This Week Health

Interview in Action @ HLTH '23 - Zeev Neuwirth, MD, Author & Former Chief Clinical Executive

November 2: Today on the Conference channel, it’s an Interview in Action live from HLTH with Zeev Neuwirth, MD, Author of Beyond the Walls & Former Chief Clinical Executive. They discuss the transformative changes happening in American healthcare and the opportunities for a renaissance in the industry. Dr. Neuwirth highlights the importance of the digital revolution, the business model revolution, and the humanistic revolution in healthcare. Can healthcare leverage the power of AI and analytics to unlock the value of data? How can business models and payment systems be transformed to drive positive change? And how can humanism shape the future of healthcare delivery? Join us as we dive deep into these questions and explore the path towards a better healthcare system.

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Transcript

This transcription is provided by artificial intelligence. We believe in technology but understand that even the smartest robots can sometimes get speech recognition wrong.

Welcome to This Week Health Conference. My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of This Week Health, a set of channels and events dedicated to leveraging the power of community to propel healthcare forward. Today we have an interview in action from the Fall Conferences on the West Coast.

Here we go.

All

right, here we are from HAL 2023 out here in Vegas, and today we are joined by Dr. Zev Neuwer, formerly with Atrium Health, currently author of Beyond the Walls, which I really want to talk to you about, and you're going to sign this later. For you, Bill, absolutely. I'm looking forward to it. So it's Megatrends, Movements, and Market Disruptors Transforming American Healthcare.

This is a moment, isn't it, in healthcare? You can feel it here that there are things happening that we digitized everything, that was painful and difficult. But, I'm talking to health systems now that are saying words like we've unlocked the 80 percent of the data that was unstructured, and we're making value of that data finally.

It feels like we're at that moment where meaningful use... had a promise That's finally being realized decades

later. Yeah, no, I think you're absolutely right. And I'm glad you said that. You're actually one of the few people who I've heard say that we are in a moment in American healthcare I would suggest to you, given what I've been studying and researching and observing for years now that we are at a moment in time where I think that we are potentially on a precipice of really sliding back.

And we're also at a moment where we can enter into a really, a renaissance of healthcare. This is the moment. What it's going to require is a different type of strategy. And so I spent the past 10 years doing in-depth interviews with the leading entrepreneurs, leaders within legacy healthcare who are actually transforming healthcare, who are creating a new healthcare system.

And out of literally hundreds and hundreds of these In depth interviews over the years, I've distilled the three major strategies that we must combine. They're core critical and they're overlapping and we must do them together. If we're going to do what you just suggested, which is to really unleash the value we have in our healthcare system, the first strategy, if you don't mind, I'll share with you, the first strategy is kind of what you were alluding to.

It's what I call the digital revolution. And by digital, I don't mean telehealth or telemedicine or virtual care alone. I mean exactly what you're talking about. Taking all of the information, actually all of the actions in healthcare, all of the diagnoses, all of the treatments, every interaction, and putting it into zeros and ones, recording that, and then using the power of analytics to really decipher that information, using the power of AI to really use that information.

That is the digital revolution. I don't think most people have any understanding of how that's going to transpose American healthcare. I believe five to seven years from now, If we look back, we will not recognize where we were in the early part of this decade. It will have transformed. That's only the first part.

There are two other parts that we will have to do if we're going to get into a renaissance of healthcare.

I want to get to the other two. Is there something that's going to keep us from getting there? The first one, getting everything digitized?

That's a really good question. I think there are a lot of obstacles, and you're probably more expert in this than I am.

I think that what we need to do is really advance regulations, advance policy. I think interoperability is such a huge factor. And this is one of the reasons I wrote the book. We have to figure out a way that legacy healthcare systems, small and large can adopt the technology, and again, it's so confusing, it's so overwhelming.

Every hospital system cannot have the expertise. In fact, I would argue that many, if not most, don't have the expertise required. So we have to figure out a different way, and I think we're seeing that. There are companies popping up that are helping provider groups, hospital systems. The payers decipher how do we make decisions about digital health and also how do we integrate it so it's not just these one off point solutions, which again, that could be the death of us if we don't get over that.

So there are a lot of hurdles just in that first domain of the digital revolution.

Okay, second.

The second revolution is really about what I call the market revolution. It's about... Business model change, and it's about payment change. And I would put regulatory in there. But what most people don't understand, that just as important as the technology and the digital revolution, is the business model revolution.

If we do not change our business models, and I, yes, I'm talking about value based payment, but even beyond value based payment, The types of partnerships and collaborations and coalitions. So let me give you an example. This is actually a business model transformation. As much as it is a technical or digital platform, most people, most leaders in healthcare have no idea what a platform actually is.

A platform is not a technology. A platform is a business model transformation. Instead of that... Creating products and selling products in that linear business model. It's essentially bringing vendors and services, having them sit on your platform, bringing customers to your platform and making it easy, seamless for the customers to, really find the right services, find those right vendors.

That's what a platform is. It's a business model transformation. If you look at the types of partnerships that the retailers, the pharmacy chains, the insurance companies are making right now, they're unprecedented business model transformations. Instead of trying to build it all themselves like hospital systems have been doing for decades, those folks don't do that.

They acquire them, and they integrate them, and they're moving faster than fast. And what we're seeing now is hospital systems beginning to adopt collaborations and partnerships. I mean, look at Civica RX. Look at TruVeta. Look at Graphite Health. Look at what's happening there with Ryzen Health. I mean, these are new business models.

They're not the same business model. So if we don't couple the business model transformation, the financial transformation, the payment transformation... We don't couple that with the digital revolution. We're going to have a bunch of toys without a business model that actually will take us into the future. 📍  We'll get back to our show in just a minute. We have an excellent webinar coming up for you in November. We had an excellent conversation about AI in September with three academic medical centers around the topic of artificial intelligence.

It really was exceptional, and we released it on our podcast channel so that we could share it with a wider audience. I wanted to explore that topic a little bit more, and I asked a couple of additional health systems to join us to explore the use of generative AI and other forms of artificial intelligence to see if we can identify some pragmatic approaches to how health systems are looking at taking advantage of this technology.

The webinar is on November 2nd, 1pm Eastern Time, 10am Pacific Time. You can reserve your spot on ThisWeekHealth. com and one of the things we love is that you can submit your questions in advance and we can make sure that we, answer those questions and keep the webinar relevant to the things that you're looking to talk about.

So, please join us November 2nd, 1 p. m. Eastern Time, 10 a. m. Pacific Time. Now, back to our show. 📍   📍

 Wait, but you mentioned those four. Civica, Truvetta, and the rest. At the end of the day, those are very interesting to me. And we've covered that when we've talked about them on the show. But the payment, the underlying payment models, the incentives are, so when, when a patient comes in, there's legal risk we're trying to mitigate, there's other things, and so we reorder a whole bunch of tests that were done two weeks ago, just happened to be done down the street, and now we're doing them again.

We have all these weird incentives that are still around. Are you talking about that as well?

Well, that's actually, that's embedded in that part. There's no question that the payment has to change. The incentives, as you say, the compensation. It has to go down to the level of like, you know, look, no matter who you are as an individual, What you get paid to do, it's hard to fight that.

You're going to fall in a line, and so we do have to change payment, we do have to change compensation, we have to change incentives at all levels, and part of that has to do with CMS and the government. I think they're moving there, right? They're moving policy. But I think you're, no, both of those are absolutely critical.

Third, the third, and this is probably the most important, but the thing I want to say about this is the humanistic revolution. Now, this isn't just a marketing term, this isn't a slogan, this isn't something you put on the side of a bus. I am talking about what is happening in healthcare. At this moment in healthcare, we have been in the dark ages of healthcare delivery.

It is rife with sexism, with ageism. With racism, with ableism, which is a bias against people who have infirmity or disabilities. Reductionism, classism, industrialism. Our industry, the healthcare system, is rife with systemic and structural isms. What we need to do and what leaders are beginning to do is replace that with another ism, which is humanism.

And again, it's not a slogan. There are hundreds and hundreds of organizations that are using humanism as their core principle and literally embedding it as these are our KPIs, this is their goal, this is how they're measuring themselves. And, again, I can tell you story after story about this, whether you're a woman who's trying to find a, a treatment, a diagnosis, and a treatment for menopause.

If you're an 85 year old, on 17 medications, that 20 minute visit with a generalist doctor is not going to cut it, you know? so that's, that's ageism, racism, the, and classism the difference in lifespan. In every major city in our country, from the poorest zip codes to the richest, is 15 to 20 year difference, okay?

This is not just about health and health care. This is literally tearing apart the social and economic fabric of our country. You look at the cost of health care., over 100 million Americans are in medical debt. 100 million, this is not a sideshow. This is, and that number is growing by leaps and bounds.

It's so that's a third and a significant percentage of it will never get out of medical debt. All it takes for the majority of Americans, all it takes is one major hospitalization or one major chronic disease, and you'll be in medical debt and you probably will not get out of it. Okay? This is what's happening.

The problem is worsening again. It's tearing apart the social and economic fabric of the United States of America. That is why humanism, is the centerpiece of what I talk about, and I'm not talking about it. I am showing you dozens and dozens of examples companies who have put humanism at the center of what they do.

Now, here's the final point. The path to humanism is through the digital revolution and through the business model revolution. Those are the two paths. What leadership has to understand... We have to accelerate the digital. We have to accelerate the business model transformation, the financial transformation, the payment transformations, the regulatory transformations.

We have to do it, and we have to have humanism as an actual, concrete goal for our boards, for our CEOs, for our C suites. If we don't do this I think, you know, all the machinations we're doing are for naught. Because again, we're in this conference, look at the hundreds of billions, the trillions of dollars that are being spent in healthcare.

All I can tell you are the facts, which are, at this moment in time, despite the fact that we are spending more money than anyone could ever imagine in healthcare. Our costs are increasing, our affordability is less, our disparities are worsening, our lifespan is decreasing, chronic disease is on the rise.

One out of every two Americans has hypertension. All for 50 percent of those are uncontrolled despite all of this stuff. We are not doing right by the American public and the only way to do it is what I've outlined in the book there. And I've taken 10 years to finally come to that realization that is a tri part strategy that has to be done all together.

And again, I can show you example after example of successful companies who are actually doing this and actually creating a new healthcare that is humanistic.

It would be easy for me to end the interview here, but I want to put you in the boardroom. Actually, I'm going to put you in the boardroom as the CEO.

Congratulations 16 hospital system out of Southern California. You're now the CEO All the things you've learned over the last 10 years. Where do we start? How do we get started in this process? Now all of it can't be solved. I mean we talked about policy changes What can our health system do?

Yeah.

Well again, I would follow the strategy I outlined is we clearly are going to have to invest In the digital revolution, in the data ization, in all of that technology, we are clearly gonna have to invest and focus on how do we change our payment models, not in an incremental approach because again, incrementalism works great if you're in the C-suite or in the boardroom or you're a leader that's great because you have a lot of money.

But I'll tell you when incrementalism doesn't work, when you're that patient with your child in the ED or your. Father or grandfather are in the hospital, that's when incrementalism doesn't work. So what I would do is actually create a strategy based on that. The C suite their KPIs and their bonuses are based on humanistic outcomes, okay?

And then what I would do is, if you can't do it alone, if you don't have the capital, if you don't have the resources, if you're not big enough to do it alone, then read the last section of my book because then what I would do is I would partner. There are coalitions, collaborations. Others, and whether it's a venture capital firm look at General Catalyst with 15 or 17 hospital systems, starting that health insurance, a great example.

Look at Hospital for Special Surgery. They didn't launch Rightmove by themselves, they brought in Flair Capital. The partnerships and collaborations... are what we need to start, we need to start to get beyond the walls of our medieval fiefdoms, right? That's why I named the book Beyond the Walls.

It was

interesting, I interviewed Dr. Glasgow while he was at Jefferson. I love Steve. And it was interesting because he talked about that we've just changed his compensation model to be about the health of the people within the zip codes. And my question to him was, you don't control. I mean, you could, you had control of the things that were within your four walls or your clinics or whatever.

He said, yeah, but... this is what it's going to take to change. He's right. It's now I need to figure out how I'm going to reach those people that maybe aren't necessarily coming into Jefferson, but they live right here That's right. It's this zip code. And he gave the same example of yes, this zip code over here That's a good over there 12 years difference

in life.

Every city in the country 15 to 18 years difference we wonder why there's so much political and social unrest in our country. People may not know the stats and the facts, but they see the reality of what's happening around them. They know, I'll tell you the healthcare system in America, and this has been written about is really destroying the American dream.

You can't get ahead when your wages are taxed by your healthcare costs, and they are. And again, like I said a moment ago with you we started is. We are at a moment where we have all the opportunity, but it's going to take exactly what Steve Klasko said. And he's a great example of this. It's going to take courageous conscientious, aware, bold leadership.

And he's one of the, one of the greats in that domain. I take my hat off to him. We need more of that. And I believe the leaders out there have the skill, they have the ability. I just don't. Think they have the awareness of where we are and the possibility of what we might become. And that's why I wrote the book.

Fantastic. Beyond the Walls Transforming American Healthcare pick up a copy. I have a copy and be honest you, I'm gonna have you sign this. It's gonna go on my shelf, but I'm gonna get

Yeah. I narrated it myself. It Fantastic. Thank you for your time. Oh my God, bill, thank you. Appreciate it.

Another great interview. I want to thank everybody who spent time with us at the conference. I love hearing from people on the front lines. It is phenomenal that you shared your wisdom and experience with the community and we greatly appreciate it. We also want to thank our channel sponsors who are investing in our mission to develop the next generation of health leaders.

They are CDW, Rubrik, Sectra, and Trellix. Thanks for listening. That's all for now.

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