Digital Health Talks - Changemakers Focused on Fixing Healthcare

The Hidden Crisis in Women's Health: How Tech Innovation is Closing Care Gaps and Reducing Healthcare Costs

Episode Notes

Join us as Joanna Strober, CEO of Midi Health, reveals how virtual care platforms are addressing the significant gap in women's midlife healthcare. Discover how treating menopause symptoms properly reduces long-term health complications, lowers healthcare utilization costs, and improves workplace productivity. Hear firsthand how this digital health pioneer is partnering with major health systems and employers to deliver measurable clinical outcomes that benefit patients, providers, and payers alike.

Joanna Strober, CEO, Midi Health

Megan Antonelli, Chief Executive Officer, HealthIMPACT

Episode Transcription

Welcome  0:01  Welcome to Digital Health talks. Each week we meet with healthcare leaders making an immeasurable difference in equity, access and quality. Hear about what tech is worth investing in and what isn't as we focus on the innovations that deliver. Join Megan Antonelli, Janae sharp and Shaheed Shah for a weekly no BS, deep dive on what's really making an impact in healthcare.

Megan Antonelli  0:30  Hi. Welcome to Digital Health talks. This is Megan Antonelli and I am so excited to be here today with Joanna Strober, CEO and co founder of MIDI health. MIDI health is a virtual care platform, transforming access to specialized menopause treatment nationwide after successfully founding and selling curbo to Weight Watchers, Joanna brings over two decades of investment experience with breakthrough companies like Blue Nile Baby Center and her insights on technology solutions for Women's Health gaps couldn't be more timely as Health Systems and consumers and people and patients all over are looking at effective ways to improve outcomes and control costs around this. Joanna, welcome to the show. Thank you. Happy to be here. Yeah. I am so excited to talk to you. I am just so impressed with what MIDI health is doing. And of course, your story as a female founder of both Kirbo and MIDI health, two topics near and dear to my heart. Tell our audience a little bit about, you know, your founding founders, story times too, with with kerbo and now MIDI health.

Joanna Strober  1:34  You know, I've had a long career, I guess just because I'm old, but my my passion has really been things that I like to solve, problems that I'm experiencing quite honestly, like I, you know, for example, when I was I was an early venture person, and I funded babysitter when I was 28 and pregnant, and met the founders of Baby Center, And I was like, Oh, my God, I need this. And I saw the same thing with with Blue Nile. You know, they were there was no one believed that people would buy diamonds on the internet. No one believed that, right? It was early internet days, but it was clear that buying a diamond was really hard and getting a high quality diamond unless you could have had a friend to the diamond district. Was really hard to do. So I think about that. And both those companies are still around 25 years later, because they were solving really big problems. And so what's exciting to me about healthcare is that you can find big problems and try to solve them. And you know, for shortage of problems, that is for sure, right? But that's amazing. And then with this company, the goal was just to solve big healthcare problems.

Megan Antonelli  2:49  Yeah, that's amazing. I did, I the Blue Nile thing. I actually, somehow, I've done events on a lot of things, and at one point I worked for Nielsen, and they had a jewelry event. And we did this, like whole e commerce for jewelers, and it was for independent jewelers to sell their jewelry online. And, you know, I mean, how amazing, and Blue Nile was was new then, and all the small retailers were trying to compete with that and figure it out. And what, you know, to think of it now, it's so it's so crazy. So that is, it's amazing that you were there and kind of solving those problems at that time. So tell us a little bit. I mean, kerbo, obviously you sold to Weight Watchers, a huge success. Tell us, you know how that your experience, kind of building and selling kerbo has shaped. You know how you've approached MIDI?

Joanna Strober  3:39  Yeah. So childhood obesity is a big problem, and it's a hard problem to solve. We tried to solve it before COVID, which meant that we couldn't easily get insurance coverage for what we were doing. And honestly, the most interesting thing about kerbo, however, was not the payment model, it's the fact that if I was successful and I taught your child better habits, you didn't need me anymore. And so the better the product was, the less you would need us. And that is a really interesting challenge from a business perspective. So when we set out to think about what I was going to do next, I really wanted something with a 20 year value proposition. I wanted something that we would, you know, start taking care of you in your 30s, continue taking care of your in your 40s and your 50s, and we build a company with a 20 year value proposition. So it wasn't, you know, if you think about weight or dating, success means stopping. We didn't want a company where success meant stopping,

Megan Antonelli  4:41  right? Well, that's a good point, and it is, you know, I think the women's health space now, I mean, you know, in terms of menopause, it's sort of having a, you know, a moment, right? You know, we've got Amy Schumer and Oprah and all these folks talking about menopause and and even talking about. Health, which is amazing. But you know, I, as you mentioned, the insurance piece of that is, it's tough, and you've done that rather quickly in terms of getting coverage. Tell me a little bit about that story and kind of the coverage piece of it, and how you were able to do that, because I know a lot of digital health companies struggle, yeah.

Joanna Strober  5:19  So I think what I want to start by talking about what is menopause and what is perimenopause, and what does all this mean in your body? Because there's a picture of menopause companies and what does that mean, and menopause insurance coverage, but perimenopause, which just means pre menopause, is about your estrogen and testosterone fluctuating and starting to go down in your 30s, not you know, it's not for old ladies we think of like menopause gray hair, but it's not. It's women in their 30s and 40s, and it's the estrogen fluctuations that create a lot of havoc in our bodies, and that Havoc includes the things like anxiety, depression, night sweats, painful sex, joint pain, really, most of what women's care is during that age. If you ask most primary care doctors, they're taking care of women during this age is actually mostly menopause symptoms, if they understand them. And so the our revelation, or our understanding, is that you needed to combine the expertise of OB GYN and internal medicine and essentially create a new type of women's primary care. And that is essentially how we think of this. We think of it as a way to treat, treat women for the non, the non urgent things that they are taking care of, although eventually we'll do Urgent Care too. But think of it as women's care, not menopause care. Don't think of it as menopause care. Think of it as women's care and hormone care. And so what we've realized is that we can basically become a primary care provider. And so we're here, we're a primary care provider essentially focused on women's issues, and that way, we're able to get in network with insurance companies as a primary care provider. So that was our our unique understanding. And so we set out, and we got our doctors licensed in all 50 states, and we were able to get insurance coverage for them, because we're providing care as a primary care provider in all 50 states. And when did Mindy launch? We started taking pair pair of patients in 2022 Oh,

Megan Antonelli  7:35  wow, so, and this was sort of during the pandemic, so the rules had, had just changed, and what have you that then allowed for you to do that, right? That's awesome, right? I mean, what timing in terms of that? And I think, you know, I mean in terms of what you've sort of laid out it, you know, what I find is so interesting about women's health and the way that it was traditionally kind of divided up right into sort of this adolescence, child rearing, years, and then menopause. And the reality is that the hormonal trajectory of women, it's all tied together, and it is, it, in fact, is the most important part of our health, right? So as you've kind of positioned that to folks, right? I mean, where menopause maybe, you know, at a time when menopause was less of a, you know, sort of everybody talking about it because it is, has been sort of more recent. But tell us a little bit about what, you know, what the response from the market was when you were saying, you know, this is a continuum. We want to address this continuum.

Joanna Strober  8:36  It was actually really fun. We started out doing a pilot, and we had two doctors and 150 patients, and we essentially took care of them for three months, and we took care of their bone health and their brain health and their menopause and perimenopause symptoms. And at the end of those three months, we're like, Okay, we're done. Now we're gonna go, like, create this thing. And all the women panicked, and they were like, No, you can't stop you can't go away. We have nowhere else to go to get this kind of care. And so that's actually when we knew we were creating something that mattered to the world. Was when we got that response. And you know, essentially, our job is to take care of you in the way you want to be taken care of. No more gatekeeping, just essentially no more gaslighting. Just give women the care that they want, and then they will come back to you, and that's really what we're building,

Megan Antonelli  9:24  right? And, I mean, it's controversial, and it's also, there's a lot of misinformation out there, and I mean it the Women's Health Study of that, you know, sort of around hormonal replacement, and all of that has really sort of skewed all of this. How are you dealing with with that as an organization, both with the medical community. I mean, I know now there's a lot more acceptance of of the treatments, but it, you know, I certainly still went to my traditional we GYN and cut, got them. Well, you know, you're still fine. It's okay. Don't worry about it. So what's the you know. So is there, you know, in terms of the clinical information that's coming out, the research that's being done, are you guys working on research? Are you just mostly amplifying the research that's there? Tell us a little bit about kind of, I know you do. It's like evidence based protocols that you guys work towards. How are those, you know, getting created, and where do you, you know, where do you guys live within, within that space.

Joanna Strober  10:22  Yeah, we always start with the science and the research. I mean, there's a lot that has actually been done the so we start with the science and the research, and then we construct our care protocols on that. So, you know, getting back to hormones, by most f by most calculations, 4% of women in the United States are taking hormones, 4% approximately 95% would benefit from them. And the when I say that, when I mean benefit, I mean, think about the fact that your bones, if you take estrogen, your bones don't deep, deep deplete, right? It enables you to sleep better. It takes away joint pain. It can take away anxiety and depression. Often, when women present, they get given an SSRI instead of hormones. But the fear of hormones is so prevalent that I think no matter what we do, most women are going to not want them. And you know, it's very sad that that's the case, but the reality is, you know, sometimes we're accused of, like, if we tell people the evidence and the research, we're accused of pill pushing. And often patients are like, I don't want a hormone. And I respect that immensely. If they know the information and then they don't want it, that's that's fine. It's great. If you make your own decisions. That's what I want. Just want you to make educated decisions that are not based on fear. There is emerging research, and it is emerging that shows that taking testosterone or estrogen can be heart preventative, can be brain preventative, can help you with bone strength, right? These are things that are emerging, really interesting research. And my job at MIDI is to give you that information. You choose what you want to take, but I want you to have all the right information and be guided by the right science, right?

Megan Antonelli  12:11  Yeah, no. And that's, I mean, it's, you know, healthcare is hard and it's complicated, and then the coupling of, you know, kind of social media and where people get their information on what people trust in a world where, you know, Dr Oz is the head of CMS, and there's, you know, lots of celebrity kind of influence that that in some ways, can, you know, it can be very powerful, right? I mean, Oprah's, you know, you know, she made him who he is, and now, you know, here we are, and and so what do we trust and how do we trust that? And then, of course, you know with these, you know, virtual healthcare and that relationship that you can have, you know which can be, you know, in some ways, you know your virtual healthcare provider can give you more time and more information and be more engaging in the lives that we live. So what are you guys seeing in terms of that, and in terms of the power of of that, you know, kind of virtual health as a tool to really help people, you know, discern the, you know, misinformation from the truth and from the science?

Joanna Strober  13:15  Yeah. So one thing that we do differently than most digital health companies is that we provide lunch, longitudinal care. So we don't think of this as one off. You have one provider, just like the long term relationship you used to have with your primary care doctor, right? We have one provider. You stick with that person for all the different things, unless we need to send you a specialist, and either we can send you to a specialist else where, via a partner or within our own platform, we have specialists as well, but our job is to develop, develop a trusted relationship with you, and that is what we focus on. A lot, on building that trust and building a trusted partnership where, you know, often women will ask us a question, and we don't know the answer, and we just go and do the research, and we get back to them, and we have a whole lot of experts on our on the back end that we can reach out to. And you know, sometimes I'll see five different specialists comment on one case and give input on how one patient should be taken care of, and that's something you could never do very easily in a doctor's office. But, you know, they can go on slack in the middle of that visit and say, Okay, here's the patient, here's her issues. Should she, you know, what do you recommend? And she'll get five answers from really great specialists about how to, how to take care of this thing. So what we're trying to do, really, is scale care like this. So this is a much more scalable version of care by providing it online and and, you know, being able to then access a lot of other experts at the same time.

Megan Antonelli  14:45  I mean, it seems like one of the things that's a little bit different about many from some of the other telehealth models like this, you know, is you, you are taking a pretty holistic view of of the patient, and you're moving beyond just menopause and into different different. Spaces, and I think that's important, because I do, I find myself even, you know, I've got my oura ring measuring this, and I've got my this and that, you know, I've got different, you know, different digital health apps for for every condition, right? And so in the in the quest for kind of dealing with it in all one place, or holistically, I've now got more providers. So tell me a little bit about where you guys are headed with that, and what's what's looking what it looks like,

Joanna Strober  15:26  right? I mean, a lot of my value proposition to payers is that we reduce the number of providers that one woman needs to have. So Right? Like we are, we train our people, and it's both through a training program and then through the specialists in the back end, and using AI, we train our people to take care of everything. The average Primary Care Provider refers 25% of their patients to specialists, right? So you go in and they say, go see this person and this person and this person. We don't do that. We take care of everything that we possibly can without sending you elsewhere. This actually came because we found that often we were sending women elsewhere, and then they couldn't get into those people, and so we were sending them into the void, right? Sending someone to a specialist they can't get into for four months is not taking care of them, right? So what we found is we can give all of almost all of the care, right, not all of it, but a pretty good percentage of it, by having back end experts. So instead of going to six different visits with MIDI, you can just go to one. And, you know, I think of it a little bit like a V so up here you might have psychiatrists and psychologists, and then here's MIDI, and then up here you have specialists, primary care doctors, and here's MIDI, if you start here, you may or may not need to go to a psychologist or psychiatrist, and we'll refer you to the right one, but we might be able to also keep you out of it, same thing over here. And so we, we really want to make the care super efficient and and make sure that, you know, there's one place that you can go to, yeah,

Megan Antonelli  16:58  that's amazing. And have you, I mean, in terms of quantifying that, you know, for the insurance companies and for, you know, kind of that, that ROI and investment and value paradigm. And I noticed also, I mean, have you done that? But also, it's two part question. I noticed also that you have on your site, you know, that you work with providers and you work with employers. Tell us a little bit about where you you know, how that works. Yeah.

Joanna Strober  17:21  So, I mean, so you know, 50% of the women who come to us do not have a primary care doctor. The other 50% do, and we collaborate with those doctors. So we're not ever trying to take you away from your primary care doctor. We have a lot of cancer specialists who refer their patients to us for their menopause symptoms. For example, they keep going to their cancer doctor for their cancer and they come to us for their menopause. Their menopause symptoms. That happens a lot. Dermatologists refer to us like there's lots of different ways that we can partner. We're not trying to take your patient away, but we have the time and the expertise to deal with Peri and menopause symptoms that are complicated, and that's where we that's our core function for the women who have a primary care provider. If you don't, then we can end up doing a lot more of the care that that a woman needs so and then what we're doing is we're having partnerships with healthcare systems around the country, such as Mount Sinai and USC and Memorial Hermann. If you have cancer, for example, which we are diagnosing all the time, then we have a relationship with them to get you in efficiently, to get really high quality expert care. So the way that we think of it is, you come to us, we're going to get that mammogram for you. We're going to get that colonoscopy for you. We may, and we do find cancer every day. And so then we'll make sure that you get into a cancer specialist. So the concept is that we can be this layer of care that's appropriate, and then make sure, when in person care is necessary, that we get you into the right place.

Megan Antonelli  18:49  Got it, which is a perfectly then for my next question, because one of the things I've heard you talk about, which I, you know, I love this idea, is sort of how prevention or how longevity, is a rebrand of prevention. Yeah, right. And so what I'm hearing you say a lot of is, like a MIDI is, is really that? It's that prevention arm, it's, it's a lot of, you know, yes, you've got symptoms, but a lot of these symptoms are easily managed. A lot of these symptoms are, in fact, aging, you know. But can prevent them, you know, we stopped the inflammation, we stop that, that process from happening. So tell me about that, because I know there's a lot of exciting research and conversations happening, but tell me what Mindy is doing in that space. Yeah.

Joanna Strober  19:30  So it really learned is what you just said, that longevity just means, like, you know, preventing disease, right? And that is what it is like, it can be a really sexy name, but longevity is basically preventive care, and that is what we do. If we get you the mammogram, if we get you the DEXA scan, if we get you the colonoscopy, we are preventing you from getting sick. That is basic preventive disease, right? Prevention. We are also looking at your blood tests early. Let's see if there's things. That we see in your blood tests that mean that you'd have issues that you need to be managing. The one thing that we found is that lots of women in their 40s, 30s and 40s, they don't think they're in perimenopause. It's they're they're not ready to say that they're in perimenopause, but they do want to be healthy grandmothers, and they do want to be around to run after their grandchildren, to take care of those grandkids, to to live the eight they live the life they want when they're in their 80s. And if you do things in your 40s, you can prevent a lot of those things that happen in your 80s. And so we spend a lot of time thinking about that. When we think about women's health and all of our health, really, a lot of it is things like cancer prevention, Alzheimer's prevention, having our bones not deteriorate. Those are all longevity. That is longevity right in the end, you can take some supplements that might make a little difference, and there are some emerging research that I'm learning about with peptides that could help. I've come to believe that GLP ones are probably one of the best longevity medications, and we've started doing some testing on patients that are interested on micro dosing GLP ones to see if they feel better with inflammation on that all those things are on the border, like they matter, but really what matters is, are you getting your cancer screenings, exercise, sleep, diet, the basics, right? Those things really matter. And then for women, hormones, and that is a huge difference between women and men, both testosterone and estrogen a key component to our aging. There's not enough research on it entirely, but there's enough emerging research that makes me enthusiastic that we're going to find that estrogen is very correlated to Alzheimer's prevention, for example. And you know, there are tests being done to see whether taking estrogen prevents Alzheimer's, but honestly, I'm going to have Alzheimer's, and before that is like known, right? We're all going to be dead before those tests are done. So for me, it's enough, like I know enough to know that it's worth trying. And to me, that is what I want women to get access to, enough that it's worth trying if we know there's no downside to estrogen, as long as you don't have breast cancer or a blood clot, and you know that there is perhaps evidence that it can help your bones stay strong. We know that it can help avoid Alzheimer's. It can help reduce cardiac disease. Why wouldn't you do it? And so that is a big component of women's health. Also testosterone. Women have testosterone, just like men have testosterone, and and it also starts going down in their 30s, and there are a number of impacts on that. So if you're interested in trying testosterone, that's something that can give you certainly more interest in sexual health. But also there's some really good research that it could help with your bone health, with your mental acuity. Why not try it? And so that my, you know, my, my way of thinking of it now is that our job is not to gatekeep and it's not to gaslight like it's not. It's just we want to give you access to information, education and help you to make the right choices for your body so you can stay strong. And you know, for me, it's about being a healthy grandmother, like I'm I, you know, I had kids a little bit when I was older. I want to go run after those grandkids, and I want to go read books to them like I that is very motivating to me. So what can I do so that when I am in my 80s, I can, you know, be a good grandmother,

Megan Antonelli  23:38  right? No, and that's whatever, you know, I think that it speaks to what people care about. It's kind of ironic when I think about it, though I feel when I the longevity space is sort of male dominated, right? I think of all those pale, those male podcasters and the conversations that they've had around that, and they've got, you know it, but they'll also, they've been putting God knows what, in their in their bodies forever. They'll take any supplement, anything, you know, weightlifters and bodybuilders and all these things, all these, you know. And you know, there's a lot of research and work on, you know, sort of the high doses of hormones in that place where maybe there are start to be negative side effects. But there's, you know, there's a body of of people and willingness where, you know, sometimes, when it's out of the scientific discord, people are more willing to put things in their body, right? And so, you know what excites me about MIDI health and other providers like this is where you know that it comes together. And while, yeah, the gatekeepers not there, but you do have a partner in this health. But as I've listened to you speak a number of times I think, Well, men do need this too. You know, they age as well, and you know, the car doesn't help, you know, the new car and the weightlifting, it helps a little, but they also need help, and in some ways, are often not as educated. In the evidence based science side of things. So is that on your trajectory at MIDI health, or is it just just women all the time?

Joanna Strober  25:09  You know, I think we actually have men come to us now. They as female as our site looks. Often. It's a woman who says, go to their husband. You should go try MIDI. And the way I've come to think of it is that we are a hymns for people who want to talk. So there's plenty of people who just want a product and they don't want to talk to anyone, but there is a group of people who want to have a relationship, who want to talk about their health, who want to understand their options, and that is where we fit in. So we do have men actually booking visits, and they want to come talk about their hair loss. So they what their options are. They want to talk about they they want to talk about their cholesterol, they might want to talk about weight loss and understanding their weight loss options. So we're, we're very much a women's health company, but it is usually spouses, and they go, oh, you should go talk to them too. And, yeah, no, discriminate. We will take care of anyone.

Megan Antonelli  26:09  Oh, good. Well, I think that that's great too. And I think it is interesting. I mean, I think the way that we're, you know, as people, you know, as we age, and as this becomes more available to people, that people will be able to take take advantage of it, which is great. And so I really do appreciate the work that you guys are doing. We always like to end on like, kind of what's good and what's good in healthcare as you look at what's going on, you know, in the healthcare space, particularly digital health or women's health, you know, what comes to mind as kind of the this is exciting, and this is sort of, you know, where you see a good, good area.

Joanna Strober  26:45  You know, honestly, I'm going to be pretty basic, telehealth is revolution. Is revolutionary, honestly. So we take care of some of the most powerful women in the country, and we take care of a lot of Amazon factory workers and everything in between, and the fact that you don't have to leave your house to get good care, the fact that you can pick up the you know, you can be in the carpool lane and while you're waiting for your child get on a call and get some information, as long as you're not driving at the same time, the fact that women can call us, you know, At nighttime from their bedroom closet, and actually is transformational. There's a lot of care that people don't get because the barrier to taking a half of day off of work and sitting in a doctor's office and going to that doctor, that is a big, big barrier. I don't think you can underestimate that. And so I think that offer, offering, you know, just the basic being able to have a relationship with someone online has actually and will actually continue to change healthcare. And I believe that, you know, over the long term, most care will be delivered like this when you don't need in person care, right? So if you need to see someone in person, if there's a physical ailment that you need, you will go in person, but I believe that over not that long, most care will be delivered like this. And I think you can actually, in many ways, have a better experience. I don't know about you, but when I go to the doctor and you have to take off your clothes, and you sit on the mat and you you don't really want to talk to them about your hot sweats, and you're like, you just want to kind of get out of there as fast as possible. And so this is actually a much better way to have an in depth conversation, I think. So I'm very excited about just telehealth and the basics.

Megan Antonelli  28:33  Yeah, 100% and I think, and I know you've done a lot of work going to Washington and lobbying and making sure that those laws that you know, were passed and, you know, sort of put into place, the regulations put into place during the pandemic. Stay right. Are you hopeful about that, too? I am. I'm pretty sick that that,

Joanna Strober  28:50  I mean, what really was upsetting to me is, you know, they were considering, and they it's not, it's only extended for one year. They that requiring people to go back to an in person visit in order to get a controlled substance prescription. And they made it. Make it sound like controlled substance is some like dangerous thing, right? But controlled substance in seven states is gabapentin, which is something that helps women who have breast cancer so that they can sleep better. That's not something that should be difficult for them to get. But in those seven states, there are very, very few providers who are educated on this and to have to drive two hours in order to get the prescription, means that women just will not get the care that they need. So I am, you know, cautiously optimistic that this administration will realize that actually, you know, rural health care is fundamental, and we need, we need to make it easy to get access to care and not put more barriers in front of people. Yeah.

Megan Antonelli  29:49  I mean, absolutely Amen to that. And I think the, you know, telehealth has been this sort of, you know, the promise of access and convenience, you know. And. It really, you know, obviously converged in a, maybe not, you know, not so positive way during the pandemic, but has been life changing for so many and that it's given them access. And the women and menopause is only one slice of that, in terms of how much, you know, convenience and access it's given. So agree 100% I do think it's, it's revolutionizing how we approach our health care, and it's making it more convenient every day. So, you know. And I think both the areas that you are focused on, with kerbo and and with this are amazing. And, you know, I think mini health will will help to revolutionize that and make it something that people will say, don't take it away from me.

Joanna Strober  30:40  Yes, exactly. That's exactly, right, yeah. Well,

Megan Antonelli  30:43  thank you so much for being here, Joanna. So such a pleasure to to meet you and to our listeners. You know, if you want to learn more about MIDI health, and you know, maybe take care of some of your symptoms, go to join midi.com and you know, Joanna's great. She's very accessible and and available. Is there a good way for folks to reach you? Joanna, is it LinkedIn?

Joanna Strober  31:07  If they reach out on LinkedIn, I usually pretty good at responding

Megan Antonelli  31:09  Yes, and they do a number of of you know, I just participated in a LinkedIn live, and she speaks all the time, so you can learn more. And of course, if you want to hear more from digital health talks. Subscribe to us, and this is Megan Antonelli, and it's a pleasure. Thanks so much for joining us until next time.

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