The Impact of Digital Care to Patients and Healthcare Providers

Dr. Ray Costantini, MD, co-founder and CEO of, discusses the future of virtual care and the impact of digital care on provider groups and health systems. With the ability to triage patients via a computer interview in their own home, digital care is helping doctors and nurses regain time in their schedules without disrupting workflow and reduce unnecessary time spent with patients to open up spots for more critical care. He also talks about how SmartExam(TM) does all of this and even chart notes.

Dr. Ray Costantini is a pioneering healthcare business leader, innovative physician, and seasoned entrepreneur, passionate about disrupting the healthcare industry. He is Co-Founder & CEO of, a Portland based startup already recognized locally and nationally as a market leading company that’s transforming how health care gets delivered.  Prior to founding, he led the design, build, deployment, and operations of three 3 ground-breaking telehealth and digital health products at one of the largest health systems in the country. He also previously founded three successful companies, and is a national speaker on healthcare innovation, telehealth, and patient engagement.


Neal Howard: Welcome to this Health Supplier Segment here on Health Professional Radio. I’m your host Neal Howard, thank you for joining us. Our guest for this segment is a pioneering healthcare business leader, a physician, a seasoned entrepreneur and a passionate advocate for disrupting the healthcare industry, he’s co-founder and CEO of Welcome to the program Dr. Ray Costantini, how are you?

Dr. Ray Constantini: Very well. Good morning to you, how are you doing?

Neal:  I’m doing well doing well, thanks for asking. Well as a pioneering healthcare business leader, let’s talk a little bit about your background and

Dr. Constantini: Sure. I’ve got a kind of a complicated background. I’ve had a long history in entrepreneurship, actually that’s even before getting into healthcare and really shifted into the healthcare industry because I was truly excited about this space and about healthcare as a whole and there’s a as much a calling as anything. And then I got my medical degree and practiced and really felt like there was a need for folks with experience on the clinical side of the house to help reshape the industry and hopefully make it better. So that’s what really brought me to the executive side of the industry. I worked at a large healthcare delivery system on the West Coast, helped build out their digital health services group, brought in some pretty exciting products into that organization and then really recognize that some of the tools that were out there really weren’t meeting the underlying needs that the industry was facing and that was a big part of the inspiration for

Neal: Now as an addition to all of that, you’re also a national speaker on healthcare, telehealth,  patient engagement and things of that nature, where did you buy the time to launch

Dr. Constantini:  Entrepreneurship is often a calling of passion also, you find the time for those kinds of things. So it was like I said, it really it came from this desire to help make healthcare better and really recognize that a lot of the tools, especially around telehealth really weren’t solving the underlying needs that healthcare was facing. It’s kind of funny to be in a time in healthcare where you can talk about traditional telehealth, means where the industry is moving faster than it ever has before to be able to say something like that but when you look at traditional telehealth tools, they’re really built to solve a problem of geography. Patients and providers are distant from each other, it’s pain to deal with traffic and parking and waiting rooms and so we’ll connect via video to change the location of care but what really the healthcare system is facing is a challenge around supply and demand. The reason why patients don’t have the access to care that they’d like is rarely because of geography, it’s because there is enough provider capacity to go around for patient needs. We’ve got about a 25% shortfall between the number of primary care providers, the capacity that they can provide for care and and what’s the patient demand is today and that’s growing every single year. So what was built to do is to take a very different approach and rather than just thinking about how do we make care more convenient, we’re certainly going to do that as well but our focus was on how do we help make it more efficient. How do we help providers spend more of their time at or near top of license practice?

Neal: How does, do you offer a platform for telehealth or do you consult? Is it a combination of both of those or more much more?

Dr Constantini: We are primarily a software company. We build software that helps automate that care delivery process. A good way to think about us as think of it as a virtual medical resident. When we talk with healthcare delivery systems that’s usually something they’re pretty familiar with and if you think about what a resident does a big part of their job is gathering and organizing information and putting it in a format that is easily consumable by their attending physician. They are not licensed to deliver care but they are there to help support that process. And so we do something very similar, we start the patients at home, they have got one of more than 400 conditions that we help support care for, they reach out to their healthcare delivery system who has licensed our software product and instead of having to come into the office after having waited days or weeks for that appointment, they’re able to go right there onto their  smartphone or onto their computer and our system starts that process right there. And the first thing that it does is it goes into the electronic medical record system and pulls out all the information about that patient as relevant to their care, demographic information, clinical information, meds, allergies, problem, the things that they’re really key to understanding the patient’s care needs at that time and then we use that to be able to through our advanced technology we’re able to adaptively dynamically interview the patient for the provider. Providers spend about 30% of their time during information that they know that they needed before they even walked into the room with the patient and so we’re gathering all of that for the provider. Once we’ve gathered that and again we use this in a very personalized way, we’re learning about the patient as we go through that process. We try really hard not to ask dumb questions, there is such a thing as a dumb question and I tease about the frustration I end up feeling every time I get asked whether I’m pregnant. I’m still pregnant, probably won’t ever be pregnant but it’s much more in-depth than that. It’s really understanding their situation and being able to dive deeper into areas that are clinically relevant and not ask questions that aren’t. And then we take all of that information and we synthesize it into the format that the providers expect and need which is a chart ready note in a SOAP note format. So all written out on the forms they’ve written tens of thousands of, we create a differential diagnosis, what’s likely to be wrong with this patient, we have suggestions around treatment that are all evident based and supported. We do order entry, prescriptions, billing files, personalized patient education material and give all of that to the provider so that now instead of spending two out of every three hours doing administrative work, they’re now able to focus their attention on instead creating that content, they’re now a reviewer of content. They can look at that information, decide if they need any additional information but then move forward and the majority of the time, we’ve been able to gather more than they will have in an in-person setting because we’re not time constraint. And so we give that to them, they’re able to review that and deliver more thorough, more evidence-based care that has better patient and provider satisfaction scores and we are able to do that in about two minutes of provider time rather than the twenty minutes that it typically takes them in an in-person or video basee-setting.

Neal: And with all of the ratings that are required for compensation that is increasing, this goes toward the patient satisfaction, the outcome and the physicians rating as well. Where can we go online and learn more about I guess

Dr Constantini: You can go to, that’s exactly right. So that is our website, we’ve got delivery systems even more important than our own website, we’ve got delivery systems across the country who are offering this SmartExam product to their patients and we had delivery systems offering it to their established patients. Interestingly enough, it’s been a really powerful tool for delivery systems, it’s also used for new patient acquisition. I think that’s a really important piece for delivery systems to be thinking about. Patients expect convenient care and their choices of where to go to get that are increasing all the time. We’ve actually seen one of our delivery systems 30% of their SmartExam patients have actually been with new patients so it gives you a sense of just how much of a call that kind of convenient low-cost high-quality care can be for a delivery system.

Neal: Well it’s always great to hear about innovations especially when those innovations relate to efficiency in healthcare. Thank you that Dr. Ray Constantini, it has been a pleasure and I’m hoping that we’ll talk again in the future.

Dr Constantini:  A pleasure as well, thanks so much for making the time.

Neal: You’ve been listening to Health Professional Radio for this Health Supplier Segment with Dr. Ray Constantini. Transcripts and audio of this program are available at and

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