This Week Health

Krish Ramakrishnan from Blue Jeans stops by to discuss Telehealth past, present and future on our next discussion from HLTH 2021.

Transcript
Speaker:

Today in.

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Health it interviews from the health conference in Boston

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My name is bill Russell.

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I'm a former CIO for a 16 hospital system and creator of this week and

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health it a channel dedicated to keeping health it staff current and engaged.

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Just a quick reminder, I'm going to be dropping interviews

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over the next couple of days.

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And into next week from the floor of the health conference.

Bill Russell:

All right.

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Another interview from the health conference in Boston,

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and today we were with.

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Rama Krishna.

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Exactly.

Bill Russell:

I did that well, thanks.

Bill Russell:

Uh, well, welcome to the show.

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I'm looking forward to the conversation.

Krish Ramakrishnan:

Yes.

Krish Ramakrishnan:

Thank you.

Krish Ramakrishnan:

Thank you for

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having me.

Bill Russell:

And you don't have your title here, but you're with blue jeans

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network, which is a part of Verizon.

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W what's your, you have innovation and strategy.

Bill Russell:

Yeah.

Krish Ramakrishnan:

Well, the founder of blue jeans, there you go.

Krish Ramakrishnan:

And now I run strategy and the chief innovator for the telehealth

Krish Ramakrishnan:

space at, uh, Ryzen by blue

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jeans.

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Yeah.

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And I'm looking forward to this conversation cause we've.

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So many people come on to talk about, uh, uh, tele-health we,

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uh, in fact, I ran into Dr.

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Joseph Cavita or this morning over in the, uh, Omni hotel.

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And we were just talking about the stats that he said, you know, during

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the pandemic tele-health went up to 60, 70% of visits, some staggering number.

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I asked them what the new baseline is.

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He said, you know, it's slowly been coming down, but he said, it feels like

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right now the baseline is like 5% of.

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Visits at health systems has gone up.

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I'm like, wait, that sounds low.

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And he said, yeah, well backtrack a couple of years.

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And that number was like, 0.0, something percent.

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He said, so that's significantly, that's a significant rise.

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And what he's seeing is a lot of health systems are evaluating now

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with this experience where they can appropriately put tele-health in.

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So I wanted to touch base with you and just talk about, uh, let's

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start with the pandemic that.

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Really crazy.

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The amount of phone calls and work you guys had to do early on to get a debit.

Bill Russell:

Talk about that a little bit.

Krish Ramakrishnan:

Um, during the pandemic, it was really crazy, but

Krish Ramakrishnan:

let me just step back a little bit.

Krish Ramakrishnan:

Blue jeans was always in the video conferencing business.

Krish Ramakrishnan:

They were selling to enterprise larger hospitals, universities.

Krish Ramakrishnan:

That's our core, uh, model, uh, compelling video content.

Krish Ramakrishnan:

So as it turns out during the pandemic, everybody wanted to have

Krish Ramakrishnan:

a video tool that they can do.

Krish Ramakrishnan:

We had many hospitals reach out and say, we need to get our inpatient to remote

Krish Ramakrishnan:

telehealth right now over the weekend.

Krish Ramakrishnan:

In fact, I will tell you, university of Pennsylvania over the weekend, they

Krish Ramakrishnan:

said, next week we are shutting down.

Krish Ramakrishnan:

How are we going to do it?

Krish Ramakrishnan:

We had to run a team out there, create a service improve capacity, 400%, 400%

Krish Ramakrishnan:

one week in terms of not only telehealth.

Krish Ramakrishnan:

Yeah, that was during the pandemic and we saw people embrace tele-health.

Bill Russell:

Yeah.

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W th they really didn't have a choice for the most part, not from a safety

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standpoint, this became the preferred method, the preferred medium for all

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health systems, uh, to, to move forward.

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So it was a, I call it a pilot at scale.

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I mean, it all, all of a sudden went from, Hey, we're playing around with.

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Now we're going to do it across the entire health system.

Bill Russell:

Um, I mean, did that present different kinds of challenges?

Krish Ramakrishnan:

I actually, I would say it's more of an opportunity.

Krish Ramakrishnan:

Uh, we had to roll out video conferencing for everybody, but what we realized is

Krish Ramakrishnan:

video conferencing is a meeting tool, collaboration office tool, because

Krish Ramakrishnan:

it's not designed for tele-health.

Krish Ramakrishnan:

So when we became part of horizon, What if we can accurately look at video and

Krish Ramakrishnan:

in the context of teller tele-health and how can we repurpose bill for telehealth?

Krish Ramakrishnan:

And that's the innovation that blue Jean arrived and brings to the table.

Krish Ramakrishnan:

So we can talk about

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that.

Bill Russell:

So we get, we get into the pandemic.

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I assume what happens after the initial, uh, excitement of we've got

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to get all this stood up very rapidly.

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There's a.

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We've got to integrate this better.

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We've got to make it better for the workflow.

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The physicians want it to be easier.

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We want to make sure we don't drop any calls and that kind of stuff.

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So talk a little bit about, as it matured, as it went along,

Krish Ramakrishnan:

what we realized is in order for tele health to be

Krish Ramakrishnan:

successful, the user experience has to be at the top notch.

Krish Ramakrishnan:

Right?

Krish Ramakrishnan:

So most people were using it.

Krish Ramakrishnan:

Uh, Some kind of ID support.

Krish Ramakrishnan:

We wanted to make sure that it worked the first time.

Krish Ramakrishnan:

Doctors are not, it support people now in

Bill Russell:

order

Krish Ramakrishnan:

they want to be, they want to be, but turned out initially.

Krish Ramakrishnan:

That's what happened.

Krish Ramakrishnan:

I cannot call.

Krish Ramakrishnan:

I can not hear, I have echo.

Krish Ramakrishnan:

We want to make that compelling.

Krish Ramakrishnan:

We, second thing we did, uh, innovation wise, we made it mobile without an app.

Krish Ramakrishnan:

Download just one, click and join a.

Krish Ramakrishnan:

And then we made it easier for the hospitals to launch televisits by

Krish Ramakrishnan:

doing all of the EHR integrations so that we could have, uh,

Krish Ramakrishnan:

the patient record pulled out.

Krish Ramakrishnan:

Then we looked at this and said, one is we can simulate a real world waiting room.

Krish Ramakrishnan:

After all, when you go into a real clinic, there's a waiting room.

Krish Ramakrishnan:

There is an intake form.

Krish Ramakrishnan:

Uh, Things that

Krish Ramakrishnan:

you

Bill Russell:

need to do for

Krish Ramakrishnan:

education, all of those things.

Krish Ramakrishnan:

So we created a, one of a kind waiting role where the patients

Krish Ramakrishnan:

go in and they have intake form.

Krish Ramakrishnan:

They could look at all the videos and they can be notified.

Krish Ramakrishnan:

Even if the doctor is late, all of those things, those things

Krish Ramakrishnan:

we're missing an industry.

Krish Ramakrishnan:

That's something that BlueJeans brought to the table of revamp

Krish Ramakrishnan:

reading and then post visit.

Krish Ramakrishnan:

What are some of the.

Krish Ramakrishnan:

Uh, text messages, all those things were integrated so that we can build a, a very

Krish Ramakrishnan:

purposeful television application rather than using a collaboration application.

Krish Ramakrishnan:

I'll

Bill Russell:

tell you in the, I lived down in Florida and so, and

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I moved into a neighborhood where they referred to me as the kid.

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Now I'm 54 years old and they refer to me as a kid.

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It gives you an idea of the people I'm living around.

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And my neighbors were coming to me.

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Oh, you're the healthcare guy.

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I have a visit.

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I have a telehealth visit today and I can't figure it out and

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I'd go over to their house and they'd have an AOL browser.

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And I kid you not an AOL browser AOL email address, and they're trying to connect.

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And it was, there was a lot of friction in that experience.

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And there was a special, one of the, one of the people I was helping was

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had a meeting with a specialist at a prestigious hospital, and he ran

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about 17 minutes late and we had no indication that he was 17 minutes late.

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So.

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10 minutes in we're troubleshooting.

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We're trying to figure it out that that experience is, is critical.

Bill Russell:

And I would assume that a lot of health systems are really looking to, to, to

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optimize that experience on both ends the, the patient side and the clinician side.

Bill Russell:

I

Krish Ramakrishnan:

felt that, uh, experience that you just related

Krish Ramakrishnan:

is not, uh, it's not uncommon.

Krish Ramakrishnan:

We have heard of about that lot at that point.

Krish Ramakrishnan:

I can, it's a perfect compliment blue jeans, the video app.

Krish Ramakrishnan:

Uh, couple with Verizon the network.

Krish Ramakrishnan:

So one of the macro trends that is happening across all

Krish Ramakrishnan:

industries, not just tell how it service, it's moving to the edge.

Krish Ramakrishnan:

Right?

Krish Ramakrishnan:

What I might mean by that in a thing, there is the network component there,

Krish Ramakrishnan:

the computation element and where the service is rendered, more and more

Krish Ramakrishnan:

services are rendered at the home.

Krish Ramakrishnan:

That is the new edge, whether it be watching a compelling.

Krish Ramakrishnan:

Whether you want to eat at a gourmet restaurant that shows up at your

Krish Ramakrishnan:

home, telehealth is no different.

Krish Ramakrishnan:

We want to make the experience of delivering tele-health

Krish Ramakrishnan:

better than being there.

Krish Ramakrishnan:

Well, better than being there.

Krish Ramakrishnan:

That's the north star for blue Jean.

Krish Ramakrishnan:

And by coupling that with the network so we can deliver 5g

Krish Ramakrishnan:

capability, no missed calls.

Krish Ramakrishnan:

Crystal clear video, no choppy audio.

Krish Ramakrishnan:

You're making the.

Krish Ramakrishnan:

That much better.

Krish Ramakrishnan:

And then you can then now with this integration of apple health data,

Krish Ramakrishnan:

it minimize the amount of time.

Krish Ramakrishnan:

times you need to go to the clinic to deliver that.

Bill Russell:

You know, we're seeing a lot of, I saw entrepreneurs here

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and they're talking about hospital at home for chronic conditions.

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We see a medically home where, uh, Mayo and, uh, Kaiser, uh,

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partnered essentially in medically home and they're taking stuff.

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Best buy is announced.

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They're a healthcare company.

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They're standing up the home.

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Uh, so I want to talk about the future because the future might be

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communication through blue jeans, to the, the, the, essentially the

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primary care docs and the others.

Bill Russell:

But the, the hospital room is, is my bedroom is my, my home

Krish Ramakrishnan:

on the, on the money bill.

Krish Ramakrishnan:

The new clinic is.

Krish Ramakrishnan:

Surrounded by satellite clients that are more like your community

Krish Ramakrishnan:

hospital, something of that nature.

Krish Ramakrishnan:

And then there's the four, the bigger one, the bigger hospital, but it

Krish Ramakrishnan:

going to be a three tier system.

Krish Ramakrishnan:

But the primary clinic is your home.

Krish Ramakrishnan:

And therefore you need some of those, uh, data collecting devices like remote

Krish Ramakrishnan:

patient monitoring, uh, Diller and I like apple, uh, And then compelling, uh, video

Krish Ramakrishnan:

communication to make it very immersive.

Krish Ramakrishnan:

Yeah.

Bill Russell:

Well, and that's, it's, we're entering a new world.

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I've heard a bunch of the speakers here.

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Talk about the fact that the things that are happening have happened through

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the pandemic and will happen over the next two years will shape healthcare

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for the next couple of decades.

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And this is one of those areas where I think we're going to be talking to

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our doctors a lot more through this.

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We're going to be receiving a lot more of our care through this media.

Bill Russell:

So I'm excited to continue our conversation and hear how things progress.

Bill Russell:

This should be fun.

Krish Ramakrishnan:

Yeah.

Krish Ramakrishnan:

I'm excited too.

Krish Ramakrishnan:

One of the areas that really you're going to benefit from this is rural health

Krish Ramakrishnan:

bringing expertise to the rural area.

Krish Ramakrishnan:

I'd say Verizon mission blue didn't mention that is I'm very excited about

Bill Russell:

that.

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All becomes about the network at that point.

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Right?

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So it's.

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Uh, I talked to a CIO for the Cherokee nation and I said,

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well, tell me about your teller.

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Cause they ramped up.

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Tele-health pretty significantly.

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It was all over the phone.

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They did no video because they were in such remote places, all across

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Oklahoma that he goes, you know, we couldn't reliably do video visits.

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And so it really is about the network.

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At that point, if we had 5g and the promise of that bandwidth across

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the entire country, we really would change the nature of employment.

Bill Russell:

Healthcare the nature of a lot of things.

Bill Russell:

So

Krish Ramakrishnan:

as I said before, the new edge is the home.

Krish Ramakrishnan:

Yeah.

Krish Ramakrishnan:

This allows 5g and mobile edge compute allows the rural home to be part

Krish Ramakrishnan:

of the edge and be, uh, be part of the smart home and smart clinics.

Krish Ramakrishnan:

And everything's smart about it.

Krish Ramakrishnan:

Or even educate remote education to the rural areas, no longer the laggard.

Krish Ramakrishnan:

And that's most exciting.

Bill Russell:

Yeah.

Bill Russell:

And I've often said, you know, if given the choice, if I get sick and you know,

Bill Russell:

I'd like to pick my health system based on what's the best one I have, maybe

Bill Russell:

it's Mayo, maybe it's Cleveland, maybe it's UCLA medical center for cancer.

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And, uh, and I don't care that I live in Florida.

Bill Russell:

You know, when I have that kind of chronic disease, I'd like to

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interact with the best care I could possibly find in the country.

Bill Russell:

And this, this really leads us in that direction.

Krish Ramakrishnan:

Gives us flexibility.

Krish Ramakrishnan:

And even the future, you may not have to pick between a or B.

Krish Ramakrishnan:

I think we are always confronted with these choices.

Krish Ramakrishnan:

Uh, should, should I go with one or two?

Krish Ramakrishnan:

What can I be plethora of choices?

Krish Ramakrishnan:

I have fought this.

Krish Ramakrishnan:

I'll go here for that.

Krish Ramakrishnan:

I will go there.

Krish Ramakrishnan:

Maybe for most of my care I'll be at home.

Krish Ramakrishnan:

Maybe I can walk to a neighborhood clinic, maybe for a check-in.

Krish Ramakrishnan:

I go to a hospital or even a remote location that.

Krish Ramakrishnan:

This is what tele-health and rich communication is

Krish Ramakrishnan:

enabling for you in the future

Bill Russell:

for first.

Bill Russell:

Thank you for your time.

Bill Russell:

I really appreciate it.

Bill Russell:

Thank

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you, bill.

Bill Russell:

Check back for Morris.

Bill Russell:

The, we continues.

Bill Russell:

A lot of great interviews, a lot of great conversations.

Bill Russell:

I'm looking forward to sharing them with you.

Bill Russell:

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