How We Zoom: Co-Founder & CEO Dave Sanders at TEDx Portland 2017

August 11, 2020

How ZoomCare Works

On April 15th, ZOOM+Care Co-Founder and CEO Dave Sanders took the stage at TEDx Portland to reveal the 3-part formula that has already begun to revolutionize healthcare. Watch the crowd-rallying talk or read the full transcript below.

The Future of Healthcare: 1 Billion Served

Within the next 5 years, the first modern healthcare company will emerge. It will be the first to care for 1 billion people. But first, I want to talk about mom.My mom, a grade school teacher by day and a political activist by night, taught us we could be whatever we wanted to be - as long as it was a doctor or lawyer. My brother and sister are lawyers. Back in first grade, I was perfecting my life-saving surgeries on my collection of formaldehyde frogs. My granddad, Grampa Joe, was a rag recycler on Chicago’s South Side. He picked up industrial rags in his truck and brought them to a plant to be shredded and recycled. He got paid by the pound. In 1955, Ray Kroc opened his first McDonald’s in Des Plaines, Illinois. My grandad was always talking about his dream to save up enough to buy a McDonald’s franchise; he never did. It left me with lifelong fear of squandering opportunities.I still can see the sign under the golden arches displaying the ever-growing millions and billions of burgers served. Ray Kroc was neither lucky nor a genius. He recognized that restaurants - a mom and pop industry - was ripe for remaking.As a physician and lifelong near-vegan, I’m not a customer.But, hundreds of billions of burgers later, we can say McDonalds pioneered a formula to deliver radical accessibility, affordability and consistency.That’s what we call Scale.Today, my dear healthcare is our nation’s largest industry measured by total spending - over $3 trillion with a T per year - yet it languishes with poor access, low affordability and inconsistency.It’s like the restaurant industry in the 1950’s, before McDonald’s....  It’s a 3 trillion dollar cottage industry.As a doctor, my diagnosis is this: the U.S. healthcare industry is suffering from a bad case of Pre-Scale Syndrome. Meanwhile, we’ve seen major industries remade before our eyes.....Transportation has been reimagined by Lyft. Grocery has been shaken up by companies like Blue Apron and Instacart. Hospitality undone by AirBnB. Entertainment has been redefined by Netflix and Youtube. Shopping has been totally reinvented by Amazon.In each case, a twenty-something wizard seemingly overnight brings an ancient industry to its knees and scales to serve hundreds of millions of people.How do they know how to do this? Well they aren’t making it up as they go. They are following a formula - a modern version of the McDonalds scale formula turbocharged with technology and social.You know the formula well:

  • First, bring people together - to share or sell their gear, a room, a ride - even their expertise
  • Second, strip out all the friction - compress time and space between your desire and delivery
  • Third, put you in total control with tools and transparency

This is the three-part formula that is remaking our world.An equally astounding reinvention of healthcare should be inevitable… it’s a no-brainer, right?...but it hasn’t happened and healthcare remains sadly inaccessible, unaffordable, and inconsistent.For the past 11 years, our company has been at work in Portland and Seattle trying to bust through the barriers that stand in the way of getting healthcare to the point where we can serve 1 billion people. So the THE fundamental question is: How do we do it?The good news is we don’t need to invent a new formula. The same formula that’s remade these other industries, will remake healthcare - if we get out of our own way.And when this is done

  • Patients and caregivers will come together in a social health network
  • The time and space between you and your care will be compressed
  • You will have radical access and control of your health

We can do this today and here’s how.

  1. To bring together patients and caregivers in a social health network, we have to let go of the old doctor-patient relationship and accept that physicians are overqualified for frontline care.

Like most people who went to med school, I started out as a physician bigot, too… Only “real” Doctors can treat patients! But we had to face the reality that there are not enough physicians to go around.So we began to work with Physician Assistants and Nurse Practitioners, and we discovered they were as good or better than our doctors.Unfortunately, regulation blocked these caregivers from working at their full potential. So, we helped to pass landmark legislation to establish the first team-based care where physicians serve as team captains and other providers deliver frontline care.Our motto became Performance not Pedigree.That was just the first step on the journey from the old exclusive one-to-one doctor club to the limitless potential of a many-to-many social health network where people care for each other.

  1. To compress the time and space between you and your care, we must demote the hospital from the center of the healthcare universe to the periphery - the place of last resort.

Let me share with you how hospitals really work. Hospitals pay for their marble and their waterfalls on the backs of sick people.Doctors offices are funnels - to the most profitable hospital services - cancer, cardiac surgery, advanced imaging. That’s why hospitals have bought out the doctors offices.And the ER is the hospital’s front door. Despite 20 years of exhaustive public health research demonstrating ER overuse and needless expense, the ER remains unreformed. You better believe that If you own a billion dollar hospital, you’ll find a way to keep it full.Now let’s flip this archaic system on its head.Start with an online carebot — yes, a carebot — that takes your history, diagnoses, and treats basic conditions. And if you need more, there’s a doctor in your pocket, and if you need more, you order a house call on demand. If you need more, you go to a ubiquitous complete-care clinic. And if you need more, then and only then - it’s hospital time.This is already starting to happen. And it’s working. And if it continues, we’ll shrink our nation’s healthcare bill by 30%, and reduce the uninsured by 25 million.18 months ago we built an alternative to the emergency room to treat conditions like bad wounds, broken bones, shortness of breath, emergency stuff. And we eliminated $22 million of ER bills.It didn’t go unnoticed.Six months ago, our state - under withering pressure from hospitals - said “Not so fast” --  if you’re not a licensed hospital, you can’t call what you’re doing emergency care. What else would we call it?So, once again, we fought back with Senate Bill 817, to modernize emergency care in our state. The battle goes on...Day by day, we move closer to all your care being on demand, and flipping the system from hospital first to you first.

  1. To provide you with radical access and control of your health, we must at last pull the curtain back on healthcare -  reveal hidden prices, quality facts, everything!

People are craving-clamoring for more control of their healthcare - they just expect it now - they have it in all the other aspects of their life. Yet, healthcare helplessness has never been higher.Even people who run the health system don’t understand it.Here’s an example...In our early days, we had 7,000 seniors who relied on us for their care. We aren’t in the Medicare system, but we charged $99 per visit, and they loved it.Then, one day, I got a letter from Medicare saying “If you take care of another person on Medicare, we will fine you $10,000 per visit.I wrote back and said “No, you don’t understand, these are people who couldn’t find care. They paid for the visit themselves, and we didn’t bill Medicare.”They wrote back in bold letters: Federal law prohibits Medicare beneficiaries from buying care for themselves. So I met with the highest ranking Medicare officer in the land. I told her the story, and she said, “No, no, that can’t be right.” But she looked into it, and sure enough it is law, and she said “That should change.” It hasn’t.This is just one story that demonstrates the inexplicable opacity of our healthcare system. You’ve all experienced it one way or another.I’m sorry, but our industry has beaten you into submission. Think about it. Would you stand for a second if any other product or service in your life didn’t have a price tag or even a description.But this too will topple and transparency will reign.My grandfather’s McDonalds dreams instilled in me a certain fear of squandering opportunities. Before us today is the opportunity of a generation to build the first modern healthcare company - to care for a billion people.Healthcare must be as magical as the same-day doorstep delivery from the everything store, the on-demand movie, the car at your beck and call.There are 4 other teams around the world racing night and day toward the same goal of scaling healthcare.Now, we’ve made some progress toward that goal.We have 5 big years ahead of us, but if we commit to being unstoppable, thenHere in Portland, we’ll be able tell OUR grandkids, we helped care for a 1 billion people.

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