Solving for Healthcare’s Biggest Issues with Data and Privacy with Stan Shepherd, Founder and CEO of Instant Access Medical: Audio automatically transcribed by Sonix

Solving for Healthcare’s Biggest Issues with Data and Privacy with Stan Shepherd, Founder and CEO of Instant Access Medical: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

Saul Marquez:
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Saul Marquez:
Hey, everyone welcome back to the Outcomes Rocket podcast, Saul Marquez here and today I have the privilege of hosting the excellent Dr. Stan Shepherd. He’s a visionary leader in healthcare IT, Founder and CEO of Instant Access Medical. He gained a BSC in aeronautical Engineering before qualifying in medicine and entering general practice. He was one of the earliest users of computerized records before combining his skills in medicine and technology to develop an electronic healthcare record, still a leading system in three countries and used by the Special Olympics in every US state and one hundred other countries. As a clinician, he understands the business of health care intimately. As an engineer and I.T. specialist, he understands systems and using technology to improve health care outcomes. His focus is Instant Access Medical, and its comprehensive, lifelong personal care record for citizens to enable the most clinically effective and most cost-effective care to deliver the best outcomes and lowest cost for patients, providers, funders, insurers, and employers internationally. He’s a member of the Special Olympics International Medical Advisory Committee and is medical advisory to Special Olympics Great Britain from where he’s calling in today. He’s a councilor on the Digital Health Council of the Royal Society of Medicine and is responsible for external partnerships and alliances. I’m excited about today’s conversation and really looking forward to spending some good time with the outstanding Dr. Stan Shepherd. Stan, thanks so much for joining us.

Dr. Stan Shepherd:
Thank you, Saul. And thank you for that lovely introduction. My mother would have been proud of you.

Dr. Stan Shepherd:
Well, Stan, you just are such an impressive person and just have done so much to add value to health and health care. And so I love to really understand what inspires your work in health care.

Dr. Stan Shepherd:
It actually goes back, Saul, as a young doctor when we initially, many years ago put the first computer in our practice, in our medical practice. And it meant we had data and we knew how many of our children had been immunized. We knew how many of the adult females had that pap smear and so on. And in those days, very few people knew that data. And because we had that data, we were able to focus our attention. And once we started to get our immunization rates up to 90 plus percent and our pap smear rate up to 85, 90 percent, people started to say, oh, you’ll never get one hundred percent, you’ll never get 100 percent immunization. You’ll never get one hundred percent up tick off anything. And that was when I realized something that stayed with us ever since. Which is as a doctor, it’s not my job To get one hundred percent uptick for any immunization or any other procedure. That’s up to the patient. But it is my job. It is 100 percent my job to have 100 percent knowledge of who has had an immunization or have a pap smear and who has not, especially those who have not. And it’s my job to know why they have not.

Dr. Stan Shepherd:
Did nobody invite them? Are they unclear about the benefits? Are they mistaken about the side effects and so on? So I realized that my job was to have 100 percent knowledge about my patients. It wasn’t to have a 100 percent uptick rate of something, but 100 percent knowledge. And you can’t do that on bits of paper. So that got us into the whole computerization of medical records and that’s what we’ve stuck with ever since.

Saul Marquez:
You know, that’s a really great distinction, Stan to have landed on. Yeah, it’s not Up to you to to to insure, but you want to understand your patients so intricately. That’s consumerism, you know. And so, you know, it’s awesome that you have been thinking about this for so long. It’s dawning on the industry. And so talk to us about how you look at things and really through the lens of Instant Access medical. Talk to us about what you guys are doing to add value to the health care ecosystem.

Dr. Stan Shepherd:
Well, I mean, think of for all of us, every citizen health care data is scattered across all of the clinics and all the hospitals we’ve ever been in. And there are different record services in all of those different sites. So the care cannot be integrated. You can’t deliver integrated care if you have got integrated information. We’re a long way from hospitals and clinics in any one country or even one state, let alone internationally sharing information. There are huge consequences of that lack of integration, that lack of sharing of information. So we believe fundamentally in Instant Access Medical that the citizen should be the primary data owner. The citizen is the common point for all services impacting in healthcare. So it kind of follows that their record is the most comprehensive long of the care they have received. And so it should be the citizen as the primary data owner to share it with providers. I would say should and they will. But the providers has become controllers and processes of that data. The other reason for putting the citizen at the center is good health is not something that just happens to you. Like wealth, good health has to be created and managed.

Dr. Stan Shepherd:
Now, everybody, we’ve all got lifelong records for our credit card statements, bank statements and so on. But almost no one has a lifelong record for their health. And yet everybody, if you said to anybody, is your health more important than your wealth, the 99 percent population would say yes. But we’ve got all these great records, lifelong records throughout all of our old life, long records for our wealth. But almost none of us have our own life record for our health.

Saul Marquez:
Stan, I mean, I’m part of that group that doesn’t. And you really make me think and I’m sure, folks, you’re probably thinking, wow, you’ve got a point here. What am I doing about my personal records? And I mean, I just think about getting these vaccinations and what happens to the records. I mean, there are pieces of paper that are frankly scattered in different files in my home. Whenever I need something, it takes me forever to find it. And sometimes I can’t even find it. So I know that, you know, everybody listening. You’re probably in the same boat. If you’re not, you’re very unique. So, Stan, you’re focused on changing this. So talk to us about what you guys do that’s different and why it’s a better way.

Dr. Stan Shepherd:
Sure. Let’s think of this. Just push the wealth one little bit further. Imagine you were trying to manage your spending and instead of getting a credit card statement at the end of every month of all the transactions you’d made in whatever stores you’d been to, imagine you got a list from each store just of the transactions you did in that store. And by the way, not all the stores bother to send you one. How are you going to manage your spending? How are you going to know what’s going on? It’s impossible, but that’s what goes in health care. So we think if you’re going to be the primary owner, then every citizen needs their own lifelong personal care record under their own control. Just as your credit card is under your own control. You have you’re in charge of it and you use it as you see fit. Now to have a lifelong personal care record, it’s got to be comprehensive. And that’s got it’s got to be for two reasons. Nobody is going to be happy with separate apps, one for diabetes, one for their arthritis, one for this, one for that scattered all over their phone. They should be together in one place. And each of us needs lifelong personal care in one place. But the other thing is the needs, the functionality, the features, the services that are lifelong personal care record will give us varies over a lifetime. What you need as a newborn baby or your mother needs as a newborn baby is different from what you need as a five-year-old. It’s different from what you need as a teenager. It’s different from what you need as an adult female or an adult male. It’s different as an elderly male or female. It’s different if you’ve got diabetes. It’s different if you’ve got cancer or you haven’t.

Dr. Stan Shepherd:
We’re all different. We can all have a common platform. We don’t have the same structure in our record. But the actual content of our medical note to people doesn’t matter how many billion people we’ve got in the world. No two people whose personal character is going to be the same. So it has to be comprehensive so that as life evolves, as different things happen to you, your reocrd to is that not only to record the data, but to support you with its function and features. And that’s what we’re driving to do. So we really do focus on the person, on the patient. We want people to take control of the health.

Dr. Stan Shepherd:
Everything you read, people talk about patient-centered care. It’s a great phrase that trips off the tongue. But actually most care in the world currently is still delivered a doctor -centric care. And it’s inevitable because only the doctor or the health care professionals have the information. Patient-centric care has to be about putting the patient really at the center, which means the patient having their own data. So we need to move to a situation where instead of patients struggling to get to see their data in the doctor’s system, patients take having their own lifelong record on their mobile phone, on the web, taking it with them so that we get to a position of doctors seeing patients data rather than patients seeing doctors data. That’s not to say the doctors shouldn’t have it. Of course, they need that data, but the center of gravity is in the wrong place for patient-centric. That’s what we want to do. And the vehicle to do that is your personal care record.

Saul Marquez:
Yeah. So Stan is you, as you well know, here in the States, we had discussions, a big debate around a national patient identifier, you know, and then it didn’t work. Right. They voted it down. Some confusion and ideas around. They’re going to basically confuse things. Records would get mixed up. And to your point earlier, Right. The wealth example is always a good one because, hey, you know, I don’t wake up and magically have three extra zeros in my bank account. Like that mix-up doesn’t happen. And there are controls to ensure that doesn’t happen, you know, so. What you’re saying is so key, and if we’re not going to do it through our government system, then it’s critical that we consider avenues such as yours Instant Access Medical to get there because it’s important and there’s a lot of benefits that can come with really understanding the lifelong record. So talk to us about how in your journey you’ve been able to improve outcomes or make business better for the employers and people that you provide this for.

Dr. Stan Shepherd:
I think it is still early days. I know I haven’t got any glib answers, but the early adopters we’ve worked with and we know that people value having their own data. There is an increasing thirst for people to have their own data, but also to manage services directly themselves. One of the big outcomes of digital transformation, I mean, health care hasn’t gone through its digital transformation yet, but retail finance, travel insurance, they’ve gone through their digital transformation. And if we look at the lessons from there, one of the things they had to do was create a longitudinal record for each consumer. Certainly here in the UK, if you will, if you will, with a particular bank. And you had a bank account in London, three bank accounts in Cardiff, two in Birmingham alone in Scotland. They had no idea that you were the same person because all of the systems were account-centric. If you had an Insurance policy, a home insurance with an insurer and you changed, you moved home and told the insurer you changed your home address. They didn’t know what to tell the car huys because their Systems were policy-centric. They had to. And it was a huge effort to make their systems consumer-centric. So now not only do they know if you’ve got a home insurance, but you’ve also got coverage because they know the insurance is you don’t have. So they can promote those insurances to you and so on. So in health care, we need to get to that same position where we’ve got a longitudinal record. You will manage your patients better with you health record, just as banks, insurers and so on Can manage their consumers better with along a lifelong record for each one.

Dr. Stan Shepherd:
Now, that’s one aspect but the other great aspect of digital transformation. And this is where you start making big impacts on costs and efficiency is all those other industries. Retail, finance, travel, insurance, enable the consumer to manage as many services directly themselves as they could. So I can book a flight a year from now. I can choose my seat, I can order my meal. I can barely. In medicine, we think it’s miraculous that you can book an online appointment with your doctor, but not more than three weeks ahead. So there’s a big mismatch here and a public.

Dr. Stan Shepherd:
We know that the I think the numbers in the UK have some 70 percent of people book their flights online and it’s something like less than five percent interact digitally with the health service. So the problem is not public appetite or public capability. That’s not the problem. It’s just that in health care, we have made services available for people to interact digitally with from their personal record in their own position.

Dr. Stan Shepherd:
So we can see the power of putting the information in the hands of the patient. But we can then do more than that. We can give them much more than just data. It’s still regarded as pretty leading edge to a patient see the doctors data. well in the nicest possible way without wishing to be patronizing another doctor, seeing that data knows what to make of it. Many people see the data and don’t necessarily know what it means to them. But if you put that data in their own lifetime personal care record, we can then put in, as we have done, we can put in algorithms, alerts, reminders, explanations and other support mechanisms around that individual’s own data.

Dr. Stan Shepherd:
We can give them personalized care pathways, personalized alerts remind us to help them make sense of that data and to make it useful. So that’s the direction of travel and that’s how we see our ability to improve both improve the outcomes for patients, but also to make the businesses better. There’s an understandable reluctance about many doctors amongst many doctors that many health care organizations, hospitals and so on to trust the public with that data. But actually, it’s worked brilliantly in all those other industries and it has brought increased efficiency, is better outcomes, is brought lower costs, and actually it’s brought increased customer satisfaction. We can do with all four of those in health care, I think.

Saul Marquez:
Yeah, it’s certainly very promising, Stan. And so as you reflect on maybe some of the biggest setbacks that you’ve experienced in this in this journey to make the records available for consumers for their own, what would you say is one of the biggest setbacks you’ve experienced and a key learning that came out of it

Dr. Stan Shepherd:
Is being too early in the market, being before our time. How many years ago I had that realization About 100 percent knowledge, not about 100 Percent uptake. It’s been hard. It’s been a long, hard road to get across the Concept of why it’s so vital for people to have their own Information, and it’s really. Only, as I touched on just now after the digital transformation in those other industries, that people have said, wow, we can gain those same benefits of digital transformation in health care. So we were before Our time and we just had to wait until people were ready to see the vValue and the need themselves. But that’s changing rapidly now through COVID.

Saul Marquez:
Yeah, it’s certainly tough you when you see the vision and others don’t yet, or the systems are just not aligned yet, you know. And so I see it. I definitely see it. And I know the listeners there, they’re forward-thinking, too. They see the promise of what we’re discussing here. So what are you most excited about?

Dr. Stan Shepherd:
Well, I’m most excited about the fact that we’ve got the tools now. We’ve got the software tools. Certainly mean software development assessment for dramatically. Almost everybody has a phone of some sort. The vast majority have a smartphone. People have their own ways of accessing. We’ve got the Internet. We’ve got the ability for the data to be shared and to be owned by the individuals. And we’ve got those eExamples of those other industries. And so people are realizing that it’s actually health care is the odd one out now. It’s not the others of what. It’s health care. That’s the odd one out and COVID for all its tragedies. And it’s desperate, but it has alerted people that they can and need to have their own information and they need to start managing their own health care. There’s plenty of examples we can give or take the really simple one. And people are now talking about health passports. Now, nobody thinks is strange that you have to have a passport to leave, move from one country to another. Things are strange at all. And yet we’ve never bothered to take our house with you. When you’ve got an airplane, you fly somewhere, you leave your house behind. You might get in in a foreign country, but you’ve got no information. The best thing you can do is give him the phone number, your physician at home. That’s about it. But if you have your health passport, if You have a lifelong health record And as multilingual because of our previous business experience, if you have your multilingual personal care Record on your phone and you’re ill in acc foreign country, then you’ve got the data with you to show foreign doctors and perhaps show them in their own language as well. So arrying a health passport is saying, well, we’re going to help hospitals.

Dr. Stan Shepherd:
That’s one. Another simple example is the vaccines. We can’t say we know, but it is highly likely this vaccine will mutate. It’s highly likely it will go the way of the other coronaviruses like flu. And we may need annual or at least from time to time, further top up vaccinations. But of course, we haven’t done any haven’t had the time yet to do any testing is if you have a vaccine from Manufacturer A now, can you have the top up from manufacturer B and will you even remember who you had the first one from if it’s nine 12 months later? Well, if it’s in your personal care record, there’ll be no ambiguity and no doubt about that at all.

Dr. Stan Shepherd:
The other thing, even beyond COVID, is much more exciting is the whole notion of person generated data. It started with Fitbit, counting of steps, your heart rate, your sleep and So on. But that’s racing away now to your blood glucose, your blood pressure, all sorts of bodily parameters can be measured. Now, where’s all that data going to go? It’s not going to go to your physician system if you’re measuring your blood pressure once a day or twice a day. The physician does not want all those blood pressures in their record. If you’re doing real-time glucose analysis of your blood glucose, the physician doesn’t want to see every one of those bits of data. But the perfect home for them is your lifelong personal care Ricco not only do you then carry those with you, but inside the personal care record with algorithms, we can create that data. And we did an early adopter where we had people measuring their blood pressure twice a day. And instead of feeding all those results to rhe doctors. We simply averaged it out over a week and sent the doctors the weekly average. Now, I think that’s great for the patient, but it’s also going to be great for getting control of those long-term chronic conditions, even in the best run diabetes service today. You see your doctor or nurse once a quarter, four times a year, three hundred sixty-one days of the year, you’re on your own.

Dr. Stan Shepherd:
So when you see them and they say, well, your blood pressure’s your blood sugars, your blood pressure’s a bit high. What have you been up to? Well, none of us can remember what we’ve been up to in the last three months. So on the other hand, if you’ve got a blood pressure monitor, these things are very inexpensive these days. If you’ve got a blood pressure monitor and it’s feeding its results by Bluetooth directly into your personal care record, what we say to people is, look, when you’re measuring your blood pressure, you do it regularly. But if you just had a row or a family upset, check your blood pressure. If you just had a lovely evening, a calm, quiet evening, or you’ve been for a lovely walk on a sunny day, check your blood pressure. If you forget to take your tablets before you take a tablet, check your blood pressure when you take your time. Check your blood pressure a few hours later. Because that way people will start to associate their personal behavior with the blood pressure that’s going up and down, because the problem With modern chronic disease is long term conditions. You don’t feel anything. You don’t feel anything of your blood pressure going Up. You don’t feel your blood glucose going up and down unless it reaches extremes. So you’ve got no way of knowing what you’re doing, how that’s affecting your physical parameters. But if you’ve got that data, you start to say, hey, every time I have a relaxed evening, her blood pressure goes down. Every time we have a row, it goes up. So from that association comes understanding of what it is I am doing that makes my disease get worse or better. And from my understanding of what I’m doing comes control. And I think it’s exceptionally hard for people to come to Grips with long-term conditions seeing a physician every three or four months. So I think that’s the biggest, the biggest change. We’ve got to have truly personalized medicine where my bodily parameters, my measurements feed to my personal care record and my personal care record is helping me understand the impact they’re having on me and guiding me towards a better outcome.

Dr. Stan Shepherd:
And I think the world is becoming ready for that. I think COVID has been very important for citizens, for individuals. It’s also been hugely important for corporates. Biggest market right now is to corporates for the health of their workforce. Corporates have been talking for years about the health of their workforce and very few have done anything about it. covid has made them realize they have to take the health of their workforce seriously. And we’ve got the tools to do that to help and support that people with all sorts of long term conditions. So I think with then we’ve been patient with the waiting for our overnight success. After many years, we’re ready. And I think the world is ready for this now.

Saul Marquez:
Well well put, Stan. And it is an exciting time. And all of the examples that you’ve given us are great examples of how we could benefit from owning our own personal record and inputting the data into this record to be smarter about the recommendations. You know, if Amazon Could give us recommendations about the things that we don’t even know we need to buy, but when we see it, it’s like, oh, wow, that’s really good. It’s not about those suggestions in our health, right?

Dr. Stan Shepherd:
Exactly right. And say this is not to replace physician systems at all, instead of hospital system. It’s just there’s this great gap we have. Ricco is optimized for cardiologists. We have records optimized for urologists. We have records Optimized for physical therapists, as well as the records optimized for the citizens. We don’t Have that.

Saul Marquez:
Yep, you are spot on, Stan. And so grateful that you and your team are doing this work and the time is now. I forget who said it, Stan, but the quote is not even all of the world’s armies could withstand the right idea at the right time. And I think this is the right time. So kudos to you and the work that you’ve done. The lifelong work that really has culminating into this. And so really appreciate you educating us today. What would you say is the best place that the listeners could get in touch with you and any closing thoughts?

Dr. Stan Shepherd:
Yeah, well, I mean, I think I agree with you and I’m delighted you feel the same that the time has come. So if your listeners have liked what we’ve said, whether they agree or not, we have a website, Instant Access Medical Dockum. And if your listeners would like to contact me there and we’d be delighted to hear from them, I’m delighted to keep them briefed and updated as we move forward. So thank you. Thank you. So it’s been really great talking to you and thank you for the terrific questions.

Saul Marquez:
My pleasure, Stan. Appreciate all you do.

Saul Marquez:
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