Though his career has taken some unexpected turns along the way, Christian Armstrong, M.D., M.H.A, has devoted his career to improving health outcomes. After fulfilling a lifelong passion of becoming a physician, he sought greater work-life balance and turned to technology. But from the beginning, he’s been driven by a single focus – to help care providers take better care of their patients.
Now a software product development manager at Fuse, Cardinal Health’s innovation engine, Armstrong says he fell into technology early and by accident. “I always had wanted to study and practice medicine, but that’s a long and expensive road; I first had to earn money to pay for it. Fortunately, my reputation as a hard worker led to a job offer right out of high school – from the uncle of a friend – who worked with an educational technology company. I spent a couple of years helping to upgrade IT infrastructure in schools.”
Once he’d saved enough from his tech job, Armstrong went on to college, then to medical school to study obstetrics. “By the time I started clinical medicine, I was married with two children and a baby on the way. We were living in Atlanta, Georgia, and I absolutely loved my work. But I hit a real turning point not long into my training: I had delivered 10 babies over the span of four days. When I finally got home, exhausted and not having seen my family for days, I got called back to the hospital, because another of my patients was in labor. I knew I couldn’t keep up that pace and keep my family together, too.”
This would be the first time he chose to stop and assess what might be next in his career.
Launching a business
After some soul searching, Armstrong and his family moved to Central Ohio, where both he and his wife had grown up. “We wanted to be near our families,” he said. “But I came back here without a job, and had to pretty quickly figure out what I was going to do to earn a living. It made sense to me to try to combine my knowledge of the practice of medicine with my technology skills.” He decided to try his hand at starting his own business.
With the support of a few investors, he launched MedPAC Technologies, created to provide an electronic health record (EHR) platform for long-term care facilities. “Long-term care lagged behind other areas in health care – and continues to do so – in terms of using EHRs, largely because these facilities aren’t eligible for the federal EHR adoption incentives that the HITECH Act provides,” Armstrong said. “So when patients are transferred from hospitals to long-term care facilities that still use paper records, some of their hospital medical records can be lost.”
It seemed obvious to Armstrong and his investors that MedPAC could be a win: “Electronic health records improve the management of clinical documentation – and in turn, can help providers make better care decisions for their patients,” he said.
Though he got his EHR product as far as late-stage beta testing with some 40,000 patients in multiple long-term care facilities, sales were slow and his funding was running out. “I learned a very valuable lesson: For health care systems, the challenges that come with system-wide change can be so daunting that the savings potential of better technologies can seem irrelevant.” Over and over again, he heard similar responses from long-term care facility leaders: “Paper health records were working for them. Even though I could show that our EHR could free up a full-time employee to focus on something else, they couldn’t get past the near-term challenges and costs of implementing a new system.”
Learning to code
Without funding, Armstrong was forced to shutter MedPAC. “Once again, I was in the position of trying to figure out my next step,” he said.
“I knew I wanted to continue to work in health care and technology. By this time, I’d learned a lot about Fuse from presenting MedPAC to potential investors there. Fuse was – and is – widely known by area innovators and the tech community as ‘the place to be.’ I felt like that would be a really good fit for me, but I knew I needed to gain more expertise in coding to land a job there.”
So Armstrong enrolled in Tech Elevator, a 14-week coding bootcamp. “I think that was one of the best moves I’ve made,” he said. “It was an intense program; I studied as hard during those 14 weeks as I did in med school. And I came out knowing what I needed to know about software development.”
Once he got hired at Fuse, he initially took on the leadership of a team of 6 software developers which later grew to two teams over 15 team members. Together, they design products intended to help care providers improve health outcomes.
Supporting pharmacists and their patients
“My team and I develop solutions that help pharmacists take better care of their patients and run their businesses more efficiently,” Armstrong said. “We dig deep to understand what their challenges are. What are the bottlenecks they face? What are the time-consuming, administrative chores that, if taken off their plates, would allow pharmacists to spend more time with patients? We try to solve for those challenges.”
Currently, Armstrong’s team focuses on expanding the impact of the Outcomes™ Connect platform, a digital ecosystem that connects pharmacists, payers and pharmaceutical companies to maximize clinical opportunities and mitigate the challenges of medication nonadherence, a common and costly problem, particularly among patients with chronic health conditions. Research has shown that medication nonadherence – that is, not taking a medication as prescribed – leads to tens of thousands of preventable deaths and hospitalizations each year and costs the health care system more than $528 billion.
“When pharmacists focus on the patients who can be moved from medication nonadherent to adherent, they help those patients live healthier lives,” Armstrong explained. “They also can realize significant cost savings to their business, because the more patients a pharmacist has who are medication nonadherent, the more Direct and Indirect Remuneration (DIR) fees the pharmacist is likely to have to pay to health plans and pharmacy benefit managers (PBMs).” DIR fees are charges that reconcile pharmacy claims against negotiated drug prices; transitioning a nonadherent patient to an adherent one can save a pharmacist thousands of dollars in DIR fees each year.
Armstrong and his team develop tools that use data to help pharmacists identify which of their patients are likely to become more adherent with such supports as phone call reminders, in-person consultations or medication delivery services. They’re also working on a new tool that enables pharmacists to engage digitally with their patients to influence decisions at key points in their care.
Whatever their current project, Armstrong said, “I’m always pushing myself and my team to study. We have to keep learning, to keep exploring technology to find new ways to help resolve existing problems for our customers – to help them improve health outcomes for their patients.
“Ultimately, the question is, how can we give health care providers more time to do what they’re trained to do, and help make their patients’ lives better? That’s the potential of technology. And that’s what drives us.”