Nomad Health interviews Dr. Sylvia Romm, Medical Director of American Well
Telehealth is arguably one of the most exciting new delivery models in recent times, enabling doctors and patients to connect quickly and meaningfully with fewer location and time constraints.
Hearing about the potentials of this technology is one of the many reasons we loved speaking with Sylvia Romm, MD, MPH. As Medical Director of American Well, one of the nation’s largest telehealth providers (who currently have over 30 jobs available on Nomad), she spends her time helping American Well’s partners best implement the platform for their unique needs.
But that’s not the only work she’s done in the space. She’s also the Founder of MilkOnTap, a telehealth company focused on the needs of nursing mothers.
In this latest edition of our “Doctor And…” blog series, we talked with Dr. Romm about her path as a doctor, medical director, and founder, and why she thinks telehealth is such a game-changer for doctors and patients alike.
What drew you to medicine? What did your initial path toward it look like?
I feel like I know so many people who knew that they always wanted to be a doctor, have cute pictures of themselves as little kids with stethoscopes and reflex hammers, and have one cohesive story.
My story is definitely not like that.
I went into undergrad thinking that I wanted to be a botanist, but eventually wound up doing an undergrad thesis in molecular neurobiology. After college, I worked at the University of Munich and then at a biotech company doing research in genetics and cellular biology.
Then, my employer sent me to India to set up some clinical trials looking at experimental cancer therapeutics, and I worked with physicians there who were helping recruit and enroll patients in the study. They seemed to dedicated not only to the success of the science, but also to the patients themselves and their stories. At the time, I was also heavily involved in Amnesty International, and I realized that I wanted to do work that allowed me to integrate my love of science with my passion and commitment to social justice.
Pursuing medicine seemed the most obvious way to connect those two areas of my life. Sure enough, in medical school, I was actively involved with advocacy groups around healthcare access, and I then went on to get my Masters of Public Health. I still like to think about the larger picture of healthcare as I’m with relating to the history of the person in front of me.
At what point on the journey did you decide you wanted your work to include more than clinical practice? How did that begin to take shape?
I think that I never saw my clinical work to be in isolation from the larger-scale things that I had always done in advocacy, access, and quality improvement. Where I pivoted was looking at how technology could allow physicians to reach those aims, while still being able to have strong (or maybe even stronger!) relationships with our patients.
Many doctors feel that the technology advances that have been encouraged in the past ten years (such as EMRs) have gotten in the way of the physician-patient relationship, and as an extension, much of health tech is viewed skeptically.
What I wanted to do was use technology to bring to healthcare what it had brought to so many areas of my life: more convenience, more connection, and more flexibility.
I’m able to order my groceries from my phone to be delivered to my door, why can’t I make an appointment with my doctor?
Tell us a little about your first company, MilkOnTap.
MilkOnTap came from my experiences with my second child, as well as my background as a pediatrician.
Before I became a parent, I had so many women ask me questions about breastfeeding and they always seemed at such a loss. I gave them the best answers I could, but I didn’t yet fully understand how hard it is to keep these little human beings alive.
Then, my second child had a lot of trouble breastfeeding, and I ended up leaning on my lactation consultant friends heavily to make it through the first few months. I must have wondered a dozen times how anyone is able to get through breastfeeding without having a rolodex of lactation consultants as friends.
At the time, I was also starting to do telemedicine visits as a pediatrician, and I realized that mothers really needed that same service with lactation consultants for breastfeeding. I started the company with the help of several of my friends who had founded their own start-ups, and within a year we had a group of lactation consultants up and running on our telemedicine platform.
It was such a fun and satisfying experience to not only be helping mothers, but also the lactation consultants, who themselves were excited to be working from home and with flexible hours.
From there, how did you connect with American Well? What drew you to that company and mission?
Soon after we launched, we were approached by American Well to provide lactation services through their platform. I had always been impressed with them in the telemedicine space because of the way they white-label their technology so that systems like Cleveland Clinic can use their trusted brand to reach their own patients more effectively.
When one of their primary clients was interested in starting a program for their new mothers that included breastfeeding support, American Well decided that it made much more sense to find a company that was already offering these services.
It was a perfect fit, and now after the program launched with their first client, we’ve had several others step up and say that they would like to provide lactation support as well. It’s been wonderful seeing the interest in serving mothers really thrive.
How would you describe you work there today? What are some of the challenges and solutions you’re most excited about tackling?
The technology that we are proposing isn’t difficult to use, but it’s still new in healthcare, so many organizations in healthcare need guidance in how to best implement it into their workflows.
I heard a speaker recently say, “People and process improve care – not technology,” and I wholeheartedly agree.
I spend a lot of time taking my knowledge of the technology, the regulatory environment, the clinical administration, and the clinical work itself and translating that into potential solutions for the organizations we work with.
We’ve learned that just trying to turn on a separate system of electronic healthcare delivery next to the traditional one doesn’t work very well, and that truly taking advantage of our technology for patients and clinicians alike requires the ability to look at workflows that have been in place for a decade, and realize that many of their limitations no longer apply. Creating these novel programs is not without its ups and downs, but it’s really exciting to see them come to life.
You still practice virtually. Tell us a little about what that’s been like.
Doing urgent care through video is very similar to doing urgent care in person. So from a clinical standpoint, you flex a lot of the same muscles in your brain. I love that I can fit in patients between other meetings, and keep up my clinical skills while I’m still looking at the bigger picture of changing the fundamentals of how we practice. I feel lucky to have that combination!
What kind of potential do you see in telemedicine for doctors today?
Right now we’re at the stage where we’re looking at replacing parts of in-person medicine with telemedicine. Next, we will be thinking of completely new treatment plans that could only be possible with technology that makes frequent and short visits feasible.
As healthcare as a whole moves to value-based care with a focus on prevention, being able to remove the barriers that prevent connections between patients and their providers will be paramount.
Think about all of the times in your life that you have to rearrange your schedule in order to see a physician in person, and how many of those really needed to be in person. If you replace even 20% of these visits with video connections, then you will have revolutionized how people think about the accessibility of getting help for their health.
What advice do you have for doctors looking to integrate telemedicine into their practice or career path?
If you’re interested in doing telemedicine, know that the technology of the video visits itself is the easy part. The complication comes from regulations, reimbursement, workflows, and integration with other technologies. So find a trusted partner to help you through the rest.
Telemedicine has been around long enough at this point that there are a significant number of physicians out there who have gone through the process of rolling it out, and they will be invaluable in helping you work through any of the hiccups. Once you have it up and running, both physicians and patients say that they are very happy with the convenience and quality of care that you can achieve.
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