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Outcomes Rocket Podcast -Learn What it Takes to Influence Behaviors and Improve Health with Olga Elizarova, a Senior Behavior Change Analyst at Mad*Pow

Learn What it Takes to Influence Behaviors and Improve Health with Olga Elizarova, a Senior Behavior Change Analyst at Mad*Pow

: [00:00:01] Welcome to the Outcomes Rocket podcast where we inspire collaborative thinking, improved outcomes and business success with today's most successful and inspiring healthcare leaders and influencers. And now your host, Saul Marquez

Saul Marquez: [00:00:19] Outcomes rocket listeners, welcome back once again to the outcomes rocket where we chat with today's most inspiring and successful health care leaders. Thank you so much for tuning into the podcast today if you like what you hear or you just love the show in general, go to and leave us an Apple podcast review and rating. We'd love to hear from our listeners and can't wait to hear what you have to think as well. I want to introduce my outstanding guest today. Her name is Olga Elizarova. She's a senior behavior change agent at MAD Pao. Over there, they're doing some research strategy and design of digital experiences and health and behavior change intervention. Obviously we all know behavior change is crucial to improving health care outcomes and they do it through user experience design process. From research strategy through design. Olga's got some really cool experience here so what I want to do is open up the mike so she could fill in any of the gaps in the intro. Olga, welcome to the podcast.

Olga Elizarova: [00:01:21] Thanks for having me. It's great to be here. And I'm very excited about the interview. So just to add some information to what you already mentioned I work at Mad Pow The senior MBA or change agent. All the analysts I work on the team of change designers we collaborate with strategists and content people researchers. It's pretty exciting job and we have a lot of interesting projects but some of the side projects that I'm involved with involve social impact work and we work with different organizations such as way to well they'll help them in different underserved communities to cultivate their resilience and creativity. Disregarding the socioeconomic status and access to resources and opportunities and with some of my friends we volunteer and we coordinate volunteer projects through which we partner with those communities on bringing human centered design to the places that need it most.

Saul Marquez: [00:02:18] I think that's so great. Olga and you know just focusing on the people that need health care the most you know population health is so crucial to the overall wellness of people our economy. I mean it's just pervasive. So I think it's so cool that you guys are doing that even on your time off.

Olga Elizarova: [00:02:34] Yes. Slowly and it's definitely a passion of ours and we are trying to discover the ways that we can make designing for the underserved communities collaborative and financially sustainable. And also always constantly exploring academically and practically how we can design interventions to address the root causes of recurring public problems not just the symptoms because that is actually one of the patterns that we saw a lot in the last year and also before adjusting the work that we do that some of the companies and organizations are just very focused on fix and the symptoms and are not going deep into the understanding of the problem space and trying to parse out what are the root causes and why these problems are in a cure especially if we're thinking about people who have less resources and less opportunities.

Saul Marquez: [00:03:24] Yeah. We spend a lot of time focused on the symptoms. And I think it's true within the walls of the hospital is true within communities. And I know that you guys are very focused on getting to the root cause. And speaking of root causes Olga. What is that root cause that got you into health care.

Olga Elizarova: [00:03:41] Sure. So I went for a step into the medical sector was driven by my curiosity and I thought wow isn't that going to be cool to go to medical schools spend six years there studying pretty much yourself. It's going to be amazing. The whole of my anatomy that to me all of the physiology and that's exciting because if I'm ever going to forget anything I can always look it up and I can always think about something because it's you. You are. That's right. Other people like me and I think that human bodies are the most complex and interesting subject for research. So there are many unanswered questions worth exploring but curiosity is also something that in general allowed me to get to where I am right now meet incredible people who taught me everything that I know and helped me not to be afraid of change and new things. And I saved my career from being a dentist when I was 21 to become in a project we had on a ten year long federal project in Russia designing the environmental services for people with disabilities. And when I started my work there when there were jobs job my first big project was designing the environmental services for people with disabilities that never ever happened before it was brand new for while. It was 2012. The director of our department was just getting started on this project. He was looking at examples in other countries how we can train this how we can get support from other ministries from finance from transportation from social development from healthcare. So all the aspects that would be important to make sure that the services and the products are adjusted for people with disabilities. And there were things that I have never thought of before that actually happen and were not adjusted. So we have the team 12 people I was responsible for strategic planning and evaluation of the pilot projects and three federal subjects which are pretty much like states and states and their regions. Okay gotcha. And they Insight's learned from those three pilots in those three subjects will be applied will be used then to implement this project. Nationwide's to the whole country. Eighty five different states and it was incredible and challenging to learn how different that level of work. Working at the level of the country would be different from working seeing patients daily just 1 on 1 you and the patient and that actually helped me to understand all the gaps in all the things that I did not know and things that they don't teach them at school. They don't tell you that there is such a thing as epidemiology or statistics or it is very important to look at some aspects of intervention design and how would you even design and instrumentation at such scale. And so I get into public health and I went to Brown. I started my public health fast there and then I met Mad Pow and then the conference together factors and that this company human centered design agency and I started as the original analyst and designer and at my current company I'm focusing on design and change interventions primarily in the health care fields and in my three years at the company and worked on so many different projects starting from mental health to healthy lifestyle and wellness to smoking cessation. And it's incredible to have an opportunity to work so closely with patients providers health insurers other stakeholders communities as a dentist or a public health professional. I would have never been able to see the problems from those Birju perspective and understand them at a system level because there's clearly a difference between individual level and systemic problems that we are interested in and then looking at the solutions on how systemic solutions would be fundamentally different than the individual ones.

Saul Marquez: [00:07:44] Wow that is quite the journey. And you went from med school to dentistry to public servant and dealing in Russia all these these really interesting things. I think it's so cool that the Russian government is investing in their country that way. I feel like over here in the U.S. we do a really good job but we've got to do a little bit better for the public sector and investments such as the ones that you are involved with. I would say listeners if you're in policy if you're in the government and encouragement to take a little tidbit from Olga's story and what the Russian people are up to. Why don't we learn from them. And why don't we take a little bit of of action in terms of helping our public services out to the extent that they have over there. Although I think that's so cool and now you fast forward to today working over there at Mad pow dust Dustin I think for for the intro there was fun to connect with him at Health 2.0. I mean you guys are really doing some cool things in the realm of behavior change. How do you get people to change behaviors. What is the message that you would give to health care leaders on how this should be done.

Olga Elizarova: [00:08:54] Absolutely. So as you said I work in the design agency. We have a lot of exciting interesting projects that also means that we're exposed to multiple problems coming from different industries and sectors. It's not just healthcare. And though the sectors are different it is not hard to see a repeat in patterns. As one of those patterns is that we work to sew complex problems systemic problems that are intertwined with elements and touch points both inside and outside of the sector and the change and evaluations are two things that I believe are going together and a very important and critical to success or success of healthcare as an industry and the success of the work that we do overall. And let me explain because for those of you who might not know what behavior change is this wanted to give a brief kind of overview and definition of what it is behavior change as we see it from our perspective the work in intervention design and it is a set of processes and activities that are used to design an intervention whether it's a product or service that aims to change a defined and modifiable behavior. So those are two key words for us. We want to make sure that we are able to define and make sure that it's very granular. What exactly do you want to change. And we also are looking at the evidence and looking at the research that was before doing our own primary research with target audience and trying to understand how modifiable this behavior is at all because we don't want to be investing in just solutions or different products that are created with very little expectation of this behavior to be changed at all. And so behavioral a change in direction design process is something that thrives on the intersection of behavioral and social science motivational psychology, Data Science, human computer interaction and design and it gets all this little bits and pieces from each of those sectors and many others that I didn't mention and then it combines them together with one object with one goal to understand the behavior and system interactions and context and implement human centered solutions addressing this behaviors and the value of their facts the impact that we're making.

Saul Marquez: [00:11:11] Olga you just drop so many valuable things here further listeners really appreciate your thoughtful answer. And you know the thing that stuck out to me and listeners that you should think about is definable. You've got to set yourself up to success. And is it modifiable. Because if you're going to be pouring a bunch of resources and time into a problem make sure you have that problem well defined. I know this may seem elementary but so many times people don't do it. I've been guilty of it too.

Olga Elizarova: [00:11:44] I agree with CNN many many many times it's not something uncommon that happens. But the key here is for us as consultants as people who are subject matter acts words and behavioral change is to guide our clients to guide people we work with through the process of defining what is the problem space which specific behavior you want to change and would specific business objectives. Do you have what health outcomes you want to change. What are your expectations. What is your timeline defining all the long term outcomes that we are aiming to change all that short term outcomes. All the intermediate variables that we might be able to measure earlier because we lie want to reduce the costs of your visits but we are going to have to wait four years in order to be able to measure that whether if we are going to look at some intermediate variables like people's knowledge or attitudes or beliefs and behavioral determinants we might be able to measure them way earlier than something that is long term.

Saul Marquez: [00:12:50] Olga you work on a lot of projects and you've seen behavior change in healthcare and in other industries. Can you give an example to the listeners of some a setback that happen and maybe what you learn from it.

Olga Elizarova: [00:13:04] So something that didn't quite go right, right?.

Saul Marquez: [00:13:07] Yeah.

Olga Elizarova: [00:13:08] Sure I think that in my experience and again don't want to be very don't want to be very negative about this. But I personally don't really I'm not a big fan. I don't really like the projects where people come to us and tell us what kind of deliverable they want to see and they and I know they're all different kinds of restrictions and limitations and we are all having different organizational structures that bound us to a certain kind of work and responsibilities and project types that want to be doing. Let's say if we work with a digital department of any organization a new large insurance or pharmaceutical company and it says that it's in the name digital department we kind of expect that they're going to ask us for some digital product. But the idea is we shouldn't be doing it that way it's doing the work backwards if someone comes to us and asks us could you design a digital product to solve this problem. This is not the right direction to go the way we should be going is going backwards from research from talking to people trying to understand their needs trying to understand what are their problems what kind of gaps they have what are the opportunities that we can use and how does it fit in their context of their lives holistically and how does it fit in the context of health industry and where we can really provide value. And I think the best example that I could think of of explaining that if we are a pharmaceutical company and let's say we're looking into developing a new medication we are not sitting there in our first kickoff meeting and thinking and brainstorming. Should it be an injection or should it be a pill or should it be the bandaid or whatever. Like We are not brainstorming the vehicle the vehicle yet we are deciding after we chose which is the right molecule and which is the active ingredient. Then we're thinking okay which mode of delivery which vehicle would allow us to deliver the most of this ingredient people without loss of this active component.

Saul Marquez: [00:15:13] Yeah you know and it's like you can't use a hammer for everything. So you got to sit back think through the problem and that hammers not always gonna be that solution. Sometimes you may just need a knife or a towel or a fork anything. Yeah exactly. Love it. And I think that's a good way to think about it you know. So the question is listeners have you been trying to solve a problem and the way you approach it. Have you been just trying to solve it with some sort of vehicle think outside that one vehicle that you're approaching it with and ask those fundamental questions about what you're trying to achieve how you're trying to change it and then apply the vehicle. I mean that's a great note there. Olga Kay thank you for sharing that. So OK. Share with us a point that was so exciting so amazing. A proud medical leadership moment.

Olga Elizarova: [00:16:05] Oh OK so there's going to be a difficult one. I don't have such an little internet or I think this moment is coming out sometime soon hopefully. But I admit that I'm very grateful and honored every time I'm being invited to Joe's hackathon so bootcamps and provide feedback just start ups and entrepreneurs because it's just such a rewarding moment and it makes me feel very happy to know that my experience in the field and feedback that I'm given to those teams can actually help them further improve their products or services and ultimately with the work that they do improve health outcomes. So that would be my proudest moments. Every time I'm on the panel helping to facilitate some process boot camp hackathon or just doing a 101 coaching for start ups. That is something that makes me feel very happy and I hope it's very helpful for them as well.

Saul Marquez: [00:17:00] I love it, Olga. I'm sure it is. And so if you have a hackathon coming up or if you're a startup that wants some expert advice we'll give you a chance to have Olga's best way to contact Olga here at the end of the show so that you could tap into her passions and she can help you make your business more successful and improve outcomes. Olga tell us a little bit about an exciting project or focus that you have today.

Olga Elizarova: [00:17:26] Absolutely, love to. So there are two projects that I want to talk about. One of the projects that I'm most proud of is a project where we worked really closely with patients who have an autoimmune disease clinicians and a client to design a patient centered solution tool that would help to address their unmet needs and hopefully will make their life a little bit more positive and easier. And we aim to create a motivational and empowering experience and address some of the things that doctors currently might not be addressing because they don't have time for it or they just not sure how to better address it or whether they have the right access to some emotional aspects of the problem. And it was just so heartwarming to hear the feedback from people during the tests of the application. So it was the mobile app and we did the first usability testing and the results of this test were the positive feedback from people sharing how this is really very different from everything else that is out there how this is very supporting and empowering all the different design criteria that we have identified for us that we want to make sure that this tool is hitting on scored really high on all of them. So that made me feel very happy because we were working on this project for almost a year and it's going to be launched in January 2018 and signed. Yeah it is very exciting. And the credit Arwed is that we were able to be on this project from the very beginning which means your view of the evidence. Guidelines looking at what actually could help. So just reviewing the evidence like no design yet no prototypes like would make sense to integrate what makes sense to put in this tool and then tested it with patients and code design and asking clinicians for their input and testing that again. So it was just such a great workflow and creative process. And the second project that I recall of the second project that are really like is our imagine care which was done together with Dartmouth Hitchcock and Dartmouth Hitchcock is a leader in population health management. The work that they wanted to do as accountable caring innovation was very much focused on how can we keep patients out of the hospital this is exciting isn't it. We help patients to avoid being in the hospital in the first place. So they wanted to create this remote patient monitoring system that is going to have both patient centered interface and clinician centered interface. And we were involved in building this tool as well. I was a mobile and web application that supports this virus and it disrupts the healthcare as we know it. It is having all those different components the blood pressure Kov Kales the wearable devices they're all wirelessly connected to the application that has the complicated algorithm developed to code developed together with clinicians that allows us to notice when a patient starts trending that and send the alert early on and it has a really interesting aspect of algorithm when it's going to go to the nurse versus when it's going to go to the child but or a system that has said it will then some problems there and there were some really good results for this project as well.

Saul Marquez: [00:20:52] Well you're definitely up to some really amazing things. Oh that's exciting. You know on the two fronts you know the remote monitoring system and also your project for the mobile device for the immune disease. I think it's such interesting projects that you have I'm excited to keep up with them so you'll have to send me the links to those companies I'd love to learn more. Let's pretend you and I. Oh thank you so much. So Olga you and I are going to build a medical leadership course right here. It's a syllabus it's 101 or the ABCs of Olga and so I'm going to give you four questions lightning round style and then we're going to finish up with a book for the listeners. You ready. That's awesome. All right. What's the best way to improve healthcare outcomes.

Olga Elizarova: [00:21:37] The best way to improve healthcare outcomes surprise cert measuring them. Now you know said the best technique ever. We have two types process evaluation and impact were fact evaluation. I think that as soon as companies and organizations are going to start measuring things create and benchmark baselines and actually evaluating both the process and the impact then the final outcomes we're going to move towards improvements in the healthcare outcomes.

Saul Marquez: [00:22:09] Awesome. What is the biggest mistake or pitfall to avoid.

Olga Elizarova: [00:22:13] In healthcare and in life for confidence. I think that that is probably one of the biggest mistake to be made when you were sure that you know everything and you're making assumptions and I don't think there ever ever are stupid questions to ask and people should be asking more questions. They should be checking their assumptions and making sure that they are not being too confident and not jumping into conclusions too fast.

Saul Marquez: [00:22:41] I love that. How do you stay relevant as an organization despite constant change.

Olga Elizarova: [00:22:46] We as an organization are learning all the time we're learning from our clients. This is the most exciting part but we're cannot match. It is that every next project that we work on is different from the previous one and that I think is what allows us to stay relevant. As an organization we are very collaborative. We are working with our clients in a way that allows us to provide the expertise and best knowledge and the best practices to them but also learn from them and learn about the different problems in the industry and learn about the different ways that people and organizations are approaching them so definitely more work and great clients. I still think that allows us to stay relevant.

Saul Marquez: [00:23:30] And finally what's one area of focus that should drive everything else in the organization.

Olga Elizarova: [00:23:35] Collaboration between different teams. I think that there is never enough of that. There is never enough of this like collaborative spirit of having this entrepreneurs in the company and giving people the opportunity to work on passion projects giving them the opportunity to collaborate across disciplines and working with different departments so we were lucky that at all we have an opportunity to do that. So if I want to work with our development team I can do it and I can go and ask Graham when they're going to be excited work and some project with me. So I think that that should be something that should be implemented in many organizations allowing people to explore their passion and work with other teams.

Saul Marquez: [00:24:23] Awesome and Olga what book would you add to the syllabus here for the listeners.

Olga Elizarova: [00:24:28] I mean I can add two books.

Saul Marquez: [00:24:29] And you can add two books.

Olga Elizarova: [00:24:30] That's great. OK. So I think that first line is going to be a Richard Dawkins Selfish Gene that no one else had mentioned that you know and.

Saul Marquez: [00:24:39] That's the first and I have to take a look at that one.

Olga Elizarova: [00:24:42] Yeah it's a great book. It's talking about genes centered view of the evolution which is just a very different perspective and quite interesting for anyone where it can be changed. And I like all the examples that the author promotes in the book with mostly animals and insects but it makes you think about what is the role of genes and behavior and how much they are responsible for the things that we do in our life. So that is a very interesting one. And the second one that I'm finished in right now is how emotional made the secret life of the brain by Liz Feldman Barrett article is also a very interesting book for everyone working in behavior change but in general for people because aren't interested in how emotions energy absolutely insane insane. How do you fall in love while you're happy. What are the things that drive you crazy. Why do they drive you crazy. Is it vain that is very intrinsic. Or is it something that just happens to you like the classic theory says I'm just responding to the outside triggers and this is how emotions are made. Or is it something that the book is are gay. Is it something that is being constructed by your brain. So I would definitely recommend.

Saul Marquez: [00:25:57] But I love it. And listeners you have it. You got some great books. Some great takeaways to think about. Don't worry about writing any of this down go to outcomesrocket.healthdot/Olga. O L G A and you'll see all the show notes as well as the links to the books and mad pow and all the things that oboes up to. You'll see it in the show. So check that out Olga, before we conclude can you just share one closing thought and then the best place where the listeners can get ahold of you.

Olga Elizarova: [00:26:25] Sure. The last thought I wanted to leave the listeners with is that if you work in the health care you should be thinking about it differently than any other industry. I realize that it is and that it creates a range of business opportunities to pursue. But healthcare is truly different from retail or any other business. Stakes are high. Decisions are made very fast. You risk losing and everything and incentives are misaligned to the very basic level since what people want is health. And would some companies and organizations ones are producing health care and we shouldn't be thinking that poking people digitally through another health and wellness app on the App Store without understanding what exactly you were doing and how it works can be harmful. It can harm people emotionally physically financially and that's why it matters to everyone sitting in the room and listening to this podcast and in the end of the day don't forget that it's not about winning. It is about health and you can get in touch with me through that website. so happy to get insights and answer any questions you might have

Saul Marquez: [00:27:38] Awesome, Olga. A powerful ending message there and really really appreciate you taking the time to be on the show.

Olga Elizarova: [00:27:43] Absolutely. Thank you for having me.

: [00:27:49] Thanks for listening to the Outcomes Rocket podcast. Be sure to visit us on the web at for the show notes, resources, inspiration, and so much more.

Recommended Book/s:

The Selfish Gene

The Best Way To Contact Olga:

Mentioned Link/s:

Episode Sponsors:

Healthcare Podcast

Outcomes Rocket Podcast -Learn What it Takes to Influence Behaviors and Improve Health with Olga Elizarova, a Senior Behavior Change Analyst at Mad*Pow

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Outcomes Rocket Podcast - How to Build a Flexible Culture in Health without Compromising Values with Drex DeFord, Indie Healthcare IT Consultant

How to Build a Flexible Culture in Health without Compromising Values with Drex DeFord, Indie Healthcare IT Consultant

: [00:00:01] Welcome to the Outcomes Rocket podcast where we inspire collaborative thinking, improved outcomes and business success with today's most successful and inspiring healthcare leaders and influencers. And now your host, Saul Marquez

Saul Marquez: [00:00:18] Outcomes rocket listeners, welcome back once again to the outcomes rocket where we chat with today's most inspiring and successful health care leaders really want to thank you for tuning in again. And hey if you like what you hear today or in general I want to ask you to just give us a rating and review on Apple podcasts. Just go to and you'll be able to rate and review the show and give us some feedback. And even if you don't like it which I'm sure that won't happen with today's guest, let us know and we'll make sure that we make it better. We want to make sure that the show adds value to you so please and thank you. Without further ado, I want to introduce our outstanding guests. His name is Drex DeFord. He's an independent healthcare I.T. consultant. But he has a long list of achievements in health care. He's been the chief information officer at various institutions including Seattle Childrens at Scripps Health and a long list of other things that he's done even in the Air Force. So what I want to do is just open up the microphone to Drex and have them around out that introduction Drex. Welcome to the podcast.

Drex DeFord: [00:01:35] Saul, I'm glad to be here. Thanks for having me.

Saul Marquez: [00:01:38] Absolutely. It's a pleasure to have you.

Drex DeFord: [00:01:39] To tell you a little bit about myself. Yes sure I'll try to do the short version as much as I possibly can. I'm a farm kid from Indiana didn't have money to go to college wanting of joining the Air Force as an enlisted guy went to school as I finished my degree and sort of wound up weirdly in the right place at the right time became a CIO at a small hospital in one of our regions and one of our medical centers was the chief technology officer for Air Force Health in DC for worldwide operations before I retired after an accidental sort of 20 year career. And then who was recruited to Seattle Children's. No sorry scripts health see there's so many of these things I can't even describe. But I went to scripts and was there for a few years. We recruited to Seattle to be the CIO both the hospital and the Research Institute and Steward Health Care in Boston and I did start up with a friend of mine and about two and a half years ago my own shingle and have been lucky enough to be able to work on the things I really want to work on and that I'm good at and not work on the things that I don't want to work on and I'm not good at it. So it's been fun. I'm really very very lucky.

Saul Marquez: [00:02:51] Now that's great Drex I know had an opportunity. Folks I had an opportunity to meet Drex at a health I.T. meeting and struck up a conversation and I was just really moved by some of the thoughts and things that Drex was doing and I just said Drex you have to be on the show the listeners will get a lot from having you on. So I'm really glad we were able to put it together Drex. What would you say a hot topic you feel should be on every medical leaders agenda. And how are you addressing it with your clients.

Drex DeFord: [00:03:22] Hot Topic. Well you know I'm lucky enough now I do get to speak to a lot of conferences and do some some things like that. And when I do that when I engage with any of my clients or really talk about building an organization culture that kind of has the ability to bend and flex and change and be innovative you know ultimately building an organization that can take advantage of and thrive in the new model of health care. Because I see a healthcare storm moving from feet per service to value based care and that's going to happen without a doubt. We have healthcare organizations certainly that are stuck in the peak or service side of the fence and they've built a whole culture around this model and they're taking their sweet time making a change. Not only did it really change. Because it's not fun but you know in my opinion it's time to embrace the stuck. You know as we say in the military. Change means figuring out what what's going to work and what will work what won't work. You're not going to do that overnight. This new model. So I'm always a big proponent of sort of started now build a culture that allows for failure and enter iteration learning fast and taking advantage of the opportunities that are ultimately going to reveal themselves during and after the storm because I think when the storm is over there's going to be a lot of fire sales. And I can almost guarantee you that you're not going to want to be on the wrong side of that MNA. So yeah I think cultural changes being flexible that's kind of a key to the operation.

Saul Marquez: [00:04:54] Drex, I think that's such a great highlight there and I've been a part of great cultures and I've also been a part of not so great work cultures for the leaders listening to your words of wisdom here what would you say in a nutshell is the key to creating an agile amazing culture.

Drex DeFord: [00:05:12] That there's really a bunch of things that go into this. I also one of the things I well it really is this idea that everything is connected everything else. And so trying to change one thing and thinking that if I just do this one thing then everything else is going to fall into place may not be true. But there are things that if you focus on I think you can be more successful and that's really things like relentless prioritization. Right. We have a hundred things going on in any health care organization or vendor or startup or VC firm today. You know there's a hundred things going on and you have to focus. You have to prioritize and that means that sometimes the things that are below the line the things you choose not to prioritize or focus on that doesn't mean those things are bad ideas or things they shouldn't do. It's just that you have to realize that you only have so much energy and you have to focus on the things you focus on. I think for health systems a lot of it is to drive driving hard on analytics and continuing to focus on security because we're definitely in that world now where you just can't afford to have that kind of a stumble or that kind of a problem. So you have to focus on security and then innovation is a big part of it. And innovation is one of those words that means almost anything that anybody wants it to mean. So for me a lot of the innovation is I have a big background in Toyota production systems and lean methodologies. Know again to be at Seattle Children's very organizations very sort of focused on that with three and half years in Japan. I was able to go back and spend time with Yamaha piano and Toyota and others direct mostly on home care. I might be.

Saul Marquez: [00:06:54] How many times did you make it to the White House.

Drex DeFord: [00:06:58] Only once and only as a tourist.

Saul Marquez: [00:07:01] Ok all right. All right.

Drex DeFord: [00:07:03] Yeah but it's it's that kind of stuff. You know there are a lot of components in this that you know and I would say the bottom line probably of all of this is that you have to re orient your organization as much as anything else to focus on the patient. There are a lot of health variations you talk about that today the patient is our customer but saying the patient is your customer and actually acting like a patient is your customer all the time is a huge difference.

Saul Marquez: [00:07:29] That's a great callout directs be a call out. And I think for everybody listening you know what are you doing to make your patient your customer. And I think right now Drex in this health care consumer is a magnificent word. But you know rising deductibles the patient is starting to be more cognisant of where they spend their money and what they spend their money for. And I think it's this is pushing our our healthcare providers to be a little more cognizant of tailoring their services in a way that makes the patient the consumer.

Drex DeFord: [00:08:03] Oh yeah I think so too. And I think the other thing is and we may talk about this more in just a little bit but this idea that especially from information service departments perspective the customer is not the doctor or the nurse or lab of radiology or pharmacy or whatever the case may be. Those pieces of the organization and the AS Department have to be partners in the provision of great care to our customers the patients and family and that every place that I've gone into when I've brought that attitude to the organization. And so. So I'm I'm I'm kind of a change guy I mean a been a change guy my whole career. Unfortunately that replaced that I've been invited into as chief information officer has been specifically to make change. Things weren't going well and that's why the position was open. You know that's why I was hired. And so when you come into it with that you're really sort of changed the whole game for everybody right. Doctors and nurses and lab rat and everyone else start to understand that you're not there to win they say jump say how high. You're there to win they say jump say well let's talk about jump and what that means and what he will do. And you know I want to make sure I have your back in all of this and building that partnership make and make all the difference in the world.

Saul Marquez: [00:09:24] That's a great point. Direct you know you've had a really fruitful career and through the abs and flows you've taken some opportunities to turn around bad situations. Can you give the listeners an example of what you did in one particular situation that helped improve outcomes or helped turn the ship in the right direction.

Saul Marquez: [00:09:45] Sure I spend a lot of time but I spend some time thinking about mistakes that I've made and there's a bunch of them right. I mean I don't think you get to do all the different stuff that I've been able to do. And hopefully as well as I've been able to do it without sort of sometimes falling down and. But the important part of that is really getting back up right. So the problem is easily making a mistake easily usually recognizing that there's been a mistake and then admitting it and doing something about it. So you know there was one that I was I really sort of pull out here and talk about kind of tied to the last part of the conversation it was 2008 probably not long after I arrived at Seattle Children's. We had this really tragic patient incident that led to an accident an accidental medication overdose for a patient and the nurse had made a calculation error. And you know the patient was very sick anyway. And all of this sort of combined together to cause the patient passed away and everyone was crushed. I mean the family of course that the family first and foremost. But when it came to the hospital everyone in the hospital family was also crushed after this had happened and the nurse especially and I don't think people really understand until they were through it when a clinician makes an unintentional error and harms the patient they carry that with them for the rest of their lives is really a terrible burden. And so that children as we brought everybody into the auditorium and it was kind of one group after another for several days in a row and at every different shift and we asked the really simple question What can we do keep this from ever happening again. And we got lots of different responses all sorts of feedback on the way that the system and I don't mean the computer system I mean the capitalist system was broken or had a problem. And for my part as a CIO I kept hearing about how I was looking for consistent patterns places where maybe we were making a mistake or there was there was a challenge and a lot of it was run slow currencies and logging on to computers and sometimes I just go by what I remember because it's hard to get PCs to boot up sometimes takes a long time and all of that very generalizable complaint. And I realized through all that and this is really the lesson mistake that I had made for much of my career going back to this idea that information service shops and healthcare organizations are just a service and support department. And as I said earlier we're way more than that. We're partners with our clinicians in the delivery of great care to our patients and families. We're not something separate seriously I think we are part of the delivery care team and rightfully so. Our teammates expect us to have their backs when the going gets tough and if we do this right they'll have our back too. And so back to the Seattle Children's Story. Slow PCs were impacting patient care and patient safety. They were really just sort of another clinician obstacle to getting the right thing done for the patients and family so I decided that what we have to get out of the PC business which sounded like a ridiculous idea but we've been doing a virtual desktop infrastructure pilot inside that apartment. This was 2009 so hardly anybody was really doing health healthcare. And I said as my CTO job in the name of West right now the CTO etc. and I said Dude we have to get out of the PC business somehow. And so we did. It was a massive effort. We had the backing of the CEO. We had partnerships with a lot of great companies like Citrix anextra hop. We pulled almost all the PCs out of production and replaced with 0 clients in virtual desktops kind of follow clinicians around everywhere that they when they booted up in just a few seconds they didn't take their desks. I mean literally just virtually take their desktop home with them and run them on their own PCs or their own Macs at home. And it went a long way toward convincing everyone on the team that the highest department was a partner in their provision of great care to our patients and families not just a service providers. So every piece of work that I do now with CEOs and vendors and startups and investors now includes that very simple point that you made earlier how is what you did adding to the value a larger team. How's it making care delivery now better faster simpler safer easier access patients and families. Our customers and the other part of that is how are you being the kind of partner that everybody wants on their teams. It's got to be part of it. So yeah mistakes as they say mistakes have made a few. But it's kind of how do you how do you recover from those when they happen.

Saul Marquez: [00:14:15] Drex, that's such an amazing story. And you know it sounds like you guys definitely shifted in a big way. You didn't just take an incremental step here you shifted in a big way that was thoughtful. You didn't just innovate you listened which is the number one thing that I think led to you guys making an impact that actually mattered. You listened and I really admired that about you even when we were at the conference I mean you are such a great listener and so you took that and you applied it at mass scale and you got out of the PC business and made it so much easier you became a partner instead of getting in the way of clinician's and I think that's so cool. Thank you for sharing that.

Drex DeFord: [00:15:00] Yeah sure no problem no I think the listening you know listening is a key part of it. It would be easy for me to say I'm working on a book with a friend but I'm working on the very early stages of sort of scratching our head about how would we write a book about yes but listening as a part of the concept of empathy as a leader and as a teammate is a huge deal. Empathy is in many ways empathy is just the key to everything. You have to whether it's your enemy or it's one of your teammates you have to understand where they're coming from and what they think and what they need. If you get that then you're way more likely to put together a plan whatever it is. And I am really lucky to see Seattle Childrens was kind of a big evolutionary change maybe not evolutionary maybe intentionally innovative change to bring better service to my teammates and ultimately to the patients and families. But most of the time those mistakes and those changes are little tiny iterative innovations that make things just a little bit better maybe almost unnoticeable. But the ideas that they build that culture that sort of continues to promote that. So can we make mistakes. We'll figure it out and we'll go from there and everything that we're doing we're not doing perfectly. There are mistakes built into it. Our goal in life should be to find those mistakes and make them less of a mistake or eliminate them in the process. And again if you can do that with empathy in mind you are much more likely to be successful.

Saul Marquez: [00:16:41] That's a great message Drax and you know I think I'm excited for this book when it comes out. Let us know any better.

Drex DeFord: [00:16:48] We'll see if that ever actually turns into a book but it may turn into a series of blog posts or I'm not sure exactly what's going to happen.

Saul Marquez: [00:16:55] Which would be cool too and a little bit later here we'll be able to share your website with the listeners so that they could tap into some of the blog posts that you do. Drex is definitely an amazing contributor not only to his clients but also to the health space as a thought leader. So definitely make sure to check out his info here. We'll provide it to you soon. Drex, not to get in the weeds but you know we had some changes recently with the executive order of Trump. Now what are your thoughts on all of that. You know as we dive into this how do you think that's going to impact health care.

Drex DeFord: [00:17:29] A really kind of set of questions and we could probably spend the whole day talking about those. But I go back to this idea of flexibility and creating organization the table to take advantage of whatever might happen to tear up the old Marine Corps saying simplify I used and tell my things and I and my team today Semper Numbi right. You know always flexible. I don't know what that means ultimately I know that there's a lot of change and I know that there are things that health systems may have been counting on to happen that may or may not happen here today but I think it's pretty clear to me we are running downhill towards value based care and that's going to happen right. So no matter how you slice it whether it's a single government payer or it's a model like we have today with a lot of payers including the government they want to move toward value based care. So the best thing you can do is to keep your eye on that and that's going to happen. How do you go through this process of working with your clinical partners and your payer partners and everyone else that's involved in the healthcare industry. How do you go through this process of making the transition and doing it in a way that makes sense for you and makes sense for your market makes sense for your patients and families if you focus on that. I think the other side you know regulation or regulation there. You'll figure that out. Don't start digging your heels in fee for service and you say I'm not going to do anything until they figure this out because I can tell you there's going to be a really bumpy ride and by the time they figure it out you better already be down the road or you're going to be on the wrong side of that. And today she talks about it.

Saul Marquez: [00:19:14] But Drex and I appreciate you saying that you know. Friends, we have to make sure that we are not distracted by the noise and the things that happen in the news and ensure policy it's noise. But I think direct says has highlighted for us that where the puck is going is value based care. And if you stay focused on that laser focused you're going to get an outstanding performing culture that is in it for the long haul tracks. What's the proudest. One of the proudest medical leadership moments that you've experienced to date.

Drex DeFord: [00:19:49] Wow. I would say that's a tough one to say. I think probably I don't know that it's a particular high or event but it's probably more that people that team teammates that I've worked with over the years the folks that I've coached and mentored. But many of them have coached and mentored me right back. So that's great. I've been left you know fine really smart people who want to do that do the right thing and that really is kind of you know solving our problems. I've been able to mentor some really great folks and gone on to be amazing CIOs and CPA folks like Patrick Thomas who recently retired CIO Scripps and Julie Berry replaced me as CIO steward and of course I can't forget West Wright who was with me in the air force and at Scripts Health and in Seattle Childrens. And I'm proud to have been mentored by some really great people like Ivan Nelson who most people probably knows the founder of Healthlink that owns for health resources. He gave me my first shot as a CEO and then you guys like Ralph dilatory the CEO Stuart who has has a whole different radical way of looking at health care and that has proven to become the new model of healthcare. So from a personal standpoint I would say the things I'm most proud of are probably my time as the time chair of the college healthcare information management executive chair. It's great learning experience for me again surrounded by a bunch of other great CEOs and a great staff led by rich Karylle and Keith Brandenberg. People like that around it's pretty easy to make that things happen. We hired Russ Frenzel the CEO of Time during that during that time period too and that's proven to have a positive long lasting impact on the college. Oh and now I'm I'm the I'm a board member at center gearstick which is best in class healthcare security consulting firm with great we recently Mack McMillan and David just joined us back in February. See this is another one of those things where you scratch your head and go I don't know why these things happen to me or how they happen nothing happened so bad. Back in February we rang the closing bell on the New York Stock Exchange and that was just a crazy moment to experience. So a lot of good stuff that happened to me throughout my career. A very lucky guy. I don't know. Wake up every day. Just so you know. Today's the day they're going to find out that it was just not me.

Saul Marquez: [00:22:05] That's awesome. Now directs. I love it. And you know the message friends as you are the average of your five closest peers and. Yeah yeah yeah. And you agree with that right, Drex? Surround yourself with amazing people. You're going to do amazing things if you surround yourself with bad people you can do bad things and so Drex you've been surrounding yourself with amazing people. You're an amazing person and you just continue making things happen in healthcare and I think that's a strong message. Tell us about an exciting project or focus that you're working on today.

Drex DeFord: [00:22:39] Yeah thanks. I'm kind of all over the place I work with health systems and vendors and startups and investors and it's all pretty exciting but I guess I'm going to pick out one thing right now that could turn out to be a very big deal under a product development effort with major health care I.T. and that's no renovation. And one of their vendor integration partners can provide a lot of details. Unfortunately because we're kind of in the early stages of it and under NDA if we figure out how to create this product in the right way and if we can do it at the right price point I think we could kind of radically change the way healthcare organizations deliver services to clinicians eliminate distractions improve workflow getting vitality out of the way eating technology out of the way is a huge deal that I've discovered over the course of my career and in the hospitals and clinics where we pilot and clinicians have fallen in love with it. And I guess most of all I would say you know it's not just a technology solution it's a workflow driven solution that's enabled by great tech. So I'm in the early stages right now doing that. Tell me why this is a stupid idea. Discussions with healthcare execs across the country and so solve the hidden probably Southern California in Dallas during the end of the year and it all plays out I'll be able to tell you a lot more about it in 2018.

Saul Marquez: [00:23:59] Way to put a hook in. I love it. Keep up with your blog to make sure that I know what's going on but this sounds exciting so and if you're anything Drex. I'm sure that there's something there so really appreciate you sharing that. Let's pretend you and I are building a medical leadership course on what it takes to be successful in medicine today. That's the one of course or the ABC is of Drex DeFord and so we're going to write out a syllabus for questions. It's going to be a lightning round. Then finish up with a book that you recommend to the listeners. You ready.

Drex DeFord: [00:24:33] Ok I'm ready.

Saul Marquez: [00:24:34] Awesome. What is the best way to improve healthcare outcomes.

Drex DeFord: [00:24:38] Yeah that one's easy. We've already talked about it remember always that the customers the patient family it's easy to lose that truth. Air quotes truth in the complex and chaotic healthcare environment that we've built. But that's that's true for us. For all the other stuff that we do in our industry.

Saul Marquez: [00:24:57] What is the biggest mistake or pitfall to avoid.

Drex DeFord: [00:25:00] I would go back to prioritization. You have to focus your energy on a limited number of things if you really want your organization to make a difference and if you can't do that then it's hard to understand what you really stand for you have to focus.

Saul Marquez: [00:25:13] How do you stay relevant as an organization. Despite constant change.

: [00:25:18] Yeah I talked about this earlier to embrace the suck. OK change her. It's no fun. We don't like it as humans. I actually did write a blog post about a year ago about healthcares antibodies to change and how we seem to have people who have has an additional position description stop all things from changing and they come out of the woodwork when you have a new idea and they just attack it and your organization and you have to get rid of those people. You have to embrace the. You have to create that organization that's nimble and agile and really to take advantage of opportunities as they arise. One of the quotes I use all the time is from Darwin and actually not from Darwin I always say that Darwin is misquoted as not the strong who survive those who can change the quickest. Right. So in today's environment it's not the big fish the small fish it's the fastest and the slope. So don't be a slippage.

Saul Marquez: [00:26:12] Love it. Embrace the suck and wonder one. I love that. I'm going to put that in a quote right here my recording booth that extracts you made the booth ball what what's one area of focus that should drive all else in the company.

Drex DeFord: [00:26:27] In my company. And remember I'm really a solo independent consultant so it's just me but for me it's about working on hard problems number one. Number two that make a difference to patients and families. And number three working with people that I like or people that I think are smart and that I can learn from. So I mean that's for me. Those are the three things that that helped drive me or were different people and those are pretty broad. So there's a lot of things that can wind up getting into those arrangements but that's what works for me.

Saul Marquez: [00:27:00] And finally Drez what book would you recommend to the listeners.

Drex DeFord: [00:27:04] So now I read lot more than I ever have work. So can I give you a couple. Actually.

Saul Marquez: [00:27:08] Absolutely. Give us a go.

Drex DeFord: [00:27:11] I would say Jay Samit Disrupt you. There's hope back and great ideas in that book and it's a pretty easy read and you'll put new stuff from the book to work every day. And even as he read the book Jay Samit Discrupt you and then I had another really good book called Give and Take Why Helping Others Drives Our Success by Adam Grant. This was a book that was a friend of mine Jeremy Shumack who's the CEO of Blue Tree. He's become a good friend of the last couple of years. He actually gifted that book to me at one point after an early conversation and as Shaw says that giving away your time to others is just good karma. And in the end you get it you get back way more than the universe has a way of balancing themselves. So I really like that book. And then I'm also in the process of reading just finishing now the subtle art of not giving a by Mark Manson of that book that's actually a quick fun read and it drives home the point that you only have so much energy so you have to relentlessly prioritise and all of that for me a lot of it was just reinforcing the way that I kind of go through life anyway but it's good to have that reaffirmation of history I really like life. There's a lot of a lot of great books out there but those are the stories that I would say.

Saul Marquez: [00:28:33] There's the top three so listeners we have an amazing syllabus here put together for you with three amazing books go to and you'll be able to find that syllabus as well as the shownotes for the things that we discussed with Drex and and so don't worry about writing any of the stuff down all the links will be there. Drex, before we conclude. Please share a closing thought with the listeners and then the best place where they get in touch with you including your blog site that we've talked about.

Drex DeFord: [00:29:05] You know. So my blog site is really not nearly as good at this as I probably should be. So the blog stuff that I write usually is on Linkedin cool you know so you can publish stuff there now and I don't write nearly as often as much as I should. But you have an author has not fluff that you can find me on LinkedIn of course and then Web site is really simple. www. I know you can always email me at I'm pretty good about responding. Follow me on Twitter and @drexdeford. I know Donald Trump but I do tweet about some pretty cool stuff from time to time and like I said I'm very particular on LinkedIn so I get a kick out of hearing what everybody's working on and closing thought that's a good one. I think I'll talk about this probably as a personal thing but right if you do the right thing you have integrity that's probably to me the most important personal trait to have. In the end it is new. I think in the end you only have your reputation and that really ensure your integrity and you know for everybody listening to this you were raised right. You know the right thing to do and if you're in turmoil about it because you feel like something that you're going there is a gray area. Go ask your mentor or ask somebody you admire they can help you with that. So if you start with integrity as an anchor then everything you do will make sense. You know people right all seem to fit and it will be consistent. And so do the right thing. That would be my my final word.

Saul Marquez: [00:30:38] I love it. Drex thank you so much for sharing that and really appreciate your taking the time to be on the show with us. Spent some really great time talking about some valuable things and I know the listeners are going to get a lot out of it. So really appreciate your time.

Drex DeFord: [00:30:52] Oh my pleasure. Keep up the great job of podcasts. I mean you are you're interviewing some really cool and interesting people. I love that you do the show notes. It's really easy to get to and listen to. And you know when you're driving in your car whatever. It's really great till you're doing a good service. And so you know speaking for me. But I think probably for a lot of your listeners thanks this has been great.

: [00:31:18] Thanks for listening to the Outcomes Rocket podcast. Be sure to visit us on the web at for the show notes, resources, inspiration and so much more.

Recommended Book/s:

Disrupt You!: Master Personal Transformation, Seize Opportunity, and Thrive in the Era of Endless Innovation 
Give and Take: Why Helping Others Drives Our Success

The Best Way To Contact Drex:


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Outcomes Rocket Podcast

Helping Physicians and Patients Make More Informed Decisions with S. Thacher Hussain, Patient Advocate, and Front End Developer at WiserCare, Inc.

: [00:00:01] Welcome to the Outcomes Rocket podcast, where we inspire collaborative thinking, improved outcomes and business success with today's most successful and inspiring healthcare leaders and influencers. And now your host, Saul Marquez

Saul Marquez: [00:00:19] Welcome back once again to the outcomes bracket podcast where we chat with today's most successful and inspiring healthcare leaders. I invite you to go to to rate and review the podcast And I have an amazing guest for you today. Her name is Thacher Hussain. She's a software developer and patient advocate. She's currently serving as a front end developer at Wiser Care Incorporated in Seattle. Her focus is definitely in clinical situations preferences and values aimed to give more confident treatment decisions to both patients as well as physicians and clinicians. She's done a lot of things as a patient advocate as well. She's motivated by her own diagnosis of Type 1 diabetes and she's become very active in improving the healthcare ecosystem for both patients and providers. Whether it's speaking writing or just using her skills as a developer she is fully committed to helping patients find their voice and providers learn how to best support these patients without further ado. I just want to open up the microphone to this amazing woman and welcome you to the podcast, Thacher.

Thacher Hussain: [00:01:31] Thanks for having me.

Saul Marquez: [00:01:32] It is a pleasure to have you. And I wanted to ask you what got you involved into this system to begin with.

Thacher Hussain: [00:01:40] Yeah actually I was an industrial and systems engineer in university. I guess I am an investor engineer now and I had the opportunity as the senior to do some research where that point is somewhat new field of healthcare engineering and it was the first time I felt like I was doing something big with what I was good at and so that was a real sort of game changer for me. Going from a student thing you like to solve problems to hey look this is something where there's a real area for improvement and something that I think I can help with. And so that actually well before my diagnosis set me in the healthcare direction.

Saul Marquez: [00:02:24] That is so cool and it's so neat that you found it pretty quickly out of the gates just a way to apply the things that you're amazing at in a field where you get the sense of gratification and that you're making an impact.

Thacher Hussain: [00:02:37] Yeah absolutely. And I mean for better or worse health care has a long way to go. So on the one hand as an engineering problem solver that's a great problem. The other hand you know as a patient and looking to help providers. We've got some good news to make.

Saul Marquez: [00:02:53] For sure for sure. Totally agree. Betcher what would you say should be on every medical leaders agenda today. And how are you guys focused on this particular topic.

Thacher Hussain: [00:03:03] Yeah I I'd say bringing patients into the process is probably the thing. And so there's some. But beyond that is really just working as a team with all parties involved. Sometimes you get patient advocates speaking and not to notice at all if the patient narrative the diagnosis message definitely has to be heard and it's something that I've spoken to as well. But we need to take the next step and go towards obtaining discussions between doctors and patients and the entire care team. So turning that into productive discussion to not only bringing patients into the process of bringing patients caregivers whether it be pharma or trials and having an entire conversation that need to be everyone in a room physical conversation but making sure that all parties involved who the care of this patient on the design of this product or whatever task you're addressing are all involved at every possible stage so that you don't get something like a product that's been built phenomenally by your researchers and engineers that hasn't seen review from either a doctor or a patient when you're already getting to prototyping and those are just gashing that should be happening well before you are talking about anything physical.

Saul Marquez: [00:04:23] Yeah I think this is great you know and blowing it down to the basics right you've got to have the people involved in the problem. All in the room. You can't move forward on this. Every single person all the stakeholders are in the room. What is it that you all are doing where you're at now Thacher to make this happen.

Thacher Hussain: [00:04:40] Yeah I'd say probably most in my independent work that's something that I'm trying to help our organizations to do. I'm being grateful to have opportunities like Medicaid and Health 2.0 to really speak to larger groups of physicians and professionals. He has as much power as we have as patients we really need the buy in from the medical teams in order to make that conversation happen. So even just free up the idea you know whether that's professionally a software developer. I get to have input on how we build our platform to help doctors and patients make more informed decisions that are going there and so that is definitely a piece of what I think about bringing my perspective as a patient into what I do as an engineer. Every time I'm building something like OK how now that we've built it and where does it still fit what we're looking for for the patient. So really just trying to promote that model of decision making with bringing all your stakeholders like you said to the table and making sure those decisions, direction, mission whatever whether it's an idea or project to me an idea or product or a physical promise that it's coming through with all of the expertise that you have access to. Nothing should be wasted. You want to hear from every doctor with an important opinion. You want to hear from every caregiver every patient every researcher has something to give you or make sure you're taking advantage of that.

Saul Marquez: [00:06:13] I think that's absolutely point. And you know a lot of times we get into situations and we neglect including the people as part of the decision and that's when things fall through the cracks and we don't achieve our actual goals or the implementation or the product that we had in mind doesn't exactly go as as needed. And so listeners, there's a great note to take from Thacher in the things that you have will be a device company pharma or provider or physician. Just making sure that you're always including the different people that are at the table. Thacher. Can you give us an example of something that you guys recently developed or an experience that you recently had a story of how you've been able to do this successfully.

Thacher Hussain: [00:06:58] Yeah absolutely. I'd say 4 with wiser care as a decision support platform. We really aim to take into account both physicians and patients and then being research fact as well. So we're taking into account the physician prescribes our platform essentially to the patient at the time of diagnosis. For example prostate cancer is one of our models that we use. And then the patient goes with this thing rather than having to make immediate decisions you know on the spot with the doctor which let's be real no one's making single decisions after receiving a diagnosis like that. There is absolutely no way that your calm and rational laugh and have enough information to make a decision. So that's what the problem that we're trying to address in giving the patient access to this forum to be able to really learn and go through and apply their preferences so that they're best prepared and going back for that discretion with the doctor because there are things that we can't change you know in a heartbeat or tomorrow or even next year you know that 20 minute conversation with a doctor if we get any longer for insurance reasons for practical reasons for staffing reasons. But how can we optimize that time and so that was a product. You know we talked to physicians all the time and are using the product we go through the schedulers and clinic admin to make sure that the patients are being heard in every way that we can bring the opinion to to me those opinions and to the way that we build the product. That's what we're doing.

Saul Marquez: [00:08:41] Very very powerful and you know I just go back to a year ago you know I had had a friend that just from one minute to the next like he got diagnosed with some pretty bad cancer and within a couple of months he was gone. And this was a year ago and it just you know being on the outskirts of that I was even just I was at a loss for words and just trying to have to make decisions decision that. Imagine being that patient receiving that news and what you do to decide on your care and the time frame that these physicians have Thacher. Like you said is just so limited. I think it's wonderful that you guys are putting together programs and software and tools to help maximize that time. So I think that was a great sharing. Thank you for that.

Thacher Hussain: [00:09:27] Yeah absolutely. It's something that I really believe in and I think that this product is going to help a lot of people.

Saul Marquez: [00:09:33] Thacher you're you as a software developer and patient no better than anybody else that there are bumps in the road and that on the way to figuring it out there's bumps in the road. Can you share with us a time when you had a setback and what you learned from it.

Thacher Hussain: [00:09:49] Yeah absolutely. From a more personal perspective here I am different type 1 diabetics or people with diabetes depending on who you talk to and how they like to be referred to. We'll have differing opinions on that. But for me every time I have a bad low blood glucose event that's a failure for me. Failure is a strong word. I'd say maybe more of a mistake than a failure but because of the system that I use the open artificial pancreas. Augments pumps that are insulin pump that I wear combined with a blood glucose monitor continuous blood glucose monitor every failure is not necessarily only food or exercise or behavior. For me I get to sort of abstract and look at it as a system failure or an engineering troubleshooting exercise. So it's not necessarily something that I have to feel emotionally bad about although that is definitely from a patient perspective it's really hard to separate out what is my fault and what is negative about fattier versus what is something that is out of my control. But I like to really try to turn that around every single time and figure out what I can learn from it and whether that hey you know 45 minutes on the treadmill it's five minutes too long or hey I had an interruption in their service and my system went off line for half an hour and I didn't notice. And I got stuck at a basal radio. What have you been into those details but being able to break that down and very engineering type way and sort of postmortem for the worst word ever. I guess you review what the possible causes for there were how to best address those. Next time is really helpful for me and definitely killing that mistake around to learning plane is helpful in every way I can think of.

Saul Marquez: [00:11:50] Love it. A great great example Thacher especially one that you're living with and so many millions of Americans and people across the world are living with. And it's something that when you take it to the system's level it's something that can be applied very very elegantly that it like Google says you've got a fail forward and don't do things personally right. Better look at the system things that could be improved at potential connectivity issues or whatever it could be so that you could fix as many of the variables as possible so that when you move forward you have a system that's working really well. So I love your example because it applies so much to the individual level as much as it does to the systems level. And just thank you so much for sharing that personal story. Absolutely. What about on the other side of a proud medical leadership moment that you had or can you share one with the listeners.

Thacher Hussain: [00:12:43] Yeah absolutely. I think and I was thinking about this listening to some of your other episodes which I love by the way you're doing a phenomenal job.

Saul Marquez: [00:12:51] Thank you.

Thacher Hussain: [00:12:52] I think being heard as a patient and this has happened in more public and more private moments as far as individual doctors coming up to me and saying you know I hadn't thought about it that way or I didn't consider this that or the other that I honestly believe that everyone in healthcare is coming from a place of wanting to help. And that's something I think that gets lost sometimes. So being heard as a patient and getting that narrative across to people who may not think about that every day because that is my every day. And so being able to hear from other people OK they're thinking about something in X Y or Z. From that perspective but then being able to turn that around and say you know yeah building a better more efficient fill in the blank is very important. But have you considered the emotional ramifications of that product. You're asking a person to wear a nebulizer mask 12 hours a day. Have you thought about the fact that they have three children under five. Completely absolutely not. It's little things like that. So if I can help one physician ask one more question with one more patient I'll consider that.

Saul Marquez: [00:14:12] Love it. This is awesome. And you know there's no doubt Thacher that you're definitely leading the way here as a voice for the patient and advocate. And so keep doing what you're doing because what you're doing is inspiring others to do the same and you're being the CEO of your own health care and that's what matters that's what's going to make this entire experience for other people powerful. So kudos to you and your leadership in this field.

Thacher Hussain: [00:14:39] Thank you so much.

Saul Marquez: [00:14:41] So Thatcher let's talk about an exciting project that you're working on today. Anything you want to share or can share.

Thacher Hussain: [00:14:47] Yeah absolutely. I have a project that I'm working on the pet project for sure but oh I think it's relevant to what we've been talking about. I met a friend who I guess made a new friend from the accelerator program through Diabetes Hands Foundation. Almost a year ago now and I was struck. She's a diabetic educator in Costa Rica also a type 1 diabetic and I'm very into all of the technology stuff as we've talked about and the products I went with there was taking using Apple Halket and taking the data that coming out of the continuous glucose monitor and putting it in a format that is more conducive to a system Diprose could continue that theme and to be able to see your patterns more easily. But I had almost a 180 degree pivot after having conversations with her and a couple other people at that event because I realize how lucky I am to have access to the care that I do. The fact that I live in a country where insulin pumps and continuous glucose those are available that I'm in a position where I have insurance and can afford that. And while this is not sort of a woe with me or you know any sort of thing like that realizing that where she is that and the patient that she's dealing with they don't even have access to continuous glucose monitors. Financial yes but even taking a step back and not even available in order to have a continuous glucose monitor in Costa Rica. You have to go through with the U.S. which has numerous regulatory and financial affects that just make it completely out of reach for the majority of people. So taking the idea that I had to bring in two basal rates was that was what I was looking at something in diabetes care. If you don't have your basal rate right you know it's just there's nothing else that's going to go right free throws like if you don't have the ground floor the rest your house can collapse. Yep. So in order to get that right for people who are probably on long acting insulin pens are shot and not having access to an insulin pump. How do we help those people find to their base. All right. And so that's something I'm working on with her now taking my software expertise. I'm looking at building an application that can be deployed and now we're looking at a whole different kind of project restraint. So rather than oh this is really cool let's use Apple healthcare. We're going to build on IOS. We can't build on IOS are expensive. Now those are really expensive and not attainable for a lot of people. All right we're building on android Data wireless data is not as reliable and some people can't afford plans that are going to have the amount of data that someone like us in the U.S. has access to. So it needs to be something that's solidly on the phone. So these are things that I've now visited and are we are addressing from a totally different perspective and I'm just so grateful to have met her and to be able to see. I was going to say this strong from another angle but really just this whole different problem that because of the perspective or how has me. I hadn't even thought about before so that I like set up a pet project something that I am working on with this friend and on my own trying to get a prototype out of her as fast as possible so you can see there's also very high. Yeah I was quickly as possible don't get the user feedback and you build a better product but hoping to finish that soon at least get the first round out.

Saul Marquez: [00:18:38] You had that sure. This is exciting and you're working on this amazing thing to help people. And the reality is I think what's going to end up happening is here in the states as well. We've got this you know social determinants of health that affect patients that don't have access to a lot of these things even though they're available. And I was reading an article by Jane Saranson Kahn she talks about how broadband. You know having broadband connection can be a social determinant of health because you know you can get access to information or whatever you know. And so I think what you're doing even though you may not see it right now I think it's going to have its applications here in the States too.

Thacher Hussain: [00:19:21] And it's definitely an interesting thing to consider I'll have to look at that article.

Saul Marquez: [00:19:25] Yeah I'll send it to you. And so wow super cool. Thank you for sharing. And it's like you know my side project. I'm just shipping out solutions to solve diabetes and other nations. It's already a Thacher.

Thacher Hussain: [00:19:39] That's a grand a grand statement for what I definitely feel health project. But I will I will accept.

: [00:19:46] That's so awesome. I love you for that you keep it so simple. You're very humble. Keep doing what you're doing. So awesome. All right. This is crazy how fast time flies when you're having fun. So we're here to the end. Let's pretend you and I are building a leadership course on what it takes to be successful in medicine. Except now it's the ABCs of Thacher Hussein. But this is going to be all about using software and patient focus and health care. So I got four questions for you followed by a book for the syllabus that we're building for the listeners are you ready?

Thacher Hussain: [00:20:16] Yup.

Saul Marquez: [00:20:16] All right. What's the best way to improve health care outcomes with software.

Thacher Hussain: [00:20:20] Work with your whole team all parties included your patient your MDs, clinician and your researchers.

Saul Marquez: [00:20:28] What's the biggest mistake or pitfall to avoid with patients.

Thacher Hussain: [00:20:32] Thinking that you got this and that you know everything that you need to know because no matter who you are on the team that's not true.

Saul Marquez: [00:20:41] Love it. How do you stay relevant as an organization. Despite constant change she could answer that one. However you see fit

Thacher Hussain: [00:20:48] Stay curious stay hungry.

Saul Marquez: [00:20:49] And what's one area of focus should drive everything else in your organization.

Thacher Hussain: [00:20:54] Helping people live better.

Saul Marquez: [00:20:55] And what book would you recommend Thacher for the listeners to read.

Thacher Hussain: [00:20:58] A little bit of her are related but Man's Search for Meaning.

Saul Marquez: [00:21:05] I love that.

Thacher Hussain: [00:21:06] Yeah it's one of my absolute favorite. It's applicable to everyone.

Saul Marquez: [00:21:10] Victor Frankl.

Thacher Hussain: [00:21:11] It was a game changer yeah.

Saul Marquez: [00:21:12] Oh my god.

Thacher Hussain: [00:21:13] The game changer when I read it.

Saul Marquez: [00:21:15] Totally couldn't agree with you more listeners. Great book. Amazing tidbits here. Pearls of wisdom from Thatcher. All these things are available to you. Don't worry about writing them down. Just go to That's t h a c h e r. Thacher. This has been amazing so much fun. Before I conclude I'd love if you could just share a closing thought with the listeners and the best place where they could reach out to you and follow you.

Thacher Hussain: [00:21:40] Yeah I'd say as opposing just brings humility empathy and passion into everything that you do and you can't go wrong. Something that I try to remember from myself every day. And then as far as finding me you can find me on the Twitter @thacherT1D or on my website.

Saul Marquez: [00:22:08] Love it. Love it.

Thacher Hussain: [00:22:11] There's a link to my professional portfolio on there too but I think that one is more relevant hold that if you don't recension.

Saul Marquez: [00:22:18] It's beautiful I love it.

Saul Marquez: [00:22:21] There's like my favorite url now.

Thacher Hussain: [00:22:23] It came from a from my first Facebook post after I was diagnosed and I didn't know how to process it so I process by writing letters to diabetes. That was the first letter that is so short and sweet.

Saul Marquez: [00:22:37] That is so cool. Well listeners all these things if you want to get a hold of Thacher just go to and you'll find I'll put her twitter link in there I'll put her dear diabetes you suck website and make sure you get in touch with you of something she said resonated with you. Thacher. This has been so much fun. Really appreciate you jumping on the podcast with us.

Thacher Hussain: [00:22:57] Yes absolutely, thanks for having me. Keep doing what you're doing. I love I love listening to your episodes.

Saul Marquez: [00:23:03] Thank you.

: [00:23:07] Thanks for listening to the Outcomes Rocket podcast. Be sure to visit us on the web at for the show notes resources inspiration and so much more.

Recommended Book/s:

Man's Search for Meaning

The Best Way To Contact Thacher:

Mentioned Link/s:
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Outcomes Rocket Podcast
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Find Out How to Win Investment Money and Support from Bayer for your Startup with Anna Lorenz, Global Innovation Manager at Bayer

: [00:00:01] Welcome to the Outcomes Rocket podcast where we inspire collaborative thinking, improved outcomes and business success with today's most successful and inspiring health care leaders and influencers. And now your host, Saul Marquez.

Saul Marquez: [00:00:17] Welcome back once again to the outcomes rocket podcast where we chat with today's most successful and inspiring healthcare leaders. I thank you for tuning in and I welcome you to go to where you could rate and review our outstanding guests. Today we have an amazing guest. Her name is Anna Lorenz. She's the Global Innovation Manager and grants for APS US program coordinator at Bayer. She's doing some amazing things for healthcare. She's really just such an open minded enthusiastic and amazing team player very curious on work and in new challenges very analytical and outcomes driven that's why we have her on today's podcast. Her background is in business and she's also got a really awesome background. Half German, half Dutch. Now we get to have her here in the U.S. So I really want to open up the mic to Anna as a continuation of our previous guests that we had. Eugene Borukhovich and so Anna I just want to extend a warm welcome to you on the podcast.

Anna Lorenz: [00:01:23] Thank you so much for having me and for the amazing intro.

Saul Marquez: [00:01:27] Oh you're an amazing person and an amazing person needs an amazing intro and. And so and you know you've got a business background but now you're with Bayer you've been with Bayer for for a few years now. What got you into health care.

Anna Lorenz: [00:01:42] Yeah I was actually purely by chance to be honest. I spent some time in the automotive industry. I really loved it. I had a great experience there. But after I finished my university and everything I looked for something that was very operational focus position I looked for something more strategic and I found something at Bayer. And I just thought thought that was going to be a really interesting challenge to tackle and I dove into it. And I've actually come to love the healthcare sector very much because it gives you the opportunity you truly have an impact on improving lives are at you and working towards a better tomorrow. Instead of like yeah about a tomorrow compared to yesterday which was in the automotive industry. More of the fun aspect which was great and having a really nice more luxurious car is an amazing piece too but it just doesn't have that feel of you're providing something of value to society.

Saul Marquez: [00:02:45] Yeah you know and I share that with you too. You know I've been in health care for 10 years and it's that impact right the things that you do are affecting lives and it's so so powerful.

Anna Lorenz: [00:02:57] Yeah absolutely.

Saul Marquez: [00:02:59] Anna what would you say. You know you guys are doing some really interesting things that Bayer now. What would you say a hot topic that needs to be on every medical leaders agenda today. What is it?

Anna Lorenz: [00:03:10] Honestly exactly why what brought me into health care here is it's creating a better tomorrow. And I think that right now we run into so many regulations and processes and all of these things that have been out there for for such a long time they're somewhat antiquated compared like especially for the digital solutions that we work on. And it's really is about pushing the boundaries as much as you can and pushing towards a more futuristic scenario and the whole frame that we're operating in.

Saul Marquez: [00:03:47] Yeah and it's definitely an interesting point right. It's one of those things where you we have to challenge ourselves as healthcare leaders to think beyond the current health care box. And what would you say Bayer is doing today to do that within your realm of responsibility.

Anna Lorenz: [00:04:08] Yes so I think Eugene already gave a really nice overview of our T4A that stems from the grant frappes program is already doing and there's a lot of activity there which is amazing to see and I feel really honored now to be part of our US part of this program. So we just launched our T4A generator it's called the U.S. consumer focused one which is looking to advance healthcare together with a greater ecosystem. So we're actually looking right now it's open for applications for like minded health care innovators in this space and for challenge areas from self care in general nutrition support external pain management and skin and some protection to work with us and strike a tragic deal with Bayer to actually to gather advance self care and help fulfill the full potential of health care.

Saul Marquez: [00:05:01] That's awesome. And listeners ears just perked up because you're a startup that's been working on something or for your company that's already gotten off and running but something that that Anna said resonates with you and you want to participate. We're going to be including the specs that they're looking for on the show notes as well as a link so that you could get engaged with that and has been gracious enough to give us all that information and give that to you here so in the midst of your search and you know what what is it that you're looking for in these in these these entrepreneurs. What characteristics. What types of things are you looking for?

Anna Lorenz: [00:05:47] So we truly look for ready to go solutions. So we're looking more to more towards to towards more mature start ups that we can really work with and commercialize something really quickly to bring valuable new product solutions service model whatever whatever frame it or whatever. Whatever form it may take to to really help our consumers live a better and healthier life. So it's about partnering and that's set. So in those four challenge areas there are some really detailed outline for each of the challenges on our webpage Sonti for a generator dot com you can read up exactly what the team is looking for what types of solutions they have in mind and what specific problem and what is that they desire abilities they want to fall for the consumers.

Saul Marquez: [00:06:43] Beautiful and given that you guys are extending this program to the U.S. something that already was extended in Europe. Things are working sounds like. Can you give us an example of some of the results that have come out from the Europe Program.

Anna Lorenz: [00:06:59] Sure. So I think the biggest success of course right away was a pharma company opening up to this conversation and starting to engage with the ecosystem when Berlin started it which was believe it or it 5 years ago we were definitely the first one up there and the team did an amazing job until they we had in Berlin the biggest ever so healthy. And last year for example for the kickoff et cetera. So there's been a lot of traction and connections that were made. And I think it took a bit of a time as well to really see where the value lies in actually working together and what kind of results and what type of outcome you can bring together and when you connect these to the big pharma company and the startup world. And we're really seeing this take off right now. So it's really exciting to see. They also just added a new program to the original accelerator which is much closer to where we base our generator on. It was cold or cold deal. It's really about bringing in ready to go solution to work with and and start a project together collaborate and bring it to life or bring it to the masses. And I think that within other major staff and really seeing what could be possible if you bring the two to growth together.

Saul Marquez: [00:08:20] That is that's pretty awesome. And you know I really appreciate the openness that that you your team Beyer's is as is approaching the market with and just saying hey you know what we could come up with a lot of great things on our own but we've got to be open to the innovations. Others especially the smaller entrepreneurs already have up and running solutions that could be nimble and make changes because when you get into a bigger organization like like Bayer or a bigger organization you know the big names it's hard to be nimble and. And so what would you say about that.

Anna Lorenz: [00:09:01] No absolutely. I think we we definitely realize that there are certain things that we're just not past that. Then there's also things things that we might not want to be the best at because there are others that can do it much much better much quicker much more agile. And I think that with the major learning from me personally as we coming into this world to see that there is really a huge amount of things that we can profit from each other from and instead of working in parallel on challenges where nobody really gets as quickly to help the consumer as we all want to. It makes much more sense to just really work together and help people live better lives. As soon as possible.

Saul Marquez: [00:09:45] Well there's there's no doubt and super insightful Anna and there's absolutely zero doubt in my mind that Bayer is leading the way with this. You guys are doing such an amazing job is just creating these solutions. And so it's exciting to see that you guys are expanding the program to the US. I'm thrilled to see this opportunity and listeners again you know make sure that you visit it's B A Y E R you're going to find all the specs there with the link that Anna is going to share. now Anna, what would you say through the process the time that you've been in health a mistake or a setback that you had and what you learned from that.

Anna Lorenz: [00:10:32] Honestly there's been multiple and I think yeah to be honest my biggest takeaway which I really love is seeing that at the end of the day they've all had some type of value either. iF there are so many things that we did now that we wouldn't have been able to do if he hadn't done that mistake. Way back when or if you had just tried and seen how it works. And I think especially now with the generator program he really went about it in an agile way. We we created it we went and basically prelaunch it and helped 2.0 last year in September before we even had a timeline or an exact concept nailed down. But really open up and talk to all the startup that were there and into other innovators and say hey let's create it together let's hear your thoughts on how how should we shake this up and what you need. What what do you need from us to say. And I think that that was one of my major experience to see in that process honestly we went from left to right and up and down and it was such an interesting and interesting process of creating it and what we thought it was going to be the whole page or the Web site tomorrow it looked completely different the day after that. And that was to me the major saying really take away and say at the end of the day every single every single failure made it made a shape the way it is right now and that wouldn't have been as good if we hadn't done that.

Saul Marquez: [00:12:10] Now that's a great great story. I had the opportunity to run in a couple of your folks out at the Health 2.0 meeting and it was definitely interesting to see you guys in action. Listeners you got to just do it. Get out there. Work it out. Find a solution. Don't let perfection drive your solution. Perfection is the lowest standard you can have and if you take the words of wisdom from Anna here you know what they did with their program as they went out there they got feedback and in the end their website was completely different than what they thought it was going to be. And that's oftentimes what happens when you get that candid feedback from the users. Anna tell us about one of your proudest leadership moments to date at Bayer.

Anna Lorenz: [00:12:59] Honestly is that that's working in this specific program. So working to bring a program like g4 generator to life has been really my proudest moment so far maybe I'm biased because I'm currently still in it.

Saul Marquez: [00:13:13] It's great to see though.

Anna Lorenz: [00:13:15] Yeah I know it is. It feels like you actually create something that's that consumers react to positively just as much as the startup world does. And it's back to this. That's my first sentence earlier. It feels like you're actually creating something impactful and that's really what I love about it so much.

Saul Marquez: [00:13:35] Well it's definitely something to be proud of Anna. You're leaving your fingerprint on the lives of the people that are gonna use whatever comes out of this and that's pretty amazing to have been part of something like that and I'm excited to keep up with where this goes and listeners you'll you'll definitely have to keep up with where the program goes. Get involved if you if you fall into the qualification specs of it because these folks are definitely doing some interesting things in health care. The focus right now is obviously the program in the U.S.. Anna what about that program are you looking to focus on here within the next six months.

Anna Lorenz: [00:14:17] So we're open right now into March 23rd. So that'll keep us busy right now getting the word out. Then of course we need to evaluate pick our finalists that will be invited to that they kickoff event in New York in May we'll pick the winners there. And they get to xey. Well everybody who comes to the event gets to meet all of the final FXE and talk to the startups there. But of course the winners will also automatically get a letter of intent and a cash prize to really strike this project dealing get get Alpha get started right away basically and writing. Yes so that that will be my main focus for the next weeks and months to come let's say and then we'll of course have to work on on making these these partnerships and collaborations as impactful as possible.

Saul Marquez: [00:15:07] Wonderful. So it's so exciting and you guys are moving so fast so end of March the applications are due and may. You guys are going to be moving and shaking with some decisions and some cash prizes. It's just I love the speed at which you guys work it's so so inspiring.

Anna Lorenz: [00:15:27] We definitely try to be quick.

Saul Marquez: [00:15:30] You sure are. So. So again we're launching this episode immediately listeners. Make sure you take advantage of this. OK. And let's pretend you and I are building a medical leadership course on what it takes to be successful in medicine. It is the 101 of Anna Lorenz. And so we're going to write out a syllabus for questions lightning round style followed by a book and a podcast that you recommend to the listeners. You ready.

Anna Lorenz: [00:16:00] Sure.

Saul Marquez: [00:16:01] Awesome. What is the best way to improve health outcomes.

Anna Lorenz: [00:16:06] So there is such a such a basic response but I feel at least from my own experience we've not really inherited it yet. It's really to get out there and understand your consumers. So somebody really interesting we sat just yesterday to me if you want to know the life of the alliance don't go to the zoo go to the Safari or go to like go to the actual and make their actual place where they're free. And it's the same with the consumers. I think if we spend way too much time in the past focusing on assumptions and watching our consumers and focus groups or other ways ways where it's just bias and it's not the real life situation and you really don't see what their day to day pain and what keeps them up at night. And I think that's one of the main things if you truly understand that only then you can also really react and work on these issues.

Saul Marquez: [00:17:00] Love it. What is the biggest mistake or pitfall to avoid.

Anna Lorenz: [00:17:05] Perfection. We talked about that earlier and I'm totally with you on that.

Saul Marquez: [00:17:09] Yes. How do you stay relevant as an organization. Despite constant change of changes everywhere.

Anna Lorenz: [00:17:18] You should go with the change and not just go with a change shape the change. Be the one who does the change.

Saul Marquez: [00:17:25] What's one area of focus that should drive everything else in your organization.

Anna Lorenz: [00:17:32] So our I think our mission assigned for a better life right. So to me it's really innovation in all areas to create better tomorrows and improve the lives that we have today.

Saul Marquez: [00:17:45] Beautiful what book and what podcasts would you recommend.

Anna Lorenz: [00:17:51] So this may be really people will be surprised but I absolutely recommend Lean In which is from Sheryl Sandberg a book about women and leadership. But that's why it's so interesting it's baffling not just for women and it's not just about leadership. I mean the title already says that lean in and it's inspired me. I've read it five times at different stages in my life and I've learned. Every time something new and at the end of the day like the title says that lean men change your environment and play things that new you think need changing speak up and dare to be that person who pushes the boundaries.

Saul Marquez: [00:18:32] I love that line and listeners lean in to health care and what podcasts would you recommend.

Anna Lorenz: [00:18:40] Honestly I have. That's one of the things I have. There's so many interesting things out there. I would just take your main topic. What keeps you up at night like right now and that may change next week. So definitely just go look and pick that one. And there's so many good things out there and we're listening to one right now I hope.

Saul Marquez: [00:19:03] Thank you Anna. Yeah and you know the reason why I put this question in here it's a newer one Anna about the podcast is because I definitely believe that podcasts have the potential to provide inspiration resources and and the reason why we started outcomes rocket is to just just get rid of the silos and open up the conversation so to Ana's point listeners whatever your cup of tea is or whatever your challenges go to your Google podcasts or go to your apple podcasts or just google a podcast about whatever it is that you're looking for and I promise you it's probably out there or there's somebody talking about it and it's the best way to find your tribe. It's the best way to find the people that are that care about what you care about and do what you do so. And I love that response is just such such a great great insight for the listeners to approach podcasts with.

Anna Lorenz: [00:19:56] Absolutely.

Saul Marquez: [00:19:58] Anna before we conclude I would love if you could just share a closing thought with the listeners and then the best place where they could get in touch with you or follow you.

Anna Lorenz: [00:20:07] Sure. So I had to write a little innovation story for our internal page two years ago and I was thinking about so many there are so many amazing quotes out there and so inspirational and I had to pick one right and I picked the one and I still love it. Two years later. Every accomplishment starts with a decision to try. So just go out there and try and push it and keep going. And I have it up on my desk and I look at it every day and I still still follow it. I hope you read the best. I think I'm all of the social media these days. But I think my best the best bet will be Twitter. I'm there as an AnnaLe299 and tweeting a lot about digital health and topics a topic that keeps me up at night right now.

Saul Marquez: [00:20:57] I love it and there's no doubt that you have inspired and encouraged the listeners to lean in and were excited to see what happens with the decision that you guys make there at Bayer so Anna we're going to keep up with you guys and I really appreciate the time that you've carved out for us.

Anna Lorenz: [00:21:15] Thank you so much for having me.

: [00:21:20] Thanks for listening to the Outcomes Rocket podcast. Be sure to visit us on the web at www, for the show notes, resources, inspiration and so much more.

Recommended Book/s:

Lean In - Sheryl Sandberg

The Best Way To Contact Anna and the Bayer Team:

Anna Lorenz on LinkedIn

Anna Lorenz on Twitter

Episode Sponsors:
Healthcare Podcast
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Outcomes Rocket Podcast - Michael Fratkin

How to Improve Care Giver Well-Being with Dr. Michael Fratkin, Director/Founder at ResolutionCare

: [00:00:01] Welcome to the Outcomes Rocket podcast, where we inspire collaborative thinking, improved outcomes and business success with today's most successful and inspiring healthcare leaders and influencers. And now your host, Saul Marquez

Saul Marquez: [00:00:18] Outcomes Rocket listeners welcome back once again to the outcomes rocket podcast where we chat with today's most successful and inspiring healthcare leaders really want to thank you for tuning in again and I invite you to go to leave us a rating and review through Apple podcasts. This gives us the information that we need to get this show to be amazing for you so that you could go back and improve outcomes with what you do so without further ado, I have an amazing guest for you today. His name is Dr. Michael Fratkin. He's a director and founder at Resolution care. They've done an amazing job. It's really been just an opportunity for them to follow their mission to bring capable and compassionate care to everyone everywhere. They use innovative technology payment models and strength of the community to help their patients. But more importantly the people that they help go through the end stages of life. I want to open up the microphone to Michael so he could open up that introduction with anything that I may have missed. Welcome to the podcast Dr. Fratkin.

Michael Fratkin: [00:01:26] Thank you so much, please call me Michael as he started to and I think he gave me like four amazing in that introductions I'm not sure having a go at all is amazing. No the work that we do is amazing that people gather together and do the work are amazing people we care for amazing. So I see your for amazing. And for more.

Saul Marquez: [00:01:51] I love it. And you know one of the things I really appreciate you Michael is just your you're a very present individual. And it's something that is valuable in today's day in health care. A lot of times they leave the care out of health care and I think you do a really amazing job of that. So let me ask you what got you into this sector to begin.

Michael Fratkin: [00:02:13] Oh I am myself I'm 55 years old. I'm a dad and my husband brother. So I got great friends I hope to be a great friend if that's what they say at the end of my life, Michael is a great friend would be a pretty good cash for my life. I started my exploration around serious illness and like when I was just early in college and a friend of mine who was gay and I started talking about all the young men that were dying of HIV. And he didn't know that I knew he was gay. That's a sort of suicide. I was worried because I was watching the stories about a young man coming out into the world having their full experience and to be treated with a mysterious horrible disease like HIV infection. I wondered what it was like to be a man that was dying. And so we both became volunteers in a hospice program in south Florida and we got a look at a few experiences how these young men made their way to complete their lives. And it wasn't with us. It wasn't just a horror story. It wasn't just terrible. It was terrible for grief and discomfort and trouble fear for us. There's also something pretty extraordinary and how resourceful a serious human beings are. And so that definitely planted the seed for me. It was a long time before I decided that I was going to go to health care. But once I started in the emergency room. So you're intact I got more and more interested and thinking about my status as a paramedic or a nurse. But I got through it cursed by a couple of important physicians to keep on going and never forget. And I you know just like everybody else did all of the free stuff from an University of Utah Medical School that again was created by the HIV epidemic during medical school and worked as HIV medicine was turning for sure hospice care is something else. It's a change where there was a whole bunch of therapeutics that were being applied. So when I came out there became an HIV doctor internist and the rest is history.

Saul Marquez: [00:04:56] That's so interesting and definitely sounds like you were awestruck by everything that was happening and history of the human experience and also the surprise of what you saw these these young men going through and it's evolved and it's created into what you've got here now and thing that you guys are doing with your organization what would you say Michael. A hot topic that every leader in health care should be focused on today and how are you all focused on.

Michael Fratkin: [00:05:26] Economics economics economics. It's so easy to be distracted by policy and politics but ultimately human beings behave in a fairly predictable fashion. They follow incentives and the sentence should it ought to be improved quality of life living for people that has better satisfaction and reduction in the horrendous wasteful and excessive suffering that comes with excessive utilization. So the triple aim is critically important area particular focus for me in my work because my working emerge my personal burnout has under-resourced position in a crazy healthcare system. This idea of quadruple this idea that those people over there that are in discomfort or pain or money are no more or no less importance than those of us that have dedicated our artwork that we matter as much. We are people they are people. We need to build new kinds of healthcare structures that tend to be both of those critical stakeholders as well as all the rest. Two sailors move from the center with the industrial design of our system of health care to 20th century now into the 21st. That's where our focus is on the people actually receiving and providing care.

Saul Marquez: [00:07:07] So Michael I think this is such a great cause and we've had previous guests talk about you know that quadruple aim and making sure that we take care of our physicians. And I think it's such a great point. What's the best way to get there. I mean from your standpoint what do leaders provider leaders need to be focused on to make this happen.

Michael Fratkin: [00:07:29] Well we had to get into the DNA of the organization. I mean the amount of pressure there is to think about people as a populate spreaadsheets rather than the way the real world is enormous. And so we as an organization have done is engage with certification as a corporation. So for those that don't know anything about that because or organizations that have committed to a rigorous assessment of their practices and isolation that measures that assesses all their practices are position with all of their stakeholders including their workforce the people that care for their heart in their heart. Companies that are willing to commit at the very core of their structuring to delegate themselves to the well-being of all stakeholders and to do good with their business. Our business is actually outperform in our financial markets. And so by engaging with the lab and becoming the elite who are certified it puts us in the same category of companies that have an identity that they are clear. So Patagonia and charities matter. So this New Belgium Brewery there's a few companies that are willing to say out front now that they a good product you provided incredible service that you will hear each other and themselves and that is that their heart as well as.

Saul Marquez: [00:09:07] I think that's really great and a distinction between what you and your team are doing and I guess the majority of companies in healthcare and outside of healthcare. One of the things that really got my attention Michael was was a quote from your one of your sites says we're an inspired team of palliative care professionals who understands that people are more than their bodies more than their diseases and more than merely patients. Walk us down that in the context of what resolution care your team there is doing to improve outcomes.

Michael Fratkin: [00:09:40] Yeah for sure. Well I mean I introduced myself as a dad and husband and a good friend for good reason because that's where I happen to have a skill set as a physician. Now I'm currently focusing on enterprise and as a person is really at the core of how I made my way through life. And it turns out it might surprise you. And that's exactly how he's doing. They're doing it from the center where they identify themselves. And so people who are sick do not apply or else and less that sort of thrust upon it. People are saying get who they are but they're stuck in a system where for example a person with cancer is undergoing cancer corrective treatment may in the last six months their wife have 150 doses for doctors appointments. Xrays last hundred thirty times leaving her home getting themselves together. How did their daughter take half a day of work to drive them to the doctor's office. Walk into the door to sit in a crabby waiting room with 10 year old People magazines and the sick people in to be sitting there and have another clipboard that same clipboard shoved in your face for 150 a time while you're noticing and asking yourself in a sort of distress existential just say is that person next to me sicker than me am my sister than them that person calls something or a hole in my direction and distant are so afraid 150 times in the last six months of your life. Right. Those people begin to see themselves as a patient and they are processed through a system and gas cylinder example where a doctor sits down the room and then turns their shoulder so that they can tap away at the computer keyboard and gather all the data. That isn't necessarily there to serve that person but he's there to serve the box checking algorithmic crowing based guidelines that everybody's breathing down that provider's neck out and then you rebirths that you're and get a resolution care is people power technology enabled Health Care Services takes care of people not patients in their homes not in clinics. And so when we engage with a person we send them to got that time we send down an e-mail hyperlinking they split into their health care see the doctor nurse a social worker that sharply dockworker who is right there with perfectly framed not invading their house or the home and read their mind to find out how we can be of service whether it's to improve their symptoms whether it's helped them understand their situation the choices depending on whether they're here planning discussions documentation whether it's to coordinate it so that the other members of their family can all be included on the same page about what they're facing. We do that not having to drive people out of their homes and make patients on them.

Saul Marquez: [00:13:00] I think that's really you you've got a really interesting and very interesting is not the word human way of taking care of this. You've obviously given the topic a lot of thought. You do something over and over again it becomes part of your identity. And so how do you deconstruct this system in such a way that helps treat people as people. And I think you guys have done a really beautiful job of that where you're at. What would you say an example of how this has helped families recently.

Michael Fratkin: [00:13:34] Well I can say to say that last week in Cary for a guy youngish man the long history of addiction and very serious had cancer it was estranged from his family. We connected and four members of his family in four different locations in the U.S. to talk it through he hadn't seen their faces or over eight years. We walked through we talked it through and let them know that his addiction was a big part of what was challenging his cancer care how he really needed the support. And so within three days his sister who is now provide caregiving with she's provided a structure that will get him out of the hospital and then will complete his cancer care program. His cancer treatment a new cancer treatment and then as he recovers from that we expect to help him relocate and resell it to his favorite Bacchis without the technology. There is no family meeting totally. There is no talking through the complexities of issues facing and. Trying to find its way at his family. And so using this video conferencing technology we were able to do something simple and it wasn't. How great is the technology how it works. All I know is that I could set it up and how human conversations with human beings are seamlessly.

Saul Marquez: [00:15:11] Yeah I think that's really important. This is such a wonderful story. Super happy to hear that this gentleman was able to reunite with his family and now on a road of recovery. Whereas before hey you know what could have happened to him. You know I think it's likely.

Michael Fratkin: [00:15:27] He said without our support all the way over this last month he couldn't have completed his cancer treatment because he was too socially behaved really burdened by his homelessness and ongoing drug abuse. It took our advocacy are holding hands together. And what could well be cured cancer treatment could translate just by working with all the social determinants of health getting it from place to place getting fat getting in house and all of this can translate into 20 30 40 years of life and with a little luck may surprise us too.

Saul Marquez: [00:16:12] That's wonderful. I think that's so interesting and tell me something Michael. So you've had some success in this area. Give us an example of maybe a shortcoming or a setback that happened and what you learned from it in order to make it even better.

Michael Fratkin: [00:16:29] Let's see that's a good question. As I pause to reflect it's hard to ask that you are so used to saying I'm crazy. It hasn't worked. What I would say is it's really really hard to construct from the raw materials of the status quo. So they are actually very fresh and new. It's very hard to take nothing and make it into something and a step along the way. There are these inflection points these evolutionary moments where everything turns gets turned upside down in those moments I freaked out a little and it was like wow that was exactly what was necessary for any of the listeners or parents they'll understand exactly where you get to a certain place and you're like oh my god this is so crazy I can't go another step. And then you do you learn something about the process of creation. So for me I miss a lot of the space I think with being so emotional reactive when really what was happening wasn't normal illusion and growing and developing new review.

Saul Marquez: [00:17:47] I think that's a great call out and listeners think this is a good message as you move forward in your endeavors to provide healthcare to improve outcomes. Whenever something happens that you're not expecting just think this is part of the process accept it and what comes from here will actually be something that's happening for you not to you. And then it becomes an opportunity that helps you be stronger. And you know I take this message very very to heart. Michael and I appreciate you sharing it.

Michael Fratkin: [00:18:18] Yeah I mean it actually doesn't take too much imagination to bring it out of the sort of enterprise environment and to ask yourself how you made your way through life in a series rising and then collapsing and rising and collapsing and being so caught up in the pain and grief difficulty that you almost can't remember what it was to feel otherwise but then you keep putting your feet and you keep taking steps forward. Keep learning. And all of a sudden you realize that without that conflict there is no tomorrow. You can't get to the future that you. And so are you.

Saul Marquez: [00:19:01] Yeah. No I think it's great. I think it's a really powerful message. And the other thing that it reinforces is the thought. And it really jives really well into what you're doing is that the power of now I was a similar story but a little bit different when I was in college I went to volunteer at a hospice and it was around the holidays and we were putting together holiday cards. And so I'm sitting there and I'm about to work on my first one. Michael. And I'm like What do I write like I'm so used to writing hey you know. Have a wonderful you. I hope next year is awesome and you know what I mean. And so I'm in this place where all of a sudden I'm forced to be in the now and we spend so much time yesterday or tomorrow. And I just zoomed in and then I sort of gained an appreciation for the Power of Now. I said hey you know and I remember my first letter that I wrote was enjoy. Today it's a beautiful day. It might be sunny. It might be windy but everything is there for you. And just a note that I have never forgotten. And it's just kind of you polished it off with some of your thoughts right now. So thank you for that. And yet listeners so be present in the moment and make it work for you.

Michael Fratkin: [00:20:11] Exactly. And this is Resolution care is simply of that position. That kind of thinking integrated into a complicated crazy healthcare system. Health care financing system taking advantage of the economics of incenting outcomes that we wish to get to than fee for service structure which has constrained our ability to grow better manage the well-being of our society. So by leveraging this payment and structuring our relationship to health. That's not to say I was sick but actually I'm not around that bill. Will now we're paddling in the same direction and were able to do what makes sense for the very individual people that are caring for her. It's not about her protocols it's not being responsive to the people we care for. Define what success looks like for now and then it turns out their quality goes up their satisfaction goes up and lo and behold we get them an alternative to the emergency room in a hospital. And their costs go down. Everybody's happy at rocket science.

Saul Marquez: [00:21:33] I love it. It's great. It's so wonderful. So we've got some really cool ideas crank in here. Michael let's pretend you and I are building a medical leadership course on what that be successful today. It's a one on one or the ABC of Dr. Michael Fratkin. And so we can write a syllabus right now for the listener really go for questions. Lightning round and then finish up with a book. You ready.

Michael Fratkin: [00:21:58] Yeah.

Saul Marquez: [00:21:58] Awesome. Awesome. What's the best way to improve healthcare outcomes.

Michael Fratkin: [00:22:02] Focus on aligning yourself with the people you care for the people doing the care center your care around human stakeholders that need to be re front and center.

Saul Marquez: [00:22:16] What's the biggest mistake or pitfall to avoid.

Michael Fratkin: [00:22:19] Getting sucked into the status quo compromising too greatly for expediency what seemed like a good idea to create something new turns out to be just another iteration of what's broken.

Saul Marquez: [00:22:34] How do you stay relevant as an organization despite constant change.

Michael Fratkin: [00:22:38] We talk to the people we care for. It was a way. We're so immersed in the mystery of the human experience and the care that we provide to people that there's no way to get bored. There's no way to lose that sense of.

Saul Marquez: [00:22:52] What's one area of focus that should drive everything else in your organization.

Michael Fratkin: [00:22:56] Love

Saul Marquez: [00:22:58] Powerful. I love that. What book would you recommend to the listeners Michael

Michael Fratkin: [00:23:03] I heard Michael Lewis talking on the radio today see us doing projects and there's two reasons. So the new project is a story Tversky and Kahneman as they sort of redefined social economics or economic theory around issues. There's two reasons why it is that I always loved opera singers don't leave everything and think that. Their work is entirely about how we lose ourselves thinking we understand what we see and how we work. I love that part. The other is the story of the human relationships that led to tries to quirky Israeli scientists very different personalities. The story of their relationship the professional relationship interactions with those around them and their relationship. Guys I thought that was beautiful and brilliant. So Undoing Project, Michael Lewis.

Saul Marquez: [00:24:07] Love it. Some really great shares there. And listeners don't worry if you don't have a pan or if you're out for a jog or driving just go to that's F R A T K I N as Nancy FRATKIN.

Michael Fratkin: [00:24:22] And don't forget as well.

Saul Marquez: [00:24:28] No absolutely. And that. And Mike you know in the show notes when you got to that site that I think you'll be able to find links to Michael's company you'll be able to find a link to his LinkedIn profile answers to the syllabus as well as a link to the book. So everything you'll be able to find right there. But for the sake of reiteration and clarity. Michael's Website is Resolution care just as it sounds Pretty cool place where you'll be able to learn a little bit more about what he does. Michael thank you so much for this. Before we conclude I just want to ask you for a closing thought and then the best place where the listeners could get a hold of you.

Michael Fratkin: [00:25:11] Don't sell yourself short to think you got the job or that you are your job. Or that you're a patient or that you're a doctor or you're an entrepreneur. Show up to your life free of all those labels. Bring your stuff out or be a part of collaboration with other people. Don't get fooled into thinking that the role you have is who you are. You know who you are and if you don't know who you are your wife or your husband can probably help you figure that out. I can be reached any way at, on Twitter. @michaeldfratkin And I don't know if you send smoke signal, I might see you.

Saul Marquez: [00:26:01] Love it. Michael listen I really want to thank you for taking the time today. It's been a really big pleasure. Dove through some really great things and just want to say thank you very much.

Michael Fratkin: [00:26:11] Thank you so much, Saul, really has been fun. Really appreciate it

: [00:26:17] Thanks for listening to the outcomes Rockett podcast. Be sure to visit us on the web at for the show notes resources inspiration and so much more.

Recommended Book/s:

The Undoing Project: A Friendship That Changed Our Minds

The Best Way To Contact Michael:

Twitter - @michaeldfratkin

Mentioned Link/s:

Episode Sponsors:

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Outcomes Rocket Podcast - Michael Fratkin

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Outcomes Rocket Podcast - Bruce Brandes

How to Cut Vendor Evaluation Costs and Improve Outcomes without Sacrificing Quality with Bruce Brandes, CEO, and Founder at Lucro

: [00:00:01] Welcome to the Outcomes Rocket podcast where we inspire collaborative thinking, improved outcomes and business success with today's most successful and inspiring healthcare leaders and influencers. And now your host, Saul Marquez

Saul Marquez: [00:00:19] Outcomes Rocket listeners welcome back once again to the Outcomes Rocket where we chat with today's most inspiring and successful health care leaders. If you love what you heard today or loved the show in general please go to and leave us an apple rating and review. This is how we know what we're doing is working in helping improve outcomes for you. Driving this conversation to help the feedback common enemy which has bad outcomes and inefficiency and so without further ado I want to introduce our outstanding guest. His name is Bruce Branders. He's the CEO and founder at Lucro. Lucro is a digital platform helping healthcare organizations make better purchasing decisions. He's been in healthcare for almost 30 years as part of Martin ventures. And he's also been executive vice president and president at other health startups. He's done such an amazing job in this field but what I want to do is open up the microphone the Bruce to round that intrp. Bruce, welcome to the podcast.

Bruce Brandes: [00:01:24] Great thank you so much for having me Saul. Really appreciate this forum.

Saul Marquez: [00:01:29] Absolutely. And Bruce why did you decide to get into the medical sector.

Bruce Brandes: [00:01:34] Well it's actually wasn't really my decision coming out of business school in 1989 had a great opportunity to go work for IBM. And at that time IBM would assign you by industry vertical and IBM just so happened to assign me to the healthcare vertical. And I remember coming out of business school as IBM gave us training to better understand the industry how it worked and obviously in education about technology as well as I learned about the business side of how healthcare work that kind of scratch my head and said Well this is completely illogical and makes no sense at all. And then as I got deeper into it I kind of puffed out my chest and I said but I work for IBM. Certainly technology can fix all this. I kind of chuckled over that you know the last 45 years we've shuffled the deck chairs on the Titanic but we really haven't meaningfully adopted technology the way potentially could transform an industry the way it has other industries so really excited to have been part of healthcare through this whole journey but particularly excited to be part of healthcare today.

Saul Marquez: [00:02:32] Bruce It sounds like it was just luck of the draw I guess that you were put into this segment but yet it stuck. And so you obviously found that to be an area where you could contribute and you have through various different companies and ventures. What would you say a hot topic that should be on every medical leaders agenda today. And how are you all at Lucro focused on it.

Bruce Brandes: [00:02:55] Yeah that's a great question and I I think my hot topic is one that is not news to anyone. I think everybody is struggling with it but the reality is the health care industry is currently facing unprecedented financial operational clinical challenges that are coming at a much more accelerated rate change whereas historically doing nothing was always a viable option for healthcare executives. I don't think doing nothing will serve you anymore. There are going to be winners and losers as this industry consolidates. Whether you're a provider or a pay or a vendor serving the industry and I believe that the ability to develop core competencies in focusing and developing agility regarding innovation and cost containment is going to be critical to any of the organizations that are to survive much less thrive. And we started Lucro specifically to address that issue and what we started by doing was building a network of healthcare organizations that collectively operate over 20 percent of the hospitals in the United States to band together to reinvent how the buyers and sellers interact so if you think about traditional things that are used like cold calls and emails and RF no shoving a chocolate down someone's throat at a trade show. I mean these are all antiquated notions and processes that may take 12 months 24 months to make a decision around a you know a complex collaborative AIST new evaluation that needs to happen no longer acceptable. We don't have that kind of time as an industry anymore. And so we've delivered a trusted market place that can reduce the time and costs required to evaluate and choose vendor partners specifically concentrated in purchase services so not so much commodity sized items. But really you know health I.T. digital health outsource services consulting those types of areas which purchase services collectively account for upwards of 30 percent of all the non Labor spend in hospitals. There's a tremendous opportunity for us and trol over that spend and get better returns from the investments that we're making. At the same time help the vendors that serve those spaces that in the same way.

Saul Marquez: [00:05:06] Bruce It's so true right. I mean we were faced with just growing costs and and just the need to continue cutting costs. Lucrow is focused in this in this area where I think there is no system. Currently there's just kind of multiple different ways of doing it and there's just no one way of doing it. What does Luke road do that makes it more effective.

Bruce Brandes: [00:05:29] Well if you think about the traditional vendor evaluation selection process it's really fraught with a lot of fragmented components and pieces of information whether there are a lot of in person meetings that may or may not really be a good use of people's time spreadsheets e-mails very antiquated notion. So first of all built a technology platform that builds a community to enable us to do things differently and so fundamentally that's the first thing that we've built. I'll give you an example of how how this manifests itself. So we have one of our clients is a health system that runs 10 hospitals in the Northeast and the bay had identified that they needed to replace their physician credentialing application by RFP process. That would be about a 12 month process and they recognize that they didn't really have 12 months. This was one of many projects that they worked on that they really needed to do an evaluation quickly and be able to move on even though it required input from lots of different stakeholders. So they actually created what we call a project board in Lucro in lieu of an RFP required that those vendors enter their content in Lucro not just for their benefit but for all the rest of the health systems in our in our network. But they use that as the platform to be able to ask questions and compare to evaluate the different actually they started with six. They found two more through our platform and ultimately narrowed that evaluation down to 2 and then made a final selection in about half the time with about half of the resources required to be able to make that decision. But then the power of that was even better when it gets amplified across our network because there was another helps healthcare organization which was a 200 organization ambulatory surgery center that operates nationally that have the same need for physician credentialing. And because the first health system has engaged all these vendors. The second health system actually just went into our platform searched for physician credentialing found those eight vendors in the robust set of information that they needed to do an initial look at the market and he looked at me and the CIO looked at me and he said you know what this process would have taken us weeks to do this market research. And I got my shortlist within five minutes. And from there they could ask questions you know create qualifying questions to narrow their choices and then the more detailed questions all within our platform. The power of that for the vendor side as well as the health systems are getting benefits. It's also beneficial for the vendors as well because those eight vendors only knew about Lucroy because they engaged because the first health system told them that they were required to to be able to compete. The next thing they knew they got an e-mail notification in lucro saying hey you've been kynde to the project board for this other health system that's looking for physician credentials. And they had no idea who that organization was much less that they were looking to buy what they do. And so the power of that is now that's a much more concentrated use of their sales and marketing resources that they can redeploy. And then where that scales as we've can then notify the entire healthcare community that if you're in the market to buy over the next 12 18 months physician credentialing software you can sign up for Lucro for free and get all. And we're not going to tell you which one is the best. We don't have an opinion. But ultimately you can use this platform to just like for the other two to save significant amount of time and expense in making that vendor selection.

Saul Marquez: [00:08:40] Bruce thank you for sharing that and so many of our healthcare dollars are spent on inefficient processes and just you know waste. And so I think what Lucro's doing is you know this Hub where best practice sharing can happen and not reproduce the same processes that happen when the with the buying process because it's the same it could be the same. And if they need to tweak it they could go in there and tweak it which is great. And then if you're a vendor that you don't even know if something was going on maybe you get alerted and now you have an opportunity that you didn't even know you had.

Bruce Brandes: [00:09:14] And perhaps you can redeploy the dollars you're spending on your database lists to spam e-mail the whole market assuming everybody must be wanting to buy what I do or to have people cold calling you know assuming that every buyer must want what I'm selling. The reality is really needs to be turned around and have the buyer's raise their hands saying these are the things I'm trying to solve for. And if you have a solution for that. This is how I want to learn about it.

Saul Marquez: [00:09:38] I think that's great. And I'm excited to see how this thing unravels because you know it definitely is. You know I've been through the process myself on the vendor side and it is painstaking not only for the vendor but also for the provider you know the purchasing officers just it takes a lot of time a lot of effort a lot of resources to manage an RFP and it's really cool to hear that that what you guys are doing is going to help simplify that.

Bruce Brandes: [00:10:03] Yeah absolutely. And I think we will talk a little bit more about this but I think there's a tremendous opportunity to come together as an industry and challenge ourselves on the way we've always done things because there truly is so much waste and duplication that can go away. It's really not difficult.

Bruce Brandes: [00:10:19] So Bruce you've created results and improved outcomes by simplifying things the example being your you know the physician credentialing. Can you share with the listeners a time when you had a setback it could be with Lou grow or it could be somewhere along the lines of your 30 year health care career. Give us an example of a setback you had and then a pearl that came out of it.

Bruce Brandes: [00:10:42] Sure. And actually this is one of my favorite hard lessons learned that actually at the time and this was 15 years ago. At the time it was happening we said someday they're going to write about this in business school textbooks on how to mess up a great company. And sure enough I actually serve as entrepreneur in residence at my alma mater University of Florida's business school and I guess next on this case study in 2002 I ran a division for a company called Eclipses which was a leading electronic medical records system company. We actually were winning virtually every large academic medical center every complex position driven decision for electronic health records. We were really winning a lot of time and so we were rated first in class and what we then recognized was that there was a lot of money being spent on all of the hardware and infrastructure required to operate our application. And so our CEO and founder at the time Harvey Wilson who was a great industry visionary saw the opportunity for us to develop a truly web based EMR as the Internet was really starting to take root. And so he made that announcement we as a company announced Hey we are going to build this next generation web based EMR that essentially today will cloud based tmr that will eliminate the need for all of this other cost and infrastructure and complexity and implementation time and great vision. Absolutely and we froze the market as we announced it and then spent the next 12 18 months building it only to learn once we got close enough and in delivering it that the bandwidth of the Internet at the time given the complexity when a physician's entering in an order for example the complexity of the rules engine made the response time of entering it in order just unacceptable. And so the real lesson learned from that was and I would contend that's actually what gave rise to epic and their dominance in that space because we are at eclipse us winning all those deals that have been subsequently started to go to APIC and by freezing the market and then missing that window of development opportunity and reverting back to the older platform once we realized didn't work we really messed up a great company. Now eclipse this is now part of Allscripts in 2010. They merged and they still endure. But I would rebound. And I think the real lesson learned from that is to make sure that you don't get too far ahead of the market and your ability to deliver and make sure that you set proper expectations and do that at the appropriate time publicly. Those are some of the lessons that I took from that.

Saul Marquez: [00:13:10] What a great share Bruce and I think it's one of those lessons that I'm sure will remain in your mind forever and now you're teaching to your students. I think it's a wonderful one to have shared with with our friends here our listeners. Tell us a little bit about maybe one of the most proud medical leadership experiences or moments you've had to date.

Bruce Brandes: [00:13:28] Thank you. That was a great question. And as I reflected on it I smiled because there is one story that I have great fondness for. I was chief strategy officer of a company called airstrip which was pioneering the use of mobility and health care. Back in 2000 9 10 11 before anybody really knew what that meant. And in many ways became the face of iPhone and iPad in health care and got a lot of great visibility through our Apple relationship. And one of the applications that we delivered was a way for an obstetrician to be able to see the real time and historical waveform data on their smartphone of a mom while she was in labor at the hospital while the physician was anywhere that they might be over the course of their day to be able to do that type of real time near real time remote monitoring of patients. I was sitting. Because normally that's handled the phone call and then the physician of drop what they're doing and you know get to the hospital. And lots of time delayed. Anybody who's had a baby knows that experience. I actually was at that was at church and met a guy sitting next to me we struck up a conversation and it turns out he was an obstetrician and he asked me what I did and I told him and he actually was a user of our platform and he shared with me a story about when he was he had a mom in labor and had late decelerations in a contraction in the heart tracings and noticed when he was away from the hospital something that was very distressing before the nurse ever even called. He was proactively monitoring that mom and he caught something because he had access to that information in real time that otherwise probably would have taken some time for the nurses to discover and then subsequently for him to be able to act on. And he shared with us that ability to intervene at that time right away may very well have saved that baby's life.

Saul Marquez: [00:15:16] Wow that's amazing. And that's just one of those things that it lets you know what you're doing is impactful right.

Bruce Brandes: [00:15:23] At the end of the day. Back to how did I get into a health care kind of Rwanda at IBM. I noticed that when they assign me to the healthcare vertical I had and that was a marketing rep. So I was basically selling IBM hardware and I noticed my colleagues who were assigned to other industries I really couldn't get motivated. I'm not a good enough sales person to sell computer you know servers to the banks. I mean frankly you know by whichever one you want whatever's cheapest forms are here. But when you look at it in healthcare it's really about how can we as an organization help doctors and nurses to save people's lives. How can we help people with chronic illness to be able to manage that condition so they don't have a sentinel event that sends them to a hospital in the first place. So I think that there's a tremendous opportunity for us to really do good in health care.

Saul Marquez: [00:16:07] Bruce tell us a little bit more about an exciting project or focus that you're working on today.

Bruce Brandes: [00:16:13] Yeah well back to Lucro as I mentioned to you we started by working with some of the large national and regional health systems and understanding their needs because we were trying to get scale in building our network. But what we found is the needs that those health care organizations shared frankly most smaller organizations whether it's a small you know hospital or physician practice have the same needs around being able to operationalize innovation faster to be able to filter the universe of all the shiny things that are out there to find the right solutions in the right way and to advance that we actually I'm not sure when this will be aired but we signed last week a partnership that will be announced next week with the American Medical Association to be able to take the platform that Lucro has built and to have AMAA be able to offer it across all of their memberships so that all of these individual group practices that have needs and oftentimes common needs for the AMA to essentially be a facilitator to bring together practices that are all looking for ways to reduce wait time or better serve a population of diabetics as they're looking for innovations we can bring them together to collaborate in a new and efficient digital way to be able to learn from each other and be able to make decisions with input from people that they know and trust. And you know we as a small company don't have the resources to be able to reach all those audiences. But clearly an organization like the AMAA that is already a trusted partner for these practices and physicians really gives us an opportunity to significantly scale the power of what we're doing so that's one of the more exciting things that we're working on right now because I think it takes the benefits of what we're doing and really scales it in a very big way.

Saul Marquez: [00:17:57] Bruce is so exciting congratulations on that partnership. I think it will definitely add value to those physician practices and help Lucro get a foothold of the market I think that is so exciting congrats on that.

Bruce Brandes: [00:18:10] Thank you.

Saul Marquez: [00:18:11] So let's pretend Bruce that you and I are building a medical leadership course on what it takes to be successful in medicine today. It's the 101 course or the ABC of Bruce Brandes. That's our syllabus. I've got four lightning round questions for you and then we'll finish with a book that you recommend to the listeners you ready.

Bruce Brandes: [00:18:31] Let's go.

Saul Marquez: [00:18:32] Awesome. What's the best way to improve healthcare outcomes.

Bruce Brandes: [00:18:36] I believe by empowering the consumer. And notice I say consumer not patient but empowering the consumer to be able to be in control of the decisions for their health care.

Saul Marquez: [00:18:46] What is the biggest mistake or pitfall to avoid.

Bruce Brandes: [00:18:49] Misaligned financial incentives. I think have been the single most biggest distraction to us as an industry being able to do the right thing.

Saul Marquez: [00:18:58] How do you stay relevant as an organization. Despite constant change.

Bruce Brandes: [00:19:03] Listen and think more than you talk.

Saul Marquez: [00:19:05] What is one area of focus that should drive all else in your organization.

Bruce Brandes: [00:19:09] I believe having a common passion that the healthcare industry can do much better than we do today in terms of cost quality outcomes. I have always believed that you need to put your mother your wife your daughter's face on the person in need of care and make it very personal and let that fuel your passion.

Saul Marquez: [00:19:29] I love that Bruce what book would you recommend to the listeners.

Bruce Brandes: [00:19:32] There are a lot of really great business books that I would get a snippet from. Here they are. As I reflected on that there's one in particular that stands out to me over the last 10 years as being very helpful that I refer back to quite commonly and it's a book called insanely simple my Ken Segall and he was one of the marketing executives that was involved with Apple in the early days. And it's a book about what makes Apple different than all the other companies that built similar products to what they had built. I'm particularly looking back over the last 10 or 15 years and what he describes is their obsession with getting past complexity and going the extra mile to make something very simple. So if you think about it why does the iPhone or the iPad just have one button instead of three. Why is it so intuitive that a two year old or a 90 year old can just pick it up and know how to use it. And so there are a lot of great lessons there not only in product design but also in how you build a business to make things simple. And as I reflect on everything that we do in business and everything that I appreciate in my life it's things that are more simple. But a key tenet of that is that simplicity is much more difficult to achieve and complexity.

Saul Marquez: [00:20:46] And it's such a great recommendation. Haven't read it but will definitely be going on my list. Insanely Simple and for that listeners friends you want to go to B-R-U-C-E. And you'll be able to get all of the show notes a summary of what we've discussed the syllabus that we just put together and that links to this book as well as links to Bruce's profile and Lucro. Bruce, thank you so much. Before we conclude I'd just like for you to share one closing thought to the listeners. And then the best place where they could get a hold of you.

Bruce Brandes: [00:21:22] Great. I'm just so optimistic about what can be achieved in the next generation of what healthcare can be and whether you're a healthcare leader at a health care organization or your healthcare solutions provider. I would say that together we have a real opportunity to make a meaningful difference in this industry. And so I would just encourage people not to get so caught up in the legacy of we've always done it this way but to look with an open mind and be part of developing that new solution and to engage. If you're interested whether you're a health care organization or a health care vendor I would invite you to go to and you can sign up and engage in Luchino. There's no cost. If we've built it right and designed it right there's no real implementation or training required. But feel free to reach out to me with any questions. My email address is and I would welcome the opportunity to together help to change the industry are our businesses based on predicated on achieving network effects. And so now that we've built the platform we're inviting every healthcare organization that might want to be part of this. Every vendor that might benefit from being part of efforts to join us now and help us to build a better health care together.

Saul Marquez: [00:22:43] Bruce I love it and I'm so certain that you guys will do it and you'll partner in a very meaningful way. So glad that you're able to join us to share the insights that you guys have been building over there and excited to stay in touch. Bruce thanks so much for being on the podcast.

Bruce Brandes: [00:22:58] Saul thank you for the opportunity.

: [00:23:03] Thanks for listening to the outcomes Rockett podcast. Be sure to visit us on the web at for the show notes, resources, inspiration and so much more.

Recommended Book/s:

Insanely Simple: The Obsession That Drives Apple's Success

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Outcomes Rocket Podcast - Bruce Brandes

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Outcomes Rocket Podcast - Dr. Clarence Lee

How Including All Care Stakeholders Improves Workman's Comp Outcomes with Dr. Clarence Lee, M.D., M.B.A., CMLEEJR Companies, LLC

: [00:00:01] Welcome to the Outcomes Rocket podcast, where we inspire collaborative thinking, improved outcomes and business success with today's most successful and inspiring healthcare leaders and influencers. And now your host Saul Marquez

Saul Marquez: [00:00:19] Outcomes Rocket listeners, welcome back once again to the Outcomes Rocket podcast where we chat with today's most interesting and inspiring health care leaders. I really want to thank you for tuning in again and I invite you to good outcomes rocket dot com slash reviews where you could take a look at our Apple podcast and leave a rating in review. I love hearing from you all. And so take your time take a minute leave us a note about what you thought about the show today and I always will promise to make sure that you have any ideas, we'll make sure to implement them that's what outcomes improvements all about it's about listening and doing your best to make sure you deliver to your customer, which is the patient. And so without further ado I want to introduce an outstanding guest today. His name is Dr. Clarence Lee Jr. Dr. Clarence Lee Jr. is a physician consultant. He is the founder and CEO of CMLeeJunior companies. He is also an author of a book called persists how to beat things that make us quit. An amazing gentleman that does also practice in health care. And so what I want to do right now is open up the mike to Dr. Lee and have him fill in any of the gaps in the intro. Dr. Lee welcome to the podcast.

Dr. Clarence Lee: [00:01:32] Thank you. Thank you for having me on. Yeah that's great great kind of overview of some of the things I've been able to do do some work in the personal development space and that's where the book kind of came from. And I just enjoy working with employers trying to help them get their workers comp costs down.

Saul Marquez: [00:01:48] And it's a critical initiative. Dr. Lee to bring those costs down because they can often be one of the largest line items aside from labor for employers. And so I think it's really interesting that you focus there.

Dr. Clarence Lee: [00:02:00] Yeah unbelievable line item depending on the structure of the organization. Yes I'm just straight pay cash for everything and just deal with a third party to handle their claims. But just what I've found is sometimes with the employer there's a disconnect with how the case is being managed and so you know I bring my experience as occupational medicine physician just trying to help the employer work with employee engagement and health and wellness as well as if there is a claim you know how do you compress that claim get the employee. Taken care of with proper care and in back to work as soon as possible.

Saul Marquez: [00:02:35] Man that's so cool and so Dr. Lee tell us something what got you into medicine to begin with. What's the genesis of it all for you.

Dr. Clarence Lee: [00:02:42] Yes my mom's a nurse so she introduced me into medicine very very early on. I'll try to keep this short story brief but one night so much she started off nursing. She was working the night shift and I don't know how exactly she negotiated this but one night I was at work with her single mom and I was going to do a good job to me work with her. And I had the opportunity to see what it was like she worked in the NICU to the neonatal intensive care unit so she worked in there took care of the really really small babies. So what made me make the decision. I saw a physician come in saw neonatologist come in one night and something hadn't been done for the baby. And this doctor was very very upset. So one in my life I had seen anger used in a positive way I had never seen anger used to do good. So this comes in and she's upset with something that didn't happen. And you could just see the passion in her eyes of how passionate she was about doing right by this patient. And so I just when she came in it's like hey this will get done this can be done this can get done. Oh let's just make sure we take care of this and focus on why we're here. But it gave me a perfect example how you can be very passionate about something and you can do good with it. And so that's the reason I said hey you know that looks like something I want to do. I can fight for a good cause and make some positive change in health care. So that was kind of the the main kind of catalyst that made me decide I think I was the physician.

Saul Marquez: [00:04:14] And that's so cool you're in this department. Nick you where you know things are so frail and gentle the patients the kids are there and you have this woman that walks in and just shows that you could use anger constructively and all of a sudden you're just the next thing you know years later you're doing some pretty amazing things. Dr. Lee and I love it you know. Appreciate you sharing that story.

Dr. Clarence Lee: [00:04:36] Yes absolutely. I think everybody has you know has a low catalyst but for me. You know that was the catalyst. And so I try to take that with me as I practice and as I consult with just understanding that hey the patient is let's not forget about the patient. I know I know there's numbers. No there's no know there's work schedules but at the end of the day that the patient is the number one thing. So I just try to practice with that with that kind of example in mind for sure.

Saul Marquez: [00:05:04] And so Dr. Lee you know you work with workman's comp and these segments. What do you think a hot topic that should be on every medical leaders agenda today should be and how are you and the organizations you work with approaching it?.

Dr. Clarence Lee: [00:05:18] I'd probably say at the top of my list from my advantage point is employee health and wellness. So I think in the market space there's a lot of chatter about how much are you getting pay what your compensation package what your benefits package things like that but what kind of gets missed a lot of times is the health and wellness promotional piece that a employer can do for their employee. And so we all kind of know in general if something's going on with the employee and they engage Miss not their profitability is going to be hit almost immediately productivity and profitability. Those are both things that are going to suffer and at the end of the day your customer as well. So if if your employee is not engaged that trickle down effect it happens on a lot of different levels so I think at the at the top of my list would be the health and wellness for employee.

Saul Marquez: [00:06:12] Such a key topic there you know and especially with the amount of health care deductibles being shouldered by employees. Yes what it is a company to do with this dynamic and incomes the idea of of oh, healthcare consumerism now. The actual employer has to start thinking about where they spend their healthcare dollars. What are your thoughts on that yet.

Dr. Clarence Lee: [00:06:33] Yes and you know depending on the state structure and you know your employer you're going to be paying it you know somewhere the poor are going to be paying about half of what that benefits package is for the employee. And I know at least in my experience a lot of the employees they don't know all the benefits that come with a lot of the programs that they pick or the the plans that they pick. And so you know I think from an engagement standpoint obviously education will be a piece of it but just letting the employee really understand what they're paid for and what they get with that and what comes along with it from a health and wellness standpoint because it's you know honestly medicine and medical insurance it is very reactionary right. All right. Something happening at all. What do I do. What do I do now or what's my plan now. But I think on the health and wellness piece focus and more on prevention obviously and then education on hey this is what your benefits are. You know I think those are huge huge ways like low hanging fruit on how you can decrease healthcare costs.

Saul Marquez: [00:07:40] That's interesting that you've always obviously been down this road many times and give us an example of how you and your organization have improved outcomes by focusing on this particular area.

Dr. Clarence Lee: [00:07:54] So I'd probably say it's very very very simple. Just getting all the stakeholders at the table and having a conversation. So just give me a example work with an employer. And depending on the company's structure you know they may have a national medical director or a consultant that they're working with that kind of communicates with the treating physician on how to manage the case and so many times you've got there's a bunch of players right. So you've got the insurance company you've got maybe a nurse case manager you might have a medical consultant then you've got the treating physician right then you've got the employee and you've got the employer. So many times people are operating in silos and when I say many I'm talking almost 90 percent of the time everybody's working and nobody at the table talking together. And so I just think a big piece of it is getting people in understanding what everybody's role is in having everybody on the same page about what we're going to do for the case. But yeah very very simple. And I found that when say your data adjuster is working an insurance company you've got a Trudel physician that wants to get something approved with everybody operating in silo you know it might be months or weeks before something gets approved and it's the right thing for the patient. What I found when you open those doors communication and get everybody at the table I can get things done very very fast for the patient when I've got a buy in from all the stakeholders. It makes sense.

Saul Marquez: [00:09:22] It does make sense. And so putting these these stakeholders together and just in a way that's going to help them make decisions quickly to help the patient in the end improve outcomes. You know Dr. Lee that's part of the reason why why I started outcomes rocket is because coming from med device for over 10 years I saw that a lot of people aren't talking to each other. There's a lot of silos in healthcare in general and you know you said 90 percent. I mean that's the truth. Right. And so you were dealing with numbers this high. It's imperative that folks like yourself Dr. Lee take the first steps in creating it. How do we make this siloed structure the methods that you have in a place how do we scale this Dr. Lee. How do we make this available across the board.

Dr. Clarence Lee: [00:10:04] That's a that's a big big question. But I would probably say that in the beginning stages is education and I know we all have our computer based learning and we've all got our thing. We've got to do our modules on and learn about. But I think in many cases people don't know what everybody else is doing. I think that the big problem though it might be a few people that understand the connection. But most folks don't know how many players that actually are there. And so I just think you know education on the overall process would be helpful. And it's funny because I was eating at a California Risk Assessment Conference a few months ago in my in my breakout session I was talking to a lot of risk managers and safety officers organizations and I said well how many of you guys have an actual education system where you educate the employee on the process of the worker's comp claim like what's going to happen. You're going to get a nurse case manager you're going to have a treating physician. This now works when you get things authorized. This is how charism will be rendered. And 75 percent had no no no education in place at all. It's like oh yeah we give them the packet. We say hey read this 4000 paid manual here.

Saul Marquez: [00:11:29] Oh you know what happens to the package.

Dr. Clarence Lee: [00:11:31] Yeah yeah. We'll check in with you in a couple months and see how you doing. Well that's going to lead to bad outcomes because the patient doesn't understand that and they think you're not on their team and you're not you're not trying to take care of them. And again with customer satisfaction so with employers employees not satisfied then that leads to litigation at least the longer cases right. But if you if you educate on the front end hey this is the system this is how it works. These are the stakeholders. This is who they have taken with you regularly the case gets compressed significantly and costs go down big time. So you know I would just say education if from a worker's injury you know employee injury perspective if you're an employer what is your system on educating that patient. Greeno for me about educating the patient on what's the process in the clinic.

Saul Marquez: [00:12:17] That's a great great call out there Dr. Lee and yeah you know it's as simple as understanding getting out of the trench and understanding that bird's eye view of what your treatments looking like so they know how to manage it. That's awesome. I know it's simple but not a lot of people are doing it. Let's let's get this attention to the bird's eye view and educate the patient. The patient wants to be involve outcomes listeners the patient is a person and you know we want to make sure that he has a patient I want to know exactly where do I need to go if something is stuck. So I think this is really really awesome that just tidbits that you've shared. Dr. Lee thank you for sharing that.

Dr. Clarence Lee: [00:12:52] Absolutely yes. And we want to get you know you want to get the patient taken care of as quickly as possible so I can avoid hurdles. That's what I want to do. But I can tell you the majority of people when they're dealing either with their insurance just in general just not understanding the process and feeling like the machine isn't working for them. And so I think you know here we do have a responsibility as an organization you have or possibly as organization to do your due diligence and make sure you are handling your finances appropriately. So I get that. And that's the line item piece. But there's also the patient side. Right. And so sometimes there's a conflict between the two on the care in say the line item how much something is going to cost and I just think as you open those doors of communication and the other piece I would say also is the treating physician needs to be rolled into this. So that's another thing that treating Doug. So does he get considering those conversations as well. But yeah it's we've got we've got a lot of work to do. But you know I'm dedicated to helping folks and sharing the knowledge that I have to help both speed speed care up and get cost down.

Saul Marquez: [00:14:06] Dr. Lee, that's so cool. And so give us an example of a time when you had a setback in this space and what you learned about it.

Dr. Clarence Lee: [00:14:14] Let me see. You know I saw that question before I was like Which one. There's been so many. You're learning every day. But yeah I would probably say it would be along the lines of what I'm preaching about communication. You know I had a case where a patient had had a fracture we needed to move quickly on it had reached out to the employer and tried to get to claim you know sped up and get the adjuster on board. But the adjuster. And so I punnet so I'll tell you that the the mistake that I had is that I punted it to who was handling the claim at the employer and long story short. It ended up taking weeks for the patient to get what they needed because we couldn't get the authorizations through. And so what I learned from that is the exact thing that I'm preaching now and I learned from it was all of the stakeholders were not in the conversation. And so it wasn't enough for me to just do who who was managing the claim with the employer needed to pull in the insurance company also needed to pull land the claims adjuster and a nurse case manager because there's a lot of stop gates along the way. So you know it was yeah just me kind of thinking stuff was going to happen without without me like buyers are there everybody good every value included and the patient ended up suffering at the end of the day. So that was the huge huge huge mistake on my part going on as a this is something I can learn from. Get the stakeholders at the table upfront. Wow

Saul Marquez: [00:15:47] And so this is sort of what became the start to your platform right. I mean you basically felt the pain and you saw it happen and now I guess just said hey never again I'm not going to let this happen.

Dr. Clarence Lee: [00:16:00] Yeah. It's you know this is personal. You know personal philosophy that I have it's like hey I believe everything happens for a reason and hey I need to learn the lesson even this is something that I need to learn the lesson from this and then try to do everything I can to make sure this doesn't happen again. So that's how I kind of started doing more consulting with employers. And hey let's make sure that this doesn't repeat with yours or hey what's your system like in place you know what was the system that you do have in place and say something did happen really quickly and you needed something to go quickly. How would you handle it.

Saul Marquez: [00:16:32] And you handled it really well. Dr. Lee and listeners this is the reason why there's questions here. The reason why we ask this to all of our guests is that in your biggest challenges and your biggest setbacks if you look at it with the right perspective you're going to find your biggest opportunities and. And Dr. Lee obviously did that and what he's done is now created a ripple effect of positive change in the healthcare system. What can you take a look at now. You know if you're going through something right now what can you do to change the perspective and see the challenge that you have in hands as an opportunity. What comes out of there is up to you but it could be pretty amazing. Dr. Lee give us an example of one of your proudest leadership moments in medicine today.

Dr. Clarence Lee: [00:17:14] Now switch gears slightly but from a leadership perspective I believe that everybody that you're working with it is important for you to know their goals and aspirations outside of their current role. So I say that because in the organizational structure where I work in the clinic it's like hey I've got medical assistance I've got back office I've got chiropractor I've got physical therapists I've got nurses I've got all these folks. But for me I always want to be interested and show my interest in what independent of their role what dreams and aspiration does that person have. And so the story I'll tell is having the way that I currently work with and been working with for two years. And when we first met kind of go through this hey what are you into. What are your dreams what are your what are your aspirations. What do you want to do with you. What are you going to do with your life. I to start that right. Oh my God they're just about to go. Were you. You know the question the most story short you kind of voiced her interest that she was interested in becoming a nurse at the time. And you know that was her dream. So every day just kind of asking Hey what's your plan what are you going to do and you have enrolled in school and how are you going to do this. And just kind of talking and about two year timeframe she is in her last year good very start her nursing program and she was full time. She is now doing part time in a finish up her nursing degree. Less than a year. So that's the type of stuff that really liked me from a leadership perspective if you're leading people they need to understand that you care about them not just their role not just the organizations benefit from having them there but show that you are genuinely interested in them being successful in life. And as a person and you got to know their dreams and aspirations to do that. So when she or she came in and said hey I'm going to go part time I want to finish my degree I'm less than a year out but just wear my heart up with joy that I was able to just continue to encourage her and give her that confidence that she can do that she can figure this out.

Saul Marquez: [00:19:28] That's so awesome. Yeah that's and that's a good reminder Dr. Lee you know we work with people and are not just robots in a factory and it's just it's so important to line up to other people's needs wants and desires and dreams.

Dr. Clarence Lee: [00:19:41] Because once you have once you have their body and once they know that you're interested in them and not just their role or their profit line that they're associated with they're more engaged in the workplace that they're more engaged in the workplace because they know that you have now aligned yourself with their goals as well. Not not is it just the employers goals. If that fence you're now aligned with their personal goals and that's that's the ultimate level of engagement there.

Saul Marquez: [00:20:08] Powerful yeah I totally totally agree. Dr. Lee getting close to the end here. Let's pretend you and I are building a medical leadership course on what it takes to be successful in medicine today. It's the 101 course or the ABC of Dr. Lee. And so we're going to write out the syllabus here. I've got four lightning round questions for you we'll answer those quickly and then we'll finish up the syllabus with the book that you recommend to the listeners are you ready.

Dr. Clarence Lee: [00:20:33] Yup, ready.

Saul Marquez: [00:20:34] Awesome. What's the biggest and best way to improve healthcare outcomes.

Dr. Clarence Lee: [00:20:39] I would say man I was already for. I would say I would say education. Yeah I would say education.

Saul Marquez: [00:20:44] What is the biggest mistake or pitfall to avoid.

Dr. Clarence Lee: [00:20:46] Not communicating operate in silos. What are they. Well we've been talking about it.

Saul Marquez: [00:20:52] How do you stay relevant as an organization.

Dr. Clarence Lee: [00:20:54] Despite constant change say no cutting edge always looking for the next thing in anticipating or expecting it. Instead of optimizing what's working right now always be looking toward what's up becoming.

Saul Marquez: [00:21:07] What is one area of focus that should drive all else in your organization.

Dr. Clarence Lee: [00:21:11] I say employee engagement you know how engaged are they how aligned are the organization's goals with that person's individual goals.

Saul Marquez: [00:21:19] And finally Dr. Lee what is your all time favorite book that you'd recommend to the listeners on the syllabus.

Dr. Clarence Lee: [00:21:26] That will be a tough one. But I'd probably say of the Seven Habits of Highly Effective People. I think it's a brilliant brilliant book and an excellent framework for activeness.

Saul Marquez: [00:21:37] Outstanding. Listeners, you don't have to write any of this down go to That's Dr. Lee. And you'll be able to find all the show notes that we've discussed as well as the syllabus that was just created for you and your success as well as links to the book as well as the links to all the things that Dr. Lee is up to visit that You'll be able to find that there. Dr. Lee, before we conclude I'd just like to ask you to share one closing thought to the listeners and then the best place where they could get a hold of you.

Saul Marquez: [00:22:14] So I always kind of endless and personal development stuff but I would just say hey if you have a vision get a vision for your life or your organization just to keep pushing out there and continue to optimize and do not give up too early and the best place to connect with me is you can just visit me on the web my Web site. It's

Saul Marquez: [00:22:37] Fantastic Dr. Lee. Thank you so much and listeners. Be sure to persist like Dr. Lee talks about and beat those things that make us quit. And Dr. Lee again just want to extend a big warm thank you to you and on behalf of the listeners and myself for being on the show today.

Dr. Clarence Lee: [00:22:53] Thanks for having me on. I had a great time.

: [00:22:59] Thanks for listening to the outcomes rocket podcast. Be sure to visit us on the web at for the show notes,, resources inspiration and so much more.

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Outcomes Rocket Podcas

Why HCA Invested in Precision Health Initiatives with Mick Correll, President at Genospace

: [00:00:01] Welcome to the Outcomes Rocket podcast where we inspire collaborative thinking, improved outcomes and business success with today's most successful and inspiring healthcare leaders and influencers. And now your host, Saul Marquez

Saul Marquez: [00:00:19] Outcomes Rocket listeners welcome back once again to the outcomes rocket podcast where we chat with today's most successful and inspiring health care leaders. Really want to thank you for tuning in again and I invite you to go to to give us a rating and review and let us know what you thought about the show. Love hearing from our listeners. And today I have an amazing guest for you. His name is Mick Correll. He's president at Genospace. Mick has done a fabulous amount of work in the space that he's currently in. He's held several different roles. I want to do is give Mick a warm welcome and have him as the expert dive into what they do at this amazing company. Welcome to the podcast.

Mick Correll: [00:01:07] Thank you Saul, it's all a real pleasure to talk to you today and you know thanks again for invite me also.

Saul Marquez: [00:01:13] Absolutely Mick. So maybe we can walk through a little bit of what you guys are up to at Genospace for the listeners.

Mick Correll: [00:01:20] Yeah sure. So you know you space is a software company we're based in Cambridge Massachusetts and it's really what we focus on is the application of Nomex in medical care. So we're kind of two parts what we do on the one hand. We're trying to help make gnomic information useful to doctors and nurses and patients at the point of care. So powerful technology complicated. How do we use these resources to help the individual involved to make better treatment decisions. That's one part of it. At the same time though we really recognize that this is kind of a special opportunity that we shouldn't think about Nomex just like any other laboratory test and we're really trying to capture that detail so as we as we applied to Nomex in mainstream medicine how do we actually enable them to fuel more of a learning healthcare system. How do we capture the details from this routine practice to help build an aggregate better data that can drive future research development and application.

Saul Marquez: [00:02:28] It's really interesting. You guys have done some really cool things matching patients to trials. Population analytics. I mean you guys are really diving into some pretty cool things and even getting deep into like molecular pathology reporting. I mean super fascinating. I want to take it back to the genesis of it all to why Mick is in medicine what is it that got you into this field.

Mick Correll: [00:02:52] You know it's been an evolution over time. I started out you know pretty early in life I was really drawn to biology and a lot of ways it really wasn't even much of a question for me. You know I thought about the different things that I could study and apply myself to the science of life was incredibly attractive to me. I mean I've always come out to think about the big questions you know who we are why we're here kind of midway through my education I stumble into computational biology and I was blown away like this is going to change the world moved out of Cambridge she started working at a startup company and in the Maxfield and this was more on the research side of things. So it was more oriented towards the pharmaceutical target identification development. It was cool it was really interesting but it was also a little bit abstract to me. So this was drawn more towards the clinical application side of things it really all that sort of jelled together when I when I started working at Dana Farber I can tell you. I mean you know when I'm coming to work every day the fiber had kind of come to the third floor and I walk past the Jimmy Fund Clinic which is the pediatric oncology unit and we've work in a place like that you never question why you're coming to work every day. You know I've always I've always loved the science but kind of having that that feeling of kind of more direct connectivity to how and why what you're doing is actually helping to you know impact you know individual people's lives has sort of been brought into it.

Saul Marquez: [00:04:18] I think that's so cool. And you know you came from the science background and research and then you get to the point where you're constantly reminded you know when you have a clinic right there every time you walk into work you're reminded of why you're doing what you do. And fast forward to today with this amazing solution that you guys have built. I'm just curious what do you think in the array of different things that are out there for leaders to focus on. Should be that one thing that leaders should be focused on today in improving outcomes.

Mick Correll: [00:04:49] You know I'll give you it's probably a little bit of all of a long winded answer here. And obviously I think to Nomex and understanding the molecular basis of disease is a big deal. I mean I think this is going to change the entire practice of medicine at the same time you know I think there's something bigger going on as well in a lot of ways it can be best captured under the umbrella of synthetic biology. You know I think you combine the capabilities of genomic and I use that term broadly that's giving us this incredible microscope to really understand what's happening in ourselves at a molecular level. But observation isn't enough necessarily right. I think what gets me so excited about synthetic biology is in the past we had these really crude tools for manipulating biological systems and synthetic biology is a game changer in the sense that now we have these really precise ways to manipulate these biological molecules. And the reason I think it's so important is that it's moving biology away from being simply an observational science to more of an engineering discipline that now we can we can take this machine apart and put it back together again. The reason it is so important is I think this is going to be an incredible source of innovation. I don't think that I think we're already starting to see some of this hitting the clinics. And you think about Karti therapies and the resurgence of gene therapy. When I look ahead I think we're going to have one new treatment capabilities that are fueled by the US and I think of how this intersects with the healthcare system that is I don't think innovation going to be our challenge. I think it's going to be how do we disseminate that innovation and how do we actually get a better understanding of how to use these tools how and when and where they actually are effective because trials are going to get you there. It doesn't. Even our biggest and our best trials they're pretty effective at understanding safety profile and establishing that something has efficacy. But the reality is most drugs don't work in most people and I think we need a system wide perspective to get much better at measuring and tracking what's working where so that we can become much more focused and targeted about. This is why the implication. You know I think there's a lot of capability out there some can be expensive. We get to give a lot more about how and when and where to use these kind of tools.

Saul Marquez: [00:07:27] I love your passion. You are a gentleman that really understands this stuff and you're so passionate about it from the firsthand we connected to now I just I love it. Man every time we talk I get energized and I think you sort of nailed it on the hand here with the thought that innovation is not going to be the problem. It's implementing this innovation and disseminating this stuff that's going to be the challenge of this century and how we're going to push forward our our health care system. As a leader Mac what do you do. You know as a as a leader provider as a leader payer as a leader let's just say Medtech space or manned device space. How do you digest this what do you do with these capabilities that are going to flood in.

Mick Correll: [00:08:10] I think across the board I really think it comes down to being much more purposeful about what is success look like and how we didn't know when we see it right and then we can talk about improving outcomes. What are we actually mean by that. How are we measuring that. And then I think getting across the board both an individual perspective. You know I think there's a ton of potential in wearables and devices that people themselves can get involved with the systems themselves. Me I think you know I think every stakeholder has a role to play here. But I think that like you said to me I think it's going to be an implementation and the dissemination. But I think the key is going to be how are we going to longitudinally track and measure the factors that we're trying to optimize around from the moment you know from the medtech software side of things it's a clear area for innovation. Doctors don't you know we've turned some of the most valuable actors in the whole system and turn them into data coders and capture them see that they don't like it. No they don't like it at all.

Saul Marquez: [00:09:14] It's a problem.

Mick Correll: [00:09:15] You know the more the more poor job with them we play it. I think you know I think more electronic medical record systems for the clinical work was I think you know there's a lot of different ways to come about it but I think being more purposeful about really thinking about what the endpoint we're trying to optimize around and then how do we capture them so that we can have millions or to grow this but you don't understand understand trying to optimize on most your models are going to be pretty weak.

Saul Marquez: [00:09:44] I love that Mick and it just really is the basics right blocking and tackling. Understand what you're going after.

Mick Correll: [00:09:51] You do have the right and it's you know a lot of it can really revolves around billing optimization of billing system not around health outcomes.

Saul Marquez: [00:09:59] And then the other thing too right. So based on that topic make these big health EMR HHR systems are big billing tools. They're not really outcome tools. And so what are we doing to optimize these technologies to help improve outcomes. I think shifting that measurement from billing to outcomes improvement is going to be key. Would you agree.

Mick Correll: [00:10:22] Absolutely. I think at that point of care I mean you know being able to understand why did someone come to a doctor. What did we do. And how did it work. Just those basic elements are something that we don't capture very well. I mean you know the only other other layer on top of that is we've got to be able to exchange that data in a pretty precise way. We've got a really fragmented healthcare system not about you but you know when I think about even like getting my medical records I don't know where I'd start. So we have different doctors and hospitals across well I've got to remember how well they are may not even exist. So this is like people are just staying in a single system their whole lives. I think they're moving around between lots of different sources so I think you know we've certainly seen that there's a lot of power at an individual level that people can be a real force of change here that the natural aggregator of your medical history is you. But but but that's going to depend on the systems having captured Reliable data in the first place and then having mechanisms that they can exchange it and make it accessible to each other and back to the individuals themselves.

Saul Marquez: [00:11:35] Yeah I think that's such a great point. Mac can you dive into let's zoom into the genospace activities and can you share with the listeners a way that you guys have helped improve outcomes.

Mick Correll: [00:11:47] I think some of them are really really clear and direct. I can tell you one of the things that really gets the team here really jazzed and proud of the work we do is when we get these stories back from the clinics. So from the work we're doing with our molecular pathology partners a lot of those there are those who dared to say listen I had a tough case come in had you know really interesting you know set of you know molecular characteristics I was seen in that tumor Alamosa were most produce in cancer you know say you know using your tool. Came across a drug or a clinical trial that had been recently approved who was associate with those mutations and you know I are still to come back and give that doctor that patient option that you know without you might not have ever found. So those are really clear examples of just where the tool is helping to use this rich information source to help inform some of the profit might be. I think on the other on the other side the harder to measure some of the research aspects of things. I think with our tools so we've done a lot in making making the information more actionable and commutable key thing for us is thinking a lot about data models. You know one of the one of our real differentiators is how we structure information of what and what we can do with it. And I think you've taken a pretty innovative approach there. So being able to make those kind of bring those insights into clinic but then on an ongoing way capturing in a much deeper way and rendering that body of facts to drive researchers to sort of be the other and that I think could take more time I think that up to a fully mature but we're seeing some early signs of that.

Saul Marquez: [00:13:29] It's really interesting. And now you guys are really taking a detailed very interesting approach in how you guys formulate these data sets. It's pretty interesting to see your company and your team really dive into the details of this because it will make a difference. And I am curious you know you've done a lot of really great things. Tell us about a time when when something didn't go the way you wanted to and what you took from that.

Mick Correll: [00:13:54] Well I mean there have been plenty of mistakes along the way.

Saul Marquez: [00:14:00] We all make them and I think that's when we learn the most.

Mick Correll: [00:14:04] Yeah you know I mean I think there is one instance that really stands out in my mind. So there was a point in the development of our company in the not in the not too distant past when there was a pretty significant change around the reimbursement of these oncology tests to these molecular tests and oncology. And at the time I got a call from from one of our customers. It was also a close relationship and they become you know a friend of mine and he called me he said you know I don't know if you saw this or not but this is a big deal. This is going to be something that's going to have a big impact on us and I think on YouTube and sort of registered a little bit of time. But it's hard to really see like sort of how a change in one part of the system is going to directly impact what you're doing. And I think to a large extent I mean a lot of our philosophy has been that your own ability to execute is far and away going to be the most important factor of success. Right. So it's not just having a good idea it's it's the execution had to do it. Right. And so to some extent we were kind of like heads down like yeah. Wasn't that the change. It feels like it's so far away from us that isn't really going to impact us. So oh we going just continue on the course but we kind of like double down. We like really accelerated our efforts in that space. And sure enough four or five months later it was a really challenging place to be working in. It was a it was just a strong headwind as a small company and I look back on it was like, listen I miss the signal. You know it was there somebody actually called me and delivered it.

Saul Marquez: [00:15:43] And when it happened Mick did they just cut reimbursement for those tests or what exactly happened there.

Mick Correll: [00:15:48] Yeah I mean the change was you know prior to that was sort of a stopgap mechanism that was what this code staffing approach. But the real change to me was on the one hand it was positive in the sense that they were recognizing the validity of these multi gene panel techs and actually giving it a code. So it's good I mean this is you know basically accepting the clinical utility of the tests at the same time the reimbursement rate got set for it was really low and it was just going to be in that clinical sequencing is kind of a linchpin for what we do. Right. And so it just introduced I think the economic headwind that immediately you know it was a couple of hops away from us. But you know you play that for four or five months and it had you know a challenging effect on the landscape.

Saul Marquez: [00:16:39] So what did you learn from this. How did you guys pivot. Where are you guys now.

Mick Correll: [00:16:42] So I mean what I learned from it was you know I think I do believe there's merit to that heads down execution approach at the same time it really impressed upon me the importance of how that needs to be modulated by the macro trends in your industry. I think healthcare especially is one that is subject to pretty wild swings based on you know intervention and regulation. I think you don't see him coming out right now. Right and I think you know government and other actors can loosen heavily influence the way the whole marketplace works. I think especially when you're growing enterprise about deep pockets. You got to be paying attention to that stuff. You need to modulate what you're doing based on some of those larger factors was an important learning from me. I mean I think what divorce is. I mean it did force the company to make some more of a pivot that you know I think we had always kind of preserve option out of what we were doing. We tracked adopt point we saw that the clinical lab space was going to be challenging and we tracked hard towards the health systems and went all in on that. And listen we got to be tough with the play we got to we have to think about how our tools can be applied in other parts of the system. And we went after the health networks in a big way and you know ultimately that was going after those groups that in the acquisition of a company.

Saul Marquez: [00:18:02] That's really cool and make I really love this story that you told because there is merit like you said to putting your head down and just grinding and staying focused on your goals. But in this space that we're all in listeners this space of healthcare it is so important to realize that these macro trends these changes in policy these decisions that get made can truly impact our business models in a big way. Take this pearl from Mick and make sure that you take into consideration these changes don't just ignore them. So the acquisition that Mick is talking about is that they pivoted. They refocused and they were acquired recently. How long ago was it to January of this year. January of this year. So you guys were acquired by hospital HCA right.

Mick Correll: [00:18:53] Yep. It was Sarah Canning which is the cancer institute crêpes. Yes.

Saul Marquez: [00:18:57] Amazing. So something that was so challenging for you make you and your team turned around and started focusing on these larger networks which are not easy to get into but you guys pivoted went for it. They saw the value of it and acquired you.

Mick Correll: [00:19:14] It was an exciting time a company. I mean I think we have been Serkin was a group that we had been involved in discussions with for many years. And just at the point where you know things are starting to get challenging in the lab space meant opportunity came up to kind of get back in discussions with them and I think most people would say we made it we went all in on base. We stopped work on everything else in the company said we've got to win them. This is where we have to win right now and we put everything we had into really proving to them that we had the capabilities and technology to really significantly impact where they were going and how they can get there.

Saul Marquez: [00:19:51] Mick I think that what you did that decision of saying OK I'm going to stop working at everything else because I see this as a priority. I see this as a strategic place to focus is a skill that is so valuable in a leader and for the listeners running's health systems and companies and you know insurance plans. What is your focus and having the ability to turn everything else off and focus on that one or two things is going to be pivotal to your success make such an exciting time. And kudos to you for being able to say all right this is where it's at. I'm going to focus. Was there any fear behind your decision.

Mick Correll: [00:20:34] Yeah. Yes.

Saul Marquez: [00:20:37] What was the view would be a better question.

Mick Correll: [00:20:39] I mean I think the whole you know the whole experience of running a startup is it's an emotional roller coaster and I mean it can be terrifying sometimes.

Mick Correll: [00:20:47] I mean we like you don't know playbook you don't know at the time if you make of the word decision or not. So yeah there's a lot of line. I think you know you've built these relationships with your customers and they're depending on you you've got all the people that work there. They're putting their heart and soul into it every day. Sometimes it's as a leader sometimes you have to make those tough calls. And as you know you get a lot of people depending on you and you don't want them out now for sure.

Saul Marquez: [00:21:14] Now it's a big one and you got to have the courage to say no. I see I see this I hear the music and I know this is where it's going. And then just going for it not hesitating just making a decision. Mick, I wish we had more time we're going to have to keep moving here. Let's pretend you and I are building a medical leadership course on what it takes to be successful in medicine today. It's the 101 or the ABC of Mick Chorale. And so let's write a syllabus together. I'm going to ask for lightning round questions and then finish it up with a book that you recommend to the listeners. You ready?.

Mick Correll: [00:21:48] Yup.

Saul Marquez: [00:21:48] What's the best way to improve health care outcomes.

Mick Correll: [00:21:51] The system that we measure and track and wanted to know.

Saul Marquez: [00:21:55] What is the biggest mistake or pitfall to avoid.

Mick Correll: [00:21:57] Got to understand clinical implementation and economics. Going to use your product and why. And understand the flow of dollars. It's not easy to do in health care but if you don't understand that it's going to be a real uphill battle.

Saul Marquez: [00:22:12] Love that one. How do you stay relevant as an organization despite constant change.

Mick Correll: [00:22:16] To solve the hardest problems or at least try to.

Saul Marquez: [00:22:19] What is one area of focus that should drive all else in your organization.

Mick Correll: [00:22:24] For us, keeping science at the center has been important. It's been one of the defining characteristics of our culture that we attract and retain our people being passionate about the domain of the love that is why they're here. And you know being data driven and disciplined about what we do is at the center of it.

Saul Marquez: [00:22:41] Finally Mick, what is that favorite book that you would recommend for the listeners and put on the syllabus.

Mick Correll: [00:22:48] Those are the hardest questions. You know I love to read. I don't read out of business books but I like to read books for fun. So not on the syllabus. But you know my favorite book of all time my desert island book Infinite Jest. It is almost 20 you know Infinite Jest by David Foster Wallace. And that's one of the most good boys about a lot of different things. The big sprawling complex. But in terms of kind of understanding what it means to be a citizen of this country both time and place in history. I feel like it just brings so much perspective. I love it. You know my favorite book that is awesome.

Saul Marquez: [00:23:25] Well listeners I will definitely have to pick that one up I encourage you to do it as well. Go to That's M I C K and you're gonna get all of the show notes to everything that we just discussed today. Details and also links to Mick's company the things that they're up to as well as this book that he just mentioned. Mick, really wanna thank you for being on. Before we part, I want to ask you to just share one closing thought and then the best place where the listeners can get a hold of you.

Mick Correll: [00:23:57] You know my closing thought is kind of where I started. Synthetic Biology. I think I would encourage all the listeners to think for a few minutes about what it's going to mean when when we gain mastery of the molecules of life. I think and have ethical considerations way beyond health care. I think it will decide we've got to start having dialogue. So think about it. The best way to find me you know info@genospace.

Saul Marquez: [00:24:22] Outstanding Mick,. Listen I really appreciate your thoughtfulness and the words of wisdom you've shared and the stories. I know that it's going to resonate with the listeners and and I really will be keeping track of what you guys are up to because it's so exciting. And definitely be thinking about synthetic biology so Mick, thank you so much for taking the time to be on the podcast today.

Mick Correll: [00:24:47] Thank you. My pleasure.

: [00:24:52] Thanks for listening to the Outcomes Rocket podcast. Be sure to visit us on the web at for the show notes, resources, inspiration and so much more.

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Outcomes Rocket - Sanjay Shah

Why Implemention is The Best Way of Innovating in Health with Sanjay Shah, Director of Strategic Innovation at Dignity Health

: [00:00:01] Welcome to the Outcomes Rocket podcast where we inspire collaborative thinking, improved outcomes and business success with today's most successful and inspiring healthcare leaders and influencers. And now your host, Saul Marquez.

Saul Marquez: [00:00:19] Outcomes Rocket listeners. Welcome back once again to the outcomes Rockit where we chat with today's most inspiring and successful health care leaders. Thanks so much for tuning in. Visit us at And that's where you'll get an opportunity to give us a review on Apple podcasts. We love hearing from our listeners as well as our guests. And so take the time give us your perspective and we'll make this show even better each time you turn it on. Without further ado I want to introduce my outstanding guest. His name is Sanjay Shah. He's a director of Strategic Innovation at Dignity Health. He helped support dignity's health innovation efforts which seek to create test and invest a novel services programs partnerships and technologies from within or outside of healthcare that have the potential to reduce costs of care, improve quality or increase access to healthcare services across the organizations 39 hospitals in Arizona Nevada and California. He's got a wealth of experience in healthcare. But what I want to do here is open up the microphone to this wonderful man. Sanjay welcome to the podcast.

Sanjay Shah: [00:01:37] Thanks. So how are you doing.

Saul Marquez: [00:01:39] Doing fantastic man. It's a pleasure to have you on. It was great to connect with you at Health 2.0.

Sanjay Shah: [00:01:45] You know there was a great energy in that environment. It was all interesting I think for all of us to see now that HIMMS has acquired Health 2.0 to see what would happen what would change what would be different. Matthew Holt come out in a tie and get inside come out with shorts as well. But you know it was none of it changed. It was a fantastic event. As usual a lot of great early startup energy passion and focus on the patient voice and how that should be heard and can impact the way health care is created practiced and provided.

Saul Marquez: [00:02:20] Yeah I agree. It was awesome and really enjoyed the energy. Yeah that's a good call. The energy and I loved talking to all the people that stopped by the outcomes rocket and you know I wanted to ask you. We didn't get to connect on this but what got you into medicine in the first place.

Sanjay Shah: [00:02:36] You know if you're if you're South Asian or Indian descent your family and in my case my father especially kind of prescriptive wants you to be a doctor that they planted that seed early on. But I'd say that pretty quickly became my vision of what I thought I really wanted to do and it really was being a practitioner and to be a physician had no thought and specialty in terms of what would be an interest or a focus. And so as as I was going through junior high school and even my first year of the college someone would say What do you want to be. And it was I want to be a doc and then I opened up the cat. My first day of studying for the Incat and I shut it immediately afterwards. I don't want to be a doctor. This is one of those things where I was fortunate to be able to experience a couple of different fields while I was still in college and I took my first business class after a semester of prelaw half a semester of education and political science. And then I took my first business class and it just clicked. I said there's something around the aspects of business and then that aspect of business and health care that really connected to me as what I was excited to do going forward.

Saul Marquez: [00:03:58] Wow. And then you just kind of found your space business intersection of healthcare and here you are.

Sanjay Shah: [00:04:05] Yeah. You know I've been fortunate to experience all different sides of healthcare. And so in the beginning there was a local durable medical equipment company called the low rental on Warren Michigan. It happened to be one of my best buds today. The name Shaji Jacob and it was his family owned family business and his father gave me a chance to understand how to run a small health care business from the ground up anything from patient care to billing to position management claims supplies and management and delivery. And so it was it was a great apprentice. And from there I got a chance to really just go right I understand how to how to navigate something including when reform and regulation happened which completely changed the business that you could bill a traditional fee for service on a monthly basis to a capped service. So you pretty much lost your patience after three years and if you weren't a large enough player you had to change it. Think about your model differently so it was fascinating to see all of that and then matriculate down you know from an MBA to a little bit you know if you're from the Midwest you have to spend some time usually on a motor company. So after I did I did my stint at Ford Motor Company for a little bit and at that time actually found the end of Excel it exists. I created a sheet that actually got all the way to the end. How can I go any further. Yeah. It's like triple Z or something like that. But.

Saul Marquez: [00:05:31] It's funny.

Sanjay Shah: [00:05:31] You know it was it was good to experience that but then was fortunate to do what was called an innovation function about the medical innovation center at the University of Michigan. Some consulting in the innovation space all related to health care healthcare in academia healthcare in practice and even in industry. And then came out to California with the California Health Care Foundation which was to practice not only the grant side and development of grant initiatives but to also invest in introduce or entice startup companies to focus on their patient markets and had a great four years there and learn a lot about really the distribution of funds and managing funds into the venture side. Even though it was from a nonprofit a non-profit sector but they were real venture Metro levers and I wanted the chance to get really hands on in operations. And that's what the opportunity a Digne health became two years ago and it's been fantastic ever since.

Saul Marquez: [00:06:28] That's so cool and you really have had the full gamut of every single stakeholder in healthcare. This theme of innovation Sanjay it's something that is on the agenda of a lot of healthcare leaders. But what would you say makes innovation strategic rather than just innovation for innovation sake.

Sanjay Shah: [00:06:45] I'd be remiss if I you know quote my my boss the chief cities innovation officer a Dignity health betroth and today. It sounds cute but it's real innovation in healthcare today. Implementation. We're catching up as an industry on all of the different technologies and mediums that exist in so many other industries. We're just incorporating them now into healthcare and whether that's good or bad is not really the debate but it's happening which is what what's good right we're catching up folks that have purchased things and experience solutions and experience purchases and different service layers in finance and consumer product goods and shopping and even food. Those are becoming core now to health care. But in healthcare while we're catching up on all those things the key is is to implement. And it's not just the pilot but to implement at scale is really the secret sauce of innovation. If I go back to my innovation consulting days when we when we played the semantic game around what's an innovation it wasn't invention right. Invention is the idea that you build something right. Innovation happens when people adopt it when you scale it. So it's not so much concerning around whether this is incremental versus disruptive but it's about the fact that are people using it and arm people making it a part of their everyday practice. And I think that's the key. That is the key differentiator of innovation in healthcare today. Some things are still early on in stage and invention level and others we have been able to go ahead and full fully really revamp and change and transform the way health care is practiced and those are the real innovations that we're standing on today.

Saul Marquez: [00:08:26] Sanjay that's such a thoughtful response there and innovation is implementation listeners. And so think about that across the continuum of services and industries. We have so much going on by way of you know new products new services new technologies. How can we implement these into our facilities into our patient care methodologies in a way that helps improve outcomes. I think this is so awesome Sanjay and a great perspective to put on innovation its implementation.

Sanjay Shah: [00:08:58] You know I had a thought yeah backing off implementation and this notion of outcomes and you know you titled this podcast outcomes rocket there's something to innovation in outcomes as well. That's a little different to healthcare. Healthcare traditionally and the way it's reimbursed and the way it's measured in the way health is defined is for all all the right reasons. On a longitudinal scale and so traditional metrics take a long time to get to there are scientific and their approach. Their evidence base their research their research. You know in its purest core. But then you try to overlay that in the innovation world which has to move at a different pace whether it's for catch up or to get ahead. And I think one thing that just came to mind is this notion around taking those traditional metrics that are still valuable still impactful still the way that a majority of the business and operations run. But unpacking them in a way whether you call them K.P. eyes or micro metric things that will show you trends things that you can measure in three to six months that you can feel confident on and will help you scale that innovation help you implemented further versus waiting for the full you know 18 to 24 month cycle to determine did we avoid a readmission or did we significantly improve patient insurance based off of you know the full end of outcomes on the back end. And so I think there's something to also this these two sides that are against each other when it comes around innovation and outcomes and starting to strip away the traditional measures in more digestible pieces which will then help your innovation scale further and farther and give you the time you need to build momentum and a business case and value to prove those hierarchy outcomes that you started with in the first place.

Saul Marquez: [00:10:50] Now that's a really interesting idea Sanjay so basically you're coming from the premise of the cycle the time cycle in health care can be a little too long. Why don't we chop it up into more digestible units. To then be able to scale more effectively.

Sanjay Shah: [00:11:06] Absolutely. I mean if you look at any startup partner and the venture partners and with us being in the Bay Area obviously we're swimming in a great market of all kinds of very interesting activity from venture corporate the tech companies and the startup companies. But if you tell them that they're on an 18 to 24 month evaluation that can be literally in and of itself can be what really is a startup initiative. It can be what ruining something that was entrepreneurial. So by unpacking the traditional metrics into bite sized chunks it allows the company to keep hitting strides or the innovation initiative to keep hitting strides and build momentum but still allow you to kind of buy into it and spend into it so that you're not prematurely ending things because you're afraid of the long tail or long process. Wish those two things are at odds with each other right from the beginning. You can't move fast and evaluate innovation if you're tying into a metric that takes two years to get together.

Saul Marquez: [00:12:04] That is so true. And so how do you make it work then. So if you have such a you know a long traditional cycle how do you make it into bite size pieces.

Sanjay Shah: [00:12:13] I think it comes in our case and in our environment to health what's really helpful is we bring a lot of different stakeholders in any innovation initiative together and deliver that might be the operating team key executive leadership I.T. legal H.R. administrative services. And we look at an innovation initiative we understand are our processes that we're going to have to do to get something from our initial review to actually getting into the operations and implementation. But then we're looking at well what would be really needed for an impactful along the way we understand what the eventual target is or the goal and what could we uncover along the way that would meet our near term objectives. So if you think about something like avoided readmissions could you be looking at items or metrics like time to first follow up appointment or refill of initial discharge medication. You know Linkous they there really time time to go home or some form of checks that were processed on understanding of patient instructions and medication medication list. So you start to take what would feed into and you know you've got it get a little complex right. This process of ebbs and flows where the budget is wider and narrower wider and narrow to get to the end goal. But if the end goal and avoid readmission if possible for 30 60 90 day time frames what are the things in those first 14 days the 30 days that you could uncover working with your team including that your sare soordination team. Have outreach with them within the first week or so and are you able to do some form of assessment before they get to their house or after they get home. Those are the types of things that you can actually do in the near term. And if you look at them and you put them in aggregate you will feel confident if they're positive on even in those micro metrics or KPI that you're on your path to a successful larger more impactful outcome.

Saul Marquez: [00:14:12] Love that, that's such a great example. Thanks for walking us through that. Sanjay I know I was sort of wondering how do you break it down and I'm sure the listeners were wondering the same thing and I'm so glad you were clearly able to walk us through that because oftentimes you have that end goal but you have so many outputs there are going to help you improve outcomes along the way. So keep your mind and your eyes and your ears open to those things as they come.

Sanjay Shah: [00:14:39] Absolutely.

Saul Marquez: [00:14:40] That's so great. Can you give the listeners an example of a successful innovation or implementation that lead to better outcomes recently.

Sanjay Shah: [00:14:48] So you've got to we've got a couple that are hitting the press in different ways right now but if you look at our partnership with a company called magnetics which does tell ascribing and other supportive services the Google Glass as a platform and you know that is significantly impacting patient experience provider experience. I think it easily allowing providers to see more than 2 patients per day while spending less The EHR around almost two hours a day less on a daily basis. So we're creating more access. And at the same time taking a task of patient charting off of physicians plate allowing them to establish a much more connected and deeper relationship with their patients because they're focused on the patients and not on the computer screen. So that's an example of something that's scaling across the health system as we speak. You know it's ironic because that's one where we were the first health system partnering with them and working on validating the use case in technology in a clinical environment in the first place so it's great to see that is where it is today. On the other side of the House would be you know our recent focus we're collectively dignity help and a few departments that took the lead helped set up our Office of Digital that's led under Dr. Shez Partovi and we really wanted to not only uplift what we call our digital front door but on the clinical side of the House or as we transform more into the clinical side of the house beyond kind of surgeons schedule and some the basic functionality that people just need and expect to experience when they're looking for something and they want a booking schedule. But we were looking at patient journeys and on the maternity patient journey where we started first or if you want to call an old be patient journey. We looked at two partnerships that we've established with companies one Docent health and the second is a partnership with wildflower health on a Digney health maternity called my baby. And so with this layering of docent Health which has both a technology and a service layer to help consumers navigate their journey from what services they should consider what questions they may have. You know they do everything nonclinical and when something breaches clinical they help that consumer weave back to the clinical team and including you know on the day of delivery helping that individual says you get to their room or get a real of or Sipes service so helpings really nice patients with kids who might have to want months of coloring or Harsley certified that they can help install CARSI and helping complete the end to end the physical side. And then you pair that with my baby as a mobile app to support the mobile side and the digital journey that someone may be experiencing outside of our four walls. And you really created something that's seamless and helps improve and impact a patient journey which is you know from end to end. Not just one point in time when they're coming into a hospital facility for their birth but how they may be thinking about options for you know let's say breastfeeding versus formula feeding and the benefits and when you may have to consider one or the other for nutrition purposes and really helping folks understand the value of breastfeeding in the golden hour that we talk about and things like that that people can learn about each consume and digest in the mobile format similar to how they're digesting in other categories or other sectors of their shopping. But we're starting to put healthcare in that realm.

Saul Marquez: [00:18:24] I think that's really cool

Sanjay Shah: [00:18:24] the only great outcome. Yeah. It's fantastic. You think about as consumers look this is how I somehow want it to be. And so the outcomes that we're seeing there are folks are absolutely more satisfied or extremely satisfied with their patient experience and they feel better connected with their physician. They feel that they have been better heard or listened to and were able to also support of why a wider aspect of their care from including surfacing sometimes in a postpartum depression concerns because they have a relationship with more than just the condition they have a relationship with dignity health and their experience and their partners whether it be through the Docent that Docent health whether it be through my baby mobile application like there's more ways that they feel connected in a part of their their journey their process. And so that's been great to also see more recently matriculate across our health system.

Saul Marquez: [00:19:17] Now you know and my wife and I just had a baby eight months ago. And you're talking.

Sanjay Shah: [00:19:21] Congratulations. Thank you. It means it means you're not sleeping.

Saul Marquez: [00:19:27] Yeah pretty much. And you know as you're talking through the experience and I just kind of kept thinking about all the things that we did through the process and you know a lot of times we found these on our own or we research them on and to have a health system that would have supported us the whole way and just thinking wow how cool would that have been.

Sanjay Shah: [00:19:48] You know I think it's it's our job. You know this is this is where we are in health care and we're not the only healthsystem doing this. There are plenty of peers that are also thinking about this format or the view of a patient journey. And if our right to improve that health care experience like you I've got I've got a 3 year old and a 9 month old and a 3 year old with a gun that we kind of test pilot ourselves. We have five apps amongst ourselves and different resource and we were really active and involved including the right tracker's for the ins and the outs and we had to do a Niki's day because of Donnis. And you know we made it easy for the healthcare team. And it wasn't a burden on us because we wanted to be a part of that. Indeed yes these tools helped this track those rate and in some cases where we were more concerned and we were really concerned about ins and outs and feeding times and sleeping time. These trackers the though it has a digital asset helped us get through that journey helps us track it because you're not sleeping so to try to keep that mental memory is not going to work very well. And so that's that's the goal right is to accompany the journey that is a health care or health experience and make it better and improve upon it. And that's the potential for digital and digital tools today.

Saul Marquez: [00:21:07] Love it. Sanjay this is such great stuff. Time flies when you're having fun and I want to ask you what is a focus that you're working on right now. That's exciting.

Sanjay Shah: [00:21:17] Yeah the notion of patient journeys and it's applicability to others. So we're we're figuring out right now I think is really exciting. I think rightfully so. All of us in healthcare are really actively looking at social determinants of health. Yes and finding a way to talk to a little bit about Digne health but you know as a mission based organization focused on making sure that all who need care have access to care it's vital for us and really consumers in the numbers and the communities that we serve to think more about the episodic issue which is sometimes the health care issue and think about the longitudinal issues or the community issues and how we can play a role in improving and impacting those. So whether it's access to food transportation educational resources housing not only providing access and transparency to them and facilitating those but also bringing those back in loop on how we practice healthcare. And so I'm excited with my peers across multiple streams from you know I.T. to legal to population health community health and the different clinical champions across the health system. This is something we're starting to really band together on and many health systems are an understanding that our impact our mission goes beyond our four walls goes beyond the traditional definition. And I don't know if it's the traditional vision but it's the evolved definition of health care and we're going beyond that. You could probably go back how it used to be which is a person is a whole person and everything that impact them it would impact their wellness their well-being. And you know more so that that's really what's behind the human kindness. So this notion of journey the notion of social determinants of health are two really exciting opportunities for us to direct our focus on which also helps us bring our mission and really correlate that with innovation all at once.

Saul Marquez: [00:23:15] Yeah I think that's so exciting and it's interesting because yeah. Lot of hospitals a lot of companies and you know a lot of payers are all focused on this area of social determinants of health. I think with this focus the next few years we're going to get some pretty cool solutions that come and I'll be looking to dignity health to see what you guys are up to for sure.

Sanjay Shah: [00:23:37] It's an exciting opportunity area because it's a chance to do so much more than just provide you know foundational healthcare which is hugely valuable. But again that's an episodic view versus being a partner with an individual as they're going through their journey. And you know that ties into this third area that I think a few others including Dignity health are really excited about is this notion around Medicaid Innovation and considering that and trying to help transform that into being a strong and viable market in and of itself or the place where innovation can start and translate upstream a lot of things to start for commercial patient areas or commercial volumes or commercial settings in terms of a payer perspective. And that's where innovation starts because the belief is is that the business model that can support it. And I think today now more than ever with the socially minded and socially responsible entrepreneurs with the focus and attention to funding with health systems like Dignity health and others that have focused on this base and the fact that we're part of these communities. We might be able now to include the venture community that are also supporting the areas to think about the market the Medicaid market being an innovation first opportunity and in of itself that business models can be validated here and derive value where you're designing for a broader patient base that might still translate up to all different types of nano and.

Saul Marquez: [00:25:04] That's for sure. It's super interesting. I think that it's it's amazing time to be in healthcare. So Sanjay let's pretend you and I are building a medical leadership course on what it takes to be successful in medicine today it is the course or the ABC of SANJAY SHAH. And so we're going to write on a syllabus someone ask you four questions lightning round style and then we'll finish up the syllabus with a book that you recommend to the listeners. Ready.

Sanjay Shah: [00:25:33] Got it.

Saul Marquez: [00:25:33] Awesome. What is the best way to improve health care outcomes.

Sanjay Shah: [00:25:38] Remembering that health care is a service industry.

Saul Marquez: [00:25:42] What is the biggest mistake or pitfall to avoid.

Sanjay Shah: [00:25:45] What I said earlier. Tying yourself to traditional longtail clinical outcomes.

Saul Marquez: [00:25:49] How do you stay relevant as an organization. Despite constant change.

Sanjay Shah: [00:25:53] Focusing in refocusing and laser focusing on patient and provider experiences or mentoring that both are extremely connected.

Saul Marquez: [00:26:03] What is one area of focus that should drive all else in the organization.

Sanjay Shah: [00:26:07] Go back to the roots of what healthcare is and the mission and you know we call it Hello human kindness here Dignity Health but it's the compassion and the values that you bring in supporting someone in that time. And if you think about that and you whether you look at it from a provider perspective I no longer than an the response but you think about it if you think about it from a provider perspective a business perspective a payer perspective. If we all commit at that length and the consumer as well we should be able to come out of that and feel like we won like we all succeeded and no one should feel at a loss of a tug of war scenario.

Saul Marquez: [00:26:42] I love that. What's one book Sanjay that you recommend to the listeners.

Sanjay Shah: [00:26:48] This is tough. Ok you know one book that folks don't usually. And this is back from the innovation space I remember the black swan theory by Taleb. That's a great read but I'm going to caveat with like one B and one C is pretty much anything by Malcolm Gladwell and another book. I really do like in terms of understanding how big businesses are formed. It's just a great read from a historical perspective and the way that's what was put together but it's a book called anything by Robert Greene. But the book that I'm really thinking of is 48 Laws Of Power.

Saul Marquez: [00:27:22] Love it. So outcomes rocket listeners they have it Sanjay. He just put together an awesome course for you. Go to outcomes And you're going to find all of the show notes as well as the tidbits in the syllabus and book that he just put together for you. So don't worry about writing it down. Just come go to outcomes Sanjay this has been a lot of fun. Before we conclude can you just share one closing thought and then the best place where the listeners can get a hold of you.

Sanjay Shah: [00:27:57] In light of everything that's going on right now with respect to change and potential change in focus on what does that mean. Whether it be for fee for value I think all of that put aside we still are responsible for improving the health care experience for everyone and improving that from both a business model a practice model an inexperienced model. And therefore innovation within healthcare really has no opportunity to stop now has no opportunity to change and is required and will always be required if we're going to improve upon the practices and the model that were established a long time ago and transform over time. So I think as you put it saw an exciting time to be in healthcare and continues to be so. And I'm really looking forward to what we establish now in the near term the next three to five years. And what we may really be able to leverage from a technology perspective when we're talking about voice and VR and mixed reality in 3D printing and you know the value potential decreases the block chain and whatnot. So that's what's really inspiring exciting about this time today in healthcare innovation. And lastly you know you'll find that they give you help myself my colleagues at your expected national you know health events whether it be J.P. Morgan or HIMMS or Health 2.0 any entrepreneur or event that you can expect happy to and feel free to send us a note on Twitter you know see us on that you know whether through the dignity health account or personal stuff that you can find there and we're happy to engage with you there as well.

Saul Marquez: [00:29:27] That's so awesome Sanjay. Hey really appreciate that. And listeners reach out and collaborate. This is what the outcomes rock it's all about. Sanjay this has been so much fun every time I chat with you. I just get jazzed up I get excited about what's next and so really looking forward to having you on the show again in the near future. And just thank you again for making time for us.

Sanjay Shah: [00:29:50] Fantastic. Thank you so much. Appreciated this. And I for one love the fact you're doing a podcast. I know our team is the huge fan of them. They make all our plane trips and bike rides than any other work. We go and go by so much better so I don't know whom to listen to myself because that's always interesting experience do look forward to listening to the other outcomes rocket Podcast.

Saul Marquez: [00:30:10] Thanks brother.

: [00:30:15] Thanks for listening to the outcomes Rockit podcast. Be sure to visit us on the web at for the show notes, resources, inspiration and so much more.

Best way to Contact Sanjay:

Recommended Book/s:

The Black Swan: The Impact of the Highly Improbable

The 48 Laws of Power

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Outcomes Rocket - Sanjay Shah

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Full Podcast Transcript

Addressing Global Health Inequalities by Empowering People with a Vision with Vanessa Kerry, M.D., CEO, Seed Global Health

: [00:00:01] Welcome to the outcomes rocket podcast where we inspire collaborative thinking, improved outcomes and business success with today's most successful and inspiring healthcare leaders and influencers. And now your host, Saul Marquez

Saul Marquez: [00:00:19] Outcomes Rocket listeners welcome back once again to the Outcomes Rocket where we chat with today's most inspiring and successful healthcare leaders really want to thank you for tuning in today. And if you love what you hear today or in general visit and that'll take you straight to our Apple podcast where you can leave us a rating and review. We love hearing from our listeners so drop us a line. They're always excited to hear from you. Without further ado I want to introduce to you my outstanding guest. Her name is Dr. Vanessa Kerry. She's the CEO of Seed Global Health. Seed Global Health is a nonprofit organization whose mission is to work closely with developing country partners to promote and support new generations of health professionals to serve as global health educators and work within countries facing critical human health care resource shortages. She is also a doctor in critical care at Mass Genn and has an outstanding history of just being a contributor and health care. Without further ado, I just want to open up the microphone to our special guest and let her in any of the gaps in that intro. Vanessa, welcome to the show.

Vanessa Kerry: [00:01:34] Thank you so much. It's a pleasure to join you. And it's a really I think tremendous thing that our is doing just in terms of trying to highlight stories in health especially I think that one of the things we just talked about it seemed is that health is really the underpinning of almost everything we do or want to do in life. So telling these stories is incredibly important and we're really honored to be able to join you.

Saul Marquez: [00:01:59] Thank you so much. Dr. Kerry and so why don't you share that beginning story that first domino that led to it all. What is it that got you into health care.

Vanessa Kerry: [00:02:08] You know what got me into healthcare in the first place. I'm not actually so sure. Now I think that was just a very intrinsic thing in me. I was always interested in science in general. And then I had an outstanding biology teacher prop up Polly in seventh grade and Mrs. Polly. Just something about the way she taught her own excitement about the work ignited biology especially for me. And I actually decided in seventh grade that I was going to be a surgeon. I had no idea what that would. You know I'm not a surgeon. But it's not really my idea of being a physician. And there's always determined to go to medical school.

Vanessa Kerry: [00:02:47] I think that what became interesting is how that got shaped and molded by various experiences in my life. One being the daughter of two public servants. I had a father that was very engaged in international relations and I had a mother who was very proactive about fighting the stigma of depression and talking about depression a time when nobody else was. Both my parents grew up abroad.

Vanessa Kerry: [00:03:10] And so I had a real understanding of how you can be 100 percent American. Love this country still understand how we weave into the world outside of our borders. And then I think through my own experiences that I had I really realized that I wanted to be engaged in global health. When a story they always tell is that I had this unbelievable privilege of going to Vietnam when I was 14 and really saw an extraordinary poverty unlike anything I'd ever seen before and couldn't really make any sense of it as a 14 year old I just hung on that experience. And that ended up catapulting me to spending a lot more time abroad working in Uganda and working in Rwanda and so as I was finishing up my residency I really knew solidly that I was going to have a career that worked on the health disparities in the world both what we see in variable resource limited countries abroad as well as I think becoming invested in what some of the Raspberry's are in this country.

Saul Marquez: [00:04:08] Wow what a story and really appreciate you sharing that. You know a combination of your parents and teachers and then also your exposure to the world has sort of taken you around the globe and around this the system of health care to now. Frontline practitioner to now leading this amazing team in this effort that you have at Seed Health. Really excited to jump into some of these things. Vanessa what would you say a hot topic that should be an every medical leaders agenda today. And how are you guys addressing that.

Vanessa Kerry: [00:04:41] It's a great question.

Vanessa Kerry: [00:04:42] I actually very strongly believe that one of the most important topics we can be addressing in any health related or leaders agenda needs to be people and how do you train really good people. How do you have the right resource mix of people and how do you have them working in the right place. Urban versus rural clinical versus hospital how do you incentivize people to create that spread. And I think very importantly how are you keeping them in the health care industry. And I think that's an issue in any country whether you're United States or elsewhere and certainly in the places we work. So Seed Global Health really just in this space we are training future doctors nurses midwives in countries that have very severe shortages of these health professionals. These health professionals are critical because are the leaders of their health care system. They are able to not only provide outstanding care to patients immediately but they're able to support the health care all the health workers and the health folks in the health care workforce across the whole system and very importantly they're able to train their successors so that you can ensure there's a pipeline of qualified providers that are going to be available to these countries that are in your face these incredible shortages. Just to give an example a country like Tanzania has one woman die every hour from a complication of pregnancy or childbirth one every hour. Yet this is a country that has only one physician and 24 nurses for every 100000 people. Wow. To put that into perspective. You know the United States has about 240 physicians and 980 nurses for the same population. So we're talking about really severe shortages of healthcare providers. And I think this is going to be one of the really critical crises that we're going to be seeing globally.

Vanessa Kerry: [00:06:31] If we don't do something about it and it's even measurable predicted the World Health Organization knows that if we don't step in and do something about the human resources for health crisis in the world there were no shortage. Just going to grow from seven point two million doctors nurses midwives to 18 million by 2030. If we don't change how we're addressing.

Saul Marquez: [00:06:52] It is a definite issue. And even here in the States too you like shortages are happening. How do you retain people from getting out of this business of healthcare. We have the issue here in the States too. It's even bigger abroad. And so you seemed to be a leader, Vanessa that loves to tackle difficult challenges. Right. You go to critical care where it's definitely not the easiest problems to address in health care. And now you're you're going to these countries Malawi, Tanzania Uganda, right. It's just these countries that really need help and you're doing the grassroots efforts. Can you give us an example of what you guys have done to create change and better outcomes there.

Vanessa Kerry: [00:07:35] Absolutely. So I can give you two examples. One example would be in Malawi in nursing where we had one of our nurse volunteer in nursing clinical educators many Weschler was working in hostile northern Malawi. And during her work she saw trauma and surgical patients who were getting their dressings and other things done without any pain medication. And she realized that there really was a lack of understanding of how much pain medication could help and that it could be used appropriately and that there was a year of addiction of these pain medications and so using a small grant that we supported she gathers and her colleagues and they work together do a practice improvement project where they ended up really redesigning not only the algorithms and protocols by which the medication could be given for these patients but how the medications are distributed in the hospital how their sort of access them. So what happened was that they ended up doing this whole education program and it not only got successfully rolled out in the wards that patients were getting their dressings changed and other procedures done with appropriate pain medication but in up getting rolled out across the hospital and I think it's been a real example for other locations about how this can be done appropriately. And it means that patients dressings were being changed wounds were being kept clean they're getting appropriate treatment to care infections go down and has a real in addition to just leaving people horrible pain.

Vanessa Kerry: [00:09:03] It has a real impact also just on outcomes and how people do and I think that's really you know I think for us powerful story of how one person can institute a pretty large systemic change. Another example is Dr. Ali Asghar Caskey who is a medical student in Tanzania who taught by one of our clinician educators. After spending a couple of weeks with our educator Dr. Esther Johnson he went on to one of his other rotations and the they're doing morning rounds there's a baby that wasn't breathing. And Ali Asghar instituted the protocols he learned as a clinician educator realized the baby still had a pulse he could resuscitate this baby saved the baby's life. And Ali Asghar was so affected by the realization that he could have such an impact on a patient life with just knowledge that even more equipment necessarily ended up organizing a training for 200 other providers at his hospital became a master trainer neonate or a citation. Now he's traveling Tanzania teaching others. And if you ask him what he wants to do when he finishes training he'll tell you he wants to be a Tanzanian Doctor Who stays in Tanzania and who teaches others and his successors.

Vanessa Kerry: [00:10:12] I think that's the kind of real example that we're trying to show because Seed Global Health does is trust things on a very personal individual level your relationship and sort of you know shared problem solving. But we then really try to institute that systemically and to have that have a lasting effect across generations so that our hope is that in five 10 years we will work ourselves out of a job we will have trained their replacements. That's a big reason that in Swaziland one of the five countries where we work now we were asked to expand to afford nursing training schools there they're all for training schools in the country which allows us to have a really systemic countrywide impact on the quality of education and nursing leadership. It's why the president of Liberia asked us personally to come to Liberia and help our country rebuild after Ebola and to both support medicine and nursing education and training. And I think that what we've been struck by is that in the last year alone we had over 20 requests for partnership or expansion which I really think speaks to our model and the reputation that we're starting to build.

Saul Marquez: [00:11:18] I would say so as well. And what amazing stories that you've shared and you know just kind of puts it into perspective. There is an opportunity out there to improve outcomes and in a place where it's appreciated not that it's not here but there is an opportunity to truly improve outcomes for people that really need it and appreciate it. So I had a guest on my show not too long ago. He's the chief medical officer over at Sutter Medical Group one of the things that his program provides for physicians is being able to let them go abroad and providing a stipend of like 2500 bucks to help them do that. Are you guys looking for more physicians to help with your trainings. What kind of partnership could have been here now.

Vanessa Kerry: [00:12:05] I love that. And we're only going to solve really big problems if we do it through partnership and through collaboration.

Vanessa Kerry: [00:12:12] And I think strategically about how we can complement one another to tackle these big issues us as one of the unique things about our model that I'm very proud of is that we require people to go for a minimum of beer. Oh wow that allowed it. To and I know that seems that's a commitment. But what it does is it allows people to build the relationships and the trust needed on the ground to be really effective at what they do.

Vanessa Kerry: [00:12:37] And one of the stories I love is that we had one of our volunteers was the guy from San Francisco who was under the bed fixing foley catheter when a Ugandan tour came through and one of the visitors asked Ugandan host whose name is Ogu which is the term for foreigner under the bed and the Ugandan host's response was that's not. That's Ari and he's one of us. And that was so striking to me about the rock the trust that we feel. And I think it's one of the things that's really profound for our model. We know that the big problems sometimes take big solutions. I know we're always looking for silver bullets and fast ways to achieve big outcomes. And I think there are ways that we can contribute to healthier lives better prevention really knocking down some of the big health challenges that we see in the world through some of those answers. But we are going to have to put the time and the effort in to training people who become health leaders and can really be profound agents of change in their country see the country strategy that need to be done.

Vanessa Kerry: [00:13:44] Know how to implement the technology appropriately and in the right places know how to use silver bullets fly them widely and disseminate them. And that's the work that he is very committed seed global health is very committed to doing.

Saul Marquez: [00:13:57] Love your vision. It's so awesome so compelling makes me want to go out there for a year and for the listeners. If you do have that type of commitment if you are looking for that stretch you know I think this is an organization you should follow. Seed Global Health. Check them out there on LinkedIn. They're on social media. Definitely an organization to follow. Can you give us an example of a time when it was difficult. And you know Dr. Kerry you had a setback and what you learned from that setback.

Vanessa Kerry: [00:14:30] And I feel like we're starting an organization we're only five years old. We're laced with setbacks along the way just by the nature of being a young organization. We've had really rapid growth and that part has been incredibly I think validating and exciting to see that demand for the work we do. I think the setbacks are there's all different types of setbacks. I mean a I would say that one of them you know just on a personal note a setback for example.

Vanessa Kerry: [00:14:59] I think that I had a just for example when I first got into this work and I remember my first trip to Uganda and I was charged with figure out ways that we could build partnerships with one of the institutions we were working with there. And I just went in gung ho ready to go in patient, time to get things done. This is TELL ME EVERYTHING you tell me and when can you meet me and how can you do it. And I got two pretty speedy feedback through you know a colleague also working there that I had managed to insult her off foot about half the partners on the ground.

Vanessa Kerry: [00:15:36] And I was really devastated by that because I went in with the best of intentions right. But what I sort of had failed to realize was one there really was a cultural norm and to to be patient. And I think that that was a very important reminder to me that I feed into our work its Seed Global Health. That's the long hard real work is about partnership. It's about listening. It's about studying. It's about understanding your context and it's about really working together. There's an African proverb that I will get slightly wrong but they say if you want to go fast go alone. If you want to go farther go together. And I think that's a very important lesson that I try to carry with me every day because the work we do is hard and sometimes we do need to stop and pause and defer and really ask ourselves are we doing this right or what values are we put into it.

Vanessa Kerry: [00:16:35] And I think one of the reasons that we've built the reputation we've built and we've been able to expand to five countries and we've had the impact of training over 13000 doctors nurses and midwives in our first four years has been because we've tried to really adhere to that kind of philosophy.

Saul Marquez: [00:16:51] If you want to go farther go together and listeners think about this as you build your initiatives whether it be here in the states whether you be a provider or a payer industry if you want to go farther go together think about that and think about your front line what are you doing to replace yourself. What are you doing to train your bench. What are you doing to give these people decision making power. This is the focus that Dr Kerry and her organisation do so well. What are you guys and gals doing about this for your organisations because this is what's going to determine the future is what's going to help improve outcomes. Dr Kerry let's focus on a good thing. Tell us one of your proudest leadership moments to date.

Vanessa Kerry: [00:17:34] Oh my gosh. I don't know if there's any one I have to tell you. I'm I think when I can just step back and see that Seed Global Health is working at 34 sites in five countries that we've helped train over 13000 doctors nurses and midwives in four short years that we've built a reputation you know that people want to work with us that has been a tremendous source of pride for me. Every day we have an outstanding team. I and my colleagues are incredible our partners are incredible and so every day for me frankly is one of huge pride. I think there have been moments where I've been pretty stunned though or that it crystallizes a little bit more strongly and I would say that one moment was in 2013 when our first group of 30 came to their orientation and lined up to go and were standing there before me and something that had started as a grassroots movement because that's how we started. We were just an idea trying to get people to support it. To see the value of sending US physicians and nurses and midwives abroad to not just deliver care but to educate and to train and to build that from a movement into something that became reality in a way was extraordinary.

Vanessa Kerry: [00:18:52] And then when we expanded in 2014 it was announced that we'd be expanding to two new countries. That was a moment of just extraordinary pride because we were still going. But you know I got to be really honest with you every day that we're still standing and still having an impact especially I think at a time when the world is changing so much. It makes me really proud. I think seed global health is doing really great work and it is wonderful work that not only impacts the places that we work in Africa I think it brings benefits here home to the US as well where we know that over three quarters of the people who participated in our program are working in education or with at risk populations here in the United States. And so seeing seed global health impact I think just in terms of redefining how we engage with people how we engage in health how we engage with one another some ways is really important. We try to stay humble and we try to be really iterative and try to always make seed global health be more effective at what we do.

Saul Marquez: [00:19:58] Yeah that's really cool. And you know didn't even think about that aspect of it but the cultural dynamics and the processes that are formed abroad can really help serve in the efforts of population health at risk populations here in the States. And I think you know like these people that have dedicated themselves and then they come back. Wow. Like I'm sure they can just put things into perspective and say to their peers hey you know what level this out. I've seen worse. And we can make this happen. This is pretty cool.

Vanessa Kerry: [00:20:34] Yeah I mean I think it's we are we are very blessed with a lot of resources in this country which can make that delivery of medicine easier. I will say though part of the reason I say practicing clinically even a little bit so I stepped away from my main practice is because it's really important to stay grounded in the vulnerability of being a patient and being reminded of that that my practice is critically important because they are patient United States are patient abroad. When you're facing some sort of medical issue you're suffering and hopefully here in the United States there is a possibility you know for treatment and care being able to get better. That is probably more robust and in many places it is more robust than many as we work. But. The vulnerability of being a patient is very real in all aspects and I think that's the special thing about being a health care provider whether it's a nurse midwife doctor or others that you really have this incredible trust to do the best you can to care for folks for sure.

Saul Marquez: [00:21:33] Yeah it sounds like you definitely are staying connected keeping that part of practice real that you know patients are people and when they're in their biggest need that's when they depend on you. And so I think it's so cool. Dr. Kerry, let's pretend you and I are building a medical leadership course on what it takes to be successful in medicine. It is the 101 course or the ABC of Vanessa Kerry M.D.. And so we're going to run out the syllabus with this lightning round. There's four questions and then we're going to finish it with a recommendation for a book.

Vanessa Kerry: [00:22:10] Oh great. Sure.

Saul Marquez: [00:22:12] So here's the syllabus. Listeners, get ready. What is the best way to improve healthcare outcomes.

Vanessa Kerry: [00:22:17] For me the best way to improve healthcare outcomes is to really put more emphasis on prevention and on trying to get to the upstream causes of disease because it's far more cost effective and there's far less suffering if we can cut things off earlier rather than having to worry about treating people when things are full blown. And that for me is definitely around not a treatable disease which is an increasing issue. I think globally in addition to some of the preventable infectious diseases that we could be treating earlier. But it's something that I think we as an entire global culture need to be better at.

Saul Marquez: [00:22:52] What is the biggest mistake or pitfall to avoid.

Vanessa Kerry: [00:22:55] I would say the biggest pitfall to avoid is to assume that there is a silver bullet or a fast way around really big problems. It doesn't mean that you can't get a really powerful leveraging answer or impact it could have a huge effect or it needs to be often really rooted and better set in a much more long term and probably complex solution if you're going to really tackle a complex problem.

Saul Marquez: [00:23:20] How do you stay relevant as an organization despite constant change.

Vanessa Kerry: [00:23:24] I think for seed global health we stay relevant because we're addressing a very fundamental problem that has needed to be addressed for years the shortages of doctors nurses and midwives around the globe are very significant and only growing and it's not a new problem. It's one that's been made. I can go into the history lesson but it's a lightning round that has been made for years for a whole variety of reasons. And so for us I think we are going to remain relevant because we are tackling a fundamental problem that if we don't tackle we're going to find ourselves in the exact same place in 20 30 years that we are in today. And so by the nature of training health leadership and future providers any training we are insuring an investment that can you know last generations.

Saul Marquez: [00:24:07] Awesome. And finally what is one area of focus that should drive all else in your organization.

Vanessa Kerry: [00:24:14] I think the one area of focus that drives all else the Seed Global Health is that we really believe that we need to close the two standards of care that exists in the world and make sure that we increase an understanding that health is integral and essential to everything we as a global community want to do. It has to be critical to the economy. It is critical to climate is critical to political stability is critical to national and global security just to personal well-being. It can be the difference to a household being above or below the poverty line. But we live in a time it's 2017 where there remain two very profound standard of care and that can be both across countries but even within countries and we are very committed to trying to close those two standards and just showing the world that it doesn't need to be in 2017.

Saul Marquez: [00:25:03] Love that. What book would you recommend, Vanessa.

Saul Marquez: [00:25:06] So there are two books I think for later reading Corelli's Mandolin is just one of my favorites. I don't know what it is about it. My mother grew up in Italy and there was an Italian. He writes out the book I just adored. And it's just a wonderful wonderful allegory. And then I think long walk to freedom by Nelson Mandela. Nelson Mandela was a really extraordinary leader and you know not without tremendous sacrifice and complexity but I think his vision his beliefs his calm his patience but just his optimism that we can help people do the right thing is a really powerful message and only more so today.

Saul Marquez: [00:25:50] Love it. What a wonderful recommendation. Haven't read that one so I'll definitely be picking that up and listeners don't worry about jotting this down. All of these show notes all of these books all of the links to see global can be found at that's S E E D. And you'll be able to access everything that we've discussed in a nice neat format and linkable to all the things that you want. So Dr. Kerry I just want to say thank you so much. But before we conclude I just want to offer one opportunity to give a closing thought to the listeners and then the best place where they could reach you and your team.

Vanessa Kerry: [00:26:28] Thank you so much for letting me in the story of seed global health join you today. I think my closing thought is that we really should be optimistic about these big problems are solvable. We just need to join together to I think tackle them and all bring our different strengths to the table. But I think most importantly we as a global community just need to think strategically about what are the ways that we can make us healthier, happier or safer and for us at people health our contribution is really about building that health care leadership the doctors nurses and midwives needed in these places of dire burdens of disease. But without the needed personnel to help them tackle it. And if we can create a global population that is healthy. And from that comes opportunity and hopefully I believe more peace security in all of these things. So I think it is about dreaming big but making sure that we make a contribution to that vision. If you want to find out more about the global health you can go to And again that's S E E D like planting seeds for global health for years to come. Thank you so much for letting us join you.

Saul Marquez: [00:27:44] It's been a pleasure Vanessa and looking forward to keeping up with your organization and what your team accomplishes here in upcoming years.

Vanessa Kerry: [00:27:51] Thanks.

: [00:27:55] For listening to the Outcomes Rocket podcast. Be sure to visit us on the web at for the show notes, resources inspiration and so much more.

Recommended Book/s:

Corelli's Mandolin: A Novel

Long Walk to Freedom: The Autobiography of Nelson Mandela

Mentioned Link/s:

Healthcare Podcast