Running Towards Better Healthcare (ft. Reva Sheehan)

Thanks for tuning to Digital Voices podcast, where we chat digital transformation challenges and opportunities across healthcare and life sciences.

And now, your host, Ed Marx. Hey everyone, welcome to another edition of Digital Voices. So glad that you could join us. I know there's a lot of different things that you can listen to and you've taken the time to be with us, so we're going to make it worth your while. And today, I want to introduce to you Riva Steen. She is with Empulse. Riva, welcome to Digital Voices.

Thanks for having me.

Yeah, I'm excited because we're going to cover sort of in the payer space, spend a little bit more time on member experience and engagement. Oftentimes on Digital Voices, we, we delve into life sciences and biotech, but spend most of our time on the provider side. So it's always good to mix it up a little bit. And we first met really via LinkedIn and online in terms of seeing some of the great things that you're all doing at MPulse. And I know that you recently had your, I think, annual conference, and a good friend of mine was your keynote speaker, and he's written the foreword for my new book on innovation in the payer space, and that's Dr. Sachin Jain. So I've been very intrigued about everything that you do, Riva. But as a way to get to know you, and perhaps the most important question we ask on Digital Voices is, what songs are on your playlist?

That's one of the first things I noticed when I was checking these out. So a couple of things. I'm running Chicago Marathon in a few weeks, and I just got accepted into Boston last week. So I'm building out my, let's say, about 4-hour-long playlist that ranges from '90s rap to pop, Phish, all sorts of stuff. Each of those songs kind of has a meaning when I put those large ones together. But most excited, I'm about Uh, Leif Vollebek is a Canadian indie folk singer who just released and updated a new album last week. So kind of digesting that one now. So it's anticipated on my playlist. So quite a juxtaposition there between those two. But, uh, yeah.

Yeah, no, that's awesome. And we do have a Digital Voices playlist on Spotify, and I don't think we have Leif on there, so we'll definitely be looking to add that on. And yeah, so All right. Tell us about the marathons. So, is, is how many have you done so far?

6, 5, 6. I, I think I kind of lost count. It was the, did lots of half marathons and then finally was like, okay, well what's 13 more miles? I'll do one, one and done. Which those folks in my run crew here in town are all done kind of the same thing. So this will be my first Chicago. I've put in for the lottery for a handful of years and never made it, but my time last year I had earned a time that was good enough to get guaranteed entry. So I was pretty pumped about that. I also qualified for Boston last year for the first time ever, but they cut the field by 5 minutes. So it edged me and about 10,000 other people out. One of the benefits of getting older is when you run these types of races, each, each age category you, you go up, you get a little extra time. And that was beneficial for me this year. So helped secure A 2025, uh, entry. So really excited about that. I'm, yeah, I'm not quite coming to the end of, you know, one current marathon training season. I usually like to take a break, you know, around the holidays and it's cold here in Michigan, so it's cold and dark and harder to get out. But, uh, just kind of wrapping my head around, there's a lot of work to be done in preparation for April, but I'm super excited to go and, and, uh, yeah.

Yeah.

This is a big, big Big achievement.

So yeah, no doubt about it. Have you thought about doing— I forget what they call it, but it's like 5 main marathons around the world. I think Boston is one of them, and Tokyo maybe, or Berlin. Have you thought about doing any of those?

Prior to getting into Chicago and Boston, no, because it's just so hard and you just have to maintain, you know, this level of performance. Some of them are harder to get into than others, but I think it's the Abbott World Majors, and now there's rumor of maybe adding in Australia, but That's a lot of travel. I try to balance the amount of time I spend out running and on the road with things that my family likes to do also. But I'm sure they wouldn't complain if I was like, hey guys, we gotta go to London. He's running the marathon.

Right.

So we'll see. We'll see what happens after, after this fall. But I guess technically I'd be 2 out of the 5 down. So, yeah.

No, that's definitely something maybe you should pursue. I've got some friends that have done it. I'm a competitive athlete as well. So, I understand the drive and the motivation. Tell us about your life message and mantra. Are there words that you live by?

I'm a perpetual optimist. I think some of the folks in my family or inner circle sometimes are kind of annoyed by that, but I think we balance each other out really well. I think it's, you know, of course, there's realistic things in life, but I really think that You know, being optimistic and taking chances and thinking outside of the box and going, well, what if? What if there's something that seems so unrealistic or impossible, but maybe, like, let's give it a shot. I feel like that's, you know, one, and kind of just day-to-day grind of life and being a working mom and, you know, that sort of thing. It's really good to just kind of stay grounded and that, like, just the hope for all sorts of different things. So. I would say that's probably always been me, is maybe it's a rose-colored glasses type of phenomenon, but that'd be my mantra.

Yeah, no, I love it. So, Rima, we already know a little bit about you. You are a mom, and you run, and you work for Empulse. Tell us a little bit about yourself, a little bit deeper, like maybe where did you grow up?

Sure. I grew up in a small town called Napoleon, Michigan. So, if anyone's watching and knows a Michigander will point on their hand to where On the, on the Mitten they grew up. It's probably right about middle, uh, central here. I moved to Grand Rapids, uh, after high school, um, and then never went back. I thought, okay, maybe small town life isn't for me. But, you know, now that I have a child of my own and can really see some of the value of having kind of that small town, you know, we were free-range kids. We were out—

Yeah.

When the sun was up in the summer and home when the streetlights came on. Um, you know, which is, uh, we learned a lot of great, great things. Uh, youngest of 4 in a blended family, so I was the baby. Uh, we didn't always all get along, but now my siblings and I talk almost daily. Uh, you know, usually a group text thread, or, you know, we make jokes about things that we got away with when we were younger that, you know, Mike and Mary Lou had no idea. But, uh, yeah. So Napoleon, Michigan. I think I graduated with, uh, this quite some time ago too. I won't age myself too much, but 72 people in my graduating class, so pretty small. Everybody knew everybody, which there's, you know, pros and cons to that, I suppose.

Was there a decisive moment growing up, or maybe it was in college, or at some point where you were like, wow, healthcare is it, this is where I want to spend my career?

It was accidental, really. I was meant to be a gym teacher. I was studying phys ed. I've always been active and You know, athletic, I guess, if you will, and didn't really like you know at the age of 17, 18, moving to Grand Rapids, didn't really have a whole like I want to be a lawyer, I want to be a you know I just thought well this is something I enjoy, so it should just come naturally. And then I had a friend who was working at a long-term care pharmacy in town, and they needed some help, and I was looking for some extra work. And so I started working there when I was really, really intrigued by the work that they did there. So primarily that. Particular pharmacy supported skilled nursing homes, adult foster care homes, long-term care settings. So really getting to work with the caregivers and their families, the families of, you know, the patients or the residents. So spent a fair amount of time in long-term care and compound pharmacy. So that's always kind of been my something shiny. I kind of geek out on drugs and patents and, you know, pricing and that sort of thing, which is really kind boring. But from there, I moved over to the payer side. So I took a role in pharmacy operations at a health plan here in Michigan, and really learned the other side of that whole experience in the business. And then from there, moved into health plan quality, which I really enjoyed working in senior markets. So supporting our Medicare lines of business from everything from, you know, preventive screenings, member experience, making sure people have access to medications and physicians and helping coordinate care. It's really a full scope when you get into, I think, Medicare quality or any kind of quality improvement roles. I used to joke, and I'm sure people that I spent time with last week have already heard me say this, but we used to say, I'll do anything to support senior markets. I feel very much this way about my role at Impulse, and I'm lucky to be able to work with so many different groups, but I draw the line at cleaning the toilet. That's not going to happen. But anything else in that scope—

Got it.

you know, that needs to be done, like, let's do it. Let's make it work. Let's make it happen. We've got the resources and the tools. So, yeah. So then I moved over to MPulse in August of 2020. I think my role is similar. I joke sometimes too, it's kind of like being a mom, right?

Okay.

You get your hands in a little bit of everything. Everyone needs something from you. They're all really grateful when you help and support them. But really a lot of what I do here at MPulse is ensuring that the underlying rules, regulations, requirements, and that sort— those sorts of things that health plans primarily— we do work a fair amount with provider groups as well— but that the solutions that we provide and deliver meet those underlying needs and requirements. So I stay on top of regulatory changes or requirements, star ratings, NCQA measure changes, that sort of thing to really ensure that those products that we deliver to our clients meet those needs and that can help take care of all of their member population. So I kind of ended up here by default. And then I have moments, I volunteer at my daughter's school and coach her track team in the spring. And I have moments where I was like, man, I wish I was a gym teacher. But it's a bit late, I think, in life for career change. So it was kind of by happenstance, but I'm happy. Happy to be here. Again, that optimist, everything happens for a reason, right? So—

Yeah, Reba, you were sharing a little bit about MPulse. So how do you work with your clients? Give us an example about MPulse, and then we'll dive into some success stories.

Yeah, so MPulse in general, we're a leader in digital engagement. We've just recently acquired a couple other organizations to build out an HXI, which is Health Insights and Experience. Platform. So really looking at the scope of from enrollment, onboarding through to care coordination, care delivery, et cetera. So primary models are decision points insights. We have predictive analytics, member engagement. When you get that text message, hey, we have an appointment tomorrow, or you're due for a flu shot, those are the types of things that we're deploying, as well as some member portals. So we've got changes coming down the line for prior authorizations and interoperability. So supporting really the full scope of payer and provider landscape.

Yeah, no, that's super cool. And I know part of your passion too is related to mental healthcare. So how do you help the patients get access to mental health?

Absolutely. So I'm not a mental healthcare professional by any means, but really understanding a lot of the work that we do, a lot of what we do on the Impulse side too is grounded in behavioral science, behavioral economics. But most importantly, and I think what we've seen over the last couple of years, and this is the optimist, you'll see a theme here, I think.

Right, right.

You know, the global pandemic was terrible for obvious reasons, but there were a lot of good things that came out of it. And I think mental health flexibilities and telehealth, especially around mental health, but telehealth in general was huge. So we've got some provisions that have been extended for Medicare Advantage indefinitely. There are some that have been extended through the end of this year, which maybe I think we'd like to see them, you know, continue. But really a lot of it and a lot of the work that we do in the mental health space is access, right? How do we get people to the places they need to be? How do we help them understand that, hey, you do have this potential service or coverage, or I can help connect you, you know, whether it be a digital resource or, Like, I mean, use digital resources to get you to an appointment across town and help provide you with transportation. We do a ton of work in the educational space. We help people navigate typically hard things, right? Okay, I don't understand this. I'm new to this. What does this mean?

Yeah.

How do I do this? So we've had some good successes there. And, you know, it's just the educational piece too. And a lot of that as well as reducing stigma. You've got some significant differences in how people view mental health or mental health care from different age bands. And I think that seeing some of the numbers and the metrics coming out of HHS out of the pandemic shows that we've got folks who are typically not maybe higher utilizers are happier to use it. If I don't have to walk into the mental health clinic, if I'm a senior and I'm more—

Yeah.

Inclined to view those types of services as negative or, you know, biased, et cetera. Now folks have the ability to seek that care in the comfort of their own home or in the privacy of their own home, or maybe they're just homebound or have other, you know, difficulties getting out of the house or getting to a qualified provider. We've seen a lot of improvements in that space, and that's some of the work that we do at MPulse is Helping move those folks. Again, like I said, it's understanding what is the benefit, what is there for me, and my benefit from my health plan or my community service provider, and then connecting those folks to those resources and ensuring they stay engaged, right? You can get them there, but if they don't then utilize and continue to utilize, it's not done as good of a job as you wanted it to.

Right. Yeah, and along those lines, how do your customers use this experience Experiential and real-time data. So you're providing a lot of data for them. How are they internalizing it and actually doing something with it?

Absolutely. So kind of our sweet spot when we talk about engagement is 2-way SMS, 2-way mobile text messaging. We have natural language understanding. We have a vast— I gosh, I should know the scope, but a massive library of healthcare-specific responses and responders. That can be tailored to the individual, that can be tailored to the client, the plan, the provider, whoever it might be. And what's really cool about those is it's ever-evolving and ever-learning, right? So it's understanding people's responses. So for example, if I'm going to say, hey, Ed, this is your health plan, we've got a flu shot is waiting for you, and you're like, I don't have a ride, or you just—

Yeah.

Any kind of word related to that, our system is able to recognize that. And then one, provide that information back to your healthcare provider or payer to say, all right, we have someone who is in need of transportation. But in that real-time exchange, I can say, okay, no problem, here's the phone number to transportation in your county, give them a call, you have coverage for said services, right? So it's again back to that kind of educating folks, but we can tell them what's there for them, but if we can't get them to utilize it, it's not— we're going to really improve Any health outcomes. So using that data too, we've got the robust models that can kind of predict and tee up certain things for individuals. Same thing of you know being able to send preferred language, right? Cultural racial content. When you're talking to someone that looks and sounds like you, you're going to have a better, a deeper connection, and we're able to do that even in the digital space. So we take those data points if we know. Known data about individuals to tailor content to them. We know we don't have a lot of really great data completeness when it comes to race, ethnicity, and language, but we can capture some of those preferences back in and continuously not only feed our model for better use, but providing that information back to the health plan or the payer provider using those data points to then say, "Wow, across my entire membership in Michigan, these folks down here in Napoleon have the hardest time getting." To the physician. So what can we do in that community? How can we use that data to leverage community resources? Is it, you know, educational schools, local municipalities, churches, whatever it might be? So that's kind of what I kind of geek out on when I look at the ability and capabilities to use the data that we know and then the data that we learn to really make an impact change.

Yeah, that's a great— those are great examples. Very similar on the provider side as well. Just the techniques that you're leveraging to really engage the member and make sure that they get all the best care that they can. What are one or two coolest experiences that you've heard about so far? Maybe it's a client that's using your system, but any story of just sort of like A dramatic help of any kind?

Yeah, I think we, we see some kind of unexpected things, right? Like, again, we look at how many— we host a billion conversations on our platform annually. We've got folks across all lines of business, demographics, age bands. You know, we're reaching out to adults for children, right? We do it with parents Guardians of young children who need services and access as well. So we have this massive, you know, kind of scope of what we know and and and what we learn and continuously improve. But I think it's exciting when we see some kind of like almost like aha moments or moments where we were like we didn't expect that, but that's amazing, right? We did an e-adoption program for a health plan a year or so ago, and really just trying to get them to connect to like hey you have these. Electronic data services, and we want you to opt in to utilize and use them. I think this one maybe started during some of the shutdown in the pandemic. But we saw what we didn't anticipate. We saw a high— we use photo novellas, which are visual kind of streaming content. It's kind of like a comic book, right? And we'll create those to walk through everyday scenarios. So it's Reva and Ed talking about, hey, my doctor just told me I should get a flu shot. And Ed says, no, I'm healthy. I don't need one. And I say, well, that, you know, it's walking through kind of those scenarios in real life kind of experiences or images, if you will. So we use those photo novellas to help people click through a comic to say, oh, well, this is why I should get this e-visit or adopt this tool, whatever it might be in that case. And we saw an extremely high click-through rate with this particular group in Black females aged 60 and up, which was their historically hardest to reach, hardest to engage folks. So we have this notion of like, we think this is probably what's gonna work, or we look at things and say, is better an option, right? Instead of getting just a mailer, you know, saying, hey, you have this or you should do it, let's give them a better experience. So seeing kind of some of those aha moments have been really kind of fun. I think too, and also coming out of COVID having started here in 2020, Just being able to see the responsiveness, you know, that we can provide, not only us to our clients, but clients to, to Impulse to say, hey, I have a challenge, or this is something new, what should I do? How can I help? Really just being able to collaborate with our clients and understanding the needs and the challenges that they face to help those individuals. So I think those are kind of some of the fun aha moments when we see something we didn't expect or when we already know That this is going to create a better outcome. And you've got folks that might be a little hesitant to try something new. And then we get them to develop a— we develop a photo novella together and then say, see, like I told you, it actually worked, right? So it's kind of changing some of the perception of how we engage, right? Those— you've got different groups of people that need different things and not a— it's not a one-size-fits-all approach. Like for me, if you text me and say, hey, schedule your preventive, whatever. Yeah. I'm going to go right into my chart and do it. I've probably done it before you even have to text me. But there's other people that have a deeper need to understand what is it, why should I do it, how much is it going to cost, how long is it going to take, where do I go, all of these questions. And to really be able to kind of help manage those at scale is really kind of wow to be able to see coming from one small health plan in Michigan to now this large scope of all the folks that we work with and see the impact I think that we really truly have, you know, on those communities.

Yeah, no, that's a great example. Hey, let's transition a little bit into leadership. Is there anything early in life that helped prepare you for your current role? Because, you know, a lot of our listeners might be earlier in their career. I mean, it might be trying to just figure things out, put things together. What do I want to do? But were there some things that may have shaped you early that help you today?

Yeah, absolutely. I think I've maybe always had a little bit of that. I'll draw the line at cleaning the toilet, but whatever else needs to be done, I'll do.

Yeah.

Really, I think just for me looking back, having had leaders and been a leader myself, is really that curiosity of what else is out there, right? I want to understand why, right? So if someone's like, hey, this is what I need you to do, or we're going to do this this way, I want to know why. Why? Not because I'm challenging you or being problematic, but help me understand, right? I've learned so much and had exposure to so many different things by being curious and asking why. The help me understand, help me understand why we do this this way. I really think that helped lead me from long-term care pharmacy over to the payer side, and then moving out of pharmacy into quality, which is, which again spans just the full lifecycle of Of Medicare Advantage, from enrollment to management, that sort of thing. So being curious, I think, and kind of not don't be shy, right? If there's good leaders out there and bad leaders, and that's a fact of life, right? So being able to understand how well you work with other people, I think has been has been key for me because you can't always. Get away from someone who you don't enjoy working with or who's not your leadership style or isn't supportive or whatever it might be. I think just not being afraid to share how you feel or share your voice to ensure that you are being respected and treated appropriately and following those kind of chains of command.

Yeah.

Let me see if I can resolve it together with the two of us, and then if I can't, knowing where to go after that, I think, you know, has been good for me. And I've had great leaders. There's one in particular, if she's listening, she'll know who she is, who made me then want to be more of a leader, to say, you know, gosh, I'm living my best no direct reports life right now, but I would love to have a few folks like young Riva and really be able to give them this positive female leadership, or just any positive leadership experience. Yeah. To help them grow, right? Looking back and finding times where, man, that was a tough couple of years. If I can help someone else avoid that and then give them those tools and resources where they can then continue, you know, that's something I'm I'm passionate about. That that's this individual kind of brought out in me, and then also just pushed me harder, right? I would ask questions of say like, well, what you know who who needs to see this or how How how done does this thing have to be? Right, and and so the joke was always it has to be BOD ready. It's got to be board of directors ready.

Right.

You don't know where it's going to go once it leaves your desk. That's what she would say. Is better an option? I say that to my child sometimes too, and she doesn't like it. But you'd kind of go, you know, it is. So I think just being pushed positively and supported in that space has helped. You know, helped me grow as an individual, individual contributor and leader as well.

Yeah, that's good stuff. What about those listeners who heard in the very beginning, you know, that you run marathons? And they, so, and you didn't start off running marathons, you started off half marathons, and I'm sure before that, maybe it was a 5K, 10K sort of thing. What advice do you have to listeners who might have thought, never thought about running a marathon, but when they started listening, they're like, hey, I wonder if I could do that. What would be like, uh, one or two like initial steps for someone?

Absolutely. Um, find yourself some friends, find yourself like-minded folks. Um, you know, we joke that, uh, my particular group here in Grand Rapids, that we're a drinking group with a running problem. I don't think we have a drinking problem, but we'll meet at different breweries or restaurants and go run together and we enjoy each other's time and then we'll, you know, kind of take a break and have a bite to eat. But I would say find yourself some friends to run with.

Yeah.

I have built just amazing, I think lifelong friendships over the last 10 years in this community here in Grand Rapids. So find yourself some friends, realize that there are a million different ways to complete a marathon. There, you can Google, there's the Galloway method, there's a Lydiard method, there's all sorts of different professional methods that you can, pick one that works for you, right? And I think it's that just forward motion in general. Oops, the glasses up here. You know, we're not all good. Took me years to even break 4 hours, let alone, I didn't think I'd ever qualify for Boston.

Yeah.

And then I thought, okay, well if I do want to do this, I'm gonna have to change things a little bit in my training cycle. But I think anyone that wants to start should. And, and the old notion that, oh, I have bad knees, like it's just bad shoes.

Yeah.

You know, we say in Michigan too, like, oh, it's bad weather. There's no such thing as bad weather. It's just bad gear. If you've got the hats and the gloves and the shoes, you can run in January in Michigan. So, yeah.

Yeah. And totally on the shoes. And the reason I asked that question is because I think people infer it for themselves. We're not going to unpack it for them. But what you just described there in terms of that journey is the same with leadership. So, there's a lot of corollaries there. So, What about downtime? So, you're very active, you're a mom, you're executive, you're a super runner. What about downtime? What's one piece of advice you would give other people, like, to chill?

Oh, that's a good question because sometimes I wonder, like, gosh, did I get any downtime today? You know, it's 9 o'clock and kids in bed, and I should go to sleep because I'm going to get up and run in the morning, but I want a little bit of time. I travel a fair amount for work as well, which is I always try to find something to do in a, in a new place, right? If I'm on the road, um, to kind of be able to enjoy a little bit of my space. But I would say with being busy, it's make a plan, right? Make a plan. Uh, this was my whole mantra for marathon training last year. I kind of picked the best bits and pieces from different, um, kind of proven training cycles if you want, and worked them into like, these are the times in my day or my week when I can get out and I don't need You know, my daughter's 10 now, but I used to push her in a jogger. I mean, I think that's double miles, right? But so I found the times that worked best for me to get in what I needed to do that didn't overly disrupt everyone else. But I was very flexible with that. I never felt stressed out. I had a plan, but I felt okay to deviate from that plan if I needed to. If I didn't feel good Friday morning at 6:00 AM and I didn't get up and run, I didn't beat myself up over it. So. Yeah.

Yeah.

I think for finding downtime, you find the things that you enjoy that you can fit into your schedule or your week or your calendar, whatever it might be. Um, having a plan is great, but don't beat yourself up over it, right? Same thing with work. Like, I've got things that I need to get done, you know, I was going to say before the end of the 3rd quarter, but that's today. Um, we're going to be flexible and move them to the first part of the 4th quarter. But I think, yeah, that's all I could say is having a plan and Stick to it as best you can, but make it realistic, right?

Yeah.

That plan.

Yeah. Reba, we covered a lot in a short amount of time, everything from some indie music. And then we went on, talked a lot about marathon, but also then wrapped it in kind of like life and leadership. We talked about where you serve today with Impulse and a lot of what you're doing on the payer side to help with engagement and experience. So a lot of good information there. And then leadership, asking why, being curious. I love the concept of, hey, is a board of directors ready? That's great. Is there something we missed or anything you want to double down on? I'll give you the last word.

Yeah, I think that doubling down and going back to the is better an option, when we look at experiences across different populations within healthcare, we know a lot about our people, the people that we care for. And I think sometimes it's, it's hard to get out of the status quo, right? If we've already done these certain things, we call them legacy systems or legacy mailers or legacy communications. We don't really know if they move the needle. Do they? Do they not? Again, I think back to being curious is better an option, but then using data, let data make those decisions for you or help inform those decisions. So if you need additional resources from senior leadership to launch something, Um, you know, campaign or to invest in programs for your members. You need that member data to really push those decisions. If you have things that aren't working really well or you don't know, start to measure them. You know, tap your friends, find the people that are like you, that know things similar to you, or that can help support you. But I think that's a lot of really what I enjoy doing here the most is kind of pushing that status quo and saying better is an option. We can deliver better messages to folks. We can give them better experiences and help set them up for success. So ultimately, maybe someday they won't even need us, right? They won't need text messages from M-Pulse, or they won't need nudges to adopt the portal because they'll already know and just do that by good behavior. But yeah, I think using data, being curious, and it is better an option when it comes to, you know, managing folks that rely on us.

Yeah, Reva, this has been super fascinating. And again, just Learning on the payer side, experience and engagement, and also a lot about running, which is one of my favorite things to do. Thank you for being a guest on Digital Voices.

Yeah, thanks for having me out. Appreciate it.

All right, that wraps up another edition of Digital Voices, and hopefully you'll be motivated to go out and run a 5K later today.

Thank you for listening to Digital Voices podcast with Ed Marx. If you enjoyed this episode, subscribe on your preferred streaming service and leave a rating and review.

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