Changing the Healthcare Game with At-Home Diagnostics

This is a transcript is from an August 2023 episode of Outcomes Rocket between Ash Wellness CEO David Stein and Saul Marquez.

[00:00:22] Saul Marquez: Hey everybody, welcome back to the podcast, Saul Marquez here. And today, I have the privilege of hosting David Stein on the podcast. He's the CEO of Ash Wellness, a B2B at-home diagnostic company launching remote care services for health care organizations and DTC businesses. Ash Wellness offers white Label operations management, testing via CLIA, CAP, Certified Lab work, kitting and fulfillment and modern technology infrastructure. In his role, David is responsible for mission, vision, strategy, oversight, fundraising and corporate development. He is an outstanding leader and lives out of New York City, passionate about the way that we do care in health care. So, David, such a pleasure to have you here with us.

[00:01:13] David Stein: Thank you. Thanks for having me. Thanks for the very kind introduction.

[00:01:18] Saul Marquez: Listen, man, you're up to some really great stuff and we're going to uncover the work that you're up to in the B2B at-home diagnostics pace. Before we do, though, talk to us a little bit about what inspires your work in health care?

[00:01:32] David Stein: Yeah, so we launched Ash about three years ago out of the grad school program and came together with three other co-founders at the time who had had pain points in accessing sexual health and wellness as queer individuals. So kind of came around or came together around the idea, rather making sexual health and wellness more inclusive and accessible for the queer community. And we launched initially as a consumer company and then Covid hit and we more or less realized what a huge opportunity we had on the B2B side and said, look, with at-home, self-collected diagnostics, we really are making health care more inclusive and accessible by bringing kind of diagnostics wherever is most convenient for patients. Let's pivot to the B2B side so that we can make all of healthcare more inclusive and accessible.

[00:02:27] Saul Marquez: I think that's great, and David, I think what a lot of entrepreneurs find out when they get into the business is that the driver of volume is B2B. It's just really hard to tackle health care B2C, because at the end of the day, it's insurance companies, it's employers and it's the government that pay for health care. And so it's great that you've dug in and gone this route. As you think about the very important work that Ash Wellness is doing, we talk about equity in health care and really how much sense it makes both for wellness, but also dollars and cents around equity. And so talk to us about how Ash Wellness is adding value to the health care ecosystem.

[00:03:10] David Stein: Yeah, I think as I was kind of alluding to before, 70% of medical decisions are based on diagnostics and diagnostic data. And by bringing self-collected at-home testing kits into a home or wherever is most convenient for patients, we truly believe that we're making health care a lot more accessible and inclusive. And what I mean by that, in specific to the value that we're providing from a patient level, is just that by doing that, we remove so many structural and social barriers to accessing health care, be it having to find child care while making an appointment for a lab visit or having even the transportation to get to that lab visit. Or if you're a shift worker who works 9 to 5 and West or Lab corp's hours are 9 to 5, it just there's a lot of barriers to accessing that. So for a patient level, that's value we provide. From a B2B level, we really handle all the logistics and tech needed to turn on ad hoc testing programs in a completely white labeled way.

[00:04:19] Saul Marquez: I think that's great. And Labs is one of those things where you always end up having to show up for those things. God, why do I have to go? And these places are like stodgy and stale smelling. And you're right, it takes a lot of time. Hey, I'm not hating on the lab space, but you really got to find a way to modernize folks. And it sounds like wellness is doing that. And by the way, if you're curious about them, it's poweredbyash.com, if you want to find them. But let's dig in. So what is it that makes you guys improve outcomes?Because obviously it's clear how you're different, but maybe you want to dig into how you're different a little bit more and then talk to us about how you're making outcomes and business better.

[00:04:56] David Stein: So as far as outcomes being better, what we've seen is that with at-home self-collected testing kits, adherence to actually going through the testing process and collecting samples is actually higher. So what we've found is with some of our clients, they'll come to us and they'll say, hey, we run a virtual primary care offering and everything in the care continuum has been virtualized or made remote except for diagnostics. And when we send an order to a cluster lab or in-person collection site for a patient, 25 to 30% of those orders go unfulfilled. So I've done a televisit with a doctor at this company that the doctor determines that I need diagnostic data to find that follow up care and he order, he or she orders me a lab order for Kaiser LabCorp. And what they're basically saying is that so many people don't actually go get those samples collected. As far as an outcome kind of improvement, right, we just overall see adherence higher to add home self-collected testing kits versus getting a patient to go in person and I think, I live in New York, I don't know where your listeners live, but we forget about Middle America where a LabCorp request in-person collection site can be as far as two hours for some people.

[00:06:22] Saul Marquez: Just from a point.

[00:06:24] David Stein: ... Perspective there it's a lot better. As far as difference to other offerings or players in this space think where Ash kind of specializes is the fact that we actually have never sold a Covid test and so we've only sold at home testing in clinical areas that are outside ofCovid, which means we have the most experience as far as self-collected samples that need to go back to the lab and as a result have really built a platform and product that makes that user experience better and optimizes really for the easiest experience and fastest turnaround time.

[00:07:04] Saul Marquez: That's hugely valuable. And so appreciate you going there. This 25 to 30% of lab visits go unfulfilled, it's mind blowing, just blows my mind, it needs to happen. And so when you go to see the doctor, they give you lab work and you stop there like we need to find ways like. Ash to really complete the cycle of care. I do want to dig in. David, you mentioned at the beginning that there was an element here to help, you said the queer community. So talk to me more about that, I'd like to unpack that some.

[00:07:37] David Stein: Sure. Yeah. So I mean, we right now we have five co-founders and a team of about 25 people. And within the co-founding team, I'd say four of us identify as LGBTQ+ or queer. When we set out to put our brains together and our skill sets together and our time, we really wanted to affect our own communities and realize that from a social perspective, as queer individuals who might go into a doctor's office, a clinic or whatever, there are a lot of social barriers to accessing health care, be it if you don't fit within the gender binary of male-female, be it if you don't have sex the way heterosexual people have sex, there's endless kind of examples of, you know, something that was important to us was making really sexual health at the start more inclusive and accessible for queer individuals. But I think more broadly, what we realized as we pivoted to the B2B side, that is by designing an experience and a platform that is optimized for those who are on the sidelines actually makes everything more inclusive and accessible. And it's proven to be something that whether we're working with a company that is specific to the LGBTQ+ community or a company that is providing services generally to anyone, our offering tends to be better just because we design it for those on the sidelines.

[00:09:10] Saul Marquez: So awesome. That's so great. Yeah. And I had a conversation yesterday actually doing a podcast series on the future of health care and a guy that was previously an actuary and he had an entire analysis on how given, like improving access and equity in healthcare can actually lead to a reduction of like $3 trillion in annual spend like a few years from now, it makes sense people.

[00:09:37] David Stein: I think that there's a double meaning to that for us just in that, yes, making health care more inclusive and accessible and equitable and all that kind of stuff saves money. But what we're also doing is testing and screening. So we're doing a lot of preventative healthcare.

[00:09:55] Saul Marquez: I Like that. Yeah.

[00:09:56] David Stein: ... Stuff early to find a.

[00:09:59] Saul Marquez: That's really good.

[00:10:00] David Stein: Of the problem from the get go. And for us that kind of has two meanings. Yeah.

[00:10:05] Saul Marquez: Man, that's so great and I'm glad you highlighted that. That's definitely something that is key, the preventative side of things, because we are in a world where it is important to get that done, not just sick care. We want to get ahead of things, spot on, David. So if you guys been building this, you got a team of 25, you got five co-founders, things are cranking. What's one of the biggest setbacks you've experienced and what was the key learning from that, David?

[00:10:28] David Stein: Yeah. I think in any business you build, you are reliant on vendors externally to some extent. And I think one of the bigger setbacks we've had over the last couple of years is just realizing that some of these vendors might not stick around forever or might not meet the expectations that you've set together or the expectations that your clients have for your overall offering. And so when one of those goes down, ultimately the people looking for answers come to you. That's so ... I think the biggest lesson we learned just related to setbacks that we've had is that we have had real redundancies for every kind of external dependency we have, just to make sure that our operation can continue, no matter what macro or external forces are at play.

[00:11:24] Saul Marquez: I think that's great. Yeah. You always have to think about, okay, what are my dependencies and is my entire business going to shutdown if one of these goes down? What's my contingency? It's my other plan. I love it. That's such a great call out. And something for all of us to think about in our businesses is if one person or one vendor stops. does that stop your business? And what is your game plan? Love that. Thank you for sharing that. And especially as you scale, especially as you get much bigger, it becomes an even more important thing to prepare for.

[00:11:56] David Stein: Right.

[00:11:57] Saul Marquez: Love that. All right. What are you most excited about today?

[00:12:01] David Stein: I, ooh, great question. I think, you know, the space generally as far as at-home stuff like the testing kits. And what I mean by that is we exclusively do samples that are collected at-home, so we get blood from home, and it's also collected by patients. So blood, urine, saliva swabs, stool. I just think the industry itself has reached a pivotal point in that major players, be it major retailers, major health systems, the government, et cetera is on board with at-home testing and ready to turn out programs. And so there's just so much work in front of us that we're really excited about and excited to have a hand in. And I think ultimately, right, our mission is to make healthcare more inclusive and accessible. And we feel that finally we are working with these major healthcare systems that really have the chance to do that.

[00:13:00] Saul Marquez: That's great and it's great for, if you're listening to this, you've been looking for a solution to do remote lab works. That's what we do this for, in the show notes you're going to have a way to get a hold of David and his team, links to his LinkedIn, the company website, take advantage of it because now's the time. And I'm excited about this too, David, because if we're able to meet people where they are in healthcare hybrid models of care, we've got an exciting future for health care. I can't thank you enough for spending time with us today and the work that you and the team are up to. What closing thought would you leave our listeners with and the best place they could get in touch with you to learn more?

[00:13:40] David Stein: Ooh, closing thought. That is a good question and probably something I should have prepped for it.

[00:13:45] Saul Marquez: It's all good.

[00:13:46] David Stein: I think two things. One is just that we really are probably the most experienced in the space as far as at-home self-collected samples.And so we know how to run these testing programs. We know where things will go wrong and where your best bet as far as a partner in this space and I think, two, is that we really care about making health care more inclusive and accessible. And we've doubled down on that in every way. So if that is something that your listeners are looking for as far as partners in this space, we are all ears and ready to be flexible and make that happen and as far as contacting us, as you mentioned, our websites www.poweredbyash.com, but my email is just David@PoweredbyAsh.com so open to any which way people want to reach out.

[00:14:37] Saul Marquez: Amazing. David can't thank you enough for being on the podcast today and folks reach out. Now's the time for you to take your health system to the next level and really appreciate the opportunity for you to tune in to our show today with David. David, thanks for joining us.

[00:14:53] David Stein: Thank you for having me.