“I didn’t know much about nursing homes when I started this. It’s kind of in some ways, in medicine, an ignored part of the healthcare system. I had never stepped foot in a nursing home because it wasn’t part of my medical training. It wasn’t part of medical school or residency. So what I did was I lived in a nursing home for three months and learned everything I could about that experience while treating patients.”
Peck, who went to NYU School of Medicine and did his residency at Harvard, spent time in Silicon Valley at the famous incubator, Y Combinator. As the first class of healthcare companies in the Y Combinator, he came up with the idea to launch a telehealth company that caters to the nursing home community. When these patients are transferred to the ED from nursing home, it’s a no win situation for providers, patients and their families.
“[Many] of them have dementia and almost all of them become delirious and confused upon transferring them to the emergency department. And when they’re there, their advocates and family are rarely with them and we don’t have time to call their family in the busy emergency department. We order every test under the rainbow in order to understand them, which is not good for patients or for cost,” Peck says.
Peck spoke to Chief Executive about what he learned living in a nursing home for three months, the barriers to telehealth adoption, how being an MD prepared him to be a CEO and more. Below are excerpts from this conversation.
There are a lot of telehealth companies in the market, it’s an emerging field. What makes you guys different, what makes you stand out amongst all these competitors in telehealth?
I think it’s the population and the market that we’ve identified. As I said, there’s a large population that’s dealing with emergencies. There’s 1.3 million transfers from the nursing home to the hospital every year. Medicare says that two-thirds of these transfers are avoidable and that represents a $40 billion unnecessary expense. It’s an enormous market opportunity, but also really a big problem.
How were you able to get into a nursing home?
I treated patients, I gave my service, I promised that I would be there with the patients and developed technology [for them]. We really used it as a pilot, but had a little bit of an understanding that I would treat patients and give quality care to the nursing home while I was there. So that’s how we did it. It was a nursing home on Long Island. They took a chance. It was great of them to do so.
But that was part of Y Combinator. Make something people want is what they say, and teach and go, know your user, understand your user intimately. And that’s what prompted me to do that. I wanted to understand how to build technology and services for people, right? The product development is very human centered and we used human centered designs to do what we did.
What are the barriers to telehealth adoption?
The technology for telehealth is wonderful. There are Silicon Valley engineers building our products and others out there with a lot of ability to use data to make things better and be data-driven. And I think the public in general sees that in their daily life that these technologies are possible. I think the one thing that they’re not aware of is the current laws and statutes in the U.S., especially at the federal level, are antiquated. But what’s also interesting, what they don’t know, is that there is major bipartisan support to make change right now.
There hasn’t been federal legislation changing telehealth since 2000, and there’s been five bills that have been passed this past year alone, which is a huge kind of tailwind building up for telemedicine. And what made that happen is bipartisan support. So in this very partisan world that we’re living in right now, especially with elections being 50-50 in some states right now, there’s bipartisan support for this, which is amazing. And so we’ve been advocating for something called the RUSH Act, which is the Reducing Unnecessary Senior Hospitalizations Act. And that was introduced with a very bipartisan support, liberals and conservatives on the same bill, introducing it. And that, hopefully, that will get passed soon.
Is this the bill that you testified in front of Congress for?
I did, it was an amazing experience. We were laughing about this before I got on the phone, actually, at this point I have met with 200 different representatives and senators and their staff and have had all these conversations with these people and advocated for our patients and for the RUSH Act. That’s been an amazing one-on-one experience, to really get to know people and what motivates them and why they joined politics and how they do want to help healthcare and the people it benefits. But when I was testifying before Congress, all of a sudden all the TV cameras are on me. This was not just one-on-one conversation, but 30 different Congressmen asking questions and fielding them, it became a moment of, “Wow, I’m really part of the legislative process right now. I’m really part of actually making changes to the law and to the constitution.” So it was a pretty incredible experience. It woke me up and said, “This is something that’s important, and one day you’ll be able to pass by any nursing home in the country, not just the nursing homes that we served, and say, ‘I did my part to make life better for those patients in those nursing homes.'”
Going from being a doctor, with your M.D. and obviously training for that, and doing residency, and having that experience, to running a business, two different skill sets there. Talk about that experience, going from being a doctor to running your own business.
I’m an emergency doctor and I think emergency medical doctors have some business acumen. You have to think fast and make real critical decisions under pressure. If you don’t make the decisions, patients can die or be hurt. And so you tend towards action rather than kind of passive thought, which is something that I think a business owner, especially a founder, a startup founder, needs to be inclined toward action. And so you learn a lot about that.
You also learn about team building and team dynamics and leading teams. Because medicine is not only what we think of it of a physician and a patient sitting in an exam room together, one-on-one, but especially in the emergency department. It’s a huge team that you’re working with, 20 people, that you’re orchestrating the care of multiple patients at the same time. It’s more of a management job than an individual contributor job, which prepares you for running a company quite well.
What advice do you have to your fellow CEOs?
I think friends are important. Friends and family are extremely important. And that not only means making time for them, as well as making time for your business, but don’t be afraid to bring them closer to your business and to your issues and the problems that you’re trying to solve and face, and ask for their help both intellectually and emotionally. And I think that has been a large part of my success is asking friends and family for their help when I need that, and being vulnerable.