Wellness Reimagined: Joe Gagnon Of 1upHealth On 5 Things That Should Be Done To Improve and Reform The Health & Wellness Industry

In our world of constant change, and with life moving faster than ever, topics such as mental health, self-care, and prevention have become popular buzzwords. People are looking to live healthier lives, and there is superb care out there that is being offered. At the same time, there are misconceptions about the meaning of self-care and exercise. Many opt for quick solutions — surgery, pills — to dull the problem without adequately addressing the underlying cause. Meanwhile, many parts of the industry are unregulated and oversaturated. People with years of training are competing with people with weekend training. Many providers are overworked, overwhelmed, and underpaid. The general public is not educated about asking the right questions when selecting a wellness provider. In the face of all this, what can be done to correct the status quo? In this interview series, we are seeking to hear from a variety of leaders in the health and wellness industries who agree that the wellness industry is in need of an overhaul and offer suggestions about what can be done moving forward. As a part of this series, I had the distinct pleasure of interviewing Joe Gagnon.

Joe is currently CEO of 1upHealth a cloud-based data interoperability platform that unlocks healthcare data to improve outcomes. He is also an avid blogger, co-host of the Chasing Tomorrow podcast, and a serious endurance athlete.

Thank you so much for doing this interview. It is an honor. Our readers would love to learn more about you and your personal background. Can you please share your personal backstory? What has brought you to this point in your life?

My story starts off like many others — finding my way into technology early in my career, and then getting into healthcare. After becoming frustrated by the status quo, I dedicated myself to uncovering how technology can transform a business and maybe even an industry. This was all in the early days of the web and e-commerce, so the recent shift to an open cloud computing environment has re-ignited that same innovative spirit inside of me.

In my journey, I have also found that there is more to life than just work — as exciting and stimulating as it can be. I have committed to discovering my greater purpose by expanding my own lifestyle to experience new things and push myself to constantly grow and evolve. I dove into becoming an ultra-endurance athlete and focused on writing, podcasting, and traveling around the world. I spent a lot of time observing, learning, growing, and at this point I feel like it’s been invaluable and I’ve “got my money’s worth.”

What is your “why” behind the work that you do? What fuels you?

My driving force is the belief that everyone should have an equal opportunity to live a long, happy, healthy life. But in today’s world, I feel like that is not consistently available to the majority. I want to see more people leaning into their potential, having equitable access to community, support, and education, and being supported in health and wellness efforts. I am also fueled by the knowledge that this is fixable — if we all put some effort into a better system we can build a better world for all.

What are some of the most interesting or exciting new projects you are working on now?

It’s a privilege to get to work on 1upHealth and lead the business. We are really a disruptor, the David versus Goliath in a very, very large industry. Thinking about how to make the most of health data, improve healthcare quality, and reduce risk is an engaging, challenging, and fun project.

My other, more personal initiative is something I just coined, “The 20-year Project.” Over the next 20 years, I will explore how I can optimize the way that I live and the lifestyle choices that I make, using what I know about human biology, so that I can consume as little healthcare as possible and be a productive member of society for a long period of time.

It has been said that our mistakes can be our greatest teachers. Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lesson you learned from that?

I made one memorable mistake that may not have been funny, but it was certainly instructive. Early on, I thought I was pretty smart, but this sometimes made me overly critical of existing processes. As a result, I once told a customer that they were doing it all wrong and they never talked to me again.

I realized that they did want help solving the problem, but they didn’t want to feel like they were wrong. I learned that changing the approach to less all-knowing and more supportive (“here’s how I can help you”) is much more effective at actually tackling the problem.

OK, thank you for all of that. Let’s now shift to the core focus of our interview. From where you stand, why are you passionate about the topic of Reimagining The Health and Wellness industries? Can you explain what you mean with a story or an example?

For some background, the US healthcare system has evolved a lot over the past 50 years. We’ve introduced a lot of major programs from third-party payer systems to Medicare, Medicaid, and the Affordable Care Act, but none of them have been connected or designed as one big system. As a result, today’s industry is huge — costing somewhere over $4 trillion a year — but our population experiences some of the poorest health outcomes of all developed nations. The health equity index is low, care quality is low, and if there was such a thing as a “customer” in healthcare, satisfaction ratings would be the lowest of any customer-oriented industry out there.

When I look at the situation, I see a huge opportunity to re-engineer, reimagine, redesign, and rethink how healthcare gets delivered.

In some ways, it’s simple. We all want access to care when we need it, and to do that we need to think about our own health. We also need services and support to be affordable and tangible. And since that isn’t how things are today, I’m excited about the opportunity to work on transforming health and to deliver better healthcare for all.

When I talk about Reimagining the Wellness industry, I am talking about reimagining it from the perspective of the providers as well as from the perspective of the recipients and patients. Can you share a few reasons why the status quo is not working for both providers and patients?

There are three core actors on the front-end of healthcare: the provider who provides the service, the payer who pays for the service, and the patient who receives the service. We’ve created somewhat of an awkward relationship between those providing the service and those receiving the service because someone else is paying for it.

To address this, I think we need to start by moving from a fee-for-service model to, eventually, a fee-for-outcome approach where the payment structure helps better align the provider with individual health interests in the medium- and long-term. In this new model, providers would invest early on in health and wellness education, talking about nutrition, mindset, exercise, community, and all of the elements that impact health. When there is a need for urgent care, maybe it would be offered in a fee-for-service model, but certainly it would be easier to access than in the current system.

This shift at the provider level would also change how patients utilize the healthcare system. They would no longer need to fill out paper forms, send faxes, or call the office (often enduring long wait times or not getting called back) to access services. In a more transparent system, patients would have easier access and a better understanding of the care they’re receiving — what the service entails, how much it costs, and how it aims to improve their health. This would encourage more patient support, buy-in, and involvement in their own healthcare.

Interestingly enough, we’ve been able to do this in pretty much every other industry so now it’s about applying those proven models to healthcare and allowing the patient-provider (or customer-supplier) relationship to evolve.

Why do you think there is a good opportunity now to improve and reform the health and wellness industry?

The health and wellness industry is ripe for change given the size and scale of the challenges we’re facing. There has never been more of a need for improved quality care, lower risk, and better experiences. However, because healthcare is implementing cloud computing technology, we’re also perfectly positioned to address these challenges. We are now tapping into the critical data, networking, and computing standards that can open up new possibilities for how patients and healthcare entities can access data and move through the healthcare system.

Leveraging this universal infrastructure, and effectively combining clinical, claims, and all data together, is the first step. From there, we can collaborate better on healthcare decisions and think more critically about how to improve care and make it more tangible, even up against social determinants of health and other barriers. This could lead us to the ultimate goal of a better healthcare experience for all parties — with patients receiving the best care possible, and providers getting paid the proper amount.

Can you please share your “5 Things That Should Be Done To Improve and Reform The Health & Wellness Industry”?

First, we must embrace some of the capabilities that can make the industry operate better. So, for example, we should adopt open standards-based data and interoperability. We’re starting down that path, but it’s not collectively executed and agreed upon, though there is an understanding that this will make a massive difference.

The second thing is to fully adopt cloud technology. A lot of care is delivered locally, yet a lot of regions don’t have equitable access to vital resources. What could ensure someone who’s living in rural North Dakota gets the same care as someone in downtown Boston (which has some of the best teaching hospitals in the world)? The cloud! It allows us to compute at a meta level and affords anyone, anywhere access to the universe of resources needed to drive improved health.

The third priority is to closely re-examine the third-party payer system and rebuild it with patient empowerment front and center. We need the patient, AKA the customer, to have a full view of the care they’re receiving and to know that their experience matters. For example, patients should be able to receive care and write a review of their experience (good or bad), pay the appropriate amount based on the services and quality of experience and outcomes, and even witness improvements to the system based on cumulative feedback and reviews over time. Being more in control of the relationship and the services we’re paying for, as patients or customers, is critical for an improved system.

Fourth, we’ve got to get better at sharing data. Data must be fluid, open, and standardized. At the end of the day, seamless data-sharing will empower many downstream systems too. Everything will operate better because we will be making assumptions on more accessible, diverse data.

Fifth, we must shift from this idea of “sick care” to healthcare. Today we focus on caring for people when they’re not feeling well, but we don’t do much when people are feeling good. There is little advice on proactively taking control of our own health — how to eat well, how to exercise, how to build healthy habits, and how to cultivate a better mindset. People become patients when they are already in a bad way and something is wrong.

Focusing on sick care is how we arrived at the current situation — $4 trillion of spend and a lot of unhappy customers/patients with a lot of risk. But if we optimize on health, we can turn all this around and support a productive, healthy, and happy community.

From the recipient and patient side of the industry, can you please share a few ways that patients and recipients should reimagine what the wellness and healthcare industry should provide?

In many ways, patients already know what they want from healthcare. They want the same digitized, convenient experience they have in every other aspect of life. They want to use their mobile device to pull up an app, get a notification, text and communicate in real time, and seamlessly access information, resources, and community.

These extremely powerful interfaces operating on our phones allow us to order goods and food, research information, connect to friends, and engage with the world. We now need to bring this profound capability to our healthcare lives and cut ties with proprietary, facts-based, overly complex systems that don’t support the needs of real-time computing or make patient lives better.

What do you think are the biggest roadblocks to reforming the industry? What can be done to address those hurdles?

Many roadblocks in this industry have been around for ages, and embedded self-interest is a big one, sadly. Protecting customers and customer relationships does not allow for innovation, and healthcare’s revolution has been slow because the incumbents are protecting the way we used to do it and resisting change.

Part of the industry’s insistence on using proprietary closed systems is that, at one time, they were the only approach that worked. Recent technology advances are bringing us to a tipping point where we can finally start chipping away at that roadblock. Moving into open computing and adopting the end-to-end supply chain perspective where customer analytics and information flow at speed of light can unlock massive change — whether that’s brought on by current industry incumbents or, perhaps more likely, new entrants.

I’m very passionate about the topic of proactive versus reactive self-care and healthcare. What do you think can be done to shift the industries towards a proactive healthcare approach? How can we shift the self-care mindset for consumers and providers alike?

It’s never easy to make a big shift, so let’s acknowledge this undertaking will take significant work. For the most part, when we’re feeling good we don’t think much about our health or invest as much in it. But when something goes wrong, we start thinking retroactively about how we should have been eating better, sleeping more, exercising more, and so on.

To address this, we need to start defining the components of an ideal lifestyle over time. How does one’s life evolve? What’s that avatar and how do they live that? That could help us better see why and how self-care works. For example, imagine if you could create a digital twin and compare health and wellness outcomes over time, based on different lifestyle models.

Demonstrating to people the benefits of proactively taking charge of their own health — and how that can save them money and allow them to continue doing the activities they love — would go far in supporting this mentality shift. No one wants to be sick or wheelchair bound if they can help it, so we must find new way to show people that the time to change is before symptoms or issues arise.

Thank you for all that great insight! Let’s start wrapping up. Can you share your favorite “Life Lesson Quote”? Why does that resonate with you so much?

I’ve always embraced this idea that magic happens at the intersection of curiosity and courage. It’s along the lines of…”I want to know this thing. Can I go find out? Am I bold enough? Do I have the confidence and courage to go do it?” It’s a great life lesson quote because that’s how improvements happen personally, at a societal level, and at a business level. It encompasses a very endearing fact of being human that speaks to me.

We’re curious and we have courage, which is why we’ve improved throughout time. If you zoom in on one moment in the timeline, it might seem like we’re struggling, but if we zoom out and look 10, 20, 50, or 100 years ago, we’ll see the massive improvements and strides forward we have made. Those advances took curiosity and courage to be acted upon and done at scale — but that is where the magic happens and big improvements unfold.

We are very blessed that some of the biggest names in Business, VC funding, Sports, and Entertainment read this column. Is there a person in the world or in the US whom you would love to have a private breakfast or lunch with, and why? He or she might just see this, especially if we both tag them 🙂

It would be an honor to have lunch with a lot of the people who read this column because you can learn so much from leaders across all industries. However, if either Barack Obama or Bill Gates would have lunch with me, I would have a lot to say. They both, in their own ways, have championed the idea of change and human responsibility for the world’s evolution. They have also both committed themselves, and their resources, to making the world a better place for all. I want to line up, learn from, and collaborate with anyone who wants to do that.

I appreciate your time and valuable contribution. One last question, how can people reach or follow you?

On LinkedIn at https://www.linkedin.com/in/joegagnon/ or on Twitter @1upHealth https://twitter.com/1up_health

This was very inspiring. Thank you so much for the time you spent on this. We wish you only continued success.