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Assessing the Impacts of Social Determinants on Population Health with Rob Fields, SVP, Chief Medical Officer Population Health at Mount Sinai Health System

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Assessing the Impacts of Social Determinants on Population Health with Rob Fields, SVP, Chief Medical Officer Population Health at Mount Sinai Health System

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 Saul here with a special guest. His name is Dr Rob Fields. He's Senior Vice President, Chief Medical Officer Population Health at Mt. Sinai Health System. He is really doing some fascinating work. His career began by opening a new practice at a residency focusing on using technology for quality improvement and serving the Latino population in western North Carolina. The practice was the first to use a patient portal on the first to achieve PCMH Level 3 in 2010 which is huge. In 2012, he spent a year teaching at a community health and family medicine residency at the University of Florida. He was recruited to come back to Asheville as the assistant medical director for primary care at Mission Medical Associates. As the ACO planning began in 2013, Mr. Fields but the quality steering committee and helped the initial planning of what was to become Mission Health Partners. He's done a lot for that community but also across his experience in health care to improve outcomes and it's a pleasure to have him here on the podcast with us to discuss what's on top of his mind. So Rob pleasure to have you on the podcast today.

Thanks for having me Saul.

It is a pleasure. So what is it that got you into the medical sector Rob?

Yeah I mean honestly my older brother. I have a brother who's 10 years older and at one point had wanted to go into medicine and that's how the idea first got in my head and then had some experiences in high school and volunteering and kind of got a sense that I was pretty sure I wanted to do primary care even then just kind of solidified you know you go through undergraduate have different thoughts but really always came back to medicine as something that was really met all my needs that need for a service and a need for to be renewed my love of science and relationships and all that. So it is a thing to combine all the things I love. And it's been great, been a great career.

That's outstanding man. Yeah it's such such a great place to get all those wonderful things man and also help people in the process. And so as you've worked your your feel for technology as well as you know caring for patients. Tell us what a hot topic you believe needs to be on health care leaders' minds and how are you guys at Mt. Sinai taking care of that today?

Yeah. World is changing pretty dramatically. I mean I think one of the things I've learned over the last 10 years or so both actually starting with my journey and private practice all the way to working on system kinds of problems and in particular here in New York City is that the world is changing such that really the economics are changing though. Our systems, our government, our society, is running out of money to take to really handle health care and the way we've always done it. We need to think differently about how to do it in a particular way in a market like New York City where we have a lot of competition a lot of high branded internationally renowned institutions or really focused on on specialty care and the way the systems have always operated is really about trying to be come up with the newest and greatest thing that is actually a back to basics philosophy that the systems really need to adapt by going back to the basics of relationship-based care. Building Primary Care base is managing population trying to reduce cost and utilization in the hospital in many ways sort of the antithesis of the things that they were built to do. But I think all healthcare leaders that are looking at the way the finances are working around that and healthcare economics and seeing the writing on the wall or are trying to figure that out. How do you change our systems from delivering the kind of care they've been delivering to something that really goes back to and I think the basics of population health which are the basics of medicine, a strong primary care, strong relationships with patient and trying to positively affect behavior to get better outcomes.

Yeah now that's such a great point Rob and there's definitely a lot of heavy lifting that's happening right now and has turned to more value based care and I love to hear some of your thoughts and what you guys are up to over there at Sinai. And just to help improve outcomes and do things differently.

Yeah there are a couple of things or several things but maybe it's the basis you have to change the economics of the health system and the financing of the health system in order to change the operations right. So you can't disconnect the two so much that you try to change your operations in a vacuum. You have to be able to do your contracting and change your contracting to support the kinds of things that you want to do. So we have entered into value-based agreements with all of our payers in some capacity all the way from full arrest to just pay for performance and everything in between. So I think that's one thing that we started doing several years ago and the second is of course is establishing the right leadership and start to address the cultural issues within the institution to kind of move us towards value. But I think more concretely there are a couple of things. One is really working on primary care redesign. So if we agree that the foundations of Population Health are really about empowered primary care that provides the appropriate foundation then it can't be the primary care of the lot, 15 to 20 years. I think that led us to physician burnout, it led us to relatively low number of medical students deciding to do primary care. It just needs to change, we needed to improve or empower our workforce. We need to support them a lot more in a star building team based care infrastructure. So we've done that you're kind of starting to introduce the concept of integrated care with behavioral medicine with social work with clinical pharmacy. So we're starting on that process now for rebuilding primary care in redefining primary care. And then the other big thing among all the things we're working on that is really important is how we use our information systems and data and analytics to really fuel our operations and top health both in terms of measurement of operations and quality and efficiency but also prediction. Now how do we use all sorts of data to start to predict who is likely to have a better outcome and start to define our population. The idea being given in limited resources and in a place like Sinai your population is potentially infinite right you have people traveling from all over the place to come here. We don't have enough resources to cope to really deal with an infinite population. We need to use data and analytics to help define our population a little more discreetly and then organize our operations around that. So I think primary design and data and analytics have been bought by our two biggest investment.

Love that and that super clear focus on these two metrics and feel like is the key to to really drive some great results and maybe along the journey, you guys saw some some setbacks and some learnings. I feel like we learn more from those than than the successes. Definitely want to dive into the successes here by one hour before we get to those learn from maybe one of the setbacks that you and your team had and what you learned from it.

Sure. Yeah I'm in I'm still relatively new to Sinai but I think some of the challenges here are not unique to either their troop or other large health system. I think population health is soon to be in vogue thing right. Every system says we need to do pop health that are quote not really understanding what that is and often start on the same journey of trying to build primary care. I think where it gets a little law is really undervaluing the what we call the less discrete part. So what part makes primary care so impactful. So I think there's a general under appreciation for how important those relationships are to improving outcome. And we know that patients generally do better. They utilize less, they have better outcomes if they have a consistent and reliable relationship with a primary care physician and that isn't often reflected on profit loss statements or balance sheet. So a primary care practice so our primary care division which for most systems often loses money. I think there is a lot of other value there especially when we talk about you know population health model that has to do with having a reliable place for a sick patient to become someone that knows the patient, that knows their social contacts, that can have meaningful conversations that are not just a singular conversation but an accumulation of conversations over years in that relationship that is incredibly impactful but it doesn't generate our views. So I think our mistakes as a system have often had to do with resourcing decisions in primary care that are based on balance sheet and not about the overall value. What primary care brand. That's easy to do. I mean when you think about a division that might be losing money out of balance sheet then decide well we can't afford to resource it differently or build team based care model. I would argue you really can't afford not to, given the new economy and and it's beyond the balance sheet. I think that's a pretty common mistake across systems but I think that I've had experience with.

Wow that's so insightful and those are the tough calls that visionary CMO and CEOs leadership teams and general ad provider institutions need to be thinking about. You're definitely thinking about these things and I think it's key for others to really start sharing into that vision of hey you know it may not make sense on the balance sheet right now but if we take a look at the impact overall, what we could get out of this for patients and just the system that the health care that we're providing could be big. What would you say has been one of the proudest medical leadership experiences you've had to date?

From a personal standpoint who's actually maybe for the Sinai and even before a mission. I spent a year as you mentioned at the University of Florida teaching in the family medicine residency program and are my personal proudest moment as a leader was getting faculty of the year there and teaching residents about these kinds of topics and transformation and just having that connection with people. And I was only there for a year and it was a really powerful experience for me in terms of having those kinds of relations so I think that's certainly one of my proudest. I think certainly that I think in terms of pop health my proudest moment was being in my previous organization. When we we first were able to generate shared savings in our model. And I say that because it was somewhat of an untested model. We worked not exclusively but quite a bit on Social Determinants as the core of our operations and how we dealt with poor management of health. And I think we had uninvolved nationally with a CEOs and there are a lot of people that those that don't really believe that a social determinant model is really the way to go in managing populations. And so there were some naysayers out there and we were able to generate significant savings despite some significant headwind and that was certainly a proud moment for me that our model tested true and has delivered a result. And we're working towards the same things here at Sinai and I'm excited to be a part of it.

That's awesome. Well you know what, success definitely leaves a trail and I'm excited to see apply some of the things that have already worked for you and your previous teams to what you do at Sinai. Rob there's no doubt in my mind that you're going to succeed. So as you work to unravel some of the things that you've got going on what's an exciting project that maybe you want to share with the listeners?

Sure. Yeah. In taking on some of the social determinants work here at Sinai that the thing is I'm really excited about our how to use the data sources we have and use things like machine learning for example to be able to describe our populations differently and so we're able to now using our one of our analytics partners able to predict with a reasonable degree of certainty who in our population is likely to end up in the hospital unnecessarily in the next 30 days before. And so whereas most analytics talk about readmissions predictors and other types of I think more common metrics and predict use other common uses of predictive analytics. We're trying to think more upstream and predict the next unplanned admission to really try to have a more meaningful impact on patients and not only do we are we able to do that but we're able to do that with a little bit of information on these patients regarding their social determinants so we can actually tell based on more I would say less typical data sources. So like purchased data you know using big data to help provide social context for these patients so not only can we say hey they're likely to end up in the hospital in the next 30 days but they're likely to end up in the hospital and also have an issue with housing or transportation or finance. And that way our social workers and our nurses that are trying to manage the population have a greater degree of insight even before talking with the patient and can most appropriately helped them by closing those social determinants gaps. So it's really sort of an empowered approach to care management and proactive upstream thinking in terms of care management that I'm pretty excited about. Not to mention the opportunity to partner with our nonprofit than New York City to be able to really help close those gaps in a meaningful way.

Wow that's super exciting and yeah you know I had a guest who was about a year ago actually and he was talking about you know he had as part of his portfolio a Socio Determinants of Health test and the patient would take it on the tablet when they got to the doctor's office or the E.R. and based off of that it would give the care team an understanding of where they sat, what the risks were. And this is more like just a piece of the entire vision of what you're painting. But it seems like it's at its core I think like a lot of times it's tough for people to envision these things that you know you're just laying out for us. But the power behind what a system like this can do is pretty big for the health of people and for the way that hospitals manage populations. If if somebody's listening to this what Rob is saying is if it's resonating with you, Rob what would be the best way for them to get in touch with you to to start a conversation.

Probably by e-mail my e-mail's that's probably the best way to start a conversation or to have a conversation about what we're working on. I remember working with somebody that worked with vulnerable populations back in Asheville who is credited with the quote that went something like You know it's hard to take care of your diabetes if you're living in a tent. And that to me is probably as concrete as it comes because you're right. I mean I think data and analytics and predictive analytics is kind of out there and some people get it and some people don't. But I think that line can easily resonate and whereas healthcare, I can write a million prescription. And that's what I'm trained to do. Somebody has diabetes it's done under control. I can write a thousand prescriptions for insulins or for other medications all day long and have zero impact because I've done nothing actually deal with the priorities that the patient has and just surviving the day. And I think ultimately when I think about what that the core pop health is trying to deal with those basic life needs that you have to deal with, otherwise you don't get to the right outcome and it just so happens that the way the financing of healthcare is changing that's more possible today than it might have been 10 years ago in the first purely fee for service environment.

That's a great way to put it. Rob and and definitely resonates with me. And folks if you need to rewind us in here again it's definitely one that I'll be rewinding and listening to again because Rob's definitely given us some great insight into population health and the things that matter and the promise that we're about to see around the corner with the changes in the economic infrastructure and health care. Getting close to the end here Rob, let's pretend that you and I are building a medical leadership course. And what it takes to be successful in healthcare. The one on one of Dr. Rob Fields. And so we're going to design a syllabus for questions lightning round style followed by a book that you recommend to the listeners. You ready?

I'm ready.

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

Always keep the results in mind.

What is the biggest mistake or pitfall to avoid?

Don't substitute a process for a result. I think we go a good job of creating processes. But again we lose sight of the result that we're intending.

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

Keep your, be true to your mission. Always. I think it starts there.

What is one area of focus that drives your organization?

I would say culture and I think this should be true of all organizations. Think you've got to get the culture right and that should drive everything else to do.

What's your all time favorite book that you'd like to recommend to the listeners on the syllabus?

Oh man. Lots of great books but I'm going to kind of stick to the basics and I'll recommend The Little Prince. I think there are a lot of truths about life in that children's book.


I think hold true to that today and I credit my older brother for introduce me to that too.

That's awesome. Kudos to you older bro. And yet you know I've listen, I've heard that recommendation once before so now Rob with your recommendation it's definitely climbed up on my must read list so appreciate you for sharing that. And that listeners, you want to get a hold of this syllabus that we just crafted for you along with a transcript of our interview, just go to as in Rob Fields and you'll find it there. Before we conclude I love Rob if you could just share your closing thoughts. And then the best place where the listeners could follow you or learn more about your work.

Sure. Maybe a closing thought is that the thing I'm most excited about in the new economy is that it turns out that doing the right thing by patients turns out to be the least expensive way to provide care. And then when those things align I think good things can happen. I'm excited there and again probably the best way to get me is via email. and we also have our own podcast that we Mount Sinai partners, Apple podcasts, and Google podcasts as well. That's helpful.

Outstanding. We'll definitely have to check that out Rob and we'll provide a link to the podcast that they offer on the show notes as well. So if you want to check out this is just the tip of the iceberg ladies and gentlemen. If you want to dive deep into Rob's thoughts and what they're doing over there, check it out. Just go to and you'll see a link to their podcast down there so you could dive deeper. Rob this has been a true pleasure. Really appreciate you taking the time with us today and yeah hopefully we could get you back on in about a year or so to hear how things have gone.

Sounds great. Thanks Saul. Appreciate your time.

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

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Unique Approaches and Lessons in Population Health with Corbin Petro, President and CEO at Benevera Health

Unique Approaches and Lessons in Population Health with Corbin Petro, President and CEO at Benevera Health

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

Welcome back once again to the outcomes rocket podcast where we chat with today's most successful and inspiring health leaders. Today I have Corbin Petro. She's the President and CEO of Benevera Health. A technology enabled health services company focused on population health and person centric health care. These are buzzwords that you all have heard on the podcast. Population health being one of them being focused on the care of populations versus just a single point of care and then person centric health care taking care of that person consumer centric health care is really on the cusp of the changes that are happening in health care. She created this from a payer provider joint venture Benevera a health provides tools and resources to support value based care including analytics, risk and Insurance strategy and locally based care coordination and patient engagement services. Prior to that she was a Chief Operating Officer of the Massachusetts Department of Medicaid Mass Health. A 13 billion dollar agency providing health care to one point four million Massachusetts residents. She oversaw operations at t function several program areas and helped develop new value based payment and delivery models so as you all can see and hear she's no stranger to value based care and to the cutting edge in what's happening to health care so it's a true pleasure to have you on the podcast, Corbin. Thanks for joining us.

Thank you Saul. Appreciate you for having me. It's good to be here.

Absolutely. Now is there anything in that intro that I left out that maybe you wanted the listeners to know about you?

You know I mean that was a great overview. I think broadly My background is pretty unique and I've spent my career my entire career in health care but spent time in both the public and private sectors in consulting as well as being an operator and focused on innovating in multiple segments payer provider services and so I think you know with this lens I have a pretty unique view of the healthcare ecosystem.

Oh without a doubt. You know and everything is so siloed and healthcare that to have somebody like you Corbin that has seen and tasted the way things roll in the different silos it's hugely valuable. And so I'm just curious you know a whole career in healthcare what got you into the medical sector to begin?

Well for me it's really two things. The first one is why I was drawn to healthcare in the first place and then the second is more about how I think about having an impact in healthcare. So you know the first reason to start, I grew up just outside of Cleveland Ohio in a family that valued hard work and public service. So my father was a public servant. So it's really the service side of health care that attracted me. You know there are a few years growing up where my family went around the state talking to people of all walks of life to understand really what they needed from government. Ohio has 88 counties. The majority of which have a county fair and you know one summer I remember going to something like 75 county fairs.

Wow, in one summer fall in one summer?


Wow, amazing

So you know talking with people who have different backgrounds needs and economics was really striking to me. And health care is really the ultimate equalizer it's something that impacts all of us at some point. And I was struck early on at how different the experiences can be across people. So you know health care as a service fans you know across both public and private sector that affects all people regardless of background is really what I was drawn to. The second part is more around where I thought it could have impact within health. So I was an athlete growing up I was a distance runner in both high school and college and as an athlete how I performed in a race wasn't driven by one or even two things. It wasn't just my genetics or my training or my diet or what I ate the night before or how having my lucky socks impacted me mentally or the fact that I could afford the best shoes. It really a combination of all those things. So you know health care is the same way and as a former athlete I'm always surprised at how we address it through just one or two aspects. So you know my mission and focus in health care is through the service supervised by acknowledging the span of factors that can support oneself.

Love that very very thoughtfully approached, Corbin. And you know I think it's fascinating right. You spend that summer going and seeing these different fairs and I think one of the things that we need to do better in healthcare is get that feedback from customers, our patients and listen better. And I feel like that was an advantage that sort of you formed very early in your career by doing that. What kind of impact would you say that summer that you did had on your formation as a leader today?

Well I think you know understanding that people have different perspectives and different experiences and particularly in healthcare how those can now percolate to the top in terms of what somebody is thinking about and what's impacting their day to day lives. I think all of that in sort of that broader perspective helps me be a leader and a manager but also helps me and in the view that I have toward healthcare.

For sure. That's interesting. So there's obviously a lot to tackle within the sphere of healthcare Corbin but today what would you say a hot topic needs to be on every medical leaders agenda and how are you guys addressing that?

Sure, well, you know you talked about barriers and silos and a big part of my career has been breaking down traditional silos whether that's data organizations or how we think about patients. One example is when I was working as chief operating officer of Medicaid in Massachusetts one of the things we did was launch an analytic tool to help us identify waste and abuse a tool incorporate data from a bunch of other state agencies. So it gave us insights into a person or organization or a physician's activity with the state. Well outside the walls of the Medicaid agency the fact that data between the Department of Revenue and the different aspects of state government wasn't shared with so shocking to me. They didn't have a single record for a person a citizen of the state. But this is really how data exist everywhere. It's not like Amazon is sharing their data with with Walmart. We think about how important data is and analytics but it's always within sort of a siloed sphere. So in healthcare I think it's really important that we recognize that a person's health and the data associated with it shouldn't be siloed and so that definitely goes for the way we think about treating patients and what we're doing at the end of era. So everything we do at the end is about breaking down those silos and just mention data. And that's one area where we're certainly innovating through our model. We bring together that's the claims data from the insurance partner and we integrate it with EMR data from our provider partners and then we bring in publicly available data and patient report data have to have a really rich picture of the patient as well as a provider behavior. So I think it's important in healthcare for us to think about the service and the public aspect of healthcare as something that impacts everyone and how we can work together to improve health more broadly we shouldn't think about data like Amazon or Walmart and think about hoarding it for our own benefit. We should think about it as as a means to improve overall health.

I think that's a good call out Corbin and you sit in a unique seat as leader of of an integrated payer provider system. So you see a lot from both sides of the aisle that maybe a lot of companies don't see or allow hospitals and a lot of insurance companies don't see the full picture. Can you give an example of how you guys have done things differently to create results and improve outcomes?

Sure. I mean I think our model itself obviously is very unique. So there are basically two major innovations in our model that that involve doing things differently and breaking down those those silos I mentioned previously. The first is is on the insurance side. So first part of end of era is the insurance aspect so what we did and the joint venture is took Harvard Pilgrim who is the insurance partner their market in New Hampshire and put it into the joint venture so that the hospital partners are owners of the insurance business. So in being owners of the insurance business and sort of blurring those lines between payer and provider it really allows us to learn more from the hospitals as what are the sort of the pain points and the community needs of their communities. So that helps us to develop different products and services that the community needs as well as what you know understanding those physician pain points so as an example our hospital partners told us early on that some of their challenges with high deductible health plans was that the patients weren't paying their patient portion the you know the coinsurance and deductible and that really encouraged us to move more toward transparency and point of service pricing copays for example and to build products that limited the patient cost sharing specifically for our partners. So really let them focus on delivering care instead of going back and capturing the financial piece from patients. That's sort of on the insurance side you know the second part of our model that we've talked about was spinning out a new company doing tech enabled services focused on population health and again we sort of break down the silo by sharing data across parent provider obviously giving us a really rich picture of the patient as well as a better understanding of how providers are delivering care. We think about patients holistically and try to address all their needs through our engagement model whether that's housing or helping them understand insurance, scheduling appointments, transportation, scheduling visits. Understanding how to manage chronic complex conditions and then for providers we're able to have real and local benchmarks that they trust to help us identify outliers. So those are sort of the ways that we're innovating and in terms of outcomes quantitatively are our results have been pretty fantastic. So you know we've had significant reductions in E.R. and inpatient missions that drive about a 35 percent reduction in costs for patients who are engaged in our program. It's about four times or why those are sort of the quantitative results. But you know the real results are brought to life by some of our patients physicians stories.

Yeah that's really wonderful. You guys are definitely so focused on moving the needle there for patient care but also it's so important to keep the eye on on the organizational business success because hey without margin there's no mission so it's super key. And a lot of hospitals are struggling to find new revenue models. And taking this unique approach is I think definitely opening up some doors for you guys as a system. But I'm sure with that comes a lot of lessons learned. Can you share with the listeners a setback that you had and what you learned from it?

Sure this is a great questions in many ways. Failure and mistakes are really just when reality doesn't meet expectations. So that can be because of unrealistic expectations it can be because of falling short or mistakes so that you know there have been many times in my life where reality didn't meet expectations and many of those felt like massive personal failures. But in my current role at Benevera we expected the hospital and provider partners in the joint venture to really sort of create a consortium amongst themselves learn from one another and for Benevera to ride services to them as a collective. And for the most part that just hasn't been the case. The market dynamics have changed dramatically in the area that we that we serve. So for example Elliott Hospital which is our second largest hospital decided to merge with another hospital that's not part of the joint venture. So you know the hospitals that we once thought would be we could see them aligning closely together started to have less and less reason to do so.


We also realized that the providers who are in our joint venture are in a very different place when it comes to moving toward value based care so Dartmouth Hitchcock is the largest hospital in our joint venture and you probably heard of them. There are large academic tertiary hospital with a lot of community group practices around the state of New Hampshire and they've been participating in Medicare ASIOs and are in many respects contract so they're well on their way to value based care. On the other hand Frisbie Memorial Hospital is our smallest hospital partner. There are 75 bed Community Hospital located in a part of the state where their patient mix weighs heavily on public programs so they have a lot of Medicare and Medicaid patients in their area and the joint venture is really frisbees first foray into risk and the first time they really thought about moving toward value based care. So those two polar opposites are really just examples of how our provider partners were in very different places and needed very different things so we sort of had to acknowledge that the consortium model is sort of serving them as a collective wasn't going to prevail. So we pivoted. So instead of serving all the providers together we started thinking of them individually and with their unique needs. At times it feels like a failure because you know I really wanted them to sort of think together as an elective and treat them as a consortium but in other ways you know we're able to add a lot more value in this model. Being a true operating and servicing partner to do are a different provider groups and meeting them where they are.

Now that's super interesting and I appreciate you sharing that, Corbin. You know it's when you meet with the like you said right. When when reality doesn't match your expectations. You said it so eloquently and you guys have made shifts to adjust and give these providers what they need. And I think it's all about making sure that we pivot that we do the things that are are really being asked for us rather than sit there in denial and trying to do things because that's where things really hit the fan wouldn't you agree.

No that's exactly right. I mean I think recognizing and pivoting when things aren't going as planned while balancing that with with patience. Right. So we know that in healthcare care things are very hard and change is hard and takes time and so knowing when to adjust course and when not to. I think that's really important and to sort of recognize them.

Now that's a really good call and appreciate your walking us through that. So how about the other side of the coin, the positive. What's one of your proudest experiences or moments that you've had to date with your work there?

So the teams I've I've been a part of building and the impact we're having on people's lives makes me proud everyday in the work that we're doing. The team at Ben is mission driven smart thinking practically about how we can innovate and improve the lives of patients or our work every day I hear amazing stories from my team and that makes me so honored to be working with such amazing people. But sort of on that on the team side when I when I moved into my role as a CEO it was you know was my first time reporting to a board and generally just being a CEO and I wanted to be successful and I knew I had a lot to learn and so I asked my board if they would support an executive coach for both me and for my team. It was a big ask. At the time since you know a required investment early on but once they agreed to it I was so proud to be able to support the development of my leadership team and you know we all benefited personally and as a team from the investment and personally I see it as one of the most valuable leadership development activities engaged in and I know that the folks on my team who were able to engage in and with the executive coach feel the same way and so I'm proud that I have brought them into the fold and was able to develop them in that way.

I admire you for that, Corbin. A lot of times people believe that they've got to know everything, that they've got to just fake it till you make it and that couldn't be farther from the truth. In I'm a big proponent of coaching too I've hired professional coaches to help me through my journey. And I'll tell you what it saves time, saves money and it really helps provide that guidance that I feel like we all need especially as leaders in healthcare so kudos to you for not taking that mindset that hey I got to find a way and fake it till I make it. Because that really I think is what makes a big difference in a leader in today's healthcare environment so congrats to you on that.

Thank you. Yeah. No I think you're right. I think we're always there is a bit of sort of fake it till you make it. Of course. But I think it's important to acknowledge where we have weaknesses and where we can grow. And I'm certainly a believer that you can constantly be learning and growing.

Totally. Now tell us about an exciting project or focus that you guys are working on today.

Sure we'll sort of in that that same growth mindset sort of trend. A big part of our work is continuing to just change and improve on a day to day work that we're doing engaging with patients leveraging data and technology and working with providers to move toward value based care. So we're constantly just improving our technology how we're using data how we're using all of our technologies to improve how care is delivered you know on the patient side we're working to integrate new data sources into our analytics and reporting back so that our analytics and algorithms are constantly learning and providing better identification and recommendations. We're also launching new ways to engage patients including web and app based tools to extend the work of our very human based teams. But on the on the provider side which is where we do a lot of our work helping providers move toward value based care we have a renewed effort right now around working with providers on identifying low value care which has a negative impact of quality outcomes and obviously is a big waste within the broader healthcare ecosystem. So in one example we looked at some basic diagnostics, imaging and pharmacy. Those three areas are areas that we know from literature often overused and prescribed. We've got a lot of outliers but in one example there was an endocrinologist who was prescribing high end diabetic medication significantly more than his peers within his organization and at surrounding hospital system. So he was like three to four standard deviations above the mean. We showed this to the Chief Medical Officer of the system and she looked that and was ready to have a conversation with the doctor on his future age and the potential negative impacts. And he embraced the conversation and actually changed his behavior. So in this case it was really at the local unreal benchmarks that we have and that we use with our partners finding sort of actionable efforts within that data and then having real live conversations with providers that really lead to impact and you know it continues to be something that we're focused on today is sort of looking at that low value care identifying actionable efforts and things that we can do and then delivering that to our partners.

Corbin I think that is so valuable. What a great story. Firstly I was recently doing an interview with Marcus Osborne. He's the he's the V.P. over there at Walmart for healthcare. And you know the big thing that he brought up like you're bringing up right now and it's a trend. It's like we're not giving our physicians the necessary metrics that they need to get feedback on whether they're doing well or are not as well as they could be or maybe overprescribing or under utilizing resources. And I think these metrics that you're setting up internally are so key. And the next step to helping providers get that feedback that they need to deliver better care. I mean there's not a provider out there that wants to do a bad job everybody wants to do a good job. And folks pressed rewind on this because I think that was a great story that Corbin shared and some best practices that leaders definitely need to uptake. Lots to be learned here from Corbin Petro. Corbin, this is coming to an end. Time flies when you're having fun 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 Corbin Petro. I've got four questions lightning round style for you followed by a favorite book that you recommend to the listeners you ready?

Sure. Let's do it.

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

I think you're gonna like this one, Saul. But breaking down silos

Love it.

And working together so in most cases we have everything we need to improve outcomes. We're just not using what we have effectively because of access to information and misaligned incentives so you know in our case turning once adversaries, providers, and insurers with misaligned incentives and to advocates for the patient that's really near term I think the best way to improve healthcare outcomes.

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

So we all know health care is pretty complicated so I'm not fully understanding all the different dynamics and players in health care and not thinking through unintended consequences. So you talked about consumerism a little bit earlier. So for example one of the challenges and consumerism of healthcare is that the patient for the targeted consumer has historically not been the one making purchasing decisions nor are the vast majority of people thinking about their health care all the time. So you know as we know the usage of digital apps and tools has for the most part been pretty lackluster. So I think before innovating in the healthcare space it's really important to understand. Again all the sort of different dynamics and players within healthcare.

That's such a great call out and for the entrepreneurs or even you know large companies looking to innovate in the digital space. A big note to take there. How do you stay relevant as an organization despite constant change?

So you know I think having a growth mentality constantly improving evolving and embracing change and then hiring people with that same mindset is really critical. So at Benevera who we are today as an organization should absolutely not be who we are three to five years from now if we are we've failed. And I can you know I can relate this back to my time as an athlete. Never being satisfied with your last performance and constantly changing techniques, training, diet with the goal of constantly improving. That's really just critical to any organization but particularly in healthcare.

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

For us really the patient - the patient as a human and as a customer. So we aim to address all of a patients needs that we can and to think about them and their complexity not just as a disease or as a condition. So I don't know if I've mentioned this but we focus on what we call the whole person in person and then more broadly as a as a joint venture about delivering patient care better together. So we believe that by working together we can deliver patient care. So everything we do is aimed at trying to improve the lives of people and we really stay focused on that work every day.

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

So I have I have a lot of favorite books. Most of your listeners probably want something health care or sort of improvement related.

Whatever rises to the top of your mind.

Yeah okay. So I love David Brooks' The Road to Character which really helps. Think about how we as people evolve throughout our lives and seek meaning and purpose in what we do. And so it helped me think about how who I was and what I was doing isn't entirely about intent and my own personal goals. It's also about where the world needs me now. So that's a really that book struck me at the time my life that I that I read it and then it just in terms of general reading. I love all things Michael Lewis, Haruki Murakami, and Kurt Vonnegut.

Love that listeners we've had our great discussion with Corbin Petro today CEO at Benenera health. You could find all the show notes as well as a transcript of our discussion. Links to the organization links to the books that she has recommended for your learning. Just go to and you'll find all that there. Corbin, this has been a blast. Really, really appreciate the time you've made for us. If you can just leave us with a closing thought and then the best place we're the listeners could get in touch with you or follow you.

Sure. I'm gonna end with a little story about a meaningful experience that I had. So about 10 years ago I rode my bicycle across the country solo self-supported and self-guided. I started...

From coast to coast?

Coast to Coast, so yes.

Good for you, that's amazing.

I started in Seattle and ended in Washington D.C. and I covered thirty two hundred miles and 33 days so each day I would I would navigate my way through places I had never been and was able to see and talk with people of all walks of life. Most people thought I was crazy and they would gladly spend some time about their lives and challenges and everyday for me I had really high highs like reaching the top of the 9000 foot elevation and really low lows like you know when a state highway turned into a dirt mountain pass. So you know the challenges were physical and mental and often the really challenging parts were not what I expected. So for me not having physical contact with another human being for weeks at a time. It was really the only time in my life that I didn't hug another person for close to a month. Most of us have that human connection on a daily basis and it was really impactful the longing that I had for physical human connection. So my closing thought is that you know as humans we need human contact and especially in health care it's you know it's a very human endeavor. So technology can help us enhance but it really can't replace human contact. So as we think about innovating and health care. You know I encourage people not to lose sight of patients as humans and our need for human connection especially as we age.

That's a great story. And pretty amazing that you did that and it does bring home the message you know the importance of care.

Yeah absolutely. And I think you know it's obviously very striking for me and I think just continually thinking about patients as humans is a big thing that we try to do at the end of era. So in terms of connecting with me obviously check out our website Benevera health and then personally I have a very Google-able name only Corbin Petro who is out there. So I'm on LinkedIn and Twitter under my full name.

Outstanding. Thanks again Korban. This has been a blast. Listeners. The beauty of podcasts is that you could go back and listen again. I know this is one that I'll personally go back and take more notes on. So you'll be sure to do the same thing and just want to say again Corbin, thanks so much for making time for us. Looking forward to staying in touch with you.

Great. Thanks Saul. I had a good time. Appreciate having me on.

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 Check it out today and find a new way to leverage the sales, marketing and outcomes of your business. That's

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Recommended Book:

The Road to Character

Best Way to Contact Corbin:

Linkedin - Corbin Petro

Twitter - Corbin Petro

Mentioned Link:

Episode Sponsor:

Simplifying Health Insurance with Sally Poblete, Founder & CEO of Wellthie Inc.

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

Welcome back once again to the outcomes rocket podcast where we chat with today's most successful and inspiring health leaders. I have an outstanding guest for you today. Her name is Sally Poblete. She's the founder and CEO at Wellthie. Sally is the chief visionary Growth Officer insurance geek and cheerleader at wealthy. She spends most of her time listening to the customers envisioning new ideas and building the best teams. She envisions a future world where purchasing insurance is a satisfying and confident experience. We're going to definitely dig into that and prior to starting wealthy Sally spent close to a decade as an executive at Anthem Blue Cross Blue Shield where she led product development and launch large enterprise initiatives across the country. With the builder's DNA, Sally spent the first decade of her career wearing business development marketing and product hats at successful startups like Medscape and other insurance startups like Health Markets. She's got a wealth of experience and background in this space and it's a thrill to be able to have the privilege to have Sally on so Sally welcome to the podcast.

Thank you so much. It's a pleasure to be here.

Absolutely. Now is there anything that I missed in that intro that you want to share with the listeners?

I think just the fact that I've been in healthcare or the health care industry my entire career and earlier before I specifically work in insurance I was in a provider space as well in Hormel as well as digital health in general so delighted to be talking with you and I know most of your listeners being in the health care industry.

Absolutely that's great detail there that we missed on that. So folks Sally comes with a lot of experience from across the healthcare space and I think a lot of the things that we'll dive into with her will resonate with you. So why did you decide to get into healthcare to begin with Sally?

I think like many many people who are in healthcare there is a desire to do good in the well. Healthcare is first and foremost an industry where there is so much opportunity to help people in improving their health. And I think that's a really gratifying reason to get up in the morning and work hard and that there is a very tangible impact to others that I think it's really great. And then on the doing well side I think the healthcare industry is responsible for a significant aspect of our economy and lots of dollars flowing in the healthcare sector. It's obviously a very big growth industry and so there is an opportunity to do both. So for me as a trained businessperson, it is the industry that I could both accomplish a higher level mission to help others and also fulfill a business goal.

Very cool. Yeah I'm so I'm so intrigued with the path that you've taken through insurance and now starting your own company. Sally, can you level set the listeners on wealthy what is it that you guys do? Problem you solve? Who do you solve it for?

Yes so Wellthie is focused in the process of purchasing insurance. So we have the marketplace and national marketplace for small businesses to purchase insurance in so in an easy fashion simple easy. And with the help of a human expert and that which is the broker, so we essentially have a marketplace where those small businesses can find the wealth of options for insurance products from hundreds of insurance companies across medical, dental vision and other value added services and then be able to do that on their own and see the products and services that they want to buy and then also get the support of a licensed broker along the way.

Fascinating. So typically listeners if you own your own business you obviously know it can be frustrating. It could take a lot of time but the efforts that Salihi has poured into this platform and her background in insurance. It really gives the user the opportunity to make it less complex. And so Sally what are some of the things that people are saying about your solution what's resonating?

Yeah I think first and foremost what's resonating is the agreement across the board that the existing process has not satisfied the needs of our thinkers right that it is very cumbersome enduring a manual labor base. So having a destination to say, oh now I can understand how much insurance costs or having my broker really be able to help me through my decision making process. So both have an online experience and the human support of a licensed expert to help me make the right decision is really a great combination. Because you know it's not all about being 100 percent digital and there's still so much of the population that wants the combination of digital experience and also access to the live human beings who really knows their stuff.

That's so so on point Sally and You've gone through so many different experiences on the insurance side. I'd love if you could just share what you believe a hot topic that needs to be on every leader's agenda today. And how are you guys tackling it?

Yeah I think a hot topic in healthcare in general is the focus on consumer experience. And I think that that is universal that is a hot topic in insurance that is a hot topic among the provider industry topic. Even within pharma, it's really across health care and it's hard to it's really a very big goal right. To improve that consumer experience and focus on for me that means a focus on simplicity. It means having less steps for the consumer again and consumers are patient if it's not it's a small business owner buying insurance or whomever it is it is having less steps to get to Point A to point B to get something done. It is having less friction. It is meeting the consumer where their needs are where they want to interact. So for us it its right in millennial business or wanting to research online. Great. And if it is another kind of business owner wants to follow that is good too but it's meeting the consumer where they're at in looking for any and all ways to as I said reduce the number of steps and friction for us to deliver whatever product or service that we are providing within the health care industry.

I think that's a great call. And listeners if you are curious. Yes I definitely invite you to go check out their site. It's w e l l th i e and you'll see all the resources the beautiful layout that Sally and her team have have made for you just a wonderful sight that I think you'll that will resonate with Sally's comment about user experience. Can you give the listeners an example of how you guys have created results and affected things positively?

Sure. So in behalf of We work with many insurance companies across the industry and one of the things we do for them is obviously we're trying to help them increase their sales because of all of the brokers in our network who use our platform in the small businesses that are shopping right. We're able to really improve our platform growth as well as speed of closing of essentially the shopping process and ultimately over time also give them a lot of consumer insights about what our buyers are customers are looking for and as for shopping what they're clicking on what essentially their demographics and matching that up so that we can inform our in this example carriers on the products that really resonate with your audience.

And Sally what was it that got you to start wealthy like what was the thing that made you say you know what this has to happen or was it why did you do it?

Yeah I think that for me it was less of an aha moment I saw that rather a long and indeed firsthand experience in our industry. Having worked at one of the largest carriers in the country for eight years and other carriers for that, I really saw the opportunity for a need for better or simplier experiences in insurance. So that time and time again and I knew that while certainly big insurance companies have a desire to do that that I could have a bigger faster impact by starting a company starting a technology company working with Ethar technology experts, design experts, data experts put together solutions that are really applicable for the industry as a whole and that was for me the moment at which I wanted to really embark upon starting Wellthie.

That's wonderful. Now listeners, this is great and an example of the leaders that are on this podcast but also you that are listening right. You see a problem. But in that problem you see an opportunity and Sally took her experiences and now is doing a service and art to be able to give you the best way to get insurance. And I admire you for taking that leap Sally because you know it takes courage to do that.

Thank you so much. It does and I found the experience to be certainly still both more challenging and more rewarding than I even expected.

That's great. And so that's a great segue here. We believe that we learn more from our failures than our successes Sally . Can you share one of your setbacks that you've had here in the last five years with Wellthie and what you learned from it and how you became better for it?

Yeah. How much time do we have. I think that difficulty in answering this question is picking one among among several but I think I'll say from my perspective, we have gone through several iterations many many iterations of our product. And one would say well you know every iteration of that product could have been a failure because right we embarked upon what direction we thought we had a premise or hypothesis to prove about the solution we were offering and then we kept on tweaking we'll on the way. So what was the mistake. Thing. What were some of the mistakes or things that we tried it didn't work out as well. I think whenever we did so our design a particular solution that we design on our own and did not have enough market input market, insight, customer feedback, customer testing, those were things that we learned were opportunities for improvement. And I think so much in healthcare we have really good ideas internally right in our own minds about how to do things and try them and then realized that the really the end consumer isn't that's not what they want or they prefer to shop or do something differently. So I think a lot of the lessons for us is just continuing to ask our customer base test and get feedback that always has been lots of great opportunities for learning there. And that has helped us strengthen the product over time.

For sure. And and if you had to double click on on one of those things that you took out of it what would you say. One of the key lessons that you learned and one of those tweaks that you made?

Well one of the lessons that in terms of the product tweaks. So let me think about an example. So one of them was exactly this notion that we thought initially consumers couldn't just get through the entire process on their own. The full digital experience was sufficient and that was what because we are in a digital age and that is all that we need are really Slate user experience online and on the mobile phone is all that is necessary and then we realized that so many consumers still really wanted to talk to a human being and the role of a licensed broker or an agent to help support them in their experience in shopping was still really necessary. So then we added that component to our solution because that was you know an area that again our customers felt was necessary.

What a great learning Sally. And you know we've had other guests here that are embarking on their digital journeys and healthcare and that same goes on the patients side, right? There's been companies that have tried leading with a fully digital solution one that comes to mind as Carol Leupp right there a caregiver support tool and they found that lesson too, and as soon as they incorporated that human touch with the tech it was just like the secret sauce that led to major adoption and things that you've shared a really great peril for us to really appreciate that. What would you say one of your exciting and most proud moments in the space has been the day?

So I think that on the exciting front the pieces that I want to share right now is that more regulation is coming, changes in the regulation I'll say is coming with regards to insurance space so we think that in a time of increased complexity in the regulation there's always an opportunity for technology companies and again people like us who are company like us who understand the industry understand how to take the complex and may even simple, that's really a time an opportunity for us to shine because we can take that complexity and use technology and decision support and really great user experience just to help navigate, help our customers navigate the choices that they have to make as it relates to insurance. So we were really excited about that.

That's awesome. I admire your approach. Sally you're definitely tuned into to the challenges and you have the experience to be able to have those insights to really make an impact in this space. We need it and from an entrepreneur, to you and I and the listeners as well we thank you for what you're doing.

Thank you very much.

So tell us about an exciting project that you're working on with wealthy or maybe even outside of Wellthie.

An exciting project outside of wealthy. So yeah I have recently volunteered to talk to teenage girls in that disadvantaged neighborhoods about their career in entrepreneurship. So outside of wealthy hey I do really enjoy helping younger girls consider a career in technology, in entrepreneurship, in healthcare, in the sciences and really help them see that there's just a world of opportunity out there for them. And that given that in health care 80 percent of the decisions are made by women. I think that there is just lots of room for younger women to pick leadership roles or to pick a career path in healthcare and really aspire for leadership roles. I think that that's even more necessary. And again within disadvantaged communities so that they can find a career path that really makes a positive impact on others and themselves.

Sally I think you're doing wonderful things in business and for the community. I tell people all the time that I truly believe that health care will be changed for the better as we include more female leaders into the ranks. To put that care into the system so kudos for what you're doing on the business front but also on the community front. It's what the system needs and what communities needs to have that success. Really great to hear that you're doing that.

Thank you.

Wow. Wow. We're getting close to the end here Sally. So we got this lightning round then we'll conclude with your closing thoughts. But let's pretend you and I are building a course on health insurance and leadership. What it takes to be successful? The 101 of Sally Poblete. And so we're going to write out a syllabus with four questions, lightning round style followed by a book that you recommend to the listeners, you ready?

Sounds good.

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

Think the best way to improve healthcare outcomes is to focus on the consumer experience, is to focus on all of the elements of that experience within health care and outside of healthcare that are driving why patient to your consumer and health care is making decisions.

What's the biggest mistake or pitfall to avoid?

Related to the first question I think it is designing solutions without or with very limited customer input I think is a very big pitfall.

How do you stay relevant despite all the change?

I think you see it relevant by getting out of the four walls of your office your medical practice, your insurance company, your pharmaceutical company I think is walking and learning and being with people in their natural habitat, natural environments upside and really absorbing learnings from other industries.

What's one area of focus should drive everything in an organization?

Back to the first question. I think it is a human focused consumer.

Wonderful and what book would you recommend to the listener Sally?

So I recently read Sheryl Sandberg's option B and Adam Grant and Sheryl Sandberg wrote that book I found that book to be incredibly inspirational and relevant for everybody young and old. I think it's a lesson on resilience. And I think for readers, entrepreneurs and not entrepreneurs alike so much of health care requires a lot of patience and persistence because our it's not an easy industry to innovate in. So when we have setbacks, no matter what they are I think finding the strength to increase our energy to bounce back and keep on going is really a helpful lesson in that that I took away from that book.

Outstanding recommendation Sally. Listeners take note of these things by going to . Again that's a W E L L t H I E and you're going to find all of the show notes the transcript links to the book recommended and all the things that we discussed here today. This has been so much fun Sally. I love if you could just share a closing thought. And then the best place where the listeners could get in touch with you.

Yeah so I think my closing thought is really to the listeners who are perhaps inking about insurance as a career path or an area of innovation I would invite other practitioners to consider starting a company in any aspect in healthcare. And then if any anyone is interested in innovating within the insurance industry there's there's a lot of talent and help that we need here so please do come and join join our efforts. And yeah I can be reached really on our website and on LinkedIn.

Outstanding again unless there's the addresses, w e l l t h i e dot com and Sally again just want to say a big thank you to you for joining us today. I know that the things that we discussed will plant a seed in the folks listening and help improve outcomes so I just want to say thank you so much.

Great thank you so much.

Thanks tuning in to the outcomes rocket podcast. If you want the show notes, inspiration, transcripts, and everything that we talked about on this episode just go to And again don't forget to check out the amazing healthcare thinkathon where we could get together to form the blueprint for the future of healthcare. You can find more information on that and how to get involved in our theme which is implementation is innovation. Just go to that's and be one of the 200 that will participate. Looking forward to seeing you there.

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Recommended Book:

Option B: Facing Adversity, Building Resilience, and Finding Joy

Best Way to Contact Sally:

LinkedIn: Sally Poblete

Mentioned Link:

Episode Sponsor:

Leveraging Mobile Technology to Improve Outcomes with Patricia Mechael, Co-founder and Policy Lead at HealthEnabled

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

Welcome back to the outcomes rocket podcast. Today, I have an amazing guest. Her name is Dr. Patty Mechael. She is the co-founder and policy lead at HealthEnabled with many years of health care experience. Her focus is in global health and digital health and all that it takes to be successful in medicine. And so I want to open up the microphone to Patty to fill in the gaps in the introduction. Tell us a little bit more about herself and what is it that they do at HealthEnabled. So Dr. Mechael thank you so much for being with us today. Welcome to the podcast.

Thanks Saul. I'm really pleased to be here. So not sure where to begin except to say that a lot of my work has been in global health. I have spent probably in the last more than 25 years primarily working in Africa, Asia and Latin America. And my background really is in public health so really looking at how do we prevent diseases that we can prevent and strengthen health systems to address conditions and help people in ways that they need to be helped if and when they do get sick. And for about the last 20 years almost, I have been looking primarily at the use of mobile technologies to improve access to health and health information in a broad range of different settings and was the idiot savant that did a Ph.D. looking at mobile phones and health when the penetration rates were about two and three percent in this country. So even before the telecommunications companies anticipated that we would have more mobile phones than people on the planet.

That's amazing. What got you interested in that particular topic. Did you see where it was going. Or was it luck? What are your thoughts there?

I didn't see where it was going. I had taken a bit of a break from my work in global health and I was working for a dotcom in New York. And when one of my mentors approached me to apply to Ph.D. programs which I had never really planned to do and so I was like sure I'll apply to a Ph.D. programs. And at that time everyone was looking at and I wanted to look at technology and health but everyone was looking at the Internet and I had spent time working in places like South Sudan during the Civil War and Somalia and Uganda and Kenya where there is just no basic infrastructure so there is no running water, there's no electricity. There wasn't going to be the Internet for at least 10, 20, 15, 30 years but, we were starting to see mobile phones appearing particularly in the urban centers in different developing countries. And so it's just like well what about cell phones like what if people had access to cell phones, could use those cell phones to access emergency transportation like consults with a doctor. Like how could we leverage this emerging technology in a way that could really help improve health outcomes. So I applied to a couple of programs. I was really fortunate because the London School of Hygiene and Tropical Medicine had a science and technology studies sociologists on faculty. When he saw my application which is like you have to come to school here you have to do your Ph.D. here. And he was so enthusiastic about it. So I sort of began my journey not really knowing kind of what to expect. It was more around the like well what if people did have cellphones. And what if they could use those phones to do interesting things related to health. And then quickly it sort of really started to pick up even in my Ph.D. research which was an ethnographic study because nobody had ever researched it before people we're already very informally starting to use mobile phones to access health services and health information and organize themselves and do disease surveillance. So even just a natural progression in the use of technology was very very interesting from very very early, early early days.

Well it's become very practical Patty and I think it's really neat that you decided to get on this track why medicine to begin with?

So I'm a first generation immigrant to the United States. My parents emigrated from Egypt in the 1960s and so of course as is typical of immigrant families if you have kids that are good at math and science then you're going to be the family medical doctor and so it was one of those and I was always very passionate about helping people and so I I kind of had that that then. And when I was in high school I was an EMT and brewed .. in my town in New Jersey. It was very keen to kind of get into that field and I was I was incredibly fortunate to have done my undergraduate degree at at Johns Hopkins because at the time I was an international relations premed student so. So I wanted to work. So I had this like dream of being like a flying doctor in Africa. And so I wanted to do medicine and health in underserved countries and populations. And I didn't quite know exactly what I wanted to do and how I would go about doing that and why in my first year at Hopkins the School of Public Health offered a course in the winter session called careers in international health. So I took this course and I was amazed that all of these people who had worked with WHO and with UNICEF as well as ministries of health from around the world. And this more sort of population-based approach to health which is sort of like instead of going to one by one and diagnosing and treating individuals. How do we start to look at, you know entire populations? And that got me really really excited. And so I sort of felt passionately in love with the concept of public health and then started reading everything that I could in this space including the World Development Report from 1993 which was focused on health published by the World Bank which I think is the same document that got Bill Gates excited about global health which I learned like 20 years later and I was like that's awesome so I'm like, "you, too" so then you know I decided to pursue a Masters in International Health and really spend time living and working primarily in East Africa working on sort of a broad range of public health related initiatives.

That's pretty cool. And you know it's fun to hear your story about how one thing led to another and you just got involved with this group over there. Hopkins that was doing more population based things and it just sort of fell in love with it and as we fast forward today the reality whether it be global or domestic, the importance of managing populations and health population health management is a very key topic. What would you say is a key topic that needs to be on every medical leaders agenda today?

Yeah I think we're getting to a place where the personalization of health I think is becoming more and more possible and really helping people to integrate health into sort of their everyday everyday lives and existence and so oftentimes our intersection with the health care system is around a disease or around like a particular health condition. But as human beings we're more than our disease conditions and we live in the real world and we have things that are really passionate about and things that get us excited. And we have families and we have. And so I think it's really important to contextualize health with sort of the person and to really start to think about how do we move towards a more personalized approach to health which I think ultimately will lead to better community health and better population health. And I think that right now we have a highly burdened health care systems that can't afford to deliver services to their populations, don't have the workforce to meet the demand. Don't have the right distribution of healthcare providers in rural areas that can serve different types of populations and that sort of thing. And so it's becoming more and more important to engage individuals in their own health care and in their own health. Ultimately like nobody wants to be sick. So there is like OK let me go out there and fall sick so you know if we can keep healthy people healthy for as long as possible and engage them in fun and new and interesting ways in their healthand provide them with you know insights into what's going on in their bodies either through wearables or different types of technologies. I think that's certainly a really important push but then also for those that do fall sick to provide services and engage them in ways that really acknowledged that each of us is very different and has a very different set of needs interests approaches etc. and that health is a very personal personal issue and should be treated as such.

Yeah I think that's a really great thought there. Dr. Mechael you know when we take a look at a patient just as a sick person a disease, their particular disease it doesn't doesn't help with thinking about it more broadly is going to help us come up with better solutions. I'm curious so the work that you guys are doing at HealthEnabled, maybe you could walk us through some examples of how you guys have created results or improved outcomes in these rural populations by doing things differently?

Sure to a lot of our work at health and able for the past few years has really focused on nationally scaled and integrated digital health systems so we spend a lot of time working with governments to develop supportive policies that can help sort of these emerging technologies be scaled to the entire population of of their countries. And so, for example we've worked in South Africa with the National Department of Health on a platform called MomConect, which a few years ago set out to register every pregnant woman in South Africa and provide stage and age based messaging throughout her pregnancy as well as for the first year of a child's life and was largely designed using a lot of ethnographic work and research with voices and text messages that are acceptable to the population. And it was incredible. The Ministry of Health and the Department of Health of South Africa took an incredible leadership role and it was one of the first sort of stale implementations where they're currently reaching over a million pregnant women and they have about a million I year of pregnant women and so it's basically like they're reaching practically every pregnant woman in South Africa with these messages and the data and the research on these types of mobile messaging programs is now starting to catch up with the innovations. And it's really showing that there are improvements maternal health practices that we're starting to see improved outcomes among children and newborns. And it's a really exciting time particularly for these types of for these types of programs. We've seen similar results in India and other countries as well have had started to implement these types of programs including Nigeria and China. I mean the United States has our own version text4baby which is largely built on the same set of core, set of messages and approaches.

That's pretty great. And the nice thing is that once you once you build it you could customize it to the particular country for acceptable messaging and maybe like fill in the gaps in cultural traditions. And then it's just sort of like an out-of-the-box tool that could be customized for each country right?

Yes and no I mean..

It's never that easy.

It's not that easy.

I have a colleague at UNICEF and we joke with each other that we should write a book called And Health Is Hard and because its actually it's a sophisticated kind of epic undertaking.

That's too funny.

What you think should take a few months could take a year. But yes there are some aspects of these types of programs and it's mostly like the approaches that can be replicated from one setting to another setting. A lot of times that basic health and key health outcomes that we're really striving for can be standardized across different settings. But one country might have to prioritize certain health outcomes another may have to prioritize other health outcomes. For example in a country like South Africa where you still have relatively high HIV rates things like prevention of mother to child transmission of HIV in the messaging becomes really critical during the pregnancy and you know or you know in a country like India where anemia is quite high and you do have eclampsia pre-eclampsia and those sorts of conditions they're making sure that the women are able to identify the risk signs as well as like take preventive measures to prevent those conditions and maintain a healthy pregnancy. But then if and when they do start to notice things during their pregnancy is that they can take action at the appropriate time.

Yeah that's really interesting. So snd health is hard.

It is.

So Patty through your journey I'm sure you've had mistakes, setbacks that you've learned a lot from. Is there one in particular that you want to take us to and sort of share and what you take out of that?

Sure. So early on in my career so I was really fortunate when I finished my Ph.D. and it has been about 2006-2007. I moved back to the U.S. and I decided that I wanted to live in Manhattan. So I started contacting different colleagues and networking and I got a call from Jeffrey Sachs at the Earth Institute and a totally random. And he invited me to brunch the next day at his house and was like..

Just randomly like that.

I mean something that sent him my CV and gay guy and they were about to launch a partnership with Ericsson to look at mobile technologies across ten countries in subsaharan Africa and they had prioritized health is what are the first areas that they want to look at. And they were like you just finished your Ph.D. looking at mobile phones and health, like would you be interested in helping us figure out how we look at mobile phones and health. And one of the early projects that we designed and implemented as part of this program was using text messaging to register pregnant women and then track their pregnancies and then register children and then track their make sure that they got their immunizations and those sorts of things. And we did this in 10 countries. And I think what we did as a spread ourselves too thin and I don't think we did a very thorough job of like really explaining kind of what this was, etc. And so some of the countries picked it up really well knocked it out of the park. We're starting to show like improved health outcomes, et cetera. But we had one country where when we bend like a year later went back and did an evaluation like discovered that they had a whole pool of pregnant men in this community in Africa and I went to a country but, it's one of these things early, what in the world is going on. It was interest agates and people were the health workers were using the system but they weren't actually looking at the data that was coming out of the system or using the data that was coming out of the system. And it was one of my first one of my early experiences really around data use. And we find this all the time is that you know health workers are really overburdened. They were sent having to collect data if they're not getting value out of that and taking the next step towards like encouraging a culture of data use is an epic undertaking it is. It is a very difficult to change sort of workflow and add value and help people to really see the value of data if they're not used to having data in their day to day engagement or work. So since that, I spent a lot of time looking and working on data use and I think the other thing I think that's really important to me is that I've learned over time is to just because you build it doesn't mean they're going to use it. So really making sure things are done in a participatory design approach that's whatever it is that you are doing is like actionable that something can be you know if you're collecting some information that you can actually do something about it that you're feeding that information back to people in a way that they can really use it and glean meaning from it. So I think some of those lessons came out of that. But I but I like looking at the data, it's coming out of this country and I say, pregnant men? This is weird?

And so what a great learning there Patty. Let's make sure we build the solutions in conjunction with the end user and let's socialize that data use aspects of the programs that we put forward. I think some things that that are very easy to take for granted that I think you call about Patty very important to highlight in the projects we take on. How about something that you're super proud of in your experience. What would you say that is one of those moments that you're like wow this is why I got into this?

So a few years ago maybe more than a year and so I think with 2014, 2013 so I had done a lot of work in Nigeria around health systems strengthening, around health information systems as well as around mobile health and I developed a very good relationship with the Minister of State for Health at the time and he was really keen to see Nigeria become a leader in the digital health field. So he asked me if I would help facilitate the development of a national health I.T. framework for Nigeria and Nigeria is a very complicated country it's a federated system similar to the United States, India etc. So the states have a lot of autonomy and then you have a federal government or a central government so it's always a bit of like who has the authority,.


Kind of a question. And we got some funding from the government of Norway to do this to do this initiative. And we took a very participatory approach to the design of a national strategy and as we were developing it, it was co-chaired by the Minister of Health as well as the minister of ICT information innovation technology and we had over 150 stakeholders over the course of a two year period that were really actively engaged in the design of the strategy as well as the implementation alongside the design so as we were developing the strategy and working through the strategy development process, bits and pieces that were already being implemented which was really really exciting and then it got officially adopted by the parliament of Nigeria. So for me that was probably one of the projects that I have been involved and that I have like the most proud of.

That's pretty awesome.

Mostly because it's so needed like countries really need to have a road map because otherwise with technology, it's really easy to get distracted and to kind of go in a million different directions and not necessarily be able to have an impact or are really be able to systematically improve health outcomes or strengthen the health system. So I am a huge, like advocate and firm believer that you know the enablers and the enabling environment and the sort of policy is related to be in place to support technology and innovation because the technologies are going to keep changing and new innovations are going to keep coming. But if you have the right sort of supportive policy environments, then that can really help guide you both short term investments as well as the longer term investments. You need to have in place for these technologies to have an impact.

That's excellent. And Dr. Mechael, have you had a chance to visit back with that health minister to see how they've been doing since the adoption of this roadmap.

So the minister changed midway through our process and actually it still ended up being successful and which was actually like probably one of the biggest successes that we have.

Staying with it despite the change, right?

Absolutely. And I think you know he was an excellent minister and I think he he set it up in such a way that it could succeed without him. Knowing that ministers in some countries only last a year or two years or three years. So that was also like part of the success of it that was that even after he had laughed the process continued on and there was so much buy in and such a commitment to see this thing through and that we were able to get it through him. And yes I have and have gone back to Nigeria and have a lot of colleagues that I still engage with over there. And you're doing great. It's incredible. To see it's the the national strategy is being socialized at the state level and it's really providing the framework that they needed to have to make sense of technology.

Congratulations that's a wonderful accomplishment.

Yeah, thanks.

Can you share an exciting project that you're working on today?

Sure sir. And we're about to launch in a few weeks at the World Health Assembly in Geneva which is a global digital health index. So while HealthEnabled as an organization, our focus tends to be to go deep in a handful of countries as well. So they work very closely with large scale health implementing organizations. We want to have one activity that could kind of help raise the bar on the field. And and so we've kind of debated different things and you know like national prize or different types of awards and then you and a colleague at our at our incubator, the global development incubator suggested an index like potentially is the field of digital health ready for an index. And So we spent a bit of time to benchmarking looking at different indices, looking at different areas and really assessing the digital field to see if it was a time for an index and really consulting with the digital health community around this. And so the aim of the index is to really help countries at a national level measure and track their progress and maturity in digital health. And so essentially it's a national digital health maturity model that has been designed and developed using the World Health Organization, International Telecommunications Union e-health strategy toolkit and in consultation with everyone from the government of New Zealand and Denmark to Peru and India. So we had 13 countries work with us on the prototype earlier this year and now we will be launching at the World Health Assembly alongside a digital health resolution that's being put forward by the governments of India and Australia as a tool to help kind of countries really advance their work in this space and have some visibility into kind of what, where they are and where they need to start moving towards.

That's pretty exciting and I think it will be a pretty useful tool for for the folks focused on countries outside of the ones you guys are focused on.

Absolutely. Absolutely. I mean we can't be everywhere and our goal is ultimately to work our way out of a job. So it's like OK how do we get everybody start to do these things. Yeah it's an exciting time.

That's awesome. Congratulations on that tool. I'm sure it's going to be pretty exciting. Folks if you want to learn more about what Dr. Michelle and her team are up to, just go to and you'll be able to learn more about their purpose, their mission, their five-year roadmap, their team. They're doing some pretty cool things for health across the globe. So definitely be sure to check them out. Getting close to the end here, Patty let's pretend you and I are building a medical leadership course on what it takes to be successful in medicine. It's the 101 or ABCs of Dr. Patty Mechael. And so we've got a syllabus here for the listeners. It's going to be a lightning round. So I've got four questions for you followed by your all time favorite book. You ready?

Got it.

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

Measure them. measure them. That which is measured gets done. Oftentimes we don't measure them and we don't plan to measure them and we don't prioritize them. We just implement programs, hoping for the best health outcomes don't improve that way.

What's the biggest mistake or pitfall to avoid?

Implementing programs without having a primary health outcome in mind. So designing in the absence of a specific health target.

How do you stay relevant despite all the change?

It's hard to stay on top of it on top of everything. I remember there is a moment where I realized that I couldn't wrap my arms around the entire field of health anymore because it was too much happening and too many new players and too many new technologies. I think the idea is to really state focus on what you're trying to accomplish in health and then as you are able to sort of identify some of the new innovations and tools, really think through how they can be applied to improve this health outcomes in strategic ways.

And what's one area of focus that should drive everything in a company?

Well-being if we're all about health and the health that we should be all about is the health of our people. As an organization and I'm not going to cut to the chase on your next question around the book that we actually at HealthEnabled, when we created that organization and we wanted to create an organization that we would want to work for. So we we make everybody read the book Thrive by Arianna Huffington, which really looks prioritization of well-being, you know including things like sleep and stress management and all these different areas that really do have an impact on productivity as well as quality of life. So if we're not able to sort of put the oxygen masks on ourselves as healthcare providers or advocates, et cetera, then it becomes a lot harder to try to extend that to the communities that we serve. And I think it's a really important aspect and often underlooked aspects of the workplace and one that can lead can add years to and healthy years to people's lives. When you look at the sleep research and you look at the stress research and the physical activity studies, etc. There is so much to be gained from mindfulness meditation, from enjoying your time with your family and disconnecting from work. And so you know like people are not allowed to e-mail when they're on vacation. Like you just know. like I'm on vacation.

Yeah I think this is so great. Patty you know and listeners. One thing that you should take away from this recommendation, Thrive by Arianna Huffington. One book that I haven't read Patty but I definitely I actually as we were chatting here just downloaded it from an audio book. It's so important for health leaders to take care of yourself because if you are running on fumes there's no way you're going to be able to take care of the people and the populations that you're responsible for. So I think this is a wonderful recommendation. Patti thank you so much for that. Yeah you're welcome. And listeners don't worry about writing any of this down. You can go to as in Healthenabled to find to find all the things that we've discussed, the transcript, shows notes, as well as links to and also links to the book that Dr. Mechael shared with us right now. Patty would love if you could just leave us with some closing thoughts. And then the best place for the listeners could get a hold of you or follow you.

Sure. So, final thought innovates, we need innovations and health. We need new ways of doing things and thinking about things that are really going to improve people's health. We'll just do it in a way that is grounded and respectful of people and really people-focused and also consider the enablers that need to accompany those innovations that are coming into the health care and public health setting. And if you want to, can you can find me on LinkedIn as well as on Twitter @PattyMechael and through Healthenabled.

Outstanding Patty this has been so much fun. Really appreciate you sharing your experiences and and your stories with us. Really look forward to staying in touch with you.

Sounds good. Thanks Saul.

Thanks for tuning in to the outcomes rocket podcast if you want the show notes, inspiration, transcripts and everything that we talked about on this episode. Just go to And again don't forget to check out the amazing healthcare Thinkathon where we can get together took form the blueprint for the future of healthcare. You can find more information on that and how to get involved in our theme which is "implementation is innovation". Just go to that's Be one of the 200 that will participate. Looking forward to seeing you there.

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Recommended Book:

Thrive: The Third Metric to Redefining Success and Creating a Life of Well-Being, Wisdom, and Wonder

Best Way to Contact Patty:

LinkedIn:  Patricia Mechael

Twitter:  @PattyMechael

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