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 Today, on this week Health, I came into the healthcare industry as a patient I. Long and evolved relationship with a bunch of different hospitals for cardiac issues, and I was just struck by how amazing my physicians were, how amazing the staff were, but how difficult it was to engage in my care outside of the four walls of the hospital.

This was an industry really that should be world class when it came to that experience. Patients have so started a company to try to tackle that issue.

It is Newsday. My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of this week, health At Channel, dedicated to Keeping Health IT Staff current and engaged. Special thanks to CrowdStrike, Proofpoint, Clearsense, Meditech, Cedar-Sinai Accelerator Talkdesk, and Doctor First, who are our new state show sponsors for investing in our mission to develop the next generation of health leaders.

Alright, it's Newsday, and today we are joined by Guillaume Zerk, the CEO and founder of Arter. Welcome to the show. Thank you, bill. Thanks for having me. People aren't gonna know what Arter is, so why don't you give us a little background of, of what Arter is and what you founded in 2015. Well, you actually just reminded me that we're called Arter.

We used to be called Well Health Inc. Which is really unique name, very memorable. No other companies have well in the name. It took me seven years to realize it was becoming a problem for us and we underwent an exercise. It's been going on for a few months. Renamed a company just a few weeks ago. So it's now called Our Art Terra.

And we, I know we we're gonna talk about platforms today, but we're a patient communication solution. I'm gonna stay away from the word platform so that we can save that airtime for a deeper conversation. But . Our mission is really to make healthcare the gold standard in customer service. I came into the healthcare industry as a patient.

I. Long and evolved relationship with a bunch of different hospitals for cardiac issues, and I was just struck by how amazing my physicians were, how amazing the staff were, but how difficult it was to engage in my care outside of the four walls of the hospital. It was always on the phone. It was it. Back and forth voicemails and felt that with healthcare's, infinite resources, market size, with the vulnerability that patients have, this was an industry really that should be world class when it came to that experience.

Patients have so started a company to try to tackle that issue. Yeah, that's awesome. What industry do we point to and say that is the the gold standard for customer service? Yeah, I mean, I tend to focus on what the worst industries are and those are, so let's start there and then let's talk about the positive.

Let's talk about the ones that have really improved, but you know, cable companies the worst. They're at the bottom of the list. Then it's federal government, so think about the last time you went to the DMV and then you have healthcare. The last time I was at the DMV was in Southern California and it was.

I had to wait about seven hours, finally talk to somebody, and they said I had to come back the next day. So that would be the bottom of the barrel is what you're telling me. Yeah. I just actually gave away a scooter. I live in Southern California. I gave away a little vest, but I have two kids now. It's too dangerous and filled out the title thing.

They have an online option now, so I was excited to try their new service, filled everything out, sent it in. Three weeks later I got a response that I filled it out wrong. My car was not properly transferred well. I no longer have the car. I don't have this person's contact information. I no longer have the title.

There is nothing I can do, so I'm waiting to find out if I'm still gonna be getting like bills every year and if I'm gonna start getting tickets sent in the mail to me. I'm actually a little nervous, but most in heard of industries Travel has actually made phenomenal upgrades. Most people still point to transportation.

As a poor industry, I fly a lot in my job. I can tell you that there have been huge upgrades with, with United and Delta and some of the other airlines, but the very best industries tend to be e-commerce. The other one that I've had a recent experience with is actually a gym, physical fitness. So there's a company called MINDBODY that builds a lot of software for gyms and this gym, after my first visit actually started texting me and when I didn't show up for a week, they checked in on me to see if they could get me back into the routine.

And I've been going steady for two months. I don't know if you can tell Bill, but. The gym. The gym service has been working pretty well for me. That's fantastic. I mean, most of the time people point to like Ritz Carlton or those kind of things. So your premise though is that communication is going to catapult healthcare forward.

Precisely. I mean, think about whenever we build software as healthcare IT companies, we think about our customer. What does our customer need and what does our customer want? Who's the customer In healthcare? It's, I mean, I would argue it's the patient, right? And what does the patient need and desire more than anything else?

In my case, it was just convenient access on my terms, and I never got that. I never got that. When I was going through my healthcare, the burden was always on me. Don't get me wrong, like I loved my physicians. I thought the facilities were phenomenal. The people who picked up the phone, when they finally got to me, those were wonderful human beings too.

They were a little agitated 'cause every patient that picked up the phone was mad at them. But I thought to myself, how can we get rid of all that friction? I. So that when I call or if I text or whatever I want to do, I always get an answer. I get it pretty quickly. I get it from the right person and my queries get resolved and I don't have to chase everything.

I mean, I think if you serve the customer good follows, there's a lot of problems in healthcare, but that's, that's the specific problem we're focused on. Yeah. Alright. Three stories today. Digital health decision makers on picking from . Of options. All right, so digital health, modern healthcare. So digital health is the digital version of modern healthcare that's out there.

So every week decision makers at health systems, insurance companies, employers, and pharmaceuticals take a chance by striking a deal with a digital health company. What's the risk? I mean, I'm one sentence in, but what's the risk of striking a deal with the digital? Health company. I mean, there's there's thousand.

There's, this article actually goes on. It says there's 11,000 digital health companies, but we're entering a time where we could see some upheaval in that space. I would assume you were ACIO, right? I mean, probably the biggest risk I would think, but you should honestly be educating me. Here is one, I'm gonna put a bunch of resources to integrate this thing.

Take 'em off of other projects and the company's either not gonna work or it's gonna go out of business or get bought. So I've just wasted a bunch of time and energy for no value. I would think that's the, the biggest risk, and then probably security. These early stage companies, it is almost impossible to comply with a level of rigor when you're just starting out then when you're many, many years down the road and have spent the millions of dollars going through through certification.

But I would think those are some of the things going through your head. That first client is so hard. To get, because healthcare is a very much, tell me who you've done it for. Let me take a look at that kinda stuff. But the reason we do that is to minimize our risk. Yeah. Right. Because, so if you've already gone through the, the process with Cedars or with somebody else, I know that you, first of all, you have healthcare experience.

So you've, you've been in the healthcare world for a while. You understand how we operate. You understand the challenges of operating with us and you understand how we communicate and how we do projects. Tho those are, those are big deals. 'cause if I, if I'm the first one you're doing it with, that's a significant learning curve for a lot of organizations, especially as they're hiring up.

And so we do end up making a significant investment in some of these. Implementation. So it's nice when somebody can come in and and go, yeah, we have three health systems just like yours that we've done it with. And let me tell you what the process is. They're actually walking us through their process as opposed to us trying to figure it out together.

Yeah, they're just awful lot of time and Cedars has done a very good job of that with their accelerator they're creating. More of a kind of fair playing field where they're getting equity in exchange for some of these early stage companies going through their accelerator. Providence has done some things here as well with kind of their incubation division.

A lot of health systems have done this. I think that's been great for healthcare IT innovation in the last couple of years. I mean, we went through the Cedars Accelerator. I wouldn't have been able to have that meeting with somebody like you without having that in my back pocket. We learned a lot from them.

Yeah, it does. It does go a long way. So they, they go on and talk about that selection process and. Some of the challenges, one of the problems that was articulated and defined, one of the people says that one of the things that helps 'em to avoid the shiny object problem. And so we had doctors coming to us all the time saying, Hey, look at this thing.

I saw it at a conference, and it's the shiny object. And one of the things they, they talk about in this article is starting with the problem, what's the problem you're trying to solve? Is that problem acute? Is that problem strategic for you? Because if it's strategic in acute. You're gonna get the money and you're gonna get the resources to do it and do it well.

But if it's not, if it's not strategic and acute, then even if you bought the solution, you're gonna struggle from day one UN until you finally put it to to rest, because there's just too many pro, there's too many competing priorities in a health system. So they talk about starting with the problem set.

Do you find that to be some, some of the best implementations as people who start there? Yeah. And, and, but I think it goes a level further, and I think the article missed this. Talking to your users internally and what their problems are. I. That's just one of at least four things that go into prioritization.

There's the external factors. What is, what does the market want? If you're a health system, it's what do your patients want? Two, what are your users, what are your staff members? Three, what is the competition doing? How do you stay? How do you stay up to speed with the folks in your geographic footprint?

And then four is, what's your actual corporate strategy? What are trying to do? What is the business trying to create four years down the road? And so. Tackling just one of those is much better than just saying yes to the orthopod because they bring in a ton of money and you want to keep them happy and keep them employed.

But really, really good prioritization comes from thinking about those four things, setting a master strategy from the CEO down. And then when decisions get made, you can always point to that strategy. Internally, we use something called Horizon's Rally cry. And I hear this in every single meeting, does this fit with our rally cry?

Does this fit with horizon one? If it doesn't, it's a clear proxy for saying no. It doesn't matter how much money can be made. It doesn't matter if you know the, the problem is acute and strategic because there's always acute and strategic problems. I mean, there's a hundred different vendors that you could buy tomorrow that would solve a hundred different problems.

But how do you pick the top three today? How do you know what the top three are? That's really hard to do. I mean, that's, that's strategy, right? It's very, very hard to do. All right. Conference season is upon us and our team this week, health team and I will be at the Chime Fall Forum celebrating their 30th year in San Antonio.

And we're also gonna be at the Health Conference HLTH in Las Vegas the following week. While at these events, we're gonna be recording our favorite show on the road, which is interviews in action. And as you know, what we do is we grab leaders from health systems, healthcare leaders from across the

Country and we capture 10 to 15 minute conversations with them to hear what's going on, what they're excited about, what are their priorities, and those kinds of things. It's a great way for you to catch up very, very quickly on what other health systems are thinking and doing across the industry, so don't miss a chance.

To hear what's happening from these great leaders. We actually air this on the community channel this week, health Community. It's the green one. So if you go out onto your podcast listener of choice and do a search for this week Health, you're gonna see three channels. The Community Channel is where we're gonna air the interviews in action going forward.

This channel is . Also where community members like yourself have been invited to do interviews of their peers, and so that is moving forward as well. So check those out as well. You can subscribe wherever you listen to podcasts. Just go ahead and, uh, do that in your podcast listener, or head over to this week health.com and scroll down to the community channel and you can subscribe there as well.

So look forward to catching you on our interviews in action. You talk about healthcare like it's operating in a . Capitalist market segment like, Hey, you need to be considering your competition. You need to be considering all these things. I would say, okay, so I haven't been at a health system as ACIO since 20 20 16.

In 2012, when I came in and I started talking that way, they like took me aside and said, you need to understand how we, how we work, and how we function. I'll tell you what, by the time I, I left in 2016, we were talking that way. We were talking about look at hands on, look at one medical. I mean, it's impossible.

Like if you think you're in Des Moines, Iowa, and, and no one's around you. I don't know if there's much competition in that region, but you're wrong now. I mean, digital is a competition. Amazon's knocking on your door. You know when medical was before they got acquired. Everybody's out for your lunch and you've got time.

Look, it's gonna take a while. Healthcare is so complicated. So yes, Mr. And Mrs. Executive, maybe you have 10 years, but 10 years goes like that. And it's so funny, we would've been friends in 2012 that. The thing. The thing that's interesting is 10 years, if you'd have told me 10 years from 2016, I probably would've said, you're being kind.

If you tell me 10 years from today, I'm telling you, you're being really kind. 'cause I'm not sure you have 10 years from today because these companies are starting to scale up really rapidly. You have Aaron Martin going over to Amazon. I think that's gonna give them a lot of credibility as they move into that space.

Gosh, Walmart's hiring some phenomenal people. CVS has some phenomenal people. You're gonna have all these, these, you talk about South Dakota or North Dakota for that matter. Walmart's in those locations and they have a history of starting in the rural locations, garnering the market and then moving into larger markets.

I, I think it's fair if I'm in South Dakota Yeah. No, I think that's fair. The prevailing thing I've learned in my seven years in healthcare is that healthcare is complicated. A lot of these things are tough to unwind. We have seen Google try this before. We have seen Amazon try this before the Berkshire Hathaway, JP Morgan merger.

That doesn't mean we should dismiss the new efforts because I mean, you're right, Aaron Martins. Like he's gonna give, he's gonna give Amazon a really good run for their money. Walmart, the CVS signify acquisition going into homeowner. I mean, I think there's, there's a lot of threats out there and frankly, from my seat, I just want, whatever's gonna be best for the patient.

Yeah, I would love, I personally believe that the. A physical patient, physician relationship is key to health, is key to great health and longevity and being proactive and thoughtful. So my money's with the health systems, my investment is gonna be with the health systems. But you're right, I mean there's threats from every corner right now.

Alright, let's, let's hit one last thing in this, 'cause I love this distinction. There's a fundamental difference between digitization and digital transformation. Digitization is taking the existing process and workflows and essentially performing a lift and shift into a new tool. But you really haven't changed the process or the workflow in a meaningful way.

You haven't reduced the complexity. I. And prior to that it said, but it's not always easy to integrate solutions in a way that improves provider or consumers digital experience. A lot of health systems end up putting digital processes on old workflows, and it's digital transformation, first of all happens.

People are like, well, you gotta do digital transformation. No, it's happening, happening all around us. The question, are we gonna adapt? Are, are we the transformation part of it? Are we gonna transform healthcare and sit back and rethink our communication, the modalities that we're going to engage the patient, the hours of operation?

Are we gonna rethink those things? Are you finding health systems are becoming consumer centric in terms of their approach to delivering care? Or are we still provider centric in terms of, are we still trying to walk the line between the two? The very best health systems are definitely becoming consumer-centric, but we'll have physicians on committees so that they're considering the needs of their users as well, like their, their real staff users.

I'm thinking of, there's a Baptist in Florida that just hired somebody from Disney, I believe, as their chief Digital officer. Houston Methodist is a great example of this with Diop committee, the digitally. Obsessed, innovative people. I think I have it backwards, but I we're seeing a lot of investments in leadership roles around digital, bringing in people outside of healthcare, then building committees around those folks that include A-C-M-I-O or ACMO.

I spend a lot of time, a lot of time I spend, I take a trip every year to amdiss and I do that because you get close to the clinicians, you get close to the CMIOs, and it's a really, really good perspective that, that you otherwise would ignore. So I'm seeing it happen with the very best health systems.

Now, on the, on the opposite end, when you think about not transforming and just lifting and shifting, a classic example of that is an RFP. If you're on old tech and you're setting all your requirements and giving that to digital vendors, that's a definition of a lift and shift, right? Do everything I used to do.

Do it on your digital technology. So I think RFPs are dangerous, but I don't know that you, if you want to go into that or not. . No, I'm curious. RFPs are dangerous. We, we, we didn't do a lot of RFPs if I thought about it. And we did a handful, we did 'em around, we were redoing our data platform and rethinking our analytics platform and we put some RFPs out in that space.

But on the digital side we did a, a, a million pilots. Right. So we were one of those, yeah. Death by a thousand pilots kind of organizations. It really was almost like the, the gladiator kind of thing. We brought in 50 digital companies and they were all doing their pilots, and whichever one's survived the longest, maybe got a contract.

There's, there's problems with that, but, but that's our approach. What's the better approach if it's not RFP and it's pilot, what is, what does it look like? I think, I think it goes back to where we started, which is what is our strategy as an organization this year? And getting that trickle down the entire organization so everybody knows what are priorities, one, two, and three, and every piece of work that you do needs to level up to a priority.

If you do that, then you, then you trim down the universe of 10,000 vendors, probably do a couple hundred, and of those couple hundred you set your own priorities and maybe you have 10, and then you find the one that you like best. It doesn't have to involve an RFP, it's like is the sales rep being authentic?

The way they're selling you the technology or they're be, are they're being mischievous? Is the client success executive gonna have your back? Have they been at that company for a while? Does the vision of the company align with what you want to do with your own business? To me, it's kind of those more qualitative things and then referencing them.

Right? Have they actually, do they stand up for what they say? Do other companies get the results they're promising me? To me. I mean, that's how we make decisions that well with vendors. To me that's a more effective way. Yep. Everybody's talking about hospital at home health at home. A market watch article states that in-home hospitalizations saves five to $7,000.

Per episode and with the economy where it's at, and the pressures that are on health systems, this is an important topic. On December 1st, join us for a webinar with a panel. They're gonna be able to share how they stood up a successful program and work through the complex requirements for helping patients recover in a comfortable and familiar setting.

You could register on our website this week, health.com. Go to the upper right hand corner. We have current webinars. And upcoming webinars. You can register right there and, uh, you could also in that registration, put any questions you have and we will try to address those questions during the webinar. We love doing that and love having you be a part of the conversation.

So I look forward to seeing you there. Next story. This is the platform story, right? Transforming healthcare through platforms. This is President CEO of Mayo Clinic, GCO, Faria. As I'm reading this story, I. Very impressed that ACEO is delivering this message. That's the level of technical acumen I would hope that most CEOs are bringing to bear at this point.

Anyway, he, he goes on, he says, our current healthcare model functions as a pipeline. I. Which is linear, highly transactional, and inflexible. The failings of this model were clear during the pandemic where collaboration was limited and stress to individual nodes led to points failure. This in turn, hampered and in some cases paralyzed the entire system.

A platform model of healthcare and ecosystem is fundamentally different. A platform is built around secure collective resources such as powerful analytic engine. An open ecosystem of trusted collaborators and is highly dynamic self-learning, inherently accessible and scalable. This approach brings together providers medical, a whole bunch of partners to design integrated end-to-end solutions that are supported by longitudinal clinical data and AI algorithms.

A platform is purposefully collaborative and fuels innovation and access. And I'm just gonna give a little bit more and then we will go. Into a conversation. So for any such platform to be adopted at scale, you need to reconcile two seemingly contradictory responsibilities, safeguarding patient data and privacy and security, while enabling innovation through broad access to results and AI models, highly trustworthy and scalable at the same time.

So platform again, 2012 through 16. For me, everybody was saying Cloud, cloud, cloud. It feels to me like everyone now is saying platform, platform, platform. The thing I like about this article is it actually defines it. It's loosely federated set of systems that are highly scalable, secure, private, that you can bring disparate entities on it, maintain that security and privacy, and access that data, access it with algorithms and start to produce results around that.

And. It really almo. It's only limited by the imagination. 'cause you can continue to bring different organizations together and search for different solutions. Like how, how he describes it. What are you seeing or what's your experience with platforms in healthcare and with regard to what he's saying, its ability to transform healthcare.

Well, bill, I think the word platform is dangerous. I like the way it's described here. Mayo has a unique access. Asset and their data, but it's a word that when I have pitched VCs over the last seven years usually gets a bit of a guttural reaction or prove, prove to me that you have a platform. Right. I think the, the piece that's really interesting here is it's, it's really hard to access.

Health system data today, you're typically using HL seven. Maybe you're using FHIR, maybe you're going through the EMRs. You're not going directly to the providers themselves, and you're piggybacking on some APIs that they've created, and those are typically customized. So what I would do for Mayo Clinic would be very different than what I do for an Intermountain or another health system.

So it is tough to get access to the data. He also mentioned that he has a longstanding partnership with Mercy or a 10 year agreement with Mercy. So it's not just his data, which is interesting. He's already doing the work of de-identifying it, I should say. They are. Mayo Clinic is, and they're providing this promise of tapping into that data.

I think that could be incredibly interesting for research purposes. What he's describing really to me as a data platform. It's a data warehouse that's de-identified with very simple calls that you could make queries into and out of that data set, enrich data over time. Interesting. When I think about a platform and and truly creating a mass market platform is it has to create a lot of value for both sides.

So there has to be in a lot of company best platforms or think about the iPhone, the app store, right? The value Apple was creating was access to all of their users. Post a store on the app, people can self-discover. Then eventually when there was enough traction, they asked for money back and it created a wonderful ecosystem.

Salesforce, same way they built the rails, then people could build applications on top. They had all the users, so it created value. I think I. As I read this article, it sounds like the key to me is gonna be getting more and more data. Mayo's data probably won't be enough. Mayo and Mercy's data probably won't be enough.

They're gonna need a lot more health systems, a lot of devices. They need to create enough value for people to want to plug in and extract that information. Again, for research, I think value immediately makes a ton of sense. But for healthcare it. They're gonna have to big build a consortium to really make that take off and I think live to the promise of the platform.

But that's my take as a, as a healthcare guy, I'm certainly a different position than the CEO of Mayo. Yeah. I. And that's exactly what they're, they're competing with the other entities that are out there. There's a large consortium of players that have thrown all their data together. I think one of the things we had, we've had John a Lamco on the show Yeah.

A couple times. And he talked about this, this platform. And one of the things that's distinct about it is it doesn't give the data back. So essentially you can run your algorithm and it can give you the result of the algorithm, but you can't query the data. You can't query the data and have it sort of come back to you, and that's why they talk about the glass wall.

It's like you can run your experiment in there and it'll say, Hey, here's, here's what the experiment did, or Here's what the AI algorithm did. Oh, that's neat. Against the dataset. And so they're talking about a different level of protection. Then say another huge platform that has a lot of partners in it at this point that is taking a little different approach.

You could, 'cause, look, there's no, no such thing as de-identified data. It, it can be re-identified. We've seen the cases over and over again. It takes some work, it takes some skill to do. So that's, that's one of their claims to claims, to fame around that. In terms of, of platform, the, I sort of wanna talk to you about the EHR 'cause when you describe it.

The, the platform of creating value on both sides, and the more people who sort of get engaged, it creates more value. The platform sort of builds and builds value. I mean, that's what we saw with Yeah, you, you name it. That's what we saw with Facebook. You have 10 people on it. It's not that big. You get a billion people on it.

It creates value every day for everyone associated with it, the EHR. And so when you. We don't traditionally think of the EHR as a platform, but when you think about Cosmos, cosmos has a, an inherent advantage in the amount of data that it has available in this kind of model. And so I, there, there are times I, I don't like referring to it as a platform in that it is so closed.

Um, and you described some of the challenges getting data out, doing the kind of. Need to do with it. Do you consider the EHRA platform for healthcare? Is this the kind of thing that he's talking about that a platform could take us and and really help to solve some of the problems that healthcare is facing?

I think the EHR could be, I. I think going back three, four years, Athena had the best shot. They were really investing in their more disruption, please, all the APIs that were coming out of that team. I think the financial model made sense. The challenge right now is that at the individual health system level, as I mentioned a second ago, it's still so highly customized.

It is hard. It is. It is, I would argue, near impossible for a vendor to come in, integrate once into the EHR and then have that be. An application that any of their customers could deploy. Even in the investment in the APIs that Oracle, Cerner, Meditech, epic are making, there are still a lot of gaps. So only so many applications can be created on top of that information that they're providing.

Then I think the third complexity is that the EHRs are also competing directly, and that's a fundamental difference. I. Facebook, Salesforce, even Apple have have approached this where they've really stayed in their lane. We're gonna own the oss, we're gonna own the devices, but you know, we're gonna stay away from gaming.

So gaming developers, go and build your applications. We're not gonna try to defeat, compete with Call of Duty too, with a better version of that game. Amazon is running to some issues right now, right, with their Amazon Basics product. A lot of folks distribute their products on Amazon. Amazon see 'em take off, they clone it, provide a cheaper version and distribute it.

It's creating a lot of backlash, which is why there's the rise of third party companies now that you go to the different e-commerce websites that might not necessarily be on Amazon. So I think that EHRs have the potential to be a massive part of the solution. They're close and we're seeing a lot of progress from them.

But I think those three components are keeping them from, from helping us realize the whole value that it could provide. Yeah. And we we're just about out of time. I mean, the last article here was Administrative Ways comprises 15 to 30% of healthcare spending, healthcare shows. Uh, I mean, their conclusion is the government needs to do something.

I think as, as I look at this, I mean, they're saying, look, prior authorizations, billing, complexity. All these things are driving increased administrative burden within the US health system. The US health system, as compared to other nations is a lot higher. And they're saying, look, there's, there's models, but it's probably going to have to be driven in some way by the, by the government changing some things.

Could be single payer, could be some things around. I don't know, uh, simplifying the, the billing process. I don't know. Uh, it's, this is an interesting article. I'll give you the last word on this. Anything outta that story that, that you want to highlight? I mean, only that I'm from Canada. I haven't been there in 30 years.

A lot is written about single payer and the system that we have here, and there are pros and cons to both. There's a lot of focus on equity these days. I think single payer could help with, with equity. There's a lot of costs to, to taking on that system. So I think it is a very, very complicated problem and there are very wise people thinking through this.

I'd love, I'd love a solution because we haven't been talking about it for a while. I'd love something that really moves the, but unfortunately I haven't thought of a better idea yet, so I. I'm along for the ride. Fantastic. Kiem, I want to thank you for your time and great conversation. I really appreciate it.

Likewise, bill. Thank you. What a great discussion. If you know of someone that might benefit from our channel from these kinds of discussions, please forward them a note. Perhaps your team, your staff. I know if I were ACIO today, I would have every one of my team members listening to a show just like this one.

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