This Week Health

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Darren and I served as CIOs in close proximity to one another. Our conversations over the years have challenged and inspired me. When we created This Week in Health IT, these were the conversations that I wanted to capture and share with the next generation of Health IT leaders. I hope you enjoy.


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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. My name 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.

This podcast is brought to you by health lyrics, helping you build agile, efficient, and effective health. It Let's talk visit health lyrics do com to schedule your free consultation. Our guest today is Darren Kin, the c i o of for Cedar-Sinai in Los Angeles and, and just an all around nice guy. Good afternoon, Darren.

Welcome to the show. Good afternoon, bill. How are you? I, uh, I, I'm sort of breaking the, uh, the premise here of saying Good afternoon. Most people think we record these in the morning, but, um, I record them based on the schedule. And, uh, you've been pretty busy. So you, you, uh, you just got back from hims and, uh, we're gonna talk a little bit about that.

Um, but one of the softball questions I throw out the start is, you know, what are, what are some of the things that you or your team are working on that you're really excited about right now? Uh, there's a lot going on, uh, which I think is, uh, no different here at Cedars than anywhere else. Uh, we are, uh, constantly juggling the ongoing optimization and maintenance work, the ongoing growth and sort of new projects and trying to squeeze as much as we can in, in terms of sort of the new and the exciting.

And I would say in that last category, which is generally what people sort of wanna know about. We're stuff, uh, really trying to understand sort that digital frontier and really what it means to, uh, for the first, really think about moving a little bit away from enterprise software. Started to think ourselves as, uh, in the consumer software business.

Interesting. Well, we will definitely, we will definitely circle back to that, uh, that as part of the conversations. Um, what I wanted to do with you, since it's so fresh in our minds and we ran into each other at himss, is this is gonna be the final show where we take a look back at. Event to bed. But, um, now just a couple questions around hims it it, was there anyone's presence or absence that surprised you from, from this she's h show?

Um, you know, there, there was a few pleasant things. I, I think that, uh, we're finally seeing fewer and fewer, uh, cart vendors and, uh, sort of desktop vendors and sort of some of the, um, you know, things that used to sort of occupy, uh, the show floor. You know, a lot of the usual suspects there. Um, and I think maybe the, the new entrant that we're starting to see is a little bit, what I alluded to is folks that are starting to think about sort of that digital frontier and sort of that, uh, consumer piece.

And so we start to see a few of those folks. I will say though, um, as a C I O, uh, for a large organization that, uh, feels like we buy almost one of everything. I'm always amazed at just the sheer number of vendors that are there, and I, you know, inevitably sort of maybe by, uh, aisle, uh, 6,000 or so, um, start to scratch my head and think, how could it be that all of these companies exist?

Yeah. And you're not exaggerating when you say, The, um, I had a meeting at one end of the floor to the other end of the floor. And, uh, I, I think I put on at least 2000 steps just doing a straight line from one end of the floor to the other. So it was, uh, it was pretty big. So some of the people that did have a presence, uh, Google dramatically expanded their presence.

Amazon did as well. Uber, Lyft, um, you saw a lot of those, uh, those, I mean, traditional. I think the same booth and, uh, Cerner switched up their booth a little bit, but it's about the same size. But those new digital players are starting to come in. How are you, how are you viewing that? I mean, how are you either, you know, thinking about, uh, relationships with them?

Because I know you guys have done a lot of announcements around different players like Apple and others. Um, although we didn't see Apple there, did we? I don't think Apple is a big show. Attender. Yeah. All right. Well that's, that's just one of those that was absent, but how are you thinking about those other players?

The, the Ubers, the Lyfts, the, the, the Googles, the Amazon? I mean, do you, do you feel like they're, they're coming with solutions at this point? Are they still sort of, um, just selling the things that they have saying, okay, we've got a lot of really great tools and we're looking for partners who are gonna help us to figure out how to apply this stuff.

Well, listen, it's a big group that you described. I sort of have to put them in a bunch of categories. I think the Uber and Lyfts are easy to, uh, pair up against each other. Uh, I think they are. Uh, I get the sense they're still trying to decide do they want to be a service provider to startups that will build on their platform, or do they want to build their own software tools and directly integrate?

Um, I think for now the answer is probably yes, as they're trying to sort of figure out what that means. And, you know, since I started with them, I'll pick on them first and I'll say that, uh, they are probably winding themselves through the journey of, wow, healthcare's a really big market. Let's jump in.

And then somewhere, uh, in those, uh, first early stages of the journey, one realizes that, huh, a little bit more complicated, more nuanced. Uh, I've gotten to row 6,000 and realize there's a lot of people to integrate with, uh, and I think they're gonna have to make a decision soon of how deep they really wanna get into the vertical, or whether they wanna be sort of a supplier to it.

Um, you know, some of the other ones that you mentioned, uh, I think they're such big organizations that they also subdivide. Amazon, um, you know, it's hard to talk about them as one thing. Uh, a w s and our approach towards, uh, using a w s we're big fans and, and we're big users of a W s I think is sort of one category.

Um, you know, Amazon has, uh, made a few moves and sort of, uh, you know, uh, it's been alluded to a bunch. Uh, play a role in the supply chain, uh, for all of the big tech vendors that are talking about disrupting. I have to say personally, uh, I can't wait for Amazon to disrupt the supply chain. Um, I think it's one of those things that, uh, will benefit, uh, health systems providers and ultimately patients by bringing down costs.

There's an awful lot of people that touch things on their way to the patient, and there's an awful lot of cost that gets added to. Um, you know, with no inside fantastical knowledge, I would say that Amazon would be great in the D M E space. They would be great in sort of some of those areas that, uh, you know, traditionally, uh, you know, needed some disruption.

Obviously there's lots of rumors, uh, with their pill pack acquisition and what they may do and sort of the P B M space, but, I think that's sort of, uh, you know, uh, um, wide open. And then the third category, uh, for Amazon is around, um, you know, what they're doing with voice and Alexa, and I think that sort of represents sort of another area.

Um, and then, you know, finally, um, some pretty exciting announcements from, from them around medical comprehend and what they may do. Sort of, uh, n l P. So, you know, it's different strategies with different things, but what we're trying to do is get focused on the things that we can make use of right now. Um, and probably the, you know, everybody likes the word, so I'll use it.

Uh, the best disruption that we can take advantage of with Amazon right now is really leveraging as much as we can. In the cloud. Um, and frankly in that area, it's not even the most exciting things. Um, some of our biggest projects in the cloud is to look at the myriad of, uh, legacy systems we have, um, that we have to maintain for VA various, uh, regulatory reasons or other, uh, sort of, uh, complicated, uh, scenarios and seeing if we can sort of move those and just reduce the cost of operating.

Um, so, you know, it, it, it varies. And I, you know, similar sort of story with Google, similar to story with Apple, similar story with Facebook and on and on and on. Yeah. They, they're really big companies and you have all the benefits of the scale and the, uh, resources that they're bringing. But you also have, they're big companies and they're silent.

The, uh, for all. The, uh, appearance from the outside that it's, you know, a, a single entity growing in the same direction. Um, anytime you put, you know, a hundred thousand people in an organization, they tend to, uh, form silos and head off in different directions. So sometimes it can be hard to navigate those companies and how you get the best results out them.

I, I would, I mean, that's been my experience. Has that been your experience? Well, Uh, absolutely. And, and I think that, you know, frankly, a lot of times these companies are coming to market, um, in, uh, as much of an experiment experimentation mode as early stage companies. And we sometimes just confuse because they're so big and because they're so well capitalized that they must know everything.

Um, and I think that, you know, they have an amazing capacity to learn and to invest resources. Uh, but you know, they're very much sort of feeling their way around the. The interesting part is that, uh, those vendors, uh, that are in healthcare and sort of the, you know, the anchor tenants of the hims floor that we were referring to, um, you know, they've long learned that healthcare is not one thing and that, you know, it might be easy to say that it's this trillion dollar market that you're gonna sort of.

You know, you start by dividing it into pharma and uh, payers and providers and then, you know, we love to focus on the provider side, but then you take the provider side and you put into hospitals and sort of the rest of the system. Then you take a look at hospitals and you split academics and you split.

You know, sort of the community hospitals and then if that wasn't bad enough, you have to start looking at sort of what core systems they have. And they'll have a different IT approach if they're an epic shop or a Cerner shop, or a Meditech shop or an Athena shop. And so, you know, the hard thing for these companies is they're used to launching businesses that move in big blocks and are billion dollars in market size and you know, can move their needle.

It, you know, once you start breaking it down, I think that what they start to realize is that it's not always as interesting as it appeared. While they still maybe wanna play a role, um, I think that they often realize there's, uh, maybe a better role for them to step back and have other companies sort of work on their platforms in their ecosystem.

Yeah. So you've been one of the, uh, I'm sorry, I'm going after this, this easy stuff to talk about, but, um, you know, I you said supply chain for Amazon and, and I think yeah. Core competency. That's if, if they were to ask a hundred healthcare leaders, Hey, can we help you with. This space, they would probably get a response of, yeah, if, if you, if you would attack this, that would be great.

But I feel the same thing's true on the, um, the consumer experience side with Apple. And, you know, you've been one of the early adopters for Apple, one of the early, um, supporters of almost just about everything they've done in terms of the watch, in terms of, uh, the medical record and.

But if we could focus Apple on the experience on being able to, uh, you know, remove the friction, I mean, I think that would be the, the area for them. Would you agree with that? Yeah, uh, absolutely. And there's no doubt in my mind that, uh, you know, the expertise and prowess that they have in, you know, consumer experience and understanding how to sort of delight their customers is something that we.

Could and should take full advantage of, but at the same time, you know, you can't get lost in the fact that, you know what Apple is really good at. And you know, my sense of what they wanna do more of is figure out how to apply that to consumer tools. I think the, uh, rumors of, uh, uh, what is it, uh, Jim Cramer shared with us that, uh, apple was gonna buy Epic.

Uh, I, I doubt they have an but besides the fact that Epic will never sell, um, as you know, many of your listeners will well know. Um, I don't think Apple has any interest whatsoever in jumping into deep enterprise software space. I think that they recognize their gift is how to serve the consumer. I think that they're gonna add a patina and series of functionality around that, that frankly, I think their personal health record is a great example of that and, you know, they'll probably continue to thrive in that area.

Yeah, I, you know, Kramer staff should have been, uh, when I read that for the first time, they should have been smacked. All it would've taken was a, you know, a single phone call to anybody within and. If, if, if you know the leaders of that company, you know, they're not gonna sell. That's number one. And number two, you know, name an enterprise application, enterprise software solution that, that, uh, that Apple really has done well with.

And, you know, you just, that has not been their. Uh, since Steve Jobs came back, it has always been on the consumer and on that experience and what can we do at the consumer. So I, it's, that was fascinating. Alright, let's go, let's go back to the show. So, um, let's start with the kickoff. So, uh, you know, I'm, I'm Chris Ross's, kickoff of Thess event.

I thought was, uh, was phenomenal. I mean, he shared about his. I, I thought it was a great display of leadership for him to take the time in between his treatments on stage three cancer, uh, to come in and really provide context to the work that we do within the industry. Uh, I I assume you caught that, that opening event.

Absolutely. And, uh, Chris, a dear friend, I, I have to say, um, I was, uh, humbled to, uh, hear his, uh, his opening and I think a great reminder to all of us, frankly, of. Uh, why we, uh, pursued careers in healthcare and why we sort of do what we do. Um, and just frankly, um, you know, the ability that he had to sort of convey his messages was.

Yeah, and I, I thought he a great context for, uh, for the whole show. They, they have this whole heroes of healthcare thing and to have someone who, who is a hero of healthcare and is also on the other side right now, uh, in probably one of the best places in the world to be receiving care. So he is very optimistic and, uh, you know, we wish him the best.

And just kudos on just a phenomenal job kicking it off. But the next thing, so I, I talk to you a little bit about this. You know, some of our friends are up on stage there talking about you had DeSalvo, you had, uh, an uh, Chopra Governor Levitt. They took the stage and they talked about information sharing within healthcare and how we're ushering in a new era of innovation, uh, because of the information, uh, blocking rules, uh, that, um, uh, c m s had come out with and, uh, including the, um, including the payer data as well, and now making that, uh, available to the con uh, a consumer initiated request.

But making that available to the consumer premise is essentially that. We could now see a whole new generation of data aggregators and people who take that data and, uh, data stewards really, who take that aggregated data and, uh, provide intelligence and, uh, insight onto it and provide value to the healthcare consumer moving forward.

Uh, that's, that's the premise. And I wanted to talk to you about the intent and really the impact of, of that announcement from, from your seat and. Well first, um, I, I think the, uh, the impact can't be underestimated. Um, I, I, I think it was a big announcement, um, and it's gonna have some big effects, uh, in terms of, uh, what happens going forward for no other reason than that, you know, all of those vendors that were on the show floor at hims, um, are probably now gonna redirect much as they did with meaningful use.

A large portion of their r and d development and sort of opportunistic time, uh, towards meeting those new regs and regulations. And I think that, you know, they're not insignificant. Um, and there's sort of a lot to do. That being said, um, you know, I think that I'm still trying to digest them. Um, it's a thousand pages and I wish I could tell you that I've, uh, made my way all the way through it.

Um, I paused for a little bit and alternated between reading and skimming and reading and skimming and skipping. Ultimately, I think, you know, I, I've gotten a little bit of the gist of it and, and, uh, thankfully, uh, lots of folks have published some really good commentary. But, you know, it, it's an interesting set of, of regs at a high level.

Um, frankly, as, as a consumer, um, I am unbelievably pro the idea of making information available. I think it's hard to find folks in healthcare, uh, that sort of have a mission orientation. I would say that it's their data and they won't share it. I think, I know there's lots that get sort of covered around that, but, um, for most folks the intention is, is pretty much there.

I think the hard part's gonna be what does it all mean and, and how do we do it. Um, and you know, I always worry about, um, When government regulation is put in place, um, you know, it has to by definition move the needle or move one or two things forward, and it ultimately, you know, can run the risk of unintended consequences.

As you know, sort of the implementation finds an equilibrium. So I'll give a couple of examples. You know, when, you know, in the regs they talk about releasing all data that's in any certified E M R. Um, that's different data across different EMRs. And by the way, do you really need all of that data? Um, do you really want all of that data?

If you got all that data, would you even know what to do with it? Do you get to a point where maybe too much information is just as bad as not enough information? And so how are we gonna sort of translate that and sort of open all of that up? But you know, as a whole, um, you know, I think that Cedars generally has tried to adopt the philosophy of we'll make information available anywhere at any time in whatever format you want.

Um, what I love in theory about this is that it takes an organization like Cedar Sinai and says that if our patients want access to our data, and increasingly we're starting to see that happen. Then they ultimately have a choice of how they do that. We will provide tools for them to see the data and interact with the data.

Hopefully they'll find our tools delightful and want to interact with their data in our tool sets. But if they don't and they want their own tool sets or they want to do different things with it, they can take their data and, you know, work with that in, in different formats, in different ways. There's some great altruistic ones, like, I want to download my data and donate it to science for research.

It's wonderful stuff. Um, some of them I frankly worry a little bit about in that, you know, what happens when, uh, a family member of mine, uh, decides to download their data, which parenthetically has a large amount of family history. So indirectly information on me. And chooses to sell their data for whatever purpose the individual wants to use it for, but they're just happy to get the data.

Did I really consent to give my data? How does that work? And I think that, you know, we're gonna have to figure out sort of some of those things. I'm not saying any of that, that it should stop us from moving forward. But you know, I think that, um, the unfortunate part is I think there's a 60 day comment period.

Um, and then there's a relatively short implementation period. This is gonna be a little bit of, uh, trial by fire. Um, and I think we're all gonna have to sort of hold onto our hats a little bit as it starts to roll out. Yeah, it's, uh, it's really complex. The, the, the, uh, example I always use on this for government.

How this sort of played out. So I hit a. It's not the easiest thing to even find the numbers on 'em, but you know, they're there so you find them. And, and on some of them you literally download a spreadsheet with, uh, you know, a thousand items on it and you have to determine which kind of m r i you got to see, you know, what the price or you're gonna get to determine what's the price.

And I think what people don't, um, really grasp, uh, or what a, what a consumer doesn't grasp with somebody who's not in healthcare and healthcare. The information that's in that, uh, in that medical record is extremely complex, not easy to digest, uh, for, for the average person. And, uh, and it's, and it's, it's fairly nuanced between, you know, this kind of m r i, this kind of m r i, this kind of m r i.

And so you can't just say an m r I costs this, um, because, I mean, because there's, you know, you know the charge master as well as I do, there's, there's millions of items in there. And, uh, and the intent of a reg and then how it gets implemented. I'm sure if you went to SEMA Verma and said, Hey, there's spreadsheets out on people's websites, and they sort of look like this, she'd say, alright, it's a start and then we hear this a lot.

That's the start. That's not really what the intention was, but that's a start. And I think what you're saying is we're gonna see the same thing here with, with a lot of different interpretations of it and a lot of different implementations of. The, of this particular data blocking and sharing Reg. Yeah.

And, and I think it's gonna be one of these sort of incremental journeys that people will discover. And, and I'll go back to Apple because I, I really do give them, um, lots of kudos for what they did with Apple Health, what we really loved about it, and ultimately the reason why we sort of raised our hand and, you know, went first with them.

Uh, you know, there was lots of folks that were asking for their data to quote unquote download it. So we did that a while ago. We made it available on our patient portal. You can go in, you can, again, as I said, hopefully you find the experience on our portal's delightful, and you want to view your data within there.

But if you don't, you can hit the download button and away you go. But if you hit the download button, it was sort of disingenuous 'cause we gave you an X M L file and I don't think patients, you know, wake up in the morning and say, you know, what I really want is an X M L file of my data. Um, and so what Apple Health did was it gave you a vehicle to really sort of use it.

Yeah. And it was also great 'cause it used, you know, standard based APIs, fire, blah, blah, blah, blah. But you know what it really did was it gave the consumers. A taste of what they really wanted, which was, I want my data and I want it in a usable format that I don't have to figure out how to consume.

Somebody has figured out how to sort of give it to me in a consumable way, and I think we're gonna have to figure that out with a lot of what's. Um, you know, in, in sort of these regs and sort of in these pieces, I think that there was a lot of, um, Silicon Valley influence, um, in those regs. Uh, and I say that from the perspective of there was a lot of, uh, VC-backed companies that I think felt like they couldn't get their applications.

To get data. Data. And so that became synonymous with patient rights of getting data. I'm not sure those are exactly, uh, aligned in, uh, in what patients are sort of looking for. They might be, um, but I'm not sure they, they are fully. Um, and as the, some of those things sort of play out, it'll be interesting to see what people really want to use.

As you know well, and you know, your listeners know well, you know, it's one. What will really be fascinating, frankly, is what percentage of patients really choose to engage in this information. And what they really want. I mean, I, I don't know the national numbers around patient portals and we can knock them.

'cause we can say maybe the patient portals aren't perfect, but that's just part of the problem. Part of this is that patients aren't engaging in some of the information that's available to them. So it'll be interesting to see who are the early upticks of this, and I suspect it's gonna be more third parties than it's going to be patients themselves.

Some of these a p I connectors, right? Because they're gonna make meaning it, right? It's mint. The mint of healthcare so it get all. From each one of my banks and my brokerage and everything else. But what they're able to do is pull it together, gimme one view to it, uh, gimme a nice budgeting, charting, and all that other experience.

And that's what I, I expect and hope will happen in healthcare. Not that somebody's getting my entire medical record, but somebody who's helping me with diabetes. Is, you know, getting that portion of it and presenting the data in a way I can consume it because, you know, just handing I, you know, I'm glad you handed people an XML file.

That's a lot better than what, what the alternatives are. But you know, it used to be we were carrying around a stack of papers that it was, you know, a blue button kind of thing of here's your medical record, which you can't really do a whole heck of lot with. We'll get these data stewards, which are in.

Um, the health systems and the payers and the consumers that can create, I don't know, uh, just meaning from all this data that can help me to live a healthier life. I think that's, that's the, that's the goal of patient-centric interoperability. Yeah. I, I agree. And, and I think the inherent challenge in that, uh, well, I'll say it this way, um, when that eventually gets solved, and I am optimistic that we will get closer and closer to that when we look back on the.

My opinion is that the ability to get the data, which is really what the announcement was all about, um, is gonna have been the easy part, the really hard part ahead. Is, how the heck are we gonna normalize that data and make, uh, what is today, um, you know, esoteric configuration that exists in each of the different systems somehow, uh, matching.

And, you know, the old joke in healthcare as we like standards so much, we have many of them. Um, you know, but, so we're just gonna have to figure out how all of that stuff is gonna sort of come together. But again, um, I don't mean this to come across as sort of negative. It has to start somewhere. And so I think that this is a great place.

Um, I just hope that, um, it continues to take, uh, um, an orientation that's really about the patient being able to get their information so they can over, they could ultimately be a custodian of their healthcare. What I worry about, and there's some language in the regs or in the, in the draft regs that allude to this.

Is there's some real interest in making these APIs right, as well. And I think, um, you know, a lot of that language feels like it was around trying to level the playing field from a vendor perspective. And I'm not sure that was, uh, at least in my opinion, the main, um, uh, effort of what these rules really should have been.

Um, I think if they stick to this idea of empowering, enabling patients, I think it'll be hard to get too far off track because it's a good true north for us to focus on. Uh, but if they start to drift into everybody's system, has to be open to everything from a read and write perspective, um, you know, I start to worry about it.

And I just don't know how we're gonna maintain, not just normalization of the data, but then ultimately integrity of the data as we all have to start to police what everybody is doing. Absolutely. Um, I wanna, I wanna shoot. So we do this and I wanna shoot four questions to I'm at our time. We should goal of this, have back and.

Um, so you have an accelerator, uh, for innovation, uh, for innovation in healthcare that, that you have at Cedars. Uh, it's been widely published and, and, uh, you've had a fair amount of success with it. So you just opened class number five. Can you give us a little preview of what Class five is, uh, is focused on?

So the best part I can tell you is we do not know yet. Um, the, the most fun part of the way the accelerator is sort of built, especially, um, sort of as, as life as a C I O is I spent a ton of time as a c i o picking and being involved with leadership in core systems that, you know, to use shorthand around it.

We push back onto the user base. The accelerator is the exact opposite. We have a great team that figures out how to take this massive funnel of companies that are applying to wanna innovate in healthcare. We do all the diligence we need to do to make sure that they're all viable opportunities, and then we take those companies and they all present.

About a seven minute video session to a team that we call the selection committee, which is made up of clinicians and administrators and all sorts of folks from in around Cedars. And we just watch 'em go at it. And when they turn around they say, I need that, I want to play with that. I get to, um, uh, suspend my normal c I o uh, challenges and I just get to be in the Yes business.

And I say, that's a great idea. You should work with them. And so, you know, we, we really do let, um, sort of the users of the systems, whether it's in the clinical or administrative or business area, really sort of drive, um, you know, what, what they wanna work on and where they sort of see the white space.

And so to me it's the, it's the most fun thing. Wow, that's a, so we've seen a lot of different, uh, innovation models within healthcare. You have accelerators, incubators, you have internal innovation arms, you have external innovation arms. Um, so, you know, you chose the accelerator model. Why did, why did you go that route?

I mean, it's exciting what you're talking about because, you know, it's, it's, uh, you know, it's, it's pool, I mean, essentially the organization. It's, it's, they're, they're telling you what they wanna work on and which is a phenomenal model, but why that model versus one of the other models that's out there?

So first let me start and say that, uh, what we really started with, uh, which was sort of ahead of the accelerator, was we have a rich history of technology transfer and really supporting our faculty and the unbelievable ideas that they have and helping them to, you know, commercialize and bring to market.

Um, you know, those, those ideas, those solutions and frankly those sort of health discoveries that, you know, wonderful things that have really sort of transformed how healthcare is delivered. The new part is in looking at outside innovation or innovation that was on the outside, recognizing that perhaps we didn't have an exclusivity on good ideas.

Um, how could we help those companies really sort of get to the next level? What we really discovered in talking to them is that the best and the brightest and entrepreneurs were a little bit intimidated by healthcare. Um, face it, it's a little bit of a black box. It's not really clear exactly what goes on and you know, we were sort of scratching our head of why are some of the best and brightest building more.

Social media apps and more games. And there's nothing wrong with social media apps and games. The world probably does need more of them, but wouldn't it be even cooler if we got some of those folks to want to solve, not just problems in healthcare, but problems in healthcare for like acute and chronic patients.

I don't think we needed another band, uh, for uh, somebody who's super well to be even more. Well, I. And perhaps, you know, beat their personal best in a marathon. Again, there's a place in the world for those things, but I'm not sure that a health system like Cedar has needed the help to propel those. So we put, we picked an accelerator.

Because we truly wanted the companies to get this 90 day intense period to accelerate their idea and see what happens. And by the way, for some companies, they realize in 60 days of the 90 days that, oh my gosh, this wasn't a good idea at all. We need to go do something else. And, you know, while it's easy to sort of talk about that sort of, you know, uh, at a high level sort of after the fact, it's painful for the companies to go through.

But, you know, they turned around, they told us later, and some of them are our biggest supporters and our biggest sort of, uh, mentors in, in the network that we've built, that they otherwise would've toiled around for two years before they figured out it wasn't the right market. Obviously there's plenty that, you know, we've helped sort of accelerate them and propel them by giving them direct access to, you know, quote unquote, what is the wet lab of Cedars?

And they really can sort of understand what they need to do. So you have an investment. So, uh, summation is your, uh, investment arm and there's um, you know, how should healthcare be thinking about their technology investment arms, you know, what's the end game? Um, you know, standalone entities, new revenue stream.

I mean, what, what's the purpose of the investment arm? Yeah. Listen, I, I, I won't, um, you know, try to sort of, uh, share why all of healthcare should sort of think through investment in sort of one way or a different way for us at Cedars, um, we were trying to solve a couple of things. Number one. Um, going back to my, you know, story of, you know, uh, the world has lots of social media apps and wellness apps for, well people and games and things like that.

You know, there, there wasn't a large amount of early stage VC funding for companies that were gonna, you know, solve problems in the chronic, acute and provider delivery market. And so, you know, one of these things was providing access to capital to let some of these great ideas sort of be there. The second is we absolutely, absolutely above all else, consider this to be a strategic fund.

So, um, if we see the next amazing idea, but it's not something that we would use, we pass it on to other folks who are in the business of traditional venture capital or traditional private equity. What we are investing in are things that we know that we're going to use. And not only are we gonna use them, we intend, or we imagine we would be a fairly large customer of.

I think of the venture fund as an extension of our working capital. Just applied in a different way, in a different day and age in terms of how quickly innovation is moving through it right now. I wish, frankly that all of our needs can get solved by going to a show like HIMSS and buying the best of the three vendors that has a fully baked out solution that solves all of our problems.

The challenge we have is that not all the problems we have match up against those vendors. And so how do you sort of create a market for ourselves? And that's really what we look for the venture fund to do. Yeah, it, um, fills a gap. So let's shift gears, uh, only slightly here, but, um, you're looking at a lot of different companies.

You're seeing a lot of different companies. You're up in Silicon Valley, you're talking to people. Uh, where do you see digital really transforming the patient experience, that specific area of the patient experience, uh, in the next, I don't know, 12 to 18 months? Definitely blockchain. I just wanted to say that, um, I, I, I think it's gonna be in the, uh, reduction of, uh, friction of interaction.

Um, maybe said sort of more simply, um, I think it's gonna be around service. I. And, and I think that, you know, what's happening and we're seeing it, is that more and more of our patients are sort of expressing to us, listen, the care you provided was wonderful. We are grateful, we appreciate everything that sort of, you know, was delivered to us.

But boy, if it didn't feel like so much like the D M V, that wouldn't be so bad. Um, and, and how could we figure out how to cover some of the service and access pieces that are often the first few steps into the healthcare journey and make those, you know, the trendy words, say as frictionless as possible, but really frankly, how do we pattern match them to make them the same for our patients as they are on the rest of their lives?

And so, you know, we have whole segments of patients that can't remember when they last, if ever picked up a phone to make a restaurant reservation, they might not want to call to make an appointment. They might wanna be able to expect to do that sort of online. We have lots of reasons why that can happen because we have 137 different appointment types and it depends what your prequalifications are, insurance, but all of that stuff, um, candidly, we have to start to approach as that's our problem.

We have to figure out how to simplify that. It will never be as easy as OpenTable. But at the same point, there is a heck of a lot of room between OpenTable and what it is today. Uh, calling to make an appointment in the average healthcare system. Darren, uh, thanks for coming on the show. You know, the first time we met, I think, was on a panel discussion and I was new into healthcare and I thought to myself, oh my gosh, I am not gonna be able to do this job.

This guy is so smart. I don't even know what I'm doing on this panel. Uh, sit down, have coffee. Um, you know, you were like, Hey, my experience is your experience. How can I help you to be successful? And I, I've always appreciated that and, uh, and I'm glad to be able to share, uh, just some of that, uh, experience and knowledge with, uh, with our audience.

So thank you again for coming on the show. Bill, you're very welcome, uh, very, uh, kind of you to say. And, uh, you have, uh, done your, uh, own remarkable things in, uh, paving the way for us, so I also appreciate it. Well, thanks. So this shows production of this week in Health It. For more great content, you can check out the website at this week in health or the YouTube channel at this week in health

Thanks for listening. That's all for now.


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