Creating a New Healthcare

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!

In this episode of Creating a New Healthcare, Dr. Zeev Neuwirth interviews Mike McSherry, CEO of Xealth.  Mike represents a new breed of highly accomplished digital tech entrepreneurs who have spent the past decade or two reshaping the landscape of digital tech; and who are now entering healthcare, ushering in a new era of healthcare delivery – an era that this interview will offer you a glimpse into. Mike’s amazing portfolio of accomplishments includes Swype.  It’s an application that is embedded in over a billion android smart phones across the globe; allowing user’s to essentially ‘draw’ words rather than ‘tap’ them out – enabling faster, easier text input. The point here is that Michael and his colleagues are not only technologic wizards.  They are clearly world-class experts in user interface (UI) & user experience (UE) – something that is sorely lacking in healthcare!  As you listen to the interview, just imagine what healthcare might look like if there were dozens or even hundreds of similar UI/UE digital experts engaged in healthcare across the country – working collaboratively with clinical colleagues.  Now, that’s a roadmap for Creating a New Healthcare. In this interview, Mike introduces us to Xealth – an application he and his long-time colleagues have created – that allows any digitally connected app or service to be placed onto a user-friendly platform.  For starters, Xealth is a digital formulary – allowing physicians or other providers to ‘prescribe’ an app or service. Physicians can now decide what digitally connected services & apps they want in this formulary – and just like adding a new medication – a new digital app or service can be added in less than a tenth of the time it traditionally takes.  The types of services on Xealth at the time of this interview includes traditional apps, but also includes transportation services, home devices such as glucometers and CPAP machines, and even food delivery and transportation services.  (Although not discussed in the intervew, keep in mind that, in the literature on ‘social determinants of health’, inadequate food and transportation, along with social isolation, are some of the leading causes of poor health outcomes and avoidably higher costs of care.)  The Xeatlh platform also offers automatic monitoring of patients’ patterns of usage, as well as predictive analytics – keeping track of how often, and in what ways patients are using these apps, as well as guiding the provider to better identify which app or service might work better with a particular patient.   There are numerous pearls in this podcast.  Among them, Mike shares the best piece of his advice he has ever been given, which has guided the way he works; and has greatly contributed to the tremendous value and success he and his colleagues have created together.  Most importantly, you’ll hear a fresh perspective on how cutting edge thinkers and doers are attempting to augment and leverage the value proposition in the provider/patient relationship.  What we find particularly encouraging from interviews with digital tech gurus like Mike is their unabashed support of physicians and other providers of medical care, and a deep respect for the patient/provider relationship.  We have heard this theme repeatedly in this podcast series.  Far from disrupting that relationship, these digital tools serve to enhance it. Mike brings an encouraging and inspiring message for providers – a set of support tools that will enhance one’s ability to optimize patient care and augment one’s efficiency. For patients, this should be viewed as healthcare catching up to other industries in terms of customer service, convenience and engagement – making it easier to be healthy.  And for payers and healthcare leaders, this represents the emergence of a new paradigm in patient/customer engagement – a novel approach to realize the triple aim of improved healthcare, improved outcomes & more cost effective care.

Sami Inkinen, founder & CEO of Virta Health, shares his remarkable journey from the real estate industry to healthcare. They discuss Virta's innovative approach to reversing type 2 diabetes through a low-carb, high-fat ketogenic diet. They explore the potential of digital technology and scientific expertise to transform healthcare and improve patient outcomes. The podcast also touches on ambitious goals, barriers to adoption, and predictions for the future of healthcare.

In this episode of Creating a New Healthcare, Dr. Zeev Neuwirth interviews Robert Andrews, CEO of Health Transformation Alliance (HTA).  HTA is a non-profit alliance of nearly 45 Corporations who are working to improve the outcomes of healthcare and reduce the costs of medical care.  The Alliance includes such names as: IBM, Coca-Cola, 3M, Walgreens, Marriott, Pitney Bowes, Verizon, Dupont, Shell, Prudential and Fedex – to name a few.  Rob outlines HTA’s bold mission which is to “fix our broken healthcare system”; to “help companies take better care of the people who take care of them”; and to reverse the perverse incentives of the current Fee-For-Service payment model by paying physicians for value-based preventive care and improved health outcomes. Placing himself in challenging situations in order to serve the public, taking on ambitious goals, and getting them accomplished, is not a new pattern for Mr. Andrews.  Prior to his current role at HTA, he served as a Congressman in the U.S. House of Representatives for nearly 24 years.  Upon his departure from the House, President Barack Obama praised Rob’s service as “an original author of the Affordable Care Act… and a vital partner in its passage and implementation”.  In this interview Rob outlines the three major tactics the HTA is taking in order to accomplish its mission. The first is to lower pharmaceutical spending through appropriately cutting out non-value added costs in the pharmaceutical supply chain.  The second is to select provider groups with a demonstrable track record of delivering excellent health outcomes, cost effectively.  And the third is to engage employees in becoming proactive participants in their own healthcare.  These activities are all informed by IBM Watson Health’s supercomputing analytics.   It seems like HTA is well on its way to achieving its goals.  They are predicting healthcare savings of hundreds of millions of dollars in the first three years.  However, Rob Andrews convincingly argues that HTA’s mission is not primarily about cost; but instead, they are focused on improving health outcomes, which will drive costs down – a win for employees and their employers.  You’ll be inspired by the conviction, integrity and energy that Mr. Andrews brings to this critically important task at hand.

This is the second of two inspiring interviews featuring the integration of digital health into one of the largest integrated delivery networks in the country.  In this episode of Creating a New Healthcare, Dr. Zeev Neuwirth interviews Aaron Martin, who came to Providence St. Joseph Health (PSJH) directly from spending nearly a decade at Amazon, where he was an executive – the North American director of Kindle & print-on-demand services.  In that role, Aaron led a disruption of the print publishing industry that catalyzed tremendous value for readers as well as writers.  What is remarkable about this interview is that, despite being a technical leader in the digital realm, Aaron spends the first few minutes of the interview describing the leadership principles & cultural norms that were critical factors in Amazon’s success.  In those first few minutes, what becomes abundantly apparent is that Aaron brings to his work an intense dedication to patients and providers; as well as a unique combination of value-based thinking, authentic leadership, and industry-leading technical capability in healthcare redesign and innovation.  In what is an inspiring and refreshing dialogue, Aaron describes the two most important stakeholders in healthcare – the ‘creator’ of value (the provider of care), and the ‘customer’ (the patient or consumer of care) in the healthcare value chain. In this interview, he shares how he views his role as supporting the professional commitment of providers & enabling the ‘sacred moments of care’ between provider & patient. Aaron views digital health & the consumerist approach as integral enablers of medical care, and not as disintermediaries.  He also lays out a very clear picture of why and how design thinking, digital health, and a consumerist approach are critical success factors for any organization that expects to thrive in the future healthcare delivery market.  With straightforward examples, Aaron demonstrates that, unlike some previous deployments of technology, digital health leads to a markedly better consumer experience for both patients and providers; leverages and enhances the value proposition of providers; improves health outcomes, and solves for major organizational challenges such as access to care, growth and affordability.  Aaron and his colleagues hold themselves accountable for producing demonstrable and measurable results – outcomes that matter to patients, providers, and payers.  

This is the first of two amazing interviews featuring the topic of Digital Health and its integration into healthcare delivery at Providence St. Joseph Health.  In this first interview, Sara Vaezy describes, in no uncertain terms, the ‘Existential Imperative’ that makes digital health an absolute requirement and a critical success factor for any organization contemplating a robust future in healthcare delivery.  Sara shares two customer-centric examples of how digital health is transforming healthcare at Providence St. Joseph Health – in their on-demand care services (Express Care); and in their Women’s Health offering (Circle).  She points out that, far from being a nice-to-do, the consumer-oriented digital health integration is moving “big needles” in terms of access, consumer satisfaction, growth and revenue. Sara talks about the work she and her colleagues are collaborating on – to create a 10X experience that enhances engagement and improves health outcomes. By 10X, she means a patient/consumer experience that is ten times better than what patients currently experience!  When asked to describe the personal leadership characteristics that make this sort of transformation possible, Sara has two answers. First – “resilience… in the face of a non-steady state environment”; and second – an “unwavering commitment to what’s best for our patients”.  You’ll not want to miss this authentic and insightful interview with someone who is clearly one of the up and coming leaders in the digital health movement.

In this episode of Creating a New Healthcare, Dr. Zeev Neuwirth interviews Stuart Levine – one of the most experienced & accomplished physician executives in the realm of value-based care.  Dr. Levine has been deeply engaged in providing comprehensive care under global capitation for decades.  He brings a clarity and practical wisdom to the complex topic of clinical care & cost stewardship; as well as a deep sense of professional responsibility to high quality, safe & effective patient-centered care.  He describes a managed care environment that is both practical and personalized.  He also describes a healthcare construct that is rewarding and sustainable for physicians & other providers of medical care.  In this in-depth interview, Stuart outlines ‘the six pillars of care’ – a time-tested and proven model for population-based, value-based care.  Stuart places a tremendously high premium on spending more upfront & supporting a relationship-based approach to patient care – which he has proven saves both lives & money.  He advocates for a human-centered care that is fiscally responsible.  The picture that Stuart paints provides us with hope for a better future in healthcare.