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Great by Choice

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A Universal Vital Sign for the Brain with Ryan D'Arcy, President and Chief Scientific Officer at HealthTech Connex 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 slow. 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 have the outstanding Dr. Ryan D'arcy. He's the co-founder and Senior Scientist Entrepreneur for HealthTech Connex. He's a trained in Neuroscience and the Medical Imaging. Dr. D'Arcy holds a B.C. Leadership Chair in the Medical Technology and is full professor at Simon Fraser University. He also serves as the Head of Health Sciences and Innovation at Fraser Health, Surrey Memorial Hospital and is widely recognized for founding Innovation Boulevard. Dr. D'Arcy received a BSC with distinction from the University of Victoria along with his Ph.D. degree in Neuroscience. He's done a lot of training and has implemented a lot of the design and technologies in the space of Biomedical Imaging Clusters. So I'm really excited to have him on the podcast today and to hear the insights that they're up to. Sir Ryan, warm welcome my friend.

Thanks for having me.

It's a pleasure. So anything in that introduction that I missed that maybe you want to fill in?

No no. It sounded great.

Awesome. So what got you into health care,Ryan?

I've always loved biology and I think I also always loved technology and physics. And then I'd stumbled on the brain and was just fascinated with the brain really towards when I was finishing my undergraduate degree. And from there the rest is sort of history because everything I do is using advance medical technologies to wash the brain in action and help primarily from a neurology neurosurgery standpoint but increasingly broadening out from there.

Well it's super interesting the work that you've taken on. I'm personally fascinated by neuroscience and am intrigued about the discussion we're about to have. What would you say Ryan is the hot topic that needs to be on every medical leaders agenda today?

Oh well the hot topic on every medical leaders agenda today I think for me it's not so much about the buzzword of innovation as more about sort of the translation and implementation of innovative lab findings. So I think the hot topic is really the idea that you know medical training really trains sort of a procedure and don't deviate from that procedure.

Right.

And when you have a world that is kind of thrusting on with new innovative solutions that are about you know really trying things that might be risky or new or novel or that sort of thing. The hot topic is for us as a society to find ways to embrace that particularly to find ways to allow clinicians to embrace their inner innovator and still of course be completely you know highest quality and safety and patient care, the whole thing. But really that's going to just bring so much advance so much more quickly. And I think that's got to be the hottest topic in my mind.

I think that's a really interesting point because you know embracing that inner innovators what you call that. And I think a lot of clinicians and physicians want to do this. But to your point Ryan you're just sort of limited to what you could do because of the training. And so it be interesting to hear your insights that how can they do this better? What techniques could they use, what tools can they use to embrace and encourage their inner innovator?

Well you know it's interesting because there are a lot of forces at work that any any clinician could tell you they feel on a day to day basis that it once you've had an idea of a wait and do something better. It's really challenging to know. Well how exactly would I make that happen. And I think it takes a lot of bravery in an otherwise extremely busy job to find solutions to that issue seeing your practice. You know there's there's an obvious innovation there's this step from identifying it to you know implementing it successfully and in a few patients and scaling it to many is really something that pulls from a training standpoint is counter to the training from the systems administration standpoint historically hasn't been something that you know you might find encouragement in universities and hospitals that are busy delivering services. That's not something that's topped their radar. So I think that what we're seeing is really interesting to watch is forces outside of the hospital system are starting to make that more possible particularly we're seeing shifts in as we are across the world in care being delivered outside of the hospital and more community care-based and much more a shift from a paternalistic model to kind of you know the patients managing their own services and that sort of thing and more kind of shifts in trends that way are actually a good thing for clinicians because it's creating a new circumstance that allows them to just sort of whether the like it or not digital health will be an excellent example have to really tackle some of these innovations. And the last thing particularly if I use the Canadian health care system as an example we just simply can't outspend our way out of the problems we're having in terms of the clinical care delivery in busy hospitals with congestion and that sort of thing. So when you bring the word innovation as a way as a new way to solve problems I think that's really helping us. And it's particularly helping us when we start to entertain the idea of you know learning things quickly in our private sector and then actually allowing them to get tested there and then make their way into our public health care systems. So big forces are I think changing things.

That's pretty interesting that that theme sort of framed it that way,Ryan. And you know one of the things that I like to think about as it relates to innovation within the healthcare system is that, a good way to start is on the process and workflow innovations that don't necessarily directly aim at patient therapies and things like that. What's your thought process on that? Sort of just scaling from process to patient therapies.

Oh yeah absolutely. Some of the most innovative things are the things that are the least threatening to the system and the fastest to incorporate right. So I mean with your background working in medical technologies those are what we traditionally think of as innovation and we built tradition...

Right.

Thought patterns around. Well then this must apply. But I absolutely agree 1,000% with you that some of the most innovative things we've done that have been rapid and had big outcomes have been shifts in in just process and low hanging fruit that were in the health care system that helped that you know not only the clinicians but also the administrators to understand where we are. This really can be an impactful thing and it can impact service delivery in a positive way. So let's learn more about it and let's try and tackle the more complex things. So I think you know viewing innovation as building a new MRI versus better public health around handwashing for example you know it's a continuum and when you tackle the ones that are more easy and obvious if you start there first it makes it easier to hit the harder ones.

That's so interesting. So take us down a neuroscience pathway here. How can we take a look at this topic of innovation and neuroscience? What can we use from neuroscience to get better?

Well that's my favorite area so I'm happy to take it down there. We really focus on being highly translational being highly outcome oriented. And I have a pathology of being very tangible. I only like to get involved in things I know we're going to make an impact positive impact on the person sitting in front of me. And so a couple of examples where that spin have been from on a valuation standpoint there's a huge gap in neurology from being able to do an evaluation and diagnosis at the sort of clinic side things really haven't changed that much. You know neuropsychology is done with paper and pencil testing still it's moving to computers for sure but that's not as quick as one would have hoped. Structural MRI's are still used to diagnose and evaluate you know very very sophisticated changes in brain function and you know disorders and diseases. And that hasn't really changed too much since the 80's. But if you could walk into an advanced imaging lab like mine there's a massive gap chasm between the two, right. So we focus on you were what are some practical ways we can take the super advanced brain imaging that we have in our labs and make impacts on patients that are outcome based implants and one example is a very famous when Canada was involved in Afghanistan as peacekeeper. We had a very famous case with a soldier who was there as a peacekeeper was meeting their platoon was meeting villagers. His name was Captain Trevor Greene and his job was to sit down and say "hey we're Canada how can we help. Can we help you with food water education? How can we help?" And as a sign of respect they would take off their helmet lay down their side arms and a young teenager who was working on behalf of the Taliban came up behind him and varied in axe into the top oh his head.

Wow.

And that's a very well-known story it happened 10 years ago actually over 10 years now 12 years ago and we started working with Captain Green because he was making astonishing goals in proving that his outcome was not predetermined wasn't a false hope case. In fact you know he not only recovered phenomenally from a coma and a whole lot of complications at a hospital but ultimately started a goal to recover his brain function to neuroplasticity and return particularly the ability walk and where the axe had struck impacted a lot of his critical areas of his brain for walking. So what we did is we used advanced imaging techniques that exist and were pretty cookie cutter to be honest a technique called functional MRI where we could map the active areas of his brain. Well he was undertaking his own home rehabilitation and we would just take these advanced pictures to show that his brain was rewiring, neuroplasticity was engaged, and he was recovering his function beyond any expectation. That was really fun. Back to your point of process and practical because what happened was we could show a picture and you know that expression a picture is worth a thousand words. Well tissues were made many more I think. And that when the clinicians would see that it was really motivating because they could drive harder to rehab and Captain Greene and his wife would drive harder and try and push further and we could also narrow the treatments so we could be more specific to what functions were trying to help with. And as a consequence of that over the last decade really he's made leaps and bounds into uncharted territory in recovery and he's inspired countless other brain injury survivors with his story and his journey and so much so I think the world knows about the Invictus Games which were recently held in Toronto and he actually opened them with Prince Harry and Derek Hansen and inspired people across the globe with his recovery. Thirdly as an outcome. And I loved that to point this out because his outcome as the hospital system had determined was to put them in a care home and his wife and child would get on with their life. Now he's training to climb to Everest base camp and we're using...

Amazing.

Technology to do so. And you know he's since had another child and is basically out there inspiring people to recover from brain injury. So I think that innovation doesn't have to be a new fancy you know high tech MRI although we love those. It can be something as simple as realizing that you can bring the power of something that's in the laboratory in an innovative clinical way to help drive an outcome. And I think that's what it's all about.

Yeah that's so neat and what a great story I hadn't heard the story of the soldier and it's an amazing what you guys were able to do with some of the techniques and images now available. So walk us through some of the potentially things that haven't gone so well maybe a setback unnecessarily with a patient but maybe something that he tried implementing that maybe didn't work as well as you wanted it to. Something you learned from that.

Well I approach this with a long game approach so I assume that it's going to be a tough go and that there's going to be it's not going to work out quite as easily as you think. And as General I always if I hit a barrier, I move laterally until I find a way through and just don't give up. So I get you know the innovation across the line and certainly that best example of that would be that when I started my training which I won't tell you how long ago that was. But it was long enough ago that we knew the record brainwaves and that could be used for both potentials to diagnose neurologic conditions so auditory evoked potentials some visual of potentials they're used in a number of different. You know if there's a question about multiple sclerosis or you know if there's a hearing problem versus something more central and that sort of thing. So these were well established clinical tools but yet in our laboratories we had these powerful capabilities to push that farther up the chain and evaluate higher level brain functions cognitive functions and that sort of thing. And I remember when I started my training being told that well those are too unreliable that'll never be in the clinic. And I guess that didn't sit right with me and it turns out that you know in the past over now two decades I've worked to solve that problem and that's come with some setbacks for sure. So the first attempt was really to do research that showed that when we did these cognitive about potentials you could overcome a lot of the problems with neuropsychology that are completely reliant on a subjective behavioral response. And the problem with behavioral response is that if you have a brain injury or brain damage or disease, you decouples your brain function from your behavior. So automatically your behavior is not the best way to go about finding out how somebody is doing inside. And one of the best examples of that is for people to really understand would be something like if somebody was locked in if they have Lou Gehrig's disease it would be an example. Then their brain is perfectly intact and healthy in terms of cognitive function it's just they cannot respond behaviorally and this is a problem that really stymies a lot of evaluation right at the beginning of your critical care decision making process right. Because you can't really tell us when is a function. So our goal was well maybe we'll just use these objective physiological brainwaves and electrify as it were neuropsychology challenged with that was that we made we made a lot of progress in the laboratory but it wouldn't necessarily translate easily into the real world in ways that neuropsychologists could you know switch over what they were doing and you know all sudden record breaking news. Then we moved to the idea. Well we know about the Glasgow Coma Scale and when somebody comes into the hospital Glasgow Coma scale is one of the sort of metrics that are rapidly used to assess the level of functioning. Can we do the same thing as the GCS but replace a subjective and error prone. And just to give a scary statistic that literature shows that it's actually misdiagnosing as high as 43%. So when you landed in E.R. and you get a CS basically a 50/50 chance whether or not the care team knew what that actually meant. So could we just upgrade...

Pretty low and worth investigating right?

Yeah, yeah. So we upgrade that with brainwaves, write and record and you know do the same thing where it's it's fast it's easy to communicate and do it at point of care but instead of using these large object brainwaves. And we've done that with patients and we've done it across the country and we created actually a technology version for that and around that time, the epidemic with concussion and increasing concerns with dementia broke out. And one of the setbacks there was that as a deployed sort of unit it's not a very big market size for people who are in let's say vegetative state. So the business world doesn't want to take that as a product because not necessarily a large market to make money out of.

Right.

What we focused on was we stood back with saw what's the bigger problem if this concussion is coming up and that's our thing and it occurred to us that actually what's missing is you don't have a simple vital signs or brain function and you can have and look at all the vital signs you have and how important they are and how you know things like cardiac risk factors have been informed by vital signs and how ubiquitous they are and without human goodness we've got to change that. So what we did is we we finally stepped back from that setback to create a framework we actually reverse engineer from bloodpressure and said okay well how did we get blood pressure how can we extract from EEG, a vital sign framework so we could have a simple vital sign for brain. And so for the last five years we've successfully done that and we put it into a point of care completely automated device that...

Nice.

Happens in five minutes. And we've used that we use that now routinely and nurse our skin up. To have a unique fingerprint for concussion. We're working in care homes with dementia and a number of other applications just to provide if you can believe it. Finally hopefully we're successful the world will have a simple yardstick for brain function so they can establish a baseline. Find out how a treatment works. I know what's going on. Find out if there's rapid cognitive function deterioration and that's sort of, so that is kind of it started with setbacks but because you know we're tenacious we just stayed at it to try and ultimately refine it to something that hopefully will be very impactful clinically in neurology.

That is fascinating and great that you guys stayed with it because I mean it sounds like we we are in desperate need for something more accurate and a good baseline and as it relates to the topic of delirium for instance this is an increasingly sadly topic that comes up more and more you know delirium after surgery. How would it help with something like that?

Yeah.

If at all.

Well it does. It's interesting because in neuroscience we're always trained to focus on kind of the condition. Right. So you know you can...

Right.

Be a dementia researcher or you know an epilepsy neurologist or what have you and effectively where I really love that technology angles and the medical imaging angles it's cross-cut. So delirium definitely applies because effectively if I have a yardstick that I can take an objective measure quickly of what your brain function is my favorite question to ask is "Do you know how your brain is today? Do you know how was the day before and before that and if you don't...".

I don't know.

How are we possibly properly equipped to manage your brain which when you think about it is scary because one in three...

It is.

In statistics you know have something go wrong with the brain in their lifetime so you only need three people in a room and one of them will be affected. But it's also scary because we all I mean that's the seat of who we are right that's what makes our money, it's our soul, it's our spirit, it's our consciousness, it's our personality. So if you don't have so much as a baseline of what is going on, when you come out of surgery and there's a question about delirium you have nothing to compare it against. But if you have a brain vital sign you can measure your brain by a sign during surgery you can measure it and if you see an issue can detect it against your baseline and after there's a question you can say with an objective and physiological measure, yeah we actually think there was a change in and that's kind of what we're trying to go at. So it would apply frontally and...

Interesting.

Applies to concussion. It will apply across all the conditions rather than just focusing on solving concussion which I think is a silly question because I don't still understand what the answer could possibly be for that question.

Yeah I think that's super interesting and thanks for expounding on that I was able to wrap my head around the whole topic of you know this vital sign having a baseline comparing it to pre and post events, pre and post procedures. Definitely see the value of having something like this. If the listeners were curious and wanted to learn more by your work and the things that you're researching, where could they find that?

Well I have a pretty good presence on the web so they would find it through our company health techniques for sure. There's a lot of research articles so we have a lot of scientific articles that are published on this that are and we type. We're really trying to publish in open source articles now so that are accessible so that frontiers in neuroscience has the actual science published behind this as does translational science articles that came out this year. Yeah and other than that I think there's a number of media articles that have been done so I certainly would suggest google would be a friendly start point for that.

Fascinating. Well there you have listeners. Take a look at Ryan has done some pretty interesting work and just google him, google his work. Check out their website and you'll be able to find more. If we talk about today doesn't necessarily satisfy you fully because the nice thing is that these episodes are 25 to 30 minutes long. The thing that is a lot of people wish is that they were a little bit longer when topics like these come up and they're super interesting so tell us a little bit more about an exciting project or focus that you guys are working on today at the company.

Well it's certainly our our lead goal and our very exciting project is to bring vital signs to a world wide so that's our our major focus. But we actually work in a district called the Health and Technology District which is embedded with actually not only Canada's busiest hospital in the world but I think it holds the North American record for most emergency visits and a model we work in in an environment that has a high volume hospital and we built an entire technology sector health and technology sector within the campus of that hospital and within that it's just beautiful fusion of bringing together not only your clinicians who are identifying our problems and we're trying to solve them with technology solutions. But you're scientists from our universities and also your business and we have a whole ecosystem of businesses that have our technology solutions that we try to bring right into our clinical environment. So that's probably one of the most exciting things is that we've tried to lead by example with our technologies and brain but also create an ecosystem that allows this to be a sustainable model that people can replicate and utilize. You know join and partner with. And so we spent a lot of time partnering across the United States, with Israel, Europe and as a consequence of that is kind of interesting because what are the answers to your question is when you have the yardstick for brain function and you can objectively measure this one of the cool sort of outcomes is a lot of people come your way with treatment solutions because they want to see if we can measure better whether or not their treatments are working. So we've just entered with a company quite closely named Helios which is a U.S. company that's taking a device called Parnes which accelerates brain plasticity and recovery from brain injury and we've done clinical trials with them and have been working scientifically with them to evaluate this completely non-invasive, nondrug, non-surgical technology, for accelerating recovery for not only concussion but other brain injuries. So it's been really fun because effectively we're really starting to see the most advanced neurotechnologies in the world are making their way to us into this ecosystem and being able to validate them implement them in patients and help them scale up and get across the globe.

Super exciting yeah. Didn't even dawn on me but that's such a great application of this right. The whole validation piece and all these companies with solutions to brain issues very very exciting and kudos to you and your team for developing the foundation of what's to be in this brain function space.

Thank you.

So talk to me Ryan. We're getting close to the end here. We've reviewed a lot about your work the things that are going well. Lessons learned in this in this part of the podcast. We go through the one on one on what it is to be successful and the business of health care and so I've got four questions for you lightning round style followed by a book that you recommend to the listeners. You ready?

For sure.

All right. So what is the best way to improve health care outcomes?

I think by focusing on implementation too much has focused on which is building without focusing on a problem and finding a solution you can successfully implement and see that it works.

What's the biggest mistake or pitfall to avoid?

Definitely the biggest if you're coming from a clinical point of view the biggest pitfall to avoid is not being open minded clinicians are overwhelmed. And a lot of times it's too easy to dismiss the aspects of innovation and it takes too much work and finding that extra time to investigate and explore allows you to actually improve outcomes just by being you're embracing or clinical endeavor.

I love that. What would you say an area of focus of your organization is the number one area of focus?

Oh you are, you know the term BHAG? Big Hairy Audacious Goal. We want to absolutely end brain disorders and diseases. We want to make them a thing of the past.

I love it. And what would you say is the way to stay relevant as an organization despite all the change?

This relates to the book I'm going to suggest you accept a changing world and I just finished a book which is Great by Choice and it analyzed all the companies that succeeded in spite of changing and came up with a couple of key factors. One was that either a company or person who succeeded and thrived in an always changing environment was extremely good at three core things. One was being productively paranoid and always looking for things that could be problems or come up with solutions. The second was being using evidence and being very internally driven. And the third was disciplined and being incredibly disciplined. And then when you combine that with motivation Stage 5 motivation sort of stuff those people can succeed in highly changing times and I think that that applies more so than anything to health care outcomes. I think that recipe and that book are really well it's born out of the business world I would highly recommend it for any health care.

Amazing, what a great recommendation and a good framework to consider folks who could get all the things that we've been discussing today. The entire interview transcript, notes, and takeaways, and links from the podcast go to outcomesrocket.health/darcy. And as Dr. D'Arcy here and you'll be able to find all that there. Before we conclude Ryan I'd love if you could just share a closing thought and then the best place for the listeners could get in touch with or follow you.

Oh absolutely so the best place to follow me would be through either health techonics or the health and technology district both of which have websites and are on LinkedIn and Twitter. The terms of my closing thought I would suggest that tackling the brain is really, really rewarding because it's scary and it's on the outer edge. It's complex and it's something that you should be scared. Because if you can make success in something like that it means it's optimistic you can make success. If I can make successful outcomes you know complex brain injury patients. It means that any problem that comes our way in health care, there should be solutions that we can find and it just takes guts and I think that health care innovators are the people that are going to change the way that we deliver our outcomes.

That's so interesting and I think it's a great challenge for you listeners. So make sure that you keep your mind sharp and stay focused, stay resilient with whatever topic you've decided to tackle within health care. So Ryan it's been such a pleasure to have you on. I'm excited to get this to the listener so that they too could get that inspiration that you are just spreading across your medical facility and all the people's lives that you're touching. So thanks again for spending the time with us.

Well thanks Saul for inviting me and for having me. This was just delightful.

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 slow. 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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Why Evolving Medical School Training Will Improve Healthcare with Dr. King Li, Inaugural Dean at Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign

Why Evolving Medical School Training Will Improve Healthcare with Dr. King Li, Inaugural Dean at Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign

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 the amazing Dr. King Li. He's the Inaugural Dean at Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign. Dr. Li's experience includes research, clinical, educational, and entrepreneurial roles at the NIH Clinical Center and Stanford University as well as Wake Forest in Houston Methodist Hospital. He studied physiology and biochemistry at the University of Toronto earned a medical degree from Toronto and an MBA from San Jose State University. He's been widely recognized by the Association of University radiologists in 2018 and he's received several awards in innovation and leadership. This award in particular recognizes a visionary who's made significant contributions to advancing radiology research, innovation, leadership, mentorship and growth of the RRAA - that's the Radiology Research Alliance. He's brought together all of these wonderful experiences and expertise to start the Carle Illinois College of Medicine. So I'm excited to dive into Dr. Lee's experience and then also talk more about the exciting projects that they have going on there so. King welcome to the podcast.

Saul, thank you for having me.

It is a pleasure. So is there anything in the bio that I left out that maybe you want the listeners to know about?

Yes I think I am also inventor. I have 17 inventions already. Also some entrepreneurial experience studying about tech companies. So you know that aspect also strengthened my experience in putting this new college to work.

That's fascinating. I didn't know you were an inventor as well. And and so this makes a lot of sense. You know why you're the Dean there but for the listeners that don't know maybe it would serve to give them a nice introduction about this school of medicine that you guys founded in Champaigne.

So the Carle Illinois College of Medicine is the world's first engineering focus college or medicine. So what is engineering focused college of medicine. So fundamentally we're actually combining Engineering and Medicine in teaching students. So we actually start by selecting students who have quantitative science background in addition to the medical requirements so that at a time they come in we can actually use a curriculum that actually leverages engineering principles and technology to actually teach medicine. So there are many schools for us that have actually layered engineering on top of medicine. We're not layering. We're actually combining so that they learn medicine they learn it through the lens of engineer and also through the lens of basic scientists. So we actually have four pillars in our education. So traditionally is just clinical sciences and basic sciences. We did it to this engineering and also humanities. That's the fundamental difference between our school and the College of Medicine.

It's super interesting King How you guys made a decision a conscious decision to do this and put together a program a facility all focused toward this especially now and in the realm where technology just keeps getting better and cheaper. And so I think the need is going to be there for physicians that have that engineering talent. I'm curious though, what made you decide to get into medicine to begin with?

Well so I've always been interested in the quantitative sciences and I was debating between hardcore science engineering or medicine. I learned that in medicine you can actually combine all of those. So to me that also gives a possibility of helping people. So to me that was a no brainer to get into medicine at that time.

That's really interesting. So we're at the forefront of a lot of new things in health we got value based care, we've got new treatments for oncology, digital health. Out of all the the soup of new things and buzzwords King, What would you say a hot topic that needs to be on every medical leaders agenda today and how are you guys addressing it there at the school?

Right so I think the one thing that people stick in technology and medicine is the really technology should be used to strengthen humanistic aspects of medicine rather than to distance the healthcare providers from the patients or actually not just patients but anyone that they tick off whether they're sick healthy. In our world we actually want to emphasize rebuilding relationships using technology so they include human to human relationships, human to machine relationships and machine to machine relationships. I think that's the hot topic how to actually leverage technology to enhance relationships is a topic that we focus on a lot.

So what would you say an example of how you and your organization approach that? This how tech can can enhance relationships?

So for instance right so if you walk into a doctor's office today versus walking into a doctor's office 30 years ago.

Yes.

You find that most of the technologies that doctors use today in the office has not changed, right? See the stethoscope that was invented 200 years ago or telescope the instrument that doctors look into years of patients with was invented 180 years ago. And this technology's actually low fidelity and they also low efficiency. Why. Because they tie in four different processes into one. So data acquisition. So the doctor has to listen and acquire data using their own years rate which is as we all age of her daddy goes down. Yeah second is it data analysis, right? That too actually requires the brain of a weltering person the right to actually analyze data is not recorded. So it has to be processed instantly. Right. Then you have to have decision making right. So you have to combine the data analysis with added data to come up with the decision and then counseling. Right. So that doctor has to decide on a course of action in the end and hopefully get the consent of the patients and proceed with the course of treatment. So you can see all four processes are tied to the most highly paid person in the food chain right.

Yes.

If we can't divide up the processes and use an instrument to have higher fidelity that can actually record the sound and record the waveforms and the second step data analysis can be using artificial intelligence assisted analysis and the gift that decisions support to the physicians and actually we can now combine that data with all the other data from the clinical records and elsewhere to give that doctor the best decision support. And then all this can be done separately from where the doctors sit. So theoretically it can be done remotely and this data and the decisions report can then be sent to the doctor. The doctor can then write make a decision and then talk to the patients remotely so he can see how by leveraging that type of technology we can increase the efficiency and quality of healthcare and also make it lower cost and more accessible to patients.

That's a really great breakdown and a good example from a very basic physical to your physician. I didn't realize these instruments were that old 180 years old on the ah...

That's why you know we're still used as status almost as a symbol of the physician right. That's interesting that we haven't really improved that instrument until most recently.

Very interesting. Some of these things oftentimes go unquestioned listeners we gotta start questioning even the most fundamental things in what we do. It could be those minor shifts that could lead to large scale outcomes improvement and new business models. As you look to approach these two things in healthcare it's really important to King's point. Dr. Lee can you give the listeners an example of how you and your organization have created results with this new campus?

Absolutely. So the first thing that we need to do is to actually fundamentally read them the curriculum. So to do that we actually in each of the courses we have three course directors. Basic science, one from clinical science and one from engineering. And their purpose is to make sure that the curriculum integrates all those disciplines. And we also have humanities professors that actually look through the threat to make sure that the social aspects, the humanistic aspects of medicine is incorporated in the curriculum and the curriculum is through active learning in the pre-clinicial years. That means that instead of hearing lectures. So the students are divided up into groups of eight and we give them cases for down to solve. And during the case solving process they will learn to use a different knowledge base including engineering basic science, clinical science. We can also set up cases where they learn to write the practical social and humanistic aspects. For example imagine you have a heart disease patients coming in and the patient doesn't even have money to fill the prescription. So just writing a prescription doesn't help that patient. So you give the patients support to the group and they can look up the potential support system that can help the patient right. So that gives them more training than just learning to prescribe the correct medicine.

That's great. Yep. And so tying up this I think it's fascinating that you guys have put together this system within the organization. You know the science, the clinical science, the engineering and then the humanities I really think that that really captures nicely all the elements of medicine and it's great that you're giving students the opportunity to start early on in their career with this. One of the things that that has come up in discussions with other healthcare leaders I've had several chief medical officers on the podcast they've said Our students are not learning how to be leaders. And one of the deficiencies unfortunately as we seek to make physicians leaders of large ideations is leadership skills. Is your campus doing anything to hold the leadership skills of these people?

Absolutely. So in the critical years we want to really stimulate curiosity and creativity in our students. So for every critical rotation our students are required to come up with a new idea to change things. You call them your projects and you help them. We actually have engineering rounds so in clinical rotations right the students do rounds with the clinical professors. But in addition to the clinical professors we have engineering professors going two rounds with our students. The idea is that our students are young and they are curious they will look at the way we do things and they will challenge the way we do things and come up with potential ideas of changing things right. So do we have some ideas around with both a clinical professor and also the engineer and professor to see whether those ideas are actually feasible or have anyone thought of them before. Have they done before. Each rotation there will be a new and through the idea projects one will be selected to be there Capstone projects in the capstone projects. They will be the leader of a team of artists that they select from campus. For example you can't have a business school and you can have engineering students you can even design student right. So they would lead the team to turn the idea into a prototype so they would learn the actual leadership skills in leading a multidisciplinary team. I think from ideas to a prototype.

That's great. Sounds like you guys have captured a lot of the things that have been lacking in traditional medical schools today and that's it's pretty exciting to hear that you've put it all together as part of a capstone project sort of from the beginning just teaching them to question, teaching them to question convention.

Yes I think there are four qualities, ee call them the four Cs that we emphasize.

Okay.

Right. The first is compassion training doctors. Second is competence. Those two are quite common in the medical school values. But the last two Cs are quite uncommon that is curiosity and creativity. So the idea that in most medical education we're learning the so-called standard practice. So we were taught when we were going through medical school to learn the standard of practice almost never question right. Why we practice the way we practice. But for our students we encourage them to actually question, to ask the question why. Typically we educate students to ask right - what, when, and how and not why. So our students will be encouraged to ask the question why. Why are we doing this? Why are we treating this patient this way? Right. So that is fundamentally different.

Yeah. It's that creativity and just understanding the why behind it. Whereas before they didn't Yeah you know I had I don't know if you know or Arlen Mayers he's the guy that started society of physician entrepreneurs.

Yeah.

Yes. You know he comes to mind and I was at a meeting and he was very passionate about these two pillars you know creativity and just being able to be curious and to your point, Dr. Li it's just I think it's such a wonderful thing to focus on. And the best organizations know how to keep things simple. And you guys have definitely done that with these two pillars to really capture this this much needed skill in physicians today. So congratulations for being able to boil it down to just those two pillars.

Thank you.

So what would you say King is one of the things that during the inception of this school and everything that you guys did what was a setback that you guys had that you learned a lot from that you want to share with the listeners?

So one of the things that we were actually trying to do to actually finance the actual medical school was fundraising.

Yes.

So we were actually behind in our fundraising and the target set for our fundraising goal was very high. So there was a setback that we experience but luckily the university has come up with the support that is needed to give us all the resources that is needed to make the medical school very successful. Clearly we are continuing to raise money and very actively actually. But that was a mistake that was made to actually set the fundraising target very high in the beginning.

And so you'd think it would have been better said a little bit lower?

Or actually not use it as a major pillar in the beginning for funding Medical's enterprise.

Got it. Got it as sort of as a requirement to make it happen.

Yes.

Gotcha gotcha. OK. Because obviously hey it's not cheap to run a medical school and just being able to not make it a requirement and finding creative ways like you guys did with the university to make it happen.

Yes. So we have many ways of making it very efficient. So for example instead of hiring a lot of full time faculties the major advantage for us is we are within a large comprehensive university so most of our faculty is actually part time from other colleges. In fact we have faculty from 10 different colleges. It is a huge advantage because imagine. Right. Who can really teach behavioral change and marketing professor from business. So we actually have professors from liberal arts and sciences, engineering, business you name it all the way to fine arts. So that's why we can be a lot more efficient financially and also it builds in from the beginning the disciplinary nature of how Education Research. And so on.

Fascinating. Well congrats on being able to make that happen. Kane you've had a fruitful career. What would you say out of all the things that you've done is one of the proudest medical leadership experiences you've had to date? It could be on the business side it could be on the practitioner side, what would you say?

I would say definitely the current job right. The inaugural dean of the Carle Illinois College of Medicine is clearly the most impactful job I've ever had. Because can be seeing the turning point in not just a medical education. The delivery of healthcare in the world. And you really look at health care right at a time when major changes are required. So the costs of health care in this country is already about 18 percent of GDP. Aging population. Right. We have a urgent time to find solutions that can improve the quality decrease cost increase access ability and increase equity in health care. And we believe that technology and engineering can bring solutions that can help healthcare to move in that direction. We let the people who actually are trained specifically to do it. And so our school is targeted to that purpose and that can be a turning point in our group. Dean that this fantastic mission is clearly the most impactful job ever had.

That's outstanding congratulations on that and listeners if you're looking for a school that is at the forefront of getting things done in the new age of medicine. You guys definitely have to check it out. We'll leave a link for the school as well as the best way to get a hold of the folks over there here at toward the end of the podcast which we're getting close to. So Li, getting close to the end. Let's pretend you and I are building a medical leadership course and what it takes to be successful in the business of medicine - The 101 of Dr. King Li. We're going to build a syllabus with four questions that are lightning round style followed by a book that you recommend to the listeners. You ready?

Yes.

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

As I mentioned earlier is rebuilding relationships. We have to look at how to rebuild a patient doctor relationships currently around you only see a doctor once a year or even less when you are healthy and then use suddenly I have to see them. Often when you get sick they really don't know you as a person by the way that we build relationships. Very different from the family doctors that West portray. Right. Many years ago. Right. Dr. Marcus Welby that actually watch when I was a kid. So the way to use technology to rebuild relationship is look at how for example I get contact my grandkids in California or I can Skype with them. And so on. How can we actually build relationships again so that doctors and patients actually feel like they really didn't know each other so that important important. Also rebuilding a network of support systems that doctors know about not just the patient people who are around the family their friends and so on. Right. And then the second is so called person to machine relationships. Currently the doctors have a hyper now rate because electronic health records really require doctors to enter a lot of data that is actually draining energy instead of putting it into patient care actually pulling it into capturing data. So that needs to change. And lastly machine relationships. Imagine you have one electronic health care record not talking to an electronic health record right patients actually carrying this from one doctor to another. Now what needs to change also. So rebuilding relationships fundamentally, leveraging technology but not to decrease the humanistic aspect but increased a humanistic aspect is the most important and the best way to improve healthcare outcomes.

And what would you say the biggest mistake or pitfall to avoid is?

The resistance to change is the major barrier right. For example we as doctors are used to patients coming to see us now. But before the industrial revolution, doctors used to go and see the patients.

Right.

In their home. So imagine you're 83 year old, living alone. It's snowing outside the closest doctor is 35 miles away and you're sick. You have to drive to the doctor or you have to call an ambulance to transport you right. That's highly inefficient and not accessible. So how do we leverage technology to fundamentally change bring high quality health care to sick people where they are inside too. That's right. Well imagine the day when you can actually use Alexa to take their medical history.

Love that.

Then a drone would send the right equipment to do the data collection. Using artificial intelligence and then the doctors remotely can come up and say so and so. I thoink you have pneumonia. It's not so bad. You have to go to the hospital. So the next drone coming in would take the drugs to you. Right. This is how you take them. You have any questions you can call me anytime. And by the way you can't put all those instruments under drone and then flies back to where we are so that way you can take high quality medicine to where patients are right. That's not a pipe dream right. It can be done using even current technology. So those are some fundamental changes that doctors have to that too. Right.

Absolutely. And that's a great way of focusing on and where things could be. What would you say your favorite book that you'd like to recommend to the listeners is?

The book that I like the most recent reading is called Cancer the Emperor of all Melodies. He's Siddhartha Mukherjee is a winning book and it's not just talk about cancer. It actually went back into the history of how medicine, modern medicine, the concept of modern medicine get to the point that we are right. So it really opens the eyes as to why we feel that modern medicine can cure everything. If you are obese you want to take a pill and get it working your cure rate. That type of stuff is actually stand from the biggest success in modern medical history which is dealing with infectious disease right. You find a very specific course of the disease. It give a very specific treatment the right antibiotic and then your cure. What it's the biggest success in modern medical history. And we now have the mindset that everything is like that right we called deterministic for example give you are most likely to get sick. The randomized x you get cure right. Most diseases that will deal with today chronic right. So for example heart disease, diabetes and so on. And there is no magic cure. There's no single right treatment right. A lot of it is actually related to lifestyle. Everyone knows if you eat well, exercise well you have lower chance of getting a lot of those chronic diseases. How come we are not enabled to change behavior. Right. Because doctors are not trained to change behavior. Right. We are used to writing prescriptions in the concept of infectious disease but in the new world right where we're trying to actually do preventive care prevent this from happening. That goes to another core problem that we have this our biomarkers are too late. For example I can keep checking your blood pressure. By the time your prep pressure is high is actually late. I can keep checking your kidney functions by the time the kidney functions appears abnormal in the lab tests really have lost a lot of your kidney function. So how do we actually give very good predictive value of when you will be in 30 years and help you change your lifestyle right to prevent diseases from happening. Where does that data come from. Right that data actually doesn't come from measuring the the blood pressure, blood sugar, and so on. Actually measuring what you are doing is icing eating the right food and so on and that data actually sets in a lot of digital transactions, digital transaction become the norm. All that data is actually available. What food are you eating? Are you going to the gym with a cell phone in your pocket, theoretically we can trap where you have been. Have you been running? Have you been going to the park? You've been sitting there watching TV. Right so. So in that new world right. How do we actually leverage that data will it give us much better readout of what we call the risk. So again most people think that the CCS so-called deterministic. That means there is a cost right. And then you know it's definitely the result just like if I hit you right with my fist and your face you get traumatized. Deterministic medicine. Most diseases with deal if are not deterministic stochastic yes say not everyone smokes will get cancer for example lung cancer. Not everyone who don't smoke will not get lung cancer. So isn't it increased the risk, decreased risk. The whole mentality of dealing with stochastic diseases versus deterministic diseases is very different and that mindset is not naturally dear for both the practitioners and also patients.

Fascinating and like a good professor you've left us with a lot of questions to ponder. You've left us in a good place. Dr. Li. Before we conclude our love if you could just share a closing thought and then the best place where the listeners could get in touch with or follow you.

Well the closing thought is I think we have a lot of young people with the right mindset that is willing to actually put the energy in helping the healthcare system to perform better make it higher or lower costs and more accessible and equitable. And the way we can help is actually unleash the potential and make them more successful. And best way to do that is really fundamentally changing education system. So.

You're doing just that.

Yes.

And so am excited to see your work continue there. Dr. Li. What would be the best place for the listeners to get in touch with or follow your work?

Yes. We have a website. If you just google Carle Illinois College of Medicine you get to a website. We have a lot of updated news and so on. So you can actually follow the progress or if you want to get in touch with me personally my email is kingli@illinois.edu and I would welcome the opportunity to communicate with anyone who is interested in what we're doing.

Thank you so much, King and folks I'll put all of the links that Keen's shared Dr. Lee shared on on the show notes you could find those at outcomesrocket.health/kingli you're going to find that there. His email, a link to the new school and the book that he recommended as well as the full transcript of our discussion today so King really appreciate your time and your insights today.

Thank you very much for giving me a chance to share my thoughts with the audience.

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 Emperor of All Maladies: A Biography of Cancer

Best Way to Contact King:

kingli@illinois.edu

Mentioned Link:

https://medicine.illinois.edu/

Check out this Link:

https://outcomesrocket.health/podcast

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Empowering Doctor Patient Interactions to Improve Outcomes with Neel Metha, Vice President and Chief Operating Officer at EpiFinder

Empowering Doctor Patient Interactions to Improve Outcomes with Neel Metha, Vice President and Chief Operating Officer at EpiFinder

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 healthcare leaders. Today I have the phenomenal Neel Mehta. He's the Vice President and Chief Operating Officer at EpiFinder Incorporated. EpiFinder is a healthcare software solutions and neuro spectrum differentiator differentiation company. It empowers doctor-patient interaction which we all know is very important to outcomes and provides a robust proprietary platform where it encourages patients to take ownership of their health through the Patient Portal. It provides the doctor a clinical decision support tool and bridges the communication gap through engagement and analytics. Neel is an empathy-driven Healthcare Futurist, Multifaceted Entrepreneur and Biomedical Informaticist with over seven years of experience in Digital Health, Leadership, and Healthcare Innovation. He loves to travel, he loves to hike, do yoga in the leisure time and he is an enormously dedicated individual on healthcare. So it's with that introduction that I welcome Neel to the podcast. Welcome.

Hi Saul, thank you for having me.

It's an absolute pleasure Neel. Now is there anything that I left out in that introduction that you want the listeners to know about you?

Wow that pretty much sums up a quick intro about who I am and what I have done to date. I just love healthcare and so thank you and I'm excited to continue our discussion.

Absolutely. Me too man. So as we take a look at the things that you guys are up to patient portals we're in this digital age where patients are now more empowered. We've got this divide of patients of hey you know some are millennials while others are medicare patients so we're dealing with very different populations. It's gonna be interesting to dive into some of the insights that you and your team have come up within this realm. But before we do Neal, what is it that got you into the medical sector to begin with?

Well that's a good question. I would say that I'm originally from India,grew up there, studied in London and also in Australia in Sydney and then eventually came to Arizona to pursue my higher education in Biomedical Informatics. So since that time I grew up my parents, my mom and dad always wanted me to become a doctor and I didn't want to. So...

Oh boy.

Yes.

You're a rebel you're a rebel.

So since I did my undergrad in bioinformatics since then the next logical step for me was to do something in my higher education especially in my graduate education to do something that I can connect to with the healthcare system, the medicine. And I decided to pursue biomedical informatics. So that got my mom and dad happy because the healthcare and I work and sit with the doctors and that got me happy because I wanted to do fundamental and applied science along with focusing on engineering and the innovation aspect in technology.

That is so interesting and Neel so you're applying your talents in this biomedical informatics field to improve patient outcomes. You've been at it for a while. What would you say today is a hot topic that needs to be on every medical leaders agenda and how are you guys applying that at EpiFinder?

So that's a great question Saul there a lot of hot topic out there and it all depends on which perspective of which angle each individual is facing that topic on a day to day basis. But for us it's all about access to the rewarding care to the patients, and from their home all the way to the end up in the emergency department to the intensive care unit to being in the hospital and so access to care is predominantly much more effective in U.S. of course we have issues but at the same time if you look globally there a lot of challenges when it comes to that meaning in the second world and the third world nations where the individuals have and don't have access to care to even see their family care doctor and the wait is so long that sometimes you have to wait up to two to six months. So I would say the way of our organization at EpiFinder behind the other poaching is that we have the rewarding digital health platform solutions to connectivity interaction between a patient and a doctor. So our entire goal is to empower doctor patient interaction while providing the tool which helps them to do that. So on the healthcare professionals side, we have a clinical decision support to have doctors to go through that process with the patients to identify a particular type of epilepsy syndrome based on the patients symptomatic information and the way the doctor receives those information is from the patient portal. So a patient gets the ownership of the health by using that tool and they are able to go to their day to day incidents or events or anything which they want to mention or take a note off and send it to the doctor before their visit. So now what it empowers the patient is to be what we call like that they are not anxious, they are not agitated, they are not like nervous to meet with the doctor because they have shared all of that information to the doctor before the visit. And for the doctor as they are always running out of time, they are seeing a lot of patients every day, now they have that information prior before they go and see the patient in the examination room or in the hospital unit. So this is where through the use of technology we are bringing back the human to human interactions which a lot of patients complains about.

Yeah that's a really great topic there and how we use technology to get that done. It sounds like you guys are focused in on epilepsy as a core area. How did you guys decide on that being the focus?

Yes the way we got into the world of epilepsy is really kind of the universal choice and the law in a way where my co-founder whose name is Robert Yao, he was misdiagnosed and bedridden when he was a medical student back in Chicago. And long story short, he ended up starting this huge need in Biomedical Informatics at Arizona State University and that's where he and I met and sat at EpiFinder and the way what he believed was a complex and difficult to diagnose conditions were actually built an algorithm to identify and help doctors to judge those patients and solve any present or the solution to a team of faculty and doctors here at the University. Two of the epileplogists are from Children's Hospital and Mayo Clinic said, "hey Robert you should focus on working towards building this algorithms for epilepsy, because there are 3.4 million people in US who have epilepsy, 65 million people worldwide and one in 26 Americans will have epilepsy at any given point in their lifetime." And what happens is that about get a 40% of the patients either go undiagnosed or misdiagnosed when they see the doctor for the very first time during the first visit. So the challenge is life is huge and it cost the U.S. healthcare system 15.5 billion dollars a year. On average, a patient is diagnosed or get a light medication after being in the healthcare system for about 7 to 10 years. So it's very challenging, it's very frustrating. And the reason behind all of this complication is not that doctors cannot identify epilepsy. They can, but there are 62 different types of epilepsy syndromes and seizures. So what happens is most of the time the diagnosis is this one epilepsy and it wasn't one particular type of medication but after two months you identify oh wait a minute he might have this type of epilepsy or this type of condition. And so it's like a lot of back and forth until you are able to identify that. So what doctors told Robert that night is that if you didn't build an app,a tool which they can use that in their hands while they see a patient in a while get on rotation. So in the clinic it will be very helpful for them to include the patients clinical signs and symptoms. And it should pop up that differential diagnosis for the patient. So we teamed up together, built a team and in nine months we were able to do that. So when we showed that to those doctors the only one word which came out of the mouth was "wow, this is phenomenal." Why it took them over 10 years to identify standardize and why a unique family of care we are able to do it so...

That's awesome.

That by the child's epilepsy.

Very cool. Very cool very clear to why you guys decided to do that. So now you've got a product. Have you released it in the U.S. or are you guys mainly working internationally?

That's a great question. So any time you build that digital health solution you have to go to at least two or three clinical studies. They are not clinical trials per se but there are studies to validate the effectiveness, the accuracy, the sensitivity and, the specificity of a tool. So we conducted the very first pilot Mayo Clinic study last year and here it's been or not their power tool was used in compare them to the gold standard which is out there today it's called EEG and adoptive to fathers is they are not always truly able to screen that patient even before they go into the epilepsy monitoring unit and they get that e.g. Sondakh. So when the digitals came out it was 86.8% accurate. So that's a massive shift compared to the current 60% which is out there. So now we see that every tool improves the clinical lead up diagnosis by over 25%. So that was really was initial study. So now we have undertaken two more clinical studies. One here in Phoenix with Phoenix Children's Hospital and another one with Boston Children's Hospital in Boston, Massachusetts. And to really prove a tool that it can be applicable in any hospitals or any clinical setting whatsoever, once we complete this three studies, once we go to the regulation aspect in terms of making sure everything is in compliance and also making sure that we need all the chapters, then we'll launch it here in U.S. In the meantime are looking for opportunities to have this tool applicable and available especially in the Asia market in India and China.

Excellent. Now that's really great to know and and for those of you listening to the podcast today and you're in the process of figuring out your path to approval just know that you know it takes time but you've got to stay committed to your solution and see it through. It sounds like Neel and his team are very focused on that. Around the corner will be the time when they get it out there. But in the meantime it's showing upwards of 25% improvement in the diagnosis and appropriate addressing of epilepsy. So kudos to you and your team Neel for coming up with this great solution.

Thank you so much. And yes I agree with you. It takes a long time to bring a solution especially in healthcare out in the market because this is not a gaming solution which is not just a quit app. This is yet dealing with people's lives. So anything which is used, we want to make sure that we are doing no harm. And if you are doing something, it's upwards, and it's towards the benefit, towards improving patient outcomes.

Love it. Yeah absolutely Neel. And so can you give an example of a time during that process where you had a setback, may a setback that almost made you want to stop. What did you learn from that setback that you could share with the listeners?

Sure I mean there are plenty but one of the big ones which comes to mind is that we talk that Sessions helps the professionals will be a cakewalk after Mayo Clinic Study. But we realize that they have a great respect for that individual expertise. But what happens is that it varies across the board so others go and mount the other two will mean you've got the health deficiency as to the uniformity of care to patients. What we are doing is we are standardizing the beds the patients symptoms says collected we are sanitizing of the algorithm is working we are sending have the patient-doctor interaction takes place. So by doing that, our goal is to overcome the difficulty in adoption and we want to make sure that doctors love the use of a tool that we are not disrupting the workflow. But other than that we are supporting that existing workflow and providing a guided solution so that they feel more confident they feel at ease when they are using it in front of the patients that a lot of things we see in the news, we see it in day to day discussions and annualizations that yes we wanted to be the next great idea which disrupts the healthcare. But what I see is that it's not about the disruption rather than it's about existing, rather than it's about helping the use of rewarding better support solutions to the existing workflow. Because if you clear disruption if you want to replace doctors if you want to take away one of the processes which are out there. You're not making friends rather you are creating a way that, you're creating a lot of discomforts in the ecosystem.

That's a great call out and we are dealing with a healthcare system that has interests and ways of doing things and so the question is do you want to disrupt or do you want to make micro changes that lead to big outcomes? And we've discussed in previous episodes the importance of how application and implementation is the railway to innovate and healthcare to Neel's point. You really don't have to turn the whole system around to get some big results. And I think this is the picture that he's trying to paint here for us. Neel, if you had to point out the single greatest moment that you've experience in healthcare, what is that thing?

Wow that's a great question. I would say that earlier this year in 2018 back in March I was invited as a keynote speaker at a medical technology conference here in Arizona. And you're not have like sat on the panels and have I have logged some of my work but never an opening keynote speaker. Right. So that was a big moment a proud moment. As a Biomedical informaticist and Healthcare Futurist, I wanted to share a vision which is beyond me. Which is they about EpiFinder, which is something which should be all working how to be a doctor, be a patient, be a pharmacy, be a healthcare insurance company or pay anyone who is dealing on a day to day basis. I wanted to share something which is applicable with our lives and to them and what they share at the end of my talk, it's not about the technology itself. We don't you lack innovation. We don't lack technology around us. What we lack is access of the human inertia because human beings don't want to change unless they see an impact. Good outcomes by using something which are not used to and you can only make that possible by getting the buy in rather than enforcing it, rather than making it by creating penalties around it because you can do that but you would not get that actual bite. They will do it because it's a mandate. But how about we create something which they love doing it, which they can do it no matter where they are, who they are, or how they are impacting healthcare. And so last but not the least after my talk, one of the MD stood and like kind of upped the question and instead of questioning like my talk, he said "Neel you really hit the point hard. I've been a neurosurgeon, I've been in the industry for the world 35 plus years and every day a young kid will pop out and will come and meet with me like wearing T-shirt and jeans and say hey I have a new app for you without even thinking why it's beneficial to my organization and the way you articulated and made sure that this is a challenge for all of us to take back to our organization and think deeply that how we can focus on our workflow rather than focusing on bringing a new technology just because it's cool." And that was I guess a proud moment, not that because I was a keynote speaker, but it was very well received by over 300 people in the room.

That's awesome man. Congratulations on that. Sounds like it definitely struck a chord especially with this neurosurgeon. And you know this theme does come up often on the podcast we talk about the importance of understanding our end customers needs. And prior to going and building the next shiny object or technology making sure that you listen and that you listen carefully before you start building and getting that feedback that you need to Neel's point to aid their workflow not to try to replace it. And so love that you shared that it's super exciting congrats that you had the keynote too. I'm sure that was fun part of what you had to do out there.

Yeah and it was a great moment for me to bring together all of my experience and all the things we do and I've led in healthcare in a quick 15 minute talk. So that was concise, precise and it was action-able orientated.

Love that. So tell us about an exciting project that you and your team are focused on in EpiFinder today.

So current project one of the projects which are Search Me is to understand the true economic impact of epilepsy. We are in a healthcare sector but we have fallen behind the courtroom in a sense that we don't calculate the cost. We don't calculate the impact of any changes or any new innovation or invention which we'd bring out in the marketplace. So what we are looking to do is identify that if we are able to identify a correct epilepsy for that patient in the post wizard child that would look like how much the adult will be able to save for that patient in particular for the pay of in particular and also benefit pharmaceutical companies because of the medication. In fact in in terms of the devlopment and what the new Bloxwich they're bringing out in the market if they are used by the patient had some that was there. Hopefully they are more effective. So we're building economic models from various viewpoints to really prove that because CNN backed him that's a tool for everyone who lives in what the patient or the payer or the farmer or the provider or the hospitals. And you know I'm from India, there are 12 million people in India who have epilepsy and about 1 million people high because of epilepsy each year not just two hours each year. And it's because that they don't have access to care. They don't have access to a tool but they are able to connect with a doctor. They don't have access but they can share what's going on with them. Now involvement in a case where he felt comfortable. Typically they are home not in the hospital. So we are feeling forward to work in the area and bringing about a positive difference in people's lives not only in the U.S. but globally.

That's awesome Neel and I could definitely hear the passion in your voice. It's backed by hard numbers of people that you are looking to improve their lives and so keep up the great work my friend. It's great work that you guys are up to.

Thank you. I appreciate that.

And so now let's turn. You and I are building a medical leadership course and what it takes to be successful in the business of healthcare,the one on one of Neel. And so we are going to write out a syllabus here with your help. I've got four questions for you lightning round style followed by a book that you recommend to the listeners, you ready?

Yes.

All right what's the best way to improve healthcare outcomes?

So there are multiple ways. But from my viewpoint I would say like taking into consideration of every stakeholders interests just what you are talking about. You know you have to look into who is our customer, who is our target market and then rewarding the uniformity of care in any specialty. It doesn't have to be epilepsy because that's where we are focused as a product but build in other products build in cacer, build in diabetes because by rewarding uniformity of care now you can bring about an informative and engaging discussion between different doctors who might have different viewpoints. But at the same time they know that they are doing it because they are putting the patient at the center.

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

This is for all the entrepreneurs who are out there just like me because we all have seen the movie pulled up names and they talk about if you build it they will come. That's how we started at EpiFinder three years ago. That's where the cool next gen app of a label for a doctor at any point that they can use from any anywhere at any point and all the doctors will say yes and we'll start making money. And it's not the case we have to really understand every individual in that ecosystem and design and align the technology so that they are receptive of that change and of that new habit or method that they have to implement into the day to day lives.

What a great message. How do you stay relevant as an organization despite constant change?

That's a great question. I would say that just like the pretty face always in this case talking with you. But I'm very grateful and very supportive of my business partner Robert and our 23 team members who worked day in and day out to bring this technology to life. And so we all do like a quick cuddle every day and have weekly team meetings where we discuss about new changes, new updates. And so I listen, I hear from them, I showed up a couple of things which I read on social media on various healthcare blogs has seen touch with Health 2.0. They really amazing organization which brings about new things which are coming out in the market. And along with that lot of updates from CTC from hid.com and places like that.

That's awesome. What would you say an area of focus that should drive every company in healthcare? What is that?

One focus which we live it and believe is that we are passionate about making a difference and succeed by million peoples lives globally for epilepsy as our first step. And then are starting clinical studies with the two clinics as I mentioned before. So we are focused on making sure that our stakeholders are happy, we are creating a study which is unbiased and randomized so that is a natural outcome and not just because we wanted a good number or a good name out of that, you are putting patients at the center so that's the focus which drives all of us every day.

What book would you recommend to the listeners, Neel?

I would say that I will recommend my very good friend's book, he just was on his second book. It's called The Connection. In fact his name is Goidie Boston and he just turn thirty I'm turning thirty in like the next six months. So when it comes to like inspiration, motivation, he's a great individual. So what he really talks about in this book is, you know when everything is siloed you know human health is siloed. So when you bring different stakeholders into the mix you'll build a solid connection. Of course you have to put it in a way that you know you're not creating any means but make more lends and it's logical and rational as well as emotional, especially in healthcare. So he talked about that he talked about his life story and what he has done so far and how is like making a difference in people's lives. Of course, it's completely if somebody broad book but it's applicable in healthcare as well.

Great recommendation, listeners check out all the things that we discussed today by going to outcomesrocket.health/epifinder and you'll be able to find the show notes the transcript links to the book that Neel shared as well as a link to his company EpiFinder. You're going to find all that there outcomesrocket.health/epifinder. Neel before we conclude, I'd love if you could just share a closing thought. And then the best way that the listeners could get in touch with or follow you.

So I would say that you get into healthcare. But be really patient and listen from everyone who is involved and make sure that you are not just putting your interests at the center because in healthcare especially it's not about the person who's buying or paying for it. It's getting the what do you call the fact of the benefit. Someone else is paying for that, someone else is using i,t and someone else is getting the benefit. So they are not like some black chevy in out. But at the same time the more time you spend the logical steps you take and the connections which make, will help you succeed in healthcare. And I would say the best way to reach me is LinkedIn. My name is Neel Mehta and type Healthcare Futurist after my name so you will be able to find my link. And also you can follow me on Twitter, it's I believed Neel my first name, my last name Mehta and 14.

Outstanding Neel and listeners will provide links to Neel's email as Twitter everything there on the website. Neel, this has been a blast. I really appreciate you spending time with us today and congrats on all the amazing work that you and your team are doing for epilepsy. I think it's great to have a company as energetic and focused as yours on on this particular area. So thanks again and looking forward to staying in touch.

Thank you Saul for having me and thank you everyone that Outcomes Rocket.

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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Best Way to Contact Neel:

@neelmehta14 

Link to Check:

https://www.epifinder.com/

Check this out:

https://outcomesrocket.health/podcast

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Why Improving Women's Health is Important to Healthcare Outcomes with Heather Bowerman, CEO and Founder at DotLab

Why Improving Women's Health is Important to Healthcare Outcomes with Heather Bowerman, CEO and Founder at DotLab

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 the amazing Heather Bowerman. She's the CEO and Founder at DotLab, a personalized medicine for women's health. She's a Bio Engineer and Entrepreneur recognized as one of the 100 most intriguing entrepreneurs by Goldman Sachs. One of the world's top 35 innovators by MIT Technology Review and a World Technology Award finalist for health and medicine. Prior to finding DotLabs, she ran business operations at Enlitic. We've had guests from Enlitic here in the past, a silicon pioneer in applying machine learning and deep learning to healthcare data. And she was a Management Consultant and McKinsey & Company, some very forward thinking companies as you all can hear. Before that she was a Policy Associate at Obama's White House in the Office of Science and Technology Policy (OSTP). Heather began her career as a Biotechnology investor at funds in Boston and New York where she led deals such as the acquisition of molecular diagnostics company to combat epidemics of H1N1 and H5N1. She's an outstanding contributor to Healthcare and it's a privilege to have her on the podcast. Heather welcome.

Thank you for having me and it's nice to be here.

It is a true privilege. Now Heather, did I leave anything out of your intro there that maybe you want to touch on to the listeners know more about.

No you've got it. But I would be remiss to say that I would not have been able to have all of those wonderful experiences without creating deal on the way. And I think my favorite thing about the diversity of the experiences that you outlined there running from policy to private sector to investing to know kind of a random walk shall we say is that healthcare and particularly diagnostics has been the common thread. And I think looking back is really valuable to understand the healthcare ecosystem from all those different vantage point.

Yeah without a doubt it's your experience spans many verticals so I think that's pretty cool because one of the things that we find in healthcare is really kind of siloed nature of it. So having that you've been through many of those gives you an advantage and just out of curiosity right while the verticals have been different it's been in the medical sector so what got you interested in the medical space to begin with.

Now well as we mentioned I studied Bioengineering as an undergrad that was at UC Berkeley and my first roll out of college was as an investor at a junior level of course at a fund in New York and I had a chance to participate in the deal on the diagnostic side and that was back in the days as swine flu and avian flu if you remember that after the 2000 and I've really been in the diagnostic world ever since I was put in Enlitic in that category as well. But coming at it from the deep learning side where I was really interested in doing throughout my career that I never had the chance to do until that lab was to build a product within diagnostics for women's health. And I think there's just an incredible amount of opportunity within women's health right now. And so I was really looking for a chance to build the product that I felt was missing in the world and that background and in diagnostics certainly help both with identifying the technology and developing it but also doing some self reflection in assessing when I felt it was the right time for me to take that step in my career.

I think that's super interesting and so we had recently Kevin Lyman, COO there in Enlitic i don't know if you had a chance to work with him while you were there or not.

I didn't. But I am so thrilled to see with where the company is going and I think there's just so much promise for deep learning. I think that we really only began to scratch the surface of where we can see that why particularly are on the single payer side in coming years. So it's really exciting.

It is. So the company that you've put together here is are you guys incorporating deep learning as part of it?

We have not announced that yet. I think to take a step back there's certainly opportunities for it, but it's not part of our immediate roadmap. That said, I think within women's health, we have seen multiple new therapies come out in the past couple of years. So I think there may be sources of inspiration to apply deep learning in the near term but it it's not on our immediate roadmap.

Got it, super exciting. So Heather as you've been a part of so many different aspects of healthcare through your career what would you say a hot topic is today that needs to be on every medical leaders agenda and how are you and your company focused on it?

Yeah I mean it's really interesting and you could probably answer that question a number of different ways depending on whether you're coming it healthcare from the buyer side or as a producer of services or from the pharma and device side. But I think what stands out across all of those is really the move to value-based care, where I think unfortunately today value creation or application does not equal where we can extract value within the ecosystem. And I think this move to value-based care regardless of what stakeholder type you may work within in the healthcare world I think that's the most meaningful shifts will be in coming decades regardless of what happens on the policy side.

Yeah that's cool you know and I feel like value-based care means a lot of things to different people. How would you define value-based care?

Yeah I mean for me I think there's certainly the health economics piece and that usually tells the story but I think it's so important that we bring it back to a patient. So with what we do without labs, we are working in a way that has had no innovation in really 50 years for a condition called Endometriosis that affects one in 10 women and today there's only the extremely crude and based on method of surgery which requires general anesthesia called laparoscopy and that's the only way to confirm active disease in women who are afflicted by the endometriosis. And as a result of that the downstream factors of the disease are caught really late, all these compounding or can cost accrue over time and so where it gets really interesting is trying to introduce the new not invade the technology which is what we're doing about lab that would display of the incentives that currently exist around surgery that with value-based care, I think at the end of the day what it really means to me is thinking about the patients and what will improve her or his quality of life, and having the health economic story be built around that and what this system is with a line can do toward. So I do feel optimistic directionally about where the U.S. will be in the course of the next 10 to 15 years and I think we'll continue to see bumps along the way. But as technology accelerates and I think with how mobilized certain patient groups are payers are certainly engaged and often aligned towards the end goal. But it will take some time.

Yeah for sure and it's pretty cool that you've narrowed it to endometriosis you know and you mentioned it affects a lot of people in the U.S. every year and it's something that hasn't been visited as far as innovating an approach to it so it's so so exciting to hear that you and your team are actually working for for better results within this space.

Thank you so much and we feel the same way. And I am genuinely excited to wake up every morning and work on it and I think for us what's so interesting is within diagnostics this emerging field as you know call it liquid biopsies or other types of non-invasive biomarkers. And I would argue that liquid biopsy just means bloodpath. But for us it's really about understanding how we can improve the sensitivity and specificity was widely accepted to be the gold standard whether it's surgery or some other diagnostic test in order to have new women's health forward collectively. So with a case of endometriosis the reason it's so interesting is that it's truly a blackbox within healthcare still. And so if we think about pelvic pain, one in seven women experienced pelvic pain and it's pretty straightforward to rule out some of the key causes namely Polycystic Ovarian Syndrome, Uterine fibroids compares to endometriosis, these are really simple paths to run in order to provide patients with those answers. Be it just an ultrasound or a blood draw both endometriosis the average delayed diagnosis is still 10 years and...

Is that right?

It's not part of that initial. Yeah and it's not part of a checklist for what the SAT in the physicians office. So exactly it's a very long time and I think what we're really seeing is a shift toward with our path something that's specific and sensitive for endometriosis in order to identify patients early as far as the stage of disease and help them make sure that they're in a place where they can pursue certain therapies or other treatments that can help to improve the trajectory of their lives. So with young women for example who may start experiencing crippling pelvic pain in high school, often these young girls or teens don't go out for sport because what if they're menstruating on the day of a big game or they don't go out for the school play because of fear that endometriosis typically I note endometriosis will interfere. So it's incredibly meaningful to be able to really help these patients at a young age and then subsequently women are thinking about the assets of endometriosis that are more closely linked in fertility.

So how are you guys diagnosing it then? Is this something that you could chat with us about?

Yes sure. So the DotLab test for endometriosis we call it Dot Endo.

Okay.

So we have identified with Dot Endo biomarkers called micro RNA though that are specific and sensitive for endometriosis. So ours was the thick micro RNA biomarkers which are under worldwide patents. We identified from a reading of thousands of different micro RNA's sequences using comprehensive micro arrays of these micro RNA's. So from the tens of thousands that we started with, we identified a panel that showed really significant differential extraction and we've spent the past couple of years not only developing that Assaye but validating it retrospectively and prospectively in endometriosis patient. So I think the most significant sort of milestone that we're really excited to be able to share is that our prospective data will be published later this year. And it came out looking really strong and we presented our interim data at the American Society for Reproductive Medicine meeting and won the Indian state prize for the whole conference which was attended by about 30,000 physicians from throughout the U.S. and internationally. So really pleased with our data and excited to bring the product around the world.

Congratulations. That's pretty exciting.

Thank you.

So this is phenomenal you know and as you think about this chronic condition it's something that affects the lives of hundreds of thousands of people every year so to have a way to detect it and fix it is a huge win. So tell me how there, is there a time when you had a setback whether it be your time right here at DotLabs or within clinic or one of your prior engagements that you had a setback that touched you so much about healthcare that maybe you want to share with the listeners.

Absolutely. The answer is every day but one that comes to mind right away is thinking about how to develop and deploy the tech piece of our product. So I think it's really tempting when launching anything and help technology to think that you understand the tradition workflow and it did come out that we're in a position to be able to bring our test out to you position. And looking back we overinvested our time and resources into the tech product where we think in the future we'll certainly under invest on that side, do things manually before building an app that we're certain really need the real world physician workflow requirement. So I mean just like I think any entrepreneur will tell you there's nothing like a customer or in our case position in our view to really open your eyes about what's really needed from your product. So as always it's just critical to get out and talk to different stakeholders to get a strong sense of what we'll take your product to that next key milestone which in our case was not overinvesting in the tech product too early.

Yeah that's such a great call out there. It's so easy and we all fall victim to just wanting to build this awesome technology and then we sort of forget to just kind of stop even before we get started. But maybe even you know if you've already started to stop midway and just kind of do a gut check to make sure the end users gonna like it and it flows well.

Absolutely. And we have a great team here at DotLab and I think we learned from that and really quickly almost immediately when we went out to do new position interviews and I think it's just a matter of really internalizing that feedback quickly and reacting to it and adjusting. But I think there are smaller versions of that that happen every day in a startup and we're always just out there looking for all the information we can to make sure that we're ruthlessly prioritizing shall we say what we accomplish internally at DotLab on any given day.

That's awesome Heather, anyhow so this is great advice and I'm sure with the leadership that you're providing to this team you guys are definitely going to go far and Im excited to see that happen now as you have you worked on different things would you say one of the proudest healthcare leadership experiences that you've had to date is.

Yeah well thinking back to when I was a student I had the opportunity to work as a fellow in the technology transfer office at Harvard. And I didn't necessarily know at the time how that would serve me well in the future. So the proudest moment that immediately comes to mind is over the course of more than a year working with Yale University to get the exclusive license to some of our early IP. So I was able to procure it out license but it was a long process and I was pursuing the intellectual property as an individual as opposed to a large corporation. And so my negotiation leverage was as you can imagine not quite on the same playing field but being able to get a license and over many competitors who thought the IP as well, that was such a turning point in the company's trajectory a couple of years ago and was the impetus for our efforts for subsequently going out and taking our first outside capital and turning our cores from being a research and development shop to a commercial product company. So I look back on that probably for sure that we were able to accomplish that.

It is a David and Goliath victory. What would you say contributed to your ability to do that?

Yeah I think it's just understanding how technology transfer works which I had the opportunity to observe when I was there as a research fellow but also in the Obama White House. One of my areas of focus and passion was around this idea of lab to market that there are just so many incredible technologies and scientific breakthroughs that have been discovered by our universities and federal labs. And I think the biggest mistake in my view that health tech companies make is that under leveraging what's available within tech transfer offices so I had that thesis kind of in its earliest stages at the beginning of my career but when I reached an inflection point where I was really looking to build a women's health company, it came full circle. So I think to answer your question it was really a combination of understanding tech transfer and the incentive and a little bit about the process. And then just being persistent.

Love that. That's great. There's nothing like a little understanding of how it works and then that persistence to put the bow on top right.

Exactly.

I love that. Well congratulations that's a huge win and sort of the beginning of a lot of great things so definitely inspiring to hear that story. Within your company DotLabs, what would you say is an exciting project or focus that you're working on right now?

Yes so I am incredibly excited about our prospective studies. So a little bit about that and why that's significant. So as a catch, we are looking at the first technology to confirm active endometriosis disease and laparoscopy or surgery that really it hasn't evolved meaningfully since my grandmother's time. So that said in order to compare our technology to the gold standard or the gold standard rather surgery you have to collect the patient samples during laparoscopy. So in the case of the prospective body we looked at the biomarker levels that were significantly elevated in patients with endometriosis compared to control and the expression of the biomarkers was consistent with that and impatient with the active endometriosis that were not found to have the disease upon surgical evaluation. So in other words the samples were collected during surgery which is critically important because if you cut out the disease prior to analyzing the biomarker levels are going to score your result. So this is an incredibly difficult study to run when you're looking to compare against surgery. And we are able to accomplish that and to share the interim data with the key opinion leaders in the field and received such a warm reception. So really proud of that and excited about the future.

That is super exciting. Congratulations on that. And so you guys worked hard to figure this out. You've got the diagnostic piece put together. Is there also a treatment piece to the company?

Not to the company but in the news last week was the approval of the new class of therapies specifically generations. Is also known as a goal X and b has a new drug called Orlistat that just got approved. And before that the only second line of therapy in the bay with Louve prawn Wesch I'm making a little extra or less is known to you or it's not administered orally the side effects can cause unpleasant complications or patience. But as we speak that we're seeing the innovation take place from the therapeutic side and in women's health and particularly in endometriosis which just has incredible prevalence. The diagnostics are uniquely a bottleneck and that's part of why I was so inspired to build the company is bad. Unlike in most cases where a diagnostic doesn't exist and you expect the therapeutic not to either. In this way there are quite a few therapeutics out there lupines now illegal and even just the regular oral contraceptive pill or birth control can help in the earliest stages of endometriosis. While none of those are curative the limiting factors are not on the therapeutic side comparatively and where I felt that we could make a huge impact from patients which was really on the early detection and diagnostic development side. So it really is really interesting.

Yeah that's awesome. Sounds like the solutions out there and just marry both to treat the right patients at the right time with the right drug. Or nothing at all right?

Yeah. If you don't have that disease I would hope so. And I think what's interesting about health task and I think this movement towards digital health is that precision medicine is somewhere on the periphery of bad yet it offers much hope to patients and I think that it really does tend to marry different disciplines such as diagnostics with machine learning tentatively in the future in order to best serve patients. But initially you have to build that data set.

For sure. Now super interesting Heather and you guys are doing such an outstanding job there, getting close to the end of our interview the time flies I'd love if you could share some answers to these lightning round questions. We're gonna to build a syllabus for a medical leadership course, the ABC's of Heather Bowerman and four questions lightning round style followed by a favorite book that you recommend to the listeners, you ready?

Let's do it.

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

Align incentives particularly financial ones. When I say align incentives I think that it goes back to the value-based care that we were talking about earlier where I think purposes medicine should really take hold in women's health but in other areas of healthcare and medicine well ultimately the health economics cases need to be built. And so whenever a new therapeutic is in that is offered or an underserved population or any technology that displaces the way things are done in a way the various stakeholders are incentivized today I think that we just need to keep a close watch on our system to keep incentives aligned, aligned as much as we can. And of course I mean I unfortunately you know unable to control that or the weather or myself but what I can do is think about where we deploy our technology in order to generate as much traction in the near term as we can at places where we view the incentive alignment on stacking up more favorably.

Love it and what would you say the biggest mistake or pitfall to avoid is?

There a lot but of course what rises to the top is hiring that meet team members. I think of startups like I don't know where we're world both to where there are only a certain number of seats on your boat. As a startup that you need to make sure that each seat is filled with somebody who is really going to paddle on your behalf whether you're paddling at the moment or not. And I think that especially with early stage startups really anything before theory be is just so important that you fill your boat with as many a player as you can.

You don't want any dead weight out in the ocean right.

Exactly.

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

I try and never stop learning. I listen to podcasts like yours. I read every day. Realistically most of that reading happens on my phone. But really staying on top of the day and looking for just where you're state is going and what's happening adjacent to you. I think that that's critically important. And that's gotta be with you stay laser focused on our products and what we're building but they're really just learning from. You can. I think the best that you can do for your company.

Love that and hear that the average CEO reads 50 books a year.

I believe that I think no I think a lot of those are on audio by now. But I would believe that.

I agree with you completely. I used to have a kind of a challenge I would say well I don't technically have read them,I listen to them. But now I read them whether you listen to them or read it you still read it right?

Yeah you're consuming the information and I'm with you.

Yeah that's awesome. I love it. What would you say one area of focus that should drive every company in healthcare should be?

I think it's really about creating value for patients. So for us I think we're so inspired by filling this gap in women's health is so glaring where unfortunately there's often a mismatch between straightforward business models and technologies that can truly fill a gap in patient care. So if I think about a company that is probably gonna have excess fundraising it probably something more with a no proven footprint on the commercial side. But if you're developing a new technology you unlock or scratched the surface of a black box in medicine that course probably hasn't been charted for you. So I think just staying focused on what you can do to bring value to patients and not getting deterred by the obstacles in your way, that's really the way that we can start to fill the gap.

I think that's such a great call out and not of these awesome books that you read and the resources that you check out every year Heather, what book would you recommend to the listeners?

There are so many but one that I love that comes to mind is Ben Horowitz's book The Hard Thing About Hard Things. He has a chapter called nobody cares and he talks about failure and excuses mainly that the former never justifies the latter. So there will always be reasons why something didn't go well. But the bottom line is that your energy is better than being a solutions person which really resonates with me as a CEO. And at the end of the day nobody cares to do your job.

Love that. Straight to the point. Keep it simple. And listeners you can find all of these resources as well as a link to Heather's company. Just go to outcomesrocket.health/dotlab you'll be able to find all that there. Heather this has been fun, I'd love if you could just share a closing thought with the listeners and then the best place to get in touch with you or follow you.

Yeah I think my closing thought is just how excited I am for the next five years in women's health. I think there are so many great companies emerging and so closely watched that base particularly when Intel companies that are female led which is a new trend that we're starting to see an end directionally. I think there's just so much promise for the next couple of years and you can find us on Twitter at hello.lab or get a hold of us by email at hello@dotlab.com.

Outstanding. Heather, thank you so much for making time for us today and we're really excited to see where you take this field of women's health in the future. Thank you so much for participating.

Thanks for having me.

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.

Automatically convert audio to text with Sonix

 


Recommendeded Book:

The Hard Thing About Hard Things

Best Way to Contact Heather:

hello@dotlab.com

Twitter: @hellodotlab

Mentioned Link:

https://www.dotlab.com/

Check out this Link:

https://outcomesrocket.health/podcast

No comments exist
Why Video is the Best Resource for Medical Education with Roman Giverts, CEO at VuMedi, Inc

Why Video is the Best Resource for Medical Education with Roman Giverts, CEO at VuMedi, 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 where we chat with today's most successful and inspiring health leaders. Today I have the amazing Roman Giverts. He's the CEO at VuMedi, the leading healthcare video network for doctors. Over 200,000 doctors use VuMedi to improve patient care and grow their practice. They provide a large targeted marketing opportunity for healthcare companies using a native advertising model. Roman founded the company from his college apartment as an undergrad engineer at UC Berkeley. He's a huge believer and bootstrapping from nothing, loves helping entrepreneurs get their companies off the ground. Before starting his company, he worked that techcrunch at the original Office in Mike Arrington's home. Additionally Roman was the first intern in NBC Universal's Antipiracy Group where he was exposed to pioneering companies in the online video space. So it's a pleasure to extend a warm welcome to you, Roman I really appreciate you making the time for us.

Thanks Saul. Really excited for this conversation.

Absolutely sir. Roman you could have gone out a lot of directions. Obviously video is is a fundamental tool for marketing and communicating in any vertical. But why did you decide to choose health care?

Right. Good question. So video is getting really hot as YouTube was launching and I was taking this internship and I really had no background in medicine so a little bit accidental that I stumbled into it but I just happened to be dating a girl, who thankfully is my wife or this would be an awkward story told over and over again. My girlfriend at the time in college her dad is actually an orthopedic surgeon

Nice.

So, one day I was just kind of walking around their house and I just stumbled on him watching a surgical video. And this was about maybe 10 or 11 years ago and before Netflix if you remember we had these like racks of DVDs you know.

Yeah.

So yeah something like that but it was surgical videos and he kind of explained to me that he uses those videos to learn. And of course I said there isn't a website where all of you physicians can go and look these kind of videos up and you know there wasn't and that was kind of how I stumbled into it. He said "you should go create it." And I had three or four other ideas and the other ideas I had zero users and I thought I had one here. OK well I think this is my best idea and I guess we're kind of maybe where I got a little more invested in the industry was when I really two things you know one a lot of the other you know my friends in college you know everyone to start a company or build an app you know their ability kind of cute consumer applications, the Apple app store had just launched. So people do a little cute picture apps. I just thought this concept are a lot more meaning behind it. Helping physicians treat patients and improve patient care just kind of inspired me more. And then you know when I learned about the size of the market I just couldn't believe healthcare is number one vertical in our GDP. So it all together had meaning from a big financial opportunity and I kind of thought this was a great space to be. And so I was actually supposed to go to law school and I had gone in and had to tell my parents I wasn't going to a top 10 law school. That's something...

How was that? How did that go?

Well I started telling you about the product and I didn't tell them about until we had like I think a thousand users but it went pretty well.

Very cool. Hey if you sold that to your parents those investors were a cinch.

Parents want you to go to grad school. All they've got to do is go to grad school like you know and to throw all my test scores out. And in fact, I'm not even getting a job, I'm going to work for free and live at home instead.

Got to love that man. Well fast forward to today. You guys have definitely picked up some good traction and you're doing some great things. What would you say Roman is a hot topic that needs to be on every medical leaders agenda today and how are you and your team at VuMedi tackling that?

Yeah I think what we see probably the most exciting inspiring trend is just the rapid innovation in some of the specialties particularly oncology and Rheumatology you know having called you're changing humanity right so probably the biggest one is going toggery now is the approval of karty cell therapy. So kids who are under 25 and none of the available treatments could save them and get a curtsies so Transperth piece of therapy and really saving lives is pretty pretty incredible. You know people call us from oncology every week there's a new FDA approval. So it has all of that has enormous impact to just about every field right whether you're a clinician right. Your ability to save lives. The economics are very controversial so these therapies are very, very, very expensive. The FDA pathways have been modified now because again you're saving lives and think there's no rapid approvals. Things like that. And then you go from a point of view it's a significant change in practice to actually apply these therapies. And so when you see headlines like 400 percent increase in survival in bladder cancer. And that's something that as an oncologist you want to take advantage of. That's not like 10 percent minor impact in some type of quality of life measurements of lives being saved. And so they have to get educated and they have to keep up and they have to learn and so from VuMedi point of view that's really where we fit in is trying to help these oncologists as well as many other specialists. There's rapid innovation, rapid change and of this are trying to keep up and treat patients that are trying to help them.

That's awesome. Super important too right. That rack of DVDs is a day of yesterday and we're in the streaming age. So no doubt it's important for clinicians to have a point where they can actually go visit get what they need and move on. Can you share with the listeners how you've applied some of these technologies to help leverage and scale the new solutions that are available?

Yes sure. I mean I think that the educational pathway is complex. I think that we take for granted how hard it is to actually know just to stick with the oncology example and actually change your practice and use one of these therapies let alone change how you do a surgery which is even more complex where even how you treat a patient with diabetes and a few comorbidities very very complex educational pathway. I think a lot of what's traditionally been out there from the days before the internet it was textbooks all the way to today. There's a lot of news websites you know that cover in a paragraph or a short video about pathway is complex it's hours of education. And so that's where technology comes in. In VuMedi we have 50,000 videos just on one topic we might have 30, 50 or 100 videos. You just can't do that with the DVD rack. We started talking about, you can't do that with basic search right. We have very advanced taxonomies very advanced understanding of like basic, intermediate, advanced content understanding of related content. And then we're also you know investing a lot to understand what are users where they are in that pathway. And the only way to do that is with technology and I think that's what technologies enabled the physician to be able to not only to get access to so much more content right with 15000 videos compared to 20 but also to enable the platform like the VuMedi. So then recommend that actually help make decisions and help guide them to the right place.

That's a great call out. And folks if you're curious the website for vumedi.com, check them out over there see what they're up to. Really cool stuff. Making education simpler. It doesn't have to be complex. And with all the changes it's super important that we have a tool to make it that way. So Roman talk to me about a time when something didn't work out. A setback that you guys had. What did you learn from that setback? Take us to that moment.

Sure if I could spend the whole podcast on those probably I think the top of the list. I think there's a tendency to prioritize and do things that sound good over doing things that have the greatest economic value and output. I'll give you just one example that we've made that mistake many times but I'll give you just kind of the one biggest example you know our goal is to get as many doctors on the platform as we could and we chased big round numbers of 50,000, 1000,000, 2000,000 so we would open up specialties that had very large numbers of doctors on pediatrics, radiology and so forth with over 50000 physicians. What we learned though is that that's not necessarily the greatest economic opportunity for human right so what sounded good. Getting to a hundred thousand doctors wasn't actually the optimal way to grow the business. And you know today you know we've learned that it's actually the greatest opportunity for us for specialties like oncology or rheumatology which are significantly less physicians but physicians spend a lot more money. Those products cost a lot more. So every one of those physicians is much much more valuable to the platform and to the potential advertisers. And so I think that if you're a product guy like me and you know you want to solve a problem for physicians which we did you don't always put your kind of businessman hat on and actually think about how do I build the biggest business the fastest way possible and I think we've learned from mistakes like that. And I think now in everything we do on a day to day basis from every single product decision, every single expansion decision, every investment we make we think about what is what is the economic output of that investment. And by doing that you grow a lot faster.

Yeah that's a great call out Roman and one that we're working and the innovation of a product your company needs to keep this in mind just because it sounds good doesn't mean it is good. Good ideas aren't necessarily good business plans and so it's a great message from Roman that he's shared with us today so let's keep that pressure test those things. Hold yourself accountable. Don't just go with something that sounds good. Well how about one of your proudest moments Roman what's been something that you guys have achieved today that you're like man this is awesome.

Yeah. Just give you the achievement and then maybe give you a little backstory for why it was so important to us which is you know also learning in Q4 of last last December's lots of months ago we had our first 100 percent renewable quarter in Q4 as our biggest quarter were more large percentage of our sales comes in. And so that's a nice you know a nice metric but is really a journey of about a year and a half. Previously we've had a bit of a transition at the Meddie sales which previously did not report it to me in reporting it to me which is a whole new area for me to learn about. And we really transition that the company from celebrating sales to celebrating customer success. And I think there's a tendency to get really excited by when you close a new deal. Right. And we still celebrate that by all means. But I think what I've learned is that growth comes from the success at the conclusion of the delivery of what you sold. In other words in the renewals right. And so one of our company values that we created about two years ago was customer success right and everything was not about the sale. It was about delivering success. And so you know we want to our customers are on an annual cycle. So you know that January is when we began a lot of these investments in their success. So you know we didn't know whether they would you know we invested a lot and then you kind of wait wait wait and then you get to the end of the contract you're up for renewal. So we saw that all of that, all the investment that we made in the success of others translating was a renewal and the reason which have been important for the company was that it showed us that the methodology that we were undertaking the principles of philosophies that they were working in I mean you know not only did we beat our forecast and it was a great financial year show that like we as a company knew what we were doing and we really were delivering to our customers. And it inspired us for the future growth that we made if we could continue to do that so it was sort of an exciting last day of the year there. But a long road getting there.

That's awesome. Congratulations on that Roman to you and your team and you know it's those little shifts that can make a huge difference. Roman, your last name as Giver. You are a giver my friend. You're a go giver not a go getter.

I never heard that but I'm going to use it, thank you. I'll share with you we have we have a joke internally we call it if anyone remembers a song from the early 90s called OPP or yeah I remember that it is other people's problems and so one of our core values is you know we care about other people's problems. We want to solve other people's problems and that's sort of a funny use of customer success.

Love that. What a great story there. Roman and I love that you guys have those little playful ways to engage culture there at your organization you're doing a really nice job there man.

Thanks, Saul. I appreciate it.

Absolutely. Now tell us a little bit about an exciting project or focus that you guys are working on at VuMedi today.

Absolutely. You know I mentioned sort of oncology as a theme. You know that's by far the fastest specialty we've ever launch which took us three or four years and other specialties we drew just in a year of over 6000 oncologists using the platform hundreds of videos and partnerships. It's a great space to be in. But you know I think what we're learning also then is the targeting and how important the targeting target technology is in that field particularly in that a typical oncologist treating 20 different cancers that's changing every like you said every week there's a new FDA approval. Furthermore you don't see these cancers are really rare for specialties like blood cancers. You're seeing one or two patients a year. Right. So you're not you know you're trying to stay up to date. So you know we're really working on is targeting the physicians when they actually need it, when they actually have that problem. Right. So you get a lot of news letters I get a ton of them. Well reality is I'm dealing you know 20 types of cancers right now. My problem is the breast that you're sending me something along that's not going to do it for me right. And so knowing the users really well as well as having the content and actually having the technology in the taxonomy that underpins a lot of that knowledge to be able to recommend the right content at the right time. I think that's really exciting and I think that all of us shop on Amazon have seen that type of thing in action that's what we're trying to bring to medicine and I think it has a huge opportunity to really change workflows of physicians and how they acquire information and and as a result how they change their practice and treat patients.

That's pretty cool. Yeah I mean as a consumer you definitely value companies that could say hey Roman I know that you've kind of interested in this so why don't you check this out. Oh my gosh thank you. I think it's amazing when you have a technology that helps you do that and it's not easy right. I mean you sound like you guys are putting in the technology, the algorithms, machine learning, whatever you guys are doing to actually make the platform smarter so that it makes smart recommendations. I get into my car in the morning and it says it's ten minutes to your son's daycare. And then when I get back in it's like all right it's 15 minutes back home. Those are the kinds of insights that people want. Right.

As you said it's really complex. I mean the quantity of data is just extraordinary and the scale of it our engineers are just talking this morning. They were up to 1 am upgrading our database last week. You know the amount of data points you know imagine every opened up an e-mail, every impression, every page view, every tiny thing that a user does tells you whether they're interest in something or as importantly that they're not interested in something and then you know trying to take all those data points and add hundreds of thousands of users to come to a conclusion. It's very complex and the credits are just the quality of our really advanced engineering team sort of the backbone of humanity.

That's awesome Roman. And yeah I mean you know half the battle like you said is like separating the signal from the noise. If they don't open it that's just as important as if they did. So you know that you should be focusing on something versus not. And folks when you're thinking about how you use data within your organization take some of these thoughts that Roman has left us with an understanding you've got to separate the signal from the noise. If you're going to make those true insights to improve outcomes and and build better business models. Roman, getting close to the end here let's pretend you and I are building a medical leadership course on what it takes to be successful in the business of medicine - the 101 of Roman Giverts. We're going to write a syllabus for questions lightning round style followed by a book that you recommended to listeners you ready?

Yep.

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

Study just measuring everything so that the data exists and then making it transparent so that at the very least you have access to even multiple organizations can have access to analyze it and innovate around it.

What's the biggest mistake or pitfall to avoid?

Not having a fully completed interdisciplinary team health tack or digital health. It's an interdisciplinary field. You know it's healthcare technology as well as often other other fields. And what I see most often is a company started by technologists or actually started by a physician or clinician that doesn't have all of the pieces together. And I think it's required if you don't have one of those pieces. So much struggles to succeed.

How do you stay relevant despite constant change?

Yeah I mean it's important. VuMedi has been around for 10 years so that's a good one for us to talk about. It's really all about growth. We grow much faster the last 3 years than our first three years. The faster you're growing the more relevant you are and that growth is all about creating results.

Absolutely. And finally what is one area of focus that drives everything in your organization?

What I just said results were all about creating results.

Love that and you're all about the OPP right?

Results and OPP. I was wondering how my mid 90s love for rap would intersect my professional career and finally.

I love it man. What's your favorite book you want to recommend to the listeners?

Yeah the book I've read is at least ten times is Crossing the Chasm. It's very well known in technology marketing if it's known as a medical book. But it is by far the most important book that helped me succeed. I probably read it five to ten times just in the first year. Every time I was stuck I'd go back and read. Crossing the chasm explains to you when you start your company your first year you're going to have customers or users or whoever stakeholder is trying to acquire that say no you and that don't use your product or don't buy your product. And that book explains to you why they're not buying it. And that allows you to understand sort of where you are and your trajectory and where you need to be going. And we talk about that book at VuMedi on a regular the concepts in that book of crossing the chasm and early adopters of fragment pragmatic buyers product solutions on a daily and weekly basis to this day and following their niche marketing strategy is literally what we're allowed to succeed because we started real real small as a site for shoulder surgery and in just a few decades. Now as you mentioned we have over 200000 physicians in over 50 specialties by now. It all started with a really targeted niche marketing strategy that I got from crossing the chasm.

Gotta love it. Great recommendation Roman. Folks if you want to get a hold of this book as well as the transcript from our conversation today just go to outcomesrocket.health/vumedi. You're going to see all the links there and you could get your learning on. So Rumman, this has been a blast. I love if you could just leave us with a closing thought. And then the best place for the listeners to get in touch with you or follow you.

Yes sure. My closing thought is just to take you Saul for organizing this podcast I think Healthcare, health tech, digital health education is necessary and there's so many podcasts online. Technology is really great. More exposure for our field and view giving a platform to people like myself to come on and share share thoughts and beliefs and ideas on this skills. Also thank you for doing it. Thank you for having me on and I really appreciate it.

Absolutely Roman. It's a pleasure. And if anybody out there listening to this sort of what you said struck a chord with them. What would be the best way for them to reach out or follow you?

Yeah. The best thing to do is I always gave out my e-mail and I'm going to do it. But you can just e-mail me directly at roman@vumedi.com and if I don't reply just just send it again. We get a lot more inbound than we used to but I tried to make myself look for many people as I can.

Folks if you write an e-mail to Roman just type in Outcomes Rocket in the subject and the likelihood of him answering will go up.

So myself by the way for other people I've listened to so that's a good call.

Absolutely. So folks there you have it. Roman Giverts with Vumedi. Roman, this has been a blast. Really appreciate you sharing your insights and looking forward to catching up with you soon.

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.

Automatically convert audio to text with Sonix

 


Recommended Book:

Crossing the Chasm: Marketing and Selling High-Tech Products to Mainstream Customers

Best Way to Contact Roman:

roman@vumedi.com

Mentioned Link:

vumedi.com

Check out this Link:

https://outcomesrocket.health/podcast

No comments exist
How To Create Actionable Value Based Care Policies and Best Practices with Chris DeRienzo, System Chief Quality Officer at Mission Health

How To Create Actionable Value Based Care Policies and Best Practices with Chris DeRienzo, System Chief Quality Officer at Mission Health

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 Dr. Chris DeRienzo appointed member of North Carolina Medical Care Advisory Committee. He's a dedicated husband and proud father and also a triathlete. He's also a physician executive dedicated to improving health for all Americans and currently serves as a chief quality officer for Mission Health. In this role, he gets to practice neonatology with Mission Children, teach as an adjunct professor of pediatrics with both Duke and USC and volunteer as a member of the Blue Ridge Regional Hospital Board, the Mercy Health Board quality committee and the YMCA Blue Ridge assembly board mission Impac committee. He's board certified in both pediatrics and neonatology Dr. Dary Enzo completed his M.D. Master's in Public Policy and postgraduate medical training at Duke. He's certainly passionate about what he does for populations and it's a true pleasure to have Chris on the podcast with us Chris. Welcome.

I'm happy to be here,Saul Thanks for having me.

It is a true pleasure my friend. Now did I leave anything in that intro that maybe you want to share with the listeners?

The only thing I might add is I'm a mediocre triathlete at best.

Hey listen you know how to finish them and that's all I care about my friend.

Amen to that.

I was able to do two triathlons and man major respects. Do you do the Olympics, do you do the sprints? What do you prefer to do?

So I started in the in the shorter course. And I actually just did it an Olympic. We were visiting some friends in New Jersey this past weekend. But I'm trying to work out towards the Iron Man. It is a lot of training and I have an incredibly understanding wife.

Oh my gosh. That's awesome. Well if you're shooting for the Iron Man, I've never done it but I admire those that could get it done. And if you apply even a fraction of what you've been able to do in your career and what you do and what you love so much, I have no doubt you'll be able to finish it.

I appreciate that. We shall see come mid October.

Fingers crossed. Hey so Chris why did you decide to get into the medical sector?

Yeah when I was a kid I was really interested in science and I had this fantastic neighbor who is an oncologist and she took me into her lab one summer she was doing great research on cancer science and I thought it was really cool but I felt like I was missing something. And finally one day she brought me to one of their cancer conferences where they talk through patients and what the best strategies were to help treat this cancer that cancer and something just clicked for me and I said wow I can really very directly have impact on individual people's lives and on lots of people's lives at once by getting into benison and once that's sort of been struck I was off and running.

That's so cool. So from the very beginning Chris you were interested in and impacting populations at large. What would you say today, you know now fast forward to where you are in your career and as a healthcare leader is a hot topic and needs to be on every medical leaders agenda and how are you guys addressing it?

I think that we are clearly undergoing a time of great transformation in healthcare from the way that we think about providing health care to what's available to us to treating patients not just inside the four walls of our institutions but throughout the courses of their lives. So I think if folks are not innovating today, if they're not continuously improving then you're already ten steps behind the rest of the field.

Yeah you know that's a really great call out. And so as a health leader within the system, a provider system - what type of advice would you give to others trying to do something trying to innovate?

So within Mission we've been really successful in innovating through our continuous improvement pathways. And so the way that we think about continuous improvement is kind of like fishing. All right so you've got to first teach folks that it's part of their job that they need to fish. Otherwise they don't know that they either can't do it or need to do it. So right from day one, the Chief Operating Officer of our system in day one of orientation tells everybody at mission that you've got two jobs. First to do what we hired you to do as well as you possibly can do it. And second figure out ways that we can make it better. And so we go folks who join the team in from the very beginning that continuous improvement is in our DNA. And so once you know that you need to go fishing you need to have some tools to fish. So we equip folks through a variety of different trainings with the tools that they need to perform continuous improvement at the bedside and finance and H.R. you name it. And we use a variety of tools including analytics platforms more basic continuous improvement methodology and then we teach folks how to use them. So once you've got your fishing pole unless you know what to do with it you know it's not of much use to you. So you've got to focus time, energy and resource on training and coaching on how to use continuous improvement tools and methodologies relevant to whatever that individual's area of practice is. And then finally once your teams begin achieving great outcomes and you know that they will because equipping folks at the frontline - frontline managers line level leaders with continuous improvement methodology is all of a sudden their eyes are open to the opportunities surrounding them and they will achieve outcomes. Their leaders have to then positively reinforce it. And so we highlight those outcomes everywhere we could possibly think about it. We have quality awards every year. It's on their boards, at their units, in their clinics and it begins to generate this profound flywheel effect on continuous improvement.

Chris I think that's wonderful and it's very clear to me that continuous improvement is inside of the very fabric of the culture of your organisation from the beginning through out the individuals' careers their mission and I could hear the passion in your voice for this continued improvement that leads to those innovations. You use the fishing analogy I recently had a guest on a podcast that talked about you've got to keep tension in the line and that tension in the line always helps you understand the communication between you and the things that are going on within the organisation. And I think it just meshes really well with the example you've provided. Can you give the listeners an example of something that's come out of this culture of continuous improvement?

Absolutely on the clinical side we structure that continuous improvement around something called care process models and so a care process model team comes together around a clinical condition or a disease state and very purposefully walk from start to finish through what are the best practices nationally on driving patients to the best possible outcome with colon cancer, with lung cancer, with paediatric asthma and so on we bring those teams together and we give them 90 days and say in a 90 day sprint We need you to find the problem. Figure out what the best practice is we resource the clinician who leads a team with a member of our performance improvement team with informatics folks, with an analytics resource, with education resources, and then with all of the folks in the clinical care team who are relevant to that condition so if it's in the clinic environment we're talking about medical assistance, nurses, pharmacists if it's on the inpatient environment you know care managers are there and so and so forth. So we empower that team to tell us what is the best practice said it mission we need to build into our workflows and then we build it we build it into the electronic medical record in a workflow that is as frictionless to use as possible which makes it easy to do what our CPM has decided is the right thing and just a little bit harder not to follow that pathway. But that's not enough. You then have to measure outcomes. So we've built the analytics environment for each and every one of these care process models so that we can get to a physician, provider and a patient level and know are using the pathways making a difference on relevant clinical outcomes. So for example in the inpatient world if we're using the sepsis CPM what the differences look like in patient mortality, in readmission rate, in length of stay, in cost per case. And right now I could pull ups Saul across over 60 of these care process models and if you were you know one of my supervisors you would say Derienzo "you know if you look across our group most folks are using the pathway 80 percent of the time and this is what their outcomes look like. You using it 30 percent of the time and look at your readmission rate is higher this number is where what's going on?" and sometimes we found that conversation is well you know my patient panel has a really high percentage of say chronic renal failure and we don't have the right dosing built into the pathway. And then within two weeks we fix the CPM and now it's there and sometimes it's more of an eye opening conversation saying oh my gosh I didn't realize that I wasn't using x. And so we then bring folks along and we have seen dramatic, Saul, dramatic changes in clinical outcomes as a result.

What a great example Chris. Just thinking through this application you know I had a guest about a year ago we were talking about she's at the New School of Medicine, Nadia, who I'm putting this conference together the healthcare thinkathon. She talked about how innovation in health care is implementation and what you're talking about here Chris is implementing right away like not even waiting. You have the conversation you identify the gap and then boom you get to work.

That's exactly right. When I think about implementation science and health care we've got still a lot of low hanging fruit in just knowing what the right thing is and finding as seamless an easier way to do it. And when you move from that place you begin with that foundation and start to turn a flywheel. Your caregivers then begin innovating and saying why is over here when it could be over there why are we having to file 13 different ways to do X when all we really need is one. And so by teaching folks continuous improvement by resourcing them to do it you begin turning an innovation flywheel that begins to then drive itself.

That's so awesome. And folks I also want to give you a heads up so we're having a great discussion with Dr. Chris DeRienzo. He as you can tell is so in just deep into this subject of continuous improvement but overall improving patient outcomes. And I want to invite you to check out some of his thoughts. He keeps a blog. You go to drderienzo.com, you'll find his blog where you'll see much of his work. He's got videos on their blogs. It's just a wealth of his thought process there so don't miss that if you're a clinician or anybody in the industry looking to get better. I truly recommend this blog to you. He pours a soul into it and allow best practices. So definitely one to check out and we'll also leave a link to that show in the show notes that we'll share a link to you for as well. So Chris obviously some great things going on at Mission with what you and your team are doing. Can you share a time when you had a setback as a team or personally and what you learned from that. I feel like we learn more from those times and the successes.

No doubt Saul. And I think one of our greatest successes being the CPM work. We also feel that in almost every possible way you could without impacting patient harm or regulatory failures. And so as we walked through a driving CPM work we took way too long at the beginning. My chief quality frame to Tory Dr. Darrell I think compares it to the gestational period of an elephant which is something like 600 days or taking a year year and a half to get these care process models live. We were biting off way more than we could chew at the start and we were winding up with 80 to 90 page documents which were filled with great practice but were not usable and so we learned from that mistake. We didn't have the right folks on the team. We didn't ensure that those who would be using the CPM were the same ones developing we didn't protect the time right for people who were engaged in it to really focus on this work and as purposeful a way as they could and so we made lots of mistakes and in healthcare as long as you've defined the box to avoid your mistakes reaching patients and causing harm I think we need to be comfortable making mistakes on our continuous improvement work because the best innovators are going to make mistakes. And unless you're making those kinds of mistakes you are within a safe boundary. You're never pushing hard enough.

I think that's such a great column Chris and you mention that documents got up to 90 pages what did you guys get it down to.

So we've improved from there. We still have eight to ten page documents with references for folks who want to review them but now we actually have just a video walk through now how to use the pathway and then a demonstration in the analytical portal of how to measure that utilization and as you imagine utilization has dramatically increased when you make it much easier to learn how to use it.

Wow that's outstanding. You know it's eight to nine pages of video from ninety pages. Huge kudos to you and your team, man.

Well again I can't take much credit for that. That's turning it over to the team and saying here's what our goal is. We need to work from getting one of these live every 45 days to one every 10. And the why is because as our state moves very purposefully into treating populations we need to be prepared as a health system to meet that need. And we knew three - four years ago that we weren't there and that it was going to take a getting 30 to 40 of these care process models life each and every year across subspecialties, inpatient and outpatient ambulatory and post acute. So when we sat down with the team and said what's it going to take to get there we had to totally redesign the document totally redesign the EMR workflow. We had to totally redesign the approach in the analytics environment - moving from perfect solutions to 80 percent solutions and then creating incremental improvement from there. And so it was that kind of teamwork and then some momentum as we started the very first one. Gosh I want to say it was like November 2016 and Dr. Dauer actually took ownership of it herself on the ambulatory side and put a win on the board and folks could see wow. No one believed we could do these in 90 days. And all of a sudden there's proof. And that one it was copd exacerbation. That one alone Saul has prevented emergency department use it's prevented inpatient hospitalizations and saved on the order of 200 thousand dollars a year in direct cost.

Huge. That's so awesome and you know so kudos to you guys for really putting the right team together and just getting it done and you know Sir Richard Branton once said It takes a true expert to simplify anybody could complicate things. And there's no doubt in my mind folks listening to this that Dr Chris DeRienzo and his team are experts at what they do so if you wanna learn more about them again check out Dr. DeRienzo's blog where you could find a little bit more about him and the things that he's up to. So what would you say your proudest medical leadership experience is to date, Chris?

Oh Saul, there are many. I have been really fortunate to be a mission for four years working with some spectacular teams. But one one early win that I had I'd call out. I remember it was a couple of years ago and we had just begun really the socialization work of building our culture of continuous improvement that would be grounded in data analytics that I had spent a lot of time with various clinical leaders showing them dashboards and pitching the story as to why this mattered and how it could serve to improve the work that they were doing. And I remember one day in a meeting one of those clinical leaders without any prompt just pulled the dashboard up and started driving it himself. And I thought to myself oh my gosh this is the tipping point. If Jeff can pull this up in a meeting be confident in the data use it to make a point and drive it home then I know that we have crested that hill of acceptance. And we're only going to keep driving from here. And that was like three years ago and I'm just incredibly proud of how far teams have been able to come with that since.

That is amazing. And what would you attribute the uptake on because a lot of organizations do struggle as you know, Chris.

I think there are a couple of things. First as we started our work in analytics and we began with what was most core to our mission which is the bigger aim to get each patient to their desired outcome first without harm, without waste and with superlative experience for every patient family and team number. And so beginning in that space speaks to the core of who we are. And so it got to the Y right. If you begin notes why then it is much easier to explain the House and the what's that springing out of it. It's about beginning with why because we need to dramatically improve the health of the population we serve developing tools then didn't become just shiny objects that sat on a wall. They became the house to delivering on our why.

That's so cool that's so cool and yeah just again a reminder listeners we've got to keep that why front and center, find ways to weave it into the culture of your organization and that message got to come from the top all the way through the organization and that's how we make outcomes better. Tell us about an exciting project or focus that you're working on today, Chris.

Yes it's springing from the same why. One of the things I'm most passionate about right now is the ability of using technology in much smarter ways to scale humanity in healthcare. And so our first data science project that's bringing a machine learning model live into the clinical environment is around readmissions predictor. So we have terrific teams of transitional care managers whose role it is to screen through lists of patients who are discharged and figure out who do I need to focus on today and how can I keep them home and healthy and not be readmitted to the emergency department or the hospital. And that is an incredibly challenging job and it's a job that impart only a person can do in that you've got to figure out what do I do for this person. But who to focus on is a problem that machine learning can help solve. So our spectacular data science team led by Dr. Andy Johnson spent months developing the machine learning model that consumes data every day about the patients who were discharged yesterday and serves a prediction at 8:00 o'clock in the morning to our transitional care manager team on who is most likely to be readmitted and why. And what that does as we've iterated and continue to improve the user interface and continue to improve the model itself is allow our care managers to spend less time hunting and pecking for information that tells them who do I need to focus on and scales the time that they actually get to spend focusing on patients. That's what they went to school for. That's what brings our caregivers joy. If you ask any unit, any clinic, anywhere at Mission we've done it a hundred times. What brings you joy. The answer is spending time with my patients spending time with my team. And so the more that we are able to scale opportunities for our caregivers to be with patients and connect with their teams the happier they are the better outcomes we're going to get. So I'm super excited we're now six months into implementation. We've gone through multiple, multiple waves now Vater of improvement aspect will keep doing so for the next six months and I'm confident this will become a core part of the way that we approach readmission prevention moving forward.

That's awesome. Chris congratulations to your team for that. And you know it's a great example of how staying focused on the why and the specifics of what your organization is up to that you can actually use tools like machine learning to augment the work that humans must contain to do.

Amen to that.

Getting close to the end here. Let's pretend you and I are building them medical leadership course on what it takes to be successful in medicine. The one of Dr. Chris DeRienzo. We're going to write out a syllabus - four questions followed by a book that you recommend to the listeners. You ready?

We'll go for a man. I've listened to lots of these and so I'm hoping it's lightning fast as the guests.

I know you're going to kick butt. What's the what's the best way to improve health care outcomes?

Focus on getting better. I think that we constantly fear perfection and we've got to focus everyday on just be better than yesterday.

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

Fearing making mistakes.

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

You need to continuously improve.

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

It's our mission if we return to the Y which is our big dream. What we do next is never in doubt.

Love that. What's your all time favorite book, Chris, that you'd like to recommend as part of the syllabus?

Oh my gosh I've got so many good ones. I think on the leadership side every year I return to Colin Powell: It worked for me because there are just so many solid lessons in leadership that every year that I've been in a leadership role I wonder rereading it and getting some other kernel of good learning out of it from just totally off base book perspective. I just finished reading River of Doubt which was about Teddy Roosevelt's journey down an unknown River in the Brazilian rain forest. And you want to talk about sort of exciting an adventure that was a kicker.

Wow that sounds super interesting. Two amazing books both haven't been recommended before. So for the listeners take those down and check them out. All the things that we discussed today are available at outcomesrocket.health/derienzo You can find that there links to this podcast links to the show notes, as well as a full transcript. Chris, this has been a blast. Really appreciate you spending time with us before we part though. I love if you could just leave the listeners with a closing thought and then the best place where they could get in touch with or follow you.

You got it man so I think I'm just so grateful that you're providing this kind of a platform for folks across health care to engage with each other. You know I think that increasingly as healthcare evolves from being a field in which we engage with people episodically in different settings for walls to continuously throughout their lives we have to be thinking fundamentally different than we did yesterday because our solutions for yesterday are not going to solve problems of tomorrow. And so I think that the foundation that you're creating here the platform for folks across industry vertical and horizontally to get together to talk to each other and to spark ideas is just spectacular. And so you've mentioned my blog. I really appreciate you noting it there are there links to follow me on Twitter and on LinkedIn there as well. And always happy to engage with folks who are committed to continuously improving the way that we deliver health to Americans across the country.

Outstanding Chris. And again listeners the blog is drderienzo.com. Chris it's been an absolute pleasure and we're really looking forward to keeping up with your success and the things that you do for our industry so keep up the great work and thanks again for making time for us.

Likewise, Saul. Really appreciate it.

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 Books:

It Worked for Me: In Life and Leadership

The River of Doubt: Theodore Roosevelt's Darkest Journey

Best Way to Reach Dr. Chris:

Linkedin - Chris DeRienzo
Twitter - @ChrisDeRienzoMD

Mentioned Links:

https://drderienzo.com/

https://missionhealth.org/

Check out this link:

https://outcomesrocket.health/podcast

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Why Being Where Your Customers Matters in Healthcare with Lucien Engelen, Director REshape Center at Radboudumc

Why Being Where Your Customers are Matters in Healthcare with Lucien Engelen, Director REshape Center at Radboudumc

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 Lucien Engelen he's a Director at Reshape center Radboudumc and Global Strategist Digital Health Deloitte Center for the Edge. He's working at the intersection of technology and patient empowerment. This is where he really hit his stride. He's a founding director at the Radboud University Medical Center's reshape center. He's a fellow at the Deloitte Center for the edge. Core Faculty at Exponential medicine that's the Singularity University group based out of Silicon Valley. His new book augmented healthcare is all about the end of the beginning. He thinks that we're at the end of the beginning of an era of creating awareness, highlights, proof of concept etc. in the digital transformation of healthcare. He's done a lot from hosting TedX conferences speaker at the TED conferences and he's delivered a lot of value through various different startups roles that he's fulfilled. So it's a pleasure to have Lucien on the podcast today and I want to open up the microphone to you Lucien to fill in any of the gaps of the introduction that I may have missed.

Well thank you very much, Saul. The only thing that we should add is that I'm proud dad four.

That's awesome

And a lovely wife of course making sure that we had besides all the fun thing that we can do in our work which actually is not work but more kind of a mission and a great joy to be in at this moment in time. Also trying to spend time with my family of course.

That's beautiful. That's a beautiful thing. So you've been in the health care space for a while, Lucien. What is it that made you decide to get into it to begin with?

Well first of all I'm from a business family. We were in automotive. We sold cars we had gas stations. We also had a few new undertaking services and also ambulance services which back in the days was pretty normal in the Netherlands you could see it were they were combination of activities that kind of fit in. You could not think of that any more. Now in the 2018s that that will be a common thing at least in the Netherlands. And that was more mostly involved at the funeral site of it and the ambulance services. And when we sold companies due to the fact that we thought there should be also some other things and also other meaning into it. I pursued in the ambulance sphere for over 35 years involved as a director and also create all kinds of mergers and acquisitions and building despite Centaurus for I think like 25 years in total and the last thing I did we merged a couple of ambulance services and a dish center in a foundation. And as the CEO of that foundation, after five years I thought well you know now somebody was coming up and watching the shop actually and I'm more like a builder. And that's when I joined Robert University Medical Center in 2008 trying to reshuffle the acute health care services over there. Also responsible for the trauma helicopter. We made sure that the thing also was able to fly in the dark with these night vision goggles which was also an interesting project that we can tell you and gradually also for my role as advisor to the the exclusive were stepped into healthcare innovation and at first for a couple of hours and one day and now it's like seven days 24/7. One of the biggest joys of my life apart from my family.

That is such a wonderful, wonderful story. Lucien and you know now you're spending this life's work and as you call that it's not work it's actually a mission. When you hit that point where were what you do every day becomes a mission you don't even feel it that's when you know you hit your sweet spot. It doesn't happen overnight folks. You know Lucien's been in this game for a while as you heard in his intro. And so I'm really excited to hear your thoughts. Lucien on what you think a hot topic that needs to be on every medical leaders agenda today. What is that topic and how are you and your companies approaching it?

Well that's a choice to make to be honest the only choices I could make would be patients which seems so obvious and each and everyone that stepped into healthcare from a nursing perspective or from a physician perspective or as an administrator everybody wants to serve patients as good as possible. What I sensed however when I joined is coming from a business family is the approach of patients and family and their informal care which is mostly from I know what this patient needs. And we've seen numerous reports and studies actually a couple of weeks ago again surfaced another study that mentions that the average physician interrupts their patients within 11 seconds when they start talking about what they need at least that they think what their patients need. So what we've done everything that we also created within a reshape center is that at first every project we start starts with the patient and their family right from the get go. So this is not something like So let's create a project and then somewhere down the middle or at the end let's call in some patients or family and let's have them reflect on it really starting it off from the first moment in time and you could call that human centered design or design thinking or server design or whatever name you want to call it. It is acting from the perspective of the ones who matters the most. Which sounds obvious again about the things we've seen is that with all good intentions in that medical process often the strong signals about mechanisms of disease, about symptoms and all kinds of other things get the most attention and the weak signals where patients share what their values are and what they like to most of them get tucked away for good reasons. at one end of which so try to do is to emphasize those bring that into play. And with that also created better adherence from B to treatments and the exercises or say the whole intervention's of it. So again also it sounds obvious. I still think that there a lot to do and I actually think that the let's say and I'm using this in my keynotes right now that the user interface that we have built in healthcare is broken. If you reflect on that from for instance what we see in our everyday life things are completely different. To give you an example if you were I would order something at 11 a.m. at Amazon Prime we would get grumpy if its not been delivered by tonight.

Right.

That's what we got used to. If we take our smartphone if that's an iPhone or an Android doesn't matter the user interface is as easy that you almost don't have to explain it.

Right.

And in healthcare the majority of the processes we have to explain to our patients and it's a bit like a joke. If you have to explain the joke it's not funny enough anymore. So. We need some social recalibration of the process of healthcare with everything else that's happening in society.

Lucien. Now you bring up a really great point. I mean we recently had a guest that walked us through his company trusty.care where he's helping seniors get access to Medicare because it's so confusing. So to your point the user interface is broken and it's a shame but it's also an opportunity right. So how do we start approaching this in your mind who fixes it. Who does this fall on and what can we do to make it better?

Well first of all I don't think this is a right or wrong kind of thing. It's more like over time we now have tools we got technology got experiences. Our society has moved on where the way we deliver health care. Like two centuries ago was great for them. And if we would have the same tools only today it still would be great but we've moved on. I something to reflect on it also from a distance like we did with banking. There was nothing wrong with banks and tellers and the buildings that you have to go into. At that point in time. But now nobody could imagine that you would have to go to a bank to do a transfer. And I think the same is true in healthcare. So to your question Who is going to fix it. I think the patients are going to fix it. What you see right now is that the combination of patients and given tools into their hands just to name one. Apple is launching in the U.S. right now their personal health records. In the operating system of the iPhones. This is the same commodity as your calculator, as your notepad, as your camera in your smartphone and within five years from now nobody even recognizes anymore that there was a moment in time where we did not have our medical records on our phone. And not only from that one hospital which is now the case with that portal and their app no one app that has all the holistic approach on that. So what I think that's happening and that's where healthcare. I think also needs a bit of help is that this is coming from outside in.

Yeah.

At first neglect these kind of things like the things that Amazon is doing right now in the healthcare space. We've all seen what happened with the acquisition of Whole Foods and the initiative with J.P. Morgan and Berkshire for their one point one million employees where they now start delivering health care and asking Atul Gawande of all people to join them who we did. And recently last week. So because Grove former CEO of the Cleveland Clinic George Google cloud. So at first we neglect these kind of things and then all of a sudden we start to realize this is getting serious. And that's where exactly the same will happen as we've seen happening in the travel industry, in music, in entertainment, in news. And recently also for instance in mobility like what happened with Uber where the former cab driver said no no these travelers just want to travel only with us as trusted parties and we know where that went. So I think helps need it. I think the help is now coming from a completely different angle than some of us have expected. It's coming from tech titans. It's coming from transformational firms also like Detroit that is stepping in and helping organizations to make that digital transformation. What also happened in retail and in banking and I think health care is next.

Now it's interesting and also I would add consumer focused companies such as Walmart. Yes. Right.

So I think Wal-Mart is trying to tip their toes in the water for a couple of years. And I do trust that at one point in time they will surely step into it if I now however look into what Amazon is doing and the pace and the investments and the steps that they're making within a very short period of time. From a new book I've created this graph where I pictured all the announcements of nontraditional healthcare players. Over the course of a year with announcements of them stepping into healthcare and that's getting pretty scary I can tell you that's really an exponential curve right now and I see a lot of companies in there about for instance not a company like Walmart.

Now it's interesting they're moving a lot slower but you know, folks, the other thing that I want to highlight for you is Lucien book. It's called Augmented Health(care)™: "the end of the beginning". If you haven't had a chance to check this out this is one that you definitely want to look into. You could find it on Amazon and pretty much anywhere you could get books. Is it available on audio yet?

Not yet I'm in the process of narrating it. I thought it made sense to do it myself but it takes a bit of time. So to the title Augmented Health and care and the smaller print because.

Yeah why did you do that?

You know we really have to make a shift from healthcare to health at least in the Netherlands 90 percent of the total annual budget goes into fixing stuff.

Yeah.

Well we know that from a preventive aspect. We can do a lot more and prevent things to occur and that has to change business models and that's not something that happens overnight of course. But I really do want to stress out that we really should strive for a better health in that and the augmented aspect of the title is that from all the data that is now getting collected on a much more high fidelity as ever before. We're now running from spot measurement where you will be called into a hospital into a continuously monitoring by your smartwatch or the based on the hip as somebody recently called it. So that brings in different approaches. You have to translate that data into information and maybe even visualisations. And then from three pillars one would be medicine create meaning for it. The other one will be from a care perspective your home delivered by care companies. And the third one will be lifestyle. And those three combines for me create an augmented layer surrounding the patients. And even before you become a patient to make better choices and better judgments of the things that are happening and it could prevent us from running into a life event for your friends.

It's a very interesting framework Lucien and folks will leave a link for Lucien's book and the podcast Schoenaerts. He definitely comes with a lot of different insights and experience that I think we can all pull a little something or a lot from. And so really appreciate your walking us through that Lucien. Can you give the listeners an example of a time that you created results or improved outcomes by doing things differently?

Sure. One of my favorite examples is however from a couple of years ago this was at the fairly at the early start of our REshape center where one of my colleagues who is a professor in medical oncology stepped up to me while she was busy creating an outpatient clinic for adolescent young adults with cancer. So these would be kids in the age of 18 to 35 suffering from whatever kind of cancer and they would have special needs. They would typically be too old for children's oncology and actually too young for grown oncology and not specific not only in treatment but also in the things that matter to them. This is an age that you start building relationships sexuality it's about your work. It's about your education, finance these kind of stuff so she thought it made sense to create this outpatient clinic specifically for them on a nationwide scale. And she stepped up to me she said I need something digital. These kids are completely digital. And this is what I think we need. We need a website and there should be side effects and there should be treatment options and there should be all kinds of things that she thought that were needed. And we said sure but so let's ask them what they need and then she said no that's not needed. I know what they want and we made a thing out of this shole we said there's no way we're going to build something first and then step up to them. We think it makes sense to first join them listen to them thoroughly what they need and then facilitate them in building the platform. Yes. And this was really an argument where she kind of bent over and said so I'm an oncologist for 25 years and you're saying I don't know what my patients need? And I said no that's not the case. But maybe there some of this what I now like to call weak signals that could help them and us to buy into that system.

Yes.

That we could jointly create a bigger adherents so in the end of the day we've pursued together with her and it's one of my big favorite friends ever since and we've built that network and the platform is now being enrolled nationwide is now going to the UK and also into the Nordics. So.

That's awesome.

As simple as this sounds it was hard. This went almost up to the board. I can tell you. So this is not something from process it's not about technology. It's also about culture. And I think culture is an animal in healthcare that is blocking a lot of things and I don't think that technology often is the barrier anymore and sure enough we need more evidence for some of the things that are happening right now and some of them will be copying, some of them won't work. But if you really look at that user interface and listen really listen what's needed. I think we could achieve big things for not a lot of money extractors.

Lucien and very insightful what a great story too and it's sort of that that area that we often run into you pinpointed that space where, look you have professionals in a space: physicians, nurses at No and in air quotes. What's wrong. And then you have the patient that has their story and they know their story and the way that they live their life. Let's listen to those weaker signals because they oftentimes are what we need to hit that tipping point to create something that will work. And I asked the question a lot Lucien and to our guys like tell me by the time you had a setback and what you learned from it and one of the things that comes up so often Lucien is this exact example that you gave except the opposite where they built it and nobody came.

Go figure

And they happened so often. So I've got to ask. You've been around the block several times. You know the game and the patients at the center of it oftentimes it's hard to collect feedback like what kind of advice would you give to the listeners and getting the feedback. I mean you do it digitally? Do you do it by picking up the phone, surveys like how do you do it? What's the best way?

So first of all I think there is no best way. The things in your Midwest might be completely different than for us in the Netherlands.

Yeah.

I think the generic answer should be: be where your patient and their family are. And if they are on Facebook, go on Facebook. If they are spending time in your waiting rooms or in the works be there. If they are in an age or in a situation that you know that they're heavily involved on the Internet, be there if you know that they are using apps. So my answer would be not typical one. It's more like be where they are. And one of the things we did actually was that ideally wanted to make sure that we got this right. So I appointed I think the for every first chief listening officer in health care back then which is in 2010 their names Corinne Jansa and she did a tremendous job in being able to just listen to her patients have to say and every project that we would ignite would start with her working on that. But from that start we figured out all kinds of other constraints that they have in all the other processes like in the on boarding for outpatient clinics or the pre-op or post op kind of things. So making sure that you have that listening part good is I think the most important one. And the interesting thing is if you ask patients to join you in such a process we've never been disappointed by the outcomes. We've never been disappointed due to the fact that we had too little or less patience for it. They really love to help us improve healthcare. So we're using all the tools that you just mentioned but completely different in some sectors sometimes from demographics something from location based, sometimes from disease based that it makes sense to do something different or use something different technology.

Lucien, so insightful. Be where they are folks. And there's no one size fits all. And you know this I recently had Corbin Petro's she's president and CEO at Benevera Health and she told a story when she was a youngster her dad was in government in Ohio and she remembers one summer attending 72 different county fairs in Ohio and she went and got to know the perspectives of the constituents of the state. And the insight was that everybody was so different and it takes me back to this political campaign you know in politics people go where they are and get those insights and such an insightful comment, Lucien. I really appreciate that and I think that listeners if you got what you should have gotten out of this you will find it very insightful. If you missed it maybe you've got the distracted that hit the rewind by and by 30 seconds and start again because this is really good. Lucien, how about on the other side. You want to share a setback that you had and what you learned from it?

Oh yeah. So again this is a choice to make because there are so many maybe the best thing is, it's not 2018. I think 2012 we've seen all kinds of new technology come up like the iPad for instance where we would be gimmicking and laughing and making fun out of the fact that I could video call you from the tablet and first playing fiddling around with it also said wait a minute what if we could use this technology for bringing in patients that don't have to be here physically all the time. And it really is an energy drowner for a lot of patients to come from their home to the hospital. We all know how that works. So to picture the historical setting that's called like that. Yeah. Those were the days where we had these polycom video conference systems in the boardroom that cost like 20k and you could do with it after you've called in an ideal specialist was to phone and call the different university medical hospital if you got things right. So that was the setting back then. So we said wait a minute if this technology is able to help why not try it. So we went on a stroll as in our day companies are already doing that and it was early days technology was crappy but also there was no reimbursement. As you can imagine for that legislation most counterproductive into it's no certification whatsoever. So it took us like four or five years to create a product together with some companies that was kind of stable enough to do it. We were able to convince the government and the healthcare insurance that they also had to put in a tariff to make sure that it doesn't matter anymore. If you come in real life or through a video conferencing because in our system if you will sit at our desk that will be reimbursed if you would call in through video it wouldn't. So we were able to even change that. We were able to create certification shims for it. And actually I think we've got all everything right and then we thought so now it's going to hit the road and it completely didn't. And actually it's now 2018 and it still doesn't. So if you look into it there is evidence enough there is no barrier anymore in terms of reimbursement. There is no problem at the patient side because they would say hey guys I'm having a video conference with my grandkids or family or colleagues twice or three times a week. Why can't I have the same with my doctor? And we've tried everything. We've built a room specifically for our professionals so they could sit in there, great audio great lighting everything top notch and still not using it. So the sad bad occurred from two different angles that we weren't aware of. First of all, there still is in it 40% administrative burden for our colleagues. So they're almost more in administrative tasks and seeing patients and they have the feeling that this is something also in that perspective. They have to do a lot, it's not when you just have your outpatient clinics it's one patient after the other. It's your being used for it. You've been trained for it. Everything fits. The second thing is that the culture of patients changing the schedule and also the pace of professionals was also something that we underestimated. They thought that now the patients are making and stealing my schedule and basically they're not because we have created a completely digital waiting room for that. So overall we had some training in that we really had to recognize that this will take a generation actually and this will take a generation even though each and every one of them has multiple video calls a week with their colleagues, friends, family what have you but still not with patients. So they are from say well my patients don't want it. And that's the interesting thing in the Netherlands 76 percent of the patients. Yeah sure. Do it. I'm fine with it. And now there are actually patients calling into health care insurance, patients who are self-employed that would say wait a minute this would cost me a 800 buck a day to take a day off to make sure that they can't get into the hospital for this 10 minute visit. Why not learn the conference. So now patients are really stepping up and demanding this at their insurance organizations. And also at physicians.

Very fascinating. And then you get to the thought process of OK so there's some there's some chokeholds from the provider perspective and the practitioner. What about practice innovation right? You've seen a big shift to direct primary care models. Is this an opportunity for them to say hey you know what. We're willing to do it.

Absolutely. But the same applies here as well. These guys and girls are trained for like 7 or 17 years to do with and in their particular way. Secondly they they have been used to mitigating risks. Of course they have to, they're physicians their professional their nurses. So this is not an easy thing of course that you know you're running into and this literally physical distance running through technology is something that just takes time and the same old to be in terms of shifting and business and process models and in terms of primary care. I could easily imagine that this is going to happen more and more. But I kind of lost the what it's not the confere, the idea that this is going to be a quick fix which is not, although it could be a big fix for a lot of things. Let's be honest.

Yeah. Now super fascinating and a great example of just when you think you had all of the factors figured out there could always be more. And always a great lesson. Now what would you say one of your proudest leadership experiences in medicine has been, Lucíen?

Well I think that was the one that I've shared earlier on with our adolescent and young adults. I think that that's one of the examples that that really stands out because it also sets the bar for us where we say. So if this is the case then the changes that we can and have to make are simple they're not easy but they're simple. We often tend to think that it's way more complex than it is in the end of the day. But the complexity of all the constrains as in reimbursements and different silos that we've created in health care. So being able to do that and taking that as our core modus operandi within our center to me still is one of the aha moments or epiphanies that it is possible to change health care from inside out. And also from outside in. Now with all the technology that I'm confident that we will fix the user interface in the end of the day and by fixing user interface for health care also creating the hox as I like to call it the health care user experience for a lot of people. And actually I often talk about my four Ds where healthcare is changing. The first D will be the localization of healthcare that we're now able with technology deliver healthcare from a different place and moment in time. The second will D about a democratic nation a citizen or patient. We'll have way more data and we have as a university medical center. We only have like 5 percent of the data of our patients. The rest is outsider. Patients are now gathering that themselves. So we will take a subscription on the data of patients as opposed. Now we give them access to a bit of our portal and no portion the 30 would be about digital and that's not only about the technology framework but also about the speed. Now in the early days we needed a missionary and a boat to get something from Europe to Africa and now we could youtube. So the adoption rate in the end of the day from citizens and patients is dramatically increasing. And the last one then as the would be about dollars. This is about big companies trying to get a foot between the door investing tens or even hundreds of millions of dollars to make sure that they become part of this journey that we call health.

Yeah, such a great insightful framework that you provided there. And it's super interesting to hear how you've created stages for each one of these successions in health. Getting close to the end here, Lucien, let's pretend you and I are building a medical leadership course on what it takes to be successful in the business of healthcare today it's the 101 of Lucien Engelen and so I've got four questions lightning round style followed by a book that you recommend to the listeners. You ready?

Hmm-mm

What's the best way to improve healthcare outcomes?

I think the best way is to create health care right from the get go - together with patients, family and informal care so the whole system in the room.

What's the biggest mistake or pitfall to avoid?

To assume that you know what patients need.

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

Be curious. Look over the defense make sure that you take your nose also into other industries so make sure that you have crossed over. Go and visit a conference that has nothing to do with health care. Go into a plumbers association really Saul that I'm very serious about this. We tend to go to conferences where we know what is going to happen.

Yeah.

We're not even close to being challenged anymore. Go to a conference of a completely different sector in terms of neuromarketing or God knows what. So have you done this recently, Lucine?

I'm doing that once or twice a year and I'm judging each and every one in my team to do exactly the same. The thing is that you will come back with insights that you would never have had if you just would stay in your Passi conferences.

That is so interesting.

Go out. Stick your nose in somebody else's business and be amazed what you can learn from them.

I love that as so out of box I love that the last question here as well is one area of focus should drive everything in a health care organization?

The experience. So healthcare is not Disney although I dearly love the work of Fred Lee who was also one of my speakers at one of my first that exist who wrote the book "What if Disney run a hospital", a hospital is not Disney World but we could learn tons of hospitality and we just. More and more are running that and we now see that we have onboarding processes that are very similar to our experience when we book a flight which we're used to already. So the experience that patient's family and also visitors have is one of the areas where we think that we really should be able to drive the change for.

That is wonderful folks. You could find all these questions and answers on the website, particularly Lucien's podcast's page is outcomesrocket.health/lucien and that's Lucien. What book would you recommend to the listeners?

Well that's an easy one. I think it should be a standard work for each and every one working in healthcare. Eric Topol's "The patient will see you now". I think that Eric is not only the godfather of digital medicine but also is able to guide us and has guided us for numerous years into the change that's coming up in healthcare. If you also take into account the things that he has seen also as a physician himself and the great stories that are also in the book that should be on your desk right away.

Amazing will definitely put that on the scene. For those of you that have not read it it's an amazing book. Of course apart from Mr. Lucien's book Augmented health. Lucien, we're here at the end I'd love if you could just leave us with a closing thought and then the best place for the listeners can follow your work.

Yeah we're at the end. So again the subtitle of my book is the end of the beginning. It's a tongue in cheek to Winston Churchill's statement of course. Be amazed about the change that's coming up. A lot of people think that we're in the midst of it or at the end of it were not the overhaul of health care from a traditional service being delivered as separate interventions from different silos. It is going to transform into what I like to call HASS, which is health as a service. This will not come overnight. We will underestimate the speed of it. As Roy Amaar always said we will overestimate the speed that it can but underestimate the impact of it. And I think that's something that we all really should take into account. I got like 13000 colleagues and I really would love to have them to have a relevant job in 10 years from now. But that won't come easy. We really have to make sure that we will recalibrate with society.

Great great thought there. And what would you say the best place for people to your work is?

So I blog as I linkedin influencer on LinkedIn so find me with Lucien Engelen on LinkedIn. It's over 750,000 followers or something like that already. Next to that I also write a lot on my own website www.lucienengelen.com. And my Twitter handle is @lucienengelen as you can imagine.

Outstanding folks if you haven't had a chance to read Lucien's blogs fascinating and thought provoking. I highly recommend them. Lucien, this has been a true pleasure my friend. So glad that you joined us today and we're very thankful for you.

Thank you for the opportunity and have a great day.

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 Patient Will See You Now: The Future of Medicine Is in Your Hands

Best Way to Contact Lucien:

Twitter: @lucienengelen

Linkedin: Lucien Engelen

Mentioned Link/s:

http://lucienengelen.com/

Lucien's book: Augmented Health(care)™: "the end of the beginning"

Health Tech Incubation Insights with Andrew Richards, College Technology Incubator Officer, Elson S. Floyd College of Medicine at Washington State University

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. Today I have an outstanding guest for you today. His name is Andrew Richards. He's over at the College of Technology Incubator Office at Elson Floyd College of Medicine at Washington State University that is. He's got over 10 years in the tech industry and he's held many year old in software. Q and A with development process starting as a developer. He's been part of QA Software Design Software Architecture and has been hands on in a variety of development environments. He strives with every challenge that he faces. But the beauty of the work that he does with health care is particularly interesting and why we wanted to have him on the podcast so without further ado, just want to welcome you to the podcast, Andrew.

Oh thank you and thanks for having me. I'm excited to be here and to chat a bit about some of the fun things I'm working on.

Yes so anything in that intro that I left out that maybe you want to share?

I think you nailed it pretty well there. I've got quite a varied history of what I've worked on in the technology space. I like to tell people that I've done all kinds of crazy stuff artificial intelligence and language processing to working on tax software and online gaming. So it's been involved with everything and little bits and pieces here and there and somehow landed in healthcare and health technology and I've never looked back.

Man that's awesome. You definitely have done a little bit of everything. So what made you decide to get focused on health care?

Yeah. So one of my previous companies I was working at and CTO of we did a lot of service work consulting or protection groups. And like I mentioned we touched on tax software and online gaming and we started having some health technology clients and that really fascinated me and it felt good to be working on solutions that actually had this impact on life. We knew that the things we built and fixed proved would make lives better for people and I clung on to that and over time I eventually had an opportunity to co-found a health technology company so I jumped at that chance and I've been in the sector ever since and that's led me to where I am now at the Elson Floyd College of Medicine. I'm building this new technology incubator from the ground up.

That's awesome man. So now you're doing this incubator. You're seeing a lot of issues surface with problems that we have in healthcare and all the things that have come up. Andrew, what would you say a hot topic that needs to be in every medical leaders agenda today. What is that?

So this is interesting is that I work primarily with rural and urban underserved population. That's the big focus for a college of medicine. One thing we've seen a lot of is ways we can be sharing data better and that's evolving. We've been talking about this in the health tech space for it for quite a while. You know the advent a fire and all the ways that is being shared Glock's and of course being the buzzword right now. Apple in particular has done a great job with healthcare. We've been working with all of that. But what I think is the next big thing coming out of this is the evolution of kind of patient experience type solutions where as a patient owns their data they're going to drive their own care and who builds those solutions that allows the patient to drive their care. And I'm not talking about 25 siloed apps that run from different hospitals and clinics because we see that specifically in these rural populations is everybody is different than segmented out. But what about me as a patient what can I use to manage my own care? How do we tailor those solutions? And so I see that is a challenge we're going to need to address sooner rather than later to really empower our patients to have better health outcomes.

Now that's a really great callout and as you guys dive through this and you what would you say you and your organization are doing to create results with this incubator?

So are our incubator takes a unique approach in that many out there will look for really innovative and exciting technologies and help improve them and rapidly validate their models and the market. Are big driving factor is the challenging healthcare environments in the state of Washington and that's our goals in med school is to address that. So rather than building a single teaching hospital we've affiliated ourselves with clinics and hospitals statewide. We just signed our fiftieth hospital and we're on track to 100. It's fantastic.

Nice, congratulations.

Yeah. Thank you thank you. We work with those affiliates to understand the challenges they face and those problems are the solutions we go after as an incubator and we look for technologies and companies that fit into that space which puts us in an interesting position where I've seen some amazing ideas that really we don't really have a market for them to our incubator that fantastic crispr research and innovative solution. That's awesome. I'm concerned at this moment about really high readmission rates and to rural hospitals in rural Washington and as much as CRISPR research is fantastic. I need to worry about those patients right now. So our hyper focused on embrace at the end of the day has really allowed us to work on a very a niche set of problems and comes from really exciting solutions.

That's such a novel approach you know and you go straight to the folks that need what you need. I mean c'mon. So many people build products and they think it's going to work. And I think that's the approach that you guys are doing is definitely going to help generate some great ideas for the startups that you guys end up incubating.

Exactly and working directly with our affiliate partners allows the companies to rapidly validate their solutions. And you hit on a really important point. So much tech innovation that we see in the healthcare sector is built on a bubble. It's an engineer or even a patient or a provider that said had this cool idea I'm going to build this app or this widget or whatever and they don't have a place to validate they don't have the workflow to plug into. They don't have the end user telling them throughout the development hey that's a great idea. I would love if that would work. I don't have time to use this or this will be functional if it worked this other way and I could fit it into my day. And we provide that. That's one of the really exciting put together is the ability to rapidly validate your your ideas and solutions in a realistic environment and really work with honestly probably your first customers.

That's awesome man and hugely valuable first startup companies wanting to get off the ground. What would you say. Andrew I time that you made a mistake or had a setback. And what did you learn from that moment? Take us to that story.

Oh how long do we have? I've got quite a few. Because I'm a serial entrepreneur so I have made quite a few. But I'll pick one that really aligns to help technology and that would be one of my startups I was working with in that we built the technology that we thought like we better hurry up and get this launched. We're going to get to market everyone this is already going to be out there and we thought we had this really narrow window to get it out the door. We raced and we built and we launched this technology and we thought the train had left the station. But we realized the train tracks hadn't even been built yet we were so far ahead and we've been approaching this as engineers and people in other technology sectors would have approached it. We ended up in the health tech in these meetings and presentations where we go here's our solution and then we had a back up and actually explain what the problem was and why you need to solve it. And then you need to use our solution to solve it. We were so far ahead of the curve that we saw herself. And it gave me pause and I'm in a really stand back and go some of the processes and ways that innovators work outside of a healthcare space needs to be re-evaluated. You take a look at a different lens. When you were in the health tech space and things move differently there is regulations and procedures and payer systems and care delivery models and even the culture around accepting new ideas and technology. Healthcare is completely different than other industries and there's these big barriers around it like you know you can't just everyone says they want to "disrupt healthcare". We can't just flip a switch and disrupt healthcare. This isn't the taxi industry where you can just say The heck with it I'm doing my own thing. And health care people die when we do that. So how do you work within a system and within those constraints to make those changes. And I honestly didn't realize how big of a hurdle that was when I first got into this industry and it was a humbling lesson. What I think I've come a long way and that's something I've been working with partners on quite a bit ever since those early days.

It's super valuable realization to make and. And what about the other side of things. You definitely have had some successes. Talk to us about one of the most amazing leadership experiences or moments you've had in health care?

Yeah I would I would have to say it was the there's two components to this. So as we've been watching the incubator at the med school here one of the big successes for us was raising the funds to drive it where being in the startup world for many years. We've all done fund raising as part of the hustle to build your company. And everybody we met with that had even expressed an interest in being part of our incubator. They said yes not only did they say yes they exceeded our expectations. I've never batted a thousand when building a business on the financial side. And I was this mind blowing. Wow we're on to something in the story of that is we're community driven. This is about helping patients. It's about the changing outcomes improving healthcare that's our driver. The fact that we can generates revenue too. That's great. But the reality is that what we're trying to do so that was a really problem for us for me personally was to see that buy in and the other component of that as well was meeting the companies and the affiliates that want to participate with us where they started. Hey wouldn't it be cool if we could do this and now we're at this for all these elements have come together and it's something I'm really proud of to see all of this. Just close. We are we're really excited to do final formal announce that we've kind of been doing this in stealth mode in the worst off mode ever because everyone knows we're doing it but we haven't really announced who the investors are or who the companies are which specific affiliates but all the pieces are there. So we're really excited to publicize all of the good work come together that seeing it happen is fantastic.

Now big kudos to your team, brother It's hard to get buy in on that you know and to get somebody to not only buy in but invest is a huge milestone and very important. So big congrats to you guys.

Thank you. It's been a long road but the people that we've worked with believe in it and they resonate with this story resonates with them and they're excited to you know help change things. And it's great.

So tell us a little bit about an exciting project or focus within the incubator that you're just stoked about.

Well I would love to talk about all the companies we're working with but I think my legal team will come stick to me about that but I'll tell you something we've done in relation with an incubator so while people who have hackatons four years ago yeah we said it those five years ago. So part of the incubators role is to interact with our med students and for people that don't know the Alcinous Floy College of Medicine is brand new. Our first class finished their first year are out in June and yes our second class starts in August so we are literally building a new med M.D. program from the ground up. So we are we have this blank slate ahead of us an incubator is the path that it's on and the incubators part of that is we're owning the technology future of what healthcare delivery should look like for these students. So we started finding ways how do we get students and the technology companies start playing ball together how we get them in Iraq. So we built a hackathon where you can make a lot of people dunnies. So we did an interdisciplinary hackathon here at the med school in April and we had med students but we also had students from all the different colleges at WSU but also in the Spokane region so you know Gonzaga University a bunch of the colleges. We had high school students come and we pick them up with experts from around the region. We had people flying in from around the country to participate with us. And we saw that students build solutions for rural health care challenges using augmented reality. They were using all kinds of just like cutting edge stuff and it was great to see a med student working with a doctor working with the developer working with some of that as user experience design and they'd never met. And by the time they were done they built these solutions. And three of them have already spun off into businesses and now we have students that have coming out of this hackathon and they are doing. They want to pursue their idea scholarly work which is a project that our med students have to do in conjunction with the curriculum. There's like 320 hours of her three or four years after the outside of the workload of being an MBA student and the incubators are weaving into that. So we're working on ways to teach med students to look forward to critically think about technology to kind of when you go into a hospital clinic don't look at it and go This is the way it's always been done this is how we have to do it. Start thinking about what that hackathon was like working with the incubator. What was that like looking at an idea from a different lens?

I think that's so interesting and a very novel way to approach. Again the whole medical innovation piece so kudos to you guys and super exciting time to be working in rural medicine. The strides that can be made are pretty impressive.

Absolutely. Firm believer that the barrier to entry is low. And I mean that's a very positive way that a lot of these clinics that we work with are independent or there are small consortiums and they're willing to try new things. You know there's not that they're not culture. No there's not 12 layers of lawyers and 90 teens to tell you why you can't do it. It's a small group of people that are willing to try new things. We know obviously within reason that can help solve their problems and it will to have a partner come in and help them do it. Having a med school and university and investors all willing to participate in all of us being on the same page and working towards the same goal is just a delight to see all these things come together.

Now for sure. Now getting close to the end here Andrew. Great things ahead with this lightning round. Let's pretend you and I are building a medical leadership course and what it takes to be successful in the business of healthcare. The 101 of Andrew Richards. Got four questions for you. A lightning round style followed by a book that you recommend to the listeners are you ready?

All right let's do it.

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

I would say engage patients they need to have an amazing experience. And if your patients are engaged ideally to maybe simplifying your interactions with whatever your healthcare system automate where you can you're going to hire teams to practice the top of the license nurses and doctors don't need to take all the calls automate stuff like that. How can you make a patient interact with your system efficiently. They'll be happier and you'll deliver better care.

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

I mentioned this earlier. It's the culture of no. It's dismissing an idea just because you don't understand it or if you say well there's not 10 years of evidence to back that up and understand a person from a health technology perspective so not something that if you do it wrong people are going to die but be open be empathetic be willing to say yes and try new things.

How do you stay relevant despite constant change?

You need to set aside time to keep up with what's happening. A lot of specialists will keep up with what's happening in their field which you know makes perfect sense. We need to have time set aside for specialists to keep up with what's happening in technology space and maybe people under 18 keep up with that. I'm an informed specialist so everyone can kind of understand what's coming and best ways to use that to better deliver care.

Great callout. What is the one area of focus should drive everything in a health organization?

Understand what your care delivery model is and how to best meet that. For us it's challenging healthcare environment and the state of Washington. That above all else is our mission. So how do we deliver care improve outcomes for patients or reduce costs reduce burnout. We dress all kinds of problems identified that drives us is going to be different for every health system that you need to understand what the core vision is and go after it.

What would you say your favorite book is that you recommend to the listeners, Andrew?

Was kind of a curveball but one of my favorite books is An Astronaut's Guide to Life on Earth. Chris Hadfield the first Canadian to walk in space and he's that book has awesome insights on life on challenges and just always being prepared for what life's gonna throw at you.

Love it. Listeners you could find all of the questions that Andrew and I have just been chatting about the transcripts, links to the book that he just recommended just go to outcomesrocket.health/Richards. That's Andrew Richards. You'll be able to find all of the resources there. Well Andrew time flies before we conclude that love if we could just have you share closing thought with the listeners and the best place where they can get in touch with you.

Yes absolutely. Just remember specifically in this health tech world you know we're all in this together right. We need to all fight that culture of no. We need to be willing to say yes need to listen we need empathy. The only way we're going to change things. So find that niche that one thing you're good at and go for the best way to get a hold of me is on Twitter my handle @andrewintech I'm on there quite a bit and love to chat with you in this kind of conversation.

Outstanding. Andrew big thanks for spending time with us today and super excited to see where this incubator goes.

Excited as well. Thank you so much for the time.

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:

An Astronaut's Guide to Life on Earth

Best Way to Contact Andrew:

@andrewintech

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The Power of Staying Consumer Focused in Healthcare with Marcus Osborne, Vice President, Health & Wellness Transformation at Walmart

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 Marcus Osborne, Vice President Health and Wellness transformation at Walmart. His background is in healthcare at Walmart. Various years as vice president payer relations, senior director of healthcare savings programs and global sourcing even did business development and health care prior to that as a consultant. But many years in health care and it's a privilege to be able to have Marcus on the podcasts and Marcus welcome.

Thanks for having me.

An absolute pleasure. So I wanted to kick it off by asking you number one did I leave anything out in that intro that you wanted to share with the audience?

No not really. I think he probably had I guess the only thing I would say is I spent a lot of time a lot of my life was actually not in healthcare and so in magic helping I was actually in government and working on Internet policy and had a kind of recent very small step going to do in China trade policy. That's a lot of my sort of as I sort of think about healthcare a lot of my thinking actually comes with a little bit of bias about what other what happens outside of healthcare. I think health care is a little bit insular as an industry and so yeah. So I think it's probably the other stuff that I've done that I tend to think is more important than my own we'd say for healthcare experience.

Very interesting. Definitely want to dive into that a little bit more as we as we open up here. So what made you decide to go from your previous expertise now into the healthcare sector?

I don't know that. I often say I didn't decide it was probably not what I would have decided to do. Sometimes make a joke. It was it was bad luck. But in reality it was I mean specifically here with war. It is kind of a bit of a strange thing about Walmart. Walmart is not a health care company but I've spent 11 years doing healthcare work in the company my entire time with the company. I was given really kind of goes back to as I was kind of a late entrant to business going into her business and was late entrant. And as I was leaving and looking at opportunities I was intrigued by Walmart intrigued by platforms and the ability of platforms to have impact in people's lives. I've been involved in some other significant platforms including federal government and the White House and new could saw what could happen if you could really leverage platforms and innovative ways to drive value in the market. But when I sort of came on I was given for options those told I could go in and work. Walmart was doing a lot of work in the financial services area and there was an opportunity to disrupting that space and that there was an opportunity disrupt in the food space. But the key leader that was engaged with that time who wouldn't end up becoming the CEO of a company of U.S. business. But if you're asked me I think the health of all businesses is the one that has the potential to drive impact. So he sold me on it. So that's how I sort of got into the role and why I kind of stuck and have stuck with it.

That's outstanding. And so this idea of platforms is intriguing you know and as we see more and more MNA activity folks wanting to center themselves around platforms what would you say a hot topic that needs to be on every medical leaders agenda today and how are you guys addressing it.

That's a good question. I would say that probably the number one thing that needs to be on a medical leader is I would actually sort of broadened that to think about anybody, I mean particularly if you're an employer like Walmart or AT&T or Verizon or General Motors whoever it is that you employ a lot of people and you're paying for their health benefits. I would say you're a medical leader and so I sort of take that as a very broad if you're paying for health care if you're consuming healthcare if you're providing health care. You know what if you're producing things that are used in healthcare then you're in the health care sector. I would say that probably that the key topic right now is I use this analogy a lot that if you start the race poorly you finish it poorly. So I actually think are sort of what I find is that we are starting the race poorly as it relates to healthcare in the US and what I mean by that is we are the kind of analytics and insights that occurs within the service sector and industry to help us truly understand a couple of things. One the real kind of the true healthcare reality of all of us as individuals. What is my source of true healthcare reality in the moment for me. Do I have for crime diseases or do I have any kind of disease or disease risk or if I do have a disease, how is it progressing? You hear all this noise you hear a lot of talk not noise but talk about social determinants and their impact on our health and health care spending. Do I know whether how do I know whether it's also terminal reality is applying in my life you know. Do I think about terminal very broadly to include things like not only am I employed? You know what's my financial situation? Have I lost my job? Do I have marital stress? Am I a caregiver for an aging parent? Have I been through adverse childhood events that now might be impacting my health? All those things matter and what I tend to find is we're blind and that's because we're using data very poorly we're not leveraging the vast amount of data that exists not just traditional healthcare data like clinical data or claims data but thinking about all the behavioral data that exist about us as human beings and leveraging it understand our health. Secondarily we are doing absolutely atrocious job systemically at really analyzing providers of care and when I can what I say is often it should go without saying but people don't want to say it. There are good physicians and there are bad physicians there are some physicians practices they are doing an atrocious job. They're providing wildly inappropriate care. They are providing low quality care and they're doing it at a high cost yet. Yet they continue to practice and in most cases they're not distinguish within the networks they operate and that I think we are doing a bad job then of enabling our physicians actually understand how they're performing are we transparently sharing with them not raw data but the analytics and insights that tell them how they're performing how they're performing relative to somebody else. What does good look like and what do they need to do to get to it. And so when you think about both sides of it horr job that I think we're doing around consumer health analytics and the poor job we're doing around pariter performance analytics I believe everybody in the health care sector whether you're the payer whether you're a provider whether you're a product should be saying we're starting the race early because we're completely unintelligent and blind and the solutions out there they are kind of failing. And so the real question is how is we as an organization you know if you're an organization that leader what are you doing to either change analytic approach or sort of force the system to kind of bring you something that's better I think more needs to be done there.

And that's a really really interesting insight especially around the idea of optics right. We're starting the race poorly because we don't have the right information and we don't understand what good is. So what are you guys doing over there at Walmart? Anything in particular that's helping you bring Walmart some better optics to get things done better?

Yeah I mean I guess one that probably not even though I sit on the business side which means I serve a lot of what I do or most of what I do is about helping address consumer healthcare needs or you know how do we address the needs of Walmart customers as it relates to healthcare. The thing that I know that I have really been most impressed by recently is some work is actually coming out of our benefits organization in support of our associates and related to we have one of the oldest programs in terms of going directly to providers outside of our A-S and working with in this case health systems to try to get better care for our associates. And so we really were at the forefront of what now called the centers of excellence movement. So you know groups like Boeing, Lowe's, and others who have pushed. But what was interesting is if we look at that you know where we've now pushed International an over 20 kind of therapy categories are procedural categories so it's not just like hips and knees in that placement that is now for for cancer for Cancer Care. When we look at the results that it's just amazing right. I mean what we're in with the results were really in many ways unanticipated and they were but it was built on the belief that not all the providers are same and that you need to identify the providers to deliver who are the highest value. And one of the things was interesting you look at the results that COE, our COEs individuals who are being directed for hip and knee replacement over 30 percent of them were being basically sent home and put on a new process where they told you know you don't need to have your hip or any replaced over half of individuals being told they need to have a burn rate fusion after being told. Now there's a better approach. The vast majority of individuals being sent with first placement were being sent home so you don't actually need it. There's a better path. And even on cancer some of them we've seen some frightening things frankly but over us are there right of a third of ourselves as being sort of tell that a treatment protocol you're on for cancer is inappropriate and that you know being told that you don't need six months of chemo you only six weeks or you don't need to be on chemo and radiation and a drug you don't need the drug. And the benefit is one it's massively improving the health that pushing that model and us are finding that you needed double quick and kind of push on trying to drive utilization of these high value providers because you need to get the most appropriate care at the highest quality at the lowest total cost that the benefit has been one do our associates who are living healthier lives. Getting back to work sooner when they are in work are more productive. That too is driving significant cost savings to us as a plan an employer in doing it. And so I think that's really kind of pushing us to say you know back in the earlier point which was we need to get our providers to do better for us to do right. And we can't entirely hold them responsible because they don't entirely know how they're performing. So until we tell them where and how they're performing we can't expect them to kind of do more because most providers think they're doing the right things they are not. But yes so that's one of the big errors were thinking about how you take that idea of how to identify and assess the value of a provider and do it not just for our sources but actually how do we bring that information to our customers and help them make smarter decisions as they are engaging more broadly the system.

That is a fascinating tweak to something that has provided a lot of value to you and your associates that frankly can help a lot of health care consumers. I think that's a really great idea and I think you're definitely paving the way for something really good here for the folks that decide to work with Walmart on this. Can you share with the listeners a time when you had a setback maybe something that you didn't expect to happen within this space and what you learned from it?

If you're really trying to push the envelope and be innovative and try to better serve consumers do I have a whole bunch of failures mistakes. There's a lot. I think the one that I tend to sort of focus in on goes back to actually when I came in I was involved with trying to get to iterate and think through what is sort of the next version of our clinics business look like they are right about the time when all the retail clinics all the retailers are trying to reach out clinics and now become a little passe with you know Mediclinic VVS and care at Walgreens. But one of the big mistakes we have is we actually sell at one and it still sort of it where we had a very kind of constrained scope of service on the clients that are operating within our four walls. And the reason for that is we were very much kind of listening to the AMA and other groups about what was appropriate not at retail. So we took that to heart. We were inter providers. This is you should only deliver these kinds of services and so on. And I can remember a situation in one of our markets that happened when the Colorado market where we had one of our partners that was operating clinics in our stores that had done a survey and we had constrained their scope of service so they had that we tell them these are only services you can provide you know pinkeye, strep throat, flu maybe some back scoop. But they did surveys and was asked there are existing individuals who would use the clinic you know where they're happy and where are other services they'd like to see rendered and they actually don't ask other customers who had not used clinics but maybe were willing to consider doing so were their services that if they didn't render them they would use them. And one other thing that was interesting was a overwhelming response from both groups were around women's health services pap smears and pelvic exams particularly and the rationale for it was pretty logical. You had women who were saying these services are really hard to access. And I have to go utilize them every year because if I don't then I can't get my birth control free up and all I really want is a simple and easy way to get my birth control every year and not have to go this massive process with a lot of expense to get an appointment with OB-Gyn and have to do all those stuff and get a procedure like it's just too much like it shouldn't be that hard. But we we as a business we're sure. So keyed in on what we were hearing from the metal community and everything else that those kinds of services are not appropriate or that we would hear from leaders within the company who would say well you know women don't want to come into a retail setting into a clinic and disrobe and have these things happen. So the failure was that caution is that and it's because I happen to live here and have seen it with other organizations the healthcare system often fails to listen to the consumer and at the end of the day, health care is a direct to consumer business is the exact same as retail. It is a consumer business. It is in the interest of payers, interest of providers, interest of pharma and device manufacturers do not matter all that matters is this right thing, is this sort of what the consumer wants and so I think the failure mistake on our part was that we continued to constrain a scope of service around something that we consumers were saying I'm more willing to do more with you give it to me. And there was no actual reason that we couldn't do those things other than we were too busy listening to the interests of other parties as opposed the interest of the people that we were trying to serve which were individual consumers.

Fascinating. So did you guys expand now or are you offering those services?

We do. Yeah and our primary care client we do.

Outstanding. So a great lesson to learn from and appreciate you sharing that line. Marcus listeners if you're approaching things you're an employer how are you handling your business? Number one and number two to Marcus's point here it is a direct to consumer business healthcare. So what are you doing to listen more to your patients. This is so key. Tell me about one of your proudest medical leadership experiences that you've experienced today, Marcus? Anything you want to share?

Yeah I mean is probably the reverse of the example I gave you the failure which was I guess goes back maybe about you know a number of years ago and maybe 7 years ago now but we were saying I think about the Medicare Mark and particularly the prescription drug plan space and what we were saying was there seemed to be this kind of push partially from CIMS and partly from the groups that are offering plans the market that it felt like everything was becoming homogeneous that it was all the same like it was hard to distinguish one product from another except for brands. United AARP product and a blues product or Humana product or at that time Coventry product and will start over same with when we actually engage with consumers particularly seniors and said What are you looking for? What we're finding is that there were whole big swaths and segments of the Medicare population that were being largely underserved by the solutions in the market. And so we start to engage with a lot of the plans are out there and an opportunity at that time to engage with Humana and in the course of service we said we think there's an opportunity to create a unique product in the market that is designed for a much more cost conscious Medicare consumer who will in fact change their pharmacy of choice and will in fact is very open to considering generic alternatives over the branded alternatives or branded products in the market if they can get that overall plant at a very low cost that is priced in a consistent way and that's open and transparent.

Yeah. A

nd so we sort of work with them and said we would like to launch with launch a PDP point that's built around that logic around that maybe not for all consumers but there's a big chunk of them that would benefit from it. So you know as I look back on it we did it we launched what was called the Humana or Humana Walmart plan. It was ended up being far more successful than we ever imagined it would be far more successful. I mean even the first year in our wildest dreams in the most absurd expectation of what we thought would be the total number enrollees in new plan it exceeded that by 2 or 3x.

Amazing. Congrats.

But it wasn't the sheer numbers that came on it was just the fact that you know I think that's a good example like we actually listen to customers and we've built something that was while not perfect was more based around what we thought their needs were and they rewarded us. They told us love your product because over a million of them enrolled the first year. So I look at that as as just a great moment because obviously it drove great business results certainly for Humana that benefitted us. But I look back and there was a study that was done and I don't remember that for a whole but they look at that when that plan was launched and then what the reaction that caused them has been the market and the Desmet is it sort of say systemically it's helped drive over savings over ten billion dollars annually. I know a lot of that accrued to consumers individuals and I think about mothers on Medicare, my father's on Medicare, my stepmothers on Medicare. And so I think about the environment that they kind of enter when they became eligible for Medicare which is right around that time that I think it's for health that I know that what we did kind of help them even if they're not on that plan and actually have no idea what plans there are because we don't talk about it but I know that it ultimately benefit them and so I feel proud to have been involved in that.

That's awesome and what a great story and a great insight. And you know it just kind of makes you think you know how do you do better listening. You know one way is surveys, do them online, you stand there with a clipboard like what's the best way to get feedback from consumers as it relates to their health care?

Yeah you answered question I think some of it is that I think some of it honestly reduce be prepared, you have to listen, and you have to say it can be surveyed it could be quite you know it could be the traditional way to listen with it. And you have to go out and try stuff. You have to be afraid not be afraid of trying a whole bunch of different things. What also tell you that in health care there's a reality that some of this we just don't know until you try because consumers haven't consumed it in that way. Right. The idea of getting women's health services at retail. Well nobody is doing it how can you tell me I will like it or not. Right. And you do it if they don't show up then guess what. They probably didn't like it or you modify it. Well maybe they did come. And so I think a lot of it is you have to be able to kind of put in an aggressive test to learn. There has been test and learn mentality which as you visit would be willing to go do it. Don't bet the farm that is going to try it. And then just see what happens. Right. And then there you will learn immensely. You'll learn about it.

Man what a great call. Yeah it's because you know that's a great point you're not going to get everything that you want to hear especially if it doesn't exist yet. So you got to have that culture of trying and failing forward. And I think that's a wonderful way to listen as well. So you're working on a lot of things right now. Marcus tell us about an exciting project or focus that you're most interested in right now?

Well there's probably quickly tell you to served going on today as just one that I sort of find really compelling based on the results and thinkers. I think there's a lot of focus about delivery of medical care particularly in retail settings. One of the things that I'm also kind of interested in is this idea of what we call them kind of ancillary specialty services that can be delivered at retail. So today Walmart is the largest provider of vision center services in the U.S. But we've more recently started testing with some partners retail dental services and I have just been blown away at just the sheer uptake of those services by our customers. And what is telling me the reason I'm so excited about it is twofold. One is that I think we have massively underestimated the demand for some of the more basic services and that desire. If you really want to engage consumers in their health give them the services that they actually are looking for not the services you want them. And so I'm sort of excited about the dental test and the success that we had I'm excited by a joint venture that we've launched with Quest Diagnostics and the ability to bring health screenings in labs and diagnostics more directly to the consumer as opposed to having them going to have to go around it or go through an arduous journey through the traditional system. So I'm excited about improving kind of convenience and access and know I'm excited by going back to the ancillary part of the thing I'm excited about. As I look at some of the innovation is occurring look for example of some work that Google or Alphabet has done for their Verilli subsidiary where they've helped create a technology using 3-D imaging of the retina to do diagnostics where you can now only diagnosed with diabetes but potentially use that same device for a whole range of things. You think about now going to my optometrist. It used to be just about determining whether any glasses or not. What if that optometry visit can now be I can get a whole health screening to determine whether I've got brisque for a whole range of chronic illnesses just based on looking at my you know what if going to the dentist I could use as a venue to actually kind of engage you in your health what if every time you sat down in a dental chair I did a health risk assessment where I ran biometrics on you asked you a few questions and use as an entree to engage you more broadly in your house. The answer is you can write the answer is we are. And so I'm really excited about this sort of idea of using things like that or even you know we just had a Walmart wellness which is a free health screening event. We do and all our stores have just this last Saturday and for hours in the summer. Mind you which tends to be not as busy. We did full health screenings for 320000 Americans and within that we over identified ate 10000 individuals who were who are likely diabetic and almost triple that who have hypertension. And so I'm so excited about thinking about these new approaches to care delivery and how they are engaging people and enabling us to kind of start the journey better.

That's super exciting Marcus and thinking through these aspects of population health and what you can do to reach these people whether it be urban or rural settings. This could have very far reaching positive benefits to communities

Yup, I agree. I agree. That's the hope. That's the hope.

Hey listen man you guys keep up the work because definitely exciting work that you guys are up to there. As we get close to the end of this podcast we're going to do a lightning round so let's pretend that you and I are building a medical leadership course on what it takes to be successful in the business to health care. It's the 101 of Marcus Osborne so I've got four questions for you followed by a book that you recommend the listeners you ready?

OK.

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

To spend more time listening to individuals or consumers.

What's the biggest mistake or pitfall to avoid?

Not listening to consumers and spending too much time listening to the interests of the payers or the providers or the product manufacturers.

Strong. How do you stay relevant as an organization despite constant change I think one by truly listening being empathetic to consumers that officers say by not being so isolated to your own industry but looking for solutions in other industries and other markets in other areas other countries.

Love that. And finally what's one area of focus should drive everything in an organization?

At least in our organization. I think it is that when we're actually at our best we are relentlessly focused on the needs of the consumers that we serve the individuals we serve. And that as long as we're sort of focused on actually truly serving people and do that in an empathetic way and do as well as we possibly can I think then that'll sort of enable us to continue to be successful.

Love that keep listening folks. And what's your all time favorite book that you recommend to the listeners as part of the syllabus.

Always been a big fan and I've read it many times The little prince.

Do you know who the author is?

He's French I can't remember his name. I can't I can tell you but I've mispronounced it so instead of embarrassing. I took one year of French in high school. It was abysmal. I performed the worst in that class of all classes I've ever taken. And so I don't attempt to embarrass myself. Little Prince, you can't you can't miss this.

There you go. So little prince it's an outstanding book. Check that out. And folks you can get all of the things that we discussed today go to outcomesrocket.health/MarcusO as in Marcus Osborne you'll be able to find all of the transcripts, details, a link to The little prince so you could continue your healthcare education here. Before we conclude Marcus I'd love if you could just share a closing thought and then the best place for the listeners could get in touch with you.

Sure. So closing thought I think is probably this is sounds like a little bit of a broken record but I think I can go back and talk about this kind of a lot now of it to the extent you can if you're really looking to address change. Think about what it means to build a consumer only an individual only solution. Like if we build in such a way that the only thing that we took into account were the needs of the individual. What would that look like and start there that may not be where you have to end because other things come to bear but start there. And certainly if someone wants to reach me or walk a mile people have mastered email generally so it's just marcus.osborne@walmart.com

Outstanding Marcus. Thank you so much and listeners you have again the opportunity to check out the show notes, go to outcomesrocket.health/MarcusO and you'll find all the things that we discussed there. Marcus, it's been a pleasure to have you. And super grateful that you carved out time for us.

Thank you so much for your time.

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 Little Prince

Best Way to Contact Marcus:

Marcus.osborne@walmart.com

Episode Sponsor:

Lowering Cost While Addressing Baby Boomers and Millenials in the Same Business Model with Keith Figlioli, General Partner at LRVHealth

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 or rocket podcast where we chat with the day's most successful and inspiring health leaders. Today I have an outstanding guest for you today. His name is Keith Figlioli. He's a partner at our LRVhealth ventures where they do a lot of venture investments in firms in the healthcare space. Most recently Keith was premiere's incorporated senior vice president of Healthcare Informatics. In this role he oversaw the company's enterprise healthcare technology business unit spanning strategy sales, marketing, clients, support, development, delivery and operations. Most notably he was able to as part of the leadership team helped this firm and its members raise 820 twenty million dollars in its IPO. It cochaired premiere's member technology improvement committee. Before that he was able to be part of many different companies including one that was acquired by scripts where he provided many different leadership roles. Bottom line he is a shrewd entrepreneur. You'll mind a leader at many organizations and we're super excited to get his perspective here today on the capital side of healthcare so Keith it's a pleasure to have you on.

I appreciate it. Thank you very much.

Absolutely. Now Keith, anything that I left out of your intro that you want to fill in the listeners on.

No I think he did it. I think he did it nicely and had a lot of good detail so that's appropriately. The only other thing I've I have done in the past is it has done a little bit of regulatory work with the federal government as part of the open NCAA standards committee which was important work back then and continues to be.

Very cool very cool. You know health care is one of those industries that is just tough to navigate. So folks with the experience that he has I think you're going to get some really great insights today. Keith tell us a little bit about why you decided to join the medical sector to begin with.

Probably go way back which is I don't tell the story much but I was a economics major at undergrad but ironically had a minor in neuroscience. And don't tell me how I got there but I got there about how effective that college career and I quickly realize I'm like wait a minute maybe I just don't want to do business. Maybe I want to get into more of a deeper science kind of healthcare background. So it actually started way back then. And you know I came out of school that your body came out of school. I came out of undergrad in 93 so I can what part of my background as I came up with kind of the Internet and it bounced around a bit with some consulting work in a variety of industries and quickly kind of found my way back into health care and that was always my focus and kind of married the best kind of business the growing of the Internet technology and healthcare and that's sort of how I got my start. And more important for the last almost 20 years purely focused in the medical sector.

That's awesome and said it's really been at the root of your interests. And fast forwarded. I mean the time fly doesn't that's crazy. It's 20 years already.

It is a little nuts. Yes. I just actually had my 25th year college ring. Oh yes. I'm dating myself here.

Hey man that's experience that's experience for you. And it counts that health care for sure. Now talk to us Keith what do you think. A hot topic that needs to be on health care leaders minds today and how are you guys approaching it at LRV.

Yes a little talk about maybe start with a little bit about LRVhealth and it plays right into that so and maybe even sort of my time at Premiere. So premiere which a lot of people don't understand is actually almost like an association back in the day where it had a 180 a different health system owners as the actual equity owners of that and we took a lot of the concepts from there and LRV health has been investing with strategic investors meaning health care payers and providers for 17 years and we kind of put that on steroids with our latest fund. So at the core of our strategic investors meeting our limited partners as well as our partners are currently 10 health systems and payers that deliver care across 23 different states and deliver care about 45 million lives. So at the top of can tell you how many people we've talked to between my premier time and obviously my time and energy health you know were consulting with healthcare administrators and leaderships of payers and there's sort of two major focus areas for focus right now if you break it down at a demographic level most people talk about the baby boomer generation and what's happening as their age group ages and gets more chronically complex from a medical sort of use pattern. So there's a lot of people within the system trying to figure out how to use service that group as they go from commercial plans down into lower reimbursement plans like Medicare and Medicaid and have a plans. How do you serve them as their utilization of the system goes up but at a lower cost rate. So the emphasis on cost right now and so we talk a lot about that with folks that thing that people don't realize is the age group that actually just you clips the baby boomers is the millennial generation and that millennial generation now is bigger than the Baby Boomers and they want a completely different service offering from health care system they want self service they want all the different things they expect from their mobile phone and less access until that point so people talk about those independently. We actually talk about those together and I hope you find opportunities that while you can take down costs. But then you can deliver a new care experience to a different age group that's coming into the system now and also start to utilize the system. So both of those intersections circles if you will are sort of what we call our north star and we think it's top of mind for pretty much every leader across the health care sector.

Very cool Keith and definitely a great point right I mean we're dealing with two very different consumers and I think with the approach that you guys are taking given that it's driven by investors that are the provider payer space it's a really kind of frontline approach which is very differentiated. I would say I mean that's a huge advantage that you guys have.

Yeah I think I mean for us this is as much about being good investors and providing a solid return for investors. But it's really about operational intent can we partner with our healthcare systems and our health care payer leaders to really drive different operational changes for them. And then also obviously get some kind of return back from them given that it's a venture capital platform but you know all of us myself and our other partners at LRV health you know collectively we have about 70 plus years of operating experience in the healthcare space.

Nice.

To bring a whole different lens to this problem if you will rather than just a pure financing lens.

Now it's really. Now there's a lot of companies in your portfolio. Keith maybe you could walk us through one and sort of a success story something that you guys have done differently that yielded results.

So I guess I talk about one which is called intelycare.. It's an investment we made in our last Farnes when I first came into LRV health about two years ago and had a pretty big service line. When I was a premier around healthcare labor we did a ton of rounds labor productivity as well as labor benchmarking. And the thing that was interesting there is that I don't know how much you guys follow the trends but you know health care labor has outpaced every other labor class in any other industry through the recession. So there's a tremendous amount of opportunity that sits around labor. So we spent some time in that market and found a company called intelycare which is all around basically oversimplifying it Oubre 5 million higher per Diệm or the by our.

Interesting.

Workforce in post. Q So in skilled nursing, in assisted living type facilities there's an average 50 to 75 percent turnover. Most of these facilities there's about 2300 regional staffing firms around this country and the largest staffing firm has about a 7 percent market share. So this is a industry ripe for disruption it's all phone calls emails analog takes forever for people to sort of find people and these guys have actually built a technology enabled with a lot of predictive capabilities to understand what the temporary market looks like and each one of the geographic regions that they plan to they plan for states are going to about 6 in the next couple of months and they have a you know a national footprint goal to sort of really think through a different way to deliver high quality and safe care givers meaning nurses and caregivers to these facilities that really have a hard time finding the right type of people in the market so almost think of it as a matching principle and each one of these markets where there's a ton of people that have flex resources and have flex needs but they don't know how to match up with the ideal type of facilities. These guys enable that all through technology.

I think that's brilliant. And in this post to keep space with such high turnover I mean it is definitely a great platform. What are some of the things that they've been able to achieve as far numbers and not necessarily revenue but just kind of outcomes and stuff like that.

Yes. So the average is just a couple ones. So the average time it takes to have somebody find the caregiver at some of these facilities is typically a week to two weeks. So if somebody has a shift that goes unfilled they need to go out to the market. They typically use five to six different what is called staffing agencies today. And it takes them about at least a week to two weeks to do that. These guys are doing it in 30 minutes with a push of a button. A ping goes out to 3000 nurse network. You know each one of the geographic markets and you can quickly sort of find the right type of resource. And it sits right there next to the actual scheduler and the person that actually runs these facilities. So that's a big deal. Secondly most of these folks get about a 60 percent efficacy of being able to fill a shift and intelycare is doing it at 90 percent rate. So it just changes the dynamic. It's classic use of you know technology disrupts and where it's still a tech enabled services business but it's using technology in a smart way to disrupt what is a very big business. I mean this is a 4 billion dollar market that people don't really even know about. So we've had some great success and it's still very early but great success.

That's great. And now folks if you're a provider, a leader at a provider institution take a look at an telecare this is a fantastic solution for your post acute areas. Intelycare so it's intelycare.com. Take a look at that really great resource shared by Keiht today. Now Keith, talk to us about a time when things didn't go so well a setback that you had or one of your companies had what lessons did you guys learn from that.

Yeah I think it's an early lesson more from my operating days and I think when I first got into healthcare I came from a general technology background where we had helped build a company that worked with most of the Fortune 50 businesses around this country and world with places like Philip Morris places like Procter Gamble. And I think my use pattern or my thought pattern coming into healthcare like I think a lot of people when they first come in and I think a lot of people are experiencing this now because they have a lot of newcomers in the space. You don't fundamentally understand the social system and how things really work. And I can remember building technologies early on during my days at eclipses which is now part of all scripts where we thought was like the cat's meow or use the latest technology rebuilt like a clinical documentation module and literally people threw up all over it. And what's the other use pattern. We spent years you know probably a year and a half doing that work. And so I think he learned very quickly that's a very specific example where I learned very quickly that if you don't fundamentally understand the workflow the social system what actually goes on day in day out. And I think that's what we have in a lot of areas of healthcare technology today where we have a lot of great technologists building a lot of great infrastructure but they haven't thought through the use case and the social demographic side of the equation as best they can frankly and you know you can look at that even in the broader H.R. space today there's a reason why there's so much angst in that space today is because you know those systems were basically built for billing they were built for their workflow and things to that degree.

Now that's a great share. Keith and one that that listeners go back rewind relisten to it. The purpose of the podcast model for you to be able to access these notes when you need them. Keith, what would you say at one of your proudest leadership moments in healthcare has been today?

You know so it's interesting when we were at Premier early on this was 09 in 2010. You know the ACL movement the value based care movement took place under Obama and what was so interesting for me was working with 70 different markets and 70 different health care leaders to sort of figure out what an ACL was and what value based care was. Nobody even knew what this was so we used to get all these people in a room in DC and things like that and get hundreds of people huddled around at the health care provider landscape and the first question was always like what is this. I think that was a pretty proud moment to be part of that leadership team to try to drive to an understanding of what value based care is and that's still obviously morphing today but being really on the front lines on something that was completely unknown had been tried historically including a state that I live in Massachusetts many many years but at a scale level of what they were thinking about and specifically what CMM Ohio was thinking about at the time. You know we had partnered with Dr. Rick Gillfillan we now heads of Trinity out of Michigan. And it was a fascinating time. It's a proud time because you know we didn't have all the answers. We didn't figure everything out. But being able to work in what has stuck with me forever and big part of why I love what we've done at LR health is this idea of working hip to hip with health care leaders the people who are delivering the actual care day in day out on these complex problems because you know the shock waves that happen in the healthcare industry literally every couple of years and most people don't really understand what the shockwave is you know MIPS is a perfect example right now where you know people don't even understand what that really is but they're having to deal with it more openly the reimbursement is tied to it.

Now that's a really great call out and it's tough to navigate these waters and maybe we could dive a little bit deeper into that experience. Keith what is it that helped you guys navigate this definition and trying to figure out and land on on an idea. Because oftentimes I feel like as a group you could land on an decision what something means but it really doesn't mean that. How did you guys vet that out and how did you land where you landed?

Yeah I think that the vetting for us. And the nice part about the premier platform at the time is just access. I mean I think yeah we by design have a tagline at LRB health which is called Inside healthcare. And the reason why we use inside healthcare it's very deliberate. Meaning you need to be inside the game and really understand the game and have the right type of people around your platform to truly understand and solve these problems. Because these are not simple high level issues. These are very complex. You know there's reimbursement issues there's regulatory issues there's all these issues in healthcare that people in my opinion a lot of times I'm going to gloss over. But the effort get into it for a while though like oh wow this is a lot more complex than I thought. I mean even take a Trump quote from about a year ago he's like oh I never knew health care was as complex as soon as you get into it. You quickly realize that. So I think for us what would solve that a lot of our issues during the ACA and the baby's care ramp up back in those days was having people like doctor Rick your phone which when you know was a consultant for us. But then he went let's see my under cims you know having those type of people front and center with you is second to none. So to do that you know we take a same approach we help when we invest and when we think about problems you know we're getting the best minds of the people that have lived this for decades. We have advisers that have been in the health care space for almost 50 years. And so you know their entire careers have been spent on this stuff. In my opinion the key to these problems.

Love that. That's a great way to approach it. And so now you're here today. Keith you're working on so many great things a great portfolio companies. What's an exciting project that we had to point to one thing that you and your team are working on today that you want to tell us a bit more about.

Yeah I mean it's talked about a lot of Oliver Wyman a lot of credit for this terminology I'm about to use but we're spending a lot of time around sort of what we call in a call and I've used as well which is the digital front door to healthcare into you know when you start thinking about what's really happening back to this idea of delivering sort of the front end of access. And when you think about healthcare access and how hard it is when you think about navigation when you think about sort of even Rev's cycle from a patient standpoint it's all very opaque. And so we spent a lot of time over the last six months or so and will continue to spend a lot of time and then ultimately invest in a few of these type of companies that are helping people think through a different way to navigate sort of the front door to healthcare. And they run the gamut. They can be things that look like health savings account type applications they can be the front door of physician practice and how that actually extends out to a mobile application and then connects back into the system. It could be scheduling. There's all different things that this could shaped on you know during our annual meeting this past April. We had brought in you know one executive from an employer to executives from health systems and executive from a payer. And then we brought in the woman that leads this area for all the women in purposely sort of had this open discussion which was a very kind of interesting discussion with all those type of characters and a very hot topic around this like who's going to own the patient and who's just navigating principle so like typically when a payer calls you on anything that they see that you've accessed the system most people don't call the payer back. You always called doctor bag you always call you know your practice back but you know who's going to own nettled somebody as the employer don't know that given what obviously the tools reach an appointment and what JPM is doing and Amazon Berkshire and you know health care transformation alliance young employee to ramp up now because the problem is so big in terms of their cost infrastructure. So this is really a huge problem right now and it's not something as simple. This again goes back to the depth of really understanding the problem and finding the use cases that actually are going to matter and more importantly deliver real jobs.

I think that's a really interesting project that you're working on and I love how you tagged it. The digital front door to healthcare. And if you're listening to this today and you're working on a solution that is the digital front door to healthcare Keith and his team are obviously looking at this seriously. So at the bottom of the show notes you'll find a way to reach our LRV and potentially even collaborate with them with your idea. Keith, This has been fun man we're getting close to the end here. Let's pretend you and I are building a medical leadership course on the Capitol side on what it takes to be successful. The 101 of Keith and so we're going to write out a syllabus. I've got four questions for you lightning round style followed by a book that you recommend to the listeners. You ready?

Sure

What's the best way to improve health care outcomes getting capital?

Got to show our wife if you can show proven or awide typically the old 10 x factor. It's very hard to get capital these days.

What's the biggest mistake or pitfall to avoid?

Think the technology is going to solve it.

Love it. How do you stay relevant despite all the change?

I think you have to be a ferocious reader and if you're not a ferocious reader and healthcare you're pretty dead in the water.

Do you do all your reading books stirred you do audio.

I do pretty much everything from podcasts of videos to books to not from Kindle to the hard copy book.

Love it man. You know one of the things that so we do a five day week podcast on health leaders are always recommending their best reads I found an app called Blinkist. I don't know if you've heard of Blinkx just know this they basically give you synopses of the book in audio and in written form. So I've got out my books through Blinkist and it just saves me so much time.

Very cool.

Yeah and there are like 80 bucks a month. But really cool resource. Listeners if you haven't checked out blink. Check them out. They're a fantastic app and I'll put a link on about bottom on the podcast as well so you could check that out. But last question here. What's one area of focus that should drive everything in a health care organization?

Understand the social system more than anything else.

Dive a little bit deeper into that what do you mean?

So I just mean the end of the day the social system and health care drives every decision and drives every workflow. So what I mean by that is you know we're constantly painted that we're slow costly painted that we adopt technologies five to 10 years later. If you don't understand the pace of adoption and the pace of usage so give you a perfect example of giving all the details. I built the technology stack during my career days that was fairly expensive thought it was absolutely right in the middle of a sweet spot and the social system refused to adopt it. And it's a no brainer. The whole reason why Amazon is coming in the space right now and it's no different than what Amazon house. So it just you really got to understand how people adopt certain new ways of doing things.

Got it. Very clear very clear. Thanks for clarifying there for us. Keith and very helpful. Well what would you say a book you recommend to the listeners is in this space?

Yeah a lot of people are talking about this book right now and I hesitate to say but I'm going to say because it is that good. And I would say it's not. It's not one book. It's actually two books. So if you look at all know as books sapiens in Homo deus. OK. Read them both and they're big books but they're quick reads but they are fascinating. Saipan's is all about the history of mankind and then homo Deus is really about his predictions of where mankind is going in the future of our planet and it opens up your eyes to the reality of what the human race has actually done to society let alone the planet. And it's really good stuff.

Wow. Very cool listeners check those out. You could find all of the resources links to the books book's links to Keith's company go to outcomesrocket.health/LRV. You'll find everything there. Keith, this has been a blast. Before we conclude I'd love if you could just share a closing thought with the listeners and then the best place where they could get a hold of you or follow you.

Yeah so I think I'm kind of to the title of your podcast outcomes just everybody you know there's a lot of I just wrote an article this past week about maybe there's too many people in health care now trying to solve these problems. But I think everybody that's focused has to continually focus on this is not about making money. I talk a lot about health care being sort of capitalism running amok which is this is about delivering care and bringing society up it's the reason why I do what I do. I could easily do technology type things and it complicate things and many other industries. But I decided long long time ago that this is what I want to do because every day I wake up and I feel good about trying to drive a societal benefit. And I think people cannot lose sight of that. And I think a lot of people do when they get into space because they're sort of chasing what is the latest greatest trend. You know I've been doing this so long that you know digital health wasn't even a word ten years ago. No one no one at the venture capital community would even invest in a company. Our firm has been doing it for 17 years. We did our first patient gauge investment in 2003. So it's just a different pattern. And to get a hold of me you know the best way is you know either my Twitter account @KeithFiglioli or you know ping me on LinkedIn by all means I typically respond to that pretty well.

Outstanding. Keith thank you so much for spending time with us. It's been really insightful diving through some of your thoughts on on the capital markets but also on the social aspects of medicine and things that today's healthcare leaders needs to spend on so really, really appreciate the time you carved out for us today.

No problem I enjoyed it. Thanks for the opportunity.

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.

Automatically convert audio to text with Sonix

 


Recommended Books:

Sapiens: A Brief History of Humankind

Homo Deus: A Brief History of Tomorrow

Best Way to Contact Keith:

@KeithFiglioli

Keith Figlioli

Episode Sponsor: