Nirmal (Nim) Patel - Faces of eHI, Leadership Council

Nirmal (Nim) Patel - Faces of eHI, Leadership Council

Nirmal (Nim) Patel, MD, MPH

Nirmal (Nim) Patel, MD, MPH

Chief Medical Information Officer

Teladoc Inc.

Q&A with MD, MPH

What are the most pressing challenges facing us in healthcare today?

Having trained in England, one thing that strikes me about the American healthcare system is the excessive cost burden we face, which doesn't relate to high quality. Consider our suboptimal immunization rates, mortality rates, maternal and infant mortality, adult lifestyles. The most pressing challenge is the cost, the quality, and also the variability in care and lack of health improvement measures. Ultimately, we lack efficiency in our healthcare system, which then feeds into the other three.

What are the steps needed to transition to population health?

I think there are several. One of the biggest initiatives that the Federal Government, then the private sector, needs to address quickly is payment reform from volume to value. A good primary care foundation also promotes a well-functioning healthcare system and greater access can be enabled by HIT such as telemedicine. We have issues around interoperability, however with the use of better integrated data and the leveraging of EHRs to assess risk, implement interventions and then measure effectiveness is key to population health. The key steps are payment reform, care reform, and technology reform, and all of the above are taking place, which I'm very excited about.

Where do you see the future of healthcare?

We've made a start in the marketplace to introduce HIT, but are still very much in our infancy in that journey. Telemedicine, for example, is an important part of the future to drive towards the triple aim and is a modality that can be very effective for certain diseases. In the past year, Teladoc introduced behavioral health, dermatology, sexual health and tobacco cessation programs – with more rolling out in the months to come. Our vision is to create a single, connected platform and delivery system for both our clients and our members that delivers superior care across a number of clinical specialties that is coordinated, measurable and therefor superior to community. Availability of high acuity images from Hi-definition smart phone imaging means that teledermatology can be practiced asynchronously using mobile technologies when only a few years ago, this could only be done using large screens within an office setting. For behavioral health, using telemedicine, we can increase access to care, coordinate care across different types of providers and embed tools to measure health improvement. Placing an importance on offering an optimal provider experience that is intuitive and simple to use, will result in better technology adoption and therefore results. The advent of remote sensors will allow us to manage chronic disease better and address the 5% that drives 60% of cost in the marketplace. Telemedicine is exciting since it is has the potential of being a systematic form of data creation, transfer, analysis, and action, and therein lie some really disruptive opportunities.

What role does a group like eHealth Initiative play in supporting executives and companies like you/yours?

From our perspective at Teladoc, eHI creates a platform and a forum for dialogue with other key healthcare constituents. It also helps us have a voice for regulatory stakeholders, which is important, since telemedicine is a disruptive, nascent form of care. As we interface with other stakeholders and members within eHI, the dialogue helps us understand the key business imperatives they're dealing with, their needs, and will help us innovate more. We find it to be a very helpful forum, and voice.

It may surprise people to know that...

The notion of telemedicine is not new. Soon after Alexander Graham Bell invented the telephone in 1876, this new technology was being used in the mid-west by physicians to diagnose croup in children in remote areas. We talk about this as recent and disruptive, but it is an old concept and doctors have been using it creatively for hundreds of years; now the time has come to use HIT in a more systematic way to solve larger problems.


Dr. Nirmal (Nim) Patel, a primary care and preventive health physician, has nearly 25 years of experience in healthcare delivery — including clinical care, administration and health information technology, and the global management of health and wellness for large populations. As Teladoc's CMIO, she is responsible for outcomes measurement, including quality of care and cost management, for all product lines and offerings.

Nim's prior experience includes serving as corporate medical director and chief physician for Cisco Systems; CMO for HCMS Group, a data analytics and clinical services delivery organization; and, most recently, CMO and global head of health and wellness for Morgan Stanley.

Accomplished in developing innovative, strategic solutions for hospital systems, consulting clients and large corporations, Nim has been committed to advancing the health and well-being of populations throughout her career. She has led global healthcare strategy and programs for large employers and implemented effective advanced primary care through innovative, technology-enabled health centers. She has provided counsel and thought leadership to providers, technologists and benefits professionals and supported the development of new telemedicine solutions and markets.

In the area of health outcomes research, her experience includes the design and implementation of pilot programs and studies to quantify the effectiveness of telemedicine-related healthcare interventions across global healthcare delivery systems.

Nim is passionate about high-quality, patient-centric care delivery, and using advanced data analytics and information technology to enhance efficiency at the point of care and achieve critical imperatives that are necessary in healthcare today.

She received her medical degree at the University of Manchester in the U.K., completing her training at University of London and the Yale School of Medicine.

Nim lives in Greenwich, Connecticut with her husband, Shai, and children, Ishaan and Prianca.