David Tsay, M.D., was appointed chief medical officer of Counterpart Health, a Clover Health subsidiary, this month.
Counterpart Health is Clover’s AI assistant tool for physicians. It is sold to payers and providers to help improve health outcomes for patients and bring down costs.
Tsay, a practicing physician, most recently served as chief medical officer for health tech company Cue Health. He also spent two years as associate chief transformation officer at New York-Presbyterian Hospital and led the clinical team for medical device products at Apple through the pandemic.
Fierce Healthcare spoke with Tsay to learn more about his career, what excites him about Counterpart and Clover.
This story is loosely edited for length and clarity.
Fierce Healthcare: Take me through your professional background.
David Tsay: Over my career, I’ve developed a deep passion for understanding how technology can be transformative in care delivery. Really it’s about democratizing high quality of care for all. I spent a number of years over on the provider health system New York-Presbyterian towards that aim building things that improved access, like digital health services, ultimately with the overall goal of like, improving outcomes across the health system.
More recently, I’ve been spending time in the technology industry focused on developing consumer health technologies … that empower patients with and providers with new health data to enable earlier diagnoses and better outcomes, mainly through wearable technologies and at-home diagnostic technologies.
FH: How does your experience at Cue Health and Apple translate to Counterpart?
DT: Sure. For instance at Apple, [we] developed software technologies in the cardiac space, like ECG, irregular rhythm notifications and tracking blood oxygen, to leverage wearables in a way that would give you diagnostic data outside of the four walls of a hospital. But then also making sure that that data would be readable and easily accessible by providers.
At Cue Health, we developed diagnostic health technologies to make it easier to get diagnoses at home. We launched one of the first, in-kind fully FDA approved molecular home test, and it really was an ecosystem that helped take a patient from testing to diagnosis to treatment and closing that loop.
I think that a lot of what Counterpart does in terms of empowering providers to be able to better diagnose, treat and proactively address health issues for their patients really comes down to the same core concepts that software technology can help them with.
FH: What attracted you to Counterpart?
DT: I would say there are two unique aspects of Counterpart that drew me to them.
Firstly, I would say the technology platform of Counterpart Assistant was developed as a scalable tech platform to specifically empower providers. I passionately believe this is the right place and right time to have this conversation.
Secondly, I think Counterpart Assistant is incredibly unique. It was entirely incubated and developed within the Clover Health Medicare Advantage plan as an effective technology platform. That has really made the design as a function of the product very specific and effective for providing use in a way that drives value-based care success.
Just down to the granular detail, the software is helping providers in the moment at a patient-specific level address gaps in care, preventative screenings, early diagnoses they may be at-risk for as identified by our proprietary AI algorithms.
FH: Counterpart gives actionable insights for patients. What do those look like?
DT: When a provider goes into our software at the point of care, there can be very specific things like, ‘hey, this patient needs a colonoscopy’ based upon clinical care guidelines. Either they meet the age criteria, they haven’t had one yet. Here’s an opportunity to address a gap in care.
Sometimes those clinical insights might be to identify a patient that may be high risk for diabetes and suggest screenings and proactive care, so we can diagnose chronic conditions earlier and treat them earlier to prevent subsequent outcomes that come down the line.
Especially in today’s practicing world, it’s an incredibly complex landscape, particularly from a data perspective. The typical patient may have a primary care doctor, then see several specialists and get labs from a health system. These pieces of documentation may exist in three or four different EMRs, their pharmacy records or in other places.
As an independent practice, doctors have an EMR for themselves they built for their practice, but they don’t have the ability to search through all of the complexity of the data landscape. Counterpart Assistant makes it easy, a one-stop-shop.
Another one is medication refills. There’s automatic insight. ‘Hey, this patient hasn’t had their refill.’ There may be a medication adherence problem, maybe there’s a copay problem. We flag that. When you look at primary care providers today, with so limited time to sift through all the data and develop all those insights, we’re trying to support them.
FH: You mentioned earlier you view this as the “right place, right time.” Why?
DT: When I look at Counterpart and Clover, we’re taking a different approach than most companies. It’s really focused on clinical care and value-based care.
I’ll give you a hypothetical scenario. There’s a lot of software nowadays that is trying to help physicians in their practice workflow, particularly around administrative tasks. That’s important, of course. But imagine a world where you have this great software and you reduce all that time, but the clinical care didn’t change. That’s not Clover’s definition of success.
What’s intriguing about the way that we’re building our technology is it’s about driving toward value-based care success. I think we’re really just touching the surface of that. In the end, it’s really about making sure everyone gets all their preventative screenings, having their chronic diseases managed to prevent progression and really about focusing on the best quality of care that we can democratize to all of our patients and members.
FH: How else is Counterpart using AI to generate insights?
DT: One of the really unique things that we do is we take a lot of the data and run it through proprietary AI algorithms … to predict when a person might have a new diagnosis or be at risk for a certain diagnosis. We present that context to the physician to review to let the physician have the most up-to-date information.
As you get older, you’re going to develop multiple conditions. Those conditions, as we all know, are the leading causes of morbidity and mortality. Particularly in the Medicare population there’s cardiovascular disease, diabetes, renal disease, cancer and on and on. Understanding and interpreting all of those conditions, and what that means in terms of risks or new conditions and other types of clinical patterns, we try to make that much easier for primary care doctors as part of holistically taking care of the patients.