Why Canary Health is Leading the Way in Self-management in Healthcare with Adam Kaufman, CEO at Canary 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: [00:00:18] Welcome once again to the outcomes rocket podcast where we chat with today's most successful and inspiring healthcare leaders. I invite you to go to outcomes rocket dot com slash reviews where you could rate and review what you think of today's episode because we have an amazing guest today. His name is Adam Kaufman. He is the president and CEO at Canary health. He's got a really long track record of success but at Canary health they are the leading provider of digital health self-management programs which includes a CDC approved online Diabetes Prevention Program a chronic disease self-management program in an exclusive partnership with Stanford University's Education Center they're doing some really interesting things to help improve outcomes and that is why we wanted to have Adam on the show. So Adam please fill in any of the gaps in that intro and welcome to the podcast.
Adam Kaufman: [00:01:10] Surely, Saul, thank you. It's a real pleasure to speak with you and share the insights that we have. I think the only thing I'd add to that is that by way of background I'm a health economist by training I worked in applied statistics so I'm actually you know I realized later that was an attorney when I was in grad school. I'm a data scientist so it's been interesting to see the power of data inside the healthcare and also somewhat humbling as I look at human history and it reminds me of the ability we have and certainly are the canary health and marrying technology which is really focus on human centered design and engaging people. So I'd just add that I come at it from a sort of I know this but early in my career that kind of data and analysis solve it all and realized how surprising and most clinicians would have started there. And that's not going to be sufficient. It takes a lot more to really engage people.
Saul Marquez: [00:02:09] That's a really great insight Adam and appreciate you sharing that Adam. I'm sure when you when you realized that it was just a huge aha moment.
Adam Kaufman: [00:02:16] Yeah I wish I could say it was like one moment I maybe I'm a little bit slow sometimes that over time that is sort of like wait a minute you're like you know I think health care what is the problem. I mean we certainly work on it for a long time the about doing something to someone. And maybe now is with someone but in my case for doing is for them and letting them and we and there's a sort of moment of humility that we all have to trust that someone knows what matters to them and they can lead that journey and they'll get a better outcome better quality of life. And we have a system that will get healthier happier people and use less health care. But it was right when they turned on and there was a series of reminders none of which are more powerful than the chance. We have talked with our participants in the and the people we've interacted with and remember that it's a part of their life. It's an emotional journey it's not just you'll have therapy. I had a disease or multiple is it all this and all the other aspects. So I wish I could say it was one single innovation in life but certainly it took me a little bit of time to come to it.
Saul Marquez: [00:03:28] No it's great and it's it's interesting to hear the journey and couple of things come to mind. Adam that I'm curious about. What got you into the business of healthcare. And to tell us a little bit more about the name canary health and why you named it that I'm kind of curious about that.
Adam Kaufman: [00:03:43] Yeah sure, let me let me start with the second question. Canary health is a loose allusion to the story of the canary in the coal mine. And for those listeners who don't know it was common practice for years to bring a canary into a mine. One of the big rigs in mining was the release of methane gas and that had become explosive and one of the great innovations in requiring visual testing all the time in the hundreds was that unfortunately or fortunately I guess a bird and canary figure is more sensitive to methane. So these are warning signal that something dangerous is happening and so they actually haven't bird in a cage and you know the birds started getting sick and even die. That was a signal to get out of the mine something. Right. So for us we really wanted that moment before something becomes catastrophic and we think that there is a great opportunity to engage folks earlier in their disease path earlier in their trajectory and prevent that progression prevent that catastrophic event. So we don't we know on that story have we. But we thought about what we wanted to be and what we wanted to represent which is I mean preventing that catastrophic.
Saul Marquez: [00:04:54] So that's right. Yeah I love the analogy it's powerful it's I never knew the full story I always I know what the analogy means but I didn't know that's exactly how the miners did it. So how fascinating. That's really cool.
Adam Kaufman: [00:05:08] Yeah. What was surprising to us. I mean we always knew it was ending until it was still common practice in my mind. So again the digital I mean now there are gas meters and it's sort of an oddity anyway you know for a century is a solution that requires some digital technology. So the way I came to healthcare kind of to have figures of that my parents are physicians. I had both seen patients but also worked as sort of a system level. So kind of you know around the dinner table it not just stories about individual cases but also why society works in a certain way when we don't let me like healthy or healthy. And there was always something I was interested in but kind of had a whole thousand engineers and I never went to work in the .com world. Nothing to do with health care. Kind of thinking about how the old Internet businesses and all that are a number of years when guys are interested in statistics I was saying earlier in search of data in economics feel and I thought I'd be a professor someone that's right. Really. You monkeys. Yeah. My Ph.D. in economics started in what people would call behavioral economics is kind of applied gave you a really nice mathematical theory and economics and a lot of it much more apply ended up doing in statistics writing my dissertation around health care outcomes. And this is right around sort of early stages of Obamacare and just by the part of that transformation. After teaching for a couple of years went to work for a media company that combines television access tools and print media even to build quality improvement programs. So that was my early take. How do you know the impact that people were saying oh edgy you know Atlanta what we're doing is an area.
Saul Marquez: [00:07:01] That is so cool and a really interesting journey that you've taken. So tell me a little bit more Adam about what you believe. Every healthcare leader today needs to be focused on what's that hot topic.
Adam Kaufman: [00:07:14] I think there's probably three if I could and I'm in a.
Saul Marquez: [00:07:17] Let's dive deep, man. Let's dive deep. That's what you do.
Adam Kaufman: [00:07:21] Forget the economists I mean first would say I think the move to value is critical and it is not a single thing we're all process especially in the U.S. are transforming I'm sure the other guests. Yes I know I'm talking about from fee for service the payment verbally and that underlie this sort of massive shift in the way healthcare is organized. So any leader whether it's the delivery side the insurance side by side needs to think about how healthcare is going to organize itself to deliver better value. And that's really what we ask clinicians to do what's called pay for anything important. So I think that's one big piece.
Saul Marquez: [00:07:59] Just to just kind of dive in for a second you know I feel like just looking across the healthcare provider system and the incentives that are given it feels like a lot of providers are still being very fee for service oriented. What are your thoughts on that. What's it going to take to actually make that shift.
Adam Kaufman: [00:08:19] Yeah great sensitivity to the challenge providers have they got more than what contract they want to practice medicine in one way and it's not going to be sufficient. If one insurance companies get 10 percent of their patient populations I'm going to pay this way the. I mean most people would die and I would agree that Medicare is going to have to play through the dominant force and change that I think the ACOs have started doing it I think the program the alternative payment model now and you're even hearing now you know a goal. I can't remember 2- 4 years 60 percent of payments will be tied to sort of alternative value based payments. I think you'll see two raise. I think you'll see the of store or classic palpitation show and sort of putting all the risk and opportunity on the providers and then the end is being all about how you provide an alternative path. There is still fee for service. But we're going to layer value and we're going to start doing more. And I think those will converge. I need to say a little bit longer and maybe we would have thought a couple years ago. But the big shows are starting to see this transformation and CMS I think is at the forefront of it. And then the commercial payers. It seems like and I don't see it directly in a service delivery organization or payer but as we talk to both sides the model and the alternative payments to the very commercial they're trying it now.
Saul Marquez: [00:09:47] Appreciate the insight. So you feel like the basis for these changes are there and it's in motion. It will get there but it's it'll get there. Ultimately.
Adam Kaufman: [00:09:57] Yes. And I'm a California guy. Southern California hit by sort of training and health care experience and so you know the futures are here in Southern California. I think most. Yeah and the fact is rehab. Yes. So the it feels like you know a for those listening. I. I've got a certain lens on it but it does feel like we talk about a home outside of California is beginning to move that way. Street is the same all over the country. But certainly I think that's a model that the federal government is seeing moving away more. And so I think you don't get there what it looks like in the interim is what we're all trying to figure out.
Saul Marquez: [00:10:36] Got it. All right. You said he had three right. So what would be the other to shift to value of value.
Adam Kaufman: [00:10:41] I think the move towards really leveraging data is a huge part of what's going on. And I think a lot of people both in and out that I'm certainly a consumer of health care and more than that. But I think the third one is really where we Canary focus which is now increasingly because we've built these systems because we're now compensating our providers for it and Mangia to no interactions for our colleagues because we now have a lot of benefits. I think we have a really unique opportunity to put the consumer back center. Here. So I really do think this move towards patients centered or person centered care this idea that someone should control their journey and activated consumer deciding what matters to him or how that makes them there and are driving that journey is going to be the key element to hide the rest of it ever and alternately while we care about outcomes and there are really what we should care about is the people getting what they want. And often it is very alive. So there's very few people want to say and want to spend more money on health care but they're not it sounds the same. We have orphan interact thousands of consumers around and self-management and it is interesting however what matters to you how you organize your life and your health to get what you want. And there's never anything inconsistent with Bell but it's not exactly the same right. No one wakes up in the morning and says I'm worried about my A-one sea level and diabetes I'm worried about getting sick or I'm calling in that I have my relationships. And so if we can shift the system so that person's back at the center I think we'll get one. So for us the third piece of that major trend that's where we spend our time and canary needs to go hand in hand with the other two major elements to get the outcome we want as an individual.
Saul Marquez: [00:12:30] Adam that's interesting why don't you give the listeners an example of how can we help you and your team have created results improved outcomes through what you've done there.
Adam Kaufman: [00:12:40] Yeah. So let me share it very individually and then I can share some of the same. So you said that you know we're very fortunate to work with incredible researchers out of Stanford University I believe researcher there is a woman who has dedicated her life to this conference herself in case more. There's a lot of imagining what they do. One of the things that strikes me is the way that they constructed a process how someone set a goal in place. And it seems intuitive. But there is this balance that I hadn't made a sort of ambitious enough and they are not meaningful but also close enough and understand what happens. Sealable so there's a sort of elegant simplicity they have and how they help people. And what strikes me is when you look at this I will often see action plans and I'm reminded of a particular artist who has multiple chronic conditions diabetes a rare rare condition or inner year on years. And when you asked her what manner the first thing was about getting control of her life and why from a healthy Ahwaz she just didn't feel like she had control. And so the first action plan she said was about how she could talk to herself. And there's nowhere it's sort of classic health care is the first thing you help someone with is you know how do you have a conversation with yourself. What was neat to on the law. I'm going to get a hearing aid. I'm going to take better care of myself. And so it reminds me that we need to empower that person to first what we've seen now and expand that and again this is very exciting new research that our colleagues Sanford conducted with and with a thousand people with diabetes went into our digital version of standard program 300 of the in one city in person so we really we know from choice and what they were able to show was a year after the program remarkable improvement in diabetes outcomes is named by A-one C which is the main measure for that. But what really led to it was incredible reductions in the rates of depression there. Here's the medications a better sort of self advocacy and confidence that someone could actually control it. And how Howard the has a short period of self-management support showed outcomes a year out Amsellem and Stanford has published the clinical results of this study. So they've actually demonstrated that a peer review and very shortly they'll be talking about the impact it had on healthcare utilization and cost. And so you started a very human level and it actually demonstrated to add a population level critical outcomes
Saul Marquez: [00:15:22] What a great example Eidelman listeners something to consider each and every one of you is an individual. And this idea of self-management. We all have our own Canary and so we've got to figure out what that canary is and like Adam was just saying you know this this patient that just wants to connect with their spouse. Now what is your hot button that is going to be the domino that makes the rest of them fall for your health. And it seems like Adam you guys are doing it so well. What's the secret sauce. How do you guys get to that thing that makes everything else tick.
Adam Kaufman: [00:15:57] I mean they sort of work as you will at am remembering that the individual is what matters and I been to numerous times we've sat with Kate Lorig the research from Stanford on just about language and this little thing. I assume you sound like you're telling someone what to do and you're telling them what matters. And there's a very subtle distinction but it goes to the words we use to the way the tool works. And so we try very hard and probably haven't achieved it but I say the secret thing is we never tell someone when we do a lot of work to build a framework where there's models that are here they have had your stories coming from you then you're not going to achieve it. And then we do a lot of work to help support all but I guess maybe that's the one thing we don't know what's there for you now. Yeah I think that it could be and have a ton of support when you take it but you've got to decide that.
Saul Marquez: [00:16:56] I think that's beautiful. And just even at the beginning Adam when you were kind of discussing the idea of OK we do health care to people or are we do health care with people or do we do it for them and provide them the support. It's something that I notice that you do. You're very sensitive to the word that you use and the meaning that you give what is happening. And so I really appreciate your thoughtfulness and in your approach and I think this will be very insightful for the listeners and the viewers.
Adam Kaufman: [00:17:24] Well it's been a pleasure to share the insight and hope it is for them.
Saul Marquez: [00:17:30] So what would you say a mistake or setback that you've experienced that has given you some huge pearls of wisdom in what you do.
Adam Kaufman: [00:17:38] It's a good question. The road is never kind of you know the ground up into the right and it always is always. I think and still believe it so I hate to say it's sort of a given setback. I think we have accepted that to a large extent health care still thinks about kind of these vertical silos by engaging in disease or physiological system. And so we will be willing self-management and we have the solution that actually we're supporting so many regardless of what anything you haven't worked and we know that the market has already served this horizontal idea of self-management is probably my thing. So what we've been working on for months and years really and what we'll be looking for is to our management plan for inside services a day much more easily into diabetes services or other conditions and not the windmills to use that old expression if you will in healthcare to see the kind of people independent diseases that they help in framing health and get more basic than what matters. So I say a little bit of a challenge from the go to market strategy and the way we've encountered healthcare is so oriented around diabetes cancer as opposed to probably each of those things at the center of your person. So we're no way of ending that kind of thing about impacting our services in the way that health care is still thinks.
Saul Marquez: [00:19:10] That's pretty cool and you know one of the things. So for the entrepreneurs listening to this you know something to consider you know when you when you build your product or service how do you position it. You know and Adam's been very thoughtful about that. Adam your your particular solution. Who pays for it.
Adam Kaufman: [00:19:25] Is designed to go to the payer so often the insurance companies and self-insured employers growing to hours today the today's providers. But we really focused on those folks who essentially have the insurance.
Saul Marquez: [00:19:39] Yeah and makes a lot of sense. And it's funny not funny but interesting because there's a lot of great ideas out there and oftentimes what happens is they they run into problems because they don't get strategically positioned on who's going to pay for it and then the ideas die and some so glad that you've done such a great job of positioning in a way that's that's you know been successful.
Adam Kaufman: [00:20:00] Yeah I'm having one of the things for the Offner about their budgeting and health care is not a transparent process. I used to work in the Internet world saying about new models and the challenges there were much more technological. When you deliver a new immaturely groovy to whatever the process was will always are. So I don't mean to me and I know that all that. If you can demonstrate that they have health care because there's so many competing priorities because it's partly driven by regulation is partly driven by you know in your priorities has an academic feel in some sense in on. There's all this are the same wire. So it is always very tricky to figure out how budgets are allocated reality is saying and then we just kind of figured out for oneself but that doesn't translate necessarily to another by the other part the countries of the world. So a lot of whole we are with where strategy is you know it's trial and error in some degree and law in a. Where are you.
Saul Marquez: [00:21:13] Now really cool thanks for saying that and boas you say one of the proudest moments that you guys have experienced to date here with canary health.
Adam Kaufman: [00:21:21] I think probably it's a moment we have every week. So you know I can't really think of one of the nights that are in our company and we share a story of at least one participant.
Saul Marquez: [00:21:32] Love it.
Adam Kaufman: [00:21:33] It's a credible to see you know as I see it more. Some of our team is interacting with foreigners and all the time. We're a good part of our team that's young I think that is doing support helping shape and so that moment where I get a chance to see the team and we all see it and to be able to do that that changes our people incredibly powerful in that moment. Every and often those stories were captured on video as you can see the person sometimes or just read to know that no way in hell that one person and see that story when you know that know it's more like thousand people.
Saul Marquez: [00:22:15] That's beautiful man. My wife is in the pacemaker business and she's a clinical specialist. Then she comes home and she tells me this stories about a little lady or a little man that rehash some memories. But you know was having pain and she just comes back lit up and these little things that you could do that make such a big difference. And it sounds you guys are doing it daily. And I love what you've done Adam kudos to your leadership style and kind of leading your team over there of making it a point to bring up the reason why you guys are doing this on a weekly share and for the leaders listening to this. What are you doing to build your culture within your organization. Adam's given us a really great example right share patient stories are what are you doing what can you do so. Time flies when you have fun. This has been a blast. So here's a part of the podcast where we build a syllabus for the listeners it's the 101 of Adam Kaufman how to be amazing at health care. And so I've got four questions for you lightning round style we'll go through those and then we'll finish it up with a book that you recommend for the listeners. Ready.
Adam Kaufman: [00:23:17] All right, let's do it.
Saul Marquez: [00:23:17] Awesome. What is the best way to improve health care outcomes.
Adam Kaufman: [00:23:21] Put the person back in the center.
Saul Marquez: [00:23:23] What is the biggest mistake or pitfall.
Adam Kaufman: [00:23:26] To avoid feeling that you've got the right answer the first.
Saul Marquez: [00:23:29] How do you stay relevant as an organization. Despite constant change.
Adam Kaufman: [00:23:35] Be agile.
Saul Marquez: [00:23:35] And finally what is the one area of focus that should drive everything else in your company.
Adam Kaufman: [00:23:40] Hope you can edit out the silence. I think that the one area of focus should always be are you improving the consumer side of whatever might be in a way that matters.
Saul Marquez: [00:23:55] Love it and Adam finally what book would you recommend to our listeners on this syllabus.
Adam Kaufman: [00:24:01] I have to pick the book the innovators precription from Clay Christensen and his team so really through innovation and how that model applies to healthcare and some really good insight on a macro level and some of them that serve any individual company or service.
Saul Marquez: [00:24:19] Awesome. That's really interesting. Listeners don't worry about writing any of this down this syllabus. Our show notes everything's available below and it's also available on outcomesrocket.health/adamk That's Adam K for Kaufman. You'll be able to find all of these so just go over there and check it out. Before we conclude I just would love for you to share a closing thought with the listeners and also the best place that they could get ahold of you.
Adam Kaufman: [00:24:47] Sure would like to give the easiest way just by email firstname.lastname@example.org or you go to our Web site and and those comes directly to me or someone on the team can go free. I see you that I look forward to hearing from you. I thought I'd share it and especially for leaders who have been outside of healthcare. I wasn't coming to healthcare. Remember to join and it is a journey for the individual an intimate and integral part of their life. And so it's not a single thing that a single article about how these character in this story. They're all held in Pakistan. And so we want a law that agrees with them and I want them all. And your own health care story with this product and the service is going to be and you can certainly Nothing's ever a straight line. But as far as regulation is going to change your market will change. So using that sort of North Star making people live better and then working towards is the best advice I can give an annual major and hopefully not too many gowns but they'll come I'm sure for people so you know like aviators change in general. It's not just the but it's how you help people recognize that you know there are going to be always what they want next to an individual level pride for some reason.
Saul Marquez: [00:26:15] Awesome. What great words of wisdom. Listeners enjoy these. Take them into consideration in your day to day and in your overall strategy because I think there are some really insightful tips. ADAM, again I just want to say thank you on behalf of me and all the listeners and looking forward to maybe having you on again.
Adam Kaufman: [00:26:33] Great, well really appreciate, Saul. Thank you, it was a fun conversation and I really appreciate the opportunity to speak with you and the listeners here. Whatever whatever wisdom they can take away from it.
: [00:26:47] Thanks for listening to the Outcomes Rockett 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 Adam: