Month: February 2018

Getting Your Clinical Data Where You Need It, In Seconds with Debi Willis, CEO of PatientLink

Getting Your Clinical Data Where You Need It, In Seconds with Debi Willis, CEO of PatientLink

: [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 successful and inspiring healthcare leaders. I want to welcome you to go to outcomesrocket.health/reviews where you could leave a rating and a review of today's episode. Without further ado I want to introduce our outstanding guests. Her name is Debi Willis. She is the CEO and founder at PatientLink Enterprises Incorporated. They're doing some pretty amazing things over there she's been at it for almost two decades. There are tons of experienced tons of results lots of partnerships will be diving into the things that she's done. But you know she started off as an engineer so I'm going to let Debbie dive into a little bit of the background but wanted to give you a warm welcome. Debbie welcome to the podcast.

Debi Willis: [00:01:08] Thank you. Thank you. It's very exciting to be here. Thank you.

Saul Marquez: [00:01:11] Absolutely. So did I miss anything in your intro that you wanted to tell the listeners that.

Debi Willis: [00:01:16] No I think that's a good flavor to start with and I'll just add more layers as we go.

Saul Marquez: [00:01:21] Perfect. So I always love to start off with the genesis of it all for my guests. And what is it that got you into the medical sector to begin with.

Debi Willis: [00:01:30] Well I was a software engineer at the Federal Reserve Bank and the Federal Reserve has always really been automated for a very long time. And I met a doctor who told me about this brand new thing in the 90s card electronic medical records. He was so excited about them. So I thought well let me check this out. And I thought it was fascinating to actually automate medical records. You know they're not going to be on paper anymore they're going to be in the computer. I want to be part of this so I jumped from the Federal Reserve into medical or had to learn all new acronyms. It was yes it was but it was it was quite a ride. I really enjoyed it.

Saul Marquez: [00:02:11] And you took the dive. You saw you had a vision 18 years ago. Deb and fast forward to now. Are you glad that you made the jump.

Debi Willis: [00:02:21] Oh most definitely. I feel that what's happening in medicine right now is incredibly exciting and this is a new era that's going to change health care health care. Technology is going to change health care and we're going to find cures faster. And so many exciting things are going to happen in the next few years. And it's all because of technology and I'm thrilled to be here. It's incredibly fun.

Saul Marquez: [00:02:44] Well your life's mission is certainly clear. Debbie I got that just from catching up with you here before recording. And I wanted to ask you so tell us how things that led for you to create the company.

Debi Willis: [00:02:58] Sure. I never intended to have a company. I just wanted to really help the doctors. They were getting electronic medical records and very very frustrated with having to type all this data in as a doctor. They were used to scribbling on a piece of paper anywhere they wanted and being able to really focus on taking care of the patient and not on where documentation went. But once they went through electronic medical records yes just like on the right part parts and on the computer screen and types of data and they were they were crazy mad about it as an angry and they said well let me see what I can do. I mean see if we can make this better. So they were very kind and let me follow them around what they were doing. Did the doctors and the nurses I sat in the waiting room and watched the people and realized about 85 percent of what they were having to type in was actually coming directly from a patient. And I thought well you know why can't we have the patient get the information directly from the patient into the electronic medical record. And so really the genesis of all this was to solve a problem not to start a company. And that's where I started a thought. Well let me see if I can help these doctors. And I thought what format do I want to use for the patient to feel very comfortable to enter data. And. At first I thought let's do this on a computer. Let them sit at a little kiosk and type to date. But this is back in 1999. So I realize that's probably not very comfortable and it's going to be a backlog. People are going to be struggling with the computers. They're used to paper. So let me create something that allows them to answer the questions that the doctors need and now on paper digitized that data and send it to the right places in the current medical record. I actually wanted to find a product that did that. But there was none. And so I wrote that and I am implemented at a couple of clinics where my clients and I then went in 2000 and presented at a national conference and it was standing room only and there and it was actually terrifying because I am a quiet person. You know I know this and I have thousands of people watching me do this was terrifying but so exciting and I had all kinds of people coming up saying hey would you write this for me. Would you build this for me. And so then I decided Well let me patronymics because nobody had ever done that before. Tolda it's impossible to get a patent don't even try it. No I don't think it's impossible. I tried and the people at the patent office couldn't understand what an electronic medical record was. That's true. Yeah. So they kept coming back with the same as they are this is the same as that. No it's not. I actually flew to Washington D.C. and I brought my product and I said this is an electronic medical record. This is what doctors have to do with outpatient minC. Now let me show you. Patient link and how it helps doctors. And this light bulb went off and they said Wow. Now we understood. Yes you can have the patent. And I wanted to jump across that just a bit. Literally Mannhai in a side.

Saul Marquez: [00:06:17] Wow. Hey how long was that the process like having a try to get your patent for this how long was it hard to take.

Debi Willis: [00:06:24] Several years. It. Yeah yeah. That. Yeah but it was definitely worth it if you are an entrepreneur and you have a good idea you need to protect it. If it's protectable not everything is patentable but that one was. So we start with the paper product and then in 2006 when there was more use of the Internet we went to patientlink online people could fill out the same questionnaires from their home. And now we have patient link available also in clinics on devices you know any electronic device or a kiosk or whatever so whatever makes a patient comfortable. That's why how we want to engage with them and then send the data in as electronic data so that the doctor has all the information when they start the visit to they can have more quality time with the patient.

Saul Marquez: [00:07:15] Wow that our idea that's fascinating and listeners I'm sure you're taking some notes from this conversation just from the get go you could tell Debbie's passion for what she does. Her intentions and all saw her drive to make it happen. To get outside of her comfort zone to present this stuff in front of thousands of people standing room only to take a flight to D.C. to actually show the patent office what it is after years of trying to get this protected. This is a lady that's fully committed to what she does and I hope you're getting some inspiration from her story and definitely some ideas on what it is that you can do if you're creating a product or if you're driving an organization to create results. Debbie what do you think. A hot topic that should be on every medical leaders agenda today.

Debi Willis: [00:08:05] Well they should really be proud to bring the patient and to be part of the care team and that's our new product. I was hoping that you could transition it into that pledge to help. I think the demanding that commune's you know awesome this is. But if you've ever been a patient or a caregiver you realize that our data is fractured across our multiple caregivers. You know in my mom's generation one doctor took care of everything. You know if she had a stomach ache or if she had heart disease. One doctor. Now we have a doctor for every organ of our body specialists. Yes. Yes. So this all kind of started years ago. My sister had cancer and we were really trying to find research and find information really about she had brain cancer. And so what I saw in that was really the little information just to educate people. Not even the nightmare of trying to get your own records. Yeah. And then a few years after we lost her I had cancer and my God and I got my kidney cancer and I was really grateful that I found it in time thank God that I thought yeah. So I mean I'm a cancer survivor but enormous experience. Thank you. I learned some very important lessons and besides the fact that every day is precious that something important that I really underscore the day. But what I learned is that the real true patients struggle to get their information. I've been focusing for awhile on getting information for doctors to take better care of patients and improving that communication. But now I wanted to turn my focus to helping patients get all of their information from all of their doctors and then be in control of one aggregated record. And I started this vision actually am I woke my husband up March 12

Saul Marquez: [00:10:05] What do you want. What's going on. There's a not going to be your ideas.

Debi Willis: [00:10:10] Yes. You get to lead. I have an idea. I'm going to build something for how patient and I wanted to be able to pull their data from all of their doctors. No more waiting in lines to get paper copies and bring it over to the next doctor who then makes more copies. So he said OK. And I carried a tablet and pencil around with me for two weeks and then whenever I had an idea I wrote it down. And at a time in 2012 that was impossible. I mean really it was like trying to decide to go to the moon in the 1920s. You know it's like not going to happen but I thought we can find a way. I'm just going to design this program and then I will design how we're going to actually connect it to all of these different places. So a few years ago which would have been maybe two or three years after I decided to start this. The government started talking about a new API application programming interface to gather medical records and it's called Fhir. F H I R yes. Back to healthcare interoperability resources. And I watched it for a while I thought and I want to just jump on this brand new thing and waste time and money. I just want to see it is it going in the right direction is it real. Now once I got convinced yes I'm going to take this route. We added fire to mailings to actually be that connection. And then we entered our web application into a government contest at the open sea and we won first prize was like thrilled thank you. Because it's you like big highly funded organizations on the east or west coast. And here we are a small woman owned company in the middle of the US. I love it when we went to Oklahoma. AB Yeah. Yes we're focused. Do we just knew this was so important to patients. And there are several things I've been really keeping my finger on the pulse of government policy. Where's that going. Where is health care I.T. going. Where is the needs of our clients who are physicians and hospitals and where is the patient's needs and really taking all those three together and then building my links. And so there is. Speaking of government policy there is no meaningful use. We mandate it was going to be from January 2018 and it got moved to 19 which I'm really happy about that mandate says patients have the right to use any application of their choice to download their medical records as long as that application is conforms to the API of that H.R. which means I can't be forced to gather my records from a portal I can use any application to aggregate all my records so that really ignited the industry to add the fire API to the charges. That really policy pushes business decisions. So I was thrilled about that. And then the 21st century's cure act is really pushing things further saying really mandating an easy way for patients to get their data. And it can't be data blocking anymore. And so there are a lot of government policies that are really pushing the industry to its you know driving it for interoperability which is so needed. So our goal is to really empower the patient get them part of that care team in my personal case honestly. Had I not been so insistent that I felt something was wrong with me I kept going to different doctors and they all told me I was absolutely fine. Had I not been persistent I would not be here today because. Yeah finally one. Actually it was a nurse practitioner she said we'll have to do a sonogram you know because I was complaining and complaining. And they found the cancer that way I had done every expensive test with every well yeah. So the patients really persistent in their health care is so important and in order to be persistent I think you really need to be educated meaning to understand your condition and the best way to understand your condition is by looking at all the records and then reaching out to the experts. So we call it Miling because it links patients to their doctors and their records. It links patients to researchers were in the process of building that out and it links patients to each other because we as humans we're social creatures we are we really. Unity is huge can't do this for ourselves. Yeah just and so we have a forum there that patients can talk with each other publicly. But if somebody looks interesting to me and I feel like I want to reach out to that person I can click on their name and I can see more about the post that they've done and I can actually have a private conversation with them which I think is so important. When I got diagnosed with cancer I came home I sat on my sofa and I said I want to have a conversation with a woman in Oklahoma City who had kidney cancer. I wanted to be specific by she said Oh you'll be fine. But I really wanted to talk to somebody who's been there. So that was impossible. I mean it doesn't allow you to ask your doctor who else has kidney cancer. You know want to to them. So that is what we're building. Well I never found that person. You didn't find that. That's why I built this into my links is a platform that you not only can gather your data but you can connect to other people. So that is going to really empower people to keep going. Sometimes too we have points and their lives are like why even try. You know and then you kind of major your cheerleaders around you say no you can do this. Yes possible.

Saul Marquez: [00:15:56] I love it. Now this is great Debi. I love the evolution. You know you've taken this consumer facing in such a way that will help any patient who's a person. You know I think oftentimes we lose track of that we're all patients we're all people and we all need this human connection which the community part will provide. But we also need this education and access access to our data. And you didn't mention one piece Debbie you said that you were glad that this law got postponed the meaningful use part by a year. Why were you glad that it got postponed. Maybe I'm not clear on that here.

Debi Willis: [00:16:31] First I was disappointed. Oh man I really want this to happen now. But I realized that this is such an important piece that the H.R. vendors are putting in their electronic medical records and testing with the all the clinics that it's now going to be a more sane rollout.

Saul Marquez: [00:16:50] Okay got it. Yeah he gives people Heilbronn hide and get paid for it.

Debi Willis: [00:16:54] Right. Right it will happen. It's just that we're now going to have it in a more organized the way. Got it.

Saul Marquez: [00:17:01] I'm with you. I'm with you OK. Got it I didn't want to assume. And so appreciate you highlighting the why behind that makes a lot of sense. Yes. Yeah. You know I find oftentimes Debbie that good ideas happen and entrepreneurs well developed. Who pays for this. Does a consumer pay for it. Does the insurance company for it.

Debi Willis: [00:17:22] Yeah a lot of people are asking that question right now I'm paying for my retirement my grandchildren's education my children aren't listening but all that money that I've been saving all my life I've gone into this and I will continue to fund it because I want it to be free for patients and free for doctors. And I want really to sponsor this and really call it a sponsorship sponsor as they can be always free to patients and doctors would be the people the researchers who want to connect because my mom had Alzheimer's and I would gladly give my DNA. I would gladly answer questions on a quarterly monthly weekly basis or whatever to find a cure for Alzheimer's and three members of my family died of brain cancer that something you know I want to find a cure for that autism Parkinson's you know so many things. I believe people are passionate about wanting some sort of way to participate in finding a cure. And the way that they can participate in finding a cure is by really engaging with research whether it's just giving your data with the identified or whether it's giving your data with a dye densification or with it whether it's actually really engaging in long term research to help find the cures and to me research doesn't mean I have to take a drug you know it may. Oh absolutely. Them finding out about me as I progress through my years what's impacting me what's making me better or worse so that I think is one element of who will pay for this but I really can't bring people back to things like Facebook you know Facebook is free but they definitely do generate revenue. Sure. Because there are paid services. I think those things don't spring up. It's such a need. My focus right now is just to get patients have a secure place for them to go to have them really enjoy the application and the connections they can have. I do want to say no data is ever shared without the X Lycett. OK okay from a patient. We don't take their data at all. I mean I want people to treat. I want to treat everybody like I want to be treated everybody's data is their data. Until they say I want to share this they can be shared just specific elements of it.

Saul Marquez: [00:19:36] It's super interesting Debbie and I love your passion for this. The mission is clear crystal clear. So is this active. Now can patients access it now.

Debi Willis: [00:19:46] Right now we are actively getting all the H.R. vendors ready. They are several of them already. If anybody had an epic like they have in my. They probably will be able to get on because epic has a lot of their clinics using it. We are very engaged with our scripts and on next gen we're also able to connect with Cerner and that Jeenah in several different ones but they're all of the clinics are right now installing their API. They have to be ready by January to and 19 got it. But this is going to be the year where you might be able to get on but you might not be able to get your data from all the clinics. And so the way we're handling this is we're letting clinics invite their patients like Facebook started invitation only. Yeah. We want people to actually ask their clinic Hey you ever heard about my links. I would like an invitation to my links please. And so then they would contact us. We would make sure they are ready with their API and then we say ok start inviting people. So that's the way we're going to handle it is by invitation from a clinic. And then once we feel that there are enough clinics who have their fire API we're going to open it to everybody.

Saul Marquez: [00:21:00] Beautiful. I love the long term vision. Everything seems well organized. Listen you took notes on your notepad. You've really been very thoughtful about how you do this. Bobby I am pretty certain things are going to work out really well and it's exciting to know that a resource like this will be available. It truly is the future. And I appreciate you being the visionary that you are like you did with patient link. Now at this new platform Miling. So as we get closer to that time frame we'll love to have you back on the podcast when it goes live so that we could spread the word for you.

Debi Willis: [00:21:35] Thank you. I would love that I really would.

Saul Marquez: [00:21:38] And so Debi. This has been tons of fun. This is more of an structured fun conversation that you know we kind of veered away from the typical format of the show because it was just so cool just to talk to you about your passion and your project. And so I usually close off with asking for our guests to share a closing thought and would love to open that up for you. And then also the best place where the listeners can get a hold of you.

Debi Willis: [00:22:03] Yeah. Well my closing time is we really truly are entering a brand new era and we're in this together. All of us together are going to be able to find cures faster by joining both together. And if anybody wants to get a hold of me you can just email me at Debbie and ask for letters debi@mylinks.com or debi@mypatientlink.com either one going to come to me, glad to hear from people.

Saul Marquez: [00:22:31] Debbie thank you so much for that. And listeners if something that Debbie said struck a chord within you or a researcher looking to partner up with an organization that has a future vision or are a physician that something or a patient whoever you may be take her up on this. I have a strong feeling that this is going to be a resource that we use in the future so Debi again just want to say thank you so much for spending some time with us today.

Debi Willis: [00:22:55] Thank you so much for the invitation.

: [00:23:01] Thanks for listening to the Outcomes Rocket podcast. Be sure to visit us on the web at www.outcomesrocket.health for the show notes, resources, inspiration and so much more.

The Best Way To Contact Debi:

debi@mypatientlink.com 

Mentioned Link/s:

 

 

Advancing Interoperability in Health with Dr. Peter Tippet, CEO Healthcelerate

Advancing Interoperability in Health with Dr. Peter Tippett, CEO Healthcelerate

: [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. I want to invite you to visit outcomesrocket.health/reviews where you could leave us a rating and review on what you thought about today's podcast because our guest is really amazing today. His name is Dr. Peter Tippett. He is a CEO at healthcelerate he's involved in health I.T. security and compliance. He's an entrepreneur has been down this path of an entrepreneur as well as a frontline provider. Our chief medical officer at Horizon Net1 point I mean the guy has an incredible amount of background to help make outcomes better and I thought it would be such a pleasure to have him on. So without further ado I just want to welcome you to the podcast Dr. Tippett.

Dr. Peter Tippett: [00:01:10] Well thank you.

Saul Marquez: [00:01:11] So you know one of the questions that I love kicking off with all of our guests is why health care to begin with?

Dr. Peter Tippett: [00:01:18] You mean why people need to be cured of diseases.

Saul Marquez: [00:01:23] Why did you decide to get into health care to begin with.

Dr. Peter Tippett: [00:01:28] I was drawn to health care by the science of it and the the rigor of it and I liked the people of it. I kind of have a gump has you touched on my background. I kept falling into environments that people were wildly successful. I worked for a guy when I was in college that won the Nobel Prize for sequencing the first protein. And another guy that I worked with synthesize the first protein and he won the prize. Also nice and I worked at another lab but figured out the cholesterol problem and these are all health related organizations so you know I got sucked in because they were exciting people exciting places doing great things might really enjoy helping people get better too.

Saul Marquez: [00:02:10] Wow that's awesome. You're very modest Dr. Tippett. That's one of your distinguishing qualities. You know I do believe that you are the average of your five closest friends and so you keep surrounding yourself with amazing people like Dr. Tippett listeners you will to be successful. So what would you say. Dr. Tippett is a hot topic that should be on every medical leaders agenda today.

Dr. Peter Tippett: [00:02:32] The topic that I've been worried about and trying to fix for the last several years boils down to the abysmal state of communication and health care. We in the rest of the world of PCs and the Internet is things like e-mail and chat and Dropbox and we share a word documents and we share messages and we ask each other questions and we tell each other where we are and we leverage the digital world to make our businesses better. And the productivity of the rest of the market place outside of healthcare grew several fold during the 80s and 90s when the whole PC revolution internet revolution happened. Healthcare to get that same growth in productivity didn't get any growth and productivity. In fact the cost of healthcare has gone up every quarter since we've had health care insurance for decades and decades and decades. There hasn't been a single quarter when it's gone down. Per capita. Not one that's good. But that's not true of anything else. You know the cost of everything else per capita. You know in constant dollars mostly has gone down PCs and computers for sure but also automobiles milk everything is better and cheaper now. Yeah it's not health care and a lot of that I think has to do with the fact that we haven't figured out how to leverage that even 10 and 20 year old infrastructures that added so much efficiency to the rest of business.

Saul Marquez: [00:04:02] That's such a great call out. Dr. Tippett And what advice would you give to the leaders listening on how they could implement this technology that exists.

Dr. Peter Tippett: [00:04:12] Now. Well I was on what was called the PITAC the president Information Technology Advisory Committee which is but that first. Oh and see when that started was started with this presidential charge to go figure out how we could add computers to health care and get something like web banking got when they had computers to banking gadgets. And we said you know if you could do but roughly had parity with what banking with computing by doing a similar analogous stuff with healthcare we'd wind up with wildly better outcomes. People live longer and be healthier wildly lower cost. Our estimate was 70 billion dollars a year of savings in thing but after our committee ended the Institute of Medicine thought that it was more like six or seven hundred billion. Just while costs. And we'd have a whole new kind of science. We know that what we now call precision medicine but you wouldn't have to do studies to find out answers to things you could just look them up across populations. But other than that it probably wouldn't be worth doing so we wind up with huge benefits across all aspects of this and all of our businesses will be more efficient. So what's the advice the advice boiled down to digitize everybody and make it possible for everybody to communicate medical records and messages seamlessly. At the time I thought that both of those were great ideas and they'd achieve the goal. I knew that it was going to be hard and I thought that installing Amar's is going to be the easier of the two steps but I didn't think that the digital communication was going to stay as broken as it has for as long as it has. I mean the P in hippo is portability hippo sharing records. It wasn't about privacy. Privacy was just the mechanism to make it easier for people to understand the basics so they could more easily share medical records and messages. And that's 20 going on 22 years ago now.

Saul Marquez: [00:06:11] Now that's and that's amazing I think a lot of people don't actually either know that or think about it they just kind of gotten stuck in the privacy aspect of hippa.

Dr. Peter Tippett: [00:06:21] Right. So we blame the lack of medical record sharing on Heppell we blame it on standards problems. We blame it on business issues through a hospital aid of and give all its medical records to a hospital because it's a competitive thing we blame it on vendor issues because the vendor doesn't want to operate with vendor bids because otherwise I'll beat them in the marketplace. We blame it on all these things. And I call this the myriad problems probably are a dozen categories of problems for why we haven't gotten there. But in the end it boils down to productivity. In the end it boils down to value. In the end it boils down to improving patient outcomes and to the extent that we can make our companies better reduce our costs improve our efficiency maybe get paid more. In all cases now especially with the switch to quality and switch to CEOs you know we actually get paid to know more about our patients and to not duplicate tests and. And even if that's only eight or 10 percent of our revenue now it's easier to show that that communication if you make it working really does add to the bottom line not just detract and we're going to get all the benefits the all the other industries go out on the Internet that the health care has not gotten to two plus fold improvements in productivity. That's going to happen too. It's just that we can't imagine that and don't want to count on it.

Saul Marquez: [00:07:43] That's right. And that's such a great call out. And as you guys take steps toward alleviating some of these these challenges Dr. Tippett what would you say an example of how healthcelerate and your team. You had a chance to meet Kathryn Thomas so there she was wonderful on the rest of your team over there. What would you say you guys are doing to help improve outcomes.

Dr. Peter Tippett: [00:08:05] Well we've done the healthcelerate that we've we've decided to try and make a general purpose platform that could make it possible for any clinician or anybody who works for a clinician to get a medical record of any EMR and get it to any other clinician in the country and do it without that recipient even knowing that help separate exist without them installing anything without them buying anything without them going through nine yards of stuff just like FedEx 40 years ago said if it absolutely positively has to be there overnight. Give it to us and we'll get it where it needs to go. That's what helps already is doing for medical messages like texts or e-mail like things or medical records like what you get out of your EMR. Get the other one and when it gets there the recipient ought to be able to put it in our EMR so that it becomes native to their own EMR. So we want to make this thing that would work no matter who no matter what in any way shape or form with medical messages or records of any size and make it interoperable essentially with all the Amar's and make it work whether or not anybody installed anything or bought anything. Now that's a high order. Hey we know we know the networks are not particularly valuable if they don't have many members. If you had a telephone and you were the only guy with a telephone you would have anybody to call. And that's roughly where we are with these HA's or with these data sharing networks like that vendors have put together or that others have put together. They don't tend to get to the tiny players even HA's the best run do well with the hospital but not with the small practices the vendor networks work with their own vendor but they don't work for the other vendors. The networks that are joined together by institutions tend to be bigger institutions but not tiny and certainly not small practices and we wind up with one way flow of information but that's largely because the value of a network is the cube of the number of users of the network unless you can give it to everybody. It doesn't work. So you need to build something that's got that instantly makes it possible for you to get a record to anybody in the country whether that recipient knows it or not. And that's I realize this is kind of hard to explain but basically we've bind all the standards like direct and access and and fire and all the things that meaningful use required and are already installed and working even though nobody's really using them. We took those plus all the things that we learned how to do across the last 20 years of the internet like you know how to download a file and how to upload what to do e-mail and how to do texting those we all understand how that works.

Saul Marquez: [00:10:41] Yes.

Dr. Peter Tippett: [00:10:42] We combine that sort of mind the memory the muscle memory of how the new text messaging with how to get things and the EMR layered on top of that sort of issues to deal with privacy and security and regulatory compliance and Hipple compliant and interoperability so that that could all be invisible in the background and made it so that a person could solve the problem whether or not the I.T. department want to get involved. So if a doctor somewhere says oh my god this patient's going back home I just cured her of a weird disease and I really want that doctor to know what's going on. Wouldn't it be great if the doctor could do what the doctor wants to do which is get the record off to the non-competitive other caretaker and keep it in a digital form so that they can have the best chance of continuing with the high quality care. Same for getting your better billing. You know if you're operating in a quality head world you get paid for knowing whether or not you're diabetic had an eye exam or a foot exam or in a 1C or the right number of other tests. The same is true for other kinds of chronic diseases you don't need to do those tests yourself. In fact if you did them all yourself you wouldn't make enough on the incremental money to pay for the incremental work you did. But if you can figure out the result from the ophthalmologist or the podiatrist or the hospital or the other doctors in the circle that that patient has already met without have been to redo the work you could get the value and get the payment as your bonus money. And the only thing you really need to make that happen is to be able to communicate. The other thing that's weird about this communication thing is that somehow in healthcare we decide that all the data will wind up in one place and everybody would get it from that place. That's sort of the mode of an HIV or anymore right. But that's not how it works in our businesses. You know if you have an employee who did a great presentation at some conference somewhere and you say I want to use that presentation of yours at this place I'm going to go to a meeting and you don't go download it from some central place for your company. Keep everything to ask the employee and the employee gives it to you right time. The employee might even say if you like that when you're going like this one even better. This is more about what you see let people think this is what the P and C was. This is personally enabling folks it's enabling that person to the value right. And that's why PCs dominate over mainframes because the the mainframe model is that I.T. thinks about all the problems and solves them for everyone. The PC model is that that's true but also individuals can go solve their own problems with tools and local power. And all we're really trying to do on the wholesalers side is add the personal part for the caretaker and giving them some value and the proposition of sharing records or getting records or adding value to the other care provider. When doctors brief each other on patients that they do endlessly they pride themselves in giving the shortest possible story with the most possible information. They call it the bullet train and doctors do that when we sent us mail to each other. Right. And then a transfer summary or some kind of a referral. We prided ourselves in creating as small as possible a summary of the patient problem and the questions that we really want answered and then the person who took that referral was pride themselves and taking all that information figuring out the real nugget of it and providing back a synthetic answer of the shortest possible way to do the best for your patient. That's the history. Like we just need to enable that for our care providers and they'll take care of it themselves.

Saul Marquez: [00:14:24] Yeah. Yeah this is a really interesting and appreciate you sharing the history and putting it together with the beliefs that currently exists about what technology should do. I think a lot of people take these things for granted right now. We expect to find information in this central repository. Well it's not there. So let's abandon that belief.

Dr. Peter Tippett: [00:14:49] You know what we really want and when you think about it in every other respect we want a central repository where it makes sense and we want to be able to ask questions to fill in the gaps. So if you're working in an intensive care unit and somebody comes in from three counties away and you know you're trying to save their life you're doing a very complex set of you know intensive care interventions. The simple question about something that might have happened two years ago. You see a weird thing on or weird thing on an MRI or you know you've got some question wouldn't it be nice if you could just fire off a question to the doctor three counties away or three states away or three without one of them and say did this EKG look like this before and an answer. I mean it's a simple thing but this is how we all behave in business in business we provide each other with data we provide each of the portals we share information where it's appropriate. But in the end that high bandwidth communication comes because we can tweet each other or text each other or e-mail each other or say this that file that contains the information you're looking for. It's on page 27 and we don't need to repeat it all terribly. We don't need that. It doesn't matter that our Yem ours aren't exactly the same. It's humans that were solving the problem for that matter and now they can reengage 27 they can even cut and pasted and centage make it even easier right now.

Saul Marquez: [00:16:17] Dr. Tippett this is really great and I love how you can keep things so simple. I mean there's beauty to that throughout the process. You guys how separate have spent time in refining your systems hasn't always been pretty. Can you share a time when you had a setback and what you learned from it.

Dr. Peter Tippett: [00:16:35] We're trying to do something very complicated by making it simple and the analogy I like to use is the iPod. You know Apple came out with the iPod and really that was an MP 3 player and but Microsoft hadn't and P3 player already was gorgeous and it had a nice farm actor and well-designed targets and Logitech had an MP 3 player. They're not tiny companies they've got great marketing budgets and so on but it turned out that Apple completely cleaned up the market with the iPod. This is before the iPhone. And what they wanted doing was the reason that that worked for them isn't because they're a better design engineering firm and have more cache in the market it's because they also decided they had to solve the problem of how you're going to get this music in the first place right. What are you going to do about the CDs you've got left and the ability to rip them they decide they solve the problem of Mac versus PC by making things work on both platforms. They decide how to get music purchased from the people who made the music. And so they talked to over half of them and got them to provide their music in a Bucha track. They sold a dozen different probably solved legal problems and regulatory problems them buying problems and interoperability problems and sharing problems and library consolidation problems and sharing with it over time because they solved these I call them the seven hard problems they solved these this range of problem then the market tipped to make it so that it worked. And the iPod and the iPhone and music through iTunes and the whole thing worked what everybody else has been doing in this market is solving a piece of the problem. And it's very difficult to figure out what the scope of a problem is in advance. Right. Totally. It clearly includes things like hyper compliance and the ability to let people in on a network without spending a day or two getting their identity proofing working in the medical credentialing and passports and driver's license questions and yes all that stuff that is required and you know you still have to do strong identity. You have stuff to do strong security stuff to make sure that people won't screw up with the data you give them about a patient and make it compliant with it. You have to make it so that when they make mistakes it doesn't cause security problems to make it so that even if you send a record to a random doctor in the middle of nowhere that doctor throws his phone in a taxi cab and sends it off to HHS and they take it out and look at it that even though the doctor saw the patient record there 20 minutes ago when it went up on the front step of the investigator the data is no longer there. It is safe. We have to solve all these problems and the mistakes we've made boiled down to that combination of making these things look simple but actually work that's really hard. You know we've been at this now and have Sellery for two and a half almost two and a half years and almost all of our time is spent on making whatever we thought were simple even simple or making something that looked like yeah that should work. But as soon as you show it to somebody we don't know what to do next. And if I had to look at a manual I'm not going to do anything. Yeah that's why we decided that e-mail should be a metaphor because people know what to do. Totally right. And it works out to be a metaphor or this is a text or email but it looks like text and e-mail and people know what to do uploading and downloading things. People kind of know how to do that. Yes. And you know if somebody sends a PowerPoint to somebody else by e-mail they know how to do that. Why can't we make that be the same metaphor as sending a medical record. It could be automated it could be built in so that it just happens automatically and pops up inside your own EMR or but why wouldn't we also make it possible so that can happen annually. And one other thing that really surprised us. We hired a UI design user interface designer. Yes. Done this three times now in a year and a half. And each time we make a quantum leap in improvement we wanted doctors or clerks in doctors offices to be able to pick which portion of a record that was sent to the other doctor or if you receive a medical record from somebody which portion I'm going to put in my own EMR because you don't want all 600 pages. I just want the you know the labs problem list of medalists a couple of other things. So we had to make that selecting of the subset or whatever you got what you were going to push into your EMR. We had to make that easy. And the first couple of times everybody thought it was wildly easy and they were all excited about it but we got another designer who really made the medical record that you were selecting from pop. It looked gorgeous it had these Fishbone things that when doctors take notes on 3 by 5 cards the next market they have shorthand way of writing down labs and we put that same shorthand on the screen and they have shorthand ways of organizing things so metaphor the love search almost all the EMR's aren't as good at search as Google is for example why wouldn't we improve Snickets so people could search for one thing they were looking for and look at things in so order and then look at Fishbone sort of lab results and other things and widgets things that would would put things in a view that you're particularly interested in whether you're a pediatrician and want to see growth charts or whether you're an ophthalmologist want to hear you know some summary of something or maybe or call the clerk and you want to see which parts of the patient record are missing from the viewpoint getting calls a point whatever that is. It'd be nice to have those things pop for you. Mrs. we've built that interface and started testing it. People said this is the best looking I've never seen local data. Look this Chrispin clean and before can I use this to just look at my own medical record. And we said Well can't you look at your own EMR on your mobile phone right now. And they said no and it didn't occur to us that the vast majority of doctors have no way to get the data of their EMR untruthfully or a tablet. But it didn't occur to you to totally asses that value was there. And it also was simple and an organized Apple. There's a great word for a way that in a way that was custom to the individual the initial goal was to simplify some selecting the part you wanted and finding just the day we were looking for. And as soon as we made it easy for people to find a value they said well if I'm on call and somebody who goes to another doctor across town calls me because I'm on call for the other doctor Montone about flummox and feeling in their chest. I don't know what flummoxing feeling is what the heck is that right now. But if I could look at the chart and see if this person ever used the word flummoxed before and all of a sudden I typed that as a search term and pops up whatever that person said to that doctor last year last month. I can quickly figure out whether this is similar to what's happened before or not. Yeah and on. And it's just this notion of combining search which by the way Google showed us search works really well and people said it's not new right. It's how it's how we added value to the rest of our Internet experience. Right. Great communication models that we also understand was enough to really get over that hurdle.

Saul Marquez: [00:23:47] That's excellent and a great example. Dr. Tippett On how you could just you know just listen man and you don't know what you don't know and you guys dove into it and found another opportunity to vote you say today is an exciting project or focus within accelerate that you guys are focused on now.

Dr. Peter Tippett: [00:24:04] Well we're we're really focused on getting this thing out at scale. Right. We'd like to make it so that any doctor or nurse or nurse practitioner or anybody working for any of those people can get any message or record to or from anybody else and make it so that it feels seamless to both ends of that transaction. And it's working well. But you know if this works really well it'll be as ubiquitous as Gmail or anything else that we all use all the time and track. So we're really really working at looking for the actual underlying value that really drives things because nobody had to push anybody to use email. Nobody had to bribe them with twenty dollars a month to produce e-mail or bird processing or any others. It was so obvious that everybody just said I'm going to write. And so we really are spending our energy trying to make sure that we have multiple points of value so that when people find different people will find different value for different reasons. Some people might like texting each other some inside or outside your hostel or texting some doctor. A thousand miles away and making that work. Other people might like the ability to look at their own medical record. But we're discovering when you get down under the covers what are the real problems and what are the names of those people that care coordination or referral management or even figuring out whether the insurance company is going to pay or not. You know this sort of quality metrics are you know the degree of words around these because people are building giant workflows around each of these things and all of them boiled down to good communication and an easy way of seeing the information so that you can act on it. Right. So to the extent that we extend what we've got which is basic communication basic interoperability basic sharing of medical records and messengers and add little things that sort of do a lightweight job of referral management or figuring out where the insurance company is going to pay for this procedure or not and get people into the quick way of getting something back and forth. We have a we talked to a farmer a pharmacy the other day that shows a picture of the pharmacist 40 years ago and the pharmacist was talking to the patient and the current picture of the same pharmacist in the same store as a pharmacist with the phone cradled under their ear and chin. On the one hand and both hands on the keyboard they're spending their whole time talking to somebody to try and see what they can give this matter that are finding out from one position where they want it this way or that way or going back to their insurer and figuring out whether this will be paid for or not. Why on earth can't they send a text and ask that question. The answer will come back out of phase the other band when the other time it's ready it might be a month and a half from now. But in that movie the half you could have done something else. That's right. That's right. That is again how we get our productivity working and all the other parts of business.

Saul Marquez: [00:27:02] I love it. Now this is a great example. Dr. tip you're just calling out the things that we need to be demanding from our communications systems and you guys are working on so that's exciting. I'm really excited to see how things develop over there and having these types of resources that make things simple available to any provider that wants it. So let's pretend you and I are building a medical leadership course on what it takes to be successful. It's the one I want or the ABC of Dr. Peter Tippett. So I've got four questions for you there. Lightning round style. And then we'll end it with a book that you recommend for the listeners. You ready.

Dr. Peter Tippett: [00:27:43] Ok.

Saul Marquez: [00:27:45] All right. What is the best way to improve health care outcomes.

Dr. Peter Tippett: [00:27:49] Communicate better.

Saul Marquez: [00:27:50] What is the biggest mistake that lives or you and I and it was a doctor and I love it. It's priceless. What's the biggest mistake or pitfalls to avoid.

Dr. Peter Tippett: [00:28:00] I would avoid big system mentality and let's get into person the person mentality.

Saul Marquez: [00:28:05] How do you stay relevant as an organization. Despite constant change.

Dr. Peter Tippett: [00:28:09] I think you drive change to stay relevant.

Saul Marquez: [00:28:12] And finally what's the one area of focus that should drive everything else in the organization.

Dr. Peter Tippett: [00:28:16] It's focused on the Patient Focus on the person's focus on the individual. Make it happen for them. Everything else follows.

Saul Marquez: [00:28:23] What book would you recommend to the listeners. Dr. Tippett.

Dr. Peter Tippett: [00:28:26] You know what I was thinking about this and I was involved I wrote a cover recommendation for a book called How to measure anything by Hubbard. Nice it's kind of a book that helps people do to hysterics when you only have three people you need a thousand person or 500 or some large numbers to do the typical analysis of whatever. But it turns out if you take a few people who actually know the space you can ask them to estimate the statistics for any given question and you can come up with at least as good an answer by taking smart people and putting them together. It's a great book.

Saul Marquez: [00:29:02] Well they haven't listeners and Dr. Tibbett thank you for that recommendation. Don't worry about writing it down everybody. Just go to outcomesrocket.health/drpeter. Just do D R P E T E R and you're going to be able to find all the show notes, links to healthcelerate there's a link to this book. Dr. Tippett This has been so much fun. Before we conclude I'd love if you just shared a closing thought with the listeners and the best place where they could get a hold of you or follow you.

Dr. Peter Tippett: [00:29:30] Well I'm at healthcelerate.com I'm ptippett Like ptippett@healthcelerate.com and I think you know the best thing you could possibly do is keep your head up and do the work on behalf of your patients and your employees.

Saul Marquez: [00:29:43] Thank you so much Dr. Tippett. And listeners. Take the man up on checking out the cool things that they have going on over there. And again Dr. Tippett just want to say a big thank you from everybody.

Dr. Peter Tippett: [00:29:53] Thank you.

: [00:29:58] Thanks for listening to the Outcomes Rocket podcast. Be sure to visit us on the web at www.outcomesrocket.health for the show notes, resources, inspiration and so much more.

Recommended Book/s:

How to Measure Anything: Finding the Value of "Intangibles" in Business

The Best Way To Contact Dr. Peter:

ptippett@healthcelerate.com 

Mentioned Link/s:

https://www.healthcelerate.com/

Episode Sponsors:

Healthcare Podcast

Advancing Interoperability in Health with Dr. Peter Tippet, CEO Healthcelerate

Outcomes Rocket - Dr. Nick

How Incremental Shifts can Have Exponential Results in Health with Dr. Nick, Chief Medical Officer at Basehealth, Inc. and CEO at Incremental Healthcare

: [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: [00:00:20] Outcomes Rocket listeners welcome back once again to the outcomes rocket where we chat with today's most inspiring and successful health care leaders. You know really want to thank you for tuning in again. And if you enjoy the show leave us a rating and review on Apple podcasts. Just go to outcomesrocket.health/reviews and you'll be able to leave us 5star review or whatever you want to give us and give us some feedback. Love it when I hear from you guys and gals it just helps us put together our show with what you guys are looking for. So without further ado, I want to introduce my outstanding guest today. His name is Dr. Nick. Dr. Nick's been in health care for quite some time with many different companies and really he's a guy that wears a lot of hats. And what I wanted to do is rather than dive into the details of where and what he's done. I wanted to open up the mic to Dr. Nick so he could fill that in. Dr. Nick, welcome to the podcast.

Dr. Nick: [00:01:23] Thanks for having me. Always a pleasure to join you and excited to share some of my experiences so you appreciate the opportunity. So as you said I've had many roles the primary one and the one that sort of drives me most frequently is as a physician but ultimately I've really focused on digital health and the enablement of people in the healthcare field with technology. Most recently I was the chief medical officer for Dell and founded a company called incremental healthcare that was really looking for those small changes that you find from other industries that add up to the big change that I think we're looking for in healthcare and I try and find those and bring them into healthcare. But my most recent adventure is really the one that I'm most excited about and that's working as the chief medical officer for Base Health and there are a comprehensive predictive analytics company that's focusing on population health management in a completely unique way. They really try and tease out what we call the invisible patient the one that never gets to the healthcare system until it's really too late or if it's not too late it's certainly going to be very significant in both impact on personal health and also impact and costs. And we can find those patients before they descend into this spiral of unhealthy medical experiences and allow the medical profession to play intervention before they would have seen them or been able to actually improve those health outcomes. And that for me is very exciting because that's really the medicine that I went to medical school to practice.

Saul Marquez: [00:02:53] Now that's really great. Dr. Nick and just focusing on those patients that I think is so special and so key so kudos to you and base health for taking an aim at that part of what population health. Why did you decide to get in a medical sector to begin with.

Dr. Nick: [00:03:09] You know it's funny that question comes up a lot and it's actually for me very easy to answer. I have a very specific event that occurred when I was still quite a young boy. I was with my brother we were walking in London walking out of a train station and a crowd had gathered at the side of a road and somebody had been run over and my brother was a doctor at the time and he pushed his way to the front of the crowd and you know asked people to let him through. Excuse me I'm a doctor and you know he was concerned for me so he had me sort of standing to one side because he was really taking care of me at the time. And I remember looking on as all these other people looked on this patient and my brother was playing intervention and offering care and treatment until the ambulance showed up and that was a seminal moment for me. I realized that I wanted to be him actually involved in delivering the care and supporting and you know being the active participant as opposed to the observer and that really sort of formed the main trajectory for me that made me decide that I wanted to do medicine so that I could play the most active role in contributing to people's overall health and being able to deliver care in urgent circumstances and ultimately what I did most of my practicing clinical career was working in the emergency room where you see an awful lot of those kind of things as well.

Saul Marquez: [00:04:34] Very cool. Dr. Nick, that's so cool and now thank you for sharing that story you know and you just took me back there kind of felt like I was part of the crowd and saw you walking through and you save the gentleman and now you're just you fast forward and you created that for yourself and now you're able to provide that help to the people. Very inspiring story and the like as leaders in this business we all get a reflect back onto that time that created that spark and why we're here and that spark is what keeps us ignited and keeps us going when the going gets tough. You obviously have decided with your recent involvement with base health to focus on population health. Right. And so I always ask what a hot topic you believe should be on medical leaders agenda. But maybe you could take a step further. There within population health and dive into where should leaders be focused today.

Dr. Nick: [00:05:24] Well so I think the primary driver in terms of exciting opportunities in healthcare is data. And then the second most exciting area or topic that we should be focusing on is data. And I'm I'm joking it's not to the exclusion of the patient or the personal aspects and that's really the medicine that we all want. It's also the medicine that clinicians want to deliver but we can't do that without data and we haven't had really good access to it. So for the longest time medicine was reasonably safe but not very effective. Over the course of the last several decades it's become increasingly challenging to practice good medicine much more risky for the patient and very difficult for the physicians because they're being overwhelmed with all of this information these various choices. And really the key asset that we want as a clinicians is to deliver the best possible care so that individual patients. And I think one of the things that we failed in the past is to sort of focus on the individual in all of this. And by that I mean calling out the details so we talk about diabetes type 1 and 2 but in fact as we've analyzed the data and now we know there's at least three types of diabetes not just two. And that's just based on the data. I can't tell you exactly what the classification will break down but we can see it in the data maps that show these groupings of patients and in fact I think it's even more refined than that. So as we analyze and start to take access to more and more data I think that's going to become the magic 8 ball in healthcare. It's going to allow us to understand our patients better. It's going to improve the advancements and the changes that we can deliver to those patients that is customized to their particular circumstance. So your clinical condition albeit labeled the same way as somebody down the street will be different because of so many other aspects. I think the analysis of that and in particular I think the key asset that we have is artificial intelligence and machine learning that really go about to sort of add to this tool which is still one of the best processing tools on the planet. But it's not good at certain tasks. It's not good at processing huge amounts of data and being very consistent is very good at teasing out patterns that we have to present that information. So for me using advanced analytics to find the patients and to deliver the very specific care that's appropriate for them what's the one intervention that we can do. If you are going to focus on one thing and there's probably lots that you can do that will change the trajectory for that patient. Let's focus on that and then if we can add other things it's a little bit like you know the steps of trying to lose weight. We don't focus on losing losing 20 pounds although some people set that target the first target is that first half a pound or a pound. Every successful journey starts with these small steps and I think it's that very much with data. And when you think about data it's about the lens. How do you focus on the right pieces of data and allow the physician to see when you see this enormous tsunami of information. How do you tease out because a lot of patients all look the same. I don't mean that physically but you know in terms of if you looked at them on paper gosh they're as sick as each other similar data elements. But how do you tease out the differences in the ones that are significant and the ones that are not. There are people that walk around that never have any challenges live to 100. And then there are others that don't. And we want to find those make sure that they get to the clinicians so that they get expert care as early as possible. So I think that capacity. And the other thing about data is we already have lots of it. There's a hundred and fifty million articles in pub med scientifically validated literature and are we applying all of that knowledge to the point of care. You get the best possible care when you go and see your physician. Maybe not not because he doesn't want to give it to you but he may not know how does he know at the point of time that he sees you that this is the right piece of evidence the right piece of science. And that's where technology comes into play to support that so that you can present those options to the patient and the physician so that together you come to this consensus. This is the best path and the best choice because there's no more than one yeah.

Saul Marquez: [00:10:03] Now Dr. Nick it's obvious you're very passionate about data and I'm just curious for the listeners can you give us an example of how you've used data and whether it be machine learning Iyer or just any basic analytics to improve outcomes. It was a specific thing that maybe other leaders in the field can apply.

Dr. Nick: [00:10:23] So I'm going to focus on the invisible patient because that one's very contextual to me. I think it's really it's a very narrow group of people. So when you look at a population you essentially have this typical distribution of risk that everybody understands that the percentiles the media the big bump in the middle and most people understand very clearly the ones at the top end the folks that are high risk chronic diseases recurring issues very expensive and lots of things going on. And then there's all the folks at the bottom end who are low risk who very active doing lots of sports eating well all of those things and then this big group in the middle. The biggest collection we have trouble finding individuals in there that in fact in hindsight when we look back after a year of data we realized that there were certain folks in there that became very very sick. They'd show up in the emergency room they'd have my Cartland function they progressed to stenting and bypass and then ultimately have congestive heart all a terrible outcome from what we know is that if you could place some intervention earlier on based on science so based on the science of the PubMed database and all the published studies if you did one or perhaps some more things for that individual you could have changed that trajectory and prevented them from showing up in the emergency room and maybe prevented the disease from even occurring. That's really exciting. We can do that and we can do it accurately in such a way that now it's very much to me like the Boeing engineer that sits in Seattle at his computer screen and he's looking at data coming from seven fifty seven that's flying from San Francisco to Washington D.C. and he notices because of the eye and the artificial intelligence that there's a problem. So what does he do he calls up the captain and says Hey I think you've got a problem with engine number two. They go troubleshoot and the logon eyes. The engineering team to be on standby and if the plane's got issues and that's proactive engineering but we don't do that in healthcare we tend to wait until you know something catastrophic happens. And this is now the outreach that goes to that patient. And for some that's a little bit unusual. And there's a challenge of trust here in the healthcare system where can you imagine receiving a phone call if you're like me you don't answer your phone at 5:00. Is Not a chance in hell if my phone doesn't know who you are then I'm not answering the phone and saying he's innocent but round the foot to one side and say you know assuming there's a trusting relationship you receive a call from a trust the vizor your physician or your healthcare team to say hey we think there's a problem or we'd like to see you come in and apply some assessments and get some additional data get some lab tests get some vital signs and you feed that into the model and then either that patient is proven to be at risk. The following reasons and you present that to the physician and say we need to do the following things let's put them on an ACE inhibitor for their blood pressure. They need to be on a Istat it or they prove to be healthy based on the data and you say well that's great actually there's no problem this is good news but we've done a good wellness. This wasn't sick care this was wellness care and that for me is just a complete change in the way that we practice. When you think about why you went to medical school it wasn't for the catastrophic interventions it was to prevent those. It was the humanity to say how can I extend people's lives and their quality of lives as much as possible. That's for me very very compelling as a message and a concept in terms of the data and the proof points.

Saul Marquez: [00:14:14] That's a great example Dr. Nick and maybe we could take it a step further. You know maybe. Is there a particular type of condition that you guys have been able to let's say pick out the crowd and say you know what. Thank God for this new way of doing things that we are able to identify. Do you have any stories like that yet.

Dr. Nick: [00:14:35] Yes so in fact it's not necessarily a condition. I think that's one of the historical aspects to health care although we do categorize so coronary artery disease as a classic example. Diabetes is another. What tends to happen is though those don't occur in isolation. So if you're a diabetic you quite often have coronary disease with it you might have peripheral vascular. So it tends to be a constellation of things. But I'll give you a specific example. So we ran data or against a dataset from 2013 and 2014 blinded. So we had no idea about what had happened. This was after the fact and we got the data as if we were looking at it in 2013 we ran an analysis and we were able to identify patients with an accuracy around 97 percent that essentially were going to spiral into poor health and we look to one of those patients. Good example. And it was an individual that in February bearing in mind that January through to December is the typical timeframe for these insurance pools and the risk pools. Yes. And in February they presented in the emergency room and they had a heart attack and then they presented again and had another heart attack. Then they had some stenting ended up with coronary insufficiency. And on long term coronary support because they have congestive heart failure they're challenged with exercise and based on the data they are if we'd seen that in December of 2012. So the you know the month before all of this kicked off we picked out that individual and said absolutely. High risk major challenge. And it wasn't a big list. So it's a rank ordered list that says here all the patients and here all the things we think are going to happen in order of both significance medical significance and cost. And then importantly taking account of patients. Our best estimate or guesstimate of their ability and willingness to participate and comply. So we look at all of the data associated with this and say Who are the people that are likely to respond because there's no point in going to a patient that you know you say hey you got all these problems but they refuse to fill the prescription or they refuse to come into the clinic. And some of that can be social determinants of health. So you know nonmedical factors and if you can place an intervention you can do that as well so provide the boats to get them into the clinic and so forth. But in those instances where there's just a wrong noncompliance that maybe not the highest priority. It's not that we don't care. But let's focus on the people that are willing and able and engaged in the first instance and then with what we've got left will start will attract some of those others. But that's a huge and that turns an at risk group from red ink to black ink. That's typically the patients that will turn you into a loss making proposition on a risk pool in a Medicare Advantage program for example.

Saul Marquez: [00:17:35] Dr. Nick that's a great great call. You're not going to be able to impact positively every single patient out there. I mean let's just be honest with ourselves. You know if you're a payer and if you're a provider looking to minimize your losses and maximize your outcomes I think it's important to take note of what Dr. Nick just mentioned here. You know focus on those patients that are going to help themselves that are going to help themselves right. And so it's a great call out. Dr. Nick can you give an example to the listeners of a time when you've had a setback and something that you learned from that setback.

Dr. Nick: [00:18:13] So I thought about this a little bit. You were kind enough to share some of these questions ahead of time and you know the first thing I would say is that on a routine basis I consider myself failing in many aspects of my life and world. And not in a negative way. I think the key asset and thing to remember is not to take failure as the end point failure is just a learning opportunity to me and to be clear you know I'm preaching versus you know what I practiced. I'm sure I internalized a lot of this but I wouldn't say that my most embarrassing failure is a personal one. So many many years ago my wife and I had our first child who was a boy born in Glasgow and my wife's a very accomplished nurse midwife health visitor. I'm a physician and we went through hell on earth as many parents do with a very difficult child. Never settle. Valma you name it. Just all the things and I know lots of people will listen. Yes I was. Big deal. But here is the failure and this was the hidden data hidden patient. The fact that I couldn't see it all my wife couldn't see it. Despite extensive clinical experience my brother who's a GP the one that you know inspired me to be he comes up to visit finally to see the family and he couldn't have been in the house more than five minutes and he says Oh my God he's got a milk allergy.

Saul Marquez: [00:19:39] Oh my goodness.

Dr. Nick: [00:19:40] I don't know why. Yeah you know. Now you see I'm within a couple of days we had moved them off. You know regular milk put them on soy milk a man's whole demeanor had changed. Amazing. And for me that encapsulates everything about Dator it doesn't matter even if it's staring you right in the face in a face. You don't always have the capacity to see it and that's where technology analytics machine learning all those things I think are contributors there are the supporting act. They're not here to replace you. They're here to you and allow you to do better work better jobs essentially better medicine.

Saul Marquez: [00:20:24] What a great example Dr. Nick. And I'm glad your brother showed up and that just goes to show right you spent enough time and you're so passionate about something you could care so much about fixing it or getting it right. Sometimes it helps to just get around a group of people that have a fresh perspective know help you see the solution.

Dr. Nick: [00:20:49] Very much what we would call the curbside consult in the traditional form of right medicine. The thing that used to take place in the doctor's mess as it was called in my time all the area where the clinical team used to gather. Now nobody gathers there nobody actually it turns out that that's only used for putting terminals into people to access the electronic health health record which to me we've lost a little bit of that interaction. And I think one we should encourage more of it too. We should allow technology to be part of that Cope's like cancer process.

Saul Marquez: [00:21:23] Now that's such a great callout and a great story. Thank you for sharing that. Let's take a look at the other side of this. Dr. Nick what's one of the proudest medical leadership experiences that you've experienced to date.

Dr. Nick: [00:21:35] So I wanted to share a nonmedical one first. Yeah I know. So I actually I would say from a leadership standpoint the thing that I've learned the most from a leadership standpoint is has been from animals and children. And I would say that my capacity to understand or put myself in other people's shoes to help me nurture and and move people's views and opinions into a concerted direction particularly with training of my Labrador when she was around told me this tremendous amount. I wish I had a dog many many years ago because it taught me the true understanding of how you look at other people's perspective. Because her perspective was much simpler for a different mind. And I had to insert myself and the other thing was with kids especially very very young kids that I used to train to soccer. Same principle not the dogs but they were very similar in some respects in terms of their behavior and allowing a means to understand their drivers and their perspective and all of that has really helped me over the course of time be better. I would call more of a nurturer versus a leader. And I've learned a lot. And when it comes to health care I would say for me the proudest time I had was working at Dell for Michael Dell in fact and one of the most inspirational people I've had the opportunity to meet who quite frankly given how successfully is and what he's managed to establish such a humble gentleman really inspirational to see somebody of that stature just as an ordinary guy. And that for me was just a real joy to work with him work for him and the people that he inspires around him I think true LEADER I'm one I try and mimic certainly in my behavior.

Saul Marquez: [00:23:32] Thank you Dr. Nick. It's pretty cool that you had that experience to work with Michael Dell and you know you definitely have had your fair share of success as well and I would put you in that gentleman category. And you know I think as as leaders I think your call out here that what you learn from animals and children I think is a good one right. To nurture and instead of just lead I think that goes back to the idea of putting that care into health care and what a great callout. So glad you brought that up. Maybe you can focus a little bit on a exciting project or focus that you've got going on.

Dr. Nick: [00:24:09] So I've talked a lot about base health. Maybe it's worth talking a little bit about the incrementalism for me. One of the things that I realized some time back is that you know we're all looking for this huge change. The eureka moment if you know the Eureka story and the origins of that with the Eureka measurement of displacement by water while they occur they tend to be infrequent and the majority of our learning opportunities are small incremental changes that add up. And that's true in healthcare. When you think about patients it's not that you can come in and be this fantastic clear and airway obstruction the Heimlich maneuver that most people can understand. That's very gratifying. But that's an unusual experience. It's much more likely to be a complex long condition changes minor issues and teasing that out. So the small pieces of data and what I've discovered clearly is that other industries use this very effectively and there are so many learning opportunities in other places. This past year I presented at HIMMS in conjunction with Hilsen who do this Fent stick job of hospitality. And yet we in health care do a pretty poor job in most hospitals and healthcare systems. You know we tend to not give our patients the best possible experience. Why can't we learn from them. Put in place some of the. So it's bringing all of that together in this incremental approach that for me is really the best scope we have revolutionizing healthcare. This is not gonna be a quick fix but it will add up to something. And when you look at over if you look at the history and the timeline it's lots of little small course corrections it wasn't this big. Oh my God we've got to have ōba. Nobody thought that. Right. And I think the same is true in healthcare and you know those small changes that when you look at them you go well. That's obvious. That may be true but it's not being used and it wasn't that obvious and implementing that I think is going to add up to the change we desperately need in Health.

Saul Marquez: [00:26:13] Dr. Nick. And I think that's an awesome callout and I think an important ingredient in that recipe for big change is consistency. Right. Once you make that shift staying consistent with it seeing it through.

Dr. Nick: [00:26:27] Yeah. And the other thing I would add incremental changes is also insurance against risk. And why do I say that because if you make small changes and they don't work you find out quickly you haven't made a huge sort of financial jam into some direction and you've got the ability to course correct from there. So you're right. Keeping consistent and building on is important but also that learning opportunity failure is not a failure it's simply learning. And if they're only small changes it's much easier to recover from that and quicker to recover and that's mitigation of risk in my mind.

Saul Marquez: [00:27:08] Awesome. I love that. Yeah. And this is such a great example Hakims Raggatt listeners and what you could do in your organization you know make those small changes that tie into your mission that tie into your goals and ultimately course correct as you go through. It's insurance. You can make the small changes you're not putting big dollars or big pounds into your decisions. So Dr. Nick let's pretend you and I are building a medical leadership course and what it takes to be successful in medicine today. It's the 101 course or the ABC of Dr. Nick. And so you and I are going to write out the syllabus. I've got four lightning round questions for you. And then we're going to finish up with a book that you recommend to the listeners. You ready.

Dr. Nick: [00:27:49] Yep absolutely.

Saul Marquez: [00:27:50] Awesome. So what is the best way to improve health care outcomes.

Dr. Nick: [00:27:54] I think the best way to improve healthcare outcomes is to use the existing pool of information and data turned into knowledge supported by technology and enable the highly skilled individuals that we have working in the system to work importantly to the top of their license. And that's not just physicians that all clinicians and it's the enablement of that potential rather than asking them to do tasks that I think don't actually deliver better care. They demean and reduce that capacity.

Saul Marquez: [00:28:31] What is the biggest mistake or pitfall to avoid.

Dr. Nick: [00:28:34] I think the biggest mistake we make is failure to understand other people's perspectives. That's one that is a big topic or a big issue for me. Let me pick something controversial vaccines. The idea that any parent comes into a pediatrician's office with the intent of harming their child is for me with a very very tiny minority possibly is just preposterous. So the fact that they're resisting the science based supported evidence of regular vaccine schedule is not malintent and we need to understand that position and help them understand why that's wrong if we believe that's wrong. The Swade not impose so the importance of understanding other people's perspectives I think is the most compelling issue for me or the most important issue.

Saul Marquez: [00:29:24] I love that. How do you stay relevant as an organization. Despite constant change.

Dr. Nick: [00:29:29] Oh I think a welcome change is the key learning point for me. That's easy for me I just can't be any more excited. Think about all the changes happening to age maker. Yeah that happens in terms of it's good news and if it doesn't work that's okay. Recognizing the risks and the challenges associated with loss of time and effort and so forth but setbacks and again the small changes try these things out and see if they work and if they don't course correct but welcome it. This is an exciting time to be alive in healthcare and in life in general look at all the stuff that's going on. This could not be more exciting.

Saul Marquez: [00:30:07] As brilliant I love it. I totally agree. And finally what's one area of focus that should drive everything else in your company or organization.

Dr. Nick: [00:30:15] Oh that's got to be the patient. I think the most impressive organizational chart that I ever saw for a hospital was one that I helped build in Glasgow 20 to 23 years ago. And instead of putting the CEO at the top they had the patient at the top and I bet they'll. And you know it seems simple but my goodness you know focus the mind. Why are we here. I'm not here to deliver medicine I'm here to service the patient. I am not the most important person in the healthcare delivery system. The patient is it's all about a patient and if we're not delivering good care to them we're not being successful in my mind.

Saul Marquez: [00:30:52] That's a powerful visual thing you know just I love that I've not seen that before the visual. I've heard people talk to it but just having that organizational structure with the patient at the top. Wow. I love that Dr. Nick. You've obviously done some really cool things and you've read a lot of books but what would you say if you had to boil it down to one you'd recommend put on the syllabus for the listeners.

Dr. Nick: [00:31:14] You know this was probably the hardest question but it's it's one that sits by my bed albeit sometimes in the drawer but not you know it's a short history of nearly everything by Bill Bryson. It's not medical it's not futuristic it's scientific and I just want to read for you the first couple of lines from the preface. In fact it's not even the opening yet. Welcome and congratulations. I'm delighted that you could make it. Getting here wasn't easy. I know. In fact I suspect it was a little tougher than you realize to begin with. For you to be here trillions of drifting atoms had to somehow assemble into an intricate and intriguingly obliging manner to create you. It's an arrangement so specialized in particular that it has never been tried before. And you will only exist this once and it goes on and it's essentially everything about the world the universe everything down to Patre and atoms and beyond and then all the way up to the scale of the universe and to get a sense of how tiny and insignificant and particularly to put things in perspective. I like to read. I actually keep that on my desktop. I have another shot of that. And it goes on a little bit. If you read nothing else just read the preface of that book. I will blow your mind.

Saul Marquez: [00:32:37] I love it Dr Nick and so outcomes rocket listeners they have it check out that book and by the way don't worry about pulling over writing it out. Don't worry about stopping your run if you're listening to this and you're on the go. Just go to outcomesrocket.health/drnick D-R-N-I-C-K you'll see all the show notes of our discussion today as well as a link to that book and a link to all the things that Dr Nick is up to including his websites and the best place to get a hold of them. So Dr Nick before we conclude let's just hear you share one closing thought and then the best place where the listeners can get a hold of you.

Dr. Nick: [00:33:15] So my closing thought is for the most part the same. This is the most exciting time period it is the best possible intersection of healthcare and technology. I'm excited about it. It doesn't faze me at all. I think technology has always been about enabling human potential and we have enormous opportunity in front of us. And I'm just delighted to be here at this time. As for reaching me pretty much if you can't get to me the Internet is down. Least that's my view. I feel like I'm reasonably well connected. You can find me on Twitter. @drnic1 on LinkedIn Facebook you name it. And in fact I did test this I was curious you can search for Nick Vantaa Heyden but if you can't spell that Dr Nick and I do appear although I do get muddled up with the Simpsons Dr Nick and also Dr George Nikolopoulos who was the original Dr Nick he was Elvis's physician. That is funny. So Ofeibea I am actually on the first page of Dr Nick so.

Saul Marquez: [00:34:24] I just pulled it up and there you are.

Dr. Nick: [00:34:26] Yeah which is pretty cool.

Saul Marquez: [00:34:29] Yeah that is cool. Awesome while our comms racket listeners a habit you got to the best way to get a hold of Dr Nick show Nochiya they're ready for you to review and you can always listen to the episode again have something inside of it inspired you so Dr. Nick. Just want to say thank you so much for joining us today and looking forward to stand in touch with you.

Dr. Nick: [00:34:47] Likewise. Thanks very much for having me. I enjoyed it.

: [00:34:53] Thanks for listening to the Outcomes Rocket podcast. Be sure to visit us on the web at www.outcomesrocket.health for the show notes resources inspiration and so much more.

Recommended Book/s:

A Short History of Nearly Everything

The Best Way To Contact Dr. Nick:

@drnic1

https://www.linkedin.com/in/nickvt/

https://www.facebook.com/drnic1

Mentioned Link/s:

http://incrementalhealthcare.com/

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A Digital Health Solution for the Silver Tsunami with Victor Wang, CEO at care.coach

A Digital Health Solution for the Silver Tsunami with Victor Wang, CEO at care.coach

: [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: [00:00:20] 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 and I invite you to go to outcomesrocket.health/reviews where you could rate and review today's amazing guest. His name is Victor Wang. He is the CEO at care.coach. Victor got started tinkering with tech at the age of six. Programming role playing games and he worked in telemarketing environment research aerospace main factory in particle physics, oil sands, medical robotics, and the military before grad school at MIT and starting a career as a health care entrepreneur. This guy's pretty interesting had a chance to meet him live at Health 2.0 where I really gain an appreciation for his work. So what I want to do is offer him a warm welcome to the podcast. Victor. Welcome.

Victor Wang: [00:01:14] Thanks for having me, Saul.

Saul Marquez: [00:01:15] It is a pleasure my friend and so maybe if there's any gaps that I left out in your intro maybe there's a good chance to fill it in.

Victor Wang: [00:01:22] I thought that was a pretty flattering intro.

Saul Marquez: [00:01:26] Thanks man. Hey you know it's real. It's true it's it was really fun to kind of do a little background on you man. You've done a lot in a very short time and and it's exciting to see the new wave of entrepreneurs doing some pretty cool things like you. And so what is it that got you into health care to begin with.

Victor Wang: [00:01:45] Yeah actually I mean it was this company is what it was and I don't think that starting it off I really thought of it as a health care company.

Saul Marquez: [00:01:56] Ok.

Victor Wang: [00:01:56] It's more of solving a problem kind of a company. Those kind of based from family experience with now and my grandma in Taiwan and just going through trying to support and care for an older loved one remotely. And how challenging that is and then just trying to solve that problem. And I guess I kind of thought of it as like senior care but not necessarily health care to begin with.

Saul Marquez: [00:02:24] Yes.

Victor Wang: [00:02:24] And it has evolved a lot since then.

Saul Marquez: [00:02:27] Yeah. Know it's really interesting the evolution and you said it really wasn't health care was more so solving a problem that that you had personally. So are you are you using the technology to to care for your parents your grandparents now.

Victor Wang: [00:02:42] One day she actually speaks Mandarin oh doesn't really speak English at all.

Saul Marquez: [00:02:47] OK. OK.

Victor Wang: [00:02:48] So we have to have a service that works currently in English and Spanish only.

Saul Marquez: [00:02:53] Oh nice. So you got Spanish in there too. Yeah.

Victor Wang: [00:02:56] And you know one day Mandarin.

Saul Marquez: [00:02:59] Hey you got to start somewhere. And the point is you got your vision. It was inspired by family situation. And so now you're here. Fast forward to today. Can you give the listeners an example of what you believe needs to be done on healthcare leaders agenda.

Victor Wang: [00:03:15] I would say the aging population. I've just I don't know what kind of answer you're expecting but you know this is kind of my field and it's actually kind of boggling to me how some people don't have this theme of aging you know on their agenda are in their awareness of actually you know not going to name any names. Very senior people like CMO is a top academic or things like that like oh you know I notice you mention this. How come like aging and the fact that there's a thousand baby boomers retiring every day and the changes that health care faces when dealing with this kind of you know older adult population with multiple chronic conditions and so on that come with age. You know how is this aging of the patient population factored into this overall strategy of viewers because you can't just think of people as individual diseases that you're treating when it comes to geriatrics and you know it's just surprising that

Saul Marquez: [00:04:21] Yeah why do you that i. Why do you think that is Victor why do you think aging is a bigger part of the overall strategy and plan and human thought process. Why do you think that is.

Victor Wang: [00:04:33] I think there's a lot of answers to that question. I mean one from the perspective of medical education I mean I'm not a doctor I happen to be wearing a fake lab coat right now. This simulation going on there. I don't even have a Ph.D. but as far as I know I'm in that case you really have to go into a geriatrics kind of a specialty to really grok what it means to care for elderly people because I feel like a traditional medical education even my limited understanding obviously think of people as you know what are the problems that need to be treated. And it's very individual and I would say even until now we don't really have a robust complex you know multiple conditions kind of a model that's been widely accepted and understood by most physicians. Even things that are considered innovations relatively new like the diabetes related disease self management programs and things like that they're really focused on single conditions and you know if you look at the statistics that people get old there are very few people you know in retirement age and beyond have one chronic condition.

Saul Marquez: [00:05:50] Right.

Victor Wang: [00:05:50] And so that kind of mindset doesn't really work. But everybody still kind of stuck in that kind of a mindset of treating individual conditions. Medical education is potentially some other issues and this starts to get into you know caregiving and it can be hard to reach people who are caregiving for older parents. But it's also just not a topic that's you know in the popular mindset particularly sexy right. In a way. You know it's cooler to talk about like stent technology or something like that than it is to talk about you know your mom or dad who is ailing and can't drive anymore. You know maybe needs help getting dressed and things like that it's kind of a touchy subject for a lot of people and it's kind of a topic that people tend to shy away from a little bit. It's a little bit taboo as well to talk about a certain kind of elder care related things. There's a lot of issues at play I think.

Saul Marquez: [00:06:49] Yeah that's really interesting. Vicker you can dive into some really really fascinating thoughts there particular this idea that not only are we siloed as far as communication in healthcare but also you know siloed in the way that we approach different chronic conditions and different specialties. And I do look at this as as an opportunity for the leaders of healthcare listening to the podcast right now to ask themselves what is it that you can do to remove the silos and think of this horizontally rather than vertically think that a patient goes through an entire continuum of care. A patient can have more than one specific disease to take care of. So the ideas that Victor's sharing here specifically in the elderly it's very important that we start thinking more broadly. So Victor appreciate you highlighting that and the things that you guys are doing at care.coach are really tied into this. Can you dive into a little bit more about what you guys do there and what makes you guys unique in the market.

Victor Wang: [00:07:52] Sure. So the short version is we psychosocially support complex high name high risk patients across the continuum of care. So in the hospital or at home to drive health care outcomes and that sounds incredibly broad. It's basically what we do and because we're focusing on this population which is very high need and high risk and I don't by default say elderly in there but in many cases that's kind of implied. But when you work with this kind of a population necessarily that's the easiest way I can frame what we do because if I were to go into the exact outcomes that we drive you know it varies. So for hospital customers we're reducing delirium occurrence and risk when you do detect it and increasing the detect ability of delirium and then that's one way that we actually reduce fall rate among hospitalize Alder's and there's other ways that we reduce foller among houseflies others where you can also help to engage and redirect people to reduce the need for restraints in the hospital which is a huge thing. And then at home completely seemingly completely different environment and we're supporting people to alleviate depression and anxiety. That's kind of what we've been known for for a while but then on top of these social relationships we're coaching people to better manage multiple chronic conditions like heart failure plus diabetes plus COPD plus hypertension loss depression plus you know they get anxiety related emergency department visits that are otherwise avoidable. Now these are the kinds of patients that we work with and I don't think it would be very easy to point to any specific technology startup that does all this charitable. You know that's actually what makes us unique and in a long winded way is we actually support at a personal level these very complex high need high risk patients that otherwise are completely underserved as far as technology point solutions.

Saul Marquez: [00:09:53] Yeah that's interesting that there and would you say that your solution falls under the self-management sort of movement of technologies and processes that drive individuals to take care of themselves across not just one disease but basically everything that they're dealing with.

Victor Wang: [00:10:10] Yes essentially and beyond just the clinical indications like you know we're going to put together this self-management program for heart failure and diabetes that's been done. It's a feat to do a good job. Although it's been done so I think what sets us apart even from that is just the personal support that we're providing. So we have this avatar actually that talks with people and with research that shows that it actually builds friendships and a real social relationship with that person.

Saul Marquez: [00:10:37] A little dog.

Victor Wang: [00:10:38] Yes.

Saul Marquez: [00:10:39] I showed it to me at the meeting super super nice. Tell us a little bit about that. The avatar and sort of what role it fills in this. You call it a psycho social aspect of the service that differentiates it from the typical chronic disease management.

Victor Wang: [00:10:54] Sure. So what people see is the little dog the cat Yeah and it's pretty disarming when you see it because it's just adorable little dog or cat.

Saul Marquez: [00:11:03] Oh there's a little cat too.

Victor Wang: [00:11:05] Yeah there's a cat a cat lover, Saul.

Saul Marquez: [00:11:07] Well you know we do have a cat. And yes I am. So how do I use the cat.

Victor Wang: [00:11:12] OK. Well let me know if you. Maybe in a few years or something. Yeah. So you know they see this little pet and as kind of disarming Richter's what's actually happening is a lot of complexity in the background. So what we're doing is we're realizing that in order to adequately support this highly complex isolation you really need real people. And there's there's other startups out there trying to do things like what we're doing. But do you know social robots or some artificial intelligence. You know maybe one day in a couple of decades we'll get there.

Saul Marquez: [00:11:52] Right.

Victor Wang: [00:11:52] But in the meantime we're recognizing that real people are the best at providing this kind of high touch personal support. And so we have real people that we hire all over the world 24/7 that provide this kind of social interaction conversation and really can talk with somebody, pray with them, with listen to what's troubling you, know talk through some issues that are going on or share in things that are that you're interested in or that make you happy and really provide that level of support any real people. So that's what we have. Now you have a problem when you have a team of 24 7 people all over the world providing this kind of support is you will have to talk with several different people at minimum throughout the week. And depending on what time it is or if you wake up at 3:00 a.m. and you need to talk to somebody in the middle of the night it's going to be probably different than the person you talked to. This is day afternoon. Let's say right the avatar is there to unify the care team and to have that persona which is not particularly helpful for elderly patients.

Saul Marquez: [00:12:51] That's very interesting. Yeah. And does the voice change or is that stays the same too.

Victor Wang: [00:12:56] Stays the same. So we can change the voice so we have for example of Stanishev voice engine and you know we can change the pitch or the speed depending on the person's listening preferences or impairments. But for a given Avatar once you've picked a good voice it's just the same.

Saul Marquez: [00:13:13] Oh that's so awesome. So the whole team can speak through the Avatar it stays the same. So there's continuity for the person using.

Victor Wang: [00:13:20] Exactly yeah.

Saul Marquez: [00:13:22] That's really sweet.

Victor Wang: [00:13:23] Now and then it's kind of like a more lighthearted fun non-judgemental kind of a relationship than you would have with like a virtual doctor or like a virtual nurse or something like that.

Saul Marquez: [00:13:35] Wow. And that's really cool. So who pays for it.

Victor Wang: [00:13:38] So our customers pay for it. It's what we call them customers.

Saul Marquez: [00:13:42] So like I guess I'm just wondering if it's typically the hospital the insurance company.

Victor Wang: [00:13:49] Was that it's tongue in cheek manner so because I was going to say right now we working with hospitals and these special health plans that gacha targets for elderly people. So it's actually an interesting concept if the listeners don't know about it. There are these things called Heyst health plans or program of all who care for the elderly is. So if anybody is listening and hasn't all their parents for example perhaps needs to go into a nursing home soon anything and doesn't want to because he wants to do that and he might want to look into the potential availability of one of these pace programs because they're basically an alternative model where if somebody is qualified to go into a skilled nursing care under Medicare or Medicaid coverage they can instead take that coverage and stay in their own homes not go anywhere. Yeah and the pace health plan is everything and they will actually take you to a day program. They'll pay for the shuttle shuttle you back home they'll pay for home nursing visits as necessary and so on and this model of care is basically caring for people that would otherwise be in a nursing home. So that's one kind of organization that our avatars are very helpful for. As you can imagine for this very high need high risk kind of a population.

Saul Marquez: [00:15:03] Victor, I think what you're doing is really awesome. And you know I put myself in the shoes of somebody going to through this and just getting to that point of life where yeah you know you really start depending on others again kind of full circle. I wanna stay in my house. And so if you're a listener if you have an elderly parent or grandparent and you find yourself in this place where you're in a bind and you know you may have to take them to a elderly home consider this program that Victor just just mentioned and the space programs. And so what I'll do is Victor if you can share the link. All included in the show notes as well as a link to the things that you provide but definitely a really great alternative. Victor let's talk about some of the outcomes that you guys have created. You mentioned delirium mentioned fall prevention. What would you say one of the proudest outcomes you've been able to achieve with this technology and your people. Obviously it's not just technology it's people.

Victor Wang: [00:16:03] Yeah I think he basically said it's the falls and the delirium outcomes are probably the pinnacle of what we've achieved so our history. So we actually started over five years ago as we started to develop the product. As you might imagine if you know several years ago when this was an idea it might have seemed kind of like a crazy idea like let's get these people are all over the world like no other country has to staff these avatars and very cost effectively provide high amounts of psychosocial support to older adults in the US through these talking dogs.

Saul Marquez: [00:16:43] You know when you put it like like I think it is.

Victor Wang: [00:16:50] So we actually started out just kind of you know there a prototype like testing it. And some of our early rece. I mean you have to actually test this out. And we found sort of New York's great professors at a university doing some research with their nursing students and computer science students. And we actually found that our original hypothesis was true is that you know you put together this crazy system and you actually can combat loneliness and provide social support to people and that was really powerful because it was like boom we basically achieved our initial goal as far as the feasibility of the product to do this and then we did some more research and actually University of Washington has a few papers published already about how we help to combat depression like the Paish Q9 Servais improve measures of social support like Yemo social support sub skills. So there are several published papers on that and then we're kind of like OK. So as a business as a social enterprise you know if we can scale this up this is great we solve loneliness. But as a business where's the value in solving loneliness. So we realize that we could actually scale much better if were you know making driving more value to whoever customers are and we drive a lot more value and incidentally save lives and deliver more social value if we layered on top of that these clinical outcomes beyond just making depression is a clinical outcome but I mean things that are even closer to actually the things that the doctors care about in the hospital the nurses care about the hospital like Delerium or falls. And so we realize that when you have this psychosocial relationship with somebody you can use that to help you know influence behavior towards risk mitigating healthy behaviors. So then we did other research for example what you just mentioned in the hospital that was a 95 patient study where we showed in excess of 80 percent reduction in fall rate among hospitalized elders by affecting behavior you know making sure people ask for help to go to the bathroom instead of getting out of their beds alone by getting people to do cognitive orientation tasks and cognitive exercises and wear their glasses because of vision impairment is actually a major risk factor for delirium. And to do all these different things and elicit all these different needs out of the patients on top of this friendship in a way that is protocol driven based on evidence you know saves people's lives.

Saul Marquez: [00:19:26] Is what matters. Yeah that's really interesting Victor so thanks for walking us down the path there of how you guys are adding value and it's interesting right. Like here's a note to the entrepreneurs listening. You could start somewhere with an idea and then get to the point where you realize that hey you know while I'm creating good and doing good they may not Not necessarily be a financial model behind it to support what you're doing without margin there is no mission. And so what Victor did with his team they pivoted and they found a way to impact something that affects the bottom line of these providers. And you guys did it beautifully and you found some some great areas to focus on. So don't give up on your idea, people. Think through the things that you're doing and think how you could broaden what you're doing don't just abandon because there's no model behind it right now. And Victor is a great example of of doing just that. Victor give us one of the proudest leadership moments you've experienced to date.

Victor Wang: [00:20:28] Proudest leadership moments.

Saul Marquez: [00:20:31] You've been on the stage at TED MED you've Ted health. You've done a lot of really cool things you've been published on different magazines you've done a lot of cool stuff but out of all the things that you've done what sticks out as one of your most proud moments.

Victor Wang: [00:20:45] I would say it's just having this team that's stuck with me a.

Saul Marquez: [00:20:49] Tell me a Little bit more about. I mean it's a chance for you to give them kudos right now.

Victor Wang: [00:20:53] Yeah I'm proud of my team and you know we all really believe in the mission and just the fact that we're all still working together after so long and you know so committed. It says a lot I think and we've been through a lot together. Like my co-founder Schwall like we've been working together for over five years now and then another example is my wife.

Saul Marquez: [00:21:17] Very important part of the team.

Victor Wang: [00:21:18] Who I met at an aging conference called Aging in America. So we made this it's like newbie table. And I was like wow OK let's get lunch. I don't know. She was impressed that I was like some young guy out there presenting some research outcomes of an avatar and she kind of felt me kind of inspiring. You consider that to be a leadership moment because that got me the date and then we reconnected after the got married. She joined the team she started volunteering because she wanted to help. And you know now she's with us full time. I think that right there is probably my proudest leadership moments.

Saul Marquez: [00:22:09] Hey congratulations. I Like that is that is pretty amazing. You did it. You met the woman of your dreams. You guys just bonded over common interests and now you guys are both doing better for the world. So that's an amazing story. Thank you for sharing that. What's her name.

Victor Wang: [00:22:28] Brittany.

Saul Marquez: [00:22:29] Brittany Brittany your husband loves you. And I could tell. I could see I could see him right now he's he's like beaming. So that's awesome man. Congratulations. Tell us a little bit Victor about an exciting project that you're working on within care.coach.

Victor Wang: [00:22:44] Sure. We're always working on a lot of stuff because we're a complex system of people and protocols and technology. I feel like I can't talk too much about the details but yeah I got into it.

Saul Marquez: [00:22:59] I don't want to put you in a bad spot either.

Victor Wang: [00:23:01] Yeah a lot of it has to do with like automation. So we have a very unique position as far as our technology. So a lot of other companies are approaching it from the point of view of let's build this ultimate artificial intelligence that's going to be able to do what we see in the movies. And that limits the kinds of interactions and patients that they can actually have an asset whereas we don't have that limitation. So we in a pretty unique place where we are you know our avatar is literally the best friend of a lot of our patients. I know that's probably hard to believe but it's actually.

Saul Marquez: [00:23:36] I believe it man.

Victor Wang: [00:23:37] Yeah and you can actually believe it that University of Washington I wish them the kind of things that we talk about with. I mean if you imagine that we had this technologically enabled entity this best friend kind of a relationship and we're getting the data from that it puts us in a very powerful position to potentially leapfrog with a lot of other people are doing it. We have a very unique set of data so we have a lot of things that are in the pipeline because of that.

Saul Marquez: [00:24:06] I think that's really interesting. And yeah you know the nice thing that you just highlighted Victor is the IPA when you come up with a strategy. It's not only about what you do but it's also about what you don't do. And I think you've highlighted very clearly that you guys are going to embrace artificial intelligence. But guess what you don't have to go all the way and you're not going to do it all the way in. And I think there's beauty in that and that you know your strengths and you're going to leverage the tools to augment. You know I like to think of AI as augmented intelligence not just artificial right.

Victor Wang: [00:24:41] We've developed a very strong understanding in this healthcare context of what people are inherently good at versus what software is inherently good and yet our entire system is just around kind of marrying the two. That's beautiful man possible.

Saul Marquez: [00:25:00] I love it. It's exciting to hear that you guys have other things brewing over there so definitely we'll be following you guys to make sure I stay on top of the cool thing that you guys are up to. Victor let's pretend as we get closer to the end here we got about three 4 minutes left but pretend you and I are building a medical leadership course on what it takes to be successful and medicine today. It is the 101 or the ABC of Victor Wang. So we're going to write a syllabus. I got four questions for you. That's going to be lightning round style day. And then at the end you're going to provide a book that you recommend for the listeners you ready.

Victor Wang: [00:25:33] OK.

Saul Marquez: [00:25:34] What is the best way to improve health care outcomes.

Victor Wang: [00:25:37] To understand truly understand why they're not where you want them to be.

Saul Marquez: [00:25:45] What is the biggest mistake or pitfalls to avoid.

Victor Wang: [00:25:48] Thinking that you know more than you do.

Saul Marquez: [00:25:52] Love that one. How do you stay relevant as an organization. Despite constant change.

Victor Wang: [00:25:58] Keep learning reading getting out there. I know what other people are up to. Keep an open mind.

Saul Marquez: [00:26:03] Finally what's one area of focus that should drive everything else in your organization.

Victor Wang: [00:26:08] Your mission whatever that is.

Saul Marquez: [00:26:11] Love it. Stay clear on that. And finally what book would you recommend to the listeners. Victor.

Victor Wang: [00:26:16] I'll be a little biased because there's mention of us in there but the new mobile age by Dr. Kvedar.

Saul Marquez: [00:26:22] Love it. The new mobile age Dr. Kvedar. So listeners take these nuggets of wisdom Don't worry about writing them down the links to the book the links to Victor's company and all the things that they're up to as well as the pace site which he's going to provide to us go to outcomesrocket.health/Victor and you're going to find all the show notes as was these resources. Victor, this has been a lot of fun. Before we conclude I would love that you just shared a closing thought and then the best place where people could get in touch with you or follow you.

Victor Wang: [00:26:53] Well I thought, geez, this was fun. Let's do things sometime later.

Saul Marquez: [00:27:01] We'd love to.

Victor Wang: [00:27:01] As far as how to get in touch with me. victor@care.coach don't add a .com.

Saul Marquez: [00:27:09] No .com listeners you get that it's care.coach They make sure that their data is awesome Victor.

Saul Marquez: [00:27:18] Hey this has been a blast. Really appreciate you spending time with us and looking forward to having you back on soon.

Victor Wang: [00:27:24] Thanks so much, Saul.

: [00:27:29] Thanks for listening to the Outcomes Rocket podcast. Be sure to visit us on the web at www.outcomesrocket.com for the show notes, resources, inspiration and so much more.

Recommended Book/s:

The New Mobile Age: How Technology Will Extend the Healthspan and Optimize the Lifespan

The Best Way To Contact Victor:

victor@care.coach

Mentioned Link/s:

https://www.care.com/

Finding a PACE program: http://www.npaonline.org/pace-you/find-pace-program-your-neighborhood
A recent Reuters article about some of the stuff with do with PACE: http://news.trust.org/item/20171023113851-u2etw/
Some of our research and publications: https://www.care.coach/publications.html 

One of the UW papers with free full text is: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5333281/

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A Digital Health Solution for the Silver Tsunami with Victor Wang, CEO at care.coach

How to Get Better at Human Care with Addison Hoover, Senior Director, Client Development at Docent Health

How to Get Better at Human Care with Addison Hoover, Senior Director, Client Development at Docent 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] Welcome back to the Outcomes Rocket podcast where we chat with today's most successful and inspiring health care leaders. I want to invite you to take a look at our rating and review page through Apple podcast. Go to outcomesrocket.health/reviews and you'll be able to check it out. Give us a rating and review for what you thought about today's episode because we have an amazing guest. His name is Addison Hoover is a consumer experience advocate multi industry innovator currently at Docent Health where they're moving and shaking with client development and their Charter. He's charged with deep ethnographic and market research efforts to understand the complex healthcare ecosystem we all know how complex it could be and he looks at ways that Docent health can really use software and human services bounce at all out to get amazing patient experiences. So he's been doing it for quite a while. I want to open up the microphone to Addison to round out an introduction. Addison, welcome to the podcast.

Addison Hoover: [00:01:21] Thanks all I really appreciate you having me. Yeah well really flattering introduction and excited to spend some time talking about what I think Docent health considers to be the patient revolution that we are experiencing in healthcare today. So thank you again for the warm introduction and really look for today's conversation.

Saul Marquez: [00:01:38] Absolutely and we had an interview with Sanjay Shah a couple of months ago and he just couldn't stop saying amazing things about you and what Docent does. So really excited to dive in there as well.

Addison Hoover: [00:01:51] Sanjay is one of my favorite partners and people to engage with a real healthcare thought leader and it's a huge compliment that he's a big fan of Docent health love to hear.

Saul Marquez: [00:02:02] Absolutely. So what would you say got you into the medical sector to begin with.

Addison Hoover: [00:02:06] Yes so I have kind of an interesting background in that I still consider myself to be a relative newcomer to the healthcare sector and so the first decade or so of my career was really spent focusing on the transformation that were taking place in the retail and hospitality and the kind of end of my run in the banking sector and what was really the consistent thread across those was this idea that there was a customer revolution happening in each of those spaces and retail it really started as there was a transition to e-commerce and the Amazons of the world were threatening kind of traditional brick and mortar in the hospitality space. This idea of consumerism and access to digital channels was rising in the banking space and industry that actually think I can draw a lot of parallels to the healthcare sector heavily regulated have to deal with a lot of compliance data privacy regulations are often considered a really archaic industry was beginning to have major agita about the new entrants of digital players about these aging archaic branch networks and what we're going to do to help augment the customer experience in a manner that would meet with sort of new tastes and the new approach that was required by customers and so that had been my focus for the better part of the 10 or 12 years. And in parallel just kind of through great timing I was introduced to one Docent inhealth cofounders royal Tuthill who is a new york based entrepreneur and healthcare whiz. And we began to have these conversations about the similarities that I was seeing in those adjacent verticals what healthcare was beginning to see in terms of megatrends around growing coinsurance and high deductible plans and the rise of urgent care and the fact that this industry seemed really primed for disintermediation because of things like consumer frustration and new technologies and data availability. And I began to feel this real personal excitement that oh my gosh health care was primed for transformation and I believed this next you know run of entrants we're going to be the ones to get it right. And I wanted to be part of that. And so I don't know that joining the medical sector was an idea I had at the earliest stages of my career. But as I had begun to develop pallete for consumer experience and design what I saw coming on the horizon in healthcare really excited me and that was where the opportunity and the alignment with Dosen health was really just a perfect fit for me.

Saul Marquez: [00:04:24] Well there is absolutely no doubt in my mind Addison that you're passionate about the consumer experience and I love what you said. You said the consumer revolution right. The industries that are ripe for it. The parallels with the financial industry. It's exciting. And so it just makes me wonder within the topic of consumer experience what do you think a hot topic that leaders should be focused on today in healthcare.

Addison Hoover: [00:04:51] Yes and I'll start by saying I am passionate I do think this is going to be without a doubt. I know as I hear it I see it. I don't feel any sense of negativity or blame for the things that health care is grappling with today. I feel nothing but optimism and appreciation for the chance to help mold and shape where I think healthcare can go and I think if there's a topic or an area of focus you'll hear a lot from health system leaders today around engagement and empathy. I would take that maybe a layer deeper I think those are the right starting points but to really unlock value in the space of engagement I think we're really talking about is service design and thinking about how we create this marriage of people in technology and use those and are really mindful manner to meet the needs of a changing consumer marketplace and you started with this idea of a consumer experience and I like the idea of referring to patients as consumers. I believe they have changed in so many unique ways because of some of the things I mentioned earlier on high deductible plans because of things like FSA and HSA. They are looking at health care decisions like consumers would in a retail purchasing decision in a travel purchase or in a financial decision and so I think making sure that we from a leadership perspective understand that engagement really trickles down to this idea that we design services and experiences through technology and people in a meaningful way. And I would also say in a way that doesn't isolate it to what happens within the four walls of the brick and mortar hospital located. Thinking about that continuum of care to me is I'm obviously biased and I'm passionate about this space but I think this is becoming kind of a preeminent focus for healthcare leaders today and I think it's the right one. It really excites me that there is this newfound energy and focus on how do we optimize for that longitudinal patient journey. What happens before the patient experience what happens when they're under our care within the hospital's walls. What happens long after they left the hospital and returned home and begun their normal lives again and thinking about health care in that way I think really changes the paradigm for how we think about delivering quality service and care to our patients.

Saul Marquez: [00:07:02] That's really insightful Addison and just before the holidays we had the pleasure of having Dean Galea. He's he's the dean of the school of public health at Boston University and he talked to us about changing the script in healthcare and I think this is exactly what you're doing. You're taking this very simple but powerful shift in let's stop calling these people patients let's call them consumers because that's what they are. This small shift could lead to huge huge change.

Addison Hoover: [00:07:34] It's small but it's a really difficult one in that I think healthcare is going to hurt. It's not just understanding that we have a consumer ship but it's unlocking the types of things that are significant to consumers because they're not often the things that show up in an age gaps report and they're often dissimilar to the things that we're talking about in health system leadership meetings and so I think a point of pride that we have a docent health is that we don't just take people first attitude and then chalk it up to grabbing a couple of people for a panel. When we take on a project in maternity or an orthopedics or in cardiovascular we actually go out into the marketplace and spend time interacting with people that have had a hip replacement or given birth recently those types of conversations especially when they're in ecosystem someone's home in someone's neighborhood in a local hang out up you begin to unlock these insights about what mattered to them across their patient journey. What were their points of apprehension where were their expectations met or not met. These are things that are really hard to glean from a patient satisfaction survey or an H Kaps report or administering a quarterly patient panel with two or three voices that are the same ones showing up each time around. And so I think doesn't health has really try to take a deep ethnographic approach to understanding how we can unlock value and to really personalize these experiences and I think that's the only way at least philosophically to me we can create tremendous customer experiences in the healthcare sector and so I think your point. It's small but it requires some really unique approaches to finding where there's those tributaries of value in the eyes of the actual consumer that the patient themselves.

Saul Marquez: [00:09:12] You guys are the anthropologist's of healthcare man. You're getting in there. You're figuring it out. You're not taking survey data you're getting into the field and getting it done and listeners if you're trying to find a way to make a better impact and to unlock as Addison says unlock that value you've got to spend time with your consumer, with your patient. And so there's some really great things here. Addison can you give the listeners an example of how you guys have improved outcomes with these ideas and what you guys are up to.

Addison Hoover: [00:09:42] Yeah happy to. So you mentioned Sanjay Sanjay is a leader at Dignity health for their great partner of Docent health and as an example of kind of a project that really got deep and sort of ethnography. We spent several months in and they've got programs live with us today across maternity crossed with Predix and spine and a number of areas and cardiovascular. Each time we would do that we would say let's say there is nothing in the playbook right. We were totally rewriting the script. What would we want to do differently in this new World of maternity O.B. ortho etcetera. So we'd actually go spend time in the communities at Dignity health Serb's gaging with patients having them walk through a longitudinal patient journey with us identifying all the positives and negatives they experience their emotional biorhythm and then from there using our service design team at Docent health we'd say we really thought all of this where there are moments where we could really choreograph the theater of this experience and add an appropriate touch points and information and education at stages were perhaps that patient is it being engaged with. And so as you begin to do those things you're not just improving the experience and you certainly are right. If you look at NPF scores are each kept score as willingness to recommend. There are some really important deltas when you do those things right along that critical path so to speak. But there are other vectors of values here too right. We're also beginning to see things like behavioral change right as you engage more actively as you provide greater degrees of support and across channels that are the preferred means for a given patients like to be over the phone over text over email. All of a sudden right we're starting to sound like the retail industry or the hospitality industry as you do those things. Haters begin to change with our patients so you know I can quote We've got a project in the maternity space with Dignity health where their patients are 10 to 12 percent more likely to take Digney health prenatal education classes when they're being supported by the Docent health program. Those are really monumental shifts in terms of patient behavior that happened because we're taking a more consumer centric approach to supporting them along their maternity journey. Other vectors of value are things like how we provide additional support and do the right things for these patients so can we make sure that they're feeling a level of preparedness with their DME or they understand their caregiver transitions post their total knee replacement. These are things that often we believe are being taken care of but they're being taken care of and are really fragmented away or in an inconsistent way by clinicians via physician work that a patient has when they're there meeting with their surgeon or when they transition into the care of the hospital. Those are elements that we're trying to stand out. Those points of friction with when you do that you'll see changes in education and expectation management in terms of providing additional support and then ultimately all of those begin to roll up into improved age caps and net promoter scores.

Saul Marquez: [00:12:27] That's really cool. And Addison you know I'm I'm sure the listeners that are not familiar with the way that Docent does with what you guys do they're probably wondering well what is this is this is a software platform is this an army of people like what is the solution here that we're talking about here.

Addison Hoover: [00:12:44] I probably jump right into it and.

Saul Marquez: [00:12:45] It's all good. I just want a little of that. Yeah.

Addison Hoover: [00:12:48] And to be totally candid Docent health didn't exist 24 months ago. So we're a startup Boston based. And we have I think a really unique philosophy that says hey there are some difficult challenges to be solved for in the Patient Experience realm within healthcare today and Docent health has taken a stance that on the human side of things providing more people can be wonderful and can create higher touch experiences. But in addition it's very costly and it's very difficult to scale on the technology side. There are some great data science. There are some great workflow tools. There are also very cold. So you don't necessarily create the level of touch and relationship that we think is important for transforming patient experiences and so those in health has really taken sort of a marriage of both of those and designed along not just a digital or a physical or human axes but across X Y and Z axes of each of those. And so we can deliver various sort of configurations based on hospitals needs. And think of it as sort of like the tech is enhanced CRM platform. We talk a lot in this world today about like precision medicine that CRM platform is how you get to precision experiences and how you choreograph the right steps for individualized patient journey. And then we also have Docent hospitality trained employees that if a given hospital says we just don't have the liaisons or the coordinators or the volunteers that can help manage some of these points of outreach and touch points in the inpatient setting we can actually embed those Docent health service team members into your environment to help augment that patient journey and provide additional bandwidth to your standard traditional clinicians. Right. Your charge nurses your physicians et cetera. So Docent health has really kind of taken a two pronged approach that's both technology and this sort of advanced precision experience driven CRM solution on one side. And on that second side for those in need of assistance on providing really high touch experience we actually have a service offering as well.

Saul Marquez: [00:14:44] That's really cool and appreciate you jump in to those details for the listeners because at the end of the day folks what Addison and his team are up to and what you could see and probably hear you hearing this is that the commitment the level of commitment and it's that whatever it takes attitude that they're putting into this whatever it takes to make it work and looking inside and outside of the health care box as we talk about here on the podcast they're all and so really just appreciate it highlighting how you guys do it. And it's really whatever it takes.

Addison Hoover: [00:15:18] 100 percent. And I believe that Sanjay would talk about this our partners at the Hospital for Special Surgery would talk about this and we're really lucky in that we've gotten to work alongside some world class organizations that share this philosophical focus on this is the wave of the future and this consumer revolution that the tide is just now beginning to crest and we are lucky to work with so many thought leaders that feel the same vigor and energy and passion that we do and so that we are 100 percent. And it's it's an exciting time for of.

Saul Marquez: [00:15:51] Well I could see your sleeves are rolled up and you are just gathering friends. Best way to spend the morning with you. All right so let's walk through a couple of things here. You guys have obviously had some great success early out the gates. Four months into it. What would you say in this time frame a setback that you had or the company has had and what you learned from it.

Addison Hoover: [00:16:11] I think it's maybe of a partially shared set back for both the company and for myself professionally. And this is sort of the nature of the biz when you transition verticals and you come to a space that's so differentiated as healthcare is. I think in the first probably six to 12 months of our business we were talking all about the customer experience and obviously that's woven into our DNA. But I think for a number of health systems in America today the concept of focusing on the customer experience is still relatively in its in its infancy. And so we didn't necessarily do a great job out of the gates of creating that connective tissue between a focus on customer experience is really a focus on creating improved engagement that drives retention that drives loyalty that can drive growth and acquisition of new patients. And ultimately we have data to show the downstream consequences that this can have on culture on operational efficiencies on staffing age and all of these these positive tributaries of value. I just don't know that I think in my first probably six to 12 months with those health I did a great job of connecting those dots between hey we're talking about customer experience what we're really talking about are the things that customer experience does for you in terms of creating a propensity for loyalty and growth and improving culture and operational efficiencies. And I think healthcare is in that sort of stage of maturation where making sure that we can draw those correlations is really important because industries like retail and hospitality for the last 10 20 30 years they've been absolutely focused on customer experience. They know what that means in terms of bottom line impact in terms of customer satisfaction impact. I think for healthcare the lesson I've learned in my transition has been to make sure that I can create those correlations so we understand what we're talking about and continue to highlight it for those health systems that haven't necessarily prioritized customer experience. Why this is so important for you as we look to the future.

Saul Marquez: [00:18:12] That's such a great great lesson and really appreciate that. You know just thinking about all right. I'm totally into the consumer experience but I am in a new land with new language and I just have to figure it all out again. And you did it really quickly so kudos to you for doing that so quickly and doing it because some people don't do it and they suffer. Right. So congratulations on that and the insight that you just shared is really awesome. Thank you. Thank you. Tell us a little bit more about an exciting project you're working on today.

Addison Hoover: [00:18:43] Yes I kind of hinted at this idea of precision experiences and one of the fun things that happens when you're a startup is you go from the earliest days where you're beginning to engineer a product and you're beginning to partner with great teams like Dignity health and the hospital for special surgery to understand where their pain points are and where can we provide assistance in helping them better cure rate experiences for their patients. You know the earliest days of Docent health who was just beginning to get that shit pointed the right direction will now at just over two years in our own company maturation. We now have tens of thousands of patients that we've interacted with. And so I think as far as an exciting project that gets me really I think really jazzed is this idea that we now have this trove of data that we can begin to carve up and analyze in creative ways at least to my knowledge in my infancy within healthcare. I haven't seen done elsewhere that's beginning to give us this insight into maybe not so much big data but maybe what I would call really small individualized data that can tell us here's the ideal critical path for serving this type of patient. This moment in time at this stage in their journey based on their experiences. And as we begin to kind of sort through that that really personalized small data as opposed to big data we're getting to some really big answers. And I think it's going to allow for us to take the work we've done with some of our anchor clients and extend that now as best practices for the next sort of traunch of customers and partners at Dosen health begins to work which is really exciting to me.

Saul Marquez: [00:20:15] That's really exciting and it's that domino effect of creating amazing things in one place. And you guys have a template that you could share with other providers across the nation. And that right there is all about removing silos and improving outcomes which is what we're all about here outcomes Rockett and you guys are doing such an amazing job so I'm super stoked for you guys.

Addison Hoover: [00:20:37] Thanks. Disney used to talk about it and he's like a personal idol of mine in terms of experience design but the magic of people in the setting and processes. And I think healthcare is so lucky to have so many of the best people I've ever worked around. I mean so dedicated and so committed to the hospital and patients that they're serving what I think we're beginning to unlock are some of those values on the setting and the process piece because I think we're beginning to open that aperture to where we can design services outside of the four walls of the hospital itself. And beginning to think about healthcare as a continuum not as a static moment of time. And I think this is where the industry is going in the fact that I believe we're beginning to unlock some of those best practices. Gosh just so ecstatic right.

Saul Marquez: [00:21:24] Now that's so great. Addison this has been a lot of fun. We're down to the part of the podcast where we're going to do the leadership course you and me putting it together here. The ABC is of Addison Hoover and health healthcare outcomes and so we're going try out a syllabus for questions. Lightning round style followed by a book that you recommend to the listeners you ready.

Addison Hoover: [00:21:44] Let's do it.

Saul Marquez: [00:21:44] Awesome. What's the best way to improve health care outcomes.

Addison Hoover: [00:21:48] Let's go with engagement. And I think it's the right engagement so it's not just gauging with patients it's engaging with nurses and physicians to understand what the needs are and unlocking value across those different key stakeholders is really I think the most important and best way for improving health outcomes.

Saul Marquez: [00:22:04] What's the biggest mistake or pitfall to avoid.

Addison Hoover: [00:22:07] Assuming everyone understands the value proposition of investing in customer experience.

Saul Marquez: [00:22:12] How do you stay relevant as an organization. Despite constant change.

Addison Hoover: [00:22:15] I think for us the secret sauce is listening and it's listening not just to your customers but to every member of a patient's journey and making sure that we're in tune to their changing needs. And if you do that I think you say humble about assuming you know the answer is I think that's a trap that in this course that we're going to teach we're going to try and make sure to ensure that we really have to know our customers and not assume that they think and are wired the way we are. If we do that I think that's how you stay relevant as an organization.

Saul Marquez: [00:22:47] And finally what's one area of focus that should drive everything else in your organization.

Addison Hoover: [00:22:52] For us I think it's people right. I think it's people both in the sense of customer and in terms of the key stakeholders nurses hospital leadership for us they can try to keep people at sort of the center of our vision is the ethos of Dosen health.

Saul Marquez: [00:23:05] Awesome and Addison what book would you recommend to the listeners here on the syllabus.

Addison Hoover: [00:23:10] You know I came prepared. I've heard you asked this question and I said I knew I knew it was coming and I think I'm going to give to just because I think you know most get a health care provider and if there's one health care book that I really think in many ways probably shaped my decision to switch industries. And that book would be transforming health care it's written by Charles Kennedy. It's really the Gary Kaplan story of transforming Virginia Mason. If you've not read it I just I feel like it really shifted my thinking about health care leadership in the modern era and it's an inspiring read that cools and I have a bias for this but it pulls from a lot of different industries in terms of design terms of Lean In terms of processes and I think if there are healthcare leaders listening to this podcast that are looking for a bit of inspiration I think the work that Gary CAPLAN as Virginia Mason team have done and how it's captured in the Transforming Health Care book is as a phenomenal read and then my second one is not healthcare related and it's old but my favorite book in all of my coworkers are going to laugh at me when they hear this on Dale Carnegie's How to Win Friends and Influence others I think is timeless. I look at so many of the pieces that are alien the customer experience in healthcare today and I go back and read that book each year to refocus on those insights around how we communicate through body language the verbiage we use how we make eye contact. So many of those things are the very essence of the relationships we build with the people that we're honored to support when they walk through our doors and I think you know we have a responsibility to think about how we deliver our best selves when we have a patient that we're engaging with either in their home in a clinic in a hospital and I go back to that one. I think it's it's informed so much of how I think about delivering great quality human to human experiences and in our course if we're teaching this one so those are the two books that we're going to have is kind of required reading.

Saul Marquez: [00:25:02] Boom there you have it. Listen there's an amazing selection of books I love the commentary there. Addison How to Win Friends and Influence People. Maybe the title should be How to Win patients and influence people.

Addison Hoover: [00:25:15] I like that feature.

Saul Marquez: [00:25:16] And I've so listeners don't worry about writing any of this down just go to outcomesrocket.health/Addison that's A D D I S O N and you're going to be able to find all of the show notes as well as links to Docent and the books that Addison just recommended. As in this has been a blast and what I want to do is just open up the mic to you one more time so you could share closing thought. And then the best place where the listeners get a hold of you.

Addison Hoover: [00:25:44] Yeah so I mentioned the very top of our conversation that my last stint prior to coming into the healthcare space had been in the banking sector. Another industry that's been really struggling to kind of course correct in terms of customer experience and when I was in that role I ran a survey for several months where I ask folks about the best customer service they'd experienced in recent memory and we surveyed thousands of people from coast to coast was a really cool piece of market research and I remember looking back at it and in the financial sort of focus of my day. I was pointing to all of these bankers and credit union leaders and saying look at this. When people think about great customer service only 5 percent of people mention a bank or a credit union as the last place they were served really well. Well now I'm in healthcare and I went back to that old research and it was sub 1 percent had would say that their last great customer service experience was somewhere across a health care journey and so I guess maybe where I'm going with this is my last thought is I believe that that number can be exponentially higher than 1 percent and it should be. These are such important moments of truth and I want our patience and the docent health customers that we partner with to feel empowered to provide experiences that are if not equal to better than the experiences delivered in hospitality or in travel or in retail or in banking. I think the charter I feel today is to help make that vision a reality. So I'll leave it with that and say that if anyone wants to engage in that reality you can find me pretty easily on LinkedIn. On Twitter I'm @addisonhoover and would love to keep this type of conversation going. I really enjoyed our dialog today, Saul.

Saul Marquez: [00:27:30] It's been a pleasure and I really appreciate the insights. Looking forward to staying in touch with you my friend.

Addison Hoover: [00:27:34] It's been great. Will talk soon.

: [00:27:35] Thanks for listening to the outcomes rocket podcast. Be sure to visit us on the web at www.outcomesrocket.health for the show notes, resources, inspiration and so much more.

Recommended Book/s:

Transforming Health Care: Virginia Mason Medical Center's Pursuit of the Perfect Patient Experience

How to Win Friends & Influence People

The Best Way To Contact Addison:

Episode Sponsors:
Healthcare Podcast
How to Get Better at Human Care with Addison Hoover, Senior Director, Client Development at Docent Health

How to Leverage Technology to Improve Patient Engagement with Lygeia Ricciardi, President, Clear Voice Consulting, LLC

How to Leverage Technology to Improve Patient Engagement with Lygeia Ricciardi, President, Clear Voice Consulting, 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: [00:00:20] Outcomes Rocket listeners. Welcome back once again to the outcomes rocket where we chat with today's most successful and inspiring healthcare leaders. I really want to thank you for tuning in once again and I invite you to go to outcomesrocket.health/reviews where you could go to Apple podcasts and give us a rating and review on what you thought about today's episode. And so really again just want to say thanks. I have an amazing guest for you to listen today. Her name is Lygeia Ricciardi. She is a digital health expert president of Clear Voice consulting. She works to empower individual patients and consumers and health using digital tools. She does a lot to help her clients who share in this goal as well to successfully navigate the quickly changing digital health business and policy landscape and position themselves for success within it. I want to open up the microphone to Lygeia to just fill in any of the gaps in that introduction and welcome you to the podcast Lygeia.

Lygeia Ricciardi: [00:01:22] Thank you so much, Saul. It is a pleasure to be here and I'm excited to be joining you.

Saul Marquez: [00:01:27] It is so exciting to have you on all the way from D.C. Lygeia. You're in a really hot spot there with a lot things going on but what is it that made you decide to get into health care to begin with.

Lygeia Ricciardi: [00:01:39] You know interestingly Saul, I started out getting into technology and saying technology is the biggest force. I think that's really changing the landscape. My first job out of college when I was an undergrad was reading business case studies for a Harvard Business School. And so we were looking at business history like what are the big themes. And so of course the question came up what are the big themes now and technology. Hands down seemed to be redoing everything not just about business but about society. So I got really interested in how information technology can not just make things more efficient say but how it can fundamentally change social structures and hierarchies and things like that. And I saw that early on in both education learning and also in healthcare. So I got really interested in that subject went back to grad school there weren't any courses in how is technology going to totally change healthcare. So I had a sort of like put the pieces together and make it up you know working with people who I thought were inspiring whether at the MIT Media Lab or the Kennedy School of Government as well as the education school and just trying to string together ideas about like how are we going to use this technology to fundamentally change. Well in this case healthcare. And at its essence the answer to that for me came down to empowerment and empowerment of what's been called the most underutilized resource in healthcare which is patients patients and families are more motivated than anybody else to have positive health outcomes and their actions make a huge impact on what actually happens in terms of wellbeing and health generally as well as even in acute settings. So the question is how do you take healthcare and really leverage technology to help patients be more engaged and effective.

Saul Marquez: [00:03:32] That's really interesting you sort of were ahead of your time idea you wanted to somehow put technology and health care together and fast forward to today. You're very much at the center of how do we engage patients better and so on that question how do we engage patients better. What would you give the leaders in healthcare today if it was like a number one thing they should keep in mind to do this.

Lygeia Ricciardi: [00:03:56] Yeah. So what a really basic thing. And I think many people who know me in this field know me for a role that I had in government a few years ago. I went to the Department of Health and Human Services in NC and the national coordinator for health I.T. when they were ready the beginning of figuring out what Meaningful Use Policy looked like. And as your listeners probably know that the thirty 36 billion dollar program more or less that has been largely responsible. I would say for helping us as a country move from paper health records to online. Records. So I jumped in there and I said if we're doing this process and where revamping healthcare and be thinking about how it could be digital let's not just make it about providers and hospitals. Patients need access to their own information as well. So I worked on a variety of things I created the Office of Consumer e-health and really pushed to have patients and consumers be part of the equation. So part of meaningful use requirements are that patients and families need to have online access to their own records. So one simple answer to your question if you're already in the health care industry is make it easier for patients to get their own data. And make it not just a one way thing so that they can find out about test results or read their records. But make it a two way think about how you can incorporate only questions they may have. But we've had this immense explosion of technology in the outside world and by outside I mean outside of healthcare. Yes. Phones for example just in the last five or ten years everybody now carries around what has been a supercomputer 10 15 20 years ago in our pockets as well as all kinds of wearables. And there are all these new technologies that are collecting data about us that is potentially extremely relevant in a healthcare setting. So if you are in the current health care system think about again not only opening things up to patients but being receptive and open to their information and their priorities as well. So that's probably in some ways the lowest hanging fruit. From my perspective.

Saul Marquez: [00:06:08] That's a really great idea and would you give the listeners any example of how maybe a project that you've been involved with or discussion that you've had that led to improved outcomes because of this.

Lygeia Ricciardi: [00:06:21] Yeah. So I'll give one example of a project that I've worked with called open notes that you may have heard of some of your listeners may have heard of. It comes out of Boston and it is a program that essentially helps hospitals and healthcare providers to give access not only to medical records their patients but also to the doctor's notes. So these are these little notes that physicians in the past and other clinicians would make to themselves only that were always presumably because patients would have no need to understand them or wouldn't understand them or wouldn't be interested. But it turns out that really isn't the case. And so with notes as unable to spread awareness of this idea of access to data including patient notes really on a national basis and they've found that in situations in which providers were very reluctant to share their notes and don't have the data in front of me. But essentially one of the biggest concerns was providers just didn't want to share their notes didn't are comfortable with that. And almost everybody who's participated in that program from a provider perspective has found that it impacted their relationship with their patients positively and impacted outcomes. Similarly patients who were perhaps a little reticent and bought out. Does that apply to me or why I wouldn't want to look at my notes anyway or any of the studies found that they were more engaged they understood their healthcare better. Other data certainly from other projects you know there's some data that I cite often from AARP which has to do with the fact that more engaged patients are more likely to avoid medical errors and to be readmitted to a hospital within 30 days you know significantly as well as to help avoid this basic communications error or issues that come up because the patient knows their body better than anyone else. So you don't have to you know have an M.D. to know all of that if you're a man and you're listed as pregnant. There might be something wrong perhaps your records are messed up. So some of these are sort of basic things like finding errors. But there are a lot of other things too like patients often know usually have a much clearer idea of what's going on with their medications than anybody else whether they're taking the medications they picked up or not or why they're not why they didn't work or how they are hugely important.

Saul Marquez: [00:08:46] That's a great call out and definitely patient engagement huge. We were both at the Health 2.0 conference and I was eating breakfast and I was sitting next to this gentleman Danny Sands. He's the physician out of Boston not sure if you've heard of the guy.

Lygeia Ricciardi: [00:09:04] Oh Danny Well yes.

Saul Marquez: [00:09:07] You know and he was just kind of making some great points. You are all about patient engagement and the patient engagement movement and how it does improve outcomes and so appreciated taking that path down that lane. I really do agree on. So the question is incentives. You know it comes back to incentives and how do we get companies or providers to start doing this if there are no financial incentives. Because oftentimes that's what drives it right.

Lygeia Ricciardi: [00:09:37] Right. So great question. First of all the question is incentives per se. You know I spoke earlier about the meaningful use program that for instance a billion dollar program that is still alive and well and going on and in order to participate in health care providers need to show that they have the capability and have exercised to a more limited extent than I would like but nevertheless have given patients the ability to view download or transmit share their records. So there are incentives in the sense that a piece of that finger 36 billion dollar pie requires that participants use an H.R. that has this type of capability and that they actually engage in it. And I hope that that will just be the beginning that helps health care providers to see that this is worthwhile. What's as interesting or maybe more interesting to me right now is that we're starting to see health care organizations organically understanding are coming up with their own theories and motivations to invest in patient engagement that have nothing to do with meaningful use. So for example a little earlier in the fall I was at the inter systems health care Leadership Conference. And they bring together folks from not only the U.S. but China the U.K. Australia and other areas. And I wanted to find out I'm now helping them think about what was going on with patient engagement I led some sessions I did presentations. I moderated some panels and I was expecting to hear more about meaningful use as a motivator for investing in patient engagementt. But what I heard was that the biggest motivator was really paving the way for value based care which makes complete sense. Now like hands down. That was what people were talking about and that's why they were investing because they're figuring health care depends to a large extent on what patients do outside of the clinical setting. It's about when you decide to seek care and whether you follow up on what was prescribed or not. And it's also about daily behaviors do you choose to smoke. Do you use the seatbelts. What do you eat. Do you exercise all that stuff matters. You may have seen or heard the statistics that only about 10 percent of your overall health is determined by what happens directly determined by what happens in the health system. So if that bigger picture depends in large part on things that are within patients control you have to engage them. If you're going to see better outcomes over the long term and I think a lot of folks are recognizing that. But they also gave a couple of other reasons too. One was some were seeing immediate cost savings in engaging patients. So your example. Well there are a couple reasons. So one issue is that there are an awful lot of higher than I realized a large number of no shows when patients sign up for appointments. So it's actually 42 percent of appointments result in no shows. Wow. So you can imagine. Yeah it sure is. So you can imagine that again if you think of engaging patients generally as reaching out to them having a conversation all that stuff. Reaching out to somebody having a relationship and ensuring that they're more likely to actually come in for that appointment. Makes sense no matter what your payment model is certainly in a fee for service world. You don't want to miss those appointments because they might be missing not only you know one appointment but perhaps it's a consultation or something larger like a surgery or something like that. So there's that basic idea of pulling patients in and keeping them engaged. There's also the point that sometimes if you can get patients to do some online preparation before a visit for example filling out some basic details or looking over their medication list to see whether it's correct and flagging any issues you can save a lot of time person time and effort not only for the health care system but also for the individual. If you get that all done ahead of time these are the kinds of things. Again it's not rocket science. Lots of other businesses are doing it but it's nice to see health care recognizing some of these benefits as well. There's another reason they came up during these conversations that they address this summit and that was that essentially customers or consumers expectations are starting to shift. So it's really about marketing and customer attention. And people are used to a much higher level of service than health care generally gives. In many areas of our lives and we think about how many services are available basically on demand you can have things delivered to your door within hours by your own name. You know there are lot kinds of stuff going on in the locker down the street. What have you. So you know people are less interested in sort of the game you have to play sometimes to participate in the traditional healthcare system. You know you're calling oh sorry they're out for lunch you cannot leave a message to people. This whole thing is a lot harder than getting online to book a consultation. And certainly there are a lot of particularly smaller new companies that are helping to bridge some of those service gaps. So it's not just that health care organizations are providing those services directly but there are companies that are doing that for them that they hired to work with.

Saul Marquez: [00:15:07] Hey Legia that's a really great point and I'm glad you pushed back on my initial hey you know the incentives aren't there. Like why. Why would people do it. So thank you for doing that. Why do you think this idea of health care consumerism rights come up. Why do you think it's becoming more pronounced now compared to in the past.

Lygeia Ricciardi: [00:15:26] I think a couple of reasons. One is that healthcare costs are really hurting us badly in a broad brash sense our whole economy is suffering. Certainly companies that are suffering and providing healthcare services but individuals are suffering a great deal too. There's been a lot of obviously uncertainty over coverage and costs related to political debates about care reform but the fact is health care costs continue to go up and continue to be one of the main reasons for personal bankruptcy and other kinds of just strain and stress. Even people who don't file for. Bankruptcy may be really struggling under the burden of health care costs. So there's that issue and sort of hoping that we could pull in consumerism harness it to make it to help people make better choices. And another initiative that I think is really terrific by the way is the one called Choosing Wisely which helps people better understand that sometimes one of the problems we have in this country is over care there's too much care prescribed and there can be too much of an incentive even financially for healthcare providers to say let's run another test or let's do that procedure. So really thinking about whether that makes sense for you as an individual either from a health care wellness perspective and or from a financial perspective is important.

Saul Marquez: [00:16:46] Totally and even like for instance that's for the access to your care information can make sense to write like over prescription MRIs as a result. Oftentimes a lack of interoperability.

Lygeia Ricciardi: [00:16:59] Exactly right. Yeah. Yeah. Because it's hard to pull up that test from two months ago or even two days ago. You know it's like oh let's run another one so we can get the answers immediately. That's that's a lot of waste and cost but it's also potentially with some tests opening the patient up to some unnecessary risks totally whether or not.

Saul Marquez: [00:17:19] And and so if you're a patient listening to this aka you are and you are you're an employer listening to this let's pause for a second and think about what we can do to get more access to this information because there are ways for us to curb costs. You've got to look and think creatively that things like Lygeia's mentioning she does put some blog posts out there with ideas on the things that she's working on as well. So definitely encourage you to check out her work. And so, Lygeia tell us a little bit about something you're excited about working on today.

Lygeia Ricciardi: [00:17:58] Sure. I think something I'm interested in is I mean I'm been exploring a lot of ways in which we can kind of take patient engagement to the next level. I see it as sort of barebones that we exchange information with patients and that we draw them into the care process even though their partners in their own health care. But as I kind of look forward and think not only what is health care going to look like in say five years 10 years but what is health going to look like. I'm really interested in exploring ways in which people are taking a health and making it their own. So for example I just did an interview for a podcast series that I'm going to be launching later exciting 2018 but it has room to admit it right around the corner. I didn't say exactly when to burn it but you know there's some really fascinating stories out there about people who have taken what we might think of and by people I mean often patients have taken what we might think of as a disability or a health care problem and turn it into a source of strength and something really unique. So for example somebody who doesn't have a limb like maybe lacking half a leg or something like that and instead of saying like Okay well what can I do to kind of be like everybody else. And I get a prosthetic for people to thinking that I'm quote normal cause you know just like everybody else instead. What could you do with that leg to make it yours uniquely yours and maybe even give us sort of an edge like this superpower above what other people might happen to think of it as something cool. I mean I'm on a much more everyday level. You know when I was a kid when people had to wear braces they hated it it was like embarrassing metal mouth you know you looked really stupid. Well I have a daughter pre-teen daughter who has braces and she was kind of excited to get now that they'd do anything special. But the point is she is allowed to update by putting colored hops on them. So she's got like her December holidays thing going on and she's got red and green for Christmas. The point is it's not just oh health care is like beige, dull, boring an awful something you have to do but it's more about like helping you be your most awesome healthy self. Yeah I didn't get that direction I'm exploring absolutely and trying to support the thing.

Saul Marquez: [00:20:32] That's really interesting and excited for your thoughts and that and the podcast to let me know when it launches. Do you have a link for it. By the way yet or not yet.

Lygeia Ricciardi: [00:20:41] Not yet but stay tuned. You'll hear about it.

Saul Marquez: [00:20:44] Ok. Fantastic. All right Lygeia. Time flies when you're having fun let's pretend you and I are building a medical leadership course on what it takes to be successful in medicine today and in fact the patient engagement today. And so we're going to call it the 101 of Lygeia Ricciardi and so we're going to write out the syllabus. We've got four lightning round questions followed by a book you recommend to the listeners. Ready.

Lygeia Ricciardi: [00:21:09] Oh OK. I think we should do this.

Saul Marquez: [00:21:12] Let's. So what is the best way to improve. Health care outcomes.

Lygeia Ricciardi: [00:21:18] The best way to improve healthcare outcomes is to empower the patients and families who are actually more responsible for shaping them than anybody else.

Saul Marquez: [00:21:28] Love it. What is the biggest mistake or pitfall to avoid.

Lygeia Ricciardi: [00:21:32] One mistake I'm not sure it's the biggest but it's certainly big is assuming a kind of a one size fits all solution where I have seen that healthcare systems be particularly successful and technology companies too is thinking about how you can use technology to tailor things to the needs of the individual. So whether that means a larger font size for people who have trouble reading something small or it means putting it in their native language or maybe it means the approach. So for example there is an app I like Noom which is supposed to help with weight loss and motivation. And it asks you what kind of coach do you want do you want like a drill sergeant who's going to let you go or do you want a really supportive friendly you got this kind of coach. And those kinds of things play into personal preference in a way that isn't just something you might know about somebody from the demographics. So pulling in those individual needs and addressing the specific case of the individual is something you really want to do to succeed. And can you avoid doing so again at your peril.

Saul Marquez: [00:22:47] And you mentioned Noom how do you spell that.

Lygeia Ricciardi: [00:22:49] NOOM

Saul Marquez: [00:22:50] And and that's an app from the apple store. Ok cool. Our listeners will include that as well as any other links that Legia mentions in the show notes. So how do you stay relevant as an organization. Despite constant change.

Lygeia Ricciardi: [00:23:05] Ok so are you asking about me and my organization or one. This is the syllabus for our class. How do you say yes. I think the best way to do that is to build a real connection to your customer who again may not directly be patient but increasingly in a value based world. Patients and families need to think of them as your customer. And you need to sort of keep communication keep in lock step with them because they're going to be changing their needs are going to be changing their expectations are changing and you're not going to know where that comes from unless you can have that communication going and certainly there's a lot going on with sort of population based health and tracking large populations and understanding differences in how particular groups are acting or what their needs are. That's really important too. But having those really personal connections there's nothing else like.

Saul Marquez: [00:24:00] A great call out. And finally what's one area of focus that should drive everything else in your organization.

Lygeia Ricciardi: [00:24:06] I mean it really has to be the patient and their family. It has to be like what's going to make them healthy and help them meet their own goals. So I choose those words deliberately. It's not just about making them healthy. There are certain health care situations in which there may be a tradeoffs. How quickly do you want to get better versus how much range of motion is it important for you to something like that you need to keep talking about patient and family and find out what they want. Maybe they don't want to live as long as possible but they want a higher quality of life. Listen and respond to that as opposed to some generic sense of either. This is what we think health means or we've managed to heal a particular problem you know we fix the hip but the patient died anyway. You know it's like what matters. That is what you should always keep front and center.

Saul Marquez: [00:24:58] Awesome. I love it. And what book would you recommend to the listeners Lygeia.

Lygeia Ricciardi: [00:25:01] So I want to recommend a book that doesn't really have to do with health care or with patient engagement. I recently finished reading tools of titans by Tim Ferriss and what he does for the book is to interview a whole lot of people who are exceptional leaders in their fields. Some of them are amazing athletes some of them are amazing business people thinkers podcasters even all kinds of folks and tries to understand their secrets and put them all. Secrets of Success and put them all in a book. And I found that really inspiring and I you know I kept putting little tabs on stickies and as I was going and by the time I was done it's quite a long book. It was like all covered in flour. There was so much that was so inspirational and it made me you know want to be a better person professionally as well as just in a very holistic sense.

Saul Marquez: [00:25:59] What a great recommendation. And yeah you know we got to think outside of the healthcare box. I think this is a great recommendation idea listeners if you want just check this book out as well as the syllabus that we just created for you. Go to outcomesrocket.com/lygeia that's l y g e i a. And you're going to be able to find all the show notes, as well as links to the resources we checked out with her today. So before we conclude Legia this has been a lot of fun. I'd love for you to just share a closing out with the listeners and the best place where they could get a hold.

Lygeia Ricciardi: [00:26:32] Thank you so much, Saul. And you know I think I like that point that you made about thinking outside of the box and we often talk in health care about silos and how there are silos maybe within industries different health systems don't talk to one another even within conferences. There are too many tracks and people stay in their tracks. So maybe a resolution for folks for 2018 would be to get outside your silo. And by that I mean not just in healthcare. Think broader think always about how what you are experiencing maybe with technology or quality of life generally outside of healthcare. How can you bring some of that back. You go to a restaurant you have an amazing customer service experience. How might that relate to something you know within your health care waiting room for example or something like that. So let's try to be creative and get outside of the usual silos.

Saul Marquez: [00:27:25] A great call out Legia and what would you say the best place for the listeners to reach out to you or follow you would be.

Lygeia Ricciardi: [00:27:32] You can follow me on Twitter. I'm at @lygeia you can reach me on LinkedIn. I was just elected to the 2018 class of HIMMS social media ambassadors.

Saul Marquez: [00:27:43] Congratulations.

Lygeia Ricciardi: [00:27:44] Hang out online. I was lucky to be part of that group in 2017 as well and it's a lot of fun. But yeah I mean I'm out there on social media. I also have a Website lygeia.com so you know please feel free to reach out and share ideas, reactions, thoughts.

Saul Marquez: [00:28:02] that's outstanding, Lygeia. So again listeners just join me in saying a big thank you to Lygeia. We really appreciate the time you took to talk to us about patient engagement today.

Lygeia Ricciardi: [00:28:12] Sure. My pleasure.

: [00:28:17] Thanks for listening to the Outcomes Rocket podcast. Be sure to visit us on the web at www.outcomesrocket.health for the show notes resources inspiration and so much more.

Recommended Book/s:

Tools of Titans: The Tactics, Routines, and Habits of Billionaires, Icons, and World-Class Performers

The Best Way To Contact Lygeia:

Twitter -  @Lygeia
Linkedin - Lygeia Ricciardi
 
Mentioned Link/s:

https://www.noom.com/

Episode Sponsors:

Healthcare Podcast

How to Leverage Technology to Improve Patient Engagement with Lygeia Ricciardi, President, Clear Voice Consulting, LLC

Thoughts on Healthcare Consumerism and What It Means To Health Leaders with Brian DeVore, CEO and Co-Founder at Sifft

Thoughts on Healthcare Consumerism and What It Means To Health Leaders with Brian DeVore, CEO and Co-Founder at Sifft

: [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 inspiring and successful health care leaders. Really want to thank you for tuning in again and I invite you to go to outcomesrocket.health/reviews. Leave us a rating and review. We'd love to hear from our listeners. Let us know what your thoughts are on today's episode or anything that you listen to comes rock at dot com slash reviews. Without further ado I want to introduce our outstanding guest today. His name's Brian DeVore. He's a health innovator strategist entrepreneur and user design leader. His focus is the consumer, the patient and he is here to discuss that today. And so he's co-founder and CEO at Swift. Well he's been a member at the Oregon Health Policy Board, Director of Strategy eco systems at Intel and has his experience has been in healthcare for quite some time. So really excited to introduce this amazing guess. Brian welcome to the podcast.

Brian DeVore: [00:01:22] Great, thanks for having me.

Saul Marquez: [00:01:23] It's my pleasure. And so today Brian we're going to dive into this topic of health care consumerism. But I did want to ask you what made you decide to get into the medical sector to begin with.

Brian DeVore: [00:01:34] I came into the medical sector sort of when we were way back in the 90s when we all moved to the consumer directed health plans I would make them by turning to Wall Street for years of making was really where I was trained and in the 90s as you remember the consumer directed health plans kind of took off and enjoying it helped start a company in a that was focused on getting these things up call the help of candidates which ended up being held Etting accounts. Were actually money back then because it was owned by the company but it was giving consumers some money to have them in the game. And when I made the switch back in the late 90s who's going to set up the account went out and talked a lot of the banks the Wells Fargo the world and they were like What are these thing. Never heard of what they are why what we want to be in health care of course now you've got the folks a lot of the large physicians that are involved with health care so that's how I got into healthcare. It had bolthole role. And again most have always been on behalf of cuber when you use your healthcare to drive you know better value at a lower cost engagement multiple ways. Whether personal health record or buying Intel on behalf of our members or employees and you really trying to insert innovation into a market that's ripe for innovation on the diagnostic and treatment side a pretty archaic. When you go and get to the blocking and tackling every other vertical and working in whether it's retail travel you name it banking have all gone and realize the consumer is a pretty powerful person in healthcare hasn't quite figured that out yet.

Saul Marquez: [00:03:04] Hey you know as leaders begin to think about the health care consumer there's obviously and we had a chat before this. You know there's there's the consumer which is who is the consumer it's the person receiving services. Is it the payer is it you know who is it. As leaders look and tackle this issue of health care consumerism what insights would you give them on this, Brian.

Brian DeVore: [00:03:28] Well again I think it's been a big focus on the patients and you have to realize the patient is not the or not yet the consumer either is somebody who's thinking about losing healthcare or housing needs healthcare or both the consumer and the patient. But there's a lot of folks in this country that don't really a lot of care and they don't engage in very often. And yet we are designing the sort of systems for people that we to be overjoyed with the fact that they actually have to engage with their doctor with the hospital or with an emergency room or with an ambulance. And the truth is it's sort of a weird market. You have a sort of a non willing consumer in healthcare. I can't recall when the other day if you were to bump into an 85 year old man and ask him Have you ever been to who a doctor and he said no would you say to him absolutely disappointing sure that you haven't had a chance to engage our wonderful health care system. And you know you say that's fantastic you can't believe you're healthy and well and so you ask people what do you think about your health. How often do you really enjoy going to the doctor from you two. No. So I think we've got sort of this model here a model of engagement around the patients already in the system. The company like really was built around engaging them well before that. So I mean with so the expectations are what makes them tick is six inches between the space of their ears. And that's for a lot of health care and something is driven in certain by mindset opinions beliefs values expectations and we don't know that no one's really uncovering that it's sort of a hidden hidden gem. And if you can begin to call that out by engaging them before they ever begin to get care there's a lot of doubts in saving you can drive this point knowing how people are sort of wire and what they do what they don't want what they believe and what they don't believe in. So another might that the vertical have done this and the reasons why you get post are BMW or postcards from Toyota. There's reasons why you check into a hotel they know that you have the third floor with foam pillows and the king size bed. They've uncovered those sort of beliefs and desires ahead of time. So you don't want an early wakeup call you don't know it's because they ask you and a lot of them because they've actually observed or bought the notion the company. So who are they. So again I think we just need to clearly understand that Consumer Healthcare typically unwilling consumer and we need to do things to engage them in a way. Other industries have done without drawing community. The morass of healthcare. Honestly I don't think folks really want to think about their health. They can get about 50 other things that are more important to them.

Saul Marquez: [00:06:02] I think that's a great call out Brian and for us to get specific. Maybe you could dive into a company or a client or somebody that you've worked with that doing things differently and creating outcomes because of it.

Brian DeVore: [00:06:16] Well I mean I've about Intel I can't speak for Intel with the currently doing what I did there. I think what we did take time to do which took time and delayed the project a little bit which is important is we actually went out or hired a lawgivers. Those are people that study human behavior and not just to the tool of observation and that was really telling to me because a lot of the beliefs I had on how people do things that what they really want is based upon what surveys told us or what people would vocalize. Sometimes the vocalization of concerns troubles desires or they often offer proxies but they don't really know how to solve the problem themselves and so they'll ask for a proxy because that's really all they can think of is how to solve that problem. They can be in a variety way over the health care or the work life balance. It could be. Elder care could be how you get paid. Are a lot of things that people say they want because it only know how to verbalize what it will be worth and Intel actually went out and hired a firm because you obviously couldn't do it on employees. We hired a firm to actually and observe how our population interacted with the healthcare system. Though they may say they used an online service within the to get the health information the truth is that they probably don't know they probably up next or neighbor where to get their health information. And they probably don't use the doctor tools or tools that are out there they probably walk again next door to their neighbor and ask about the knee surgery that he had and the surgeon he had a day like him with it. He'll okay with the treatment. Good. That's how people make these health care decisions. Relationship based despite the fact that we'd like people to pick the 5star if at all they just do not conceive that way and so by observing that you end up building up relations with people you do what they really want not what they actually say they want. And again you can only really gather that through observation with something that has gone into not just the two of them my own company but a lot of that kept popping up a other large employers making sure they understand their population. Your observation is not just your surveys that you'll be missing some nugget though that handling them when it points you.

Saul Marquez: [00:08:19] That's an interesting point and how many of us put higher ethnographers to figure out what consumers are actually doing versus just telling us. And yeah I mean I think that's a really interesting way of approaching the situation. It's definitely one way to just dive deeper and even validate the things that you've heard. Are you seeing the things that you heard or the responses that patients and consumers are actually giving to you. I mean that's great. I mean it's a really good call out and based off of these particular steps here Brian. Have you seen any type of improvements in outcomes for any of the people you've worked with.

Brian DeVore: [00:08:57] Well we could the data to show that people will get better and typically have better personal health if they are engaging as either a trusted provider or a trusted system one that they believe is has their best interests in mind and that the body is out there and not have to go with that out there. You can sort of put up a Web site built on trust and so anything you can do to enhance trust in heightened trust get obviously we can drive better behavior I think it drives trust drives lower downstream utilization because folks still believe that the system is somehow designed or rigged against them and they really do believe that they believe the healthcare system is somehow impaired or are not listening providers. They're defensive and they believe that the insurance company is somehow in it for the money and the doctors are doing it just to drive more income and so that's why you know with US opinion of the system is so poor. So again if we can enhance trust by uncovering those sort of beliefs and expectations and values I think we the data show that once you engage with your doctor in a more mutually rewarding relationship you will do better. You will take your medication because the doctor actually said that ahead of time you don't like me. You don't like certain medications that make you feel guilty or whatever. Sometimes those questions are never out. A lot of assumptions happen in healthcare. So the two we built it worked really well it's not designed to be the end all be all true but it doesn't cover some of those beliefs and passing that information on to the care team whether it's an HBO which is responsible for that. Or you want a fee for service model. Once you understand what's making people tick you don't try to push people in directions they don't want to go in again. Getting somebody aligned to a primary care doctor mental health whatever it might be. It's got an online mindset allied expectations aligned values that it is pretty strong at their care.

Saul Marquez: [00:10:54] Now that's pretty cool. And so with the two that you and your team built Brian over at Sifft that's S I F F T you guys helped put together this information so that when the patient actually gets to where they're going to get care they have the provider has a more complete picture of the patient. Is that correct.

Brian DeVore: [00:11:16] Yes. Critical though. I cover those critical things through observation through history of physical those kind of things you testing we're uncovering again those soft science the psychographic questions which are really gathering that I get every other industry wants to uncover. Why do you drive fast you drive slow. I mean those are things that once they figure it out they're going to market what kind of cars. Uber the difficulty are we don't do that in healthcare and this is about you know anywhere from 25 to 30 percent thrash every year people going to doctors that kind of art aligned and they don't like this don't agree with that ethics experience a lot of it's just we just didn't seem to gel. You know it just feels like you're on a different wavelength. And so this was designed to uncover some of those questions about your opinion of healthcare specifically what you're looking for example that I you know pediatrics biblical future with your kids. Great question. As we talk a pediatrician does he believe in vaccinations. Know the same I do not with vaccinations. Why on earth would I send you to somebody who's pro vaccination that is going to get frustrated and have arguments the get go. And that's not a trusting relationship that's going to cause friction using only natto with that question around the antibiotics. Are you scared to just what antibiotics your kid right off the bat are you one of the lucky the wait. The question is when we try to uncover in this tool those questions that drive me or somebody further away from a certain provider or order to provide it and ideally we get the genesis of the whole case. When I was at Intel we were asked to assist them do a much better job in taking our members and tools really are pretty poor sort of like you know you trusted the directory. How do you find a doctor when you sort of choose your insurance if we trusted them to get a date. The tool became dating engines like match.com. You'd never find anybody where you're looking at right you did give you 7000 men or women in your zip code that you go to. It doesn't help overwhelm people when you overwhelm people. They shut down and they could do anything. So we tried to use teachable moments when people are choosing something even to pick an insurance plan or they have to go find care as sick. The teachable moment tool you can design to uncover those things. So it's really sort of those weird questions that people often don't even think about asking the addict ahead of time but once they get in the process. Most doctors do interogative the question you know a year a year and a half and then in the meantime the patients are unhappy and they're frustrated because the mission and following their protocol. They've asked for they can't figure out why a person will not take their drugs and never actually do it without their permission. Do you even want drugs. Like are you are you a drug person or not a drug person that is not a drug person. That's me. Why would I go to somebody who's like here just take drugs or take a prescription. We're just going to have this really weird relationship where I don't live i trust him because he's just giving me stuff I never really wanted the first thing. So often patients not verbalize that they're they're afraid of challenging Doctor, challenging provider and so we ask that question Who are you willing to judge a provider state status sort of what you believe in. But how is with the diagnosis and treatment is in some doctors. We appreciate that and some really don't like that. So again and again interesting or aline with somebody you could ever trust with a truly the goal.

Saul Marquez: [00:14:31] It's a really good idea. So can you give an example to the listeners of how this has helped you know some of your users improve outcomes.

Brian DeVore: [00:14:39] Well we will definitely lead to a Harat adult benefit Internal Medicine. We know that older patients especially the poor lady looking for her mother who did not want to take medication that made her dizzy and she was very much in the natural benefit of vitamins and is frustrated with the hurt locker and he kept handing her packets of different prescriptions. And so what is happening was she just not going to the doctor if she didn't feel like he was really listening to her. So they used that tool again some tool designed for health plan. The point when the current testing we did on the open market for the consumer that the patient actually go back and get my mom found somebody that she really liked the stock was totally divided and totally into alternative medicine. And they really feel like she's you know she's out of the she's listening really listening said the patient and we have somebody that we have engaged patient instead of somebody who's not engaged. So the challenge is is there any sort for the weird application of this is not rocket science. These are questions that most care providers of care teams should be asking to think any way some do. Most don't. Too cumbersome and yet once you sort of in the system they ask you about your blood pressure see everything about your physical health. It's mental health. It's not often about what you really want to carry you doing. We are seeing some of the stuff happen in the last year. So folks are starting to ask those questions is really weird odd questions about you want to be sustained if you are not or or you know not alive or sort of yes door and those similar questions. So what are you what are your expectations. And it's a new science is new to the world with healthcare. So good example where we know we help the consumer get better care if they were much more aligned to who treating it.

Saul Marquez: [00:16:24] That's a great example. Brian let's pretend you and I are going to build a leadership course in medicine and what it takes to be successful. Today it's the 101 course or the ABC of Brian DeVore. And so we've got four questions here. Lightning round style and then we're going to finish with a book that you recommend to the listeners you ready.

Brian DeVore: [00:16:45] Yeah I think of the book really quickly because you have to be health care book and.

Saul Marquez: [00:16:50] It doesn't have to be. It could be any book you want and this syllabus. OK. All right so here's a question what's the best way to improve health care outcomes.

Brian DeVore: [00:16:59] Measure what really matters.

Saul Marquez: [00:17:01] What is the biggest mistake or pitfall to avoid.

Brian DeVore: [00:17:04] Measuring what doesn't matter too easy to measure what doesn't matter.

Saul Marquez: [00:17:09] Indeed indeed. How do you stay relevant as an organization.

Brian DeVore: [00:17:13] Despite constant change understand the market constantly look for ways of innovating internally.

Saul Marquez: [00:17:20] What is one area of focus that should drive everything else in your organization.

Brian DeVore: [00:17:24] Reduction of errors and the consumer again and eliminating waste. So be Liem wherever you are and look to improve whatever processor charges.

Saul Marquez: [00:17:35] And finally Brian what book would you recommend to the listeners.

Brian DeVore: [00:17:39] Well I just finished reading I saw a record of that what was it really like there was shoe dog which is so like biography and how we started like he was something that makes a little point. I thought I knew the story like he pretty well and I didn't really know how long it actually took it. How closely were you going belly up a number of occasions. A great great example of perseverance understanding the market taking risk being willing to pull yourself up go out of business actually for the benefit of the consumer.

Saul Marquez: [00:18:07] Love it. Listeners take that book down. And if you don't have a pen or you're driving just go to outcomesrocket.health/briand that's B R I A N and D is in Devor and you'll be able to find all of the show notes in the things that we discussed today as well as the syllabus that we constructed for you along with a link to that book. He just shared. Brian. Time flies when you're having fun. But before we conclude I'd love for you to just share a closing thought with the listeners and the best place where they can get in touch with you.

Brian DeVore: [00:18:38] Closing thoughts your listeners getting involved. Health care is more complicated than cell. Be careful those who believe in a silver bullet. Because I haven't seen one yet. It's pretty complicated and I think that society need to come to a conclusion have a larger discussion as to what exactly do we want to do. Now it's pretty polarized. Other countries have done the same thing. You can e-mail me at brian@gosifft.com and I'll get back to you.

Saul Marquez: [00:19:12] Awesome Brian really appreciate you sharing your thoughts today. It's definitely an environment that we want to spend some more time thinking about is just how we take care of this healthcare consumer and I'm sure your insights will definitely help the listeners reframe things in a new way. So just want to say a big thanks to you and looking forward to stand in touch.

Brian DeVore: [00:19:30] Sure you bet.

Outro:: [00:19:35] Thanks for listening to the Outcomes Rocket podcast. Be sure to visit us on the web at www.outcomesrocket.health for the show notes, resources, inspiration and so much more.

Recommended Book/s:

Shoe Dog

The Best Way To Contact Brian:

brian@gosifft.com

Mentioned Link/s:

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Healthcare Podcast

Thoughts on Healthcare Consumerism and What It Means To Health Leaders with Brian DeVore, CEO and Co-Founder at Sifft

The Healing Power of Music with Walter, Founder at HealthTunes™

: [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 healthcare leaders. I really want to thank you for tuning in again and I welcome you to visit outcomesrocket.health/reviews where you could write review today's show on Apple podcast. We love hearing from our our listeners and we're really excited to hear what you think of our outstanding guest today. His name is Walter. Now folks it's kind of like Madonna. Madonna doesn't need a last name. Walter doesn't need a last time you've got to know who this guy is. He's done some pretty amazing things. Walter is the Founder & CCO at MusikVergnuegen and he is also the founder of healthtunes an exciting company that's creating music to help people recover faster and heal better. And his his extensive experience in music is almost three decades of production. And what I want to do is just open up the microphone to Walter to just fill in the introduction anything that I may have missed. Walter welcome to the podcast.

Walter: [00:01:25] Thank you. Thank you for having me. Rocket introduction. Love it

Saul Marquez: [00:01:28] Thank you. I appreciate that you're a rocket person.

Walter: [00:01:32] Thank you so much. Just don't ask him to sing. Other than that it's all fine. I might dance during the podcast Friday to be with you today on this wonderful first of December 2017. Yeah it's probably snowing already in Austria. It doesn't snow here in California. I'll send you some Sunbeams and I appreciate it.

Saul Marquez: [00:01:56] Yeah. You know Chicago was definitely a snowy city. Haven't gotten any snow yet but I will appreciate the Sunbeams.

Walter: [00:02:03] Perfect on the way.

Saul Marquez: [00:02:06] Thank you. I already feel I'm already feel them.

Walter: [00:02:08] Good good and I know you feel the music as well so yeah thanks for having me on the podcast. What kind of a tell you. I grew up with music and music in the city of music. Born in Vienna. It's a fantastic place. It had one obstacle when I grew up. It was still a bit closed and since at least every big name composer of history died in Austria like Beethoven was German. But he died in Vienna wi with this strong history our teachers would always tell us that our interest is just fantastic. But we the young ones we suck. It's just like you can never hold up to those master's shoes to fill. It wasn't really big shoes to fill. And whatever we tried it was never never reaching those goals and never reaching the expectations of what the teachers and professors. So what we learned is that suffering is a part of writing music. And if you look at all those pictures of Beethoven and alone Broms whenever you see them in the pictures that they don't look that happy I think that music music that makes us happy has. And we'll talk about it and we'll get so many qualities beyond just listening when we hear music it moves us. It's like emotion and emotion emotion as the word emotion in that it makes us more of our soul and mind and everything is moved with it. The film industry is tapping into that. That's why we still have film music and is a huge part of the success of a movie. If you listen to music out music and they've done a ton of movies over the last 30 years it is less than half the impact. Imagine psycho like that show a scene without those shrieking violence. If you turn the sound down it's not scary. It's just another day it's another day and the kids always don't have those funny bouncy beats too. That just doesn't translate. So yeah it's important world and so growing up in Vienna and studying there was exciting but I'm so glad that the United States opened the arms post graduate you USC Los Angeles and really got lucky to be able to work here and to become citizens. So I'm very proud to be in this fantastic place.

Saul Marquez: [00:04:48] That's awesome. Motter and pre-heat you're walking us through bringing it back down to the basics of music and the high expectations that your teachers had for you. Really I think maybe raised the bar for you and the amazing things you've been able to do thus far and so I think maybe it got you somewhere even though it was tough while you were there.

Walter: [00:05:10] Yeah it's a great time. Big goals might have changed it initially goal when I picked up music was I was quite shy in class and the guys who played music and was singing they had always the best girlfriends. And so I thought I need to pick up the guitar pun intended. And I did. My goal was that girls would look at me and fell in love with the guitar. And suddenly practiced my 10 hours a day and everything else was forgotten. And that brought me into the conservatory and the university and finally did the United States. And here I founded the company of music for Nugan and the company got really lucky. Creating the intel mnemonic and melodies which are top of the list world wide for LG and sends an incredible and so on and on working on Minority Report that Spielberg movie with Winburn there. And it's an exciting life to write music. And now I'm at a point in my life where I thought on a even more with music and learned through my personal story how music can help in the healing process.

Saul Marquez: [00:06:28] So tell us a little bit about that. What got you to make that transition into health care.

Walter: [00:06:33] My son Luca see pictures.

Saul Marquez: [00:06:36] Yes of handsome young man.

Walter: [00:06:38] He is 11 now when he was 5. He got diagnosed with leg pretest and leg pretest. Is this very strange and painful syndrome. And doctors know the name of that syndrome but nobody really knows what to do with it. It basically shows the theme of those kids falls apart to basically walking without the head of the hip bones and it disintegrates extremely painful and grows back up to six year process to grow back. It sometimes doesn't grow back nicely round them so it will be a lifetime challenge for that person. So the doctor said OK we might do surgery we don't know what happens with surgery. That said just having been bad for the next two years still it heals. Some would say have braces on. And my wife is this wonderful strong person mother and Marisol are the strongest. Right. She suggested let's just do something different than what they suggested and we went into osteopathy acupuncture a very regimented diet. A year later Luca our son was back at the hospital they were really wondering just thought they switched the report and then figured out this is the same boy. And they could see it in the x rays that it was healed and that there was something before that opened up this dialogue with them and it was a really beautiful dialogue. And the hospitals are so open about this. How did you do this. Now we started talking and that was basically the initiation the Big Bang of health tunes for myself and the healing touch license of my wife and we are really immersed into this field because of that really personal story.

Saul Marquez: [00:08:30] Thank you for sharing that. I know it's a pretty vulnerable moment for your son and for the family. And I'm really glad to hear that you guys came out on the other side with some some insightful ways to approach a problem that really has no real solutions and so are really exciting to hear that. Walter and so now that you went through all of this you kind of went through the depths of this difficulty I can imagine. I mean I have a 9 month old son you know to find something like that out. It's really you know you pull from your strength and now that you've gotten to this point what do you think some of the outcomes improvement that could be created from it. What is that. And have you seen any of it in effect already.

Walter: [00:09:14] Oh it's just a tremendous beautiful and touching effect health tunes this company I created has and purposefully made it a nonprofit and free of charge and really want to give back to the community got lucky and my business life and one of my companies was purchased by BMG. And that really allowed a lot of knowledge and the time and funds to create this from the ground up. And because I've been through this experience also to be respectful to the perspective patients and also being scientific which I miss in many of the other applications out there that we bring music medicine we call it music medicines. If music is furnished to help the healing health and healing and well-being that is music medicine and it's prescribed like any other medicine with a dosage take it twice a day. Now if minutes over seven weeks of so it basically is like a pharmaceutical drug and it increases the efficacy of pharmaceuticals. And so pharma isn't really liking what we're doing and the best moment was UCLA Medical endorsed us and they put us on the website so this is just an incredible dream come true and not even half the year of running health tunes. We are on one of the best university clinics out there.

Saul Marquez: [00:10:46] That's awesome. More congratulations. Thank you for that. You don't just get put on a website for no reason. And so you guys are definitely making the impact that needs to happen. And what I love about it Walter is you know people it's big in medicine now you know like what are we doing with virtual reality your augmented reality. And a big part of those services is awesome music. Right. And what effect that music plays on the brain and in the healing process can you give the listeners an example of how the technology is already being used or maybe even how you plan for it to be used.

Walter: [00:11:22] Oh love to share both currently. One sector of health tunes is to help premies. So NICU and that's Los Angeles as well as an Ahlstrom a couple of hospitals. The music is matching the elevated heart rate of a baby. Let's see the harder it is 180 and that can share some videos with you when you see it is magic. And we play music at that and rate and slow it down with a specific algorithm and you see one and a half minutes later that baby at 155 or close the resting heart rate and amazing next to the baby. You see the mom in tears for joy that finally the baby is feeling better and anxiety is alleviated and the stress is coming down and you can see and feel the baby breathing normally again. And that's just music and one and a half two minutes.

Saul Marquez: [00:12:21] That is amazing. That is amazing. And these kids are so vulnerable that you just make that connection through music. And the physiological effect. So is there work being done like a clinical evaluation of this.

Walter: [00:12:36] Yes yes we do have those and we are in the middle of a process of putting a patent out how to amazing make this really available to anybody worldwide. You could already tap into this playlist. We have healthtunes.org that our hospitals use it and they really see how powerful that is. And it's the good side effect of that is that the nurses and moms love that music as well. Yeah that's right. That's a nice side effect.

Saul Marquez: [00:13:08] I love that. And then you said you're also going to touch on the plans for the future.

Walter: [00:13:12] You know the plant in that sense a plan for the future is to develop specific wearables which then of course have to be FDA approved. And that's quite a lengthy process. Any listener suggestions here please contact us. I know you know the best people out there the best people are listening to your podcast. So yeah we have these ideas how to make it even easier in hospitals but also for at home use is like gift that primi finally gets to that family and back home. Those moms and fathers they want to see the baby in safety in safe hands and that technology can definitely assist to that.

Saul Marquez: [00:13:56] I love it. Yeah just spanning the care continuum from the hospital all the way to the home.

Walter: [00:14:01] Yep.

Saul Marquez: [00:14:02] So there's the youth and then you know what comes to mind Walter is that is that movie where they went to the elderly homes and they brought music to the elderly and the amazing transformation that happened with these people. How about any segment of the population. Any any work being done there.

Walter: [00:14:19] Yes a lot of insight was a fantastic note to all of us how music can help in that cycle than it could S.A.G. could feel it and realize it. And that was a really great door opener for the whole world. Oliver Sacks talked about it and wrote about how music can help in dimension Alzheimer's and so we took that knowledge and find that even further we do have it's based on data of birth of the patients and that is also an almost stage one and two we can at least halt the development of Alzheimer's and we can and shouldn't over promise. But what we have seen with patients is just overpowering. It's just not only the joy those patients have when they listen to music but how they interact with the music and then the city of our brain is just incredible and we are learning more and more about this. Brains are never done. They constantly change. When I grow up people scientists would still say that we only use a third of our brain and then once you're 20 years old it doesn't grow anymore and that's it and it falls apart. But we know now at every second in our lives that the brain is changing and there's a static part and as a fluid part to it that plasticity is just incredible. However it's called shlock wrote great papers on stroke patients how he could help them to talk again after speech impediments. And he's teaching them how to sing and so his patients would start singing for a while. Then three four weeks later they start talking. It causes the plasticity of the brain. Again it's it seems like magic but we tend to live with the science behind it.

Saul Marquez: [00:16:13] Yeah that's really exciting. And all these assumptions that are I think a lot of people including myself still have you know you only use X percent of your brain and after this point it stops developing or growing. And so I think it's time to you know I guess the message to the listeners is it's time to re-evaluate what you believe about the brain and maybe we can use this episode with Walter as an opportunity to do a Google search or to dive in a little bit deeper on what you believe about the brain because maybe it's not right maybe it's not real and maybe it's going to hold you back from healing faster or helping your loved one heal fast. Right Walter.

Walter: [00:16:52] Totalally totallly agree. And I want to ask every listener think about it. Do you think are you your thoughts your brain is your personality or emotions or is it more. Where is your personality. Who are you. Who am I. And the brain is definitely a big part of it. But it's probably much more. And when you think about your life it was probably different the year ago and you're consistently changing in adopting. And that's just the beauty of it.

Saul Marquez: [00:17:23] I really is. I totally agree with you Walter and you've left us with a lot to think about and as we all approach our responsibilities in this health care sphere it's very important that we approach our own health and our own development in a very thoughtful way and so think about that listeners friend just got to think about this question What would you say Walter a time you know you've been through three decades of just great development and success. What would you say a time that maybe you had a setback. That you learned a lot from.

Walter: [00:17:55] You know every setback was actually the birth of a new idea. And we talked about what it's like seeing my son crawling on the floor in pain not being able to walk. That is a setback. I think even if the listener is not a parent you can imagine how painful that is for Luca, my son but also for us parents and for the whole family and it just totally turned around. It became a new entity and a modality to help other people. So I would invite love to invite all the listeners that any setback has something positive as well. And we can go through tons of tons of this but I would like to invite all of you. Just think about the last big setback you had and then see what happened. It might take a couple of months maybe a year or two. But there is some positives.

Saul Marquez: [00:18:53] Yeah totally totally agree and you know it takes me back to the beginning of the podcast Walter before I had any guests on it. Nobody wanted to be on it. You know I was just like the crickets man there was crickets. I'm just like man. I mean do I suck. There's this thing is said would have no legs. Like I really hit a wall. And it's not as distracting or serious as what happened to your son but I hit a wall man and I just found a way to work through it and it became just a new way of developing systems for the business. So yeah I mean I agree with you completely. And so let's see the other side of this wall or so. So that's the setback how about one of your most proud moments to date.

Walter: [00:19:38] Proud moments in terms of business family. Where which sector would you like to.

Saul Marquez: [00:19:43] Really. You know I'm thinking like healthcare but one that rises to the top it doesn't have to be health care. Why don't you go with your proudest moment and then let's apply it to health care somehow

Walter: [00:19:53] One of my last proud moment was when I got the video from the Nichijou in Austria and seeing this baby in absolute stress and anxiety. And you could tell that the doctor next to the baby that really more than sympathy and compassion it's like a little fear I'm standing there and the music starts and something shifted right there and seeing that mom she's like you can tell she's crying of joy. And when the baby starts moving differently and even all the monitors would show what is happening. Those are moments which are as beautiful as when I was 5 6 years old and the magician comes in and does something you just don't understand. But you're mesmerized. You know the magic of that mold is so powerful. And you know I don't want to miss those moments. It's just that many out there. It's just incredible.

Saul Marquez: [00:20:58] And thanks for sharing that. It's that feeling that you get when you don't understand that but yet it's just so beautiful in here it's like in our awe.

Walter: [00:21:06] And then I love to say music is here. Music is what words can't tell. There is something where no words can tell us that and it can describe everything so beautifully but also subjectively because the music touches you differently than your wife may be or or any other person in your family and your own tastes. And there's so much context in there if let's say you are married. And I'm sure when you're her the wedding march at your wedding it brought everybody to tears. Your parents and in-laws and whoever they is and it's such a beautiful moment you hear that melody but then maybe you are late to a meeting with a boss of yours and you in an elevator and the music plays that same melody that wedding march in that elevator and you think oh God stopped that music and it's the same notes. And again it's about context. So it is the music has so many layers to it and how you listen to it and the beauty is when somebody is diagnosed of whatever illness that they become or open to music and receptive and so they become a better antenna to soak it in and let those cool it is heal the body and the mind.

Saul Marquez: [00:22:36] That's so deep. Man appreciate your insight here. And there's no doubt in my mind that given this a lot of thought Walter and then it's because of that you've been able to create this creating platform to impact the world in a really positive way. We met at Health Care 2.0 and I could tell right away like you're just so engaged you're all in and very lucky to have just met you out there.

Saul Marquez: [00:23:01] What would you say Walter is an exciting project within health tunes that you're working on today.

Walter: [00:23:07] We are planning a bone marrow transplant study and that is also in hospital in Austria at the AK H. It's the largest middle European Hospital and they have six rooms for that modality. That bone marrow transplants. So basically if the patient gets so much medication that that this person is almost dead and will get bone marrow and hopefully grows back to normal. So those people are a couple of seconds away of being dead. And it takes no weeks to bring them back to normal. And they are laying there and you only you can help them with masks on. And it's super hygiene hygiene in there. It's barely any machines in there because they're so afraid that this is an infection going on now. So those whore patients definitely have since Zorich deprivation. And with that wording now you know the healing doesn't take place as good as well as you if you would be at home with having a flu and they can listen to music it can watch a video you sip your tea your family comes in and you feel better right away. But those moments and those patients are in isolation. So music can transcend that isolation and can bring memories back as a mention like that embedding memory. You can think about the wedding if they had one and they listen to the music and all that comes back in their mind. They have since Zorich memory that it's like olfactory and sounds and touch and whatnot and that really helps the healing. On top of it we give them music which helps a faster healing through a brainwave entrainment and so on and so on. So we know it will be a 30 to 40 percent faster turn around faster healing which is of course beautiful for the patient which is great for the family. To get the last ones back but also for the insurance companies because they will 30 40 percent less so hospitals and hospitals have more turnaround in Datsuns. There's no lose it's only winners and that with that modality. So we're looking forward to do that. We are open to work either with Amazon or Google and that's because we definitely need voice control and they both have very good systems. So we'll see who will be part of that study and it will start April 2018.

Saul Marquez: [00:25:47] Super exciting Walter. Always something going on with you. I love that and that's a very worthwhile project with these patients that are really terminal and suffering going for those that need it most. Love that.

Walter: [00:26:01] Thank you

Saul Marquez: [00:26:01] And Walter getting to the end here. This is a fun lightning round so we're going to build a course on what leaders should do in health care it's the one on one or the ABC of Walter. And so it's a syllabus for questions. Lightning round style followed by a book that you recommend to the listeners you ready.

Walter: [00:26:18] OK.

Saul Marquez: [00:26:20] All right. Let's do it. So what's the best way to improve healthcare outcomes.

Walter: [00:26:25] To stay positive and still help the patients to think and feel positive. Were they able to heal yourself. Sorry.

Saul Marquez: [00:26:33] No that's fine. What's the biggest mistake or pitfall to avoid.

Walter: [00:26:37] To intensify with the illness and the disease to think you are the cancer or you are the depression.

Saul Marquez: [00:26:44] Love that. How do you stay relevant as an organization. Despite constant change.

Walter: [00:26:49] I embrace change a thing that's one of the best things there are. Change keeps us alive.

Saul Marquez: [00:26:56] And finally Walter was one area of focus that should drive everything else in the organization.

Walter: [00:27:02] To stay in the loving and compassion and not make things a business and keep it and with the modality which reaches the hearts and the health of the people.

Saul Marquez: [00:27:15] Love it. Walter what book would you recommend to the listeners.

Walter: [00:27:19] When Breath Becomes Air. It's this book about a doctor summing up his life and I don't really give it all away. It's a fantastic book for anybody in this field and the doctor and I see doctors because they have to work so hard, close to burnout and other and burned out and exhausted. Read that book and make decisions based on that.

Saul Marquez: [00:27:45] Great recommendation. I'll definitely have to pick that up and listeners pick it up as well. Don't worry about writing it down. Just go to outcomesrocket.health/walter right there you're going to find all the show notes as well as links to Walter's companies and this book. Walter, before we conclude I would love for you to just share a closing thought and then the best place where the listeners could get a hold of you.

Walter: [00:28:08] Thank you so much. I can't believe that we have to stop already. And that is fine. It's great fun. That's the key word. Have fun enjoy. We know that humans if they have more joy in your phone they're less likely to get ill and sick. And even if they do get through it quicker. And music is part of the fun. Music can help you into that fun and even when you really sad listen there's something really. For some reason it balances this out and it brings it up again. And that's the thing. It's one of those things where it brings you up.

Saul Marquez: [00:28:48] That's really interesting. I love that idea because it's almost counterintuitive right because you think hey maybe I should listen to something upbeat but then it's only that maybe that empathy. Right. That's creative.

Walter: [00:29:01] Yeah. It is sympathy and empathy and being of the same intensity as you are when you're really down and somebody comes in with this Polca that is annoying. It does not help you.

Saul Marquez: [00:29:15] Get that folka out of here.

Walter: [00:29:17] Yeah. Shoot the polka player.

Saul Marquez: [00:29:20] Hilarious. Love it. Walter what a great message to the listeners and what would you say the best place for them to reach out to you or follow you is.

Walter: [00:29:29] Just log into healthtunesorg. You'll find all the information including phone numbers. Love to hear from you. Test it out and tell me how it's helping. I can't wait to hear and see.

Saul Marquez: [00:29:40] Hey thanks Walter, and listeners take them up on that. He is all in on this mission and so reach out. Check him out and all the things that he and his team are doing over there. Again Walter just want to say thank you on behalf of myself and all the listeners and looking forward to staying in touch.

Walter: [00:29:57] Thank you so much. It was a pleasure talking with you. Thanks for the interview.

: [00:30:04] Thanks for listening to the Outcomes Rocket podcast. Be sure to visit us on the web at www.outcomesrocket.health for the show notes, resources, inspiration and so much more.

Recommended Book/s:

When Breath Becomes Air

The Best Way To Contact Walter:

Linkedin - Walter

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Outcomes Rocket Podcast - Lisa Suennen

Why Health Leaders Must Seriously Consider Social Determinants of Health with Lisa Suennen, Senior Managing Director, Healthcare at GE Ventures and Managing Partner at Venture Valkyrie, 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 successful and inspiring healthcare leaders really want to thank you for tuning in. And I want to invite you to outcomes rocket dot com slash reviews rec'd leave a rating and review for this podcast. So without further ado I want to introduce our outstanding guest. Her name is Lisa Suennen. She's a senior managing director for healthcare and G.E. ventures. And so she's also a writer and blogger and podcaster at Venture Valkyrie and so she's done a lot of things. You guys are probably very familiar with who she is but what I want to do is welcome Lisa to the podcast and then have to fill in any of the gaps in the intro that I may have missed. Lisa welcome.

Lisa Suennen: [00:01:03] Hello there. Well that's about that about covers and I do all kinds of crazy stuff but that's the main thing the main day jobs.

Saul Marquez: [00:01:09] I love it. I love it you're up to some really cool things. And so I always love to ask why did you get into health care to begin with.

Lisa Suennen: [00:01:17] You know it wasn't really an intention. I was working in the tech world. This is back you know in the 80s I was finding it frankly pretty boring sultry Internet kind of stuff right. Yeah. And I talked to my dad who had been in a health care entrepreneur who was healthcare entrepreneur. And he said you know there's some really interesting health care companies you might find that were inspiring and I meet up with a guy a new CEO of a company and the rest is history.

Saul Marquez: [00:01:43] That's pretty cool. You know and it sounds like your dad kind of had the roots in healthcare entrepreneurship and you just kind of led that way and you haven't looked back since.

Lisa Suennen: [00:01:51] I look sideways every once in a while but no not too far.

Saul Marquez: [00:01:55] Nice nice. I love it. I love it. So you're doing some really cool things at G.E. movement and shaking with your own podcast. I have tuned into it. Really great great conversations listeners I'll include a link to Lisa's podcast on the show notes for this one so you could listen because Craig Onix. That's right. Called tectonics and so take a listen. She's doing some really cool stuff on there too. Lisa what do you think. I know all the things that are going on in health care is a hot topic that should be on every medical leaders agenda today.

Lisa Suennen: [00:02:27] Well I think a lot of people would expect me to say technology stuff and there is a lot of technology stuff going on. And I'm glad for that. But I also think that one of the most important things that we can really pay attention to is figuring out how to systematize productize and simplify the access to the social determinants of health. Things around housing nutrition transportation and other related categories that frankly have far more impact on the cost of health care than do many things that we attribute the cost of health care too. And so while I am a big fan of technology and health care and excited about a lot of things that's probably the number one most impactful thing we can do is expand our view of precision health to include an entire patients life.

Saul Marquez: [00:03:15] I think that's really interesting and you know the first thought that comes to mind. Lisa I've been doing a lot of thinking about this and one of the things that you've probably very aware is when companies get into this space oftentimes they're faced with the problems of who pays for it and when you talk about the social determinants of health. Who pays for it.

Lisa Suennen: [00:03:33] Well it's a touch you know obviously the 64000 dollar question as well. I think in a system that's a closed or fully at risk capitated type of system the answer is easy it's the payer right because frankly the downstream cost of not attending to these issues is so high. You know if a patient needs to get an A for services and treatment but they have no transportation it's going to be more expensive take care of them if they can't get access to behavioral health services keep him stabilized they're not going to take care of their diabetes or her condition. Right. So it's really easy on the interest financial interests are aligned when they're not. It's tough you know and the truth is the same in the end I think ultimately it was ever financial risk for the program for the person or the member whomever it may be is who should pay for it. If they're looking to reduce healthcare costs and improve outcomes.

Saul Marquez: [00:04:26] Yeah and just kind of diving deeper into that Lisa. The thought is OK well maybe these patients where now they're being tagged with readmission fees right the provider. So. And yeah so just it's a really great idea and just picking through it could be really impactful. You know anybody doing cool stuff in the space right now.

Lisa Suennen: [00:04:46] I do, actually I think there's a couple companies like healthify, Nowpow and ConsejoSano who are doing finding ways to create for profit business models out of these things companies like CareMore the healthplan. Oh yeah they're doing some incredible stuff particularly around lowliness which frankly is considered to be more deleterious about health and smoking now among older populations. It's very interesting yeah. There's a lot of a lot of work been done about that. So there are some really great programmatic work being done out there. There's a great organization called the Health leagues which is working on this for years. So you know there's a lot of good stuff. It's just not widespread yet. Unscalable and I think some of these organizations are trying to figure out how to solve that.

Saul Marquez: [00:05:32] Yeah for sure. Some great examples and definitely listeners take a look at these companies because if you're exploring the space if anybody knows companies doing good thing that's Lisa. So take a look at those for sure. I'll provide links in the in the show notes too. But Lisa give us an example of how you maybe GE or through you or your own you know podcasting are seeing outcomes improvement through the things that you're doing.

Lisa Suennen: [00:05:59] Well I think that our goal actually ventures is to invest in things that align incentives improve outcomes and reduce costs for all parties involved. We are really excited for instance about sysops which is a company that I did interview the CEO Ken Tarka on my cast recently. They combined data from Myanmar's and genomic data and the like to help identify what's the most effective likely treatments for cancer patients. You know personalized medicine approach. Yes I think that's a good example of that. We're working with another company called Health reveal which uses similarly large quantities of data from disparate sources to identify patients who are not getting treated in accordance with best practices of evidence based medicine. Identify people who might be very likely to have a stroke or heart attack or something and intervene with them before those horrible things happen which obviously saves money but more importantly saves lives. Yeah. So you know that's a big focus of what we do and to the extent we can identify those types of things that align incentives for patient payer and provider. Those are things we look for.

Saul Marquez: [00:07:08] I love that those are really great examples of the sign it's so great that you're doing this you know having these people on your show having these conversations because half the battle is breaking down the silos and communication and health care and so kudos to you for taking the six that so maybe you could share with us. Lisa you've done a lot in health care of a time when you had a setback or a failure and what you took out of that. What pearls of wisdom you took out of that.

Lisa Suennen: [00:07:35] Well I mean those of us who've been inventor or have had numerous setbacks and failures. The odds of all of our companies succeeding are pretty low. And I think about one for instance along the way that what does it do. Actually it was kind of focused on the social determinants thing. Ironically it was. But cancer was focused on getting ancillary services to cancer patients like physical therapy nutrition counseling financial counseling behavioral counseling. You know things that address the side effects of having cancer and being treated for cancer and it was set up kind of as an in clinic model with them physician offices within cancer clinics you know particularly the community sometimes in hospitals and it failed. And I was really upset by that because I didn't really believe what they were doing was good and it was clearly good. I mean there was no dispute as to whether it was helpful to patients patients loved yes but physicians just the oncologist at the time and this is now probably 10 years ago sort of early on in the discussion of paying for the social determinants types of stuff or the ancillary services type stuff. I think it's more common now particularly at the NCI Caterson cancer centers and the like physicians just couldn't remember to refer to it didn't bother to refer to it you know and I think part of it was workflow didn't exactly fit the workflow. Yeah the part of it was frankly it didn't add real revenue to their practices and that we know stood in the way of success and really taught me about how how important that aspect of it is not just the workflow I do about the workflow aspect. We worked hard on that. We obviously didn't get it right but also the financial incentive alignment was a stark example because you're doing something you know is good. You can't get people to refer to it for financial reasons they just didn't make any real revenue from it while they didn't lose money from it. It just didn't care enough.

Saul Marquez: [00:09:27] Yeah Lisa that's such a great great lesson and listeners something to consider as you dive into your business ideas or if you're looking to implement something into your hospital. Lisa brings in some really great examples. This company that just the heart was there but the money and the incentives weren't truly aligned. And it's something that you really have to make sure it's aligned. Yeah. You know Lisa one of the things that comes to mind when we talk about aligned incentives is the implementation of CAP Nagra fee to avoid respiratory compromise in hospitals. And I'll tell you what. You know it's one of those things that should be done but frankly is not done everywhere and it's just an example of you got to make sure you find a way to either bake it into the order set the physician or otherwise find a financial incentive because otherwise it's not happening.

Lisa Suennen: [00:10:23] Yeah well there's many examples of things like that unfortunately and until we have a system where the financial alignment is ubiquitous we will continue to find examples of things like this.

Saul Marquez: [00:10:33] Totally. LISA Okay. So that's one side of the coin. Let's look at the other side the much more bright and amazing side the stuff that you do. What are your proudest moments to date in what you do.

Lisa Suennen: [00:10:45] We'll give you not what you probably expect to answer but my proudest moments are really two things that come to my mind immediately. One is that my daughter told me not that long ago my daughter is in college that she appreciated that I was a role model for her and I know that's like. But you know it really meant something to me that I was always the mom that worked among many moms that didn't around me and that I felt really committed to that and I did what I could to be with her of course but that I felt it was important to have a career to model that for her and she all the guilt that I felt all those years of not being around for whatever programs at school. I think that all washed away with that discussion. For one thing the other thing is now you know being of a certain age and not in my 20s anymore. I spent a lot of time advocating for women and strictly women in leadership and health care and I appreciate that people look up to me for that and that I've been able to do something active and create a company called C-sweetener for mentoring of women in leadership and health care that's been taking off and I know that people respond to it and feel excited about it. And it's very gratifying. I mean it's of course gratifying to invest in a great company and see them succeed. That's incredibly gratifying. But some of the other stuff has been super exciting too.

Saul Marquez: [00:12:09] Totally. And you know what. It's so wonderful. Thanks for sharing that. Lisa I'll have to replay this part of the podcast for my wife because she and she does get these feelings of guilt. And so you're doing an amazing job. Just trust me you are. And so I'm hoping that my son when he grows up he can say the same thing he said to you and I'm going to give him some guidance. So thanks for sharing that and the other organization. I wasn't aware of that when me so that you started that. So that's very encouraging to hear that you have a movement like that in place.

Lisa Suennen: [00:12:44] Yeah it's a company called the C-sweetener. He could find it on the web light of what is going on Match.com.

Saul Marquez: [00:12:50] Why the name, it's a really interesting name.

Lisa Suennen: [00:12:52] It was a play on the word c suite is the target women who are already women in the sweetener were either in the c sweet or near to the c sweet, to make it a sweeter experience. Hence the name. And like that it's kind of a match.com model where women can sign up as men to use it's for women who are you know senior level and match with mentors through batching that's both skill based and interest based as well as personality based with mentors who've signed up and committed time who are extremely experienced people both men and women dedicated to helping women find more in their careers.

Saul Marquez: [00:13:31] That's so cool. Definitely another one we'll have to check out listener so if you find yourself as somebody that can give mentorship or you want to receive mentorship your lady wanting to receive mentorship please visit. But if the mentors could be men and women right.

Lisa Suennen: [00:13:46] Yes the mentors can be men and women I mean we really feel strongly that if men don't participate in the change it will never be struggling.

Saul Marquez: [00:13:53] Yeah for sure. Oh that's so great. So listeners you'll have a link to that too. Lisa doing some amazing things. Tell us about an exciting project you're working on today.

Lisa Suennen: [00:14:02] Well I think we're starting to do a GE where I work is very much a leader in 3-D printing broadly and we're starting a project on the investing side to really focus it on where the opportunities are going to be to make a material difference no pun intended. And I was just going to say a 3D printing world applied to healthcare and I'm really excited about that. I feel like that could have. It's early in the 3D printing application elsewhere but I see how it could have really a big impact over time. You know and we want to be at the front of.

Saul Marquez: [00:14:37] That it's really exciting. And so if you had to say one thing that that's exciting say ten years from now in that space what is the prospect of fill in the blank.

Lisa Suennen: [00:14:46] Printing scanned printing organs printing bone.

Saul Marquez: [00:14:49] The biological side of it.

Lisa Suennen: [00:14:50] Yeah. I mean we're already using it for her some things health care at least experimentally but boy can you imagine how many lives could be saved if you could could use some of those things and use organic products and the body great can.

Saul Marquez: [00:15:06] That be really great. No more donor waitlists.

Lisa Suennen: [00:15:09] Imagine if you could print about heart valves that fit properly. Amazing was made of natural material that would be amazing.

Saul Marquez: [00:15:17] Now our but super interesting definitely Lisa. The list goes on and on and what you do and so appreciate you kind of getting those little gems out to the listener.

Lisa Suennen: [00:15:25] Sure.

Saul Marquez: [00:15:26] All right. Getting to the end here what we're going to do Lisa is you and I. Let's just pretend we're building a medical leadership course on what it takes to be successful in medicine. It's the 101 or the ABC is over. Lisa Suennen, it's a syllabus right now for questions lightning round style followed by the book that will add for our listeners. You ready. Yes. All right. So what's the best way to improve healthcare outcomes?.

Lisa Suennen: [00:15:51] Design products and services that really align particularly financial ones can focus deeply on the clinical side of that. I mean without clinical depth it doesn't go anywhere.

Saul Marquez: [00:16:03] What is the biggest mistake or pitfall to avoid.

Lisa Suennen: [00:16:06] Hiring weak people.

Saul Marquez: [00:16:08] Ooh, that's so great. How do you stay relevant as an organization despite constant change.

Lisa Suennen: [00:16:14] Never stop learning. I mean I think you have to not believe your own B.S. You have to always assume other people are smarter and you have to like go seek out information all the time.

Saul Marquez: [00:16:23] What is one area of focus should drive everything else in your organization.

Lisa Suennen: [00:16:28] Creating value for patients.

Saul Marquez: [00:16:30] And finally. Lisa what book would you recommend to the listeners here on the syllabus.

Lisa Suennen: [00:16:34] Now in an age where data is becoming more and more important I love to recommend Moneyball. It is about baseball it has nothing to do with health care. Yeah. The analogies are terrific. I think the cleverness in which data was applied to make decisions about teams about strategy you know in a way that nobody really had written about before. It's funny as hell it's great.

Saul Marquez: [00:16:57] Lisa so I've seen the movie does it differ from the book much.

Lisa Suennen: [00:17:01] It's a lot more in-depth about how they use data. It's a lot more wonky in a way. Yeah but it's still absolutely fun to read apply. You know and I wasn't big baseball fans. I love it. Didn't know that about you very cool listeners so there you have it Moneyball along with the answers to this syllabus. You could find everything on the show notes. Just go to outcomesrocket.health/Lisas and you're going to be able to find everything that we just talked about today right there. So Lisa before we conclude I just invite you to share a closing thought with the guest and then the best way that they can get a hold of you or follow you.

Lisa Suennen: [00:17:41] The best way to follow me is at venturevalkyrie.com on my Website you can sign up for my blog. Or you can follow me on Twitter @venturevalkyrie and my closing thought is if you don't ask you don't get go out there in the world and ask for what you need you know find partnerships ask for help and ask for opportunity. It's amazing what you get when you ask.

Saul Marquez: [00:18:02] What a great message Lisa and listeners. Be sure to ask and again be sure to visit us at outcomesrocket.health/reviews. Let us know what you think. Lisa just want to say thank you so much once again for spending time with you.

Saul Marquez: [00:18:16] Thanks so much Saul.

: [00:18:20] Thanks for listening to the Outcomes Rocket podcast. Be sure to visit us on the web at www.outcomesrocket.health for the show notes, resources, inspiration and so much more.

Recommended Book/s:

Moneyball: The Art of Winning an Unfair Game

The Best Way To Contact Lisa:

@venturevalkyrie

Mentioned Link/s:

http://connectedsocialmedia.com/category/tech-tonics/

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Outcomes Rocket Podcast - Lisa Suennen

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 outcomesrocket.health/reviews 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 www.outcomesrocket.health for the show notes, resources, inspiration, and so much more.

Recommended Book/s:

The Selfish Gene

The Best Way To Contact Olga:

http://madpow.com/contact-us

Mentioned Link/s:

http://madpow.com/

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