Untold Innovation: A few minutes with Daniel Lord
By: Dani Clark
This year at Untold Content, we’re focusing on stories of Untold Innovation. As a firm committed to innovation storytelling from thought leaders across organizations and sectors, we have embarked on a journey to uncover stories of innovative thinking that are galvanizing change and growth in four main industries: tech, medical, science and human impact. We’ve asked you to nominate thought leaders in your field who are driving innovation, and you continue to deliver!
Our next innovation story comes from Daniel Lord, Director of Clinical Programs at Crossover Health. In our interview, we hear more about new ways of approaching health care and the amazing work that can happen when we remove restrictions from the innovation process. Daniel reminds us that innovating also means failing all the time—that’s where the real discoveries happen. So, take a breath, relax, and settle into Daniel’s innovation story.
P.S. Keep sending in those nominations of others for us to highlight in our Untold Innovation series. You can complete our nomination form or email us with their information.
Daniel Lord‘s Innovation Story
Daniel is the Director of Clinical Programs with the integrated primary care medical group Crossover Health. Crossover Health is a next-generation healthcare organization that uses a membership-based approach to fundamentally change the way health care is practiced, delivered, and experienced.
UC: Tell us about yourself and your field of specialty out of tech, science, human impact, or medical.
DL: My background is in the medical field, but as a chiropractor playing in mainstream medicine, which is unique to say the least. I have an interesting lens, because I’ve always worked in integrative practices. I don’t even know what it would be like to work by myself, which is different because most commonly, chiropractors tend to work in solo practices. They put their sign up on a building somewhere and act as solo artists, whereas my perspective focuses on how much better the profession could be, and would be, if we were more collaborative.
UC: Where does your personal innovation story begin?
DL: My first job was in San Francisco. I miss living there—it’s ridiculously expensive, but when I enter that city, my heart goes, “Ah, San Francisco.” I started working up there in a multi-disciplinary practice that had physicians, chiropractors, physical therapists, acupuncture, health coaching, and some athletic trainers. It was really focused on Sports Medicine and elite athletes. However, we saw a range of people and health care needs. We were downtown in the Financial District, so we also saw a lot of desk workers. That experience showed me that this is the right kind of team because I learned more problems could be solved if team members could work shoulder-to-shoulder with a variety of health care providers. You can really make a dent in the primary care services scope—differently than if a primary care doctor or chiropractor was working by themselves.
When health care providers work alone like that and another health care provider is just down the street, turf battles can emerge and referrals can get clunky, if they happen at all. No one shares notes or uses the same platform. Collaboration does not happen on the fly, so patients suffer because they don’t get to the right treatments efficiently. This multi-disciplinary practice in San Francisco had me thinking, “Wow, this is symbiotic when we all work on the same team.” You get the best answer when you have multiple people sharing their perspectives and collaborating.
The problem was the practice was still insurance-based. Even though we had the right people, we couldn’t necessarily provide the right care because the insurance model is based on a fee-for-service framework. Basically, if you don’t have the billing code that matches the therapy, you’re not going to get paid for it. What happens is, providers practice based on what Current Procedural Terminology (CPT) code can reimburse them the most, and I’m just being blunt, but financial incentives are legit. They change the behavior of any provider, even the most ethical ones. Providers in the community, including chiropractors and physical therapists, are simply trying to keep their lights on. For example, many patients in the community receive passive therapies, such as ultrasound and muscle stimulation, in order to bill more to insurance even though these modalities may not improve healing or decrease pain.
Even further, if a clinic owns an x-ray machine, guess who’s getting an x-ray? Should a provider see their patient for a six-visit program or a ten-visit program? The patient doesn’t know which program is better and providers are driven by monetary incentives. It’s murky because more therapy won’t “hurt” the patient, but clinicians push the envelope in order to make more dollars. In many cases, patients just need education and do not need any rehab at all. Unfortunately, providers are not reimbursed for being efficient. Providers get paid for the physical therapy part of what they do. Anyway, the moral of the story is there are limitations in a fee-for-service model.
The next stop was Oracle Team USA…I happened to meet these guys at a sports performance gym where we had mutual contacts. I started seeing a couple of the captains for their back pain and got to know them over a number of months. Little by little, they’d say things like, “Hey, why don’t you come and check out the base and treat us right onsite a couple nights a week for a couple hours?” Which then turned into, “Hey, can you come a couple of days a week and take care of some of the other sailing team people and builders? Can you develop a rehab program for us, because we get injured on the boat all the time?” And then they said, “Hey, as we get closer to the America’s Cup, we need a whole medical staff–a whole clinical conditioning, strength training team.” The America’s Cup is like the Olympics for sailing. It’s basically an arms race to see who can build the most exotic boat.
I ended up leaving my integrated clinic in San Francisco and joining the sailing team. It was the most unique and challenging experience. Long story short, I was given the opportunity to develop the sailing team’s training program and create my own multi-disciplinary team. I hired a team of Sports Medicine people and a strength conditioning coach, a physiologist, a sports medicine doc, a physical therapist, and massage therapists. The unique thing about this experience is that I had no restrictions. We could deliver comprehensive sports medicine without barriers. I could buy any piece of equipment I wanted. There was no insurance to consider. We were just paid to be there. We developed a wild program.
In this big 6,000 square foot space, where they were making all these sailboats, I had a model sailboat built on the floor that was a replica of the America’s Cup boat. Not the sails, but the base. A 72-foot catamaran with a big net. We set up these courses where we knew the exact dimensions of the course—we knew when sailors had to tack and jibe and how long the race would be. We set up our training to mirror the course. We had heart rate monitors on these guys. They would go through the motions, and we would track and place the different people in positions based on their performance and heart rate. Then we would make them solve problems once they hit 90% of their heart rate, so they could practice thinking clearly when they were at their most maxed-out heart rate, which was really interesting. Anyway, we dorked out in a major way. We learned what we could do when we had no barriers. When you can customize a care plan to truly get the patient back to their daily life faster, it doesn’t matter who has the right answer.
Then Crossover happened. I got an email from Scott Shreeve, the CEO, that basically asked, “Do you want to change health care with me?” It was one of those emails that you read and you’re like, is this a real email or is this some person trying to spam me? He was just super passionate. And he was talking about fairy tales—a health care model where I could practice the way I did with the Oracle team, but with the general public. So, I decided to be a part of it. The first time I got on the phone with him, he was like, “Yeah, we’re opening up a clinic at Facebook.” I didn’t even know what that meant. I went down to campus and realized a software company has a lot of people. It’s not just a website [Laughs].
Crossover Health began to partner with “health activist employers” who wanted to invest in a better model that supports integrated primary care—a way to take care of people in a whole new way. We have this amazing opportunity to design a different healthcare model. Now, we have a real triple aim where we have improved outcomes, improved patient experience, and decreased costs because our model isn’t driven by a fee-for-service. Our model is driven by outcomes and patient-centered care, which is great lip service, but when you can actually do it, when your business model is wrapped around that mission, you can execute.
UC: What might other folks in your industry have to learn from your innovation work?
DL: From a healthcare perspective, the fee-for-service model has to die. Completely. It absolutely has to die, and I would murder it myself. It drives volume. It drives low value care. It drives part of the opioid crisis, truly, which has massive consequences, right? It creates unnecessary surgeries, injections, and pain medication. It creates a ton of extra costs to the system, which we know is already so expensive.
There are several entities working on the health care problem, including the government, but I believe that by changing incentives, we could make a massive shift and take a big chunk off the top of the large costs of health care. If we created a model that was reimbursed based on outcomes and patient satisfaction, we would change the behaviors of the doctors in the system. In an integrative team, in a medical home, we’d prevent more secondary care, and that’s what drives health care costs. Five to eight percent of healthcare is spent on primary care. The rest is this huge secondary care market, but because of fee-for-service, doctors will see each patient for about eight minutes. They’re not going to get to know them. They’re not going to be able to problem solve. Then they try to refer you to get all the images, take all the tests, and send too many patients to specialists when most problems should be solved with conservative care.
I want this to be a solution for everyone in some way, shape, or form. I know that you can’t plug and play because there’s all sorts of constraints, but there’s a model out there that can serve a lot more people in a much healthier, robust way, and I hope we can be part of the solution.
UC: What role do you feel storytelling plays in innovation? Or could you describe the importance of storytelling to your own work?
DL: Data is all good, but it’s just numbers on a page. In order for anyone to buy into what your message is, you have to have a story. Really putting your stake in the ground on some of the innovative processes you’re building and the results you’re getting is humanized when you tell a story about it. People can relate to it. That’s how teams can go from this isolated thing that they’re working on, to creating more of a movement. Now, we’re getting our message out there to more and more people, and really trying to influence more to go on the same path. Part of content strategy is creating your own thought leadership and awareness from a marketing perspective, but I don’t necessarily think that’s the end goal. It’s more about how content strategy can support your mission.
UC: What is one piece of advice would you give to future innovators? And this can be in your discipline or in general.
DL: People who are successful at innovating, fail all the time. They fall on their faces all the time, and they get right back up and they keep trying again. It’s so obvious, but I always hear this. I’ve seen it enough where people are too afraid to fail, or when they fail, then they give up and they were so close to actually making something work. The ‘obstacle is the way’ type of mantra is so important because you learn from those mistakes. They’re never as bad as you think they are, and sometimes they can lead to opportunities that you’ve never even thought about.
Thanks for reading Daniel’s innovation story. You can read more about our Untold Innovation Stories series in our Untold Innovation Stories kickoff post.
*Interviews are not endorsements of individuals or businesses.