Innovative Solutions for Healthcare Problems

Episode Transcript
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Mark Haney (00:00):
And now we have Dr Sarah Almilly on the show today and we're going to talk about her entrepreneurial journey and her way of tackling this, this industry in Medicine.
That in a little bit different way.
So welcome the show, sarah.

Dr. Sarah Almilli (00:15):
Thank you.

Mark Haney (00:16):
So talk to me about how you got into this business.
Obviously, you're a doctor, but then what made you decide to take it in this direction?

So first things first.
I wanted to clarify.
I am a doctor of pharmacy, so what that?
Means is that I'm an advanced clinical provider and I cater to primary care medicine with the specialty of cardiovascular disease Lots of big words to really mean that my specialty is really in diabetes, heart attacks, strokes Anything that touches your heart, your body and your organs.

Mark Haney (00:48):
Okay, you said pharmacist, but you know, do you prescribe?
Is that, is that what your role is?

We can, yes people that have certain Practices and certain collaborative practice agreements in place.
We can actually prescribe medications Based on certain agreements we have with the physician on board.

Mark Haney (01:05):
Okay, so let's back up and go how did you get into this?
And then maybe dive into the customer journey.

So I got in this because of two main reasons.
Number one is my own dad his health care journey.
He had a stroke a few years back and From there on I was able to step away from my duties as a health care professional and be the daughter that I needed to be, and I saw health care with a completely different lens.

(01:33):
I kind of knew that it was happening, but I did not have that reality check and I think that was my reality check.
Which brings me to the second reason, which has been my experience in health care in general.
So I've been in the field for 10 years.
Fortunately and unfortunately, I was in front line for a short amount of time and then I quickly Climbed up that ladder to corporate level and high levels in the corporate and from there I realized that we could do better to our patients.

Mark Haney (02:02):
Did you work for a Hospital group or a pharmacy?
Hospital group Okay.

Yes, I've worked in health care systems, absolutely so.
I've worked in five major ones, to be exact, and they all had very similar gaps.
So, confession, I was part of the problem for a while and then, when my dad had the stroke and then I kind of stepped down to see the problem from a different lens, and that is why I created a lick between my experience from a personal level, professional level, I knew something different needed to happen and I decided to be the difference and what what's broken that you're solving?

(02:40):
Lots of things, so let's try to categorize them.
So the first thing is the amount of Demands, right, heightened demands on the health care system.
Right now we have extremely high burnout rate.

Mark Haney (02:53):
We have very high burnout rate amongst medical professionals.

Yes, we had the all-time highest this year 64 percent across the country.
Before COVID it wasn't the 30th percentile and now we're 64 percent.
Sacramento, to be exact, we're hitting 42 percent burnout rate for physicians.

Mark Haney (03:10):
Yeah, and then when that happens, when when the Healthcare professionals are burned out, that translates to the patient translates to the patients healthcare costs increase right at the more burnout.

We enter the vicious cycle.
They get burned out, they leave right.
And if they leave, what happens?
We have more staff shortages and if we have more staff shortages?
What happens then?
The patients don't have the education they need to get yeah, quality of your services care decreases, right.
The appointment length of time decreases and instead of spending Spending 20 minutes, we spent 10 minutes.

(03:42):
Seven minutes, right?
What kind of diabetes can you explain in seven minutes?

Mark Haney (03:47):
Yeah, yeah, it's like it's.

You get treated just like a number instead of like a person right, and a vicious cycle continues on both sides of the house right, the physician side of the house, or the primary care practitioners and the patients.
And now you're seeing that medical schools, for example, right, less and less students are becoming primary care physicians because they're seeing the burnout.
Oh yeah so the vicious cycle is a lot more bigger and extreme than we think, than just what's under our feet and from the patient standpoint, we have a huge, high rate of patients entering our hospitals and eddies and creating that bottleneck Because of the lack of education, because of the lack of quality of care.

(04:23):
So they're both happening at the same time and they're hurting each other.

Mark Haney (04:27):
Yes, so which one are you?
Are you addressing both?
So you said you talked about because our lifestyles are putting us in the hospital, and then we get to the heart of the doctor, and then we get to the doctor and you know we get worse treatment, right?
Okay, so tell me about your solution.

I so the solution is to cater to both, because I think every other solution we've had so far caters to only one side patient side or the physician side and I think ILLIC is innovative in a way that it's catering to both sides of the house.
So what that means is for the physicians or primary care practitioners in general whether they're nurse practitioners, dos, mds then we go and support them.

(05:03):
Let's remove this administrative burden that they have.
We're advanced pharmacists, we're clinical pharmacists.
We can do practically everything a physician can do except diagnose.
So let's get the refills out of the way.
Let's get the prior authorizations out of the way.
Let's get the trainings out of the way, your competencies, all of that.
Let's get that out of the way and let you focus on what you need to focus on the most and the best.
Then, from the patient standpoint, let's get you what you need to get the quality of care that you deserve.

(05:29):
So instead of having the 10-minute appointment with your physicians, let's sit them for an hour, because, believe it or not, an hour will have a lot of things surface that need to be treated, more than the problem that's presenting in the 10 minutes.
And if you hit those core problems, your other problems will kind of solve themselves out.

Mark Haney (05:46):
Okay.
So when do I call you?
Okay?
So I'm feeling good.
Should I go get a checkup or should I go visit you?
I'm feeling bad.
Should I go to regular doctor or go you?
I'm trying to figure out, like what's going to prompt me to come see you.

So a couple of things, or a lot of things.
If you have already, or if you already know what problems you have and you're currently concerned about these problems, so let's say you have.
You know you have diabetes and now your blood sugars are acting up.
You know you have heart failure and you're seeing that you're accumulating fluid in your feet.
If you know that what the problem is and you're seeing exacerbations or symptoms of that problem, you can come straight to ELIC, because then we can help you out.

Mark Haney (06:29):
So then I go to you and you're not a general practitioner, you're not a I shouldn't say regular doctor, you're more like a doctor of pharmacy, correct?
So in terms of like, comparing to, I'm gonna get more time with you, but are at what kind?
What's the difference in my care?
When do you send them over to the hospital or what?

(06:49):
How do you sort that out?

So that's the beauty of ELIC, right?
So when you come to me knowing exactly what diagnosis you have, I get to dig deep into what the problem is.
That's the one hour that we spend together multiple times, or one time.
From there, we assess together Do you need a physician?
Is this the time that we start involving your physician, or is this the time that I need to help you out without a physician at this point, while communicating to the physician?

(07:12):
Do you absolutely need that access?

Mark Haney (07:14):
So you're the place we can go to.
That's not a physician, physician and the and the normal treatment you get.
It's more like a concierge service to help get us directed to the right place or maybe get something simple, just handled, correct, absolutely.
Give me.
Walk me through an example.

(07:34):
Let's say I'm feeling good, but you know, I feel like I need a physical to make sure because I'm getting old and I want to live a long time.
But I'm feeling good.
Should I go see you to get pointed in the right direction for that?

No, if you're feeling good, you need to make an appointment.
I encourage everyone to make their one year at least one year of physical checkup with their physician or whatever hospital they go to.

Mark Haney (07:58):
Okay, so it's when I have some sort of symptom that I would come and see you and then walk me through maybe something typical, some of the typical scenarios where I walk in I've got you talked about diabetes, I've got some of these symptoms, and what do you do at that point?
Walk me through that journey.

(08:18):
I get my one hour consult with you and what kinds of things.
What would that feel like?

So I would first start collecting your health history right, just like any physician, except that they may have they may do it on steroids.
I will do it over 20 minutes just to collect what else is going on.
Why do you think you have the symptoms?
What has happened in the past few weeks or few months?
Who lives differently with you?
Where do you live differently?
Everything from a financial standpoint, social standpoint, emotional, mental, everything.

(08:47):
Collect all that history, because everything counts, and then, from there on, I look at your medications.
What is it that you're taking?
Are you still taking them?
Are you taking the right things?
Did you decide to improvise and add things on your own?
The supplements and the herbs?
Are you sticking to what you're supposed to be taking, the way you're supposed to be taking them, and believe it or not?
From all these conversations cause it's a lengthy one lots of other things surface.

(09:10):
For example, I had one of my patients that came to me just for diabetes, just speaking of that, but it turns out that it was the PTSD from.
Something completely different is what's messing up her blood sugars, and I really needed to leave diabetes alone.
Address what is really the core problem, then go back and fix the blood sugars Cause.
Bendating blood sugars is not gonna work.

(09:31):
Hitting the core is what's gonna work.
Oh, interesting.

Mark Haney (09:33):
The PTSD was changing their habits and what they do all day what they put into their body.
Yes, and that was the ultimate cause, correct?
Okay, so you're getting more to the root of the cause.
Okay, interesting.
And what about somebody who has a cold or maybe just feels like they've got the flu, or oh no, maybe I have COVID or something like that?

(09:54):
Would I go to you if I'm just like feel like I might have a virus coming on?

Yeah, so we have specialties under ELEC.
We have the chronic conditions, which is everything we just touched on, and then we have medication therapy management and then we have consultations If you're feeling like you have a cold and you need someone to really walk you through the cold symptom without it being diagnosed.
Ie, a lot of patients of mine don't even sometimes have a physician at all, or they don't want to go to a physician, they just have a cold.

(10:19):
They want over the counters, they want something to help them out.
Then, yes, then we can help you with this.
This is usually a much shorter service.

Mark Haney (10:27):
I don't need an hour for that.

Yeah, but the beauty of ELEC is that they also have that provider on demand and at their fingertips.
You can call us at 7 pm because you are at Rayleigh's not knowing what to pick out of the shelf.

Mark Haney (10:40):
And we'll help you out with that.
Oh, interesting.
Okay, so you have an actual facility that I can walk into or just handle something over the phone.

It's all virtual or we go to you.
It's really the most old school way of doing healthcare.

Mark Haney (10:53):
Oh, okay, so there is no facility.

Yeah, there is no facility.
It's remember those times when we used to maybe my parents would know that more but we'd call a doctor and they'd come to you and have this bag and it has like a stethoscope right and a thermometer and a Tylenol and you have the bag.
It's practically very similar to that.

Mark Haney (11:11):
Oh wow, you come to the house, so Okay, good dog.

I have been to some of my patients houses to go and cater to them if they're elderly.
Some of them a lot of my patients like virtual, so we do a lot of virtual zoom calls and team calls.
Lots of my patients like to meet elsewhere and then we also cater to public education.
So a lot of times I'm giving like public education speaking engagements about medication, adherence, COVID, whatever you name it.

Mark Haney (11:36):
Now, in terms of the industry, there's a lot of people that are.
You use the term supplements so that a lot of people want to take, want to be as healthy as they can, so they end up taking different types of supplements.
Are there certain types of things that you recommend for healthy people to take, or is it predominantly just sick people?

So vitamins are no brain right.
If I can make one public advice, it would be the vitamins, because they're the safest part.
I think it gets tricky when you dive into things off of social media Like if you take this, your blood sugars are going to like be okay.
The other day I got an email that if you make this one hand movement you will cure your diabetes.

(12:17):
Let's not do that Because that's not going to work.
So I think supplements are good if they want to have them, if they have the affordability.
From where I sit, a lot of medications are a lot of these things over the counter are not FDA approved or they have not been tested through safety and other measures, so I try to caution against them if the patient is on a lot of other medications.

(12:41):
The other thing people don't know is they will do a lot of internet search and Google will tell them all the kinds of different things, which is great.
Some of it is credible, some of it is not.
But most patients don't know what's a credible source versus what's not a credible source.

Mark Haney (12:55):
So I'm a believer in exercise, very strenuous cardio, weightlifting and things like that.
As far as health, I do yoga.
In terms of recommending lifestyle choices, obviously I've kind of mentioned what we put into our bodies, but what about the activities that we do?

(13:15):
How important is exercise, you think, in keeping us healthy?

Oh, crucial, very important, very important and I would say, know what you need to do.
If you're a healthy man and you're doing yoga and different vigorous exercises, great.
If you are a person that has a congestive heart failure, that may not be the route for you Right.
If you have a disability of one sort or another, some people resort to say like, oh, I can't move, there are exercises to do, while you cannot move certain way or whatever.

(13:50):
So every disease state also prefers a certain type of exercise.
Some need cardio, some need muscle resistance, because it depends on what your body is going through.
So exercise overall is crucial for our health.
What kind of exercise?
That is dependent on the person and what they have.

Mark Haney (14:06):
Okay.
So in terms of the business so you referred I got referred to you through Scott Crocker and he's a friend of mine.
He's a business consulting guy, has a marketing practice.
What are you in terms of like building a business like this?
Is this a scalable type of business, I mean, or is it just you and your one person show and you do your thing?

I'm going to follow your statement here.
No great company is built on one person, right, oh you?

Mark Haney (14:35):
saw that down below Nobody builds a truly great company alone.
I love it Okay, cool, tell me about that.

Definitely not alone.
I am the co-founder with my husband.
We are both co-founders of this Elec idea.
That started as an idea.
We saw a problem, we saw an opportunity.
We wanted to solve it.
Now we have a team.
We have a team of seven people, so our company is growing.
It is scalable because people are longing for that attention when it comes to their health.

(15:02):
People need that bond.
Think about this it's the strongest bond in the world to talk to someone about their health.
Why?
Because health is not one of those things that can come and go.
Finances come and go, relationships come and go.
Health, when it goes, it doesn't come back.
So that is one strong bond and you want to bond with someone, you want to have that continuity of care, you want someone to listen to you and that is why it's scalable.

Mark Haney (15:27):
Absolutely.
You have a very excellentamisit device, probably easier to scale.
I know I'm invested into one telemedicine company that's done really well and grown fast, and I think they were.
You know you don't have all the infrastructure costs with brick and mortar that you had with brick and mortar.
If you're doing it online, it seems like it is kind of a more scalable opportunity.

Absolutely so.
Right now, for example, we have partners in Sacramento and then we also have partners in Los Angeles, right.
So it is definitely scalable, at least in the California market right now.

Mark Haney (15:58):
Do you envision scaling it be?
How's the company gonna change?
Will you be adding different kinds of offerings, or is this duplicating what you've got now only?

So it's going to morph in different ways.
If I were to tell you our business strategy in a big way, first is the patient part.
The just the patient piece alone is scalable because it's different subscription packages, right.
There are the patients that need something on demand, one and done and go.
And then there are patients that want to be with us for the three months or the six months or even the year because they have a chronic condition.

(16:32):
A chronic condition is non-curable by definition and is not going away.
And then we have the physician side.
So physician sides are more like partnerships.
Please take care of these patients, please take care of this part of the clinic for us.
Multiply that by the different physician clinics or like groups in general physician groups.
And we also cater to the organizations that cater to the public, so healthcare organizations or non-healthcare organizations.

(16:58):
A lot of them are nonprofit organizations.
So I know we've done COVID, vaccine clinics, for example.
We've done speaking engagements to teach about how adverse child experiences impact your stress level and your diet and exercise.
As a 30 and four year old man, right, you would have never thought about that.
How to have better medication adherence.
And that has scaled.

(17:19):
Started out by the nonprofits, and now it branched out to having us go to like Escatons and other facilities that cater to senior livings, assisted livings and so forth for their patients.
And then, lastly, the next step is that the employer groups.
If we can cater to your employees and be there for them, then you have less people absent from work, you have much better retention right and you have a lot less workers come because of the stress of the work environment.

(17:47):
If you have a provider right there with them, then they can cope with that stress a lot more and better and that way, as an employer, you're benefiting a lot more than what you think you're putting in.

Mark Haney (17:57):
So in terms of I'm here at a few different revenue streams.
So you have, you've obviously got people that you supply medication to that's probably paid for by the insurance company many times.
Yes, okay, and then I guess they can pay cash forward or they can use their insurance, but your service is more of a subscription model, correct, is that right?

(18:21):
Okay, and then maybe from a speaking engagement, that would be like a one-off type thing.

Correct One-off or you know, you'd be surprised.
Some facilities wanted us to go every three months for a different topic.

Mark Haney (18:31):
Very interesting.
Okay, what else am I missing in terms of those revenue streams there?
So kind of simplified it to three because it's how my mind works.
But where else does the money come in for you to grow the company?

I think these are the four primary ones.
The business to consumer, which is straight to the patient, and then the physicians.
These are like BTCs right.

Mark Haney (18:51):
Okay, and that's a referral to a physician, correct?
Okay?

Yes, and then we have the non-profits or the different organizations for the public education or their patients, or bulk or whatever and then we have your employer groups.
The last one I haven't talked about is a different side of ELEC and it's not the most famous side right now, but that's okay which is the operational performance improvement side, and that is currently another revenue stream that we have.

(19:17):
So I personally and that's a one-man show piece I personally have been in performance improvement for like almost a decade, right.
So I've been certified in multiple of these avenues per se, whether lean or six sigma.
I know these are terms that are probably foreign to most people, but because of these certifications, what I can do, and what I have been doing, is that I go to an operation, any organization that has productivity measures that are suboptimal staffing issues, performance improvement issues, and what I do is that I go in and enhance those opportunities or jump on the opportunities, enhance the performance, increase productivity, increase staffing.

Mark Haney (19:58):
You do that, for you said all organizations.
You don't have a focus within healthcare, then it could be anybody.

Oh, correct.
Currently I'm doing it with two different entities One is related to healthcare and one is not.

Mark Haney (20:10):
Wow, that's interesting.
Why did you start that when you got this other stuff that's rolling.

You know, I think it's because I'm a problem solver by nature.

Mark Haney (20:18):
Yeah, you're an entrepreneur.
You're going a lot of different directions here.
Very interesting, Okay.
So what did I not ask you?
That you wanna make sure that our audience gets a chance to know about you and your business?

I think one thing that I wanted to make sure everyone knows is that this company is built based on real, real human, like Reliability, if that's a word right A lot of companies.
Sometimes we see them and we think like, oh well, they don't know what they're talking about, or like that's so far removed, or the current situation where healthcare is run by, like, administrators and not clinicians.

(20:55):
But this company is founded by clinicians.
My co-founder, my husband, is a pharmacist as well and he's a different kind of professional pharmacy, and together we complete each other to cater to everyone that we encounter.
So I think that's the one part that distinguishes us so much where it's clinicians running a healthcare and that has become rare.

Mark Haney (21:17):
Yes, yes, well, very cool.
I love the idea that you're attacking this problem from a different direction, and I think that's how that's what entrepreneurship is all about You're innovating on something that needs to be innovated.
So thank you for bringing this to the world, and I wish you the best of luck.

Thank you, thanks for having me here.

Mark Haney (21:37):
Congratulations on your success.

Thank you, thank you.

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