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How to Operationalize Personalized Medicine with Dr. Karen Sutton, Orthopaedic Surgeon at Hospital for Special Surgery

Hey Outcomes Rocket friends, thanks for tuning in to the podcast once again. As a leader in health care, you have big ideas great products, a story to tell, and are looking for ways to improve your reach and scale your business. However there's one tiny problem. Health care is tough to navigate and the typical sales cycle is low. That's why you should consider starting your own podcast as part of your sales and marketing strategy. At the Outcomes Rocket, I've been able to reach thousands of people every single month that I wouldn't have otherwise been able to reach if I had not started my podcast. Having this organic reach enables me to get the feedback necessary to create a podcast that delivers value that you are looking for. And the same thing goes if you start a podcast for what you could learn from your customers. The best thing about podcasting in healthcare is that we are currently at the ground level, meaning that the number of people in healthcare listening to podcasts is small but growing rapidly. I put together a free checklist for you to check out the steps on what it takes to create your own podcast. You could find that at outcomesrocket.health/podcast. Check it out today and find a new way to leverage the sales, marketing and outcomes of your business. That's outcomesrocket.health/podcast.

: Welcome back once again to the outcomes rocket podcast where we chat with the day's most successful and inspiring health leaders. Today I have a wonderful guest for you. Her name is Dr. Karen Sutton. She's an orthopedic surgery at a hospital for special surgery. She's got a lot of different hats. She's also an associate professor at Cornell Medical School. She's the head team physician for the U.S. lacrosse team the ladies team. She's a chief medical officer at the International federal lacrosse organization. She's a researcher, a mom of four, has worked with Peewee athletes all the way to the Boston Red Sox and Bruins. This lady is moving and shaking in health care and it's a pleasure to have her on the podcast. I want to give you a warm welcome, Karen. Thanks for joining us.

: Thank you for having me.

: It is a pleasure. So tell me is there anything that I missed in your intro that you want to tell the listeners about?

: That one thing just to exaggerate on the position now with chief medical officer for the Federation of International across we're looking towards making lacrosse a more international and hopefully Olympic sport. So I really had the privilege to hit the ground running with that quest for the sport of lacrosse.

: Outstanding Yeah I mean it definitely is a sport. Not sure why it's not in the Olympics yet. So I think it's a great endeavor for you. What's the...

: We're moving it forward.

: What would you say that time to make it happen is?

: We're hoping maybe 2028 where the Olympics are going to be in Los Angeles. That's what we're shooting for.

: Ah that would be awesome. That would be amazing.

: Yeah I'd be thrilled.

: Definitely wish you the best in those efforts and they pick the right woman for the job.

: Thanks I appreciate it.

: Absolutely. So Karen tell me a little bit about what got you into medicine to begin with.

: Probably started from working with my dad when I was little and just learning to write. He was doing EKG and reviewing them as a cardiologist and I used to follow his lead and pretend to copy his writing even though not one word was eligible. From my standpoint I thought I was doing a good job as a junior cardiologist then.

: Nice.

: I followed the lead going into college where I majored in chemistry with a focus in biochemistry and enjoyed the research aspect of that. I started shadowing some doctors especially my father wanted me to shadow women surgeons to understand what the lifestyle is as a female versus male surgeon in the field because it's a lot more balancing from my perspective for sure. Then when I got into medical school I shadowed and mentored with an orthopedic surgeon named Dr. Morman who at the time was the team surgeon for the Ravens. So he was fantastic we wrote lacross research papers together. He really motivated me into the field of orthopedic surgery. And despite the fact that he was probably 6"5 and a few pounds heavier than I was he was convinced that orthopedic surgery was the way I should go. And I followed his take on that.

: I love it. So it's just amazing right. I mean the influence that our mentors have growing in this field and fast forward to today. Sure he's very proud. Him and your father for all the things that you've done and so now you're here. Dr. Sutton what would you say a hot topic that needs to be an every medical leaders agenda today and how are you all approaching that?

: I think a hot topic compared to maybe a decade or two ago is personalized medicine for patients. We're getting all of these data points on people whether it's genetic advanced imaging being able to put a puzzle piece together a lot better than we have in the past. The other thing is partnering with a lot of these wearable devices where we can get in real time what especially athletes are doing what's their average heart rate. How much are they exercising. You can even have them track their calories so you can get the energy they're using and the energy they're putting out and tailor some of your treatment to that scale.

: Yeah that's a really really neat approach Kiran and you know we recently just did an interview with Keith. He's over at LRV Capital. He was talking about the digital front door of health care. And you know much like you mentioned this consumerism approach is definitely becoming the focus. Give us an example of how you and your practice or one of the organizations that you're part of have have enabled this.

: One organization I work with so I used to work with the Yale athletes and we found a lot of stress fractures were happening on one of the teens with female athletes. So we needed to get some feedback in terms of how they were eating what were they doing on the field. And some of the trainers were able to track some of their nutrition and we realized that in terms of availability for their nutrition after practice there were limited resources so we start to get an odd blip in terms of what they were eating after practice and certainly stress fractures multifactorial. But if we can control at least the energy that they're taking in it will help to prevent progression have a stress fracture or even a stress fracture from starting. So we were actually able to work with the university to determine more cafeteria's more options for the athletes to eat after practice. And that was one way of dealing with just tracking nutrition and then how you can impact change after that.

: That's pretty cool. So a lot of it came from what the girls were eating. So what were the results after they sort of changed their eating?

: So looking at both eating as well as footwear I think that we noticed that they needed to have a lot more footwear options on the field you can't just wear cleats throughout her versus grass versus artificial turf as well. And everything has a different length and needs a different grip with the cleat. So once we changed cleats and then nutrition started to see a trend to where certainly decreased incidence of stress fractures.

: That's awesome. Congratulations on making those tweaks to help the players be healthier and more productive on the field. That's a big win.

: Yeah it's nice. It's always good when organizations who are very responsive to changes that need to happen.

: Absolutely. Now tell us a time when things didn't work out something that you experienced a setback and what you learned from that.

: The first thing that comes to mind is going from middle school and then playing volleyball in high school. One of the coaches of the volleyball team asked our gym teacher in middle school who are the best athletes who do you think could be recruited to play volleyball. So freshman year I went for the volleyball team made it and it just didn't seem to be my forte. I was setting which I did a fairly good job at but I had to take a step back and really assess my strengths and weaknesses because I felt like I wasn't really progressing as a volleyball player. One thing I do in many aspects of my life is try to get a 360 degree view of what's going on so I talked to the coach, I talked to the players. I just looked at different training techniques and I started realizing I'm much more of a sprinting athlete on the field pivoting cutting athlete. And so I was talking to some of the other coaches and then ended up switching over to field hockey. So I think a lot of us have to delve deep within ourselves and decide Is this the path that we're going down. How do you make the most of your talents as well and looking in life especially as you're driving your career even as you're driving your recreational activities making sure that you have those efficiencies that you're doing.

: Karen, what a great example. And I think this is one thing that that applies as much on the field as to people's careers and businesses. And it's hard to make those decisions that hey you know what I've got to change what I'm doing. What kind of advice would you offer to the folks listening that are maybe in the middle of something that they know deep down inside. Hey you know I'm maybe not the best at is. How do they peeve it.

: I think one thing is to take a step back. So we all want to just keep going going going and move forward and make a change possibly an irrational decision. So it's always important to have a quiet space. Start keeping a journal and I learned from Oprah always that we need to write down our immediate goals our short term our long term goals and our lifetime goals and start deciding is your life at that time really lining up with how those goals are forming. Fortunately and unfortunately I guess those changed throughout our life where your goal when you're 20 is definitely going to be different than your goal when you're 40. So one thing when I started out as a surgeon in your first couple years you're not as busy clinically so I had a few friends tell me words of advice to start sitting down and decide where you want to go with your career as a surgeon. One thing I always wanted to do was get back to the sport of lacrosse so I started looking into the options for being a team physician for the United States. And I talked to some of my connections and got some feedback how to get to that pathway. Then I reached out to us lacrosse and they ended up having a under 19 team that was going to Germany. And they asked if I would be willing and able to serve as the team physician for that team and I certainly jumped at the chance and have gone forward ever since with them.

: That's awesome. What a great step by step process that you laid out here for the listeners Dr. Sutton and I think it's something that we definitely need to do more of. We tend to want to go go go without having to take a step back and step back getting clarity and like Karen said writing out your clear objectives will definitely help you navigate the system a lot better as well as your career. Tell us a little bit more about a time that you are the most proud of Karen something that happened in your medical leadership experience to date.

: One thing was probably joining the hospital for special surgery staff Hospital for Special Surgery is the number one orthopedic hospital in the country. And I always thought in the back of my mind that it was someplace that I wanted to be they just really focus on patient care. It's an amazing experience when somebody walks in the door there from the person who greets you to the person who's walking into the operating room to of course the surgeon and the supporting staff around you. One of my mentors virtually I think she knows it now but she didn't know it back in the day because I was always following what she was doing with Dr. Joe Hannifin. She's a leader in the field of women's sports medicine and she was conducting all this research on ACL injury on female athletes she was the first to start a women's sports medicine program and she actually reached out to me last July and asked if I would join the HSA staff. And of course when you're mentor or your virtual mentor asks you to do that. It was something that I was extremely thrilled about and then to be able to be in the same building with her and pick her brain about different things that she's done and how she's treated athletes has really been a privilege for me.

: That's so awesome. Karen and I just got goosebumps when I heard that. It's so cool to just kind of have that path be opened up for you. And just by being clear being intentional and working through it now you're here you're doing some amazing things at HSA as with what you're doing with the lacrosse team all the things that you're working on. What would you say one exciting project you're most excited about?

: One thing that everybody's surprised that an orthopedic surgeon would do is I work on frozen shoulder and breast cancer patients. I started noticing early in my career that frozen shoulder was occurring in these patients who did not have the usual risk factors. Typically we see an association with diabetes a severe trauma or even a thyroid disorder. But these patients weren't checking any of those boxes. So looking into it and then talking to my colleagues who are also treat shoulder injuries I said Have you noticed anything with breast cancer patients in frozen shoulder. And then they picked a few patients that came to mind and I started looking reviewing my charts and they were all on a certain medication these aromatase inhibitors. Interesting in the back of my mind I started hypothesizing that potentially the aromatase inhibitor was causing some sort of increased fibrosis in the shoulder capsule and maybe that was causing them to have frozen shoulder. So I worked with a breast cancer nurse and we started doing first some background research on it and then clinical research to see where the association lies. Is it from the breast cancer surgery is it from the radiation the Axler or no dissection or could it be from this chemotherapeutic agent that these patients have to take.

: That is fascinating. So it sounds like this is a project that is live and you guys are digging in.

: Right. Right now we're looking more at the imaging behind it so trying to compare some of the breast cancer patients who are on a robot inhibitors to the more typical frozen shoulder patients such as the diabetic patient and seeing what the differences are there. And the main point behind it is people are living a lot longer with cancer and knock on wood hopefully doing a lot better with cancer. So not only do we want them to be in remission for their cancer and hopefully fully treated but during that time it's important to be active and have a wonderful lifestyle during that time too. So if a frozen shoulder is really aggravating somebody and they can't play with their grandchildren swim do their usual activities. I think that's still a key aspect to their lives.

: That's such a great call out. And folks if you're listening to this and Dr. Suttons work sparks an interest or maybe an idea that you've had by all means at the end of the podcast here we're going to give you a place to reach out and collaborate on this project that she's working on. Dr. Sutton, let's pretend you and I are building medical leadership course on what it takes to be successful in medicine today. It's the 101 of Dr. Karen Sutton. We've got a syllabus we're going to build for the listeners lightning round style for questions followed by a book that you recommend to the listeners. You ready?

: Ready.

: Awesome. What's the best way to improve health care outcomes?

: Avoid subjective measurements and try to get objective measurements as much as you can whether it's outcome scores wearable devices. Really get that feedback from the patient that doesn't just come from subjective discussions.

: Love it. What's the biggest mistake or pitfall to avoid?

: Biggest pitfall is jumping to conclusions and seeing something from the surface without delving into the details of the subject or the issue at hand.

: How do you stay relevant as a healthcare organization despite constant change?

: I think it's important to look from a global perspective. So really getting yourself involved with international associations national associations getting out there and going to meetings whether that's virtually going or going in person and trying to challenge yourself by presenting your own research. And it really pushes you to drive change in your field.

: Love that. And what's one area of focus that should drive everything in a health organization.

: Patient satisfaction. I think we try to overthink all of these different ways. How should we make that are prettier or should we have better lives. Should the MRI work a little bit faster. But no matter what the goals for all of those achievements should be patient satisfaction.

: Love that what book would you recommend to the listeners, Karen?

: SO as a female orthopedic surgeon and there are only about 4 to 6 percent of us in the field as well as a mother of four. The Balance Project book is the first that comes to mind. The balance project is a book written by Susie Schnall and she did some background research in terms of interviewing professional women who are also mothers. And she went through a series of questions to see how do we actually get through the day. How can we balance parts of our lives or how don't we balance parts of our lives and then that segues into her book it says a fictional book too about how this woman balances her being a mother as well as a professional woman.

: Outstanding. And as I've said before I do believe that it's going to take more women leaders in health care to make health care better. So check out that balance project folks. Great recommendation by Dr. Sutton here. Everything that we've discussed today including a transcript shows notes as links to the things that we've discussed these books are available. Go to outcomesrocket.health/Sutton You're going to find all that there. KAREN This has been so much fun. We've really talked about some really cool things improving outcomes and just staying focused. Can you share a closing thought with our listeners and then the best place where they can get in touch with you.

: Sure. I would say one of my favorite quotes is look a challenge straight in the eye and give it a wink. I think that's always finding where you see this huge mountain that you need to climb over. But take it passed by path and if it has to be a windy trail then that's OK. People can reach me at Twitter @KSutt001 Instagram KarenSuttonMD. as well as at Hospital for Special Surgery You can look me up on their website.

: Outstanding. Karen, has been fun listeners look at your challenge and give it a wink. Well great words to be left with here. This has been so much fun Dr. Sutton really appreciate you carving out time for us and looking forward to seeing what you do about these women Olympics the lacrosse team so we'll be staying in touch with these soon. Thanks for joining us.

: Excellent thank you.

Hey Outcomes Rocket friends, thanks for tuning in to the podcast once again. As a leader in health care, you have big ideas great products, a story to tell, and are looking for ways to improve your reach and scale your business. However there's one tiny problem. Health care is tough to navigate and the typical sales cycle is low. That's why you should consider starting your own podcast as part of your sales and marketing strategy. At the Outcomes Rocket, I've been able to reach thousands of people every single month that I wouldn't have otherwise been able to reach if I had not started my podcast. Having this organic reach enables me to get the feedback necessary to create a podcast that delivers value that you are looking for. And the same thing goes if you start a podcast for what you could learn from your customers. The best thing about podcasting in healthcare is that we are currently at the ground level, meaning that the number of people in healthcare listening to podcasts is small but growing rapidly. I put together a free checklist for you to check out the steps on what it takes to create your own podcast. You could find that at outcomesrocket.health/podcast. Check it out today and find a new way to leverage the sales, marketing and outcomes of your business. That's outcomesrocket.health/podcast.

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Recommended Book:

The Balance Project: A Novel

Best Way to Contact Karen:

@KarenSuttonMD

@ksutt001

Mentioned Link:

https://www.hss.edu/

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Looking up Home Remedies Has Never Been Easier with Serena Oppenheim, Founder at Good Zing

Hey Outcomes Rocket friends, thanks for tuning in to the podcast once again. As a leader in health care, you have big ideas great products, a story to tell, and are looking for ways to improve your reach and scale your business. However there's one tiny problem. Health care is tough to navigate and the typical sales cycle is low. That's why you should consider starting your own podcast as part of your sales and marketing strategy. At the Outcomes Rocket, I've been able to reach thousands of people every single month that I wouldn't have otherwise been able to reach if I had not started my podcast. Having this organic reach enables me to get the feedback necessary to create a podcast that delivers value that you are looking for. And the same thing goes if you start a podcast for what you could learn from your customers. The best thing about podcasting in healthcare is that we are currently at the ground level, meaning that the number of people in healthcare listening to podcasts is small but growing rapidly. I put together a free checklist for you to check out the steps on what it takes to create your own podcast. You could find that at outcomesrocket.health/podcast. Check it out today and find a new way to leverage the sales, marketing and outcomes of your business. That's outcomesrocket.health/podcast.

: Welcome back once again to the outcomes rocket podcast where we chat with today's most successful and inspiring health leaders. Today I have an outstanding guest for you. Her name is Serena Oppenheim. She's the founder and Good Zing. She's the CEO there as well and what they do. Good Zhing is that there are tech enabled platform democratizing health information. Good Zing gives users access to a greater degree of self care while improving health literacy. The expert and user generated content. The platform brings the world of health and wellness together. Now this topic of wellness continues to come up in the discussions that we have with our guests and in the general health care conversations out there. So this is a podcast that you're going to want to tune into Serena at Good zing won the 2016 business of wellness pitch contest and was voted people choice before it launched in 2017 spring. She's been featured in The Evening Standard the Huffington Post and Virgin. So thought further ado. It's true pleasure to welcome you on the podcast Serena.

: Thank you so much for having me. Absolutely. Now did I leave anything out in the intro that you want to share with the listeners.

: Not really when it comes to good zing. I'm sort of more I guess from a personal background which is unlike most people who come into the house space. You know I haven't come in as a doctor haven't come. And not from the medical angle I've come in because I know what it's like to lose your health. And you know what you've got into the house gone. So my personal background is that in 2005 when I graduated from college in the U.S. I partied a bit too much and I ended up with viral meningitis which developed into chronic fatigue syndrome and fibromyalgia both serious issues but not sort of have any medical not something that a drug can cure. Not something that is life threatening but is life altering. And so when I started this business which is largely by accident is I realized that I'm totally obsessed with the health space because this is what actually has a huge impact on people's lives. Yes there's some great businesses in hotels or in food or in shopping but actually without health you're nothing. So that's why I'm so passionate about this industry and it's great that people like you are doing podcasts like that it's bringing communities together.

: Serena, what a great call out and listeners you're healthy. Most likely you're listening to this and you're healthy and maybe you're taking for granted that health and Serena's message here is strong right. I mean without that health wealth is insignificant. It's a basis that we all need to continue building on and keeping strong. It's clear why you got into the business Serena. What about a hot topic that you feel that needs to be on every medical leaders agenda today and how are you guys at Good Zing addressing it?

: So I'm pretty much obsessed about this one plan is improving health literacy because if we don't have strong health literacy than all the other things we're doing around it just don't like strong health literacy to have the positive housing health outcomes. So I was doing some research around this a couple of months ago. And I read this report which said that only 12 percent of Americans and I know the figure is roughly similar. And U.K. and central Europe as well can be expected to fully understand the health and the implications. So whether that comes down to navigating health systems understanding what the doctors are telling them understanding what they should eat what they should do is it turns out the top many wonderful things in school and an education but in the way that actually gives people people on Sunday and health literacy were not taught that. And so if my one big bug is that every medical leader and everyone in the house should actually be thinking how do we improve everyone. We're not just talking about the elite and we're not just talking about the poor but everyone's health literacy. So they can actually take a stronger directive to the cost of the road in health. A stronger understanding that you know if they are sick and they get told to take pills why they have to take those pills at that time why they have to eat before that pill why they have to exercise. Because just for my own health experience when a doctor says to me you should exercise more and I guess what they all say. But actually why more impact does it actually have. And it all comes down to health literacy and I'm sorry I'm totally obsessed with the Zarya now.

: You know what. It's great to be obsessed with this area and for the providers listening for the med device companies really, pharma companies everybody listening this health literacy is a serious thing. We as healthcare leaders suffer from the curse of knowledge and the curse of knowledge is that we know the topics inside and out. We're at a level 10 and companies like Serena's help us touch our end user our patient our customer at level 2 which is really where we need to be and so many of us are missing the mark. So I'm excited to really dive into some of these things that Serena speaks to us about in particular Serena, I love to hear about an example that you and your company have done to improve outcomes by doing things differently in literacy.

: What before I even get to that point I should point out that I'm definitely not at level 10 I'm. So you know I was I did not do well in science at school. My concept basic biology is very low. So what I'm building Good Zing and when we're looking at the platform when we're editing articles that the doctors have written or editing articles that nutritionist writing looking at health tips we always say bring it back to layman's terms that someone says you should eat fiber. Really. I'm pretty educated person. But this isn't my area of expertise. What the hell do they mean by fiber? How much should I be having sup for munch? Should I not? It's breaking it down idiot proof and it's the same in any industry. So I used to work in renewable energy. I remember my first couple of weeks working the space at home with the road jogging to me and you slowly get it. But the bomb in the health space is there a Sermanni job. There's so much jargon. And there's sort of a wonderful thing that doctors are gods because they save our lives which is like the doctors that have saved my life I've had nine operations I've had a whole bunch of other issues that I haven't mentioned I freakin love all my doctors. But at the same time the ones that have had most impact, the ones I've broken it down for me. So I've actually understood what's going on in my own body without having the fear that I'm too stupid to get it or that they know everything when actually you know your own body but going back to your question I guess it's the biggest thing that is when people come to us and say they found a tip on the zing that helped. So there's one story that always makes me smile which is so occasionally we get sort of messages, e-mails, via social media people saying and they found tips that worked. There's one story I've really loved because it was a mother of three young kids based in Amsterdam and she emailed us to say that her 2 or 3 year old daughter had really really bad x mind seen lots of different doctors and a kid had been put on very strong medicines for it.I think it was steroids and she wrote say that she got good zing found a whole bunch different eczema related remedies from the bats and had gone to the doctor and said Hey can I try some of these. And she started putting her kid and a box or something and I turned around and home remedy. Now the kids Eczema is actually dramatically improved. And she had taken some of the nutrition steps and the kid is not actually on drugs anymore for the eczema and they have it under control. I quite frankly thought only happened to one person I believe. OK. We fulfilled it, that the mission of the company. But the fact is that it's happening a lot more. But what's quite interesting is when we started this it was only for common ailments so things like eczema or insomnia and would put up things like fibromyalgia chronic fatigue syndrome because I had those and I knew how hard it was to find that health contents without sort of being a blog space where people were ranting and raving about how terrible they felt. Know I will not call solutions not was the point. But then actually a friend came to me and said I think you should put mental health up there. It was a couple of years ago when we were still in beta still an idea was before mental health become trendy. And that is the area that we're seeing the most results because mental health is still something that people are how to go around saying they've got eczema they don't have it around so they've got embarrassing things like constipation. But it's most of the day to day issues that when it comes to mental health people in the UK and I know from my experience in the U.S. they're not that happy to talk about the fact that they are struggling with panic attacks or anxiety being vulnerable is very hard in our western society. What we're saying is people coming to us saying that they found a great meditation on good zing or they found a psychiatrist talking about why you should see a psychiatrist they've started saying one it has really helped them. So the whole point is that one heals differently. And what we're saying is that people are using good zing very differently to find tips that help. And that makes me very happy.

: That's pretty cool. Folks, if you go to goodzing.com you're going to see they have a very easy to navigate site. You can search topics from a to z.

: I'm going to push back on that and I apologize if anyone is looking at good zing. It's like one of our biggest screw ups.

: I don't think it's bad will cause I think it's pretty straightforward but hey you know we're our own worst critics.

: We're an anti bootstraps starters we didn't take a... because if we did a couple of big VCs in New York said they light up. They were and they wanted us to charge people for access to the well-being tips which went against every core belief of why we're starting this which was giving access to people who didn't always have it. So we decided just to bootstrap it. And it's been a great decision on some reasons. But we are currently working on fixing our UXO. Hopefully in the next two months.

: Well folks I'll tell you it's not that bad. You go to the website. goodzing.com whatever it is that you're feeling right maybe you have a sore tooth today or a migraine or an ear or whatever you go there you find it and you click on it you click on to take for instance and similar to a blog page where you have all the blog posts on it. You have solutions that pop up for that particular one kind of cool and definitely beats googling and getting a bunch of ads and random things try. Good zing next time. Definitely a fascinating platform to find those solutions to the things that may pop up for you or your kids. Very nice. Very nicely done Serena.

: Thank you. The big thing is also that it's user generated so let's say someone out there you have a great tit for eczema just because we were on that topic that your grandmother will buy or that your nurse told you about. Put it and the system is the whole point is user generated content because we all have these great tips on our own hands. Think about all the times you've been sitting around having lunch with friends or at a brunch and someone says I've got a sore throat. You know I can't tell time to be sick. Someone will always come up with a solution. That's the whole thing about it is like let's bring all these solutions into one place and set them all rated and reviewed with all these experts from different backgrounds. Also putting in that helps. So ultimately let's have a top ten list and that's the aim of that.

: Love it. Serena you guys are doing a great job. Can you share time with the listeners when you had a setback or something didn't go well besides your UX of course.

: Yeah. So we've made so many mistakes on the way

: What did you learn from it?

: What do we learn from it as is many. But it's basically as an entrepreneur it's about resilience. It's about philosophy and just getting back up. A year ago we sent out an e-mail that wasn't necessarily the quality that should have been. We got on a bit of negative attention from some UK lawyers and it was actually great because it made us take a step back and think actually we've got to be ten times more responsible than we thought this is. This is how content this has health information and lot of incredibly vulnerable young people out there that any knowledge of health or any knowledge of everything is via Google. So we sort of looked around in different ways we could be about content that we came across something good the well-spoken mark which is in the UK and in the U.S. And basically they're looking at is wellbeing contents and wellness content which as we all know you know you only have to flick through Instagram and you have a young beautiful blogger doing an amazing yoga pose on the beach who's giving a whole bunch of health advice but it's probably not qualified to do so. So what we've watched with this company whilst Berrigan is to ensure that our platform is as keen and who's responsible as possible so all these people are well-spoken man of all work in pharma or health and we've just been clearing things up so it certain topics that were not really going into anymore. We're checking absolutely every expert certification. No tip goes live on the site without our approval. You know we're doing all these things just to be as responsible as possible but you know we should have done that from day one but it was a mistake and we've learned from that and we've actually improved the product as a result.

: That's awesome and the important thing is that you get out there start something and iterate as you go forward.

: Yes and as every startup founder knows no matter what space it is you're constantly learning and you constantly iterating because you think you know what you're building. But actually once people start touching feeling that product, it's a whole different kettle of fish.

: Absolutely. And this message has come up a lot listeners. So hopefully you're taking note don't build it fully and expect them to come. You've got to build it somewhat get some feedback and keep iterating. Just like Serena and her team have. Serena, what would you say when are your proudest medical leadership experiences to date is?

: You see, I would never put myself in the word medical costs for me medical is all the wonderful doctors, it's the wonderful nurses it's the wonderful people who run the hospitals and run sort of what you do you know within sort of medical devices. For me it's more about wellbeing but I would say one of the proudest things is sort of reaching personal milestones so when we launched in May last year May 2017 you know we had a feeling of where we wanted to be a year later in terms of numbers unique to the site and we blew through the roof in five months and then we blew through the roof of our second year goal and actually at the end of year one says the proud moment is reaching those and knowing that we're reaching so many consumers. But the other aspect is this very proud to see people in the medical community starting to reach out to us speaking at different conferences. Basically the medical community. What makes me proud is when they realize that actually sometimes people like me who were the patient were the consumers that were coming at it from a different angle and that we are generally trying to help people when not trying to innovate in a way to get rid of them we're just trying to be there to help people and sort of when names that I really really respect in the industry have given us the OK that they've liked tarsal they've invited us to speak. That's when I get very proud. But I'll be a proud when 100 million people every month coming to this and finding all that solutions. That's what I'll be proud.

: That's awesome. You've done a lot and a lot more to go. What would you say right now is an exciting project or focus that you guys are working on?

: Something quite excited about. So at the moment we've got four categories: habits, emotions, beauty, and common elements which is the one we Sonson off that. what we're beginning to look at now is what are the other categories we should be looking at. So obviously pregnancy and baby two of the biggest ones but there's so many different topics were that. And so we're starting to look at how we can roll that out in the coming year but with that we've got to find a whole lot more experts say you know we're puting for midwives, nurses, pediatricians, doctors we want a lot more mothers as users on the platform so that they can share their experience as you know from babies, teething or what to do when yout ankles are swollen when you're pregnant. So all those kind of topics and sort of continually adding more content to the platform. That's what I'm excited about.

: That is exciting and if you had that category you know I've got a 16 month old I know my wife and I would have been on your good zing constantly. There's always something new.

: That we realize. But you know that's a mistake. You know I didn't have kids. And so when I started this I was like well these are the issues I struggle with. My friend came to me saying mental health. And you know so I went with the ones when you brought in a product you go with what you know and that now a lot more of my friends have kids you know my sisters have lots of beautiful children. So now I'm realizing that actually it's the pregnancy and baby category which you know so many people are struggling, struggling with confidence and we used to raise children in a village. So there were always different people you could talk to.

: Right.

: Now we're all living away from our families and it's a small family units. So who do you turn to for sort of what to do for your kids teething when you find that doesn't work but there might be another roots. So yeah that's our next big project which is terrifying.

: I love it now. It's super exciting as well. Terrifying and exciting and I know you guys will do well. Serena getting to the end of this here. Let's pretend you and I are building a course on wellness and what it takes to be successful in health. It's the 101 Serena. So we're going to write a syllabus four questions that I'll ask you. Lightning round style followed by a book that you recommend to the listeners. You ready?

: Ready.

: All right. What's the best way to improve healthcare outcomes?

: Health literacy.

: What's the biggest mistake or pitfalls to avoid?

: Not trusting your own gut. You know what's best for you.

: How do you stay relevant as an organization despite constant change?

: Constantly innovate.

: What's one area of focus that should drive everything in your company?

: Content, content, content. I might have talked about the UX but at the end of the day we're a content play and all we want is the best content from a variety of sources that people have the best information available to them.

: Amen. I'm right there with his sister. What book would you recommend to the listeners?

: There's two one which I'm halfway through at the moment it's called you True North: Describe your authentic leadership by Bill George.

: Love that one.

: It's so good conscience.

: Gosh it's so good. Yeah.

: And the other one from the wellbeing space is Why we sleep by Matthew Walker.

: Interesting.

: Everyone should read this. If you weren't already obsessed with sleep you will be after reading this.

: Oh boy.

: Even my problem her existed on three or four hours sleep has to change having read this so everyone go and read it.

: Love it. Ok. There you go listeners why we sleep. And true north. All of these things that you'll be able to find on our website just go to outcomesrocket.health/goodzing and you're going to be able to find the transcript, links to those books, link to the website Good zing where you could find trusted ailments from the community that Serena has built. Serena, before we conclude I love if you could just share a closing thought. And then the best place for the listeners can get in touch with you.

: So the best place to get in touch with me is either my email serena@goodzing.com or serenopp on social media. I really just want to say thank you because healthcare is really about bringing people together and so often it's quite a siloed industry so every conference I get into is the medical health, or wellness. It's actually in podcasts and groups like this and if we can bring those two together then we can really enact some really exciting change for the next generation when it comes to health. So really like if we can all work together that's where we can have really good impact.

: Love it, Serena. This has been a blast. Listeners called the action check out goodzing.com for your next little thing that bothers you. You're going to find some good solutions there. So Serena big thanks to you for making time for us really appreciate it.

: And thank you for having me. Stay in touch.

Hey Outcomes Rocket friends, thanks for tuning in to the podcast once again. As a leader in health care, you have big ideas great products, a story to tell, and are looking for ways to improve your reach and scale your business. However there's one tiny problem. Health care is tough to navigate and the typical sales cycle is low. That's why you should consider starting your own podcast as part of your sales and marketing strategy. At the Outcomes Rocket, I've been able to reach thousands of people every single month that I wouldn't have otherwise been able to reach if I had not started my podcast. Having this organic reach enables me to get the feedback necessary to create a podcast that delivers value that you are looking for. And the same thing goes if you start a podcast for what you could learn from your customers. The best thing about podcasting in healthcare is that we are currently at the ground level, meaning that the number of people in healthcare listening to podcasts is small but growing rapidly. I put together a free checklist for you to check out the steps on what it takes to create your own podcast. You could find that at outcomesrocket.health/podcast. Check it out today and find a new way to leverage the sales, marketing and outcomes of your business. That's outcomesrocket.health/podcast.

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Recommended Book:

True North: Discover Your Authentic Leadership

Why We Sleep: Unlocking the Power of Sleep and Dreams

Best Way to Contact Serena:

serena@goodzing.com
Twitter - serenaopp

Mentioned Link:

http://www.goodzing.com/

Episode Sponsor:

 

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Why 3D Human Imaging Will Save Lives and Dollars in the New Healthcare Economy with Aaron Oliker, Cofounder, BioDigital Inc.

Hey Outcomes Rocket friends, thanks for tuning in to the podcast once again. As a leader in health care, you have big ideas great products, a story to tell, and are looking for ways to improve your reach and scale your business. However there's one tiny problem. Health care is tough to navigate and the typical sales cycle is low. That's why you should consider starting your own podcast as part of your sales and marketing strategy. At the Outcomes Rocket, I've been able to reach thousands of people every single month that I wouldn't have otherwise been able to reach if I had not started my podcast. Having this organic reach enables me to get the feedback necessary to create a podcast that delivers value that you are looking for. And the same thing goes if you start a podcast for what you could learn from your customers. The best thing about podcasting in healthcare is that we are currently at the ground level, meaning that the number of people in healthcare listening to podcasts is small but growing rapidly. I put together a free checklist for you to check out the steps on what it takes to create your own podcast. You could find that at outcomesrocket.health/podcast. Check it out today and find a new way to leverage the sales, marketing and outcomes of your business. That's outcomesrocket.health/podcast.

: Welcome back once again to the outcomes rocket podcast we chat with today's most successful and inspiring health leaders. As the time change we have to consider many different options to tackle the problems that we're faced with in health care and resources dwindle. We've got to look at other options that's why today I'm so excited to introduce our guest. His name is Aaron Oliker. He's a co-founder at Biodigital Inc.. Aaron is an entrepreneur, 3D animator, programmer and academic working in the field of medical visualization and 3D simulation. Aaron founded his first medical visualization company called Cyber fiber incorporated in 2000. He's got over a decade of experience close to two decades of experience in this area. And so I'm privileged to really highlight some of Aaron's work here with him. He's been a pioneer in a new paradigm in the field of medical and surgical education. His current focus is the advancement of new features and applications using the bio digital human platform. And it's a thrill to be able to welcome you to the podcast Aaron. Glad you could join us.

: Thank you. It's a real pleasure and honor to be here. I can't believe it's been two decades in the field but things are evolving and I'm very happy to have this opportunity to speak with you.

: It's a pleasure. And Aaron you know you are a pioneer. You've been in this before it was even a popular thing to do. And now companies are starting to look at 3-D visualization as a true option for doing more with less. What is it that's kept you in the game for so long?

: I think the game is always evolving as you say things are getting cheaper. Technology keeps improving and I'm I'm such a techno nerd and an anatomy nerd and these are the things I really love. And I wake up I can do it whenever it's like a videogame game to me but it helps people so I just love the tech and I love the fact that we're doing something positive that improves a person's health. So that's just my motivating factor I guess for us to keep doing it it's just selfish enjoyment at the most basic level.

: That's awesome. And listeners if there's a partner they want to work with somebody that is willing to do what they do for fun for their own reasons that just tend to dovetail into what you're doing. Biodigitals their team over there Aaron and his team have had the privilege of working with some of the largest organizations in health care including Boston Scientific, Novartis, GlaxoSmithKline just to name a few and so I always loved to understand the genesis of it all. Aaron I know you love this stuff but what is it that got you into health care to begin with?

: I think the most basic level for me again is you know my sister was a physician and she actually got she had. And that's when she was about 27 years old. She is a resident. And I was a 3D animator at the time just starting out learning myself. I'm a little younger than her. And just to see her get sick and all these things and all these questions that came up in our minds. I said I wanted to do something in healthcare with my ability in 3D. And that's kind of what led me on this path. I got very lucky and I met a surgeon who wanted to do animations and it turned out that I was the first surgical animation that was ever done. We started our work at NYU in 1999 for a charity called Smile Train.

: Amazing.

: And that was the very beginning of my work in this industry.

: Super cool man. And Aaron, you know I'm a firm believer that coincidence. I don't know if there's such a thing. You know when you're when you're properly aligned and focused. These things do tend to happen. Now you've been in this business for 20 years. What do you think a hot topic that needs to be on every medical leaders agenda today is and how are you guys approaching it at Biodigital?

: So I think the real hot topic right now that's on people's agenda is what's going on with augmented reality and virtual reality and how that's affecting on medicine and for a special device companies, pharmaceutical companies, hospitals. I just came from a conference in Berlin a medical executive leadership conference for pharma and device and I did a presentation on what the direction of augmented reality is in medicine and it seems to be something that's very interesting to a lot of the big companies out there everybody including the institutions as well. A lot of people really want to understand where this is going. I feel like it's it's like the mobile technology of the early 2000s. And I think that's where it's going so I think that's the big hot topic right now. I think it's going to change a lot of things.

: Now that's pretty interesting Aaron. And you know we've had several guests on the show come talk to us about augmented reality and virtual reality the applications being you know hey you know there's fellowship and resident training, there's company sales rep and clinical training, there's a lot of applications that that technology could be useful for can you take us down maybe what you think the top 2 or 3 areas that our listeners could apply this tool to?

: Yeah definitely the education is number one. Education and communication. And that's basically what our product does. Just to take you back a couple that surprised the Biodigital human has is probably the biggest library of 3D interactive assets on the planet. We literally were building. We built out every nerve every vessel, every vein, every bone and what have you and we're building out every disease state and disease condition and you can interact with it in 3-D like we Guler to the human body. And what we're doing now with augmented reality is we're taking it into the real space like you use like a house like. Some people use it with like Pokemon and you're just overlaying something onto your field of view of a smartphone and you're just looking at something and there's like a filter there. But what we do is we use more advanced headset and you're able actually able to walk around and inspect and interact with the body at which is lifesize. So I think it's a game changer meaning where you can look at the body and go through a procedure and have a surgical view would have been impossible before unless you're in an OR or in a certain scenario. So I think it's great for education, for sales, I think it's it's also very powerful because it's something people haven't really seen done well before. And now you're able to see the body and look at it from any angle and look into it and it's like right in front of you like it would be if you were in an operating room or an exam table. So I think it is going to have a very powerful effect once it's in wide distribution with good equipment.

: That's pretty awesome Erin. So as a customer whether it be institutional or even maybe an individual. Do you guys offer it to both just one or the other and how did they how do they access your platform.

: Our platform is a cloud based platform. You can literally on any device you can go online. Just log in and have access to the entire human body and we've got pretty much any disease state or condition known to man and see it in 3D. And the same goes for mobile. So our platform is really device as an operating system agnostic. You should be able to access it from any device or any type of system you're using.

: That's awesome and so as far as as users as institutional users only. And then in that you access it through your institution or can you get it as an individual too.

: So my digital acumen is like I said before it's a cloud based platform so anyone can access it you can be a third grader and get on and explore the body.

: Nice.

: The really exciting thing about what we do is we integrate into other people's systems so we have an application programming interface and a software development kit. So if you're running a school or a student or something you can go on to Biodigital human and explore. Like you would like Google Maps.

: Amazing.

And just like if you're like me and you're like an anatomy geek geek and you want to just just mess around and look you can look and look up everything you can see the beating heart and dissect the heart. I look up a bit. This is where you can hear in the way we work with device companies and clients is a lot of times they'll integrate our system into their website or they'll add their CAD files to our system and you can visualize how devices work inside the body. You can create a procedure for you so you can see a procedure step by step. You can see how the device affects the body. You can create air your pathways if you're a pharmaceutical client or a pharmaceutical, we go mechanism of action but it's interactive it's not just an animation and rotated. You can interact with it. You can test it you can test people on it and that's essentially how it's used where we use different types of configurations whether you're configuring for you know an MOD or you have a new device or you're doing training or something along those lines. We customize the system to whatever the client need is and they can disperse it internationally on all devices and in multiple languages for all the different users that target audience might be.

: That's super powerful and super powerful. And to know that the base of the technology exists kind of like that like you said right the Google Earth for the human body. And then when companies or providers or anybody wants to make use of it they just go, reach out to you guys and then you guys find a way through API and SDKs or whatever get access to what you guys are doing to make it a playable to their particular needs?

: Right. Very much so. And a lot of times what we want to do is make it cheaper and easier for people to get access. Like you said people have less resources and less time and things are always getting more demanding. So think of it like almost like a Lego set and you have all these different building blocks and so if you wanted to do something yourself you know you wanted the storyboard something or or just add a condition to a Web site. It's very easy just to come in and you know like a YouTube movie and you get embedded into a Web site or into a mobile application or you need something more complicated. We definitely do a lot of different complex projects for enterprise projects for the large institutions and organizations.

: That is outstanding. Now you guys are doing a lot to improve outcomes in this way. Is there one particular thing that sticks out Aaron as something that has been just amazing that you guys have accomplished?

: Yeah you know there were several great projects that we've worked on in a couple come to mind. One is the outcome health project. You know it's wallboards that people use that point of care for patient education and essentially what happens with these Walboards that in doctors offices and doctors to the patients. And right now that technology was embedded into 50000, 50000 doctors offices around the country. It's not just that one client but several different clients that yes you add to that in that capacity and you hear the testimonials and it's amazing. So better to think of it as a point of care application. A 3-D technology is very powerful because the better you can communicate with your patient population and they really truly understand what you're saying the more likely it is for them to take that advice and regimen to heart. So you're going to get better patients because they really understand why the why they should. They're not just talking at the patient they're talking to the patient in a way that the patient understands and that it's extremely powerful. So for a point of care we find this is one of the most powerful usages of our technology to really connect with the patient alleviate their anxiety, to really communicate them about what's happening inside their body in a way that's very quick and easy to understand really efficient and something that can affect their behavior which is probably the most important part.

: Now at super critical and for those of you listening that are providers looking for ideas to take your practice and outcomes to the next level. Think this is a really great education and communication tool as as Aaron described it to help patients really understand and level set with providers at the point of care. Aaron how about on the other side of this. Have you had a setback in your journey. And what did you learn from that setback that you could share with the listeners?

: Oh there's there's always a setback. Many setbacks. I think one of the biggest things that I can say is it's just before we had a platform we really did a lot of one off projects that were very expensive to create very expensive to maintain. And that's what led us to this. And I say it's a failure because it drove us to some difficult times because we we really needed was just so hard to maintain many different applications that were so. And we spread ourselves kind of thin as a result of that and what we did the positive thing as a result of this kind of failure to create a more consistent to have a system in at these one off projects is to create the digital platform was born out of that that failure to have a consistency where you're trying to reduce cut costs really and create something that that's very high quality for our clients and like easy to maintain. So the failure I guess was just not having that consistency in technology which is very difficult to do. It's a learning process I guess.

: Yeah, so you guys went through the pain of having to figure this out going from individual projects that were expensive tough to maintain. And then you sort of hit this point in the road where you're like we've got to fix this and that's when the Biodigital platform was born. What is it that makes the Biodigital platform so I guess able to serve so many customers. Because you guys serve a ton of customers.

: It's the technological evolution that made it possible. In about 2000 when we wanted this to happen. We knew kind of struggling with the way the system was and in 2011 when she came out web G.L. like the graphics card because the games the graphics started improving in the computers and mobile technology really started improving in about 2011 web G.L. came out where he didn't need a plug in because before you have that the reason you have to maintain all these different graphics cards and all these different things and the big companies like Apple like Google and Firefox got behind putting 3D in a browser. And so what that allows us to do was just focus focus on delivering 3D. Like you didn't have to download anything you didn't have to have certain dry resolves whatever crazy stuff that happened a decade before and now because of that it was just say OK let's just focus on making awesome content. Let's just focus on making one really great engine and that's what we did. The more focused the more you can kind of narrow how much how many technical things you have to do the better the outcome is.

: That's so cool. And I appreciate you walking us through that air and you know it's been an evolution and folks like I was telling you before you know if you're looking to partner with somebody in 3-D Aaron and his team literally have been around the block and back several times and they've seen an entire shift in our ability to access technology as it sits today even in the actual browser. So take a look at what they have to offer. Their Web site is biodigital.com. They've got some pretty cool demos available there. Aaron this has been a blast to walk through. If you had to say right now and one of the most exciting focus areas in your company is today what is that?

: Yeah I think like I mentioned before the augmented reality in our expanding library what we're doing right now is very exciting. It's something that I'm leading and I'm really enjoying every minute of it just because you're taking something from a flat screen just like put things in the browser. Now you're taking it out of the computer and putting it into like a real space. And I think that it's super exciting and it's a real experience so I'm very excited where everything is headed on that front.

: Yeah and let's just take it a little glimpse at the med device piece of this. You know folks if you're looking to use augmented reality, you buy yourself a pair of those glasses. Let's just say on the high end they cost you five six hundred bucks and you are able to provide your sales force, your clinical people with training from home. And they don't have to fly. You don't have to get them hotels. All of this is going to save a bundle with technologies like the one Aaron is talking to us about. So if you're not excited about this I think it's time to learn a little bit more because it is truly an exciting time and we're turning around the corner of some excellent efficiencies. And would you add anything else to that?

: Yeah you know and not just at home but just like conferences people eat it up. It's really great just to run the sales and one of our med device clients that uses it was telling me that you know they really once you have that one of these headsets on their people they're not going to you're not going to run away that easily. You really get a good conversation going. So it really does lead to some good great conversations with prospects and whatnot if you're doing the sales on that conferences. So that's another great way to use for sales.

: So awesome yes. So so many great applications so if you haven't started thinking about this I would add this question to your arsenal of potential problem solving questions. How can I use 3D how can I use augmented reality as part of a solution to my problem. So Aaron Timeflies and you're having fun getting close to the end here. Let's pretend you and I are building a medical leadership course on what it takes to be successful business and medicine. The 101 of Aaron Oliker and so we're going to we're going to build a syllabus here for questions lightning round style followed by a better that you recommend to the listeners are you ready.

: Yeah.

: Awesome. What's the best way to improve healthcare outcomes.?

: It's a safe focus. I think to have the best communication possible with your patients. And that means that really great communication if you can communicate well with your patients, if you can communicate well with the surgeons that you're training with your clinical staff, you're going to have great outcomes.

: What's the biggest mistake or pitfall to avoid?

: Spreading yourself too thin trying to do too much in too many areas. If you end up doing nothing well jack of all trades and a master of none. So I say it's really important to stay focused and to really master one thing at a time at the very least.

: Love that. How do you stay relevant as an organization despite all the constant change?

: You work really hard. You really have to stay on top of technology. You really have to stay on top of what's going on and have a great team. I think the other thing is just love what you do. It's sounds that kind of a corny cheesy thing to say but to really stay on top but to really work hard you got it. You got to enjoy it. So that would be my answer.

: Love that. What's one area of focus Sessa drive everything in a health care company?

: Outstanding experience for the end-user. I think the more you focus on creating a really fantastic experience. Easy to understand just intuitive and natural. I think you're going to be successful.

: Love that. And finally Aaron what book would you recommend to our listeners?

: A great book that I like. It's more of a business book right. It's Dog by Phil Knight the Nike story.

: Love that. Oh yeah, oh man, it's so good.

: Yeah. And you just listen to the struggles he goes so it's an incredible book and fun to read. I got a lot out of the in a couple of times.

: Folks.

: I recommend that book.

: Great recommendation my Aaron there shoe dog by Phil Knight the founder of Nike. Incredible story inspiring. Much like Aaron's story and the path that he has taken and now where where his technology and him and his team are taking this so if you have any questions about today's interview, you can go to outcomesrocket.health/biodigital, B I O digital and you're going to be able to find all of the show notes the transcript as well as links to the resources discussed here today. Aaron if you can just leave us with a closing thought and then the best place where the listeners can get in touch with you.

: Yeah my closing thought would be that it's a really exciting time in medicine and technology. All these different technologies are converging to create better experiences for education, for physicians. And it's just it's really a lot of fun. And if anybody wants to check out what's going out the body is like our system is constantly evolving, please check out the site. It's free to just get on in and look at it. So I highly recommend just going on and taking a look at some of the stuff we have to offer. I really appreciate that.

: Outstanding Aaron. Absolutely. So take that call to action folks go to a biodigital.com and check out the platform that they're offering here. And again Aaron just want to thank you for carving out some time for us to discuss this innovation and we're excited to stay in touch with you.

: It's a real pleasure thank you. The honor and a pleasure. Thank you so much.

Hey Outcomes Rocket friends, thanks for tuning in to the podcast once again. As a leader in health care, you have big ideas great products, a story to tell, and are looking for ways to improve your reach and scale your business. However there's one tiny problem. Health care is tough to navigate and the typical sales cycle is low. That's why you should consider starting your own podcast as part of your sales and marketing strategy. At the Outcomes Rocket, I've been able to reach thousands of people every single month that I wouldn't have otherwise been able to reach if I had not started my podcast. Having this organic reach enables me to get the feedback necessary to create a podcast that delivers value that you are looking for. And the same thing goes if you start a podcast for what you could learn from your customers. The best thing about podcasting in healthcare is that we are currently at the ground level, meaning that the number of people in healthcare listening to podcasts is small but growing rapidly. I put together a free checklist for you to check out the steps on what it takes to create your own podcast. You could find that at outcomesrocket.health/podcast. Check it out today and find a new way to leverage the sales, marketing and outcomes of your business. That's outcomesrocket.health/podcast.

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Recommended Book:

Shoe Dog

Best Way to Contact Aaron:

LinkedIn: Aaron Oliker

Mentioned Link:

BioDigital Inc.

Episode Sponsor:

Wearables and Their Power to Improve Outcomes with Pierre-Jean "PJ" Cobut, CEO & Co-Founder at Spryhealth

Thanks for tuning in to the Outcomes Rocket podcast where we chat with today's most successful and inspiring health leaders. I want to personally invite you to our first inaugural Healthcare Thinkathon. It's a conference that the Outcomes Rocket and the IU Center for Health Innovation and Implementation Sciences has teamed up on. We're going to put together silo crushing practices just like we do here on the podcast except it's going to be live with inspiring keynotes and panelists. To set the tone, we're conducting a meeting where you can be part of drafting the blueprint for the future of healthcare. That's right. You could be a founding member of this group of talented industry and practitioner leaders. Join me and 200 other inspiring health leaders for the first Inaugural Healthcare Thinkathon. It's an event that you're not going to want to miss. And since there's only 200 tickets available you're going to want to act soon. So how do you learn more? Just go to outcomesrocket.health/conference. For more details on how to attend that's outcomesrocket.health/conference and you'll be able to get all the info that you need on this amazing healthcare thinkathon. That's outcomesrocket.health/conference.

: Welcome back once again to the outcomes rocket podcast where we chat with today's most successful one inspiring health leaders. Man we talked to so many awesome folks here on the podcast but today I have a special treat for you. His name is Pierre-Jean Cobut also known as PJ. So wanna tell you a little bit about P.J. P.J. is the co-founder of Spry health. Spry health has a mission to help chronically ill patients receive proactive care and help them stay out of the hospital. He got his MBA from Stanford. Pierre is an experienced entrepreneur with expertise in strategic and online marketing sales and finance. Pierre is passionate about empowering people to make positive change and he's doing that at Spry health. Chronic diseases are a problem that we're all faced with, people that we love are faced with and oftentimes don't know what to do it could be confusing and for health systems too are big confusing area about how to manage populations well I had the pleasure of introducing P.J. Cobut to this podcast so we could talk a little bit more about spry health does and his experiences in health care. So P.J. It's a pleasure to have you on.

: Yes pleasure being here. Thanks for having me.

: Absolutely. Now is there anything in that intro that I left out that maybe you want to share with the listener or something you want them to know about you.

: I think that's a pretty good intro. The mission of the company is probably most important to me and as he said chronic condition is a really complicated problem. It affects a lot of people and often people that have to struggle with a lot of other difficulties socio-economic difficulties as it's a problem that we really really care about here. So thanks for putting that in the center of this intro.

: Absolutely my friend and he is a huge issue. You know and one that you guys are tackling excited to go into some of the things that Spry health you and your team there are doing. But before we get into that, I'd love to kick it off with understanding more why you decided to get into health care.

: Yeah absolutely. So this is my my first healthcare company. For me health care has been you know something that's been on my mind for a long time I was a premed in college back in the early 2000s. So initially wanted to be a physician but then pretty quickly realized that you know med school and the lifestyle position wasn't really what I wanted to do and so you know some took another route. And did an undergrad and a master's in engineering and business and worked in consumer goods for a while and started another company back when I was still living in Europe and you know decided that they're coming from a time where you've invested a lot in your education and your career. And there comes a time where I think you really have to back home and really do what you care about and what makes you happy. So for me that was starting help your company and because I found that to be you know I guess it was an old dream of mine. And I find that to be a super impactful industry where so much change is needed where were opportunities for business are really there where specially in this country in the past few years there's been big changes on the regulatory front and then create other opportunities to really kind of the right time for me.

: That's outstanding man. What a great background. You know you went from wanting to go into med school but then had the foresight of seeing sort of the quality of life things that sort of clash with your idealism and now you're from a small circle had some successful entrepreneurial ventures doing which you love. You are so cool. Exactly. That's so cool man. So now Spry, so with spry healthy. How would you sum up in a few words what you guys do what problem you guys solve and who do you solve it for them?

: So we're focused on providing people who have chronic conditions with the right care at the right time. And what that means is when you're honestly it doesn't matter who you are. You put a actually someone who is at risk who has several chronic conditions the time that goes on between your interactions with a physician the other route large even someone who has T-3 chronic illnesses don't see a physician maybe three 4 times a year for about 10 minutes. But what happens in between. That's really kind of what we're focusing on is understanding how someone's conditions evolving over time when they're not under the direct supervision of a physician. Understanding you know how their physiology is changing so that when something doesn't look quite right we can get them help. That's the idea.

: Excellent. So PJ are your customers health care organizations that aid the patients themselves, are they ACOs?

: Yes. So I mean we're still relatively early on our journey with customers. But the sweet spot for us is working with payers that are providing some level of care. That's what we found to be really the best the best place for us. So you said you know a CEO's health plan like Medicare Advantage plans that are providing some level of care France's primary care. Obviously all the way to big integrated systems that are doing absolutely everything and then that's something that we've found to be the right spot for us because first they have the financial incentives to really keep people out of the hospital and drive the best possible outcomes. But then second they also understand the realities of what it's like to provide care for this population. You know that is the higher risk and more complex and so we'll work with patients the patients don't pay us. We work directly with the health care organizations.

: Got it. Fair enough. PJ hot topic what do you think needs to be on the top of every health leader's mind today and how should they be addressing it?

: There is one thing that I'm particularly interested in that has become sort of a hot topic but in my mind often is mostly words and pretty marketing but without much action behind that. And that's you know the idea of patient centric is I think it's kind of interesting how everybody just works in healthcare and is focused on you know driving the process and building value etc. etc.. But sometimes we forget that healthcare is fundamentally about people that are this idea of patient centricity is something that's come up a lot in the recent year or two maybe. But I think there's still a lot of work to be done. And I think in our particular space that you can kind of generalize under the category remote monitoring right to really understanding what's going on with people when they're outside of the walls in the hospital the traditional way of doing this has been well you package like five to 10 medical devices and a big box. You send them to somebody at their home and you tell them hey like why don't you use these every day maybe twice a day. Write down data with data and then that way we can help you. And that's like in my mind that is the absolute opposite of patient centricity because it's really not thinking about what's it like to be someone with multiple chronic conditions. And then I think you know this is something that I care a lot about and talk a lot about that you should go and walk a mile in the shoes of someone like that and really understand what it is that they need. What are the biggest things they struggle with. How can we build a product that engages them and bring them value in a way that they've never seen before that really helps them navigate the difficulties of facing everyday a chronic condition or several. So that's not something I care a lot about but I think some healthcare organizations are really starting to work on. But as I said I think there's still a lot of progress that can be done.

: As such a great point PJ, how do we bridge that gap year opinion what's the best way to bridge it?

: I mean I think it's basic empathy I think is the way I think about it and in our company we spend a lot of time on user research which basically get out of Silicon Valley. You go to places where technology isn't really a thing or not. Not that much you go meet the people that are potentially going to be your users who are older who maybe live in government housing, who don't have a steady paycheck are struggling with congestive heart failure COPD chronic kidney disease diabetes and you spend a lot of time with these people and you ask them a lot of really tough questions. And a lot of really personal questions that you really get to understand. What's it like. And I think this is something that's obviously really really needed and really true for startups and even more generally speaking for med tech companies even the large ones I guess would maybe even benefit more of this. But I think even when your paper for instance really sending people to understand what it's like to know how to serve them that I think is really critical. And again you know you definitely see companies do a really good job of this. There's a lot more that can be done.

: Now you've highlighted a really great great topic there PJ. You know we definitely have to understand what our patients are going through better and higher. Right. I mean with so many factors and so many players in the system the system is built in such a way for it to be B2B so the the consumer the Haitian sort of gets left and the other thought here is while we walk a mile in the patient's shoes I was talking to my mom the other day and she was telling me about my grandfather. He's got diabetes and it's from a caregiver perspective. Her and her sisters are taking care of him. And they caught them coming back from the store with a bag of coke, Coca-Cola you know and my grandfather loves the Coca-Cola man. So he's just like sneaking Coca Cola's into his house. So what do you do. How can you support caregivers because they're the heart of this too. Right.

: Huge huge. We've spent a lot of time talking to caregivers as well and understanding their view of what it's like and what's difficult. And I think companies like ours again small or big have a huge role to play here where there really can be a win win win. So win for the patient and a win for the caregiver and a win for the health care organization. But it just requires a lot of work and a lot of time trying to really understand what makes these relationships complicated and what you can provide that you know kind of reconcile everybody. That's a really interesting topic in my mind.

: For sure. Hey. So P.J. tell us a little bit about how Spry health has created results or improved outcomes by doing things differently.

: So we were about four years old though as a company and you know maybe two and a half years of that time has it has basically been pure are in the building the technology that's enabling us to do what we do. So we're starting to roll out hybrids. Now I'm starting to see people really interface with with the product and with the technology. So I think it's a little early still to say that we've really improved our terms. But I'll tell you when you know when we do sit down with users and we don't want to buy them right. We talk a lot about their issues and what's difficult etc. etc. But then we always finish that time with them by a presentation or what we do and why we're here and what this product could do for them and that's a really proud moment I think when people feel like oh we're like this is really amazing like the idea of giving them a product that looks consumer feels consumer but is really medical a product that enables them to always be connected to the physician. You know if anything looks a little wrong that somebody will help them. So this idea of having a sort of a safety net really. And the idea of helping them with medical information but is translated in a way that they understand and that they can really act on that gives them you know the peace of mind that they're looking for. Kind of the reaction that we get from people is always really heartwarming. So I don't know if that's really an outcome just yet but as you know in a sense it's a it's an indication that this is a product that will really help people with what they need.

: Yeah it'll resonate you know. Absolutely. And while you guys are early on I think you're doing it the right way. You're doing all the research necessary at pushing out solutions that you think may work. You're doing all the hard work getting all the answers. There's a lot of companies that don't do that and they're faced with the bad news that it's not going to work. So you know the other thought for you P.J. and your team is you guys have done four years of work and four years of research. What you know and what you have learned is valuable and a platform where you can disseminate this information to others can also be something of an interesting platform of information for cash flow that will help other companies become successful in this space.

: Yes absolutely.

: Just as an option but definitely not something that you guys have to do or don't want to do but just kind of something that came to mind. Right. We don't get a lot of the time here on the podcast talking about breaking down silos and what I find is a lot of times people do the same work over and over again and you know resources are wasted.

: You know I think that's absolutely true. The way we you know sort of leverage that all of that research all that learning that we've done so far obviously goes right into our business and our product definition and how we talk about it with companies that may end up being customers. But it's also doing things like talking about it because the reality is these themes and the methods they're not new, they're just not necessarily always applied in healthcare where the needs are huge. And honestly every company that is working on anything that is remotely close to healthcare and improving outcomes should really be doing that. So whether it's doing podcasts or mentoring other entrepreneurs you know that are there at an earlier stage in your journey like all of those are impactful.

: That's right on point brother. I really agree and it's awesome to have you here to chat about some of these things. Can you share with the listeners a time when you setback and what you learn from that set back?

: Do you have all day? And what we learned. Sure. Yeah I mean this is maybe something that is really interesting to people who are starting to think about starting a company of their own and maybe are good or students or you know just kind of in the early stages of thinking about that. You know I think one mistake we made early on when we were looking for our first round of funding and this is I guess it isn't necessarily healthcare related to really apply to any startup that is looking to raise money. But we know we were fortunate enough to have met an investor that we had a relationship with that eventually grew into him telling us he was interested in leading the rays of our seed which was really exciting for us because you know we could definitely use the money. And also we really liked him as you know that was a really great moment and the error we made as we thought well you know everybody's always told us when you get a term she is like that's the part. After that it's always easy. So we kind of went around town. We had some other investors that we knew and we thought well now for sure we're going to raise that around two weeks or something and then we can go back to work. But I think what we realized was a real mistake that first of all that none of this is true and investors don't just throw money at you just just because you have a term sheet is because you have shown some progress. And it kind of made us learn the hard way really the importance of managing relationships on that side too which obviously you do a lot and you know internally with employees. You know we build a lot of spend a lot of time building these relationships. But with investors to kind of decoupling the risk around the business risk and the personal risk in many more time with investors when you don't actually need money to understand what they're about so they can understand what you're about. And then when the time comes up where you actually need money then they already know you they're already comfortable with you and then the discussion shifts a little bit and we kind of realize doing all of those in the span of an hour just was never going to happen then. So that was a really difficult time for us are kind of getting hit in the face with all these realities of being an entrepreneur. Fortunately we did learn a little bit from them and managed a lot better the next time around.

: Such a great share, PJ. And now you guys are investing the time up front. I forget what the saying that is like dig your well before you are thirsty. Yes I would definitely yeah dig your well before you're thirsty and solicitors take that into consideration. I mean I think PJ's is offering here his wisdom is is one that comes from experience and one that you should definitely take into consideration if you're a startup looking to raise some funds. Really appreciate you sharing that PJ.

: Absolutely.

: So tell us about the other side of the coin, PJ. Tell us about a time where you were most proud of in your leadership career.

: Yeah that's a great question. There's several things that come to mind. I think it's interesting because when you're sort of at the top of the organization and it doesn't really matter how big or small. But I find that to always be true or seem to be true that you know there's never really going to be somebody who's going to be giving you pat in the back and telling you a good job because that's where you're supposed to do for everyone else. Right. So I found my own journey as an entrepreneur and as a leader of this organization to try and find my own sources of joy and pride. And couple things that have come to mind. I think one that we already discussed that when I talk with a patient or you know someone with a chronic condition and understand their issues and then when they give me feedback on what we're doing and the way we're doing it that's always a huge huge high for me to hear how much we could help improve their lives. I think the other one that is kind of more of a constant feeling that I have are when I look around that team that we've assembled and you know how smart and friendly and caring all these people are and how well they work together that's a huge huge moment of pride for me. I think that's the best feeling in the world and when you do what I do.

: Yeah. It's a great point. PJ You know I mean it is kind of thankless when you're when you're hearing the organization and assembling great teams it's hard and it's hard to find great people that are aligned with your mission. But it sounds like you guys have done a really great job about that.

: Yeah I mean it's I think it's it's hard and it takes time. But what we've always done and you know now that we're starting to be at a point where other people are going to start to make hiring decisions. What we always tell them is don't settle. Really have a high bar. Every single time and that means it will take more time to get somebody on board. Did you have to take all the boxes as you said like do they really care about this mission you know. Do you want to. You want to feel privileged they are working with that person. You know it's either because of who they are or their technical jobs or whatever. But never ever ever lower that bar. But I think that pretty well so far.

: Love that PJ. You're setting a high standard there and yeah it's exciting it's exciting yes you are actually. I mean high stakes right.

: Exactly. Like when you think about the start of journey. I mean it's really you against the world which makes it a little bit insane. But the only way it's going to work is if you have the absolute best people around you to to work with you on that. There's no way around it.

: I love that man. Yeah. One of my favorite sayings is you are the average of your five closest peers and if you hire somebody that has a low average they're going to pull your group down.

: Yeah or up. Right.

: Exactly.

: The other expression I heard from I can't remember who it was. But it was somebody who was a guest speaker when I was in business school who said his objective as a leader was to hire people that were much smarter than him so that he would be the absolute dumbest person in the room..

: Love it man I love it. Yeah and I had a chance to stop by your site and take a look at some of the very talented folks on your team. No doubt some heavy hitters there. Congrats and kudos to you and your partner for assembling such a great group.

: Certainly that's one of the best compliments you can make.

: Amen. It's the truth. And listeners by the way if you're curious about what spry health does and you want to check them out a little bit further go to spryhealth.com and you'll find their site their solutions. And what they do how they do it and news updates that they post up on there and definitely check them out. spryhealth.com. So.

: And job openings as well.

: And job openings so they're looking for new roles. They're growing company folks so check them out. Whether he be a provider looking for solutions for your chronically ill or looking for if you're an individual looking to make a career leap into a company that's innovative with the high standards culture spry as a place you got to check out. So I mean it's crazy how fast time flies. But this has definitely been a lot of fun.

: It really does.

: Let's pretend. PJ You and I are building a medical leadership course on what it takes to be successful in the business of healthcare. It's the 101 course on P.J. Cobut. And so. Here's the man, we're going to do a lightning round so speedy answers for questions followed by your all time favorite book. You ready.

: Sure.

: All right. What's the best way to improve health care outcomes?

: Put people first.

: What is the biggest mistake or pitfall to avoid?

: I say I'm going to try to be super short and this is something we see a lot in Silicon Valley. But you know healthcare isn't an industry where you have to follow the rules so go fast and break things is not a part of it.

: How do you stay relevant as an organization despite constant chang?

: This is where I started. Do I think we are the change right. So it's all about innovation it's all about spending a lot of time with with a lot of different people in this industry getting the best possible opinions and then going as fast as you can.

: What's one area of focus that should drive everything in a health organization.

: I'm going to repeat myself. It is people patient first. What do they need. What is their biggest issue that isn't just medical? Sometimes it's logistics getting to the hospital. Sometimes it's behavioral biases so thinking bigger and according to a more dimension. That's the most important.

: Awesome. What would you recommend as part of this syllabus PJ.

: Well it's a book that has nothing to do with healthcare but you know being a French speaker I'll have to go with a French author. The Little Prince by something that I recommend is a classic. So probably a lot of people read it but it is in my mind one of the most. One of the best books about personal growth personal development and relationships with which applies everywhere does not have to be about healthcare.

: That's wonderful. What a great recommendation. Always like the off the beaten path recommendations. You need a break from the health care books. You know the business.

: You do, yes, absolutely.

: Love that listeners. If you've listened to this before. Say it again. All these amazing resources are transcripts the show notes you could find all those and outcomesrocket.health/spry. And there you'll be able to find a link to the books the company as well as all the things that we've discussed it's been so much fun. PJ even the good things have to and so what I'd like to do is just offer you an opportunity to give the listeners a closing thought. And then the best place where they could get in touch with you or follow you.

: Yeah absolutely. You know I think what I said earlier when we started the interview around there's so much to do in healthcare. Go and find something that you really really care about and go make a change. There is so much to do. So few people doing it. And I do fundamentally believe that doing what you want and having an impact is really what makes somebody happy. And if it's not done then you know what else. There's no other point that would be my parting thought and to you know follow us on Twitter. Twitter handle is spryhealth as you said spry we post a lot on LinkedIn as well. Easy to find I'm on on Twitter too I post a lot about health care but all kinds of other things my Twitter handle is pjcobut and that's about it.

: Outstanding. P.J. Hey thanks for that those words of encouragement listeners. You can't just be somebody that watches on the sidelines. If you have a vision like P.J. said, go for it. And there's not enough people doing enough so be one of the few that stands up and goes for it like PJ suggests. PJ this has been fun. It's been inspirational. Really appreciate the time that you've dedicated to us.

: Yeah well that thank you so much. I really appreciate all the questions and also had a good time. Yeah. Thanks so much, Saul

Thanks 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 could get together to 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 and be one of the 200 that will participate. Looking forward to seeing you there.

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Recommended Book:

The Little Prince

Best Way to Contact PJ:

@pjcobut

@SpryHealth

Mentioned Link:

http://spryhealth.com/

Episode Sponsor:

How Video Games can Improve Your Health with Anna Sort, Engagement Design Expert, PlayBenefit

Thanks for tuning in to the Outcomes Rocket podcast where we chat with today's most successful and inspiring health leaders. I want to personally invite you to our first inaugural Healthcare Thinkathon. It's a conference that the Outcomes Rocket and the IU Center for Health Innovation and Implementation Sciences has teamed up on. We're going to put together silo crushing practices just like we do here on the podcast except it's going to be live with inspiring keynotes and panelists. To set the tone, we're conducting a meeting where you can be part of drafting the blueprint for the future of healthcare. That's right. You could be a founding member of this group of talented industry and practitioner leaders. Join me and 200 other inspiring health leaders for the first Inaugural Healthcare Thinkathon. It's an event that you're not going to want to miss. And since there's only 200 tickets available you're going to want to act soon. So how do you learn more? Just go to outcomesrocket.health/conference. For more details on how to attend that's outcomesrocket.health/conference and you'll be able to get all the info that you need on this amazing healthcare thinkathon. That's outcomesrocket.health/conference.

: Welcome back once again to the outcomes rocket podcast where we chat with today's most successful and inspiring health leaders. I really thank you for tuning in because today I have an amazing guest in healthcare. Her name is Anna Sort. She's from Barcelona, Spain. The beautiful country, beautiful city. She is expert in engagement and design. She's the CEO and founder at PlaBenefit gamification. She's an entrepreneur, a nurse, a professor in various universities. She specializes in health gamification. She's intrigued by video games, human behavior and positive psychology. Her motivation is to bring what makes us happy playing games into taking care of our wellness and health. I'm so excited to have Anna here on the podcast because she really brings forth her passions and a lesson that you don't have to solely be passionate about health care to be successful in health care and bringing solutions, you could bring forth other passions such as game design to do that. So I really want to just give a warm welcome to the podcast Anna welcome.

: Hello. Thank you for having me Saul.

: It is a pleasure Anna. So did I leave anything out of your introduction that you want to share with the listeners?

: No. It was impressively true.

: Thank you. Thank you. Well you know Anna, we've had a chance to connect before the podcast but I didn't get the story about why you got into healthcare so maybe you could share that with us.

: So I wanted, I ended up studying nursing and I think my deter was more like how does someone that the nursing or the health care sector end up in the technological sector, maybe. So for me, my turn away is I want to go back to France to study because I did an Erasmus there which is an exchange program for student. So I find a job in Paris where I went and it was on the media sector. So you have a company that's over 600 employees in Paris, you need to have a nurse full time and that request me.

: Wow. Very interesting.

: So I was at a company called Blizzard Entertainment. You might know it from games that just will work rapter Overwatch.

: Oh yeah.

: Do they have like 21 million players just to over what..

: Very big company,yeah.

: Exactly. It's very very big. So I was there. I'm a gamer myself as you describe. I actually was playing World of Warcraft at the time.

: Nice.

: So to be in a company where people actually does the game, it was a little experience for me.

: Yeah.

: So after a while you know I was working there for a while until one of the guys I mean these company was super young like the average was probably 30 or something like that I was really really young. So after a while I was doing a lot of prevention because there were people that were sitting in the chair all day, went home had a pizza at SUTS again in the computer play games so lot's of prevention to there. So one time, one of the guys had a pulmonary embolism between the other things.

: Oh boy.

: An undiagnosed diabetes yet that's a very serious medical problem. And it was like 24 hours before it was not reversible so that was very lucky.

: Wow.

: So anyway so he came back and when he came back from the hospital it was up to me to give him his diabetes introduction and medication. Right. So I did as I was told at university. I sat him down on the table talk to him for about an hour about diabetes with questions and everything and that gave him a pamphlet and said see you in two days. So what happened. So after two day he came back and it was like they hadn't like pulled him like..

: Same thing.

: He like remembered about 10 percent of what we talked about. And this is he, this is I mean this is important.

: Super important.

: So I will play what happened here. Try to analyze what happened because I knew this guy was really smart because he was playing World of Warcraft at the high level. And let me tell you, World of Warcraft is way more complex than diabetes.

: You've got to be on your game. You got to be on A game to be at that highest level of World of Warcraft.

: Exactly. This is way more complicated. So it is definitely not a you know he's got smart type right.

: Right.

: So like should I do diabetes more like they'd do World of Warcraft?

: Interesting.

: To have people learn more about what it is.

: Yeah. So here was my turning point that my moment of realization that someone asked me who had a passion for helping people and a hobby that were a video game that I had to put them together in order to make help fun so everybody would want to do it.

: That's awesome.

: So I came back to Barcelona. I did masters. I mean at the time there were no masters we're like digital and health connected. So I ended up being one of the Masters that had like a health branch but you need to be a programmer like I was with programmers and with designers and it was me. The only one that had ever been there. I had to take a course on programming you know in the summer because I couldn't get it if not.

: Yeah yeah.

: So I did these masters and they talked about really cool things actually from the five pieces that they offered, three of them were had to do with health care because there were like things to help with rehabilitation and platforms to help encourage exercising through the games, right? And stuff like that. So that was interesting. Like what has this to do with health care.

: Yeah, interesting. So I learned about serious games which are games that are designed to actually learn something beside just being fun. I learned about a gamification which is what I do mostly nowadays which is how can you have people getting into these gaming mindsets in real life with real challenges. And I also learned about executing platforms which are the platforms that you do exercise through games. So I thought this is an amazing world that I wanted to get in. So I started after awhile, after I started Play and Fit which is my company. And we do consultancy for hospitals and pharmaceutical companies and any other company that designs digital solutions for healthcare that they want to have innovation as in gamification in them to have more engagement from their users piece a cake.

: Very cool. And thank you for sharing that story Ana. So anybody looking for if they have digital solutions if they're looking to add a a more jazzy or better gamification solution to it. You're the person they call?

: Yes definitely. And I've even had people from outside healthcare do it because I figured out that, if I wanted to do it like the proper way I would have to do behavior change on it. So we do like the basis of behavior change and then add gamification on top of that. So that's a really effective gamification approach to take. So people from outside they're like no, but we are convinced that you're going to help us better than other doctor you do the thing you know and I'm like Yeah but you know I'm a nurse right?

: That's too funny.

: So yeah.

: I love them.

: And another funny story. There's actually WoW diabetes add-on, so you can download an add-on for your World of Warcraft where your character from level 1 to level 10 have diabetes.

: No kidding? Are you serious?

: It's really furious.

: So your character in World of Warcraft could actually have diabetes?

: Yeah this.

: Was this you're doing? They do this because of you?

: Yeah this was one of my earliest achievements when games for health which is like a Congress here. And I was like I have an idea, I want to do this and then I like I was playing the game. I knew what you could do inside the game like how could you record exercise to put it this way and happened on your sugar in your blood. And like the game has tons of food so I knew I could use that to like having an impact on your chewer and your bod as well. So I guess so I like this I did the whole thing. And then Rochester Institute of Technology professor there called Steve he was like OK you know I see your thing. Let's do it. And we made it.

: That's awsome. Folks, there you have it. You know if you have an idea don't be afraid just go for it. And Anna saw this opportunity to introduce a very real problem of diabetes. You know a lifestyle condition that needs to be introduced even to the day to day gaming part of the world. So she just did it and that's what we have to do here you know in health care, it's about implementation, not just innovation. You've got to find out ways to make these ideas happen. So Anna you've done quite a bit in health care. Can you sum up what you think a hot topic that needs to be on every leader's agenda today?

: Yes. So what I think is most important and where we fail most of health care actually is health care prevention. So we know that a lot of chronic disease is just like where we spend most money in health care wise. We know they are preventable. But what are we doing about it. Because if you think about how the health care system is constructed, most health care prevention is done by nurses and then there's a little health prevention by doctors. But when do people find nurses and doctors when they have you know they're ill or when they have a problem and they actually go to see them. So right then and there you cannot do health care prevention because the people is focused on other things. So it is very inadequate and we do not do it very well because the other side of health care prevention is the TV ad saying hi a day which does not work either very well. So that's definitely on top of my agenda. And I think it should be an every every agenda. And I think it is quite general.

: Yeah, no, that's a great point Anna you know it's the difference between health care and sick care. And I think we all think of health care as really as sick care right when you're already sick. You see these people. Anna, tell us what you and your company are doing to address the health care space more than just the sick care space.

: Yeah we're actually work a lot with the healthcare space that we do also work with secure space specially at the consultancy when we have to develop platform for chronic diseases and whatnot. But my preference is in healthcare as you said it. So for example, some of the things that we do in consultancy like let me tell you about the last one for example that we put in. So this is a platform to help adolescents when they have been diagnosed with an STDs, so it's sexual transmitted disease, sorry. They have trouble telling their couples they made their friends that they have this if they've been you know sexually in contact with them. So we developed a game actually make them understand how important it is, and to actually help them contact this person and tell them you know pre sort of word semi design way. So they actually do it more. And this is because they have noticed that closing this communication issue the earliest the less spread you have. So it's having a really big impact versus what they do now which is giving them like a paper so they can give it to the partners that they've been with. So that is like it improves a lot, the system.

: And it goes back to prevention, right?

: Exactly. It does. And ourselves. We've just developed a product which is called, free energy we cheese and that helps people learn more about food, exercise, sleep, their digestive system, the environment how can that help them to improve and their mindset. And this app is actually all prevention like it's based on what we nurses have to tell or are told to sell or patients to actually help them with their health care prevention. So it's very scientific it's very medical. But we've made it funny in a way that we've made it that the information pills that are really straight to the point. One of the biggest failure that we do in health here is the following. It's actually what I did with my diabetic patients. So one thing that I've noticed games do very very well. It's like the autonomy and competence balance. So when you know very little about the game, you have very little competence so they give you a little autonomy like you have one or two buttons to push. And then as you grow more, your competence grows, you start having a little more to do with little more buttons to push it a little, They give you a few more spells or whatever. So it grows as you're growing with your competence the autonomy, right.

: Yes.

: So what happened with my diabetes patient. He had practically zero confidence and I gave him two full days of full autonomy to explore and through whatever so obviously the system was badly designed and he left the system. He was able to take care of it. So with this app what we're trying to do is like concentrate the information in very small pills like we try to tell you just one little thing like if we talk about food we talk about why do we say that we should be eating five times that day for example and we describe studies that point out this direction which is that normal standard. It's like if your studies that pointing to other directions but they are smaller studies or whatever but at least you find your where is it that you feel more comfortable with. And then we give you like a little quest to do for example for this one. So you can just learn something and now you have to do something with this information like right away. And exactly, if not you not able to just put it in your head. For example in this case it's like trading at five times a day on the next five day. So you have to put like that time that you commit yourself to trying to eat something and then the energy tells you give to your mind that signs and also you feel like a little tip suggests or you know it's 4:00 o'clock in the afternoon. If you have a little fruit remember that if you have a little nut is going to help you, absorb your vitamins better and stuff like that so yeah.

: That's very cool. That's very cool. Some great examples there Anna. And folks, if you're curious about what Anna is up to. Check out her website, it's www.playbenefits.com and if you want the English version just do a slash en for English. www.playbenefits.com/en. She's got a really great examples of the wonderful work that she's doing and the people that she works with solutions that she's created in her team so make sure you check that out. If you're looking to gamify your chronic disease strategy or the things that you're doing in health care. Anna, can you talk to us a little bit about a setback maybe something that happened where it didn't work out quite well and what you learned from that.

: All right so PlayBenefit has a little bit of a side story I guess all the companies that survive, log-it off half one of those, I'm going to guess here because I don't really know.

: You're right. You're right.

: So I started PlayBenefit with like a second hand like a second person on board them with me and we were together working for about two years when I managed to get some funding to create the energy and some private funding. And then what happened was that I got my team and everything to focus on energy. And he took care of that consultancy which know was working for a while then and basically I focused on the product and everything and he was focusing on that consultancy. So what happened was we got to January 2017 and I noticed that for about six months we had one the consultancy job done. And we were running out of money. We did not have the app. Yes it is. So we did not have the app finished and I was like oh my gosh this is really bad. So actually we invited this person who I had been working with for two years and you know almost three years by then we invited him to go and then I took in charge consultancy and the app. Obviously the app I have..

: Both sides.

: Yes I had to sort of put something a bit aside because you know I'm only human. I only have certain hours a day. But I did want to focus a lot of consultancy because whether you won it or not likely Playbenefit consultancy sort of what keeps as afloat and then..

: Sure.

: Was to help the app to like do better and bigger but later on obviously. So six months after its June and I run out of money I'm going to have to make the biggest decision had to fire everyone. I had put money in the company to actually make sure everyone must spade and everything. The last month and you keep that everything that we have here in Spain and it was a point where sort of..

: How do you feel that day, like that morning and you had to go tell everybody I mean what was the feeling?

: Actually no, the feeling was the worse is to come yet. So yes so it was stressed I was like everything but I had the feeling that the worst was still to come. So even though it was bad I did not feel like it was bad, bad.

: Ok. OK.

: No, I know what you mean. You felt like there is something around the corner still coming.

: Yeah I don't know. It felt like you know this is bad. But you know the worst is still to come and I just to take it easy and so forth. And then you know how things go. You sort of give something to big universe and the universe gives back,.

: Angry.

: Stuff like your own reason.

: I agree.

: And then in August I get the biggest consultancy job.

: So a month later one month later? Oh my God.

: So you..

: Talk about a roller coaster.

: Exactly. You have been calling to people and be like you know those vacations that we've talked about how about not being together again and we actually close the best year consultancy wise and I was able to get my money back and everything is been going well since then.

: Wow, what a story. And if you had to go back and share with the listeners what your key learning from this was what would you say it is?

: So there were lots of things learned there. But I think one of the biggest once was keeping things in check as with metrics twice. So you don't feel like you're asking you're number two or you're equal to put it this way. You were demanding from them anything it's just like OK so we have this meeting where we do the metrics and the metrics and numbers. And so I'm not subjectively telling you something I'm objectively, where objects following a process exactly putting a process in place that is metric, that it's not emotional that everyone feels comfortable and everyone agrees in.

: I love it. What a great share of that accountability. Like the great Ronald Reagan said Trust but verify.

: Exactly. I don't saying not trust your partners. It's not like the good thing to say. I think..

: Business.

: Exactly it's business. It's something else and it should not be. Yeah it should be metrics and should be.

: I love it.

: If that makes sense.

: And what a great share. Wow. I felt like I was there with you. I was like oh my gosh we're losing everything we have to fire everybody. Next thing you know you got the biggest contract and then everybody is working with you again. Wow. And so folks what a great share by Anna. Don't assume that things are getting done. It's always good to have redundancy. It's always good to have systems and processes that are going to guarantee that you're getting the information. The optics that you need to have a successful business because that's what your car has a fuel gauge. You know when your car is running out of gas you've got to have the same thing in your business. Great share Anna.

: Thank you.

: So what would you say one of your proudest medical leadership experiences has been to this date?

: So I think I've been quite lucky to feel many of these moments throughout my career because for once I was a pioneer. And that means it's a very cool word but actually means that it's extremely hard. And you feel like quitting many, many times. So I think the peak of it all was when this year I've received the Youth Talent for nursing prize from the Nursing Association in Catalonia.

: Congratulations.

: Thank you. And I it was one of the peak because for us nurses who were hard to recognize each other. I don't know why it's something that's been there for a long time like we are aware of it. We know it.

: Yeah.

: And for your kin to tell you there's and sort of honor me this way was like wow this is the best experience I could ever got.

: That is so awesome.

: So yeah.

: That is so awesome. Congratulations and so did they have a ceremony and?

: Oh yeah there was a lot of that of that and there were like long dresses and stuff like that.

: Wonderful. That's awesome. And you were honored at this event by your peers by your kin. Sort of like a homecoming right like this.

: Because as I said it's so hard for other nurses to actually be aware of each other. And for me I've been always sort of recognized but as see health care professional from a technological part so I had never been recognized from my peers. I was always the odd one you know the ones that's weird. But I know it sounds probably other people would look at my eyes and say Oh you would have to say you know this medical achievement or these other one are being able to participate in these steps or having the first mhealth corps in the whole world which was you know in Stanford and what not for me, my biggest one, is this one.

:  I love it and that's what spoke to your heart right. I mean it's what drove you it's why really made you feel alive.

: Exactly. I mean I'm here for this.

: That's so great. How about now, you know you guys are working on a lot of different projects Ana. What would you say one of the more exciting projects that you're focused on today is?

: Well definitely be energy. I would say like with the consultanty we have quite some exciting projects like we have one with that ICU. Sorry. No that's not the, that's a Spanish word. It's intensive care and stuff like that which is really cool. But I would say be energy the one that touches my heart. And the one that I am it's probably the one that's going to get most attention because I really want to get the IUS data out and we have some studies that we want to start. We have studies with the two hospitals here in Spain and one hospital in Columbia and the studies are super different like we have ones that want to give the application the app to the patients and see how they're doing. They're improving their lifestyle, if they find some improvement this way. There are some studies that is like they have surgery patients they just have surgery patients and see the app let's you look at your..

: Bowel movement?

: Bowel movement there you go, I have it written somewhere. Anyway, it allows you to log your bowel movement and with the metric like a scientific metric and what not. So it's very useful for them, if they and they want to see how that works. And then there's another one the one in Colombia. What they want to do is give the app to nureses and see if the nurses themselves learned from the app enough to actually translate this information into their patients like and help them with these tool be more proactive in the prevention and help them if the present. So those are super exciting things that I have in the future. And I really want to start them.

: That's that's super exciting Anna. And with the focus and the drive and the passion that you have for it I'm so sure you're going to take this project and turn it into a successful application and health care so we wish you the best of luck on those.

: Thank you.

: So this is closer to the now now let's pretend you and I are building a medical leadership course on what it takes to be successful in healthcare gamification. Let's call it the 101 of Anna Sort and we're going build the syllabus here. I've got four questions for you lightning round style followed by a book that you recommend to the listeners are you ready?

: Ok I'll try to do my best?

: And let's do it. What is the best way to improve health care outcomes?

: I would say focus on users and when I say users, it doesn't mean the treatment. It means the patient the family the health care professionals whoever is going to use your app. And just a quick tip, we know that patients are the most underused tool we really need in health care.

: Absolutely. What's the biggest mistake or pitfall to avoid?

: You assume you understand like I am a nurse and with the ICU for example experience that was telling you about just need to go and be a nurse there for a while before I understand who the patients are because they can't tell you things but since I know I mean I need to know who is there, what the mobility they have and what they can do what they cannot do. Like to be suspected, I mean you can assume you know something because I'm a nurse and I know about this because I've been told about it in university and so on. But I think the biggest mistake is to assume that you know.

: what a great great piece of advice there. How do you stay relevant as an organization despite constant change?

: Oh that's very good one. I think the biggest mistake you could do here would be to focus on technology. If you focus your organization in technology you'll be always out of a good decision. But as the technology, nursing has been relevant for over 150 years If I portrayed is in my organization and my organization is seen as a digital nursing for example. Then it will definitely stay relevant no matter what technology changes.

: Love it. What's one area of focus that should drive everything in your organization?

: I think I would say prevention probably in healthcare. That's what interests us all and what we try to do.

: Awesome and what book would you recommend to the listeners, Anna. So one of the first books that sort of had helped me or inspired me to be in the course that I'm taking today in my life was from Jane McGonigal who a scientist and a video game designer. And it's called Reality is Broken.

: Reality is broken.

: Yeah and it was on that time that I was that Blizzard Entertainment. And I knew and I saw all these people playing these games because life is much less rewarding. You are not rewarded for your efforts in games, you are. So we need to make life more like a video game.

: I love it. I love it. What a great recommendation listeners if you want to get a hold of the things that we talked about the transcript, everything that we've discussed, links to the book that not recommended just go to outcomesrocket.health/playbenefit and you'll be able to find all that there. So don't worry about writing it down. Anna, this has been a lot of fun. I've really enjoyed our time together here. You've shared so many interesting things that I'm sure the listeners are taking notes on. So Anna, this has been a lot of fun. Before I conclude I'd love if you could just share a closing thought. And then the best place where the listeners could get in touch with you or follow you.

: Yeah. So this is not much of a closing note but I think it's relevant because I've just told you about Jane McGonigal's book, Reality is Broken and I actually tweet some and I wrote up myself which sort of tries to portray what we do in healthcare and how important and how it's playing with video games, how we could improve doing that. Do you know that I told you before about balancing competence and autonomy.

: That's right.

It's like a lesson learned from video game industry because that's exactly what they do and they did very well to keep users and gate. So how can we keep patients engaged or users engaged through their health in a scientific matter. And there's a lot of scientific findings in this book and I try to always relate back to how this world so the book is called, From Games to Health: Lessons learnt from the games industry. Find it on Amazon on eBooks. Some Pretty much anywhere I think we have been all plugged from discover I think.

: That's amazing. So folks what we're going to do here is just add a link to Ana's book as part of the show notes. So if we go to outcomesrocket.health/play benefit. We're going to have a link there. So if you're curious about this, I think you're going to want to pick it up because is definitely a lot of lessons learned that Anna shares in this piece for you is so I know this is a great share. Thank you for that.

: Thank you.

: And what would you say the best place for the listeners to get ahold of or follow you?

: Yes I'm on Twitter. Most of the time, I check it every day. You can find me as @lostnurse because at one point in time I was like a lost nurse. I didn't I don't know how to, say I could have stuck and I'm still the lost nurse, say I'm right.

: I love lot.

: And If not, I'm definitely researchable on LinkedIn in Anna Sort just Anna Sort in LinkedIn, where you found me actually. Yeah, I respond to that as well.

: Fantastic. Well, there you have it. Listeners, Anna Sort from PlayBenefit. Anna, this has been a blast. Truly fun interview and I'm excited to stay in touch with you.

: Thank you. Thank you.

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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Recommended Books:

Reality Is Broken: Why Games Make Us Better and How They Can Change the World

From Games to Health: Lessons Learned from the Video Games Industry

Best Way to Contact Anna:

LinkedIn: Anna Sort

Twitter: @lostnurse

Mentioned Link:

www.playbenefits.com/en

Episode Sponsor:

Software Medical Treatments known as Digital Therapeutics with David Klein, Co-founder, Executive Chairman and CEO at Click Therapeutics, Inc.

Thanks for tuning in to the Outcomes Rocket podcast where we chat with today's most successful and inspiring health leaders. I want to personally invite you to our first inaugural Healthcare Thinkathon. It's a conference that the Outcomes Rocket and the IU Center for Health Innovation and Implementation Sciences has teamed up on. We're going to put together silo crushing practices just like we do here on the podcast except it's going to be live with inspiring keynotes and panelists. To set the tone, we're conducting a meeting where you can be part of drafting the blueprint for the future of healthcare. That's right. You could be a founding member of this group of talented industry and practitioner leaders. Join me and 200 other inspiring health leaders for the first Inaugural Healthcare Thinkathon. It's an event that you're not going to want to miss. And since there's only 200 tickets available you're going to want to act soon. So how do you learn more? Just go to outcomesrocket.health/conference. For more details on how to attend that's outcomesrocket.health/conference and you'll be able to get all the info that you need on this amazing healthcare thinkathon. That's outcomesrocket.health/conference.

: Welcome back once again to the Outcomes Rocket Podcast where we chat with today's most successful and inspiring health leaders. I really thank you again for tuning in. And I welcome you to go to outcomesrocket.health/reviews where you could rate and review today's podcast because my guest today is a distinguished health care investor and entrepreneur. His name is David Klein. David is a healthcare investor and entrepreneur with over 16 years life science industry experience. He's played key roles in founding financing and operating more than 10 life science companies. In 2012 Mr. Klein cofounded Click Therapeutics which develops and commercialize a software as medical treatments also known as Digital Therapeutics, a name that they coined their other company. Following a groundbreaking clinical trial clicks industry leading smoke cessation program is available nationwide through a variety of payers providers and employers. Clicks lead prescription program is entering into a multicenter randomised control parallel group Phase 3 FDA registration trial for the treatment of major depressive disorder in adults. He formerly served as managing director at Opus Point Partners, Senior Consultant to Pfizer and strategic advisor to numerous publicly traded and privately held life science companies. I'm so excited to have him on the podcast today and can't wait for him to expand on that introduction. David welcome to the podcast.

: Thank you Saul. Thanks for having me. Yeah, that was a pretty comprehensive intro, I'm the co-founder and CEO of a company called Click Therapeutics. And my background really is in life science specifically biotech investing and actually operating companies and co-founded Click Therapeutics to about actually almost six years ago to focus on developing and commercializing software as medical treatment.

: Fantastic. And it's interesting that you are going in that direction because more and more today, we're looking at technology and other options other than medications to prescribe to alleviate issues so I'm excited to dive into some of your thoughts there David. But first I'd love to hear why you decided to get into the healthcare sector to begin with?

: Sure that's a great question. I think I kind of fell into the health care sector at least after college to some degree. You know I can focus a bit on why I decided to go into healthcare technology which might be a more interesting answer.

: Sure.

: Really. In 2012 I was at a biotech hedge fund I've been there for years and was working with a fellow at the time was that had a clinical neuro psychiatric for now and we saw a lot of money really going out of farm minus CNS space. I think that the feeling was that the endpoints in the studies were were very hard to hit. Obviously you know for the most part's objective, that's not like let's say shrinking a tumor or something of that nature. And at the same time we saw this real real rise in mobile phones and the kind of increasing prevalence of mobile phones and really seemed like it was a movement to some degree that was sweeping over the country. And we saw that mobile phones were actually changing people's behavior. So it was very noticeable that the mobile phone was changing people's behavtior and we thought well wow what if we can use the phone as a vehicle to drive clinical outcomes. And in 2012 we found that Click Therapeutics based on that premise and actually created a turnout digital therapeutics which has since then been popularized. I think other other people's credit is just great.

: It really has been popularized from treatments of A.D.H.D. to I mean just it's amazing what's what's happening on the space digital therapeutics. Pretty cool that you guys came up with that. Didn't know where it originated. Now we do.

: Yeah. No we originated that term in 2012 really based on the fact that software can drive kind of drug like clinical outcomes or or really work in conjunction with pharmacotherapy is to make for a more effective treatment.

: So within digital therapeutics. David what would you say is a hot topic that needs to be an every leaders agenda on healthcare today?

: Sure. So within the field of digital therapeutics I think there's a there's a number of hot topics that say commercialization is one very hot topic. So best practices in commercialization and the different routes to take. There is obviously in theory you commercialize an app, even direct to consumer if you want or there's more a call it business of business kind of managed care for companies actually targeting employers and the health care insurance companies. And then there is the more I'd say somewhat traditional route. You know call it a pharmacotherapy business model of actually garnering FDA clearance for the programs and commercializing really direct to physicians who will ultimately prescribe the apps to patients. I think that's a that's a really hot topic and you know which products to go which route on and and which is this business angle I guess ultimately will will prevail or or maybe all three will.

: Yeah that's interesting that you bring that out David because a lot of people getting into this space building companies oftentimes run into some big problems with commercializing their technology. What advice would you give to the people listening that are building companies to really tackle this hot topic?

: Sure. So advice that I would give companies is really to you know I'd say to be open minded I'd say and I think that people really need to serious to approach this space in the seriousness that any new therapeutic deserve. So really focus on robust and meaningful clinical validation and really proving that these programs work. Very similar to like maybe a small biotech would prove that their new compounds work but then at the same time I think that there really has to be a healthy balance. And technology and user experience and data science and engagement really need to be respected as well. So I think really understanding the balance between call it neuroscience and data science and engagement science is a very important ingredient to succeeding in this space and really getting that balance right I think is key and it does require really respect for for all the fields involved.

: It's a really great takeaway. And so as you guys work to build your companies, can you give us an example of a company or or something that you guys have done to get results and improve outcomes?

: Sure. So our first program and that's as I noted there's a number of different business lines in this space. Our first program is actually a program that's being marketed to employers in managed care companies albeit our follow on programs are we are seeking FDA clearance for it. But our first program is click a team and it was designed really as a smoking cessation program.

: I like that.

: Click a team for smoking session and say it's a fully digital program. Actually we're on our sixth peer reviewed publication granted 416 person clinical study. And at the six month mark, 35.3% So it's 147 of the participants had achieved 30 day sustained the abstinence so that's an ... analysis of about 35% quick rate. I think potentially even even more importantly it really is our engagement with our engagement numbers and we average about 2 app opens per user per day over the eight week courtship period. So 2 app opens per user per day. And that's really those are numbers that have carried over really into our commercial population so we're very excited about the levels of engagement that we're seeing and are continuing to see and really actually working very hard to optimize in terms of creative results as if Q2 actually Click at Team will be implemented in really as a result of our partnership with Magellan Health for the most part Click a Team can be implemented in 20 employers will be in seven different payers and covering 7.1 million lives and counting. We're actually and it's very very meaningful RFPs now has actually multiples of that hopefully by the end of this year or early next year so.

: That's outstanding. David congratulations on that.

: Oh, Thank you. We're super excited about it as well.

: You know smoking is one of those things that definitely deserves to be looked at under wellness programs and I think it's great that you took the model of companies you know and employer benefits to offer this type of service.

: Yeah, no we think that that's great to it. It seemed like the logical business route to take for a program like this. I will say our next program CT152 which will hopefully be the first ever FDA cleared program for the treatment of depression. We've now actually been through two randomized controlled trials and shown almost 50 percent reduction in handpiece a clinician rated depression symptoms against a sham control group in both studies which show between 20 and 25% reduction. So we're extremely excited about our depression program and we actually. The program has also been through a objective FMRI study and that really resulted in data which also supports our hypothesis that the program has a neuroplastic effect. So two positive randomized controlled trials and a biomarker. And we're super excited about that program. I'd say the ultimately albeit direct to business is great. It's a very viable avenue with things like smoking cessation which businesses purchase already. But ultimately if somebody has whether it's high cholesterol or if they have insomnia or depression, it's really the physician that people go to their doctors for help for these things they don't really get help from let's say their H.R. departments. So I'm a firm believer that the direct to physician and prescription model holds a great deal of promise.

: That's pretty neat and exciting too. But also a demonstration of your commitment David to this you know you're you're in a long game right when you decide to get into a an FDA approved device. You're automatically in the long game right you're committed to making sure that this thing gets approved and that it gets addressed and utilized as a medical device. And it's interesting that you've decided to take the prescription model on this one and your logic is totally totally on. Listeners, when I want you to think about and observe is how thoughtful Dave it is in a way that he approaches these businesses when you stop and think about how you're going to have the biggest impact you really have to be thoughtful about your approach because if you're not, then all your efforts could really suffer. And really the people that could benefit from your technology won't. So we've got to get our act together as it relates to this. And so let's make sure we learn from David and his way of doing things. Really appreciate your sharing those things David. What would you say today is something that happened a mistake a setback that caused some pain. And what did you learn from that?

: Sure. So in terms of you know mistakes or failures. Look we've made plenty of mistakes and you know I personally have made mistakes and I've had failures so I'm no stranger that I think that the key is really to learn from those mistakes and you know I think that in general on somebody that can accept when I'm wrong or I've made a mistake and can really try to learn from it. I'd say our mistakes in general or things we haven't been terribly successful at are probably misjudged timelines in the healthcare industry. So when we first started the company in 2012, we thought that the industry would move much quicker. So when we created this term digital therapeutics we thought it was very natural and that people would get it right away. And we thought it would take off much much quicker than it did. And I think you know largely due to other companies who started using that term a couple of years later and really have made giant strides and progress for the industry largely due to many other companies have really helped the space gain acceptance so I think that timelines in really understanding the timelines in health care has been somewhat of a failure. We did think that the space would gain acceptance and traction much quicker. I say that you know just in general we've worked we're kind of for the most part X biotech people clinical trialist and investors and investors and operators and we probably have too little of a focus on things like public relations and have not made great efforts towards PR kind of things of that nature that I think were could have done a better job on and I'd say in the beginning something we learned very quickly was really to rely kind of too heavy or too too heavily I'd say on clinicians for designing the app. So in 2012 when we were first created it was really the kind of core of our program if not the whole program was really designed by our cofounded by a neurologist and then also a clinical neuropsychiatrist. And without really taking into consideration user experience and data science then engagement and for example when you first opened the beta version of Click a Team five years ago it asked you to answer 40 questions and then answer them on a ... scale from 1 to 7.

: It's a lot of questions.

: Yeah it's a lot of questions. We're still learning on that front really. You know how to get better and better at engaging patients I think is key but learning that there has to be a balance in the products of best practices from all fields not just nueroscience.

: That's such great shares David and really appreciate you sharing them with regard to not being able to commercialize or socialize this digital Therapeutics. The whole timeline thing in healthcare is tough. So definitely leveraging those around you and just kind of almost being as close as you can to the pulse of what's being accepted, how it's being accepted to help you better understand and just kind of like when you're doing construction on a house you always have to put in a little fudge factor there for 15 20 percent extra time won't you say?

: Yeah at least.

: At the very least. So you guys have come a long way. You've pivoted from the lessons learned. What would you say today. We've talked about a lot of things and the innovative things you guys are up to. What's an exciting project that you're working on and why?

: In terms of an exciting project we are actually in the process right now of planning and hopefully starting or initiating a multicenter randomized controlled parallel group FDA registration study to gain clearance for our depression program to actually treat depression. So I think that's a very very exciting project that we're working on. It is tough to liken it just to a project because it's such a core focus of what we're doing. So I'd say that that's that's one very very exciting and kind of core project that we're working on is planning and preparing to begin a relatively large randomized controlled trough.

: Now that's really great and congratulations on that. You know I was speaking with a physician entrepreneur and one of the things that she brought up to me was even within the medical student and practitioner communities depression is a big problem. And so I think what you guys are doing with this technology not only you're going to be able to help patients but also physician patients that are struggling and need help. And so I think there's that quadruple aim that you're doing there by being able to help the people that provide the care.

: Yeah I agree. I think that in many different therapeutic areas depression included. We're really talking about a win for everyone. There's a need for new products in these in these areas and is really this you know very significant unmet need. I mean in depression alone you've got two thirds of more patients would prefer a nonformal logical intervention for depression. So there really is a significant need. And even in spaces that you wouldn't really think too much about when it comes to digital therapeutics but in cardio for example what's the kind of areas where medications are sorely needed and there are some very very good medications for. But if someone has a heart attack, there is terrific medications out there for them now but really what's the number one thing that a patient could do to prevent having another heart attack and that's really changing their behavior. So there really is a huge opportunity for our programs and and other companies' programs to help a great deal of people and I think that this space in general we're talking about really a win win win situation where the patients win by having access to more effective and efficient treatments. And whether it's pharma companies or payers win by whether it's increasing profits or decreasing health care spending and physicians win by having healthier patients and being able to prescribe apps whether it's in conjunction with drugs or in lieu of drugs that are effective treatments. So I think unlike many other revolutions in technology, this is one that really doesn't have a lot of victims in the business world it's really a win all around.

: I think that's a great point David. And for the listeners that want to get involved, where should they reach out. How should they reach out to get involved.

: Yes. Anyone can reach Click Therapeutics really at any time by just emailing info@clicktherapeutics.com. So anyone who whether somebody has a technology that they might be looking to commercialize a health care technology or kind of a business opportunity or whether it's a payer, or an employer that wants to launch Click a Team to their population or even if it's research scientists who want to work on some of our studies, we're pretty open to people getting and really becoming involved with the company.

: And that's info@clicktherapeutics.com.

: Exactly.

: Fantastic. Listeners, there you have it and that's what the Outcomes Rockets all about, right. Just bringing down those silos we call a silo crushing here. And so David has just walked us through all the amazing things he and his team are up to. Why reinvent the wheel right. Why reinvent the wheel, reach out to David and see how you guys could collaborate. Info@clicktherapeutics.com is the best way to reach him. And David really appreciate you walking us through this stuff. Now here we're close to the end. Let's pretend you and I are building a medical leadership course on what it takes to be successful in medicine. It's the 101 of David Klein and so I've got a lightning round quick four questions for you followed by a book that you recommend to the listeners. You ready. Sure.

: All right. What's the best way to improve health care outcomes?

: I think even ahead of and I focus on my area which is digital therapeutics. But even even ahead of really clinical science would be engaging the patient I think that that's one thing many many people and companies overlook are you know we've got this great way to help people we're going to put-up an app and it's going to help everyone and people have to understand, the average app gets opened one or two times and then it's never opened again. And there really needs to be a focus on engaging the patient and really understanding how to get people to use your programs. So I think that if I was going to you know let's say teach a course on a you know as you put it 101 course it would be. There has to be a focus on engagement and a good product can help anybody if nobody is using it.

: And what would be the biggest mistake or pitfall to avoid?

: I think that you know I can back up into that a bit but really ignoring engagement and design science and user experience and you know I can again it's it's kind of a repetitive answer to some degree. But I would say really ignoring that is certainly kind of detrimental fall on top of that ignoring validating your program it's not really good enough to just base a program on on evidence. You've really got to run robust and meaningful clinical trials very similar to like really formal therapies studies. I think what we can learn from these studies and mimic them to some degree when it comes to healthcare technology and there's a reason why pharma and biotech companies run clinical trials. And I think that that's a pretty significant pitfall to just think you can develop a great technology and that it can help people without actually going out and proving it.

: So how do you stay relevant as an organization. Despite all the change?

: So I'd say you've got to be able to change with it. And you know I think we stay relevant by being nimble. It's really critical that companies in our space are nimble and really are capable of pivoting. I think that it's I would say that staying relevant as an organization is really the forefront of what we're doing and really getting better and better and better at what we're doing. Protecting what we're doing in the forms of intellectual property and trade secrets I think is critical. So just never never stopping and really striving to get better and better. I hope we'll we'll track us relevant. And I think has kept us relevant so far.

: Awesome. And finally what's one area of focus that should drive everything in a health organization?

: Ultimately helping people really is should be the driving force in healthcare and that's Click does it through the creation of engaging and efficacious clinically validated technology. When you start from the early and kind of build around it. But I think that remaining and kind of keeping the patient at the center and creating patient centric technologies is really at least what drives us. And I believe should be a very very important factor in every health care technology what's best for the patient and how do you really create patient centric technology. I think it's absolutely critical. And ultimately that's a formula that all that are really win for everybody.

: That's great. What book would you recommend on the syllabus?

: That's a good question. I could tell you. The last book I read and like this kind of off topic so it's not really on the syllabus it's a book called Red Notice. And you know very very interesting story for people who need a break from healthcare I guess about.

: It's good to get a break.

: That's called Red Notice and it's by Bill Browder. Again a very very interesting story about one of the first Western investors in Russia. So I certainly recommend that book.

: Fascinating. So there you have listeners an interesting off the beaten path book. Some great information here on the syllabus that we've constructed for you. Don't worry about writing anything down. You could find it all on outcomesrocket.health/click as in click therapeutics and you'll be able to find our transcript as well as David's bio and everything that we discussed here. David, this has been a ton of fun if you can just leave the listeners with a closing thought and then the best place where they could get a hold of you or follow you?

: You now closing thought is look I think we're we're really nearing a revolution in healthcare. Were apps in the very near future so 5 or 10 years or in the coming months or a year or two we'll be prescribed by a physician in conjunction or in lieu of pharmacotherapies so will be prescribed by physicians. And I think that's extremely exciting and if there's one thing I'd love to leave the listeners here is to really understand that that revolution is happening apps will be prescribed by physicians. There will be reimbursement from payers and it will be a I think disruptive but welcome force in healthcare so patients who go to the physician whether it's insomnia with depression or some sort of heart disease. I think that people are going to start having nonformal logical interventions prescribed in lieu or in conjunction with pharmacotherapies and I think that's very exciting. I know that your listeners that the time is coming in the very near future where you might go to your physician and they might offer to prescribe a app. And I think that's terrific and exciting. In terms of following therapeutics or getting in touch with us, anyone can always I guess visit our website at clicktherapeutics.com or email info@clicktherapeutics.com or you can follow us on Twitter. I believe it's @ClickThera on Twitter. So @ClickThera on Twitter and I think we post most of our kind of more public updates on on their system could follow us there for like.

: Wonderful. David this has been a blast and a really innovative discussion. So listeners take David's advice and start planning about how you're going to fit digital therapeutics into your practice into your business. And David I can't tell you how much we thank you for your perspective and your insights and looking forward to staying in touch my friend.

: Great well thanks again for having me. And now feel free to reach out for anything you need.

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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Recommended Book and Podcast:

Red Notice: A True Story of High Finance, Murder, and One Man's Fight for Justice

Best Way to Contact David:

LinkedIn:  David Benshoof Klein

Twitter: @ClickThera

info@clicktherapeutics.com

Mentioned Link/s:

clicktherapeutics.com

Episode Sponsor:

Digital Marketing Tips to Help Your Organization Increase Sales, Attract Talent and Win Mindshare with Gary Monk, Healthcare Innovation Consultant

Thanks for tuning in to the Outcomes Rocket podcast where we chat with today's most successful and inspiring health leaders. I want to personally invite you to our first inaugural Healthcare Thinkathon. It's a conference that the Outcomes Rocket and the IU Center for Health Innovation and Implementation Sciences has teamed up on. We're going to put together silo crushing practices just like we do here on the podcast except it's going to be live with inspiring keynotes and panelists. To set the tone, we're conducting a meeting where you can be part of drafting the blueprint for the future of healthcare. That's right. You could be a founding member of this group of talented industry and practitioner leaders. Join me and 200 other inspiring health leaders for the first Inaugural Healthcare Thinkathon. It's an event that you're not going to want to miss. And since there's only 200 tickets available you're going to want to act soon. So how do you learn more? Just go to outcomesrocket.health/conference. For more details on how to attend that's outcomesrocket.health/conference and you'll be able to get all the info that you need on this amazing healthcare thinkathon. That's outcomesrocket.health/conference.

: I thank you for tuning into the podcast again. I really appreciate that. You know I've gotten a lot of information, a lot of e-mails saying how certain episodes have resonated so don't be shy follow up with us on Twitter at @outcomesrocket, we'd like to hear from our listeners because today I have an amazing guest and I also invite you to rate and review us at outcomesrocket.health/reviews. This guest is an amazing collaborator in health care- a digital healthcare innovator with over two decades of experience. Originally from London, England. But now here in the United States specifically in New York City. His focus is on helping healthcare institutions differentiate themselves through innovative strategies using digital and also technology and so his focus is social media. Its digital platforms for marketing, anything that will help you as a healthcare professional as a healthcare leader within an organization. Promote what you're doing but also get it to the right hands at the right time. So Gary just want to welcome you to the podcast and fill many of the other gaps of that introduction that I may have missed yet.

: So I think that's great, that was that was all good. I should say I moved over from London to New York several years ago. I'm actually originally from Birmingham so I don't want to forget my roots. That's from I'm originally from the UK but I spent many years living in London and I've worked over that at that time in healthcare. Worked within pharmaceutical companies a lot of Simon Johnson Johnson and then working in agency and consultancy. So a broad broad experience but I think you covered it very well. So yes looking forward to this.

: Absolutely. And so are we. So the reason why I wanted to bring Gary on here is to get a little taste of outside of the normal health care box right because in general we've got to find better ways to target our customers our patients and really get a better outreach. And I think we all struggle at this. And so Gary is here to provide us some insights. But before we do get into that Gary what got you in the healthcare to begin with?

: Yeah I mean I'm a real science nerd so my study I guess you'd call a major here and majored in organic chemistry and medicinal chemistry. Yeah and I was really fascinated with how these humans build molecules can interact with the body receptors at these sites and have a profound sense of profound positive effect but also how we could minimize side effects and make sure they were really specific. So it's I found that side of it is fascinating so that got me into healthcare and interested in pharmaceuticals and also the scientific pursuit of it, very exciting but also that potential for doing something good for humanity was compelling. So that's got me into it. I spent some time in the lab. One small anecdote probably in my life I definitely have got the skills for science but in terms of the humbling part of that is I certainly did not have the practical skills because at my time at the Glaxo research center in England I was working in the hydrogenation suite there and Trott's and finely divided catalyst on the floor, started a small fire really created the next small fire has to be the catalyst kind of expose the air and set on fire. So luckily we didn't end up with the next Hindenburg but I kind of realized I have in mind for science that maybe not the body and the practicality and the coordination but that got me in there and then I moved out of the lab and the rest is kind of history really.

: But that's awesome I'm nothing terrible came out of that Gary but your passion stuck and now you're helping people build fires so that they can get attention to their practices and businesses so you're doing it in a positive way.

: Exactly, a lot that's Yes that's true.

: So that's fascinating. What would you say today Gary is a hot topic that needs to be on every medical leaders agenda and how are you guys approaching this?

: Yeah the thing I think of is data an artificial intelligence sounds like two topics but clearly they're very deeply intertwined. And when I say data I'm talking specifically about personal and patient data and they kind of like sound like dirty words now particularly with the times with what's going on with Facebook. But we got these initiatives going on around real world data, population health, outcomes driven health care lot of those was but important initiatives. But none of these are actually going to produce anything of value without the right use of data. The right approach and the use of artificial intelligence for example in artificial intelligence is will highlight we can set up a program, say Population Health Program. Artificial intelligence is going to actually highlight factors that the researchers program managers have not even considered in the set-up page and really help us join the dots in the ways we might find it hard to do. So say yes that's very big and it's a complex challenge. So when I think about my approach and our approach to that one, thing that comes out is very specific. Clearly we need to get all the set up right about understand the problem make sure asking the right questions. But what I would say is probably actually more of a general point that could apply to other things outside of artificial intelligence as well but is to really think broadly in the thinking in the ideation phase. So to give you an example in most cases pretty much all cases you want to go super broad in terms of the types of data collection. But let's take a hypothetical example if we're running a program in New York around mental health and we're trying to support patients who may be on medicines but we've got a coaching program on online coaching counseling program support program that they can go to. Obviously we can pull a lot of metrics of how patients are engaging but we probably want to take as much information about that patients as possible and those patients to feed into the system. So what I'm talking about the ideation phase is when the planning that is to really look at the types of datas that would be useful to us. And look at them without judgment. So conceivably we could think for those patients that would be great to you know where they are, whether they're going out, use a geolocation on that phone, how active they are, how much exercise they're doing, any activity based from their phone. Any wearable devices they are using, if they got a sensors in their home measure their exact movements, monitor their phone calls, a number of phone calls, frequency duration of calls. Same with text messages how long they are and even what they are saying from their voice modulation intonation to actually what they're saying. The more I can't keep saying it probably sounds very very creepy. But the important point I'd want make in it, yeah.

: In the back of my mind I'm like holy cow. Like that's a lot of information and it makes you think right like we could get a lot of information from our cell phones. So how do we use it. What are some guidelines there and what are some examples of what you guys have done.

: Yes. So there's a lot of good examples of that. I mean this one I wasn't directly involved in but I think it's a nice example one that I'm actually involved in kind of sharing out, blocking around it. It's a little while ago now. I think the company slightly pivoted but a company called Ginger.io. So I've actually pulled that into proposals, the clients, the pictures has been actually build it out but that was fascinating technology where they actually use the mobile phone I believe they use the tracking of the phones of the geolocation, and the sensors, the patient moving around as a proxy for how their depression was going so clearly if they're sitting around they're not moving much generally that probably moves probably lower if they're functional moving around, going to the shops, going going out, seeing friends, socializing that's obviously good. And I mention a bit about voice to kind of throw that in there. But actually I believe they using not going as far as monitoring what the patients were are actually saying which I appreciate sounds creepy but understanding their voice modulation. So how often they are speaking. So actually, now okay, if they're isolated and they're not sending text messages, they're not calling their family, they're probably not in a good place. But if they're making frequent calls you know we're not interested in what they're saying, snooping on the conversations but actually if having those conversations on a regular basis, it's probably a good thing. So using those metrics. So I think that's a really good a good good use case all. The reason I put this about listening to the patients in there, it's kind of to be provocative. But I think it's a really important point when we start thinking big on these projects. There's no harm in thinking these things initially, I feel the problem I'm kind of going on a ramp here now. But I found a problem with big companies as opposed to start, having work in both will shot down ideas like next lessons what the patients are saying.

: Right

: Explore that and we might get to a point of actually ethically that doesn't work, it doesn't work for the patient. But let's explore where that could lead to and maybe it leads to the point of actually we listen to the patients conversations. Not what they saying but how often are they saying it, the voice modulation that we anonymize everything, they identify everything. So we get to kind of an exciting place because we've opened our thinking rather than someone then say a farmer of a big biotech company. No we can't do that, we can't listen to what's patients are saying over the phone and it kind of gets shot down as soon as it's thought about and conceived and then the end idea often ends up very vanilla and really not that valuable. So you see what I'm saying.

: I totally agree.

: Thinking big initially. Yeah, and then we pull it back in and we make sure we're doing the right thing on the patient ethically and we don't go spying on patients et cetera. We start thinking what data could we actually use and how would we get it and how would it serve us.

: Yeah. Gary, and you bring up a good point, right? The point here is listeners you've got to be open-minded if you're going to innovate, you've got to be open minded and sure, it might be a little edgy but let's find ways like anonymizing and de-identifying and stripping away the things that are patient information and making those voice markers or key keywords something that could serve the people that it's intended to serve. And Gary the thing that brings up kind of thought in my mind about this discussion is the whole area of digital therapeutics and what's being done with digital technology to help patients. It's super interesting what's going on out there isn't it?

: Yeah absolutely, absolutely. And you know obviously what you said I can cover a lot of things but it's simply fascinating when you've got digital tools that can even, that actually help patients. I was speaking to a friend who works for a startup and I say what he does as a digital therapeutics but actually helping patients sleep better. So analyzing understanding their sleep patterns by sensors on the body but also in the room where they're sleeping. And then part of the digital therapeutics is actually adjusting their environment, the temperature of the room but also the important thing that he's doing is actually using research to actually place specific segments of white noise at certain times when patients are sleeping, deep sleeping, their having their delta waves of deep sleep and the scientific research shows when the right sound is played at that time it can actually extend the period of deep sleep.

: Fascinating.

: And mean, the patient, the human being gets a lot more restful sleep. So I would say that's a good example of a digital intervention where it's listening, understanding but also giving that kind of response via feedback and there's a good patient outcome hopefully at the end of that.

: Gary what a great example and programs like video games to help you with ADHD instead of Ritalin. Listeners,the point here is what Gary is telling us is that we've got to think outside the box and we've got to push the envelope and oftentimes large organizations get trapped with the knee-jerk 'No'. And the little guys come up the little digital Davids and they kick butt. And so just a little thing to consider this little warning like be open to innovation and be open to ideas even though up front they may not seem like it distill them to the point where you can actually maybe get something that's not vanilla to Gary's point and it doesn't make an impact. So Gary can you give the listeners an example of some of the things that you've done to help your clients create results and get things done better improve outcomes?

: Yeah, I got a couple of examples. One thing is coming to mind that I've been working on quite extensively recently which is a hot topic is a social media. So I can't get to many specific examples but I've worked on clinical trial recruitment using social media which is very exciting because we've been able to get patients to enroll to play with trials faster than they normally would. And also more of them faster but also importantly at a lower cost as well. The cost of acquisition is between 10 and 100 times lower than using traditional methods. So that's been very exciting using social media for that. I even shared something yesterday I wasn't involved in it but the use of artificial intelligence attached to medical records to recruit patients for a clinical trials, that's how it's kind of evolving, that's such a big a big area where there such potential to help patients that there's a global shortage of clinical trial patients and also ensure that done cost effectively as well. So that's the big thing. I kind of broaden out to social media generally again because it is such a hot topic. So I've been working on, I mean I love social media from the perspective that using things that Facebook, you can target patients directly and actually understand whether they've taken specific actions seen adopt the measure if they've moved on that journey towards better outcomes. And the reason I mention Facebook sub-16 in the news a lot recently Zuckerberg been hold up in Congress. But yeah, it's very it's got a lot of good potential within healthcare but obviously it's got the potential for misuse as well so that I'm optimistic we can get to a point where the goodwill will triumph and we can use it but I'm just really concerned that the people don't get the point of like Facebook using this is bad, start using it. There's a lot of good that can actually be done if it's done in the right way using using this and other other channels.

: Now totally man and you know Gary let's talk about Facebook. So a lot of folks in the industry will think about campaigns whether it be driving patients to a trial, medication trial whether it be a training business clients in the healthcare space. I've heard the debate Facebook versus LinkedIn, which one is more effective. What's your take on that?

: Yeah I mean I've got a lot of experience doing this and obviously it does depend a lot on who you're targeting and exact and what you're doing. Overall, forget about the audience in terms of the power of the targeting. Currently Facebook I know they're pulling back some of that based on you know some of the abuses that they've had. So we'll have to see how that nets out but it still looks like the targetings would say a lot more powerful than LinkedIn so from a fuel targeting perspective, I find Facebook more valuable. In terms of treating patients in most cases Facebook is going to be where more of the patients are and easier to reach in context. Obviously a number of them maybe on LinkedIn, but in terms of actually reaching them the right way around that condition it's usually accepted more for that message to come through something like Facebook than LinkedIn. The work I've done targeting health care professionals actually it's been a mix of, I've had mixed results depending on the type, the type of project, the type of physicians working on LinkedIn versus Facebook. Often my advice would be, you know without knowing more about a specific project, if it's healthcare professionals, look at doing both and then see what's really working. Why are you getting the most benefit, you the getting the most reach and then send over the, leave the budget on to one that's working. So I'd always advise clients to be flexible. You have got this pot of money. We decided we're going to put like, play safe part on LinkedIn, half on Facebook but we have to quickly dial it up one way or the other if we're getting impact one one platform versus the other.

: So overall you feel like Facebook allows you to do more acute targeting meaning more specific targeting and LinkeIn not as much but you recommend sort of try a mix of both measuring and then pivoting once you figure out what's working out.

: Yeah absolutely. And what surprised me from practical expense is how effective Facebook can be about reaching doctors because you know you see the statistics a lot of doctors are using Facebook for personal reasons.

: Right.

: But a lot less using it for professional reasons. But that's kind of a bit of an arbitrary distinction because when a physician is on that for personal reasons, if someone is coming out in context the doctor's not going to switch off that it's relevant to them or their practice. So they're still going to click through on that ad if they're using it to keep in touch with their family or look at their friend's holiday pictures they're not going to ignore it and say oh I'm not clicking on that even if it's interesting and relating to my profession. Now that's not going to happen, they're going to they're going to click on it. So yes, definitely consider Facebook for doctors.

: Fascinating. Now that's some really great insights. And listeners as you consider these newer digital platforms you know take some of these thoughts from Gary and plug them into your strategy and do some testing as you work to reach those people that you want to impact most whether it be patients whether it be providers or industry. Just do these tests and ultimately the end result will come from being able to tweak, tweak until you get the result that you're looking for. Gary what would you say one of your proudest leadership moments in healthcare have been today?

: Yeah. So that's a tough question, there's a lot of work I've done. But yes but the one thing that's coming to mind that kind of leaves lodged in my memory because I kind of built on it since was a couple years ago I led a team hackathon in Cleveland Clinic.

: Nice.

: Yeah it was great, it's very exciting and we created a solution to potentially helps chronic pain patients reduce their dependence on opioids at new stage or not artifitially intelligence to learn what interventions were having an impact outside of the medication. So even things like kind of acupuncture, yoga, meditation. So there's a great achievement by full disclosure on that, it won an award at a hackathon which was great so it was successful from that perspective Due to array of reasons didn't get that built out. I'd still love to build that out. So I think that's extremely exciting but the real positive from that and I'm proud of it is the learning of thinking from Math is there. I have been able to move that on into other projects, advising startups, biotech pharma companies on similar projects. You know if you examine the field of mental health. So it's taking that value even though not directly in that project and using that knowledge in other projects. I think the reason I'm proud of that and those type of projects is you know I really believe in what pharmaceutical companies can do. What I also believe in is the importance of having that kind of a holistic approach of what's working for the patients. Sometimes drugs are great sometimes they are not right great. Sometimes they are very important in the context of other interventions. So that's really important for me is having the right interventions for the patients that may or may not include drugs but we're not just totally focused on the early onset is a pilland a medicine so you know that's kind of where my head is with that.

: Yeah that's really interesting Gary and thanks for sharing that I know a good percentage of the of the listeners are also entrepreneurs building things. And so if what Gary mentioned to you sounds interesting. By all means at the end of the podcast Gary will share his contact information how you could get a hold of them. Maybe it's a project that you and Gary can pick up, dust it off and get it going because there's definitely a need for solutions to solve the opioid epidemic. And so the imitation is there, right Gary?

: Yes absolutely. I'd love to keep working on that. Definitely.

: Tell us a little bit about an exciting project that you're working on today?

So, I'm working on as I said those types of projects there where I'm working on actually using real world data to support patients from various different devices. It's hard to talk like exact specifics but to give you an idea of some of the range of stuff I do something important is working on a number of digital transformations for mainly pharmaceutical companies which is really moving them from a position of not using much in the way of digital channels and communications to their patients and their doctors in their in their marketing. Actually using it in a really defined smart way in a way I don't even want to say multichannel but in a way that really understands the needs of the end customers and actually takes them on the journey and the digital tools they use in the right way and that's exciting for me because that's measurable using digital and technology to take whether it's doctors patients on a specific journey and get to an endpoint. And the beauty of that measurable pace is we can really tie that back to outcomes rather of the the easy way of doing things it's like we need to be digital, let's do e-mail, like Websites that builds an app and just kind of throw things at the patient not the doctor. There's a fair chance that's not to work anyway. But if it does work we kind of don't even understand what's really working and what's not. So some of those transformation projects you know for me are very exciting. And then the more those some of those projects working on building in the technology were actually supporting patients not just using medicines but actually using technologies and other interventions so those ones but those are the ones that I find even more exciting.

: Super exciting and you know we need more of that Gary, so keep up the awesome work there. There's no doubt that companies are starting to come to grips with the fact that this is the way that things are going so keep up the great work.

: Great.

: So Gary getting to the end here let's pretend you and I are building a leadership course in medicine, the Digital Leadership Course in Medicine, the 101 of Gary Monk and I want to build out a syllabus with you. I've got four questions that our lightning round style so some quick responses to these followed by a book and a podcast that you recommend to the listeners. You ready?

: Yes great.

: All right. What's the best way to improve health outcomes using digital?

: So the key thing is understand the patient's situation. I know you wanted it sure but that probably sounds like a cliche, really challenge what you know about the patient and observe the patient understand that pain points. I always like to think if you were if you wanted to understand how a lion lions hunt you don't go and watch and see to the zoo. So forget focus groups just really observe the patient and understand them.

: Great analogy. What's the biggest mistake or pitfall to avoid?

: The key thing to me is we need to stop by asking the right questions. So yes I mentioned dates you and I are important. But if we're not careful we might start to get the right answers to the wrong questions.

: How do you stay relevant despite constant change?

: The two big things I've mentioned the focus of the patients are really understanding them as they evolve but also involving the changing technology landscape so involved both. Get both reported, the patients actually more so because if we understand the patients and not the technology well enough the outcomes are going to be sub-optimal. If we understand the technology and not the patient, it's going to be a disaster.

: Love it. What's one area of focus should drive everything in a health organization, a digital area of focus.

: A digital area focus. So I was going to just answer the easy thing which is important and bring it back to the patients. But actually if you saw a digital area of focus it's understanding that patient, the patients not to see things out necessarily digital, non-digital but just really understanding what they're using, what channels they are using but also why are they using them, what problem are they actually trying to solve with that so just getting real deep in understanding that from a patient's perspective.

: Outstanding. What book and what podcasts would you recommend to the listeners, Gary?

: Yes. So in terms of a book. I finished a recent book actually called Life 3.0 by Max Tegmark and it's about the future of the artificial general intelligence now the some healthcare examples. But what I love about it is it really takes the future forward about where artificial general intelligence can go when machines get smarter than humans. And before I read think more about science fiction. But actually this stuff will be a reality it's just a question if it's whether it's 30 years or 300 years from now. I mean that's what the experts are debating, not whether machines will get smarter than humans but just will it be hundreds of years away that we have think about it in our lifetimes or could it be sooner. But actually it was really good. So understand that from a kind of visionary perspective and then to tie things back from healthcare and understand where it can go.

: Life 3.0. And how about a podcast?

: Yeah. So I feel like your questions I'm comfortable with them all but this one's kind of stomp me you, know I listen to a range of podcasts like not including yours, but I'm just starting to really get into them because you know I've mentioned that book Life 3.0 and it was the first book that I listened to on Audible. So yes, I've found that now in New York when I'm I've got so much time to kind of more like listening to stuff and reading stuff you know when I'm on the subway it's a lot easier to listen than to read so probably next time I'll have a list of cast but really anything to do with technology so I dip into any podcast-related technology. I have listened to digital marketer, once on digital marketing, such really keep up to speed on digital social media and technology so I kind of dip in but also it's a recommendations from you and your listeners as well apart from this podcast and the others I should be listening to so yeah.

: Outstanding Yeah. And now sinner's that's the beauty of podcasting. You know you could go into the podcast app type in your topic of choice whether it be health care or if you want to just take a breather from health care and learn about tennis or cooking or marketing whatever you want. It's all there. The platform is powerful. So do like Gary does you know search for what you're feeling in the moment and just go for it. Gary, before we conclude I'd love if you could just share a closing thought and then the best place for the listeners can get a hold of you.

: Great. Yeah, I mean the closing thought really would be that the one thing that we discussed that kind of that I feel the most strongly about is just that real you know without you know not wanting to sound like a cliché but thinking big and by that is like just really fearlessly going out thinking about what you need to do to achieve the specific outcome without judgment and criticism. And you know I've read the Debono book many times and it's kind of that green up thinking where I'm judged, not you are creative, we're not judging. And then we bring in the critical thinking later about what the current issues to regulator issues might be. So to think big and open it first would be the really big change to make this stuff happen and don't let me off thinking initially. So that's be the really the big thing to me and yet I'd love love if the listeners want to get hold of me, that would be great. I'm very easy to find on LinkedIn. And I'm very open to connecting so you can put all the extension into LinkedIn and it's Gary W. Monk would just search for Gary W. Monks that's one 'r', search for me their own LinkedIn and switchapp, it's just simply @GaryMonk,so that's where the two best places to find me and I'd love to connect.

: If you're on the road don't worry about writing anything down just go to outcomesrocket.health/monk and you'll be able to find all of Gary's information, links to the books that he recommended and a transcript of today's conversation. So Gary, just want to say thanks again for spending time with us and looking forward to staying in touch.

: Yes definitely a pleasure. Thanks all and looking forward

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.

Automatically convert audio to text with Sonix

 


Recommended Book and Podcast:

Life 3.0: Being Human in the Age of Artificial Intelligence

Best Way to Contact Gary:

LinkedIn:  Gary W. Monk

Switchapp:  @GaryMonk

Mentioned Link/s:

https://ginger.io/

Episode Sponsor:

Exploring Digital Technology and Wearables to Improve Quality and Outcomes with Dr. Stephanie Carreiro, Medical Toxicologist & Emergency Physician at UMass

Thanks for tuning in to the Outcomes Rocket podcast where we chat with today's most successful and inspiring health leaders. I want to personally invite you to our first inaugural Healthcare Thinkathon. It's a conference that the Outcomes Rocket and the IU Center for Health Innovation and Implementation Sciences has teamed up on. We're going to put together silo crushing practices just like we do here on the podcast except it's going to be live with inspiring keynotes and panelists. To set the tone, we're conducting a meeting where you can be part of drafting the blueprint for the future of healthcare. That's right. You could be a founding member of this group of talented industry and practitioner leaders. Join me and 200 other inspiring health leaders for the first Inaugural Healthcare Thinkathon. It's an event that you're not going to want to miss. And since there's only 200 tickets available you're going to want to act soon. So how do you learn more? Just go to outcomesrocket.health/conference. For more details on how to attend that's outcomesrocket.health/conference and you'll be able to get all the info that you need on this amazing healthcare thinkathon. That's outcomesrocket.health/conference.

: Welcome back once again to the Outcomes Rocket podcast where we chat with today's most successful and inspiring healthcare leaders. I really thank you for tuning in again and I welcome you to go to outcomesrocket.health/reviews where you could rate and review today's podcast because we have an outstanding guest, an amazing contributor to healthcare. She takes a unique view into the health system the opioid crisis, medical toxicology in general. Her name is Dr. Stephanie Carreiro. She's assistant professor of medical emergency medicine and medical toxicology at U Mass. The University of Massachusetts Medical School and at the University of Massachusetts she really has derived a passion for novel translation research and is specifically interested in the integration of wearable technology with behavioral interventions in the treatment of substance abuse disorders. Her current research pursuits include the utilization of mobile biosensors and micro RNA profiles to evaluate drug toxicity, substance abuse, and addiction. And in this age of the opioid epidemic and a lot of the issues that we're having in healthcare I just thought it was so timely to have Dr. Carreiro on the podcast so I want to give you a warm welcome Dr. Carreiro and open up the mic to you to fill in the gaps in the introduction that maybe you want to fill in.

: Excellent thank you so much, Saul and thank you for the opportunity to be on the podcast and for creating such an interesting forum for knowledge exchange. I enjoy listening and I've actually learned a lot just listening to a few podcasts. So I actually as you mentioned of a medical toxicologist, an emergency physician and a researcher in the health space and I really have tried to focus my interest or my work on wearable biosensor approaches to addiction that build bridges between patients, providers, engineers, scientists to create innovative solutions that work for addiction but also that can create exemplary model for integrating technology into or patient care space.

: It's so fascinating and we share that passion, Stephanie of knocking down silos between different specialties and I love your passion for this particular hot topic. So how would you define the hot topic that needs to be on every medical leaders agenda today and how are you focused on tackling it?

: That's a great question. So I actually think not just in substance abuse space but in health care across the board. We really need to look at how to optimally integrate technology into the provider workflow and the patient lives. There is a phenomenal explosion of both mobile and nonmobile technology and there's a tremendous amount of data coming through. The problem is if the approaches to using it in care are not practical and usable then they're not really yielding much benefit. So poorly designed and poorly executed technology really increase the workload it costs money without any measurable benefit. And when I notice that providers and patients really want is something that seamlessly integrates into their life and workflow in the background it really gives them something to complement and enhance what they're already done not necessarily create more work or more burden. And so that's kind of where I've tried to focus my efforts and I think that's important for the bigger picture as well.

: Yeah, you know seamless integration works within the workflow. These are some common themes that a lot of physicians are just clamoring for in the midst of all this technology that's being pushed into hospitals. Can you give us an example Dr. Carreiro of how you've been able to help this effort?

: One of the things that we work on again is wearable and mobile solutions right. So we have wearable sensors that are simply physiology. We're working hard to create these robust and accurate detection algorithms that identify things like for example in my work. We're looking to identify when patients use drugs like opioids or cocaine when patients are particularly stressed when they're craving drugs et cetera and that science is wonderful and exciting. But if the response to that detection is not something that the patient is poor provider is excited about or fits with what they're doing then all of that work on the detection Divac and detection strategy really goes to waste. So for example patients and providers talk a lot about work fatigue and data overload. And so if we create a system where we detect multiple events in a day and send a provider 50 alerts per patient for example with completely unusable data then again the detection system is essentially useless if we find a way and this is kind of more we're headed to combine all that netted data so to speak into one single alert for a provider that encapsulates really the bigger picture the patient for a day as opposed to minute by minute updates. We've found that that is much more accepted on the part of the provider and provides a much more useful tool for them to go forward and help the patient essentially.

: Yeah this is a really great call out you know listeners how many of you are in a provider setting and you find yourself overwhelmed with alarm fatigue. You find yourself overwhelmed with data that you really don't know what to do with. I think this is very common. So the question that Dr. Carreiro just leaves us with is how can we make this information more exciting, more useful so that we can translate it into actionable results? And she also mentioned the opioid epidemic. I thought this would be a great opportunity for Stephanie somebody that spent a lot of time in toxicology and on this topic of the opioid academic for her to give us a little background like how did this thing all start. You know that question comes up all the time. Maybe you could guide us through the history and how we got to today.

: One of the things that we've seen over the last 10-20 years is really the explosion of prescription opioids that many people feel have driven this epidemic in so 10 to 20 years ago. Physicians were really encouraged to treat patients. Now that's not a bad thing right. We should be attentive to human suffering. All of us and physicians want to alleviate that in any way possible. I think the problem came when people decided that opioids because they're good at doing that they're good at treating pain he decided that opioids should be given somewhat ubiquitously. And also there was a very prominent misconception that if people have legitimate pain they could not become addicted to opioids. That's what I was taught in medical school. Not incredibly long time ago. And that's an egregious misrepresentation to one of the things that I actually asked my trainees to do when a patient presents with an opioid overdose. Once obviously resuscitated and out of the critically ill period. I asked my doctors treating, my residents and my medical student to talk to them about how their first opioid exposure occurred. How did they get to the point where they were in the emergency room and a near death situation as an addiction. And by and large what we hear from people is that they often started with a legitimate prescription from a physician for opiate medication. It's often they had an injury or a surgery or a condition that was painful and some probably well-meaning physician gave them a prescription to alleviate their pain and that often spirals out of control. And so I think we're just probably the last five years come to realize that very altruistic kind of idea that we should treat aggressively treat is coming back to bite us essentially. And so it's led to a lot of talk about how we change our prescribing practices to protect people to balance the need for pain control with the risk that these these strong medications carry. And also coming up with not always to identify who is at risk and protect them. Unfortunately all those efforts will likely make an impact going forward. So people who don't have an addiction problem will benefit from them. But we're also kind of stuck with a large population of people who currently have an addiction problem. And we have to we have to deal with that as well.

: Yeah, this is a great insight and thank you for that timeline and what I love about Dr. Carreiro's story here is that as leaders we have two options we could either look through the window and blame somebody for the epidemic or we could look in the mirror and take responsibility. And what I find is that the leaders in healthcare like Dr. Carreiro, like Dr. Peter Chai who recommended Doctor Carrero to be on the podcast as well. They're taking responsibility for this and they're saying what can we do. And so the message here to the providers but also to industry is look in the mirror instead of looking through the window and pointing your finger because in the end that's how we're going to curb this issue. And so I want to I want to thank you Stephanie for your courage in taking that and saying what are we going to do versus hey they're the ones responsible.

: Absolutely fingerpointing is isn't going to get any of us anyway, right.

: Totally

: So I think one of the biggest advantages I have in my practice is be able to see this on a daily basis to constantly remind me that it's not a problem we can sweep under the rug. It's not a problem that we can point at someone else to blame or even say their responsibility is sick. I think we all need to own a part of this and move forward.

: Totally and I'm going to take another side street on this one and say so, okay maybe you're not a provider, maybe you're an industry maybe you're a payer. Well guess what? The onus is on you too because a lot of this and my wife have talked about too, Dr. Carreiro like OK if something happens how often are you leaving your medications in a place where they're easily accessible to your child or your child's friends. Part of the effort for this opioid epidemic is for you to safeguard those medications and to talk to your neighbors and talk to your friends during parties about doing the same thing because a lot of these things happen on accident.

: I couldn't agree more. I think it again kind of limiting prescriptions is a fantastic way to present to personally prevents some of the issues we've seen. But there's so much more to it than that. So a responsible opioid prescribing responsible opioid use by patients are responsible opioid disposal. So any time we can get opiates out of the hands of the community is a wonderful thing or limit the opiates in the community to the spots where they're needed but also kind of talking to people opening the discussion decreasing the stigma is huge, you know realizing that this could happen to any one of us it's happening in communities of nice people with wonderful families. No one is really immune to the rest.

: Yeah.

: And so I love that you're talking about it and that you're can open this up to everyone's problem as opposed to a problem that we can look that we ascribe to a different group of people or someone else.

: Totally. Yup. So I'm inspired by your accountability Dr. Carreiro and I encourage everybody else to take accountability for this because it's not just our providers, it's us. And what we're doing in this realm I recently found out about about a website called bluelight.org. It's not a Kmart website but it's kind of sickening. It's a site that guides people on how to manipulate their physicians to get more pain meds. And so there are just resources out there to help get and continue this problem. We've got to shed the light on these and turn these things off. But it starts with conversations with our neighbors and it starts with conversations like Dr. Carreiro and I are are having so really really appreciate your shedding light on this problem. Dr. Carreiro the problem will continue to improve as long as we keep talking about it. I'm really glad you brought it up.

: Yeah I think that bringing the epidemic to the forefront has helped but again it has to. That discussion has to proliferate on every level. You know providers in the community and industry think that in order for us to be successful we need to look at addiction the same way that we look at diabetes or high blood pressure or other chronic diseases. We're not blaming the patient or blaming someone that we're actively looking for ways to mitigate or solve the problems.

: Awesome. I totally agree. And what would you say one of your, you've done a lot of really awesome things and up to this point in your career. Dr. Carreiro, what would you say one of your proudest medical leadership experience is to date has been?

: It's interesting so it's always exciting to see something that I have worked on it be a success. But I think actually what makes me the most and in my career is watching my evangelist or my junior colleagues that I've trained go out and solve problems and be successful on their own path kind of taking what they've learned from working with me and using that to dry and something because I feel I think this is a common theme in medicine because we would train people coming up. I feel like that's the most rewarding because then you can really see your work spreading and see younger people with new ideas flourishing. So that's been the most exciting for me.

: So tell us a little bit more about an exciting project or focus that you're working on today.

: So right now we're actually newest and I think one of my most exciting projects to date in is project using wearable sensors to evaluate people who are newly stuck on opioids to try to identify when patients are at risk for developing tolerance and addiction and potentially intervening before that happens. So all of my research to date has really use wearable sensors and mobile apps to monitor and intervene on patients who already had substance use disorder and are either actively using or in recovery. What we're doing now is we're taking all of that knowledge that we gained and all the data that we obtained and we're applying that much earlier in the spectrum before people become addicted to opiates. And to me that that's really exciting because the idea is that we can potentially prevent addiction from happening by studying how people physiology changes every time they are exposed to an opiate for the first time and really identifying when the risk of being on an opioid outweighs the benefit of the pain control that you're getting from it as a potential point of discussion between patients and providers when it's time to transition off it or when when that risk is too high.

: Truly exciting and at the end of the project provision for it like what does this look like?

: What I'd like to have as an end product of this is a wearable and app most likely wearable and app based combination that we can give to providers when they start patient on a new opiate. For example if a patient comes in and has a broken leg from a crack then obviously that's a painful condition in most cases would be reasonable to treat with an opioid if necessary. We'd like to have a product that the physician can use in the healthcare environment where they can watch closely how the patient's response changes to that opiates over the first couple days two weeks and then again have a discussion with the patient about when that potentially becoming too risky and potentially stop therapy before it becomes a problem.

: Very cool. It's sort of opioid risk like real time screening tool.

: Exactly.

: Very cool. Very cool. And yeah you know just thinking through every patient's different. You really can't. It's not a one size fits all especially considering even on the back end of it when you're getting put down on your anesthesia every patient will take medications differently for sedation. So I think this is a really cool tool to use outside of the clinic when things do become a little more risky.

: Exactly. And what we're noticing even in our preliminary data collection is that some patients show signs very early for example the first, second or third day after initiating opioid therapy. We're noticing some pretty big red flags in terms of risk whereas other patients can take them for a week and has no perceived change and no difficulty stopping the medication. So this really kind of plays into the idea of personalized medicine and really targeted therapy to meet people where they're at understand how or how their response is changing and how we can help that one patient.

: Awesome. Sounds super exciting and dappling want to stay in touch with you as as you move that project forward. And when it does come out please share it with the listeners. We want to get you back on.

: Absolutely.

: So Dr. Carreiro let's pretend you and I are building a medical leadership course on what it takes to be successful in medicine. It's the 101 of Dr. Stephanie Carreiro. So we're going to write out a syllabus and I've got four lightning round questions for you followed by your favorite book and podcast that you recommend to the listeners. You ready.

: You're absolutely.

: Awesome. What's the best way to improve healthcare outcomes?

: Key is to get early involvement from all critical stakeholders and end users. So this will identify your barriers early on and also generate early investment in buy in from the people who live in the community that you want to adopt your ideas.

: What's the biggest mistake or pitfall to avoid?

: Definitely would be generating ideas in a vacuum and expecting success on the first try.

: How do you stay relevant as an organization despite constant change?

: Too we're constantly looking for the next step and then using our data and our experience from prior successes to propel us forward.

: And finally what's an area of focus that you think should drive everything in a health organization?

: That would be collaboration. Absolutely. So kind of using the skill sets of others to create something that's better than you could come up with on your own.

: And finally Dr. Carreiro, what book and what podcast would you put at the end of the syllabus?

: Respect to the obesity epidemic specifically. I'm currently reading the book Dreamland which is eye opening even for someone who works with patients with addiction every day. So if you're interested in understanding how we get to where we are in the opiate that make I would definitely recommend checking that out.

: Dreamland.

: In terms of podcast. Yup, the podcast I'm an emergency physician and so one my favorites actually emergency medicine abstracts on the em:wrap podcast that can help me keep up to date on all the current literature and there's a lot of great toxicology content on there as well.

: What a great resource. Dr Carreiro, thank you so much for that. This whole syllabus is available. Just go to outcomesrocket.health/carreiro. You're going to be able to find all of that there along with a transcript of our conversation, links to the things that Dr. Carreiro mentioned. So excited to have you check that out. So Dr. Carreiro, thank you so much for your time today. Before we conclude I'd love if you could just share a closing thought with the listeners and the best place where they could get ahold of you.

: Absolutely. So the best place to get a hold of me. You could either follow me on Twitter and just at @dr_carreiro on Twitter or you can also check out my team and more about our research and who we are at umasstox.com, talks a little about about our research endeavors and also includes our newest philanthropic initiatives. The overdose prevention fund which is a phenomenal community and research oriented organization you can check that out and I appreciate the opportunity to talk to everyone. I would encourage people to dig a little more. The opiate epidemic is a fascinating issue and it will lead to more people thinking about creative solutions.

: Outstanding Dr. Carreiro, so really want to just say thank you again and listeners feel free to follow Dr. Carreiro on her Twitter. She definitely posts some informative and engaging posts there and again just want to say thank you so much for spending time with us.

: Great thank you, Saul.

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.

Automatically convert audio to text with Sonix

 

 


Recommended Book and Podcast:

Dreamland: The True Tale of America's Opiate Epidemic

Emergency Medical Abstracts

Best Way to Contact Stephanie:

@Dr_Carreiro

Mentioned Link/s:

https://umasstox.com/

Episode Sponsor:

 

Outcomes Rocket - David Weingard

Fit4D is Improving the Lives of People with Diabetes with David Weingard, CEO and Founder of Fit4D

Thanks for tuning in to the Outcomes Rocket podcast where we chat with today's most successful and inspiring health leaders. I want to personally invite you to our first inaugural Healthcare Thinkathon. It's a conference that the Outcomes Rocket and the IU Center for Health Innovation and Implementation Sciences has teamed up on. We're going to put together silo crushing practices just like we do here on the podcast except it's going to be live with inspiring keynotes and panelists. To set the tone, we're conducting a meeting where you can be part of drafting the blueprint for the future of healthcare. That's right. You could be a founding member of this group of talented industry and practitioner leaders. Join me and 200 other inspiring health leaders for the first Inaugural Healthcare Thinkathon. It's an event that you're not going to want to miss. And since there's only 200 tickets available you're going to want to act soon. So how do you learn more? Just go to outcomesrocket.health/conference. For more details on how to attend that's outcomesrocket.health/conference and you'll be able to get all the info that you need on this amazing healthcare thinkathon. That's outcomesrocket.health/conference.

: Welcome back once again to the outcomes rocket podcast where we chat with today's most successful and inspiring health leaders. I really thank you for tuning in and I welcome you to go to outcomesrocket.health/reviews where you could rate and review today's podcast because we have an outstanding individual and leader in healthcare. His name is David Weingard. He is the CEO at Fit4D. Their goal is to solve for diabetes medication adherence in a very unique way. And David's got a really unique background with the technology and sales background. Spent some time at Microsoft then went over to start his own company as part of the startup health moonshot to help the diabetes solutions. He's done some really great and innovative things that fit Fordie. So what I want to do is just open up the microphone to David so he could fill in any of the gaps and then we'll get into the diabetes discussion. So David welcome to the podcast my friend.

: My pleasure. So great to be here.

: Hey it's a pleasure to have you. And so what is it that got you involved in the health care, David?

: So I got into health care because one day I went to my doctor and I had absolutely no energy stepped on the scale of 159 on a good day and I was 129 and I lost 30 pounds in three weeks. And the doctor told me I had type 1 diabetes. So my life changed at that moment. And I was completely overwhelmed. I've been an athlete my whole life been a runner. I had already done nine man track funm. No diabetes in my family. So I needed help. And the doctor was able to prescribe medication for me, insulin and given a point with his nurse the next day to learn how to take it. But I really needed somebody to help me through and educate me. I looked online a lot of good information out there wasn't personalized to me, went to the local hospitals and the next diabetes training classes were two months away. Wow. And I needed help now. And I was fortunate to meet a great diabetes educator a lady named Cecilia who took the time to personalize all that content online and make it meaningful to me. Give me the support, the compassion and really help me get to an empowered place in my life. And that really changed everything for me it was a magical experience. And from that I decided to dedicate my mission to improve the health of people with diabetes and leverage what I learned through Cecilia.

: That's amazing. David. What an amazing story. And you know I could feel the confusion, the frustration and in come Cecilia and she just lights the path for you which is amazing right. And not everybody has a Cecilia and so it's interesting that that you were able to locate her and she was able to provide that insight for you. What do you think today is missing from the health system? What's a hot topic that needs to be on every medical leader's agenda?

: Well when you look at the providers and ask them what's the number one thing they want to accomplish with their patients they say we want them to follow our care plan and take the medication and the number one thing they don't have time to follow up on is exactly that. So how do we deliver a value based service that makes it easier for the provider to deliver outcomes for their patients and to get them back into their office to take care of them. And so when you look at diabetes specifically this 30 million people in the United States with diabetes about 5 percent of them have type 1 like myself. Body doesn't create insulin anymore. Type 1 is also called juvenile diabetes. And the other 95 percent of Type 2 people with diabetes which is more what you hear about in the media about type 2. And you know when you look at the numbers and getting connecting those people with Cecilia's, there's maybe 30000 of them in the U.S. the only way to do that is with technology to scale Cecilia's so they could virtually meet the needs of the population. People are busy. They take care of their families their careers. How are they going to take the time off to get to a diabetes educator and how are they going to do all the work in a way that fits into their life? And so I think that's a huge issue is about fitting into people's lives making sure that they follow the care plan that the doctor prescribes and actually delivering measurable outcomes.

: Yeah for sure, David. So on this topic give us an example of how you and your organization have created results by doing things differently.

: So it's interesting if we take for example two different patients one is a mom who's taking care of her kids. You can't take care for diabetes till the evening something so simple as having diabetes educator on the phone or communicate through technology like e-mail and text when the kids are in bed is a way of fitting into the person's life you know rather than trying to figure out how to do it during the day or traveling to a doctor's office. The virtual component is really key. The other part is really personalizing to what the person needs the most. May have a patient that was diagnosed a specific diabetes medication and the side effect is nausea in the first 30 days. We can't really talk to them about improving their diet until you help them with what they're stuck on because they don't want to hear about it. They might not even take the medication or drop off because they're dealing with that nausea. So getting them through that issue and then moving to the things that you can try behavior change so the level of personalization making it meaningful. You know another example is someone who walks out of a doctor's office overwhelmed with a sense of failure maybe their grandfather passed away from diabetes. So again you have to have compassion and support and help them through that experience before you're going to help them learn how to take the medication. Do the behavior change that's critical to take care of the diabetes. Meeting people at where they are. It's one of the biggest lessons we've learnt.

: So totally love the outline that you just provided, David. How do you guys meet people where they are? How do you do that?

: So one of the things that are diabetes educators do me they focus on building trust with the patient and it's always the same. Diabetes educator that works with the patient. So if we're calling on behalf of a health plan we are saying you know what I got your back. Basically your personalized diabetes educator for the next X months. And people really resonate with that. They're not used to that level of service from their health plan or provider. They appreciate it because the patients are motivated to change. You just don't know how to do it. They don't either have the education or the time or they need somebody there to keep them accountable. And so what we make sure our educators do is they build a trusted relationship first solve for what the patient is stuck on and then start moving them through the diabetes journey. And that's an art. I mean it's taken us eight years of innovation and testing in the real world with big pharmaceutical clients, medical device clients, health plans. How do we do this in a way that not only creates trust but is scalable. There's a lot you can pay clinicians ten different ways if they are with 10 different patients. How do you do in a way that is scalable drives return on investment for the clients the is measurable outcomes. That's the art and that's really what we spent most of the time on during our innovation years.

: That's fascinating. Now listeners David and his team are doing some outstanding things. They recently made an announcement of an expansion with Humana to deliver personalized diabetes coaching in South Florida. David you want to dive into a little bit of that and kind of give the folks some insight into what you guys are doing over there?

: Sure. So if you look at Florida as an example one out of every four people in Florida have diabetes.

: One out of every four. Is that right?

: Yeah. It's a large part of it is that there's such a large senior population and type 2 diabetes usually progresses as people get older. But we really these people are overwhelmed and even if they can visit the doctor and they have the mobility to do so and the support system they really need somebody that's going to get to know them and motivate them and help them through the questions and their stocks around some of the things we've talked about so far the medication. How do I change my diet? How do I integrate exercise at my age? There's so much education that needs to be done. So Humana recognized that there was a need. The providers were completely overwhelmed to our earlier point of you know the number of diabetes patients and how did they get them educated and on a healthier direction without spending hours that they don't have per patient of their own. And so Humana stepped up to deliver this service to for their benefit to lower costs and improve quality measures and for their members benefit for that to improve their health. And so we're really the provider that's delivering the service. And it's a win for the physicians it's a win for the patients and it's a win for Humana.

: That's amazing. So just want to say congratulations to you guys on that partnership but also the bigger picture you know helping this population that is that is struggling and that is Unnur served in a really big way. So it's a big kudos to you and your team, David.

: Thank you. We're making a difference every day and it's one of our core values is the passion we have for members and it's really incredible to see how lives can be changed.

: Let's zoom into that a little bit more. Maybe this example or maybe another example that you guys have changed lives. Can you tell us a little bit about how you guys have improved outcomes?

: Absolutely. So this a clinical measure called A1C which is the average blood sugar level over three months and that is from Medicare it's a triple weighted quality measure in the commercial population it's a key measure that the commercial population uses to measure the likelihood of diabetes complications. People don't die from diabetes they die from or have complications because of related things like heart a heart attack or a neuropathy where they lose feeling in the nerves and the fingers or in the feet. And so A1C is a key measure to see how diabetes health is progressing over aid is considered poorly controlled. So we'll work with health plan or watch provider group to take their patients that are poorly controlled and work to do the behaviour change to get them on the medications and get that agency measure down in one population we work with. We were told that the patients were all on an oral diabetes med and when our diabetes educators got to work we found out they were prescribed mealtime insulin as well which you know gets into a lot of medical science here but basically a mealtime insulin covers the food that you're eating. So when you eat carbs you need insulin to cover those carbs so you're enjoying the meal. And these patients didn't want to take the injection they didn't know why it was important and just want to stick with the pill. And by getting these patients to recognise the importance of taking the insulin we were able to change the A1C measure and deliver quality measures lower costs and get the patients healthier.

: Amazing. What a success story and something as simple as finally looking through what was going on. Identifying the problem and just communicating it being that that heart and that voice to be present during that care scenario at the home. So I really appreciate you diving into these very personal and impactful moments that you guys have been a part of David. In your mind to date it hasn't always been smooth, what would you say a setback that you guys experienced as you guys developed the company and what did you learn from it has made you guys stronger?

: Well I think when I go back to eight years ago the health care landscape especially for innovation wasn't as mature or resilient as it is today. So we went to look for funding and we were basically told unless we were a million multimillion dollar business we wouldn't be able to raise money and it was true. So we went out and we delivered results by signing real paying clients where we innovated while we got paid and we were all we showed that we were results based and were able to innovate while we engaged in the market. Nowadays you can kind of get a startup amount of capital to begin testing but frankly I'm glad we did it this way because by the time we finished our art of signing multiple clients and growing up business, we had real data in the real world as opposed to just small pilots here and there.

: That's amazing. So you really were just forced into signing your clients and delivering value ASAP and that was character forming.

: It was great and it built the cultural business one of our five core values as being results based, on being results based for our clients delivering return on investment and quality. Another one is compassion for our patients so these really develop during these years and getting things done.

: Love it. Hey have you ever read shoedog?

: I Haven't.

: You haven't I think about that because it just kind of resonates. You know those guys. Phil Knight and his team. Man, they were struggling they winning they couldn't get money from any banks and that was one and their one of their tough spots and with much grit and focus and vision just like you guys have that Fit4D. Much to your credit they were able to persevere and now look at them. So I think it's so awesome. Appreciate you sharing that story with us and listeners. The takeaway here is don't lose sight of your regime. Keep working at it and get those results. The money will follow. David you say one of your proudest medical leadership experiences to date is?

: We have a system in our company where we share with our clients the best call the week. And I wouldn't say there's one particular call but it's the process of capturing those magic moments and sharing the wins with our health plan clients where we have patients who are literally crying on the phone for help and how they'll then subsequent calls saying how we change their lives. And those are the kind of things that we've learned to capture and share and treasure. And then it's you know simply things like understanding culture and language. We have now not only life in English but in Spanish and Chinese. And to understand.

: Nice.

: You know if you're going to guide people to even within a Spanish culture speaking culture to a taco it should be a Mexican Spanish speaking person as opposed to what we deal with here in New York which is mostly Dominican Spanish so the patients really appreciate that their clinician understands them understands their socio economic background and it's not just reading from a script. They're really authentic and really trying to help them in a very personal way.

: Amazing. I love that David. And definitely something to be proud of. And you know I love that you mention that you know systematizing these magic moments rather than just experiencing them like let's let's find a way to capture them. And that's really thoughtful because being in the trenches it's easy to lose track. And so where did the inspiration to start documenting these and saving them come up from.

: It actually came up from one of our clients they said you know we'd love to hear it. And this goes back maybe four years ago and said that's great let's do it. And we started realizing the power of both at a client level and also internally.

: I think that's so great something that we can all take a note from. Tell us a little bit about an exciting project or focus that you're working on today, David.

: So we continually enhancing our platform to be able to scale our clinicians and one of the things that we're being asked for is not only to help with diabetes but comorbidity as well. So a lot of the same patients who were dealing with diabetes were also dealing with cardiovascular disease. And so there's a slice of the population that we can help at a much deeper level and so continue to innovate. There is a big focus when you look at a health plan that's 18 percent of patients account for 40 percent of the costs. And for us to be able to focus on that 18 percent which is really the hardest part of the existing care management programs that sees management may help someone out there may help the core population. But the chief medical officers are really struggling with the people who are poorly controlled and an 18 percent. And so branching out with diabetes and cardiovascular as exciting new opportunity for us.

: That's awesome man. And with the success you guys have had in the core offering I'm sure that will definitely be another area of high impact. So excited to keep up with the things that you guys do and and really look forward to hearing more about that. David let's pretend you and I are building a medical leadership course and what it takes to be successful in diabetes and in medicine. It's the ABCs of David and so I'd like to write out a syllabus with you today. I've got four questions, lightning round style followed by a book that you recommend to the listeners. You ready?

: Absolutely.

: What's the best way to improve healthcare outcomes.

: Human touch, trust, leveraging technology. After building trust by the human being.

: What's the biggest mistake or pitfall to avoid?

: To rely on apps or web sites to change behavior.

: Love that one. How do you stay relevant as an organization despite constant change?

: Teamwork and communication and learning every day.

: What's one area of focus that should drive everything in your organization?

: Patient care. The outcomes of the patient drives everything.

: And what book would you recommend to the listeners as part of the syllabus?

: One of my favorite books is a book called Blueprint to a Billion. It's especially would be dear to anyone who's an entrepreneur or a business minded talks about getting marquee customers about building your board of directors. And it has a lot of data from the most successful companies about how they got to this spot that they are so highly recommended.

: An amazing shared thank you for that. Definitely going to have the added to my list, David. And listeners don't worry about writing any of this down. I know David's provided so much value in this episode. Just go to outcomesrocket.health/fit4D and you'll be able to find all the show notes links to fit for DS website as well as a transcript of all the things that we talked about and links to the book. So David before we conclude, I love if you could just share a closing thought and the best place where the listeners can get a hold of you.

: You know this has been great and health care is in such a state of transformation now and the pace of innovation is accelerating. That we're excited to be part of it and I encourage everybody to engage as a transform and be open minded to what's what's possible fit4d.com is our website. We also have a Linkedin community called Diabetes Innovation and a Facebook community. Love you to engage and if we can help you let us know.

: Outstanding and David they could get a hold of those communities through your website. fit4d?

: Yes www.fit4d.com.

: Outstanding David just want to say thank you again for spending time with us and we're excited with the stuff that you guys are doing to make the lives of people with diabetes better. Keep doing what you're doing man. The ripple effect is huge and we thank you for spending time with us today.

: Thank you very much.

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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Recommended Book:

Blueprint to a Billion: 7 Essentials to Achieve Exponential Growth

Best Way to Contact David:

https://www.linkedin.com/groups/4356467/profile

https://www.facebook.com/groups/DiabetesInnovationHub/about/

Mentioned Link:

https://www.fit4d.com/

Episode Sponsor:

The World's First FDA Cleared Wrist Pulse Ox Sensor with Leon Eisen, Founder & CEO at Oxitone Medical

Thanks for tuning in to the Outcomes Rocket podcast where we chat with today's most successful and inspiring health leaders. I want to personally invite you to our first inaugural Healthcare Thinkathon. It's a conference that the Outcomes Rocket and the IU Center for Health Innovation and Implementation Sciences has teamed up on. We're going to put together silo crushing practices just like we do here on the podcast except it's going to be live with inspiring keynotes and panelists. To set the tone, we're conducting a meeting where you can be part of drafting the blueprint for the future of healthcare. That's right. You could be a founding member of this group of talented industry and practitioner leaders. Join me and 200 other inspiring health leaders for the first Inaugural Healthcare Thinkathon. It's an event that you're not going to want to miss. And since there's only 200 tickets available you're going to want to act soon. So how do you learn more? Just go to outcomesrocket.health/conference. For more details on how to attend that's outcomesrocket.health/conference and you'll be able to get all the info that you need on this amazing healthcare thinkathon. That's outcomesrocket.health/conference.

: 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 go to outcomesrocket.health/reviews where you could rate and review today's program because we have an amazing guest for you today. His name is Leon Eisen and he's a Ph.D. inventor, entrepreneur and contributor to healthcare. He is most recently well known for the formation of Oxitone Medical where they invented the world's first FDA cleared risk sensor blood oxygen monitor without a bulky fingertip probe to meet the basic health care needs. Keeping people healthy or at home by providing hospital grade digital continuous care with AI capabilities. We're going to be diving into some of the things that went into that and the thought processes of how this could improve health care are a little bit later. But what I wanted to do is offer Leon the opportunity to fill in any of the gaps of the introduction. He is coming to us recording from Israel so a big thanks for jumping on with the time difference Leon. Welcome to the podcast and tell us a little bit more that you want the guests to know about you.

: Thank you much. I think you'll said a lot about me even more that I could say about myself.

: It's a pleasure. It's a pleasure Leon. There's no doubt you've done a lot in technology and also in medicine and I love to get a better understanding of what got you into medicine to begin with.

: Oh it's interesting. After I graduated from PHD, I went to post doctorate research one of my friends just asked me to help with optical design of new redesigned sensor.

: Yes.

: Device. And today this device is in the market by the way it's the only device on the market to measure hemoglobin. And I said okay, I can help you. So this way I get involved into a very interesting, very promising and very important for all of us healthcare business, technological business, technology business. So I was so much excited about doing and the building medical devices so I left my post doctorate research and joined this company. So I joined another company and another company like executive then my father just go out on the street being free hours discharge from the hospital.

: My goodness.

: I called our physician and ask him, so what happened? Why?

: Yeah.

: He said I don't know. I saw him three hours ago. He was great. I don't have any capabilities to check what happens in real time. So it will sound someone came it took 15 minutes to make some trash to measure all this stuff. Thank God, my father was still alive. But this was my humbling. So I have all capabilities, all knowledge even technology in my hands which I can use to monitor patient continuously did what happened before. Why can we monitor oil, engine, but why we cannot monitor continuously human being?

: Totally agree. That's a great point.

: So we decided to do something that's impossible. We decided to move graph, decided to start up oxygen sensors from fingertips to the reef. So this way it becomes very comfortable. It allows us to measure 24/7 and just we left the state we have about 2 middle patients under continues oxygen administration. That's really where fingertip device is 24/7 impossible to look to their fingers how they look like. So we decided to solve this problem before. So we are first on the market. Many, many companies just entered into this area. They decided to like Wombles for example failed to measure what pressure, glucose has always maintained patents to allow nothing except it. Will that work for us wireless sensors for oxygen monitoring, FDA cleared and by the way you take Apple with all noise around apple health care. There are no medical devices. You know oxitone is a world first FDA cleared medical device which measure pulse, rate, or medical grade.

: And when did you guys get your FDA approval Leon?

: But with did very complicated clinical trials in Colorado only two sites in the United States where you can make this iteration tests. Here are can come comparative test invasi oximeters.

: Yes.

: Like my Seema like any medical like all other devices today fingertip devices.

: Yes.

: The unit is just trial deals they didn't believe because they said many companies came to us, it doesn't work. We succeeded they checked it many times. And finally they said OK, it works. This is where technology, so this is literally technology without more than 5 portals ground paternalistic knowledge world wide and we're using very unique ways, unique configuration of sensors that nobody could repeat it.

: Congratulations on the approval. When did it happen.

: Exactly a year ago. By the way today I have my birthday.

: Today is your birthday?

: Yep.

: Happy birthday.

: Thank you very much. Exactly at my birthday a year ago. We got FDA clearance.

: Did you really? Talk about an amazing birthday gift. That's amazing. That is amazing. So big congratulations to you Leon. It's not easy to get approval especially on a device that others have tried to develop and have failed and so a year ago you got approval. What are you guys planning to do now?

: We've planned this year on developing sales infrastructure. Because it's not just sale like other devices for atmospheric measurements. It requires some technical support. It requires continuous connection to the healthcare environment. We've developed finalized with portal patient or the patient application because I can't even tell you that some companies they are not ready to take wire to catch up this. It's such such a huge stream of data. They are all dedicated to omcethey are once we mainstream and by the way all these measurements you post when they feel that, they get measurement. In our case will whole digital continuous care. While the US entry into the digital continuous care. And what is the difference? The difference that each should have continuous care yoi have produce.

: Yes.

: A lot of evidence base. So if you a once a day once a week, you cannot predict anything but it does have some impact on vital signs. And by the way we measure what oxygen saturation holds the rate activities, temperature, pulse rate variability so it's against stress. So we have the department continues potom of data. So if something changes, it's a blueprint or a patient like they may. And this is will be catch up in time.

: It's definitely exciting. And so you're putting together the infrastructure you're putting together the platforms for for patient portals connectivity to help others do the digital continuous monitoring and definitely exciting for this technology to come forth. For you, Leon what would you say the future looks like? Let's call it five years from now. Where is this technology being used? How is it being implemented and who cares about it?

: Very very difficult question because this creation belongs to resistance of the current medical system to new development of design and I think in any it's importance for high risk patients.

: Yes

: So the main important use case is the high risk patients recently discharged from the hospital. All we talk about hospital at home. So patient in stable going to the hospital to be admitted after the emergency room visits. They could be sent back home with the same level of hospital grade monitoring like they would have in the hospital. So I think at least acknowledge it. And by the way there are other companies like wide to come that they also they provide the digital continuous care or heg from that patch. Maybe she's not so comfortable like a small wrist watch made case it was. So there is some cohort of companies we should just write to all the right who the market with their medical system to accept our technology. Digital continuous not only monitoring because it's a digital continuous care. This is the hospital great care at home. So I see them move using these technology. We can move hospital care and monitoring to the home so we can remove or reviews hospital stay very dramatically because instead of whether we have to spend two days in the hospital just for measurements of vital signs I can pull up that they take off my small fingers to monitor. Everybody knows what to do and take oxitone, go home and continue the same level of care of monitoring. So we have three main changes that will happen and our technology will intensifie just readmission reduction, very low readmission and very low, very efficient readmission because all readmissions reduction to date has been very high new workload it's very high, very costly. In our case, everything happen automatically. So you have automated continuous door at the same time. You don't have to call every day to check the patient, to care to go to the patient every day, to ask what happened. Everything goes automatically up while you're waiting for that a lot. And a lot of cell will be before something happens. The other emergency room to hold. And then our water or another change it will be a real reduction. Will the hospital stay.

: Well there's no doubt this technology will be providing a lot of benefits to patients to health systems potentially a big way to reduce costs. Right getting patients home faster and it's pretty exciting. Now maybe something that I'd love to hear from you Leon as the listeners also are working to bring forth their innovations. What would you share of a setback that you had in the long process to get this technology finally approved? Can you share a setback or a failure that you experienced and what you learned from that?

: Well you do something new. You go through a hole pitfalls you can find it. So.

: Yes a lot of pitfalls.

: Doesn't allow the easy way, you know so if you have some pitfalls you will get in. So yes it is the real problem. Somebody said if it doesn't kill us, it make us stronger. So really we investigated each mistake. It was a mechanical mistake it was technical, it was optical, so everywhere. So we made a very small step then stepped back, step fast, step back. So we systemised all these mistakes, we build working system, working system I would say and this allows today to anticipate some mistakes and to avoid it.

: Fascinating. And so there's no doubt Leon, you're a patient man.

: Not sure.

: You're a patient man with the vision. Right. And so folks if you're listening to this you know it wasn't an easy road for Leon to get to where he is now with him and his team finally having an FDA approved product and building systems to actually commercialize and distribute this product. It's Pptients. It's a vision. But to Leon's point it's also building the systems that are going to help you avoid the failures and the setbacks that you had to begin with. And so Leon really appreciate that share. What would you say today is your proudest medical leadership experiences that you've had?

: I think I can just separate leadership, medical or executive or I don't know. So just have to move. We have to move all the time. We can't just watch what happens. Dawn Oh I do not have to move all the time and the leadership experience that once I stop, I lost a lot. Never stop it doesn't matter do we have money, do have customers. If you believe in what you're doing all of the world will follow you.

: I love it. And this is such a great message. Leon I last week I had a chance to be at the Beckers healthcare meeting where I was able to hear both President Clinton and also President George W. Bush speak and they shared the same message and that message was stand for something, believe in something and stand for it and do something. So coming from two past presidents and also Dr. Leon Eisen I think it's piece of advice worth following. Listeners stand for something and do something and the world will follow you. Yeah very great share Leon. Very Great share. Tell us a little bit more about an exciting project within what you're doing now that you're so excited about and you want to tell the listeners.

: This is still the same project to have to improve our device. And the more vital signs with and more capabilities and the most important we're going to launch sales this summer. Official sales.

: Awesome

: Even from our website we have a long list of preorders. just from patients, from physicians, from institutes, universities and companies. And so our project today is to launch sale...

: So being that it's an FDA cleared device. Do you need a prescription to have it or can patients buy it directly. How does that work?

: Because you have 5000 K we need a prescription.

: So you do need a prescription, nevertheless it's available. Once you have that prescription patients could buy it for themselves.

: They could buy for themselves or insurance companies to provide, hospitals who provide them who tried different business models. Because again you don't have very well established business model yet though. So why. Because for example any proximeter is not induced by Medicaid or Medicare. It was reduced because while you do more so so be the whole use all at once a week measurements will pay for that. In our case another challenge would have to show that there is the real Weidensaul, we bring medical device or medical device in different level and we have to the reason why in this device and we have to get in there. And this is another project we are just getting started working on.

: Excellent. Well we definitely wish you the best on this on this project. I mean you've been persistent even passionate and you've been consistent in your approach and I have no doubt you're going to succeed at this Leon. Now let's pretend you and I are building a leadership course on how to be successful in health care leadership. It's the 101 of the Dr. Leon Eisen. So we've got a syllabus. We're going to put it together four questions that are fast, lightning round questions followed by your favorite book that you recommend to the listeners. You ready.

: Yup.

: Alright. What's the best way to improve health care outcomes?

: To get patients involved.

: What's the biggest mistake or pitfall to avoid?

: To accept industry resistance as no.

: How do you stay relevant as an organization despite the change?

: The whole world is changing.

: And finally what's one area of focus that should drive everything in a health organization?

: In our organization it's device.

: What book would you recommend to the listeners, Leon?

: I recommend Art of War by Sun Tzu. This book, I read every once a year. I read it again and again. I don't know, like bible. And every time it gives me inspiration and understanding how to fight.

: That's wonderful. The Art of War and listeners. Don't worry about writing any of this down. You could find the show notes as well as links to all the things that we've talked about including links to Leon's company Oxitone medical as well as the link to the book that he just recommended and a full transcript of our conversation. Just go to outcomesrocket.health/oxitone. You're going to be able to find all that there. Leon this has been a lot of fun. Really excited for the innovative approaches that you guys are taking. If you can just share a closing thought with the listeners and then the best place where they could get in touch with you to learn more.

: Here's to follow. I very much appreciate our listeners for their time. So thank you very much. And what I suggest first of all, move all the time. Do not stop, if you have an idea, you have to start to elaborate this idea. I called business you around this idea so I'm open to any questions if you have something - starting from zero. Do something personal. I'm here for you.

: Outstanding and Leon, really appreciate you spending time with us and looking forward to seeing your success and you to add value to the health system with this innovative technology. Thank you very much.

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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Recommended Book:

The Art of War

Company website:

https://www.oxitone.com/

Episode Sponsor: