The Power of Pausing: Chandra Osborn on Health, Well-being, and Career Paths

[00:00:00] Joy Rios: Hey there, and welcome to the HIT Like a Girl podcast. My name is Joy Rios, the show's host, and we're here at HLTH, and I am so excited for today's guest. I am going to give you a moment to introduce yourself, Chandra.   

[00:00:22] Chandra Osborn: Thank you, Joy. I'm Chandra Osborne. I'm the Chief Behavioral Officer at AdhereHealth.

It's a pleasure to be here talking with you. I am a health psychologist, applied scientist. I've been in academia for many years is where I started my career as a scientist. And then I moved on to industry and I've been an executive at now three companies. I just joined AdhereHealth. as their chief behavioral officer in the last month. So really excited to be a part of that company.

[00:00:55] Joy Rios: And full disclosure to our audience. We've spoken before. This is our first time meeting in person, but we've had Chandra on the show three years ago. And so this is our second time talking, but first time meeting in person. So it's lovely to actually get to spend this time with you.

[00:01:11] Chandra Osborn: Likewise. It's a pleasure to meet you in person, Joy.

[00:01:14] Joy Rios: So one of the things I want to share, because you did just join this new healthcare organization. I want to talk about transitions. Because you have experienced some transitions, and I think that a lot of our audience would be, it's beneficial for people to know that you're not, that we take breaks, and our careers are not linear, and sometimes we have to pivot.

And so I would love if you don't mind sharing a little bit about the pivot that you have had because and not in all we don't need to know every single detail, but what is that like having a break in your professional career? A lot of people think that's a huge risk and it's a scary thing to do.

[00:01:52] Chandra Osborn: You're absolutely right. It was a huge risk. It was something I never anticipated that I would find myself in and it was completely necessary. So there are many people who I've connected with over recent years who have acknowledged the pandemic was tough. We all experienced strain in our home life, in our work life.

I found myself on the heels of the pandemic. Very burnt out professionally and made a conscious choice to put my career aside in early 2022. At the time, I was the chief behavioral officer of another company. And I thought, maybe I'll take three months and have a break. And at the time that thought, I thought three months will be feel like three years.

Who knows if I'll even last that long. And it was two and a half years. And it was a big transition time for me, but hugely beneficial in so many ways I never thought would be the case. And I'm so grateful that I had that time. It was a little bit of a sabbatical, but one that was so beneficial to the next phase of my career.

Because I do feel better and stronger and really excited for what the future holds. And I wish if anyone can do it, I wish that for them.

[00:03:18] Joy Rios: I agree. I think that sometimes it's hard to think about the idea that sometimes you have to slow down to speed up. And that doesn't feel like that, like, I think so many of us often just push ourselves to like, I'm just going to keep going.

And even though I don't feel my best, I'm just going to keep going. But actually we need a pause and to rethink and regroup and strategize. How do I mean to go on? And a lot of times I think we get lost a little bit, even though we're on a path. So I think it's very brave of you to have done it

[00:03:51] Chandra Osborn: Thank you. I think it's also relevant to the digital health community where it's a race and we are trying to stay relevant and current and we're trying to win. And that requires getting ahead and moving fast, but you can't do that at the expense of yourself. And I really wish people would put first and foremost, the investment in their own wellbeing so that we can innovate because the only way we're going to serve patients and populations well is if we're well ourselves.

[00:04:21] Joy Rios: It's huge. I also think that you are an expert in behavioral change. So that part of, I would love to hear you reflect on like changing your own behavior because that's essentially what you have done and then also how that impacts trying to change the behavior of the populations that you and your organization are working with.

[00:04:44] Chandra Osborn: Yes. Great question. As different stakeholders in healthcare, we have so many different types of people who are serving patients in a variety of ways. And by nature, we're helpers. We want to help others. And sometimes we put ourselves on the back burner. I made a conscious choice. During my career break to create a program for myself that would allow me to be my healthiest version.

And I was dedicated and disciplined to it. The interesting thing is when I reflect on one of my superpowers, I'm very achievement oriented. And so I struggled during my break, not feel like I was achieving anything, but I had to shift my mindset to realize that the achievement during that time was really being my best and I had never focused on me in my career.

I was always striving for the next thing, but sometimes at my own expense. So I will say focusing on my own needs and my own changes that I need to make was probably one of the biggest investments I've made in my career.

[00:05:56] Joy Rios: Well, a lot of what health care organizations are trying to do is to change people's behavior. And so how can you apply that or are you applying that methodology to your work now?

[00:06:07] Chandra Osborn: I am. What I can tell you is that throughout my career, I've been focused on engaging and promoting healthy behaviors in different types of populations, particularly hard to engage, difficult to reach populations who need it most.

Thankfully, in my role at AdhereHealth, that is the population that we serve. We work with Medicare Advantage plans, we work with dual eligible members, and we outreach to them to promote medication adherence. I've been focused on medication adherence for almost 25 years. I started my PhD in that space and I'm now it's coming full circle where I get to do that commercially.

And so I'm thrilled to be at the company where I can provide that expertise. I'm currently bringing behavioral science into how we outreach to our members, how we communicate, how we engage them, as well as bringing behavioral science into our platform and how it engages our clients. So our clients, which are plans, use our platform.

And so that's one way that we need to engage humans, but we also need to engage their members. And we also need to engage the marketplace through our marketing approaches and so I serve a little bit of a hybrid role where I'm able to use my skills to engage and activate people in all those different areas.

[00:07:38] Joy Rios: What is it that brought you to be passionate about and learn so much about medication adherence? I think that from 25 years ago, I get to be, you know, what I'm going to explore? How does that happen?  

[00:07:49] Chandra Osborn: So strange. At age 20, I decide to commit my career to this. And the reason why is because when I turned 20, I was diagnosed with a chronic health condition.

And I had to take a single medication twice a day. And I had the hardest time taking this medication because of its side effects and because I didn't physically feel that I had a problem that I, that required this medication. And so I was very non adherent. And I thought to myself, if I only have to take one medication twice a day, and I'm struggling.

I can only imagine people with more complex health conditions or multiple health conditions who have to take a lot of medications and are struggling with this in a more profound way. And so, I really wanted to help populations that are near and dear to my heart.

I'm half Samoan. We have high rates of diabetes and chronic health issues and are required to follow very rigorous treatment plans. And I wasn't doing it. And I know my relatives weren't doing it. And so I wanted to be a part of the solution.

[00:08:54] Joy Rios: Okay. So you shared with me, I'm going to guess, I think you have 82 first cousins. Can you have, has your work impacted them? Are you able to communicate with your own family to make a difference and make sure that if they are experiencing any chronic condition that they are adhering?

[00:09:16] Chandra Osborn: Yes. So I've had many side conversations with family over the years. In companies I've worked for previously, I've provided access to those solutions. When I worked for a digital therapeutic center, we had a global footprint and there were downloads in American Samoa, which is where my family originates from and I could not be more thrilled.

I wanted to do cartwheels when I saw that was the case. That was the reach that we were having. So having that come full circle is really important.

[00:09:49] Joy Rios: Well, I'm also curious about the methods in which, it's one thing to say, okay, we want them to adhere, but how? So how do we make it work?

[00:10:00] Chandra Osborn: So, there needs to be trust, and trust has been compromised with certain populations in the health care system. And so having a trusted person who's communicating it with empathy, who's building rapport, who's really open minded and asking questions. Not to blame, but to be curious to elicit an understanding of what's in the way and then being really a partner in problem solving, to be able to provide resources to overcome some of those barriers or also just helping to educate, provide skills.

It's building training to help motivate, provide different types of support, whether it's emotional support, instrumental support, to be able to provide what it is that patient needs.

[00:10:53] Joy Rios: So when I think about people who take a lot of medications, like the easy thing is the days of the week in those little pillboxes.

And that doesn't necessarily reflect what we're talking about. Things can get way more complicated than just saying, okay, here are the two pills that you need to take in the morning. Considering the level of complication, what are some of the solutions that help people manage all of that above and beyond talking to somebody? How does it actually happen?

[00:11:24] Chandra Osborn: For one, a lot of people are uneducated on why they need to take certain medications, how to take them, how to manage side effects. They may not be motivated to take them because they might have a relative who took them who, that says, you shouldn't take that. This is what happens to me.

And that's so social influence is so powerful. And so we have to combat that. There's also fatalism where people say, well, I was bound to get diabetes, so I don't, I'm not going to prioritize managing it because this is just what's meant for me. I'm going to see that played out. There's also cost. There's transportation issues to get your medications.

And these can, there's skills with remembering to take your medications, staying organized with your medications, a variety, a whole host of different things. And I like to categorize them into knowledge, barriers, motivation, barriers, behavioral skills, barriers, as well as social determinants of health barriers.

We tackle all of those things at your health. And so you really need to kind of look at it from here's the patient and all the different layers of influence that is impacting them and there's barriers at all those different levels. And to the extent that you can understand what those are and personalize the conversation so that you're addressing the most of those for each patient, you're going to increase the likelihood of success that way.

[00:12:50] Joy Rios: And then how do you track it over time? How do you track success? I guess it’s… 

[00:12:54] Chandra Osborn: So you can track it and in different ways. My scientist hat would say using multiple measures of medication adherence, both subjective and objective. At AdhereHealth, we look at PDC. So we're looking at refills, making sure that these members are picking up their medications and that there's no gaps.

And we try to help them with that by setting mail order, automated refills, different types of things like that.

[00:13:22] Joy Rios: Okay. What about if you're not wearing your scientific hat?

[00:13:25] Chandra Osborn: If I’m not wearing my scientific hat, I would say that It's I can't wait not wear my scientific hat. It's really a part of my DNA for better or worse. It's sort of been consistently demonstrated in the evidence that the that measuring adherence is complex. If you just look at refills you're missing dosing adherence if you're looking at just self report.

There's limitations to that. So to get the fullest picture of whether or not a patient or a member is taking their medication, you really have to try to get at it from different perspectives.  

[00:14:05] Joy Rios: Okay. Thank you. Now, I want to ask, not only what are you looking forward to as you re enter back into your career, but more importantly, how do you plan to continue taking care of yourself on this iteration?

[00:14:23] Chandra Osborn: Yeah, so I am looking forward to reconnecting with people who I have not seen and been with in a really long time, which health is key. providing a fantastic avenue for that. I am looking forward to being a part of the solution again. Over the past several years, I've lost a lot of family members and colleagues and friends to chronic health conditions that medication adherence is really a solution for.

And so I'm excited to get off the bench and honor them by being a part of the solution again. I'm also an innovator and have loved integrating behavioral science with other disciplines such as AI technology, clinical expertise, and I'm thrilled to be at that crossroad again to push the boundary of what we can do with behavioral science.

And in terms of taking care of myself, I have changed tremendously during my career break, and I feel it in how I show up, in how I interact with colleagues at my company and how I'm interacting with folks here at the meeting and I'm motivated and energized by that and so maintaining that is a huge priority for me and I'm excited to fold that into my recipe for success going forward and make sure that gets the attention that it deserves.

[00:15:55] Joy Rios: Well, I think that you have learned. Are there any, is there a way that you can transfer that knowledge? Because it's one thing to learn how to set boundaries, but then to maintain those boundaries, and I know this from experience, it's just you have to practice, it's a practice, and you have to do it over and over again.

Is there any advice for you have, that you might have for others who might be experiencing a level of burnout that they could use to either create or keep boundaries?

[00:16:23] Chandra Osborn: Yeah, my advice would be to take time, even if it's a week off or two weeks off, to protect yourself and invest in that time strategically to be able to fully understand, not just reset, but to restore and repair so that when you come out onto the other side, you really feel confident and capable of taking care of yourself.

I think what often happens in the healthcare industry is people tend to abandon themselves in service of others. But the only way we can effectively serve the populations we care about is to also preserve who we are in that effort. And I think that it will feed itself. Once you start to begin to make that investment,

[00:17:15] Joy Rios: I learned about a new idea recently that I'm trying to adopt and share as much as possible upward spirals of goodness. You hear, oh, there's a downward spiral and it's like all down from there. But I would like to experience and share with others and sort of ignite, for all of us, upward spirals of goodness.

Hopefully that starts with taking care of ourselves so that you can do that. Calls to action. Do you have any that you would like if people would like to get involved? Or is it possible for anybody to get involved in your work?

[00:17:56] Chandra Osborn: Great question. I love partnering with others and have done that historically in my scientific career in academia, but also in industry. I love strategic partnerships, research partnerships. Learning from others and building bridges and connecting to do better together is hugely beneficial for both companies, both entities, but also the patients that we serve.

So I am absolutely open to doing more. Fielding connections, meeting people and exploring opportunities.

[00:18:31] Joy Rios: And if people wanted to support you on your journey, how would they do so? Or how would they connect with you to do so?

[00:18:37] Chandra Osborn: Well, they can find me on LinkedIn. I'm on the socials. They can also find me at adherethealth.com.

[00:18:45] Joy Rios: Wonderful. Thank you so much for this time together. Appreciate it.

Thanks for listening. You can learn more about us or this guest by going to our website or visiting us on any of the socials with the handle HIT Like a Girl pod. Thanks again. See you soon.

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I'm the show's host, Joy Rios, and I'll see you next time.