🔒Grand Rounds, a San Francisco-based startup, is staffing up in Lewiston

When Guy Langevin heard his primary-care doctor was moving away, he used the Grand Rounds mobile app to find a new one.

The Dead River Co. vice president and chief administrative officer had helped bring Grand Rounds, a San Francisco-based digital health start-up, to the Lewiston-Auburn area in 2016 in his role as chairman of Maine & Co., a consultancy that promotes doing business here.

Dead River was also the first Maine-based employer to sign up with Grand Rounds, which helps companies trim health care costs and boost productivity by connecting their employees and family members with the doctors best equipped for their needs.

Langevin typed his search query into the app, which came back with a recommendation with the how and why behind the choice, and asked whether he wanted an appointment. He did, and had one confirmed within a day: “It was very quick.”

Welcome to the convergence of digital technology and health care, an emerging field to make medicine more personalized, precise and efficient.

Grand Rounds aims to stand out from rivals such as Best Doctors, PinnacleCare and Accolade by using its proprietary Quality Algorithm to select the highest-quality physicians for in-office visits or to give second opinions on a treatment or diagnosis.

Grand Rounds has used its technology to vet more than 96% of all active specialists and primary-care providers in the United States. Out of a small subset of doctors with top marks in each specialty, it handpicks the best qualified for each patient. It also collects and digitizes medical records, manages appointments, and employs doctors and nurses to answer patients' questions, review files, and assist with quality assurance.

From California to Maine

Grand Rounds was founded in 2011 as ConsultingMD by Owen Tripp and Lawrence “Rusty” Hofmann, a radiologist who came up with the idea after saving his son's life by connecting transplant teams at two hospitals and donating his own bone marrow. Tripp, who serves as the company's CEO, also co-founded reputation.com to help businesses improve their online reputation. Like that company, Grand Rounds is backed by venture capital — raising $106 million so far in four rounds.

Grand Rounds brought a small team to Auburn in 2016 before moving across the Androscoggin River to Lewiston in March 2017.

In Maine, Grand Rounds works with large employers with operations here, including Walmart, Home Depot, Lowe's and Canada's McCain Foods Ltd. Maine-based employers include the State of Maine, which employs 12,000 but offers Grand Rounds to around 30,000 health-plan members.

“The program not only provides the member written clinical advice based upon the member's personal medical records, it has proven to save the state health care dollars, as the recommendations generally produce quality case outcomes, which avoids additional unnecessary or different services,” says Kurt Caswell, director of employee health and benefits, via email.

Similarly, Dead River offers Grand Rounds benefits to all 1,200 of its employees and their families regardless of whether they are in the health plan or not, says Langevin.

“The value of the Grand Rounds benefit for Dead River Co. employees is knowing that our employees who are experiencing an illness or that of a loved one can have the guidance and support of health care professionals and the access to top-tier experts who will guide them through the maze that is our health care system,” he says. “As a health care payer, there is little or nothing we can do to help our employees navigate these life-impacting decisions. Grand Rounds takes care of that.”

Experts say Grand Rounds' approach makes sense.

While 80% of people in a company's health plan tend to be healthy, “it is the small number of complex cases that drives a tremendous amount of the cost,” says Peter Hayes, CEO of the Healthcare Purchaser Alliance of Maine, a Topsham-based nonprofit. “That's where Grand Rounds is meant to help.”

Mitchell Stein, an independent consultant in Cumberland, agrees that Grand Rounds provides a useful service but underscores that it's dealing with only a small piece of health-care costs, saying: “They're not going to fix everything.”

Lewiston hiring spree

In Lewiston, Grand Rounds is now up to 80 employees, out of 400 total in three offices.

By the end of the summer, it aims to be up to 100 in Maine's second-largest city as it hires nurses and doctors as well as non-clinical staff working in care coordination and medical records, according to Danielle Snow, Grand Rounds' senior vice president for patient care and a Lewiston native who spearheaded the Maine expansion. Among open positions in Lewiston currently advertised online are staff physicians and several care team staff jobs, including a bilingual English-Spanish care coordinator.

“We're actively hiring,” says Snow, who splits her time between San Francisco and Lewiston, where Grand Rounds has a modern open-plan office in The Bates Mill Complex in a space it keeps outgrowing—going from 10,000 to 24,000 square feet it expects to add to soon.

Room to grow was, in fact, a main reason for choosing that location where it worked with developer Tom Platz of Platz Associates to create a space with the same feel of its West Coast locations while preserving the architectural integrity of the revamped textile mill.

“They're a great company because they're growing,” says Platz, who believes that Lewiston won out over Portland and Biddeford mainly because it could guarantee an abundance of parking spaces.

Grand Rounds had, in fact, looked at cities up and down the East Coast before settling on Lewiston, which unlike Portland offered tax incentives as a Pine Tree Development Zone.

“It definitely was an important part of our consideration as we looked at the financials,” Snow said. “Lewiston was an area where the incentives were available to us, which made a difference.” The Bates Mill was also ideal as a place to start small and grow in phases, she adds.

Building a workforce

Despite the challenge of recruiting in a state with the oldest population and historically low unemployment, Grand Rounds has had no trouble hiring in Lewiston, through a combination of company transfers and new recruits.

“I've had amazing luck finding candidates,” says Meryl Fogg, a Yarmouth native who left J.P. Morgan in Chicago to head Grand Rounds' care operations in Lewiston. “There is a plethora of talent at health care centers, hospitals and training schools in the area, and we've been really pleased with the people we've hired. The work ethic is incredible, and their commitment to the mission of putting patients first is truly admirable.”

Among employees who've transferred from San Francisco, 30-year-old care coordinator Nyada Batieste took an immediate liking to Lewiston.

“I love the community,” she says. “When I first came here, everywhere I went there were fundraisers going on. You could definitely tell there's a deep-rooted community-activism vibe.”

Snow says that while further expansion depends on sales, the company is committed to Lewiston even if the Pine Tree incentive program is not extended. A bill to do that is held up in Augusta.

“We came to a place where we felt we could make a difference,” she says. “We feel like we're doing that.”