Creating a New Healthcare

If you have not been following the great leap forward that the American Medical Association (AMA) has made over the past 5 years, then you’ve been missing out on something quite spectacular.  It’s phenomenal, and phenomenally told to us by the President-elect of the AMA, Dr Barbara McAneny. What you’ll discover in this interview is that the current AMA is not your father’s or mother’s AMA.  This is a bold organization that is attempting to launch the profession into the future. The breathtaking strategic initiatives and dramatic progress you’ll hear about may represent the largest inflection in the AMA’s history since the Flexner Report transformation over a century ago.  And, Dr. McAneny is, in her own right, an impressive & inspiring example of leadership. She has distinguished herself many times over as a community-based oncologist, as well as a leader on the national healthcare scene. Here are a just a few snippets of the many forward thinking trajectories that you’ll hear Dr. McAneny expound upon in this interview: People want health and are not necessarily interested in healthcare, so the AMA has been focusing on improving health outcomes through the creation of their “innovation ecosystem” network. Patient outcomes are affected as much by their zip code as by the quality of the healthcare we offer; so it’s critically important to understand, measure and intervene on the social determinants of health. Medical care is no longer just an individual clinical endeavour, and will require highly collaborative partnering which combines medical science with digital technology, health economics, analytics and an understanding of patient behavior and socioeconomic factors… In this episode, Dr. McAnaney will also describe three major strategic arcs the AMA is focused on: First – the AMA’s (moonshot) “innovation ecosystem” network – a broad expanse of initiatives and highly progressive partnerships the AMA has engaged in to radically improve healthcare and health outcomes.  It’s astounding to hear the sheer number of highly collaborative partnerships the AMA has formed with start-ups, accelerators, venture capitalists, tech developers & other organizations – in order to bring the physician sensibility to the development of new health technologies & digital technologies.  The AMA has begun to act like an innovation convener – proactively partnering with companies such as IBM Watson, GE, Intel, the Scripps Institute, Partners Center for Connected Health, Intermountain Healthcare and Omada Health. Second – the AMA’s strategy to transform medical education by creating “the medical school of the future”.   In this initiative – the ‘Accelerating Change in Medical Education’ Consortium – they’ve funded medical schools to create forward-facing curriculum and training programs.  The goal is to create the ‘physician of the future’ – not only knowledgeable in the science & art of medicine, but also steeped in the science & art of management, leadership and systems thinking.  At present there are over 30 medical schools involved, collectively representing a quarter of all medical students in this country. Third – the AMA’s focus on physician burnout and sustainability.  Approximately 50% of physicians are burnt out according to numerous studies; and physicians daily spend over an hour on burdensome administrative work for every hour of direct patient contact.  Dr. McAnaney emphasizes that it’s hugely wasteful and demoralizing to have the most highly trained and costly human resource in healthcare function as data clerks for hours each day. Of note and underscoring this point, HHS Secretary Alex Azar recently stated, “Its the patients who suffers when a provider spends more time reporting quality measures than delivering quality care”. Dr. McAneny compellingly advocates for the removal of these and other stressors, as a way to reduce physician burnout and improve healthcare.   I came away from this interview with a renewed appreciation and admiration for the AMA and its mission; and with a profound respect and gratitude for the vision, integrity and selfless commitment that Dr. McAneny has manifested throughout her career. Dr. McAneny shares numerous pearls of wisdom throughout the interview – transformational inflections that you’ll want to listen to – likely, more than once. As always, I hope you get as much out of this as I have! Zeev

Our guest this week, Glenn Steele MD PhD, is one of the most trailblazing, impactful and enduring healthcare leaders of our time.  He is a distinguished surgeon, researcher and executive.  Dr. Steele served as past Chairman of the American Board of Surgery, past president of the Society of Surgical Oncology, and a member of the National Academy of Medicine.  He has been named consecutive times to Modern Healthcare’s Most Powerful Physician Executives in Healthcare, Modern Healthcare’s 100 Most Powerful People in Healthcare & Beckers’ Hospital Review 100 non-profit Health System CEO’s to know list. Dr. Steele, former President & CEO of Geisinger & currently the Chairman of xG Health Solutions; and his colleague, the current President & CEO of Geisinger, David Feinberg MD recently co-authored a book entitled ProvenCare – How to Deliver Value-Based Healthcare the Geisinger Way.  In this interview we will uncover the major components of the ProvenCare model.  It’s a great peak under the hood of one of the best healthcare systems in the world. What you’ll discover in this interview will include: Dr. Steele’s 3 fundamental approaches to “emancipating value” in healthcare. Geisinger’s ProvenCare Acute – a protocol so reliable that Geisinger offers money-back guarantees on procedures like coronary artery bypass surgery, and hip and knee replacement surgeries. Geisinger’s ProvenCare Chronic – an approach to providing consistently high quality, patient-oriented care for chronic conditions such as diabetes, high blood pressure and asthma. Geisinger’s  uniquely bold approach to achieving outstanding outcomes in chronic disease management – one example being their ‘all-or-none’ diabetes bundle. Geisinger’s ProvenHealth Navigator – a comprehensive approach that includes Primary Care Redesign, Population Health Management, and Medical Neighborhoods. Geisinger’s ‘sweet spot’ – the integrated vertical alignment of payer/insurer & provider that has allowed them to create a powerful synergistic system for value-based care. This interview also highlights Dr. Steele’s hard-earned wisdom, which played a critical role in the repeated and sustained successes at Geisinger.  He shares a number of memorable pearls during our dialogue.   One example is his commentary on how “scaling” innovation is, in his experience, much more challenging than creating the innovation itself.  Another related example is, in his own words: “how you do the ‘sociology for change’ is actually even more important than the substance of the change”.  His explanation of these statements have profound implications for anyone interested in or working on the transformation of healthcare. You’ll also hear about the groundbreaking work Dr. Steele is doing in his newest role as Vice Chairman and clinical leader at the Health Transformation Alliance (HTA), an alliance of over 40 U.S. Corporations composed of over 6 million employees, with an annual healthcare spend of over $25 billion.  In this role, Dr. Steele, and his colleagues at HTA, are demonstrating to employers and employees that they can lower the cost of care by over 25% and decrease the risk of heart attacks, strokes and other end-stage outcomes of chronic disease – by guiding medical care to physicians within the Alliance who are using the ProvenCare model. The Geisinger ProvenCare story is one of the best in the annals of American Healthcare; and in this interview, it’s told by one of the most proven healthcare leaders. As always, I hope you get as much out of this interview as I have! Zeev

This week’s episode, on employer-based healthcare, deals with one of the most critically important & rapidly advancing issues in American healthcare today. Our guest this week is Dave Chase. He is a highly successful serial entrepreneur – who, among numerous other accomplishments, played a leadership role in launching Microsoft’s $2B healthcare platform. Dave has been named as one of the most influential people in Digital Health, and is known for the boldness and integrity of his speaking and writing. A hallmark of Dave’s approach, as you’ll hear in this interview, is his refusal to pull any punches. Over the past few years he has been on a quest to understand and address the impact of the growing costs of healthcare on employers, employees, as well as the deleterious downstream impact on our municipalities and the national economy. Keep in mind that nearly half of all healthcare costs in the U.S. are paid for by employers and increasingly shouldered by employees. Fortunately, Dave and his colleagues, as well as numerous others around the country, have been working to optimize the effectiveness & enhance the efficiency of healthcare delivery, as well as to very intentionally reduce the significant unnecessary costs of care. To this end, Dave and his colleagues have formed a non-profit called Health Rosetta, whose purpose is to drive the “adoption of successful strategies and practical tactics to fix the healthcare system through the optimization of employer health benefits programs & healthcare purchasing.” It’s essentially an open source education, training and certifying resource for employee health. In this episode, you’ll learn about Health Rosetta’s “7 Habits for highly successful employers” – the proven solutions that Dave has discovered and collected.  We’ll also discuss the critical role that “value-based primary care” and “centers of excellence” (high performing provider groups) play in reducing unnecessary healthcare costs for employers. Dave has the refreshing perspective that most of the solutions are already out there – they just need to be identified and deployed effectively. Dave also shares several encouraging examples of employers who have implemented these relatively straightforward initiatives, and reaped huge savings, which return to their bottom line and enhance their ability to extend greater benefits to their employees and their communities. It’s a real treat to hear Dave discuss these topics with sincerity and fact-fueled passion; but, if you’d like more detailed information, I would encourage you to visit the Health Rosetta website and/or download a free digital copy of his book, “The CEO’s Guide to Restoring The American Dream – How To Deliver World Class Healthcare to Your Employees at Half the Cost”. Although this interview begins with some stark economic realities and a disturbing vision of a potential future, it ends with a hopeful message.  Dave’s call to action is simple – join the value-based movement.  Dave is practical, purpose-driven, compassionate healthcare leader who brings fresh perspectives, fearless honesty and a selfless commitment to, as he puts it, “leave the world a better place for my kids than the current trajectory.” His work in the domain of employer-based healthcare is a critical endeavor to make a highly opaque and misaligned part of healthcare delivery more transparent and more sensible. I hope his story and his mission inspires you, as much as it has me. Zeev

This week’s interview is an expose in modern medical professionalism and perspectives on what will be required for the next era.  Our guest this week, Richard Baron, is a physician grounded in nearly three decades of direct hands-on clinical care and enlightened by his experience of participating on numerous national level workgroups such as at the National Quality Forum, the National Committee on Quality Assurance, the Center for Disease Control, The Commonwealth Fund & The Aspen Institute Health Strategy Group – as well as a couple of years at the Centers for Medicare & Medicaid Innovation Center, leading initiatives in accountable care and primary care redesign.  He currently is the CEO of the American Board of Internal Medicine (ABIM), which has had its fair share of controversy. Richard has a deep and broad perspective on healthcare delivery.  But more than that, he’s a remarkably and refreshingly independent-minded thought leader, and a dedicated, passionate public steward for American medical professionalism.   Dr. Baron reminds me of the many dedicated, hard working, thoughtful primary care physician leaders whom I meet regularly.  Like these high-integrity physicians, his focus is on the broader continuum of patient care – on patients & patient care, first & foremost; and then secondarily on sustaining providers.  His vision is consistent with the “quadruple aim” of better health, better care experience, better value & better support for providers.  He is an ardent champion for maintaining and elevating the standards & quality of medical care; and a vocal advocate for the critical central role of primary care in any value based healthcare system.   Richard studied English at Harvard College, and then received his MD degree from Yale.  I’m not sure if it’s his liberal arts background that has given him the ability to tease out and integrate complex themes and narratives; but I do admire the new narrative he is attempting to construct at the ABIM.  He is currently focusing his efforts on listening to the varied voices and myriad perspectives of the ABIM’s physician constituents; and seeking to understand how to recognize, celebrate and reward both the tangible and intangible benefits of the the doctor and the doctor/patient relationship.   He is keenly and realistically aware of the very real tensions of our times, and rather than ignore or polarize, he is seeking to balance.  Richard exposes the tension between science & service, between payment and prioritizing value-based patient care, between clinical medicine and community care.  He is clearly a defender of the scientific & technological narrative of healthcare – the ABIM’s purpose being to maintain professional knowledge and competence.  But, he is also seeking to support the integration of complementary narratives such as the importance of doctor/patient communication, continuous quality improvement, data-driven health management, and the empathetic skill and emotional work that is crucial in healing relationships.   This interview reveals the story of an individual physician, innovator & leader – who is attempting to do what many of us are struggling to do – to infuse & sustain ourselves, our colleagues, our professions, and our institutions with humanism, humility, meaning and purpose; and to do so in an increasingly complex world that is becoming, of necessity, more corporatized, institutionalized and standardized.   Above all else, what comes across in this dialogue is Dr. Baron’s strong sensibility that it is an incredible privilege to be of service to others – to have the gift of being able to alleviate the suffering of our patients and our communities through the practice of the art & science of medicine.   This is a story you shouldn’t miss out on.  As always, I hope you gain as much from this interview as I have!

On the surface of it, this week’s podcast is about a new migraine solution.  But, the bigger story here is really about reframing how we think about chronic disease management and rethinking the importance of self-reported patient health data.  This story is also about the power and elegance of simplicity; the value of customer discovery and agile prototyping; and the absolute primacy of paying attention to the user interface interface/consumer experience. What’s particularly refreshing about the way this product was created is that it was developed through listening to patients and providers.  Listening to patients, who define value; and to providers, who create it – and being open to continuously revamping one’s design based on what one is hearing and observing.   This week’s guest is Dr. George McLendon.  George has an impressive academic & entrepreneurial background.  He’s published over 200 research papers in chemistry, physics & biology; and holds multiple patents, which has led to the founding of several successful life science companies. George and his colleagues at SensorRX focused on headaches for a number of reasons.  Over 40 million people in the U.S. and nearly 1 billion people worldwide suffer from migraine headaches – making it one of the most prevalent chronic medical conditions.  The impact on U.S. employers is also profound – reaching tens of billions of dollars a year in medical costs and lost productivity.   The customer discovery process that George and his team took led them to a number of observations and learnings. Here are a few of their discoveries you’ll hear about in this interview: Physicians made their decision about which migraine medications to use, and the medication dosing based on only 4 or 5 pieces of patient reported symptoms. Patients grossly under reported their symptoms – more specifically, the frequency and intensity of the headaches they had been experiencing.  In their studies, the SensorRX team discovered that well over 50% of patients were under reporting their symptoms! As a result of this under reporting, providers were under treating the migraine headaches – leading to months and years of prolonged headaches.  It was this key pivotal discovery – the critical importance of reliable self-reported patient health data – which became the centerpiece of their solution. Patients would not use an app that took longer than 15 seconds to record and document their symptoms.  People wanted a quick and easy product. These realizations led the team to construct an app that literally takes 12 – 15 seconds to use each time a patient has a migraine.  The app records the necessary pieces of data; and can convey that info to the treating provider in a number of ways that makes it easier for the provider to treat the patients’ headaches more appropriately.   In their unpublished trials to date, the team has witnessed an overall improvement in quality-of-life scores of over 30%, with many patients seeing much greater improvements.  This standardized quality-of-life survey – known as MIDAS – measures the negative impact headaches have on one’s work and social life. Clearly, the efficacy has yet to be proven in more rigorous, peer-reviewed studies; but the anecdotal reports to date are compelling.   George and his team are also applying this approach to other conditions – such as asthma, irritable bowel syndrome, epilepsy and emphysema… conditions in which patient reported health data play a critical role in determining how physicians treat their patients.   There is another part of this story here that shouldn’t be lost – Dr. McLendon’s intention.  One only need listen to his telling of the story of ‘Sally’ and her daughter to appreciate that his overarching mission is to alleviate the avoidable suffering of patients with chronic conditions. This is a trait shared by most of the leaders and innovators interviewed on this podcast series.  The lesson here may be that empathetic purpose & intention are key factors in redesigning successful healthcare solutions from the consumer/patient perspective.  And, that may be one of the most significant lessons we can derive from this and other episodes of ‘Creating a New Healthcare’.

This week’s podcast is about the critically important issue of patient suffering & professional caregiver suffering.  This particular episode will speak to you, not only from a professional perspective, but also from a deeply personal one.  If you have ever been a hospitalized patient, or a family member of a patient; or, think that you might someday be a hospitalized patient or family member of a patient, you’ll want to listen to this interview.   Our guest this week is Christy Dempsey, the Chief Nursing Officer for Press Ganey Associates, who has recently authored a book entitled, ‘The Antidote to Suffering: How Compassionate Connected Care Can Improve Safety, Quality, and Experience’.  Christy has over three decades of experience as a nurse, nurse leader, hospital executive, and a consultant with deep experience in clinical operations, process improvement & patient experience.  Her approach is comprehensive and balanced; and her prescriptions are practical, and grounded in the practice of medicine, as well as in the science of process improvement and business management.  Her stories range from heart breaking to incredibly hopeful.   In this episode, you’ll learn about the ‘Compassionate Connected Care’ model that Christy has constructed and is deploying in hospitals across the country.   You’ll also come away with some amazing pearls & actionable take aways.  Here are a few examples: There are two types of suffering – inherent & avoidable; and caregivers often, unknowingly, contribute to or worsen the avoidable suffering that patients and their families experience in the hospital. People from different backgrounds and with different conditions have different susceptibilities to suffering – and knowing the specific painful issues can assist in creating a targeted plan to alleviate that suffering. It doesn’t take a lot of time to alleviate suffering – caregivers can make a strong personal connection with patients in less than a minute or two – what Christy calls the ‘56 second rule’. Professional caregivers – similar to patients – experience both inherent and avoidable suffering or distress; and if we want to alleviate patients’ suffering, we’ll need to make the alleviation of caregiver suffering a major part of our plan. Caregiver resilience is a balance between inherent/added distress and inherent/added reward.  Our goal should be to tip the balance in favor of rewards vs distress.  Christy also introduces us to the concept of ‘Emotional Labor’ and its impact on caregiver resilience & patient experience. Patient distress/suffering is not about professional caregivers being ‘nice’ or creating a ‘wow’ experience.  It’s also not about hitting the patient experience metrics on your hospital’s scorecard.  This is an integral part of clinical care & core to our professional ethic; and closely tied to quality & safety outcomes such as infection rates, hospital length of stay, readmission rates… Christy is a passionate, highly expert and convincing champion for the cause of alleviating patient & professional caregiver suffering.  What I admire most about Christy, and what she’s doing, is her courage and commitment in speaking out and doing something about a very sensitive issue that most don’t recognize or want to discuss.  Christy definitely joins the pantheon of leaders I’ve interviewed who have devoted their careers, and lives, to creating a new healthcare! As always, I hope you get as much out of this as I have!

This episode is about nothing less than elevating the human condition at the forefront of healthcare delivery.  It is about enriching and empowering professional caregivers through real-time written feedback from the patients they care for, so that they can, in turn, create a sustained culture of caring, comfort, compassion, trust and safety for patients and patients’ families. The solution we’ll discuss this week focuses on directly recognizing & appreciating the professionals and staff who are, all-too-often, the unsung frontline heroes of healthcare delivery. Our guest this week is Alex Coren – a female entrepreneur, inventor, digital tech wizard & international speaker who was named #1 female student entrepreneur in the U.S.   In 2016 she formed a company called Wambi.  In 2017, she formed Carepostcard and Humans of Wambi – two other products which elevate humanism in healthcare.  Her overarching mission is to catalyze what she has named, ‘The Compassionate Care Movement’. Alex is an impressive and inspiring leader.   She is a powerhouse of purpose, passion & productivity.  What she is doing to improve care in the acute and post acute setting is so simple and so ingenious that you’ll wonder why no one has thought about this or done it up until now.  Her personal story is equally as compelling, and provides some explanation for what catalyzed her to create such a unique and innovative contribution.  Alex grew up with two parents who were chronically ill – constantly in and out of the acute care healthcare settings.  Over the course of years, she observed, up close and personal, the essential vulnerability and dependence of being a patient in the hospital setting. As a result, she developed a tremendous gratitude, respect and deep admiration for those frontline caregivers that worked tirelessly to care for her parents, and for her. It may come as no surprise, that her first job was in an acute care facility, being a manager responsible for patient experience.  What she observed in this role – to her surprise – was the widespread depersonalization that frontline providers & staff experienced – literally the sense of ‘not being seen’ or recognized.  She also observed the outcomes – which included depersonalized care, lower patient satisfaction, worse outcomes of care, low employee morale, and an extremely high staff turnover rate. Out of these challenging experiences as a child, her early empathetic professional observations, and her brilliant and bold mind, she created Wambi.  Wambi is a patient-driven, healthcare employee performance platform aimed at recognizing and empowering compassionate care.  It uniquely addresses patient satisfaction where it starts – with the care providers – through the eyes of patients and their families.  It’s a gamified digital platform informed by real-time patient/family feedback, which supports care providers with individualized patient/customer experience data as a means to promote autonomy and inspire sustained behavioral change.   This product serves to improve care provider engagement, decrease staff turnover and burnout, and elevate the patient experience.  And it works.  The hospitals her team have deployed the Wambi platform in have experienced up to a 20% decrease in staff turnover within 5 months times; a 30 to 40% increase in staff engagement, and double digit increases in HCAHPS scores. Alex Coren and her team come at this serious & long-standing problem in healthcare with a fresh perspective and a new set of solutions.  This is an essential ‘must-listen’ podcast interview for any manager and/or leader involved in hospital, post acute care or home healthcare, who wants to create a culture of compassion. The contents of this interview are compelling enough.  But there is more to the story.  This dialogue with Alex is a profound lesson in leadership – a lesson in the art of simplicity, gratitude, courage and conviction.  Alex’s sense of purpose is palpable.  Her bold entrepreneurial spirit, and the humanistic mission she and her team are on, are hugely inspiring.  In this interview, I ask her for her secret ‘super-power’.  It’s well worth the listen just to hear her response to that question. I hope you appreciate and benefit from this dialogue as much as I have!

In this episode of Creating a New Healthcare, Dr. Zeev Neuwirth interviews Kyra Bobinet MD, CEO & founder of engagedIN – a healthcare behavior design firm which uses neuroscience and state-of-the-art design techniques that make products and communications more engaging for consumers.  Kyra has an impressive background in developing health apps, blockbuster products, and evidence-based programs in wellness & metabolic medicine.  Prior to founding her own company, she served as a physician executive at Aetna, where she designed large-scale population health management and wellness interventions for Fortune 500 companies.  In 2015, she authored the ‘Well Designed Life: 10 Lessons in Brain Science and Design Thinking for a Mindful, Healthy, and Purposeful Life’.  In addition to her companies work, she also co-teaches patient engagement and health design with Dr. Larry Chu at the Stanford School of Medicine.   This podcast episode is a critically important to anyone interested in patient engagement & behavior change.  Kyra has spent years studying and combining the most up-to-date, evidence-based brain science, behavior change and design thinking – and embedding them in healthcare programs and products.  You will come away from this interview with a very different understanding of behavior change.  As Kyra puts it, “we have learned more about the brain and behavior in the past 5 years than in the previous 5,000 years – offering the potential and power to reach, influence and improve health and well-being at scale”. There are  a number of pivotal learnings to be gained from this interview.  Here are a couple. One of the most compelling advantages of Dr. Bobinet’s approach is the absence of blame, shame or guilt.  In this model, there is no sense of personal failure.  If there is a failure, it is in the behavior design, not in the provider or patient; because the intent is not in manipulating or psychologizing the individual; but rather in manipulating the design. Another advantage to this approach is that it’s based on brain science.  Kyra describes a part of the brain called the Habenula.  It’s purpose is to prevent us from repeating behaviors that might harm us.  As Kyra describes, the Habenula is essentially a ‘failure counter’.  If we perceive a failure – like in trying to lose weight or starting some new exercise regimen or eating healthier – the Habenula downgrades our motivation.   So – not only do we not achieve the intended behavior change, we also feel bad about it, and are demotivated to try something else.  The Habenula pathway is literally a physiologic demotivator.  Realizing the unintended consequences of this evolutionary neural pathway, the Design approach attempts to side-step the Habenula’s failure mode.  If we perceive a design attempt as an externally located learning experience, rather than a personal failure, the Habenula failure counter and cycle of suffering is far less likely to be activated. The Design approach transforms behavior change from compliance-based to creative-based.  And, this is not a theoretical model.  It is a practical one that has been deployed in industry and in healthcare.  Kyra describes how companies like Facebook use this creative iterative approach.  She also shares some of her own projects that have deployed this approach. There are numerous pearls, parables and personal takeaways that Kyra offers up in this interview.   Kyra is, above all else, completely genuine and authentic; and therefore her voice is incredibly compelling.  It’s truly a delight and a privilege to share this interview with you.

In this episode of Creating a New Healthcare, Dr. Zeev Neuwirth interviews Len D’Avolio, CEO and founder of Cyft – an organization that uses data and Artificial Intelligence (AI) I to make value-based care wildly successful.  Dr. Len D’Avolio has spent the past 13 years – in government, academia, philanthropy and industry –  attempting to transform healthcare into a “learning healthcare system”.  He is clearly one of our country’s most talented minds and experienced practitioners in the use of predictive analytics and machine learning as applied to healthcare. His resume and portfolio are impressive – as an academic and an entrepreneur.  Len is an assistant professor of medicine at the Brigham & Women’s Hospital and the Harvard School of Medicine.  He has worked with superstars like Atul Gawande, deploying global healthcare projects.   Len also created the infrastructure for the world’s largest genomic medicine cohort; and embedded the first clinical trial within an electronic medical record system for the Department of Veterans Affairs.  He’s a highly sought after and nationally recognized keynote speaker, and serves as an advisor to numerous healthcare start-ups.   If you want to understand AI in healthcare – both the opportunities and the limitations – you’ll want to listen to Dr. D’Avolio’s deep knowledge and honest practical take on things.  Len characterizes healthcare largely as treating data as ‘exhaust’, whereas other industries treat data like it’s their oxygen or their life blood.  Whereas other industries understand how to use advanced data analytics to inform their daily decisions for the purpose of optimizing performance, healthcare remains years behind. What we’re talking about here is ‘moneyball’ – using advanced mathematical algorithms embedded in software programs that affords practitioners in any field the ability to make much more informed decisions – whether that field is finance, sports, retail, social media or medicine.  The ‘machine learning’ or ‘neural network’ part of it speaks to the capacity of these software programs to create probabilistic inductive hypothesis from enormous amounts of data – clearly something the unaided human mind can not do.  This may be the ‘rocket science’ of our era; but it’s not magic.  In this interview Len dispels the mystery & myths surrounding AI.  He likens it to a tool.   A hammer does not build a house – carpenters do; and so-called AI or supervised machine learning does not cure cancer – scientists and physicians do.   According to Dr. D’Avolio – and his expert colleagues, there is no magic to AI.  This is not some plug-and-play ‘black box’ that can be let loose to solve all the problems in healthcare.  It is not an independent sentient ‘artificial intelligence’ that will somehow supercede and substitute for physicians or physician scientists.  To anthropomorphize this technology is fantasy.  These tools require tremendous amounts of human expertise & attention – both technical and clinical – to program and manage – hence the term ‘supervised’.  Len also dispels the myth that one algorithm can be applied across the board to numerous use-cases.  The current reality is that it might require a team weeks, if not months, to create a program for a specific condition or situation.   On the other hand, what these tools can help us accomplish is profound and amazing.  There is little doubt that this field will transform healthcare delivery – allowing us to deliver much better care at a much lower cost – optimizing outcomes and customizing medical care.  There is little doubt that this field will transform the way medicine is practiced – assisting physicians and other providers in ways unimaginable.  And, this is not the future – it’s now.  Len shares some examples of these benefits.   This is an enlightening and inspiring interview in which we synthesize and distill the years of Len’s hard-earned practical wisdom into an hour’s time.  You will leave the interview with a greater understanding of machine learning, predictive analytics, and AI in healthcare; and will now be aware of and connected to one of the leading figures in the field.  

In this episode of Creating a New Healthcare, Dr. Zeev Neuwirth interviews Roy Rosin, the Chief Innovation Officer at Penn Medicine – the University of Pennsylvania Perelman School of Medicine.  Roy distills the “essence” of his two decades of success in customer behavior change & reveals some of the most critical ingredients. He has spent the past 5 years at PennMed – initiating over one hundred new healthcare delivery projects.  Prior to entering healthcare, Roy spent 18 years at Intuit (Quicken & TurboTax), where he was an accomplished executive and then Intuit’s first Innovation Officer. Intuit has been widely recognized for its application of innovation to enhance business outcomes, and Roy was clearly instrumental in that. Roy brings to healthcare a profound acumen in digital technology, human-centered design & super-rapid cycle innovation – which, in and of itself, would have been an interesting topic of discussion.  But in this interview, Roy focuses the conversation on what he believes matters most to achieving positive healthcare outcomes – patient engagement & activation.   The projects he and his PennMed colleagues have deployed are fascinating – using the techniques of behavioral economics to drive behavior change.  And the outcomes are compelling.  Roy discusses how PennMed is making improvements in medication adherence, blood pressure control, surgical recovery, hospital follow-ups, cost effective prescribing, readmission rates and ED visit rates.  He illustrates the profound impact and leverage that behavior change and patient engagement can have in terms of cost savings as well as life savings. One surprise that emerges in the dialogue is the realization that high impact does not necessarily mean high tech.  Some of the amazing results achieved at PennMed come about through surprisingly low tech solutions.  The use of texting, for example; or just creating default settings in the electronic medical record that drives tens of millions of dollars of savings via the use of generic medications.  One pearl that Roy drops toward the end of the interview is an innovation heuristic he lives by – “Love the problem, not the solution”.  He shares stories of how he and his teams have discovered that the stated problem is often not the actual one – and that landing too quickly on a proposed solution often short changes the desired outcome.  Roy also introduces us to a new center at PennMed called the ‘Nudge Unit’ – a unique division designed to directly apply behavioral economics onto healthcare delivery.   It’s abundantly clear throughout the interview that Roy is a humble leader, innovator and mentor.  He repeatedly mentions his colleagues and predecessors by name – and credits them for the results and outcomes achieved.  It’s also clear that Roy & his colleagues at PennMed are mission-driven and passionate about creating meaningful results.   Roy’s is a refreshing and engaging perspective.  If you have an interest in understanding and improving patient engagement/behavior change, you’ll want to listen to this dialogue – and probably more than once!