Improving Health and Well Being of Underserved Populations
Episode 473

John Sargent, Co-Founder & Co-CEO at BroadReach Corporation

Improving Health and Well Being of Underserved Populations

Providing accessible and high-quality healthcare to underserved populations of the world

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Improving Health and Well Being of Underserved Populations

Episode 473

Recommended Book:

The Alchemist

Best Way to Contact John:

LinkedIn

Company Website:

BroadReach

Improving Health and Well Being of Underserved Populations with John Sargent, Co-Founder & Co-CEO at BroadReach Corporation transcript powered by Sonix—the best audio to text transcription service

Improving Health and Well Being of Underserved Populations with John Sargent, Co-Founder & Co-CEO at BroadReach Corporation was automatically transcribed by Sonix with the latest audio-to-text algorithms. This transcript may contain errors. Sonix is the best way to convert your audio to text in 2020.

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

Saul Marquez:
Welcome back to the Outcomes Rocket. Today, I have the privilege of hosting a Dr. John Sargent. He’s the Co-Founder and Co-CEO of BroadReach. He’s a globally recognized innovator focused on developing 4th Industrial Revolution technologies to radically improve healthcare delivery and catalyze broader development sector outcomes. John also focuses on developing public-private partnerships, cultivating private sector participation with the development sector. John co-founded BroadReach in 2003 and serves as the co-CEO overseeing the development of technology enabled solutions for the consulting business. The main area that they cover is Africa and the insights that we could garner from how to reach this population. Access is is a big problem in the U.S., but what the innovative solutions they’re conducting over there, what we can learn from them is huge. He was recognized by the World Economic Forum for the Social Entrepreneurs of the Year in 2015 by Frost & Sullivan with the Visionary Leadership Award in Healthcare and by Devex as one of the Top 40 under 40 leaders in Development. It’s going to be an interesting conversation today. The applications are really impressive and what we could do with social determinants of health here in the states. And so I’m really thrilled to have John on the podcast. And John can’t thank you enough for joining us.

John Sargent:
Thanks so much. We really appreciate your inviting BroadReach onto your podcast and sharing our story. Thanks so much.

Saul Marquez:
It’s a pleasure, John. So tell me, what is it that got you into health care to begin with?

John Sargent:
Yeah. You know, I know as a kid, I was always interested in science and medicine and sort of followed the classical pre-med route. And I’d say, you know, the first I think, big shift in my life was when I was an undergrad. I had the opportunity to go work in Sierra Leone. Sierra Leone is a country in West Africa. And this was the summer of 1992 and it was devastated by a civil war. So I was working with the Red Cross. And if you remember the Leonardo DiCaprio movie, Blood Diamonds. Yes. Based on on Sierra Leone at this time of the horrible civil war, you know, the rebels would amputate people’s arms and legs. And I worked in a really remote refugee camp. Culture came up and it was, you know, no running water, no electricity. Not enough doctors, not enough nurses. And really, as a as a 20 year old undergrad sort of experiencing this outside of the US for the first time, it just rocked my world. I mean, it did two things. A number one, it made me realize that there was massive needs around the world and that if we could focus more resources and talents on public health in emerging markets, we could make a big difference. But the second thing was, even though we couldn’t get enough doctors and nurses, I could always get Coca-Cola. And that was a crazy thing even in 1992 and was to ask the question, well, what is it that the private sector knows and what do we what can we learn from other industries to change public health? And that was really, for me, the tipping point for my career.

Saul Marquez:
Well, I think it’s it’s so fascinating how these early experiences really tend to shape our careers. And sounds like it really happened with you, John, in a big way, because now you guys are are focused in that area. I think it’d be good for the listeners to better understand broad reach and the work that you guys. Can you give us a brief on that?

John Sargent:
Sure. And just a shout out to my co-founder, Ernest Darkoh. He’s my best friend from medical school. And we’ve traveled this journey together and we’re still best friends. After all these years now. So we are focused on improving access to health care for underserved populations. And that’s that’s a pretty bold statement and it’s a really complex problem. But at the end of the day, it’s a fundamental issue of economics. Demands, outstrips supply. So you’re always going to have more patients, more need than you actually have money and resources. And so our focus is how do we on the supply side? So how do we work with providers, the doctors, the the clinics, the governments, how do we make them more productive, more effective so that they can do a lot more with what they have an impact, more people. And so, you know, it’s evolved over 16 years, but it’s you know, we started out as a consulting firm, specialized in this industry and public health, you know, doing things like helping the South African government with some of their HIV policy and strategy all the way to focusing on improving the performance of the clinics and training doctors and nurses. Today, in 2019, we’ve really infused a lot of technology and we are Microsoft partner. We’ve got a platform called Vantage that aggregates data and that minds the data and it helps anyone working in the health system from somebody at the executive level down to an individual clinic manager to understand what are the priorities they need to focus on that week, what they need to do, how do they perform last week. And so really trying to focus their actions so that there are a lot more effective.

Saul Marquez:
Love it. And what is it that got you so intrigued by this area of care?

John Sargent:
Yeah, you know, I think. It goes back. So my first aha moment working in Sierra Leone. What was it about the private sector and how do how does Coca-Cola organize its supply chain and its marketing and its sales? But then with the way we got started was Ernest, after we finished medical school, we both went into management consulting to quote unquote, learn business. Ernest was on the McKinsey team that was in Botswana. So the world is waking up as 2001. The world is waking up to this HIV crisis. And so McKinsey was doing a strategy to help the government of Botswana create a national HIV treatment program. And what became really clear in that work was that those folks working in public health, doctors and nurses, very competent, very well-trained folks don’t have the training in business management. And when you’re running a national program at scale where you’re treating hundreds of thousands of people, you have to know supply chain. You have no H.R. management. You have to. All these disciplines. And that’s sort of where it all clicked together. And we decided that we were stupidly going to quit our jobs and start broad reach to hang up a shingle and to help governments and donors and NGOs and Lifesciences companies. Anybody who is delivering health care to those in need to really put together and run programs more effectively.

Saul Marquez:
I love it. So give us an example of what you guys have done to create results, whether it be improved outcomes or better business processes, profitability share for us.

John Sargent:
Yeah, sure. So, you know, today, you know, BroadReach is about a thousand employees. The bulk of the folks are based in sub-Saharan Africa. Our vantage platform today is supporting programs that are helping over two and a half million people on HIV treatment. That’s roughly 10% of the world’s HIV population who are on treatment. It’s doing a lot of great things. But I think the one program I’d love to highlight is in South Africa, we’ve had the privilege to work with one of the provinces of the provinces are like a state in the US. So we work with one of the provinces called KwaZulu-Natal Hall. And Zuna Hall is really the epicenter of the world’s HIV pandemic. It has roughly three and a half million people who are thought to be HIV positive, and that’s roughly 10% of the world’s HIV population. And in that particular province, they have about eleven million people. They have about eight hundred and sixty or seventy public sector clinics and hospitals. And so this is their number one issue. I mean, if they don’t solve this issue and everything else doesn’t matter. And so when we started working with them and this is really, you know, before the days of cloud computing and A.I., the biggest problem they had was trying to figure out what is actually happening across all eight hundred and sixty clinics. How am I doing on my budget? Am I getting as many people who need to be on treatment, on treatment of my testing? Enough people and my keeping people adhering to their medicines. And so you can imagine doing this all by paper and reports that are three months old doesn’t work. And so we’re very fortunate to have been working with them. Funded by USAID through the U.S. government’s PEPFAR program that George Bush everything started the FFR program, president’s emergency plan for AIDS Relief, and that through that funding, we were actually able to work with the government to install vantage, to provide consulting services to radically change today. Know every single day what’s happening in all 860 clinics as it relates to, you know, how many people were on treatment, how many people were tested. We can look at, you know, which staff in which clinics were more productive, which ones weren’t. So now they can make decisions every day and every week to reallocate resources and to boost performance. And it’s been some of the outcomes we look at, in particular patient outcomes. We’ve been able to triple sort of adherence rates through a test they call viral load testing to test the effectiveness of the treatment. You know, we have helped the province get over a million people on HIV treatment. Obviously, you know, we’re in the background and we’re doing the consulting work and they’re they’re out there doing the hard work. But that’s one particular shining example of the power of bringing productivity and AI and consulting to improve health care performance.

Saul Marquez:
That’s a great, great example John, and as the leaders listening to the podcast, mainly U.S. based and thinking about what they’re going to do to either tackle their problems, you know, their population health problems, access problems or maybe an entrepreneur or listening to this, that has a solution. You know, you guys probably worked. I don’t know. I mean, there’s a good opportunity to level said that, you guys. What is the budget like? Is it smaller than what somebody in the US would have to work with? And is what you guys have done translatable to help some of the access problems that we have in the U.S.?

John Sargent:
Yeah, definitely. Because, you know, I think a couple of things. First, obviously, the budgets are a lot smaller.

Saul Marquez:
So I didn’t want to assume that.

John Sargent:
So so, you know, it’s a necessity is a mother of invention, right. So when you’re in these resource poor settings, you have to figure out a way. I think it’s very translatable to us. I mean, any health care system, you always have the same problem. You just don’t have enough money and resources. To do everything you want to do, right? How do you be more effective and so for us? You know, I think there’s a couple of things that I view as leapfrog moments coming out of Africa that we can bring back into other markets. You know, number one, because we have a shortage of doctors and nurses where we work. And because most of them are so busy seeing patients, the last thing they want to do is look at lots and lots of graphs and lots and lots of KPI indicators to try to figure out what to do. And so that forced us to really do the hard work of taking all the data. And then we use natural language generation A.I. to basically translate it into very simple things. So if you’re the minister of health of the country, you’ll get an email that the system generates automatically vantage, automatically creates and tells you in very simple bullet points this year, three issues this week. You know, like we could have an outbreak of Ebola on the border. Do X, Y and Z, you know, 2nd things, 3rd thing, 4th thing all the way down to clinic managers that tells you what to focus on. So I think the Leapfrog moment is it’s taking analytics to real life applications. And, you know, I think that’s one of the big issues. I think the second thing is really then you can make the right decision, but there’s no guarantee you can actually implement it. And again, if you identify that a clinic’s not performing because they’ve got issues with their, you know, their pharmacy forecasting, how do you then implement an intervention to fix that? And again, I think the big learning that we’ve had is that you need to systematize it and you need to build best practice tool kit so that when you go in to fix up that pharmacies inventory management system, there’s an 18 step process and you can repeat it over and over and over again. And I think a lot of those disciplines can be brought back into these other markets.

Saul Marquez:
And I think that’s really neat. And my mind goes to FQHS right that are struggling to figure out a way to give their communities what they need. And efficiency problems happen in just these types of processes and systems that you guys have built abroad. I feel like we could really benefit from here.

John Sargent:
Oh, definitely. I think, you know, the difference in the US is that you have so much rich patient level data. So a lot of the analytics and the focus is very much at the patient level. And I think what’s forgotten because we don’t have the benefit of head in Africa. So we’ve had to look at social determinants of health indicators and overall systems indicators. You know, what’s your length of stay? How many patients are you seeing per number of doctors, those sorts of things. And so our approach is very much from top down. How is your system performing? And I do think some of that is translatable over into the US and other developed markets.

Saul Marquez:
Fascinating. So you guys have done a lot and you’ve been working in that area now for how long? A decade?

John Sargent:
since 2003. So 16 years.

Saul Marquez:
16 years. So going on two decades here, you’ve had a lot of success, but I’m sure that success hasn’t come without setbacks. I love if you could just share a setback that you think is the most impactful and what you learned from it.

John Sargent:
Sure. Yeah. We’ve pretty much made every mistake in the book and still survive. But I think the the one thing when we first started, you know, we started out as consultants, you know, without the technology platform. When we started developing the technology platform, we sort of had this incorrect mind shift, which was the technology is the end in itself. It’s not the means, the end. It’s the end in itself. Can I just have a good app? Good technology. People will use it and you’re magically going to change how the health system performs. And we could have been more wrong at the end of the day. Technology is a means to an end. It helps you change human behavior. But if you don’t change human behavior, at the end of the day, you know how a clinic manager manages, how they allocate resources. You’re not going to get the results. And that really forced us to rethink our approach. And so today, our approach is really bundling the consulting change management process, re-engineering with the technology and using that technology to sort of make those changes stick and to reinforce those changes. And, you know, it’s still it’s still a journey. And, you know, we face, you know, different cultures, different languages. And so it’s you’re always learning as you’re doing this. But at the end of the day, if you can’t motivate and incentivize people to change their behavior, whether you’re a patient or you’re somebody working in the health system, you’re not going to get the result.

Saul Marquez:
Love it. Great call out. He can’t throw technology on top of human problems and expect it to change.

John Sargent:
It would be great, but unfortunately not.

Saul Marquez:
Na, It’s a great call out and one that I think a lot of people listening could benefit from and probably are a no. But good reminder, folks. Your technology alone is not going to make the difference. It’s those human factors behind it that can truly get you that breakthrough. You’re looking for in your product or service or in a project that you got going on and your in your hospital. So tell us a little bit about one of the proudest moments that you guys have had today.

John Sargent:
Yeah, you know, I think the work that we talked about in cuisine at all. You know, I think there’s been a great example, but where we’re going. I’m very excited about is that, you know, we’ve recently built up a data science team. And so, you know, the work we’ve done talks a lot about systems performance, but we’re now drilling down into predicting when patients are going to stop and hearing we’re drilling down into things like how do I better shift and allocate resources on a daily and a weekly basis to make more of an impact. So for me, sort of launching this first data product around patient adherence has been a phenomenal achievement. You know, we’ve been able to back test the model with over half a million patients, longitudinal sort of history of over 5 years of patients on HIV treatment to see what’s gonna happen. I think that’s going to be a game changer, because now if we can get the health system to improve and we can also identify those patients who are at high risk of stopping their meds and getting case managers to reach out to them and sending text messages out to them, that’s sort of another, I think, a quantum leap for us.

Saul Marquez:
Man, that’s huge. You guys just continue to make progress. And, you know, I’m just so intrigued by this area of soon a towel. And what is the goal there then? You know, I mean, so it’s 10% of yeah, I guess AIDS population as there is a goal to reduce that by a certain number, by a certain time or?

John Sargent:
Yeah. So there are standards that’s for the public health industry has set. U.N. AIDS in particular and W.H.O. and we we want to basically end the pandemic of HIV in the way you do that typical treatment cascade. So you need to identify those who are HIV positive, get them on treatment, take us to treatment. So there’s targets we have to hit. We need to identify 90% of those who are tested. We need to make sure they know they’re positive. Sorry that 90%, those who are positive that we test them and they know that they’re positive. And of those 90% need to be on treatment. And of those, 90% need to stay on their treatment. So, you know, same thing. And diabetes is a classic sort of patient cascade. And so in cuisine at all, in every country that has HIV, that’s the overarching sort of three indicators you’re focused on. If you can hit 90% across that cascade, we can get the HIV pandemic under control. And so that that’s absolute focus of cuisine at all and everywhere else.

Saul Marquez:
That’s a big goal. And I definitely admire you guys for being there and doing that work because it’s it’s definitely not easy.

John Sargent:
No, but, you know, it’s it’s a passion and it’s a calling. So, you know, it’s earnest. Mike Microfiber always says, you know, every day doesn’t feel like I’m going to work. It feels like I’m doing something I love. And when it stops feeling that way, then it’s time to change.

Saul Marquez:
Yeah, I definitely admire you guys for that. And so you’re obviously making some huge strides and I can’t congratulate you enough for the work that you guys have done. What’s next here is the Lightning Round and followed by a book you recommend to the listeners. You ready, John?

John Sargent:
Sure.

Saul Marquez:
What’s the best way to improve health care outcomes?

John Sargent:
I think teaching those in the health care system, management and leadership skills and then giving them the tools like data powered insights to help them do better.

Saul Marquez:
What’s the biggest mistake or pitfall to avoid?

John Sargent:
Falling in love with your own idea? So what we say, don’t drink your own Kool-Aid, because when you do, you sort of don’t open your eyes and you don’t collaborate with others, because ultimately I think collaboration is the best way to solving these complex problems.

Saul Marquez:
I love that. How do you stay relevant as an organization despite constant change?

John Sargent:
We keep our core principles are true north always the same. So it’s about improving access. How we do that changes with time. So we started out as consultants. Today we’re more technology data with wraparound consulting, but the principle is always the same.

Saul Marquez:
What’s the area of focus and drives everything at your organization?

John Sargent:
Patient outcomes. So we actually have if you walk to our offices, any of our offices, you’ll see that this poster where we’ve got our sort of moonshot vision that by the end of 2020 we want to be empowering twenty thousand leaders in a health system with vantage and ah, consulting products to help influence and impact the cash from population of 1.5 billion women, children and men. So that’s sort of up there front and center for it for everybody. When you walk in and we have screensavers and say that as well.

Saul Marquez:
Doesn’t get any clearer than that. And I love that we have it on the screen. savers, too. You know, just having it visible, you know, I believe in it. And that, you know, just having it front and center helps that focus.

John Sargent:
Absolutely. Yep. Yeah. If you don’t if you don’t have a target, you’re never gonna hit it.

Saul Marquez:
Yeah. And if you write it down and keep it in a file on your desktop or, you know, in your drawer, it’s not as powerful as if you put it in front of you.

John Sargent:
Exactly.

Saul Marquez:
I love that. And that’s a great way to do it. Big reason why you guys have been successful is these little things that you do. And so I love if you could share your favorite book with the listeners.

John Sargent:
Yeah. That’s a tough question. I love to read and it depends. But maybe as a cheat. And also there’s two books. So in the early days of Broadway, we used to always give people to books when they joined. So the first book was called Paulo Coelho’s The Alchemist.

Saul Marquez:
Mm hmm.

John Sargent:
And the second.

Saul Marquez:
Favorites Man.

John Sargent:
Yeah. It’s an awesome book. And then and then James Collins, Good to Great. And we always say, look, if you’re gonna solve these these serious pressing issues, you have to like combine the heart and the mind or the left brain and the right brain. And we should say, you know, Paulo Coelho’s Alchemist is more sort of the heart, the right brain, and then sort of Good to Great as is a left brain. You’ve got to combine both. Ultimately, if you’re going to solve these problems.

Saul Marquez:
Love it, man. That’s a great message and some great recommendations and gosh you know, listeners, you where to go go to outcomesrocket.health. In the search bar just type in John Sargent or type in BroadReach and you’ll get the entire show notes, the transcript to our discussion with Dr. John Sargent today. John. This has been a blast that I love. If you could just leave us sore with the closing thought. And then the best place for the listeners could reach out if they want to continue the conversation.

John Sargent:
You know, we are always looking to partner and collaborate with different groups. And so I would love, you know, if there are folks there listening to your podcast regularly, you know, whether they’re part of your medical device companies, governments, donors, life sciences companies, private sector in the US, you know, we’re looking for ways to collaborate with other groups and to expand our reach. You know, we would love to. I think we were discussing before the podcast, we’re really focused on figuring out how we can grow into other markets. So we’d love to collaborate and work with folks and you can contact us. Best Way is on our website Broad Reach Corporation, all one word, broadreachcorporation.com and there is a contact section and you send send a sort of contact information and we’ll get back to you as soon as possible.

Saul Marquez:
Love it. John, really appreciate your time and the insights that you’ve learned being and doing work out there in Africa, improving access. I feel like there’s a lot that we could learn to improve access and outcomes here in the states. So just want to give you a big thanks for joining us today.

John Sargent:
Great. Thank you so much. We really appreciate it.

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

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