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: I thank you for tuning into the podcast again. I really appreciate that. You know I’ve gotten a lot of information, a lot of e-mails saying how certain episodes have resonated so don’t be shy follow up with us on Twitter at @outcomesrocket, we’d like to hear from our listeners because today I have an amazing guest and I also invite you to rate and review us at outcomesrocket.health/reviews. This guest is an amazing collaborator in health care- a digital healthcare innovator with over two decades of experience. Originally from London, England. But now here in the United States specifically in New York City. His focus is on helping healthcare institutions differentiate themselves through innovative strategies using digital and also technology and so his focus is social media. Its digital platforms for marketing, anything that will help you as a healthcare professional as a healthcare leader within an organization. Promote what you’re doing but also get it to the right hands at the right time. So Gary just want to welcome you to the podcast and fill many of the other gaps of that introduction that I may have missed yet.
: So I think that’s great, that was that was all good. I should say I moved over from London to New York several years ago. I’m actually originally from Birmingham so I don’t want to forget my roots. That’s from I’m originally from the UK but I spent many years living in London and I’ve worked over that at that time in healthcare. Worked within pharmaceutical companies a lot of Simon Johnson Johnson and then working in agency and consultancy. So a broad broad experience but I think you covered it very well. So yes looking forward to this.
: Absolutely. And so are we. So the reason why I wanted to bring Gary on here is to get a little taste of outside of the normal health care box right because in general we’ve got to find better ways to target our customers our patients and really get a better outreach. And I think we all struggle at this. And so Gary is here to provide us some insights. But before we do get into that Gary what got you in the healthcare to begin with?
: Yeah I mean I’m a real science nerd so my study I guess you’d call a major here and majored in organic chemistry and medicinal chemistry. Yeah and I was really fascinated with how these humans build molecules can interact with the body receptors at these sites and have a profound sense of profound positive effect but also how we could minimize side effects and make sure they were really specific. So it’s I found that side of it is fascinating so that got me into healthcare and interested in pharmaceuticals and also the scientific pursuit of it, very exciting but also that potential for doing something good for humanity was compelling. So that’s got me into it. I spent some time in the lab. One small anecdote probably in my life I definitely have got the skills for science but in terms of the humbling part of that is I certainly did not have the practical skills because at my time at the Glaxo research center in England I was working in the hydrogenation suite there and Trott’s and finely divided catalyst on the floor, started a small fire really created the next small fire has to be the catalyst kind of expose the air and set on fire. So luckily we didn’t end up with the next Hindenburg but I kind of realized I have in mind for science that maybe not the body and the practicality and the coordination but that got me in there and then I moved out of the lab and the rest is kind of history really.
: But that’s awesome I’m nothing terrible came out of that Gary but your passion stuck and now you’re helping people build fires so that they can get attention to their practices and businesses so you’re doing it in a positive way.
: Exactly, a lot that’s Yes that’s true.
: So that’s fascinating. What would you say today Gary is a hot topic that needs to be on every medical leaders agenda and how are you guys approaching this?
: Yeah the thing I think of is data an artificial intelligence sounds like two topics but clearly they’re very deeply intertwined. And when I say data I’m talking specifically about personal and patient data and they kind of like sound like dirty words now particularly with the times with what’s going on with Facebook. But we got these initiatives going on around real world data, population health, outcomes driven health care lot of those was but important initiatives. But none of these are actually going to produce anything of value without the right use of data. The right approach and the use of artificial intelligence for example in artificial intelligence is will highlight we can set up a program, say Population Health Program. Artificial intelligence is going to actually highlight factors that the researchers program managers have not even considered in the set-up page and really help us join the dots in the ways we might find it hard to do. So say yes that’s very big and it’s a complex challenge. So when I think about my approach and our approach to that one, thing that comes out is very specific. Clearly we need to get all the set up right about understand the problem make sure asking the right questions. But what I would say is probably actually more of a general point that could apply to other things outside of artificial intelligence as well but is to really think broadly in the thinking in the ideation phase. So to give you an example in most cases pretty much all cases you want to go super broad in terms of the types of data collection. But let’s take a hypothetical example if we’re running a program in New York around mental health and we’re trying to support patients who may be on medicines but we’ve got a coaching program on online coaching counseling program support program that they can go to. Obviously we can pull a lot of metrics of how patients are engaging but we probably want to take as much information about that patients as possible and those patients to feed into the system. So what I’m talking about the ideation phase is when the planning that is to really look at the types of datas that would be useful to us. And look at them without judgment. So conceivably we could think for those patients that would be great to you know where they are, whether they’re going out, use a geolocation on that phone, how active they are, how much exercise they’re doing, any activity based from their phone. Any wearable devices they are using, if they got a sensors in their home measure their exact movements, monitor their phone calls, a number of phone calls, frequency duration of calls. Same with text messages how long they are and even what they are saying from their voice modulation intonation to actually what they’re saying. The more I can’t keep saying it probably sounds very very creepy. But the important point I’d want make in it, yeah.
: In the back of my mind I’m like holy cow. Like that’s a lot of information and it makes you think right like we could get a lot of information from our cell phones. So how do we use it. What are some guidelines there and what are some examples of what you guys have done.
: Yes. So there’s a lot of good examples of that. I mean this one I wasn’t directly involved in but I think it’s a nice example one that I’m actually involved in kind of sharing out, blocking around it. It’s a little while ago now. I think the company slightly pivoted but a company called Ginger.io. So I’ve actually pulled that into proposals, the clients, the pictures has been actually build it out but that was fascinating technology where they actually use the mobile phone I believe they use the tracking of the phones of the geolocation, and the sensors, the patient moving around as a proxy for how their depression was going so clearly if they’re sitting around they’re not moving much generally that probably moves probably lower if they’re functional moving around, going to the shops, going going out, seeing friends, socializing that’s obviously good. And I mention a bit about voice to kind of throw that in there. But actually I believe they using not going as far as monitoring what the patients were are actually saying which I appreciate sounds creepy but understanding their voice modulation. So how often they are speaking. So actually, now okay, if they’re isolated and they’re not sending text messages, they’re not calling their family, they’re probably not in a good place. But if they’re making frequent calls you know we’re not interested in what they’re saying, snooping on the conversations but actually if having those conversations on a regular basis, it’s probably a good thing. So using those metrics. So I think that’s a really good a good good use case all. The reason I put this about listening to the patients in there, it’s kind of to be provocative. But I think it’s a really important point when we start thinking big on these projects. There’s no harm in thinking these things initially, I feel the problem I’m kind of going on a ramp here now. But I found a problem with big companies as opposed to start, having work in both will shot down ideas like next lessons what the patients are saying.
: Explore that and we might get to a point of actually ethically that doesn’t work, it doesn’t work for the patient. But let’s explore where that could lead to and maybe it leads to the point of actually we listen to the patients conversations. Not what they saying but how often are they saying it, the voice modulation that we anonymize everything, they identify everything. So we get to kind of an exciting place because we’ve opened our thinking rather than someone then say a farmer of a big biotech company. No we can’t do that, we can’t listen to what’s patients are saying over the phone and it kind of gets shot down as soon as it’s thought about and conceived and then the end idea often ends up very vanilla and really not that valuable. So you see what I’m saying.
: I totally agree.
: Thinking big initially. Yeah, and then we pull it back in and we make sure we’re doing the right thing on the patient ethically and we don’t go spying on patients et cetera. We start thinking what data could we actually use and how would we get it and how would it serve us.
: Yeah. Gary, and you bring up a good point, right? The point here is listeners you’ve got to be open-minded if you’re going to innovate, you’ve got to be open minded and sure, it might be a little edgy but let’s find ways like anonymizing and de-identifying and stripping away the things that are patient information and making those voice markers or key keywords something that could serve the people that it’s intended to serve. And Gary the thing that brings up kind of thought in my mind about this discussion is the whole area of digital therapeutics and what’s being done with digital technology to help patients. It’s super interesting what’s going on out there isn’t it?
: Yeah absolutely, absolutely. And you know obviously what you said I can cover a lot of things but it’s simply fascinating when you’ve got digital tools that can even, that actually help patients. I was speaking to a friend who works for a startup and I say what he does as a digital therapeutics but actually helping patients sleep better. So analyzing understanding their sleep patterns by sensors on the body but also in the room where they’re sleeping. And then part of the digital therapeutics is actually adjusting their environment, the temperature of the room but also the important thing that he’s doing is actually using research to actually place specific segments of white noise at certain times when patients are sleeping, deep sleeping, their having their delta waves of deep sleep and the scientific research shows when the right sound is played at that time it can actually extend the period of deep sleep.
: And mean, the patient, the human being gets a lot more restful sleep. So I would say that’s a good example of a digital intervention where it’s listening, understanding but also giving that kind of response via feedback and there’s a good patient outcome hopefully at the end of that.
: Gary what a great example and programs like video games to help you with ADHD instead of Ritalin. Listeners,the point here is what Gary is telling us is that we’ve got to think outside the box and we’ve got to push the envelope and oftentimes large organizations get trapped with the knee-jerk ‘No’. And the little guys come up the little digital Davids and they kick butt. And so just a little thing to consider this little warning like be open to innovation and be open to ideas even though up front they may not seem like it distill them to the point where you can actually maybe get something that’s not vanilla to Gary’s point and it doesn’t make an impact. So Gary can you give the listeners an example of some of the things that you’ve done to help your clients create results and get things done better improve outcomes?
: Yeah, I got a couple of examples. One thing is coming to mind that I’ve been working on quite extensively recently which is a hot topic is a social media. So I can’t get to many specific examples but I’ve worked on clinical trial recruitment using social media which is very exciting because we’ve been able to get patients to enroll to play with trials faster than they normally would. And also more of them faster but also importantly at a lower cost as well. The cost of acquisition is between 10 and 100 times lower than using traditional methods. So that’s been very exciting using social media for that. I even shared something yesterday I wasn’t involved in it but the use of artificial intelligence attached to medical records to recruit patients for a clinical trials, that’s how it’s kind of evolving, that’s such a big a big area where there such potential to help patients that there’s a global shortage of clinical trial patients and also ensure that done cost effectively as well. So that’s the big thing. I kind of broaden out to social media generally again because it is such a hot topic. So I’ve been working on, I mean I love social media from the perspective that using things that Facebook, you can target patients directly and actually understand whether they’ve taken specific actions seen adopt the measure if they’ve moved on that journey towards better outcomes. And the reason I mention Facebook sub-16 in the news a lot recently Zuckerberg been hold up in Congress. But yeah, it’s very it’s got a lot of good potential within healthcare but obviously it’s got the potential for misuse as well so that I’m optimistic we can get to a point where the goodwill will triumph and we can use it but I’m just really concerned that the people don’t get the point of like Facebook using this is bad, start using it. There’s a lot of good that can actually be done if it’s done in the right way using using this and other other channels.
: Now totally man and you know Gary let’s talk about Facebook. So a lot of folks in the industry will think about campaigns whether it be driving patients to a trial, medication trial whether it be a training business clients in the healthcare space. I’ve heard the debate Facebook versus LinkedIn, which one is more effective. What’s your take on that?
: Yeah I mean I’ve got a lot of experience doing this and obviously it does depend a lot on who you’re targeting and exact and what you’re doing. Overall, forget about the audience in terms of the power of the targeting. Currently Facebook I know they’re pulling back some of that based on you know some of the abuses that they’ve had. So we’ll have to see how that nets out but it still looks like the targetings would say a lot more powerful than LinkedIn so from a fuel targeting perspective, I find Facebook more valuable. In terms of treating patients in most cases Facebook is going to be where more of the patients are and easier to reach in context. Obviously a number of them maybe on LinkedIn, but in terms of actually reaching them the right way around that condition it’s usually accepted more for that message to come through something like Facebook than LinkedIn. The work I’ve done targeting health care professionals actually it’s been a mix of, I’ve had mixed results depending on the type, the type of project, the type of physicians working on LinkedIn versus Facebook. Often my advice would be, you know without knowing more about a specific project, if it’s healthcare professionals, look at doing both and then see what’s really working. Why are you getting the most benefit, you the getting the most reach and then send over the, leave the budget on to one that’s working. So I’d always advise clients to be flexible. You have got this pot of money. We decided we’re going to put like, play safe part on LinkedIn, half on Facebook but we have to quickly dial it up one way or the other if we’re getting impact one one platform versus the other.
: So overall you feel like Facebook allows you to do more acute targeting meaning more specific targeting and LinkeIn not as much but you recommend sort of try a mix of both measuring and then pivoting once you figure out what’s working out.
: Yeah absolutely. And what surprised me from practical expense is how effective Facebook can be about reaching doctors because you know you see the statistics a lot of doctors are using Facebook for personal reasons.
: But a lot less using it for professional reasons. But that’s kind of a bit of an arbitrary distinction because when a physician is on that for personal reasons, if someone is coming out in context the doctor’s not going to switch off that it’s relevant to them or their practice. So they’re still going to click through on that ad if they’re using it to keep in touch with their family or look at their friend’s holiday pictures they’re not going to ignore it and say oh I’m not clicking on that even if it’s interesting and relating to my profession. Now that’s not going to happen, they’re going to they’re going to click on it. So yes, definitely consider Facebook for doctors.
: Fascinating. Now that’s some really great insights. And listeners as you consider these newer digital platforms you know take some of these thoughts from Gary and plug them into your strategy and do some testing as you work to reach those people that you want to impact most whether it be patients whether it be providers or industry. Just do these tests and ultimately the end result will come from being able to tweak, tweak until you get the result that you’re looking for. Gary what would you say one of your proudest leadership moments in healthcare have been today?
: Yeah. So that’s a tough question, there’s a lot of work I’ve done. But yes but the one thing that’s coming to mind that kind of leaves lodged in my memory because I kind of built on it since was a couple years ago I led a team hackathon in Cleveland Clinic.
: Yeah it was great, it’s very exciting and we created a solution to potentially helps chronic pain patients reduce their dependence on opioids at new stage or not artifitially intelligence to learn what interventions were having an impact outside of the medication. So even things like kind of acupuncture, yoga, meditation. So there’s a great achievement by full disclosure on that, it won an award at a hackathon which was great so it was successful from that perspective Due to array of reasons didn’t get that built out. I’d still love to build that out. So I think that’s extremely exciting but the real positive from that and I’m proud of it is the learning of thinking from Math is there. I have been able to move that on into other projects, advising startups, biotech pharma companies on similar projects. You know if you examine the field of mental health. So it’s taking that value even though not directly in that project and using that knowledge in other projects. I think the reason I’m proud of that and those type of projects is you know I really believe in what pharmaceutical companies can do. What I also believe in is the importance of having that kind of a holistic approach of what’s working for the patients. Sometimes drugs are great sometimes they are not right great. Sometimes they are very important in the context of other interventions. So that’s really important for me is having the right interventions for the patients that may or may not include drugs but we’re not just totally focused on the early onset is a pilland a medicine so you know that’s kind of where my head is with that.
: Yeah that’s really interesting Gary and thanks for sharing that I know a good percentage of the of the listeners are also entrepreneurs building things. And so if what Gary mentioned to you sounds interesting. By all means at the end of the podcast Gary will share his contact information how you could get a hold of them. Maybe it’s a project that you and Gary can pick up, dust it off and get it going because there’s definitely a need for solutions to solve the opioid epidemic. And so the imitation is there, right Gary?
: Yes absolutely. I’d love to keep working on that. Definitely.
: Tell us a little bit about an exciting project that you’re working on today?
So, I’m working on as I said those types of projects there where I’m working on actually using real world data to support patients from various different devices. It’s hard to talk like exact specifics but to give you an idea of some of the range of stuff I do something important is working on a number of digital transformations for mainly pharmaceutical companies which is really moving them from a position of not using much in the way of digital channels and communications to their patients and their doctors in their in their marketing. Actually using it in a really defined smart way in a way I don’t even want to say multichannel but in a way that really understands the needs of the end customers and actually takes them on the journey and the digital tools they use in the right way and that’s exciting for me because that’s measurable using digital and technology to take whether it’s doctors patients on a specific journey and get to an endpoint. And the beauty of that measurable pace is we can really tie that back to outcomes rather of the the easy way of doing things it’s like we need to be digital, let’s do e-mail, like Websites that builds an app and just kind of throw things at the patient not the doctor. There’s a fair chance that’s not to work anyway. But if it does work we kind of don’t even understand what’s really working and what’s not. So some of those transformation projects you know for me are very exciting. And then the more those some of those projects working on building in the technology were actually supporting patients not just using medicines but actually using technologies and other interventions so those ones but those are the ones that I find even more exciting.
: Super exciting and you know we need more of that Gary, so keep up the awesome work there. There’s no doubt that companies are starting to come to grips with the fact that this is the way that things are going so keep up the great work.
: So Gary getting to the end here let’s pretend you and I are building a leadership course in medicine, the Digital Leadership Course in Medicine, the 101 of Gary Monk and I want to build out a syllabus with you. I’ve got four questions that our lightning round style so some quick responses to these followed by a book and a podcast that you recommend to the listeners. You ready?
: Yes great.
: All right. What’s the best way to improve health outcomes using digital?
: So the key thing is understand the patient’s situation. I know you wanted it sure but that probably sounds like a cliche, really challenge what you know about the patient and observe the patient understand that pain points. I always like to think if you were if you wanted to understand how a lion lions hunt you don’t go and watch and see to the zoo. So forget focus groups just really observe the patient and understand them.
: Great analogy. What’s the biggest mistake or pitfall to avoid?
: The key thing to me is we need to stop by asking the right questions. So yes I mentioned dates you and I are important. But if we’re not careful we might start to get the right answers to the wrong questions.
: How do you stay relevant despite constant change?
: The two big things I’ve mentioned the focus of the patients are really understanding them as they evolve but also involving the changing technology landscape so involved both. Get both reported, the patients actually more so because if we understand the patients and not the technology well enough the outcomes are going to be sub-optimal. If we understand the technology and not the patient, it’s going to be a disaster.
: Love it. What’s one area of focus should drive everything in a health organization, a digital area of focus.
: A digital area focus. So I was going to just answer the easy thing which is important and bring it back to the patients. But actually if you saw a digital area of focus it’s understanding that patient, the patients not to see things out necessarily digital, non-digital but just really understanding what they’re using, what channels they are using but also why are they using them, what problem are they actually trying to solve with that so just getting real deep in understanding that from a patient’s perspective.
: Outstanding. What book and what podcasts would you recommend to the listeners, Gary?
: Yes. So in terms of a book. I finished a recent book actually called Life 3.0 by Max Tegmark and it’s about the future of the artificial general intelligence now the some healthcare examples. But what I love about it is it really takes the future forward about where artificial general intelligence can go when machines get smarter than humans. And before I read think more about science fiction. But actually this stuff will be a reality it’s just a question if it’s whether it’s 30 years or 300 years from now. I mean that’s what the experts are debating, not whether machines will get smarter than humans but just will it be hundreds of years away that we have think about it in our lifetimes or could it be sooner. But actually it was really good. So understand that from a kind of visionary perspective and then to tie things back from healthcare and understand where it can go.
: Life 3.0. And how about a podcast?
: Yeah. So I feel like your questions I’m comfortable with them all but this one’s kind of stomp me you, know I listen to a range of podcasts like not including yours, but I’m just starting to really get into them because you know I’ve mentioned that book Life 3.0 and it was the first book that I listened to on Audible. So yes, I’ve found that now in New York when I’m I’ve got so much time to kind of more like listening to stuff and reading stuff you know when I’m on the subway it’s a lot easier to listen than to read so probably next time I’ll have a list of cast but really anything to do with technology so I dip into any podcast-related technology. I have listened to digital marketer, once on digital marketing, such really keep up to speed on digital social media and technology so I kind of dip in but also it’s a recommendations from you and your listeners as well apart from this podcast and the others I should be listening to so yeah.
: Outstanding Yeah. And now sinner’s that’s the beauty of podcasting. You know you could go into the podcast app type in your topic of choice whether it be health care or if you want to just take a breather from health care and learn about tennis or cooking or marketing whatever you want. It’s all there. The platform is powerful. So do like Gary does you know search for what you’re feeling in the moment and just go for it. Gary, before we conclude I’d love if you could just share a closing thought and then the best place for the listeners can get a hold of you.
: Great. Yeah, I mean the closing thought really would be that the one thing that we discussed that kind of that I feel the most strongly about is just that real you know without you know not wanting to sound like a cliché but thinking big and by that is like just really fearlessly going out thinking about what you need to do to achieve the specific outcome without judgment and criticism. And you know I’ve read the Debono book many times and it’s kind of that green up thinking where I’m judged, not you are creative, we’re not judging. And then we bring in the critical thinking later about what the current issues to regulator issues might be. So to think big and open it first would be the really big change to make this stuff happen and don’t let me off thinking initially. So that’s be the really the big thing to me and yet I’d love love if the listeners want to get hold of me, that would be great. I’m very easy to find on LinkedIn. And I’m very open to connecting so you can put all the extension into LinkedIn and it’s Gary W. Monk would just search for Gary W. Monks that’s one ‘r’, search for me their own LinkedIn and switchapp, it’s just simply @GaryMonk,so that’s where the two best places to find me and I’d love to connect.
: If you’re on the road don’t worry about writing anything down just go to outcomesrocket.health/monk and you’ll be able to find all of Gary’s information, links to the books that he recommended and a transcript of today’s conversation. So Gary, just want to say thanks again for spending time with us and looking forward to staying in touch.
: Yes definitely a pleasure. Thanks all and looking forward
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 outcomesrocket.health. 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 outcomesrocket.health/conference that’s outcomesrocket.health/conference. Be one of the 200 that will participate. Looking forward to seeing you there.
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