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 Welcome to this week in Health it where we discuss the news, information and emerging thought with leaders from across the healthcare industry. This is Bill Russell recovering healthcare, c i o, and creator of this week in Health. It a set of podcasts and videos dedicated to training the next generation of health IT leaders.

Hope you enjoy. You ready? Yep. All right, great. Uh, do you wanna introduce yourself? I mean, you're a previous guest of the show, but I'll let you introduce yourself anyway. Thanks, bill. Um, I'm Anne Weiler. I'm the c e o and Co-founder of Well Pepper. We are a platform for interactive patient-facing care plans, and I was kind of wi wimpy moved to have you introduce yourself, but I get your name wrong, so this is my way of making sure I don't get your name wrong.

That's pretty funny. I know. I, so, uh, here we're on the hims floor and, and, uh, you know, previous guest on the show, so I, I just wanted to stop in to see. Yeah. Um, yeah, let's . Let's start with, I, I want to get into all the digital stuff, but let's start with how's, uh, how's your company doing? What's your company doing here and what are you seeing?

Well, what we're seeing, um, we're seeing that I would say patient engagement and interactive care plans in particular have really hit the mainstream. So we're, you know, we're having great booth traffic, some pretty big health systems who are making these platform decisions. They've the point solution, the days of the point solution are over.

They're realizing that they need something that can go across all their service lines, all their . Populations, which is what we do, right? Yeah. If you're gonna be implementing something here, here, here, and here, yeah. It doesn't work. It just doesn't work at all. Uh, it's interesting. What was your, this is just me being me.

What's your strategy? I mean, you're in the 800 series. I mean, you're like, you guys are almost in the back corner. Yeah. Why are we in the small bank? So, so you probably, you probably had a lot of meetings set up, I mean, for Yes. For big systems to find you. They, that's, they know where you're at. Yeah, we do.

Um, yeah, we're back here. We're in the personal connected health. And our strategy is that this is actually quite a great location, but one of those strategies is that our partner for interactive care plan content, Mayo Clinic is just right over there. So we are right with them. And so when they're talking about interactive care plans, they can point over to us.

And then they're also that, you know, when you're a relatively small company, your, your choices are a small little kiosk with like this, right? In an area that's highly populated. 'cause people really care about personal. Mental health or a tiny booth and this is much better. So I think, you know, like you, I would, I would like to stay in an area like this as long as I can until I can do like a 20 by 20 booth and really splash out.

Well, and this, this actually works. I mean, I'm looking around and this is sort of like a who's who of startups. Yeah. I mean startups that are making it. Yeah. 'cause it's not innovation where I've, that's where I feel like we've gotten past, not that we're not innovative, we're super innovative, but we're not in the innovation, we're in the personal connected health.

'cause this is where people are looking for. Solutions for patients. Well, great. So last time you were on the show, we talked a lot about, uh, let's see, we talked about Google and Amazon and all this other stuff, and Amazon's gonna change the world, change healthcare, and I see Amazon's now has a pretty sizable booth.

Google now has a pretty sizable Google. Google is the one that's making at least publicly the investments, right? I mean, they're hiring the CIOs and the CEOs of health systems, right? So Dr. Feinberg's there now who, uh, who I think is brilliant. Yeah, me too. And I love his. His, his take on things. Um, I'll ask you the question that I'm not sure I could ask anybody else, but do you think he went to Google 'cause he looked at being in a health system as being too confining.

Like he, he really like he really wanted to, to do something that would impact the world and said, I can do it from Google. Yes. Um, I also think that he was offered the, uh, Amazon Berkshire Hathaway job 'cause he, there was rumors about him being shortlisted for that. Right. And I suspect because, you know, he's a very.

Very pragmatic person as well as a dynamic leader that what Google offered with having existing things that needed to be coalesced into a stronger strategy was probably more aligned than the the other one where it's, that's still completely unclear what they're doing. . So if you were offered that job, I mean, you would take that job in a heartbeat, right?

The Google job? Oh, yeah, absolutely. I mean, the, the resources that are available to you. So they're, they're doing great things with, um, I mean, machine learning ai, and they're bringing all . That data. And this isn't necessarily for our listeners. Our listeners are looking at me right now going, you know, I, I can barely keep up with what's out there, , and now you're talking about all this other stuff.

But we're, we are actually seeing some health systems start to utilize Google for their machine learning and ai. Interesting. We're, we're definitely starting to see them use, uh, am Well, John Hopkins is talking about using Amazon Yeah. Moving their data in there. Yep. Having Amazon process it and then just send fire alerts down into their E H R.

Yep. Um, and I think that is gonna be, that's amazing. That's gonna be the trend, I think. Yeah, I agree. Um, Just didn't have the compute power before and now it's like readily available, cheap. And I think that people now feel that they understand that the cloud is not just secure, but it can be more secure than on-prem.

I mean, I always like to use the example of, you look at the big HIPAA breaches over the last 10 years, they were all paper being left in the wrong place, or somebody selling a photocopier with records on it. . Yeah. I think we're gonna see, uh, push in two directions. We're gonna see a push in the consumer direction.

That's where you guys are living. And, and I think health systems, um, more and more are saying . How do we serve our consumer? They're doing, they're finally doing consumer surveys. They're finally, you know, how do they, how do they view our experience? Oh gosh. They hate our waiter room experience. Yep. What a shock.

Yep. What can we do to, they're actually asking the question, what can we do to improve it? And uh, and I think that's what leads them to solutions like yours. Yep. That and, and that they're starting to understand that the patient experience isn't just in the waiting room. It's every time you interact and digital is where the patients actually wanna interact.

And most of them are not . Yet at a coherent strategy. The, the leaders are like, the, the leading organizations are thinking about this holistically. Like you look at Intermountain, they've hired head of digital from Disney. Understanding that your brand and your experience is everything. It's your portal.

It's how easy it is to get an appointment. It's what happens after you see the doctor. What's the follow up? Which is what we focus on. So I'm gonna cheat as a consultant. I was just asked this question to, to name the three or four health system digital, you know, digital. Uh, success stories. The, the organizations that, uh, are really engaging the consumer that have, uh, good transitions of care, that have thought through how people, and you said most of those touch points are, you know, the bill is a consumer experience.

Yep. The, it's all, it's all of that. Yeah. And I, you know, I think right now probably Kaiser's the leader because they were able to, you know, it's an integrated system and they didn't have different groups doing different things. They got really high. They have to, they didn't have to worry about the, the competition.

No. Exactly. And they have really, really high engagement digitally with, from their patients. And probably it doesn't hurt that they're in California, you know, , uh, yeah. I mean, but still they're across a lot of markets. They are. They are. But they also, you know, their, their home base is a pretty tech savvy market.

They're in Seattle, also a very tech savvy market where there's an expectation. Do you think they have a, a benefit of being able to scale a lot quicker because they're able to, they have, uh, systems that are pretty, uh, standardized already. Across the board? I think so, although they do have actually innovation pockets in each geography.

So we're working with innovation group in, in Seattle there. So, which is also great because, oh, interesting. We don't have to, you know, they have to check in with the larger group, but we don't necessarily have to, so they can actually innovate in that market and then scale across the other markets. Yep. So Kaiser, I think everyone would've said no.

Duh. Are there others? I, I struggle to be honest. I, I mean, I need that handful, but I think it's, it's, most of them haven't delivered on it yet. It's, they're starting to think that way. Right. So, That all up Strategies center's, thinking that way, Intermountain's thinking that way. Mayo Clinic, of course, is thinking that way.

One of the things that, um, I said is one of the trends that we identified last year that we're keeping an eye on this year is, uh, the technology roles have split into three within the health system. There is chief innovation officer, chief digital Officer, and Chief Innovation Officer, and we're actually seeing a lot of systems hire three people.

Yeah. Depending on scale and size. And then as some CIOs from smaller systems are saying, Hey, they're . Looking at me for a digital strategy, what do I do? Right? And so more and more of the questions I'm getting asked is, where do I go for this digital talent? Yep. And we're still saying outside the industry, I mean, that's, yes.

Yeah. I think they need to, um, I like that the c those CIOs are asking that question though, because I, you know, I came from Microsoft IT tech, like those are my customers, right? And I hate to see innovation getting taken away from them. They, the, the I, the C I O, chief Innovation Officer. Officer and the chief information officer, I think they need to be more closely aligned.

Well, the, the one maybe the same person. Well, the one I, so we, we were talking, we interviewed Anish Chopper yesterday and we talked about this topic and one of the things he said was that, uh, the CEO's just getting frustrated because they're not making enough mm-hmm. of movement. Yep. And the ccio is looking at 'em going, look, we're we're swamped.

Right. There's, they are swamped, unfortunately, the E H R workflow integration and, you know, we just bought . Well, pepper, we've gotta bring it into our system, you know, so Yeah. But that's innovative. I, it, it, it is, but there's, there's just a whole bunch of plumbing and back room and cloud and, and, uh, those kinds of things.

And so the, the, the role gets overwhelmed. Yeah. And then they say, Hey, why aren't we innovating? Like, like Kaiser, let's just say. Right? Um, and so now they're stepping back and going, alright, it's more than one roll. Potentially two or three. Yeah, sure. But should they be peers or should one report to the other regard?

One of the thing, if I'm talking to a C E O, I'm saying, I don't care how you do it. Right. But the three have al almost have to have like a high mind. I mean, they're Right, they're, and, and your, but you and your chief strategy officer, I mean they're, they're like, yeah, absolutely. Live together. But you think like, so one of the challenges that we have is, you know, we are innovative.

We often come in through the innovation group, but we cannot get traction until . We get E M R integration and we need the IT resources for that. And it's a different group, right? And we're at the bottom of the list. So that's where I would like to see a little bit more alignment there, right? Because, you know, we, we are offering great things for patients, but until it's integrated into the workflow, the other thing I tell CEOs in these conversations is, uh, you have to decide what problems you're gonna solve.

And it can't be 50, right? It's gotta be right. We have these 10 problems we're gonna solve this year. So that when they say, Hey, well peppers are . Solution to solve this problem. It's not a problem getting resources 'cause everyone goes, oh, that's one of our 10 initiatives solution. Exactly. Yeah. Um, and it gets back to that, you know, if, and that's where I think there's an opportunity for the c i o, the two CIOs.

Innovation and information should better align. Yeah. They should be totally aligned on what those 10 things are so that when it comes up, it does get the resources. But there's different types of innovation groups, right? Yes. There's like, yes, there are . So there's like VC innovation group. Yep. And you're not necessarily coming in through them because they're doing, they're investing.

Yep. And you're sitting there going, alright, I, I've got my money. I've raised my money. Yep. And that's what they're looking for. Yeah. So, yeah, there's, it's, it's, you know, that would be an interesting. Taking maybe thing for you to write as a thought piece is like, what are the different models of innovation?

Then? They're the ones that are trying to basically compete with the companies like me and spin things out themselves. Right. You know, that's a hard one for everyone. Yeah. And then the other thing that happens is you have innovation groups that are all starting up. Their companies that are similar. Yeah.

But they have like, you know, you're aligned with this innovation group as a health system. Right. I know. And then you try to sell it to them. They're like, that's really challenging. Yeah. Yeah. Um, So they, they almost have limited markets. If you say, I'm gonna align with this innovation team. Yeah, yeah. Which is, you know, we haven't taken money from an innovation team.

And if we did, we would, we would look at it very carefully, like, what is their reach? Who are they aligned with, you know? 'cause it will cut, it can cut your addressable market. Yeah. If they say, yeah, you're aligned with these guys and, you know, we're in the other camp. It's really interesting. Any other topics you wanna talk about?

Uh, yes. Thank you for asking . Um, so we, uh, I think . You may remember this, we do a lot of research. Um, we partner with Boston University and Harvard. Um, and so we finally have the results of a randomized control trial on, well, pepper published. And it was a study done out of Boston University, people with Parkinson's age 50 to 75.

And the outcomes were, so it was a control group, so the people with paper and people with the digital intervention, they got the same outcomes, which is good. That means that the out the intervention . Right. But the people who were less activated at the beginning of the study saw greater gains. So when you think about like all those people that doctors say, well, they won't do it.

They will with digital health. Oh, interesting. So we're, I mean, one of the things we're really strong about is making sure that we're improving patient outcomes. It's not just about experience. You've gotta have that clinical validation. Well, and hopefully people have gotten path past the myth that the older generation doesn't use technology.

Yeah. They absolutely use technology. Yeah. And actually our second study, . With Harvard is, um, was Braille. Braille, they call 'em Braille seniors. Um, and that one has not been published yet, uh, in the Bureau Regional, but I can tell you that those seniors on that program had reduced ed ed visits and increased mobility compared to the control group.

So it totally benefit. I mean, that's fantastic. Thank you. And I'm looking forward to reading that research. The, so my 87 year old, I talked about this three times now in the podcast. So people are getting older, 87 year old's, grandfather moves, or, uh, father-in-law moves in. To live with us. And, uh, and you know, I'm working, I'm here at HIMS and my wife, uh, is doing a lot of volunteer work.

She's outta the house and, uh, we've given him a new friend. It's, it's Echo. Yes. You know, it's Amazon Echo. Yep. And, and it's almost like that Saturday Night Live skit he's talking to. That's, that skit was dead on. I know he's talking to do it all the time. And, uh, he will say, yeah, hey, play me some country music.

Then they'll say, Hey, who won the baseball game last night? Nice. So he is learned how to interact with it. Are you guys looking at that as Yeah, absolutely. And, and so that's gonna be a way for them to interact with their care plan? Yes. We . Actually did a focus group, uh, yesterday morning. I should have invited you.

Um, it was with Mayo Clinic on using voice and interactive care plans. We think it has huge benefit, but we also know that, uh, it's not necessarily for every task and putting a my information hat on. You know, there's this challenge of the data collection is different if you're telling Alexa something than if you're keying in a survey.

So that's a kind of a question about like these different modalities, the patient . Is interacting in different ways, but regardless, there's value, there's huge value. It's, people love it. We've, all the testing we've done, um, you know, the empathy is much stronger. Um, it's easy. Um, it's just so easy just to tell Alexa you took your medication.

I, I used to be one of those cynics that, you know, you'd see those robots in the Japanese shows. Yeah. And they'd be going around. There are a lot of those here. Yeah. And I'd be like that, that would never work. And now I'm, I'm watching my father-in-law interact with Echo and I'm like, he . He's like having conversations with Echo.

I mean, and we heard at the chime fall forum that, uh, loneliness and isolation is one of the biggest challenges we have in health. And it's, I mean, so yeah, I think robots are going to, in interacting with devices. Um, there's one other question I wanted to ask you. I can't remember what it is, but it's the end of the show.

This is what happens. Well, you can, you know how to get a house on me. Absolutely. Well, thank you again much. I appreciate, appreciate you coming on the show. I hope you enjoyed this conversation. This show is a production of this week in Health It. For more great content, you can check out our website at www.thisweekinhealthit.comortheyoutubechannelatthisweekinhealthit.com/video.

Thanks for listening. That's all for now.