Newsday – HIMSS and What Healthcare can Learn from Netflix
Episode 43516th August 2021 • This Week Health: Conference • This Week Health
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 Welcome to this Week in Health It, it's Newsday. My name is Bill Russell, former Healthcare CIO for a 16 hospital system and creator of this week in Health IT at channel dedicated to keeping Health IT staff current and engaged. Special thanks to Sirius Healthcare Health Lyrics and Worldwide Technology, who are our new state show sponsors for investing in our mission to develop the next generation of health IT leaders.

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Now onto today's show, today, this week in Health, it, it's Newsday and. HIMSS is over. Technically it's over, but we're recording this on Wednesday, so we are just in the beginning. So we have some stories from HIMSS and we're gonna, we're gonna go through those. We're actually gonna focus in on a theme today with our guest, Ann Weiler, who is the former Health Tech founder and advisor to this weekend Health it.

And we're gonna focus in on digital. We're gonna focus in on some of the announcements. Some of the. Interesting talks that were out there and see where it takes us. So, and welcome to the show. Hello. I'm happy to be here. As always, I wish I could say I was happy to be here. I'm happy to be here with you, but.

I, I really, uh, there's part of me that misses going to HIMSS . I, I, I just sounds kind of weird because it is sort of love hate. I mean, there's aspects of it that I really dislike, and then there's aspects of it that I miss. I mean, there's such a concentrated for somebody who really loves this stuff.

There's such a concentrated content. I mean, just great people talking. And it's that part of it too. It's great people. So it's interacting with great people, really understand and have a passion for healthcare. And it's just a week of that and it's a lot of fun. And so we're not there. So we are experiencing this.

You're, you're not remotely. When I was CIO it was kind of funny 'cause we had 10 spots that we could send. All right? I had 700 people that reported to me, which didn't include a whole bunch of other things. And I could send 10 people to himss. And now I know what it feels like for the other 690 who didn't get to go to himss.

You read about it in the news, you follow it on social media and you hit some of the digital sessions, but it's really, it's not the same. No, definitely not. I, I didn't even think about that having been there as a vendor and we had to go.

Are you actually even in healthcare on the. Care organization side, the number of people who were in the organization who wanted to go each year and probably never got an opportunity to, and maybe didn't have many conferences they could go to. There's always conferences, . Yeah. You know, I've gotten a couple of comments from people, Hey, comment on hims and, and that kinda stuff.

And, and I, I don't think I'm gonna do it. And the reason I'm not gonna do it is 'cause I don't think it adds to the conversation. I don't think it benefits. I think they, they were. Thrust into a very difficult situation last year. They're doing the best they can this year, and it's, it's just a very , I mean, it's like bad luck at the beginning of the pandemic and right now when it's, you have the Delta variant at its peak right now, they couldn't have had worse luck over two years if they tried.

I will say that just like just conferences in general, I think there's been a huge.

span of how people have chosen to go digital and hims. I think HIMSS could do a little better being a tech conference at the very beginning of the pandemic, I think it was like CNBC, it was back when Christina Farr was still there and they had a full day conference and the whole thing was online, but it was designed to be online.

Like it really had that . If you could actually chat with people online, and I'm hoping that as this continues, we actually get better at this because thinking about your 700 people who didn't get to go to himss, imagine that they actually got more, not just viewing this content, 'cause the content's great, but the interactions as you mentioned are also great.

How can we enable a better digital experience for ? Live and hybrid events, and I think all the whole conference industry's gotten shaken up by this, and I hope that they, they realize it's not a, it's not a cannibalization of an event that they're actually increasing their market size. To your point, you've got 10 people.

Imagine that you could have paid some smaller amount of money and had 700 people participating virtually. Right. That's an opportunity for both your staff and the conferences. It's gonna be interesting, the CHIME conferences in October, health conferences a little bit before that, and it still might be in October, but it's, it's actually before the Chime fall forum, which is in San Diego.

So San Diego and Boston. Those are gonna be probably masked mandatory states if I thought about it. Mm-Hmm. . Maybe by October it'll change. I think those conferences will, it'll be interesting to see if they're able to break through. I for one, wished they would be just easier. The content would be easier to navigate.

One of the things I used to do is the chime spring forum used to be the day before him started, and I would go and I'd go and sit in there. And the, some of the talks were phenomenal. Some of the talks were not really geared for me. So I would take that time with my laptop and I'd go through almost every presentation that was gonna be done at himss and I would organize it.

Maybe that was the start of where this week in health it came. But I would organize it, and, and then I would send it out to my teams and I would say, Hey, here are the five presentations on data science. Here are the five presentations on digital infrastructure. Here's the, and i'd, I'd send it out to my team.

So to give them sort of a taste of, Hey, here's what's being presented, and then I'd ask them, . Do you want me to connect you with the, the people who are doing the presentation or, or that kind of stuff? That's how I would go through that. It, it was arduous back then. It's not that much better now. There's just, right, there has to be a better way to organize it and someone like HIMSS has the resources to, to do it really well, I think.

Yeah, we used to do that too. We would, before him, some, someone on my team would go through. Pick all the sessions that we needed to get to and then assign them to people to make sure that it was both education and seeing what health systems and competitors were up to. And yeah, it's, that's a huge effort.

Well, let me, let me ask you this. I didn't really wanna talk about HIMSS as much. We have five stories and I've interviewed you from the floor, how beneficial. Is it having space on the floor? May, may, maybe not talking about this year, but when you did it as a small company, it's hard because you, you've seen the epic booths, , right?

And there's also like the, do you have coffee and what are the things that you have to get people to your booth? For us, it was an anchor that we could use to set up meetings. We didn't get so much like. Serendipity 'cause we're off on the side with all the startups. Depending on the year, you never knew exactly where you were gonna be.

And sometimes there was the two floors of the trade show and that was a hard one in Orlando anyway, it was really important so that people could find us. So we would set up the meetings in advance. And then I think it also provided a little bit of, I don't wanna say legitimacy, but certainly Oh yeah.

Okay. You've got a booth there you are there. There are people. There was one year we were in the startup area and we took five people, which doesn't sound like much, but it is when you only have a kiosk and we were so busy and all the other startups around, I could tell were a little envious. So it is, I think it is important.

It's important to be there and. Having just even, it is not about, not so much about is your booth really fancy or anything? It's just to be able to actually have a place that, especially for the people that you contact beforehand who are like, yeah, I'll stop by. But they don't give you an exact time because it's getting somebody to commit to a meeting can be hard.

But everybody always came by. They sought us out and so it is important, I think, to have at least some presence. And the thing about HIMSS is that. They do recognize the importance of startups and they have options if you can't get a a 20 by 20, but that's, I think the problem was like you go from the startup kiosk, you basically have to go to a 20 by 20 or nobody sees you , and it's a significant uptick in cost.

Isn't it? Significant? Yes. But yeah, I think it's important. Do you think they're, they're gonna be able to retain the mantle They, they had the mantle for years of, you had to go to himss. You talked about legitimacy. Yeah. And do you think they're gonna be able to maintain that mantle after two years of sort of false starts?

I think so. You remember the health conference, the HLTH when that one started? I mean, first of all, it's backed by venture. Second of all that, it's a team that has actually disrupted. The conferences, the Go-to conferences in other industries. They became the defacto conference for retail and FinTech. The conferences that they ran, you'll see same thing with the cartoon faces and everything.

Same model like machine. And when that one started, I was like, Ooh, hys had better watch out because this is a modern conference and it's the visionary and they're not allergic to vendors. That was the one thing that always kind of bothered me, and I get it. Sometimes vendors get on stage and they just, they're pitching instead of talking about the outcomes that their customers had.

But that conference, I felt like, Ooh, they're gonna draw, they're gonna take the innovation piece of the market from hims and that's gonna be challenging for himss. I feel like now there's been a little bit of reset 'cause, 'cause that conference, it went online and I heard it's good I didn't attend it.

But it sort of seems like, if you think about the anchors, I don't know that that conference was around long enough. I think what's gonna hurt is all of those smaller conferences that we're attempting to challenge himss. I don't know if they're gonna make it. HIMSS is gonna make it. If I said to you, if HIMSS is going on next year and it's safe, you're gonna go right.

Like you're not, yeah. You're gonna go, yeah, I'm going. And somebody asked me, they're like, do you think this is the end of himss? I'm like. They still had 19,000 paying customers. I seriously, I mean, yes. It's still an ongoing entity. Will they have to tighten their belt? Will they have to do things a little differently?

Yeah, but they have a formula. If they maintain that mantle of you have to go, it'll be back up to 40,000 within two years. Right. And then there's pent up demand from people not going, there's people that have never gone, like some of the, the people on your team. I think that the . The opportunity is that whether they fix some of the stuff that didn't work as well, that's the opportunity they have before everybody comes back is to actually learn the lessons from these, you know, innovation conferences that had more future looking stuff and learn those lessons and fix that.

If we all go back in two years and it's the same old hymns, that's when I think they may have a risk. Yeah, the health conference is a very different conference. You've attended that in person. Yeah, I've spoken, I spoke at the first one actually. It was really fun. Really good fun. Yeah. It's, it, it is. It has a different feel to it.

Definitely a modern conference as you, as you called it. I think the other reason it's very different. The first one at least was a lot of tech startups and venture. It was a lot of money. It almost took, took place of the Health 2.0 conference, right? Yes, it did. It did it. It had that feel to it. And Health 2.0 was bought by hims.

And they proceeded to. Pretty much drive it into the ground because they didn't really know what to do with it, which is sort of what I'm trying to say here, which is the health conference, right? If you wanna be in deal flow, if you wanna be talking to the money people, if you wanna be talking to the startups, you really do have to go to the health conference.

It is a really dynamic. Place to have those conversations and the, it's interesting because there's a group of people that I will see at health that I'm looking forward to seeing that I would not have seen at hims. They're just not even going well. I will say that, yeah, it was money, but the health systems were all there.

I had so many meetings with big health systems at that conference. It wasn't just venture, it was, I'll tell you what's different though. The first one was not CIOs, but the CEOs were there. Yes, it's they, they got the, they got the CEOs in as speakers and so they were roaming the halls and I was sitting there going, okay, that's another thing that made it very distinct.

The other thing is they brought in the insurance. They brought in pharma. Yep. So payer pharma, they brought 'em all in and I thought, this is interesting 'cause they see it as an entire ecosystem addressing this, this challenge. It. It was a pretty interesting. Conversation. Where do you think Health Evolution Summit, where do you think that fits?

That's a smaller conference, and, but also has that also has that same health feel to it, except really high level talks. I found those talks to be some of the best that I've ever attended. It offers the no press, right, so people feel more comfortable saying things that they may not say if the press were there.

So from that standpoint, that was a lot of the value and also just the small setting and the invite only. So if you got to be there, the access to people there was incredible because they were just like, oh, you're here. Okay, I'll talk to you. I actually, actually sort of had lunch with Judy at that conference.

Yeah. Yeah. I've gone to that several times and it's, it, it is an exceptional conference. It's very personal. I mean, you, it's, you just have great, and, and it's at the Ritz Carlton too, which I was, doesn't hurt, but I was gonna say it's ridiculously expensive. Again, as a startup, I got. So startup rates, because they had to, because there's no way we could pay what the health systems were paying.

But I still had to stay in an Airbnb , like that's, yeah, I, I live down the street, so I commuted every day to the conference. Alright, we're gonna get to stories. Let's, let's hit some of these real quick. So doctors look to tech. I, I, I like this one. Doctors look to tech for future, but need assurance. It's gonna work.

health adoption collected in:

Clearly that's changed. He goes on to talk about that. I can only imagine what these data would look like today. Aaron Feld said, noting that the data was collected pre covid. The survey zeroed in on seven types of tools. This is what I'd like to talk to you about, including remote monitoring for efficiency, remote monitoring and management for improved care, clinical decision support, patient engagement, televisit point of care, and consumer access.

Data he goes on to say, doctors are especially interested in monitoring their patients outside the four walls of the hospital or clinic, which happens to be where you were living. While all digital tools have seen an increase in, well, I'm gonna just skip to the end here. The survey results show that the number of physician interested in adopting augmented intelligence tools is very high.

rent adoption, at least as of:

I think it totally depends on what type of doctor, what type of patient. Specialists who work with people with chronic diseases. Absolutely. And they're frustrated that it's, first of all, hard to do. And second of all, how do you get paid for it? Your average sort of primary care probably doesn't want to.

And, and, and maybe there's also the, they want someone to do it , but I dunno if the doctors wanna do it right, which is probably correct, right? The orthopedic surgeon wants good outcomes from the patient, but they're not the ones who are like, do your exercises . Right? I think doctors want. The access to the information they want to help patients.

But there's a also a little bit stuck in the system, right? It's, it's all about reimbursement. And so reimbursement, it's three things. Reimbursement, liability, and time. Those are the barriers for them. It's interesting you bring that up 'cause he goes on to say. While digital adoption has come a long way, he said, for tech to take off, generally there are four questions that doctors really want to know, and you just nailed it.

Does it work? Will I get paid? Will I get sued? Will it work in my practice? Right? So the reimbursements matter. These matter a lot. Will I get sued? Is there liability if, if you're gonna put this information in front of me, do I have to act on it? Do I have to review this information? It's just an interesting.

It's an interesting concept, but doctors, I, I love the fact that you're saying don't talk about 'em as monolithic. Can we at least talk about certain practices as monolithic? Yes. Or not? Um, well, I think setting of care matters, but at the same time, I think there you can definitely talk about types of practice because that will impact their.

Need to engage with patients outside the clinic as well. I think your average primary care doctor in the current model, absolutely not. If we move to a different model for primary care and they have wraparound services and they have team-based models, and then maybe they do, but for an average healthy person, like why does a primary imagine that my primary care doctor had to have all my mys, I'm fine.

You developed one before. If you were developing a new one, would you focus in on a specialty or would you try to address a broader challenge within healthcare that could be addressed to multiple different specialties across the healthcare continuum? Well, what I did was a broader tool, and I think maybe.

This is hard. This is a very hard question because yeah, that's, that's the draw you want, you want , you want, you want something with enough market share. Obviously you want something that's, that's well enough market share, but also like when you're starting, you used to be ACIO. The CIO wants to standardize, which is why you come in with a, an individual tool and they get frustrated.

It's why ZF exists. It's why people wanna use the patient engagement stuff in Epic because. They don't want a thing per specialty. Right. Um, I know from having built the tools that the repeatability is huge and, and yet at the same time, I know that the specialties think that they're special. Right?

They're called specialties. Like mine couldn't possibly be the same. I think there's something to be said for, if you take the approach of just saying, which I didn't, so. Learn from my lessons, okay? We're only gonna do the specialty until we have one the specialty over, and then we're gonna do the next one.

And it does get you, if the specialist can actually make the decision, that's part of the problem, right? Then we go back to who has to make the decision and are they gonna buy a tool just for the specialty, or they gonna look for something that everybody can use. Yeah, it is a challenging problem. And, and the age old thing I hear from CIO after CIO is if my EHR provider has a tool for it, that's what we're gonna use because it's That's right.

It's integrated, it's built. I don't have to worry about the conversation between the tool and the EHR provider and getting integrated and that kind of stuff. 'cause it should be there and should be working. Lemme give you the, the next story and because I wait, before, before you do, I wanna point something out on, on what, when you were describing all those capabilities.

From the standpoint of the health system, I was thinking about it from the standpoint of the patient. From standpoint of the patient, that should just be one thing. , right? We, but we can't get Yeah, no, I, I, I agree with you. That's where we should be going. We should go be, be going to the point where the patient is interacting with the health system more frequently.

hat we were going for back in:

apps and out of:

So even though we had 800 apps, you'd think, oh, you have 800 instances. No, we didn't. We had the same app. It, you know, instantiated four different ways across the health system. And we had trouble just bringing all those together to get a single build, right? So the backend is disjointed, which makes the front end and orchestrating the front end.

And so in steps, tools for our second story like Salesforce, who says, Hey, we're gonna live one layer above the EHRI. I always thought this was an interesting strategy and I. Player above. And where we're gonna live is between where the consumer lives and where the, uh, health system interacts with that consumer.

ce rolled out Health Cloud in:

That means we just talked about this. So Salesforce Virtual Care Solutions also include patient self scheduling tools that suggests the right appointments for the patient at the right time, whether at home or in the office to reduce no-shows administrative costs. And time spent on calls technology company, Salesforce has rolled out updates to its health Cloud that advances its strategy of providing a front door to electronic health records, which by the way, I think that phrase is wrong.

We, we are a front door to electronic health records. That's, I don't want a front door to my electronic health records. I want a front door to my, to my health, yes, or to, or at least to my interactions with my healthcare provider. Yeah, it's, uh, well, in fairness to them, somebody else wrote the article, they probably had something in their marketing and probably rolled their eyes when they read this.

y which launched Health Cloud:

The integration was not simple by any stretch of the imagination and Right. The especially scheduling and I mean, there's just a lot of challenges for it. The other thing is Salesforce is might as well be another EHR. It's really expensive. Yes. Really expensive and requires huge amount of specialists.

Yeah. Well and that was the other thing. So we made small pilots and small investments and every time we sat down they were like, the reason you're not getting the most outta this tool is you need 15 people on staff dedicated to Salesforce. Mm-Hmm. . And eventually that number got to be 30. And I'm sitting there going.

Oh my gosh. I mean, just based on the amount of usage and the amount of people you're asking me, this will literally be about the same size as handling my EHR team, right? And made almost no sense. But still you have that, that need for something that the EHR providers are still clunky at, which is that patient engagement area.

Mm-Hmm. . I didn't really phrase that as a question, but it's more of . Does that tool that lives above the EHR, is there a space there or is that just getting squeezed to the point of, Hey, if I have Epic, I'm just gonna wait for Epic to come up with their thing or, yeah, I mean there's a lot of that. It's definitely, I, I dunno question.

Even in healthcare, right? Where you. Best of breed point solutions to the platform and back again. And right now I think Epic's trying to be all things to all people. Will that change? I think the other question is, is there a third party layer or is it like all these health systems have huge IT groups that are basically trying to build that layer.

And maybe they should because I don't know. I don't know what that layer looks like. That brings everything together. Bring together. Well, I, I'm hearing it's a weird thing. I mean, unless, unless you, somebody at some point I'm remember who this was, but I looked at them and it really felt like their strategy.

Was surround epic and make them just be like kind of a database as opposed to an interaction. I forget what company that was, but obviously whoever it was didn't succeed in that . Well, I, I, I think it was like a big tech company, but they didn't succeed in it because that hasn't changed. It's interesting 'cause I, I, I do, uh, a fair amount of our programming over here myself.

We're a small company and whatnot, and we're always selecting tools that have the a modern internet architecture. Yeah. So they have the interfaces, they're designed to work this way, and for example, you can go into our WordPress site, you can register for something, it automatically moves it over into Zoho.

It automatically signs you up for something else. And I'm connecting to four different tools, but to the end user, they just went to our website. In the backend, the people who are doing the stuff around the CRM have access to it there and the people who are doing, you know, different aspects of our production, whatever, have access to, to it there.

Yeah. But the, the difference is that modern architecture. Is by design for most of these tools. They realize they live in a world where they're going to interact with things that they, they haven't even imagined the different use cases. They just build the, the links I use, I use Zapier a lot, and it's an engine that just goes in and, and taps into these APIs and makes it really visual for me to, to go into.

Those tools are not as prevalent in healthcare and I think the deficiency is the EHR providers. Haven't wanted that. No. And have, have not made the investment in that. Yeah. No. Oh. Not that we have time today, but at some point we should talk about what Jonathan, what's his name, sorry. Jonathan Bush is doing not today.

We run, I don't know. We have enough time. Not, not today. I, I would love if anyone hears this and, and has access to Jonathan, I would love to have him on the show. Yeah. The, oh yeah. The, the zoo. I don't, but the, the zoo stuff is really interesting. Yeah. And, uh, as is the other company that he helped foster up there in, uh, Boston as well.

All right. We're always trying to learn from other industries, and that was sort of the point of my story of if, if we put the right architecture underneath this, healthcare would be a lot better off. But there are still people that are not incented to put that kind of architecture in place. So for whatever reason, what's gonna do that?

How are they ever gonna get incented ? You know, it's, it's interesting because today's Wednesday, on Friday we released the episode with Glen Tolman from Transparent. Yeah. So I, I interviewed Glen a week and a half ago, and I asked him that question, what's the future of the EHR? He's uniquely positioned to answer that question because he is trying to disrupt healthcare with transparent, has disrupted healthcare with Livongo and he used to be the CEO at at Allscripts, and he really just talked about the fact that he.

The innovation has left the EHR. The innovators have gone outside and they're saying we, we've gotta do something completely different. And so you don't have the significant innovation, you also have fewer competitors. So you just don't have the innovation that you once had in that space. They don't have to move as fast.

There's no threat of anyone coming in and stealing your client 'cause it's a couple hundred million dollars decision every time you wanna switch the EHR. And plus you're gonna lose your job 50% of the time too if you do it wrong. So there's just not a lot of innovation there. So it likely, what we're gonna see, we're just gonna see it from outside somehow, some way, shape or form.

And potentially what's gonna happen is the healthcare providers become acute care centers and a whole bunch of other care is delivered with, with new technologies in different ways, likely. Right. I hope so. . Yeah, me too. Here's an article I thought was interesting. Digital patient experiences can take cues from consumer-centric companies such as Netflix.

So what can, and this straight from the article, what healthcare can learn from Netflix. As it turns out, healthcare can learn a lot from the streaming giant, particularly when it comes to engagement. This was a talk that somebody gave. I should give them credit. Of course, I can't find their name, so I, I saw this one too.

It was league. Which is actually not entirely sure what they do. I think they're sort of an in-between insurance and provider type. Andy Harlan, he's the head of platform partnerships and business and new development at a cloud technology company called League. Okay, there you go. What can healthcare learn from Netflix?

As it turns out, they can learn a lot. When Netflix began, it offered DVD by mail service. Do you remember that? DVD by mail? Mm-Hmm. Do you know what the driver for Netflix was? A, he had a video that was late, it was Apollo 13 and it was late and he had a $40 fee, late fee on the video. And he's, this is insane.

This should never happen. And then he was also, he was looking at it and he, he said, well. There has to be a better way to do this. And he looked at the membership model, he, he looked at his gym membership and he said, there has to be a better model. Is that Oh yeah. That's what he, that's what he did. So they offered DVD by mail that engaged with its users based on a monthly or perhaps weekly basis.

This is an analogous to typical approach of healthcare providers, which is touch base with patients only a couple times in any given year. Flash forward to today and Netflix engages with its users on a daily basis through content streaming. With customers able to access content at home or on their devices anywhere in the world, it's a model.

Healthcare should emulate ssid. Harlan, the healthcare system looks like my grandparents, old fashioned cable tv. When people want Netflix. You need to expand your mindset and your addressable market. To do so Harlan suggested thinking about a tenfold increase in interaction per year. The idea is to stop thinking about people as patients and consider them instead, consumers who should be known entities to hospitals and health systems before they need care.

That's what we can learn from Netflix. This isn't the first time I've heard this concept. This is actually well, but it's not the first time I've heard the concept question becomes. Given , it's hard to make the transition, right? It's, it's incentives and, and payment models and those kind of things. How do you make the transition when, hey, they come in once a year and we get paid x, we, we want to touch them 60 times this year?

I. And, and knowing full well that your reimbursement from the payer or your reimbursement from Medicare is not gonna cover a majority of those visits, right. If you're sitting as a provider, that becomes the, the biggest challenge. How, how do you get past that? Well, you become a payer. That's what a lot of them do.

Yeah. It's interesting. If you look at the, the, you know, payer, provider, pharma, like each one of those, when people say healthcare, each one of those is a huge industry. Its own, but they all work together. Like where else do you have that level of, I don't know what differences. And actually, if you think about where things have been disrupted before, it's like supply chain.

You actually, Amazon becomes its own supply chain. Looking at the pieces between them that's not working and how do you actually disrupt there? And when you were reading that to me, the audience out there, you weren't just reading it to me about how he thought about Netflix. That was where I was thinking, okay, that's actually how to think about it.

Which is like, what are those assumptions that are wrong? Because the core assumption there was that you can't keep ADVD as long as you want. Netflix was like, at the beginning it was like, you can keep it as long as you want. You're just not getting another one, which is brilliant. Right? Yeah. So where's the assumption of that?

I think some people have tried to do this, but it's almost like you've gotta do it through the entire process. Like I've seen that the assumption that. It's patient than an hour. There's something, you can't do care outside the clinic, but it's, it's almost like each one of those is chipping away at a little thing in beginning.

Blockbusters business model. Yeah. It's interesting when you look at that, the DVD by mail kind of thing, that disrupted the go down to blockbuster and actually pick it up and those kind of things. And if you look at, you look at healthcare, you're like, okay, there's parts of it are still like blockbuster.

There are parts of it that we call cutting edge, that feel a lot like Netflix when you were mailing your DVD back and forth. Okay? But the way to make that transition is to really fully embrace the digital tools and to reimagine what healthcare could be around those digital tools. And I, I know those are buzzwords, but let me tell you what I, what I'm thinking, okay?

There's an awful lot of ways to interact with your patient on a daily basis that isn't gonna cost you incrementally that much more money. , right? You could create scale around, put a bunch of clinicians and nurse practitioners and whatever in a, in a building, and they are your digital arm and we're not talking, uh, a thousand of 'em, we're talking 50 of 'em because they're gonna be able to handle thousands of digital interactions.

And so you create that model and now you can scale that way beyond what you could the traditional campus and building and clinic. You can increase your touchpoint. Even if you increased it, you, you doubled it to two. You're better off than you were before. But just know this. Every day you don't do something around digital.

There's a competitor out there trying to figure out how am I gonna deliver care with 60 touchpoint a year, a hundred touchpoints a year, 200, I want to help them with all their health decisions, their eating, their exercise, their breathing. They're caring for their parents. They're figuring out their insurance bill.

I mean, all those are opportunities for a digital disruptor to come in. And that's where they live. That's where they're spending all their time right now. And one of the things Glen and I talked about was when Haven failed Healthcare, breathed the sigh of relief and said, see, I told you so. It's a lot harder than you think.

It's, and Glenn came back with transparent, you know what transparent is, it's haven. . I mean, I'm looking at him going, dude, this is all the promise of Haven, except it's being built by somebody who really understands healthcare, really understands the incentives, and has access to, they've raised over a hundred million dollars already.

So I understands the business side of it. I felt like Haven was a little bit too much think tank and not enough on the, you know, nuts and bolts. How do you run the business? Yeah. If I sound like a fan of Glen Tolman at this point, it, it, you're probably is because I think everybody should listen to that episode.

Well, I mean, he's got an incredible track record. Does anyone else have that kind of record in healthcare? I dunno, Allscripts, Livongo. Yeah. And, you know, we were an Allscripts customers where I first met Glen. And one of the things is I, I came in from outside of healthcare and I'm like, Hey, we need an API and.

Script had it had a phenomenal AP. We had no problems getting data in and out of all scripts, touchworks, we didn't have their. They ended up buying it at acute care hospital package, which was separate, and we had a different EHR for our acute care facility, which had no API, like never even dreamed of an API would never even consider an API.

It was like night and day. And that's the kind of thinking I think that we are, we're missing right now. I, I really wish. I wish I saw a ton of announcements from Epic on how they are going to fuel interoperability and unleash the healthcare ecosystem. But we haven't seen it. And you're laughing at me 'cause you're like, do you ever really expect to see that?

Yeah. Like that was why I was laughing. Yeah. Also, it doesn't really feel like it's in year where they need to do announcements. I mean, and to their credit, right? There's a lot, there was a lot of rapid change for Covid and.

Yeah, well I, it's 21st Century Cures. They have to be doing some work around interoperability and I think, uh, yeah, I mean, yes, I've been dying to see these announcements for the last seven years. So yes, , I'm hopeful that we'll see 'em sometime soon and it's always great to talk to you. We. Always have fun conversations.

I really appreciate you coming on the show. Great to talk to you as well. I, I always enjoy the conversation. It's great fun to spitball on stuff. Yeah. We'll, we'll have to get you back. You, you're gonna start something up again. You and I are gonna think of something. You're gonna start, you're look at, be like, I'm insane.

I've done that once and I'm not ready. You need a break. I know. Doesn't a break and no one's throwing hundred million at you. That's threw throw. Ill do so in healthcare.

Sounds good till we get back together again. Thanks. Thanks. Bye. What a great discussion. If you know of someone that might benefit from our channel, from these kinds of discussions, please forward them a note. Perhaps your team, your staff. I know if I were ACIO today, I would have every one of my team members listening to this show.

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