When COVID-19 hit, testing infrastructure crumbled. In this episode, Dr. Leo Damasco and Phoebe Gutierrez interview Devon Phillips, a digital health strategist who helped build one of the largest community testing programs in the U.S.—from scratch. Learn how she overcame regulatory chaos, scaled a digital health startup overnight, and reshaped public health tech.
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When COVID-19 struck, the healthcare system couldn’t keep up. Testing was scarce, data reporting was broken, and underserved communities lacked access to care. Devon Phillips, a public health leader, played a key role in creating one of the largest COVID-19 testing programs in the U.S., working with California's Department of Public Health, community sites, and thousands of providers.
In this episode, Dr. Leo Damasco and Phoebe Gutierrez sit down with Devon Phillips to uncover how she launched a massive public health tech initiative during an emergency, built software that connected frontline providers, government agencies, and millions of patients, and tackled telehealth expansion, digital infrastructure, and regulatory barriers—without red tape slowing her down.
Now, as telehealth and digital health innovation continue to evolve, what’s next for public health? Devon discusses what stuck from the pandemic, what’s been lost, and how technology is shaping the future of community-based healthcare.
If you work in telemedicine, digital health, or public health, this episode is a must-listen.
Three Actionable Takeaways:
About the Show:
Telemedicine Talks explores the evolving world of digital health, helping physicians navigate new opportunities, regulatory challenges, and career transitions in telemedicine.
About the Guest:
🔹 Devon Phillips – Devon Phillips is a digital health strategist and public health innovator who played a key role in launching one of the largest COVID-19 testing programs in the U.S. As Head of Strategic Initiatives at Primary Health, she specializes in scaling healthcare technology solutions that improve public health infrastructure. With a deep understanding of policy, operations, and regulatory strategy, Devon has collaborated with government agencies, healthcare providers, and community organizations to expand access to care during critical health crises.
Passionate about leveraging technology for social impact, Devon focuses on building sustainable, patient-centered healthcare solutions. Her work bridges the gap between public health and digital transformation, ensuring that innovation meets the needs of diverse populations.
Connect with her on LinkedIn: Devon Phillips.
About the Hosts:
🔹 Dr. Leo Damasco – Pediatrician and emergency medicine doctor turned telemedicine advocate, helping physicians transition to digital health.
🔹 Phoebe Gutierrez – Former state regulator turned telehealth executive, specializing in compliance and sustainable virtual care models.
📩 Connect with Phoebe Gutierrez:
🔗 https://www.linkedin.com/in/pkgutierrez/
📧 phoebe@telemedicinetalks.com
EP10 ===
Phoebe: [00:00:00] Welcome back to telemedicine talks.
Phoebe: I am so excited for this episode because we have an amazing guest. Speaker who is actually somebody who I got to work with for a lot of time and she grew into be one of like my very dear friends and she is just absolutely amazing and I cannot wait to have her share how her and I got through the Covid pandemic together and we actually built one of the largest testing, community testing programs in the whole United States with.
Phoebe: Pretty tiny team. Devin, I am so grateful to have you on the show today.
Devon: I am so excited to be here. Phoebe is someone, you are someone who I consider a large mentor in my career, and yeah, we did a lot together in a very short amount of time that I'm sure we'll touch on in this episode. But nothing says grassroots like the pandemic.
Leo: Devin, thank you so much for stepping in and sharing [00:01:00] your experiences through Covid and where this ties in to, telemedicine talks and telehealth is telemedicine has always been around, right? It's always, back in the sixties that's when it started with telegrams and the army and satellite, so forth and so on.
Leo: But we really didn't see telemedicine blow up until Covid, we were forced to go in, go home and practice medicine. And it's gonna be interesting to hear how y'all built a system, a public health system that's supposed to reach out and touch everybody, when really we weren't really supposed to re be reaching out and touching anybody, right?
Leo: That was a no-no. So yeah, I'm super excited, super stoked to hear how, yeah, we were forced to do this overnight and how you guys built a system that, helped a whole state through this whole pandemic. With the help of doctors, so forth and so on. Yeah, super stoked. Thank you again for stopping by and sharing your experiences.
Devon: Of course. Excited to be here. Stoked to be here. [00:02:00]
Leo: There, there's a lot of Hawaii vernacular. I pretend to be from here, but I love here. Oh, I'm San
Devon: Diego oh, there you go. Here some vernacular. We've got it stoked to see Hawaii
mainland. That's what I say. So cool. Cool. So awesome.
Phoebe: Yeah, so just to give you like a little bit of background of what Devin and I did together and still, when I left the last company, she actually got to step into my shoes and take over all the crazy stuff I was trying to do.
Phoebe: I dunno if that's a good thing or a bad thing, but, whatever it is what it is. You left it,
Devon: she's good. They were in good condition.
Phoebe: Okay, good. Good. But I think, like one of the most interesting things to me is when I first joined the company the big thing was , COVID was running rampant.
Phoebe: We didn't have a vaccine, there weren't testing programs. The health system actually couldn't keep up. And I think I started at that company, I don't know, maybe a few months after. It was really bad in 2020 and. Our first kind of like course of [00:03:00] action was schools, kids, what do people care about?
Phoebe: They care about kids. They care about keeping their, their kids healthy. And again, this was such a scary time. And I think like the interesting piece was, like having to run and figure out like the policy and the program while things are coming out from the CDC, while things are coming out from all these doctors that we're working with.
Phoebe: And having to be forced to run with the very limited information, but also for the first time, getting to see government move really fricking fast I think was a really interesting angle too. So that's my perspective, but Devin , give me your play by play on how it was.
Devon: Yeah, I think that's a great way, place to start. I remember when Phoebe hired me into a role that's different than what I do now. I'm on the strategy side now, but at the time I was more on the technical side. And Phoebe, as you will know if you listen to this podcast, it's not someone who pulls her punches.
Devon: And she was really transparent about what I was signing up for. She was, this is a startup. We're doing this because we care about public health. This is not about [00:04:00] making money. This is about helping people through technology and that. Spoke to me. And then I hopped on the ship and really realized what that meant.
Devon: And I think for a lot of people nowadays, you hear telehealth and it feels obvious, right? Like you wanna have an annual visit, you can hop online, you can speak to a doctor, it's covered by your insurance. It all works seamlessly. It's great. And, four, four years ago, that was so far from the reality.
Devon: And so to Phoebe's point, we were building software, but the software we were building had to constantly change based on these directions and protocols that were coming out from. Doctors who were collaborating with government, and so it was this crazy intersection of medicine, but also legal compliance.
Devon: They were changing the times that results had to be reported back to the state. What kinds of results had to be reported back to the state when people had to be tested? What symptoms you had to be tested for? All of that was rolling out. So when you and the public were reading those protocols online and saying, oh my gosh, how am I gonna manage that in my life?
Devon: For us, we were thinking, how do we bake that into a software so that people can go [00:05:00] into the field and do this work without having to know offhand what's happening at the government level, which is such an interesting intersection of different components in healthcare that I think a lot of times.
Devon: Different organizations solved separately, and we were really put in a position of having to solve them all at the same time, while also being expected to be online 24 hours a day because testing was happening in different time zones all over the state of California. We were also in other states outside of California and.
Devon: Yeah. It's just, it's wild to think back on, on all of the pieces that were happening at the time because it's so different than I think, the way people approach healthcare traditionally. Where you see a doctor and then, you don't, you pay your copay and it's great. And that, that's where it ends.
Phoebe: Yeah. For me it was like it was the first time that I felt like I don't know, maybe I'll say I felt like a Canadian oh, I can go, there's like a, you can go to a community clinic. Yeah. There's no copay, there's no nothing. And this was also like labs were just like overburdened, like [00:06:00] Kaiser couldn't keep up all these kind of like your normal insurance couldn't keep up and, point of care testing had just come out.
Phoebe: So there were all these antigen tests and like where we were at was trying to work with, the California Department of Public Health of like, how do they get that data, get those results back so they can go, okay, there's an outbreak in this community. I. We gotta go deploy some stuff so we could stop this or, there's an outbreak here.
Phoebe: And I think that was one of the big things that I walked away with , from, it was like, it was actually a really beautiful thing to see all these, communities come together, churches and different kinds of places to just have as many community testing sites.
Phoebe: That were sponsored by the state of California. So it was completely free. I think how many sites did we have like in the, like the top of the,
Devon: oh, thousands, tens of thousands probably. There's, all the schools alone, right? You consider a site, and that doesn't even count.
Devon: Long-term care, facilities, shelters, rehab facilities, sober living [00:07:00] facilities. Really, I feel like during the pandemic. As many places that were considered community gathering points were mobilized to provide these testing services because where people were going is where they were willing to receive this testing.
Devon: And I think that's another part of public health that's different than how traditional healthcare operates , like one-on-one physician services operate. Is that. If you're trying to convince people to do this thing that you, on the science side know is important. And that's really hard because you're not only saying you have to get out of your house, you have to drive somewhere in a time that's already really scary.
Devon: To get a test so that we can have data so that we can make more meaningful interventions for you. And how do you communicate with those people? How do you show them that it's important and those are some of the other? Problems that we tried to solve is that education, that access, that outreach, providing community based services and languages that were applicable to the folks that were being served in, an a DA compliant way so folks with disabilities could interact with technology and receive these services.
Devon: It was just so multifaceted when you take it to the community level because. It's not individual [00:08:00] healthcare anymore. You're now designing outcomes that are, have to address the needs of thousands of people, but in a way that people still feel like they're getting individualized care. And that's a really complicated thing to do, especially when you're being asked to do it in 24 hours.
Leo: Was it really 24 hours ? Was it that quickly?
Devon: Sometimes.
Phoebe: Sometimes it would depend. Yeah. But sometimes, yeah. And again, like. You have to throw in the nature of it's COVID. We're also a startup, so I think I was like employee 20 or something. When I left there were 200 employees, we started it was a small team of us doing this, and then it grew to like, we had 50 people because that's what we needed to actually keep the programs running.
Phoebe: And, to Devon's point, like. When there's a glitch in the system and something isn't working, people aren't getting their lab results in a timely manner. It doesn't mean okay I'll do that tomorrow. It means, Hey guys we're gonna hop into a war room [00:09:00] and like we're gonna go call these 50 people and you're gonna go call these 50 people and you're gonna go call these 50 people.
Phoebe: 'cause they're depending on us and we can't let them down.
Leo: Now , one question is, the startup was created because of Covid. Who was the trigger? Who was the call to action to actually get the start? What is, was it the state of California? Was it, I. The California Health Department I'm clueless with all structures.
Devon: Yeah. Interesting story. Yeah, so our co-founders have software backgrounds and they saw a need in a rural part of California, which is the perfect use case for what our software does. Where there was community testing happening, but no way to report it back to the state. And in a pandemic data is the most meaningful asset that a governing organization has, right?
Devon: That's the only way that they know what's happening on the ground. They're not calling local health departments and asking no one, it's time to do that. And so they really saw a need and then developed this. The software to solve and bridge that gap through just like lightweight versions of what we are now.
Devon: Basic, you can [00:10:00] have a test report it, and the state will know that it happened. The person will get a result and that's it, that's where it ends. And then through then it just became something that became more and more needed and more and more known and it just, it exploded from there.
Leo: Oh, wow.
Leo: So I worked in the er, worked the front lines of covid. Really, all I saw was end product. All I saw was, hey, here's some results. I need to act on it. So can you speak on kind of the role of community doctors? A lot of these doctors too were thrown into, now you're the expert right now, you're calling on them to create policies, so forth and so on.
Leo: What kind of roles did you see that doctors held and, how was the transition for them? And how was working with 'em. We all know how, yes. Working with doctors. Always easiest to work with, right? Never type A, but never.
Devon: No. The chillest
Leo: people I know are doctors.
Leo: Oh, absolutely. Yeah. Can you comment a little on that?
Devon: Yeah. I think in any time where there's something, and I hate to use the word unprecedented because pandemics have happened before, and also I think it's just an [00:11:00] overblown word that we use in terms of covid. But whenever there's.
Devon: Something that people haven't experienced in their lifetime or even their parents' lifetime, and anyone can point to someone and say, oh, you know something about this, so I'm gonna look to you for answers. And you have a title that makes me think that you're in a position where you're going to provide me real scientific information that puts the people on the side of, being asked in a really difficult position, especially when it's a time when no one knows anything, right?
Devon: Like we were the variants were actively being secret. We're going from PCR testing to, rapid testing. Phoebe mentioned, and then OTC testing. We don't know the efficacy of these tests long term. We don't know how, the ex even the expiration dates of when you can take these tests. We don't know what's gonna happen in, in the broad scheme of this.
Devon: And I have a lot of admiration for doctors, especially in rural areas that really stepped up and became the subject matter experts because you go from being in a clinic, seeing patients one-on-one, and counseling about their individual needs to, again, being responsible for. Population level healthcare, you're looking at your entire population and [00:12:00] saying, what do they need to be healthy?
Devon: Which is such a different set of problems than what one individual person needs to be healthy. But yeah, they were running testing events, like we knew doctors that were doing testing outta their garages with Clio waivers when the rapid testing became available and. It was just a way for them to provide an additional service for their communities because they were such a trusted resource.
Devon: But to do that was, in my opinion, brave, to put yourself in the front lines of being asked questions, especially again in a time when. The answers were loose, like they were changing daily as far as protocols and things like that. But my overall experience working with doctors was great. I've worked with a lot of doctors in my career but I also received a lot of late night phone calls and scared things because to what Bebe was saying earlier, they.
Devon: Were acting in a lot of cases individually for the benefits of their community. They weren't working on behalf of the hospital system that had these massive EHR systems and all of this tech that they could rely on. They were using our software to stand up these tiny clinics in these specific areas.
Devon: And so if our software wasn't able to provide what they needed, then [00:13:00] they weren't able to do testing or they were recording test results on a spreadsheet in the dark, quite literally. it sounds very dramatic, but it was just a wild time. And so it just became like a really collaborative environment with us and the physicians that we were working with, especially the ones that were truly providing this individualized, but on a public level, community care.
Phoebe: Yeah. Just to layer into that too we got to work with doctors on the policy side. And like for everybody who's listening to this podcast knows, like that's my background. My background is in like building these massive programs, layering the policy, making it compliant, following like regulations.
Phoebe: And it was like my first time getting to work with. Physicians on the public health side, I'd only done it on the other, like the Medicaid side. And it was really interesting because each of them had very innovative ideas on what they thought was the next, the next thing that we should focus on or the next initiative that we needed to try and tackle.
Phoebe: To get more people tested or more people vaccinated. And Devin, I, I don't [00:14:00] wanna go into it, but out of all the, we, we did covid, COVID sniffing dogs. We did oh my gosh. Yeah. We did, test to treat. We did a massive free test to treat program.
Phoebe: We did airport testing. We were the software that, like if you were going through LAX or FSFO, like you were forced to do an antigen test and that was all reported through the software. I think one of the interesting things that I thought is like for the first time on, on the government side, having doctors lead programs without the red tape.
Phoebe: Yep. Without the bureaucracy of it going, I have this idea and I have this vendor, this software vendor that could actually power it. And yeah, it might be a little glitchy and it might be a little rough, but we are gonna pilot this thing and I think one of the things that was really refreshing, we also had a CEO that kind of let us do this and I got to work with them and consult, CDPH H on I wouldn't focus on this program, but let's go do airport testing. 'cause that's really where you're, we don't want, we don't want a covid person getting on a [00:15:00] plane, and so I don't know. Devon, let's walk a little bit about like the dynamic of working with doctors on the program side, and then also just , what was your favorite like subset program that you worked in?
Devon: Oh, that's a great question. To answer the first part of that question, working with adoption, the program side is really interesting.
Devon: I think I. It's like anything, right? Like you, there's these big words that mean things when you're on the other side of the veil, like you think CDPH and you're like, okay, it's the California Department of Public Health. And it's like this big organization, like Big Brother Style that's gonna come in and say things, but then all of a sudden you're in the room with these people and they're just people.
Devon: They have various titles, but they're people and they're just trying to make things better, for the most part, for the communities that they serve. And to Phoebe's point, a lot of these providers had some ideas that pre Covid would've sounded absolutely. Bonkers. Like the idea of putting a golden retriever in a school to sniff children.
Devon: Imagine if you pitched that to someone in government five years ago, they would've been like, no, that sounds, but when you're talking about it in a way where it's no, this makes sense. We can [00:16:00] help kids. Become more comfortable with getting covid tested. The dogs can alert early if they're, if they have a symptom that we can't as humans detect with their, dog extrasensory abilities, and then we can only test that child versus having to test an entire student population.
Devon: All of a sudden, that idea sounds genius. And I think a lot of the doctors we work with, it sounded like it felt like it was gratifying for them to be able to have these ideas and to also be able to implement them in a way without having to issue an RFP and source the vendor and go through the year long contracting process.
Devon: And by that point, a lot of times the niche problem that they're trying to solve is gone, or it exists in a very different way. And the initial. Thought is less applicable than it was, but in Covid it was like, today there's a problem and tomorrow we're gonna fix it, and then the next day we're gonna see if it worked.
Devon: And I think that was rewarding for a lot of people in government. I know it was rewarding for me on the implementation side of those programs. And I know we've mentioned the dogs a lot. I would say that's one of my. That's one of my favorite programs that we've [00:17:00] implemented for sure. My personal one that I got to be a part of during Covid was the Test to Treat program that hoe you mentioned, that was actually a program that I personally got to run and implement with CDPH.
Devon: And we did a lot of work with farm worker communities in Northern California because it's a really interesting population. They have very specific needs as far as. Access to technology. There's people who are in the same place. They don't speak English as a primary language a lot of the time.
Devon: They're not comfortable with interacting with the US healthcare system. They're not comfortable with their records being shared, but they are interacting with a lot of people. They're interacting with food. How do you get these people tested for covid? How do you get them treated? How do you get them paxlovid?
Devon: And working with CDPH to solve that problem was a personal favorite 'cause it was just so complex. And I love a challenge.
Phoebe: And I think, like for me and again, like I was there like in the very early days where the first thing that we tackled was schools. The way that this was broken into was like cohort.
Phoebe: So it was like, there was like the school cohort, there was the long-term care and [00:18:00] the skilled nursing facility cohort. And then there was like the community cohort and that was like. Everything else. And we ran all those three cohort and they had to be set like segmented that way due to like federal funding.
Phoebe: It's very interesting. Very interesting times. Yes. And for me, like I think the one program that kind of blew my mind a little bit was the. Execution of at-home testing. So this was like right when, like all the rapid, the eye health tests and the Abbott Binx Nows and all of those at-home tests were getting deployed and CPH had no way to get that data.
Phoebe: So they had truly no way to understand what is happening in the community. And we worked, we built an app we worked to market this program to really get it out there. And I remember , we did it right around New Year's. So that was when we launched it.
Phoebe: And I remember, oh no I remember all of us like holding our breath going, yeah. Are [00:19:00] people gonna report this? And I remember waking up, the next day and logging into our data analytics tool and results were coming in every second. It was like, I think in one weekend we did over a million people reported both negatives and positives.
Phoebe: Yeah. And there was a really big hypothesis of why would a person report a positive? You don't wanna get in the system, you don't wanna have the contact tracers come. And it was like, you got to interview some of those people and it was like we did this for the greater good of the community.
Phoebe: It was this very beautiful thing. And so getting to be a part of that and. Again, think me thinking as a total pessimist as everybody knows going this is never gonna work. CDPH. Like it's in high hopes. And then, I still think people can actually use that and report at home covid tests if they wanna get their data to CDPH.
Devon: Yeah, it was very cool.
Leo: So with that how tricky was it to scale ? You guys start out small, you went [00:20:00] big. What was your biggest challenges and expanding on that, maybe the worst, best, and maybe just the way out there experiences that you had going through this process?
Devon: Yeah, I think anytime you scale anything you find things you didn't expect.
Devon: My background is in health tech. I've worked at Health Tech my whole career. Before I worked at primary, I worked scaling medical scribe programs like AI based medical scribe programs. So the idea of doing something weird and making doctors want it was very, in my comfort zone. But with this, what was so interesting is that our clients were so varied and so figuring out what an actual, like SaaS solution wise to a pandemic is impossible.
Devon: At the end of the day. It's a challenge that companies are still trying to figure out because. The US is massive. California is. Massive and you're serving a population that is incredibly diverse and then you're working with organizations that are incredibly diverse, like the difference between the needs of LAX versus the California farm [00:21:00] workers.
Devon: Foundations are insane. Like there, there's no way to even really compare those past the fact that they need covid test results. And so one of our biggest challenges when scaling was just trying to figure out what to prioritize. Like how do you make everyone happy when everyone's needs are valid? Everyone's doing work that's important.
Devon: We're not doing anything that is superfluous for the community, but we also only have so many engineers and we can only do so many things. And so weighing what's actually important to the broader good. What's important to a specific community? Telling people no, like we, we can't implement that feature.
Devon: We know it's important to you. We can't translate the platform into that language yet. We just don't have the time. Was so hard because you knew that saying no to an ask, but saying no to a need. And that is so different than how traditional tech operates. So personally, that was definitely a. A harder part and a challenge as far as scaling and then just scaling like the idea, like building things quickly and efficiently and finding [00:22:00] people who want to do that.
Devon: I would say, and I'm sure Phoebe can speak to that, as someone who built a lot of the teams who were a deep part of this process, getting the team that I myself was on, finding people who are willing to work in this way, find people who are down for the midnight war rooms and the calls from providers in their garage and the, just hecticness of this, especially when it does matter.
Devon: And then doing it over and over again every day with the no end in sight is, it's just a very specific kind of problem to solve as a for-profit company, it's something a lot of people get the opportunity to do unless you work for a nonprofit.
Phoebe: Yeah. And I do think too, like I do wanna applaud Andrew, the ceo , EO , and Chris, the, they were co-founders.
Phoebe: CEOs, most CTOs are gonna be like no. Where's the money? Where's the money? No. And it was complete opposite, right? It was just the complete opposite andrew would be like, if I have to get up at night and code, I'm coding Chris, same thing. And it was like, again, like after being at different [00:23:00] companies and that was my first experience with health Tech and it was, it's so refreshing now that I got to be a part of it.
Phoebe: And you really got to see how, some real leaders, got their hands dirty and said, screw it. It's not about those things. We gotta do the right thing. And to me, like that's one of the key takeaways that I take away from them, I think I learned from them exactly.
Phoebe: , if you're gonna go and lead something, you gotta know exactly how to do it. You gotta know exactly how to fix those bugs. And you have to know exactly how to, treat your customers with kindness and respect and that all asks are important.
Devon: Yeah, exactly. No, and Andrew and Chris are both huge inspirations to me. I look up to them a lot every day at my job. But it is it's a weird part of the health tech, public health universe to be in when. , you are, beholden to a bottom line in the sense that like you have to pay people and you're not receiving, that for-profit company, that, that comes with a certain amount of responsibilities, but also the goal is to do good and and in a very real way that is not beholden to [00:24:00] making, I.
Devon: Significant profit and balancing those things while also trying to scale a product that's meaningful across millions of people. It's wild. We ran some numbers a couple weeks ago and 4% of the US is on our platform, which is crazy. Like the fact that we were able to build something that has touched that many lives , like I talk to people in my personal life who are like, yeah, I got Covid tested, and I was like, that's probably on primary.
Devon: Yeah. And no one knows who we are. Like, that's the funny thing is that we are just this kind of like ghost in the background of all of this. I like to say that we're like the irrigation in the fields, but you only see what's growing. You don't see what's underneath. And that's okay.
Devon: It's fine to operate that way, but it makes scaling challenging too, especially when you're working with organizations that have an inherent hesitancy to private enterprise because they're used to. Working with community-based organizations, with nonprofits, with local health departments, and someone like us coming in and saying, can we help?
Devon: They're like, what do you want? And we're like to help. Like we, we really do mean [00:25:00] it. It can be just challenging to get trust in that way too. And that's something that we still. See and that I think during the pandemic was aided by the fact that there was a need to be doing this work, but there was still definitely that initial kind of hesitancy in the room.
Phoebe: Yeah. And I think too, like it was again, like to your point, Leo, like this was the first time that I. A lot of people got to in theory, experience telehealth. Yeah. Again, it was like, it wasn't so much as like the test results, but like a doctor is calling you from your community explaining what you're supposed to do.
Phoebe: When Paxlovid dropped, , it was all these doctors doing a lot of outreach and people really getting to experience this new kind of like method and modality of receiving care who previously. Didn't get to have that luxury.
Leo: Yeah no. It's interesting to see the behind the scenes and what happened.
Leo: And the talk. We working front it was just like, hey, it was there and when the numbers got turned on and why had the ability Great. Perfect. But [00:26:00] I never really asked how it got there. How it scaled . It was just like, oh, awesome. Thanks guys. And I'll use it.
Leo: And Yeah, I know, I knew there was a lot of work behind the scenes, but really never understood like the deep down. . Now that we have this, where do you think this is going? Where is public health and telemedicine heading next? Now that you know the pandemic's over.
Leo: But, what are we doing? It's not over.
Phoebe: It's not over. Leo. I just had Covid two weeks ago. You did? I have the world record for the person who's had COVID the most. I was on my deathbed, Devin. Oh my God.
Devon: I'm so sorry. I would say the pandemic is over, but Covid is very much not is hard. Oh, absolutely.
Devon: People in my life.
Leo: So where are we headed next in terms of, public health and telemedicine and, in, in those realms.
Devon: I think one of the big conversations that I know I hear in public health is like, what, since Covid has stuck and what have we lost and what needs replacing? What the pandemic did was it took away all of the existing [00:27:00] infrastructure, right?
Devon: There were things, ways that things were running, and they'd been running like that for the last 40 years of life, and everyone thought it was fine because patients were getting care and then all of a sudden, basically overnight. All of that died. And what happened was a lot of really amazing innovation, right?
Devon: Like the boom of telehealth through that, being able to connect people who weren't physically near each other. But then when the pandemic got to a place where folks could return largely to their normal state of business, there was this almost desire to return to some of the ways that things had been operating previously.
Devon: Because it was comfortable. It was like that was over. We did that. Super scary done. So I would like to return to normalcy. But what we're finding is that normal doesn't exist anymore because the patients and the participants have gotten really used to a certain level of ease, right? Like people wanna talk to their doctor like this, if you don't have to touch me, why do I have to go to your practice if you can order my labs virtually?
Devon: And I think it really shifted the way that people participate with their health. A lot of [00:28:00] people during the pandemic took a real ownership of. Knowledge in a way that I don't think we've seen in healthcare previously. At least, in my lifetime, of people were being expected to research things.
Devon: They would be expected to ask questions. They were being expected to really. Understand what they're being asked to do, and that has definitely not gone away. And I think that is what's driving a lot of the public health innovation, is what people are driving and what they want to see from a public health system.
Devon: Now that being said, we're seeing a measles outbreak in Texas right now. We're seeing. Bird flu explode across the US and I know eggs near me a million dollars. And you can look at that and say that, there are some learnings from the pandemic that should have been, in my opinion, implemented to prevent some of that from happening in terms of wastewater surveillance, air surveillance, like we have this technology that exists, why aren't we using it now?
Devon: On the positive side though, I think. Telehealth is the biggest gift to medicine that came out of the pandemic. And it's, you Google Telehealth and 50 providers will come up in your [00:29:00] area that want to see you, or different organizations that can see you for mental health, behavioral health to prescribe you medications that you might not have had the opportunity to access otherwise.
Devon: And. In the public health space, what we're able to do is deliver healthcare cheaper. That's a big way that digital innovation really solves a lot of the public health crisis. There's a program I was telling Phoebe before we hopped on that we're running right now in Michigan the Michigan Wellness Program, and we have stood up we used to be 22 sites, now it's 14 turf sites.
Devon: So there are these face faith-based community centers that are running point of care, CLIA wave testing at their, the home of their congregations. And they're doing diabetes screening, cholesterol screening, hypertension screening with a CLIA waiver. And that whole concept is very covid, right? The idea that lower trained individuals can deliver real diagnostic testing in a space outside of a clinic.
Devon: That didn't exist before the pandemic. And so not only is the basic model, a structure of, post pandemic innovation, but we have NPS who, when a person [00:30:00] tests for any abnormal result, if your blood pressure is 180 2 over 70, we're calling you, even though most primary care providers would tell you that you're fine.
Devon: And we're calling to educate you like it's not about prescribing. It's about. Lifestyle adjustments. It's about a referral to an FQHC. It's about telling you what's available in your community and that telehealth infrastructure absolutely would not exist without the pandemic. The idea of a provider somewhere else in your state calling you about a result that you got in a church about your diabetes.
Devon: Diagnosis and then providing you resources to seek out care in a community-based center that is still providing traditional care. Those are the programs that get me really excited that we haven't lost the core of what we took away from the pandemic. 'cause I do think it's there and I think things like that really demonstrate that even though it's easy to point fingers and say, we should've done this better and we should have done this better.
Devon: But at its core, I think the innovation of the pandemic is still very much around and alive.
Leo: No you're right. And hopefully, yeah we take lessons that we learned and move forward. And you're right. [00:31:00] This is the expectation and not just, the exception.
Leo: Awesome.
Phoebe: Devin I want the gossip. What is primary empathy ? I feel like I need to live vicariously through you.
Devon: What are we doing? What are we up to? We're doing a lot of things. We've been, one of the things I'm really excited we're doing is doing a really big data push, like helping organizations with their data.
Devon: We've been discovering that there's a lot of need for people who run things like immunization coalitions, or are really responsible for community outreach. They don't have a great way to understand the data that they're given, right? Like the state might say, okay, here's 50 spreadsheets that tell you the areas in your state where people are under vaccinated.
Devon: Go solve that problem. And that's a lot to ask of someone who's not a data analyst to sit there and really digest that. And so we are building out some more background programs that help folks in those situations understand the data, be able to really model it in a meaningful way, in a pandemic learning kind of way of real data.
Devon: Really matters. [00:32:00] And then action on it, and if they want our help figuring out how to action on it we're great program consultants. But if not it can just live with the data. We're happy to just stop there. We're doing a lot of integration work as well. We're currently working with CDPH, our favorite on integrating all of the public health labs in California for an emergency preparedness initiative.
Devon: So that way. This is one of the things that when you don't work in public health, I feel like you think is obvious. And then when you do work in public health, you're like, why doesn't this already exist? But there are these things called public health laboratories, and this is where your samples for the general population go, like rabies or public covid, flu testing, that kind of stuff.
Devon: Different states of different amounts of them. In California, there's 26, which is a lot. It's the most in the US and they can't talk to each other. Their individual lab systems don't communicate. So in the event of a pandemic, let's say like covid if one lab is at capacity or if something breaks and they can't run those samples, they have to send paper requisition forms via carrier to the next laboratory that can servee those [00:33:00] samples and then process those samples, which creates.
Devon: A huge amount, a huge margin of human error, right? Let alone just like losing things. And so we're working on a lot of data monetization work and not initiative and similar programs to really fix that way in the event of another emergency, which, knock on wood, hoping it doesn't happen, but better to be prepared there's this infrastructure in place so that these really important public health institutions can communicate that way.
Devon: There isn't a delay. Care and processing. So on the more technical side, that's what we're up to On my more favorite side, which is the clinical side. I, after PB lab took over our medical group, and so we're really figuring out the best ways to utilize that. We have a 50 state provider group. Like I said, we're doing programs similar to the one in Michigan where we're using existing community centers to really build out infrastructure where it doesn't traditionally exist.
Devon: We had an abstract accepted in 2023 about some work we were doing in a Frontier County in Montana. I didn't know until that frontier was a census designation. I thought it just meant like cool cowboys. It [00:34:00] actually means a county where there's less than 5,000 people who live there, which is extremely rural.
Devon: And the people have to drive three hours to go to a doctor and just mountainous terrain and all of these things. And we worked with the local health department to set up a direct to consumer like shipping about home test kits so that way they can receive them in their homes and get screened for diabetes and colorectal cancer.
Devon: Like all of these really important things, especially for their aging populations needs. So we're doing a lot, but I get the most passionate about programs like that where I feel like we are. Taking focus in the US who maybe have insurance, maybe think they have access to healthcare but aren't taking advantage of it because there's barriers that exist that are pretty easy to knock down if you have technology that can do so
Phoebe: interesting. I remember the Montana program. I think it was getting, it was getting kicked off right as I was transitioning out. And to your point , like I, I know that I think. One of the things I remember realizing early on while being at primary was like, I think this whole idea that we have to go to a doctor's office to [00:35:00] get care, like Covid has told us that is not the only option.
Phoebe: And so I think like building in a lot of the at-home testing programs , I think we realized like you get better outcomes if you meet people where they are or where they wanna be seen versus. Forcing them to the place that where you're at and being able to like support that, whether it's in a, at a community clinic or a, a church or in their home, I think was one of the ways that we were able to be so successful and really actually help people to start taking this seriously.
Devon: Absolutely. Yeah, I, there's an internal joke that if you could tattoo something on my head in calls, it would be like we meet people where they're at. Because I think I say it every time I talk to someone in the history of my entire career in public health, because it is like the most important thing.
Devon: And I think the perfect thing to end on is that is the thesis. And that's what I think the thesis of public health should be. It's like we think about programs globally, but at the end of the day, they only work if they. Actually solve the [00:36:00] barriers that are preventing people from seeking care. And I think a lot of people think they know what that is and from a really well-meaning place.
Devon: But unless you go and actually talk to the people in the communities and say, what are the barriers? I've been surprised by some of the barriers. You're gonna rural area and you think that it's gonna be one thing. And it's no, actually it's just this other thing over here. And it's oh, we can fix that super easily.
Devon: We would've done a way more complicated thing if we had assumed that, we knew what your barriers were and. Those are the kind of things that I think is really important to keep in mind when you're thinking about public health is that it's global, but it's also up to the individuals to take advantage of the programs for the programs to mean anything.
Leo: That's an interesting motto too, though. That kind of sums up telemedicine as well, right? Yeah. You could practice it anywhere. It's everywhere, but you're meeting people where it's at
Devon: yeah.
Leo: Yeah. It's a cool connect. So yeah,
Devon: definitely. Telemedicine is great, so I don't wanna go to the doctor.
Devon: No. I do, but I don't wanna go to the doctor. I want the doctor the way I'm speaking to you right now.
Leo: Yeah. I just don't like doctors. Yeah, [00:37:00]
Devon: that's, I dunno what this is about you, Leo.
Leo: . No, Devin, thank you so much for your time. This has been awesome. And thank you for giving us an insight into you and your experiences.
Leo: Maybe any closing thoughts either of y'all.
Phoebe: No, I just wanna say, I'm gonna, I'm gonna plug Devin for two seconds. I got to hire Devin. I got to train Devin. And I love working with people that have the growth mindset that are always learning, that are always open. And as Devin's sitting here, like talking, I highly doubt anybody knows how young and brilliant she is.
Phoebe: I'm not gonna put, I'm not gonna say your age because people are gonna freak out when they find out that you're 19. But No, but I just wanna say you are doing such amazing things and I'm so proud of you from getting to see where you evolved when we started together and getting to like there, I couldn't say that I, I.
Phoebe: If there's any other person who could have stepped into my shoes as well as you did, and I'm just, I'm so glad that it's [00:38:00] been you and I'm so glad that you are, continuing to lead the way and be a guiding light in the public health space that really needs somebody who is.
Phoebe: Full of strategy and customer success and product and technical and all of that rolled into a little ball of Devon Phillips. So I just wanted to like, just say that thank you for all that you do and that you continue to do. I'm in California in case nobody on this podcast knows, but the programs you're building and launching and leading continue to touch my life daily.
Phoebe: And so I just wanna say thank you.
Devon: That means so much. No, and I just wanna reemphasize that Phoebe is someone who I consider such a mentor. She hired me. The way I got hired a primary is like hilarious. She called me on a Friday night and she was like, you wanna work here After I had two interviews previously, like the day before.
Devon: 'cause the pandemic, right?
Yeah. And
Devon: she was very transparent what I was signing up for. She's we don't know how long this company's gonna last. We don't know how many people are gonna work here. We don't even know what we're doing really. But you seem cool. Do you wanna do cool things? And I said.
Devon: Absolutely. [00:39:00] And now we're here. And so I have so much,
Phoebe: I think you actually said Yeah, but can we talk tomorrow? 'cause I've had a whiskey That is
Leo: accurate. Yeah. That interview kind I want.
Devon: Sure. To be fair, it was Friday at 8:00 PM So my time 'cause I was on the East coast. Oh,
Leo: okay.
Devon: Okay. A lot of different just to make sure that the listeners know it was an acceptable whiskey.
Leo: Yeah, it's five o'clock somewhere.
Devon: Five o'clock somewhere. I know p has a hard stop, but I did bring a fun fact because on the notes that you sent me, there was a fun fact section and I do think it's quite fun and I would like to share it.
Devon: So think it's very relevant, but I was doing some research before this just about like telemedicine and history and when it started and all of the things, which is very on-brand for me. SPV. I learned that the first ever global disease surveillance initiative happened in 1947 by the World Health Organization.
Devon: And it was something that came out of a technology that was developed really during World War ii, and they utilized it to create this global [00:40:00] disease surveillance network. And it really was like the way that public health started in a global way. And I thought that was just like the most perfect way to end a podcast about telehealth and innovation coming out of something that.
Devon: It could have been and was really bad in a lot of ways, but also just skyrocketed a different kind of innovation and it was a cool synergy and I felt like I had to share
Leo: What was the health initiative?
Devon: It was global disease surveillance, so actually countries talking to each other to track.
Epidemics and endemic outbreaks of things to prevent another pandemic, like I would imagine probably the Spanish flu is what they were thinking about most recently at that point in history. But it was a technology that had come directly out of, world War ii, or it was before that, but had skyrocketed during World War II and Telex.
Devon: If anyone wants to be really dorky about typewriters that send electronic signals via.
Phoebe: [00:00:00] Welcome back to telemedicine talks.
Phoebe: I am so excited for this episode because we have an amazing guest. Speaker who is actually somebody who I got to work with for a lot of time and she grew into be one of like my very dear friends and she is just absolutely amazing and I cannot wait to have her share how her and I got through the Covid pandemic together and we actually built one of the largest testing, community testing programs in the whole United States with.
Phoebe: Pretty tiny team. Devin, I am so grateful to have you on the show today.
Devon: I am so excited to be here. Phoebe is someone, you are someone who I consider a large mentor in my career, and yeah, we did a lot together in a very short amount of time that I'm sure we'll touch on in this episode. But nothing says grassroots like the pandemic.
Leo: Devin, thank you so much for stepping in and sharing [00:01:00] your experiences through Covid and where this ties in to, telemedicine talks and telehealth is telemedicine has always been around, right? It's always, back in the sixties that's when it started with telegrams and the army and satellite, so forth and so on.
Leo: But we really didn't see telemedicine blow up until Covid, we were forced to go in, go home and practice medicine. And it's gonna be interesting to hear how y'all built a system, a public health system that's supposed to reach out and touch everybody, when really we weren't really supposed to re be reaching out and touching anybody, right?
Leo: That was a no-no. So yeah, I'm super excited, super stoked to hear how, yeah, we were forced to do this overnight and how you guys built a system that, helped a whole state through this whole pandemic. With the help of doctors, so forth and so on. Yeah, super stoked. Thank you again for stopping by and sharing your experiences.
Devon: Of course. Excited to be here. Stoked to be here. [00:02:00]
Leo: There, there's a lot of Hawaii vernacular. I pretend to be from here, but I love here. Oh, I'm San
Devon: Diego oh, there you go. Here some vernacular. We've got it stoked to see Hawaii
mainland. That's what I say. So cool. Cool. So awesome.
Phoebe: Yeah, so just to give you like a little bit of background of what Devin and I did together and still, when I left the last company, she actually got to step into my shoes and take over all the crazy stuff I was trying to do.
Phoebe: I dunno if that's a good thing or a bad thing, but, whatever it is what it is. You left it,
Devon: she's good. They were in good condition.
Phoebe: Okay, good. Good. But I think, like one of the most interesting things to me is when I first joined the company the big thing was , COVID was running rampant.
Phoebe: We didn't have a vaccine, there weren't testing programs. The health system actually couldn't keep up. And I think I started at that company, I don't know, maybe a few months after. It was really bad in 2020 and. Our first kind of like course of [00:03:00] action was schools, kids, what do people care about?
Phoebe: They care about kids. They care about keeping their, their kids healthy. And again, this was such a scary time. And I think like the interesting piece was, like having to run and figure out like the policy and the program while things are coming out from the CDC, while things are coming out from all these doctors that we're working with.
Phoebe: And having to be forced to run with the very limited information, but also for the first time, getting to see government move really fricking fast I think was a really interesting angle too. So that's my perspective, but Devin , give me your play by play on how it was.
Devon: Yeah, I think that's a great way, place to start. I remember when Phoebe hired me into a role that's different than what I do now. I'm on the strategy side now, but at the time I was more on the technical side. And Phoebe, as you will know if you listen to this podcast, it's not someone who pulls her punches.
Devon: And she was really transparent about what I was signing up for. She was, this is a startup. We're doing this because we care about public health. This is not about [00:04:00] making money. This is about helping people through technology and that. Spoke to me. And then I hopped on the ship and really realized what that meant.
Devon: And I think for a lot of people nowadays, you hear telehealth and it feels obvious, right? Like you wanna have an annual visit, you can hop online, you can speak to a doctor, it's covered by your insurance. It all works seamlessly. It's great. And, four, four years ago, that was so far from the reality.
Devon: And so to Phoebe's point, we were building software, but the software we were building had to constantly change based on these directions and protocols that were coming out from. Doctors who were collaborating with government, and so it was this crazy intersection of medicine, but also legal compliance.
Devon: They were changing the times that results had to be reported back to the state. What kinds of results had to be reported back to the state when people had to be tested? What symptoms you had to be tested for? All of that was rolling out. So when you and the public were reading those protocols online and saying, oh my gosh, how am I gonna manage that in my life?
Devon: For us, we were thinking, how do we bake that into a software so that people can go [00:05:00] into the field and do this work without having to know offhand what's happening at the government level, which is such an interesting intersection of different components in healthcare that I think a lot of times.
Devon: Different organizations solved separately, and we were really put in a position of having to solve them all at the same time, while also being expected to be online 24 hours a day because testing was happening in different time zones all over the state of California. We were also in other states outside of California and.
Devon: Yeah. It's just, it's wild to think back on, on all of the pieces that were happening at the time because it's so different than I think, the way people approach healthcare traditionally. Where you see a doctor and then, you don't, you pay your copay and it's great. And that, that's where it ends.
Phoebe: Yeah. For me it was like it was the first time that I felt like I don't know, maybe I'll say I felt like a Canadian oh, I can go, there's like a, you can go to a community clinic. Yeah. There's no copay, there's no nothing. And this was also like labs were just like overburdened, like [00:06:00] Kaiser couldn't keep up all these kind of like your normal insurance couldn't keep up and, point of care testing had just come out.
Phoebe: So there were all these antigen tests and like where we were at was trying to work with, the California Department of Public Health of like, how do they get that data, get those results back so they can go, okay, there's an outbreak in this community. I. We gotta go deploy some stuff so we could stop this or, there's an outbreak here.
Phoebe: And I think that was one of the big things that I walked away with , from, it was like, it was actually a really beautiful thing to see all these, communities come together, churches and different kinds of places to just have as many community testing sites.
Phoebe: That were sponsored by the state of California. So it was completely free. I think how many sites did we have like in the, like the top of the,
Devon: oh, thousands, tens of thousands probably. There's, all the schools alone, right? You consider a site, and that doesn't even count.
Devon: Long-term care, facilities, shelters, rehab facilities, sober living [00:07:00] facilities. Really, I feel like during the pandemic. As many places that were considered community gathering points were mobilized to provide these testing services because where people were going is where they were willing to receive this testing.
Devon: And I think that's another part of public health that's different than how traditional healthcare operates , like one-on-one physician services operate. Is that. If you're trying to convince people to do this thing that you, on the science side know is important. And that's really hard because you're not only saying you have to get out of your house, you have to drive somewhere in a time that's already really scary.
Devon: To get a test so that we can have data so that we can make more meaningful interventions for you. And how do you communicate with those people? How do you show them that it's important and those are some of the other? Problems that we tried to solve is that education, that access, that outreach, providing community based services and languages that were applicable to the folks that were being served in, an a DA compliant way so folks with disabilities could interact with technology and receive these services.
Devon: It was just so multifaceted when you take it to the community level because. It's not individual [00:08:00] healthcare anymore. You're now designing outcomes that are, have to address the needs of thousands of people, but in a way that people still feel like they're getting individualized care. And that's a really complicated thing to do, especially when you're being asked to do it in 24 hours.
Leo: Was it really 24 hours ? Was it that quickly?
Devon: Sometimes.
Phoebe: Sometimes it would depend. Yeah. But sometimes, yeah. And again, like. You have to throw in the nature of it's COVID. We're also a startup, so I think I was like employee 20 or something. When I left there were 200 employees, we started it was a small team of us doing this, and then it grew to like, we had 50 people because that's what we needed to actually keep the programs running.
Phoebe: And, to Devon's point, like. When there's a glitch in the system and something isn't working, people aren't getting their lab results in a timely manner. It doesn't mean okay I'll do that tomorrow. It means, Hey guys we're gonna hop into a war room [00:09:00] and like we're gonna go call these 50 people and you're gonna go call these 50 people and you're gonna go call these 50 people.
Phoebe: 'cause they're depending on us and we can't let them down.
Leo: Now , one question is, the startup was created because of Covid. Who was the trigger? Who was the call to action to actually get the start? What is, was it the state of California? Was it, I. The California Health Department I'm clueless with all structures.
Devon: Yeah. Interesting story. Yeah, so our co-founders have software backgrounds and they saw a need in a rural part of California, which is the perfect use case for what our software does. Where there was community testing happening, but no way to report it back to the state. And in a pandemic data is the most meaningful asset that a governing organization has, right?
Devon: That's the only way that they know what's happening on the ground. They're not calling local health departments and asking no one, it's time to do that. And so they really saw a need and then developed this. The software to solve and bridge that gap through just like lightweight versions of what we are now.
Devon: Basic, you can [00:10:00] have a test report it, and the state will know that it happened. The person will get a result and that's it, that's where it ends. And then through then it just became something that became more and more needed and more and more known and it just, it exploded from there.
Leo: Oh, wow.
Leo: So I worked in the er, worked the front lines of covid. Really, all I saw was end product. All I saw was, hey, here's some results. I need to act on it. So can you speak on kind of the role of community doctors? A lot of these doctors too were thrown into, now you're the expert right now, you're calling on them to create policies, so forth and so on.
Leo: What kind of roles did you see that doctors held and, how was the transition for them? And how was working with 'em. We all know how, yes. Working with doctors. Always easiest to work with, right? Never type A, but never.
Devon: No. The chillest
Leo: people I know are doctors.
Leo: Oh, absolutely. Yeah. Can you comment a little on that?
Devon: Yeah. I think in any time where there's something, and I hate to use the word unprecedented because pandemics have happened before, and also I think it's just an [00:11:00] overblown word that we use in terms of covid. But whenever there's.
Devon: Something that people haven't experienced in their lifetime or even their parents' lifetime, and anyone can point to someone and say, oh, you know something about this, so I'm gonna look to you for answers. And you have a title that makes me think that you're in a position where you're going to provide me real scientific information that puts the people on the side of, being asked in a really difficult position, especially when it's a time when no one knows anything, right?
Devon: Like we were the variants were actively being secret. We're going from PCR testing to, rapid testing. Phoebe mentioned, and then OTC testing. We don't know the efficacy of these tests long term. We don't know how, the ex even the expiration dates of when you can take these tests. We don't know what's gonna happen in, in the broad scheme of this.
Devon: And I have a lot of admiration for doctors, especially in rural areas that really stepped up and became the subject matter experts because you go from being in a clinic, seeing patients one-on-one, and counseling about their individual needs to, again, being responsible for. Population level healthcare, you're looking at your entire population and [00:12:00] saying, what do they need to be healthy?
Devon: Which is such a different set of problems than what one individual person needs to be healthy. But yeah, they were running testing events, like we knew doctors that were doing testing outta their garages with Clio waivers when the rapid testing became available and. It was just a way for them to provide an additional service for their communities because they were such a trusted resource.
Devon: But to do that was, in my opinion, brave, to put yourself in the front lines of being asked questions, especially again in a time when. The answers were loose, like they were changing daily as far as protocols and things like that. But my overall experience working with doctors was great. I've worked with a lot of doctors in my career but I also received a lot of late night phone calls and scared things because to what Bebe was saying earlier, they.
Devon: Were acting in a lot of cases individually for the benefits of their community. They weren't working on behalf of the hospital system that had these massive EHR systems and all of this tech that they could rely on. They were using our software to stand up these tiny clinics in these specific areas.
Devon: And so if our software wasn't able to provide what they needed, then [00:13:00] they weren't able to do testing or they were recording test results on a spreadsheet in the dark, quite literally. it sounds very dramatic, but it was just a wild time. And so it just became like a really collaborative environment with us and the physicians that we were working with, especially the ones that were truly providing this individualized, but on a public level, community care.
Phoebe: Yeah. Just to layer into that too we got to work with doctors on the policy side. And like for everybody who's listening to this podcast knows, like that's my background. My background is in like building these massive programs, layering the policy, making it compliant, following like regulations.
Phoebe: And it was like my first time getting to work with. Physicians on the public health side, I'd only done it on the other, like the Medicaid side. And it was really interesting because each of them had very innovative ideas on what they thought was the next, the next thing that we should focus on or the next initiative that we needed to try and tackle.
Phoebe: To get more people tested or more people vaccinated. And Devin, I, I don't [00:14:00] wanna go into it, but out of all the, we, we did covid, COVID sniffing dogs. We did oh my gosh. Yeah. We did, test to treat. We did a massive free test to treat program.
Phoebe: We did airport testing. We were the software that, like if you were going through LAX or FSFO, like you were forced to do an antigen test and that was all reported through the software. I think one of the interesting things that I thought is like for the first time on, on the government side, having doctors lead programs without the red tape.
Phoebe: Yep. Without the bureaucracy of it going, I have this idea and I have this vendor, this software vendor that could actually power it. And yeah, it might be a little glitchy and it might be a little rough, but we are gonna pilot this thing and I think one of the things that was really refreshing, we also had a CEO that kind of let us do this and I got to work with them and consult, CDPH H on I wouldn't focus on this program, but let's go do airport testing. 'cause that's really where you're, we don't want, we don't want a covid person getting on a [00:15:00] plane, and so I don't know. Devon, let's walk a little bit about like the dynamic of working with doctors on the program side, and then also just , what was your favorite like subset program that you worked in?
Devon: Oh, that's a great question. To answer the first part of that question, working with adoption, the program side is really interesting.
Devon: I think I. It's like anything, right? Like you, there's these big words that mean things when you're on the other side of the veil, like you think CDPH and you're like, okay, it's the California Department of Public Health. And it's like this big organization, like Big Brother Style that's gonna come in and say things, but then all of a sudden you're in the room with these people and they're just people.
Devon: They have various titles, but they're people and they're just trying to make things better, for the most part, for the communities that they serve. And to Phoebe's point, a lot of these providers had some ideas that pre Covid would've sounded absolutely. Bonkers. Like the idea of putting a golden retriever in a school to sniff children.
Devon: Imagine if you pitched that to someone in government five years ago, they would've been like, no, that sounds, but when you're talking about it in a way where it's no, this makes sense. We can [00:16:00] help kids. Become more comfortable with getting covid tested. The dogs can alert early if they're, if they have a symptom that we can't as humans detect with their, dog extrasensory abilities, and then we can only test that child versus having to test an entire student population.
Devon: All of a sudden, that idea sounds genius. And I think a lot of the doctors we work with, it sounded like it felt like it was gratifying for them to be able to have these ideas and to also be able to implement them in a way without having to issue an RFP and source the vendor and go through the year long contracting process.
Devon: And by that point, a lot of times the niche problem that they're trying to solve is gone, or it exists in a very different way. And the initial. Thought is less applicable than it was, but in Covid it was like, today there's a problem and tomorrow we're gonna fix it, and then the next day we're gonna see if it worked.
Devon: And I think that was rewarding for a lot of people in government. I know it was rewarding for me on the implementation side of those programs. And I know we've mentioned the dogs a lot. I would say that's one of my. That's one of my favorite programs that we've [00:17:00] implemented for sure. My personal one that I got to be a part of during Covid was the Test to Treat program that hoe you mentioned, that was actually a program that I personally got to run and implement with CDPH.
Devon: And we did a lot of work with farm worker communities in Northern California because it's a really interesting population. They have very specific needs as far as. Access to technology. There's people who are in the same place. They don't speak English as a primary language a lot of the time.
Devon: They're not comfortable with interacting with the US healthcare system. They're not comfortable with their records being shared, but they are interacting with a lot of people. They're interacting with food. How do you get these people tested for covid? How do you get them treated? How do you get them paxlovid?
Devon: And working with CDPH to solve that problem was a personal favorite 'cause it was just so complex. And I love a challenge.
Phoebe: And I think, like for me and again, like I was there like in the very early days where the first thing that we tackled was schools. The way that this was broken into was like cohort.
Phoebe: So it was like, there was like the school cohort, there was the long-term care and [00:18:00] the skilled nursing facility cohort. And then there was like the community cohort and that was like. Everything else. And we ran all those three cohort and they had to be set like segmented that way due to like federal funding.
Phoebe: It's very interesting. Very interesting times. Yes. And for me, like I think the one program that kind of blew my mind a little bit was the. Execution of at-home testing. So this was like right when, like all the rapid, the eye health tests and the Abbott Binx Nows and all of those at-home tests were getting deployed and CPH had no way to get that data.
Phoebe: So they had truly no way to understand what is happening in the community. And we worked, we built an app we worked to market this program to really get it out there. And I remember , we did it right around New Year's. So that was when we launched it.
Phoebe: And I remember, oh no I remember all of us like holding our breath going, yeah. Are [00:19:00] people gonna report this? And I remember waking up, the next day and logging into our data analytics tool and results were coming in every second. It was like, I think in one weekend we did over a million people reported both negatives and positives.
Phoebe: Yeah. And there was a really big hypothesis of why would a person report a positive? You don't wanna get in the system, you don't wanna have the contact tracers come. And it was like, you got to interview some of those people and it was like we did this for the greater good of the community.
Phoebe: It was this very beautiful thing. And so getting to be a part of that and. Again, think me thinking as a total pessimist as everybody knows going this is never gonna work. CDPH. Like it's in high hopes. And then, I still think people can actually use that and report at home covid tests if they wanna get their data to CDPH.
Devon: Yeah, it was very cool.
Leo: So with that how tricky was it to scale ? You guys start out small, you went [00:20:00] big. What was your biggest challenges and expanding on that, maybe the worst, best, and maybe just the way out there experiences that you had going through this process?
Devon: Yeah, I think anytime you scale anything you find things you didn't expect.
Devon: My background is in health tech. I've worked at Health Tech my whole career. Before I worked at primary, I worked scaling medical scribe programs like AI based medical scribe programs. So the idea of doing something weird and making doctors want it was very, in my comfort zone. But with this, what was so interesting is that our clients were so varied and so figuring out what an actual, like SaaS solution wise to a pandemic is impossible.
Devon: At the end of the day. It's a challenge that companies are still trying to figure out because. The US is massive. California is. Massive and you're serving a population that is incredibly diverse and then you're working with organizations that are incredibly diverse, like the difference between the needs of LAX versus the California farm [00:21:00] workers.
Devon: Foundations are insane. Like there, there's no way to even really compare those past the fact that they need covid test results. And so one of our biggest challenges when scaling was just trying to figure out what to prioritize. Like how do you make everyone happy when everyone's needs are valid? Everyone's doing work that's important.
Devon: We're not doing anything that is superfluous for the community, but we also only have so many engineers and we can only do so many things. And so weighing what's actually important to the broader good. What's important to a specific community? Telling people no, like we, we can't implement that feature.
Devon: We know it's important to you. We can't translate the platform into that language yet. We just don't have the time. Was so hard because you knew that saying no to an ask, but saying no to a need. And that is so different than how traditional tech operates. So personally, that was definitely a. A harder part and a challenge as far as scaling and then just scaling like the idea, like building things quickly and efficiently and finding [00:22:00] people who want to do that.
Devon: I would say, and I'm sure Phoebe can speak to that, as someone who built a lot of the teams who were a deep part of this process, getting the team that I myself was on, finding people who are willing to work in this way, find people who are down for the midnight war rooms and the calls from providers in their garage and the, just hecticness of this, especially when it does matter.
Devon: And then doing it over and over again every day with the no end in sight is, it's just a very specific kind of problem to solve as a for-profit company, it's something a lot of people get the opportunity to do unless you work for a nonprofit.
Phoebe: Yeah. And I do think too, like I do wanna applaud Andrew, the ceo , EO , and Chris, the, they were co-founders.
Phoebe: CEOs, most CTOs are gonna be like no. Where's the money? Where's the money? No. And it was complete opposite, right? It was just the complete opposite andrew would be like, if I have to get up at night and code, I'm coding Chris, same thing. And it was like, again, like after being at different [00:23:00] companies and that was my first experience with health Tech and it was, it's so refreshing now that I got to be a part of it.
Phoebe: And you really got to see how, some real leaders, got their hands dirty and said, screw it. It's not about those things. We gotta do the right thing. And to me, like that's one of the key takeaways that I take away from them, I think I learned from them exactly.
Phoebe: , if you're gonna go and lead something, you gotta know exactly how to do it. You gotta know exactly how to fix those bugs. And you have to know exactly how to, treat your customers with kindness and respect and that all asks are important.
Devon: Yeah, exactly. No, and Andrew and Chris are both huge inspirations to me. I look up to them a lot every day at my job. But it is it's a weird part of the health tech, public health universe to be in when. , you are, beholden to a bottom line in the sense that like you have to pay people and you're not receiving, that for-profit company, that, that comes with a certain amount of responsibilities, but also the goal is to do good and and in a very real way that is not beholden to [00:24:00] making, I.
Devon: Significant profit and balancing those things while also trying to scale a product that's meaningful across millions of people. It's wild. We ran some numbers a couple weeks ago and 4% of the US is on our platform, which is crazy. Like the fact that we were able to build something that has touched that many lives , like I talk to people in my personal life who are like, yeah, I got Covid tested, and I was like, that's probably on primary.
Devon: Yeah. And no one knows who we are. Like, that's the funny thing is that we are just this kind of like ghost in the background of all of this. I like to say that we're like the irrigation in the fields, but you only see what's growing. You don't see what's underneath. And that's okay.
Devon: It's fine to operate that way, but it makes scaling challenging too, especially when you're working with organizations that have an inherent hesitancy to private enterprise because they're used to. Working with community-based organizations, with nonprofits, with local health departments, and someone like us coming in and saying, can we help?
Devon: They're like, what do you want? And we're like to help. Like we, we really do mean [00:25:00] it. It can be just challenging to get trust in that way too. And that's something that we still. See and that I think during the pandemic was aided by the fact that there was a need to be doing this work, but there was still definitely that initial kind of hesitancy in the room.
Phoebe: Yeah. And I think too, like it was again, like to your point, Leo, like this was the first time that I. A lot of people got to in theory, experience telehealth. Yeah. Again, it was like, it wasn't so much as like the test results, but like a doctor is calling you from your community explaining what you're supposed to do.
Phoebe: When Paxlovid dropped, , it was all these doctors doing a lot of outreach and people really getting to experience this new kind of like method and modality of receiving care who previously. Didn't get to have that luxury.
Leo: Yeah no. It's interesting to see the behind the scenes and what happened.
Leo: And the talk. We working front it was just like, hey, it was there and when the numbers got turned on and why had the ability Great. Perfect. But [00:26:00] I never really asked how it got there. How it scaled . It was just like, oh, awesome. Thanks guys. And I'll use it.
Leo: And Yeah, I know, I knew there was a lot of work behind the scenes, but really never understood like the deep down. . Now that we have this, where do you think this is going? Where is public health and telemedicine heading next? Now that you know the pandemic's over.
Leo: But, what are we doing? It's not over.
Phoebe: It's not over. Leo. I just had Covid two weeks ago. You did? I have the world record for the person who's had COVID the most. I was on my deathbed, Devin. Oh my God.
Devon: I'm so sorry. I would say the pandemic is over, but Covid is very much not is hard. Oh, absolutely.
Devon: People in my life.
Leo: So where are we headed next in terms of, public health and telemedicine and, in, in those realms.
Devon: I think one of the big conversations that I know I hear in public health is like, what, since Covid has stuck and what have we lost and what needs replacing? What the pandemic did was it took away all of the existing [00:27:00] infrastructure, right?
Devon: There were things, ways that things were running, and they'd been running like that for the last 40 years of life, and everyone thought it was fine because patients were getting care and then all of a sudden, basically overnight. All of that died. And what happened was a lot of really amazing innovation, right?
Devon: Like the boom of telehealth through that, being able to connect people who weren't physically near each other. But then when the pandemic got to a place where folks could return largely to their normal state of business, there was this almost desire to return to some of the ways that things had been operating previously.
Devon: Because it was comfortable. It was like that was over. We did that. Super scary done. So I would like to return to normalcy. But what we're finding is that normal doesn't exist anymore because the patients and the participants have gotten really used to a certain level of ease, right? Like people wanna talk to their doctor like this, if you don't have to touch me, why do I have to go to your practice if you can order my labs virtually?
Devon: And I think it really shifted the way that people participate with their health. A lot of [00:28:00] people during the pandemic took a real ownership of. Knowledge in a way that I don't think we've seen in healthcare previously. At least, in my lifetime, of people were being expected to research things.
Devon: They would be expected to ask questions. They were being expected to really. Understand what they're being asked to do, and that has definitely not gone away. And I think that is what's driving a lot of the public health innovation, is what people are driving and what they want to see from a public health system.
Devon: Now that being said, we're seeing a measles outbreak in Texas right now. We're seeing. Bird flu explode across the US and I know eggs near me a million dollars. And you can look at that and say that, there are some learnings from the pandemic that should have been, in my opinion, implemented to prevent some of that from happening in terms of wastewater surveillance, air surveillance, like we have this technology that exists, why aren't we using it now?
Devon: On the positive side though, I think. Telehealth is the biggest gift to medicine that came out of the pandemic. And it's, you Google Telehealth and 50 providers will come up in your [00:29:00] area that want to see you, or different organizations that can see you for mental health, behavioral health to prescribe you medications that you might not have had the opportunity to access otherwise.
Devon: And. In the public health space, what we're able to do is deliver healthcare cheaper. That's a big way that digital innovation really solves a lot of the public health crisis. There's a program I was telling Phoebe before we hopped on that we're running right now in Michigan the Michigan Wellness Program, and we have stood up we used to be 22 sites, now it's 14 turf sites.
Devon: So there are these face faith-based community centers that are running point of care, CLIA wave testing at their, the home of their congregations. And they're doing diabetes screening, cholesterol screening, hypertension screening with a CLIA waiver. And that whole concept is very covid, right? The idea that lower trained individuals can deliver real diagnostic testing in a space outside of a clinic.
Devon: That didn't exist before the pandemic. And so not only is the basic model, a structure of, post pandemic innovation, but we have NPS who, when a person [00:30:00] tests for any abnormal result, if your blood pressure is 180 2 over 70, we're calling you, even though most primary care providers would tell you that you're fine.
Devon: And we're calling to educate you like it's not about prescribing. It's about. Lifestyle adjustments. It's about a referral to an FQHC. It's about telling you what's available in your community and that telehealth infrastructure absolutely would not exist without the pandemic. The idea of a provider somewhere else in your state calling you about a result that you got in a church about your diabetes.
Devon: Diagnosis and then providing you resources to seek out care in a community-based center that is still providing traditional care. Those are the programs that get me really excited that we haven't lost the core of what we took away from the pandemic. 'cause I do think it's there and I think things like that really demonstrate that even though it's easy to point fingers and say, we should've done this better and we should have done this better.
Devon: But at its core, I think the innovation of the pandemic is still very much around and alive.
Leo: No you're right. And hopefully, yeah we take lessons that we learned and move forward. And you're right. [00:31:00] This is the expectation and not just, the exception.
Leo: Awesome.
Phoebe: Devin I want the gossip. What is primary empathy ? I feel like I need to live vicariously through you.
Devon: What are we doing? What are we up to? We're doing a lot of things. We've been, one of the things I'm really excited we're doing is doing a really big data push, like helping organizations with their data.
Devon: We've been discovering that there's a lot of need for people who run things like immunization coalitions, or are really responsible for community outreach. They don't have a great way to understand the data that they're given, right? Like the state might say, okay, here's 50 spreadsheets that tell you the areas in your state where people are under vaccinated.
Devon: Go solve that problem. And that's a lot to ask of someone who's not a data analyst to sit there and really digest that. And so we are building out some more background programs that help folks in those situations understand the data, be able to really model it in a meaningful way, in a pandemic learning kind of way of real data.
Devon: Really matters. [00:32:00] And then action on it, and if they want our help figuring out how to action on it we're great program consultants. But if not it can just live with the data. We're happy to just stop there. We're doing a lot of integration work as well. We're currently working with CDPH, our favorite on integrating all of the public health labs in California for an emergency preparedness initiative.
Devon: So that way. This is one of the things that when you don't work in public health, I feel like you think is obvious. And then when you do work in public health, you're like, why doesn't this already exist? But there are these things called public health laboratories, and this is where your samples for the general population go, like rabies or public covid, flu testing, that kind of stuff.
Devon: Different states of different amounts of them. In California, there's 26, which is a lot. It's the most in the US and they can't talk to each other. Their individual lab systems don't communicate. So in the event of a pandemic, let's say like covid if one lab is at capacity or if something breaks and they can't run those samples, they have to send paper requisition forms via carrier to the next laboratory that can servee those [00:33:00] samples and then process those samples, which creates.
Devon: A huge amount, a huge margin of human error, right? Let alone just like losing things. And so we're working on a lot of data monetization work and not initiative and similar programs to really fix that way in the event of another emergency, which, knock on wood, hoping it doesn't happen, but better to be prepared there's this infrastructure in place so that these really important public health institutions can communicate that way.
Devon: There isn't a delay. Care and processing. So on the more technical side, that's what we're up to On my more favorite side, which is the clinical side. I, after PB lab took over our medical group, and so we're really figuring out the best ways to utilize that. We have a 50 state provider group. Like I said, we're doing programs similar to the one in Michigan where we're using existing community centers to really build out infrastructure where it doesn't traditionally exist.
Devon: We had an abstract accepted in 2023 about some work we were doing in a Frontier County in Montana. I didn't know until that frontier was a census designation. I thought it just meant like cool cowboys. It [00:34:00] actually means a county where there's less than 5,000 people who live there, which is extremely rural.
Devon: And the people have to drive three hours to go to a doctor and just mountainous terrain and all of these things. And we worked with the local health department to set up a direct to consumer like shipping about home test kits so that way they can receive them in their homes and get screened for diabetes and colorectal cancer.
Devon: Like all of these really important things, especially for their aging populations needs. So we're doing a lot, but I get the most passionate about programs like that where I feel like we are. Taking focus in the US who maybe have insurance, maybe think they have access to healthcare but aren't taking advantage of it because there's barriers that exist that are pretty easy to knock down if you have technology that can do so
Phoebe: interesting. I remember the Montana program. I think it was getting, it was getting kicked off right as I was transitioning out. And to your point , like I, I know that I think. One of the things I remember realizing early on while being at primary was like, I think this whole idea that we have to go to a doctor's office to [00:35:00] get care, like Covid has told us that is not the only option.
Phoebe: And so I think like building in a lot of the at-home testing programs , I think we realized like you get better outcomes if you meet people where they are or where they wanna be seen versus. Forcing them to the place that where you're at and being able to like support that, whether it's in a, at a community clinic or a, a church or in their home, I think was one of the ways that we were able to be so successful and really actually help people to start taking this seriously.
Devon: Absolutely. Yeah, I, there's an internal joke that if you could tattoo something on my head in calls, it would be like we meet people where they're at. Because I think I say it every time I talk to someone in the history of my entire career in public health, because it is like the most important thing.
Devon: And I think the perfect thing to end on is that is the thesis. And that's what I think the thesis of public health should be. It's like we think about programs globally, but at the end of the day, they only work if they. Actually solve the [00:36:00] barriers that are preventing people from seeking care. And I think a lot of people think they know what that is and from a really well-meaning place.
Devon: But unless you go and actually talk to the people in the communities and say, what are the barriers? I've been surprised by some of the barriers. You're gonna rural area and you think that it's gonna be one thing. And it's no, actually it's just this other thing over here. And it's oh, we can fix that super easily.
Devon: We would've done a way more complicated thing if we had assumed that, we knew what your barriers were and. Those are the kind of things that I think is really important to keep in mind when you're thinking about public health is that it's global, but it's also up to the individuals to take advantage of the programs for the programs to mean anything.
Leo: That's an interesting motto too, though. That kind of sums up telemedicine as well, right? Yeah. You could practice it anywhere. It's everywhere, but you're meeting people where it's at
Devon: yeah.
Leo: Yeah. It's a cool connect. So yeah,
Devon: definitely. Telemedicine is great, so I don't wanna go to the doctor.
Devon: No. I do, but I don't wanna go to the doctor. I want the doctor the way I'm speaking to you right now.
Leo: Yeah. I just don't like doctors. Yeah, [00:37:00]
Devon: that's, I dunno what this is about you, Leo.
Leo: . No, Devin, thank you so much for your time. This has been awesome. And thank you for giving us an insight into you and your experiences.
Leo: Maybe any closing thoughts either of y'all.
Phoebe: No, I just wanna say, I'm gonna, I'm gonna plug Devin for two seconds. I got to hire Devin. I got to train Devin. And I love working with people that have the growth mindset that are always learning, that are always open. And as Devin's sitting here, like talking, I highly doubt anybody knows how young and brilliant she is.
Phoebe: I'm not gonna put, I'm not gonna say your age because people are gonna freak out when they find out that you're 19. But No, but I just wanna say you are doing such amazing things and I'm so proud of you from getting to see where you evolved when we started together and getting to like there, I couldn't say that I, I.
Phoebe: If there's any other person who could have stepped into my shoes as well as you did, and I'm just, I'm so glad that it's [00:38:00] been you and I'm so glad that you are, continuing to lead the way and be a guiding light in the public health space that really needs somebody who is.
Phoebe: Full of strategy and customer success and product and technical and all of that rolled into a little ball of Devon Phillips. So I just wanted to like, just say that thank you for all that you do and that you continue to do. I'm in California in case nobody on this podcast knows, but the programs you're building and launching and leading continue to touch my life daily.
Phoebe: And so I just wanna say thank you.
Devon: That means so much. No, and I just wanna reemphasize that Phoebe is someone who I consider such a mentor. She hired me. The way I got hired a primary is like hilarious. She called me on a Friday night and she was like, you wanna work here After I had two interviews previously, like the day before.
Devon: 'cause the pandemic, right?
Yeah. And
Devon: she was very transparent what I was signing up for. She's we don't know how long this company's gonna last. We don't know how many people are gonna work here. We don't even know what we're doing really. But you seem cool. Do you wanna do cool things? And I said.
Devon: Absolutely. [00:39:00] And now we're here. And so I have so much,
Phoebe: I think you actually said Yeah, but can we talk tomorrow? 'cause I've had a whiskey That is
Leo: accurate. Yeah. That interview kind I want.
Devon: Sure. To be fair, it was Friday at 8:00 PM So my time 'cause I was on the East coast. Oh,
Leo: okay.
Devon: Okay. A lot of different just to make sure that the listeners know it was an acceptable whiskey.
Leo: Yeah, it's five o'clock somewhere.
Devon: Five o'clock somewhere. I know p has a hard stop, but I did bring a fun fact because on the notes that you sent me, there was a fun fact section and I do think it's quite fun and I would like to share it.
Devon: So think it's very relevant, but I was doing some research before this just about like telemedicine and history and when it started and all of the things, which is very on-brand for me. SPV. I learned that the first ever global disease surveillance initiative happened in 1947 by the World Health Organization.
Devon: And it was something that came out of a technology that was developed really during World War ii, and they utilized it to create this global [00:40:00] disease surveillance network. And it really was like the way that public health started in a global way. And I thought that was just like the most perfect way to end a podcast about telehealth and innovation coming out of something that.
Devon: It could have been and was really bad in a lot of ways, but also just skyrocketed a different kind of innovation and it was a cool synergy and I felt like I had to share
Leo: What was the health initiative?
Devon: It was global disease surveillance, so actually countries talking to each other to track.
Epidemics and endemic outbreaks of things to prevent another pandemic, like I would imagine probably the Spanish flu is what they were thinking about most recently at that point in history. But it was a technology that had come directly out of, world War ii, or it was before that, but had skyrocketed during World War II and Telex.
Devon: If anyone wants to be really dorky about typewriters that send electronic signals via.
Phoebe: [00:00:00] Welcome back to telemedicine talks.
Phoebe: I am so excited for this episode because we have an amazing guest. Speaker who is actually somebody who I got to work with for a lot of time and she grew into be one of like my very dear friends and she is just absolutely amazing and I cannot wait to have her share how her and I got through the Covid pandemic together and we actually built one of the largest testing, community testing programs in the whole United States with.
Phoebe: Pretty tiny team. Devin, I am so grateful to have you on the show today.
Devon: I am so excited to be here. Phoebe is someone, you are someone who I consider a large mentor in my career, and yeah, we did a lot together in a very short amount of time that I'm sure we'll touch on in this episode. But nothing says grassroots like the pandemic.
Leo: Devin, thank you so much for stepping in and sharing [00:01:00] your experiences through Covid and where this ties in to, telemedicine talks and telehealth is telemedicine has always been around, right? It's always, back in the sixties that's when it started with telegrams and the army and satellite, so forth and so on.
Leo: But we really didn't see telemedicine blow up until Covid, we were forced to go in, go home and practice medicine. And it's gonna be interesting to hear how y'all built a system, a public health system that's supposed to reach out and touch everybody, when really we weren't really supposed to re be reaching out and touching anybody, right?
Leo: That was a no-no. So yeah, I'm super excited, super stoked to hear how, yeah, we were forced to do this overnight and how you guys built a system that, helped a whole state through this whole pandemic. With the help of doctors, so forth and so on. Yeah, super stoked. Thank you again for stopping by and sharing your experiences.
Devon: Of course. Excited to be here. Stoked to be here. [00:02:00]
Leo: There, there's a lot of Hawaii vernacular. I pretend to be from here, but I love here. Oh, I'm San
Devon: Diego oh, there you go. Here some vernacular. We've got it stoked to see Hawaii
mainland. That's what I say. So cool. Cool. So awesome.
Phoebe: Yeah, so just to give you like a little bit of background of what Devin and I did together and still, when I left the last company, she actually got to step into my shoes and take over all the crazy stuff I was trying to do.
Phoebe: I dunno if that's a good thing or a bad thing, but, whatever it is what it is. You left it,
Devon: she's good. They were in good condition.
Phoebe: Okay, good. Good. But I think, like one of the most interesting things to me is when I first joined the company the big thing was , COVID was running rampant.
Phoebe: We didn't have a vaccine, there weren't testing programs. The health system actually couldn't keep up. And I think I started at that company, I don't know, maybe a few months after. It was really bad in 2020 and. Our first kind of like course of [00:03:00] action was schools, kids, what do people care about?
Phoebe: They care about kids. They care about keeping their, their kids healthy. And again, this was such a scary time. And I think like the interesting piece was, like having to run and figure out like the policy and the program while things are coming out from the CDC, while things are coming out from all these doctors that we're working with.
Phoebe: And having to be forced to run with the very limited information, but also for the first time, getting to see government move really fricking fast I think was a really interesting angle too. So that's my perspective, but Devin , give me your play by play on how it was.
Devon: Yeah, I think that's a great way, place to start. I remember when Phoebe hired me into a role that's different than what I do now. I'm on the strategy side now, but at the time I was more on the technical side. And Phoebe, as you will know if you listen to this podcast, it's not someone who pulls her punches.
Devon: And she was really transparent about what I was signing up for. She was, this is a startup. We're doing this because we care about public health. This is not about [00:04:00] making money. This is about helping people through technology and that. Spoke to me. And then I hopped on the ship and really realized what that meant.
Devon: And I think for a lot of people nowadays, you hear telehealth and it feels obvious, right? Like you wanna have an annual visit, you can hop online, you can speak to a doctor, it's covered by your insurance. It all works seamlessly. It's great. And, four, four years ago, that was so far from the reality.
Devon: And so to Phoebe's point, we were building software, but the software we were building had to constantly change based on these directions and protocols that were coming out from. Doctors who were collaborating with government, and so it was this crazy intersection of medicine, but also legal compliance.
Devon: They were changing the times that results had to be reported back to the state. What kinds of results had to be reported back to the state when people had to be tested? What symptoms you had to be tested for? All of that was rolling out. So when you and the public were reading those protocols online and saying, oh my gosh, how am I gonna manage that in my life?
Devon: For us, we were thinking, how do we bake that into a software so that people can go [00:05:00] into the field and do this work without having to know offhand what's happening at the government level, which is such an interesting intersection of different components in healthcare that I think a lot of times.
Devon: Different organizations solved separately, and we were really put in a position of having to solve them all at the same time, while also being expected to be online 24 hours a day because testing was happening in different time zones all over the state of California. We were also in other states outside of California and.
Devon: Yeah. It's just, it's wild to think back on, on all of the pieces that were happening at the time because it's so different than I think, the way people approach healthcare traditionally. Where you see a doctor and then, you don't, you pay your copay and it's great. And that, that's where it ends.
Phoebe: Yeah. For me it was like it was the first time that I felt like I don't know, maybe I'll say I felt like a Canadian oh, I can go, there's like a, you can go to a community clinic. Yeah. There's no copay, there's no nothing. And this was also like labs were just like overburdened, like [00:06:00] Kaiser couldn't keep up all these kind of like your normal insurance couldn't keep up and, point of care testing had just come out.
Phoebe: So there were all these antigen tests and like where we were at was trying to work with, the California Department of Public Health of like, how do they get that data, get those results back so they can go, okay, there's an outbreak in this community. I. We gotta go deploy some stuff so we could stop this or, there's an outbreak here.
Phoebe: And I think that was one of the big things that I walked away with , from, it was like, it was actually a really beautiful thing to see all these, communities come together, churches and different kinds of places to just have as many community testing sites.
Phoebe: That were sponsored by the state of California. So it was completely free. I think how many sites did we have like in the, like the top of the,
Devon: oh, thousands, tens of thousands probably. There's, all the schools alone, right? You consider a site, and that doesn't even count.
Devon: Long-term care, facilities, shelters, rehab facilities, sober living [00:07:00] facilities. Really, I feel like during the pandemic. As many places that were considered community gathering points were mobilized to provide these testing services because where people were going is where they were willing to receive this testing.
Devon: And I think that's another part of public health that's different than how traditional healthcare operates , like one-on-one physician services operate. Is that. If you're trying to convince people to do this thing that you, on the science side know is important. And that's really hard because you're not only saying you have to get out of your house, you have to drive somewhere in a time that's already really scary.
Devon: To get a test so that we can have data so that we can make more meaningful interventions for you. And how do you communicate with those people? How do you show them that it's important and those are some of the other? Problems that we tried to solve is that education, that access, that outreach, providing community based services and languages that were applicable to the folks that were being served in, an a DA compliant way so folks with disabilities could interact with technology and receive these services.
Devon: It was just so multifaceted when you take it to the community level because. It's not individual [00:08:00] healthcare anymore. You're now designing outcomes that are, have to address the needs of thousands of people, but in a way that people still feel like they're getting individualized care. And that's a really complicated thing to do, especially when you're being asked to do it in 24 hours.
Leo: Was it really 24 hours ? Was it that quickly?
Devon: Sometimes.
Phoebe: Sometimes it would depend. Yeah. But sometimes, yeah. And again, like. You have to throw in the nature of it's COVID. We're also a startup, so I think I was like employee 20 or something. When I left there were 200 employees, we started it was a small team of us doing this, and then it grew to like, we had 50 people because that's what we needed to actually keep the programs running.
Phoebe: And, to Devon's point, like. When there's a glitch in the system and something isn't working, people aren't getting their lab results in a timely manner. It doesn't mean okay I'll do that tomorrow. It means, Hey guys we're gonna hop into a war room [00:09:00] and like we're gonna go call these 50 people and you're gonna go call these 50 people and you're gonna go call these 50 people.
Phoebe: 'cause they're depending on us and we can't let them down.
Leo: Now , one question is, the startup was created because of Covid. Who was the trigger? Who was the call to action to actually get the start? What is, was it the state of California? Was it, I. The California Health Department I'm clueless with all structures.
Devon: Yeah. Interesting story. Yeah, so our co-founders have software backgrounds and they saw a need in a rural part of California, which is the perfect use case for what our software does. Where there was community testing happening, but no way to report it back to the state. And in a pandemic data is the most meaningful asset that a governing organization has, right?
Devon: That's the only way that they know what's happening on the ground. They're not calling local health departments and asking no one, it's time to do that. And so they really saw a need and then developed this. The software to solve and bridge that gap through just like lightweight versions of what we are now.
Devon: Basic, you can [00:10:00] have a test report it, and the state will know that it happened. The person will get a result and that's it, that's where it ends. And then through then it just became something that became more and more needed and more and more known and it just, it exploded from there.
Leo: Oh, wow.
Leo: So I worked in the er, worked the front lines of covid. Really, all I saw was end product. All I saw was, hey, here's some results. I need to act on it. So can you speak on kind of the role of community doctors? A lot of these doctors too were thrown into, now you're the expert right now, you're calling on them to create policies, so forth and so on.
Leo: What kind of roles did you see that doctors held and, how was the transition for them? And how was working with 'em. We all know how, yes. Working with doctors. Always easiest to work with, right? Never type A, but never.
Devon: No. The chillest
Leo: people I know are doctors.
Leo: Oh, absolutely. Yeah. Can you comment a little on that?
Devon: Yeah. I think in any time where there's something, and I hate to use the word unprecedented because pandemics have happened before, and also I think it's just an [00:11:00] overblown word that we use in terms of covid. But whenever there's.
Devon: Something that people haven't experienced in their lifetime or even their parents' lifetime, and anyone can point to someone and say, oh, you know something about this, so I'm gonna look to you for answers. And you have a title that makes me think that you're in a position where you're going to provide me real scientific information that puts the people on the side of, being asked in a really difficult position, especially when it's a time when no one knows anything, right?
Devon: Like we were the variants were actively being secret. We're going from PCR testing to, rapid testing. Phoebe mentioned, and then OTC testing. We don't know the efficacy of these tests long term. We don't know how, the ex even the expiration dates of when you can take these tests. We don't know what's gonna happen in, in the broad scheme of this.
Devon: And I have a lot of admiration for doctors, especially in rural areas that really stepped up and became the subject matter experts because you go from being in a clinic, seeing patients one-on-one, and counseling about their individual needs to, again, being responsible for. Population level healthcare, you're looking at your entire population and [00:12:00] saying, what do they need to be healthy?
Devon: Which is such a different set of problems than what one individual person needs to be healthy. But yeah, they were running testing events, like we knew doctors that were doing testing outta their garages with Clio waivers when the rapid testing became available and. It was just a way for them to provide an additional service for their communities because they were such a trusted resource.
Devon: But to do that was, in my opinion, brave, to put yourself in the front lines of being asked questions, especially again in a time when. The answers were loose, like they were changing daily as far as protocols and things like that. But my overall experience working with doctors was great. I've worked with a lot of doctors in my career but I also received a lot of late night phone calls and scared things because to what Bebe was saying earlier, they.
Devon: Were acting in a lot of cases individually for the benefits of their community. They weren't working on behalf of the hospital system that had these massive EHR systems and all of this tech that they could rely on. They were using our software to stand up these tiny clinics in these specific areas.
Devon: And so if our software wasn't able to provide what they needed, then [00:13:00] they weren't able to do testing or they were recording test results on a spreadsheet in the dark, quite literally. it sounds very dramatic, but it was just a wild time. And so it just became like a really collaborative environment with us and the physicians that we were working with, especially the ones that were truly providing this individualized, but on a public level, community care.
Phoebe: Yeah. Just to layer into that too we got to work with doctors on the policy side. And like for everybody who's listening to this podcast knows, like that's my background. My background is in like building these massive programs, layering the policy, making it compliant, following like regulations.
Phoebe: And it was like my first time getting to work with. Physicians on the public health side, I'd only done it on the other, like the Medicaid side. And it was really interesting because each of them had very innovative ideas on what they thought was the next, the next thing that we should focus on or the next initiative that we needed to try and tackle.
Phoebe: To get more people tested or more people vaccinated. And Devin, I, I don't [00:14:00] wanna go into it, but out of all the, we, we did covid, COVID sniffing dogs. We did oh my gosh. Yeah. We did, test to treat. We did a massive free test to treat program.
Phoebe: We did airport testing. We were the software that, like if you were going through LAX or FSFO, like you were forced to do an antigen test and that was all reported through the software. I think one of the interesting things that I thought is like for the first time on, on the government side, having doctors lead programs without the red tape.
Phoebe: Yep. Without the bureaucracy of it going, I have this idea and I have this vendor, this software vendor that could actually power it. And yeah, it might be a little glitchy and it might be a little rough, but we are gonna pilot this thing and I think one of the things that was really refreshing, we also had a CEO that kind of let us do this and I got to work with them and consult, CDPH H on I wouldn't focus on this program, but let's go do airport testing. 'cause that's really where you're, we don't want, we don't want a covid person getting on a [00:15:00] plane, and so I don't know. Devon, let's walk a little bit about like the dynamic of working with doctors on the program side, and then also just , what was your favorite like subset program that you worked in?
Devon: Oh, that's a great question. To answer the first part of that question, working with adoption, the program side is really interesting.
Devon: I think I. It's like anything, right? Like you, there's these big words that mean things when you're on the other side of the veil, like you think CDPH and you're like, okay, it's the California Department of Public Health. And it's like this big organization, like Big Brother Style that's gonna come in and say things, but then all of a sudden you're in the room with these people and they're just people.
Devon: They have various titles, but they're people and they're just trying to make things better, for the most part, for the communities that they serve. And to Phoebe's point, a lot of these providers had some ideas that pre Covid would've sounded absolutely. Bonkers. Like the idea of putting a golden retriever in a school to sniff children.
Devon: Imagine if you pitched that to someone in government five years ago, they would've been like, no, that sounds, but when you're talking about it in a way where it's no, this makes sense. We can [00:16:00] help kids. Become more comfortable with getting covid tested. The dogs can alert early if they're, if they have a symptom that we can't as humans detect with their, dog extrasensory abilities, and then we can only test that child versus having to test an entire student population.
Devon: All of a sudden, that idea sounds genius. And I think a lot of the doctors we work with, it sounded like it felt like it was gratifying for them to be able to have these ideas and to also be able to implement them in a way without having to issue an RFP and source the vendor and go through the year long contracting process.
Devon: And by that point, a lot of times the niche problem that they're trying to solve is gone, or it exists in a very different way. And the initial. Thought is less applicable than it was, but in Covid it was like, today there's a problem and tomorrow we're gonna fix it, and then the next day we're gonna see if it worked.
Devon: And I think that was rewarding for a lot of people in government. I know it was rewarding for me on the implementation side of those programs. And I know we've mentioned the dogs a lot. I would say that's one of my. That's one of my favorite programs that we've [00:17:00] implemented for sure. My personal one that I got to be a part of during Covid was the Test to Treat program that hoe you mentioned, that was actually a program that I personally got to run and implement with CDPH.
Devon: And we did a lot of work with farm worker communities in Northern California because it's a really interesting population. They have very specific needs as far as. Access to technology. There's people who are in the same place. They don't speak English as a primary language a lot of the time.
Devon: They're not comfortable with interacting with the US healthcare system. They're not comfortable with their records being shared, but they are interacting with a lot of people. They're interacting with food. How do you get these people tested for covid? How do you get them treated? How do you get them paxlovid?
Devon: And working with CDPH to solve that problem was a personal favorite 'cause it was just so complex. And I love a challenge.
Phoebe: And I think, like for me and again, like I was there like in the very early days where the first thing that we tackled was schools. The way that this was broken into was like cohort.
Phoebe: So it was like, there was like the school cohort, there was the long-term care and [00:18:00] the skilled nursing facility cohort. And then there was like the community cohort and that was like. Everything else. And we ran all those three cohort and they had to be set like segmented that way due to like federal funding.
Phoebe: It's very interesting. Very interesting times. Yes. And for me, like I think the one program that kind of blew my mind a little bit was the. Execution of at-home testing. So this was like right when, like all the rapid, the eye health tests and the Abbott Binx Nows and all of those at-home tests were getting deployed and CPH had no way to get that data.
Phoebe: So they had truly no way to understand what is happening in the community. And we worked, we built an app we worked to market this program to really get it out there. And I remember , we did it right around New Year's. So that was when we launched it.
Phoebe: And I remember, oh no I remember all of us like holding our breath going, yeah. Are [00:19:00] people gonna report this? And I remember waking up, the next day and logging into our data analytics tool and results were coming in every second. It was like, I think in one weekend we did over a million people reported both negatives and positives.
Phoebe: Yeah. And there was a really big hypothesis of why would a person report a positive? You don't wanna get in the system, you don't wanna have the contact tracers come. And it was like, you got to interview some of those people and it was like we did this for the greater good of the community.
Phoebe: It was this very beautiful thing. And so getting to be a part of that and. Again, think me thinking as a total pessimist as everybody knows going this is never gonna work. CDPH. Like it's in high hopes. And then, I still think people can actually use that and report at home covid tests if they wanna get their data to CDPH.
Devon: Yeah, it was very cool.
Leo: So with that how tricky was it to scale ? You guys start out small, you went [00:20:00] big. What was your biggest challenges and expanding on that, maybe the worst, best, and maybe just the way out there experiences that you had going through this process?
Devon: Yeah, I think anytime you scale anything you find things you didn't expect.
Devon: My background is in health tech. I've worked at Health Tech my whole career. Before I worked at primary, I worked scaling medical scribe programs like AI based medical scribe programs. So the idea of doing something weird and making doctors want it was very, in my comfort zone. But with this, what was so interesting is that our clients were so varied and so figuring out what an actual, like SaaS solution wise to a pandemic is impossible.
Devon: At the end of the day. It's a challenge that companies are still trying to figure out because. The US is massive. California is. Massive and you're serving a population that is incredibly diverse and then you're working with organizations that are incredibly diverse, like the difference between the needs of LAX versus the California farm [00:21:00] workers.
Devon: Foundations are insane. Like there, there's no way to even really compare those past the fact that they need covid test results. And so one of our biggest challenges when scaling was just trying to figure out what to prioritize. Like how do you make everyone happy when everyone's needs are valid? Everyone's doing work that's important.
Devon: We're not doing anything that is superfluous for the community, but we also only have so many engineers and we can only do so many things. And so weighing what's actually important to the broader good. What's important to a specific community? Telling people no, like we, we can't implement that feature.
Devon: We know it's important to you. We can't translate the platform into that language yet. We just don't have the time. Was so hard because you knew that saying no to an ask, but saying no to a need. And that is so different than how traditional tech operates. So personally, that was definitely a. A harder part and a challenge as far as scaling and then just scaling like the idea, like building things quickly and efficiently and finding [00:22:00] people who want to do that.
Devon: I would say, and I'm sure Phoebe can speak to that, as someone who built a lot of the teams who were a deep part of this process, getting the team that I myself was on, finding people who are willing to work in this way, find people who are down for the midnight war rooms and the calls from providers in their garage and the, just hecticness of this, especially when it does matter.
Devon: And then doing it over and over again every day with the no end in sight is, it's just a very specific kind of problem to solve as a for-profit company, it's something a lot of people get the opportunity to do unless you work for a nonprofit.
Phoebe: Yeah. And I do think too, like I do wanna applaud Andrew, the ceo , EO , and Chris, the, they were co-founders.
Phoebe: CEOs, most CTOs are gonna be like no. Where's the money? Where's the money? No. And it was complete opposite, right? It was just the complete opposite andrew would be like, if I have to get up at night and code, I'm coding Chris, same thing. And it was like, again, like after being at different [00:23:00] companies and that was my first experience with health Tech and it was, it's so refreshing now that I got to be a part of it.
Phoebe: And you really got to see how, some real leaders, got their hands dirty and said, screw it. It's not about those things. We gotta do the right thing. And to me, like that's one of the key takeaways that I take away from them, I think I learned from them exactly.
Phoebe: , if you're gonna go and lead something, you gotta know exactly how to do it. You gotta know exactly how to fix those bugs. And you have to know exactly how to, treat your customers with kindness and respect and that all asks are important.
Devon: Yeah, exactly. No, and Andrew and Chris are both huge inspirations to me. I look up to them a lot every day at my job. But it is it's a weird part of the health tech, public health universe to be in when. , you are, beholden to a bottom line in the sense that like you have to pay people and you're not receiving, that for-profit company, that, that comes with a certain amount of responsibilities, but also the goal is to do good and and in a very real way that is not beholden to [00:24:00] making, I.
Devon: Significant profit and balancing those things while also trying to scale a product that's meaningful across millions of people. It's wild. We ran some numbers a couple weeks ago and 4% of the US is on our platform, which is crazy. Like the fact that we were able to build something that has touched that many lives , like I talk to people in my personal life who are like, yeah, I got Covid tested, and I was like, that's probably on primary.
Devon: Yeah. And no one knows who we are. Like, that's the funny thing is that we are just this kind of like ghost in the background of all of this. I like to say that we're like the irrigation in the fields, but you only see what's growing. You don't see what's underneath. And that's okay.
Devon: It's fine to operate that way, but it makes scaling challenging too, especially when you're working with organizations that have an inherent hesitancy to private enterprise because they're used to. Working with community-based organizations, with nonprofits, with local health departments, and someone like us coming in and saying, can we help?
Devon: They're like, what do you want? And we're like to help. Like we, we really do mean [00:25:00] it. It can be just challenging to get trust in that way too. And that's something that we still. See and that I think during the pandemic was aided by the fact that there was a need to be doing this work, but there was still definitely that initial kind of hesitancy in the room.
Phoebe: Yeah. And I think too, like it was again, like to your point, Leo, like this was the first time that I. A lot of people got to in theory, experience telehealth. Yeah. Again, it was like, it wasn't so much as like the test results, but like a doctor is calling you from your community explaining what you're supposed to do.
Phoebe: When Paxlovid dropped, , it was all these doctors doing a lot of outreach and people really getting to experience this new kind of like method and modality of receiving care who previously. Didn't get to have that luxury.
Leo: Yeah no. It's interesting to see the behind the scenes and what happened.
Leo: And the talk. We working front it was just like, hey, it was there and when the numbers got turned on and why had the ability Great. Perfect. But [00:26:00] I never really asked how it got there. How it scaled . It was just like, oh, awesome. Thanks guys. And I'll use it.
Leo: And Yeah, I know, I knew there was a lot of work behind the scenes, but really never understood like the deep down. . Now that we have this, where do you think this is going? Where is public health and telemedicine heading next? Now that you know the pandemic's over.
Leo: But, what are we doing? It's not over.
Phoebe: It's not over. Leo. I just had Covid two weeks ago. You did? I have the world record for the person who's had COVID the most. I was on my deathbed, Devin. Oh my God.
Devon: I'm so sorry. I would say the pandemic is over, but Covid is very much not is hard. Oh, absolutely.
Devon: People in my life.
Leo: So where are we headed next in terms of, public health and telemedicine and, in, in those realms.
Devon: I think one of the big conversations that I know I hear in public health is like, what, since Covid has stuck and what have we lost and what needs replacing? What the pandemic did was it took away all of the existing [00:27:00] infrastructure, right?
Devon: There were things, ways that things were running, and they'd been running like that for the last 40 years of life, and everyone thought it was fine because patients were getting care and then all of a sudden, basically overnight. All of that died. And what happened was a lot of really amazing innovation, right?
Devon: Like the boom of telehealth through that, being able to connect people who weren't physically near each other. But then when the pandemic got to a place where folks could return largely to their normal state of business, there was this almost desire to return to some of the ways that things had been operating previously.
Devon: Because it was comfortable. It was like that was over. We did that. Super scary done. So I would like to return to normalcy. But what we're finding is that normal doesn't exist anymore because the patients and the participants have gotten really used to a certain level of ease, right? Like people wanna talk to their doctor like this, if you don't have to touch me, why do I have to go to your practice if you can order my labs virtually?
Devon: And I think it really shifted the way that people participate with their health. A lot of [00:28:00] people during the pandemic took a real ownership of. Knowledge in a way that I don't think we've seen in healthcare previously. At least, in my lifetime, of people were being expected to research things.
Devon: They would be expected to ask questions. They were being expected to really. Understand what they're being asked to do, and that has definitely not gone away. And I think that is what's driving a lot of the public health innovation, is what people are driving and what they want to see from a public health system.
Devon: Now that being said, we're seeing a measles outbreak in Texas right now. We're seeing. Bird flu explode across the US and I know eggs near me a million dollars. And you can look at that and say that, there are some learnings from the pandemic that should have been, in my opinion, implemented to prevent some of that from happening in terms of wastewater surveillance, air surveillance, like we have this technology that exists, why aren't we using it now?
Devon: On the positive side though, I think. Telehealth is the biggest gift to medicine that came out of the pandemic. And it's, you Google Telehealth and 50 providers will come up in your [00:29:00] area that want to see you, or different organizations that can see you for mental health, behavioral health to prescribe you medications that you might not have had the opportunity to access otherwise.
Devon: And. In the public health space, what we're able to do is deliver healthcare cheaper. That's a big way that digital innovation really solves a lot of the public health crisis. There's a program I was telling Phoebe before we hopped on that we're running right now in Michigan the Michigan Wellness Program, and we have stood up we used to be 22 sites, now it's 14 turf sites.
Devon: So there are these face faith-based community centers that are running point of care, CLIA wave testing at their, the home of their congregations. And they're doing diabetes screening, cholesterol screening, hypertension screening with a CLIA waiver. And that whole concept is very covid, right? The idea that lower trained individuals can deliver real diagnostic testing in a space outside of a clinic.
Devon: That didn't exist before the pandemic. And so not only is the basic model, a structure of, post pandemic innovation, but we have NPS who, when a person [00:30:00] tests for any abnormal result, if your blood pressure is 180 2 over 70, we're calling you, even though most primary care providers would tell you that you're fine.
Devon: And we're calling to educate you like it's not about prescribing. It's about. Lifestyle adjustments. It's about a referral to an FQHC. It's about telling you what's available in your community and that telehealth infrastructure absolutely would not exist without the pandemic. The idea of a provider somewhere else in your state calling you about a result that you got in a church about your diabetes.
Devon: Diagnosis and then providing you resources to seek out care in a community-based center that is still providing traditional care. Those are the programs that get me really excited that we haven't lost the core of what we took away from the pandemic. 'cause I do think it's there and I think things like that really demonstrate that even though it's easy to point fingers and say, we should've done this better and we should have done this better.
Devon: But at its core, I think the innovation of the pandemic is still very much around and alive.
Leo: No you're right. And hopefully, yeah we take lessons that we learned and move forward. And you're right. [00:31:00] This is the expectation and not just, the exception.
Leo: Awesome.
Phoebe: Devin I want the gossip. What is primary empathy ? I feel like I need to live vicariously through you.
Devon: What are we doing? What are we up to? We're doing a lot of things. We've been, one of the things I'm really excited we're doing is doing a really big data push, like helping organizations with their data.
Devon: We've been discovering that there's a lot of need for people who run things like immunization coalitions, or are really responsible for community outreach. They don't have a great way to understand the data that they're given, right? Like the state might say, okay, here's 50 spreadsheets that tell you the areas in your state where people are under vaccinated.
Devon: Go solve that problem. And that's a lot to ask of someone who's not a data analyst to sit there and really digest that. And so we are building out some more background programs that help folks in those situations understand the data, be able to really model it in a meaningful way, in a pandemic learning kind of way of real data.
Devon: Really matters. [00:32:00] And then action on it, and if they want our help figuring out how to action on it we're great program consultants. But if not it can just live with the data. We're happy to just stop there. We're doing a lot of integration work as well. We're currently working with CDPH, our favorite on integrating all of the public health labs in California for an emergency preparedness initiative.
Devon: So that way. This is one of the things that when you don't work in public health, I feel like you think is obvious. And then when you do work in public health, you're like, why doesn't this already exist? But there are these things called public health laboratories, and this is where your samples for the general population go, like rabies or public covid, flu testing, that kind of stuff.
Devon: Different states of different amounts of them. In California, there's 26, which is a lot. It's the most in the US and they can't talk to each other. Their individual lab systems don't communicate. So in the event of a pandemic, let's say like covid if one lab is at capacity or if something breaks and they can't run those samples, they have to send paper requisition forms via carrier to the next laboratory that can servee those [00:33:00] samples and then process those samples, which creates.
Devon: A huge amount, a huge margin of human error, right? Let alone just like losing things. And so we're working on a lot of data monetization work and not initiative and similar programs to really fix that way in the event of another emergency, which, knock on wood, hoping it doesn't happen, but better to be prepared there's this infrastructure in place so that these really important public health institutions can communicate that way.
Devon: There isn't a delay. Care and processing. So on the more technical side, that's what we're up to On my more favorite side, which is the clinical side. I, after PB lab took over our medical group, and so we're really figuring out the best ways to utilize that. We have a 50 state provider group. Like I said, we're doing programs similar to the one in Michigan where we're using existing community centers to really build out infrastructure where it doesn't traditionally exist.
Devon: We had an abstract accepted in 2023 about some work we were doing in a Frontier County in Montana. I didn't know until that frontier was a census designation. I thought it just meant like cool cowboys. It [00:34:00] actually means a county where there's less than 5,000 people who live there, which is extremely rural.
Devon: And the people have to drive three hours to go to a doctor and just mountainous terrain and all of these things. And we worked with the local health department to set up a direct to consumer like shipping about home test kits so that way they can receive them in their homes and get screened for diabetes and colorectal cancer.
Devon: Like all of these really important things, especially for their aging populations needs. So we're doing a lot, but I get the most passionate about programs like that where I feel like we are. Taking focus in the US who maybe have insurance, maybe think they have access to healthcare but aren't taking advantage of it because there's barriers that exist that are pretty easy to knock down if you have technology that can do so
Phoebe: interesting. I remember the Montana program. I think it was getting, it was getting kicked off right as I was transitioning out. And to your point , like I, I know that I think. One of the things I remember realizing early on while being at primary was like, I think this whole idea that we have to go to a doctor's office to [00:35:00] get care, like Covid has told us that is not the only option.
Phoebe: And so I think like building in a lot of the at-home testing programs , I think we realized like you get better outcomes if you meet people where they are or where they wanna be seen versus. Forcing them to the place that where you're at and being able to like support that, whether it's in a, at a community clinic or a, a church or in their home, I think was one of the ways that we were able to be so successful and really actually help people to start taking this seriously.
Devon: Absolutely. Yeah, I, there's an internal joke that if you could tattoo something on my head in calls, it would be like we meet people where they're at. Because I think I say it every time I talk to someone in the history of my entire career in public health, because it is like the most important thing.
Devon: And I think the perfect thing to end on is that is the thesis. And that's what I think the thesis of public health should be. It's like we think about programs globally, but at the end of the day, they only work if they. Actually solve the [00:36:00] barriers that are preventing people from seeking care. And I think a lot of people think they know what that is and from a really well-meaning place.
Devon: But unless you go and actually talk to the people in the communities and say, what are the barriers? I've been surprised by some of the barriers. You're gonna rural area and you think that it's gonna be one thing. And it's no, actually it's just this other thing over here. And it's oh, we can fix that super easily.
Devon: We would've done a way more complicated thing if we had assumed that, we knew what your barriers were and. Those are the kind of things that I think is really important to keep in mind when you're thinking about public health is that it's global, but it's also up to the individuals to take advantage of the programs for the programs to mean anything.
Leo: That's an interesting motto too, though. That kind of sums up telemedicine as well, right? Yeah. You could practice it anywhere. It's everywhere, but you're meeting people where it's at
Devon: yeah.
Leo: Yeah. It's a cool connect. So yeah,
Devon: definitely. Telemedicine is great, so I don't wanna go to the doctor.
Devon: No. I do, but I don't wanna go to the doctor. I want the doctor the way I'm speaking to you right now.
Leo: Yeah. I just don't like doctors. Yeah, [00:37:00]
Devon: that's, I dunno what this is about you, Leo.
Leo: . No, Devin, thank you so much for your time. This has been awesome. And thank you for giving us an insight into you and your experiences.
Leo: Maybe any closing thoughts either of y'all.
Phoebe: No, I just wanna say, I'm gonna, I'm gonna plug Devin for two seconds. I got to hire Devin. I got to train Devin. And I love working with people that have the growth mindset that are always learning, that are always open. And as Devin's sitting here, like talking, I highly doubt anybody knows how young and brilliant she is.
Phoebe: I'm not gonna put, I'm not gonna say your age because people are gonna freak out when they find out that you're 19. But No, but I just wanna say you are doing such amazing things and I'm so proud of you from getting to see where you evolved when we started together and getting to like there, I couldn't say that I, I.
Phoebe: If there's any other person who could have stepped into my shoes as well as you did, and I'm just, I'm so glad that it's [00:38:00] been you and I'm so glad that you are, continuing to lead the way and be a guiding light in the public health space that really needs somebody who is.
Phoebe: Full of strategy and customer success and product and technical and all of that rolled into a little ball of Devon Phillips. So I just wanted to like, just say that thank you for all that you do and that you continue to do. I'm in California in case nobody on this podcast knows, but the programs you're building and launching and leading continue to touch my life daily.
Phoebe: And so I just wanna say thank you.
Devon: That means so much. No, and I just wanna reemphasize that Phoebe is someone who I consider such a mentor. She hired me. The way I got hired a primary is like hilarious. She called me on a Friday night and she was like, you wanna work here After I had two interviews previously, like the day before.
Devon: 'cause the pandemic, right?
Yeah. And
Devon: she was very transparent what I was signing up for. She's we don't know how long this company's gonna last. We don't know how many people are gonna work here. We don't even know what we're doing really. But you seem cool. Do you wanna do cool things? And I said.
Devon: Absolutely. [00:39:00] And now we're here. And so I have so much,
Phoebe: I think you actually said Yeah, but can we talk tomorrow? 'cause I've had a whiskey That is
Leo: accurate. Yeah. That interview kind I want.
Devon: Sure. To be fair, it was Friday at 8:00 PM So my time 'cause I was on the East coast. Oh,
Leo: okay.
Devon: Okay. A lot of different just to make sure that the listeners know it was an acceptable whiskey.
Leo: Yeah, it's five o'clock somewhere.
Devon: Five o'clock somewhere. I know p has a hard stop, but I did bring a fun fact because on the notes that you sent me, there was a fun fact section and I do think it's quite fun and I would like to share it.
Devon: So think it's very relevant, but I was doing some research before this just about like telemedicine and history and when it started and all of the things, which is very on-brand for me. SPV. I learned that the first ever global disease surveillance initiative happened in 1947 by the World Health Organization.
Devon: And it was something that came out of a technology that was developed really during World War ii, and they utilized it to create this global [00:40:00] disease surveillance network. And it really was like the way that public health started in a global way. And I thought that was just like the most perfect way to end a podcast about telehealth and innovation coming out of something that.
Devon: It could have been and was really bad in a lot of ways, but also just skyrocketed a different kind of innovation and it was a cool synergy and I felt like I had to share
Leo: What was the health initiative?
Devon: It was global disease surveillance, so actually countries talking to each other to track.
Epidemics and endemic outbreaks of things to prevent another pandemic, like I would imagine probably the Spanish flu is what they were thinking about most recently at that point in history. But it was a technology that had come directly out of, world War ii, or it was before that, but had skyrocketed during World War II and Telex.
Devon: If anyone wants to be really dorky about typewriters that send electronic signals via.
Phoebe: [00:00:00] Welcome back to telemedicine talks.
Phoebe: I am so excited for this episode because we have an amazing guest. Speaker who is actually somebody who I got to work with for a lot of time and she grew into be one of like my very dear friends and she is just absolutely amazing and I cannot wait to have her share how her and I got through the Covid pandemic together and we actually built one of the largest testing, community testing programs in the whole United States with.
Phoebe: Pretty tiny team. Devin, I am so grateful to have you on the show today.
Devon: I am so excited to be here. Phoebe is someone, you are someone who I consider a large mentor in my career, and yeah, we did a lot together in a very short amount of time that I'm sure we'll touch on in this episode. But nothing says grassroots like the pandemic.
Leo: Devin, thank you so much for stepping in and sharing [00:01:00] your experiences through Covid and where this ties in to, telemedicine talks and telehealth is telemedicine has always been around, right? It's always, back in the sixties that's when it started with telegrams and the army and satellite, so forth and so on.
Leo: But we really didn't see telemedicine blow up until Covid, we were forced to go in, go home and practice medicine. And it's gonna be interesting to hear how y'all built a system, a public health system that's supposed to reach out and touch everybody, when really we weren't really supposed to re be reaching out and touching anybody, right?
Leo: That was a no-no. So yeah, I'm super excited, super stoked to hear how, yeah, we were forced to do this overnight and how you guys built a system that, helped a whole state through this whole pandemic. With the help of doctors, so forth and so on. Yeah, super stoked. Thank you again for stopping by and sharing your experiences.
Devon: Of course. Excited to be here. Stoked to be here. [00:02:00]
Leo: There, there's a lot of Hawaii vernacular. I pretend to be from here, but I love here. Oh, I'm San
Devon: Diego oh, there you go. Here some vernacular. We've got it stoked to see Hawaii
mainland. That's what I say. So cool. Cool. So awesome.
Phoebe: Yeah, so just to give you like a little bit of background of what Devin and I did together and still, when I left the last company, she actually got to step into my shoes and take over all the crazy stuff I was trying to do.
Phoebe: I dunno if that's a good thing or a bad thing, but, whatever it is what it is. You left it,
Devon: she's good. They were in good condition.
Phoebe: Okay, good. Good. But I think, like one of the most interesting things to me is when I first joined the company the big thing was , COVID was running rampant.
Phoebe: We didn't have a vaccine, there weren't testing programs. The health system actually couldn't keep up. And I think I started at that company, I don't know, maybe a few months after. It was really bad in 2020 and. Our first kind of like course of [00:03:00] action was schools, kids, what do people care about?
Phoebe: They care about kids. They care about keeping their, their kids healthy. And again, this was such a scary time. And I think like the interesting piece was, like having to run and figure out like the policy and the program while things are coming out from the CDC, while things are coming out from all these doctors that we're working with.
Phoebe: And having to be forced to run with the very limited information, but also for the first time, getting to see government move really fricking fast I think was a really interesting angle too. So that's my perspective, but Devin , give me your play by play on how it was.
Devon: Yeah, I think that's a great way, place to start. I remember when Phoebe hired me into a role that's different than what I do now. I'm on the strategy side now, but at the time I was more on the technical side. And Phoebe, as you will know if you listen to this podcast, it's not someone who pulls her punches.
Devon: And she was really transparent about what I was signing up for. She was, this is a startup. We're doing this because we care about public health. This is not about [00:04:00] making money. This is about helping people through technology and that. Spoke to me. And then I hopped on the ship and really realized what that meant.
Devon: And I think for a lot of people nowadays, you hear telehealth and it feels obvious, right? Like you wanna have an annual visit, you can hop online, you can speak to a doctor, it's covered by your insurance. It all works seamlessly. It's great. And, four, four years ago, that was so far from the reality.
Devon: And so to Phoebe's point, we were building software, but the software we were building had to constantly change based on these directions and protocols that were coming out from. Doctors who were collaborating with government, and so it was this crazy intersection of medicine, but also legal compliance.
Devon: They were changing the times that results had to be reported back to the state. What kinds of results had to be reported back to the state when people had to be tested? What symptoms you had to be tested for? All of that was rolling out. So when you and the public were reading those protocols online and saying, oh my gosh, how am I gonna manage that in my life?
Devon: For us, we were thinking, how do we bake that into a software so that people can go [00:05:00] into the field and do this work without having to know offhand what's happening at the government level, which is such an interesting intersection of different components in healthcare that I think a lot of times.
Devon: Different organizations solved separately, and we were really put in a position of having to solve them all at the same time, while also being expected to be online 24 hours a day because testing was happening in different time zones all over the state of California. We were also in other states outside of California and.
Devon: Yeah. It's just, it's wild to think back on, on all of the pieces that were happening at the time because it's so different than I think, the way people approach healthcare traditionally. Where you see a doctor and then, you don't, you pay your copay and it's great. And that, that's where it ends.
Phoebe: Yeah. For me it was like it was the first time that I felt like I don't know, maybe I'll say I felt like a Canadian oh, I can go, there's like a, you can go to a community clinic. Yeah. There's no copay, there's no nothing. And this was also like labs were just like overburdened, like [00:06:00] Kaiser couldn't keep up all these kind of like your normal insurance couldn't keep up and, point of care testing had just come out.
Phoebe: So there were all these antigen tests and like where we were at was trying to work with, the California Department of Public Health of like, how do they get that data, get those results back so they can go, okay, there's an outbreak in this community. I. We gotta go deploy some stuff so we could stop this or, there's an outbreak here.
Phoebe: And I think that was one of the big things that I walked away with , from, it was like, it was actually a really beautiful thing to see all these, communities come together, churches and different kinds of places to just have as many community testing sites.
Phoebe: That were sponsored by the state of California. So it was completely free. I think how many sites did we have like in the, like the top of the,
Devon: oh, thousands, tens of thousands probably. There's, all the schools alone, right? You consider a site, and that doesn't even count.
Devon: Long-term care, facilities, shelters, rehab facilities, sober living [00:07:00] facilities. Really, I feel like during the pandemic. As many places that were considered community gathering points were mobilized to provide these testing services because where people were going is where they were willing to receive this testing.
Devon: And I think that's another part of public health that's different than how traditional healthcare operates , like one-on-one physician services operate. Is that. If you're trying to convince people to do this thing that you, on the science side know is important. And that's really hard because you're not only saying you have to get out of your house, you have to drive somewhere in a time that's already really scary.
Devon: To get a test so that we can have data so that we can make more meaningful interventions for you. And how do you communicate with those people? How do you show them that it's important and those are some of the other? Problems that we tried to solve is that education, that access, that outreach, providing community based services and languages that were applicable to the folks that were being served in, an a DA compliant way so folks with disabilities could interact with technology and receive these services.
Devon: It was just so multifaceted when you take it to the community level because. It's not individual [00:08:00] healthcare anymore. You're now designing outcomes that are, have to address the needs of thousands of people, but in a way that people still feel like they're getting individualized care. And that's a really complicated thing to do, especially when you're being asked to do it in 24 hours.
Leo: Was it really 24 hours ? Was it that quickly?
Devon: Sometimes.
Phoebe: Sometimes it would depend. Yeah. But sometimes, yeah. And again, like. You have to throw in the nature of it's COVID. We're also a startup, so I think I was like employee 20 or something. When I left there were 200 employees, we started it was a small team of us doing this, and then it grew to like, we had 50 people because that's what we needed to actually keep the programs running.
Phoebe: And, to Devon's point, like. When there's a glitch in the system and something isn't working, people aren't getting their lab results in a timely manner. It doesn't mean okay I'll do that tomorrow. It means, Hey guys we're gonna hop into a war room [00:09:00] and like we're gonna go call these 50 people and you're gonna go call these 50 people and you're gonna go call these 50 people.
Phoebe: 'cause they're depending on us and we can't let them down.
Leo: Now , one question is, the startup was created because of Covid. Who was the trigger? Who was the call to action to actually get the start? What is, was it the state of California? Was it, I. The California Health Department I'm clueless with all structures.
Devon: Yeah. Interesting story. Yeah, so our co-founders have software backgrounds and they saw a need in a rural part of California, which is the perfect use case for what our software does. Where there was community testing happening, but no way to report it back to the state. And in a pandemic data is the most meaningful asset that a governing organization has, right?
Devon: That's the only way that they know what's happening on the ground. They're not calling local health departments and asking no one, it's time to do that. And so they really saw a need and then developed this. The software to solve and bridge that gap through just like lightweight versions of what we are now.
Devon: Basic, you can [00:10:00] have a test report it, and the state will know that it happened. The person will get a result and that's it, that's where it ends. And then through then it just became something that became more and more needed and more and more known and it just, it exploded from there.
Leo: Oh, wow.
Leo: So I worked in the er, worked the front lines of covid. Really, all I saw was end product. All I saw was, hey, here's some results. I need to act on it. So can you speak on kind of the role of community doctors? A lot of these doctors too were thrown into, now you're the expert right now, you're calling on them to create policies, so forth and so on.
Leo: What kind of roles did you see that doctors held and, how was the transition for them? And how was working with 'em. We all know how, yes. Working with doctors. Always easiest to work with, right? Never type A, but never.
Devon: No. The chillest
Leo: people I know are doctors.
Leo: Oh, absolutely. Yeah. Can you comment a little on that?
Devon: Yeah. I think in any time where there's something, and I hate to use the word unprecedented because pandemics have happened before, and also I think it's just an [00:11:00] overblown word that we use in terms of covid. But whenever there's.
Devon: Something that people haven't experienced in their lifetime or even their parents' lifetime, and anyone can point to someone and say, oh, you know something about this, so I'm gonna look to you for answers. And you have a title that makes me think that you're in a position where you're going to provide me real scientific information that puts the people on the side of, being asked in a really difficult position, especially when it's a time when no one knows anything, right?
Devon: Like we were the variants were actively being secret. We're going from PCR testing to, rapid testing. Phoebe mentioned, and then OTC testing. We don't know the efficacy of these tests long term. We don't know how, the ex even the expiration dates of when you can take these tests. We don't know what's gonna happen in, in the broad scheme of this.
Devon: And I have a lot of admiration for doctors, especially in rural areas that really stepped up and became the subject matter experts because you go from being in a clinic, seeing patients one-on-one, and counseling about their individual needs to, again, being responsible for. Population level healthcare, you're looking at your entire population and [00:12:00] saying, what do they need to be healthy?
Devon: Which is such a different set of problems than what one individual person needs to be healthy. But yeah, they were running testing events, like we knew doctors that were doing testing outta their garages with Clio waivers when the rapid testing became available and. It was just a way for them to provide an additional service for their communities because they were such a trusted resource.
Devon: But to do that was, in my opinion, brave, to put yourself in the front lines of being asked questions, especially again in a time when. The answers were loose, like they were changing daily as far as protocols and things like that. But my overall experience working with doctors was great. I've worked with a lot of doctors in my career but I also received a lot of late night phone calls and scared things because to what Bebe was saying earlier, they.
Devon: Were acting in a lot of cases individually for the benefits of their community. They weren't working on behalf of the hospital system that had these massive EHR systems and all of this tech that they could rely on. They were using our software to stand up these tiny clinics in these specific areas.
Devon: And so if our software wasn't able to provide what they needed, then [00:13:00] they weren't able to do testing or they were recording test results on a spreadsheet in the dark, quite literally. it sounds very dramatic, but it was just a wild time. And so it just became like a really collaborative environment with us and the physicians that we were working with, especially the ones that were truly providing this individualized, but on a public level, community care.
Phoebe: Yeah. Just to layer into that too we got to work with doctors on the policy side. And like for everybody who's listening to this podcast knows, like that's my background. My background is in like building these massive programs, layering the policy, making it compliant, following like regulations.
Phoebe: And it was like my first time getting to work with. Physicians on the public health side, I'd only done it on the other, like the Medicaid side. And it was really interesting because each of them had very innovative ideas on what they thought was the next, the next thing that we should focus on or the next initiative that we needed to try and tackle.
Phoebe: To get more people tested or more people vaccinated. And Devin, I, I don't [00:14:00] wanna go into it, but out of all the, we, we did covid, COVID sniffing dogs. We did oh my gosh. Yeah. We did, test to treat. We did a massive free test to treat program.
Phoebe: We did airport testing. We were the software that, like if you were going through LAX or FSFO, like you were forced to do an antigen test and that was all reported through the software. I think one of the interesting things that I thought is like for the first time on, on the government side, having doctors lead programs without the red tape.
Phoebe: Yep. Without the bureaucracy of it going, I have this idea and I have this vendor, this software vendor that could actually power it. And yeah, it might be a little glitchy and it might be a little rough, but we are gonna pilot this thing and I think one of the things that was really refreshing, we also had a CEO that kind of let us do this and I got to work with them and consult, CDPH H on I wouldn't focus on this program, but let's go do airport testing. 'cause that's really where you're, we don't want, we don't want a covid person getting on a [00:15:00] plane, and so I don't know. Devon, let's walk a little bit about like the dynamic of working with doctors on the program side, and then also just , what was your favorite like subset program that you worked in?
Devon: Oh, that's a great question. To answer the first part of that question, working with adoption, the program side is really interesting.
Devon: I think I. It's like anything, right? Like you, there's these big words that mean things when you're on the other side of the veil, like you think CDPH and you're like, okay, it's the California Department of Public Health. And it's like this big organization, like Big Brother Style that's gonna come in and say things, but then all of a sudden you're in the room with these people and they're just people.
Devon: They have various titles, but they're people and they're just trying to make things better, for the most part, for the communities that they serve. And to Phoebe's point, a lot of these providers had some ideas that pre Covid would've sounded absolutely. Bonkers. Like the idea of putting a golden retriever in a school to sniff children.
Devon: Imagine if you pitched that to someone in government five years ago, they would've been like, no, that sounds, but when you're talking about it in a way where it's no, this makes sense. We can [00:16:00] help kids. Become more comfortable with getting covid tested. The dogs can alert early if they're, if they have a symptom that we can't as humans detect with their, dog extrasensory abilities, and then we can only test that child versus having to test an entire student population.
Devon: All of a sudden, that idea sounds genius. And I think a lot of the doctors we work with, it sounded like it felt like it was gratifying for them to be able to have these ideas and to also be able to implement them in a way without having to issue an RFP and source the vendor and go through the year long contracting process.
Devon: And by that point, a lot of times the niche problem that they're trying to solve is gone, or it exists in a very different way. And the initial. Thought is less applicable than it was, but in Covid it was like, today there's a problem and tomorrow we're gonna fix it, and then the next day we're gonna see if it worked.
Devon: And I think that was rewarding for a lot of people in government. I know it was rewarding for me on the implementation side of those programs. And I know we've mentioned the dogs a lot. I would say that's one of my. That's one of my favorite programs that we've [00:17:00] implemented for sure. My personal one that I got to be a part of during Covid was the Test to Treat program that hoe you mentioned, that was actually a program that I personally got to run and implement with CDPH.
Devon: And we did a lot of work with farm worker communities in Northern California because it's a really interesting population. They have very specific needs as far as. Access to technology. There's people who are in the same place. They don't speak English as a primary language a lot of the time.
Devon: They're not comfortable with interacting with the US healthcare system. They're not comfortable with their records being shared, but they are interacting with a lot of people. They're interacting with food. How do you get these people tested for covid? How do you get them treated? How do you get them paxlovid?
Devon: And working with CDPH to solve that problem was a personal favorite 'cause it was just so complex. And I love a challenge.
Phoebe: And I think, like for me and again, like I was there like in the very early days where the first thing that we tackled was schools. The way that this was broken into was like cohort.
Phoebe: So it was like, there was like the school cohort, there was the long-term care and [00:18:00] the skilled nursing facility cohort. And then there was like the community cohort and that was like. Everything else. And we ran all those three cohort and they had to be set like segmented that way due to like federal funding.
Phoebe: It's very interesting. Very interesting times. Yes. And for me, like I think the one program that kind of blew my mind a little bit was the. Execution of at-home testing. So this was like right when, like all the rapid, the eye health tests and the Abbott Binx Nows and all of those at-home tests were getting deployed and CPH had no way to get that data.
Phoebe: So they had truly no way to understand what is happening in the community. And we worked, we built an app we worked to market this program to really get it out there. And I remember , we did it right around New Year's. So that was when we launched it.
Phoebe: And I remember, oh no I remember all of us like holding our breath going, yeah. Are [00:19:00] people gonna report this? And I remember waking up, the next day and logging into our data analytics tool and results were coming in every second. It was like, I think in one weekend we did over a million people reported both negatives and positives.
Phoebe: Yeah. And there was a really big hypothesis of why would a person report a positive? You don't wanna get in the system, you don't wanna have the contact tracers come. And it was like, you got to interview some of those people and it was like we did this for the greater good of the community.
Phoebe: It was this very beautiful thing. And so getting to be a part of that and. Again, think me thinking as a total pessimist as everybody knows going this is never gonna work. CDPH. Like it's in high hopes. And then, I still think people can actually use that and report at home covid tests if they wanna get their data to CDPH.
Devon: Yeah, it was very cool.
Leo: So with that how tricky was it to scale ? You guys start out small, you went [00:20:00] big. What was your biggest challenges and expanding on that, maybe the worst, best, and maybe just the way out there experiences that you had going through this process?
Devon: Yeah, I think anytime you scale anything you find things you didn't expect.
Devon: My background is in health tech. I've worked at Health Tech my whole career. Before I worked at primary, I worked scaling medical scribe programs like AI based medical scribe programs. So the idea of doing something weird and making doctors want it was very, in my comfort zone. But with this, what was so interesting is that our clients were so varied and so figuring out what an actual, like SaaS solution wise to a pandemic is impossible.
Devon: At the end of the day. It's a challenge that companies are still trying to figure out because. The US is massive. California is. Massive and you're serving a population that is incredibly diverse and then you're working with organizations that are incredibly diverse, like the difference between the needs of LAX versus the California farm [00:21:00] workers.
Devon: Foundations are insane. Like there, there's no way to even really compare those past the fact that they need covid test results. And so one of our biggest challenges when scaling was just trying to figure out what to prioritize. Like how do you make everyone happy when everyone's needs are valid? Everyone's doing work that's important.
Devon: We're not doing anything that is superfluous for the community, but we also only have so many engineers and we can only do so many things. And so weighing what's actually important to the broader good. What's important to a specific community? Telling people no, like we, we can't implement that feature.
Devon: We know it's important to you. We can't translate the platform into that language yet. We just don't have the time. Was so hard because you knew that saying no to an ask, but saying no to a need. And that is so different than how traditional tech operates. So personally, that was definitely a. A harder part and a challenge as far as scaling and then just scaling like the idea, like building things quickly and efficiently and finding [00:22:00] people who want to do that.
Devon: I would say, and I'm sure Phoebe can speak to that, as someone who built a lot of the teams who were a deep part of this process, getting the team that I myself was on, finding people who are willing to work in this way, find people who are down for the midnight war rooms and the calls from providers in their garage and the, just hecticness of this, especially when it does matter.
Devon: And then doing it over and over again every day with the no end in sight is, it's just a very specific kind of problem to solve as a for-profit company, it's something a lot of people get the opportunity to do unless you work for a nonprofit.
Phoebe: Yeah. And I do think too, like I do wanna applaud Andrew, the ceo , EO , and Chris, the, they were co-founders.
Phoebe: CEOs, most CTOs are gonna be like no. Where's the money? Where's the money? No. And it was complete opposite, right? It was just the complete opposite andrew would be like, if I have to get up at night and code, I'm coding Chris, same thing. And it was like, again, like after being at different [00:23:00] companies and that was my first experience with health Tech and it was, it's so refreshing now that I got to be a part of it.
Phoebe: And you really got to see how, some real leaders, got their hands dirty and said, screw it. It's not about those things. We gotta do the right thing. And to me, like that's one of the key takeaways that I take away from them, I think I learned from them exactly.
Phoebe: , if you're gonna go and lead something, you gotta know exactly how to do it. You gotta know exactly how to fix those bugs. And you have to know exactly how to, treat your customers with kindness and respect and that all asks are important.
Devon: Yeah, exactly. No, and Andrew and Chris are both huge inspirations to me. I look up to them a lot every day at my job. But it is it's a weird part of the health tech, public health universe to be in when. , you are, beholden to a bottom line in the sense that like you have to pay people and you're not receiving, that for-profit company, that, that comes with a certain amount of responsibilities, but also the goal is to do good and and in a very real way that is not beholden to [00:24:00] making, I.
Devon: Significant profit and balancing those things while also trying to scale a product that's meaningful across millions of people. It's wild. We ran some numbers a couple weeks ago and 4% of the US is on our platform, which is crazy. Like the fact that we were able to build something that has touched that many lives , like I talk to people in my personal life who are like, yeah, I got Covid tested, and I was like, that's probably on primary.
Devon: Yeah. And no one knows who we are. Like, that's the funny thing is that we are just this kind of like ghost in the background of all of this. I like to say that we're like the irrigation in the fields, but you only see what's growing. You don't see what's underneath. And that's okay.
Devon: It's fine to operate that way, but it makes scaling challenging too, especially when you're working with organizations that have an inherent hesitancy to private enterprise because they're used to. Working with community-based organizations, with nonprofits, with local health departments, and someone like us coming in and saying, can we help?
Devon: They're like, what do you want? And we're like to help. Like we, we really do mean [00:25:00] it. It can be just challenging to get trust in that way too. And that's something that we still. See and that I think during the pandemic was aided by the fact that there was a need to be doing this work, but there was still definitely that initial kind of hesitancy in the room.
Phoebe: Yeah. And I think too, like it was again, like to your point, Leo, like this was the first time that I. A lot of people got to in theory, experience telehealth. Yeah. Again, it was like, it wasn't so much as like the test results, but like a doctor is calling you from your community explaining what you're supposed to do.
Phoebe: When Paxlovid dropped, , it was all these doctors doing a lot of outreach and people really getting to experience this new kind of like method and modality of receiving care who previously. Didn't get to have that luxury.
Leo: Yeah no. It's interesting to see the behind the scenes and what happened.
Leo: And the talk. We working front it was just like, hey, it was there and when the numbers got turned on and why had the ability Great. Perfect. But [00:26:00] I never really asked how it got there. How it scaled . It was just like, oh, awesome. Thanks guys. And I'll use it.
Leo: And Yeah, I know, I knew there was a lot of work behind the scenes, but really never understood like the deep down. . Now that we have this, where do you think this is going? Where is public health and telemedicine heading next? Now that you know the pandemic's over.
Leo: But, what are we doing? It's not over.
Phoebe: It's not over. Leo. I just had Covid two weeks ago. You did? I have the world record for the person who's had COVID the most. I was on my deathbed, Devin. Oh my God.
Devon: I'm so sorry. I would say the pandemic is over, but Covid is very much not is hard. Oh, absolutely.
Devon: People in my life.
Leo: So where are we headed next in terms of, public health and telemedicine and, in, in those realms.
Devon: I think one of the big conversations that I know I hear in public health is like, what, since Covid has stuck and what have we lost and what needs replacing? What the pandemic did was it took away all of the existing [00:27:00] infrastructure, right?
Devon: There were things, ways that things were running, and they'd been running like that for the last 40 years of life, and everyone thought it was fine because patients were getting care and then all of a sudden, basically overnight. All of that died. And what happened was a lot of really amazing innovation, right?
Devon: Like the boom of telehealth through that, being able to connect people who weren't physically near each other. But then when the pandemic got to a place where folks could return largely to their normal state of business, there was this almost desire to return to some of the ways that things had been operating previously.
Devon: Because it was comfortable. It was like that was over. We did that. Super scary done. So I would like to return to normalcy. But what we're finding is that normal doesn't exist anymore because the patients and the participants have gotten really used to a certain level of ease, right? Like people wanna talk to their doctor like this, if you don't have to touch me, why do I have to go to your practice if you can order my labs virtually?
Devon: And I think it really shifted the way that people participate with their health. A lot of [00:28:00] people during the pandemic took a real ownership of. Knowledge in a way that I don't think we've seen in healthcare previously. At least, in my lifetime, of people were being expected to research things.
Devon: They would be expected to ask questions. They were being expected to really. Understand what they're being asked to do, and that has definitely not gone away. And I think that is what's driving a lot of the public health innovation, is what people are driving and what they want to see from a public health system.
Devon: Now that being said, we're seeing a measles outbreak in Texas right now. We're seeing. Bird flu explode across the US and I know eggs near me a million dollars. And you can look at that and say that, there are some learnings from the pandemic that should have been, in my opinion, implemented to prevent some of that from happening in terms of wastewater surveillance, air surveillance, like we have this technology that exists, why aren't we using it now?
Devon: On the positive side though, I think. Telehealth is the biggest gift to medicine that came out of the pandemic. And it's, you Google Telehealth and 50 providers will come up in your [00:29:00] area that want to see you, or different organizations that can see you for mental health, behavioral health to prescribe you medications that you might not have had the opportunity to access otherwise.
Devon: And. In the public health space, what we're able to do is deliver healthcare cheaper. That's a big way that digital innovation really solves a lot of the public health crisis. There's a program I was telling Phoebe before we hopped on that we're running right now in Michigan the Michigan Wellness Program, and we have stood up we used to be 22 sites, now it's 14 turf sites.
Devon: So there are these face faith-based community centers that are running point of care, CLIA wave testing at their, the home of their congregations. And they're doing diabetes screening, cholesterol screening, hypertension screening with a CLIA waiver. And that whole concept is very covid, right? The idea that lower trained individuals can deliver real diagnostic testing in a space outside of a clinic.
Devon: That didn't exist before the pandemic. And so not only is the basic model, a structure of, post pandemic innovation, but we have NPS who, when a person [00:30:00] tests for any abnormal result, if your blood pressure is 180 2 over 70, we're calling you, even though most primary care providers would tell you that you're fine.
Devon: And we're calling to educate you like it's not about prescribing. It's about. Lifestyle adjustments. It's about a referral to an FQHC. It's about telling you what's available in your community and that telehealth infrastructure absolutely would not exist without the pandemic. The idea of a provider somewhere else in your state calling you about a result that you got in a church about your diabetes.
Devon: Diagnosis and then providing you resources to seek out care in a community-based center that is still providing traditional care. Those are the programs that get me really excited that we haven't lost the core of what we took away from the pandemic. 'cause I do think it's there and I think things like that really demonstrate that even though it's easy to point fingers and say, we should've done this better and we should have done this better.
Devon: But at its core, I think the innovation of the pandemic is still very much around and alive.
Leo: No you're right. And hopefully, yeah we take lessons that we learned and move forward. And you're right. [00:31:00] This is the expectation and not just, the exception.
Leo: Awesome.
Phoebe: Devin I want the gossip. What is primary empathy ? I feel like I need to live vicariously through you.
Devon: What are we doing? What are we up to? We're doing a lot of things. We've been, one of the things I'm really excited we're doing is doing a really big data push, like helping organizations with their data.
Devon: We've been discovering that there's a lot of need for people who run things like immunization coalitions, or are really responsible for community outreach. They don't have a great way to understand the data that they're given, right? Like the state might say, okay, here's 50 spreadsheets that tell you the areas in your state where people are under vaccinated.
Devon: Go solve that problem. And that's a lot to ask of someone who's not a data analyst to sit there and really digest that. And so we are building out some more background programs that help folks in those situations understand the data, be able to really model it in a meaningful way, in a pandemic learning kind of way of real data.
Devon: Really matters. [00:32:00] And then action on it, and if they want our help figuring out how to action on it we're great program consultants. But if not it can just live with the data. We're happy to just stop there. We're doing a lot of integration work as well. We're currently working with CDPH, our favorite on integrating all of the public health labs in California for an emergency preparedness initiative.
Devon: So that way. This is one of the things that when you don't work in public health, I feel like you think is obvious. And then when you do work in public health, you're like, why doesn't this already exist? But there are these things called public health laboratories, and this is where your samples for the general population go, like rabies or public covid, flu testing, that kind of stuff.
Devon: Different states of different amounts of them. In California, there's 26, which is a lot. It's the most in the US and they can't talk to each other. Their individual lab systems don't communicate. So in the event of a pandemic, let's say like covid if one lab is at capacity or if something breaks and they can't run those samples, they have to send paper requisition forms via carrier to the next laboratory that can servee those [00:33:00] samples and then process those samples, which creates.
Devon: A huge amount, a huge margin of human error, right? Let alone just like losing things. And so we're working on a lot of data monetization work and not initiative and similar programs to really fix that way in the event of another emergency, which, knock on wood, hoping it doesn't happen, but better to be prepared there's this infrastructure in place so that these really important public health institutions can communicate that way.
Devon: There isn't a delay. Care and processing. So on the more technical side, that's what we're up to On my more favorite side, which is the clinical side. I, after PB lab took over our medical group, and so we're really figuring out the best ways to utilize that. We have a 50 state provider group. Like I said, we're doing programs similar to the one in Michigan where we're using existing community centers to really build out infrastructure where it doesn't traditionally exist.
Devon: We had an abstract accepted in 2023 about some work we were doing in a Frontier County in Montana. I didn't know until that frontier was a census designation. I thought it just meant like cool cowboys. It [00:34:00] actually means a county where there's less than 5,000 people who live there, which is extremely rural.
Devon: And the people have to drive three hours to go to a doctor and just mountainous terrain and all of these things. And we worked with the local health department to set up a direct to consumer like shipping about home test kits so that way they can receive them in their homes and get screened for diabetes and colorectal cancer.
Devon: Like all of these really important things, especially for their aging populations needs. So we're doing a lot, but I get the most passionate about programs like that where I feel like we are. Taking focus in the US who maybe have insurance, maybe think they have access to healthcare but aren't taking advantage of it because there's barriers that exist that are pretty easy to knock down if you have technology that can do so
Phoebe: interesting. I remember the Montana program. I think it was getting, it was getting kicked off right as I was transitioning out. And to your point , like I, I know that I think. One of the things I remember realizing early on while being at primary was like, I think this whole idea that we have to go to a doctor's office to [00:35:00] get care, like Covid has told us that is not the only option.
Phoebe: And so I think like building in a lot of the at-home testing programs , I think we realized like you get better outcomes if you meet people where they are or where they wanna be seen versus. Forcing them to the place that where you're at and being able to like support that, whether it's in a, at a community clinic or a, a church or in their home, I think was one of the ways that we were able to be so successful and really actually help people to start taking this seriously.
Devon: Absolutely. Yeah, I, there's an internal joke that if you could tattoo something on my head in calls, it would be like we meet people where they're at. Because I think I say it every time I talk to someone in the history of my entire career in public health, because it is like the most important thing.
Devon: And I think the perfect thing to end on is that is the thesis. And that's what I think the thesis of public health should be. It's like we think about programs globally, but at the end of the day, they only work if they. Actually solve the [00:36:00] barriers that are preventing people from seeking care. And I think a lot of people think they know what that is and from a really well-meaning place.
Devon: But unless you go and actually talk to the people in the communities and say, what are the barriers? I've been surprised by some of the barriers. You're gonna rural area and you think that it's gonna be one thing. And it's no, actually it's just this other thing over here. And it's oh, we can fix that super easily.
Devon: We would've done a way more complicated thing if we had assumed that, we knew what your barriers were and. Those are the kind of things that I think is really important to keep in mind when you're thinking about public health is that it's global, but it's also up to the individuals to take advantage of the programs for the programs to mean anything.
Leo: That's an interesting motto too, though. That kind of sums up telemedicine as well, right? Yeah. You could practice it anywhere. It's everywhere, but you're meeting people where it's at
Devon: yeah.
Leo: Yeah. It's a cool connect. So yeah,
Devon: definitely. Telemedicine is great, so I don't wanna go to the doctor.
Devon: No. I do, but I don't wanna go to the doctor. I want the doctor the way I'm speaking to you right now.
Leo: Yeah. I just don't like doctors. Yeah, [00:37:00]
Devon: that's, I dunno what this is about you, Leo.
Leo: . No, Devin, thank you so much for your time. This has been awesome. And thank you for giving us an insight into you and your experiences.
Leo: Maybe any closing thoughts either of y'all.
Phoebe: No, I just wanna say, I'm gonna, I'm gonna plug Devin for two seconds. I got to hire Devin. I got to train Devin. And I love working with people that have the growth mindset that are always learning, that are always open. And as Devin's sitting here, like talking, I highly doubt anybody knows how young and brilliant she is.
Phoebe: I'm not gonna put, I'm not gonna say your age because people are gonna freak out when they find out that you're 19. But No, but I just wanna say you are doing such amazing things and I'm so proud of you from getting to see where you evolved when we started together and getting to like there, I couldn't say that I, I.
Phoebe: If there's any other person who could have stepped into my shoes as well as you did, and I'm just, I'm so glad that it's [00:38:00] been you and I'm so glad that you are, continuing to lead the way and be a guiding light in the public health space that really needs somebody who is.
Phoebe: Full of strategy and customer success and product and technical and all of that rolled into a little ball of Devon Phillips. So I just wanted to like, just say that thank you for all that you do and that you continue to do. I'm in California in case nobody on this podcast knows, but the programs you're building and launching and leading continue to touch my life daily.
Phoebe: And so I just wanna say thank you.
Devon: That means so much. No, and I just wanna reemphasize that Phoebe is someone who I consider such a mentor. She hired me. The way I got hired a primary is like hilarious. She called me on a Friday night and she was like, you wanna work here After I had two interviews previously, like the day before.
Devon: 'cause the pandemic, right?
Yeah. And
Devon: she was very transparent what I was signing up for. She's we don't know how long this company's gonna last. We don't know how many people are gonna work here. We don't even know what we're doing really. But you seem cool. Do you wanna do cool things? And I said.
Devon: Absolutely. [00:39:00] And now we're here. And so I have so much,
Phoebe: I think you actually said Yeah, but can we talk tomorrow? 'cause I've had a whiskey That is
Leo: accurate. Yeah. That interview kind I want.
Devon: Sure. To be fair, it was Friday at 8:00 PM So my time 'cause I was on the East coast. Oh,
Leo: okay.
Devon: Okay. A lot of different just to make sure that the listeners know it was an acceptable whiskey.
Leo: Yeah, it's five o'clock somewhere.
Devon: Five o'clock somewhere. I know p has a hard stop, but I did bring a fun fact because on the notes that you sent me, there was a fun fact section and I do think it's quite fun and I would like to share it.
Devon: So think it's very relevant, but I was doing some research before this just about like telemedicine and history and when it started and all of the things, which is very on-brand for me. SPV. I learned that the first ever global disease surveillance initiative happened in 1947 by the World Health Organization.
Devon: And it was something that came out of a technology that was developed really during World War ii, and they utilized it to create this global [00:40:00] disease surveillance network. And it really was like the way that public health started in a global way. And I thought that was just like the most perfect way to end a podcast about telehealth and innovation coming out of something that.
Devon: It could have been and was really bad in a lot of ways, but also just skyrocketed a different kind of innovation and it was a cool synergy and I felt like I had to share
Leo: What was the health initiative?
Devon: It was global disease surveillance, so actually countries talking to each other to track.
Epidemics and endemic outbreaks of things to prevent another pandemic, like I would imagine probably the Spanish flu is what they were thinking about most recently at that point in history. But it was a technology that had come directly out of, world War ii, or it was before that, but had skyrocketed during World War II and Telex.
Devon: If anyone wants to be really dorky about typewriters that send electronic signals via.
Phoebe: [00:00:00] Welcome back to telemedicine talks.
Phoebe: I am so excited for this episode because we have an amazing guest. Speaker who is actually somebody who I got to work with for a lot of time and she grew into be one of like my very dear friends and she is just absolutely amazing and I cannot wait to have her share how her and I got through the Covid pandemic together and we actually built one of the largest testing, community testing programs in the whole United States with.
Phoebe: Pretty tiny team. Devin, I am so grateful to have you on the show today.
Devon: I am so excited to be here. Phoebe is someone, you are someone who I consider a large mentor in my career, and yeah, we did a lot together in a very short amount of time that I'm sure we'll touch on in this episode. But nothing says grassroots like the pandemic.
Leo: Devin, thank you so much for stepping in and sharing [00:01:00] your experiences through Covid and where this ties in to, telemedicine talks and telehealth is telemedicine has always been around, right? It's always, back in the sixties that's when it started with telegrams and the army and satellite, so forth and so on.
Leo: But we really didn't see telemedicine blow up until Covid, we were forced to go in, go home and practice medicine. And it's gonna be interesting to hear how y'all built a system, a public health system that's supposed to reach out and touch everybody, when really we weren't really supposed to re be reaching out and touching anybody, right?
Leo: That was a no-no. So yeah, I'm super excited, super stoked to hear how, yeah, we were forced to do this overnight and how you guys built a system that, helped a whole state through this whole pandemic. With the help of doctors, so forth and so on. Yeah, super stoked. Thank you again for stopping by and sharing your experiences.
Devon: Of course. Excited to be here. Stoked to be here. [00:02:00]
Leo: There, there's a lot of Hawaii vernacular. I pretend to be from here, but I love here. Oh, I'm San
Devon: Diego oh, there you go. Here some vernacular. We've got it stoked to see Hawaii
mainland. That's what I say. So cool. Cool. So awesome.
Phoebe: Yeah, so just to give you like a little bit of background of what Devin and I did together and still, when I left the last company, she actually got to step into my shoes and take over all the crazy stuff I was trying to do.
Phoebe: I dunno if that's a good thing or a bad thing, but, whatever it is what it is. You left it,
Devon: she's good. They were in good condition.
Phoebe: Okay, good. Good. But I think, like one of the most interesting things to me is when I first joined the company the big thing was , COVID was running rampant.
Phoebe: We didn't have a vaccine, there weren't testing programs. The health system actually couldn't keep up. And I think I started at that company, I don't know, maybe a few months after. It was really bad in 2020 and. Our first kind of like course of [00:03:00] action was schools, kids, what do people care about?
Phoebe: They care about kids. They care about keeping their, their kids healthy. And again, this was such a scary time. And I think like the interesting piece was, like having to run and figure out like the policy and the program while things are coming out from the CDC, while things are coming out from all these doctors that we're working with.
Phoebe: And having to be forced to run with the very limited information, but also for the first time, getting to see government move really fricking fast I think was a really interesting angle too. So that's my perspective, but Devin , give me your play by play on how it was.
Devon: Yeah, I think that's a great way, place to start. I remember when Phoebe hired me into a role that's different than what I do now. I'm on the strategy side now, but at the time I was more on the technical side. And Phoebe, as you will know if you listen to this podcast, it's not someone who pulls her punches.
Devon: And she was really transparent about what I was signing up for. She was, this is a startup. We're doing this because we care about public health. This is not about [00:04:00] making money. This is about helping people through technology and that. Spoke to me. And then I hopped on the ship and really realized what that meant.
Devon: And I think for a lot of people nowadays, you hear telehealth and it feels obvious, right? Like you wanna have an annual visit, you can hop online, you can speak to a doctor, it's covered by your insurance. It all works seamlessly. It's great. And, four, four years ago, that was so far from the reality.
Devon: And so to Phoebe's point, we were building software, but the software we were building had to constantly change based on these directions and protocols that were coming out from. Doctors who were collaborating with government, and so it was this crazy intersection of medicine, but also legal compliance.
Devon: They were changing the times that results had to be reported back to the state. What kinds of results had to be reported back to the state when people had to be tested? What symptoms you had to be tested for? All of that was rolling out. So when you and the public were reading those protocols online and saying, oh my gosh, how am I gonna manage that in my life?
Devon: For us, we were thinking, how do we bake that into a software so that people can go [00:05:00] into the field and do this work without having to know offhand what's happening at the government level, which is such an interesting intersection of different components in healthcare that I think a lot of times.
Devon: Different organizations solved separately, and we were really put in a position of having to solve them all at the same time, while also being expected to be online 24 hours a day because testing was happening in different time zones all over the state of California. We were also in other states outside of California and.
Devon: Yeah. It's just, it's wild to think back on, on all of the pieces that were happening at the time because it's so different than I think, the way people approach healthcare traditionally. Where you see a doctor and then, you don't, you pay your copay and it's great. And that, that's where it ends.
Phoebe: Yeah. For me it was like it was the first time that I felt like I don't know, maybe I'll say I felt like a Canadian oh, I can go, there's like a, you can go to a community clinic. Yeah. There's no copay, there's no nothing. And this was also like labs were just like overburdened, like [00:06:00] Kaiser couldn't keep up all these kind of like your normal insurance couldn't keep up and, point of care testing had just come out.
Phoebe: So there were all these antigen tests and like where we were at was trying to work with, the California Department of Public Health of like, how do they get that data, get those results back so they can go, okay, there's an outbreak in this community. I. We gotta go deploy some stuff so we could stop this or, there's an outbreak here.
Phoebe: And I think that was one of the big things that I walked away with , from, it was like, it was actually a really beautiful thing to see all these, communities come together, churches and different kinds of places to just have as many community testing sites.
Phoebe: That were sponsored by the state of California. So it was completely free. I think how many sites did we have like in the, like the top of the,
Devon: oh, thousands, tens of thousands probably. There's, all the schools alone, right? You consider a site, and that doesn't even count.
Devon: Long-term care, facilities, shelters, rehab facilities, sober living [00:07:00] facilities. Really, I feel like during the pandemic. As many places that were considered community gathering points were mobilized to provide these testing services because where people were going is where they were willing to receive this testing.
Devon: And I think that's another part of public health that's different than how traditional healthcare operates , like one-on-one physician services operate. Is that. If you're trying to convince people to do this thing that you, on the science side know is important. And that's really hard because you're not only saying you have to get out of your house, you have to drive somewhere in a time that's already really scary.
Devon: To get a test so that we can have data so that we can make more meaningful interventions for you. And how do you communicate with those people? How do you show them that it's important and those are some of the other? Problems that we tried to solve is that education, that access, that outreach, providing community based services and languages that were applicable to the folks that were being served in, an a DA compliant way so folks with disabilities could interact with technology and receive these services.
Devon: It was just so multifaceted when you take it to the community level because. It's not individual [00:08:00] healthcare anymore. You're now designing outcomes that are, have to address the needs of thousands of people, but in a way that people still feel like they're getting individualized care. And that's a really complicated thing to do, especially when you're being asked to do it in 24 hours.
Leo: Was it really 24 hours ? Was it that quickly?
Devon: Sometimes.
Phoebe: Sometimes it would depend. Yeah. But sometimes, yeah. And again, like. You have to throw in the nature of it's COVID. We're also a startup, so I think I was like employee 20 or something. When I left there were 200 employees, we started it was a small team of us doing this, and then it grew to like, we had 50 people because that's what we needed to actually keep the programs running.
Phoebe: And, to Devon's point, like. When there's a glitch in the system and something isn't working, people aren't getting their lab results in a timely manner. It doesn't mean okay I'll do that tomorrow. It means, Hey guys we're gonna hop into a war room [00:09:00] and like we're gonna go call these 50 people and you're gonna go call these 50 people and you're gonna go call these 50 people.
Phoebe: 'cause they're depending on us and we can't let them down.
Leo: Now , one question is, the startup was created because of Covid. Who was the trigger? Who was the call to action to actually get the start? What is, was it the state of California? Was it, I. The California Health Department I'm clueless with all structures.
Devon: Yeah. Interesting story. Yeah, so our co-founders have software backgrounds and they saw a need in a rural part of California, which is the perfect use case for what our software does. Where there was community testing happening, but no way to report it back to the state. And in a pandemic data is the most meaningful asset that a governing organization has, right?
Devon: That's the only way that they know what's happening on the ground. They're not calling local health departments and asking no one, it's time to do that. And so they really saw a need and then developed this. The software to solve and bridge that gap through just like lightweight versions of what we are now.
Devon: Basic, you can [00:10:00] have a test report it, and the state will know that it happened. The person will get a result and that's it, that's where it ends. And then through then it just became something that became more and more needed and more and more known and it just, it exploded from there.
Leo: Oh, wow.
Leo: So I worked in the er, worked the front lines of covid. Really, all I saw was end product. All I saw was, hey, here's some results. I need to act on it. So can you speak on kind of the role of community doctors? A lot of these doctors too were thrown into, now you're the expert right now, you're calling on them to create policies, so forth and so on.
Leo: What kind of roles did you see that doctors held and, how was the transition for them? And how was working with 'em. We all know how, yes. Working with doctors. Always easiest to work with, right? Never type A, but never.
Devon: No. The chillest
Leo: people I know are doctors.
Leo: Oh, absolutely. Yeah. Can you comment a little on that?
Devon: Yeah. I think in any time where there's something, and I hate to use the word unprecedented because pandemics have happened before, and also I think it's just an [00:11:00] overblown word that we use in terms of covid. But whenever there's.
Devon: Something that people haven't experienced in their lifetime or even their parents' lifetime, and anyone can point to someone and say, oh, you know something about this, so I'm gonna look to you for answers. And you have a title that makes me think that you're in a position where you're going to provide me real scientific information that puts the people on the side of, being asked in a really difficult position, especially when it's a time when no one knows anything, right?
Devon: Like we were the variants were actively being secret. We're going from PCR testing to, rapid testing. Phoebe mentioned, and then OTC testing. We don't know the efficacy of these tests long term. We don't know how, the ex even the expiration dates of when you can take these tests. We don't know what's gonna happen in, in the broad scheme of this.
Devon: And I have a lot of admiration for doctors, especially in rural areas that really stepped up and became the subject matter experts because you go from being in a clinic, seeing patients one-on-one, and counseling about their individual needs to, again, being responsible for. Population level healthcare, you're looking at your entire population and [00:12:00] saying, what do they need to be healthy?
Devon: Which is such a different set of problems than what one individual person needs to be healthy. But yeah, they were running testing events, like we knew doctors that were doing testing outta their garages with Clio waivers when the rapid testing became available and. It was just a way for them to provide an additional service for their communities because they were such a trusted resource.
Devon: But to do that was, in my opinion, brave, to put yourself in the front lines of being asked questions, especially again in a time when. The answers were loose, like they were changing daily as far as protocols and things like that. But my overall experience working with doctors was great. I've worked with a lot of doctors in my career but I also received a lot of late night phone calls and scared things because to what Bebe was saying earlier, they.
Devon: Were acting in a lot of cases individually for the benefits of their community. They weren't working on behalf of the hospital system that had these massive EHR systems and all of this tech that they could rely on. They were using our software to stand up these tiny clinics in these specific areas.
Devon: And so if our software wasn't able to provide what they needed, then [00:13:00] they weren't able to do testing or they were recording test results on a spreadsheet in the dark, quite literally. it sounds very dramatic, but it was just a wild time. And so it just became like a really collaborative environment with us and the physicians that we were working with, especially the ones that were truly providing this individualized, but on a public level, community care.
Phoebe: Yeah. Just to layer into that too we got to work with doctors on the policy side. And like for everybody who's listening to this podcast knows, like that's my background. My background is in like building these massive programs, layering the policy, making it compliant, following like regulations.
Phoebe: And it was like my first time getting to work with. Physicians on the public health side, I'd only done it on the other, like the Medicaid side. And it was really interesting because each of them had very innovative ideas on what they thought was the next, the next thing that we should focus on or the next initiative that we needed to try and tackle.
Phoebe: To get more people tested or more people vaccinated. And Devin, I, I don't [00:14:00] wanna go into it, but out of all the, we, we did covid, COVID sniffing dogs. We did oh my gosh. Yeah. We did, test to treat. We did a massive free test to treat program.
Phoebe: We did airport testing. We were the software that, like if you were going through LAX or FSFO, like you were forced to do an antigen test and that was all reported through the software. I think one of the interesting things that I thought is like for the first time on, on the government side, having doctors lead programs without the red tape.
Phoebe: Yep. Without the bureaucracy of it going, I have this idea and I have this vendor, this software vendor that could actually power it. And yeah, it might be a little glitchy and it might be a little rough, but we are gonna pilot this thing and I think one of the things that was really refreshing, we also had a CEO that kind of let us do this and I got to work with them and consult, CDPH H on I wouldn't focus on this program, but let's go do airport testing. 'cause that's really where you're, we don't want, we don't want a covid person getting on a [00:15:00] plane, and so I don't know. Devon, let's walk a little bit about like the dynamic of working with doctors on the program side, and then also just , what was your favorite like subset program that you worked in?
Devon: Oh, that's a great question. To answer the first part of that question, working with adoption, the program side is really interesting.
Devon: I think I. It's like anything, right? Like you, there's these big words that mean things when you're on the other side of the veil, like you think CDPH and you're like, okay, it's the California Department of Public Health. And it's like this big organization, like Big Brother Style that's gonna come in and say things, but then all of a sudden you're in the room with these people and they're just people.
Devon: They have various titles, but they're people and they're just trying to make things better, for the most part, for the communities that they serve. And to Phoebe's point, a lot of these providers had some ideas that pre Covid would've sounded absolutely. Bonkers. Like the idea of putting a golden retriever in a school to sniff children.
Devon: Imagine if you pitched that to someone in government five years ago, they would've been like, no, that sounds, but when you're talking about it in a way where it's no, this makes sense. We can [00:16:00] help kids. Become more comfortable with getting covid tested. The dogs can alert early if they're, if they have a symptom that we can't as humans detect with their, dog extrasensory abilities, and then we can only test that child versus having to test an entire student population.
Devon: All of a sudden, that idea sounds genius. And I think a lot of the doctors we work with, it sounded like it felt like it was gratifying for them to be able to have these ideas and to also be able to implement them in a way without having to issue an RFP and source the vendor and go through the year long contracting process.
Devon: And by that point, a lot of times the niche problem that they're trying to solve is gone, or it exists in a very different way. And the initial. Thought is less applicable than it was, but in Covid it was like, today there's a problem and tomorrow we're gonna fix it, and then the next day we're gonna see if it worked.
Devon: And I think that was rewarding for a lot of people in government. I know it was rewarding for me on the implementation side of those programs. And I know we've mentioned the dogs a lot. I would say that's one of my. That's one of my favorite programs that we've [00:17:00] implemented for sure. My personal one that I got to be a part of during Covid was the Test to Treat program that hoe you mentioned, that was actually a program that I personally got to run and implement with CDPH.
Devon: And we did a lot of work with farm worker communities in Northern California because it's a really interesting population. They have very specific needs as far as. Access to technology. There's people who are in the same place. They don't speak English as a primary language a lot of the time.
Devon: They're not comfortable with interacting with the US healthcare system. They're not comfortable with their records being shared, but they are interacting with a lot of people. They're interacting with food. How do you get these people tested for covid? How do you get them treated? How do you get them paxlovid?
Devon: And working with CDPH to solve that problem was a personal favorite 'cause it was just so complex. And I love a challenge.
Phoebe: And I think, like for me and again, like I was there like in the very early days where the first thing that we tackled was schools. The way that this was broken into was like cohort.
Phoebe: So it was like, there was like the school cohort, there was the long-term care and [00:18:00] the skilled nursing facility cohort. And then there was like the community cohort and that was like. Everything else. And we ran all those three cohort and they had to be set like segmented that way due to like federal funding.
Phoebe: It's very interesting. Very interesting times. Yes. And for me, like I think the one program that kind of blew my mind a little bit was the. Execution of at-home testing. So this was like right when, like all the rapid, the eye health tests and the Abbott Binx Nows and all of those at-home tests were getting deployed and CPH had no way to get that data.
Phoebe: So they had truly no way to understand what is happening in the community. And we worked, we built an app we worked to market this program to really get it out there. And I remember , we did it right around New Year's. So that was when we launched it.
Phoebe: And I remember, oh no I remember all of us like holding our breath going, yeah. Are [00:19:00] people gonna report this? And I remember waking up, the next day and logging into our data analytics tool and results were coming in every second. It was like, I think in one weekend we did over a million people reported both negatives and positives.
Phoebe: Yeah. And there was a really big hypothesis of why would a person report a positive? You don't wanna get in the system, you don't wanna have the contact tracers come. And it was like, you got to interview some of those people and it was like we did this for the greater good of the community.
Phoebe: It was this very beautiful thing. And so getting to be a part of that and. Again, think me thinking as a total pessimist as everybody knows going this is never gonna work. CDPH. Like it's in high hopes. And then, I still think people can actually use that and report at home covid tests if they wanna get their data to CDPH.
Devon: Yeah, it was very cool.
Leo: So with that how tricky was it to scale ? You guys start out small, you went [00:20:00] big. What was your biggest challenges and expanding on that, maybe the worst, best, and maybe just the way out there experiences that you had going through this process?
Devon: Yeah, I think anytime you scale anything you find things you didn't expect.
Devon: My background is in health tech. I've worked at Health Tech my whole career. Before I worked at primary, I worked scaling medical scribe programs like AI based medical scribe programs. So the idea of doing something weird and making doctors want it was very, in my comfort zone. But with this, what was so interesting is that our clients were so varied and so figuring out what an actual, like SaaS solution wise to a pandemic is impossible.
Devon: At the end of the day. It's a challenge that companies are still trying to figure out because. The US is massive. California is. Massive and you're serving a population that is incredibly diverse and then you're working with organizations that are incredibly diverse, like the difference between the needs of LAX versus the California farm [00:21:00] workers.
Devon: Foundations are insane. Like there, there's no way to even really compare those past the fact that they need covid test results. And so one of our biggest challenges when scaling was just trying to figure out what to prioritize. Like how do you make everyone happy when everyone's needs are valid? Everyone's doing work that's important.
Devon: We're not doing anything that is superfluous for the community, but we also only have so many engineers and we can only do so many things. And so weighing what's actually important to the broader good. What's important to a specific community? Telling people no, like we, we can't implement that feature.
Devon: We know it's important to you. We can't translate the platform into that language yet. We just don't have the time. Was so hard because you knew that saying no to an ask, but saying no to a need. And that is so different than how traditional tech operates. So personally, that was definitely a. A harder part and a challenge as far as scaling and then just scaling like the idea, like building things quickly and efficiently and finding [00:22:00] people who want to do that.
Devon: I would say, and I'm sure Phoebe can speak to that, as someone who built a lot of the teams who were a deep part of this process, getting the team that I myself was on, finding people who are willing to work in this way, find people who are down for the midnight war rooms and the calls from providers in their garage and the, just hecticness of this, especially when it does matter.
Devon: And then doing it over and over again every day with the no end in sight is, it's just a very specific kind of problem to solve as a for-profit company, it's something a lot of people get the opportunity to do unless you work for a nonprofit.
Phoebe: Yeah. And I do think too, like I do wanna applaud Andrew, the ceo , EO , and Chris, the, they were co-founders.
Phoebe: CEOs, most CTOs are gonna be like no. Where's the money? Where's the money? No. And it was complete opposite, right? It was just the complete opposite andrew would be like, if I have to get up at night and code, I'm coding Chris, same thing. And it was like, again, like after being at different [00:23:00] companies and that was my first experience with health Tech and it was, it's so refreshing now that I got to be a part of it.
Phoebe: And you really got to see how, some real leaders, got their hands dirty and said, screw it. It's not about those things. We gotta do the right thing. And to me, like that's one of the key takeaways that I take away from them, I think I learned from them exactly.
Phoebe: , if you're gonna go and lead something, you gotta know exactly how to do it. You gotta know exactly how to fix those bugs. And you have to know exactly how to, treat your customers with kindness and respect and that all asks are important.
Devon: Yeah, exactly. No, and Andrew and Chris are both huge inspirations to me. I look up to them a lot every day at my job. But it is it's a weird part of the health tech, public health universe to be in when. , you are, beholden to a bottom line in the sense that like you have to pay people and you're not receiving, that for-profit company, that, that comes with a certain amount of responsibilities, but also the goal is to do good and and in a very real way that is not beholden to [00:24:00] making, I.
Devon: Significant profit and balancing those things while also trying to scale a product that's meaningful across millions of people. It's wild. We ran some numbers a couple weeks ago and 4% of the US is on our platform, which is crazy. Like the fact that we were able to build something that has touched that many lives , like I talk to people in my personal life who are like, yeah, I got Covid tested, and I was like, that's probably on primary.
Devon: Yeah. And no one knows who we are. Like, that's the funny thing is that we are just this kind of like ghost in the background of all of this. I like to say that we're like the irrigation in the fields, but you only see what's growing. You don't see what's underneath. And that's okay.
Devon: It's fine to operate that way, but it makes scaling challenging too, especially when you're working with organizations that have an inherent hesitancy to private enterprise because they're used to. Working with community-based organizations, with nonprofits, with local health departments, and someone like us coming in and saying, can we help?
Devon: They're like, what do you want? And we're like to help. Like we, we really do mean [00:25:00] it. It can be just challenging to get trust in that way too. And that's something that we still. See and that I think during the pandemic was aided by the fact that there was a need to be doing this work, but there was still definitely that initial kind of hesitancy in the room.
Phoebe: Yeah. And I think too, like it was again, like to your point, Leo, like this was the first time that I. A lot of people got to in theory, experience telehealth. Yeah. Again, it was like, it wasn't so much as like the test results, but like a doctor is calling you from your community explaining what you're supposed to do.
Phoebe: When Paxlovid dropped, , it was all these doctors doing a lot of outreach and people really getting to experience this new kind of like method and modality of receiving care who previously. Didn't get to have that luxury.
Leo: Yeah no. It's interesting to see the behind the scenes and what happened.
Leo: And the talk. We working front it was just like, hey, it was there and when the numbers got turned on and why had the ability Great. Perfect. But [00:26:00] I never really asked how it got there. How it scaled . It was just like, oh, awesome. Thanks guys. And I'll use it.
Leo: And Yeah, I know, I knew there was a lot of work behind the scenes, but really never understood like the deep down. . Now that we have this, where do you think this is going? Where is public health and telemedicine heading next? Now that you know the pandemic's over.
Leo: But, what are we doing? It's not over.
Phoebe: It's not over. Leo. I just had Covid two weeks ago. You did? I have the world record for the person who's had COVID the most. I was on my deathbed, Devin. Oh my God.
Devon: I'm so sorry. I would say the pandemic is over, but Covid is very much not is hard. Oh, absolutely.
Devon: People in my life.
Leo: So where are we headed next in terms of, public health and telemedicine and, in, in those realms.
Devon: I think one of the big conversations that I know I hear in public health is like, what, since Covid has stuck and what have we lost and what needs replacing? What the pandemic did was it took away all of the existing [00:27:00] infrastructure, right?
Devon: There were things, ways that things were running, and they'd been running like that for the last 40 years of life, and everyone thought it was fine because patients were getting care and then all of a sudden, basically overnight. All of that died. And what happened was a lot of really amazing innovation, right?
Devon: Like the boom of telehealth through that, being able to connect people who weren't physically near each other. But then when the pandemic got to a place where folks could return largely to their normal state of business, there was this almost desire to return to some of the ways that things had been operating previously.
Devon: Because it was comfortable. It was like that was over. We did that. Super scary done. So I would like to return to normalcy. But what we're finding is that normal doesn't exist anymore because the patients and the participants have gotten really used to a certain level of ease, right? Like people wanna talk to their doctor like this, if you don't have to touch me, why do I have to go to your practice if you can order my labs virtually?
Devon: And I think it really shifted the way that people participate with their health. A lot of [00:28:00] people during the pandemic took a real ownership of. Knowledge in a way that I don't think we've seen in healthcare previously. At least, in my lifetime, of people were being expected to research things.
Devon: They would be expected to ask questions. They were being expected to really. Understand what they're being asked to do, and that has definitely not gone away. And I think that is what's driving a lot of the public health innovation, is what people are driving and what they want to see from a public health system.
Devon: Now that being said, we're seeing a measles outbreak in Texas right now. We're seeing. Bird flu explode across the US and I know eggs near me a million dollars. And you can look at that and say that, there are some learnings from the pandemic that should have been, in my opinion, implemented to prevent some of that from happening in terms of wastewater surveillance, air surveillance, like we have this technology that exists, why aren't we using it now?
Devon: On the positive side though, I think. Telehealth is the biggest gift to medicine that came out of the pandemic. And it's, you Google Telehealth and 50 providers will come up in your [00:29:00] area that want to see you, or different organizations that can see you for mental health, behavioral health to prescribe you medications that you might not have had the opportunity to access otherwise.
Devon: And. In the public health space, what we're able to do is deliver healthcare cheaper. That's a big way that digital innovation really solves a lot of the public health crisis. There's a program I was telling Phoebe before we hopped on that we're running right now in Michigan the Michigan Wellness Program, and we have stood up we used to be 22 sites, now it's 14 turf sites.
Devon: So there are these face faith-based community centers that are running point of care, CLIA wave testing at their, the home of their congregations. And they're doing diabetes screening, cholesterol screening, hypertension screening with a CLIA waiver. And that whole concept is very covid, right? The idea that lower trained individuals can deliver real diagnostic testing in a space outside of a clinic.
Devon: That didn't exist before the pandemic. And so not only is the basic model, a structure of, post pandemic innovation, but we have NPS who, when a person [00:30:00] tests for any abnormal result, if your blood pressure is 180 2 over 70, we're calling you, even though most primary care providers would tell you that you're fine.
Devon: And we're calling to educate you like it's not about prescribing. It's about. Lifestyle adjustments. It's about a referral to an FQHC. It's about telling you what's available in your community and that telehealth infrastructure absolutely would not exist without the pandemic. The idea of a provider somewhere else in your state calling you about a result that you got in a church about your diabetes.
Devon: Diagnosis and then providing you resources to seek out care in a community-based center that is still providing traditional care. Those are the programs that get me really excited that we haven't lost the core of what we took away from the pandemic. 'cause I do think it's there and I think things like that really demonstrate that even though it's easy to point fingers and say, we should've done this better and we should have done this better.
Devon: But at its core, I think the innovation of the pandemic is still very much around and alive.
Leo: No you're right. And hopefully, yeah we take lessons that we learned and move forward. And you're right. [00:31:00] This is the expectation and not just, the exception.
Leo: Awesome.
Phoebe: Devin I want the gossip. What is primary empathy ? I feel like I need to live vicariously through you.
Devon: What are we doing? What are we up to? We're doing a lot of things. We've been, one of the things I'm really excited we're doing is doing a really big data push, like helping organizations with their data.
Devon: We've been discovering that there's a lot of need for people who run things like immunization coalitions, or are really responsible for community outreach. They don't have a great way to understand the data that they're given, right? Like the state might say, okay, here's 50 spreadsheets that tell you the areas in your state where people are under vaccinated.
Devon: Go solve that problem. And that's a lot to ask of someone who's not a data analyst to sit there and really digest that. And so we are building out some more background programs that help folks in those situations understand the data, be able to really model it in a meaningful way, in a pandemic learning kind of way of real data.
Devon: Really matters. [00:32:00] And then action on it, and if they want our help figuring out how to action on it we're great program consultants. But if not it can just live with the data. We're happy to just stop there. We're doing a lot of integration work as well. We're currently working with CDPH, our favorite on integrating all of the public health labs in California for an emergency preparedness initiative.
Devon: So that way. This is one of the things that when you don't work in public health, I feel like you think is obvious. And then when you do work in public health, you're like, why doesn't this already exist? But there are these things called public health laboratories, and this is where your samples for the general population go, like rabies or public covid, flu testing, that kind of stuff.
Devon: Different states of different amounts of them. In California, there's 26, which is a lot. It's the most in the US and they can't talk to each other. Their individual lab systems don't communicate. So in the event of a pandemic, let's say like covid if one lab is at capacity or if something breaks and they can't run those samples, they have to send paper requisition forms via carrier to the next laboratory that can servee those [00:33:00] samples and then process those samples, which creates.
Devon: A huge amount, a huge margin of human error, right? Let alone just like losing things. And so we're working on a lot of data monetization work and not initiative and similar programs to really fix that way in the event of another emergency, which, knock on wood, hoping it doesn't happen, but better to be prepared there's this infrastructure in place so that these really important public health institutions can communicate that way.
Devon: There isn't a delay. Care and processing. So on the more technical side, that's what we're up to On my more favorite side, which is the clinical side. I, after PB lab took over our medical group, and so we're really figuring out the best ways to utilize that. We have a 50 state provider group. Like I said, we're doing programs similar to the one in Michigan where we're using existing community centers to really build out infrastructure where it doesn't traditionally exist.
Devon: We had an abstract accepted in 2023 about some work we were doing in a Frontier County in Montana. I didn't know until that frontier was a census designation. I thought it just meant like cool cowboys. It [00:34:00] actually means a county where there's less than 5,000 people who live there, which is extremely rural.
Devon: And the people have to drive three hours to go to a doctor and just mountainous terrain and all of these things. And we worked with the local health department to set up a direct to consumer like shipping about home test kits so that way they can receive them in their homes and get screened for diabetes and colorectal cancer.
Devon: Like all of these really important things, especially for their aging populations needs. So we're doing a lot, but I get the most passionate about programs like that where I feel like we are. Taking focus in the US who maybe have insurance, maybe think they have access to healthcare but aren't taking advantage of it because there's barriers that exist that are pretty easy to knock down if you have technology that can do so
Phoebe: interesting. I remember the Montana program. I think it was getting, it was getting kicked off right as I was transitioning out. And to your point , like I, I know that I think. One of the things I remember realizing early on while being at primary was like, I think this whole idea that we have to go to a doctor's office to [00:35:00] get care, like Covid has told us that is not the only option.
Phoebe: And so I think like building in a lot of the at-home testing programs , I think we realized like you get better outcomes if you meet people where they are or where they wanna be seen versus. Forcing them to the place that where you're at and being able to like support that, whether it's in a, at a community clinic or a, a church or in their home, I think was one of the ways that we were able to be so successful and really actually help people to start taking this seriously.
Devon: Absolutely. Yeah, I, there's an internal joke that if you could tattoo something on my head in calls, it would be like we meet people where they're at. Because I think I say it every time I talk to someone in the history of my entire career in public health, because it is like the most important thing.
Devon: And I think the perfect thing to end on is that is the thesis. And that's what I think the thesis of public health should be. It's like we think about programs globally, but at the end of the day, they only work if they. Actually solve the [00:36:00] barriers that are preventing people from seeking care. And I think a lot of people think they know what that is and from a really well-meaning place.
Devon: But unless you go and actually talk to the people in the communities and say, what are the barriers? I've been surprised by some of the barriers. You're gonna rural area and you think that it's gonna be one thing. And it's no, actually it's just this other thing over here. And it's oh, we can fix that super easily.
Devon: We would've done a way more complicated thing if we had assumed that, we knew what your barriers were and. Those are the kind of things that I think is really important to keep in mind when you're thinking about public health is that it's global, but it's also up to the individuals to take advantage of the programs for the programs to mean anything.
Leo: That's an interesting motto too, though. That kind of sums up telemedicine as well, right? Yeah. You could practice it anywhere. It's everywhere, but you're meeting people where it's at
Devon: yeah.
Leo: Yeah. It's a cool connect. So yeah,
Devon: definitely. Telemedicine is great, so I don't wanna go to the doctor.
Devon: No. I do, but I don't wanna go to the doctor. I want the doctor the way I'm speaking to you right now.
Leo: Yeah. I just don't like doctors. Yeah, [00:37:00]
Devon: that's, I dunno what this is about you, Leo.
Leo: . No, Devin, thank you so much for your time. This has been awesome. And thank you for giving us an insight into you and your experiences.
Leo: Maybe any closing thoughts either of y'all.
Phoebe: No, I just wanna say, I'm gonna, I'm gonna plug Devin for two seconds. I got to hire Devin. I got to train Devin. And I love working with people that have the growth mindset that are always learning, that are always open. And as Devin's sitting here, like talking, I highly doubt anybody knows how young and brilliant she is.
Phoebe: I'm not gonna put, I'm not gonna say your age because people are gonna freak out when they find out that you're 19. But No, but I just wanna say you are doing such amazing things and I'm so proud of you from getting to see where you evolved when we started together and getting to like there, I couldn't say that I, I.
Phoebe: If there's any other person who could have stepped into my shoes as well as you did, and I'm just, I'm so glad that it's [00:38:00] been you and I'm so glad that you are, continuing to lead the way and be a guiding light in the public health space that really needs somebody who is.
Phoebe: Full of strategy and customer success and product and technical and all of that rolled into a little ball of Devon Phillips. So I just wanted to like, just say that thank you for all that you do and that you continue to do. I'm in California in case nobody on this podcast knows, but the programs you're building and launching and leading continue to touch my life daily.
Phoebe: And so I just wanna say thank you.
Devon: That means so much. No, and I just wanna reemphasize that Phoebe is someone who I consider such a mentor. She hired me. The way I got hired a primary is like hilarious. She called me on a Friday night and she was like, you wanna work here After I had two interviews previously, like the day before.
Devon: 'cause the pandemic, right?
Yeah. And
Devon: she was very transparent what I was signing up for. She's we don't know how long this company's gonna last. We don't know how many people are gonna work here. We don't even know what we're doing really. But you seem cool. Do you wanna do cool things? And I said.
Devon: Absolutely. [00:39:00] And now we're here. And so I have so much,
Phoebe: I think you actually said Yeah, but can we talk tomorrow? 'cause I've had a whiskey That is
Leo: accurate. Yeah. That interview kind I want.
Devon: Sure. To be fair, it was Friday at 8:00 PM So my time 'cause I was on the East coast. Oh,
Leo: okay.
Devon: Okay. A lot of different just to make sure that the listeners know it was an acceptable whiskey.
Leo: Yeah, it's five o'clock somewhere.
Devon: Five o'clock somewhere. I know p has a hard stop, but I did bring a fun fact because on the notes that you sent me, there was a fun fact section and I do think it's quite fun and I would like to share it.
Devon: So think it's very relevant, but I was doing some research before this just about like telemedicine and history and when it started and all of the things, which is very on-brand for me. SPV. I learned that the first ever global disease surveillance initiative happened in 1947 by the World Health Organization.
Devon: And it was something that came out of a technology that was developed really during World War ii, and they utilized it to create this global [00:40:00] disease surveillance network. And it really was like the way that public health started in a global way. And I thought that was just like the most perfect way to end a podcast about telehealth and innovation coming out of something that.
Devon: It could have been and was really bad in a lot of ways, but also just skyrocketed a different kind of innovation and it was a cool synergy and I felt like I had to share
Leo: What was the health initiative?
Devon: It was global disease surveillance, so actually countries talking to each other to track.
Epidemics and endemic outbreaks of things to prevent another pandemic, like I would imagine probably the Spanish flu is what they were thinking about most recently at that point in history. But it was a technology that had come directly out of, world War ii, or it was before that, but had skyrocketed during World War II and Telex.
Devon: If anyone wants to be really dorky about typewriters that send electronic signals via.
Leo: Thank you. Thank you so much. This is awesome. Amazing.