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 Welcome to this Week in Health, IT influence where we discuss the influence of technology on healthcare with the people who are making it happen. We are the fastest growing podcast in the Health IT space. My name is Bill Russell, recovering healthcare, c I o, and creator of this week in health. It a set of podcasts and videos.

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It's all really appreciated and you can, uh, visit our website and subscribe to the newsletter. All of it helps. Really appreciate all your support so far. Uh, today I'm excited. Uh, we were able to, while we were in Philadelphia visit with a couple of systems and a couple of, uh, uh, great startups and this is one of the ones I'm really excited about Quill Health.

And we sat down with the, uh, c e o one of my favorite people in healthcare, uh, Karina Edwards. Uh, a great, great show, great conversation. Hope you enjoy. So today I am in beautiful Philadelphia, hot and sticky Philadelphia, hot and sticky Philadelphia. It's, it's amazing you walk around outside. Yes. And, uh, but Karina Edwards, c e o of Quill Health, uh, startup organization.

I'm looking forward to getting into that. I, but Philadelphia, we're in Philadelphia. We are. It's, it's amazing to me. So this is the second podcast I've done live in Philadelphia. I'd like to do this more as I go to cities. It's kind of fun to just, uh, to just, but there's a startup scene here. There absolutely is a startup scene here.

I think what you're seeing is this space in Philly's been known for. For biotech for a long time. And that is bridging, right? I think the worlds in healthcare, and we'll talk about today in the, in the podcast, the worlds in healthcare are the, the walls are falling down. And so you're seeing these startups emerge.

You're seeing bridging the gap in a lot of technology areas that are coming out of the, the passion and the amazing academic institutions that are based in Philly. Well, that's what I was gonna, I mean, so Philadelphia has five academic medical centers, like within a stone's throw of this building. Um, I, I can't think of another city that has.

Five academic medical centers that are competing? Correct. It's, uh, I don't, I don't know if that's a benefit or, I mean, it's throwing off a lot of people. Great education. Yeah. I mean, you have Jefferson down the street, Penn Penn's, like right over here somewhere. And the affordability of the city with the ais that it gives is amazing, you know, as a, as a Boston transplant.

I love Boston. I was, I was raised in New York, so I'm always gonna be a New York City fan first. It's hard for me being in, in Eagle's territory. I'll be on the record to say that A little tough. Oh, golly. But , but you're wearing your green, which is good. Oh, I, that was not actually intended . I'm a New York Giants fan.

Through and through. I'll put that out there. Oh, really? And we're having the worst season ever, so, hey. Ah, but you got Saquon, uh, Barkley. It's phenomenal. It's phenomenal. So, um, it's been, it's been great. But the, it's an affordable city. It's a foodie city. It's, it's really transforming. And a lot of New Yorkers are moving to Philly.

Yeah. The two, the two things I love about Philly, one is people say, you know, what's your ? What's your favorite restaurant in Philly and I'll say the street carts. I mean, you can eat any ethnic food across the, across the country from a street cart here. But the foodie scene here, the James Beard Award-winning chefs that are here, the Michelin stars were getting.

Yeah, it's amazing. Well IES here. VE a h, I mean. Yep. That's phenomenal. Steven Star restaurants. Yeah. Every now and then I come into . Philly with a foodie and they'll, you go to these like back streets and you think there can't possibly be a, and there is a star restaurant here and it's, it feels like you just walked into somebody's home.

Yeah. In some cases. It's amazing. The other thing about Philly, and then we'll get to the podcast, but I, so I'm setting up for the last podcast and the AV guys are in the room and, and I said, Hey, tough, you know, losing, the Sixers losing and, and they said, yeah. Um, I said, it's been a long time for you guys.

Uh, but let's, uh, you know, let, let's get to you. Let's get to you. I usually start with a pretty open-ended question, which is, uh, how did we get here? Last time we talked, we were in Chicago at the, I think it was the last time we talked, was Chicago at the, um, Becker Conference. Beck? Yep. And you're with Imprivata.

Yep. Pretty happy things are going well. Yeah. These are going great. And, uh, now you're a c e O for, um, a, a really interesting startup, really interesting partnership. Yeah. A well-funded startup. Uh, give us, give us a little of the story. Yeah, so the story, um, it was one of those things where, you know, uh, I got a few phone calls, um, I pushed them to friends, uh, and, and then they kept on coming back and so, I said, all right, I'll pull the string a little bit.

And what I found was a really amazing opportunity. So when I was at Impravada, what I was the most proud of was my seven year spent there. Uh, we rose the n p s score up from, you know, 16 to 60. We actually went from customer retention, 92% to 99%, and we scaled the organization going public and then going private.

And so I, that, I accredit that, that organization is, is, is doing amazing. And I also had built an organization where I had number twos that could. Then take on my role. Yeah. So it seemed to be, you know, an interesting time when I got this opportunity. Um, what's unique about this Quill is the joint venture between Comcast N B C, universal and Independence Blue Cross, both Philly based, uh, I would call them, my parent organizations are right across the street.

Right now were that, that being able to answer that question, what happens next? What do I do next? And so that's where we're focused. It's a really broad mission and vision. We're starting with episodic journeys of care to really make sure that patients and the teams that support them and their loved ones just know how to answer that question and can navigate appropriately.

So it's a care navigation play. Is that accurate? It is a. Patient Health Companion and a caregiver companion tool set. So based on digital technologies, tech stack and what Oh yeah, the tech stack. So it's, it's um, clinical content, it's lifestyle content, it's patient interactivity through quizzes and surveys, et cetera.

It's nudges, it's wearable integration. And so when we think about what's unique here, it's not just the funding mechanism, but it's also the distribution mechanism. So we are an app, we're a website. . And we're also on the television. And so there are 85 million, um, Comcast viewers every night. And so we now have a Quill, um, x one app on the Xfinity platform, and now we can, we can get that curated playlist for that, that, that individual.

If I need to see these four videos before getting ready for my hip replacement, I can now . Bring in my family to watch them with me or my support team to watch them with me because those aren't p h I related things. That's like, how do I set up my home? Yeah. How do I get organized? What, what's going to, can I drive?

It's answering all those questions. When you learn about, hey, your hip's coming out, you're not thinking in that 20 minutes of the dock, and so it's uh oh. It's bridging them through all of that. So we have to do this big wave right now to get the lights to go back on . Oh, we do. We do. We have to do, we have to do this like hold please.

It's a beautiful thing about a podcast. People are gonna be like, what were they doing? What were they doing? But they could always go to the YouTube channel and see us running around with our hands up so that the lights go back on. The lights go back on. So, um, you're, you're, uh, picking certain things like orthopedics.

Sure. At this point, um, care navigation is such a, an interesting play. Um, so you, I mean, traditionally you have phone care navigation or paper based care navigation. Uh, and by phone I mean like analog phone. Yeah. Hey, what should I do next? Um, paper. We're still, I mean, I, we still get the mail where people are saying, here some stuff we do.

Yes. We do get a whole bunch of papers handed to people when they walk out, which are almost indecipherable. Yep. To the average layman. Uh, I love the, the photocopied 17 times. So now it's not really on the page. Yeah. . It's like that little side page and here's your patient packet, and here you go. What, what was I supposed to do?

Then you have the smartphone, you have. Yep. Digital navigation, which, um, to be honest, I mean we're seeing a fair number, but now you're saying set top box, uh, set top box. Also web. You know, when you start thinking about this, you have to have an answer to meet people where they are. Uh, you know, we're in, we're in pilot right now at one of the major academic medical centers right around us.

And what's amazing is the eligible patient population. And I want that to be a hundred percent. And I don't want to limit, um, oh, you have a flip phone so you can't participate. Right. Right now I have an offering that is a hundred percent eligible because they can get the same content and that same workflow, whether it's on their television or whether it's on the web or whether it's on the phone.

And so we can engage them in different ways and we can also just bring it to a, one of the fun unique things here, the N B C Universal Tie-Ins and, and, and the content. Medical content, medical literature have been evidence-based for a very long time. Even back in my zinc days, I think when we first met years and years ago.

Oh yeah. Right. Order sets are evidence-based, but everybody puts them into a different workflow and, and so Bri bridging that gap between letting a patient go into a system with evidence-based content and teaching them what to do, but also in the workflow of that institution to make sure it navigates their way.

Right. And that's a bridge to bring interesting content. In short, . Snippet light fun. I mean, think about it. We have Al Roker that does our welcome video. We have, um, some fun, right? Yeah. Some fun folks here in access that, uh, they are, but they're familiar. It's comfortable. It's, yeah. It's, it's, it's, yeah. And, and it's compelling.

Yeah. Well, you know, one of the things for. Care navigation that we were trying to do for, for a pilot was, uh, start to record the physician talking to you while you're in the office. Yes. And I'm now caring for 87 year old father-in-law who's moved in with us. Yes. And those kind of things. Um, and part of the challenge was when he was in Pennsylvania and we're in California.

And he would call us up and we'd say, how did the visit go? And he'd say, you know, good, uh, you know, and he wouldn't remember the medication. He wouldn't remember the timeline. It's one of the reasons he moved in with us. 'cause it was just, it was, uh, it was just too hard to navigate. But that's one of the things, uh, just one of the many ways.

What is the future of care navigation look like? I mean, is it, so I actually believe right, that there's, um, there's, there will be a market. Place. Right. We will not be the only. And now I think with 21st Century Cures Act and Teka going to legislation, we have the right as patients to make our data portable.

Right? And so that's step one. Yes. And so now that I can get with Blue Button Paving the way I can bring my data into an app when I consent. Yeah. I can also consent to share my information with others. And now you have a digital ecosystem with you and your support team. Um, some people call 'em caregivers,

Whatever name you want. These are not the clinical professionals that care for you. These are your niche, your nephew, the the, the, oh yeah. The friend that's gonna take you to the appointment. Now I can see what those feeds. I can see schedules, I can see medications, I can see claims data. And from that I can share with you a comprehensive recommendation of what to do next, not just on the journey you're on.

So in the current pilot that we have now, we have some patience. . That are going in for hip replacement. Great. Full stop. Now you add to that though. Hmm. Their BMI is 40 and they're a smoker. So before we get them on the table, can we also get them to potentially change some behaviors in the next seven to eight weeks?

That makes sense. That will make them better for that, that encounter and get to the better outcome. And I think finally, . Our incentives are aligned because now with value-based bundles, right, the risk lies with making sure that patient is well. If they, if they get readmitted, then I hold the cost for that.

So what can I do to drive adherence education and really then get through this, this journey together and get them to the healthiest version of themselves? Because it's not about everyone is to go climb a mountain. And so this has to be innately personal. Yeah, right. When you think about the content, I had a friend, uh, who was going through Hip Journey.

So I said, please use Quilt. Give it a shot. Gimme a ton of feedback. And his best feedback was, stop showing me 80 year old women in Walkers, . I'm gonna be back on the golf course soon. And I said, fair point. And so I, I turned to the team and I said, . What can we do for customization and personalization? And so within a month we've now tagged all of the content and we've actually done a demographic tag.

And so literally I can present to you based on your goals, what are you looking to achieve? Are you looking to play with your grandkids? Are you looking to run a five K? Are you looking to get back to a marathoner? There's, everyone has a place they wanna start. Yeah. And where they want to go. How long have you been c e o?

Uh, 90 days. 90 days. Okay. So I say a hundred, I think. I think I, we'll see your tech team might watch this later and like Yeah. . So I, so I'm gonna drill into this 'cause Sure. The, the question becomes, alright. Uh, is it in, is it B two B, B two C? Ah, right now it's B two B. Okay. Eventually we might be B two C.

Okay, so where do you get your content? Do you get your content from third parties or do you get it from the partner, uh, systems that you're partnering with? Who are potentially the orthopedic surgeons who are who, like the orthopedic above department? All the above. Okay, so you're getting it from all the above.

Then how do you determine what actually goes out there? Do you have clinicians on staff, or are you using. Uh, algorithms to try to figure out what's, yeah. So we have clinicians on staff and we also have, um, a clinical advisory board. But more importantly, the way, um, these come together, right? So like I said earlier, there's evidence-based journeys Full stop.

Yeah. And now you bring them to an academic institution and they say, okay, well you know what? I wanna, I wanna customize the front end of that. I wanna change this language here. I wanna put in five other steps that are unique to us. And so on the tech stack perspective, we have a C m S, we have a workflow engine that makes sense and we have multi-tenant.

And so now literally when the, when the, when the individual or care team come in, they put in their code and they get to that institution's flow the way they want to see it. So now we're bridging that gap, I think between the, the battle of the brand. Yeah. Right. And then also care because each of these institutions are world renowned in certain things, and so they, they want to showcase to the individual and the patient that, wow, this is a journey that you're not gonna get anywhere else.

Yeah. That's interesting. You know, I, I, I'm trying to figure out where I want to go. Uh, next in this 'cause. Um, it's, so talking to Dr. Klasko earlier this, this week, he said, you know, there's a trillion dollar market for healthcare transformation. Healthcare will not be delivered the same in five to 10 years.

Now he is one of the more forward thinking, and I found that the more forward thinking, typically their dates are wrong. , you know, it's like we're gonna change healthcare in three years, and you're like, uh, three times what? Three times, two, three times. So is it six years? Is it nine years? Um, but it's, you're right in the center of this.

So Teca, uh, 21st Century Cures. You have, uh, the work of Secretary Azar and, and they're all saying, okay, push that data out. Sure. But that's still a challenge to, I mean, there's a whole, you want to get that claims data and supposedly based on what we're, what's being proposed. Yep. You're, you're gonna get that claims data.

We do have blue button. Yep, we do. So for a certain population you can get that data Correct. Um, but what is it? Well, I had this discussion with someone the other day, so the one thing I'll say is be careful with the, you're gonna get that data right. 'cause I don't think, I don't think any of the digital health apps want the onslaught of all of the data.

I believe there are things that, that, that we can leverage, that can help somebody monitor. A condition or monitor a journey or make it personal to them, that is not the entire potential data set of every single blood pressure reading you had during your 15 days, which is good 'cause you're not gonna get it correct.

And, and, and so I think when you, when, when you go through this process, you have to decide what's meaningful, what can drive adherence and what could actually be patient self-reported or wearable or make it easy. Right? But, but here's what's not sustainable. If. Every time you go into a new market. Sure. So you're, you're in pilot with a couple of health systems.

Yep. But if every health system you go to, you gotta, you know, look at their data set and fix it and bring it across and integrate it. So you're, you're in the Philadelphia market. Are you in other markets right now or? We are right now. In Philadelphia. In Philadelphia, yes. Alright. So you go to new 18 months old.

You go to New York, you go to New York Frisby and they go, well, hey, we're epic. You're in an epic shop or you're in a Cerner shop, we'll connect up. No problem. Hey, we'll use fire. But you know, once you get that data, you're looking at it going, okay, we gotta do something here. We gotta massage it, we gotta whatever to get it to be used.

I know that like, you know, just rewind like eight years ago when I was trying to do this. Yep. The difficulty level was like a 10 out of 10. It was really hard to do. Um, is it still hard or is fire is all this stuff? Yeah, it's interesting, helpful. Or is it like, It's still confusing. It's very helpful. I think what it's doing is it's giving us a standard.

Right. So I think healthcare institutions are getting, uh, their ducks in a row to say, okay, like a great example I had with a, a conversation with the c I O, he said, it's a double Citrix hop to get into my, um, my, my, I think he's using Cerner, my Cerner, uh, instance. Okay. So Cerner has to kind of come to the table here and say, Hey, based on the new laws, we have to publish this a p i, this a p i has to be attainable and it has to, has to basically

Give this subset of data, right? 20 elements. I'll make it up and, and from there, it's industry standard. So now a patient is consenting for those 20 elements. When that comes, clearly you have to protect that. P h i. So, so clearly we are, you know, looking at all the HIPAA laws and regulations, but this is where you, you think through.

It's not all of it because there's so much consumer and patient self-reported and care support team reported. You know, it's like when you go to the doctor and they say, how many glasses of wine do you drink in a week? Which week? Uhhuh Two. Two. Yeah. 2 1 2 today. two every five hours. And so it, it's the.

When you start getting their behavior data mixed in, so the EHRs aren't the holy grail. The claim data's not the Holy grail. The wearables aren't the holy grail. It's when you put all of this together in your consumer life and bring it to bear to help you figure out what happens. I hope you're enjoying this conversation with Karina Edwards.

We're gonna get back to it in just one minute. I wanna ask you a question, though. Is anyone helping you to advance your career? Your answer is probably no, and that's really not okay. Every person deserves a chance to learn, but developing people is time consuming and expensive because it's difficult.

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Think of these videos as graduate school for health. It in bite-sized chunks, except it's totally free. So start investing in your career. Check out this week, health.com/daily to sign up for these insights from industry leaders. And now back to our conversation with Corina Edwards. Why do we need partners to do this?

Why? Why can't health systems do this by themselves? I can answer that question if you'd like me to please . Well, your perspective's a lot better than mine. Well, it's interesting 'cause you know you have this great team. I wish I could like scan this whole thing right now. But you have this great team of really smart developers who are really focused in on a set of technologies.

Yes. So they're gonna be able to patch that when, you know iOS is gonna have a new version every year and you're gonna have to, oh yeah. There's gonna be a ton of tech debt, like immediately on, on the application, but this team knows how to do it. Yeah. Alright. So Providence has put 200 people in Seattle to do this, but I can't name another health system that has

Even remotely close to 200 people who are, who are gonna be able to keep these ver the version incorrect and all this other stuff that goes on. Um, so I mean, that's one of the reasons it's just tech data. I think that's one of the reasons. But I think the other reason too is you're bringing different capabilities to bear, you know, in our unique situation.

Right. I actually have some folks on the team that came from, um, the, the payer side of the world. Yeah. I have some folks on the team that are still employed by NBCUniversal. I have some folks on the team that, um, right. And so when you start thinking about . What, what does the nv n b Cuni Universal, that's unique.

So what would that, what would that bring to obviously access to the set top boxes? Well, that's, that's Comcast, no, that's Comcast. So n BBC Universal brings engagement. So think about it, right? Um, they have their theme parks, they have movies, they have television. And whether the television's delivered on the Comcast box or Hulu or Prime or whatever, universal is the, so it's influence.

You could influence healthcare for a pretty significant. Population, I'll, I'll say it differently. It's actually, we know how to engage people because we build the content they engage with every night. That's true. So it's taking a content play here and making an engaging content. Fascinating. Um, what does success for Quill look like?

I think like any digital health, uh, you know, enterprise, I just left a board meeting. Uh, it is, it's the series of milestones that get us to viability and scale. And so how do we make sure that. As we go out there, it's not just about the numbers, it's never been about the numbers for me, um, this is a value play.

If I can't deliver value, then we shouldn't be in business. Um, it's one of those pieces where, um, when you look at all of the tech. Startups that are out there in the landscape. A lot of them, sometimes they're doing tech for tech sake. This is tech for tech sake. This is saying, okay, there's someone trying to navigate, there's a system moving from fee for service to value.

That person trying to navigate this is at risk because they don't know how to navigate it correctly. And then the person holding the, the, the value there and the risk there is also now . Um, incented. So finally, data's accessible. Incentives are aligned, and we're just trying to serve up value for the patient and the caregiver.

What do I do? How do I do it? Where do I go? Ask all those questions that the nurse navigators answer every day of the week, um, and, and get that done in a way. And if they have questions, they can chat. Ai chatbots have come a long way, right? We can. Answer a lot of the things that happen every day, and there's value in that because now you're taking a more efficient approach, you're driving better patient adherence, and then the holy grail is right information, right time, right place.

You're gonna get to the best outcome, right? Plus, plus 80, 20, I mean only 20. Percent of, uh, health outcomes are related to, you know, research and the hospitals and, and the stuff that they're doing. 80% is social determinants. You have a way to reach, I, I, I keep coming back to this. It's a different reach.

Yeah, it's a different, the set top box is interesting to me. Um, I don't know. It would be interesting. One of the things we're missing, I think in this space is, you know, we have research on, uh, just about everything in healthcare, but not digital, uh, the effectiveness of digital tools. Uh, in order to make that, so my encouragement to you as a C E O is as soon as you can get those, you know, those published studies that say, Hey, you know, this, this percentage, this is how we move the needle.

Uh, and anyone else I'm talking to in your space would saying the same thing. 'cause I, I think there's still a, a host of people in healthcare that are saying, Hey, Prove to me that this is going to move the needle Well, and I think that goes back to, you have to go, I think, beyond some of the wellness pieces, right?

Because I think what the self-insured employers have been seeing as a whole is the wellness initiative is great, but how do I, they're having the same problem the health system CIOs are, right? They're, they're, they're looking at a tool set. Set that has, you know, 75 apps that they need to get to their employee base.

How do you start going beyond that and thinking, Hey, I've jumped into this and now I'm going through a pathway. And so that's why we're starting there because yes, of course you want the population to get better and be well. Yeah, but it's gotta start a little bit earlier so they get comfortable with the, the new tooling and, and, and the exchange.

Will this be a tool that's used within the employee population of ? Uh, Comcast n bbc Universal What? Whatnot, sort of like a Amazon, Berkshire, uh, whatever play. This is a tool that we will absolutely pilot with both populations, with, um, with Comcast, as well as, uh, independence. So yeah, we're working through the definition of those pilots and when we're gonna start them, but now we're gonna wave our hands again.

I don't think it's gonna work because we have to go all over to the light. So Hold please. It's all good. No, no. We'll keep 'em all in . The, the benefits of the eco-friendly. So clearly we're not waving our hands enough in this podcast. . Yes. Have to get, have to get more passionate about the topic. Uh, so n BBC Universal.

Yeah. And, and Amazon. Um, you are gonna use it with your populations? We are, yeah. And I wouldn't, I, I don't know what Haven's doing. I don't, um, so I don't, I don't know if we, we are, yeah, I know. If I, if I knew what Haven was doing, that would be a new story in and of itself. I think they're, they're trying to figure it out.

This point they're doing a lot of, but they're doing a lot of research. That's great. Um, which is sort of the hallmark of, uh, a tool. I think all the major players are getting into this. I think. So. This is not, these are, these are proof points that there's a need and there's a market, and how do we serve that need and deliver value?

Uh, let's. So let's get back to your journey. Sure. I sort of wanted to do that. So you have two things going on here. Female, c e o, and a well-funded startup. These are not common terms that, uh, that we hear, but I wanna talk about the, uh, uh, being a female c e o. It, it's not common. It probably should be more common.

One of the, the big consulting companies, 10 to 13% of digital health CEOs are, are women. Um, and I think 10 to what do they have? 30% are diverse candidates. And so I think the whole notion of, we have to go back to the studies that show building diverse teams produces better business outcomes. And that's the, the thing we'll have to look at.

And so there's an organization parody.org. We just took the parody pledge. And all it's asking everyone to do is how do you get a slate of diverse candidates for every job you post? Right? And that's something that's easy to do. But I will tell you, the industry isn't wired that way. I've done some hiring here in my first a hundred days, and it was nothing to against the, the recruiting firm.

I love them. I've done business with 'em, . For a long time. What was interesting to me with this new lens, when I was presented with the, the, the, the list of here's the top 20 candidates, they were, it was not a diverse candidate set. So I set them off to get me a panel of full diverse candidates and we will find the best person for the job.

This is not a quota based system. We chatted about that earlier. So is that, was that hard for them to do? It took them probably a little, it probably was a little harder, but they produced a great list and it was more, it was a direction they hadn't received from others. And so I think what we can all do as leaders is we can ask the people that recruit for us, whether it's in our own consultants, our own folks, just make sure you're looking at a diverse slate.

'cause it's eye-opening when you start getting, I'm looking at my diverse slate also is, is non-healthcare. Right? And so there's . There's all different stances for diversity that we just have to think through. That's interesting. Out. Yeah. Outside healthcare. Yeah. Um, and diversity in all areas. Absolutely.

'cause diversity of thought is good when you're trying to solve problems. This is why we have, um, liberal arts educations, right. So you . You get all this diverse thought and it helps you to solve problems. And the data shows it, all the studies showed 50 50 is the, the, the best outcome financially for businesses.

So this shouldn't be an argument that we're, we're not convinced about anymore. But not a quota system. You're not saying not a quota system. Okay, let's, Nope. Um, I think the best person should get the job. So Apple has increased one of their plays to increase diversity, which is really interesting is they've taken, uh, college education off of a bunch of their jobs.

Oh yeah. And the reason is because not everybody has the, uh, economic background and the ability to pay for, gosh, it's pay for $200,000 to go to a college. Um, but they have, you know, they have problem solving skills and whatnot. They can, they can actually learn at Apple how to be a very effective, uh, how to be a effective leader.

Um, you know, are, what kind of, what kind of things do you think is, is going to help, uh, . To build diversity within health. It, there's a bunch of, uh, I think initiatives going on, especially with the, with the younger audiences, right? Getting robotics camps in the summer, getting them involved, uh, in stem earlier way, way earlier, like in the, in the mid school high school years.

But there's also, for those that don't think college is a path for them, there's a bunch of great tech schools that are teaching. Mobile app development, uh, web development. And these are skills that, you know, if you're a creative, if you've come from an arts degree, some of the, I, I have a few folks on my team that don't have degrees, but they were artists and they're UX designers and they look at the world so differently and they bring such a perspective of thought.

They're like, oh, I never thought about that. 'cause they study human nature and these are skills that come in and they just make these aha moments. That, that, that I think are priceless. So I would, I would say as you're, as you're looking to, to build out your teams, I like the non-traditional routes. There, there are a lot of places you can find great talent that's untapped.

The, so I like to brainstorm a little bit with entrepreneurs. Um, so you're in the space, you're moving around, you're seeing things, let's assume I'm gonna do a new startup. What are, what spaces are un untapped in the digital space that you're, as you're . As you're sort of out there, you're going, man, I wish somebody would fill that spot.

Or, or, or something would sort of pop up. That's a really good question. Do you have an idea yet? As I think about this one, I, I have a bunch of ideas. Yeah. Because I keep doing these interviews and asking really smart people, um, Uh, you know, it's, it's, it's interesting 'cause there's a lot of different spaces.

There's the engagement space and, uh, can somebody just get the, the, the video conferencing in conference rooms to work? I i on just like the Yeah. The most basic level. Like, I think of the things I struggle with. I, I just, I just had that conversation with, uh, Uh, um, gosh, Michigan, uh, medicine, c i o and, uh, we, I said, you know what's one of the biggest challenges?

He goes, video conferencing in the room. You know what the biggest problem with that is? It doesn't report into it. Most times it's in the facilities . And you're like, why is that into facilities? I have no idea. Well, because they build the building and when they build the building, a majority of that stuff gets bought and put into a room.

And then they say, here, here goes. And then . And then for whatever reason they wanna own it. Well, so I was just a little, uh, tongue. I know it's tongue in cheek. Tongue in cheek, but, but it true. It's so true. True. Every, every healthcare organization you could do for seven, 10 minutes of every meeting, it's, oh, hold on.

We're not, can't get the X working. And it's not just one vendor, it's all of them collectively. Yeah. So that can be, but I actually, when I, when I look at OurSpace, there's really interesting. Change happening with new care models, with new, um, social determinants, with new neighborhood based approaches. And so as more consumer information comes in, I do think there's going to be some killer apps that come out dealing with the neighborhood effect, the zip code effect, the how do you engage.

in, in risk sharing to get a, a neighborhood healthier. That's interesting. And this is going to be, and and there's a couple instances that are out there in tandem in the, in the Philly market, ChenMed down in Florida. There's a lot of these that are now city block. Um, others that are coming to bear here,

And these are really interesting models to look at. Are they gonna address the health disparities by zip code? Is that essentially, it's basically, it is basically bringing care to those neighborhoods in unique ways and, and a digital platform is one way, but not the only way By far. It really is navigating and getting, um, a sense of what's happening and, and trying to.

Solve the problem more holistically, not just through the lens of health. That's, that's interesting. It's really, it's eye-opening stuff. It's, it's not what, we're not in that space. Space, but, well, I'm aspiring to be a, you know, a health tech, uh, C C E O like you someday. And so if nothing else, I like to spread these ideas around.

Oh, they're great ideas. Um, you know, it's, it's, it's interesting 'cause I, so I come from the health system background, so I have a little bit of a. Um, experience bias, just 'cause that's where I come from. I, I may not understand some of the areas more. Um, and, and what I'm hearing over and over again is more, you know, we need to do more with less.

Yeah. Every healthcare organization's running at 110% in the IT space. Yeah. And then somebody goes, Hey, let's bring in Quill Health. And they're like, uh, that's 115%. Um, because it's another thing to plug in. And I, I, I see an opportunity to really change the architecture and how these things are architect

Those platforms then transitioned as those industries have have evolved. So if you think about it, right, no one thinks about, hold on. Before you can, before you can transact with my bank and deposit money, I gotta do these seven things and three Citrix hops. And, and so when, when we. Think through this, we have to be able to say, I think the legislation's finally in place and now the health systems, if they catch up with it, it'll make them more efficient.

Because now there should be security based standards, there should be security handshakes. We should agree on protocols. I know I'm speaking in Nirvana, but this can't be that far away. It can't be that far away. How is, you know, if you put your hat on, how is healthcare gonna change in the next five to 10 years?

The, the most, yeah, the most. It's gonna change in just about every way. But how is it gonna change the most? I think the consumer wave is here. It's not coming. I think it's here. And I think you have a whole generation coming up that is not engaged in traditional healthcare. And this is where I think the, that the big aha moments are gonna happen as the baby boomers age out.

Um, and, and they are very expensive. And now you have an unengaged majority. And so as you're thinking about this, they're, they're looking at care very differently. They're in the highest deductible plans. They're looking for tools that are untraditional. They're not looking at that, oh, I get my 17 copays and my 15 visits.

Uh, they're not doing any of that stuff, and they need to be, they're trusting their friends. Do you think they'll start to pay to be healthy? Do you think? They'll, they'll look at a, an insurance plan and, and an insurance. One insurance plan will say, We'll pay for your care. And another one says, Hey, we're going to, we're going to invest in keeping you healthy.

It's, it's interesting, you know, you go to an employer and they say, here's our plan. And so my son's with a one of a pretty sizable firm and you know, they, they give 'em $150 a year to spend on health in any way they want. Sure. You know, they buy digital scale or they can buy golf clubs. Yep. I mean, it's like, hey, just get out and do something.

But they also have a whole bunch of other things that say . We are invested in keeping you healthy. Would it, uh, do you think we're gonna start seeing that sort of transition where, 'cause the millennials care about being healthy? They do. I think they, yes. They care. And they're also, they're engaging in their own apps.

Right. And so they're using non-traditional health apps. Yeah. And they're also selling their data. They're smart about this. Yeah. They're saying, listen, my data's valuable. There's a cafe I heard in Florida that literally for exchange for your, your lunch, you can give them $15 worth of your health data.

I'm not kidding. It's a currency now. I forget the name of that. I heard about this on another podcast, but I was like, seriously? So think about that model. There's a, there's a whole society of, of, of, of folks that are saying, listen, you're gonna get my data anyway. I'm doing everything. Uh, all these people have my data and who shouldn't have my data?

Why don't I get some value outta it? I want lunch. Get some value outta it. And, and. Side, right? Um, as you're seeing data sets be purchased by big corporations and they're building billion dollar business office, why shouldn't people share in that? So there's an interesting change of value in a shift in the economic model.

I think that's going to happen. Fee from service to value based and also what is the, how do you participate in this new economy? Well, this is exciting. So how do people follow Quill Health? How do they follow you? Yeah, Quill health.com. Uh, my Twitter handle is c Edward Ski 'cause I'm a big ski bum. Uh, and uh, and yeah, just please follow along and it's been a great conversation.

So you're not gonna get to ski as much as you have? No, it's Philly . Well, you can go to them. Poconos, but that's more of an ice skating kind of thing. Yeah. , I, I grew up, uh, I grew up skiing in the Poconos and, and it really is ice skating 'cause there's so many people on a very small mountain, on a very small mountain.

But they all love what they're doing. So at least having fun, they do. It is, it is a lot of fun. Uh, well thank you again for coming on the show. I really appreciate it. Thanks for coming to Philly. Um, make sure you check in every Friday for more, uh, news information, emerging thought with leaders, uh, from across the healthcare industry.

And thanks for listening. That's all for now.