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 Welcome to this Week in Health, it influence where we discuss the influence of technology on health with the people who are making it happen. My name is Bill Russell, recovering healthcare, CIO, and creator of this week in Health. it a set of podcasts and videos dedicated to developing the next generation of health IT leaders.

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If either of those two are of interest to you, hit the website and hit subscribe. Kristi Ong with Orbita joined us to talk about conversational technologies. I heard their presentation while at the Health 2.0 conference. . And it was too good to pass up for our audience, so I thought I'd sit down with her.

I gave her permission to talk about her product because I think it frames up the conversation around where voice and chatbots are gonna be used within healthcare. So we just sat down on a park bench and recorded this conversation for you. Hope you enjoy. All right. We have another session from, uh, health 2.0.

So it was, uh, an impressive feat, . Uh, for the group, but it also taught us a lot. And I think for me, seeing the potential of conversational technologies was extraordinary. And so when presented with the opportunity, um, to make the jump, uh, to orbit, I did, I'd actually tried unsuccessfully to recruit them into the accelerator previously.

Um, they're a seasoned team, uh, of founders. From Boston, um, with, with entrepreneurial roots. And so I, it was hard, hard to make the case at the time with their inflection point of a business, but I was, I was excited to join forces with them later on. Are, are, are, so is Orbita headquartered in Boston? We are, yep.

We're headquartered in Boston, but I. Still hang out here in San Francisco where I live. Very nice. I, um, so I've given you permission to talk about your product, uh, which I don't usually do on the show because people get annoyed when a certain product gets talked about. Uh, don't worry about that. We're, we're actually sitting on a park bench, so there might be some background noise and some wind, but we'll see what happens.

So, uh, talk to us first about, so your, your company's in voice assistance chatbots. Give us an idea of . Of what you do in, in, in what context you guys are doing again? Absolutely. So we like to say we are an enterprise omnichannel, uh, platform for healthcare. And really the product we're providing to the market is virtual assistance.

Those can be bots in the form of chatbots or voice bots, um, but omnichannel means any number of channels. So it could be a chat bot within your mobile phone or your iPhone. It could be, um, a voice bot through an Amazon Alexa. Device, like an Echo, uh, show or echo Smart speaker or a Google Action, Google assistant device.

And it could even be a conversational experience delivered via analog phone or landline. And I think why that's important for healthcare is because the omnichannel capability is really powerful to meet consumers and patients where they are through the channel that's most comfortable, um, and native to them.

Yeah. So get, help me to understand that one. So you're saying, um, I call into a traditional service desk or help desk or whatever it is, not even a help desk. I call into the call center and I'm trying to, I dunno, get directed to the right, uh, care location or the right provider. You guys have the ability to, uh, to empower my team to create the right, uh.

Uh, workflow in order to have a conversation happen between what a computer and essentially a person. That's right. Yeah. So it might help to understand a bit of the roots, as I mentioned, of our team. So our founding team came out of the web content management space and we saw, we've seen this happen with other major waves of digital disruption.

We saw it happen for web, for mobile search and social, and now we're seeing it for voice or conversational technology. And so within Orbit's platform, we are able to . Um, not only provide developers a low-code interface to create experiences, conversational experiences, but also business users. So if you think of something like Microsoft, Visio, um, the Flow workflow management tool, um, Visio for voice and for bots.

And so in essence, you can create flows, uh, that you can then deploy to any number of these channels. And what's cool about it is . The technology is sophisticated enough to handle context, to handle context switching. Um, we have knowledge graphs and ontologies out of the box that allow for certain use cases to get off the ground very quickly.

Um, and I think what's, what's fun about that is we're basically democratizing access to conversational technologies, but also in ways, as I mentioned, of getting them in front of the end user in the modality that's most. Comfortable for them. So we're not requiring everybody to go out and buy a smart speaker or an iPhone.

Um, but we can deploy that technology once you've built it, uh, across any of those channels. It's funny a lot at, at this conference particularly a lot's been talked about. A voice, but the, uh, bridging technology is text. Um, and the reason people are giving is because it's a platform that's already there.

Everyone can use it. It doesn't require a smartphone. Can be, can be done on a computer, it can be done on a, uh, on a standard phone. Um, and, uh, and, and so you guys really are at the. Intersection of where, where healthcare's next small jump is and where it's next big jump is. But you're saying, I mean, all this is available today, so can I give it to, let's say I have a bunch of, uh, clinical analysts who are sitting around and they want to, they want to help direct their patients.

Um. In a more, I don't know, more helpful way, I guess, engage their, uh, patient community. Are you saying it's as simple as they're sitting down with something that looks like Vizio and they're saying, you know, if this, then that and putting in the, the words and the context of Yeah, so it's a great question.

So, uh, we are there with, with some use cases, um, where we are earlier on in the maturation with other use cases. And so, uh, for example, um, Orbita has out of the box surveys and . Assessments. So picture almost like SurveyMonkey for a voice or chat bot. And so you're able to a business user create an interactive survey and assessment tool that you could use to check in on your patient in the home or ask them about their pain.

Um. Or ask them about how they're feeling, um, and then to get that feedback or to allow them the opportunity to then escalate into a live call or conversation or, or cue. And so it's pretty powerful. We're seeing the convergence of a lot of previous trends into what we're now calling experience management.

Wow. So, alright. Thanks for letting me sound stupid for a while. 'cause this is how I learn. I, I sound stupid. You've been sound stupid in front of, in front of, uh, thousands of people now and you know, when my podcast was getting listened to by 20 people, I could really sound stupid and people would still come back.

But now we'll see what happens. Uh, but seriously, I mean this is a, this is a, a new area for me. Just really understanding how this is gonna be implemented. Am I gonna give it to my IT team or am I gonna give it how far down in the organization I can go? And it makes it, when you say Survey monkey. I think, well, gosh, that goes all the way down to, um, a, a a relatively non-techy user.

Mm-Hmm. building out some pretty sophisticated what we, we would consider pretty sophisticated workflows and, uh, and tapping into sophisticated technology. Yeah. I mean, like I mentioned, if you think about the evolution of web, right? If you needed a website for your business 20 years ago, first of all, you were a little bit visionary, which is funny now, right?

And, uh, and people would say, well, what . Do you need a website for? What's the ROI on that? Um, and you would hire a teenager to hard code it in your basement. Um, and as we, as the technology advanced, we moved what we call up the stack. And so then there became low code developer platforms for web content management and then further up the stack than ultimately business user platforms where there were templates.

And now today, you know, no one thinks twice about for a website or web content business users being able to go in and manage that. And so . , our team who did that and was in the Gartner Magic Quadrant for that, um, in the last 15, 20 years, has now done that for voice, voice and chatbot technologies. And we're, we're exclusive to healthcare.

So what's fun for me is coming to this space with a host of personal experiences as a mother of three, um, with non-engineer, family members, some of whom are really technology, uh, forward, and others of whom will only use a landline. Um, and so seeing the promise of how this democracy. Democratizes conversational technology to some of the biggest consumers of healthcare is really is an aha moment.

So you have engaged patients, approved care, reduced costs. I'm gonna ask you for, uh, you know, maybe some use cases around those three. So, engaged patients, uh, where, where would. Here. I mean, you're really agnostic. I mean, you could be a payer provider across the board, but where are some areas where you're engaging patients today with this?

Yeah, that's a great question. We're actually, we are working, we're a horizontal go-to-market. So we are up with providers, payers, life sciences, fortune 500 companies. A lot of the health IT vendors we're powering a lot of their experiences behind the scenes. Um, and so for engaging patients, a lot of it is the ability to

You know, send notifications and reminders in a natural way that they're comfortable with, that they can own control over. So whether that's a notification on your iPhone or, um, you know, your, your, your smart speaker lights up with a color to say you have a, you have a message, um, or even, uh, you know, making phone calls.

So we actually are working with a prostate cancer patient with a large or population with a large provider. . Where they've offloaded follow-up calls and, um, PSA results for their PSA labs to a follow-up program, um, of which orbital power is a, a piece of that technology. And so that one's actually done via analog phone landline, um, which is cool because it's a conversational technology, much more sophisticated than like an IVR or old phone tree.

Press one, press two. Um, but powerful in that it delivers a more rich experience, um, and for a population that maybe may have been left behind a little bit with some of the more early adopters of technology and what we're implementing. So these two get a little more difficult. Improved care, reduced costs.

Which one do we want to do next? Oh goodness. Um, well, we're gonna do 'em both, so, uh, maybe we'll start with, uh, reduce costs. So it's interesting if you think about cost reduction, the biggest opportunity for, uh, virtual assistants is not doing the super sophisticated work of a subspecialty physician, right?

Right. It's offloading. lower level administrative tasks. It's providing 24 7 self-service, so you can do things after hours, um, that you previously might not have. And doing it in a cost effective way. Yeah. I mean, at the end of the day it's, it's voice, so we think, oh, it's really sophisticated, but it's automation.

It's automation. You're, you're automating some. Uh, repetitive, mundane task that really at the end of the day, no one really wants to do. No one wants to get on the phone and make 15 phone calls and tell everyone their their results. Yep. And so, so that automation will reduce costs. Now people worry about, is this gonna take a job?

But at the end of the day, you're not automating. The physician , you know, seeing the patient you're automating, uh, really follow up and those kind of things. Exactly. And I think what we're also seeing now is because if you, on the backend, having robust analytics and insights empowers you to really understand what's happening with your users.

So you can see what we call breakage With an 80 year old heart failure patient, what question did we ask? Or open-ended, um, query did we give them that they just got frustrated and engaged. Up or what, uh, utterances, what things are they saying that we weren't able to handle with the original design? And so we're getting that feedback real time and we're able to adapt quickly because we've been moving up the stack, um, in those, you know, in the templates that business users can now use.

And so. Again, the industry is still nation in terms of conversational technology, but it's arrived. I mean, it's here. People are using it. Um, the use cases are everywhere, and, and it's just super exciting. Yeah. I was going to, I was gonna ask you about how people are measuring the success of these programs.

Are they using like NPS, are they . Or, or are they just using the immediate feedback that they're, they're getting? It's a really good question. So the ROI question, we're actually doing a webinar on this coming up probably early October, late late September, early October. Um, talking about ROI, it's a hard question because we are an enterprise platform, so we're being used with many different use cases, some of which have a very clear, quantified, quantifiable, ROI, um, around, you know, how

NPS, how satisfied were the patients? How many cost? How much cost did we save by offloading follow up visits and bringing in net new patients. But there's also, um, there's a lot of experiential stuff in terms of being satisfied, um, access to services and some of, some of the customers that we're working with, fortune 500 companies, large providers and payers that are on the front lines.

They just, they get a good gut feel for it and they say we're diving in and it's funny, I think we've seen this before. So if you think of the EHRs, you know, for all of their benefits and all of their flaws, players like Epic and Cerner and Allscripts, they took the market if if none else for one reason and one reason only.

And it's that when you come in and you have to sunset 70, 80 legacy system point solutions. For the relative simplicity of one enterprise system. That's the stuff that operators and, and technologists and clinicians alike turn to. And so it's funny because we've had, what, 15, 20 years now of debate on EHRs in their merit or not merit, but we, we can't argue against enterprise versus point solution.

I think that we'll start to see . Maturation in this market as well. And we view from Orbit's perspective success of point solutions as a really great sign and indicator that the market is ready, that there's buying power, that there's a need for this as, as the cost pressures become stronger, um, and entities are looking to increase their revenues.

And so what better way to do it than with the flexibility of something like this? Well, let's assume I have a . Solution that's out there. So I'm, we're at Health 2.0, a lot of developers walking around and they're sitting there going, you know what, my solution would be a lot more powerful if it had, you know, if we could embed voice, we, if we could make it accessible via Alexa or via, um, I'm sorry, echo or, or Google.

Home. Are those the only two that you focus in on or do you focus in on others? No, we're, we're, we're doing many channels. So in the smart speaker market, those are the two biggest right now. Um, and that's a lot of, that's largely due to market penetration. So you're agnostic, you're a cloud platform, sit in the middle.

Yeah. And that's also why we're close partners of some of those players because, um, we're a great way to help. Get the business community up and running much more quickly. And also, uh, I think, you know, people have been talking about the industry in terms of voice or chat, but it's really conversational technology of which bots are powering either a voice or a chat or a voice and chat, you know, voice powered chat bot, um, solution.

And so, uh, a huge part of orbit's go to market right now is. Like an OEM White Label play, empowering a lot of the big technology vendors behind the scenes. So the big players, the IDNs or whatever. But I wanna go back to, you know, the developers that are in this room going, you know, I could really benefit from X or Y.

I mean, are those potential or are you really focused in on that, that. Um, payer provider market, the big developers on the vendor community. Uh, maybe the little developers who happen to be walking around here. Yeah, no, we're doing a lot. We also have, uh, big partnerships with system integrators. And so, um, it's funny, I think as we continue to grow, one of our hallmarks of success in the same way that we've seen other, even outside of healthcare platforms be successful is that the more folks that know Orbita and are trained on orbita, um, the, you know, the better off.

For industry, just because we'll be able to power change as hokey as it sounds, but we'll, we'll be able to power change faster. So, uh, one last question and it's around, uh, the automation. So clearly if you're, if you're able to call via with the PSA results and that kind of stuff, you're picking up variables.

So is there any reason why, um, we won't see this integrated into the EHR, where essentially I'm saying, Hey, you know, gimme the latest. Vitals and it speaks back to me. Give me the latest whatever. Is there any reason why we can't overlay your technology over the, the, the Cerners, the epics, the allscripts at this point?

See now you went back on your earlier statement of asking dumb questions because that's a really good question. Um, I. So that's where, that was actually the aha moment for me in making the jump to join this team is because our team has built that with those considerations in mind. So when you say enterprise, what does enterprise mean?

It means, in part, taking into consideration existing technology infrastructure and being able to build on top of that. So think of Orbita as an experience management layer for conversational technology on top of your EHR, on top of your existing databases and data flows. We're not seeking to ous that.

We have a really cool drag and drop integration layer where you can make call outs to authentication tokens where you can easily call to, um, get vitals off of a device. Some of the largest device, uh, players in the market are customers of ours, and we're giving those entities extensive. Ability into wrapping conversational experiences, voice and chat around what they would not have already or they would not have been able to do otherwise.

And so they're able to then augment and provide support in the home for a patient. You know, if say it's a patient's. A port application for taking a medication. Here's how you inject it. Um, here's what to think about. Um, patients who have, for example, wounds or drains, um, or stoma, uh, bags. What do they do after hours when they have questions they didn't think about?

And so there's an extensibility that this technology provides that can build on top of what's in the EHR and other data sources without, uh, without trying to replace it. Kristi, thank you for your time. We'll have to catch up again. . Because I'm sure this thing is moving so fast that in six months there's gonna be a lot more to talk about.

Always a pleasure. Happy to join you. Thank you. Thank you. Great conversation with Christy Iang. I hope you get a sense for how exciting this time is for healthcare. We have so many tools available to us today to improve health and to ease the burden of the patients, uh, and the providers for that matter.

And, uh, if you're gonna be there, I'd love to see you, love to chat, so please step by. Uh, second thing is that, uh, we have revamped the website, so please check it out and provide me as much feedback as you possibly can. Please come back every Friday for more great interviews with influencers. And Tuesday we don't forget, we take a look at the, uh, news, which is impacting health.

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