Interview with RxLightning CEO Julia Regan

Julia Regan, CEO of Rx Lightning discusses her leadership in the healthcare technology sector. Julia attributes her success in the entrepreneurial landscape to the discipline and competitiveness honed during her early athletic career in Pennsylvania. The conversation traces Julia's career progression, from her initial role in insurance sales to a strategic position at Novo Nordisk, where she began to blend her passion for healthcare with innovative technology.

We delve into the challenges and opportunities in the specialty medication sector, highlighting Julia's role in founding RxLightning. The company streamlines the specialty medication onboarding process, addressing the complex interactions between payers, manufacturers, and healthcare providers. 

This episode offers insights into the MedAccess ecosystem, likening its functionalities to a CRM system but specifically designed for specialty medications. Julia's journey is a testament to the transformative role of technology in healthcare, emphasizing its ability to provide efficient, patient-centered solutions that improve the quality of care.

In what may be a first on HealthBiz, Julia also shows off her company-themed earrings.

Host David E. Williams is president of healthcare strategy consulting firm Health Business Group. Produced by Dafna Williams.

Transcript

0:00:10 - David Williams
Julia Regan is a leader in the healthcare technology industry with a track record of delivering solutions that make medication onboarding simpler for patients and that improve price transparency. Rx Lightning, which Julia founded and heads as CEO, offers a single solution to enroll patients for any brand or generic specialty medication in just a few minutes, which sounds pretty good to me. Hi everyone, I'm David Williams, president of Strategy Consulting from Health Business Group and host of the Health Biz podcast, a weekly show where I interview top healthcare leaders about their lives and careers. If you like the show, please subscribe and leave a review. Julia, welcome to the Health Biz podcast. 

0:00:51 - Julia Regan
Thanks, david, I'm glad to be here. 

0:00:53 - David Williams
Outstanding. So sometimes in podcasts we do a lightning round, but this whole thing is going to be a lightning round, thanks to your company. 

0:01:00 - Julia Regan
Sounds good. 

0:01:02 - David Williams
Let's talk about your background a little bit and your upbringing. What was your childhood like? Any influences that have stuck with you through your career? 

0:01:09 - Julia Regan
I grew up in the middle of nowhere, Pennsylvania, pretty rural, a couple hours away from Philly and New York, was very competitive in sports. I think, when I look back on, what led me to be a CEO is probably all the principles that I learned growing up. Playing competitive softball and field hockey Ended up getting a division one scholarship to play field hockey, had an opportunity to play both sports and college For any of the division one athletes out there they know that it's a full-time job while going to school and it creates a lot of really great habits and work ethics that I I think I contribute to some of the success I've had in my career and definitely aligned to entrepreneurship, because anyone that started a company knows the difficulties and challenges of actually making one successful. 

0:02:02 - David Williams
Now, when you were growing up and you were doing these competitive sports, you were, like you know, like miles above everybody else, or did you have people that were in the same level of competition that you were dealing with locally? 

0:02:13 - Julia Regan
Well, from a field hockey perspective, I was fortunate enough to grow up in a community that is known for their field hockey. It's one of the top areas in the nation. So there I think I've played with maybe three or four Olympians for the US, so that I don't think is normal, and I definitely was not as good as them. So it was interesting. Softball is a little different because Pennsylvania is not known for their softball, because that's usually Florida or California because of weather, but it, I think, because I was surrounded by some of the top field hockey athletes in the nation. It helped drive me forward because I was always competing with them but I was never good enough to be one of them. 

0:03:04 - David Williams
That's exciting. Now it's interesting also some of these regional sports, like La Crosse is another one. I grew up in Maryland and it was like it's in Maryland and upstate New York. Now it's everywhere. 

0:03:14 - Julia Regan
at the time, yeah, I won't age myself, but go back to when we were growing up. It wasn't like it is these days, with every sport having travel leagues that consume these kids. 

0:03:27 - David Williams
That's okay. Well, you're the youngster on this podcast, so don't worry about that. Good. Well, let's talk about sort of after school, what you started with your early career. I saw Big Snint at Novo Nordisk. How'd you get into that? What was that like? 

0:03:43 - Julia Regan
Yeah, so I was selling insurance for briefly after going to college and then I knew I didn't want to sell insurance forever and everyone's like, oh, go into pharmaceutical sales. So I was fortunate enough to get a role with Novo Nordisk when they were expanding, selling their insulin products for their diabetes franchise, and I stayed there for eight years, actually fell in love with sales. I thought I was gonna go get my doctorate in psychology and just take some time off between my undergrad degree and my graduate school. But fell in love with actually trying to convince people to do stuff that you wanted to do and then healthcare in general, and then thought I would move up in the sales organization. So a lot of the manufacturers have different marketing rotations for like an internship. 

So I did a six month internship and when I went into the organization I thought I was gonna do digital marketing and it was right at the time where EHRs and ePrescribing were starting to get incentivized, for doctors to adopt it. But my territory was in the middle of nowhere, so doctors didn't use those tools at the time. So when I walked in they said well, Julia, for six months you're gonna figure out how this impacts us as an organization, both positively and negatively, and I was like what's an EMR? I had no clue what they were talking about, but after six months I was going through my MBA at the time and after six months of that program I fell in love with the space and during that time we actually did one of the first copay cards with Epic and Cleveland Clinic that was in, not even in at the point of prescribing in the EHR, but in the EHR more as like a composite to go in and access and download, which is, if you think about it, the first generation of what like optimized RX is today. 

0:05:44 - David Williams
Now it sounds pretty good. So you were there at NOVO for quite a while. So you must have had some success there and got beyond learning what an EMR was and figuring out how you're gonna use it for your purposes and have success. One of the interesting things I think about sales and the farm industry in general is that if you can actually get people to be successful there, it means they're gonna be successful with their health, especially something like insulin. So did you have good, did you feel good about sort of the success that you were? 

0:06:12 - Julia Regan
I did. 

0:06:13 - David Williams
Jannarita, how'd you feel about? 

0:06:14 - Julia Regan
it. Yeah, no, I loved the role. I loved to work with the providers. I loved the sales aspect of it. Once I did that rotation I fell in love with health technology and I no longer wanted to be in sales. I wanted to. 

I truly felt at that time that technology and healthcare would give us an opportunity to improve health outcomes and be better connected. In that I wanted to make a career out of it. So I went back to the field and then harassed my manager a little bit to say how do I leverage this into something bigger? And fortunately the market trends continued. Technology took off. I mean, novo created the full-time job for me. 

I went back in-house and then it I was doing that full-time, working with a lot of the organizations that were very early, selling into the drug manufacturers around the innovation of like clinical decision, sport and co-pays and really building what that looked like out. And then I had Dr First and a couple other organizations approached me at the time and say, hey, why don't you not just build these for one company, but come help us build it as an industry? And it was really hard to leave Novo because I was there so long, but the opportunity to build something that now I look back on it and it was really the foundation of what a lot of manufacturers are doing it's today brand marketing and a lot of these organizations if they all know what an EMR is and there's all EMR strategies within their budgets and portfolios for expansion. So knowing that I had the opportunity to go create some of the first generation products was exciting. 

0:08:01 - David Williams
Cool. So what was your role at Dr First Like what did you encompass? 

0:08:06 - Julia Regan
So when I went in, it was to start building out that first generation clinical decision support at the point of prescribing for that manufacturers would purchase. 

So they had about 100,000 providers, I believe at the time or so, on their e-prescribing platform. And it was how do we take that at the point of prescribing and build something that manufacturers would pay for that drives value for the prescribers and patients? I did that, did several different products and programs there and then shifted over to the payer side and worked with Humana and a lot of the other major PBMs building out the first real-time benefit check, product or price transparency product in the nation. And then those scales and my career kind of just led from there to other organizations to me saying there's such a need with a lot of these disparate technologies when specialty meds are rising and growing at the rates that they're growing in the market. We could create a platform that combines a lot of these things into one and connects different stakeholders. And it was the kind of the rise of what ARV's lightning was, because of my prior career experience. 

0:09:21 - David Williams
Got it. So you'd already seen everything from before the EMR started up until what it was like to have e-prescribing and doing for single products and then saying what is this going to be like overall? So you saw it. Now did you know you wanted to start your own company? Or was it more a matter of hey, you're not going to, let me do this at some other place? Or just why start a company? I mean, there's other ways to get stuff done too. 

0:09:45 - Julia Regan
Yeah, no, I never. If you asked me 20 years ago, would I ever start a company? I would have laughed at you. I am very risk adverse, which is completely opposite of a founder. 

I think that what really happened is I look back on my career I've always been an entrepreneur, building and innovating, and that's what I love to do. I love looking at a challenging problem or a market problem and ideating and saying like this could be the vision of how you achieve success and move the industry forward with using technology. And I think, as a result because I kind of went smaller and smaller and had products that were launched that have turned into industry standards I just got that mentorship through a lot of other founders and CEOs that have done it and I took a chance and just said like look, these other people could do it. I've never raised capital, but I know how to build a product and I know how to launch a product and I know how to hire people around me to do that. So if I could get mentorship and help from great advisors that I had early on, I could potentially raise capital. And if I can't and I fail miserably, I'll just go back to working another job, but it can't hurt to try so. 

0:11:09 - David Williams
I'll try. All right, I think it's a good attitude. So, you know, our exciting is focused specifically on onboarding for specialty medications, at least as I understand it. And so my first question is I mean, what does it mean about, you know, onboarding? Normally a drug will just, you know, I'll get a prescription and I'll take it. What is this onboarding? And then, what makes it so complicated for specialty medications? 

0:11:30 - Julia Regan
Yeah. So when we look at specialty, it's the high cost meds. It usually has different storage places so you can't just go down the street to your traditional CVS, walgreens, kroger, whatever your pharmacy is and pick it up. They're traditionally treating more complex diseases oncology, the biologics and it's the trend of what medicine is. So most medications at the FDA waiting approval are labeled in these specialty meds and they just keep getting more and more complex every year as the manufacturers keep innovating. So with that, payers don't necessarily want to just cover it for everyone. 

So there's two components to getting a patient started. After a diagnosis and a physician says I'm going to prescribe you X, there's the access journey and then there's the affordability journey due to the cost. So the access is really around. Who could fill it? How's it taken? Is the payer going to pay for it? What's the cost of that? And then the affordability is when a patient can't afford it, which is a lot of the time because these medications are so expensive. 

How do I get grant money or free drug or copay cards that the manufacturers work through? How do I get that and apply it to that patient quickly and easily? So through those processes there's just a ton of paperwork. There's a ton of technology solutions that you could go get one part of the process maybe accomplished. What we've done is we've really focused around 1,600 medications so it's specialty, specialty, late medications and we've created really a CRM system for offices that allow them to go through each step of the process the way they want to go through it, leveraging the tools and resources that the industry have made, so the manufacturer hubs or the specialty pharmacy programs they could enroll and onboard into, and then we connect the physician, the patient and those organizations together to share information transparently with technology instead of phone calls and faxes, which are just extremely inefficient. 

0:13:47 - David Williams
Got it, so I've seen this term. The Med Access ecosystem is that how you pull everything together across these different technologies and products and try to make the CRM work for the provider. 

0:14:02 - Julia Regan
Yeah. So when we say the Med Access ecosystem, it's really all the different people, the different stakeholders that are working on behalf of the patient to get them on the medication in an affordable way. Without technology, they're all kind of beating to their own drum, so it becomes inefficient. We want to create an interconnected ecosystem with the doctor, the patient, the manufacturer, the pharmacy, the payer, where they could actually coordinate and work together and not repeat the same processes over In order to do it. When we talk about the Med Access ecosystem, ARCS Lightning is not building a Med Access ecosystem in and of itself. There's going to be a lot of collaborative partners that develop this ecosystem. So, if you think about it, like 20 years we've been talking about true health care interoperability. We're talking about health care interoperability for a portion of medications and a portion of health care issues. 

0:15:02 - David Williams
Got it. So 2023 was a big year for generative AI in particular, and if I look at some of what you do, there's certainly some machine learning that's involved in this really generative AI. But what role does AI and machine learning play in your business? 

0:15:22 - Julia Regan
It's a great question, so it's evolving. There are different models that we could bring in to make it more efficient and more automated. I think that where we're at as an organization is we have really good structured data that is intelligent enough to automate most of those workflows. But pulling in the next level, generation of how do we incorporate AI in a way that could help make people more efficient where they could do less work and the technology could do it is where we want to go, fundamentally because I'm a product person and an innovator. 

A lot of times people jump to using technology that's not ready and then errors happen and we have like. Our mission is for the one. It's very personal. Every patient that is going through our platform has potentially a life or death medication on the table, or a very impactful medication from a chronic daily perspective, so there really is no option for error with us. So we step into using machine learning and AI in our technology. There are instances of it, but I would not say it's the foundation of the platform or the automation that we have yet. 

0:16:49 - David Williams
Got it. So if I'm a patient or a provider sounds really great what you're doing, but you're a for-profit organization. You've raised significant capital. I mean, who is the customer? Who wants to pay for this? What's the value proposition for them? 

0:17:05 - Julia Regan
Wel