The Future of Education (private feed for michael.b.horn@gmail.com) What AI in Healthcare Can Teach Us About Its Impact on Education
Diane and I sit down with Dr. Tom Lee, acclaimed physician and founder of One Medical and Galileo Health, to explore the parallels between healthcare and education in the age of AI. Our conversation dove into how Lee’s mission to radically transform healthcare systems mirrors similar challenges and opportunities in education, especially around the adoption and integration of AI. We discussed shifting from legacy models to more holistic, technology-enabled frameworks that prioritize both personalized service and systemic change.
Media Mentioned:
Diane Tavenner
Hey, this is Diane. Welcome to Class Disrupted season seven, where Michael and I are looking at the world of education through the lens of AI and purposely starting really big. In this episode of the podcast, we zoomed way out into an entirely different field, health care. I love doing that because often I find that I can see education so much more clearly when I contrast it with similar fields like healthcare is certainly my number one choice. To this end, we had a fascinating conversation with Dr. Tom Lee, the founder of One Medical and Galileo Health, about the impacts of AI on his world and the potential parallels in education. There were a few things that struck me that I think might interest you. The first is systems.
Tom is trying to change the healthcare system, literally, and he thinks in systems. You know, in our conversation, we talked a lot about how AI might be able to accelerate system change for good. And in my experience, most of the conversations around the impact of AI in education is focused on student, teacher, classroom level, which is obviously imperative. And the system itself will have an outsized impact on the individual experience. And so it’s critical for us to be talking about that big system. And I think Tom helps us do that. He’s also an innovator and an entrepreneur, and he’s driven to transform a system he feels isn’t serving people well. And I personally find his story very inspiring and parallel in many ways to the paths that so many great educators have taken, are taking or may want to take.
And I think they’ll find Tom an inspiring character in that. And then finally, I’m drawn to the connection between healthcare and education. I mean, let’s be honest, as educators, we can’t be effective if people aren’t healthy. And we have a ton of evidence that people are more healthy when they’re educated. And I just found our conversation to be a bit of an invitation to think about how we hold a holistic view of what it means to have the privilege and responsibility of developing and caring for humans, especially in this age of AI. So with that, I hope you enjoy it.
Hey, Michael.
Michael Horn
Hey, Diane. It is good to see you. And I’m excited for today’s conversation because actually I’ll out ourselves, Jeff Salingo on my Future U podcast. He and I, a few years back we had some healthcare folks come on the higher education because we thought M & A, healthcare. There’s been a lot of it. Maybe there’s something we can learn about in colleges and universities because there needs to be a lot more M & A, frankly. And we’re like, they’re analogous sectors. And then we, by the end of the conversation we’re like, wow, that’s why colleges and universities have like no M & A.
They’re completely not analogous in the way we thought that they were. So I love conversations where we get to stretch our bounds and learn more. And I think today’s might do just that for us.
Diane Tavenner
Well, that is my hope and my thinking and my personal experience. So I’m really excited today, Michael, to have Tom Lee joining us. And I will out myself and say that the conversations I have with Tom really do illuminate things in education for me. And so I’m so grateful when he agreed to come on the podcast. He’s not our typical guest because he’s actually a physician and an entrepreneur who has built multiple ventures that sit at the intersection of tech, care delivery and system redesign. He co-founded Epocrates, one of the earliest and most widely used mobile reference tools for clinicians. He then founded One Medical, which is a tech enabled primary care network. And he’s currently the founder and leader of Galileo, which is a value oriented technology powered multi specialty care model.
And it’s designed to improve quality, lower costs and expand access across populations. We’re going to get into all of that. I will also say that Tom is quite an amazing consumer of education. He’s got a BA from Yale and MD from University of Washington, an MBA from Stanford, and completed his training to become board certified as an internist at Harvard’s Brigham and Women’s Hospital. And while all of that is super impressive, what I love about Tom is how he thinks about healthcare, the clarity of his vision and the mission that I, I think he lives his life by. And so every time we talk, I learn something. Tom, I’m really excited to learn more today. Thank you for joining us.
Tom Lee
Yeah, no, it’s great to be on and great to connect here together. I feel like we always have great conversations and it’s exciting to share them with a broader audience and see where the worlds meet. I was exactly thinking that as you’re reading my bio. I’m unrelated to the industry per se, but I’m a very avid consumer. Unintentionally, my parents would say over, over educated. But, yes, I am happy to be here. So thank you.
Diane Tavenner
Tom, I found this quote that’s attributed to you that really resonated with me, and I thought we’d start here. And the quote is, as a young physician in training, I was like, I don’t want to practice in any of these broken models. I had worked in almost every environment, but the care model just didn’t make any sense. And when I read that, it literally is how I felt as a young teacher. And so maybe let’s just start there. How would you describe the problem when you were at that point, and what did you perceive as broken? And we’ll get into how that then creates your journey forward.
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Humanity, Systems, and Individual Care
Tom Lee
Yeah, it’s interesting. As I think about it, I’ve always felt like education and healthcare have these kind of parallel paths because, you know, at some level, they’re so important to humanity and society that we go into it with this belief and vision that we want to serve other humans. And I think as practitioners, that’s what you do. As a young clinician, you want to help other people. So you enter this process, and then as you get closer to the tail end of the process, you’re like, wow, I don’t really get to shape much of this process. I am really just a cog in the machinery doing whatever I’m supposed to be doing. And to me, it was the antithesis of delivering personalized, individualized care. As a clinician, the way I wanted to do it in the personality style that I thought my patients would want.
And so I think I just started to realize that there is some other force driving this that’s beyond. You know, I grew up as an academic clinician. I didn’t really understand how the world worked. But as I started to peel the layers away, I’m like, oh, that’s why we have this system and why it doesn’t work for patients and providers. So it’s similar.
Diane Tavenner
Yeah, yeah. Literally what I would do as a teacher, I think, oh, why are we doing this this way? This doesn’t seem to be good for kids or teachers. Maybe we just don’t know a better way. I was very naive back then.
Tom Lee
It started to build my early thinking on critical thinking. Before, I was just a good student. I was just jumping through hoops that people said I had to jump through, and I was just good at jumping through hoops. And then as I started to ask senior leaders and people who I thought knew the answers, why are we doing it this way? Nobody could answer. Then I’m like, oh man, I think we’re just going to have to start to discover on our own. And that for me has been the unlock and the joy that I have through entrepreneurship is you’re actually learning what’s actually happening and how to reshape it differently. So to me it’s the extension of the clinical process, but at a more macro level.
Diane Tavenner
Interesting. So tell us about a little bit about the journey and these three big sort of entrepreneurial ventures. You start with Epocrates, which is not a full system changer. But what were you trying to do there and how was that the beginning and kind of your first foray into rethinking?
Tom Lee
Yeah, I mean I’m not the classic entrepreneur business person. Right. I was mission-first in entrepreneurship was a means to the mission. And so for me, you know, I was naive to the economics of healthcare, the organization of healthcare, the policy frameworks. And so to me, you know, going to business school was really just the beginning step to understand how the other world thought. And you know, I really imagined myself invading the enemy camp to go to business school. And then I realized, oh man, they’re not, overly focused on, they’re not all predatory. They actually do have heart and soul and you know, some have missions that are similar to mine.
So I was pleasantly surprised. And then once I started to understand that I needed to just do the work, you know, there was a well known professor at Stanford who said you just got to do it. Like there’s no real book you can read about startups, you just kind of have to do it. And so through happenstance, a couple friends and I, you know, out of business school, started Epocrates, that was really just a starter company. Up until prior work, I had delivered pizzas and worked in a lab. So I just didn’t really have a credible managerial experience set. And so Epocrates was my training wheels on, you know, do I have what it takes to actually build a company? And then once I saw how the world worked, I’m like, oh, this is common sense, it’s math, it’s humans, it’s structures. And that gave me the confidence to start what I ultimately went to business school for, which is One Medical and Galileo is the extension of that.
So it’s kind of the redesign of services that has been my primary arc. And Epocrates was kind of a fun company. With a couple friends just to validate that I could be credible in the business world.
Diane Tavenner
Yeah, that’s awesome. That’s awesome. Let’s talk about One Medical because in my mind, I don’t know, maybe this is oversimplification, but it almost feels to me like it’s like the charter school of the medical world, right? Like in K12 we have these incumbent school districts and systems and everything is sort of in one system. And then charter schools come in and they say, well we can do this differently and you know, hold us accountable to outcomes, but let us do it differently. It feels like that’s kind of what One Medical was, tell us about it.
Tom Lee
About like so I haven’t really thought about it in that analog sense, but you’re right in the sense that you know, as quote unquote innovative as One Medical was perceived. It really was the basic chassis but with a nice, a nicer front end, a nicer experience, a more modern experience and some better elements. But it was still working on the general chassis of healthcare, which is an office based visit, a one on one exam room with a provider and a lot of human elements with a lot of front end experience. So we took a lot from restaurant and hospitality, kind of merged that into a hospitality oriented model. But the clinical care model was pretty much the same. It was just, you know, human to human. And, and so I think that’s a great analog because it wasn’t, you know, quote unquote, as transformative as could have been. But it was a first start because to me the biggest, you know, challenge to One Medical and in general any innovation in these spaces is because they’re so constrained, right.
There are certain regs and rules, there’s certain payment architectures predefined. It’s not really a free market enterprise. And so you’re really trying to optimize things that aren’t optimized in the system. The system design is actually quite contrary to what patients want, what providers want. And so you kind of have to innovate within those constraints. And so the challenge is economic innovation and experiential innovation to make that all work. And so that’s what the first innovation was at One Medical is validating that you could even build something higher touch within the economic constraints of healthcare.
Diane Tavenner
Yeah, yeah. And it seems that like your use of technology there was more sort of basic infrastructure. Right. I think you started with video appointments, which I think feel kind of common now to people, but certainly weren’t when you were doing them, you know, but, but beyond that. Am I missing something? Was there a technological component there that you felt like?
Tom Lee
There was, but it was a first gen thing partly because of what was available then. You know, back when I started One Medical, you know, it was like quote unquote Web 2. Oh, the fact that I could buy something online, you know, was a novelty. The fact that, you know, I was starting to get an iPhone. Right. Like the smartphones weren’t really a thing at the time. And so it was really web first, not mobile first as the environment back then. And it was certainly what I call, you know, first gen tech.
So a lot of the tech that we built was supportive on the back end. So our administrative personnel, our clinical partners, professionals, used our backend systems, but they weren’t the most robust backend systems because they would just do the work, but easier and better. And you know, we were one of the first companies as a service business to do our own electronic health record, which at that time seemed crazy, but the tech was getting good enough that we could do it reasonably well and it allowed us to do the basic stuff. But obviously the tech has changed so much over the last 10 plus years that, you know, now the platform is completely different.
Diane Tavenner
Yeah. And so that takes us to Galileo that you’re working on now. So tell us a little bit about how that’s different. I don’t think it’s the standard chassis. Maybe I’m getting that wrong. And where’s, you know, I think you’re doing significantly more with technology now.
Galileo: AI-Driven Healthcare Model
Tom Lee
Yeah, that’s right. You know, the front end is still nice and easy to use and modern and all the things that people would expect from One Medical experience. The key difference is the work itself is now different. So the tech stack is much more sophisticated. We use data throughout, meaning when we started Galileo, we could see where data and intelligence was going to be. And we wanted to design the operational infrastructure to support data intelligence, AI into the care itself. And so rather than layering it on a traditional model or One Medical model, we wanted to build, bake it into the Galileo model from the beginning. And so a lot of our process architectures, a lot of our data hierarchies and thoughts around truth were being formed there so that we could then leverage how data intelligence and AI would then augment what humans could do.
We always felt like humans and tech should be in the loop in a still to be discovered frontier on what should be delivered to patients because you still have this Hippocratic oath and this commitment to the Human as a person to person. But you have all this amazing technology that either augments and replaces some human elements of care. And so the real question is, how do you bring that into the fold naturally and somehow maintain the integrity of what’s actually being delivered? Because unbridled, who’s to judge? Right. And we see this already today. Right. And so the whole framework was around clinical re engineering. How do we bake that in and then put it into a structure that’s harnessed so we can take advantage of it but not be what I’ll call subject to it?
Diane Tavenner
Yeah, yeah. Can you give us like one just concrete example of how this plays out in actual care or in the clinic or among, you know, doctor and patient?
Tom Lee
Well, there’s a spectrum from basic to more sophisticated elements that we do on our care platform. So to a patient it feels seamless. I’m getting best in class, whatever care, we think of primary care as any knowledge based situation that can be addressed virtually. But we also do some home based care as well. But whatever that first level of care is, make sure that it’s excellent. And so there’s a range from simple to complex, you know, what I call unidimensional to multidimensional type of dimensions to decision making. And so what we’ve got are some basic algorithms that collect information that suggest treatment plans that are based on human based editorial processes that allow us to have conviction that everything is delivered at a minimum standard of care. And then we have different layers of intelligence all the way up into classic LLMs and AI that start to then really augment the intelligence of what a human clinician could do.
And so what we’re trying to do is figure out which tooling in what scenarios should we be using different elements to then augment what happens to the individual with a human experience. Like that’s the other thing that we’re trying to do is, you know, you can talk all you want about the fidelity of the knowledge being the most accurate, but unless there’s trust in the content, in the person who’s telling me this, still, you know, when people talk about AI, there still is human to human friction on what actually happens in society. And so how that gets translated is really critical as well. So we kind of look at all of those dimensions to kind of bake it into a unified care experience.
AI’s Role in Healthcare Transformation
Michael Horn
So Tom, there’s several things there that you’ve said that are interesting that I think we’re going to want to dig into. One of them is also like the categorization of a simple. I assume that means like an acute problem that can be solved, point of care versus a complex one that maybe requires behavior changes and all sorts of other parts of lifestyle. But before we go there and before we dig into the AI piece specifically, I suspect our audience is like, why’d you bring him on? Well, because AI is a huge part of this story. The other analog, though, that shapes how AI is used that you mentioned is the regulatory framework in terms of dictating what is and isn’t possible. The reimbursement model continues to focus around what many have called sick care, treating symptoms as opposed to incentivizing health and wellness. How do you think about sort of finding areas and business models that can go around and transform that system? And what are the broader lessons like, you know, education can be thinking about if you extract from that as you create these new models?
Tom Lee
Yeah, I think there’s no question the way we look at it is AI is again, a means to an end. And so you have to think about what are you trying to accomplish here. And so if your goal, you know, again, I’m not saying this is our goal, but your goal is to improve well being and lifestyle and preventive health. As just an example, as you know, the current healthcare system tends to not really reward and reimburse preventive health and wellness, then you can design a care model that can leverage AI to do more of that. Partly because, you know, to be frank, it doesn’t pay for itself. And so you need to find more efficient frameworks there, and AI can provide those more efficient frameworks. The real question there then is what is the content and how clear and validated is the content.
Or what is the tooling needed to do that? So in any quote, unquote goal, you can use different elements to then augment and change the experience, the content and the economics all holistically. For us, we do that. Plus, you know, what we call urgent care, primary care, longitudinal care, multispecialty care. When you think about the kind of quote, unquote, service that people want from the medical system, it’s actually not just one thing, it’s a lot of little things. And you ideally would like a provider or an organization to handle most of those situations, especially one that has a trust authority. And so what we do is we try to think about the broad set of use cases, including wellness and prevention, but bake it into a unified economic framework. So we’re looking at all the different goals and trying to put it into what we call our kind of North Star, which is really long term population health.
Diane Tavenner
This is where the parallels to education are so similar, right? I mean we both, yours is a little bit more life and death than ours. But honestly, education feels life or death and we feel like we’re raising whole humans for their life. There’s the privacy considerations, there’s the regulatory frameworks and constraints. You know, there’s so many things that are parallel and, and what I, as you’re talking, I’m mapping it on to what we do in schools where there’s a lot of goals and purposes that we have in schools that they’re not actually funded or paid for or the thing that technically we’re accountable for, but we know are good for young people and we want to do them, but how do we squeeze them in? And so I’m listening and learning from you about how to think.
Michael Horn
Yeah, because it sounds like one of the things though, Tom, that using AI allows you to do is break some of these trade offs, maybe that had existed before. And so I’d love you to like sort of walk through how maybe like the trade off, some of that it breaks and what it allows you to build that maybe, you know, isn’t getting directly funded but can be done now, if I’m understanding you correctly.
Tom Lee
Totally and this is kind of, you know, pre AI, the same mindset which is, you know, most of the world, you know, particularly from a managerial perspective, kind of view things as zero sum or on what people call a quality cost frontier. I can have higher quality at higher cost or lower quality at lower cost. And it’s just binary. I can either titrate it up or down, but that’s it. And the beauty about entrepreneurship and innovation mindset in general is you can actually get higher quality at lower cost if you’re creative. And so that’s process redesign, that’s people and training and skills, and it’s also tech and automation and AI. So AI is just another tool to push the quality cost frontier out, which allows you to have higher quality at lower cost. And so you can name whatever your output is.
Optimizing Systems Within Constraints
Tom Lee
If it’s, you know, educational goals of a variety of sets, you can do more for less. And so one thing that people would always ask us about when One Medical was in the same thing with Galileo is, you know, how are you able to transform the industry when you’re working within a broken industry? And our answer is we’re working within the current broken system, but optimizing what you can do against that, and again, it depends on what kind of constraints there are. But if you can achieve better results more effectively and efficiently. And again, you know, healthcare has some analogs. There’s some forced staffing roles and forced ratios which sometimes create that arbitrary negative constraint which basically, it doesn’t allow you to innovate. But outside of those areas, if you’re able to optimize, you can have happier workers, better outputs and lower cost infrastructure to really enable your goals. And then what we do is we take that extra savings and apply into areas of mission that are important to do from a quality perspective that likely won’t get paid. As an example, chronic condition management is a quality property.
It takes time and energy to better manage chronic conditions. It’s not really well reimbursed in the current economic architecture. And so you just kind of have to do it. But if you do it effectively, efficiently, then you can actually get the results done and not hope that you get paid more for it per se. And so there are a lot of these little trade offs you’re making by getting core efficiencies there through process automation and re-engineering. You can take some of those savings and reapply that to a mission where it’s unlikely to be reimbursed outside of a big policy framework shift.
Michael Horn
There’s another point you made in there as well, which is sort of about breaking these trade offs between, you know, low money, low quality, high money, high quality. In higher ed, for example, they often call it the iron triangle. Quality, cost, access. You can play with two, but not all three. But I love your the way you said it, entrepreneurs exist to change those trade offs and what you create as you build solutions. I’m curious how you see AI as a result, like helping existing models of care that have been around for, you know, the hospitals and doctor’s offices that have been around for years versus the creation of new models with AI sort of centering. Right. And breaking some of these trade offs.
Like how should we expect incremental versus transformational applications of AI in each of those settings?
Tom Lee
Yeah, I think it’s an interesting time right now. We don’t know what’s really going to transcend over the next several years. What we see in the healthcare ecosystem are some of the more savvy larger institutions, so the entrenched and more, heavy iron type of hospital systems, but those with enlightened leadership leaning into AI, taking advantage and harnessing that and transforming their organizational operations. Now it’s still not dramatic, but it’s certainly quite significant. And we’re seeing some organizations that are starting to do that. And whether that innovation will be durable and completely transformative I think is to be seen. And my bias is I think there’s going to be probably a ceiling on what even the most savvy large institutions can do because of the habits and norms of these large institutions and frankly, the breadth and complexity of the large institutions. When you look at de novo innovators, they almost have the opposite challenge and problem, which is there’s no structure.
And so how do you build something out of nothing? And in today’s AI first models, there are AI first clinicians out there today. But the problem there is there’s not really a great economic architecture to monetize. There’s not a great organizational infrastructure, there’s not a great trust infrastructure. And so because of that, it’s hard to say whether anything is going to truly take hold from almost an ether perspective, an AI first framework, who knows, right? That’ll all just be dependent on what’s been built. Our bias is there’s some probably middle ground where there’s some kind of lightly structured organization that’s already available that can harness some of the tooling of AI and everything else that’ll find that good middle ground to really harness and scale quickly. But, you know, who knows, right? But, I think that the question right now is not really over the next year or two. I think everybody’s going to take advantage at some incremental level over the next year or two.
The real issue is what thing becomes transformative from an experience outcomes and cost basis.
Diane Tavenner
Yeah, so fascinating. I’m just going to keep narrating some of the parallels that I’m noticing a little bit here. Like, I think those big, and we’ve seen big, large school districts jump in and they have resources and they’re building tools and they’re embracing AI. We’ve seen incumbent big publishers in the curriculum space, you know, like really. And then we’ve got these little, you know, entrepreneur startups who are truly trying to like redesign the model of school. And so it’s just an interesting parallel. I also appreciate we’ve had a really hard time getting people to really think systemically in the way that you do around change. And so this has been super exciting and enlightening.
And where most people in education are talking is like literally down at the student level. And I know you have, you go, you run that whole entire ladder. And so we had such a fascinating conversation where I was asking you, well, like, what does it look like with a patient and like what are you running into? And maybe you can tell the story, but I think people should know like you’re a classically trained doctor and you’ll describe it better. Like you, you were trained to actually like physically examine people to understand what’s going on. And that’s like an art in a way that many teachers are trained in the art of teaching and maybe we shouldn’t really be doing that very often anymore. And so can you kind of talk about that tension and how that plays out and what people.
Analog to Digital Shift in Medicine
Tom Lee
Yeah, yeah, it’s probably just luck in terms of when I was born, right. But I was born between the analog and digital transformation. And similarly in healthcare, the dying art of the physical exam into what we call the digital exam increasingly so. But you know, when I did my medical training in Seattle, you know, I trained with some of the best in the best, you know, like people who had learned the art and they could, you know, smell you from half the room away and know what your diagnosis was or they would go into your garbage and know exactly if you were compliant with your, you know, dietary intake and they could measure the size of your spleen, you know, as good as an ultrasound does today. So these are really master craftsmen at their work. And, I just did my medical school with them and I got halfway good, but nowhere near their level of expertise. And so, the reality when you start to step back from that, because that was the dogma, is you would never see a patient without having physically examined them. Listen to the lungs and you can’t even listen to the lungs through the shirt.
You have to take the shirt off completely if you really want to listen to the lungs. So that was the type of training I had. And then the further down you go, you realize that the data and the operating characteristics are so much more variable that when you really step back at it, unfortunately, and I think most clinicians would agree today, even some of the die hard physical tactile folks would say, yeah, it’s a lost art, meaning it’s hard to really get the training to that level. The science is just not supportive of it at a level that warrants its practice. And today technology and lower cost tests and non-invasive tests are becoming so cheap and available that it’s really flipped the script on what should be the standard of care for examination. And so, you know, very enlightened doctors who don’t, again, if you come to see me, it’s kind of like, well, you’re not examining me. It’s like kind of a weird thing. But that’s kind of the pressure lot of clinicians have.
But the reality is that it’s just not the standard of care increasingly so and so it’s just these habits need to change and the whole practice of medicine hasn’t fully evolved to that just yet.
Diane Tavenner
Yeah, it feels so parallel to teaching to me. You know, I was with some incredible mastercraft teachers this past weekend and they truly are extraordinary. You know, the way they orchestrate a classroom and move young people along and all of that. And there’s not that many of them and training them, developing them is so expensive and long and the tech, we have other ways of measuring and understanding where everything a student is. And so. But I think the same thing happens for you where patients are like, but wait, I want to see my doctor in person. I like seeing my doctor in person. Don’t take that away from me.
And you know, it sounds like you might have that a little bit on the doctor side as well. How do you think about that sort of human change management process?
Tom Lee
Well, part of it is you have to be intentional, right? Same thing. What are you trying to accomplish here? And if human contact is important for either side for different reasons, then you have to bake that in, but you just have to knowingly bake it in, not just blindly bake it in. And so when you think about physical experience, instead of saying, I have to do it every time for this situation, instead saying, when is a physical interaction valuable? When is a face to face interaction valuable? And how do I layer that into the journey so that when I’m doing it, it’s deeper, more meaningful, impactful, and then everything else can be done by automation, everything else. And so it’s really just starting to kind of break out the experience into the components and then being more intentional about it.
Michael Horn
Yeah, I mean, that segmentation you keep doing, that I think we don’t do nearly enough of with precision in education, keeps striking me over and over again as you think about not only modularizing the experience, but then creating a better integrated experience, frankly as well. I’m curious. Part of that also is maybe who the first users or patients. Right. Like is there a right first profile, if you will, for a new system? Like who should you serve first? If that makes sense. And I’m curious because it’s something we grapple a lot with in education of, you know, whether it’s income strata, whether it’s race, whether it’s geography, like it’s a question, you know, type of learner. We have all these questions of responsibly speaking, who is the right learner, but also who’s the learner that’s ready for maybe this radically new way of doing things.
How do you think about that when it comes to healthcare?
Tom Lee
It’s a great question and another great analog between the industries. You know, both industries serve. The intent is to serve all in a fair way. Right. And that’s kind of where we ended up with these cornerstone and so with One Medical was mostly an urban commercial solution.
And there was a bit of a premium to it. So it wasn’t designed for everybody, but it was designed to validate the first gen model of what could be offered to people that I was familiar with, you know, for the most part, which is my peers. Galileo was designed to be for all populations. And so that exercise of designing Galileo has been much more challenging. And because of that we needed to think more as a platform against all life types. And so unlike One Medical, Galileo focuses on complex debilitated seniors, low income, complex behavioral health populations, as well as the, millennial and or the high flying exec. So all of these populations we need to be more intentional about. And so when you’re trying to serve the population it’s 10x more difficult.
Customized Engagement for Diverse Audiences
Tom Lee
So I wouldn’t recommend starting there, but it can be done. And the way to do that is to break it down into the types of people that need X types of interactions first and then Y type of interaction second and you break it down into problems. As an example, we are not expecting seniors to text us their mobile number to install their app and start communicating with our providers on day one. And so we have phone numbers and we have traditional offices and ways to gauge seniors first in a way that they’re familiar with. That being said, a percent of seniors then get comfortable with the team and then might be curious about doing a web based video visit with the team. And so we graduate people along a spectrum of comfort based on where they start. And so we often just kind of break down the populations based on, who they are, what their mindset is and then bringing them on a journey and being able to accommodate all of those under a common chassis, which is the key. And so you still have to organize your work in a very general way, but think about the interfaces to those individuals in a very kind of customized way.
Diane Tavenner
I want to shift into a little bit of what’s inspiring you right now, Tom. Like what, where are you seeing the application of, of technology and the advancements in AI and like what, what can we be hopeful about? What’s actually like real and hopeful that you’re seeing?
Tom Lee
I know this is against being an entrepreneur, but I’m just like, you know, I’m the more cynical person and I must say there are very few glimmers of hope that I see in general in the media world. Right. Because it’s just so hard to cut through the noise of what you see out there today. And so part of me is so, somewhat dejected or saddened by just, you know, kind of the degenerate world that we’re falling into as everything gets micronized and fractionated and digested and commoditized. And so to me there’s that natural force of, you know, the singularity that’s kind of breaking us all apart that to me is hard to ignore. It’s just such a pervasive force, you know, and it’s not necessarily malicious. It’s just kind of evolution at scale here for us. And so that’s kind of the, I think the disheartening theme or overtone for most of my psyche as I just go through life and then especially over the last few years.
But I think the positive side are the human to human interactions. Like, you know, we don’t talk about politics, we don’t get into all this, you know, crazy stuff. It’s like we can have a normal conversation about a football game or fruit or whatever. And to me, like, I just wish we could somehow tune out this, noisy ecosystem and just go back to human to human. So I’m hopeful that we’re all just going to eventually get sick of sugar and you know, it’s like the same thing. You have too much sugar. Maybe I’m just going to go back to veggies at some point, but at some point I’m hopeful that we’ll just go into physical human experience and just kind of turn off the tube.
Diane Tavenner
Are you seeing places where, I mean, you sort of alluded to this, where maybe the use of AI makes it structurally and financially viable to have better human to human contact in care settings. And, what does that look like? Yeah, and I’m also just thinking, I feel like you told me a story about how if I remember correctly, you’re starting to use AI to do the follow up calls. So like, if someone’s had a procedure like this happens all the time where, you know, I have a procedure and the next day my doctor calls me to check on me. Those are not really good experiences. Right. Like the doctor’s having to call at night, I’m busy. Like it’s kind of weird and forced and it’s like, “okay, yeah, I’m good. Okay, bye.” You know, and I think you might be using AI for that and getting some real positive results. Yeah.
Tom Lee
I mean, it’s part of what we talked about, right? Just stitching together an experience with intent and everybody benefits. And so there’s, you know, let’s take the concept of a follow up call. There’s three ways to do it in theory. One is the provider physically calls you, which is not reliable, and scalable. It’s nice if it happens, but it’s just not likely to happen given the cost of it. The second is to have an AI chatbot pretend to be the doctor and over time it’s just going to feel artificial in saccharin and you’re just not going to feel like, wow, that was really fine. And another is to create an experience that is much more intentional. That said, hey, you know, Dr. Blah asked me to check in. I’m an AI agent, I’m here to answer any questions that you might have. And then should it need to be escalated, I’m happy to bring in Dr. Blah.
So, you know, there’s lots of ways to stitch these together so that they’re much more human, but you know, what you’re interacting with and it’s transparent and the intent by the human still gets expressed through that, which is, you know, it’s not a robot, it’s not automatic every single time, but it’s triggered by somebody’s intention. And so those little nuances, I think, help express the humanity behind the tech. And hopefully, you know, you know, we’ll still reward that in society somehow, but, you know, who knows? Yeah, that’s the hope.
Michael Horn
It’s interesting hearing you say that also because it strikes me as one of the concerns we’ve had in the education world, and we had a guest last season, Julia Freeland Fisher, who’s thought a lot about companionship, Right. And AI sort of disrupting companionship and maybe taking humans out of our lives. But the vision you just painted would be the AI doing the stuff that humans don’t really want to be doing right now. It’s not actually a very human interaction and then being super transparent about what it is to create the opportunity or free up more time for when the human really is valuable, if I’m understanding how you’re thinking about that.
Trust Matters in AI Oversight
Tom Lee
A little bit exactly. You know, let me take that example, which is a great analog here. You know, AI has the potential, as we’ve seen, to be an intimate advisor, therapist, counselor, whatever. Would you rather have the supervisor of that person or AI agent be, you know, a social media company or a therapist? And so, you know, behind the technology is what matters. And so increasingly, I think the trust authority that humans can provide helps provide that confidence of how you’re interacting with the AI agent. That’s kind of my hope is, rather than just using some random generic corporate thing, is that, trusted authorities facilitate that, oversee it, put their stamp on it. And now, yes, you can still get the same experience, but it’s, you can have some conviction that it’s guardrailed and a bit more, you know, intentional.
Michael Horn
It strikes me, that might be a nice way to do a regulatory guardrail that doesn’t stamp out the innovation and sort of the productivity gains that you’re talking about, but also allows us to not lose some of the things that are important, whether from quality of care or humanity, frankly, as we interact with each other.
Diane, where do you want to go?
Diane Tavenner
Well, I mean, I feel like we could go on forever, but I actually think that that’s a really, maybe that’s a really interesting place to close for the moment in that what it says to me is like, we, you know, those of us who are on a mission, who are expert in our work, have a huge role to play, and it’s almost a responsibility of ours to understand and engage with the technology so that we can be those trusted sources, as you just said, around like the counseling. I mean, this is completely present right now with young people and who’s behind it, who is really, really critical and maybe the place we should be looking as opposed to just to technology writ large. And so I love that. Yeah.
So before we let you go, Tom, we want to pick your brain for something you’ve been listening to, watching, you know, reading lately that is interesting and that you’d like to share with our audience.
Tom Lee
I mean, in my life these days, the easy default is my kids, who are now 5 and 3. So I find them just fascinating just as humans. And it’s fun, you know, as a clinician, to see biology, you know, right before your eyes grow. But no, I mean, outside of my kids, which garner most of my attention you know, the book that comes to mind that I’ve been reading is, again, it’s completely random. It’s just a moment in time that happened to be reading Unbroken. But it’s, you know, about this Olympian, you guys might know this story, but, you know, out on a raft for, you know, umpteen 40 plus days or something. And part of the reason why I find that book just so helpful today is, you know, we think we have it tough.
You know, people complain about society and life, and I’m like, yeah, we don’t really have it that tough. And, you know, if anything, it’s like, we should be thankful for all the people that have had really tough journeys on our behalf. And so for me, it’s like, it’s inspiring to be able to kind of, you know, continue to work hard and try to impact society for the positive.
Michael Horn
Yeah, I love that one, Diane, maybe I’ll go next and let you close out this episode, switched around just because I know you have a really interesting one. Mine has been lighthearted. I’ve been listening to a book called the Warrior Rafael: Nadal and His Kingdom of Clay by Christopher Clary, who’s the former New York Times tennis beat reporter. He wrote a biography of Federer that I confess I enjoyed a little bit more, even though I’m more of a Rafa guy as a lefty. But it’s been a great dual thing, both the biography, but also a biography of Roland Garros and the French Open, which has been sort of an interesting dual structure to a book, and I’ve been enjoying that. What about you?
Diane Tavenner
Well, good job going outside of the day to day.
Michael Horn
I’ve been escaping. I’m escaping.
Diane Tavenner
So I watched the interview between Ross Douthat and May Mailman. And for those who don’t know, May was, until very recently, the White House Senior Advisor for Special projects. And in her role in that role, she was the architect for the Trump administration’s crackdown on higher ed, and, in her words, the effort to, quote, end the culture of victimhood on college campuses. And so anyone who listens to our podcast should know that I’m very interested in conversations that get to the nuance of differing viewpoints in respectful ways where you can actually hear what people are saying because they aren’t yelling at each other or talking over each other. And I just found the conversation really informative, provocative, and important, given the work that I, you know, Michael, we do in higher ed. And so, yeah, recommend.
Michael Horn
I’m adding it to my list. So I appreciate you calling it to my attention because I didn’t know about it. So thank you.
Tom, huge thanks again for joining us. We’re going to link to Galileo for folks to check it out. And we just really appreciate your insights today. And for all of you listening, as always, keep the comments and questions coming. It does shape what we have on tap for this season and, and Diane and my evolving thinking. So just huge thanks as always. And we’ll see you next time on Class Disrupted.
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