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Scott Shreeve, MD

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I'm the CEO of Crossover Health, a patient-centered, membership-based medical group that is redesigning the practice, delivery, and experience of health care. We offer urgent, primary, and online care to our members who can access our technology platform, practice model, and provider network from anywhere and anytime to optimize their health. Email Me

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Ben Mehling, VP of Technology at Crossover Health, joined the company in 2016 and has been central to the development of the first Crossover practice portal. He ensures the operational integrity of our technology infrastructure, and is a key to the success of our development team as they build out our visionary new software platform (See Part 1).  In this second post, Ben talks about the role and impact of technology in healthcare, his approach to COVID-19 and the switch to virtual care, and his thoughts on our values and culture. Part 2 of 2.

How does your medical group and even your clients become comfortable with the new technology?

Historically, we’ve done this in a pretty traditional way. Our current portal product was developed to support the workflow of Crossover’s Care Model 1.0. The release comes out, and we tell the users what’s new and what’s changed via email updates, or through operation’s outreach or training. 

The challenge with XOP is that we’re fundamentally shifting Crossover’s care model—Care Model 2.0–while simultaneously building new software to support that new care model. Our clinical teams want to move fast, yet we can only build the software at a certain rate. Without our incredible care teams’ willingness to adapt, we would be forced to iterate at a much slower rate. We also have a team of operational super heroes (ClinOps) who have the responsibility of closing gaps and overcoming challenges in the clinics. 

Jay has recognized the challenges of swapping out the jet engines while the plane is in the air. He’s been a proponent of investing in a knowledge base we refer to as Compass—this will be the place where people can go to see changes and read about how the care model and software work together. Crossover isn’t just building technology, it’s actually the whole care model, enabled by the technology, which requires even more orchestration, communication, and clarity on how it all works together. 

How did you accelerate so quickly during the pandemic to transition your technology architecture?

For the existing clinics, we have an enterprise scheduling tool we built a few years ago. We leveraged that tool to “swap” in-person visits with equivalent virtual appointments for the members. Our care teams, who had transitioned from the clinics to working from home, did an incredible job of being flexible as they moved from a few video visits over the last year and a half to—boom!—all video visits. The providers and guilds organized a support chat group where they helped each other with tips and tricks, best practices, and troubleshooting techniques. 

On the XOP side, our Telemundo team was the first client-facing practice to be implemented. As expected, we learned a few things along the way. The challenge, just like it was when we introduced our member portal in 2012, was that we designed it for the member first—it is not fully featured and doesn’t solve all the provider’s challenges yet (remember the incredible practice teams I mentioned before?). 

In order to solve these challenges and close these gaps, we organized daily, cross-functional meetings in the lead up to the launch. Agenda items were brought and lots of debates were had as we hammered out every question and detail. The process, while grueling, was critical because we got everyone to commit to a solution. A key aspect to our approach was that we weren’t just hacking together a Frankenstein solution. We always tried to stay true to Crossover’s core principles when solving issues so that the overarching philosophy of care and the approach remained intact. The Telemundo launch was very useful in cementing how Care Model 2.0 will work. There is no better test of us than putting our care model and software into the wild, into production, with real members and providers. This experience has greatly solidified the principles of the care model. 

The pandemic seems to have accelerated everything. Did it also accelerate your development of XOP?

I would say the process was not accelerated, but it absolutely helped focus how we were thinking about the roadmap. Software development is not necessarily fast, so you carefully plan your roadmap, build your requirements, and prioritize the engineering teams. Agile development methodologies certainly help make this process more flexible (and organized) when (inevitably!) priorities shift and change, but the factory can just keep building. We have the KPIs and metrics we use to measure the velocity of the development teams. It’s a pretty standard software development life cycle process. Again, I don’t think we’ve gotten faster, but the focus is tighter and we’ve tested our team’s and processes’ resilience when change is required. Telemundo helped because we identified features we could park, ones that were urgent, and what must be added to the roadmap. Once it’s in the wild, things happen, you learn things, and you have to adapt quickly, which we have been able to do. I would also say, our investment in a good governance process with our steering committee has paid off as the committee is now much more adept at understanding what can be switched and prioritized and what happens when you commit your resources to a specific feature. These tradeoffs are all business decisions with real implications and you need to have everyone on board, have an objective process, and then be willing to commit to a path. Occasionally we’ll be wrong, but we will always be learning, iterating, and improving. 

What do you think about your member conversion to this new technology within the context of the pandemic?

When we started down this path, shifting to “asynchronous” care, I tested the concept with friends and family. I talked about the vision behind the approach and what we saw as the endstate—how members would work with their providers via technology that structured the conversation, how clinical tools would empower the providers, how question sets would make certain that important details were efficiently captured, and much more. It usually took five minutes to set context and understand the mechanics, but inevitably, the light bulb would turn on. They’d begin to understand the advantages, the convenience, how our existing collaborative care model acts as a multiplier for our providers, and how advantageous that is to the members themselves. I think this model works in regular practice and during this pandemic.

I also think that we will be stress testing how trust is established in a care relationship. If you’re an established member, you’re used to our 30- or 60-minute visits. These are designed specifically to give our providers the opportunity to establish relationships with our members not just by spending time with them in the room, but by creating clinical “space” in which they can follow up, do those extra things that are meaningful to members, and help build confidence in the care. We know that the quick turnaround on secure messaging is also a key satisfier as well. We know they’re already using those messages for refills, getting education, or asking questions without having to schedule, travel to, and attend a visit—all of which is highly convenient and a key component of the member experience. So, we will need to see if starting the relationship online can replicate that trust; we will then see the relative value of the online convenience and asynchronous access in building these relationships. 

How do the Crossover corporate values resonate with you?

I particularly like Design Everything. There’s an aesthetic to it, but there’s also an underlying systems thinking to it that aligns with my own way of working. I would add, that the value that Scott has been pushing me on for my own goals, and that XOP pushes the whole organization on, is to be “Fearless.” Fearless in taking risks and learning when we stumble. XOP is an entirely new thing—arguably unproven even though Sherpaa had some strong indicators on where the market was going—and we’re taking a calculated risk as an organization. We have to be fearless, step into it, and prove that this is actually the better way to receive and provide care. 

What are your views on how these values and culture can be maintained?

I’ve been at six or seven companies and our foundational values at Crossover are some of the best I’ve worked with. They are the most meaningful, and are embedded in our work in a way that other organizations haven’t been able to accomplish. I think Celeste Ortiz, our Chief People Officer, has done a great job of championing the idea that the behaviors that underlie the values must be an integral part of the performance management program. We have one of the best performance management programs I’ve worked with. Meaningful, without a lot of wasted time or “check the box” processes. I continually counsel everyone on my team to take our performance reviews as a real opportunity to sit down and think about our own professional roadmaps, our personal goals, and evaluate our path. 

Organizationally, we focus on the member—that can get lost when you’re fixing printers or developing software, however, everything we do to support our clinical teams floats up to the members. In engineering, we spend a lot of time talking about the ‘why,’ what is the end user’s need, and why is it this way or that way? Developers have to make a lot of microdecisions every day, trading one thing for another, and the more they know about the why, the more likely it is we’ll make the right microdecisions. 

What might people not know about you?

I’m pretty boring, I think. My wife and I like to travel. I’m a  car guy and used to take my cars to the track. These days, I’m an avid soccer player—I still play weekly in pick-up and adult leagues around OC. I also travel for tournaments a couple of times each year with my club. It’s a fun way to stay active and provides for some excellent “anger management.” 

If you weren’t at Crossover, what would you be doing?

My wife has one vice: She’s played the same numbers in the lotto every week for years. She asks me, “If I won, would you quit your job?” No, I wouldn’t quit my job. I like my work quite a bit. I like building products, I like building teams. If I wasn’t at Crossover, I suspect I’d be at another healthcare startup. I don’t think I’d leave healthcare at this point. As much drudgery as there can be in in our industry at times, I find the individuals who get into this “business” tend to have an altruistic, service-driven bent. I want to work with people who are on a mission and who are passionate about what they are doing. I have certainly found that here at Crossover and love what we are doing and where we are going as a company.

Many thanks to Peter Heywood (one of our long-standing brand advisors and business consultants) who helped conduct these interviews.

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