December 6, 2023: Paul Hoffman, CEO, and founder of inTandem Health joins Bill for the news. How does his experience as a cancer survivor shape his unique approach to health care? How does the integration of technology in medical care help patients, and what challenges does this present? They delve into the dynamic and evolving world of health care, discussing academic medical centers, the impact of human connection, and the role of AI in shaping health care practices.
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Today on This Week Health.
have lots of stories of, somebody saying I am frustrated.
I'm not getting the attention I need, I'm going to another health system. And so there's this ability for this human touch to prevent revenue loss.
Welcome to Newsday A this week Health Newsroom Show. My name is Bill Russell. I'm a former C I O for a 16 hospital system and creator of this week health, A set of channels dedicated to keeping health IT staff current and engaged. For five years we've been making podcasts that amplify great thinking to propel healthcare forward.
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Now onto the show.
(Main) all right. It's news day. And today I'm joined by Paul Hoffman, CEO and founder of In Tandem Health. First time on the show Paul welcome to the show.
Thanks bill. It's it's great to be here. Thanks
for having me So inTandem is a cedar sinai accelerator Company, I don't know if that's what we call it, but you're one of the classes that graduated from the cedar sinai accelerator I love the concept of having peers and having People and bringing people together who have gone through what you're going through and creating these connections for people so that they don't have to go through things alone.
But I'd love to hear give us a little bit about what inTandem does and the genesis for the organization.
Sure. And just going back to the accelerator, that was quite a summer when I applied. And my last interviews were with nurses, and the nurses said, they said, the peer mentors, the family caregiver mentors, they're the backbone of the health care system for us, and we couldn't do our job without them.
So I think that was one of the reasons why inTandem was selected for class seven. But what we do is we're a digitally enabled one to one community support platform that's building all these small little condition based communities within these health systems. So now. When you hear those words of a life changing diagnosis out of your doctor's mouth and they say you have cancer, you need a transplant, we're going to make it so we can reimagine that delivery of that diagnosis and you could click a button in epic.
and boom, you could connect somebody to another patient or recommend that you're a great patient. You ask great questions. You're a great listener. Would you like to give back and talk to another patient? And so we're a centralized platform to scale it throughout these academic medical centers that offer it in silos and trying to use technology to now scale and measure it.
So do people have to sign up to be peer mentors?
You do. So it's all under the Joint Commission Volunteers requirement. So you do have to go through the official volunteer. Cedars Sinai is pretty impressive volunteer program. They have 14, 000 patients that are giving back in their volunteer system.
And so what we find is at these academic medical centers, a lot of the mentors come from the Patient Family Advisory Council, so the PFAC groups, survivorship groups. And so it's healing for patients to give back. one of the first things that I did when I came up with this idea, after I went through my own cancer experience was just, I grabbed my video camera.
I ran down and I knew some Stanford healthcare mentors that were in their transplant area. And I started interviewing these people and these, people have been doing it for years and years and they really love it and they love talking to people and helping people because people that went through it alone and then you survived it, it's healing for you to get back because you don't want somebody to feel like that when they're going through it.
So. I think it's one of those areas in health care. It's been neglected and because of HIPAA it hasn't been able to like really grow. But now with technology and the pandemic happening, we're seeing there's a big demand for it.
as a clinician, and we're going to talk a little bit about the clinician experience on that.
As a clinician, I can essentially go in there and say, would you like to? And they say, yes. And within the EHR, I, I make that connection for them. is it that kind of model?
that's our next phase. Cause we came into the accelerator as a prototype and then we graduated in January 2022 and we built it, but on a roadmap.
The next big step that we're going to make is this integration with Epic and it's being done. It's, being done at a, large health system in Los Angeles that has the doctors able to connect the patients in Epic that are going through kidney transplant. So it's not a hard thing to do.
it's really best thing you could do to scale these communities because then everybody knows about it. And the whole reason I'm doing this bill is because I live up in the Bay Area. I was at an academic medical center. I won't name the name. I had a great experience with my surgeon in the city of San Francisco.
But I asked everybody throughout my journey. I'm like, can you connect me to somebody? And the doctors kept saying, no, we don't do that. And then I ended up getting, just overwhelmed and I just didn't feel like I was having my questions answered. So I left and went to do my treatments at another academic medical center.
And I asked the doctors there if they can do it. And then later on, I found out both hospitals had these types of programs in my condition, but they didn't. offer to people because there's no technology. So I said, this is an area that's just it needs to be transformed with a little bit of technology the human touch.
So that was really the real reason why. so putting it into the doctor and nurse and social worker workflow makes it so everybody will have that option to have a connection with another grateful patient.
That's fantastic. I love hearing founder stories. Because so many of them are tied to their personal journey or their personal experience.
And I think human nature, like if I were diagnosed with cancer, human nature in my head goes to the darkest place. I would need to talk to somebody.
Yeah. And you know what? it brought tears to my eyes when I did the first filming of Stanford health mentors, when one of the mentors said she had a patient that was going to stay on the medication and was refusing to go ahead with her heart transplant.
And she shared her personal story of surviving and she had a family. And if you have a family, if you want to see your family you need to go. through with this. And she said, the patient said, you saved my life. I went through with a heart transplant and I've heard these stories in other areas, and they're really moving to see how transformational it is.
When you have that story presented to you from a human survivor, it, it really is, life changing.
Even more so than a, doctor, like a doctor can tell you that story. And it's, the doctor telling you the story, but when somebody else who's gone through it, the impact has to be pretty, significant, I would imagine.
Yeah. The doctors didn't live. the experience. they didn't have that personal experience. So, it's hard for them to really know what it was like. They can tell you exactly what the percentages are of like this medication or treatment causing other illnesses.
But that's about it.
are you primarily focused on academics right now? Are you, broader
than mean, our main focus is really anybody who's doing it today. So the existing programs that are all analog and manual, but they're mainly found in the academic medical centers and cancer transplants, cardiovascular neurology.
And this also is yeah. for the family caregivers. So a family caregiver mentor can help a new family caregiver. And that's really helpful in dementia. And I don't know if you saw the New York Times stories two weeks ago, that they had two back to back stories of, healthcare caregivers being just overburdened.
And there was a lot of pent up anger in this country. And they talked about. How mentoring was empowering to these family caregivers and now Medicare has a new program. They just announced called guide where they're going to start reimbursing providers for this added support. So you're starting to see a little bit of a sea change out there.
So if you're with an academic medical center inTandem health dot net. Is that correct? Yes. There you go. All one word inTandem health dot net. And you can reach out there. You talk about the clinicians and the things they're facing. The 1st story we're gonna look at is how health care is tackling clinician burnout, but this is 1 of those ways, right?
They get inundated with a lot of well, I mean, this talks about messaging and that kind of stuff. They get inundated with a lot of communication that mentor could actually help with, I would imagine.
Yeah, I mean, the
potential for one to one support to remove some burden of these non clinical questions is big. If you don't have a mentor on your care team to support you, you're using Dr. Google and you're getting more scared when you go on Dr. Google. And so you're going to be asking the questions to your doctor, to your nurse, or maybe a social worker, and they don't have time to answer those questions.
So it's really filling that gap of helping help you stay with your condition, but now these mentors help you live with it. And that's really the key here is these nonclinical questions.
is Dr. GPT any better? You said Dr. Google. I'm, I'm, I'm just curious.
I don't, I mean, I, when I was first diagnosed, I went on a lot of these sites and it just seemed that sometimes you're just in, like you said, you're in a dark place and you're just not ready to be reading reams and reams and reams and books and books about things.
It gets you more depressed. And so it's better for, I think a human. who's a survivor to tell their story. And that makes you feel less alone. And really transmit that information in a way where you're open to hearing it.
Well, this, story touches on a health day Harris poll, almost 63 percent of physicians and nurses across the nation reported experiencing a moderate or significant level of burnout in their workplace.
That number actually seems low to me based on what I'm hearing, but they Talk about AI aided documentation is necessary. Chris Longhurst, who has been on the show says across the country, doctors are being inundated with messages and it's a real problem we need to solve. 📍 57, 7 percent of providers.
Agreeing that excessive EHR documentation is one of the contributing factors leading to burnout. And we now have a fair number of health systems. We've talked to some of them. We talked to Stanford. We talked to UC San Diego. We talked to UNC Health amongst others. University of Wisconsin Health and others have been on the show talking about piloting these things like the draft message response to inbox.
Some summarization is being done by AI and, large language models. Things that first of all are passing through algorithms, but it's not going directly to the patient, it's coming to the clinician. It's potentially giving them a headstart and giving them the ability to just edit something and send it out as opposed to putting it out there.
That's, one of the main things I'm hearing over and over again. That, and. The documentation of the visit themselves, the transcription being done electronically so that the doctor can actually face you. in your health journey, have you seen that transition from the doctor sitting at the computer, just sort of tapping away to actually being able to face you now and have conversations?
I mean, I have not seen it. I mean, every place that I've been to is on Epic and they're, they are stuck in looking at the screen. when I read that, I just wondered, like, what percent of these questions, it's like being an anthropologist when you do these. companies, you have to go interview a lot of clinicians and patients.
And one of the things I'm just curious about is like, what percent of these questions are non clinical because send non clinical questions to my doctors. And you just wonder how much of their time is being spent, on stuff that's below Why they went to medical school for,
It's one of the reasons that these inboxes end up being just crammed with stuff.
First of all, the clinicians from a time scheduling standpoint, in a lot of cases are overscheduled. And then the other thing is just the sheer number of messages. gets to be hard to respond to. And as you say, some of them are at their license, something they should respond to, and many of them are not at their license and things that could be handled by somebody else the way.
But the, key is being able to go through that inbox and determine which, is at license and which is below license and could be handled in another way.
Yeah. And, and if you unpeeled this onion of, being told you have a life changing condition. your anxiety levels are so high and you and your cognitive overload is very high because they're giving you booklets of information when you first show up.
So because you're really vibrating at, this anxiety level, you're asking more questions because you're scared. And so I think one of the things that, we've seen, and this is evidence based. I mean, there's so much information out there from hospitals like Kaiser and others Ohio State just did big research study on, peer support and transplants and, the reduction in anxiety is big.
So I think this, this is a missing piece that could impact what you're talking about because at some hospitals like Michigan Medicine, you come in, your first appointment, you're given a mentor on your care team, and then they have mentors in the hospital when you're there too.
So just having that supporter there with you during your whole journey. a different experience and it adds a little bit of humanity, which removes all this fear and that leads to a lot of these questions.
You talk a lot about the human interaction and it's interesting because one of the things they're talking about to address clinician burnout and whatnot is this whole adoption of virtual care, virtual nursing virtual, virtual, you're hearing virtual all over the place
I mean, this story talks specifically about virtual care within the health system, but you're also seeing that as, put out there as a potential solution to rural health care as well. Are we getting to the point where virtual, you and I met in person, but now we're talking via, Zoom.
I mean, is virtual better than a text message, but not quite as good as. actually talking to somebody or are we getting to the point where this is now so common for us that this this kind of communication is really helpful in the care process.
Yeah, I think the pandemic brought that out. I think it's very common and I think people are used to it and it's better than nothing, right? my wife's family lives in middle of the country in Iowa and that's going to be like a main way where you can get medical care.
And I remember the first time I talked to the head of the, the Mayo accelerator, and he was talking about the way he looked at this. And he said, we have relationships with these rural hospitals and he goes, this could be a really nice. Human touch to bring because he says we're throwing technology at these patients who are out there, but it's nice to have a little human touch to to offset just this virtual technology that that's being thrown at them when they're in a rural setting.
So I think there's lots of tools and ways to complement this virtual world that we're moving into for your care.
Well, I'm curious, because you sent over an AI story, so, you hit our new site and pulled out an AI story. But is AI playing a role in the stuff that you're doing, or?
Oh, yeah, for sure. Because I mean, the real opportunity, what we're doing is we're unlocking data that the hospital doesn't know about this patient when they're at home. So, the patient's having these monthly meetings, maybe with these mentors, and the mentors are able, through the technology report back to the care team because the mentors are, really acting as an extension for these non clinical needs of the patient.
So with AI, we can do modeling and look at, oh, we see a lot of trends in this area for this condition. And then Report that back up to the doctors and that's really one of the reactions from the doctors that, sees the tool that we have is that this will help them find out information that they don't know about today and uncover those insights about the patient.
So that's one way and then. Using all this wisdom from the mentors and creating a way where we can have these mentor chatbots where you can also get some questions asked because what we tell health systems is, is that the greatest unused asset that a hospital has today are their grateful patients.
And these grateful patients that are really good patients have so much wisdom because they don't give you a map when they tell you you have cancer and say here's the roadmap and here's what to expect. Everything like you mentioned is dark. It's a dark tunnel. You're going through the treatment as the next phase and you, and people show up for their first chemo appointment and they had no idea what they were going to see.
And all of a sudden they're there and they're like, I wish I would have known. So I think with the wisdom of people that have been through the journey, Now we can use AI to take that and serve it back up to the community.
It's interesting in healthcare, ever since Meaningful Use, we've had a lot of pushback over the years in terms of , the amount of data that we have collected around individuals and whatnot.
And the clinicians will cite that in a lot of cases of I go into this medical record and my gosh, it would take me 45 minutes to read half of the medical record because it's all in PDFs and, you just have to, sort of go through it. we at a tipping point right now with AI that we're finally, instead of getting pushback for collecting information that we're going to have clinicians looking at us saying, bring the information in because I know what you're going to do.
You're going to push it through these algorithms and you're going to model it for me. You're going to give me. actionable insights that is going to help me to be a better clinician or help me to create better outcomes.
It has to happen because you cannot keep up with all the research that's coming out every month, right?
I mean, there's, there's just no humanly way. I mean, most of the doctors that I know, they're, they're working six, seven days a week. And it's a lot of it is, the charting and, I've lived with a nurse practitioner for 20 years, 25 years. So, you've been in healthcare your, whole life.
It is the hardest job you can do. on planet earth, right? I mean, being in healthcare today and how much you have to keep up and stay up. So I think this type of AI use cases is going to be really life changing for people that you can do, you can do something like this now in the future.
Yeah, I like this story and I've talked about it a little bit on the show. Stanford Health uses AI to reduce clinical deterioration events. We have so much information. I'm thinking about the times I've talked to doctors and I'm like, Hey, do you want this information from, the Apple device?
Or do you want this information from the Oura Ring? Or do you want this information from the scale? Or do you want this information from, and invariably the answer was no.
But, there, there's power in that information over time. I understand the liability. They don't want the liability of, Oh, that was in the medical record and you guys didn't catch it. And that kind of, I get that and I understand that. But now that we have some of these tools, I'm, I'm just wondering if we're going to shift our mindset as health systems and say, No, no, no, give me the data.
We will figure out what to do with it, with these tools.
there's so much they could do with, that data that's coming from these sensors and I know the research projects that are out there, they're all starting to use sensors and devices to gather that information. So, I think it's just worth, we're in such the early days and we're in the first sitting of this, but I mean.
there's diseases and conditions that these sensors, are going to be so instrumental in, finding complications sooner. And one of the things that came out of the Ohio State health research project on peer support with transplant patients that were going through kidney transplants, is that when you have more knowledge, You find complications earlier, and so that's a beautiful thing, because if you find out too late, it might just be, that's it, you, you're going to lose your transplant that you just had done.
So I think this knowledge is, is going to improve outcomes in a, in a big way for patients.
closing question here, it's an optimism question. when you look at the healthcare system today what's your level of optimism? are you optimistic that we are making significant progress and we can make significant progress?
and how would you compare that to maybe a couple of years ago?
Well, I've been in healthcare, right out of college in 1991 and, and it seemed like there was more of an appetite 20 years ago for innovation and, and really changing things.
and I think right now unless it's an initiative coming from the top to go solve a big problem
has, or has an immediate ROI,
immediate ROI. Right. So this is what I'm focused on is like our immediate ROI, because I have lots of stories of, somebody saying I am frustrated.
I'm not getting the attention I need, I'm going to another health system. And so there's this ability for this human touch to prevent revenue loss. And so for inTandem, like that's our focus of like, if we can show like 1 million transplant patients stayed. It pays for itself 10 times over. So, I really think that the most difficult time I've ever seen with pushing innovation in these past couple of years, but I think I'm hopeful because I meet with so many incredible doctors and nurses and social workers that are so passionate about, improving the system that it gives me hope that like.
you just need a little bit of a crack and the light gets through. And then with my previous experience, my last company, we changed health care. We really did. I was the first company to create this whole patient friendly billing model where we brought together physicians and hospital billing in 2001.
And we put it online so you could do one payment and like pay everything. And that, like, set the world on fire for like the AHA and HFMA. They said, let's do some regulations. Let's take health comms clients and let's create a new model. And they pushed it out there and all of a sudden Boom, boom, boom.
Every health system was moving into this patient friendly way of billing starting in 2000. So, I saw it happen with my small little company, Healthcom, and I'm like, it can happen. So, I'm a believer that once you have a few academic medical centers doing something that's really transformational, the other ones follow.
So that's my hope.
Absolutely. Well, Paul, I want to, thank you for coming on the show. If, if people wanted to get more information other than your website, any other ways they can get in touch with you guys?
Yeah, intandemhealth.Net and we can be reached through the website.
PaUl, look forward to catching up next year at the at the events. Hopefully we'll we'll see you there.
Sounds great. Thanks so much, Bill, for having me on the show.
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