John Letter is CEO of Proem Behavioral Health, formerly nView Health, developer of the evidence-based clinical workflow software engine that helps providers triage patients and produce better mental health outcomes. He is an experienced healthcare executive serving most recently as the President and COO of a successful population health company in the sleep health space. He works tirelessly to help teams achieve sustainable growth while over-delivering on customer promises each day
At Proem, he is responsible for overall strategic direction, working alongside an incredible team focused on building digital health tools to help providers get the right answers, diagnoses and outcomes for their patients the first time. John and his wife reside in Atlanta and have two grown children.
What You’ll Learn In This Episode
- Proem Behavioral Health key challenges it’s looking to solve for the market it serves
- Users of their technology and how do they come to know about it
- Sort of challenges the users of this technology face – and how is this helpful to them achieving their healthcare mission and patient care goals
- Mental health awareness needs to have significant levels of visibility all year round in our society and within healthcare and within the business community
- Advice for aspiring entrepreneurs wanting to address the challenges faced by both healthcare workers and people who are directly in need of mental health services
This transcript is machine transcribed by Sonix
Intro: [00:00:04] Broadcasting live from the Business RadioX Studios in Atlanta, Georgia. It’s time for Atlanta Business Radio. Brought to you by on pay. Atlanta’s New standard in payroll. Now, here’s your host.
Lee Kantor: [00:00:24] Lee Kantor here another episode of Atlanta Business Radio, and this is going to be a good one. But before we get started, it’s important to recognize our sponsor, Onpay. Without them, we couldn’t be sharing these important stories. Today on Atlanta Business Radio, we have John Letter with Proem Behavioral Health. Welcome, John.
John Letter: [00:00:44] Thank you for having me. Lee It’s great to be on with you. Well, I’m.
Lee Kantor: [00:00:47] So excited to learn what you’re up to. Tell us about your firm, how you serving folks.
John Letter: [00:00:51] Yeah. So by way of background, proem behavioral health is a we call it a workflow technology engine. It’s a software product that was developed using really best in class assessment tools from the foremost psychiatrists and psychologists around the world that developed these tools to comprehensively and accurately assess broad patient populations to help get to the right diagnosis and then certainly to follow patients. These were renowned psychologists and psychiatrists that we built exclusive digital licensure with to provide these services around the world. And really what we do is we work with providers of behavioral health to screen large populations, say, say a primary care physician that’s seeing many patients can screen these patients to determine if further evaluation is necessary. So there’s a population based approach to it. And then for those that require further evaluation, we have what are called structured interviews, effectively our comprehensive interviews that are looking at a multitude of possibilities. As an example, if someone’s dealing with what they believe to be anxiety, these tools are designed to uncover. Is there something driving that anxiety? Is there a traumatic event that a person has had in their past? So it’s really about triaging and comprehensively determining what the issue most likely is, and then that that gives a provider a great understanding very quickly through the use of technology. And then when they make determinations as to what’s happening, it allows our platform, allows they and their patients to sort of follow the progress of their treatment so that they have visibility and an understanding and a dashboarding manner of reporting way how their therapy is working for them. So that’s really program in a nutshell.
Lee Kantor: [00:02:54] Now for the layperson that isn’t kind of on top of these issues and isn’t aware of maybe even some of them behavioral health. You mentioned psychiatry as one of the people who deal in behavioral health, but that includes also addiction. There’s other things that a person that could be afflicted with a variety of ailments fall under that umbrella of behavioral health. Can you kind of explain some of them or or at least identify what some of those kind of bigger buckets are?
John Letter: [00:03:25] Yeah, it’s a great question. And you’re exactly.
[00:03:27] Right. We say those that are providing behavioral health services, they’re providing them in different settings for different reasons. You mentioned substance use disorder clinics. It’s it’s some of the providers that we help, right? Typically when and typically is in a majority of the cases, when someone’s suffering from a substance use disorder, as it’s called, uncovering underlying mental illness or behavioral health issues is very, very important to treating that substance use disorder. The same is true for pediatric care for for children or primary care physicians, behavioral behavioral health providers, or frankly, researchers that are researching and developing new drugs or new medical devices or behavioral health information. So it’s a very broad spectrum with of behavioral health that we’re helping to.
John Letter: [00:04:26] Help them get it right, frankly. And I think the other thing to note is that it’s not just psychiatrists or psychologists. There are licensed clinical social workers and what we call qualified health professionals, licensed clinical social workers, licensed professional professional counselors, MDS, DOS, DS, PhDs. So very broad range of folks that are providing behavioral health care.
Lee Kantor: [00:04:53] And this this also can be geared to folks that have like chronic issues, right? Because staying compliant with a protocol or a way of dealing with their issues and they’re not if they’re not compliant, then all of a sudden that’s a domino effect that can affect many things. So in order to get them on the right path, you have to kind of know where to begin and how to kind of keep them on track, right?
John Letter: [00:05:19] You’re exactly right. I was reading yesterday something from I believe it was the American College of Physicians that talked about treating diabetics. And one of the one of the protocols that you follow in treating a diabetic is to look for underlying mental illness, co-occurring things, comorbid things that are happening to that patient so that you can properly address those in the procurement of better care for the diabetes. So you’re exactly right.
Lee Kantor: [00:05:50] So how did this come about? Like, what’s your back story?
John Letter: [00:05:55] Uh, problems started with our founder who is a family practitioner, um, that dealt with some personal tragedy in his life. And, and as a practitioner wondered, um, how can I miss it? You know, I’m a doctor, I’m supposed to see these things. So he started researching how do we get the right tools in the hands of the people that are the frontline at the time, family physicians, primary care physicians, and how do we assess broad populations? And he kept finding his way into the clinical and academic research world where all of these this great thinking and these tools were designed to include or exclude someone from a depression drug study, for instance. You don’t want a person in a depression drug trial that has underlying bipolar two disorder because that the efficacy of that depression drug will not meet the FDA standards. So he found himself there and then realized through these licensing agreements, hey, you know, we can take error out. We can take bias out by building these into modern technology interfaces that do a lot of the the legwork, the algorithmic work that sits behind a lot of these complex tools. So that’s really how Proem came about.
Lee Kantor: [00:07:28] Now, um, so how does it work? Like give me an example, say that I have one of these disorders or an addiction. How does the, the software help my, the person that’s taking care of me? Number one, make sure they got they got me on the right path. Number two, keep me on that path. Like. Like how does it kind of watch my back and protect me from myself some of the times?
John Letter: [00:07:53] Yeah, that’s the what we call outcomes measures and dashboarding. So the ability to look at a, a person once they’ve been diagnosed and a treatment plan has been acted, now you’re talking about what you’re saying, like, how do I stay on the rails, if you will? We have these tools that are designed that automatically follow the patient through by assessing them on a continuous basis to ensure across multiple pieces from from managing symptoms. So if you’re treating a person for depression, there are symptoms that you’re treating, right? So we have the ability to look at Lee once a week between therapy sessions and ask him how he’s doing with those symptoms. In addition, we look at what in in the behavioral health world is a very critical thing to ensuring successful treatment. It’s therapeutic alliance. So am I getting along with my doctor and vice versa? Are we getting each other? So that’s another piece of it. So you’ve got you know, you’re managing symptoms, you’re ensuring that the patient and the clinician are aligned. And if not, what do we need to do to do that? And then ultimately we’re looking at a third piece of it that’s called functional impairment. But effectively, how are you doing in your life? So you may think that your symptoms of anxiety or depression are getting better, but if you’ve also told us that you’ve missed work for the last five days, the clinician wants to have that conversation. So it’s really a comprehensive look into how am I doing through my treatment and how quickly in real time through technology, can we make adjustment adjustments as a patient and a provider together to help you get where you need to go?
Lee Kantor: [00:09:46] Now, are these kind of interactions done using technology, or is it a human to human interaction where someone is calling or someone is emailing or there’s some kind of a human, you know, checking in? Because I would imagine with today’s technology and all of the, you know, watch devices, you have, you can glean a lot of information that maybe the person’s telling you one thing, but they’re, you know, resting heart rate is telling you something else.
John Letter: [00:10:15] You are exactly right. And, you know, if we were to have a conversation about where it’s going, that is certainly a significant part of what’s in in our near future and things that we’re investigating. One of the things that we try and make sure as it relates to what we what you’re calling passive data collection is the accuracy of it, the clinical efficacy of it, and then the patient acceptance of it. But in terms of how it’s delivered, there are multiple ways that it’s delivered. It is all delivered through technology. There are there are patient responses so a patient can self-report. Through that through the technology platform back to their clinician in real time in between visits. There are times that when you’re in a visit that a clinician may be performing this on your behalf or asking you questions, if you will. All of which is done within the platform to provide real time results. And then there are confederates that can, you know, provide these things on a clinician’s behalf. A nurse practitioner or someone else that, you know is interacting with the patient prior to. But it’s all delivered through technology. But you’re hitting on what the future is. How do we use passive technology to ensure heart rate’s a great thing that you mentioned heart rate variability. You may be saying one thing, but your heart rate variability is telling us another. So there’s a there’s a lot of really cool things to help this world that we that are certainly on our roadmap now.
Lee Kantor: [00:11:55] Are the interactions as simple as like they could receive a text that says, How are you feeling right now?
John Letter: [00:12:01] Yes, it can be as simple as that. We use primarily or are these evidence based, what are called monitors and functional impairment tools that are that are simple questionnaires that people respond, you know, treating mental illness. There is an an x ray machine or an MRI. It’s it’s very complex. So. How people respond is very important. But it’s you know, it’s how a clinician reacts to that response based on their experience with the patient and their experience in general. That’s really important. Context in treatment.
Lee Kantor: [00:12:37] And how are the patients responding to this? Is this something that they’re open to or is this just another thing they’ve got to do? And then they’re saying whatever they got to say to be done with it?
John Letter: [00:12:47] Yeah. Acceptance is, you know, I’ve been in healthcare now for about ten years. And what’s really interesting about behavioral health is, is because of a lot of the frustration that has existed. And, you know, patients that are ping ponged around when they find what’s working for them and their clinician, we find that they’re very engaged, allowing a patient to be part of their treatment, to visualize, to see the differences over time so that it’s not a black box, It’s not something that I don’t go as one psychologist said to me recently, your patients don’t just come in and lie on the couch. And we we stand there with our arms folded and take notes. There’s a lot more to it. So we have found that involving the patient in showing them this is working for you has really created great engagement with them.
Lee Kantor: [00:13:44] And then are there or what are they the safeguards to just prevent a person from just telling you what you want to hear?
John Letter: [00:13:54] Yeah, we’re we’re providing support. It’s always up to the clinician, the expert, to ultimately determine the truthfulness. Whether whether someone’s just trying to get you off. That’s why we’re looking at it in a in a multi dimensional way. You may be saying one thing here, but doing another elsewhere. So these these tools are built with those kind of.
Lee Kantor: [00:14:23] Checks and balances. Are kind of.
John Letter: [00:14:24] Those things in mind? Yeah, yeah. That’s that’s we could talk for hours about this, but, um, yeah. And I will tell you that, you know, to the extent that to the extent that, um, passive data that’s collected can be beneficial and it’s efficacious, I think there’s a huge opportunity in treating in the world of treating behavioral health issues.
Lee Kantor: [00:14:48] Well, I think it’s fascinating. Just the just kind of the category of behavioral health is fascinating to me. And then now you layer on technology to help in that area. I think there’s a lot of possibilities. What has kind of been the experience of probably a lot of folks that are in the behavioral health side of the the room, you know, embracing technology and embracing all these tools? And has that been a smooth transition to like, because you’re really a tech firm, you know, and you’re delivering this service to this space that there’s a lot of folks in there that may not be, as you know, kind of have that tech startup be early adopter mentality that a lot of tech folks have.
John Letter: [00:15:31] Yeah, I you know, I would we look at these things every day sort of who is the ideal customer. Um I would tell you there are those and you’re always going to have naysayers. There are people that you know.
Lee Kantor: [00:15:44] Um, no, it’s been done in different way for a long time and they don’t want to be the first one in the pool.
John Letter: [00:15:50] And that’s it. So, you know, if you look at the adoption curve in the, in the classic sense, those are sort of would be the laggards. Um, I will tell you that, that we find ourselves with those that are more tech savvy. Um, you know, it’s more natural to them. But what we find more broadly is people that are that providers that are really focused on having more data at their fingertips and making their practice more efficient. Because you and I both know there’s less and less time. There’s there’s tons of pressure on providers to get it right and quickly to move on. So we’ve had pretty good acceptance rates as it relates to helping them get to the right answers more quickly and efficiently. So so technology obviously does that. But I would be I would be fooling us both if I were to tell you that there aren’t laggers that exist in every domain of business, particularly when you’re dealing with technology.
Lee Kantor: [00:16:53] Now, I would think, though, in some ways this is a good time to be having a service and a product like yours because mental health is so at the fore. It seems like there’s so much more acceptance like this generation, there’s so much less shame around a lot of these issues that back in the day, maybe when we were younger, there was some shame there was that nobody was talking about a lot of these issues. But now it seems that the more and more people talk about it, more and more people are taking action and getting help.
John Letter: [00:17:25] Yeah, it is happening. And, you know, I think there’s a natural evolution for anything. I think a lot of health care is is still to an extent, stigmatized. As I’ve said to people many times, you know, people don’t stand around the water cooler if there were one and say they’re I’m aging myself and say, hey, I’m a type two diabetic, how about you? So there is this sort of there’s an opportunity within mental health that I think doesn’t exist in other places, a larger opportunity because of that, it’s become mainstream. You know, we that we have thought leaders or celebrities that are comfortably talking about their experiences, we’re fooling ourselves if we don’t think that we don’t deal with some sort of behavioral health issue or mental illness in our lives. It’s just a reality. So to the extent that we continue the conversation, um, make it acceptable to have the conversation, the more and more we do that, I believe the the less and less stigmatized mental illness and seeking help will be.
Lee Kantor: [00:18:40] Yeah, I mean, you were talking about people aren’t, you know, bragging about having diabetes. I mean some people I don’t want to say they’re bragging, but they are outwardly talking about how they’ve been in therapy and how they’ve gotten help. And, you know, they’re encouraging their peers to to go down those paths where, I mean, that’s really a new world for a lot of folks. That wasn’t the case for forever.
John Letter: [00:19:05] You know, they used to be called mental institutions or sanatoriums, like just by virtue of the history of treating mental illness, there is sort of this scourge associated with it. And I think you’re right. I think generationally, um. It’s it’s become more acceptable and to an extent maybe more fashionable is probably a poor term for it. But that’s great from our perspective. Like that’s step one. Yeah. Do something about it is step two and the most important thing.
Lee Kantor: [00:19:42] And then and I think because a lot of these younger people are looking at technology to solve a problem they have faster. So anything you have along these lines that does that, they’re in, you know, they’ll give it a shot. Yes.
John Letter: [00:19:58] You’re right. And you know, the I think the one thing that’s also important to note here is that. Although, you know, the the illnesses themselves and we say mental illness for a reason because it is it’s like a physical illness that’s the parody part of the paradigm that we’re trying to, you know, convey. Um, although it’s very complex, it’s very treatable and, you know, getting help. There’s only good that can come of it. So, you know, it’s it’s although the issue may be complex, there are ways that you can solve it provided that you’re willing to put the proverbial work in.
Lee Kantor: [00:20:44] So what do you need more of? How can we help you? Or do you need more talent? You need more technologists, You need more clients. What do you need?
John Letter: [00:20:52] You always you always need more of all the above clients. I think we appreciate that sort of getting the word out. This ability to provide thought leadership to a marketplace from our perspective, you know, to the extent that we can have conversations with your with your listeners that are dealing with these issues, hospital systems dealing with overwrought emergency departments, because people don’t have a place to turn behavioral health specialists or primary care specialists that are seeing these things on a typical basis, we can help them get the right answers. If it’s nothing more than giving a primary care physician a head start as to where to send a patient if they themselves won’t treat them. That is is sort of we hope that venues like this allow us to to open up doors to.
Lee Kantor: [00:21:55] Well, if somebody wants to learn more, have more substantive conversation with you or somebody on the team, what’s the coordinates? What’s the website.
John Letter: [00:22:02] Yeah please do go to prom. Health.com p r o m h e a l t h.com and ask to speak with us. We would love to talk to you.
Lee Kantor: [00:22:14] Well, John, thank you so much for sharing your story today. You’re doing important work and we appreciate you.
John Letter: [00:22:19] Thank you, Lee. We really appreciate you offering this this opportunity. All right.
Lee Kantor: [00:22:23] This is Lee Kantor. We’ll see you all next time on Atlanta Business Radio.
About Our Sponsor
OnPay’s payroll services and HR software give you more time to focus on what’s most important. Rated “Excellent” by PC Magazine, we make it easy to pay employees fast, we automate all payroll taxes, and we even keep all your HR and benefits organized and compliant.
Our award-winning customer service includes an accuracy guarantee, deep integrations with popular accounting software, and we’ll even enter all your employee information for you — whether you have five employees or 500. Take a closer look to see all the ways we can save you time and money in the back office.