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May 30, 2024: Glen Tullman, CEO of Transcarent, explores the paradigm shift in healthcare through innovative uses of AI and human interaction. How does the introduction of Transcarent’s new AI product WayFinding redefine patient navigation and care delivery? Can this technology-driven approach significantly lower healthcare costs while improving the quality of service? As they delve into the impact of generative AI on privacy and the seamless integration of diverse healthcare services, the discussion prompts listeners to consider whether the healthcare industry is ready for such a transformation. This conversation not only highlights the potential of AI in healthcare but also questions its implications on the traditional healthcare models.

Key Points:

  • WayFinding: AI Technology
  • Bold Innovation
  • Patient Experience
  • Clinician Workload
  • Healthcare Finance

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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.

  Today on Keynote

(Intro)   is this the next generation from the old time Navigators who've been doing things the same way for the last five years.

And the answer is no, this is a whole generational shift.

  My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of This Week Health, where we are dedicated to transforming healthcare one connection at a time. Our keynote show is designed to share conference level value with you every week.

Today's episode is sponsored by Quantum Health, Gordian, Doctor First, Gozio Health, Artisight, Zscaler, Nuance, CDW, and Airwaves

Now, let's jump right into the episode.

(Main)  All right, today we're doing keynote and we're joined by Glen Tullman, CEO of Transcarent Glen, a lot of stuff going on over at Transcarent

it's great to be with you as always, Bill, and yep, we have a lot of activity going on. It's a transformational time in healthcare.

WayFinding. So you've recently launched WayFinding, which combines AI and human support to guide I would say patients, but really it's just users through health journeys. I'm going to come back to the name because it's a little confusing to me. WayFinding is a little confusing to me, but I think you're going to explain it now.

What is WayFinding?

First of all, there's a number of ways to think about it. You've already gotten pieces of it. So we've used all the power of generative AI that you just talked about. We haven't left out, we've re emphasized the human component of that in our healthcare experience. WayFinding is a healthcare experience, it's not a product, it's an experience that combines three things.

One is benefits navigation. We all want to know what does it cost? Is it covered? One of the most frequently asked questions. And really nobody has an answer because we all have unique special plans with different plans and they change. So first and foremost, benefits navigation. Second, the minute we know it's covered, we ask the question, what should we do?

That's called clinical guidance and that's in the same experience. And then lastly, that clinical guidance might suggest you do something. go see someone, get a digital app, and that is called care delivery. All of that is now combined in one experience. In that experience, we've added every point solution ever invented, so any point solution your employer has chosen, we'll include it in the app.

And then last, but not least all of this is available for less than half the cost of what you typically pay just for benefits navigation. And in fact, remember included in that is your telehealth experience, which now telehealth is really moving to a chat based experience. That's what the actual users tell us.

They like doing Zoom with friends. When they're doing healthcare, they actually want the answer as quickly as possible. They don't necessarily want to meet somebody new on video. And remember, most of America doesn't sit in front of a terminal all day long. Our customers, whether it's UPS, whether it's Boeing, whether it's Target, they have big populations that are doing things, they're producing things, they're moving packages, they're building things.

They aren't sitting in front of a terminal all day long, so when they want their health care, they want it right here on their phone. And they want it anytime they need it, 24 hours a day, within 60 seconds. That's what WayFinding is. It's a new consumer experience that puts all of your health and care in one place.

It's fascinating to me because this is really a health journey. This isn't just a health care journey. So when you talk about all these partners, give me an idea of, is it as a large company like Target or UPS, do I bring to you like, Hey, I'm already working with these 15 players?

And then you integrate with those 15 players?

Yeah, you might for example, and 15 or 20 would be small for some of the large companies we're dealing with. And they have point solution exhaustion. They basically now, some have 30 or 40 different point solutions. And by the way, those point solutions are pretty darn good for the unique things they serve.

The biggest challenge they have that they tell me about is we can't get people to use them. Because if I call up and even if I call a navigator and the navigator says, yes, Glen, you ought to use Livongo as an example. So what do they do? They give me a website or they give me a phone number to call.

Now, all of a sudden I just wasted a call. I wasted my time. Now I got to call another number and then maybe another number. And what we're saying is all this ought to be instant. Again, think of every other experience that you have in any other business. For travel, we used to, you and I used to wait in lines at a counter.

Now we can do it instantly on our phone. Banking, we used to wait in line for a teller. Now we do it instantly on our phone. We want an Uber. We don't have to call anybody. We can get it right on our phone. Everything available, instant, accessible, wherever you are, whenever you need it. That's what we built into healthcare.

That's called WayFinding.

Have you changed your business model at all or is it still a share model of the savings?

No, this part of the model, we still offer that for unique experiences, but this part of the model simply says you pay us five dollars, it's a published price, so no monkeying around, no hidden fees, no we're not getting any kind of kickbacks or rebates.

5 that includes all of your benefits navigation. That's a half or a third of what the benefit navigators are charging today. You know that. Second, it includes unlimited telehealth. So you can chat all you want. Now, I'll put a little asterisk. If you call us more than 25 times a year, we probably need to route you to our partner Spring Health to basically get you some behavioral health therapy because if you're getting sick that much or you need to talk to somebody that much, you might have a different issue.

But the point being that people who are paying per byte per transaction today for telehealth experiences where people can sometimes sit in front of a terminal and wait 10 or 15 minutes. No, what they want is right now on their phone, 60 seconds, connect me and have a physician answering my questions.

That's what we're offering.

of the things that when you bring AI into the conversation, people are going to ask about is privacy and security. Mostly about privacy, they're going to say, Hey, are you using one of the models out there? And how do you ensure that my information isn't training that model or going to get outside of transparent?

Yeah, it's a great question. Thank you for giving me the opportunity to answer it. One we will never sell any information to any third party. Two, we will never use any personal information to either train a model or do anything else. So the only time we use information is if you get a shoulder surgery, we might say we did a shoulder surgery over here.

That's the only way we'd use it, which is used in every medical study, every is for billing and the like, but we will never use any personal information, either sell it or use it to train any model, number one. Number two, we use an engine, but we have built, think about a car analogy. So you can get an engine, but everything that you experience in the car, whether it be the design of the car, the cup holders, the radio, All of that is what we build around the basic engine.

And that engine, all that information is proprietary to us. And this is a proprietary model we built. Now talk about training. Interestingly, you reported on the fact that just over a year ago, we purchased 98Point6 for 100 million. And a lot of people looked at that and they said, okay we know what you're getting.

You're getting great people. And we did great people, great developers. You're getting great software. Yes, we did. You're getting great customers. Yes, we did. The one thing they didn't understand was we were the largest database of chats in the world, because unlike Teladoc MDLive that are doing chats like this virtually and have for years everything we had was documented in searchable format.

So consequently, we could feed all that information, once it was depersonalized, into the model to train our large language models. That gave us a year to two year head start. Then, when we did the acquisition, we also started building our data science and AI teams and focused on this. So what you're seeing is the end result of an effort to build this WayFinding product that is, again, saying people say, is this the next generation from the old time Navigators who've been doing things the same way for the last five years.

And the answer is no, this is a whole generational shift. This is like going from a flip phone that does one thing to an iPhone that does everything. Somebody wouldn't say, Oh, I have a flip phone. You have an iPhone. They're pretty much the same, right? You could say that the flip phone or the iPhone came after the flip phone, but you wouldn't say it's just an upgrade.

You would say the iPhone is wholly different. That's what we have here because I'll go head to head with any old line navigator, ask me five complex questions. Here's what I want. I want an orthopedic specialist in Los Angeles who speaks Spanish. I want to know my benefits plan, whether it covers these four different things and what my specific copay is.

I want to know, I can answer all those within 15 seconds. An old line navigator with a person on the end, you couldn't dial the number in the time that I can answer those questions. So it is so different. Again, it's like, think of this as a really smart, personalized Google search. That's how fast it is.

And how smart it is.

Let's talk about personalization. Because this has been one of those things that we've talked about in healthcare for a while. Let's go to the old call center model. When the person on the other end has all the information in front of them about me, it is such a better experience.

But we're at a point now where it feels like we can feed a lot of information in so that when I'm interacting with my model or whatever, and this is where the privacy really gets sticky. I want the system I'm interacting with to know me. to know as much about me as possible, so I get that personalized experience.

much closer to that personalized experience are we?

We are there right now, and that's what's so unique. For example, it might say to you when you ask it one question, and this is what's so amazing, if you came in and you said I think I have a sinus infection, and then it might say, okay let's check.

Tell me are there symptoms. You might say, I have a headache. I have discharge. You might say, I think it's a normal sinus infection. But Bill, I noticed that you have Type 2 diabetes. And consequently, I also want to check on this and you're like, whoa, wait a minute. I didn't mention to them. Yeah, but if you were a good doctor, you would have reviewed the file and you would have pulled out that and you would say, is there anything else I ought to be looking for?

Now, all that information gets put in front of a real doctor, a human, who looks it over and says Bill's on the line. I don't have to waste my time asking what pharmacy he wants to go to. I don't have to waste my time re verifying basic stuff, which doctors hate. I'm going to spend all my time focusing on did we get the clinical guidance correct?

And is the path that we gave Bill correct? Oh, and by the way, the computer reminded me one or two things about Bill that the reality is I would have never had time to check. And it might even suggest, Bill, you're over the age of 50. Have you had a shingles vaccine? Now, when that happened to me, I had been through executive physicals for a number of years.

Not a single one of those doctors told me that I should get a shingles vaccine. I didn't even know what it was. I walked into a pharmacist and the pharmacist said, by the way, have you had a shingles vaccine? I said, what's that? I was astounded that I could go to some of the top healthcare organizations in the country.

Do an executive physical, and no one asked me that question. It was luck. We want to move luck to standard practice. And that's what this will allow us to do.

talk about costs a little bit here. This is an election year, so we're going to have a lot of conversation. I hope we're going to have a lot of conversation about health care in this election.

My guess is we'll have a circus, but hopefully we'll have some good dialogue around health care and costs and transparency and those kinds of things. How does WayFinding help reduce those costs while improving? You just mentioned how it improves the quality of care, but let's focus in on cost and quality.

WayFinding help really support those two things?

I always start with quality, because at the end of the day, what you want to make sure is you're getting the best clinical guidance, and then you're getting directed to the top quality solutions, whether they be a surgery, a procedure, or simply digital care.

And think about, and again, Bill, I always go back to the things that are working. Think about your experience when you go to a restaurant, okay? You have ratings, you have guidance. You have, everything about it and then compare that to healthcare. You don't have any of that. So what we would do is we'd say, Bill, let's make sure you're getting the right treatment.

You say I need surgery. Before you need surgery, we recommend that you get a second opinion. I can connect you right now. It's covered a hundred percent by your plan. And here's why, Bill, we do too many surgeries in the US and it can be dangerous. Here's some side effects. Let's get you a second opinion.

It's free. You wouldn't go to a restaurant without Checking the ratings on the restaurant. So let's do that. Now we get better buy in. People understand it. And they say, okay if it's free, it makes sense. Now you get that. Now let's say you need surgery. We know, we have the data today to tell you that all surgeons aren't the same.

And all facilities aren't the same. If someone said a restaurant had just been shut down by the health department, You wouldn't go there. So wouldn't you want to know if a particular facility in a hospital chain, the chain might be great, but there may be one hospital that they're having some challenges at.

Why would we send you there? We wouldn't because we have the data. So we'd say, Bill, I'm not going to get into who's good and who's bad. I'm just going to pick the top quartile and give you a choice, your choice of those doctors at these high quality facilities. By doing that, we've proven we can reduce the cost.

by having you go to higher quality facilities. Amazing. So that's what we can do. Now let's talk about cost. We've done a few things on the cost side. First and foremost, what's the cost of the service? Right now, believe it or not today, some people are paying 10, 8, 12. For navigating their people.

shouldn't it be easier? Like what do you pay to use Google? Nothing. What do you pay to use your Uber app? Nothing. That's pretty complex stuff. The Uber app connects to a satellite. It finds where cars is. It gives you a selection of cars. It delivers that answer back to you in minutes.

It's really complex. And you don't need anybody to teach you to use it? Come on, we can do that in healthcare. We don't need a navigator to help you. Let's just improve the app. Like, only in healthcare do we say, we're going to have a third party because this is so complex. Really? Finding a position is that complex?

We used to all do that ourselves. And so we're going to give you that information. And by the way, plenty of people Google it now and they find their own, except you don't know what you're getting on the internet. So we're going to get you that high quality information, but we're going to do it at half or a third of the cost that employers are paying today.

That cost ought to plummet in terms of what the existing navigators, but then you get to quality. Even if you pay that high cost, you can't get the same speed and accuracy that we're going to give you in our product. And then secondly, when you get better outcomes, you're going to lower costs. That's what we have to do in healthcare today.

And we're working, by the way, not just with large employers, we'll announce that we're working with some payers and other entities, some health systems we already work with, because everybody can benefit from WayFinding technology.

Wow. that's a big conversation partnering with payers.

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 I want to come back to that because I want to talk about drugs for a minute because drug pricing is a significant challenge. And I think we talked to Snezana about the different partnerships that you've done that space. Is that still a focus

Absolutely. We think that

Marker

everybody ought to get five things. Instant access to care. We call that everyday care. Two, a pharmacy marketplace where you can put in any drug and find the closest place to buy it at the lowest cost. There we partner with Mark Cuban. We partner with GoodRx. We partner with Walmart to get you the lowest price.

Three, high quality surgeries. available at top quality organizations for cancer care and number five, weight health. All that's available in our core offerings. But if you want to use someone else, we're all for it. We'll put them on the app. We don't charge them. We don't charge you. We simply make it available.

So the primary business model don't know if it was the last time we talked, but at least two times ago when we talked was self pay employers was the primary business model. So you've expanded that and It almost makes sense that payers would be a natural fit for a platform like this.

Yeah, we're, look, people have said it various times, I don't like different people.

The answer is anybody who can help us take down the cost of health care. Payers are going to be around. There are some great, innovative payers, and we're going to partner with those folks. There's other payers who are not interested in reducing the cost of healthcare, and it's true with everything. Same thing with health systems.

There are health systems that probably charge more than they should. We're partnering with ones who are focused on high quality, delivering it at a very fair price. And that's what we want. So the fastest way to get to scale to solve this, and there's payers out there who figured out, hey, anything that can help them serve their customers, they want to do that.

So those are the folks we'll be partnering with. And we're going to be announcing some really terrific partnerships. But this is, in today's world, it's not as simple as they're an enemy, they're a friend. There's friends and enemies and frenemies, and it's all mixed together, and sometimes we partner with folks and we compete with folks, and we have different product lines.

That's going to happen, but anybody committed to improving the health consumer experience is our friend. Anybody committed to reducing the cost of health care is our friend, and we're happy to partner with anybody, and we're going to do it transparently, 100 percent transparent. 100 percent interoperable.

going to move off of WayFinding for a little bit. 20 some odd minutes on WayFinding, which love because I've been talking to people about how we're going to use generative AI in healthcare. chat 4. 0 as in the letter O comes out couple days ago, and one of the things they've been really touting is this voice interface.

I'm And it is so easy and the latency is next to nothing now. And so seen examples where people have their phone just sitting there as an assistant, like they're sitting there doing their normal stuff and then they just say, Hey, chat GPT answered this question for me and answers that question or those kinds of things.

want to know from your perspective, when are we going to get to the point where. It is that next level of easy, like just common voice. I'm just going, Hey

it's here today. It's here today. So

that's part of WayFinding, just that natural language interface.

Absolutely. So when you say, and the beauty is, so WayFinding, navigation, traditional GPS and navigation assumes you know where you're going.

And the problem with that is most people in healthcare don't. So if you say, I need surgery and I have a tear of this and, great. But in most cases, the conversation starts out and you will do this yourself. You'll experience it. You'll see. My shoulder hurts. That's what she'll say, and it will ask you questions.

What hurts? How did you hurt it? Where does it hurt? Can you lift your arm? It will walk you through that. And then I'll say, let's connect you. Here's what we suggest, an orthopedic consult. Let me get you on with an expert. Let me do it right now. Or if it's better, I can schedule it for you. That's all voice interaction.

You're talking to the computer. You're using words to talk to the computer. You can also type into the computer, whatever works best.

One, it's available now, but two it's going to get better and better. So the beauty of this, now you described ambient listening. And if you talk to doctors in a lot of hospitals, what they do is they do a visit now and they set their computer up. They ask you, is it okay if we have this transcribed?

And afterwards, it does a whole visit summary. It is one of the first uses of technology for physicians, other than the pager where physicians have said, this made my life better. All of our other technology, especially technologies like Epic, they haven't made physicians lives better. They've actually added.

to the challenges and the frustrations. Now we're finally going to get, both for physicians, but also for health consumers, technology that makes life better. And that is when you look at what we have, it's almost hard to explain to our kids, how hard it was to hail a cab, what a pain it was to go to the bank to get money before ATMs, things that are hard to imagine today.

That's how healthcare will be.

So we've talked about how you partner with health systems, but I'm thinking back to my time at St. Joe's and since it doesn't exist, it's now part of Providence, doesn't exist as an entity, I'll just say it. Our benefits were not that good for our employees. we really struggled here.

It was a bad experience. They had as much, if not more, trouble navigating it and we were, I believe we were a self pay entity that had a partner that was processing the claims and whatnot. But the end of the day, it was a really bad experience. is that a primary conversation you're having with health systems is around their benefits for their employees?

I think that they represent, just as we said, our primary focus is large and mid sized self insured employers, but we're talking with everyone. So we're talking with our national independent provider ecosystem partners, which are big health systems. We're talking with payers. We're talking with everyone about the technology and finding different ways to apply it.

So the answer is, Absolutely. And again, you always hear what you just said. People say the experience isn't great. And in most cases, they say, even if we have the benefits, our utilization isn't very good. And that's because we force them through two or three different steps. One of them called them the benefits gauntlet before you can get to what you need.

And we're saying now there's one place for all your health and care. So I think it's going to change everything. That's what access does. When you think about Google, it made information equally available to everyone in the world. That's the moment we're at in health care. And it's exciting, and this is really the first, maybe other than ambient listening for physicians, this is the first use of AI that's directly going to impact millions of health consumers.

Where so again, this is off the beaten path a little bit, but General Catalysts invests in a health system. that going? does that look like, and what does that tell us about potentially the future of healthcare?

Look one, understand that we are very close partners with General Catalyst.

They're an investor in Transcarent they're an investor in my prior entities. Heymonton Asia is not only, I think, one of the great visionaries of the VC space, In a number of areas, not just health care, but also a close friend. That said, this issue of why would you buy a health system, they are so committed and so convinced that technology can make a difference, that they've said, if we are able to demonstrate By buying a health system and applying without all the delays, without all the pilots, applying our variety of technology solutions, that we can fundamentally change how that system operates, both from a quality standpoint, a safety standpoint, and a cost standpoint.

They put their money where their mouth is. Some people say why would they do this? Because if you really believe it, you're going to double down and you're going to make a bet on it. And I think it's an extraordinary commitment that says we believe in what we're doing.

We believe in the companies that we're investing in. I'm anxiously awaiting to see the results. Once it gets fully cleared. To see as you start to apply technology across the board, what you can do. And look, it's the same thing, whether you like Elon Musk or don't like Elon Musk, he didn't use incremental upgrades when he built the new Tesla factory.

He did it all at once. And because of that, his cost or something like half of what, The rest of the industry is paying now to build cars. And that's kind of their model to say, what if we didn't do incrementally one technology and the next technology? What if we put it all in and really committed without all the red tape and all the testing and when I say testing, I mean piloting.

I don't mean testing the systems. Of course, that will be done from a quality standpoint. I think that's what the bet they're making is about, and I couldn't be more excited , to participate in it and watch what happens with it.

Yeah I'm, private equity and VC sometimes gets a bad name in healthcare.

But it changes the game. I had conversations with two different CIOs for, one was a publicly traded healthcare organization and one was VC not a private equity backed company that's doing some things. And the conversation was very interesting with them. They said, one of the things that they, and they both have worked for non profits before, they said, one of the things that's really clear here is our set of objectives are very clear.

It's like we spent a lot of time and said, this is what we're going to accomplish, and this is what we're going to do. Do I said does that compromise quality or that? And they said, no, we're human beings. that's like number one on the list. Quality care is people like assume because there's a profit motive involved that will just fall off.

But you can't have a quality business unless that's top on the list.

I think, look, the reality is we've seen both sides of that equation. We have. And one of the things that I love about General Catalyst is their set of value based principles. It's the same principles we live by at 7Wire Ventures, and that we have at Transcarent

but we've seen, even recently, venture funded companies that make more money the more prescriptions they write. So guess what happens? They write more prescriptions. There are many incentives in healthcare, even for non profits, even for people seemingly who want to do the right thing, and the incentives drive them in the wrong direction.

I think you can build a business, you can build a good business, or you can build a great business, and the great businesses have full alignment with what's best for their employee or their customers. What's best for their employees, what's best for their community, and what's best for their investment.

That's a great company. And there are good companies that get a bunch of those. And then there's companies that don't do that. And, there is a role for regulation I'd rather businesses police themselves and the government not have to get involved. But, the reality is some don't.

Some do.

Sometimes you have to.

There's a role for safety and it's across the board, whether you're, whatever industry you're in. Sometimes it's good to to have those kind of check ins or those gates.

Glen, let's close with this. What's next for Transcarent

I think what's next is educating the industry about WayFinding and really engaging people in the conversation that says, first of all, you're paying twice as much as you should.

For the traditional navigation services. You're paying twice as much as you should for all of the telehealth stuff that your people don't even want. And there's an opportunity to reinvent the entire consumer experience of healthcare. that's the moment we're at a moment in the industry, this is kind of the iPhone moment for healthcare.

And we're looking forward to leading it forward. And Bill, we appreciate, as always, you being in front of the trends and talking to us today.

Glen, one last thing the first time we talked and you told me about Transcarent and where you're going, I said, look, I've got a company.

And at that point it was like four people. Now we're up to 10 people. Are we at a point where we can engage with Transcarent or is it still, little shy of the number we need to be?

Now, I think the reality is for your company. Yes. Look, the reality for WayFinding is a company of any size can engage and, that's the issue.

I will say just from a resource perspective, right now in this stage of our company, we would probably work with, and again, another population we haven't mentioned, but, brokers, there's some great ones out there. that are really working hard Brown and Brown, other folks like that, who are really working hard on behalf of their clients.

And they've already come to us and said, some of those folks, hey, can we offer this? But they aggregate a lot of the smaller companies that are out there.

All right keep growing. I'll keep growing until I get on your radar you can, work some partnerships and we'll figure out a way.

Glen, always a pleasure to talk to you. Thank you for your time.

Thanks for spending the time with us today, Bill. Always great to see

you.  

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