just having a better patient experience with the modules.
So I was able to sell all our clinics very quickly with the only final hurdle being the French language requirement for the Quebec clinics. But we worked through that. And so we literally had EnagedMD rolled out in multiple waves over, I'd say a four month period at the most eight clinics right away.
And then the other three Quebec clinics we're. Now we finally have the translations and they're implementing now. And they're very excited about that. So it's basically all of our clinics and the impact has been huge, as I say, from a education, patient experience and ensuring true informed consent.
Cause we all know. We've all faced those forms online, where it says scroll through everything and inside the bottom, everybody just scrolls all the way through and then sign. So the time that the nurse would spend having to ensure that they went through properly, it was very painful and time consuming.
And now we know that the patients are doing it properly.
[00:30:19] Griffin Jones: It's not the Apple consent. You can't just do that. Hit the long thing that who knows how many firstborns we've all agreed to give away because none of us read those disclaimers, so, okay. So you have to sell it to the clinics you got them to buy on in about four months, you were able to unroll it. How does it start? Like, let's pretend we're one of those clinics, like, and maybe, they're not working with the Fertility Partners. So they call Jeff and Stephanie sales team and EnagedMD. Then what happens from there?
How does it get into the practice?
[00:30:52] Steve Rooks: Well, basically first, I mean the very first thing is for the, the actual clinic to review the modules as they stand today, to understand what's in them and make recommendations. Well, not just make recommendations to require some modifications. So for example, here in Canada, there's a slight different way we practice, some of our approaches in protocols, et cetera.
So all of our clinics had the opportunity to say, okay, I want this language changed a little bit. We need to change that there and EnagedMD is very accommodating, they will make the necessary changes on a reasonable basis without any extra charge that's part of the process. The French language one was a whole new step, which did require some additional costs.
And we all agreed to that very transparently. So the first is to modify the modules as they see fit. And it indicated how. And then the team in parallel works on the informed consent form. So digitizes their existing informed consent forms provides necessary translations. If you needed to say English and Spanish or French, et cetera, and tee those up and work with the team to then decide on the workflow.
So helping the nurses understand how to push it out, how to designate the particular modules for a given patient, et cetera, and how to access it. So the total at a given clinic, the, the implementation time really is no more than two to four weeks max, in terms of making the changes on the modules as needed.
Digitizing the informed consent or taking the clinics are informed consent forms, digitizing it, and setting up on the platform and then doing all the training. So those nurses who are engaging with the, the patients that need to assign the modules to the patients, they go through the training process too.
So it can take less than, than four weeks for you to get at a given clinic it up and running and having an impact with your visions.
[00:32:48] Griffin Jones: What are some of the hiccups that can happen like in, that's, that's pretty quick, like are there any hiccups that people should know about?
[00:32:57] Steve Rooks: We didn't experience any real, I mean, the only area would be just ensuring that the content was in sync with the way that the clinic practice fertility treatment though, again, then that was, I think a little bit of a Canadian US type of change, but I imagine within the US in particular, there'd be very little hiccups there per se.
Because they were constantly ensuring that their modules are reflect the latest and greatest day of the. When it comes to treatment and approaches, et cetera. And we did, though, they're very good ,on LGBTQ in terms of representing that we did make some suggestions about adding on some additional representations. So we could have support our LGBTQ patient base a little bit better with the educational modules.
[00:33:44] Griffin Jones: And that's all part of the beginning, part of the process where you're making, you're modifying it to your center's standard of treatment, and that's all part of the standard process.
[00:33:59] Steve Rooks: Exactly.
And the other thing too, and the thing I like about EnagedMD they do allow you also, if you bought some very good, very specific modules, like an introduction to the clinic and other things they can also host those modules to be able to push out to the patient. I forgot to mention too, they completely white label everything so that the videos all have the branding, the logos, et cetera. As well as of course the informed consent, sir, are identical to what you would have on paper at the clinic. So that's the other key thing is that ability to add in additional video modules that may be produced.
We have one clinic. I'd say more than half of its videos are its own. While the key ones for informed consent standpoint are EnagedMDs. So that's another flexibility that's quite good.
[00:34:48] Griffin Jones: Was there anything, cause I had to go, I'd go catch a flight at from the RM meeting this. But was there anything that people said that other people didn't really know that they, oh, I didn't know, you could use it that way or we're using it. Like, was everyone using it the same way? Or was there any diamonds in the rough that people fake, oh, I didn't know. I could do that.
[00:35:09] Steve Rooks: Well, I think it's things like position is when you position the modules so that you can tee up a patient to be prepared for a discussion.
Ahead of time rather than post consult so that it's a much more informed one. The other thing that's great about EnagedMD is that you're alert. You can easily for use with, for training. So as we bring on in particular medical office assistance, admin, et cetera we can leverage the EnagedMD modules to quickly get them up to speed on fertility treatment.
And that's another great thing, especially with the knowledge checkpoints, et cetera. We're not going to get them to do the informed consent, but the training aspect of those modules are fantastic. That have been really helpful as we brought people on into the clinics.
[00:35:54] Griffin Jones: Well, let's talk a little bit about that pre-consult use because also we have to do something to keep patients engaged for these gigantic wait lists that most people have right now. So the Fertility Bridge position is that the sweet spot of waitlist is between two to five weeks. And everybody's not everybody, most people are past that right now.
And under two weeks, it's just like, what are you doing? You're in big trouble. But over, over four weeks and people, oh I'm an expert, I want to be, I want to have an eight week wait list. It's like, okay, fine. But in a millennial world that four weeks is a ton. And so to have like six week, eight week, 10 week wait-lists, which many of the people listening do?
Like, we need something for the patient in that time. We create materials and things but they also. Yeah, they also need stuff for their treatment. And if, if they can get this education that is white labeled through the practice, then it's like, oh, I'm still participating with the prac. I'm still moving towards my treatment.
I'm still moving towards the answer. I'd get in a consult, even if I'm not going to be seen for another three weeks.
[00:37:03] Steve Rooks: Exactly, Yeah. And that's the great thing that EnagedMD is now wanted recently, but developed when we implemented was they have two tiers of modules in terms of details.
So there's kind of like the foundational modules, which are very low cost for patients. So to me, those ones are a must ahead of the concept. So it's like fertility, one of for example, and that tees up the preliminary aspects of fertility ahead of the console. Now we've gone one step further. So in addition to those foundational modules, which are very inexpensive to put in front of all patients whether or not, you're going to convert them to IVF or not.
We also, as part of our triage are trying to determine some of the likely added treatments that are necessary, whether it's exi or potentially PGT or other aspects. We can then look to tee those up as well, too, if we're confident, as opposed to doing it after the consult to do it ahead of the concept to help ensure that the patient's well-educated ahead of that, the other things may be modules around some of the value-added services about how nutrition and mindfulness and , wellness, et cetera, can really help on the journey.
And we're using that as a way to teach. As you've certainly highlighted and some of your conversion podcasts that notion of attaching the value-add services ahead of the console to engage them in the process ahead of time. So that could be teed up by some of the modules, and then we can offer that as you're waiting for that first consult as a way to initiate the engagement around wellness, mindfulness, nutrition.
[00:38:41] Griffin Jones: Yeah, that way they're not only are they informed, but they also feel like they're being served. Like I'm not just waiting in line for me to pop into this office. And in eight weeks that I'm working towards something on a journey, it's a really good, it's a really good thing to be able to offer right now.
So we talked about the, the necessary burden relief for the staff. We talk about the value, add to the. I want to do a little free consulting for Jeff and Taylor on air right now. I don't know what have you got any NDAs in place or whatever? And I don't know what their product roadmap looks like either, but just in terms of either what you'd like to see from them or what you want to see, somebody in the, in the field produce to offer a lean solution, what would you like to see come out as a technological solution in the next year to three years?
[00:39:33] Steve Rooks: Around EnagedMD as a platform?
[00:39:35] Griffin Jones: If you can think of something and if not, then in general.
[00:39:38] Steve Rooks: Yes. Yes. As I say are our key things is around the language, so that was one they really addressed well, and just enhancing, of the modules in terms of knowledge, checkpoints, more and more knowledge checkpoints that again, going back to what Dr. Katz said by having those knowledge checkpoints and the ability to add more. So I, for example, would love the ability to easily tailor and customize the knowledge checkpoints given are some of the things that we're highlighting in the informed consent, so that I can be very certain that the patient understands some of these key points.
So to me, enhancing that true informed consent through those knowledge checks. It's really critical. So I'd want to really, to add more customization and flexibility around those. I haven't really pushed them on that, but that's definitely an area. I would add and oh yes, I do recall now I remember having a good session and is the ability as the patient is going through the modules to create a scratch.
So that those issues that the patients not really sure about, they can enter in that questions and the things they're unsure that can be captured and shared with the their nurse coordinator, their IVF coordinators and the REI. So those areas, so that goes beyond just having a set note checkpoint.
It's actually allowing the patient to interact. With the material and say, Hey, here's where I'm not sure about here's where I want more information. And that could be, that's actually a great way to further enhance engagement ahead of the first consult by enabling them to have Lira in those questions through the watching the EnagedMD modules, that's something I did highlight to them. And the other key thing is in tying that into the EMR. What's one thing we're working on them is to improve the, the integration of EnagedMD with the EMR to capture some of these notes and, and questions and pull them into the patient history as well, too.
So that would be a, another area as well, but I can see that value add is really enabling better engagement and insight for for the patients and being able to respond. That the IVF coordinator could see those messages ahead of the first consult and even provide responses back in a two-way engagement ahead of time.
[00:41:57] Griffin Jones: Oh, let's talk about th this concept of EMR is being able to talk to other software because I think this is absolutely was that I think that the concept that people are talking about. And the broader lexicon is a digital wallet and a data wallet, really not a digital wallet, like apple wallet that has money in it, but, or even not even at like a cryptocurrency wallet, but a data that those things would likely integrate, but like a data wallet.
And I'm willing to give some of my access to some parts of my data wallet in order to have a better customized experience. And what I want to see in the field is a CMR that integrates with all EMR psych and because everyone wants attribution. I've got a point of view on attribution that it will never be perfect, even if we have what I'm describing here.
But what I'm describing here will, we'll be closer, which is CRM, customer, relationship management, think HubSpot, Salesforce, SharpSpring, things like those, and integrating with EMR and what, what I'd like to see is that because otherwise it's like, it's just one more damn thing for the clinic that they don't want to have to deal with. So are there other things that you think like need to be able to talk to each other? And I think for those softwares that don't talk to each other, at least have the ability to in 10 years, I think they're going to be obsolete. I maybe that's wishful thinking but I think it's part of the reason I just had Gina on from kind body and they're talking about, they've got everything, like it's end to end they've got their own EMR, they've got their own scheduling software and it's like, well, that's might be part of the reason why, because in the meantime, if people aren't going to talk to each other, it's like, all right, well then we'll just create everything and it will talk to each other.
And so what do you think really needs to be able to talk to each other?
[00:43:48] Steve Rooks: Well, I do your point. some of the sort of external interactions with patients have say within support groups, the ability of through CMR integrated EMR, the ability to understand and be able to to monitor the kinds of questions.
That are being discussed on, on social media group chats around fertility, for example, to, to provide greater insight around some of the issues that the REI is. And the clinicians may not be aware are. Issues for the patients, unless the patients specifically talk about it. So having that kind of awareness, that external awareness of what are some of the, the questions that are being asked, what I want to do in a way that doesn't feel too big Brother-y.
But I see it more as if it's done in an anonymous way to at least allow the clinics to understand that. What are some of the issues that are not being addressed properly in today's patient journey that can be addressed through things like EnagedMD through the, the education of the patient, the engagement with the REI is engagement with the clinicians.
So it's a kind of, I'm trying to think of the right word, but it's, it's having that knowledge of what's not being addressed today. And the typical journey that the patient experiences within the clinic walls, that they need to look externally to patient support groups, et cetera. And it can be done.
There's no reason that you couldn't be able to not honestly review what's going on in those jackets, but that would provide you greater insight on things that aren't being properly.
[00:45:27] Griffin Jones: I want to go back to, to the point about staff and recruitment and retention. Is this at, is this happening as much in Canada as it is the United States with nurses being burnt out and going to others and going per diem and going other segments is the great resignation or what the great reshuffle it's now being called.
Is that happening in Canada as much as it is in the US?
[00:45:52] Steve Rooks: I would say, yes, it's likewise happening here as well as, embryologists are also another group of class of, of of staff that are very difficult to find. But yes, there is that, that burnout with the nursing staff, et cetera. And that's one of our key focuses again, is to help through things like lean and tools to make their day-to-day lives much easier to manage with reduced stress, less firefighting, better information flow. ‘Cause that's part of their challenge is getting the information in a timely manner, communicating it to the patient, working with the REI, to support them on adjusting the patient's medications, for example.
So the more that you can do to reduce that stress and the time constraints that they have. Again, the better it is for them. So yeah, absolutely not. That comes in with the proper integration with, with EMR. For example, one of the key things that we're ensuring is a very thorough integration between our say our testing end points, whether that's in clinic or it's external that the test requisitioning and results immediately flow in an ideally you would have that kind of augmented AI that could say, okay, given this test results, here's the recommended adjustment, the idea of 40 and you can look at it and say, yeah, that makes sense, get the okay from the REI and bang it's done. So you can have a lot more that decision-making that goes on. Be augmented and not fully automated, but at least augmented to speed up the process.
[00:47:23] Griffin Jones: Maybe we'll get there in the cup in the next couple, in the next decade or so I want to give you the thought to conclude about however you want about lean and in the fertility field.
And what you want to see happen in the next couple of years, but we've been talking about EnagedMD for those of you that our managers and, and nursing managers, this is something to bring to your superiors. This is something that. It's worth a little bit of political capital from you. And you can use this episode to do that.
If you say that you heard it on the show or heard it from me or heard it from Steve on the show, then they can get 25% off their implementation fee. But it's really for making sure that you're not losing any more nurses, making sure that you're not having patients lights you up on online reviews because you're just so slammed with capacity and providing some relief at a time where it is. It is hard to relieve the workload that your mid-levels and nurses and other staff are, are dealing with. And if you're a practice owner, it's more likely than not that you're already using EnagedMD and maybe we're preaching to the choir, but if you're not, then now really is the time. And so Steve, I'll let you conclude on how, whether it's EnagedMD whether it's Lean whether it's just what you want to see your vision for the field for the next couple of years.
[00:48:46] Steve Rooks: Thanks, Grif. I mean, for me, the key thing is finding ways to innovate that bring value to the patient that really improves their understanding and their feeling of control over the process and doing it in a way that helps also realize productivity gains across the value stream. And to me, EnagedMD is a great example of that where it provides much greater education and to the patients. So they understand better.
They're more in control of understanding the decisions that they need to be that ties into the informed consent. And more importantly, we easily justified implementing EnagedMD from just the savings of the nursing time for the education and for walking through the informed consent forms and signing off, it was, it was one to me, it was one of those, no brainer decisions.
The savings alone easily covered the cost of implementation, but more importantly, it was an ant situation where we were really adding value to the patient journey through the better education, through the better understanding for the benefit of a much more effective first consult and I'm follow on and engagements with the, with the REI.
So to me the kind of tools that we're looking to implement are things like EnagedMD, other examples, another source of challenges for patients is really understanding and setting the proper expectation that IVF in particular could easily be a multi-sectoral journey for them.
And I would, I can't tell you the meaningful percent of patients that don't quite understand that despite the REI attempt to explain that given their circumstances IVF could be a multi-sectoral journey. And we're investing in tools that helps visually explain that better. So the REI can using the visuals, help them better understand that for them IVF could be a two or three cycle journey as opposed to getting pregnant the very first embryo transfer, which can happen, but it's very rare. So those are getting the examples of having tools that really add value for the patients, but help improve the REI, his ability to explain and help them make the right decisions for their benefit.
[00:51:04] Griffin Jones: Steve Rooks, you are a true chief operating officer. You are a true systems-thinker. It is the way that your brain is wired. Thank you so much for sharing some of that brain on Inside Reproductive Health.
[00:51:17] Steve Rooks: Thanks very much Griffin and I really appreciate it. It's been an honor to actually be on your podcast.
I really appreciate it.
[00:51:24]Griffin Jones: My pleasure.