Richard Resnick is the chief executive officer (CEO) of Cureatr, a medication management optimization, tech-enabled services company. In this Q&A, he looks back on 2021, highlighting the biggest developments and challenges for Cureatr, and shares his expectations, predictions, and hopes for 2022.
Q: How was 2021 for Cureatr?
Richard Resnick: It was the most challenging year Cureatr’s faced because it was really our “break out” year. To fully appreciate it, it's important to understand the history of the company.
In 2017, I was brought on board to expand the company’s prospects and opportunities. At the time, Cureatr was a mobile application that allowed HIPAA-compliant, patient-centered messaging between care team providers. As we worked on this technology, we also gained access to medication data and developed capabilities that led to the development and launch of the medication management software, Meds 360°, in 2019. Then came 2020 and COVID-19, which would eventually lead to us finding our purpose but not before a period of substantial disruption and discovery.
As we confronted the pandemic and its widespread effects, we faced a battle for the very survival of the company. Our active deals dried up as healthcare organizations became overwhelmed with COVID-19 patients and simply couldn’t take our calls. We sensed the likelihood of becoming a COVID corporate casualty, and that forced us to ask ourselves, "what can we do to help while we are still standing? " So, we started to give things away — the software, clinical services (as discussed in this Q&A) — which became our opportunity to help the healthcare community and our saving grace.
Throughout 2020, we continued working hard at selling our software and clinical services to keep the company afloat. At the end of the year, it became apparent that we were going to close our first clinical services deal with a major insurance company. It was time to staff up.
Seemingly overnight, Cureatr had to evolve from a software company of 20 people that had been together through thick and thin over the past three years into something new: a telepharmacy clinic. This is not to say that we have abandoned our roots completely. Technology is still a core pillar of Cureatr, but increasing amounts of our technology are developed for proprietary use to enable our clinic to provide unparalleled care.
If you look at Cureatr’s growth, it is all in the clinic — and it's monstrous, as we’ve added additional significant contracts throughout 2021. We started the year handling none of our own patients to where we were doing about 100 patients a month in the summer. That grew to around 800 around Thanksgiving and now we're up to about 1,000 patients a month.
Not only did we manage to survive as a company, but now we're thriving. By the end of this year, we could easily be supporting 10,000 to 20,000 patients a month, or even more. With these types of numbers order of magnitude changes, each such jump requiring not just more residency-trained clinical pharmacists, but also continuous experimentation around new or changed processes and systems to support them. These are great problems that we're happy to be facing. Being closer than ever to the patients themselves is a daily motivator for our growing national team.
Q: What is the top lesson you have learned from 2021?
RR: Growth challenges culture. When a company grows the way Cureatr has over the past year, many decisions you might normally have the luxury of considering over a period of time now need to be made quickly. Some decisions are easy to undo. Others are more difficult to undo. And some are nearly impossible to undo.
We ran into 2021 hiring quickly to support our growth, but sometimes when you run as quickly as we did, you stumble. The work with our clinical services customers slowed down as we adjusted to the new direction of the company. We had new team members arguing about the best direction forward and how implement and scale our operations to execute on our mission but early in the year we had no patients against which to experiment and validate our methodologies – just the threat of a massive influx around the corner.
It was a challenging time and put a strain on the company and our people. We experienced the fits and starts of trying to grow very quickly, against the challenges of becoming a precision and process team after instilling a culture of pathfinding for the past few years.
This whole experience has been tough, but in many ways has made us stronger. Cureatr is growing, fast, and it's a lot of fun, and while I don't ever want to go through some of our recent challenges, I am grateful to have been able to overcome them with this amazing team and we have all grown personally as we keep increasing numbers of discharged patients from returning to the hospital.
Q: What was Cureatr's biggest company news from 2021?
RR: First is that we've become a telepharmacy clinic. We're a provider organization. That's quite a change from where we were 12-18 months ago. We're seeing patients at increasing volume, and helping them live fuller, healthier lives through the safe and effective use of medications.
I'm also very excited about the random controlled trials we are conducting with our clients that demonstrate the massive impact of our work. For example, at a 4-star hospital system we support, a random controlled study has shown us to provide a 56.5% reduction in 30-day readmissions for congestive heart failure patients that receive our medication reconciliation post-discharge service. In other words, the patients in the control group — those who do not receive our service — are readmitted at a certain rate and our patients are 56.5% less likely to be readmitted within 30 days.
This reduction in readmission rates is unheard of on the one hand, and not surprising on the other: CHF patients receive broad pharmacological treatment with increasingly aggressive medications that, if not taken properly or not re-evaluated regularly, are extremely dangerous. Of course a fully attentive clinical pharmacist armed with the patient’s integrated and national medical record and their compassion can keep a discharged patient safe; can coordinate with their cardiologist, primary care, and other specialty care doctors; and can educate patients about how to integrate the discharging hospital’s instructions with the medications that remain in their medicine cabinets at home. These results are a testament to the need medication management, and the patient stories are what propel us forward into the year ahead. We're all pinching ourselves (time permitted).
Another big development is the diversity of our team. Before 2021, Cureatr’s leaders were generally white men. As I look around my management team today, that's far from the case. We have assembled a stunning team of high-performing diversity: a rising star female Chief Product Officer in Morgan Beschle; a serious performing African-American female VP of Human Resources in Dana Barrett; and a brilliant, compassionate, decisive female VP of our Pharmacy Clinic in Dr. Zarah Mayewski. We have increasing numbers of women at the Director level as well. As we continue to increase our gender diversity we’ve also increased our racial diversity.
We won’t stop until Cureatr looks much more like all of America, because that’s the country where our patients live, work, love, and sometimes get hospitalized, and they deserve care providers who share their experiences, their languages, and their belief systems. We’re beginning to live our Equity in Healthcare corporate value.
Q: How are you feeling about 2022?
RR: The new year is simultaneously compelling, stimulating, exciting, and consuming. We need to scale the clinic and we know we can do it, but we don't know how everything is going to play out. That's one of the thrilling parts about growth but also one of the most difficult.
As you talk theoretically about problems, you can come up with all sorts of solutions, but you ultimately need to make decisions about those solutions. You need to make choices. You can only have so many missteps. We live in an economy; resources are finite. Outcomes are never guaranteed. All you can do is put yourself in a position to make the best decisions with the information you have. Our strong leadership team helps make decision-making easier. I know the solutions we're considering have been evaluated by individuals with extensive expertise and tremendous knowledge.
As the number of discharged patients we treat grows, the number of people who those you return to the hospital all too quickly shrinks. I'm inspired and driven by the substantial impact on people, lives, and loved ones Cureatr can make. It’s also a great benefit to the national healthcare system, removing significant unnecessary costs incurred by all of us due to suboptimal medication management.
That's what's motivating us all. If you ask many members of our team whether earning a living is a reason for them to work at Cureatr, they'll say yes. It should be! But many would tell you that it’s not in their top three reasons for choosing to work here and grow here. We are being led by caregivers who embody the model for providing compassionate high-quality care that changes patients’ lives for the better.
Since about 70% of all patient interventions involve a change in medication, our clinic’s approach of using clinical pharmacists as care managers makes tremendous sense. They’re focusing heavily on the medications, so if they’re in a broader care-manager role, they can be the glue that stitches together multiple prescribers to tell a cohesive story and better ensure patients stay safe.
Q: What has you concerned about 2022?
RR: I’m exhilarated by the growth but the rapid change is a constant source of “what ifs.” What if we can't? What if we don't? Our plan has us growing from 40 full-time team members to 60 plus a growing orbit of consulting clinicians while scaling our patient flow by 10-20x. What could go wrong?
I'm not concerned about whether we can meet the demand, but it's imperative that we maintain and enhance our culture while we're growing. That is my primary concern. I have a dear old friend who told me he read an article that said you can either have high growth or strong culture in an organization, but not both at the same time. Want to achieve high growth? Culture needs to be put on the back burner for now. Want to bolster a strong culture? Slow down to work on it.
Is that right? I don’t know.
But I’m choosing to disagree. Cureatr will prove that article wrong. Because of the increasing and accelerating impact we witness ourselves having on patients’ lives, every single day.