NerdMDs | Efficiency Unlocked

🎧 StackByte Episode Summary (Ep #5 – “Health Delivery 2.0”)Drs. Adam Carewe and Dale Gold distill Carewe’s recent Substack essay on rebuilding U.S. health-care economics from “sick-care” to true health delivery. Citing Medicare fee-schedule cuts, exploding costs, and tech tailwinds, they argue that incremental margin hacks are dead; only a wholesale redesign of the payment-and-care stack can keep providers solvent and patients healthy. Carewe lays out six structural “moves” — from killing fee-for-service to making data liquid and shifting hospital-level care into the living-room — and closes with three 90-day action items any operator can start today. (Read the full essay on the NerdMDs Substack).🔹 00:00 – Welcome & Why This MattersThe hosts frame the chat as a “10-minute power session” translating Carewe’s Substack into audio, warning that the current system is on a financial “burning platform.”🔹 01:22 – From Sick-Care to Health DeliveryCarewe stresses that keeping people well is now an urgent necessity for survival, not a nice-to-have. A fresh 2.9 % CMS fee-schedule cut against CPI + 5 % cost inflation shows why tweaks won’t cut it.🔹 02:48 – The Six Moves OverviewHe introduces six radical moves and warns: “Your margin … won’t save you. Your model will.”1️⃣ Kill Fee-for-Service (02:48)Volume is “officially on hospice.” Providers must swap RVUs for population-health upside payments.2️⃣ Pay for Risk, Not Visits (04:03)Capitation already touches 14 % of U.S. spend — double four years ago — and mastering RAF coding plus prevention is now table stakes.3️⃣ Make Data Liquid (05:33)The January 2025 TEFCA rule imposes $1 M fines per blocked record, forcing open FHIR APIs and edge-analytics at the bedside.4️⃣ Regulated Code Speed (07:14)New FDA “living-algorithm” guidance lets adaptive AI into care if every weight update is version-controlled and explainable—“transparency equals clearance; opacity equals 483-letter hell.”5️⃣ Shift Care Home-First (08:41)Remote sensors + 24/7 command centers turn the couch into the new ward, with hospital-at-home DRGs capturing full reimbursement.6️⃣ Retail Keeps Us Honest (10:10)Amazon-style “one-click, same-day, transparent-price” expectations mean health systems must match retail convenience or be replaced.🔹 11:19 – Three Immediate PlaysPlot your risk runway (how many PMPM lives can you manage in 12 months).Open the pipes: map every data silo and unblock within 90 days.Restage site-of-care: move one DRG home this quarter, three next.🔹 12:24 – Closing ReflectionThe episode ends urging listeners to ask what “studs are showing” in their own organizations that signal it’s time to smash, sweep, and rebuild toward a system that actually pays for health.Notable Quote: “Transparency equals clearance; opacity equals 483-letter hell.” Get full access to Rewskidotcom by Adam Carewe MD at rewskidotcom.substack.com/subscribe

Want to support Rewskidotcom Substack and the NerdMDs | Efficiency Unlocked Podcast?♻️ Share this post with friends in healthcare🫰 Become a paid subscriber📢 Become a sponsor (email me)🌟 Leave a 5-star review for the NerdMDs | Efficiency Unlocked Podcast🎧 Episode Summary:In this episode of NerdMDs Efficiency Unlocked, nephrologist and serial healthtech founder Dr. Renee Dua dives into the personal and systemic challenges of "aging while caregiving." From her pioneering days building a paperless medical practice to co-founding Heal and later Renee (a digital health assistant), she shares how her professional journey intersects with her personal experiences caring for aging parents. The conversation explores the invisible burdens placed on Gen X and Millennials, the financial and emotional toll of caregiving, and the systemic gaps in policy and innovation. Dr. Dua offers candid insights into the cultural, technological, and policy shifts needed to better support caregivers—without sacrificing their own health and future security.🔹 00:00 – Introduction & BackgroundHost welcomes Dr. Renee Dua, introducing the episode’s theme of “aging while caregiving.” Renee recounts her path from practicing nephrologist to tech founder, including launching Heal, which grew to 13 states before being acquired by Humana. Her entrepreneurial drive emerged from a desire to amplify her reach beyond “hand-to-hand” patient care.“Everybody should receive care this way—kids, moms, dads, parents—everyone in the community.”🔹 04:33 – Founding Heal & Transition to Caregiver TechRenee shares how building Heal was both exhilarating and all-consuming—launching in multiple states while raising her children. After Heal’s acquisition, she co-founded Renee, a health assistant platform inspired by her experience managing her father’s medical needs. She reflects on the inefficiency of humans doing tasks software could automate, and the deeper realization of how caregiving impacts one’s own health and finances.🔹 08:28 – The Caregiving Burden for Our GenerationThe discussion turns to the everyday challenges caregivers face—monitoring recurring medical issues, coordinating logistics, and balancing work, family, and self-care. Renee emphasizes how health and finances are intertwined, and how these pressures compound when caregivers lack medical knowledge or support networks.“We are not able to both save for college and make sure our parents don’t keep falling.”🔹 14:43 – Cultural Expectations & Uncompensated LaborRenee discusses cultural norms, such as the expectation in some Asian families that eldest daughters will care for aging parents. She points out that caregiving has been unpaid labor for so long that society assumes it should remain that way, despite its economic and emotional costs. She notes that startups in the space face a tricky go-to-market challenge, as neither employers nor insurers consistently see caregiving support as their responsibility.🔹 21:24 – Policy Blind Spots & Certification BarriersRenee critiques the lack of robust caregiver policy across political administrations and questions why informal caregivers must be certified to be recognized or compensated. She suggests caregivers could be essential partners in closing care gaps—if health plans and policymakers valued their role.🔹 26:02 – Global Models & InspirationFrom India’s multigenerational housing to Cuba’s community doctors, Renee outlines international examples of more integrated caregiving systems. She argues the U.S. could adapt similar models, combining cultural respect for elders with cutting-edge technology, but is hindered by a healthcare system designed to maximize profit over care.🔹 34:28 – Looking Ahead: Caregiver Assessment & AIWhile still in early development, Renee’s next venture aims to use AI to assess future caregivers early in life, helping them prepare financially, emotionally, and medically before the caregiving stage begins. She stresses the need for proactive planning, rather than crisis-driven response.🔹 38:29 – Nerd Alert RoundIn a lighter segment, Renee shares her love for morning walks and audiobooks (listening to 50–60 a year), her desire to master the stock market, and recent book recommendations including They Called Us Exceptional and Bono’s memoir. She also reflects on ignoring bad advice to “slow down” during fellowship—a choice that has shaped her rich, unconventional career. Get full access to Rewskidotcom by Adam Carewe MD at rewskidotcom.substack.com/subscribe

🎧 NerdMDs StackBytes Episode Summary:In this episode of NerdMDs StackBytes, host Adam Carewe explores a quiet superpower in health tech: clinical credibility. Based on his Substack piece, “Clinical Credibility: Why Every Health Tech Exec Should Still Cover Clinic”, Adam makes a strategic case for why clinician leaders—especially those building or guiding tech—should stay close to the clinic floor. More than a badge of honor, staying clinically active sharpens product judgment, preserves empathy, and ensures innovations stay relevant, not ornamental. This bite-sized episode is a reminder that credibility at the bedside translates to credibility in the boardroom.🔹 00:00 – Intro & SetupAdam kicks off with a provocative question: why do top clinician founders still take call? He introduces clinical credibility not as nostalgia or humility, but as strategy—an anchor for judgment in healthcare innovation.🔹 01:22 – Real-World Relevance in TechHe outlines the risk of becoming detached from real care environments. From glitchy systems to patient bottlenecks, staying in the trenches exposes leaders to the lived friction their products aim to solve.“If you’ve never felt the glitchy portal or lived through an overbooked primary care day, your innovation risks becoming digital wallpaper.”🔹 03:17 – The Relevance GapAdam discusses how stepping too far from clinical care weakens innovation. Tools built without context often miss the mark—elegant in theory, irrelevant in practice.🔹 05:45 – Staying TetheredHe shares how leaders—from CMIOs to AI founders—intentionally preserve their clinical touch. Whether through part-time clinics, shadowing, or patient consults, the goal is to keep their instincts sharp and their products grounded.🔹 08:12 – Credibility as Competitive AdvantageThe episode closes with a clear thesis: clinical credibility isn’t optional—it’s a moat. It differentiates builders who understand care from those who only imagine it, making all the difference in trust and traction. Get full access to Rewskidotcom by Adam Carewe MD at rewskidotcom.substack.com/subscribe

🎧 NerdMDs StackBytes Episode Summary:In this episode of NerdMDs StackBytes, host Adam Carewe explores a quiet superpower in health tech: clinical credibility. Based on his Substack piece, “Clinical Credibility: Why Every Health Tech Exec Should Still Cover Clinic”, Adam makes a strategic case for why clinician leaders—especially those building or guiding tech—should stay close to the clinic floor. More than a badge of honor, staying clinically active sharpens product judgment, preserves empathy, and ensures innovations stay relevant, not ornamental. This bite-sized episode is a reminder that credibility at the bedside translates to credibility in the boardroom.🔹 00:00 – Intro & SetupAdam kicks off with a provocative question: why do top clinician founders still take call? He introduces clinical credibility not as nostalgia or humility, but as strategy—an anchor for judgment in healthcare innovation.🔹 01:22 – Real-World Relevance in TechHe outlines the risk of becoming detached from real care environments. From glitchy systems to patient bottlenecks, staying in the trenches exposes leaders to the lived friction their products aim to solve.“If you’ve never felt the glitchy portal or lived through an overbooked primary care day, your innovation risks becoming digital wallpaper.”🔹 03:17 – The Relevance GapAdam discusses how stepping too far from clinical care weakens innovation. Tools built without context often miss the mark—elegant in theory, irrelevant in practice.🔹 05:45 – Staying TetheredHe shares how leaders—from CMIOs to AI founders—intentionally preserve their clinical touch. Whether through part-time clinics, shadowing, or patient consults, the goal is to keep their instincts sharp and their products grounded.🔹 08:12 – Credibility as Competitive AdvantageThe episode closes with a clear thesis: clinical credibility isn’t optional—it’s a moat. It differentiates builders who understand care from those who only imagine it, making all the difference in trust and traction. Get full access to Rewskidotcom by Adam Carewe MD at rewskidotcom.substack.com/subscribe

🎧 NerdMDs StackBytes Episode Summary:In this deeply personal episode of NerdMDs StackBytes, Dr. Adam Carewe opens up about the emotional complexity that followed his departure from a major leadership role at Kaiser. Expanding on his Substack essay, “The Middle Part: What I Didn’t Share When I Left Kaiser”, Adam reflects on the period of uncertainty that came after the leap—the “middle part.” This raw, unscripted episode dives into identity shifts, quiet unraveling, and the hard-won journey back to clarity and creativity. It’s a powerful listen for anyone navigating a transition and wondering why the in-between feels so hard.🔹 00:00 – Intro & Personal SetupDr. Adam Carewe introduces the episode as a deeply personal unpacking of a difficult chapter in his life. He sets the stage by referencing his recent Substack post and promises to speak candidly about what came after his big decision to leave Kaiser.🔹 01:55 – Leaving Kaiser: Clarity vs. RealityWhile Adam felt aligned with the mission and team behind his new venture in stealth, he quickly learned that clarity on a big vision doesn’t shield you from emotional upheaval. “I thought the hardest part was the decision. It wasn’t. The hardest part was what came after.”🔹 03:42 – The Drift: Emotional & Mental DisarrayHe describes a fog of micro-anxieties and identity loss that crept in post-departure. With no full-time job for the first time in his career, Adam felt scattered and unsatisfied—like his brain had “a hundred browser tabs open.”🔹 06:13 – The Wake-Up CallA pivotal conversation with his wife brings the emotional buildup to a head. He takes the GAD-7 screening tool and finally admits to himself that this isn’t just a rough patch—it’s clinical anxiety. “That only works when the engine is fine. This time, the wiring needed attention.”🔹 08:22 – Facing Mental Health: SSRI & RebuildingAdam starts sertraline and notices a major improvement in sleep, focus, and overall mood. The fog lifts, and for the first time in months, he feels ready to create again and meaningfully re-engage with healthcare innovation.🔹 10:20 – Noticing the Signs: When Silence SpeaksHe recalls how friends checked in when he stopped blogging and podcasting—a subtle but powerful reminder that absence can be a symptom. “Sometimes mental health challenges don’t shout. They whisper.”🔹 12:05 – Closing Reflections: Hope for the Middle PartAdam shares a message of encouragement for anyone in their own “middle part.” Support, vulnerability, and timely nudges can be transformational. “Problems still exist, but they feel solvable again. And fun feels a lot better than anxious and worried.”Rewskidotcom by Adam Carewe MD is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. Get full access to Rewskidotcom by Adam Carewe MD at rewskidotcom.substack.com/subscribe

NerdMDs  StackBytesA rapid‑fire audio companion to NerdMDs Substack writing—each episode packs a recent essay, insight, or framework into a 10‑minute listen. Perfect for your coffee break or between meetings, StackBytes delivers:* Top takeaways from the latest Substack @ Rewskidotcom.substack.com* Actionable tips you can apply today in clinical practice, health tech, or productivity* Concise reflections that complement the written pieceWhen it drops: Between every main podcast interview, so you never miss a fresh StackByte. Tune in, think different—and stay efficient. Subscribing ensures you catch every byte, straight from the page to your ears.🎧 StackByte Episode Summary:In this StackByte episode of Efficiency Unlocked, the digital AI hosts (courtesy of NotebookLM) shares the story behind his bold departure from a secure Chief Medical Information Officer role at Kaiser Permanente to join a healthcare startup. Framed around his Substack piece "I Left My CMIO Role to Join a Startup - And Ended up Finding My Tribe", the episode delves into themes of reinvention, fulfillment, and building systems from the ground up. It's a thoughtful narrative on how stepping away from legacy institutions can lead to discovering one’s tribe and reshaping healthcare with agility, creativity, and purpose.🔹 00:00 – Intro & SetupThe hosts introduce the episode’s theme: a deep dive into Dr. Carewe’s transition from a prestigious informatics role to startup life. They frame the conversation around questions of innovation, fulfillment, and what it means to find your professional community.🔹 01:00 – Leaving Without BurnoutDr. Carewe’s story begins with him leaving his CMIO post, not out of burnout but driven by aspiration. He reflects on a pivotal moment of silence in his car, a symbol of the major shift he was about to undertake. “It wasn’t a reaction against something bad... but being pulled toward something else.”🔹 02:00 – The Inner Voice & Bigger QuestionsThe conversation touches on the internal nudges that led to his career pivot. Rather than merely improving existing systems, Carewe felt compelled to reimagine them entirely. He started asking: “What if your next chapter is defined less by security and more by creativity?”🔹 03:00 – From Continuity to InformaticsCarewe’s journey from family medicine into health tech is outlined. His desire to bridge technology with true patient-centered care guided his work, as he championed clinician voices in tech design and innovated within the EHR landscape at Kaiser.🔹 04:00 – Cracks in the SystemDespite a successful career, Dr. Carewe began noticing “cracks”—tech adding complexity, patient journeys becoming convoluted. These realizations intensified his resolve to build anew, not just iterate on old frameworks.🔹 05:00 – Building New MusclesHe shares how he started immersing himself in the startup world, learning product, VC, and design thinking. He joined a Slack group for clinician-VCs and began absorbing insights, not through formal education but “learning by osmosis.”🔹 06:00 – The Opportunity & LeapCarewe responds to a job post in the Slack group—one that felt serious due to being shared by TJ Parker (of PillPack/Amazon fame). He joins a stealth startup focused on reinventing triage services, embracing a fast-paced, mission-driven environment.🔹 06:45 – Role & ImpactAt the startup, Carewe plays a pivotal role, serving as a translator between clinical needs and product design. He brings frontline insight while learning the startup language, contributing to the rapid success of the platform now known as General Medicine.🔹 07:44 – When the Time is “Right”The hosts reflect on Carewe’s idea that the timing wasn’t perfect, but it was “right.” The leap made sense not because of ideal conditions, but due to readiness and alignment with personal growth goals.🔹 08:40 – A New Way to Practice MedicineCarewe’s parting insight: “I didn’t leave medicine. I just started practicing it differently.” His story encourages others to see cracks as entry points for transformation and to seek out the communities that empower bold innovation.🔹 09:00 – Final Thoughts & Call to ActionThe episode ends by inviting listeners to reflect on their own paths—how might noticing the cracks in the system become the start of reimagining it? And what does it mean to truly find your tribe in professional life? Get full access to Rewskidotcom by Adam Carewe MD at rewskidotcom.substack.com/subscribe

🎧 Episode Summary:In this insightful episode, emergency physician and healthcare innovator Dr. John Dayton (LinkedIn) joins host Dr. Adam Carewe to unpack the evolving landscape of physician upskilling. They explore how clinicians can thrive beyond traditional clinical roles by leveraging communities, embracing digital tools like AI, and rethinking medical education. From crafting personalized discharge instructions to advising health tech startups, Dr. Dayton shares how intentional career design, continuous learning, and professional risk-taking can empower physicians to shape the future of medicine on their own terms.Episode Resources:* Physician Upskilling Resource* Dr Dayton’s Slide Deck🔹 00:00 – Introduction & John's Career JourneyAdam introduces Dr. Dayton, highlighting his unique blend of emergency medicine, entrepreneurship, and policy work. John shares his path from clinical practice to health innovation, emphasizing the importance of designing a fulfilling and intentional career.“You have to be careful. We all have the same amount of time... but at some point, you realize what your priorities are and how your life should be.”🔹 07:50 – Do You Need an MBA?The duo explores the role of formal education like MBAs in non-clinical physician careers. John shares his tailored experience in healthcare innovation and venture capital and reflects on whether degrees are necessary or if curated resources and learning communities can suffice.🔹 14:15 – Modern Medical Education & AI ToolsJohn discusses the shift from textbooks to digital learning, advocating for tools like OpenEvidence and AI models to enhance decision-making and personalized care. They examine how today’s physicians must balance foundational knowledge with real-time, tech-enabled insights.🔹 21:30 – The Upskilling Resource GuideJohn dives into the upskilling guide he co-created—a crowdsourced list of tools, communities, and conferences to help clinicians explore health tech, policy, social media, and business. The guide aims to make self-directed learning approachable and actionable.“A lot of physicians want to know about medical business... and this guide gives them a starting place.”🔹 29:40 – Finding Community & Creating OpportunitiesJohn emphasizes the importance of finding your "tribe"—from attending conferences like HLTH and NextMed to joining groups like Physician Side Gigs. He shares how proactively reaching out—like cold messaging Jonathan Bush—led to impactful advisory roles.🔹 37:10 – When & Why to UpskillThey reflect on personal burnout, the employee-physician dynamic, and the need for career reinvention. John explains how COVID, professional stagnation, and a tragic colleague’s passing inspired his own pivot into innovation and VC.🔹 44:20 – Filtering the NoiseThe conversation shifts to how to stay focused when exploring new interests. John suggests aligning new ventures with personal values and long-term goals and starting small—advising a startup, joining an angel group, or enrolling in a micro-course.🔹 50:30 – Nerd Alert RoundIn a lightning round, John shares his ambition to master venture capital, how he's using AI to personalize patient discharge instructions, and the underrated power of finishing every patient encounter with a well-crafted final impression.“If their cast is janky, they’ll think I didn’t know what I was doing—even if I set the bone perfectly.”Rewskidotcom by Adam Carewe MD is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. Get full access to Rewskidotcom by Adam Carewe MD at rewskidotcom.substack.com/subscribe

🎧 Episode Summary: In this episode of Efficiency Unlocked, hosts Dr. Adam Carewe and Dr. Dale Gold welcome Dr. A. Alexander and Dr. Brian Tsui, co-founders of CoreViva, a health and wellness startup pioneering next-generation whole-body MRI. Both experienced radiologists and physician-entrepreneurs, Drs. Alexander and Tsui share their motivations, personal stories, and the clinical and technological foundations behind CoreViva. They highlight how AI-enhanced imaging, faster scan protocols, and patient-centric design address long-standing challenges in early detection, false positives, and healthcare navigation. Listeners will gain a deep appreciation for how CoreViva is setting a new standard in preventative care—blending precision diagnostics with compassionate follow-through. This is a company that co-host Dr Adam Carewe became an early investor in as well, recognizing the potential for this technology in health and wellness and the future of medicine.🔹 00:00 – Intro & Background The episode kicks off with introductions of Dr. A. Alexander (CEO) and Dr. Brian Tsui (CMO), both decorated radiologists with entrepreneurial flair. Host Adam Carewe discloses his investment in CoreViva, emphasizing his conviction in their approach and inviting even skeptical listeners to hear them out.🔹 03:20 – Personal Journeys to Radiology and Innovation Alan and Brian share their unconventional paths into radiology and tech innovation. Alan reflects on his time at McKinsey and his frustration with non-patient-centric systems. Brian recounts how radiology's tech-forward nature drew him in and how gaps in patient outcomes sparked his desire to found a better solution.“I get angry when I see things that are not being done in a patient-centric way.” – Dr. A. Alexander, MD, MSc🔹 07:15 – Personal Stories Driving Early Detection The founders recall real-life cases of friends and patients who suffered from missed or delayed diagnoses. These stories underscore the emotional drive behind CoreViva’s mission—making early detection accessible, accurate, and actionable.🔹 12:01 – Why CoreViva Now? Brian outlines three main industry issues: lack of physician leadership, inconsistent image/report quality, and poor follow-up care. CoreViva tackles all three by building superior imaging, using clear reporting, and including direct radiologist consultations.🔹 17:06 – What Sets CoreViva Apart They explain their unique edge: faster scan times (~35 minutes), highest-quality images, and comprehensive reporting using custom AI. These advances reduce false positives/negatives and empower patients with understandable, actionable data.“We’re using AI at every level—from scan to interpretation to report.” – Dr. Alan Alexander🔹 23:45 – AI and Augmented Radiology The team dives deeper into how their AI augments radiologist efficiency and accuracy. It automates tedious tasks like fat and muscle segmentation, improves lesion detection, and supports seamless physician communication.🔹 28:01 – The Core Score & Ongoing Monitoring CoreViva introduces a "Core Score" assessing brain, musculoskeletal, and visceral fat health—offering a personalized baseline that patients can track over time. They envision regular annual scans becoming a wellness standard.🔹 30:33 – Physician-Led, Patient-First Model The conversation emphasizes their physician-backed, VC-free approach. Over 20 physician investors and a broad advisory board ensure CoreViva stays grounded in real clinical needs, not just tech hype.🔹 35:16 – Early Results and Impact In testing over 100 healthy volunteers, CoreViva found life-threatening or significant findings in 10%—a statistic that compelled even the founders to scan themselves. Their early impact validates the value of proactive, whole-body diagnostics.🔹 37:50 – Ideal Users and Population Trends While targeting adults, CoreViva especially sees value for health-conscious individuals seeking peace of mind and longevity. They also note that younger age groups are increasingly affected by serious conditions once considered age-related.🔹 39:52 – Future Vision and Reflections The team imagines a Star Trek-style future of instant diagnostics and sees CoreViva as a stepping stone toward that vision. They close with personal insights, humor, and aspirations—from surfing to jiu-jitsu to mastering violin.“Know your body.” – Dr. Alan Alexander Get full access to Rewskidotcom by Adam Carewe MD at rewskidotcom.substack.com/subscribe

Jay Parkinson, founder of Automate Clinic, is a pioneer in digital healthcare, known for his innovative house call practices. He shares insights on reshaping primary care and the transformative role of AI in clinical workflows. The conversation delves into his journey of integrating technology with medicine, emphasizing the importance of personal communication in healthcare. Jay discusses the challenges of automation and AI, highlighting the need for genuine interdisciplinary collaboration. Listeners will be inspired by his visionary approach to improving patient care.

🎧 Overall Summary:In this episode, Dr. Jackie Gerhart, VP of Clinical Informatics and Chief Medical Officer at Epic, joins Adam and Dale to discuss how Epic is transforming healthcare through generative AI, interoperability, and data-driven tools like Cosmos. She shares her journey from family medicine into health tech and offers an inside look at how Epic is using technology to reduce clinician burden, personalize care, and shape future healthcare policy.🔹 The Person – Dr. Jackie Gerhart’s Journey to Epic (00:00–09:50)Jackie shares her path from biomedical engineering into medicine, driven by a passion for solving problems with people rather than machines. She practiced full-scope family medicine for 7–8 years before transitioning into informatics at Epic to make broader system-level impact. She continues to practice urgent care to stay grounded in real-world clinical needs.🔹 The Company/Product – Epic’s Physician Role, Mission, and Evolution (09:51–21:15)Jackie outlines how Epic physicians evolved from demoing software to becoming strategic partners and informaticists influencing product development, R&D, and customer support. She emphasizes Epic’s commitment to usability, patient-centered design, and building tools that are meaningful, efficient, and clinically impactful.🔹 Under the Hood – GenAI, Ambient Tech, and Smart Integration (21:16–35:55)Jackie dives into how Epic is using generative AI across the healthcare stack. Applications include AI-powered ambient charting, inbasket automation, clinical summarization, and decision support. She emphasizes the need to match tech with organizational problems and to avoid jumping on “shiny object” solutions without a clear use case.🔹 The Data Behind the Product – Cosmos and Precision Care (35:56–48:50)Cosmos, Epic’s collaborative dataset of 293 million patient records, is now powering decision support at the point of care. Tools like Best Care Choices for My Patient and Lookalikes allow providers to tailor treatment plans or diagnose rare conditions by comparing patient-specific data to nationwide trends. Future aspirations include patient-facing tools to promote shared decision-making and personalized guidance.🔹 Policy, Interoperability & TEFCA (48:51–56:50)Jackie shares Epic’s historical commitment to interoperability, sparked by a tragic story that led to the creation of Care Everywhere. She explains Epic’s leadership role in TEFCA, which aims to establish common data standards across EHR systems, and how this framework will bring long-tail providers and digital health vendors into the fold.🔹 The Future of Healthcare & What Excites Jackie (56:51–59:30)Jackie envisions a world where empowered patients and AI-informed clinicians collaborate with precision data to make truly personalized medical decisions. She wants medical education to reflect this dynamic and constantly updated reality.🔹 Lightning Round – Nerd Alert (59:31–End)Jackie shares:* Favorite productivity hack: Using ChatGPT and Copilot; clinically, she loves chart search and Epic’s secure messaging.* Last book/podcast: Good to Great, Brotopia, and a STAT podcast on JPM 2024.* Comfort food: Popcorn, pasta, matzo ball soup, and nostalgia for Blue Moon ice cream.* Surprising fact: She was once bitten by a penguin in South Africa!* Must-have tech (non-phone): Podcasts and online learning platforms—critical for lifelong learning in medicine. Get full access to Rewskidotcom by Adam Carewe MD at rewskidotcom.substack.com/subscribe