This Just In Summer HITs

Speaker A: Foreign.

Speaker B: Thank you for tuning in and welcome to the special summer episode of uh this Justin Radio. We're broadcasting live from my Atlanta studios. I'm here with Roberta Mullen from Healthcare Now Radio. Welcome to the studio as well, Roberta.

Speaker C: Justin, I'm so glad to be here.

Speaker B: I'm looking forward to this. We're going to have a great three hours. Um, we decided to do this show about a month and a half ago. Um, we do a hymns radio show hims annual conference uh every year. I think we just uh decided we're going to do our sixth one coming up uh, in March, um, uh there in Orlando. Uh, but we decided you know what, let's do a mid year check in has some great guests and actually one of my guests just walked in the studio. Jeff Brown, CIO of Piedmont Healthcare. And we're going to certainly look forward to speaking with Jeff here in a few minutes. But um, but we decided you know what, let's do a mid year check in on where health care is headed, innovation strategy and in public policy. Uh and it's just an exciting time in our industry. Great uh, evolutions across the board and we're really starting to see some outcomes from technology. We've always had the promises of what technology and innovation can deliver but we're really starting to see I call it innovation enabled outcomes. And so excited to get into some of that today. Just a terrific lineup. This is my 182nd episode and due to some of Roberta's magic I'm sure she's going to be able to spread this out to a couple more shows coming up. Again this is going to be a three hour live broadcast and I wish someone was across from me when I decided to do a three hour show and bonking on the head because I scheduled no breaks for myself at all. And um, yeah but, but we'll make it happen. And certainly if I needed to take a quick quote unquote a station break. Roberta, you can step in um, and uh, in certainly Stone you are here uh as well. My friend Stone is a great partner of my show. You've been with me for gosh since the day, really day one.

Speaker D: Hey, I absolutely love doing this with you. It beats the heck out of working.

Speaker B: Yeah, you actually joined, I think it was hims 15. We were in Chicago uh, and you and I opened up and I think it was a 90 minute or a two hour straight broadcast. My very first time ever doing a radio show. Nevermind a live broadcast.

Speaker D: Well you'd have never known it. It came off Extremely. Well, I think that's why you're in such demand now. You promised me a nice meal and

Speaker B: a walk by the lake, and I

Speaker D: said, color me there.

Speaker A: There you go.

Speaker D: You did.

Speaker B: You were fantastic. I appreciate you. I appreciate your partnership. You guys have been so supportive. Uh, again, um, Stone with Business Radio X. Stone Payton with Business Radio X. They have been great. But I will say the person who I owe this all to is Roberta Mullen from Healthcare Now Radio. I remember she, uh, back in 2013, in late 2012, 2013, she posed the idea of doing a radio show. And I just. I didn't really have the bandwidth. We're still building the company at the time or getting ready to sell it, actually. And, uh, but I think the day we decided to sell it, I reached out, say, all right, let's talk about this some more. And you immediately came back and say, how about we call it this just in Radio.

Speaker C: I actually remember, remember when we met at. When you were the. At the Georgia Tech.

Speaker E: Yes.

Speaker C: Do you remember?

Speaker B: Entrepreneur and resident there.

Speaker C: And you brought me down there to show me that.

Speaker D: That's right.

Speaker C: Um, and we really do have to give props to Atlanta because you can't really do this show. You can't really do this show everywhere, Right? But Atlanta Health, it is big, and our health systems are really big. We have Pimon Emory. Uh, we've got a good ecosystem here. So, um, that's why we're able to do this.

Speaker F: Yeah, we do.

Speaker B: I mean, building on that, we actually have, I mean, at any given time, 250 healthcare and health IT companies just in the metro region, in our surrounding 12 counties. So it is an amazing epicenter for healthcare and health it. Ah, again, we'll get to be speaking with Jeff here in a little bit. Jeff Brown, CIO of Piedmont Healthcare, but a great innovator, uh, in his facility, they have been phenomenal partners because it's not just about what the innovators do, but we need the colleges to give us, the graduates to give us our entrepreneurs for our companies. But then also we need the, uh, health systems to step up and pioneer some of our innovations and take them on and help us build them. And Piedmont, gosh, they've had numerous innovations there, uh, that work early, but now much more mature. But they've done a great job helping foster some of those innovations from our community. So we're grateful for what?

Speaker C: Piedmont, Your new cardiac wing.

Speaker B: Yeah, there you go. That's right. Um, but, uh, but, you know, again, a great, uh, show coming up. We have 12amazing industry thought leaders joining the show, uh, and as well as three of healthcare's top policymakers calling in starting at 12:15pm so you can certainly check out our run a show. Uh, it's amazing. These are all not only great people, great thought leaders, but I'm grateful they're also very good friends of mine, um, every one of them. And so I'm great, I'm uh, grateful for this opportunity today. Hopefully it's going to make servers and great radio. I know we're going to some great podcasts from this later on and I'm grateful for that. For you Roberta, really carrying on uh, this message, um, and then today's broadcast. If you ever joined us before. And in our hims 15, him 16, him 17, himss 18, himss 19 and soon himss 20. Uh, these broadcasts really do um, bring you the latest innovations, technology strategies and best practices to successfully navigate healthcare. And uh, in come march for uh, himss20 again we'll be doing this again live there from the show floor and we'll bring the Most sought after CIOs, CEOs, care providers, policymakers and healthcare visionaries. And as always you'll be able to stream us@uh, brxlive.com thisjustinradio.com and certainly healthcarenowradio.com we expect over 50,000 listeners today and hopefully our network will continue to grow. Um, so certainly tune in in March when we do another live broadcast and I certainly want to take a moment here to thank our show's long term partners, you know, Lenovo, Lenovo Health, Intel, Intel Health, our new partner Rama on healthcare. But Rama and I have been good friends. He has the best daily thought, um, leadership and just compilation uh, of healthcare stories uh, coming through. So check out Rahman Healthcare. He's fantastic, great partner of mine, he's a great visionary as well, but he really showcases all the top stories of the day that happen in healthcare. And uh, then certainly my studio partners, Healthcare Now Radio and Business Radio X. You guys are phenomenal. I'm grateful for your partnership. You guys have been supporting me now for five, six years and it's been a uh, great journey. So let's dive in a little bit um, to uh, I guess, you know, what are your thoughts on where we should go, um, coming up, even this fall. I mean, I know we're going to talk about a little bit today. We have some great thought leaders, Roberta, um, but uh, I would love to know your thoughts on some of my ONC guests that are coming up. I know We've got some rules that are in the wind and so this can be an exciting day. Maybe they can announce something, maybe they can, uh, we'll just talk about where we are. But what are some of your thoughts?

Speaker C: Well, I'm very excited to hear the onc, uh, to be this close to actually speaking to them. Um, I'm very excited for the onc, especially with uh, Steve Posnick, uh, his new position. He has been a, ah, really great stable person there. Um, uh, Rutgers is, has been a great. For what we've got with the turmoil that we've got going on right now. Um, that, that department and office there has really stayed the course and have been really happy about that. You know, um, CMS all over the, kind of all over the place. But um, I think ONC have been really, really happy about that. So I'm really excited to hear from them. Uh, we're still in a comment period to the big rules that are out right now. So I'm not sure, um, I'm not sure they're gonna say anything, but they always have something to say.

Speaker B: Yeah, no, they have some great guidance and hopefully. And we'll see and we'll see what they have to say. I'm Dr. Don Rucker, who is a national coordinator. Uh, uh, he comes from actually, uh, the vendor side of the house. And now he's on the policy side and um, the government side. And he's a great partner of the industry and he's just done a great job in his leadership position. And now Steve Posnack, he's just like you said, he's been a mainstay forever. Steve's a great guy, a great policymaker. Um, he listens to the industry, he's in touch with the industry, he knows the ebbs and flows, he knows the life cycles of products and so he knows how to write the regulatory requirements around that very well. In my opinion at least. I don't want to speak for the whole industry.

Speaker C: And don't forget standards. He is the standards man.

Speaker B: Yes, he is the standards man in healthcare.

Speaker C: Mr. Standards.

Speaker B: Yes. Um, so very, uh, excited and then certainly having, um, Catherine, uh, Marcheschini, the uh, chief policy officer, Privacy privacy officer, Chief privacy officer for ONC and hhs.

Speaker C: She's one of the attorneys there. Yes, she's new and she seems to be really, uh, coming into her own there too. I'm just really happy. Uh, I was worried about everybody turning there, but they didn't. And it's been very good because the industry, um, the it side of things really needs to stay the course. Yes, has to.

Speaker E: Yep.

Speaker B: And they've done a very good job. And so we're hopefully working forward to some announcements maybe today. Um, and certainly seeing where some of this, uh, this goes. Um, but then also, um, you know, even talking, you know, we're going to have some great innovations coming up here. Uh, we're going to hear about. It's really kind of cool. You're going to hear from, uh, hims directly, but then also in some of their thoughts for where the industry is going. I'm sure some placeholders from what we're going to see for hymns 20 again coming in early March in Orlando. And I'll talk a little bit about that at the 11, um, 30 hour. Uh, but certainly want to get everybody, um, seeing what's coming, understanding what's coming, but also making your reservations. There's probably going to be 35, 40,000 of us there in Orlando. It grows every year. But I'm, uh, going to give you a little word.

Speaker C: But Orlando doesn't grow.

Speaker B: Exactly. Yeah, very true, very true. Um, but I want you to make reservations. I think you know my insider track. I've been going for 22 years and again, I'll cover all this later on as well. But, um, to make hotel reservations now, if not, you get stuck four or five miles out from the convention center. And it's just much more inhibiting when we move very quickly while we're there. You want to be able to run in back and forth to your hotel room and just get around and so book your hotel room early, uh, and get your reservation, um, early there. It'll uh, make your life so much easier. Certainly if you want to book in 15, 20, 30 meetings, you, uh, want to have easy access to your room and just moving around. So I'll give you some insider tips.

Speaker C: You know, I, I know you're going to talk to, um, your people today about the innovations, what they're doing. You've got some really cool, uh, new companies that, and stay fast. But you know, I'm on the new side. So on the new side, I think that, uh, some of the really interesting things right now are in the telemedicine side.

Speaker E: Yes.

Speaker C: And telemedicine is not new. It's been around for decades. The military used, I believe, in the Vietn.

Speaker G: Okay.

Speaker C: But you look at that telemedicine now and every day I read, um, about the new ways they're doing it. They're using mobile technology. We have so many different devices and we have so many people now getting involved in their healthcare that it's the most interesting to me. It's the most interesting. You can talk about AI, you can talk about population health, you can talk, we've been talking about that. But telemedicine has done the biggest thing, the biggest growth in the, and just like really innovative stuff going on there to meet the needs of the next generation. That is so different coming up. You know, they want their, they want their health care care like they want to go to dinner, right? They do not want, you know, their father's health care. They don't.

Speaker B: No.

Speaker G: Good.

Speaker B: You bring a great point. Actually, just reading from a timely basis here, um, Cleveland Clinic provided 46,000 telehealth visits in 2018. That actually came across my RAMA feed this morning. So ironically, um, you bring up telemedicine. I just read that. But I mean, I. The thing with telemedicine and telehealth is I think it's finally been integrated into the care strategy and care plan for the patient. It's not a standalone, in my opinion, when telemedicine was first rolled out, it was really rolled out in a standalone, um, one vertical maybe for, to help with the ER overflow or just, you know, individual patient visits, uh, that are kind of the one offs. And, and there is a model for that. But it wasn't as strong as people wanted and again, it was not integrated into the care plan. Now it's getting much more integrated in the care plan. I'm the chairman of a company here in Georgia that's rolling out. But telemedicine is a central part of the entire care strategy from the doctor, it's integrated with the doctor. The doctors visit on a daily basis. They can see all their patients via telehealth, um, in virtual care and a virtual platform or you can come in. It's part of their whole care episode and the care strategy for every single patient. And when you design it day one from that, you do change the model. It is the new generation of healthcare. It's not your father's healthcare care.

Speaker C: Well, and even more importantly, they're now paying for the visits. Okay, so now that's the most important thing that they're actually recognizing it as. And that's the virtual care side. But even on the, even on the mobile side, you have people interacting with your patients, the women, uh, who are pregnant, you know, keeping tabs on them, chronic care, specifically these niche type of things. It's education side. It's um, you want to go, well, here's your, uh, scheduling. Everything is now, you know, in that the virtual care is one aspect of it. But, um, it's actually being paid for now, so.

Speaker B: Well, yeah, it's being paid for and reimbursed for sure. And, yeah, you have the whole patient engagement, patient empowerment, and patient management through that as well. But there's also the health plans, um, that I'm aware of and I'm a part of. Actually, it's not just. The reimbursement is actually just part of the whole care strategy. There's no. Technically, there's not a reimbursement for. It's just included in the patient's membership with a health plan. So they have access to. Access to their doctor, you know, on demand, for the most part. And the doctor may be in with a patient, but the moment they're out of that appointment, they can call back and do a video visit with, uh, their patient. If the patient's not, the patient's calling in and wants that video visit. And it's not. There's no charge for the. No reimbursement. It's just part of their care plan. And that's where health care is evolving, too. Yes, there are. You know, 99% of the market has to reimburse for. But now you have these new models that are being created with telehealth. Just fully integrate into the membership of being, um, you know, a member of a plan. So very, very exciting. And I agree with you. Telehealth is really coming to its own. And I'm also excited for remote patient monitoring. But we'll, you know, I'm sure that all that will come out. Um, I do want to roll into our very first guest, my good friend, my peer on my, uh, Georgia Hymns board. Uh, Jeffrey Brown, cio, Piedmont Healthcare. Welcome to the show, my friend.

Speaker A: Thank you, Justin. Glad to be here.

Speaker B: It's great to see you. Um, were you actually able to join the board meeting last week?

Speaker A: I was. We had a great time. Good, good turnout. I think Our program for 2020 is on the right track and had, uh, a lot of fun, but also some serious efforts to move the industry forward.

Speaker B: Excellent. Yeah, they're Georgia Him's board. Great, uh, great group of people. Um, and now Sepi Brown is the. Isn't she the chairperson now?

Speaker A: She's the incoming chair. In fact. She is the chair.

Speaker B: Yes, she is. She's amazing. Um, CEPI just works tremendously hard for Hymns, for Georgia Hymns, our entire organization. But the Georgia Hymns chapter is a very special chapter. Uh, in general, um, Rob Aaron did a very good job, uh, building it. But you guys, through the years, I kind of came on in these latter years. But the whole Georgia community has done a phenomenal job building one of the most powerful hymns chapters in Georgia Hymns. So I appreciate all you do and all you donate, uh, and volunteer to that group, my friend.

Speaker A: So then it's a very important mission to take on.

Speaker B: So from your perspective, uh, we just, and we talked a little bit about telehealth because actually one of those initiatives certainly going on at Piedmont Healthcare. But Jeff, what healthcare, uh, or health IT trends are you seeing in the industry?

Speaker A: Well, I'm seeing quite a few, but I think starting at the top of it is really a whole lot of activity in our, uh, industry. On M and A, mergers and acquisitions, you're seeing that happen at the hospital level. You're seeing it happening with, with practices and even other joint venture activities. And the real challenge that comes forward in our industry is now you're blending, uh, people obviously, and cultures and that type of thing. But you're also having to have dissimilar technologies come together and work more effectively to deliver the services and the care. Uh, so that's one huge trend that I see happening. Uh, another trend is really around efforts around cybersecurity. While that's an old topic, uh, there continues to be a ton of focus in that area and new innovations like blockchain. We won't talk about blockchain today, but it's really a new way for secure information to be exchanged. And there are a number of innovative companies that are diving into that. Where we're going to see it first in the healthcare arena is probably around the financial industry or revenue cycle side of what we do and in the cybersecurity space. And, uh, we're excited about some of the things we're seeing there and we want to be early adopters of that technology as it involves. And then I think the third area, and I think probably one of the most important areas, is around the patient experience. Some people are now calling it the digital front door. Let me ask you a question.

Speaker B: I just wrote that down.

Speaker E: Yes, I did.

Speaker B: I just wrote down digital front door is one of my notes. That's great.

Speaker A: So when was the last time you traveled?

Speaker B: Uh, yesterday.

Speaker H: Okay.

Speaker A: When you booked your appointment, did you pick up the phone and do that with an agent?

Speaker B: No, not at all.

Speaker A: Well, in healthcare you're starting to see a movement to meet people where they are. And most people wanna schedule. You're busy people like yourself you get in, you wanna be able to schedule based on the convenience of time and access from wherever you are. Very true. And so we're all doing that and I think we're seeing a big push to get healthcare caught up with the rest of the 21st century.

Speaker B: I couldn't agree more. Yeah, the digital front door. Yeah, I travel now almost every week. I split my time between here and actually Sa Soda and between um, Delta Hertz and Uber. My entire life is electronic. It's literally digital. I don't talk to anybody. It's all automated and it's perfect and it's seamless. And I completely agree. We deserve that in healthcare and we're slowly getting it. And I know you've got some great innovations. I actually would like to take a second even before we move on because we have the time, uh, share maybe a minute on blockchain because that's something that we've spoken about in the industry for now many years. I don't think people really understand it. If you want to give 1 minute on blockchain and healthcare or why you're excited for it would be great.

Speaker A: Well, I'm extremely excited. First of all, it's a much, you're seeing it being applied in industry now in the financial market and it is just a much more secure way to have identity management occur, uh, with various approaches to various um, data connection points to make it literally, I won't say impossible, but for uh, someone to steal the identity of another person, institution or set a currency or whatever it is. There are ID matching types of technologies built into the blockchain environment that can't, uh, be replicated. And so if I give, if I'm, if I'm having a secure connection with you, uh, the technology behind the scene is already predefined and there are elements that I know that you don't have to know, but there are rules that guide that connection. And so it almost makes cybercrime nearly impossible. So I think that's why I'm excited because people, the health record is still known as the most valuable and that's. Right. Most sought after you can have. Right. And so, and for a number of reasons, we won't go into those now, but that's why I'm excited. Uh, we want to protect the assets of our, of our organization, but we also want to make sure that when people do business with us or have patient care and information, this private information, that we have even better ways to make certain that that doesn't get in the wrong hands.

Speaker B: Excellent. You want to. Do you have a question?

Speaker C: I do. Interoperability is a huge ordeal now. We've been talking about. Talking about. For 10 years we've been talking about it. What are your challenges? Uh, and are you finding that you have more, you um, have more areas to work with these days?

Speaker A: When I was a baby when interoperability started and look at me now. Rock the boat here in a minute. No, no, no. I think the industry has made some great strides in that regard. I think if you sort of kind of can visualize individual buildings and think about the healthcare applications as an individual building, I think that healthcare has made great progress within the building, connecting all the offices and being able to exchange things within the building. And uh, there has been some limited progress connecting to the building next to you and being able to do some things in a static way, um, or maybe exchange certain elements of it. I think where you're going to see the puck move to, if that's a good expression, is uh, this next phase where you have very dissimilar systems through policy, something you've been talking about earlier, and other things that have to happen from a legislator's perspective to get us there will be that ability to take dissimilar environments but have something, and this is a technical term, I'm talking to Georgia Hems, but there's something called open APIs. What that really means is a way for me to get information out of your system without having to comply with all of the dynamics that my system has, but a set of standards that we can exchange that information, share it and do it so in a very, uh, um, um, what I would call, um, meaningful way. And uh, I think that's the next level. And you're starting to see huge uh, efforts occur in that space, even on the innovation side of the House. With this open API thing I'm talking about, you can develop something in your living room and uh, if it's meaningful to this patient record, we can figure out a way to do that through this new uh, technology that we're talking about today. And interoperability paves the way for that. But there will need to be some legislative changes around data sharing and some other things that I know you know about in detail.

Speaker C: How's the um, Georgia Hie working out for you?

Speaker A: It's working out well. Uh, we belong to several different. So we've got care quality with the vendor side, we've got the George H. Hie environment that we play into. But all of those environments still have their own uniqueness to them. And it's not quite as fluid, uh, for physicians, for nurses, for administrators to use that. But you do get basic record information. Something we couldn't say seven years ago.

Speaker I: Right.

Speaker A: So I think progress is being made. You know, we laughed about it. Real work is being done. Uh, but at the end of the day, it's still not. Like, yes, when you sit at home and you go in and log into your financial records. Right. You're able to actualize, um, uh, information. Information from those systems. That's right. It's not quite at that level, but it's getting there slowly but surely.

Speaker B: So, on M and A and cybersecurity, blockchain and patient experience, uh, back to the three trends that you're really navigating. Um, you know, what are two or three best practices that you would share with my community on, um, you know, and help them navigate those trends?

Speaker A: Well, I think two or three things, um, just come to m. My mind immediately. You've got to work with the vendor partners. You've got to work with the innovative groups, uh, such as the work you've been tied to Justin, in your path. We're looking at working with the set of, um, new innovators that are now saying, Jeff. They're coming to me saying, jeff, uh, rather than us building something and pitching it to you, they're starting to say, tell me what your problems are. Let us go in the laboratory and come back with, uh, two or three solutions that might work. And we think that if you do that for us, others in your field probably will have some of those similar challenges. So, again, you can't develop it in the incubator at Piedmont. You've got to open it up to the marketplace. So we're heavily relying on our vendor community, the legislative branch, to be supportive and work through the. Through the government relations process to make those kinds of things happen. And then, of course, pure old innovation, Right?

Speaker H: Yep.

Speaker B: Excellent. So, thinking ahead, what do you, you know, and kind of on the Wayne Gretzky, you know, where will the puck be? Uh, his famous motto. What do you think we need to be looking at as an industry in three to five years from now, kind of looking ahead, what do you need to be?

Speaker A: Well, I think you're going to continue to see apps and infrastructure move into something called the cloud. In the old days, and maybe even the current days, people built out these large data centers, and they had servers and storage devices and all types of switches and that type of thing. I think you're going to start seeing data shared in a mega environment. And we're going to kind of say it's all up in the cloud somewhere. Now the cloud is a series of these things. But rather than each organizations having to have all that and build it and manage it the way we do today, you know, you're going to move some of that infrastructure and cost into that environment and improve the interoperability capabilities with your system. So that's one thing that I see here to stay. I also see this whole movement with the interoperability maturing. We've been talking about it since I was born. I know we joked about that. But really seriously, with these open APIs and with the fire standards and those type of things, they're really moving barriers that prevented some of the great strides from happening. It's been incremental and uh, now I think we have to do that times 10x annually. And I think that in two to three years, five years, you're going to see that no longer be a problem in healthcare. I think you're going to see that interoperability take phase and then the final is the. You know you joked about AI earlier when you talked, but I think you're going to see process automation. You're going to see AI, uh, uh, capabilities where you now will have call centers being managed by computers. Right. And I would challenge you to tell the difference if you were talking to a computer or a person in some elements even today, such as the revenue cycle, types of processes and workflows. If it's a process, they can do

Speaker B: it much better and cleaner and cleaner, 100% accuracy. All right.

Speaker A: And you can build those rules in for them to uh, react to certain tones and reaction to the public. So I think you're going to see that happen. And then process automation that's working at the code level and I'm talking to a Georgia Hems group. So you understand. But that's taking things that people would have to do to compare numbers and resources to get pre ops and those types of things. It would be automatically done and it took people to do them. Today people do those things. So I think automation is moving into healthcare in a major way and I think it's through this uh, robotic process automation. I see that being a huge part of our future.

Speaker B: Yeah, I actually have a um, I was educated on RPA about uh, a year ago. I have an investment in um, revenue cycle management. And yeah, they told me I'm sitting on a budget line. I'm m like what are we doing with all this? And they said well this is actually, this is basically how we're going to manage our rcm, you know, coming up. And it's exactly. Just taking the human aspect out of it. 100% accuracy and you got all the rules and everything built right in, and it's a fraction of the cost. I mean, it's amazing.

Speaker A: So, so the humans listening, it's not taking your jobs away, it's just. It will allow you to focus on more complex types.

Speaker F: Correct.

Speaker B: But we can't. Where a computer can't help us because there's a. There's tens of thousands of areas that we need humans involved in, but there's things that we don't need humans involved in, where humans create errors and that's where we need to get.

Speaker A: That's right.

Speaker B: Um, Jeff, as always, my friend, great to have you in studio. Great to see you. Um, thank you for kicking the show off with me. Um, and you have a great afternoon, my friend.

Speaker A: I will. Thanks for having me.

Speaker B: You got it.

Speaker A: Have a great day.

Speaker B: Thanks, Jeff. Jeff Brown, CIO of Piedmont Healthcare, and welcome Bird Blitch, CEO of PatientCo.

Speaker D: It is great to be here. I mean, and sitting next to Jeff, it's even better. Uh, I started my whole life journey off at Beavont Hospital, so I was born there.

Speaker A: God bless.

Speaker D: Yeah, it's a great place. Great place to be from.

Speaker B: Two great people. Yeah, well, no, that's the whole fun part and fun aspect of the show. Um, this whole day, these three hours is all friends and friends and family and friends of friends. It's great. So, um, it's great to, uh, to have you in studio, my friend. And thank you for joining us.

Speaker D: It's great to be here.

Speaker B: I know that you have a very busy schedule. I've just been awed by the growth of PatientCo. You guys are just doing a great job out there. Take. Tell me a little bit about the last six months of your business.

Speaker D: Well, um, I think the last six months or a year, whatever. Or a year or years.

Speaker B: Yeah. You guys been doing well? Yeah, it's exciting.

Speaker D: It's all about, um, listening to the marketplace on some of these big trends and building a great technology platform that solves, uh, these patient financial experience problems that we all experience. I mean, we've. Whether you're a doctor or a nurse or an administrator or a consumer, we all experience, uh, these challenges and every challenge is there to be solved for.

Speaker F: Amen.

Speaker B: Now, I'll never forget, um, gosh, this is about seven, eight years ago. You had just started the company. How old Does Patient go, oh, it's

Speaker D: just a little over that? Yeah.

Speaker B: So I remember seeing you started off, obviously you're out of Georgia Tech, uh, you start off in the Atlanta area. And we got a bill at our house from PatientCo and my wife opened up the bill. She's like, this is the best bill I've ever seen in my life. I'm like, let me see it. And I was still at Greenway at the time. And I'm like, that's Bird's company. Oh my gosh.

Speaker D: I need to bring you in to speak, uh, to the whole company about this experience. They get inspired by that.

Speaker B: Yeah, that was literally seven years ago or so. And she literally got this bill. This is the best bill I've ever seen. And I looked at it and it really was how you guys kind of transformed just from a normal looking bill to a statement that was very easy to understand. It's just large letterings. The way it's laid out is everything about the formatting and there's a patient co bill. And I'll never forget that, you know,

Speaker D: from the day we know the last touch in the consumer journey in healthcare is often the worst.

Speaker G: Yes.

Speaker D: And so these health systems do great job solving for the clinical aspects and then we get to the very end. And so our challenge is, you know, how do we help everyone understand what they're paying for, when they're paying for, how they're paying for. And then that solves so many other issues so that the consumer wants to continue to come back to that health system and get treat more on the clinical side. Um, and voila.

Speaker B: Yeah, no. Fantastic. Now next thing you know, you got a big company.

Speaker F: There you go.

Speaker B: Um, so what, uh, what healthcare health HD trends are you seeing in the industry?

Speaker D: Bird, you know, you mentioned early on at Patient Co, but a lot of this started around the whole advent of the deductible M. And we think of deductibles with automobiles, we think of them with houses. Who knew it would rise to be such a big deal in health care? And so the, I mean, deductibles now are certainly well north of $2,000. And well over half Americans, half of all Americans have um, a deductible. Um, and that's a lot of money. When you pile that up and you look at a health system that is dealing with a lot of facial patient financial responsibility and is tied to these trends that are being driven by deductibles, those are a lot of dollars that we have to figure out how to Solve for. And then these high cost, another big trend. This is something that I think we can all identify with. It can lead patients to avoid care for sure.

Speaker B: Oh, I'm watching that. Yes.

Speaker D: I mean I saw the other day, 54% of many, um, consumers have skipped necessary medical care due to cost.

Speaker B: No doubt. For sure.

Speaker D: Crazy.

Speaker B: Yes, yes.

Speaker D: And that's not what we want. Why we come to the office every day is to help solve some of these issues. They're really critically important to healthcare being successful and to patients, um, staying well.

Speaker B: Yeah, I would say 54% delayed or canceled care due to cost. I would certainly. I mean I literally watch it and I kind of see it. You see it. I mean even with your friends, I'm like, I mean it's also. They're not even sure what they're going to pay. It might be $10, it might be $50 or it could be a thousand. They don't know.

Speaker D: You don't know.

Speaker B: Right. And that's natural. I mean you're not sitting on tons of money. It would scare you going, you know what, I'm going to skip this and

Speaker D: most other purchases we do from a consumer lifecycle journey. We know, we have thought about it before we go in and that's something that entrepreneurial companies can solve for. That's a great thing about this country. We can see problems and go solve for them. And the talent is there in this country to go do that.

Speaker B: Excellent. So, um, what two or three best practices or strategies can you share to help others navigate those trends?

Speaker D: Well, I think if you are in a health system today and you know, health system, certainly your mission is to provide great clinical care. But you got to get patients.

Speaker B: Mhm.

Speaker D: They are the customers. And so if we are going off what we just talked about around affordability.

Speaker A: Yes.

Speaker D: I mean there is an affordability crisis here.

Speaker B: There is significant. It's growing every day too.

Speaker D: It's growing every day. And so I, you know, when you think about what health systems can do to solve for that, um, earlier this year at PatientCo we conducted a survey of patients and providers and we found that nearly 70% of patients want to enroll in payment plans online.

Speaker J: Yes.

Speaker D: As opposed to like calling the health

Speaker B: system, talking it through.

Speaker D: I'm busy, you know, I want to be able to self service. And um, so I asked more of the team, let's dig into this further. And we built a case study around that. Now Jeff just walked out, but we wanted to prove the theory around some assumptions. And Piedmont Healthcare increased payment plan adoption by 400% in just two months after offering self service enrollment. And the key there is self service.

Speaker B: Yes.

Speaker D: So when we think about, when we think about consumers, we so many times like to self serve.

Speaker B: Yes. Oh, yeah, we just talked about that. I mean, I travel now every week and I'm between Delta Hertz in Uber. Everything is self service. I don't talk to anybody and I get the very best prices and best service. It's. And it's everything I want.

Speaker D: And you're in control. You're in control of that. So I just, I roll that into this broad consumerism strategy. How are health systems thinking about treating patients? So they, they, I mean, they all have the goal of providing. You know, they want to be in the number. I'm sure Piedmont, Northside, um, WellStar, all these systems in Atlanta, they want to be leading around clinical care. But who wants to be number one in providing great financial care?

Speaker B: That's excellent. No, that's perfect. And I did not plan you and Jeff being together. I just know it's a very small world.

Speaker D: I didn't even know he was here in the studio. I recognize that voice.

Speaker B: Exactly. So, uh, no. Very cool. I just want to know from my audience, I did not plan that. This is not staged or promotion of anything anyway. It's just sharing best practices and strategies. It just happens to be that we're all friends and we, It's a, uh, a. It's a great community and ev innovators and all this is. We talked about this coming before we started the show and as we came on air about the ecosystem we have in Atlanta. And you're, I mean, again, I didn't plan this, but you're a perfect example of that. And she even brought up that as an entrepreneur in resident, uh, at Georgia, uh, Tech and their atdc, their incubator. And you came out of that incubator.

Speaker D: Oh, we did. I mean, we. You know, I go back. The wonderful thing is if you have an idea, there are resources that you can put to work to help be successful. And so the thing about the atdc, so that stands for Advanced Technology Development Center. So I'm m gonna give a quick plug, please. Yeah, but, but we graduated there. Where do you, you know, when you go, you graduate from somewhere, you typically are a big fan.

Speaker E: Yes.

Speaker D: And, um, we went in there with some ideas. Joshua Silver and I, uh, as co founders, and there were these resources and they said, let us help you. Let us help you think about customer discovery, how you build your first minimal viable product. How do you Go out and listen to the marketplace and what we already had the ideas, but they confirmed a lot of assumptions on what was building something that was critically important. And at PatientCode today we've built mission critical enterprise level software. So you have to put a lot of thought and then when you're delivering dollars into people's bank accounts every single day, you can't slip up. And all those thoughts have built into something I think of as a great company. It's a great company because of its great people. There's great people because we're in a great community that supports us. So we have a lot to be thankful for. For all the entrepreneurials, uh, entrepreneurial type segments and circles that. Supporters, supporters. And you're one of them. I mean you've been there for us at different points of the way. The journey's long and hard, but you got to be focused on the mission and be very committed to it.

Speaker B: Yeah. And I mentioned that ecosystem. So we've got, you know, great institutions like Georgia Tech that gives us great graduates like you that become great entrepreneurs. Very, very small, smart, um, and also foster them along with the ATDC as their, as their incubator. But then also the health systems like Piedmont and Emory and children's who take our innovations and adopt them and put

Speaker D: them in the market.

Speaker B: You got it. And help us build our products. And on top of that. And so that that ecosystem is critically important. You have to have all these different components. It's not just about having an incubator or having a health system or having a college, but it's about, or having other companies. It's about having them all. Yeah.

Speaker D: And the companies are so key. Atlanta has, you know, they're one of

Speaker B: the lead 250 at any given time.

Speaker D: Think about that. These Fortune 500 companies or 5000. And so what these companies have been great at is saying we want to lean on you to help build, um, some of our ideas. We want to lean on you when it comes to inspiring innovation. And they don't have the know how to build the innovation, but they have the know how to understand what the gates are, to test it, to deploy it and to hold people accountable. And they do, they hold people accountable. But that's how you build a community of something. That's great, that's excellent.

Speaker B: So yeah, no, this is a blueprint and I like talking about this because I like to help everybody. And my listeners are from all over the world and all over the country. And so, you know, Austin can do this and LA can Do this. Every community needs to do this because healthcare is, I mean we're talking about, it's a $4 trillion annual issue.

Speaker D: Crazy.

Speaker B: Yeah. Crazy amount of growth and expansion of our costs when a country, we can't afford these high growth of our costs. Um, and so we need to tackle them and we need more innovators tackling it, we need more policymakers tackling it and we need more institutions tackling it. And we as communities can do it together.

Speaker D: We can. And I just like to put a call out if you are thinking about solving important problems in the world. There's no better place than healthcare technology. And for that there's no better place than Atlanta. Um, you know, patientco is the combination of payments and they've got a huge fintech cluster here and healthcare technology. And you put that together with places like Georgia Tech and Georgia State and Emory that we can recruit out of. It's amazing what you get. And uh, I got to get you to our new offices in Midtown. We moved down there. We're right by in the center of this ecosystem and you walk out on the sidewalk, there's just energy. You just feel the energy. And so here we are solving very important issues around huge opportunities around the patient financial experience. And we're right here in Atlanta is pretty cool.

Speaker B: Love it. So thinking beyond today, you know, what do you think, what do you see as a key strategy or trend that we must be ready to successfully navigate in three years from now?

Speaker D: Well, we talked about healthcare costs, we talked about deductibles, um, high deductible healthcare plans. I think to go back to that theme of addressing affordability. Mhm. I mean every single person who's experienced healthcare knows that this is an issue and it's. You can pick up the paper, you can listen to the news, it's going to be talked about on shows like this. And so that is important. Now if you start, you know, going through the next three years, I think consumerism in health care will be the trend. Not just a trend, but the trend.

Speaker B: I agree.

Speaker D: And health systems have to think about how they are presented in a retail like way to match the consumer experiences that we all have with other type of institutions.

Speaker B: So far this is a resounding theme. Is exactly what Jeff said.

Speaker I: Did he?

Speaker B: Yeah, actually that's my notes. I wrote down my pre notes under the show digital front door in the whole consumer piece. And that was m my notes. Then he brought it up.

Speaker J: He laughed.

Speaker B: Now I'm laughing at you. Everybody's saying this.

Speaker D: It is I mean, from a healthcare system, we as consumers go in through one door and we get access to all the care and all the doctors and nurses. But what about the cost and the payment side? It's all disjointed. So we are a disruptive business as we think about that. Uh, imagine a day where you have one bill where everything is on that, just like your healthcare bill can be. You have a water bill.

Speaker B: Yes.

Speaker D: You have an amex bill.

Speaker B: Yes.

Speaker D: And all this is together. You see it all in one place. And therefore, your patient experience goes through the roof because finally you have control and you understand it. You can finance it, you can pay it, you could even defer it, but you understand your choices. And that's what PatientCo is about, is empowering us as consumers to go address this problem and create a better patient experience. And, um, and most importantly, health systems that are very happy that they solve for this.

Speaker B: And ironic that you bring up, you know, that whole patient experience and digital front door, because Dr. Monica Bobjerg just walked in studio here, um, from. And she's tackling that right now. And this is just. This is not planned in any way, but this is. It just shows how important the consumer experience, consumerism, um, you know, is, uh, for our industry and where we're going as an industry, so.

Speaker D: Well, thanks for all you do for our community. Thank you, Justin. You've been fantastic to me, many, many people along the way. And what you've done, um, to help improve healthcare technology along the way is amazing. I gotta create a wiki page, a Wikipedia page on you, right? Yeah, I think. I think it's worth doing. So I'll raise my hand, sign up for that, um, because it's gonna be inspirational.

Speaker B: Thank you, Bert. I appreciate it. Um, where are you guys? So what do you see that for the next, uh, couple of months or year for PatientCo? What are you guys hoping to expand to? Or what's the next frontier for you guys as you grow?

Speaker D: Yeah, well, I think from a, um, product perspective, you'll continue to see us being embedded so deeply into EPIC and even Cerner so that we walk into these health systems. Hey, guys, you spent $400 million on this product to help you operate better. Let me tell you how you can leverage it for all your patient communications and payments. That's where we're going. And people want to hear that. And then because of that, once you're deeply integrated into technology, uh, platforms that people already have, the patient experience is just. It's blended, it's all happening. And you don't even have to think about it. So you'll continue to see pretty strong, cool innovations from us coming, and you, as a patient, will get to experience it.

Speaker B: Love it.

Speaker D: Yeah.

Speaker B: Bird Blitz, CEO of PatientCo. Thank you very much, my friend.

Speaker D: Thank you so much. Great seeing you. Y' all take care.

Speaker B: Thank you, Bird. Take care, buddy. Dr. Monica Bobier from Cure for your. Welcome to the show.

Speaker H: Thank you.

Speaker B: CEO and co founder. Um, and you flew in for this, so I'm grateful for that. Thank you very much, Monica.

Speaker H: Well, thank you for having me. It's always a pleasure.

Speaker B: And I have to laugh. And my audience has already heard this, but you have not literally. I was making my notes. Um, Jeff Brown, CIO of Piedmont Healthcare, was right where you're sitting. And, um, I bring up. I just said, what trends are you seeing? And he smiles and he says, digital front door. I'm just like, I just wrote that in my notes. And then Bird just brought that up as well. And now this is your core business. And again, I did not have that plan, but it shows the importance of, uh, consumerism in this space. Um, uh, but why don't you give us 30 seconds on cure for you? Uh, you're a great thought leader, and I just want to thank you. You're a great, um, proponent or, um, participant in our think tank for what you, you know, your expertise in patient engagement and patient empowerment, uh, and, uh, what you bring together to the industry as a platform. But give us a couple seconds and Cure for you.

Speaker H: Thank you. Yeah, well, um, I'm a physician from Denmark, and I kind of got thrown into health it 20 years ago or something like that, because I saw a need for building tools for providers to better interact with patients when they're outside of the office. And so that's actually what I've done now for a long time. And now, um, we did the first patient portal in the world in Denmark, and now we're here, um, to, um, try to do the same thing, um, not with patient portals, but with patient apps. Another patient experience, um, here in the U.S. excellent.

Speaker B: So what healthcare or health IT trends are you seeing in the industry? And I already kind of opened that door a little bit. It's just so key. But from your perspective, I think, um,

Speaker H: it's really the two things, um, patient experience, um, so it's getting important for physicians and, uh, organizations out there to what is the experience for the patients? I think everybody is kind of, like, wanting to go in the direction where banks and airlines industry has gone before, right? Really what is it that the experience for the patient was a flow and I think we'll see them going away from desk and situation papers and all kind of old fashioned stuff like that. That's one thing. But the other thing I see is that they're getting very much more thoughtful in how they're sharing data, um, with patients. And it's not just about getting data to the physicians anymore. It's just as much about getting data to the patients at the right time. So it's instead of just dumping data in a patient portal, now it's protocol based data flows on, based between patients and providers.

Speaker B: That's excellent. Love it. Um, what two to three best practices or strategies can you help my audience, uh, for them to navigate those trends?

Speaker H: Well, I think you need to be ambitious.

Speaker B: Um, that's excellent.

Speaker H: And have some long term goals when you, when you do this. But, but at the same time be practical and have some short term goals for to roll it out. Um, you can't just go in and flip everything upside down. Um, especially because um, what in my experience the key people here in an organization to really drive the patient engagement. That's the front desk people and the schedulers. I mean and that often gets forgotten when you roll out patient engagement tools. It comes from the top. Um, and so um, having a strategy around making them comfortable, making them see that they're not losing their job anymore, but it's just other things they're doing and how they can be helpful in rolling this out is really important. Um, and then I think integration automation, um, is key. Standalone solutions don't work anymore. Single small solutions don't work anymore. Doesn't work. Um, people want all in one solutions. Like they have an HR for their physicians, they want an all in one solution for their patients so that it gets to be a really good experience for the patient as well. But also something that their organization can manage. I mean it's not manageable to have 10 different solutions for their patients as well.

Speaker B: That's excellent. So uh, diving into the all in one platform because I see that I've been seeing that evolve in the past couple of years because there's, and that's when I help companies or join their. Actually I don't join the boards of companies that have niche products because I've seen it doesn't work. Uh, but I certainly, when I speak with people and entrepreneurs and give them advice, um, you know, I've watched how the whole niche world has just imploded. Just because you can't, you get out there and you might get a health system, you might solve a problem for one health system, but that's not replicatable. And so your niche product doesn't. You can't expand past one or two customers and you eventually die out. So, I mean, I guess from your experience, you know, it's why I love Cure for you and what you guys are doing and why you're here today. You've taken all of this and made it and built on one single platform, which is critically important. It solves a lot of the integration, interoperability problems that exist out there, but also usability. So talk a little bit about all those different components and functionalities that you've integrated into one platform or onto one platform.

Speaker H: Well, and this is not. This is also because we've done it for so many years that we kind of just learned and grew with it.

Speaker B: And so that's called wisdom. It's a good thing.

Speaker H: Yeah. Um, but what we've learned is that you have to have a solution that covers the entire journey of care for the patient. So it's everything from online scheduling to checking in and paying your co pays at home. It's screening, uh, questionnaires, everything that needs to happen prior to an appointment. But it's also all the clinical processes. Uh, it's care plans and remote pays. Monitoring for chronic conditions is pre procedure, prep and post procedure, follow up, identifying patients at risk after procedures and surgeries. It's communication tools, secure messaging, telehealth, sending photos of a wound after procedures, et cetera. And once you do that, you will have your patients enrolled in one solution that follows them throughout their entire journey of care, regardless of if it's a, is it a short journey or if it's a long journey. And that creates the, uh, connectivity between a patient and a physician because now they can keep on working together. They don't end up in a block world where they now need to call and use the phone.

Speaker B: Yeah, no, and we're seeing that example keeps on coming up. I don't use my phone to manage anything unless it's a significant problem, a hiccup in my life. Everything else can be managed online through, you know, a digital app or a, uh, digital process. And, uh, every guest has brought that up. So I completely agree with you and appreciate that. So what, um, you know, looking beyond today, where do you see this all going over the next couple of years? Where, where's the puck going? In Wayne Gretzky speak, I think we

Speaker H: will, we will end up having true patient centric care. I mean we've talked about patient centric care for a long, long, long time. I was traveling with McKinsey Company five years ago and that was the issue, like the topic, how do we patients into care? But it was around how do we build buildings so that we can have the patient have one place? But it's not really, in my opinion, true patient centric care because it wasn't the data and wasn't the whole journey of care for the patient. It was when the patients were in the office. I think we'll see that we'll have an experience for the patient. When they walk into the office, there will be nothing be any front desk anymore. They'll be walking into a coffee shop where they sit down, they've checked in at home, they can have a cup of coffee while they're waiting. We're not just put into a room where we're sitting waiting for 30 minutes while somebody is typing in our data. And that's one part of it. So the experience for the whole entry into uh, an organization will be different for the patient. But I think a more important one will be that the conversations that uh, will come between physicians and patients will be about what happened for the patient while the patient was at home. So the physicians will now start looking at graphs and data from data that was collected by the patient while they were at home. Because we as physicians, we rely on what we can get out of the patients when they're in the office. We don't have any way to get a full picture. So we get to a place where we'll have longitudinal data and we can see what's going on with the patients at home. And we'll be able to much better base our treatment and diagnosis based upon that. Um, and not so much episodics data entries in the office. But that is also going to create a challenge, I think for a lot of the EHRs out there because they are not built for that. So I think they need to start thinking about how do they build interfaces that can show longitudinal data, including WhatsApp, happening with the patients when they're at home and not just in the office.

Speaker B: That's excellent, excellent. And your coffee shop, um, example makes me think of there's an ad, I don't know the bank. If it's, I don't know the bank. Um, but there's one of our, one of the top five banks in the country. They have coffee shops now for exactly what you said. Actually that is a lot of their banking is done online, electronically, they're only there for maybe an appointment, but that's pre scheduled and they're going there to grab a cup of coffee, uh, and then can move on to their appointment. It's a much better experience than, I mean, a waiting room in a healthcare facility.

Speaker H: Yeah.

Speaker B: Oh, gosh.

Speaker H: I was actually visiting one of, uh, our clients up in Cody, Wyoming, far, far away. He built his whole office around that. And you came in and then it was just like, there's nice music, you sit down, you grab a cup of coffee. There is no front desk. I mean, it was amazing.

Speaker B: Yeah, well, in, in. Roberta and I were uh, catching up, up, uh, just before the show and really discussing how we see healthcare evolving and some of the. Just the examples of um, the patient. The patient experience, how we've got to manage that differently, much more effectively and efficiently. And obviously I couldn't help but think of what Cure for your is doing and really that whole, you know, just digital front end. I mean, you want to dive in here, Robert, a little bit about what you know.

Speaker C: Well, the first thing I'm going to say is, is for those of you looking up cure for your on the, on the web right now, trying to figure it out, it is Q.

Speaker B: Thank you.

Speaker C: We're listening, right? Yes, it is Q, U, R, E. The number four and the letter U. So that's cure for you. So when you're looking it up, because I had that same problem. Um, so that's there. No, we were actually talking how, um, you know, the next generation, they don't want their health care like they want their fathers. Yeah, no, no. And the physicians and the hospitals, they have to change with the time because they are going to be looking. When we, when I grew up and everything else, you just went where your parents told you to go and you kept going. Even though you didn't even like the place. You just kept going.

Speaker K: Right.

Speaker C: You know?

Speaker B: Yeah. People are skipping. And to your point, they don't go now, they don't want to go where their parents go and they're skipping care. And we even talked about that with Bird a moment ago is people don't understand and the costs, it's not transparent. And we're seeing way too much. I mean, I think the number was 70% want, um, to pay online, but 54% delayed care or did not take C care because either cost or they didn't know the cost. And you're afraid and you can't blame them. And so having this, um, you know, this, this transparency. But then also, uh, I know you guys are on the whole payment side or you're, and you're moving down that path very quickly as well is having a full comprehensive platform where the patient can engage, they can understand what they're going in for. They intercede, you know, in your case, you know, pre or post appointment, uh, and prep and follow up, but also having all that information understandable. Uh, and you know, an employment may only cost $100 or may cost $50 or $10 or be no cost at all. But we need people seeking care. It's not. Seeking care is not a solution. That's a major inhibitor to much larger health problems later on that we're going to pay as a country. They don't just go away. So by delaying care, we're delaying. I mean we're going to be to able up for much more significant issues financially than uh, where we are right now.

Speaker H: But I think a lot of that is also about how easy is it, uh, to get to the doctor.

Speaker B: Yes, very true.

Speaker H: And a lot of people are working and some cannot go to the doctor because they're afraid of losing their job. So we have uh, examples of patients calling in on a telehealth call from their car and that helps them, but also just scheduling an appointment. I mean me personally, I don't ever get to go to a doctor because I don't have time to call and schedule an appointment during the day. But if I can go in my app I could just plug myself in nighttime. I mean that was what we saw earlier on in what's happening in Denmark was that we had like 30% of all appointments were done online.

Speaker B: Excellent. Now I completely agree and we talked about that again right before we came on air about how care is really shifting. It's now health plans that ah, they do certainly Medicare reimburses for uh, telehealth visits but. And the payers are starting to um, reimburse for these telehealth visits. But health plans and care plans now offer it integrated into the overall service and membership. And so, you know, that's what I'm most excited about. It's not just about reimbursement. It's about, it's just part of healthcare. You can go see your provider in person if it's crafted the right way and integrated the right way. You can actually go, you can see them in person, you can see them virtual care, telehealth.

Speaker H: Yeah.

Speaker B: Secure messaging and have your visit however you need to and that you know exactly what you're saying. So uh, in our closing Few minutes. What do you see for cure for you? And it's Q, U, R, E, four, U. The number four. Number four, the letter U. Thank you, Roberta, for bringing that up. Very good point. What, um, do you see over the next year for your company?

Speaker H: Um, we've been very fortunate. We've been growing, like, um, really growing crazy the last year. And, um, and being able to, um, get, uh, some very large clients sign up with us. And it gives us an ability to really go build that all in one solution that we want to do. Um, the one that we have a few pieces where we want to go into eligibility and some more payment options. Um, but I think really optimizing the flow for the patient and then also building out some tools for the physicians for the things that are missing in the EHR right now. All partnering with more EHRs. Um, that's also like, we like to partner.

Speaker G: Yep.

Speaker B: No, very smart. And you talked about the importance of the, uh, deep integration, uh, and patients deserve that. And so we certainly want, you know, as former chairman of the EHR association, I certainly want more EHRs opening their doors to innovators, certainly the leaders out there that are solving big problems. And so I'll certainly call on the industry to do that. Um, but, uh, then also, you know, you're growing like gangbusters because. Exactly. Every single guest, you know, before you talked about the importance of consumerism, the digital front door. And, uh, Denise was. Was kind enough to share some of her thoughts, and she's going to jump into and talk about, I think, patient engagement and consumerism as well. And Denise Hines from himss, uh, just joined us in studio as well. So, um, uh, everybody's coming on time. Exactly. I'm grateful because that when we're live on air at himss, you know, the radio show for annual conference, it's not always like that. It's me looking into the audience. And then, you know, we'll have people. They'll be showing. They'll show up, but they're still. They're talking to their friends. And I'm like, no, you're supposed to be live on air right now. Get up here. And I'm like, ad libbing and doing the tap dance, and Stone's like, throwing little rocks at my feet, making sure I dance properly. It's great. So, um, but anyhow, Monica, thank you very much. You traveled in from Florida, so I appreciate you flying, uh, for the show. But hopefully Atlanta will treat you well today, and you have safe travels home. Thank you so much, Dr. Monica Boeberg uh, CEO and co founder of Cure for you. Thank you for joining us. Have a great afternoon. Denise Hines. Thank you. How are you doing?

Speaker I: I am wonderful. Thank you, Justin, for having me here today.

Speaker B: So you're the Chief America's officer, Is that your title?

Speaker C: Yes.

Speaker I: Is that the coolest title ever?

Speaker B: I love it. Yes. Denise is a long. First of all, you're wonderful to our industry. You're a longtime friend of mine, um, uh, but this is a new role for you. You're one of the big leaders certainly in our state and nationally when it comes to health I. But now you've recently joined himss in this new role. So tell us about this new role.

Speaker I: Yes, well, um, it's a dream job, Justin.

Speaker B: Amen.

Speaker I: It's taking everything that you and I and many of us have worked on to advance the adoption of health technology. Working with providers, all the industry stakeholders, workforce development, taking all of that and having a global platform to deliver services and products. And in my role, I am responsible for the global conference. So, um, all of the great networking and learning and bringing together 45,000 plus people.

Speaker B: I've already plugged it one time, but I'm going to plug it again here in a second too.

Speaker I: Perfect. Um, working with the group that leads the coordination, uh, of the global conference to professional development. So all of our certification programs, making sure that we are positioning the next generation of skilled workers. So all of those services, certification, learning, education, products and services, as well as membership. How are we going to keep our members engaged? How do we make sure we are in touch with our members, providing them the services, the best services to help them continue to grow and understand what's happening in our industry. So I take all of those services, products, engagement opportunities in the Americas and work with a global UM team to ensure that all of our best practices, all of our initiatives are um, exchangeable globally, but also taking a look at what's happening globally. Yes, the digital health UM takeover, I call it or framework, is happening globally so we can look at best practices from robotics to digital health to artificial intelligence. Take those best practices from a global perspective and see how we apply those here in the Americas. So it's the dream job, Justin, I have to say, and it's been a wonderful opportunity and I enjoy all of the opportunity. I have to talk about everything we've been working on from women in health it to inclusion and diversity to health equity, to now really focusing on the patient experience and making sure we keep the patient at the center in everything we're doing.

Speaker C: Uh, do you have anything over the theme? Doing the themes for the hymns. Okay. Are you in part of that?

Speaker I: Yes, I work with the, uh, marketing team. So we have a wonderful marketing team who's actually working on the theme. So that will be revealed very soon. I heard very soon.

Speaker C: Tell us, uh, what goes into that though. How do you come up with the team for the years?

Speaker I: Well, we take a look at what's happening in the industry. We obviously take a look at what worked well. Our Champions of Health was a, uh, tremendous success last year. And the momentum from that, we want to make sure we continue to build upon that. But we also want to make sure that our industry is looking forward. We've been talking so much about digital health innovation, um, keeping the patient at the center, health equity. All of these topics are moving us into the, the future of health care. And we want to make sure that our theme not only recognizes our champions in health, but we take that forward and figure out how do we capitalize on the innovation and the forward thinking that's happening today. So our theme will reflect on making sure we are focusing on bringing positive change to our healthcare industry.

Speaker C: And then does that, does that then parlay into the keynotes? The keynotes? Yes.

Speaker I: Yes. We work with, uh, the process for planning for global conference happens years in advance. Um, and we are planning for that now. So we work with our members to go through the proposal call for proposal process. So we wade through 900 proposals to present this year. So our team, our wonderful professional development team, is looking to make sure that we provide quality content for our members, which is expected. And then we begin the process of planning the Global Conference Convention center to make sure it is a positive experience for networking, for getting to the sessions, for making sure that our keynotes are in the right areas, that we provide new and exciting opportunities to showcase innovation, new and exciting opportunities for learning, education sessions for members to get engaged, for networking. As Justin mentioned, when you're walking down the hallway, you're seeing 10 friends, right? 10 friends that you haven't seen in years. And it's like a reunion.

Speaker E: Yes.

Speaker I: So we want to make sure we

Speaker C: live 10 miles away from m. Each other. Mostly we see each other.

Speaker B: So we want to make sure did these things. That's close to me too. But we don't see him once a year at Hymns.

Speaker I: Yeah, exactly. So when we think about the global conference, it's not just, uh, one thing to think about. It's, uh, a global conference. And we're bringing people from all over the globe, internationally, to engage in this experience. And we want to make sure it's the best experience for everyone from the individual to someone who's just now entering the conference. Um, experience for the first time, which is truly overwhelming. So we want to make sure we take care of them and then we also want to make sure that we take care of the seasoned professional who is there to network, meet with, um, have specialized appointments to meet with people, um, in the industry, to people who come to listen to the keynotes, who are expecting big announcements from policy, or come to the center to see the latest and greatest in the innovative space. Uh, what's the next theme? Where is health care headed? So we have to make sure that we make this the best conference for every attendee, no matter where they come from.

Speaker C: Uh, I don't want to put you on the spot because numbers are numbers, but what is the percentage of first time people going to that conference? On an average.

Speaker I: On an average, about 40% of our attendees are first time attendees.

Speaker C: That's amazing.

Speaker B: Amazing.

Speaker C: And what about the vendors?

Speaker B: And we grow every year.

Speaker C: What about the, is the vendors the same?

Speaker I: Uh, most of the vendors are the same. But we are now seeing the influx of innovation coming into the global conference. So we are now reaching new types of vendors. So as we look at wellness and healthcare, you may see a new vendor. Um, for example, Lyft is a new vendor. Who's there?

Speaker C: Yeah, I saw them last year.

Speaker I: As we look at the full community of health care, we're now starting to see that we have to include others who aren't the traditional health care vendor to come and talk about how they impact our industry. So you're going to continue to see those vendors who you may not have ever seen before, but really have an impact in our health.

Speaker B: Yeah, we saw Lyft as a big partner of HIMSS19. And you're gonna start to see those big players. And just to do a little bit of a backup for everybody, I think, I think most of my audience is very familiar with himss, uh, the association, the Health Information Management and System Society. However, the annual conference that you're speaking about, you know, 45,000 people is what's expected. And I mentioned, I think I mentioned 40 to 45,000 when I got um on air today because it grows every year. It's a blessing to be there. Uh, and we'll actually, I mentioned, we just sealed it yesterday, but we are going to broadcast the radio show again. Hm. Live from the Hints conference. This would be my sixth year, I believe. Um, yeah, Six year. But for everybody knows it's Sunday this, the kickoff of hymns. There's probably some pre conference stuff on Saturday the 7th, but Sunday, March 8th, 2020. So I just want to make sure. And my insider, um, uh, advice for people is book your hotel rooms now. Yes, that's. I always tell everybody just do it as long as you can. I book mine a year. As soon as they open it up, I book mine because I want to be on site. I need to build a walk to back and forth my room to between. In between meetings and all that. Um, and uh, it just, you know, you have to be there and I'll cover this and you just actually helped me a lot. I did not plan this. And you're wonderful Roberta for asking you some questions because you guys have not launched all your themes yet. I think you're gonna do that in the next week or so. But I promised my audience, I know we're trying. I promised my audience a hymns Preview at uh, 1:30 today. Um, but you just gave me a lot of the answers to the test. I had some stuff ready to go because I have some insight. But um, I think you just helped um, quite a bit. But I know the official launch of the themes won't come for another week or so.

Speaker I: Yes. And we're planning to open up the global conference registration website where you'll begin to get a taste of all the themes. So that's coming very soon.

Speaker B: Excellent. So staying on track a little bit here just so we can cover some good ground. Um, you know, and you've already touched on some of it here, but what helps and health it trends are you seeing in the industry and you're navigating in your role?

Speaker I: Yes, well, for me, um, what I'm seeing is that we're now beginning to understand that the patient has to be at the center of care.

Speaker B: Um, and every single guest before you has said the exact same thing. It's a resounding theme for today.

Speaker J: Excellent.

Speaker I: So patient care.

Speaker B: Got it.

Speaker I: Keeping the patient at the center of care. So we're realizing that care is happening outside of those four walls of the hospital, the traditional settings. And now that's forcing us as an industry to take a look at the full community of health for a patient. So when they leave the healthcare setting, do they have a home to go to? Do they have good food to eat? Do they have transportation? And are they in an, in an environment that has sidewalks to promote healthy living? Do they have access to be able to come back to the healthcare setting that they need to get to for their continued healthcare experience. So if we, for example, take a patient who lives in a rural setting, who may need access to a specialist who lives, and we can just use Georgia, for example, three hours away, and the specialist is in Atlanta, is it realistic to think that that patient can get to that doctor every week and try to get well? And so we are now beginning to understand that we have to understand the social determinants of health for a patient. And I like to call it, Justin, the three P's on where I think healthcare is headed. Prediction, prevention, and precision.

Speaker B: Wow, I love it.

Speaker I: Uh, so if we can predict, using social determinants of health, how well that patient will adhere to a treatment plan, or what will that patient be predisposed to in their community, their society, their background, their DNA history, then we can begin to prevent. We can. If that patient does not have transportation, how do we introduce a way for that patient to get to their, um, healthcare setting so we can prevent, um, some of the causes of that patient not getting as well as anticipated?

Speaker B: And so three Ps, again, are prediction,

Speaker I: prevention, prevention, and precision. Precision.

Speaker B: Excellent.

Speaker I: So if we have predicted what your health outcomes will be based on your history, your family history, your social community, your access to health and wellness, um, tools that can help you get better, we can help you prevent. So we can give you the home monitoring tools to help you prevent. We can look at your past history and get you the tools and exercise and medications you might need to prevent you from getting worse or prevent you from even having the chronic illness that is predicted. And then precision. If you do contract that chronic illness, we will know enough about your history, your social environment, your past, um, family disease states to offer you a personalized healthcare experience that will help you get better and not just a generalized healthcare experience. And so that's where I see healthcare heading. And to get there, we need the tools, we need the data and information. We need healthcare providers to not be burned out by introducing all these rules and tools and requiring, uh, them to learn something new every day. And we need the skilled workforce that can wade through and bring in the next generation of technology who can understand and create these patterns and predictions and help us understand what's happening in our healthcare environment.

Speaker B: Yeah, I'll actually get a plug for where you went there. I actually had, uh, 23 and me do my sequencing and all that. And actually I was shopping last. Think I got it on Thursday or Friday of last week. I think it was last Friday. And I got my email from 23andme.m. And I went through it immediately, as in a mall. And I just went through it. And literally, I had email my mother and my grandmother, because I had no predisposition to anything. And I was just. I was so happy. I was like, thank you for good. The good genes, mom and Graham. And, uh, was just. I felt blessed because. And I was concerned, obviously, because they go through. I went through all of it. You're talking about, um, Parkinson's and diabetes and, um, uh, Alzheimer's and then all the stuff, some of the initials I didn't even know. But, uh, cancer, you know, predisposition, all that. And I don't have any of it. And that's. I just very fortunate. That's just genetics. And I am 24.4 Italian, which everybody around me knows. Yeah, it's great. So I was happy about that as well. That's actually not too bad because I'm being, you know, second generation, third generation. In America, you sometimes lose. So I'm 24, Italian. But anyhow, I actually think everybody should do 23andMe. I got it from. I don't want to. You know, I don't like to plug companies, but I did buy it on Amazon Prime Day. It was half price. It was a hundred bucks. I decided to do it. Uh, and I'm very happy because you do want to know. To your point, going back to healthcare, I mean, we do want to know our genetics, we want to know our predispositions because we can make conscious decisions. Yeah. And then this. And if I did have any predispositions, I bring this to my doctor, and then we start managing my health differently.

Speaker I: So you're able to prevent as much as you can. Um, if you are predisposed to, let's say, diabetes, then you can be placed on a health management plan early enough to help prevent it.

Speaker B: Yes.

Speaker I: Um, and then if you do contract it, then the precision of knowing what has happened in your past family history can help that doctor develop a personalized health plan for you.

Speaker B: Excellent. So we're running a little low on time, but I'm actually, if you do have time, you're more than welcome to stay in studio. We do have Dr. Rucker calling in in a few minutes here. Um, do you know if they're online? Okay. But, uh, Stone, our wonderful producer, will let us know when they come online. But I do want to hear. So go through a few of the best practices or strategies that you recommend. Uh, my audience, to navigate healthcare.

Speaker I: Sure. We're going to talk about interoperability so we're still focusing on making sure that we have access to data and good information. We also want to continue developing tools that can help the patient be in the best healthcare environment for them. So through, um, focusing on health equity and providing tools and services to make sure that a patient can experience care in the best setting for them to help improve where they are.

Speaker B: Excellent.

Speaker I: And we have to pay attention to clinician burnout.

Speaker B: Yes.

Speaker I: Um, we need to make sure that we, um, develop tools and services, but also make sure that we pay attention to what our clinicians need and focus on their health as well, and make sure that we don't burden them with so many tools and rules that they don't have time to pay. Pay attention to the patient.

Speaker B: Yeah. Ah, 61% of clinicians report burnout at some point. And that's just. That's way too high. We can't sustain our healthcare system and all that we have to accomplish with it with a 61%, you know, reported burnout rate. Um, completely agree. So in our closing minute or so, are they. Do I have. We have Dr. Rucker. Excellent. So, um, just thinking beyond today, where do you see or what do we need to think about for, you know, two, three years down the road and what we need to manage for healthcare or keep our eyes out for Again,

Speaker I: um, data and interoperability. We're bringing all these community services and organizations who have not traditionally participated in the healthcare exchange of information. So we need to make sure that we provide ways to get access to information at the right time, the right amount of information at the right time, and making sure that we are focusing on developing health tools and resources that, that, um, can increase, um, access to healthcare beyond the traditional settings.

Speaker B: That's excellent. I completely agree, and I certainly agree with your social determinants of health and really our communities of health. I love how you wrap that together with, um, homes and food and transportation and sidewalks and thinking holistically about the patient, about the community. Um, I think you're spot on. So fantastic, Denise. Again, you're more than welcome to stay in studio if you're. If you would like. And I would love to welcome my next guest, uh, Dr. Don Rucker, who's the National Coordinator for Health IT for the Americas. Um, since we have the chief Americas officer across me from hims, um, Dr. Rucker, are you there?

Speaker F: I am, Justin. Thank you. Yeah. Denise.

Speaker G: Hi.

Speaker B: Hi, Dr. Rucker.

Speaker H: Excellent.

Speaker B: Welcome to the show, my friend. Thank you.

Speaker I: Thank you.

Speaker B: And, uh, I kind of sang your praises as we came on air. Here you're a great proponent of, uh, for our industry. You're a great leader. I had the pleasure of, uh, working with you in my early days with the EHR Association. I think you were with Siemens at the time and uh, and just appreciate everything that you've, uh, given to our industry and you continue to do for our industry. So thank you, Dr. Rucker.

Speaker F: Um, thank you.

Speaker B: So what do you see? I guess a little bit the floor is yours. Um, but, but uh, what healthcare or health IT trends are you seeing in the industry? Or would you recommend that, uh, you uh, have people navigate here for my audience?

Speaker F: Yeah, I think, uh, the big trend really, and it's way further advanced in the rest of the economy than it is in healthcare, is the, um, repurposing and reimagining of services, um, using application programming interfaces. So in the broader economy, you know, this is at the heart, uh, essentially of the modern web economy, right? It is having all of the parties connected relatively seamlessly through application programming interfaces, right? This is what makes it possible for you to, you know, use Uber or Lyft, right, where you have the Map API and the Traffic API and the credit card API and the customer API and the Driver API all coming together, um, or even electronic, uh, online retailing. Somebody like Amazon, where they um, have online networks of literally hundreds of thousands of vendors that they're hooking up and then communicating with the uh, transportation infrastructure. I think we are at the early part of seeing that type of economy start moving into health care. Um, the 21st Century Cures act, um, requires that on the consumer side that providers, um, will give consumers right to their, um, information through a modern API. And I think it is also going to happen, you know, more broadly, even beyond, uh, the rulemaking. So that I think is the big trend. It has revolutionized, you know, much of the rest of the economy. I think healthcare, um, is ripe for that, um, you know, heavily networked, um, codependent type of world. And especially because there are demands really from um, everybody given the expense of health care, to overlay, um, and provide, you know, fundamental transparency on both prices and, you know, the product, if you will, or the service. So I think when you put those things together, you put the technology of transparency together with, you know, a national outcry for transparency, I think those things are going to redefine the opportunities in healthcare. So that's what I would throw out there. Justin.

Speaker B: Yeah, no, I actually agree. And each of my guests so far have brought up components of what you just spoke about. So I mean, from the standpoint of the importance of interoperability, uh, the importance of having that data, uh, transferred securely, uh, electronically and seamlessly, uh, and then also the price transparency, I mean, and the example that I brought up, Jeff, uh, Brown, a CIO here in Atlanta, Piedmont Healthcare, asked me when's the last time I traveled? And I said, yesterday. And so literally everything was done digitally and through APIs. I mean, my Delta app, I booked my ticket, paid for my ticket, scheduled everything, my flights. When I landed Hertz, had my car ready, and, uh, then I jumped in Lyft and, or Uber, uh, also. So, I mean, literally, I'm using all those digital applications. APIs are integrated into all of those technologies and innovations. Uh, and we, you know, we deserve that in healthcare. And so I completely agree, uh, with where you're going and what you said, uh, in your advice there. So diving in a little bit deeper. And again, I know that from the, this is all, you know, you're coming from the policy side here. What are two or three best practices or strategies or policies, you know, um, you know, would you share to help others navigate some of those trends that you spoke about and that we just spoke about?

Speaker E: Yeah.

Speaker F: So from a policy point of view, obviously we, um, have a rule, um, that is in process. Uh, we've got 2,000 public comments. We're going through those comments, um, and, uh, are going to have a rule requiring providers to have application programming interfaces so patients can get their clinical data in a very secure way, um, through, um, what is called OAuth2. So they're going to have a secure way. The patients have to log on to the provider. So I know there's been a lot of discussion about somehow, um, patients would, you know, that people would just somehow get the data. That's not at all true. This is 100% directed by the consumer. Um, so that's in our role. There are, uh, provisions enforcing that through, and the affordability of that through information blocking and the allowed exceptions because Congress and the, you know, it's law that information blocking, um, is not allowed. And the assumption is that consumers are going to get the data. So that's the policy. The flip side of that is, you know, for providers and for your audience to think about how am I going to provide services in that world, you know, how am I going to be an entrepreneur? How is my delivery system, my service, how am I going to make those richer products that you just described on your travels yesterday.

Speaker E: Right.

Speaker F: And that seamless, um, the theme, interesting enough of what you Described there is, I think something that is called co production. Mhm. Right. So you make your reservation, you print your ticket, you know, you tag your, your luggage type of thing. Uh, you know, we haven't really had co production in health care.

Speaker G: Right.

Speaker F: In co production and healthcare, you know, we term with a sort of a bit of a funny phrase which is patient engagement. Um, I mean that's a strange concept when you think about it. Right. In every other sphere of our life, we're automatically engaged.

Speaker H: Yes.

Speaker G: Right.

Speaker F: We don't need to talk about patient engagement to go to the supermarket or movie or to travel. Right. It's only in health care because where we've had these third parties, um, you know, third party payment systems have separated patients in many, many, many ways from control and knowledge of their health care. We think these APIs and in fact new services, new opportunities will um, re engage them. So I would say for your audience to really think about what do APIs mean for you? What services do you want to coexist with, work with, layer on in that sort of, um, very consumer driven, um, automated world? That would be a big suggestion.

Speaker B: No, I love it and I completely agree. And we're talking about that even before we came on air about how uh, you know, there's health plans now that this is all integrated into one package. It's like a membership. You get full virtual care, you get full telehealth, you get, um, you can go see your doctor in person. It's not even reimbursed. It's just part of your plan, it's just part of your care. It's a new model of healthcare. It's not kind of that older world. Um, and I'm excited to see it. I'm seeing, seeing how, you know, healthcare is evolving and we're seeing how these new models are being rolled out and all these innovations are just integrated. It's just part of the care plan. It's not a component, it's not, you know, a separate app. It's just how I'm going to seek healthcare. I might see you in person, I might ask you for a secure message back and forth, or I might, you know, ask for a virtual visit. But that's all with my doctor. Not some random doctor, it's, it's, you know, my doctor. And I love those innovations that I'm seeing out there.

Speaker F: So, and certainly with APIs, even if it is not your doctor, they will have your information and more importantly, you will have your information.

Speaker E: Very true.

Speaker F: And you know, the key part here from an economic leverage. Is this finally for the, I think literally the first time in many, many years truly empowers the American public to shop for their care. Right. The model where, I mean the current delivery system is in many markets, buy up all the competitors, um, prevent leakage and set prices for the insurer. I think that model, it's very much at risk in a modern competitive economy.

Speaker B: I completely agree. It's excellent. So in our closing few minutes, thinking beyond today, what uh, do you see as a key strategy or trend that we must be ready to successfully navigate in three years from now or in the future for health care?

Speaker F: Well, you know, I think one, we've talked, you know, obviously over the last 10 minutes about the consumer facing. Yes, part of it, I think for providers who I'm guessing are the bulk of folks listening here. I think it's also worth thinking that these technologies will also help make efficiencies on the payment side, you know, on the back office, if you know, the consumer is the, you know, the front office type, I think they're going to be just as transformative on the back office. We're working with all the large payers on accelerating fire through the FAST project and the da Vinci group. So a lot of the massive friction, the system, the whole quality measure reporting world, the prior authorization world, a lot of this will I think go away as we communicate the data in a much richer way so that we don't need these very narrowly scoped solutions such as individual quality measures or you know, individual protracted discussions about um, prior authorization. Those, those are really information flow questions and payment questions. You can reimagine that world infused really with a lot more information so that payers and the public will have a lot more accountability through machine learning and big data type of analysis and won't have to engage in these very, very expensive, one off hand curated activities. So I think the back end, you know, the back office part, the payment part of the world is going to be moving at least as rapidly as the front end consumer part of the world here.

Speaker B: I love to hear that. I know that a lot of my audience does as well because I mean that even goes to address some of the burnout issues that we've even, you know, that we talked about with Denise here before you came on air. It's just there's a lot of burden and we need to help the clinicians as much as we, you know, we need to navigate consumerism.

Speaker J: So.

Speaker B: I completely agree. That's excellent.

Speaker F: Yeah, I mean we've done um, you Know it's actually mandated in cures that ONC and CMS um, analyze burden. We've done a number of things with CMS on reporting burden, um, and we're addressing some of these, you know, more deeply rooted burdens, um, literally as we speak that uh, you know, we've just mentioned the prior authorization, some of the uh, quality reporting because those you know, it's interesting, the burden is not, it's often attributed to the emr. It's not fundamentally the emr. I mean you could argue about you know, the quality and usability of some of the you know, specific interfaces. But much of the burden is really how we've layered payment policies into the EMR workflow. And that's you know, not a great home for those things. Um, we need to uncouple, you know, we need to get the payment out of the clinical workflow.

Speaker B: That's excellent. Very good perspective. I agree. Um, any important dates Dr. Uh, Rucker, that you think we should keep an eye on from your perspective and coming from the ONC or cms, just for the education edification of my audience.

Speaker F: Well we are targeting and uh, you know rulemaking in D.C. is a complicated uh, is a complicated activity. Um, as I am ah, sort of increasingly aware, having come to this a little bit as a, as a citizen from you know, a free roaming citizen for 30 years who's now a federal policy person for the last two.

Speaker H: Yes.

Speaker F: Um, but um, you know we're targeting, the administration is targeting um, end of the year for the ONC and CMS rules to really uh, make the government part of this a reality. The um, implementation date we're targeting um, for two years after the rule is final. And ultimately what we're asking for is providers work with their EHR vendors and stand up a highly secure data endpoint that in and of itself is basically the simple ask we think uh, you know most of the EHR vendors actually already have these in prototype running as we speak today. And uh, that's basically the ask. And um, you know we hope that that will be. We anticipate that will be done in ways that does not create um, other than putting standing up the endpoint, additional ongoing work for um, providers that this is in essence an automated process. So um, those are the timelines we're looking at at the moment.

Speaker B: Excellent, very very helpful and um, and it's great work. I mean you were uh, on the uh, the citizen side for a long time. Where I reside I've done a lot of policy work but I know what it takes in, uh, what you're. What you're doing on our behalf. And we're just grateful for you and for you, and specifically you and your position. You're a great advocate for us. You've, you know, it. Shoes that we walk in as innovators. Uh, uh, and then you're balancing that very well with policy. So thank you very much, Dr. Rucker.

Speaker F: Well, thank you very much. Yeah, and I think you're going to hear from, uh, one of my colleagues here, Steve Posnack as well.

Speaker B: You got it. Dr. Donald Rucker, uh, Chief National Coordinator for Health IT and, uh, really one of our chief policy people in the industry. So thank you very much, Dr. Rucker. Thank you for joining the show, and have a great afternoon.

Speaker F: All right, Justin, thank you very much.

Speaker B: Thank you. Bye. And do we have Steve Posnack joining us?

Speaker E: I'm, um, here, and I didn't hang up by unmuting myself. Perfect.

Speaker B: Excellent. Welcome to the show, my friend.

Speaker E: Thanks very much for having me.

Speaker B: And, uh, we were. I was singing your praises, so I hope your ears were ringing, but both Roberta and I were singing your praises as, uh, we came on air. Um, you know, Dr. Rucker's terrific, and you are as well. You've been, you know, you know, industry very well. You've been in the trenches with us, trying to learn a lot about our industry through the many years. How long have you been at ONC? Has it been 10 years now or 8 years or how long?

Speaker E: If you can believe it, I've just crossed paths. 14. 14 with ONC, 14 with ONC.

Speaker B: July 2005 was that day one was ONC then.

Speaker E: Uh, it was, uh, you know, maybe eight or nine months after formation of the office. Which is April 2020. Uh, yeah.

Speaker B: Dr. David Braylor.

Speaker I: Wow.

Speaker F: Correct.

Speaker E: Excellent. Yeah, I've been through all the national coordinators.

Speaker B: Well, I got a quick brailer story. So, um, literally, uh, the first time I ever testified before Congress, I had. I didn't know who the other witnesses were. Um, I was asked before one of the. I think it was energy and Commerce. And the three guests were me, Dr. David Braylor, and then an, uh, orthopedic surgeon and a very smart gentleman. But. And I had literally prepped for probably a week and a half. I had teams helping me write my testimony. I had. I mean, literally, it was. It consumed me for, I mean, literally a week and a half. David Braylor walks in the room, had nothing prepared. He sits next to me, we shake hands, and he writes his entire Testimony, that's how. This is how smart he is. I am not smart at all. That's how smart Dr. Braylor is. He wrote his entire testimony as he was sitting next to me five minutes before we went live in the hearing room. Like I'm looking at him in awe. So anyhow, um, uh, but he was very good. He kicked all that off. Um, it really, you know, this is not, uh, um, a story about the, you know, the National Coordinator's office. But nonetheless, I was, uh, very impressed with him. So those are my first interaction with him. So.

Speaker E: Yeah, uh, yeah, go ahead, go ahead.

Speaker B: No, go ahead, Steve, follow on there.

Speaker F: A quick, quick story for you as

Speaker E: well, if we're sharing stories here. So when I first started straight out of grad school, it was the beginning of a lot of ONC's work from its infancy. And that's when we first put out the initial request for proposals on cchit, if you may remember. Yes, the original nationwide Health Information Network work and, uh, hits the Health Information Technology Standards panel.

Speaker F: Yeah.

Speaker E: So all these proposals came in and I was the low man on the totem pole. So I was in charge of, uh, copying all of these to send them out to the reviewers. The copy machine happened to be right outside of Dr. Breller's office. So I'm pretty sure that that's, you know, what he knew that I did, uh, uh, for the office, the time that he was there. Funny.

Speaker B: That's great. Um, but no, you have been. So.

Speaker F: Yeah.

Speaker B: For the last 14 years, you've been in the trenches with us. And so I want to first of all say thank you. I know on behalf of, of the entire innovator and vendor community, we want to say thank you. Uh, because for all your work and for being, you know, just, just learning our life, life cycles, I think is very important. I think you have a great beat on what we can implement. And I'm not even really on the innovator side. I kind of was for a long time. I'm, I'm now more on the investment side of the house. But I mean, I, um, I spent a lot of time, you know, still out there and, and I see how people, how grateful they are for, uh, the work that you do. So I want to say thank you again, Steve.

Speaker E: Much appreciated.

Speaker B: And you are the new deputy coordinator, is that correct?

Speaker F: That's correct.

Speaker B: When is that official? Today, Yesterday, in the last month or so. When's that official?

Speaker E: Monday, uh, of last week, but who's counting, right?

Speaker B: Congratulations. So. Exactly. Yeah, that's right. So yes. From coffee boy to deputy, uh, director. Pretty amazing.

Speaker E: That's right.

Speaker B: And you've just had your, your second child or in the last few months or year or so.

Speaker E: Is that true or uh, time. Time is dating us as well. So my, My daughter turned 6 and my son turned 9.

Speaker C: Oh my gosh.

Speaker H: Wow.

Speaker B: I remember you when you had, yeah, young toddler. I remember when you had your children's, uh, children.

Speaker H: Wow.

Speaker B: So six and nine. Oh my. Yes, I am. Well, it's all right, Roberta. When I came in studio, Roberta said I was her. What term did you say? Roberta? I was your oldest guest.

Speaker I: Yes.

Speaker B: Which is great show. Oldest show. Um, and I said yes, I am getting older. It's been six years. I've done my shows.

Speaker E: So.

Speaker B: Anyhow, but diving in now to some of your, you know, your recommendations for my audience, um, what healthcare and health I treat trends are you seeing from your perspective in Catbird Seed, Steve?

Speaker E: Yeah, absolutely. It's a tough act to follow, Dr. Rucker. So I mean, you know, just to piggyback on a few things that he mentioned as well, um, you know, right toward the end of his remarks, we are seeing an opportunity for convergence in a number of areas. Uh, the clinical and financial, administrative, uh, area that he mentioned as well. Um, you know, there's a blending opportunity among uh, the different data sets that are available equally for research too. So as we start to move into the 2020s now that we're approaching this new decade, uh, there's a greater opportunity to use APIs, application programming interfaces to really stitch together many uh, of the data sets that have existed in uh, their respective silos or uh, other areas in the healthcare system. And that is the app economy that we really see from a trend perspective shifting uh, from the uh, bespoke or I like to call it artisanal interoperability to more of this uh, modern web based, um, API oriented. The consumer experiences that we have today with Maps and Uber and other types of ways that we engage in the economy that I think we see as a fundamental shift, uh, for healthcare, uh, trends and some of it we're contributing to through our 21st century cures, rulemaking.

Speaker B: Excellent. So in helping people navigate some of those trends, what are two or three best practices or strategies or roles or information, uh, would you share to help my audience navigate those?

Speaker E: Yeah, certainly. We as your office of the National Coordinator for Health, it, uh, are participating in various different industry efforts. Uh, we also from time to time uh, convene groups so we hold workshops. There's ample opportunities uh, in a public facing way for stakeholders to contribute in the work that ONC is participating in. But equally we have a health IT advisory committee of which I'm sure you're familiar. Uh, many of our uh, key stakeholders across a wide representation, uh, are part of that, uh, that advisory, uh, committee accepts public comment at multiple times during the meeting. So that's another opportunity for um, your listeners to engage with the people that are giving ONC advice, uh, as an opportunity. The last one would be as there are additional rulemakings and there will continue to be on that annual cycle with CMS payment rules and other things that everyone is predictably scheduled to respond to. Uh, those, as I'm sure everyone has seen over the past 10 years, have become more increasingly health it focused, uh, be it for blue button related activities that CMS is involved in or uh, to make uh, alternative payment models more of a reality.

Speaker C: Now.

Speaker B: That's excellent and I will take a moment just to let my audience know. I have a good mix of innovators and vendors and also providers. But it's very important to uh, on behalf of your sector or even yourself and your own institution is to look at the rules and comment. And also I think it's important I've learned and why my relationships with Capitol Hill always work so well is I would, you know, point out what may not work or what we feel it doesn't work, but point out what does work and what, you know, what really is positive. Because people tend to always focus on the negative and the bad. But I want to make an open call, also point out what's good in these bills because we don't want to if we only hear the bad. And I mean I'm on the policy side but you know, we need you, you're a policymaker and so you need to hear what's good and then also hear what's bad. And so you can kind of ebb and flow. But you want to say a few words on that and share your ideas or thoughts?

Speaker E: Yeah, absolutely and totally, uh, would. Plus one. All your remarks there, uh, you know, just from our experience, having you know, worked on all the roles that ONC has done, it's, it's important for us to see the context in which um, you know, stakeholders think they're the ideas that we've proposed are good. And then equally to help us play out situations where um, you know, there may be an unintended consequence or uh, particular business model may be impacted in an unanticipated way. All of those help us and help everybody else get to a place where there's a better policy at the end of the day. And so that's what all of us are working toward. And that's why you know, the public comment process is really important, um, both for legislative purposes as well as for the regulatory stuff.

Speaker B: Yeah, no, excellent. And yeah, to make everybody, you know, be constructive. Uh, but again do engage, don't just ignore, don't complain, don't just go to some open forum and but, but make it a constructive comments and, and also, you know, comment within the constructive and allowed comment periods. That's very, very important. Um, as, as people. Because we're always having new people engage. I mean even from, you know, Denise said that up to, you know, 40% or 40% of attendees of the HIMSS annual conferences are new. So we have new people coming in all the time. And that's why my, I want to use my shop show as a platform to learn, learn best practices and strategies, but also how to be good, you know, good citizens here in our healthcare ecosystem. So we're all moving the uh, industry forward together because it's going to take all of us and we have a monumental task ahead of us. Um, uh, but with people like you, Steve and your office and Dr. Rucker and Katherine and everybody else there, uh, we know uh, we're in great hands on the policy side. So um, thinking beyond today, what do you see as a key strategy or trend that we must be ready to successfully navigate in three years from now? Because really looking ahead in the Wayne Gretzky world, where will the puck be or where's it going?

Speaker E: Yeah, absolutely. Um, again another opportunity to emphasize the future that we see with application programming interfaces, FHIR, fast healthcare interoperability resources, the HL7 standard. Um, I'm sure you've heard the various puns that have been used associated with all the different FHIR activities. I believe Don mentioned DaVinci. The uh, Karen alliance is working on one for patient access uh to data. There are a number of others that have started uh, as well as, and so as we start to see more effort toward implementing fhir, both for, I like to call it single serving purposes when you have an N of one, you know, patient seeking access to their data or you want to provide uh, clinical decision support services uh, based on a specific uh, individual's health, uh data all the way to understanding population, uh level services where you can use APIs today now to make that much m more efficient. And it's important context, context from a trend perspective Ah, you know, we sense an overall industry discomfort in some of the change that's occurring and that is natural with the changes that happen. Um, but what we see are analogies to today's existence. So when you talk about um, you know, population level services today, that happens under business associate agreements under the general HIPAA privacy and security framework. And what FIRE and standards like it are doing are making the healthcare experience more efficient and optimizing the way in which data is being exchanged from an interoperability, uh, related context. Uh, equally as we look toward patient access. And this may be a good segue for my colleague Katherine, who's going to follow. Uh, there are some concerns around security and privacy. Those are two different constructs. So when we talk about API related security, uh, that is something that many industries have already put in place. Uh, our proposals in the 21st Century Cures act proposed rule that we included, you know, required industry standard secure connections, uh, required the OAuth 2, uh, authentication and authorization process, all of which are put in place as layers that when you uh, to give a shout out to my colleague Devin McGraw, she described this as you hire an app, you pick the app that you want to use to access your data and then it has to still go through that security process where you give your credentials and verify your identity to a uh, covered entity in this case, uh, under the HIPAA context. And all those things are, you know, the shift from paper to electronic is something that we experienced the past, you know, say five to seven years.

Speaker H: Yes.

Speaker E: And now it's really on, on having that data be more accessible to patients and for other services that healthcare providers would engage in are the trends that we would see and what we're trying to support with our rulemaking activity.

Speaker B: That's terrific. Yeah. And I'll second plus uh, one on Devin. Devin's phenomenal. She's been a great guest in the past too and a good friend from colleague in the industry. Um, on data, uh, I mean on dates, any important dates that we should keep an eye on, Steve, that you want to let my audience know.

Speaker E: Uh, let's see here, things that Don didn't already cover. So as uh, your audience may be familiar, the federal fiscal year ends on September 30th. Uh, we have a few um, procurements that were outstanding. So we're in the process of going through and selecting the recognized coordinating entity as part of the Trusted Exchange Framework and common agreements, uh, activities to implement that portion of the 21st Century Cures Act. So that's upcoming. We also uh, have, um, investments that we make in what we call leading edge acceleration projects, or leap. And we have a few, uh, cooperative agreement announcements associated with that, uh, investment line as well. So those will be forthcoming in the next, uh, few weeks as the fiscal year ends.

Speaker B: Excellent. Appreciate it, Steve. Thank you, my friend. Always great to hear your voice and hear your wisdom and we're again grateful for you, for what you do every day for us. Um, we know you're probably doing much bigger things in the world, but you're sacrificing yourself for the betterment of our industry, uh, and we know it. So thank you very much, my friend.

Speaker F: Awesome.

Speaker E: Thanks for having me. You got it.

Speaker B: Have a great afternoon.

Speaker G: Thank you.

Speaker C: One last thing for our listeners on Steve, if you're not following him on

Speaker B: Twitter, you're really missing out for sure.

Speaker I: Thank you.

Speaker C: I've smiled more than once reading here.

Speaker B: Yeah, that's Roberta Mullin from Healthcare Now Radio. Yes, excellent.

Speaker E: Yeah, it's a mix of, uh, dad humor and, uh, other health it snark, I suppose.

Speaker B: Well, it's also the levity. We need the levity in our industry. We tackle very big issues on a daily basis and having that levity adds, uh, to our day and helps round them out.

Speaker C: That you can keep your sense of humor is a miracle.

Speaker B: Yes, we need to.

Speaker E: I appreciate that as well.

Speaker C: Thanks, Steve.

Speaker B: Helps us stay sane.

Speaker E: All right, take care.

Speaker B: Thanks again, Steve. Take care, my friend in stone. Do we have Kathryn here? Kathryn, are you there?

Speaker G: Hi.

Speaker B: Hey, how are you?

Speaker G: Thank you for joining the show, Justin.

Speaker B: Thank you very much.

Speaker G: Good, good.

Speaker B: And it's Catherine Marchesini, is that correct?

Speaker G: That's correct, yes.

Speaker B: Excellent. Chief Privacy Officer for onc. Um, and, uh, I guess you're a first time caller, uh, and a first time guest on my show, so welcome.

Speaker G: Thank you. Happy to be here. I look forward to chatting.

Speaker B: Excellent. Same here. So I guess, um, I am probably not as familiar with your, uh, role within, uh, onc. So maybe give us 30 seconds on your main charge and uh, what you're overseeing there.

Speaker G: Absolutely. Um, yeah, happy to. So as you mentioned, I'm the Chief Privacy Officer at onc, which I serve as a senior advisor to the national coordinator, um, on areas around privacy, security, data stewardship, um, and also interact closely with our federal partners, um, and really trying to make sure that in particular as we're looking at sharing, um, accessing, using electronic health information, that we're really looking at baking in privacy and security into the technology and encouraging industry to do so as well.

Speaker B: Excellent.

Speaker G: Perfect.

Speaker B: So what healthcare and Health IT trends. Are you saying, at least from your cat bird seat in the industry, or would you recommend my, uh, my audience look out for.

Speaker G: Sure thing. Um, and I know, uh, Dr. Rucker and Steve also touched on this, but Justin, one of the trends is really looking at, uh, giving patients access to their health information or health records.

Speaker B: Yes.

Speaker G: And particularly at least where ONC sits. Um, encouraging patients to exercise their HIPAA right of access to get electronic, um, access to data that most healthcare providers and plans have, um, about the individual as well as those operating on their behalf. And your listeners probably are aware of the term business associates under hipaa. I think we're somewhat at a tipping point in how industry is thinking about data and the role patients play in healthcare. Um, the HIPAA right of access actually has existed since the HIPAA Privacy rule was issued in 2003. Uh, many people aren't familiar with it or they're not as familiar with it and they often consider access, um, just as another term for or synonymous with the individual authorization under hipaa, which is a different method for sharing data. Uh, you know, in short, um, the HIPAA authorization, which is a permitted disclosure and it's usually a third party or provider initiated request, whereas what, you know, the trend is on, um, the HIPAA right of access, it's a required disclosure under hipaa and it's usually, you know, it is patient initiated, um, and on behalf of the patient. And it's actually something that a covered entity has to honor, um, in most cases. And so, you know, what I'm focusing on and also our broader office, um, we see that providing individuals with easy access to their health information as a way to empower them. I know Dr. Rucker spoke a little bit about that, um, to have more control over decisions, um, regarding health and spending and overall cost. Um, but really, I guess the individual right of access, for it to be fully realized, um, it has to be operationalized. And part of our efforts is, as you are more than familiar as well as your listeners, achieving widespread interoperability. This includes creating a mechanism for individuals to readily exercise this access. Right. And I know Steven and Dr. Rucker spoke to the API and ways to get digital information, making it, you know, available on, you know, the smartphone. Um, but I wanted to just share a little bit about what we've been hearing from stakeholders, um, since we've issued our proposed rule. Um, there seems to be, you know, there's some concern out there around the security of APIs, application program interfaces, um, practices that healthcare related apps are doing and the Secondary use of identifiable, um, electronic health information. Um, I know Dr. Rucker and Steve spoke to the security of API. So what I'll share briefly m. Just to talk about some of the privacy, you know, what we've been hearing. Um, I guess a common industry concern is sharing, you know, when you're sharing and releasing health data to the patient, is that the data is no longer going to be protected by HIPAA. So once the data leaves the provider or the EHR's control, in theory it leaves the protective realm of HIPAA. Um, so you may have been hearing this and listeners may have these concerns. It really comes down to the discussion about what is an allowable secondary use of data and how should apps address this. Um, and I'll just close with, this is part of a national discussion that it extends beyond healthcare. Um, generally speaking, you know, privacy and security protections do not follow the data. And many in Congress, um, as well as industry, you know, they're looking at, you know, how do, how do ah, apps use and disclose this data? It's not unique to healthcare. Um, we're trying our best at ONC to strike the right balance between patients, right to access, um, their information for more informed decisions and the concerns around secondary use of data. But really from a privacy perspective, it's almost about, you know, it's usually about control, um, an individual's control over the use and disclosure of their data and you know, the individual gets to decide that.

Speaker B: Yeah, no, um, that's, that's excellent. So, and you just covered some of this here. But what, what are a few best practices or strategies that you can share to help others navigate that?

Speaker J: Sure.

Speaker G: Uh, so, you know, if folks aren't familiar with the HHS HIPAA access guidance, um, this was issued several years ago and just say, you know, learn about the right of access, you know, what is and is not required regarding sharing patient information and including sending it to a third party, um, a mobile app of the patient's choice. And there's written materials, educational videos, there's actually some medical education that really speaks to this. Um, there's also some FAQs. I know there's been some questions about liability, um, and business associate relationships when information is shared, kind of what happens there. And then also, um, you know, if listeners are healthcare provider, if they're a plan, even you know, developers that might be supporting this, you know, to check in with the medical record management department or the individual, you know, within your office that overseas use this function just to see how your organization is currently handling this. Um, and supporting the right of access, uh, to see if there's ways to improve it or even automate it. And then I guess the other kind of best practice or tip for app developers listening in. While ONC doesn't regulate the consumer health technology. So for example the third party apps, onc, you know we provided um, what's referred to as the model privacy notice. And really it's a template of sorts that an app developer could use to inform a patient, a consumer individual about how their technology stores, uses the information, shares it. Um, it's openly available, it's free for developers to use. It's really our effort to encourage transparency.

Speaker B: Excellent.

Speaker G: Um, so the developers can clearly convey, you know, what privacy and security practices they're using. Um, you know some folks, most people are familiar with the FDA food label. Um, that's kind of how it's structured or way that it's modeled after.

Speaker B: No, that's terrific. So a model privacy notice and I just see that really as instilling confidence um, for the consumer. So I think that's terrific. I was not aware of that and I think that's great. So I'm going to actually. Where can we find that? Where can my audience. Where can I find that?

Speaker G: That's a great question. Yeah, I failed to mention that. Um, it's available on healthit.gov the ONC website.

Speaker B: Yeah, I know it well but I'm check that out. So healthit.gov that is terrific. I mean for developers to look at that and um, if you give them basically a model strategy on how to basically share that from their perspective and what they're doing. So that's excellent, correct?

Speaker G: Yes. And we actually even had it was incorporated public comment. There's been several rounds of trying to improve the product, um, as well as a way to make it digitally available M and I guess a user friendly format for individuals.

Speaker B: That's terrific. Thank you for that. So healthit.gov and look up for the model privacy notice. So following up just in our last few um, minutes thinking uh, looking beyond, I know as a regulator you can't do this probably with as much freedom as us that are, as Dr. Rucker said, as regular citizens. Um, but thinking beyond today, what do you see as a key strategy or trend that we must be ready to successfully navigate in three years from now?

Speaker G: I think of two things that I know Dr. Auguste mentioned as well. But I guess increased data liquidity and portability. People, you know, particularly patients are going to want their data faster. They're going to want, you know, More of it. And they're going to demand transparency on all fronts. Uh, patients are going to want to know, you know, more data than what they're receiving now. You know, labs, they want images, um, you know, things, you know, just as easily on their phone. They're also going to want more control over how they receive that data. So, you know, I know we're trying to move industry towards sharing IT mobile apps or encouraging people to have the option to have that capability, but it could be that, uh, you know, an individual wants to share with a mobile app or a provider that's not in an existing network, um, or with an individual that's not traditionally seen as a player in the healthcare space. Uh, the other kind of area, I think I just anticipate there being a greater need, I would say an overall desire for trust and transparency. Um, and that's going to become increasingly important, you know, meaning, I guess, you know, building trust of the individuals that are using the technology, uh, engaging in, you know, also your healthcare delivery system. And then, you know, as mentioned earlier, providing the transparency to individuals. I know Dr. Rucker spoke about transparency, but, you know, being transparent to your users, even when you're unprompted, um, or required to do so. I mean, patients are going to demand, you know, for example, they're going to want to know how you shared your data, what data did you share, who accessed it? Um, you know, to the extent folks can get ahead of that, they'll be better off in the long run.

Speaker B: That is fantastic. Catherine, you just finished really strong. Uh, that was kind of a grand slam of exactly where our healthcare system is going over the next three years. Terrific, thank you.

Speaker G: Also. Well, I know we're around lunchtime, and if people need to take a break or multitasking.

Speaker B: No, that's fantastic. Thank you. Um, so I guess, and as I asked, uh, Dr. Rucker and Steve, any important dates from your perspective that we should keep an eye on from HHS or ONC or anything from your perspective?

Speaker G: Sure. I, uh, know there were some other kind of dates that were thrown out earlier. In addition to what, uh, Don and Steve shared. I would mention there was a discussion about the FACA, the Federal Advisory Committee and ONCs. FACA is referred to as the HiTech, which is an acronym for the Health IT Advisory Committee. They, um, have been a little bit of a break over the summer because we worked them really hard, um, as we're working through some of the rulemaking. But there's actually going to be a public meeting all their Meetings are public. There's one that is happening on September 17th. Um, the information, healthit.gov is also where you can get the dial in. Um, there's an opportunity at every public meeting, um, to provide public comment. Um, and I know Justin, you mentioned earlier and trying to encourage your listeners to, to provide positive and negative, um, comments on the rule. So this actually is almost policy making happening in real time. Yes, um, for listeners that may not be as familiar with FACA's, um, but they actually provide formal recommendations to our office as we are thinking through particular issues. And so if you or your listeners, you know, want to participate in policymaking, um, some discussions are more lively than others. Um, but, you know, at every meeting, you know, you'll know when it happens, but there's opportunity for public input. So I would encourage listeners, if they haven't, you know, participated in the past or, you know, are just interested, um, that is happening on the 17th of September.

Speaker B: That's terrific. And I do encourage everybody, certainly if you have any expertise in the area that's being discussed, uh, do constructively share that. Again, what's working, what's not working is important for governments and important for industry, uh, to see that. And, and uh, you guys are terrific. I gotta say I've, um, not had the pleasure of meeting you yet. But, uh, but I've known Don and Steve for a very long time and how. Just your office, the uh, ONC takes our comments so seriously, reviews every single one. And I know that for a fact because we're in meetings and through the many, through the, you know, decades now, um, where any. Someone from ONC will recite a public comment that was written, a random one. And they, they know. And so we. I know for a fact, uh, they, you know, mentioned this on air, you know, these public comments. And so, uh, you know, you guys just take, uh, all of our information and distill it down and, and uh, we're grateful for all your hard work and your expertise.

Speaker G: No, thank you. Thank you, Justin. Uh, thank you for, for having me on your show and for what you're doing to help your listeners better. Better. Excuse me, Better navigate this area of healthcare, um, and encourage them and folks to get involved.

Speaker B: Well, I appreciate. And then you're great. Just so you know, your topic is extremely complex. I mean, with privacy and then the nuts and bolts of what goes into privacy and security in our industry, it's extremely difficult to understand. But you did a great job explaining it, uh, and explaining the import, what's important and why it's important and then how to engage. And so I'm grateful for that and thankful for your time. Katherine.

Speaker G: Thank you. Likewise. Take care.

Speaker B: Catherine Marchesini, ONC Chief Privacy Officer. So, again, thank you. And, uh, now we'll, uh, transition back over to our phenomenal studio, uh, in studio guests, um, Carolyn Bradfield, co founder and CEO of Interact Lifeline. Welcome to the show.

Speaker K: Thank you, Justin. Happy to be here.

Speaker B: And, uh, you're actually a returning guest. You've been at least one time, right? I have, yeah. She's a serial entrepreneur. Catherine is a, uh, Catherine. Catherine. My last guest, Carolyn, is a serial entrepreneur and actually a very close friend of me and my family and my wife. Uh, and, um, I'm just thankful, uh, that you took the time out of your busy schedule. You have a lot going on.

Speaker K: We do have a lot going on.

Speaker B: So, uh, because you've launched a new company, so maybe give us 30 seconds to a minute. It's a, um, It's a. Not a social. It's not a social enterprise. What's the, um, term? Social impact company. Correct.

Speaker K: Right.

Speaker F: Yeah.

Speaker B: So why don't you give us 30 seconds on your new venture or a minute on your new venture?

Speaker K: So the company's called Interact Lifeline, and basically we exist to help treatment organizations leverage technology to stay connected to their clients if they've been in substance abuse and addiction treatment, with the goal specifically of improving their recovery, reducing their relapse rate, and just improving their overall experience. So we have, um, technology in three specific markets. One is in the treatment marketplace with addiction treatment companies. The second is in collegiate recovery, helping automate those programs so that they can serve more clients. And the third initiative will be launched in 2020. It's called safety Net, and that's using technology to keep track and monitor at risk adolescents and young adults to prevent them from using substances and the onset of the disease of addiction.

Speaker I: Yeah.

Speaker B: Now, I love it when you first shared your, uh, plan with me. You're striking the chord. I mean, you can't pick up a headline today, or you can't read a newspaper. You can't see without seeing the impacts of addiction on our society. And then from a budget standpoint, it's a significant, growing issue. From a budgetary standpoint as well. Yeah.

Speaker K: I mean, the impact to the U.S. economy, um, with people that suffer from addiction is just right under a trillion dollars a year. And that's in health care, it's in lost productivity, it's in the court system, um, and 70,000 people a year, um, die from overdose, um, My daughter being one of them. So it's a huge, um, huge drain, um, mentally, physically and economically on our economy.

Speaker I: Yep.

Speaker B: Yeah. In our society, I mean, uh, this is a very serious topic. But I actually watch Live PD and when you watch these, I watch a three hour police show and I cook dinner for my family. I love to cook every night, then I'm home. But I put on this show in the background as I'm cooking. And you. I mean literally drug overdoses and drug offenses are, I mean 50% of the show. It's just they're always responding to either, well, car accidents due to, you know, drugs or drunk driving, um, domestic issues, drugs are usually involved, um, or just overdoses. And how much Narcan is used. I mean literally that's 56% of our, what our police response. So I mean a trillion dollars, I would say is, is simple and easy a number to achieve just facing how overloaded our judicial system is, our police, our enforcement, um, and never mind our health, I mean, and what it means to our health care in general. So I certainly see. So you're addressing a significant issue, uh, in our society and you're a successful entrepreneur, so you put that together. Obviously it's going to be a, ah, phenomenal opportunity watching you take off here.

Speaker K: Thank you.

Speaker B: So what, you know, and you touched on this a little bit, but um, what healthcare or health IT trends are you seeing in the industry?

Speaker K: Well, I'd like to actually comment on another company that we own called Convey Services, because basically that company exists to provide a connection between suppliers in the telecommunications cloud and IT services with, um, independent sellers who go into the healthcare sector and sell services. And so some of the trends that I'm seeing, um, I'll give you three specific ones, um, and then we'll talk about how it applies to mental health. Trend number one is streamlining and improving the patient experience in the way that they communicate with the facility. So for example, um, typically, um, you might have to call in, wait for a lab operator and engage with them. So unified communication technology and contact center management technology technology have come to the forefront. So now a patient connects with the hospital. If they need to talk to somebody live, um, their screen, uh, pops up. The person knows who they are, but they offer alternative ways to communicate. So it might be through texting, it might be through other electronic means. And the goal really is just to raise patient satisfaction with the way they communicate. Um, the second big trend that we see being sold into the healthcare market is technology to streamline the way case managers Stay in touch with um, patients once they have been discharged. I'll give you an example with a specific client. Um, one of our, um, telecom vendors or technology vendors works with Humana, who has to keep track of 500,000 patients and they only have 2,000 case managers to do so. So they use technology, specifically texting technology, to outreach to these clients. Um, ask questions, get a response, remind them to do things. And if they get no response or response that doesn't meet their care plan, then the case manager engages and gets involved. So it's um, that type of technology to prevent readmissions to the hospital. The third trend that we see is um, the IoT technology to track and manage assets. So just things simply like, like where's my wheelchair? Inside of a hospital. Or um, putting sensors on, um, equipment to proactively know when they need maintenance or when they might fail, um, so that you can um, make sure to manage your assets, which are an incredibly expensive thing. So we see those three, um, trends and um, the regular healthcare side. Unfortunately in mental health, a lot of, of technology has not transitioned over for treatment centers to be able to take advantage of these process improvements.

Speaker B: Okay, yeah, no, I, that's excellent. I completely agree. And you're the literally every single guest. So what, nine, uh, before you have brought up patient experience.

Speaker G: Right?

Speaker B: And that was your. So I mean you're. This is a resounding theme. So anybody listening? If you're not helping to manage patient, uh, experience and patient patient component of healthcare and consumerism, you're gonna be missing the boat.

Speaker K: Well, let's talk about patient experience and mental health because I think that that's really very important. So um, if somebody goes to rehab, you know, their disease is treated like an acute condition, they spend 30 days, they spend a lot of money, and then they exit the program with very little connection back to the program. So they, They've um, come from very significant structure inside the program to lack of structure. And they really don't know how to manage their recovery. They don't know how to um, manage uh, their treatment after that. And they're just not connected um, to the program that they trusted to treat them. So that patient experience, um, for 30 days is great, but, um, because this is a chronic versus an acute disease, it just doesn't carry, um, forward. So um, technology uh, really needs to be um, injected into that equation so that staff can become more efficient, like the Humana example that I gave you, and people can better stay connected and educated about how to execute a wellness strategy to stay in recovery and improve their experience.

Speaker B: So following that, uh, track, you know, what are a few best practices or strategies, uh, can you share for my audience to be able to navigate that and those trends there?

Speaker K: Um, well, on either side of the coin, I mean, I think what people need to do is look at where processes are manual and find technology to automate those processes. I mean, oftentimes change happens not by the fact that technology is so brilliant or so great. It's just that we need a process change. And technology is the only way, in my opinion, to um, leverage improvement there because, you know, it's um, at the, at the end of the day it becomes an inexpensive decision to make versus go and try and staff up and stay, you know, keep more staff on in order, um, to do this. So again, back to the Humana example. I don't know how many case managers they had before technology was implemented, but I guarantee you 2,000 case managers can't keep up with 500,000 people if all they have in their arsenal is the ability to pick up the phone and try and call. Um, the second big thing I would encourage people to do is look at the devices that people are using today to communicate. You know, you look at the adolescent and young adult population, which are the ones that tend to be in addiction treatment. 95% have, um, constant access to a smartphone, 88% have constant access to a laptop or desktop. So you've got to use the technology that they're using to stay connected to them. And I would highly suggest that people investigate, you know, what mobility strategies that they could use to stay connected to their clients. That's why business texting and hipaa, um, compliant, um, outreach from application to application is just so, um, critically important to understand what that, what those technologies will bring.

Speaker B: Yeah, I completely agree. And I think we're even using um, smartphones when we're working with health systems to manage even some of their providing uh, care for the homeless population. They don't have access to much, but they always have a cell. Many of them have cell phones.

Speaker K: Always.

Speaker B: Yes. And so we can access, actually manage them better and give them better care. And we use their smartphones and sometimes even reaching out and community services through Facebook, because a lot of them have Facebook pages, so they have nothing else but they got a smartphone and a Facebook page. And so we actually can, uh, uh, from. The health system wants to reach out and educate them about what services are available to them. They do that, you know, via Facebook because, because of their mobile phone. Bringing up your example exactly of using the smartphone and being smart about it. Um, so in our closing few minutes, just think, thinking beyond today, I mean, you're a great innovator and leader and entrepreneur. What do you see as a key strategy or trend that we must be ready to successfully navigate in three years from now?

Speaker K: Well, I think what you're going to start to see is the patients taking on much more responsibility for their own care. And so if you empower them with technology to do so, by giving them ways to communicate, by giving them ways to educate themselves, um, to keep reminded about what they need to do to stay healthy, then it takes the burden off the healthcare provider to do that. And so my belief is you'll start to see, um, these mobile applications, um, portal networks and educational opportunities, um, become more prominent. But I think the goal is to empower the patient to be the best steward of his or her own career, not only on the healthcare side, but on the mental health side so they know what to do to stay healthy.

Speaker B: You're spot on. That's fantastic. Um, where's your new company? Where do you intersect with all this?

Speaker K: Um, the new company has launched and we're in pilot programs right now with, um, six collegiate recovery communities, um, big organizations like the University of Alabama, Kennesaw State here in Atlanta. We're launching our pilot program with treatment centers October 1st. And we're building out some of the more interesting sides of our mobile technology, specifically with devices and wearables that will give you the opportunity to detect potential overdose and alert everybody and their brother so we can reduce the number of deaths that we experience, um, today.

Speaker B: That's excellent. And that's Interact Lifeline. That's your new company?

Speaker K: That's correct. Interact Lifeline.

Speaker B: Fantastic. Carolyn, thank you very much for joining me. In studio, Carolyn Bradfield, president and CEO and co founder of Interact Lifeline. Um, thank you for joining us. You're always a great ally of my show and me personally. So thank you.

Speaker K: Yeah, thank you. I appreciate it.

Speaker B: Got it. Carolyn Bradfield from Interact. Uh, Lifeline. Thank you.

Speaker F: All right.

Speaker B: Beth Friedman, how are you?

Speaker L: I'm wonderful. Justin, how are you?

Speaker B: Excellent. Another co founder and CEO agency. Welcome to the show.

Speaker L: Thank you. Thanks for inviting me.

Speaker B: You're also a long term friend of mine and of my family. Um, but this is your first time in studio and as a guest, correct?

Speaker L: It is. I was telling Roberta, I've often been the one interviewing and I've watched you interview people at hymns. Yes, but this is the first time where I'm the interviewee.

Speaker B: Well, I know how much wisdom and expertise is, uh, in your head. So I look forward to my audience hearing a lot of it.

Speaker L: So, absolutely.

Speaker B: You're always, you're wonderful. I always rely on you. Um, when I need to get something done quickly or something in the media or a press release, you're always my go to. I don't usually give you a whole lot of lead time, but you always react and you're extremely professional and your team is phenomenal.

Speaker E: You have.

Speaker B: Jessica Clifton is one of the best in the industry. She is, um, I've worked with her on and off for many, many years. Uh, and she's just terrific. And you have her. She's a great asset to your team. So, um, I want to thank you for all that you do, uh, and what you guys do for our industry and a lot of just my friends and peers that I push your way. So thank you.

Speaker L: Absolutely.

Speaker B: You handle and everybody very, very well. Again, Beth, um, Friedman, co founder and CEO of Agency 1022. You're out of Atlanta. We've spoken about just the intellectual capital that we have here in our community. Uh, we're fortunate all the companies, the institutions, but we just have, have an amazing, uh, ecosystem here. And you're certainly one of those pillars and foundations, so thank you. Um, so from your perspective, uh, what healthcare or health IT trends are you seeing in the industry?

Speaker L: Well, I wanted to focus my time with you today, Justin, on the revenue cycle piece of healthcare.

Speaker B: Excellent.

Speaker L: I know you've had a lot of speakers on today on the regulatory side on, um, sort of that patient communication, patient touch piece. But when I attended the, uh, Healthcare Financial Management association conference, HFMA this past June, over the summer, there were several key trends that I heard and they were different than what I've heard before at that same conference. So the first one that I wanted to share with your audience is patient financial experience. So we've been talking about patient experience all day. We've been talking about patient clinical experience for decades. I really heard the CFOs and the VPs of revenue cycle finally get it that patients, that patient's financial journey, uh, is becoming just as important as the patient's care journey. And it makes sense when you think about it from pre registration scheduling, that's a touch point in revenue cycle all the way to that last bill. So your patient journey starts and ends really on that financial side. So a lot of conversation about what they can do to improve. Improve the patient's financial journey.

Speaker B: Yeah. And I think my audience is grateful to hear your voice right now. Because literally everybody else except for, well, Birdblitch really kicked it off. That was, you know, from patient co. Talking about the patient financial experience. Jeff Brown touched on it a little bit. But we've. A lot of my, my guests have been doctors or on the clinical side. And so we've heard the kind. A lot of the resounding themes, which is what I like to pull out themes. But revenue and cycle and payment is at the point we got to pay for all this.

Speaker C: Right.

Speaker B: And we need people paying for all this.

Speaker L: That's right.

Speaker B: And so it's critically important. So this is very refreshing, uh, that we didn't leave this off of the show. And that's why I wanted to certainly have you here. When we were talking, you know, speaking a month ago about having you on and you brought up what you wanted to speak about, I thought you were. Is perfect. And the timing is excellent because it is so key and it's actually near and dear to my heart. I mean, I love the clinical side of the business, but I also love the payment side and the revenue cycle. And I call it revenue cycle performance because you can optimize our current procedures and so much that we can do on the financial side to bring a better experience. Uh, and so I completely agree.

Speaker F: Absolutely.

Speaker B: Um, anything else that you want to follow on with that or what are a couple of best practices to navigate?

Speaker L: Well, ah, following on from that at hfma, there was one other trend I wanted to share with your, um, audience today, and that's the technology piece. So I saw so much more technology at HFMA this year and being fully independent, integrated into the revenue cycle, into the workflow of the revenue cycle ops, folks. So AI analytics, um, propensity to pay eligibility. I am seeing so much advancement in the revenue cycle technologies and the integration of that into our workflows. So I think that that is a huge area of focus. There's just no reason why we should be doing things the way we've been doing it them in the revenue cycle because we've got so many more advanced technologies that can predict the payability of a patient. Do that up front. And then that really feeds back into the patient experience because you can manage that patient's account financially knowing so much more than we used to know in the past. So I think the whole bringing technology to the forefront of the revenue cycle process was another huge trend.

Speaker B: Yeah, no, and that was brought up, um, our good friend Denise Hines brought up the predictive piece of we're getting better in healthcare at that on the clinical side. But now obviously you bring it up and we're getting better at that on the financial side.

Speaker L: Correct.

Speaker B: You know, which is critically important, certainly. I mean, we need to predict payment and payment strategies there because we're trying to build an organization and you got to have an eye on revenue of where it's coming from and the, um, collectability of it.

Speaker L: Absolutely. And, uh, the biggest sector that I saw focus on at the conference was on the patient pay or the self pay. You know, that is a growing, growing, growing segment of every healthcare organization's ar. And uh, being able to apply these predictive technologies to that piece of it and then to engage that patient in that financial journey, it's really becoming a big trend.

Speaker B: That's fantastic.

Speaker C: And not even self pay, um, the deductibles are so high now. The deductibles so high that that's. You're paying most of your health care out of pocket anyway.

Speaker L: And that's the new self pay. Right. So self pay, we used to think about our homeless and our Medicaid. Now self pay is folks like me who have a high deductible health plan. And when I go in for procedure, you know, knowing that I can do a no interest patient loan for that deductible piece, that's huge.

Speaker B: Yes.

Speaker L: That makes me loyal as a patient.

Speaker F: Right.

Speaker B: Completely agree.

Speaker J: Yeah.

Speaker B: I mean, I mean, deductibles, I don't need to tell my audience they're $5,000 to $7,500. My mine's actually 10, 5. I think my deductible is. But I only pay a couple hundred dollars a month for healthcare insurance. So it is phenomenal. But I'll take it. Um, so what, uh, are a few, what are two or three best practices or strategies that you can share with my audience to navigate those trends?

Speaker L: Well, we just spoke about one. I just brought one up and I know your speaker earlier today, Byrd had, um, patient financing also that has become a must have. Some of the VPs of revenue cycle and CFOs I sat with at the conference, um, they reiterated that point that we can't just think about this. We have to have it and we have to do it very well, engaging, uh, with the patient financing companies and the patient financing programs. So that's a really important strategy for providers to do right now.

Speaker B: Yeah. Because that actually brings it to another level. So there's patient pay and self pay, but then, then patient financing is another component of that. And so I guess, yeah, if you're integrating all of that, um, and you can get 0% interest or financing. That's fantastic because I haven't even gotten to that side of the house. I'm aware of companies who will finance it for you, and they're a blessing to find for a lot of people because they can't come up with $3,000 or $5,000 or even $1,000 for some procedures. But we don't want to delay care, as we know 50 plus percent of people are delaying care based on, you know, Bird's, uh, interview earlier. But, um, uh, yeah, I mean, what are some of the products that you've seen out there? So 0% financing or allowing people to pay in stages.

Speaker L: Mhm. And you know, I'm all raised my hand. I've used a program like that twice.

Speaker J: That's great.

Speaker L: And they're fantastic. One of our clients here in town, Clear Balance, um, they do a consumer survey every year. And just this past year I pulled out some of the stats for today's conversation. Uh, 92% of the patients will return to a provider if payment options are provided. So again, going into that patient loyalty, patient financial satisfaction, um, uh, in the survey, the patients are also sharing that experience with friends and family, which is helping all of our providers. And then also over 50% of the patients nationally now, as an average, have used a payment program. So it has become the norm, uh, here in the United States.

Speaker B: That's excellent. Great stats and good strategy there. That's. I actually, I just learned something. Absolutely excellent. So thinking beyond today and kind of Wayne Gretzky speak, where's the pucks? Where's the, where's the puck going? What do you think we should look out for in a couple years from now? And basically three years, where's the healthcare industry gonna.

Speaker L: Okay, so Justin, you've been in the industry long enough in the British well, to remember the early 2000s when we were all, all putting in EMRs and EHRs, but most providers and health systems had one foot in sort of that digital boat. We knew we had to get all digitized, but we still had all this paper. Right. And uh, people like yourself would ask me a question. How many years before the paper's gone?

Speaker H: Yes.

Speaker L: Well, I think the question now is how many years will we still have fee for service? So I think that where it's going is 100%. Call it what you want, value based, you know, paper performance, risk based contracting. We are headed there and at the conference this year, I think everybody accepts that we're all on that train and the train has left the station. What we're trying to figure out now in the next two or three years is we all have to figure out what are the best practices to make that successful. From technology workflow, all these new um, tools that we have, as well as payer contracting, even using the predictive analytics to figure out how can we make better contracts with our payers when we go to risk. So I think that whole journey toward, um, 100%, um, away from fee for service, it's going to be painful. It's not going to be easy, but it is definitely where we're all headed.

Speaker B: Actually, someone could see that's provocative, but I love it. Actually I agree with you. That's kind of the health plan that I helped create here in Georgia. We've done away with a lot of the fees. Um, you still have fee for service at some levels, but for the most part all care is included in like a monthly fee. And uh, I agree it's better for the patient to holistic view of the patient. It's not nickel and diming. And they can have full transparency on what they're going to spend on their healthcare costs. And like we have it with every other aspect of our life. We have full transparency in almost everything, um, except for healthcare. So I actually agree with you. I did not, I was not expecting, but um, I love the concept. I think that'd be great for healthcare. It's just how do we successfully navigate that? Um, but I agree with you, it's

Speaker L: gonna be a journey. There'll be a lot of travails that will be painful. Um, but I think that it is definitely where we're headed. To answer your question, one of the speakers at hfma, um, when asked about when we would get there, which is the question we always would get, when will we be paperless? Um, he said it was still another decade away before 100% and I would concur.

Speaker B: I agree.

Speaker C: And in a decade we'll have totally new uh, technology, so.

Speaker L: Correct.

Speaker B: Very true.

Speaker L: To support the journey.

Speaker F: That's right.

Speaker L: That's part of it. I mean this journey can only be supported through technology, through digitized revenue cycles, through data accuracy, data access, and then also to your point, just on transparency, I mean, I know actually the White House made an announcement while we were at hfma pushing all of us to as, as healthcare as a health care industry to be transparent about our billing and our charges. And I think we're going to figure out that too.

Speaker B: I completely agree.

Speaker C: One of the Big, big news items right now is this surprise billing. You go into. You go into a hospital and you come out with these bills because out, uh, of network, uh, a, uh, complication has arisen, and you are really stymied when you get up.

Speaker L: Yeah. And actually we've got a couple clients in that space, and I have learned so much by talking to them that, you know, because I'm a big patient advocate and certainly. What patient wants a surprise bill. Correct. But then learning the other side of that conversation is really interesting. Maybe Justin fodder for a whole other show.

Speaker B: Yeah. Well, and I agree that there's two sides of that coin, because, I mean, I hear it from both sides. I hear. I hear from the health systems that they don't have all the data they want. They want transparent bills, but they don't have access to that data until it's too late. They're getting random charges, and they're trying to consolidate everything. But as patients, we deserve it as well. We can't budget for our families. I mean, uh, people cannot absorb a $5,000. I mean, I have a family member who, um, stepped out, uh, of her health plan, didn't realize she did, and then got a. If she actually had insurance, but the health system did not accept her insurance. And she's like, well, then treat me at. Just let me do a cash pay. No, we know that you have insurance, and this is a local facility here. Not something that's been on my radio show. Um, but they would not, uh, Because I wouldn't let them be. I don't like. I think this is extremely unfair. They found out that she had insurance. We do not accept that insurance. And so we're going to now charge you $3,000 for just to stitch up a finger. Because she went to an emergency room, but she had full insurance, but they did not accept it. And so they would not allow. Do a cash pay. A cash pay would have been like $1,100 for that visit, but because she had insurance. But they did not accept it. It's over $3,500.

Speaker L: And that's. You know what?

Speaker B: That's not fair. That's just.

Speaker L: And you know what? Here you go. So she told you that story, and now you're telling your listeners that story.

Speaker B: Yes.

Speaker L: So to the providers out there listening, patient financial satisfaction is huge.

Speaker B: Yes.

Speaker L: You know what? If we would have negotiated with your family member and said, okay, pay us cash. We'll take the 1100.

Speaker F: Correct.

Speaker B: And she offered that.

Speaker L: What A much better experience.

Speaker I: Right.

Speaker B: Ah, yeah.

Speaker L: What A different story you would have been telling right now.

Speaker E: Right.

Speaker B: Well, and I gave her the advice because I know healthcare, I know policy. I told her she does not have to pay the 3,300, that, uh, $3,500. You negotiate hard line with them and just walk. And they will eventually accept it, but they basically browbeat her. And it was horrible. And so that's what we're fighting for. I mean, on the transparency side, that's just, that's a business practice. That is not a surprise bill or anything that was the hospital's fault because they would not. So that we need to get away from.

Speaker L: And the surprise bills occur primarily in what you just mentioned. So emergency radiology and anesthesia and those three areas. And it's because I think the number is around 60% to 70% of healthcare organizations outsource those functions.

Speaker B: Right.

Speaker L: So your anesthesiologist. Right. And so as a patient, how do I know that that emergency physician is not in my network? It's an emergency. I'm gonna go to my emergency room that I know is covered by my insurance, but I have no clue about that physician.

Speaker C: And I think that onus should be on the hospital because if I go in as a networked person, I'm going to you because you're in my network. And then you throw all these non network people at me. There's something wrong with that.

Speaker B: Well, that's a piece of we need. That's. I mean, as a kind of like a. Just for my audience to educate is you can't. Healthcare is different today than it was 10 years ago. A lot of us grew up in. You cannot just drive to the local facility or your closest facility you have. If whatever your health plan is, you've got to research it and you have to know all that fine print. So that's like a public service announcement right there. Because if not, you could very well get a 5, 10, $15,000 bill that you were not expecting by going to your closest facility. It's like when you get on the airplane, they say, hey, the closest door maybe behind you. No, it's not just in front of you. Um, you need to look at your bill. You need to look at your health plan and know what your costs are based on the facility that you visit. Because you could very well get a surprise bill.

Speaker L: Yeah, I think the whole surprise bill conversation, I think that for the layman and for people non healthcare, it seems like a very simple thing to solve, but there are a lot of downside risks as well as a Lot of complications. And I agree with you, Roberta. I think the conversation starts with the hospital and all of those physician medical groups that they contract with.

Speaker B: Excellent. Beth Friedman, co founder and CEO of Agency 1022. Thank you very much for joining us in studio.

Speaker L: You're very welcome and thank you for inviting me.

Speaker B: You are a terrific guest and you gave us some fantastic content, um, to even just think about. I mean this is a, ah, great perspective bringing the financial aspect. Um, so thank you for rounding out our day very, very well.

Speaker L: Anytime.

Speaker B: Awesome. Thanks Beth. And so, yeah, we're actually going to roll into the hymns preview, so why don't you feel free to stay here at the desk.

Speaker C: Okay. I have a couple questions for her.

Speaker B: Yeah, great.

Speaker L: As a hymns veteran.

Speaker B: Yeah, yeah, yeah.

Speaker C: Well that's exactly a different angle of what we can talk about.

Speaker B: Yeah.

Speaker L: And Denise and I chatted in the lobby. I saw her on her way out.

Speaker B: Well, Denise gave me a lot of my answers because that was the whole piece is I was going to try to get some of the updates from hims and what's coming up from for hymns 20 but they have not released that yet. Um, but we were able to get some of that um, out of uh, Denise and I'll cover that. But I do want to take a moment just for everybody, so make sure everybody's on the same page here. Hymns Annual Conference. Uh, I did want to take a moment just to let everybody know. It is if you can go, if you have the chance to go or hear my voice now and say, you know what, I'm going to check it out. You will have between 40 and 45,000, uh, industry experts. It's all coming together and leaders of all shapes and sizes. And I think that if you're, if you want to grow your world in healthcare, be better at what you do, whether in the healthcare services side or the health IT side or innovation side, HIMSS is certainly the place to go. I'm not employed by hims. I have no formal affiliation by hims, but I know it's, it's made my industry so much better, made my expertise so much better. Uh, and just my relationships. It's really where we all go along. Lot of us, we just see each other once a year. And that is the HIMS annual conference. It starts March, uh, 6th. I think that's a Sunday. Go back to my notes here really quick with um, from Denise. Um, yeah, March, uh, so March 8th actually is when hymn starts in Orlando. Uh, and as you heard my voice earlier and you heard us earlier Certainly book your hotel room soon, if not now because you want to be close. If not you can be 3, 4, 5, 6 miles away and that's not as bad much fun if you're trying to pack in a lot and you need to service your room or just get around. It's you've got a lot of people uh, condensed and so you got a lot of buses and all that. But if you can walk to and from your hotel I highly recommend it. So go ahead and book, uh, book your reservations uh for himss and join us there. Again 40 to 45,000 people. I think some of the topics are what I'll cover really quick. I certainly will get you. I would love to get your guys your perspectives as well. Um, but and I think you've already heard resounding things theme today in the show but patient engagement, patient empowerment, um, patient enablement I uh, think are going to be big things and just consumerism, the continuous ramp up and you know you heard the clinical side, you heard Beth to talk about the financial side but it is all about the patient. And we're going to see I think much more of that um, I love that term. The digital front doors come up by half of my guests as well really seeing digital patient management and remote patient monitoring and telehealth and pre opposition procedure management and all that. Portal management. You heard even from the government how integrate all that with the API. I think you're gonna see much more of that at HIMSS this year. Um, we're actually going to host a think tank. We're gonna host another think tank. We've done that each year and I think we're actually going to change it up and do a think tank live on air. So we're actually going to do wrap their whole radio show around the think tank and, and uh, have a show similar today where we have you know, a bunch of CEOs and CIOs and C suite executives and other things, thought leaders really sharing best practices. So uh, be on the lookout for that. We'll either have it on that Monday or Tuesday of hymns. We're still pulling all that together. But uh, again that's why you want to be there in the audience. You can certainly stream it but we recommend being there in person. But then I think also Denise brought up some good points and I'll, you know for, for you, Beth and Roberta to share your thoughts. But I mean what Denise brought up is women in health. It. I think we're going to continue to see that theme um, even in her renewal she brought up patient experience.

Speaker E: Digital.

Speaker B: Um, you know, obviously the quest of digital health will certainly see more of that health equity. Um, it's been something near and dear to Denise's heart and I know that it's been a big platform for himss. And so I think you're gonna see some more announcements and innovations on that at the annual conference, Social Determinants of Health. I think you're gonna continue to see that advanced. Denise brought up some great, uh, some great things, thought leadership around that, um, and I'm sure we'll touch on that uh, as well, uh, later in this show. Um, and then the positive change in healthcare, she brought that up as a key theme coming up. So she kind of let that one out of the bag a little bit. But uh, the positive change in healthcare and what we're going to see from social programs, what we're going to see in innovations, uh, and I think that's great because I mean I love positivity. I love to uh, you know, have the thought leadership around that. That and I agree that's gonna be. If that's gonna be a key theme coming in for hims, I think, you know, I'd love to see that. So, I mean, what do you think, Roberta?

Speaker C: Well, well, a couple things the three of us are here I thought was interesting because we all go for different reasons. You know, I, I'm a press, um, I'm a press credentialed there and I go and I talk to people for our, our press side. You go, you keep up your certification and you go as, as a member. But Beth here, she has clients and what do you tell them? Why do you tell them to go to himss?

Speaker B: Great question.

Speaker L: Well, you know, certainly it's for the exposure and brand awareness.

Speaker F: Yep.

Speaker L: I mean you've got the collection. Justin, you mentioned the largest group of professionals and now global professionals that are involved day to day with information technology in healthcare, whether it's in a health system, whether it's in a physician practice or medical group, whether it's a long term care facility or ambulance, ems. So really it's that collaboration of everybody in the entire ecosystem of healthcare is there and if they're interested in any type of technology, that's where they're going to go. And they're going there to look and see what's out there and what's available. So if uh, my client has something in that, in any of those spaces, you know, they need to be there and they need to make a presence there. So uh, you know, that's one of the reasons. And then second reason for my clients is, um, we do their speaker abstracts as a PR company and as a marketing agency. So I think we submitted six this year, something like that, which is, you know, six of those 900 that Denise mentioned. So we're anxiously waiting to see if we got accepted. But a lot of our clients like to speak at Hymns.

Speaker A: Yes.

Speaker L: And so, so I think if you're going to be an attendee and you hear a company executive or provider that uses a product speak to it, then it's wonderful to also be able to go meet with that vendor after the speaking session. So probably those two reasons are the most important for us.

Speaker C: And you have, uh, follow up with them. What's their experience after? I think you've had a couple of first timers. I've actually interviewed some of your clients there. And so what is their. After the deer in the headlights that they get over that, what is their feedback?

Speaker L: Well, it's always a journey, right? Nobody, and I shouldn't say nobody. There's always going to be some exceptions. Very few healthcare organizations are going to go to HIMSS ready to sign a contract. They're going to look at technology to meet with the vendors to understand what the different companies offer and to sort of compare them. So it really is the start of the journey. So for our clients it usually, you know, it's, it could be in six to 12 months before somebody they meet at HIMSS might turn into a client for them. But it's about that initial relationship building and starting that journey. You know, they always have good experiences. I've not had any client that's gone to HIMS and said we're never going to go again. Once they start going, they keep going.

Speaker C: Mhm.

Speaker J: Yeah.

Speaker B: One thing there, and I'll even follow on on that HIMS is what you make it. That was kind of in my notes is that when I, when someone says, well why is she like, what's that the value of hims? I'm like, you can achieve all of your goals going to hims. It gives you the platform. Now you may not be able to achieve them because you didn't do a good job executing, but HIMSS gives you every thought. Most thought leaders of the industry are there. Every big player is there. Most um, of the major innovators that are making a difference are there. And so you can get everything that you want out of hims. Investors are there. I mean they have, I mean I think they have 780 in the last, the last venture, Connect 780 investors. These are huge. The biggest firms in healthcare are all there, um, looking at every perspective. Yeah, the government's there. So every, every, um, thought leader, um, interested key, key interested party is there. And so you can go there and you can do your networking, you can do your education, you can, um, you know, get your exposure. Uh, you can learn. I, I do it because a, we always broadcast the radio show there. But, but um, I learn, um, I get to see people that I maybe haven't seen in two or three years or ten years. Um, and you keep your finger on the pulse. So you really do see how healthcare is evolving, where it's evolving, what innovations are coming up next, what people are achieving. I think one thing I'm excited for this year and you start to see a glimpse of it last year, and I mentioned this earlier, is technology enabled outcomes. We're really starting to see where the rubber meets the road and where innovation is really assisting care. And then what's the outcome of that? Because it takes years for some of this stuff to come into play. And now we're starting to get some of those results and every year is going to get better. And that's what I think I'm going to experience this year. Uh, going to him.

Speaker L: One of the things you brought it up earlier today, Justin, was to see Uber and Lyft have such a huge presence at hims. I mean, five years ago, Justin, if I would have said to you that that was going to happen, you'd be like, no way.

Speaker E: Right.

Speaker L: So, and it's kind of for me, I like seeing these outside healthcare companies making a, uh, play in healthcare because I like to see where their mind is, where they think they can assist healthcare. It doesn't always work. We've seen a lot of failures. Right. But it's interesting to see them. Like I just, um, heard an interview with the health guru at Uber talking about social determinants and food deserts.

Speaker B: Yes.

Speaker L: Well, now can we use these Uber rides to deliver food to the patients that we know can't get to the grocery, aren't getting healthy food? Let's make a food prescription and let's deliver it.

Speaker B: That's right.

Speaker L: Let's deliver the drugs. Not get the patients to the pharmacy, but get the pharmacy to the patient.

Speaker B: That's right. So I'll even pick up on that. I was out in Arizona. Oh gosh. Now it was price five years, four years ago, um, and we were taking, we actually jumped in an Uber and It was like $9 for my Uber ride. And it was a great, you know, great value. And then I think I was still asking him about his business model or something because this one Uber was still new in the area. He's like, yeah, I do this, but I mainly drive for a hospital because I can charge $50 a ride or 150 a ride depending upon the ride by Uber. So that shows up the inflated cost. He's like the same m exact drive, same exact ride. But I, I can charge 10x because it's health care. And I'm like, this is why we need Uber, you know, and Lyft in our industry because those, that, that model, it doesn't make sense that this exact same driver, exact same car is just can charge 10 times more because it's quote unquote healthcare.

Speaker I: Right?

Speaker B: And we enable that in our society. And, and so that's why, you know, Lyft last year, you know, as one of the big partners for hims, you know, I was, I was, I just remember this example. The guy literally same exact ride, you just touched 10 times more because it's a healthcare ride.

Speaker L: So saying those disruptors at him is for me it's kind of energizing and I find it very, I'm curious, right? So I find it very interesting, very cool.

Speaker B: And Speaking of Disruptor, Dr. Sylvan Waller, Entrepreneur, phenomenal. Just long term friend of mine, but a great innovator in our town, in our city. Welcome to the show, my friend.

Speaker J: Thank you very much, Justin. Appreciate it. Appreciate the opportunity to be here.

Speaker B: You got it. So we're actually doing a, um, we've about five minutes left of our HIMS preview show. Uh, but you've been to him, so why don't you chime in. Why do you attend the HIMSS annual conference and will you go this year if you have the opportunity?

Speaker J: Yeah, definitely. I mean I think it was one of the first opportunities I had to be able to see a lot of different players in the healthcare technology and innovation space. Really interesting for me to be able to see what new technologies and new companies are coming out. That's definitely the space I play in. Uh, and so really important to be able to make those, those connections and a lot of those connections I made from some of my early hymns, right when I was much smaller than I was today. But some of the early conferences that I went to, those relationships, both personal and professional, have lasted and I've collaborated with many of those people over the years. So super valuable for me individually.

Speaker B: That's excellent. That's a great testimony right there. Yeah, this is my 20. This is my 22nd year going to hims, so. Not that I'm that old. I'm only 31. So I mean I've been going since I was.

Speaker C: What your dad taking?

Speaker L: I actually did take my son when he was about three years old.

Speaker H: So there you go.

Speaker B: That's great. Love it. Was it in like Orlando or something? Where was it?

Speaker L: I think it was. Yeah, we did the whole Disney thing.

Speaker B: A fun time. That's great. Um, so what do you. So what are your additional thoughts on hymns? I mean, when you go every year? Because you, you have a great perspective as well being in radio.

Speaker C: Interview. Well, yes. I mean our media, uh, going. Going is press. I, I have to go and keep, um, up with the industry. It is the biggest one.

Speaker B: Yes.

Speaker C: And so we go in as press, we interview, um, people. We do, you know, we, we do my live broadcast. Yeah, we broadcast the shows. We're going to do some more of that. We're going to do a lot more radio next year. Um, we've decided that's, that's it. Everybody wants to talk on the radio now. Um, but yeah, the, it's the pulse. I mean when I go there, I go there with three objectives I, that I look at and say, all right, these are the trends coming up. I got to see what people are saying. And then we report on that going out and we keep it like in our thoughts on the press side.

Speaker B: That's excellent. Fantastic. Um, any final comments or thoughts from you, Beth, or on hims? I mean even HFMA is a great conference too. We don't want to forget the financial component of our industry. I've been going to hfma. Actually the first conference I ever went to in healthcare was hfma, to be honest.

Speaker L: Very cool. Yeah, no, nothing. Just on a feedback from hfma. Something very interesting they did this year and it had mixed reviews, but the vendors all got sort of the standard basic booth. Like you had to get your booth from the convention hall. So, you know, when you go to hims, in some ways it's like a circus, right? Like RSNA is the same way.

Speaker B: Bigger, better.

Speaker G: Big.

Speaker B: Bigger and better. But you know, three story, but it's crazy.

Speaker L: So you know, I could see. But it, but it kind of homogenized all the vendors. So it was really interesting because sort of the startup companies looked almost just the same as the big guys. What, uh, I think that the end of the day, what it resulted in is many more intelligent conversations about the patterns and trends. It was highly, I would say it was more intellectual than it was sales speak. And I thought, you know, at first I was curious about it and not sure of being a marketing person.

Speaker B: Sure.

Speaker L: But at the end of the three days I actually thought it was a really unique way to think about that. And it makes me think, could hims ever do that? I don't know.

Speaker B: I don't know.

Speaker L: But it was uh, quite a unique take.

Speaker C: What's the size? So how many people go to that conference?

Speaker L: Maybe, um, somewhere between uh, four and five thousand, something like that. But they had, you know, just these. Everybody had sort of the same booth, you know, so it became much more about the conversation than about what the giveaway was or the promotion or you know, whatever it was that they were doing in the booth.

Speaker E: I love it.

Speaker L: And I thought it was really unique. And then they interspersed the um, booths with lots and lots of tables to sit and have conversations. So I thought it was fantastic.

Speaker B: That's excellent.

Speaker J: Hims is always the kid, uh, in the candy store. Right. You get to see all the new technology, the giant booth booths, M and certainly lots of buzz around that.

Speaker B: Yeah. And if you've never, I mean that's something you can't even prepare someone for. I mean it's, I mean if you are in and Denise brought up how 40% of attendees each year are new first time attendees. You walk into HIMS, you can't, there's no way to prepare somebody for what you're going to see. I mean you're going to see, you know, 20,000 people at any given time hustle and bustling. These three story booths. These things cost an enormous amount of money. Um, and there's 40, 50, 60 people working in that booth in the hustling and uh, then just the traffic in the large scale, the mammoth scale of hymns. I mean you're going to put on 15, 20,000 steps a day walking around. I mean we joke, we don't joke. Because when I was uh, working full time and trying to do these meetings in the morning and for the EHR association, then running back to the booth, it's a mile from where they stick our office in our meetings and then getting back to the booth. And so you got to plan for that. You don't just walk out of a meeting at 8:30 and then walk in another one at 8, 8:45, it's longer than a 15 minute walk or you have to plan it's a 20 minute, half an hour walk from that meeting because you're also going to see people. That whole aspect is you're going to see 10, 15, 20 people that you know, on the way back you can say, oh, see you next time. We haven't seen him in five years.

Speaker E: And you love them.

Speaker B: It's like, oh my gosh. So you got to stop and talk to them. And you know, so it's, it's a, uh, you have to prepare somebody for hymns. But I highly recommend the phenomenal experience

Speaker L: and opportunity, extra time and extra pair of shoes.

Speaker B: Very true. And comfortable shoes. Yeah, comfortable shoes.

Speaker J: And one of the first, one of the first times I went was with, uh, one of the folks that you interviewed earlier today, Bird Blitz.

Speaker I: Oh, yes.

Speaker J: Um, so again, you know, he was able to sort of guide me through the process and say, come here, uh, let's go over here, let me introduce you to a few folks here. Here's sort of the lay of the land. And that was very helpful as well.

Speaker C: Were you in the Georgia Pavilion with him?

Speaker J: Uh, no, when I, the one of the first times I went, uh, it was just getting to see him as I'd never been before. So he was good to sort of take me around and show me what

Speaker C: was going on because I met him in the Georgia, Georgia Pavilion.

Speaker B: You did?

Speaker C: Bird.

Speaker B: Oh, met Bird, yes, he was in there for the first several years. Yeah, yeah, because actually Greenway supported it the first year. So did patient co. There's a couple people that were early on, um, had mined booths here. Well guys, thank you very much. You're more than welcome to stay in studio, uh, if you want. We're gonna, we're gonna transition over to Dr. Sylvan Waller, a long term friend of mine, a great innovator and entrepreneur in town, Chief medical officer of Health Lab. But you have lots of different titles. Um, but that's the one we'll use today.

Speaker J: Sounds good.

Speaker B: Um, but tell me what you're up to now. Give my audience 30 seconds a minute on what you're up to.

Speaker J: Yeah, I appreciate it, I appreciate it. So, um, I provide primarily advisory services for high growth healthcare technology companies, um, and have been doing that for a number of years and love the space. Um, I've been able to collaborate with you on a couple of things along the way and that's been great as well. Uh, but primarily helping healthcare, uh, systems technology companies understand how to collaborate with larger partners, how to find product market fit, uh, help help them refine their strategies around what they're doing. And then a lot of times, you know, build the services so they May have some really smart folks who come from the technology side of things, but they're moving into healthcare and they're really looking for deep healthcare expertise. And I always say, um, you know, pairing technology, uh, and how engineers think about problem solving with folks who have deep healthcare expertise is incredibly powerful and you get really unique solutions. And ah, I think that's sort of where some of the companies that I've seen have really made significant inroads into solving some of the major problems in healthcare today. So primarily doing um, advisory work for high growth healthcare technology companies and then uh, also operate as a venture partner with uh, Shadow Labs. Um, and uh, we're putting on our summit on September 17th and 18th and so we will be speaking about the future of healthcare there with a focus on technology as well. Um, and you know, any, anyone who has specific questions about that, they can reach me, you know after the show and be happy to be able to connect them and give them more information.

Speaker B: Yeah, I won't be out of town but I would love to have uh, participated and certainly want to support it. So you guys have. What's the name of this? Shadow Ventures. Is there Health Day or what is say one more time?

Speaker J: Yeah. So Shadow Ventures is the organization. Um, and then we're putting on a summit. Shadow Summit.

Speaker B: That's it.

Speaker J: Shadow Summit on September 17th and 18th and Shadow Ventures really started on the commercial real estate side. So build tech with kp, uh, ready. Uh, and then we are launching our healthcare lab. And so uh, the 18th when we're talking about sort of the future of healthcare, um, we'll be talking about the launch of our healthcare lab as well. And we're really looking at bringing innovators and large healthcare enterprises together, helping large enterprises be able to innovate a little bit closer, a little bit faster, connect them with healthcare technology companies.

Speaker B: Love it. And I'll just give a plug for you personally. I mean I really. We try to do. We were working on a venture together and um, we couldn't pull it together because of the China. Um, they could pull their side together. But I will say Dr. Waller, what's great about you and why I really wanted to work with you in that venture and I know we will do some stuff together I'm sure in the future is you have great deep expertise, um, extremely smart and agile with how you think. But then also you get your hands dirty and so you can, and you can operate. So it's not just so you have great wisdom and vision, but also you operate. And so that's why you would have been great partners. You uh, know you've been a great Chief medical officer in that deal and co founder, so.

Speaker J: Well, thank you very much and I appreciate the opportunity to be able to collaborate on the healthcare think tank that we done over the years as well.

Speaker B: Oh that's right. We've worked a lot. You've been a phenomenal partner there. So it's been great. So yeah, I do. We haven't brought that up at all, but I think so we did. Um, we will uh, um, have another think tank coming up probably the first week or the second week of November.

Speaker G: Great.

Speaker B: Um, we're going to do it in person, but also we're going to allow for virtual dial ins as well. Um, so we're going to expand our collaboration. Uh, then we do another one at himss, uh as well and we're going to do that kind of maybe even on air. So we're gonna have some fun. So it's gonna be a big uh, a busy six months but you've been a phenomenal partner in that from day one you've supported the think tank and although we've been able to build there. So thank you for that.

Speaker J: Yeah, I appreciate it and I appreciate the comment. I mean I think the fun for me is both helping companies with their strategy, but a lot of times these small healthcare technology companies are looking for folks who've been there, done that and have deep operational experience. And so having been chief medical officer, COO of a number of different high growth healthcare technology companies, you can, you know, I always tell some of the folks that I work with, you know, I've seen the movie before, I can help guide you through, you know, avoiding some of those pitfalls. Um, and that's really the, you know, the fun for me is to be able to help guide some of these companies and uh, help them both avoid those pitfalls but accelerate their growth and their go to market strategy as well.

Speaker B: That's excellent. So from your perspective, what healthcare or health IT trends are you seeing in the industry?

Speaker J: Yeah, we've talked a little bit about it before but I, I still strongly believe in the sort of macro trend around consumerism. Um, and uh, I think consumerism goes beyond sort of price transparency and sort of the 1.0 version that was prevalent a few years ago. Um, and Accenture had a good report out recently talking about sort of the health care consumer is here. Um, and I think it's taken a long time to get to this point. Um, but healthcare consumers are really looking for their Latest looking for access, they're looking for transparency, they're looking for efficiency. Um, and in some of the information I've seen in the industry recently, when they look at sort of the demographics, it was really interesting to see that most folks are dissatisfied or very dissatisfied with the existing healthcare infrastructure. And a lot of it comes down to access. Still 30 days to see your primary care doctor. You've heard me quote that before. Um, but that's a major dissatisfier for most folks. When they have a question for somebody, um, and they need a medical professional to answer that and they potentially need a diagnosis and prescription, it's really hard to get. So we've really seen the rise of non traditional, um, modalities m of care. And I think when we talk about sort of future trends, a lot of dissatisfaction with our uh, current system. Uh, an interesting fact. 85% of baby boomers have a primary care physician. Um, 65% of millennials have a primary care physician. And Gen z born after 1997, it's like 50%. And most folks, you know, Gen Z and that group, when you talk to them, they don't want a primary care physician. So they're thinking about healthcare from a totally different perspective. And I think we really need to make sure that as we're developing solutions for these folks, we take advantage of that, um, in a positive way. Meaning we're trying to deliver services to them, but we don't gate it based on a primary care physician. We're bringing the services to them, them when they want it, when they need it to solve their problems.

Speaker I: Yep.

Speaker B: No, I actually helped start a company here, uh, in Georgia, Hip Nation. I mean that's exactly. They're providing services on call for members of their health plan. And that's. And uh, I mean it's exactly, it's all, it's on demand care. You can go in person, you can go secure message, you can do a virtual visit. But it's all on demand. It's, it's trying to address this, it's addressing all three of those demographics and sectors because care has changed. And your father's healthcare, as we were talking about earlier, their children don't want it. Um, they want care differently and we have to serve it up the way that they want it served up.

Speaker J: Yeah. And I think there's an interesting quote I've heard many times sort of saying the future is here, it's just unevenly distributed. And so when you think about things like Kip Nation and other companies that are providing those Services on demand when people need them. That's very different than a traditional primary care doctor's office. And so I think a big part of it is, you know, consumerism, the trends, the continued trends around consumerism and adapting health care to those consumers instead of the other way around, asking consumers to adapt to, you know, how we deliver care today.

Speaker B: Very good point. You just covered some of this. But what are a couple of best practices or strategies that you can share to help people navigate those trends?

Speaker J: Yeah, I think it's, you know, a big part of it is around new models of care. So not thinking about sort of the traditional big box. And, and you know, I had a colleague, um, you know, from Piedmont Healthcare, um, who I talked to and I know you had, um, one of their team members, one of their execs here earlier today, but they really talked about sort of, you know, a Chick fil a model, um, and that, you know, the old school model. This was. Matt.

Speaker B: Matt go. Yeah, that's great.

Speaker J: So as you think about, you know, consumers, um, in their communities, if you have a big hospital, sort of the big box model, and you're asking all these consumers to come to the hospital, hospital, it creates, you know, all these barriers to care and friction because people have to come there. It creates, you know, queuing problems or scheduling issues. But if you bring the care directly to those patients in their community, right, like chick Fil a, getting out there, providing services where they're needed, um, you know, that's really valuable. And so, you know, again, I, I think that definitely resonates with a lot of consumers now who are looking at how do I get access that's near me. If it's, you know, if I've cut my hand and I need to get something stitched up, it's going to urgent care. But for a lot of the questions that are out there, it's how do I access care in a way where it's super convenient? Right. It's on my phone. And we started with. Right. You know, founded a company years ago that was really focused on sort of telehealth and focusing on video. Um, we've seen a transition now to much more chat based, integrating AI into what's going on. But those alternative models of care are really powerful and that's where, where we're seeing significant traction with consumers these days.

Speaker C: So where would your point of data be? If you have spread all this out and you don't have a primary care, where would your data reside?

Speaker J: That's a great question. I mean, I think There's a big push to be able to give consumers access to that data and say it doesn't, you know, it's not Epic's data, it's not McKesson's data, it's not a health systems data, it's the consumer's data data. Um, that problem hasn't been successfully solved yet.

Speaker F: Right.

Speaker J: Health Vault and things like that that Microsoft came out with years ago, didn't have a lot of consumer adoption because it wasn't really consumer friendly. Apple obviously is tackling that now and saying we want to be able to create the type of solutions where you can store all your health data here. So we know where you've been, ah, as a patient, who you're getting care from. But more and more the coordination of that, not for super complex care, but for day to day bread and butter. More and more of that is being put on the consumer and they want to be able to coordinate some of that. They don't do it. We talk about population health, they don't do it in the most coordinated fashion, but they want to be empowered to know this is their data, they can control where it lives and that they have access to it.

Speaker B: But I can actually. Yeah, so I'll pick up on that. Just from a standpoint of what I heard today. Um, so there's two answers. Answers. I would say blockchain is going to help us with the security of that data. But now in the application layer, the API, basically what we brought up, you know, ONC spoke about in depth, uh, today, uh, is open up these APIs and forcing these APIs and for us to share this data at the consumer level, the consumers need to be able to do this through their apps. And I think API is going to be in fhir and these standards are going to be driving that, uh, and um, empowering it. And so I think those two. And then. But you have to use blockchain and you have to use security in there as well. Um, because we want to make sure this, you know, that the data is tagged securely and we've, we need access to it, but it's got to be stored securely.

Speaker J: Yeah, absolutely. And I think, well, that was one of the challenges of Health Vault early on was, you know, they didn't have the interoperability that they needed. They didn't have blockchain to be able to provide the privacy and security. Um, and consumers overwhelmingly still go for convenience over privacy and security. They do until they have an issue and then they come back and go, oh, two factor authentication. That's great. Yeah. Blockchain solution for their medical records, um, you know, that becomes more important after they've had a problem. So our job is to build solutions that are private and secure and still give accessibility.

Speaker B: Excellent. So in our closing few minutes, uh, thinking beyond today, what do you see as a key strategy or trend that we must be ready to successfully navigate in three years from now?

Speaker J: You know, I think, um, there's the old adage, right, of, of, you know, everything that goes up must come down. Um, we have continued to see healthcare spending go up year over year, and I think all the industry experts see healthcare spending continue to trend up over the next several years. In the short term, I don't think anybody's seeing, you know, a significant downward trend of that.

Speaker E: Right.

Speaker J: But when you include all the different stakeholders and you begin to. And again, it's not new, but the concept of moving from, you know, a sick career system to really a healthcare system focusing more on preventive medicine, um, but doing so in a way that is, you know, again, providing care to the patient, you know, at the time that they need it. And so Virta Health. Right. IORA and some of these other models that are saying we'll provide comprehensive care, but we're really going to focus on preventive services. Um, right. It's the idea of not necessarily narrow networks, but being able to bring, um, right. The right type of preventive care to the patient when they need it, or utilizing technology to be able to deliver it to them when they don't even know that they need it. Um, and one of the, you know, one of the folks that I've worked with in the past has some really interesting technology where they can passively monitor what's going on through your smartphone. And based on these digital biomarkers that they have, they can really determine, you know, how you're doing. Uh, they can determine when an intervention might, might be needed. And I think that type of appropriate passive monitoring and delivering, uh, technology and solutions to patients when they need it, even if they don't know when they need it, um, will become a bigger and bigger part of what we see.

Speaker B: That's excellent. And in your first part you brought up, um, I think Beth even kind of touched on that as well, where we are going to have to see something significantly change here on the payment side and how care is delivered. And she brought up that, uh, you know, not within three years, but within 10 years, we could see the elimination fee for service gone and just really managing the patient and the entire cost. I. It the term is out there. It's cap, you just have, it's a capitated model or it's, it's a, it's a, it's a risk based model and it's all under one scope. And so you're, you're paid to manage people and that's it. I mean then there's no bill for this and bill for that and bill for this and bill for that and, and surprise billing. It's just uh, you know, it's going to be managed much differently. And I think, I think I agree with that. I mean I had not thought of it from that perspective, but I do believe we will get away from fee for service in five to seven years. We'll see a glide path within three to five years.

Speaker J: Yeah. And I've been saying that three to five years for quite a while now that value based care is coming, pay for performance is coming. So, uh, I'm a little more pessimistic around that.

Speaker B: Correct.

Speaker J: I did spend a lot of time in D.C. over the last couple years really working with legislators to be able to make some changes to Medicare to see about getting alternative payment arrangements put in place. And I think the regulatory landscape and the reimbursement landscape do have to keep up. And I think that's one of the other key things that we'll see over the next three to five years. Um, consumer behavior is changing, the models of care are changing, closer collaboration between payers and providers. And uh, at the end of the day, the regulatory and reimbursement really has to keep up with that in order for us to deliver on the value proposition here. And that's the part that I'm really excited about. And that's what I'm saying seeing with a lot of these early stage companies.

Speaker B: That's excellent. Very good. Dr. Waller, thank you very much for joining us in studio. My friend.

Speaker E: Absolutely.

Speaker J: My pleasure, my pleasure. Thank you very much for having me. And yeah, if people do have questions or want to discuss any more about this, they can always reach out to me and um, I'll be happy to help and answer any questions I can.

Speaker B: Awesome. Thank you. And that is a wrap. What a great three hours again. I can't believe I decided to do a three hour live broadcast. But it all is, it worked out. It always does. You guys are phenomenal partners. I mean Stone, uh, Peyton and uh, Roberta Mullins, thank you very much. You guys have been with me from day one and have supported all of my crazy endeavors. So thank you very much and thank you to everyone for joining us today. And just a reminder to please tune in weekdays at 2:30pm Eastern, 11:30am Pacific to hear all of our latest shows. If you miss any part of this show, this is all going to be rebroadcast and certainly packaged up, uh, and looking forward to that. And I want to certainly thank my show partners, Lenovo and Lenovo Health, intel and Intel Health Rama on Healthcare, Healthcare Now Radio and Business Radio X. Uh, without all of you guys, uh, this show would not exist. And certainly himss. HIMSS has been great to me through all the many, many years. Um, so I want to make sure I, uh, plug, uh, HIMSS as well the HIMS organization. Um, and just to thank you for listening for the last three hours. And again, all of this will be available, uh, to you, uh, over the next coming weeks on SoundCloud and Apple iTunes and iHeartRadio and Spreaker and Google Play and Tunein. Um, and again, you can track me on Twitter @hitadvisor and use the hashtag thisjustinradio so I can respond to your comments from the show. Uh, and just again, let us know your thoughts. Uh, feel free to tweet at us or, um, on any social platform. You can certainly reach out to us. We're there. And you also can check out justinbarns.com, we've all launch a new website there. Thanks everyone. Have a terrific week and the rest of your day.