This Week Health

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March 1, 2021: Anne Weiler, health tech entrepreneur and advisor to This Week in Health IT joins Bill for the news. What happens after you sell a successful health startup? What are the stages of a CEO getting back into the real world? We call it health tech CEO recovery. Retail giant Walmart might be slowing down their ambitious expansion into healthcare. With the growth of telemedicine, how many handy clinics do you actually need? How much data is healthcare generating every single day? What do we have to do to clean it up? The platform Truveta will use machine learning and AI to take billions of clinical data points provided by the health systems for searchable health insights. Microsoft announced a new portal called Viva. IBM are trying to sell off their Watson Health business and CVS Health launched a senior medical alert system called Symphony. Plus how fine is the line when technology tries to start telling you how you're feeling?

Key Points:

  • At what point do we have a saturation of handy clinics? [00:09:20
  • Walmart may not be in the edgy tech space but they're still one of those companies that does experiment, learn, experiment, learn, experiment, learn and then scale [00:10:35
  • An American Sickness book by Elisabeth Rosenthal [00:15:50
  • IBM are trying to sell off their Watson Health business [00:18:05
  • No matter how smart your machine learning is, if it's not being trained on anything it's not going to get any smarter. [00:20:26
  • Microsoft announced a new portal Viva [00:32:22
  • CMS are starting to loosen their pocket books to reimburse for things that are going on in the home [00:42:05
  • CVS Health launched a senior medical alert system called Symphony [00:42:15

Stories:

Transcript

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

 Welcome to this Week in Health It, it's Newsday. My name is Bill Russell, former healthcare CIO for a 16 hospital system and creator of this week in Health IT a channel dedicated to keeping Health IT staff current and engaged. Special thanks to Sirius Healthcare Health Lyrics and Worldwide Technology who are our news day show sponsors for investing in our mission to develop the next generation of health IT leaders.

We set a goal for our show, and one of those goals for this year is to grow our YouTube followers. Uh, we have about 600 plus followers today on our YouTube channel. Why you might ask because not only do we produce this show in video format, but we also produce four short video clips from each show that we do.

If you subscribe, you'll be notified when they go live. We produce, produce those clips just for you, the busy health IT professional. So go ahead and check that out. Uh, we also launched today in Health It a weekday daily show that is on today in health it.com. We look at one story each day and try to keep it to about 10 minutes or less.

So it's really digestible. This is a great way for you to stay current. It's a great way for your team to stay current. In fact, if I were ACIO today, uh, I would have all my staff listening to today in health it so we could discuss it, you know, agree with the content, disagree with the content. It is still a great way to get the conversation started, so check that out as well.

Now on to today's show. Welcome to this Weekend in Health. It, it's Newsday, Walmart, CVS, Microsoft, and Watson Health, and whatever my co-host and I decided to talk about, which could be pretty interesting, we'll see. The co-host for today is Ann Weer, former CEO of a healthcare startup. Good afternoon, Anne.

Yeah, it's, I'm in Seattle. It is afternoon. Great. So I, I, I just had, are you fully recovered from the healthcare CEO thing? No. No. Well, yes and no. It's a hobby now , so I think that's not recovered because that might not be digital health being your hobby maybe says you need some better hobbies, . I don't know.

It seems to be, well, it's my job and my hobby now, so. Yeah, exactly. I, I spoke to Todd CE sold right?

And we started talking about the stages of health tech, CEO recovery, I guess it is. And yeah. And so let me see if I get some of them. There's, there's sort of a, a joy, right? You, I mean, you, you've sold it and, and there's sort of a relief 'cause there's just this constant pressure of running something, but then it, it, it quickly turns to sort of a, oh god, like almost a.

I have to take care of all the things in my life that I, I've neglected for the last number of years. And then, and then you say, all right, I'm gonna give myself a rest. And you start to rest, and then boredom kicks in pretty quickly because you've been running at such a quick pace, and then extreme boredom kicks in, and then you're like, all right, what am I gonna do next?

Or is that a global pandemic or a global which, which does what Get, get you back in the game quicker. Yeah. Yes, definitely. I mean, I was doing some consulting again, you know, in the hobby. I'm really interested in tools for seniors and aging in place. . So I was doing some consulting there and I did some consulting with Techstars.

They had a longevity accelerator. But when Covid hit, then suddenly, at least in Washington State, we were immediately told, you know, stay home and not just stay home, but only go to places you can walk to. So. I, I was just at the phase of like, okay, I, you know, little consulting some time off, maybe it's time to do a little bit of traveling as I contemplate, slowly contemplate my next thing.

And then it's like, well, actually, why don't you just stay home? So I'm like, well, if I'm staying home, maybe I should be working. So I, I went and got myself a, a job at Amazon, which is completely unrelated to healthcare, which is why I, well, I shouldn't say completely unrelated. We, you know, we, we have customers that are

AWS that are in healthcare, but it's not my, my specialization right now. It's my hobby. The, you know. That's interesting. Have you found, I, so you're in Seattle? I'm down here in Florida. I, I live in a fairly desirable area. Have you found that the real estate prices are going up? Yes. Like, yeah. I mean, people, I think people are leaving the cities in droves and finding places like.

Well, I'm in the city. I am, I'm in Seattle proper, but Seattle proper is a strange place because we have all these lakes and freeways. And so what ends up happening is these concentrated neighborhoods. And so the neighborhood feels very residential, but I am actually in Seattle. I'm just not downtown. Um, but yes, my neighborhood is, you know, houses are getting snapped up.

There's not a lot of inventory. Yeah. I, I was, I was, our, our subdivision, I think, I think has like 600 homes in it or something to that effect. And they, I was asking somebody the other day, you know, what, what's the inventory look like? There's, they said, well, there's only seven homes available. And uh, I said, well, is that normal?

They said, no. Usually it's like, this is the prime season to be selling down here. Said, usually the inventory is like 30 to 40. Yeah. It's just, and gosh, you have to feel bad if you're one of those seven homes, I guess. Hey, I have a question for you. I, I saw your blog post on going to Disney World and the Covid precautions that they took and everything, but I was wondering, like, given the timing of your trip, were you having HIMSS withdrawal?

Oh, that's an interesting, that's an interesting question. No, , no, I, I explained this on, on last week's show with, with Che. My, my wife was the caregiver for her father. And around Christmas time, I started saying, all right, we need to get you away. It's been three years of caring for him and I, I just, I wanted to get her away and we had gone on our honeymoon to Disney World and I thought, and I thought, okay, this, this is good because we could go there.

It's only a couple hour drive from where we're at. So if anything happens with our father, and we arranged for someone to come down and stay with her father, but then her father passed away and. So I looked at her, I said, you know, you still want to go. She's like, I absolutely want to go. And the couple that was flying in to look after her father said, can we still come down because we, you know, because there's two feet of snow on the ground here and you really wanna come down.

And I was like, yeah, you can still come down. So we went up and then came back and hung out with him. And it was, you know, I, as, as, as I've, so I, it's actually one of the most listened to podcasts on the Today in Health IT show. Is my trip to Disney World because I think people wanna, everyone's having hymns withdrawal.

Well, that's their annual trip to Disney World. I think everybody wants to know. It's like, you know, what does it look like? You know what, what does Disney World look like? Post? Mm-Hmm. Covid. And I actually, I don't think we know yet. I think, I think it will continue to evolve over the next six to nine months.

So we'll see. See what happens. Hey, you wanna talk a little health it stories and technology? Absolutely. Alright. Where do you wanna start? There's, there's a lot of interesting stuff. I like to, to save all the, all the edgy digital stuff for our conversations. Go ahead. Tell me what you've been reading. Well, yeah, let's.

I don't you wanna do home and home monitors, you wanna do Walmart strategy? And I'm like, I've been watching both of those. So. Alright. So the strategy I, I personally, I sent the story from Business Insider. The, I personally am not a huge fan of the story. They found eight. Current and former employees, they have a new CEO and they were sort of asking them, how's it, how's it going over there?

And they got, you know, like three people said, oh my gosh, we're in complete disarray. And, you know, three other people said, Hey, it's full steam ahead. Clinics are going well. That kind of stuff. And they, the title of the article is Walmart pulls back from their clinic strategy. Yeah. Uh, yeah. So, but they, they have, they're, it's slowing down pretty significantly according to the article.

And don't make those numbers up. A, you know, there, there was a, a belief that they were gonna get a, a couple hundred, or at least a hundred or so by the end of, of 2021. And it looks like they're gonna get, I dunno, 30, 40 some odd, uh, clinics stood up. And so, you know, that's kind of a hard number to, to look at and say, are they making progress?

On the flip side, there wasn't, there was a. You know, a global pandemic. Maybe that slowed it down a little bit. I dunno, but what, what do you, what are you hearing? What whatcha reading on this story? I, I was wondering, yeah, there's pandemic, there's, oh, telemedicine. You know, perhaps we don't need quite as big a footprint.

I also wonder if, you know, at what point do we have a saturation of . Handy clinics. You know, I, I mean, not sure what's going on near every Walmart, but here in the northwest we have Zoom Care, which is trying to be that everywhere clinic. And then, you know, my closest place if I wanted to go is an urgent care that is.

Owned by MultiCare, it's a collaboration. Then you've got like, you know, the concierge care, so it's the, you know, the one medicals and everybody, because healthcare has been such an in-person thing. Even somebody building it, trying to build a new virtual business is trying to have a footprint. And so I just wonder is were they looking at it and, you know, certainly the, the initial, Hey, there's a clinic in Walmart.

Like that makes perfect sense and, and convenience and all of these things. But maybe there's a question about how many . Clinics you actually need, and did telemedicine and the pandemic actually say, oh, actually we, maybe we don't need such a big footprint. Well, you know, that's an, that's an interesting point that you look at what, how this has sort of rolled out, hadn't transpired.

Maybe they are rethinking their strategy and not moving as fast. I mean, that's one aspect. The second aspect I always remind people is, you know, Walmart is amongst those companies, maybe not in the. Edgy tech space, but they're still one of those companies that does that experiment, learn, experiment, learn, experiment, learn, and then scale at a, at a massive level.

So yeah, it's, it's not something you turn your back on. 'cause if you turn your back on it too long, they might come back with something else. You might be right on the footprint though, the footprint they were building. So they were going from the in-store clinics to a fairly sizable chunk of their parking lot.

They were, they were standing up and we've seen these facilities go up, you know, it's, it's comprehensive. So you can go, you can get mental health, primary care, you can get x-rays, images, labs, you name it. It was a great one-stop shop kind of model. But it is a lot of real estate. If, if, you know, we have a fundamental shift in how primary care is delivered.

Yep. So eye. I, I just the I, I, I, I, it makes, it still makes a lot of sense to me. You know, here's a related story. Kaufman Hall today, I've read a couple of them. I think they did their study probably over the last couple of months, and I've said, you know, health systems are taking a significant hit, you know, between 50 50

primarily to.

But I think what's gonna happen coming outta this is they're gonna say, Hey, the covid number numbers never came back. And I think one of the reasons the covid numbers will won't come back to their pre covid levels is because new entrants figured out a way to sort of sneak in here and squeeze in here, especially across telehealth and, and urgent care clinics like you described.

Yeah. And then if you think about some of the beginning of the pandemic, I once sat on hold, like, you know, in hold, on hold for a telemedicine visit with the University of Washington for like five hours. I no as that. Yeah. It just like the system was just overwhelmed. This was when they, you know, this was when there was absolutely nothing in person and you immediately had to go, um, to virtual.

And I thought I had covid and I may have had covid, who knows? But yeah, the system kept crashing, kept, booting me out, kept I think, prioritizing other people's issues ahead of mine. And, you know, there becomes a point where your loyalty to your . You know, your system, whether, you know, they have all my records and my primary care doctors there.

It's not, you know, I'm gonna weigh the options of like, do I want care or consistency? Yeah. I, I had a weird, and I'm, I'm trying to figure out if I like this or not. I had a weird experience this week. I, I had to do, I iHospital. For observation with something that was going on. So I did that. It happened to happen at a time where I was between closing my company in California and opening my company in Florida, so I was without insurance.

And so, yeah. So, you know, you get the 27,000 bill and you never wanna be an observation. You wanna get admitted. That's, that's what Elizabeth Rosenthal says in her book. Really? Yeah. Yeah. See, I, it's basically she's got this whole thing of like how to avoid bills and like the observation, they can charge you a lot more money.

And one of the things is like, always ask. And if you're under observation, either say, well, either I'm well enough to go home, or I'm sick enough to admit me. Yeah, that's interesting. And I did a, I did a ton of tests and that kind stuff. $27,000 something. Oh, great. Call. Hey, we sent this to your insurance.

They turned it down. I'm like, yeah, that's because I don't have insurance right now. They said, oh, okay. Uh, well let's change this to cash. Said Okay, so they changed it to cash. They said, alright, so the new amount is right off the bat they gave a 65% discount. Wow. Okay. So I'm like 65%. Wow. This is, this is great.

And I said, Hey, is there any additional discount if I pay it all at one fell swoop? And she said, yeah, lemme look. Yeah, it's another 20% discount, 85% discount off the $27,000 observation bill. Wow. And so my first thought is, lucky me. My second thought is, does that eat away at the credibility and the trust I have with my health system to know that they, they're able to charge 15% of what they originally were gonna charge and still make money.

Yeah. Yeah. It's, uh, it's, I don't know. It's, it's, it's a weird dynamic. I, I, I clearly, I like it. I'm really happy. I hope they don't listen to this episode and think I'm ungrateful, because I'm really grateful, but, well, of course you're grateful for the care. It's the, you want the, you want the care and the.

Cost to align. I would say, I just for the, the, the listeners out there, assuming there are people listening to us talk here, not just the two of us, but the book I I was talking about was an American Sickness by Elizabeth Rosenthal, who's the editor of Kaiser Health News. And if you haven't read it, if you're in healthcare and you haven't read it, it, it's fantastic.

She breaks out the, you know, how we got to here. I think for me what was most shocking was that everyone is complicit. Like everyone, you know, they talk about everyone taking their cut, but they, there really is a lot of that. But she also, at the end, I. Says, you know, I don't have a global solution, but I have a, a local solution.

And there's this whole checklist of like, if you're going to the hospital, all the questions you need to ask. And also that business about, you know, out of network. Like you need to give them a piece of paper before your surgery saying, I am not, I, I'm not condoning any out of network physicians. 'cause that's where some of the costs come in anyway.

Not, not new news, but a great book. Interesting. Well, I'll have to pick that up. It's your hobby. So these are the kind of books you read like while sitting out by the lake, I guess. That's right. Well, and you know what I had the great fortune of, I was speaking at Mayo Clinic Transform Conference one year, and I had actually, it was pretty incredible on the way to the conference because I was a speaker, you know, they helped me get there and everything.

I was with Dr. Bonko from Jefferson. And got to talk to him about the innovation they were doing. And on the way back I to the airport, I was with Elizabeth and, uh, got to talk to her about her book. So , if I had been, if I had been one of your guests at that point, I should have been actually interviewing these folks.

And you would've, and you know, with that kind of experience, at some point I have feeling.

All right. You tee up the next story. You pick one of yours and, and just it out there. Okay. Um, yeah, so I've got two stories and they're both, uh, the reason I picked them both is 'cause I have some personal. Experience with both of the companies. Um, so one's i, BM and one's Microsoft. So there was, uh, an article about, and a number.

The one was in Wall Street Journal, but in a number of places about IBM trying to sell off their Watson. Health business. And, uh, I just thought that was so interesting, uh, because, you know, they came out of the gate, they were so early in trying to apply AI to health data to find all of the insights that we know are in that health data.

But just, it just went terribly wrong. And I think, I don't know if you remember this. But there was a session at HIMSS a couple years ago that was Mayo Clinic, MD Anderson, and Watson, and they were talking about, you know, what they were trying to do and how hard it was. And at that very day, MD Anderson actually announced that they were no longer working with Watson so that the, you know, wrangling the data was really hard.

And in fact they, you know, they were trying to do a cancer moonshot, but they ended up doing things like . Patient scheduling, which is a, you know, another problem. But, and you know, at the same time, I think Mayo Clinic is doing some work now in actually themselves and working with Google because they, that, you know, they've chosen Google as their cloud provider in actually getting those insights from the data.

So, big challenge, but my personal story here is that when we were a tiny little startup, . We were actually an IBM Watson partner, and we were like, I'm serious. It was before their partner program was even in place and we were like, wow, this is amazing. You know, and we couldn't, once we figured it out, we figured it out.

It makes, this, makes, also, makes perfect sense is that IBM doesn't actually have any data, so they have to, they have to partner. With anyone possible that, whether that's a health system or another vendor to get the data. And they are, I wanna say like, I think they're actually a little, they're alone in this, in the industry.

Like every other technology company has some place that they have some data that they can analyze and then compare things to, you know, like Google's got all the search data and you know, was doing the work with flu finder for a while. But the, I think the biggest challenge with IBM . Was that they had nothing to start with.

And if you don't have data, you can't train your algorithms. And so no matter how smart your machine learning is, if it's not being trained on anything, it's not gonna get any smarter. So I, it is an interest. It's, you know, it's great moonshot. But I think fell, fell down in the, the execution and the key execution of like, where are we going to get data from?

Yeah. It's uh, well, and they went out and bought it, right? Yeah. So they went out and they bought Explorers. Yeah. Um, and Explorers had data from. A fair number. I mean, explorers was pretty big at the time. They bought them a fair number of health systems and we were one of those health systems in Southern California.

We were also an investor in Explorers, so we were happy to see them, you know, with an exit. It, it's, it's not in the it, the unicorn exit status, but it was, uh, it was a pretty good exit at the time. Yeah. You were talking about this, let's see, 2013, they started with the MD Anderson pilot. To mine for insights from health systems, vast TROs of research and patient data, and develop new NLP powered decision support tools.

By 2018, the two organizations had fallen out with MBA Anderson pulling the plug on the project after spending more than $60 million following multiple examples of unsafe and incorrect treatment recommendations. Yeah, and I, I, I remember when that happened, came in the. They were talking about all the things that we were gonna do.

I even went to a session, I don't remember if this was at HIMS or Chime, where the IBM people were talking about what they could do for us. And essentially what they mapped out was a normalization of our, uh, a sort of a data governance slash normalization of our data to make it ready for ai and. That's interesting.

And by the way, the project they mapped out for me was probably a 60 million project just, just to clean up the data. And I was like, well, that's, that's amazing. They, yeah. They, they found, and by the way, I still think AI and machine learning on the clinical side is, is still highly risky. Very early, early, early stages.

We're seeing AI be deployed in a lot of places. And by the way, scheduling's a great place for it. Mm-hmm. Administrative, administrative, uh, cybersecurity. There's a whole bunch of places to ar, you know, ap, there's a whole bunch of places to deploy within healthcare that can literally return, uh, hundreds of millions of dollars across the health systems, if not billions.

but the, uh, and, and don't risk anyone's life. Right. And that's the thing. It can't be wrong. Right? Right. It's a doctor makes a mistake. And you know, we say you, you know, doctors aren't perfect, but if a machine makes a mistake, that's, we haven't gone down that territory yet. It's gonna, you, you're just not able to go down that territory yet.

Right.

The, you know, Watson was never going to, you know, do the surgery. It was never going to, uh, you know, it was never going to make the final diagnosis. It was always gonna be in partnership with a physician. So there's, I mean, there's, there's a lot of room for this if it gets implemented correctly. They say.

The other piece of this though, is the . It's one thing to partner on the data, like them saying to you, we'll, clean up your data. It's the other thing to actually own and understand the data, which is I think what you know Flatiron did was to say, we are gonna be an EMR for cancer. And then they understand the data that's coming in which results in less having to interpret and clean up the data to find the insights.

So I think, you know, Watson was kind of like. We're here , you know, tell us what we can do. Yeah. That's the age old mistake in healthcare. Right. To show up and say, we've got a solution. You know, let, let us help you. Let, let us, yeah. What's your problem? We'll let you help. We'll, you know, we'll, we'll let you watch while we solve all of healthcare's problems.

And they sort of almost did come at it that way. It was almost that kind. Bravado last week. I keyed you in on something that's unfolding here at this week in Health it. We started off with our influencer podcast a little over three years ago, but since then we've been able to introduce Newsday and solution showcases, and last year we expanded even further with our Daily C Ovid 19 series, and now we have a daily show today in Health it.

And I'm happy to say that we're not done growing yet. We have something really exciting happening here at this week in health. It, our goal, as you know, is to help inform, educate, and train health leaders. And we understand lots of people take information in in different ways. That's why we're introducing written content to our site.

For the first time, you'll be able to find news writeups covering each of our shows in detail as well as feature stories. And I'm really excited about the feature stories. We've hired two great, uh, feature story writers, and they're gonna take . Topics that are highly relevant to you and relevant to our industry, and they're gonna turn them into feature stories on our website.

I'm so thankful for all of our listeners and the conversations that we've had, our sponsors and the dialogue that we've had, uh, and the back and forth has really convinced me that this is the best next step. I wanna thank all of you for listening and joining with us on our journey of raising up the next generation of health leaders by amplifying great thinking to propel healthcare forward.

Tru. Is in the market. We talked, I talked with, uh, ed Marks about this a little bit a couple weeks ago, Truves, uh, an interesting play. So this is essentially a, a massive data store about, I don't know, 10 or so health systems coming together. And they're not small health systems either. I mean, it's, it's Providence, it's Trinity, it's, it's, it's just, it's, it's some very large health systems coming together of big data stores.

They're essentially going to anonymize the data and monetize it. Anonymize and monetize . You should be in marketing. Wow. That's, that's hard to say, but that's, that's what, that's what they're, that's what they're gonna do. And obviously the whole thing's couched under for the good of humanity and for the good of mankind.

But the, the reality is that's, that's in this, this same of, we are, we're gonna take all this data, but let ask you.

What, what do we have to do to clean up the data? You had to clean up some of the data. What do we have to do to clean it up to be ready for ai? I mean, is there, is there, oh my goodness. Is there a path for this? No, I don't think there is. I don't think there is. Honestly. I mean, I actually wrote, I'm happy to, I think it's still up on the Web Well Pepper website, but I wrote a number of blog posts on this one in particular called Garbage in, garbage Out, and it's not so much that

I'm, I'm not, I don't wanna insult people and say that everything in the em r is garbage, but I have, we know that it's not consistent. We know that it hasn't ne like, been consistent over time and a lot of the information is in. The notes. And you know, I just anecdotally read a pretty interesting Twitter thread of a doctor who was like talking about the terrible notes that the previous physician had put in and she couldn't follow them and they were too wordy and they weren't getting to the point.

And then she read, she realized it was her . So I think that's a lot of the challenge. Like I'm actually a big fan of small data instead of big data because. The smaller the data, the easier it is to actually interpret what's going on. And that's, you know, at, well Pepper, we had care plans, patient care plans that we had defined.

And so when the data came back from those care plans, we knew what the patient was doing and we knew what we had asked them to do. And it made it much easier to, to actually, you know, apply machine learning to see, for example, is somebody at risk of dropping off their care plan. So I would like to see less like, here's all of our data and more like, focused and perhaps even more thought about, you know, the, how much health, how much data is healthcare generating every single day?

Are, are there, are there ways that we can just make the, the ingest of that better than, rather than going back and trying to . You know, just look at absolutely everything that's been created. And then also like, what's the hypothesis? What are you trying to find out? Because there's, there's different ways to do it, right?

You can do a cluster analysis and say. Here's a bunch of data, machine learning. Please tell me things that are the same, and then you can go and say, okay, well what's the same about these? That's, it's, it's really interesting, but it's very academic and gonna take you a long time. Yeah. I was, I was always trying to quantify the value of the data.

It, the, the data with the highest value. To, to ai, machine learning and, and really a lot of our analytics was stuff that didn't pass through human hands. Right? Right. So all the telemetry data was, was beautiful. It just passed right in. It was very clean. Exactly. Yeah. So then the question became, all right, if that's, if that's our best data to work with, how do we get more of the data?

Like that. Yeah. That, that doesn't pass through you in hands anymore. And I think that's, that's the next step. I mean, clearly there's gonna be stuff we have to get through notes and that kinda stuff, but, and we could think through how we're actually collecting that and how we're getting it in. But at the end of the day, but more streaming data directly from the body is going to be a lot better for us as a patient engagement advocate.

I think the other thing is that. That what happened in the hospital is only a very tiny thing, you know, like the rest of my life has lived outside the hospital. And so that kind of goes back to again, like what? Looking at specific problems that happened within the hospital that you can fix. You know, you started off on the administrative side.

I think that's great. You know, I know there's been work done with sepsis, so. Like 90% of the patient experience and data is actually outside of the hospital. And so think about what, what are you trying to solve? Well, here's, here's what I've always wanted. I, I wanted a, a four point data set to start to apply all my data practices to, and it was essentially the R data.

Okay, great. We got, we have that data set. I, I then want your browser history and I wanna be able to mine that. I be able to your, your shopping history. And in your grocery store. I mean, I, I wanted to take those, essentially those four data sets, and I think we can make a pretty comprehensive whole person profile and almost predict where you're going to Yep.

Struggle with regard to health and, and maybe I clearly education's important there, but that's like two or three data points and away you go. Yep. So, wow. Anyway, let's see, where can we go? So that's IBM Watson. Health, you talked about Microsoft. What's going on at Microsoft? Well, so this is a little bit, not like, not entirely related to health it, but it is because it cares about, you know, employee productivity and you know, like we have all in hospitals, we have all these people who are not who, you know, administrative, running, running, the hospital, all these employees.

So Microsoft announced a new . New portal. A portal portal sounds like such an old word. So is it, can you have a new portal, a new, new way of having employee experiences? It's called Veeva. And you know, I said my personal connection to this, I, I did actually used to work at Microsoft and on SharePoint. Uh, but it has some components of SharePoint it, but it's, and I don't know if like, you know, obviously Microsoft must have been working on this for a while, but it does seem a little bit covid.

Related in that came, it came out to, you know, as we're all working at home and it's this, you know, it's like supposed to be your digital front door, I guess, to your employer and your productivity. So what are you working on? What's going on in your organization? But what I thought was interesting is that if you look at some of the articles, there's a tiny snippet of wellness.

Employee wellness as part of this. So it's not just, Hey, what's the news going on in my company? Or what documents was I working on? Or who do I need to collaborate? There's a little bit of like check-in of like, how are you feeling today? And I thought it was interesting because, you know, there's a whole industry around employee wellness and you know, companies like Live Aid, live Aid, live Limeade, and uh.

You know that Microsoft's trying to step sit, you know, put a toe in the water here, but also like there was some backlash around, you know, it's tracking your productivity and telling your employer potentially when you're working and when you're not working. So that's, you know, that's a question of, that's, that's definitely something that is not help with wellness.

But I was also thinking, so I was thinking about it from a couple standpoints, the portal. Or the internal intranet as a wellness activity, which is kind of interesting. I was also thinking about the, you know, the doctors and nurses and healthcare workers who are really, you know, talking about burnout and then they're given these like wellness modules to do and they're like, this is not, you know, that's not the problem.

Sort solve the core problem, which is, you know, not enough resources and. These things, so that, that's another component of it. And then just how, how fine the line is when technology starts to try and tell you how you're feeling and. I go back to this. You know, I, I did a talk at HIMSS one year on how to deliver empathy through technology.

And I fully believe that it work. You know, that you can, and one of the examples I gave was when I first got my I, my first iPhone, I was looking at it and it said, you have a busy day tomorrow. Your first meeting is at eight. And I was like, yeah, I do. I do have a busy day. Thank you for noticing iPhone. And it felt.

You know, like, okay, my phone's looking out for me. Let's compare this to something that Microsoft did, which is, you know, outlook gives you your productivity stats, and they do it in arrears. So they have been mo, you know, monitoring you. So in January they sent me a thing that said. You have been working outside of business hours every day for the last month except for two.

One of those days was a Sunday, and the other day was Christmas. Well, I was selling my company. You, you, you don't think I know that. I was working a lot. . Now you wanna get an argument with it. You understand what I'm going? So that, those are some of the things that this brought to mind. And I thought about like the, you know, rather than telling you what happened, maybe come up with something that can help you.

Like, Hey, I automatically put a block on your calendar because you've got these two meetings and you there's, you know, I know you're gonna need a space between them to think. 'cause one of them's with your vice president. So those are all the, the, I mean, I, it's, it is a little bit squishy of thoughts, but those are all the things that came up.

And I was particularly like, do you want your portal every day to ask like, are you happy today? Like, I don't know, , you know, I, I, I do wanna talk about this specifically. This is interesting. And by the way, the, the, you sent me a Verge article and the. Woman sitting behind the desk in the top picture. That literally could be like your picture from 20 years ago, sitting at a, at a desk at Microsoft.

Just, well, you know that the, there's a, a funny thing that Microsoft has that you can sign up as an employee to have your name used in, um, documentation and advertising. Really, and I did it because as a, you know, former technical writer and as a, you know, sometimes marketer. I know how hard it is to get fake names and, and if you do poor fake names, it's troublesome.

So I signed up and I have advertised many, many things Windows phone. In particular was when Volmer was on the Today Show. The, the demo had my name on it. Oh, wow. So you're, that was your, that was your 10 seconds of fame right there. This was my claim to fame and, and actually you'll love this too. One time a friend of mine was in a store, picked up a Windows phone, like a, the sample phone and you know, the, it started doing its little demo thing and it's like, you have a new message from Anne Weiler.

And my friend was like, . How did, how did you see that? How did, that's funny. But you know, you bring up an interesting point on technology and we've never, we have not been good at this over the years, and it wasn't until, I would say about seven, eight years ago that, you know, I started looking at the psychology of, of rolling out technology and the impact.

And how they interact with it. And I think this is a growing area. I've talked to several people now of, of development teams that are bringing that, those kinds of psychological and, and sociological just research and things to bear on how are people going to receive this technology? How are they gonna utilize this technology?

How do what verbiage. To hear and not hear from their technology. What, when they say one thing, it might sound like Big Brother, and when they say it another way, it might sound like grandmother. You know? That's, it's like, oh, that's, thank you for putting your arm around me. And so it's , it's, you know, it's, it's just one of those things.

Alright, let's, let's talk about this. This is essentially an evolution of, of the intranet. Yes. Right. SharePoint was always a lackluster in intranet. And, and a security nightmare for me. But that's a whole nother, uh, thing. I, anyway, so they, they split this up. They have four modules. They have connections, insights, topics and learning.

And it's interesting. So connections, think of connections like social media for your, for your organization. So it's, it's ways connect not only I think within your organization, probably externally. So they're probably hoping that it becomes like a slack. Of thing topics is like w Wikipedia. You can essentially look up things like what is that project within our company?

And for larger organizations like our health system, that would've been helpful for onboarding and bringing people up to speed Insights is what you talked about. You know, it's, it's looking at it some re.

You know, and they give you the smiley faces, how do you feel today? And they can track that and put all that stuff in that gives you some things. They, they got in trouble with the productivity score basically because managers, managers were able to drill down into it and say, Anne's only working three hours a week.

I mean, literally, that's the level of detail they allowed people to drill into. So that's, that's why, that's why they got a fair amount of pushback on that. I think they've updated that since that, since that time. And actually I haven't gotten a chance to look at this. I'm just reading the article of what they have and then learning, I'm not sure what learning itself is, but you know, that could be a, an LMS could be a learning management system for Yep.

And so if you think about it from a portal standpoint, they've got the, and Microsoft's good at this, they cover. How well did they cover the categories? Right. Conceptually? It's a, it's a, it's a, it's an interesting concept and teams is everywhere in healthcare. I go, oh, interesting. I go Zoom call, zoom call, zoom call.

And if I'm talking to a health system, I have to go over and jump onto teams. Oh, is that, is there a security related reason for that? Uh. No, it's, it, you know what it, an enterprise agreement really, . That's exactly what it's, it's the, it's the easiest agreement to sign and, and to extend. And given what was going on during Covid, you didn't really re wanna renegotiate another contract.

You just fired up teams and a lot of 'em were in, they were already heading in the Office 365 direction anyway. Yeah. So it was, wasn't hard to.

So that's this, this will be interesting. I suspect we'll see a lot of these sites sort of take off. And we'll start, I, I'll have to start hitting up some of the, uh, health systems to determine what their plans are with this, because it should be. Yes. Yeah, that's, that was my thought too. Should be interesting.

Can we talk about the home a little bit? Yes. So the, the home has always fascinated me. I think we're seeing CMS. Start to, uh, loosen their pocketbooks and start to reimburse for things that are going out, going on in the home. CVS Health launched Senior Medical Alert System, and it's a much more sophisticated than the, uh, you know, I've fallen and I can't get up.

It has a a, which, I forget what, what was the name of that company? Lifeline. Lifeline, yes. It's a more sophisticated version of Lifeline. It has a suite sensors, it can monitor falls motion, temperature. Also providing 24 7 personal emergency response platform for use. So, you know, CVS is partnering with them.

They see this as a, a deployment model. Clearly, if they're, if they're partnering, they're going to have somewhere where they can monitor this. They're gonna have a command center of some kind where they can monitor this and deploy resources against it.

He said, you know, we've seen a lot of these over the years. Will this one succeed? Yes. And, and I sort of looked at it and I'm like, you know, it really could, and it could for a couple reasons. It can, because it never forget that CVS is one of the largest payers in the country. Mm-Hmm. . And so they get paid to keep you, keep people healthy.

Right. And this is, this is a healthy play. Or a health. So, so that's good. It's keeping people in the home instead of, uh, getting care at more expensive locations. So financially it makes sense. Mm-Hmm. . The other thing is CV S'S reach is national. Mm-Hmm. . And, and, you know, the, the, the sensors in the technology, quite frankly at this point, are getting to be fairly inexpensive, easy to deploy.

Yep. And, uh. When he said, you know, said, we've seen a lot of these, will this succeed? My first blush at that was, yeah, it, it really could. Yeah. I think, uh, you know, there's, the technology was never a bad idea. I think there you need a whole bunch of factors in play for people to accept it. And I think most, most people, I think I, I saw a study on this for the lung time being

You know, it's like 80% of people or some research I did. I think 80% of people or more want to age in place at home. The covid certainly, you know, with all of the challenges with nursing homes to begin with, you know, being the first, the sight of all the infections and death, you know, it re really reinforced to people, yes, I wanna stay home.

And so . That may kind of remove some of the stigma of the home monitoring and the late night, you know, the late night TV help I've fallen and I can't get up. Sensors being smaller, I think help as well. You know, like wearing and

families being remote also helps. Yeah. So it's. You know, you, you know that you need some of these things to, to stay in touch. And, you know, I, I interviewed a whole bunch of seniors, uh, for, as part of some of the research that I was doing. And one of the seniors I interviewed had, she'd lost her husband about six months ago, and she had, was wearing, you know, the necklace thing.

And she's like, no, of course. Like I'm alone. Somebody needs to know if I've fallen. So I thought it was you. People really start to understand the implications more. And then I think the issue is do you trust who's doing the monitoring? But I certainly like the idea of sensors, . Better than trying to build these smarts into all these devices.

Like the, the one that I find completely ridiculous is the refrigerator . Um, no, 'cause like seniors are not gonna replace the refrigerator with some new smart refrigerator. So by the time everybody has a smart refrigerator, it's gonna be for me potentially. But even, you know, I, I just got rid of a 40 year old refrigerator.

I'm not kidding it. So I think, I think there's this, it could be a, you know, there's a trust issue, there's an acceptance of the potential invasion of privacy. 'cause it is, and then there's a timing issue. And certainly I think Covid has highlighted why people may not want to be in a, a senior living facility and Oh, and then it can then sort of like, I wanna say convenience, but there are, there are more services now I.

that you can get at home. So it's not just the, the monitoring, it's, you know, if some people like to go into assisted living 'cause they don't feel like cooking anymore and they don't feel like care caring for their home. Like there are ways that there are so many more, you know, gig economy or other types of services that it is, it is definitely more possible.

I think that my challenge is that devices are not. Like, yes, that can tell you if something happened, but I'm really interested in the preventative side and the community side and you know, it's like loneliness. That's the problem. And the, are you being active? And you know, the monitoring can tell you what happened, but it can't actually change the behavior that we need to change for people to live longer and more independently.

You know, it's, it's interesting to talk about all this stuff. Let me give you the perspective from a healthcare CI perspective. We did try to do some of this stuff in our home health program. We actually, we actually went into people's homes. We had a small team, went into people's homes. We set these things up.

Usually it was for, uh, specific cases for like monitoring for 30, 60 days. Yep. Something to that effect. Yep. And then we would go in equipment and move it somewhere else. We did have a call line. And there, you know, and they would tell me stories of, you know, there's, there's this one guy that calls every day and he calls every day mostly 'cause he wanted to talk to somebody.

Yeah. And yeah. But that was, you know, again, that ended up being part of the service that we ended up providing. Let me tell you some of the things that were hard about this one is sending that team into people's homes. That's no small deal. That there's, there's a special. Well, first, first of all, there's a legal framework for doing that.

There's a, there's a training aspect for doing that, so that, that was not easy in and of itself. The second thing is the we, we base it on an iPad that was completely wiped. The only thing you do with it was monitor a handful of your devices and make a call. They, they broke 'em. I, you know, I have no idea how they'd pick 'em up.

They'd take them. They'd move them. Yeah. They, they'd become disconnected. And so we had to continually think through, okay, how do we make this thing like completely proof of no one can break it. Yep. And so we were constantly engineering around it and that kinda stuff. And then second of all, and then the final thing I would say is that call center is really important.

It is a cost, and you need money to sort of fund it on the other side. So we were never, never able to scale this up because it never made money. Yeah. But if we were a payer, that would be a different equation. That's why I think this might work on this side, or for health systems that have a significant managed care population or an at-risk population.

Yeah, your, your point about the, you know, who's the team going into the home is, is definitely a key one. And then also, how durable are these sensors? Are they gonna fall off and give a, give false alarm? You know, there's just, there's so much complexity and, uh, I mean, CVS probably has the. Pockets and the patience to, to do this, but it's, it's really complicated.

Yeah. Well, that's all for this week. Wow. We've talked a long time. I, I appreciate , I appreciate you coming around. But before we go, I saw that you just joined Clubhouse. Uh, I did just join Clubhouse. I have no idea what it is. Well, we could be having this conversation on Clubhouse. We could, we could set up a room on Clubhouse this week in health it and people can come and listen to us live and ask questions.

Okay, can we actually, we wanna see our beautiful faces 'cause it's audio only. But you know, there are, there are lots of healthcare folks having. Conversations. There are doctors, nurses, you know, talking about patient care. There's venture folks talking about digital health. All of all of your healthcare friends are there.

You'll see. So it's like, you know, I, someone described it as like a live call-in show. It's a little bit like that. Wow. Can, can we actually like do our recording? Well, no, actually that, so the one difference is they ask that you not record it. It should be a live event. So it would be a, a lot. So, and, but what we can do is, you know, we can have a room and have people come and we can actually, you know, people can ask, ask questions and things, so.

Wow. Well, I'm looking forward, I'm looking forward to delving into it. Somebody told me this morning that I needed to be on Clubhouse and. I'll do, I'll do it. I'll say as a, you know, heads up though is they have been criticized for their privacy and I think the other really interesting thing is that, you know, there's so many people and there're having conversations and, and their employers can't hear the conversations unless they're on club.

Oh man. So it's a, you know, it's a private network right now, so it's kind That's kind of interesting. Well, it's really private. I went to sign up and it said, it said, we're, we're not, we're not ready for you unless somebody let you in. And one of my friends inside, I guess, vouched for me. They didn't ask me to let you in.

I would've let you in. . Uhhuh. Um, yeah, I was, I, I was, we'll have around. What we can do in there. Lots of lots of folks are there. I know Christina Far was looking at setting up a digital health conversation too, so cool. Yeah. Thanks for it and thanks for your time. Always a great conversation. Good to see you.

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