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: I really thank you for tuning in again and I welcome you to go to our outcomesrocket.health/reviews where you could rate and review today's show because we have an amazing guest for you today. He is an amazing person, super smart and a great contributor to Health Care. His name is Cory Kidd. He's the CEO at Catalia health. His background involves over 20 years of health and technology half of which was academia at the MIT group in the Media Arts and Sciences Lab as well as just being at the frontlines in business and so he's got such a great mix of experience in both of those and now with his new venture at Catalia health. I thought it would be wonderful to get him on talk to us a little bit about robotics, artificial intelligence and the beautiful amazing things that they're doing at Catalia. So Cory, welcome to the podcast fill in any of the gaps there that I may have missed.
: Well first thanks for having me. It's great to be here. I think that was a great overview of it just to kind of ground the conversation. Yeah. Quickly My background is a mix of number of different things an undergrad of computer science focused on artificial intelligence and human computer interaction all applied to healthcare. That was a Georgia Tech and that was at MIT as you said I did my Master's Ph.D. at the Media Lab, spent a few years at Boston University Medical Center in Endocrinology and observing and getting to spend time in the clinic seeing patients. End of the last decade, I've started a couple of companies commercializing some of the things that I found during that academic period. But the overall arc has been how can we leverage cutting edge technology to solve some of the big challenges in healthcare.
: Beautiful and so no doubt Cory that you have a rich level of experience across a lot of different areas and so just out of curiosity What got you into healthcare?
: You know I always had an interest in healthcare. 20 some years ago when I was trying to decide what I wanted to do with my life you know give very strong consideration to going to med school. A lot of my friends from that time are now practicing doctors and decided that actually the route I wanted to go was combined my interest in health care and technology as a way to potentially help many more patients that I could do as a practicing physician. So now fortunately I get to work with a lot of people in doctor and nursing and other clinical roles. But the route that I took was a way that I think we can leverage as I was saying a moment ago a lot of technology, cutting edge technology to solve some of the challenges that we see today in healthcare.
: That's so awesome and I'm so glad that it worked out for you. Obviously you've intertwined these two loves and now you're here you're doing some amazing things with the different organizations that you're involved with Cory with the company that you're focused on right now. What would you say today is a hot topic that needs to be on every medical leaders agenda?
: Well if we look at what's specifically hot right now you know we see artificial intelligence and machine learning. If we look at kind of technology and impact on healthcare those are definitely the buzzwords. But I think what needs to be on everyone's mind is not necessarily those specifics although it is worthwhile knowing some about those but how the world is rapidly changing technology is really impacting medicine today. And depending on your particular area of healthcare and that's going to vary a little bit. But broadly speaking we definitely see technology moving into actual healthcare at a much faster pace. And so developing and understanding at an organization around you that can support that I think is critical. You know what we see our healthcare system and healthcare institutions and companies that aren't adopting changes in technology are going to fall behind very quickly.
: Yeah and they're definitely a very big risk. Listeners, this is something that is worth reiterating. You know if you're not embracing some sort of organizational structure to help you embrace these digital advances these computer advances then you're gonna be left behind. And so Cory maybe we can ask you what would you recommend them. You know the listeners trying to stay up with the times. What would you recommend them as a basic step they could take.
: Well I think there are a lot of things that can be done. I mean just keeping up with technology trends and if you are not someone who's deeply embedded in the technology yourself at least have an understanding of what these things are and what these things mean artificial intelligence machine learning like I was talking about bitcoin and block chain. I think there's going to be an impact of block chain on healthcare. What does that mean to your business. You don't have to be the expert but have a high level understanding with them bringing those people around you or structure your organization so that you can at least start to answer some of those questions about what should we be doing today. What do we need to be looking at the next 6 to 12 months. What's a few years out and was completely irrelevant to us. You should have enough knowledge to be able to answer those questions and at least know where the impact in your business is going to be. And I think most importantly where the impact on providing care and providing patient outcomes is going to be.
: Beautiful. So listeners if you take anything from this episode there's plenty more to come but take just that. That framework that Cory laid out for you. Hit rewind on this. Listen to it again. Write it down. Because it's happening and it's happening fast. And so you don't want to get left behind. And so Cory you're obviously on the front end of this advances. Can you share with the listeners what you're doing potentially at the organization you're at now to improve outcomes.
: Absolutely. You know I think that we're on one of the many many front edges and that's what challenges right now is how many different things are happening. So Catalia Health is a chronic disease care management company. Now there are a lot of other people trying to deliver care management particularly when we think about the domain that we're in which is outside of the hospital or the clinic now helping patients do that everyday follow up. Now one way this is done today is you know we've got great home care agencies out there that are sending people out into the homes at a much bigger scale. This is happening using call centers full of nurses and other clinicians at times to make calls to patients. But both of those are really challenging to scale you know home health actually sending someone out that's extremely tight. It's a very expensive in many of these call center based programs. The other quote unquote high touch programs means you're going to talk to a patient a couple times a month. And that's great for the level of care that we're providing today. But we want to be able to do so much more. And that's where Catalia health comes in. So instead of these completely human driven interactions, we of course bring a bit of technology to play. We give our patients a cute little robot. It sits in their home on their kitchen counter bedside table coffee table wherever they want. And by the way if you to get a sense of what this looks like you can go to our website cataliahealth.com. And there's a short 90-second video there you can actually see someone interacting with one of these. And so that's the interface. And I think we can come back in a second. Talk about why we use that interface. But on the technology side most of what we do is the artificial intelligence behind that that's creating a conversation on the fly for that patient at that point in time. Now we build these around particular disease states for example we have these out with heart failure patients today. And these are checking in with a patient about what's going on related to their condition in the background we're modeling that patient that we can talk more about how this happens as well to tailor that conversation specifically to them. So this is partly about checking in. How are things going? Did you take your medications? What was your weight this morning? Partly about education. Helping the patient better understand their condition and the management of it and partly about motivating that patient to stay engaged. So one of our big challenges today in chronic care management is how do we keep patients on whatever that therapy whatever that program might be for an extended period of time. And that's a big area of focus for us. Now of course through this we're getting a lot of data. We have a lot better understanding about what's going on with that patient day to day than is practical to get now. So on the back end we're gathering that data doing the analysis and then sharing it with the doctor or the care manager and nurse for the pharmacy as needed depending on what patient population and we're working with. So at core we're focused on chronic care management but we have a very unique and scalable way of going about it.
: Cory, super cool and listeners take that link from Cory and you'll be able to see what the little robot looks like but more importantly you'll be able to see what the company is all about and it's that chronic care management in a way that provides data you know patient reported data. It's tough to get. And now with the advent of voice. With the advent of artificial intelligence like Cory said there's so many fronts to so many things that I think they're doing some really interesting work to help manage the patient when they leave the hospital which is a very challenging thing. Now Cory question for you, a lot of things come up you know people say it's a robot. We need humans. Is there a human touch to the robot. How's that whole thing work?
: All right there's a bunch of pieces to that you know. So let's start with what are we doing here. Where do we fit into the healthcare system. Our goal is not to replace any humans in doing their job. We're trying to help them do a better job. So we're not getting rid of those hom care programs. We're not replacing those call centers but as we were talking about those interactions tend to be infrequent. If I'm a patient dealing with a chronic disease, I'm dealing with that every day. This helps to fill in those gaps and then let the clinicians who are providing care understand the when and where they need to reach out to patients. So with that data we're able to better target the people time that we have in order to solve some of those problems. Now let's talk for a second about two quick things so one is why do we use a robot the first place? It would be a lot easier. Right. So it would be a lot easier to deliver these conversations through a smartphone or a tablet or through a web browser, on your laptop. But yes the analogy here and where this comes from is you know we're listening to a podcast right now but it would be different if we were having a face to face conversation. Now it would be logistically challenging for each of us to do that. But in business that's exactly what we do. As CEO of Catalia Health, I spend the majority of my time on the road with our customers, our partners, our investors, our patients and we all do that in business and in medicine because we understand that face to face makes a difference. And from a psychological perspective we actually know what that difference is. We're face to face with someone as opposed to a phone call or an email or even a video conference face to face means we're more engaged. We're creating a stronger relationship. We even find that person that we're talking with to be more credible more informative more trustworthy. Now as it turns out, those differences carry over into the world of technology. In other words, I put that robot in front of a patient that can literally look them in the eyes while it's starting to them. We get those psychological effects of face to face engagement. Now one or two interactions that you know may or may not be important but where that really makes a difference is over time. And if we compare head to head using an interface like we do with the robot versus delivering the same thing through an app, we're going to get much better engagement over time with our patients. And so that's what it really comes down to for us. And then the last thing I'll say on response to your question is how we go about creating this is not like a chatbot. So this is not technology that's listening for the patient to say something and then you know going out and searching a database doing some statistical analysis and trying to come up with some answer. The robots are really directing the conversation and all those conversations start with people start with experts in that disease state. At our company, obviously we are building a bit of technology but less than half of the company have are people with technology backgrounds. The other half of our product team are people who are clinicians, doctors, nurses, psychologists, writers our head writers are former Hollywood screenwriter and it's the interplay among all these things that make this work. In other words everything that maybe a robot is saying to a patient is clinically valid. It's been created by one of our researchers using you know best practices or literature that's available on managing a particular disease state. We have consulting clinicians who are experts in that disease state as well to help us understand that process and create that content but then also working with our writers to make sure that it comes across in a very friendly approachable way that's appropriate for that particular patient. Now the adaptation to that particular patient happens automatically. That's what helps the scale. Once we develop an application for a disease state it doesn't matter for rolling that out to 100 patients or 100000 patients. That part becomes easy once we have the first piece of this created around that particular disease state.
: Very cool Cory and no doubt that it's been very thoughtfully done. You guys are taking a very scientific but also human touch approach in the way that you guys are deploying the technology to help these patients. And also the people that are taking care of these patients. Can you give an example to the listeners of how your company has already improved outcomes with what you've done?
: So this company is about three and a half years old and as you might imagine from looking at the product there's a lot of infrastructure to build to get ready. So you know we've been fortunate that early this year we have finally launched with patients so we're still fairly early in the data.
: Thank you. However the first version of this was put in front of patients 11 or 12 years ago. So there's a lot of research behind this showing the ability to use this to keep patients on therapy for longer. Now our first roll-out this year of the Mabu commercial product is with heart failure patients and what we're seeing from the initial data is that patients are using this very frequently. So on a very regular basis once or twice a day and for a reasonably long period of time. So what that really means though is we're able to get the important information from patients. So in the case of heart failure we're asking about daily weight we're asking about shortness of breath and other symptoms. Now the critical things that we would want to know about a patient is as a clinician we were able to talk to them everyday and were also able to spend time educating that patient. Now, if we think about the example of heart failure but this applies in so many other places. You know, a patient gets a new diagnoses and all of a sudden there's a new drug there are three or five drugs in the case of many of these patients. And look you need to do this and you need to follow this diet. And you know here's your first follow up appointment here's your second I want you to think about this everyday and do this. It's overwhelming. It made this patient in the moment may feel like they understand it but they leave the hospital, they leave the doctors office and wait what was that. They don't recall what my doctors said about this. And the other thing that we see with our patients is that many of them are hesitant to reach out to call the doctor. I don't want to bother someone but knowing these things are incredibly important to managing care over time to improving outcomes on this disease to not going back to the hospital. And so what we're able to do and what we're seeing is that patients are willing to talk to Mabu the robot about these kinds of things day after day and so it's a way to deliver this educational content in a time and place when the patient is ready to receive it. So those are the things that we're really focused on in terms of being able to improve outcomes over time.
: That's wonderful Corey and one of the biggest problems is medication adherence right? Whatever we could do to improve medication adherence will be amazing.
: That is definitely one of the critical parts of it. You know we try to take a very broad view about managing an overall disease state. But you're absolutely right. Many of these diseases, the medication that that patient is on and today often the lack of proper adherence to it is one of the big challenges that we see.
: Yeah absolutely. Big problems you guys are doing some really great stuff to get them solved. Congratulations on launching this year with the first patients. And so now you guys are rocking and rolling as you've moved forward in this process. Cory, can you tell the listeners about a time when you had a setback on the way to this process. This launch finally and what you learned from that setback?
: Well you know it's kind of one of those things that you often see in business and particularly in technology where people see this now and you know think of it as brand new and I've been building stuff like this for two decades now. I launched my first company just over 10 years ago and obviously that was very early in terms of this kind of technology. And one of the challenges then is just figuring out what's the channel, how do we get this to market. We ended up doing deals with Pharma, with payers, providers, self-insured employers, direct to consumer and trying to figure that out. But there were a lot of setbacks along the way. You know one of the challenges when you're trying to do something new and different in healthcare is just figuring out where you fit in. And actually this is really shared across a lot of business but healthcare you know we definitely see this because for good reasons healthcare can be very slow moving. We figured out what works with patients. We don't want to change that. We don't want to introduce any risk in what we're doing. But that also has its challenges when we find something new that works in figuring out how to get it out there. And so I think one of the setbacks that I've seen often on over 10 years of working to sell this kind of technology is just figuring out who's going to pay for it and why. Part of what we're doing here is obviously developing a very new interface for patients. And what we're doing is unique. We're very differentiated in terms of that. But one thing I've had to figure out over the last decade is on the other side of this, the business side and where we fit into healthcare. How do we basically do the opposite and do nothing new? Because we have to fit into existing business models, existing payment models, existing workflow and understanding how to fit something new that we're doing into all of that has been a huge lesson learned over my career.
: That's such a great share Cory. Listeners if you're working on a new idea and even large companies. If you're implementing a new technology or a new product, who is going to pay for it and why. Truly understanding this is going to save you from a lot of headaches, heart aches, and over a hundred. Isn't there a Cory?
: Absolutely correct!
: Yeah, so make sure you think about this. You know so many people don't think about it. Make sure that you implement this thought into your strategy your go to market strategy. What would you say one of your proudest leadership moments in healthcare have been to date Cory?
Well I'm excited right now that I get to do a lot of public speaking about not only what we do with Catalia health but the impact of technology in healthcare particularly around artificial intelligence and sometimes around robotics and it's very exciting to see right now the response of this is receiving. People are genuinely excited about it and really trying to understand how they can use this to make a difference. Obviously I'm not the only one out there talking about this but it's something that I've focused on for a long time. So it's very exciting for me to see how this kind of thing is starting to have a real impact at health care.
: Tell us a little bit about an exciting project or focus that you're working on today. It could be something within Catalia or anything else that's on your mind?
: Well right now I'm very focused on what we're doing with patients with heart failure. So we launched with one of our customers about a month and a half ago it's Kaiser Permanente. So they're a great partner for us in rolling this out but we've also launched an internal pilot. So we are shipping these directly to patients and we're now getting feedback from those patients in terms of the data that we see every day. You know a data feed about what's going on across those patients but some of our nurses are on the phone with those patients and going to their homes and interviewing them and getting direct feedback. So this is something that's very exciting on the minds of not only me but everyone here at Catalia Health right now really focused on how do we make an impact on these patients and how do we use their feedback to continue to make what we're doing even better.
: Wow, that's so awesome. Definitely exciting Cory and you know I'm sure you and your team are are working around the clock to figure out how to best tweak these devices to best get patients what they need.
: It's a very important part of what we do. Starting with you know the foundational principles of medicine and psychology and building based on that but then using that real world feedback to continue to improve.
: Super amazing. I think you guys are doing some really great things Cory as we get to the end of this podcast, I've got a lightning round for you for questions. You and I are going to build a medical leadership course right here.
: What it takes to ..
: It's the 101 of Cory Kidd. So four questions on this syllabus. And then we're going to follow that with a favorite book and podcast. You're ready?
: All right. What's the best way to improve health care outcomes?
: I think what I'm seeing right now is evaluate all angles to look for opportunities. So what I mean by that is you know health care problems are complicated. Sometimes the answer is in technology like we've been talking about, sometimes it's in process. Sometimes it's in people sometimes it's how do you do something earlier or how do you postpone something to later. And just thinking about it from many different ways which usually means a pretty diverse group of people who have some knowledge of that problem I think is the best way to go about it.
: Awesome. What's the biggest mistake or pitfall to avoid?
: One thing I've seen in my career being involved with the technology side of healthcare is kind of the desire for the shiny new thing. I thought about this a little bit tangentially earlier in understanding where AI or a block chain or machine learning or whatever it might be is an impact on your business. And one of those options that I stated was it has no impact, right? It doesn't matter. Understanding that answer I think is incredibly important and I think that's the answer that's often overlooked. There are these hot technologies that catch on in certain areas. Well it must have an impact on our business. Let's do something. And I've seen a lot of health care organizations spend a lot of time and money and figuring out that that just doesn't matter to them.
: What a great call out. How do you stay relevant despite all the change?
: You know I think that's always a challenge particularly as an organization grows. I think part of it is you know just following the trends that are going on and you know understanding what they are at least enough to be able to explain what it is. I think also you know as organizations grow keeping people around you who do the same. Trying to find people who aren't just about the status quo in whatever that is, whatever aspect of your business or the health care that you're providing, but people who are excited about trying and doing different things.
: And finally what's an area of focus that should drive everything in a health organization?
: Patient outcomes. What are we actually doing with our patients. I think that's critical.
: Love it. And what book would you recommend to the listeners?
: All right, I'm going to take something from a technology perspective this is an older book several decades old called Society of Mind. So this is a book that was written by Marvin Minsky 3 or 4 decades ago now. So everyone is familiar with the term artificial intelligence. Not many people know where it came from. Marvin was one of the early people working in this space and he and Joe McCarthy coined the term artificial intelligence a little over 60 years ago now. And so the whole premise of this book one of the ones in the middle of his career is that a mind or thinking or this higher level thought processes all come from simpler things that are happening under the hood if you will right smaller simpler things that we can search to figure out and decompose. And if I look at the work that I've done for the last 20 years this is one of the principles that it's really based on. You know we build these really complex systems with Mabu and the data analysis that we're doing on the back end. But any one piece of it is fairly simple. I was fortunate to be able to study under Marven grad school and get some of these ideas from him firsthand but well before that at least a decade before that I'd read this book and I highly recommend that if you want to understand the basics of artificial intelligence. This is a very approachable accessible book.
: What a great recommendation and what podcasts would you recommend to the listeners?
: What I'm enjoying right now is Masters of scale by Reid Hoffman, he was one of the founders of linkedIn. He is a venture partner now. But he has done it. You know he has access to a lot of amazing entrepreneurs whether they be small companies or many of them are a very very big companies now. But what does it take to do something at scale? He approaches that from many different angles and I'm greatly enjoying it and trying to figure out how he can apply many of these lessons in my business today.
: What a great recommendation. Listeners don't worry about writing this down. Just go to outcomesrocket.health/catalia and you're going to be able to find the show notes as well as a transcript just so you know catalia is C.A.T.A.L.I.A. Just go to outcomesrocket.health/catalia. You'll be able to find the links to the book that Cory recommended, the podcast and everything that we talked about today. Cory, this has been a ton of fun. I'd love if you could just share a closing thought with the listeners and then the best place where they can get a hold of you.
: Closing thought would be make a change. Try to do something different. Try to figure out where you can have an impact. That's what really drives everything that I do in my career. And I love working with people who think the same way regardless of what that change is. And a couple of great places to reach me. I'm on Twitter @Coryk. I'm pretty easy to find on LinkedIn as well. If you want to reach out just add a message to it.
: Outstanding. Cory, thank you so much. We really appreciate all the things that you share with us today and we're excited to keep up with all the outstanding things that you're up to. So thanks again for making time for us.
: Well thank you so much for the invitation. This was a great conversation and I look forward to hearing from the listeners.
Thanks for tuning in to the outcomes rocket podcast if you want the show notes, inspiration, transcripts and everything that we talked about on this episode. Just go to outcomesrocket.health. And again don't forget to check out the amazing healthcare Thinkathon where we can get together took form the blueprint for the future of healthcare. You can find more information on that and how to get involved in our theme which is "implementation is innovation". Just go to outcomesrocket.health/conference that's outcomesrocket.health/conference. Be one of the 200 that will participate. Looking forward to seeing you there.
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