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The Future is Orthopedics at DOCSF with Stefano Bini, Founder/Chair Digital Orthopedics Conference (transcribed by Sonix)

Welcome to the Outcomes Rocket podcast where we inspire collaborative thinking, improved outcomes, and business success with today's most successful and inspiring health care leaders and influencers. And now your host, Saul Marquez.

Saul Marquez: Welcome back to the podcast. Saul Marquez here and today I have a returning guest. You guys have all heard and appreciated his work, Dr. Stefano Bini. He is the orthopedic lead at UCSF Center for Digital Health Innovation team. So he's a professor of orthopedic surgery specializing in hip and knee placement, ranked up in the top 5% in the US. He's a Founder and Chair of the Digital Orthopedics Conference (DOCSF) and the Regenerative or Orthopedic Conference both held in San Francisco. So today what I want to do is since the conference is coming up in January 5th in San Francisco I wanted to give Stefano, Dr. Bini the opportunity to share a little bit more about the conference since it's around the corner and also give you all an opportunity to have an excuse to get away from the cold if you're in the Midwest. Go to California and make it a productive trip. So the Stefano, welcome back to the podcast.

Dr. Stefano Bini: Well thank you. It's awesome to be back to your show. So yeah that the conference that's been a great year putting together for this coming January we do it just before JP Morgan as you know. So what sets this one aside apart from the others is I think our focus there's a lot of wonderful events that focus on loose kind of thinking and in the future and there's others that focus on the latest and greatest companies that are available to work with but we focus on is the last mile. How do you operationalize these tools? How do you get these new drugs into patients so they can be better? How do you make new tools available for patients, physicians, hospitals systems, so they can do a better job delivering care? And we argue that wouldn't you get down to the nuts and bolts of putting something in place, you have to focus. You have to get down to what's the case use and we argue that orthopedics or musculoskeletal care which broadly is everything from wellness to trauma surgery really does provide a perfect place to technology to test technology goods it's short cycle times. We get healthy well they quickly they're relatively healthy to begin with a ton of money in this space a small differences can have a big impact. And so we say okay let's get down to the nuts and bolts if these are great technologies. How do we work? How do we put them in place within the space of Orthopedics and we do that during this event? And the structure as we have discussed is really unique because we get companies to bring case studies and it's a pitch per say, it's a case study of how they work that we take two topics a year this year as sensors and robotics and we bring together an ecosystem of leaders to drive this change and move forward. And as you know we also added an entire day of leadership learning. So we have some amazing people helping with that from idea the design firm in Palo Alto to people who've been working in the space of Peter garden hose HP for 20 years and those side back as a worldwide consultant in an optimization of systems and processes to help us out. So we really want to give the audience and experience how to make this stuff work in our space.

Saul Marquez: Love that. And yeah I love that you said the last mile because ultimately that's where the rubber meets the road that's where these technologies start to get used and where they the impact happens. So who would you say Dr. Bini is the key person that comes here like who's the typical person that signs up for your conference?

Dr. Stefano Bini: The typical person is a C-level person either in a startup or in a healthcare system or physicians leading change in group. These have been traditionally our key stakeholders for this event because we have people there from venture capital with people there from the startups and startups and the CEO's usually it's a very high level group because it is how do you help the change makers the folks out there making decisions and give them the tools they need to move the ball forward. So it is that sort of level conference.

Saul Marquez: You know and sometimes folks, the one thing that I that I want to share is what we do in healthcare can often be like a lock with a couple codes and you know let's just say like a four code lock and maybe you've got the first three numbers in that four code lock and all it takes is that one extra idea to unlock opportunity. So whether you be a physician at the frontline of change like Stefano mentioned or if you're a person at a health system looking to make changes in your orthopaedic program. This conference may be just what you need to get that next insight to happen and work. So you've got to be open to two ideas. You got to be open to the right timing and I think as Stefano's group looks to focus on sensors and robotics I think those are two hot topics that are really starting to become center of Orthopedics and so definitely an exciting meeting. If you're going to be traveling a long way to get to the J.P. Morgan meeting by all means this is a bolt down that I would totally recommend. Let's talk about some of the speakers Stefano.

Dr. Stefano Bini: Absolutely were and just real quick. I love the lock idea. I love that because I hear this constantly that the value proposition for many people come to this conference they get to hear from people that don't normally interact with.

Saul Marquez: Yaeh.

Dr. Stefano Bini: On the same topic but from a completely different perspective I would be focusing on that and leadership segments. How do you pick a topic and solve it from the perspective of a health care system? Somewhere on the perspective of a payer, somewhere from the perspective of venture capitalists. They all take a very different perspective on it and as you if you're in the audience listen to this click click click, your lock opens up because now you understand how every stakeholder in the room is going to solve your problems so if you're a startup guy, "how do I sell my product into this really complicated world?" and you've just heard what everybody's lock code is and you've got them in your pocket and you're " Okay I'm just solving people's problems but I know the problems I'm solving." Bam! you're done. I love this concept of the lock I may have to play with that little bit maybe you and I kind of go to one page on LinkedIn then they lock in the lock. So anyway our speakers...

Saul Marquez: Yeah. No but you know what Stefano, it's often what it is because the people that are working in the health care space are brilliant and they're doing great things. The thing is it's oftentimes that siloed nature of what we do that leads to that missing number. And oftentimes it's just one number. Right. And and it's meetings like yours that help put it all together.

Dr. Stefano Bini: I love it. I absolutely love it. I mean that's exactly right. So speakers so let's start with the keynote. I am just blown away. Every year we've had these people come to the conference who can speak to us from a completely different planet. Right. So yeah remember that our first conference we had the CEO of nanotech that talked about how they used Pokémon Go, I had built Pokémon Go. And the purpose there is to say hey look this augmented reality stuff, it can change behavior. What can we do in healthcare with that? And then the next year we have the product manager for Under Armour come in and talked about how they're creating a company that is adding sensors to all their clothing what they're doing with that data. And he came up this brilliant vision of how they're empowering they're giving their customers and all three types of armor, digital armor, health armor, and social armor, which I love the visual of that and how that visual component so critical. So this year we brought in Sam De Brouwer, Sam's a girl she's not the guy she's a founder Chief Operating Officer of doctor.ai, I think you may have had her on your podcast?

Saul Marquez: We did. We did.

Dr. Stefano Bini: Yep that's awesome.

Saul Marquez: Yeah. So folks Sam was one of our best best best podcast episodes. You could find her episode I'll I'll included as part of the show notes the title of it is Demystifying Block Chain and A.I. in healthcare so truly one of the thought leaders in the space. But she's going to be your keynote. That's awesome.

Dr. Stefano Bini: And talking about the topics you've got your listeners have had a bit of a preview. We have asked her to come in. Given her past experience in A.I. sort of demystify I love the way you put it demystify where A.I. is really going to go in healthcare. You know there's some real challenges to a block chain into be health care because block chain used tons of energy it's not that simple a system to work through. So what areas you know what parts of block chain what problems we have in healthcare can be solved with a block chain better than with others. And so she's really the best person I could think of to really tackle that question for our audience and next what you should do as a follow your idea much deeper. So we'll do this block chain inflection and by next year I think we'll see some companies that we can bring in to really show us how it's done.

Saul Marquez: I think it's brilliant I think is brilliant Stefano and yep Sam is a brain and she's engaging, she's funny, I think definitely a great speaker to have as your keynote. And you know the other thing too is to be open you know because you don't know what you're going to get. I remember about five years ago I had the opportunity to go to exponential medicine. Right. I went to the meeting and I went and I didn't know what I was going to get. I knew that I knew what I was looking for I had goals. Well you know what I walked out of there with Stefano? I walked out of there with meditation.

Dr. Stefano Bini: Yeah.

Saul Marquez: I had never meditated before and I started five years ago after that meeting. And it's unlocked for me a lot in my health life but also a lot in what I've been able to achieve since then just because I started meditating. So you never know what you're going to pick up and success does leave clues. So when you're around all these awesome people that Stefano is gathering under one roof, the opportunities is open side suggest if you do go keep your mind open because what you went there for may not be exactly what you leave with but you probably will leave with something.

Dr. Stefano Bini: I love. I just spoke to two three days ago at exponential medicine about the...

Saul Marquez: Oh you did? Cool.

Dr. Stefano Bini: Yes my second podium there...

Saul Marquez: Very cool.

Dr. Stefano Bini: And I hated having to leave. I figured back to work. I love this conference and I hoping people feel I say well you know we have so many amazing people come and we got really come of Vice President Global franchise leader Johnson Johnson people like that we're going to China Dubai. These are people who shouldn't give you advice Hewlett-Packard. We got Eugene Berkeley's head of G4A at Bayer Mark August conformists. Robert has shown a pretty famous town guy didn't really get worked at the health work group in Europe. We got people to see me from Plug and Play we got just goes on and on and I'm super happy with the level of the people we're getting and knows what the situation is. I try to keep it about three hundred and fifty people. They want people to sit and have time to meet everybody around them.

Saul Marquez: Love that

Dr. Stefano Bini: You just can't know, you want to have coffee. If not Daniel pretty much everybody you meet here. So it's exciting. Love to get you there as well.

Saul Marquez: Hey man I appreciate the invite. I'll definitely take you up on it.

Dr. Stefano Bini: Do it, do it.

Saul Marquez: All right. Stefano so there's there's definitely the caliber of both speakers and attendees is high. So folks if you want to keep your caliber high or raise it this is the meeting to go to any opportunities for them to get a discount through us?

Dr. Stefano Bini: We love the rocket people right. We love rocket people they think like rockets and move like rockets. So we like the rocket so help but we'd love to give you guys a big discount so rocket 30 is the discount code we've built for your audience. And it'll be nice 30% off and the conference is expensive but unfortunate costs of running this insane risk are exorbitant. So yeah but we would love to have you guys there and join us. And so here it is.

Saul Marquez: Outstanding. So there you have it folks. Rocket 30. So two ways to get there. Number one just go to outcomesrocket.health and you'll find our podcast with Stefano there. Click on it and you'll get a link to get to his Website. The easy way to get there, just go to docsf.health. And you'll get your registration there. You'll register use rocket 30 to get your 30% discount and boom you're in. So again Stefano you know at the end of the day I'm a firm believer that you've got to invest in yourself and in your company. And so I look at this as an opportunity for folks to really make the most out of what they're doing in the New Year because you got to start your year with a bang. And folks this is an opportunity for you to do so. So Stefano appreciate you coming on to speak with us again folks. The code is rocket 30 for 30% off of the conference. Just go to docsf.health.

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

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Why Wellness Should Be The Core of Value-Based Care with Adrienne Nolan-Smith, Founder at WellBe

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Why Wellness Should Be The Core of Value-Based Care with Adrienne Nolan-Smith, Founder at WellBe

Welcome to the Outcomes Rocket podcast where we inspire collaborative thinking improved outcomes and business success with today's most successful and inspiring healthcare leaders and influencers. And now your host Saul Marquez.

: Welcome back to the podcast. Today I have the amazing Adrienne Nolan-Smith. She's a Founder at WellBe. She's a speaker, a board certified patient advocate, and a wellness activist. I'm excited to bring her on the podcast today because the fact is wellness is important and as we turn a chapter from fee for service to value-based care, wellness is starting to become more important. So it's with pleasure that I invite Adrienne into the podcast. Welcome Adrienne.

: Thank you so much for having me Saul.

: It is a pleasure. So Adrienne let's chat about WellBe you know tell us a little bit about what it is. Tell us a little bit more about you. Anything that I missed in the intro let's hear it.

: Absolutely so my hodgepodge of titles came from several decades of different experiences with health and wellness to just start from the beginning. I was diagnosed with Chronic Lyme Disease when I was 11 years old and basically my mother was told that there wasn't much that could be done after the antibiotics didn't work because I'd had it for too long already for the antibiotics to really be able to cut off. And so it started my family down a new path which was integrative medicine and you know this is in the mid 90's and it is very different from how it is today and definitely was seen as sort of hippie and wuwu and off to beaten path and all of the practitioners that I saw I definitely felt that way you know I was like a middle schooler and they seemed weird but the difference I realized was that through doing all these different treatments and therapies with them and we did a whole bunch of both things that you know you may have heard of. And things that are you know really out of the box but are actually becoming more popular today like hyperbaric oxygen therapy and things like that. I was healed. My Lyme was inactive by the time I was 13. And this is pretty remarkable because people really don't heal very much from Lyme once they've had it for you know a couple of years undiagnosed. So it kind of changed the course of my family's living habits and lifestyle as far as what we knew was important to both keep that disease in remission but also to just boost your immune system to prevent other health issues from coming up. And so you know we only added health food stores and saw a lot of different practitioners as part of a general protocol and took a lot of supplements and things like that. And you know nothing. I was in fantastic health until I was about 18 and I went to college at Johns Hopkins which is funny because now that I'm in the health and wellness world people always ask me you know if I'm a doctor and I'm the only girl in my sorority family who's not a doctor because so many people go there for that. But it just makes sense of course now that I got into this field. But when I went I you know again eating in the dining hall and within six months I had completely lost my menstrual cycle. And this was really bizarre you know and having never happened to me before and having one since I was 12 and went to see a whole host of endocrinologist and gynecologist and trying to figure out what was wrong. And you know they they just kind of run some blood tests and they said you know we can't really see anything you seem to be in good health. No changes in your weight whatever. Just take the birth control pill like this was you know the solution that I was given and luckily because of the Lyme experience I knew to do a lot of research before you have any kind of encounter with a doctor. And I said you know with all due respect like that that's actually not a solution. Like that's a bandaid. That's kind of masking a symptom. You're going to give me a fake period but I want my real one and I want you to help me get it. And if you can do that? Thanks, but you know I'm going to be on my way. And so you know I went through several of these maybe eight weeks and finally both at Johns Hopkins and back in New York where I'm from. And finally my father found me a naturopath after I'd exhausted a lot of the conventional options and we looked at the blood so differently together and spent you know more than an hour on it. Going through it all and talking about my different experiences and living in China and whatever and even emotional stuff that I was going through at the time as my parents were getting divorced and whatever and within six months of diet and supplement and Chinese herbs protocol that I was on with her. It came back and it's been you know totally normal for the last, over a decade. So...

: That's awesome congrats.

: That was like. Thank you. It was like episode number two of like whoa you know this is a messed up system. Right. And what am I missing, what are most people missing? Like thank God I had the stubborn attitude to actually go in and the finances honestly to go see all of these different intake appointments and a lot of them you know don't take insurance. And my family so believes in health that it was something that you know my parents would still pay for but I can't even imagine getting to the root cause of things without that. So that's a whole note of topic. But the biggest thing that happened to me and the reason that I'm founded WellBe and I'm doing what I'm doing today came when I was about 20 years old my mother had a manic episode and basically paranoia, delusions, middle of the night to put her to the back of a cop car. She thought we were trying to kill her. Was like a really crazy thing. She ran away from us all the way to Queens and we had to sort of like restrain her and basically it started you know a real nightmare. It was five years of the revolving door in and out of mental hospitals. And she was diagnosed with schizo affective disorder which is a combination of bipolar and schizophrenia and I've never had anybody that I knew have any mental illness per se maybe depressive or anxious symptoms but not like this and this was a really rude awakening to the mental health care system which if we think the regular health care system is bad like that system is just...

: Another story.

: A whole nother level of you know just kind of not getting to the root cause of things. And so when I was 25 she was so heavily medicated and such as zombie from all these drugs and she's drooling and shaking and all of that. That she you know I totally understand she found it not to be a suitable solution. Like it wasn't actually a better way of life at all. And she took her life and...

: I'm so sorry.

: It was thank you, it was a couple of days before Christmas. And at the time I was applying to business school. I'd been working at IBM and I knew that wasn't my calling. And I knew I wanted to do something that was meaningful to me and where I could really tap to change something worth changing and be a part of something that was important. And as I'm not even sure how I'm going to finish my applications because it was about two weeks before my applications were due and I kind of my friends were incredibles, came together, helped me edit drafts, scott you know one or two out the door and I was very fortunate to get into the Kellogg School at Northwestern where I went in Chicago and I told myself if I got in I would dedicate the rest of my life and use business school as the transition tool to work on transforming the health care system into one that actually gets to the root cause of health issues and doesn't just bandaid the symptoms. More my mom had a ton of other sort of gut issues and early traumas and things like that that I had no idea could be connected to mental health issues. Of course a lot of us didn't with the Microbiome Project hadn't even the results really hadn't come out. We didn't know about the gut brain connection and so had anybody kind of dove deeper and started to peel back the layers instead of just the drug drug drug you know we could be in a really different place today. And so my whole thing with that I'm trying to do it with WellBe which is a media and lifestyle company dedicated entirely to helping people prevent and reverse chronic health issues and really see the hundred choices are making everyday as health care. And then when they do have a health care experience of any kind in the conventional system understanding how to advocate for yourselves so that the people you work with get to the root cause and heal you rather than mandating symptoms for indefinitely I guess. So that's all of why I'm doing what I'm doing now. We make all original content I film people's stories of health recovery through integrative medicine but also a lot of experts that are MDs and naturopaths osteopaths who sit at this intersection between health care and wellness to try to show that there are people doing great work here to try to destigmatize it a bit. It's not all hippies but also bring a lot of research to the conversation that I'm able to see and Medscape and pub med and all of that to show that you know the whole argument is oh wellness isn't science like no it really is and a lot of great work is being done right now to show that.

: I think it's such a such an inspiring story Adrienne and it's wonderful that you're doing this. Folks if you want to check out some of the work that Adrienne and her crew are up to, go to getwellbe.com that is their website is. An incredible story and now very mission-driven business that she's running here. I think it's a beautiful thing because at the end of the day not everybody gets the results that they want from the health system. And so it's great to have another option and this option is there for as Adrienne mentioned chronic illnesses that you know you just can't seem to get the source of and I don't know and you know it just seems to me like there's a lot of things in the gut that sort of don't have all the clear answers right.

: Oh yeah I mean the more we learn the more I'm realizing I would say like 80% of chronic health issues somehow relate to just an imbalance of good and bad gut bacteria and how that then spreads into the brain and affects the immune system and creates chronic inflammation which leaves all these other things and it's like honestly peel the onion and somehow there's always that gut at the bottom. Seems to be controlling most things with just extraordinary. And I forgot to mention in my story that after I graduated from business school I worked in conventional health care for three years with hospitals on the patient engagement software side of things so I was working in health tech so...

: That's pretty cool.

: I was able to see kind of in these hospitals because I worked on chronic disease management programs and when you were talking about value-based care it actually might be because that's what I was working on a lot trying to help hospitals reduce 30 day readmission. And you know really get people bundled payments and all this sort of thing with population health management and it was originally I thought maybe I can solve this from the inside maybe I can work in a way that that does that. And I just saw that there were just so many incentives to keep the system to be you know not only fee for service but really based around a disease code. Right. And we all know that a lot about preventing chronic illnesses. It must happen before you have a disease. And a lot of the treatments related to healing from chronic illness aren't seen as a disease code right. So acupuncture or supplements those are not exactly seen as I did seem like complimentary treatments or something right. So if the system is constantly related to this DRG thing this disease code thing there's just no way that people can really pay for any steps they might want to take to heal or prevent chronic health issues and those can even be the things that we know of that start in a small way. Right. Like you just have migraines or you just have a little bit of pain that you're kind of like take a lot some Advil for and then more and then more then more and the sade's end up really harming your gut bacteria which leads to a whole bunch of other things. So something that small can really, you know we talk about chronic disease but it's really just chronic health issues because if you don't get them and heal them and you just manage them whatever you're doing to manage them can end up causing a host of other health problems so that's something I think that is really important. And what I learned when I was working within the conventional system.

: Yeah and it's cool that you had that experience obviously you're coming at this from from a very informed perspective both as a patient but also as a as a professional within traditional health care system and I think you sort of highlighted a very important thing that the way that our system is built and the way that we do billing and procedure codes it's not set up to pay for a lot of things that could potentially be helpful. And so you mentioned earlier in your story "hey you were fortunate to have an ability to to pay for an alternative let alone know what the alternatives are" right. I think it's cool that you're doing this because part of the battle is understanding what the alternatives are. And so folks if either you or somebody that you love is going through some chronic illnesses and I'm sure you could think of firsthand somebody that you know I know to three people right now and so I'll be referring them to your podcast and to your thing Adrienne because folks by the way Adrienne also has a podcast. She's podcasting with folks that are you know doing well after not having solutions to their chronic illnesses. She's covering things like integrative medicine and the microbiomes so definitely check out that podcast. Again you can check her out at getwellbe.com you'll see a link there for it. But yes so kudos to you for bringing forth this forum of discovery that I think a lot of people are needing.

: Thank you. Yeah I know when I was going through my own health issues as well as taking care of my mom. Where do we all go to search for information about health. We go to the Internet and so but when you Google something it's really both an SEO game and just you know whatever happens to be there in the way that you put it in. But a lot of the best information you know is either kind of behind research walls that you wouldn't necessarily see in Google or in some of these smaller more mission-driven sites. And so what I found was being able to see what other people, what had worked for other people who may have had my exact health issue or even like as you said I know now so many friends and family are going through things now. So being able to help them and you just how are you what's going on there like a you know my skin. I feel like I can't go outside. You know one of my best friends it's just this ongoing saga and dealing with it is not only exhausting. She's sort of given up because she's been doing it for so long. But emotionally so trying because it's now this kind of like it's part of your identity. Right to have whatever that's chronic health issue is and it feels like climbing Mount Everest to think that what you'd have to do to get rid of it it may not be that complicated. Just maybe one more person that you try to work with. One different kind of practitioner you hadn't thought of or one treatment that is interesting to you. But you know somehow you never read about it maybe just you need and so this is what I've seen with these videos when people share their stories and they truly did heal people. Look at that. So differently and say well I have rheumatoid arthritis. I didn't even know it was possible to reverse it or I have Hashimoto's. Like how did they get over that or systemic lupus like are you serious you went from chemo to existing without drugs and she's fine. Like how is that possible and so by sharing both these stories but also coupling it with a lot of the research that we cover and a lot of the experts whose work life work is just these particular topics whether it's the gut microbiome or acid reflux ENT Dr. I covered who now only treats patients with diet based on you know having been a head and neck surgeon and saying that's not the answer. I don't want to take out tumors anymore. I know it's all diet. I'm just going to work with patients that way. So lots of different kinds of things but all related to this idea that our bodies are incredible. And for chronic health issues or diseases it just takes certain therapies and practitioners and lifestyle changes in order for your body's immune system to kick in and really heal. Now of course there's emergencies and there are life long genetic conditions that you're born with that maybe can't be solved that way or they. But I believe the statistic is that 80% of all of American health care costs are related to the ones that you can do something about. And you know really only five percent of June mutations are actually determinant or you know unchangeable. So I think that's just an amazing opportunity for the majority of people who right now are like "I don't want to take all these drugs. I don't want that surgery. I don't want to have to get so much radiation. I don't want to I don't want to say try these other things first like get to that choice 10." You know when you really have exhausted everything else. But before that can you imagine you can live your healthiest life just the way that your body is without having to be dependent on anything.

: Yeah not a... some great thoughts being shared here Adrienne. And you know I would even extend this to people that don't have chronic illnesses because at the end of the day if you want to be well you really have to start looking at what you are consuming and the treatments that you're getting because a lot of things that end up affecting us are the things that we think are good for us or that we don't know and that ultimately gets us. So some great shares give us an example maybe a story of somebody that was inspired to wellness through your work.

: Yeah I'd be happy to so we get you know some terrific comments and people writing and just on the forum on our site when they've seen something and then they you know go to see that doctor and they didn't really know something was possible before. But one of them is a friend that I have and you know her child has asthma and she had no idea that it could possibly be related to diet. And she saw some research on our site where we covered this connection between asthma and the child's microbiome. And the mother and things that related to nutritional deficiencies which comes back to diet and she sort of just had this whoa like and then she's now kept reading and she saw another research piece that we had covered relating a lot of plastics and other toxins within the home to asthma and she was surprised to see that as well she always thought it was just a respiratory condition. But what people don't think about that much is that asthma is just your blood and your lungs are are quite linked hence why these other cancers develop elsewhere in the body when you smoke right. That's not it. The lungs are not isolated. That's what I mean. So these other toxins were getting into her child's lungs and causing this disease via not really thinking too much about what she ate and using a lot of toxic household products and you know even her diapers were generic and had lots of chemicals on them and she really hadn't thought about it and it kind of started to unravel for her the idea that something she thought she was just going to have to treat with steroids and inhalers and things like that for the rest of her child's life that not only were those steroids wiping out the small microbiome that he has and the good gut flora there but also there were things she was repeatedly exposing him to every day with these products as well as with his diet that were continuing to cause inflammation and therefore cause also asthma which is just inflammation of this particular lung condition.

So it was just a really neat way for you know not having to even push it. Exactly. But just it was one of the topics in our research research piece. And she wasn't reading it even thinking about her son per se but yes she's my friend and all of a sudden these things started to click and she started to kind of realize that she had to really clean out things in her home and in her kitchen and especially the product she was actually using on her child which again from a marketing perspective we thought, these are healthy, these are American household brands. Yeah. And then oh my gosh. And using environmental working group database and some of the other things that I told her. You know look out for in the agreement she discovered actually not at all. I am exposing my child to a really big array of chemicals and I need to get all of that straightened out and let's see if the asthma you know just clears up that way. So that was just a few weeks ago and I thought that was kind of a really neat turnaround in that hearing about it. Yeah. So that's one that I know of so far. And then most of well anyway I'll let you ask me another question.

: And that's good. So for the folks out there that you know have basically tried everything and you really don't know what to do. I feel like this opportunity that Adrian has created and get well be is is really something that will offer inspiration to those looking for a solution where they haven't been able to find one in the traditional health care system. So definitely something to consider if this is you I'll be putting on the show notes as well as a full transcript of our discussion at outcomesrocket.health/getwellbe just as it sounds and just like the website so you'll find that there. Give us an observation that you've made Adrienne of a setback something that that happened that you learned so much from that now you don't do things differently.

: Sure. Would you prefer. Like you mean one in like a work experience or one that I went through and my kind of health journey?

: You know what I think I leave that up to you because we definitely have been discussing a lot of both. So whichever one resonates with you the most.

: Yeah well I guess I sort of mentioned a setback certainly was my mom's experience. That one is the kind of clearest setback that I can think of as far as different things that I experience and how I, so I didn't know anything about the mental health care system before. And I would say that my biggest takeaway from that is that as I'm sure people on your show have talked about before but the disconnection between all the different specialists in the healthcare system and not feeling like anybody's actually looking at the body holistically I thought was really interesting. We were just given scripts right away scripture scripts and each drug had a host of side effects that then required other drugs so then you're sort of on a cocktail and you know anybody who's taken antipsychotics knows that it's really it's like being drunk all day on your liver, as far as the damage. And so I was just completely shocked that there was nobody in this system and these were very good doctors at Clane Hospital in Boston and they claimed you know good good good hospital looking at actually her body and saying Whoa these are powerful like we need to be doing a lot to detoxify her organs at the same time because this is not just a normal toxic burden like this is heavy duty. And so also is she getting enough of these green vegetables which will help her to actually detoxify her pancreas and her liver and all these other things as well as are we doing things with supplements to really expedite that detoxification process. And then you know the therapist that she's supposed to be talking to really is hard checking in with the psychiatrist who is prescribing things right. So that was kind of funny and interesting. But then on the what I think is the most interesting piece is the gut, the blood tests and all the different testing that could have been done on these underlying viruses and conditions which we now know impact the brain. We're not even part of the conversation. So you know whether it was like a gut health protocol that they could have put her on or things like that. There was just no sense of understanding why is this happening. And what are the different things that we can do to improve the different systems in the body such that we maybe can get her off these drugs and use this and actually restore her to a life in which it's you know she feels she's living because the vegetable state was not really living. So I learned a lot about this kind of lack of communication between specialists and then I also learned about you know how little the whole body is taken into account when prescribing things and also hardly any mention of the side effects which one of them was suicidal ideation and that is what happened. And you know we really didn't know about that. So you know it's hardly spoken about before you actually give somebody a script and then I also learned about I say those are my three biggest takeaways and the set backs that I saw. Yeah those, is that?

: No it's definitely clear and a lot of people go through this. You know you really don't know what you're getting into. And so it's important that you do the research and you get as informed as you can. But ultimately we have work to do in health care. We've got to connect these silos better and treat the body as a whole because it's definitely not being done as properly as it should be and especially with the cases that come up that are particularly difficult with chronic diseases. It does become even more more challenging. What would you say one of your proudest experiences in the healthcare space has been to date?

: Well certainly my life's work and my mission is definitely WellBe it's you know everything that I care about. And I unfortunately think that we have enough work to do that I'll be doing this in some capacity till I'm 90 years old up unless you know I do a really good job and the entire health care system transformed before then I doubt it.

: Me too.

: There's just way too many people really invested in. Unfortunately the way it's set up right now it's lucrative in some areas and I don't think anybody really wants to change that. You can't patent broccoli right. Which is why I always say. And so I would say my proudest moment would comes routinely when I get this outreach honestly from people who say something that we've done has sparked has lit a light bulb in their head that they didn't even know they sort of either accidentally watched it or they weren't even looking for something and they just it was something in their life or their family's life where they thought that was just the status quo that was just never going to change. "Oh I have anxiety or oh I had acid reflux or oh I just have high blood pressure". It's hereditary or you know these things that they were just like accepting as fact and saw as either research piece or an expert interview or you know story that we filmed or even one of our like article guides to something and just kind of didn't realize that there was a different way of thinking about something and that this was not a life sentence and decided it was really impassioned enough about that realization that they had to write to us. We're very active on Instagram as well. So I get probably a direct message like this you know once a week on Instagram but also writing into our site and each time I get one all the anxiety and stress and complications that come with being a sole founder as I'm sure you know Saul they just kind of melt away for a couple of minutes while you realize like wow I'm impacting people and it is not just about growing a brand or growing a business it's about like as I'm doing all of that. This person is able to maybe save their life if they're having this issue in their mid 20's or 30's and they are going to never really think there is a different way of looking at it indefinitely. Maybe I just changed the whole trajectory of their life. And so for me that's definitely each time that happens I just like beam from the inside and then I go back to work because I have so much to do.

: That's too funny. And for sure it's like that that affirmation that what you're doing is making a difference. And so folks the call to action they have something that you heard today is resonating with you. Check it out and share with a friend. That's the way that silos are connected right. That's the way that we are able to make a difference in this health care system is sharing it what you find impactful. And so I know I'll be sharing this interview with some personal friends and so I encourage you to take that as a call to action for today. I know are running out of time here Adrienne so what I'd like to do is just ask you for your closing thoughts and then the best place where the listeners could get in touch with you.

: Of course. Yeah thank you again for having me. It was great to speak to you. And you know as I said before I started this not because I thought there needed to be more wellness content on the Internet. Lord knows there's plenty of it but it was more that for me having done just worked in conventional health care for several years and seeing the issues you know every week that I was in a hospital, I know that everybody has to interact with the conventional health care system at some point you know whether it's they actually have something or just checkups and screenings and things like that. And then knowing that the wellness movement is booming. But you know a lot of people think it's just leggings and juicing and you know all of that and like grain, lose weight and all that stuff and I'm like whoa you know these two things like have to come together or because we are in a chronic disease crisis. I mean it's an completely unsustainable amount of disease that we've created in such a short amount of time that we're going to literally bankrupt ourselves and all die way too early as this continues at this rate. And so I thought it was something very important that I could do to bring to the conversation look I've seen both sides. I'm a wellness and integrative health person by you know passion, by experience but I've also been working in the system and I know that once they come together, once you bring that data that research and science to these things that can prevent and actually heal the root causes of disease rather than bandaiding symptoms. All of this will start to change and will start to change pretty rapidly because you won't have these crazy costs and you won't have so much disease that we know that the health care system as it exists can't even handle it which is exactly was happening. So that's what I'm trying to do and I hope that you'll visit WellBe and find us at getwellbe.com. So as Saul said it's getwellbe.com and we're also very active on Instagram. It's also at getwellbe's you can follow us there and if you don't have instagram, also Facebook and YouTube all of our interview and interviews and other content is there. Our weekly newsletter on the website which is definitely the best place to serve get new content because it comes out every Wednesday and has only podcast episodes and things like that as well. So yeah. Any way that you want to interact whether you know what to listen to a story to be inspired or read some of the research that we break down and cover in kind of a quippy way I think you'll get something out of it. I say if you have a body you probably will get something out of it because...

: Love that, love that Adrienne. Hey well this has been a pleasure. So folks make sure you check out Adrienne's podcast, her website. Again Adrienne this has been a pleasure. And really thank you for spending time with us.

: Absolutely. Thanks again for having me Saul.

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

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Recommended Books:

Creative Confidence by David Kelley

Shoe Dog by Phil Knight

Best Way to Contact Ribas:

LinkedIn

Twitter

Company Website:

www.novoholdings.dk

Check out this Link:

https://outcomesrocket.health/podcast

 

 

What it Takes To Succeed in Healthcare Entrepreneurship with João Ribas, Biotech & Life Sciences Investor at Novo Holdings

Welcome to the Outcomes Rocket podcast where we inspire collaborative thinking improved outcomes and business success with today's most successful and inspiring healthcare leaders and influencers. And now your host, Saul Marquez.

: Welcome back to the podcast today I have the outstanding Joao Ribas. He is the Co-Founder at The Future Labs Healthcare and Life Sciences Investor at Novo Seeds. He's a Harvard trained Bioengineer working at the intersection of Science and Business. He's passionate about empowering entrepreneurs and startups to succeed. Today he's phoning in from his new destination in Copenhagen Denmark which you know we had a great discussion about some of the happiest people in the world maybe otherwise their healthcare being part of it. He's an innovator he's done venture creation. He's he's got investment experience. And so I'm really really excited to have him here on the podcast so Joao welcome. Why don't you fill up that gap any of the intro that I may have missed out? Welcome.

: Thank you Saul, it's great to be here and talking to you on the Outcomes Rocket podcast. I think that introduction was pretty amazing. I didn't even know I did all these things.

: You're a humble man. You're a humble man. I appreciate that about you. What got you into the medical sector to begin with?

: Yes. When I was growing up I always showed curiosity about how things work especially biology and disease do. And for me working in solving healthcare problems sort of ticks that curiosity box. So that was one of the factors and then at the same time working health care means that I can impact positively the lives of millions of patients which is something I strive for. So I think those two as what sort of draw me into work in this medical sector.

: That's amazing. So now with the work that you're doing in this investment firm and with your own gig I think you have pretty good reach as you've looked at different companies Joao and you've done projects of your own like the X Prize etc.. What do you think a hot topic that needs to be on every medical leaders agenda today is and how you and your organization approaching it?

: Yeah although there's a lot of very hot areas that one could look into. But I think in essence what we're trying to do here we are we're sort of creators of opportunity. So we're looking for and we fund compelling and very strong science-based startups which will then lead to development of new territories where some of the most pressing clinical needs that we have out there. But of course in order to do this well we need to start early in the lifetime of the companies and then the ideas we need to back need to be transformative. So I think this is what should be on everyone's agenda is to find these transformative companies in a lot of different fields because there's different medical needs in a lot of different areas and fund these transformative companies and not just companies that are adding on to previous technology or just smaller improvements over what we have out there.

: So how do you how do you define that transformative?

: So we think about ideas and companies that really disrupt the way we're looking at a treatment of a certain disease or therapies forced into a disease and can bring an angle that no one was really thinking of before. So you can think about the CAR T the cell therapy as something that was very different from what people were doing. So we're looking for the sort of opportunities where you see that there's a different approach to things.

: Got it. Got it makes a lot of sense. And so as you've embarked on this journey to work with and fund transformative companies, can you give listeners an example of maybe one of those companies and their solution and what they're doing differently to improve outcomes?

: That's an excellent question and it's kind of hard right now to give you a specific example because we often don't talk about some of the companies that we invest in because it's such an early stage and some of them might be sort of under the radar but there's plenty of companies out there that are interesting I can give you another example of a company that I know closely from the time that I was working in the U.S. there was sort of a very simple idea a sort of disrupted a little bit the way people were doing things and this was while I was working there in Boston so this company looked into the problem of compliance of adherence to medication which in the U.S. is a really big issue. A lot of people were developing a lot of different solutions. You know these little apps that remind you to take your pills or little boxes where you put your pills. And all of these were sort of not working as well as you would expect. So these guys came with a super simple idea to package these pills for every day in a single small little package so you have a package for Monday morning, a package for Monday evening, for Tuesday morning. Tuesday evening. And it's such a simple idea. But it kind of transformed the way people were thinking about getting medication at least in the U.S. and this company's name was PillPack and it was I think probably a month or two ago was acquired by Amazon and they can feel it. Yeah for a billion dollars. So it's a very interesting story. If you were interested you should look it up from where they start up and where they are right now and their approach of looking at a problem and understanding the clinical need first and looking at things in different ways.

: Yeah you know and transformative doesn't necessarily have to mean complicated?

: Exactly. And a lot of people think that transformative always means complicated events. It's very easy to complicate but it is very hard to simplify and some ideas are simple but transformative.

: Gosh that is so great. What a great example and I love that you brought it back to today. John with this example of PillPack getting acquired by Amazon. It doesn't have to be that hard folks. It's just finding the right way to add value and so they obviously delivered value. They've been acquired. Great example there. Tell us about a story where maybe you know a company that you were working with Joao that didn't work and why that failed, a mistake. We learn more from those. I feel like...

: Definitely we spend a lot of time talking about successes and very little time talking about the failures. But going back to my time in Boston, well as during my Ph.D. there I got introduced to Healthcare hack-a-thons which are sort of became very popular right. And I work maybe two or three projects in this hack-a-thon's and they didn't work. They really failed miserably and I think this was very good. I was able to really learn and understand how a strong and validate clinical need is key to further startup idea in healthcare. And I was really not aware of these. I just wanted to work on maybe as a special technology that I was interested in and not really focusing on the clinical need. And interesting enough after failing a bunch of times trying to do these Healthcare hack-a-thons now with different ideas I ended up joining MIT Hacking medicine which is a MIT group that teaches innovation methodologies around the world. And I was able to travel all the way to Ecuador or Austria and I organize events there to stimulate the creation of new health care startups with a strong focus on finding validating medical needs. So in this way and looking back I'm very happy that I failed early on and learned from various foreign mentors.

: So that's so cool Joao. So the common theme with these three companies that they didn't work out was that there wasn't a clearly validated clinical need and then you spun around and MIT did clinical need based innovation hack-a-thons.

: Exactly.

: Love that.

: So I've quickly understood that the way I was approaching problems was that was not the best I was trying to work with a certain technology and find what can I use this technology for. And instead of starting with a clinical problem and then trusting that I would be able to find a solution in a team to that problem and that sort of change the way I was thinking about problem and technology trying to solve a problem and looking at the problem first before thinking about the technology.

: That's very cool. And while it seems pretty easy it's also difficult to stay focused on that because we tend to fall in love with technology, we tend to fall in love with the gadgets. So what advice would you give to people looking to work in this space looking to make a difference. You know like honestly make a difference. What advice would you give them so that they don't fall into these traps.

: Absolutely, absolutely. You're very right. I think working in multidisciplinary teams is key and then these hack-a-thons I was putting together teams that as a physician, an engineer, a scientist, maybe a lawyer, or a businessperson,a designer and all these people bring really a lot of different perspectives. So when you're stuck in the love with a certain technology maybe someone else is not. And they're able to show you a different way of looking at a problem. And in this way you don't get stuck. So I think that's a tip I would give to people working out in healthcare startups is have a diverse team.

: I think that's so valuable. So get your diverse team in place folks. You don't want to have people on your team with blinders or have them be too homogenous because it definitely could put your business model at risk. How about the other side of this Joao. Tell us about one of the proudest medical leadership experiences you've had to date?

: So I guess following all these failures I started learning and learning more about them and avoiding these in future projects and in 2017, I was a Innovation Fellow at the European Institute. And I had the chance to travel around Europe and talking and interviewing physicians and patients. It was really a great experience that allowed me to learn more about these unmet needs on a hands on approach just by going to hospitals and talking to, talking and observing decisions and throughout this process I was able to work in a team and find a novel solution for a problem which is colonoscopies we're really not doing a good job in tracking all apps that can lead to cancer when we do colonoscopies and because of these we have a very high rate of colorectal cancer. And throughout this experience of identifying first in medical need we're able at the end to go out with a new idea and started working on a prototype which say novel modality, medical device to address this issue.

: That's awesome man. So how long was your fellowship?

: It was for a full year was really a great experience because we were jumping from Budapest to Barcelona to Poland to a lot of different places and getting these inputs from many doctors in many hospitals where culture is different. The way of operating is different was really key to understanding what will be the most relevant need to solve first.

: Which is really cool. I mean I think it's really great that you had this fellowship tour and in general it seems to me like you're pretty jet setting kind of guy. You're not geographically bound by anything. Right.

: And he is very right there.

: You know you I'm from Boston now you're in Copenhagen so there's worldly perspective really matters. What were some of the common themes that you picked up you know you went from Mali to all these countries different healthcare centers, modes of operation, what were the common themes that you saw if you could highlight maybe one or two?

: Well I think first there's a lot of great people everywhere after being in Boston which is a center of excellence with great research I found that in Europe we can find the same thing so we can find really really good research and inequality that is at the same level. But then in terms of the way we treat patients I found really big differences between the US and Europe mostly in the way healthcare systems are efficient. So in US it seems that they're a bit less efficient. They do a lot more exams which cost a lot more money whereas in Europe, things work a little bit differently and there's more outcomes-based healthcare systems other than in US which is getting to that point.

: It's a really great great observation. And so folks from the providers side I know we're all doing a very very hard job or doing our best and in this transition to value-based care. I think taking on Joao's perspective you know he's been around the world. I think we ought to take a look at the folks across the pond in Europe to inform some of our decisions some of our pilots as we're adopting value based care. We have a lot to learn and I think our fellow Europeans could teach us some good things there. Tell us about an exciting project that you're working on today.

: Yes we're right now doing a podcast and I'm actually also working on on a podcast...

: Nice.

: Which is called the Futurelabs. And the idea behind this was that I really enjoy thinking about what the future might look like in different areas not just science and technology but other fields such as education or politics. And I started thinking about it and together with a friend we decided to start a podcast and started interviewing key opinion leaders about how they think the future might look like. And we're going to include topics as diverse as what's the future of Meet, the future of these therapeutics, and the future of open innovation. So I think that people are going to get excited with this I think.

: That is awesome man. Good for you. Now you have a name for the podcast then is it out yet.

: The podcast name is the Futurelabs is not out yet. We should be launching towards the end of October.

: That is amazing man. That's exciting. Good for you.

: Yeah thank you.

: We'll definitely do our part to share this project with the listeners because the reason why we started this Joao as you know is we wanted to make a forum where people could share best practices and connect with the people that are making a difference in healthcare. And so you're doing that. And so when you're done with that please let me know. We'll do a special episode on the release of your podcast so that we can get the listeners to check it out.

: Fantastic. That would be great. Thank you.

: Absolutely. Getting close to the end here John. Let's pretend that you and I are building a medical leadership course on what it takes to be successful in the business of healthcare. It's the one on one of Joao and so we're going to build a syllabus with a four question lightning round followed by a book that you recommend to the listeners, you ready?

: Yup.

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

: Investing in deep science companies to innovation that reaches patients.

: What is the biggest mistake or pitfall to avoid?

: Not considering reimbursement.

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

: Embrace and lead change and pull yourself out of your comfort zone.

: Finally what's one area of focus that drives everything in your organization?

: We are very focused on finding and building extraordinary interest forming lifescience companies.

: Outstanding what book would you recommend to the listeners Joao?

: Well I think I would recommend maybe two. One that I read quite some time ago and the more recent one. The one I read a long time ago was called Creative Confidence from ideal founder David Kelley and it's basically about design thinking and it really changed the way I was thinking of our problems. So very very highly recommended. And the other one slightly different is called Shoe dog by the Nike founder Phil Knight. That's a very intimate story from like his early days and all the struggles that he faced. We know Nike right now has the bee corporation but it was not always like this. It's a very very interesting to understand how was Nike made and all the problems that they had in the beginning.

: Love that. Great recommendations Joao. Folks again we have Joao Ribas. And so what I want you to do is check out these resources that he just checked out. We'll include a link to his podcast when it goes live. But also the books and an entire transcript of our discussion just go to outcomesrocket.health/ribas as in Joao Ribas. You'll find all that there. This has been a blast, Joao, I love if you could just share a closing on with the listeners and then best place where they could get in touch with you.

: Sounds good. Well maybe I'll talk a little bit about what we do here in Novo Holdings we really invest with impact. So we are a very different VC compared to other more traditional VCs and the money that we make is then donated back to science and humanitarian purposes. So I just want to pass that message that you can make money at the same time impact society in this way.

: You guys are doing great things there. So where would the listeners get in touch with you or find out more?

: Sure you can go to our company website. So www.novoholdings.dk or you can also connect with me on LinkedIn or on Twitter @ribas.JC.

: Outstanding. Joao this has been a blast. Really appreciate the time that you spent with us today and truly excited to hear your new podcast then and also keeping up with the cool things that you have going on at Novo. Thanks again.

: Thank you.

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

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Recommended Book:

Living with a SEAL by Jesse Itzler

Best Way to Contact Brandon:

blee@meshcoalition.org

Company Website:

http://www.meshcoalition.org/

Check out this Link:

https://outcomesrocket.health/podcast

Disaster Preparedness Tips for Today's Healthcare Leaders with Brandon Lee, Chief Operations Officer at MESH

Welcome to the outcomes rocket pod cast where we inspire collaborative thinking improved outcomes and business success with today's most successful and inspiring healthcare leaders and influencers. And now your host Saul Marquez.

: And welcome back to the podcast. Today I have the outstanding Brandon Lee. He's a chief operations officer at the MESH Coalition. He's also a nurse practitioner with extensive experience caring for patients in a variety of settings but not limited to Vascular and Thoracic Surgery, wound care, ICU, trauma. At the MESH Coalition, he's the Lead Administrative Officer and provides leadership to the largest Emergency Management Healthcare Coalition in the United States. Outside of this Indiana National Guard, he's doing outstanding things for our country, for our health system and it is a true pleasure to have Brandon on a podcast. Brandon welcome.

: Saul thank you so much.

: Hey my pleasure. Anything that I left out of your intro there that you maybe wanted to fill in?

: You hit all my highlights. I think what's now my profession is father of five wonderful children and actually married.

: That's awesome man. Congratulation. Boys? Girls?

: 4 Boys and one girl.

: Amazing, amazing. Congratulations to you. That's a true blessing. And you and I had a chance to connect at the Health care Think A Ton it was a fun event. We got to chat about some of the cool things that you guys are up to. What do you think is a hot topic that needs to be on every health leaders agenda today and how are you guys approaching it Brandon?

: You know it's interesting. So I'll talk on the MESH side with the MESH Coalition is a disaster preparedness organization Coalition of multiple hospitals in the downtown area. And one of the things that with all of the disasters that happen. Unfortunately tragedies happen every day. Whether it's a natural disaster with a hurricane that we see that happen again all the early disasters shares the stage. So it really is just thinking about how to get involved and try to minimize as much energy as possible. And really that's through preparation and education.

: Very cool. Now the work that you guys do Brandon is it centered around Indianapolis and the surrounding hospitals? Or does it expand from there?

: So it is centered around Indianapolis as of right down Marion County is the county which Indianapolis' house so...

: Okay.

: All our Health care coalition partners right now are there alone. We didn't have a nationally, we actually host the National Health Care Coalition's practice conference once a year. So it is a health care, its a conference for health care coalition across United States. So typically all 50 states in United States are work-centered. Typically at this, there is going to be enormous play in November.

: Very cool. Very cool so your work is focused locally. But you're organizing at the national level to help others deal with disaster preparedness.

: Yes.

: Very cool.

: And actually the unique thing is this unique partnership because actually some of the guys it's from the assistant secretary areas which is called usher. And the one of the main agenda I just decided he has is getting state partnerships and coalitions formed to help disseminate the information in training that needs to happen. So it's going to have a Federal Strategic Plan however it's seated at the grassroots state level.

: I think that's phenomenal that you guys are working on this because you're right. I mean you never know what's going to happen. You have to be prepared and you know when our health system gets the pressure of something that happens with a shooting or with you know be it where your geographical area is you'll have your given problems right. Earthquakes, fires, hurricanes, it's important that you guys are ready. If you're curious about the work that Brandon and his team are up to check out their website go to meshcoalition.org. You'll be able to see that they've got a nice social media feed as well where they post the things that they're up to their calendar. And so you obviously have a varying degree of interest right and you're doing different things man. And what got you into the medical sector to begin with?

: Well I initially thought I grow up wanted to be doing business and I didn't want to worry about other people's money. Mostly it's just the fascination I had after I laid everything out and working with the phenomenal opportunity and career.

: Yeah.

: And from there it just kind of expanded I was also joined at a college, the National Guard and it was a medic. And I think that two kind of helps nearer together. And I could just continued my career of both . So I have continued my education and became an nurse practitioner based on love for helping people and the I think with the nullitary dimes and the view of trying to make things better, faster, quicker is just kind of come around.

: I think that's so wonderful,you've really tied them together quite nicely. And so with the work that you're doing at MESH Coalition or even at the National Guard now, what would you say an example of how one of those organizations has created results by thinking and doing things differently?

: The exception like MESH is essentially thinking outside the box actually get after problems really what MESH stands for some of them are missing saying it's Manage Emergent Search for Health care which basically means how do you avoid what you describe the disaster? How do you avoid individuals from going to the hospital because the very innate nature that people do is like I cut my thumb I want to go to the hospital. I mean in a hospital, if you're in the hospital for too long you'll have the chance to getting sicker than getting better. We're working on that. So therefore what are the things that we want to do to avoid you from getting having to go to the hospital you know whether it's your social needs, fixing social determinants of health. That is an overview. The key inception of measure is actually through along the training that they've inducted that's help health systems come up with these plans to avoid those issues.

: I think it's important. So many people like you're right. I mean your first instinct is to go to the hospital. So who disseminates this information? How does the community get a feel for what to do?

: So it truly is a coalition. I mean one of our main staking Health Care Partners is the Marin County Health Department and with the health departments and actually with our preparedness division under the state's health department and basically they have separates coalition entities throughout the state as well that are there under the direction of state government. We worked with them to help get the information out that training exercises needed for the average person.

: Very cool. I think it's so great. Yes you are partnering with the public health institutions to help disseminate this very important information and some to think about right listeners. I mean we're faced with that disasters. You know here and there. So when you think about how to address this may if you don't have a pathway forward I think this is a good way to start. You take a look at the work that Brandon and his team are up to and find an inroad to a solution for your community. So it's not always smooth when these things come up, Brandon. Can you share with the listeners a time when you guys had a setback and what you learned from that?

: You know I'll just go with the most recent you know sore that we just had...

: Let's hear it.

: Who are a Grant by the Assistant Secretary of the State or a preparedness effort and this Grant was awarded the two pretty much state entities to help regionalized plans for the dash of preparedness

: So their purpose is everyone has which is really in this space you know communication is the key. And it seems like everyone has played those plans on their insides so the primary purpose is of Grant was to actually bring those plans together, make a functional make the communications happen. But it's actually a regional base meaning it's supposed to be a multi-state level and I think what happened was that are we're very competitive application. The assumption is we weren't. We were too nearer because our assets that we could actually work with were all in the entire state of Indiana. And we really needed to incorporate Ohio, Michigan, Illinois, and Kentucky to remain safe. And I think at other time we had a little bit more time than able to do unfortunately and we do that for you.

: Yeah yeah that deadline kind of drove you to just put a close eye on it. How could you have known differently?

: We didn't. Actually there was some feedback that we got was actually great feedback. I mean the whole purpose is to actually take these plans than actually replicate these plans that's the ugly face two of the Grant for like next year or something.

: Okay.

: So we'll get after it then.

: Very cool. I love your resilience and thanks for sharing that. Yeah you definitely don't know and you know I'm a firm believer, Brandon you're either winning or learning. And you guys definitely are doing just that. You've created a nice culture within your own team of that same attitude.

: Yes.

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

: Oh so I am a believer of paying it forward and I think a lot of individuals were you know resources and time into me. So that is probably my base actually that I absolutely love to do it. I, is help others achieve their goals whether to professionally academically. So I'm typically, I have a kind of a mud trail. However we come together will be better when we leave. It maybe playful but it will be better. So I have a personal goal of every soldier that I had basically here you want to plan to actually be better whether that's to achieve you know your academic career, finished college, be a better husband, father, daughter or son and just go with that work simultaneously to actually achieve that result. Because most people ironically that the my physician colleagues and high academic standards it is basically they have the vision of what the end goal is and something that's not taught and being able to help others achieve that vision is the proudest moment that I have.

: That's so great. And I know that there's multiple instances of you doing this with physicians, with soldiers and I think it's so wonderful that you look at the world through that lens, Brandon. I think it's great as you've done this work and you've helped others achieve their goals. You know it's led you to where you're at today and the wonderful work that you're doing. What's an exciting project that you're working on today?

: I guess one of the things that we're happy at MESH is so there are there's different levels of preparedness and you know most entities. Sometimes you have to comply with certain things and hospitals and large students have been in compliance and they've done that over time because it's mandate. Well few years ago the mandates changed to post acute areas such as nursing homes, rehab centers, and dialysis centers, and hospitals. And actually we worked on a program to do exercises so that they can should be compliant and learn that preparedness. So we're talking about earlier with you know bringing those planes together what we have. Sometimes we know that they have plans or they don't have plans yet. So we help implement those plans. Teach them formulate those plans and their ancillary so that's the fun project we had going on right here in MESH.

: That's pretty awesome. That transition from just a cute centers to the ancillary services. So you know you work on a lot of cool things Brandon, what keeps you up at night?

: Ooh the thing that's missed. Meaning that unfortunately bad things happen and we we've learned retrospectively.

: Yes.

: And it's those things what we can avoid to mitigate those things. That's basically it is just going to be casual. That is, it can get scarier you know just very superficial. But the more you think about health environment not to be a worrier. So if it does keep me up at night it's probably pretty serious.

: And that's why I asked you that Brandon because I'm like you know this guy worked with some pretty cool stuff. You're doing some amazing work for Disaster Preparedness Summit. What really does keep you up at night? And it's just really kind of staying ahead, going with where the puck is going on and some of these disasters and potential threatening situations it sounds like.

: Yup.

: Very cool. Getting to the end here Brandon, this has been a really fun time with you. I'd love if we do a little pretend here we're going to build the medical leadership course and what it takes to be successful in health care, the disaster preparedness piece. It's the one on one of Brandon Lee and so we're going to build a syllabus lightning round style four questions followed by a book. You ready?

: Okay.

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

: Listen to patients.

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

: Not listening to patients.

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

: Ooh that's a good one. Always thinking outside the box. once you do a couple of times that the status quo but the how do you make it better?

: Love it.

: Optimization.

: Love it.

: What's one area focus that drives everything in your organization?

: The want to help. Being a part of mankind and just wanting to help me you notice when there are disasters. All the great phenomenal stories that it seems from the Red Cross, in the news. in hospital and just being part of mankind where nothing else matters except helping your fellowmen.

: Love that Brandon. So great. What book would you recommend as part of the syllabus?

: Ooh. So this is a little crazy.

: Let's hear it.

: Books I've recently you know the traditional leadership book that I could actually say but i think Living With a SEAL by Jesse Itzler. Completely different aspect of what it is if you never heard of David Groggins.

: Okay. No.

: David Groggins is a Navy SEAL who is just insane. .

: Literally?

: Yeah true I mean literally truly insane. He was a obviously for being one of the hardest professions Navy SEAL. But also the first Navy SEAL in Army Ranger and also in the Air Force Tactical Unit as well.

: Wow.

: But one of the things that just put him on the market map was he was an individual who to help out his fellow man. Basically there were Navy SEALs who were killed and he started a foundation. In order to build the foundation he thought well "I'm start with ultramarathons so...

: Jeez.

: A week before he had this idea. He basically signed up for ultramarathons and literally run with no preparation whatsoever ever trainee, never did a marathon, did a hundred miles.

: Oh my God. That's amazing.

: So that's...

: The thing insane is the word.

: He's crazy. What happened was Jesse Itzler who was a entrepreneur business person who is, he's always reinventing how can it be better, actually at a race he reengage gallons and basically said "Hey would you come live with me?"

: Oh my gosh.

: So for 30 days.

: Oh my gosh that's so crazy.

: We think it's crazy but it's amazing.

: Wow. Wow. And it's called Living with a SEAL.

: Yes.

: Outstanding. What a great recommendation. I feel my adrenaline pumping here Brandon. So thank you. And I'm sure you listeners are feeling it too. All these awesome recommendations can be found on our website. But in particular go to the show notes for this episode with Brandon Lee. It's at outcomesrocket.health/mesh and you'll be able to find all that there including a transcript and links to all the things we've talked about. Brandon this has been a ton of fun. You leave us with continuing to want to help our fellow man and continue doing the great work that's being done in health care. I love if you could just share a closing thought and then the best place for the listeners can get in touch with you.

: Okay. Closing thought is you know everyone keep doing the great things you're doing in health care. Some of the previous people you saw are meeting in relation to changing health care. So just keep up the great work. And how do you get a hold of me as if anyone needs to as mine as Brandon Lee my initials are blee@meshcoalition.org we'll be happy to answer any questions or chat with you.

: Outstanding Brandon. Hey this has been a ton of fun. Thank you so much for your unique perspective. And we're excited to stay in touch with you.

: Absolutely Saul for just chat again soon.

Thanks for listening to the outcomes Rocket podcast. Be sure to visit us on the web at www.outcomesrocket.com for the show notes, resources, inspiration, and so much more.

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Using Real World Evidence to Accelerate Development and Impact of Treatments with Jeremy Rassen, Co-Founder, President and Chief Scientific Officer at Aetion, Inc.

Recommended Books:

The Book of Why by Judea Pearl

Born A Crime by Trevor Noah

Best Way to Contact Jeremy:

Linkedin

Twitter

Company Website:

https://www.aetion.com/

Check out this Link:

https://outcomesrocket.health/podcast

Using Real World Evidence to Accelerate Development and Impact of Treatments with Jeremy Rassen, Co-Founder, President and Chief Scientific Officer at Aetion, 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.

: And welcome back. It's a pleasure to have you all back on the podcast today. I have Jeremy Rassen. He's a Co-Founder, President and Chief Scientific Officer at Aetion. Jeremy is an Epidemiologist and Computer Scientist with 20 years of experience in the Science and Technology of Big Data. It's this awesome combination that helped them put together the resources and plan for the work that they do there. He was an Assistant Professor of Medicine at Harvard Medical School where he developed cutting edge methods for developing quality evidence using real world data. Prior to that Jeremy spent a decade in Silicon Valley. He was the fifth employee at Epiphany Incorporated where he was involved in the creation sale and deployment of data intensive applications for marketing and customer relationship management. There's no doubt that the shift that we're having in health care is going away from the typical Hey devices life sciences approach. It's all about what you could do with data to improve outcomes and so it's such a pleasure to have Jeremy on the podcast today to share his insights in this space. Welcome.

: Thank you.

: It's a pleasure to have you Jeremy. Anything that I left out in that intro that you want to share with the listeners?

: No I think that was pretty comprehensive.

: Awesome. Well listen there's no doubt that paths lead into health care and a lot of different reasons a lot of different ways. But what was the way that you got that into health care?

: You know I think in your intro you almost had it as you mentioned at the beginning of my career I spent about 10 years on Silicon Valley working on big data applications I was computer science undergrad went back to where I'm from which is a San Francisco area after school and got engaged in all the tech that was going on there in the mid to late 90's and really adored the technology, I really enjoyed the technology of using data sets to find these interesting associations to find even interesting causal facts. I wanted to apply that in a way that was different than what I was doing out there which was large as you said in marketing and customer relationship management. So transitioned to health care and my first step there was getting a doctorate in Epidemiology at the Harvard School of Public Health. And if you think about public health my parents I grew up in San Francisco they said their father is an internist in San Francisco. My mother ran a large social service organization. So if you average out the two you kind of get public health. So going to school, public health and getting degree in epidemiology felt like a return home in memories but also return home in the sense of being able to take the kind of questions you were asking of the data and apply them to a whole new field that is to say effectiveness safety and value of medications.

: I think it's so fascinating Jeremy and it's really interesting how you sort of dovetailed all that into the public health and and with your background in Computer Science. I think now is the time and everybody is talking about value-based care. What do you do? How do you do it? What does it mean? And so I love that you and your team are are working to quantify and really find a way to scale these things that are essential to our business and for our patients.

: You don't have to say that was one of the first things I've worked on in Boston and identifying named Sebastian. Sebastian had spent the prior 10, 15, 20 years thinking about how to use the data sets that came to be as part of the running of the health care system claims medical records and other data to really evaluate safety effectiveness and value in particular out of medications. And he'd been thinking about that in a very structured epidemiologic academic way. I've been thinking a lot about data and really from that from the first moment we put our hands together and said how can we take that really strong causal thinking that's developed in the field of epidemiology and put that to work at scale which is the big part of it. Put that to work at scale for answering these questions of value that we all have.

: Super interesting. So you're taking a look at this data and you're trying to figure out how to make the best impact and health care. What would you say today is the big hot topic that needs to be on all the health leaders agendas today and how are you guys at Aetion addressing it?

: It comes back to value for me. I think the inside the healthcare field at this point and talking to friends and colleagues who are outside the health care field gets pretty clear that the rising costs aren't good for patients they aren't good for the health care system and you know ultimately they have to be unsustainable. So thinking about how to spend money in a way that improves patient outcomes it also sustains the system. As a hot topic in our wrap up and call that call it value.

: It's really important to look at this and some curious how are you guys looking at value and how are you helping health systems look and measure value. I think this is a thing that a lot of people struggle with.

: Yeah we really look at values starting with decision. There's a thousand decisions made. You know every moment in health care as a scientist I have to be careful with numbers but a lot of decisions being made. Every moment in health care and those can be small decisions at a clinical and for one patient large decisions happening at payers or for pharma companies or other places affecting many many patients and I think the vast majority of the decisions are being made today or done either with intuition rather than evidence or with evidence that isn't really pertinent to the patients and that decision will affect. And so I think a lot of what we do is intuitive. We have the data and now, we have the information now to do this based on evidence to make these decisions based on evidence and not just any evidence. I think there's a lot of evidence out there. Our's a randomized trial year. That's a very high quality but doesn't necessarily describe the patients that we're treating at any given moment. It could be that the trial was done in a particular part of the country or in particular patients subsegment with a particular set of comorbidities. We need evidence that supports decision making for all patients and for patients in particular who were treating in any given moment.

: So Jeremy that's really interesting and I think it's important that we start looking at that I mean I think of let's keep it simple right like cable. If your cable company doesn't deliver what you believe is a good internet speed. Guess what you're going to cut them out in the same way as kind of happening here in health care. You know rising health care premiums have got rising co pays. So now you go to your grocery store and you've got this like Smart MRI place. Now they're actually giving you options. You're going to pay less for it. Value is something that we need to deliver. Can you give the listeners an example of how your company has helped organizations create results through this value perspective?

: You know absolutely and you know I'm thinking about the MRI exam.

: Yeah.

: That might be incredibly important for the treatment. One group of patients but much less important and perhaps even an important to remain powerful for another group of patients. There is certainly a cost of a certain kind of cost for patients with her procedure that he or she doesn't need. So that's in some ways the context that I think about value in. And so you know one example that we've engaged with here at Aetion is working with a pair here in the Northeast where they had a pretty general question and that question was, helped us better care for our diabetes population. Diabetes population at this pair large and growing and growing in terms of the disease itself the diabetes itself but also all that comorbidities that go along with diabetes and all the utilization and cost that ensue from the diabetes and comorbidities. And so those were the pretty big question. Now help us better manage her diabetes population and for us managing rather answering a question like that starts with really understanding who the patients are. Who is this population? And so to do that you want to break down the population using the data for the pair because that's representing ultimately the patients that they're caring for not national data not a randomized trial that 70 Ram payers data and really digging into those data to understand who the patients are? What kind of treatments they're currently experiencing? What kind of outcomes occur and how we could possibly change those outcomes or some or all patients? So with this particular payer we help them break down their diabetes population and show that it really wasn't monolithic in any way. They certainly knew that but described the ways in which it wasn't monolithic and in particular there was about 10% of the diabetes patients who were particularly severe particularly high risk and high risk both of a progression of diabetes but also these comorbidities type which I mentioned before. So as I said that's 10%. That's a relatively small number. But those 10% were being treated to guidelines and the way the other 90% work. And the guidelines say you start with the first line therapy that doesn't work. You move on to kind of something in the middle between first and second continue with second line therapy. And what we showed was having identified these 10% of patients if they're treated directly with the second line therapies which are more expensive they cost more but that cost is over the ensuing months represented much better outcomes for the patient and much fewer E.R. visits and hospitalizations, another kind of high cost services for the payer. So that's not everybody, that's one in ten. But if you think about how to treat the one in ten differently than the nine in ten, you end up with amazing results both for the patient and for the system itself.

: So yeah that's really neat Jeremy. And the interesting part. You know a lot like it's sort of a microcosm of the health care environment that we're in. Most of the spend goes the 5% of the issues that are out there. And the nice thing that your company is providing sounds like you're giving these people not a representation of the U.S. but a true analysis of their population.

: Absolutely. Every entity within health care has a certain group patients for whom they were responsible. A payer population, health systems, patients that they're treating. In this as you can get closer and closer to really looking at how to improve outcomes within that specific population under treatment, I think we can do better and better.

: Yeah and a lot of times we think of value-based care. Your mind and you know through conversations you typically go to like. All right. What value are you providing patients? And I think another way we should be thinking about it Jeremy and appreciate you for taking this up is what value are you providing to providers and helping them identify the best treatment for patients. As a payer for instance you're collaborating with the other stakeholders in health care. Value-based care is all about collaboration between all the stakeholders.

: Absolutely. And we see that as a very core part of what we do which is to help bring these stakeholders together on a shared and transparent and well understood evidence base that's pertinent to the patients being treated pertinent to the population is being cared for and to do that we need. Good data.

: And you know over the last 20 years I would say there's been a huge advance in a methodological basis for real world data analysis to real world evidence and say in 20 years that we are looking at randomized trials as not just a gold standard perhaps the only way of really getting at these important questions of just drug A work better for drug B among patients with very severe diabetes and substantial comorbidities. A randomized trial 20 years ago may have been seen as the only way to answer a question like that. Today we have the epidemiologic basis and scientists are sorry for going into the...

: That's all good.

: In methodologic basis for really doing that either with a randomized trial or with the data that's already generated as part of the health care system the real world data and I think that's the extraordinary evolution over the last 20 years that really gives us the opportunity to measure value and deliver value in real time. And for the patients who were being treated as I mentioned and I think that's extraordinary evolution of the last 20 years in our company Aetion in the software that we create as a platform for taking all of those developments over the last 20 years and putting them into software that can be deployed quickly and at the right points in the health care system to make these really important decisions that everybody through the system needs to make to make those decisions fully evidence-based at the highest level of quality.

: Love that love that sounds like it's a phenomenal tool. Folks if you haven't had a chance check out Jeremy's team and all the things that they're doing at aetion.com. You'll find all the software solutions they offer there as well as the team of outstanding contributors that they work with there. So things don't always work out Jeremy sometimes we hit brick walls especially in entrepreneurship and health care. So we learn more from those moments. So I want to ask you. Give us an example of a time when you had a setback and what you learned from that setback?

: Yeah I mean so we founded the company, Sebastian Schneeweiss, and I about five years ago and that's give us ample opportunity to as we go along. I'll say that there are a lot of things that that you know really came together over those first years and one of the first things that Sebastian did was to go and find just top top top down tech team to build out this software platform and we need to be able to do this fast and be able to do this scale. We need to do this on time. These are all things that you really need a top tech team to create. I think at the beginning of the outset, at the beginning we thought that our customers would have all the questions available and ready to go. And just you know we're needing software to input all those questions into you get the answers and what we learned over the ensuing years was that sometimes in fact even a lot of the time those questions were available but sometimes the questions were broader like I'm launching a new drug and I want to get ahead of any potential concerns that FDA might have about safety. How do I develop an evidentiary base around the safety of my medication or even something that was even a little broader like helped me understand my diabetes population. And so I think one of the things we've learned over the years is that the software and our interactions with our customers have to really start with all levels of questions and that we can really as an organization engage in these issues. And at any place in our customers thinking and that is something that we really learned over the last couple of years.

: And you know it's interesting because you often think like "hey you know we dive into some of these challenges that our customers have. And you imagine that the questions are already there but oftentimes as somebody coming in from the outside that's where we could offer the most value." Right. Just like seeing it from the outside and helping them formulate those questions.

: Yeah that's really interesting. You know I think coming from the outside or even coming from you know kind of just from the outside just outside right.

: Yeah.

: You can see a little bit how a pattern of thinking can lead to a series of specific questions and that's something that we can really help our customers with and something that we do you know at this point.

: I think that's so cool. You know one of the things that happens a lot with me Jeremy is kind of like a long long lines what you just discussed is you know I interview a lot of awesome folks like yourself doing outstanding things in health care. Now reach out to me and just say hey you know what are you saying and just kind of being off on that not even I outside like let's just call it sidelines right. You're still very involved. You could really help clients have that unique perspective that they need to make those breakthroughs.

: Yeah I mean the answering these millions have problems in health care. You know how do we find optimal value for patients in the system? How do we you know really get these underlying questions involves first with exactly that stating the right question. And you know I was reading a book by Judea Pearl which I highly recommended called The Book of Why, where Dr. Pearl is a one of the true pioneers in causal thinking.

: Okay.

: Helping to break down the problem and express it in a way that is truly causal. Meaning not just if I switch a drug A versus B which is going to be better for patient BUT really identifying which patients you're talking about and what that switch will mean and really can what the alternative would be to treating with standard of care and that kind of causal thinking is really needed because at the end of it if you're talking about a decision that's going to change health care or change health outcomes or improve outcomes for patients, you need to be thinking causally. You need to be thinking about "What can I change that's really going to make an impact on the patient or on the system?" So framing questions in a causal way is something that I as epidemiologist think about as a really important first step in this book by Pearl, I think talks very nicely about how to think about questions of framed causally.

: Love that. What a great recommendation there one that I'll definitely add to the list Jeremy thank you for that. Let's look at the other side of this this question right. You took us to sort of a set back and what you learned from that which is super valuable. How about one of your proudest medical leadership experiences that you've had to date?

: Well you know just as five years has given us quite a bit of time to experience the first part of that we've also had I would say a number of really proud experiences our company has as mentioned is five years old started with three people in a little office here in New York City. And we've grown now to mull over 100 where you're in York City up in Boston on the west coast and all over the country.

: Amazing. Congratulations.

: Thank you. And really the company has grown and as the company has grown the needs of the company have changed quite a bit. So one of my personal proudest moments was working to recruit Carolyn Magill, she's our CEO. She joined us a little more than a year ago and she had just this phenomenal experience growing startups and working in the payer sector and really just a deep deep understanding over her years experience of how the health care system works and the dynamics of the system. And that really complemented an important way how we've been thinking about decision making and causality and the science and the software to support all of those questions and decisions. And so you know thinking about promised the leadership experiences. I think bringing Carolyn to our organization and being part of that is something that I'm deeply proud of and has been you know incredibly successful push for our organization as well.

: That's awesome. Well Carolyn shout out to you and Jeremy nice work on recruiting her. It's tough to get the right team put together. I'm a firm believer of hire quickly but fire slow. Well it's actually the other way around right. Fire quickly hire slowly because it's hard to find the right people.

: It really is. And one of the things I really enjoy my organization is how deeply engaged in the thought that's required to really bring powerful solutions to the health care field and that's something that at all levels from literally all levels of their organization leadership there should be really thoughtfully engaging at all times and Carolyn and the leadership team that she's assembled as and she joined a little more than a year ago. I think really represents at where we are for it.

: That's awesome. Congratulations. So Jeremy tell me about an exciting project or focus that you're working on today.

: Well we talked a little bit about randomized controlled trials, RCT's and talked a little bit about real-world data. And so the sister concept abroad evidence that the DNRWE to use the lingo. For me one of the most exciting projects working on is looking at how the methodological developments over the last 20 years that I mentioned, real data in real-wprld evidence have gained ability to really support causal decision making whereas in randomized trials were kind of the big game in town perhaps the only game 20 years back. I think one of the most exciting projects we're working on is looking at how real-world data can support a regulatory decision-making. So we were selected by FDA working in conjunction with Brigham and Women's Hospital and Harvard Medical School in Boston to kind of replay history a little bit to take 30 trials that the FDA had used for decision making said 23 leading to a positive decision and seven into a negative decision and to replay history and to see if we can use real-world data. The data, it's part of the health care system data that's available at the same time that those trials were being run with real world data analysis have led to the same decision that the randomized trial ultimately led to randomized trials. As I mentioned a gold standard in causal thinking and also very expensive limited to small patients, limited to very likely among representative group of patients, older patients, patients with extensive comorbidities, lastly under represented broadly speaking in randomized trials. Could we come to the same conclusion using old data. So that's a project that's on going...

: Fascinating.

: With FDA and we're also working with regulators around the world on some more kinds of projects. And to me this lets us get to the place of really applying real-world data and all the instances where we can apply it and I want to be clear that's not every instance not every question answered by a randomized trial could potentially be answered with real-world data but in those instances where we could make that switch, let's have the evidentiary base for making that switch and let's do it because that lets us get at really key really important answers all that much faster at much lower cost. Again sort of this idea of value and the health care system and really lets us affect positive outcomes for patients as quickly as we can.

: I love your conviction Jeremy and it sounds like there's some really great groundwork happening here. It's even, take a look at causal versus randomized controls methods to do things within our space. I think that's a very important work that you guys are up to.

: And as a scientist I'll say it's thrilling work. I, it's truly thrilling work as well which is awesome.

: Fantastic. And the cool part about it all is that on the back end of it this thrilling work actually impacts patient lives and there's nothing more thrilling than that.

: Undoubtedly so and being able to do that at scale I mean being able to put it into stuff that really leads to that quality decision making and health care system access to place it's really really thinking very carefully about high quality patient outcomes and value.

: That's awesome. I totally agree with you. And we're getting close to the end here Jeremy this is the final part of the podcast. You and I are going to build a medical leadership course and what it takes to be successful in the business of health care. It's a one to one of Dr. Jeremy Rassen. And so we're going to write out a syllabus. I've got four questions lightning round now for you followed by a book that you recommend to the listeners. You ready?

: I am ready.

: Okay here we go. What's the best way to improve health care outcomes?

: So for me this course is about data-driven decision making and health care and for need and the best way to improve health care outcomes is to start by really really carefully measuring and understand health care outcomes. I think only by measuring and understanding health care outcomes can we really improve them and really prove that we have improved them.

: And is that second part that I feel like is often missed. It's like sure measure them but understand them. I love that you just throw in the understands there because it really takes it to that next level that you really need to improve outcomes.

: And you know somewhere in the you know later later courses here , the later lectures of our course. I think you get a lecture on applying what you learn and really looking to take what you learned and turn it back into that next cycle.

: Love that. So what's the biggest mistake or pitfall to avoid?

: So I think through our conversation we talk a lot about causality. For me the biggest mistake to avoid is to confuse an association that we see in health care with something that's causal something that if you made a change it would truly affect that patient. You see it over and over and over again. And to me that's the biggest mistake and also perhaps the most probable mistake.

: How do you stay relevant despite constant change?

: As an organization, you know ultimately we're answering questions alongside our customers that improve health for patients and so you know relevance in that case is making sure that we're thinking about the questions and have methodologies ready to answer the questions that most relevant for patients. As time goes from today to tomorrow to many many years from now.

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

: It's the seriousness of our mission. I think every single one of my colleagues here understands that the insights that we're unlocking are ultimately about patient health and that requires real seriousness of mission and of purpose. And I think I tried everything to do.

: Beautiful. And what would you recommend as part of the syllabus Jeremy?

: Well I guess part of the syllabus I've to say The Book of Why by Judea Pearl, which we talked...

: Talked about it earlier. Yup.

: If you ask me what book in general would I recommended maybe it's hard to look...

: Let's hear the extracurricular read listeners.

: The extracurricular read let's say I've just been really really enjoying the Trevor Noah audiobook, Born A Crime. I know this is in podcasts circles because I shouldn't say that this was one of my first audio book spoken word iPhone.

: Hey you took the jump though and that's what matters.

: It's linked the spoken word experiences. And I just thoroughly enjoyed it. His perspective is fascinating just the way he tells the story as he reads his own story. It's just phenomenal. "I couldn't recommend it more.

: Outstanding. There you have it listeners, check out all the things that we discuss. The transcript, links to those books, links to Aetion, just go to outcomesrocket.health/aetion and the website for Aetion is aetion.com. So make sure you check that out. Everything is right there for you easy to access. Jeremy this has been fun. I really have enjoyed our conversation.

: Likewise.

: Before we conclude I 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 best place for listeners to follow us is a Linkedin or Twitter or pretty much either. Closing thought, it goes back to the beginning. Ultimately as a field, we need to be thinking very deeply about value. And as we think deeply about value we you make really important decisions for the patients were entrusted, to care for. And so for me those decisions need based on quality evidence, that's pertinent, that's there, that's timely, and that's how we best serve.

: Outstanding Jeremy. Now for sure you guys are leading the way in a very important way. So keep up the awesome work one of the things that I think about Jeremy when I just kind of think about the lessons that you've shared is that we tend to overestimate what we could do in one year but severely underestimate what we could do in two or three decades. And I think the impact of that it's going to be huge. It's going to be huge. I love what you guys are doing so keep up your amazing work. Thanks for carving out time for us today.

: Thank you so much for the opportunity. We're, we 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 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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Recommended Book:

Great by Choice

Best Way to Contact Ryan:

Linkedin - Ryan D'Arcy

Twitter - @RcnDarcy

Mentioned Link:

https://healthtechconnex.com/

Check out this Link:

https://outcomesrocket.health/podcast

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

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

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.

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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

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.

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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