Transforming Healthcare: Gerard Odafe on Digital Innovation and Value-Based Care

[00:00:01] Welcome to the Chalk Talk Jim podcast, where we explore insights into healthcare that help uncover new opportunities for growth and success. I'm your host, Jim Jordan.

[00:00:18] Welcome back to Chalk Talk Jim, where we explore the intersection of technology, healthcare and innovation. And today we're joined by Gerard Odafe. He's the Associate Director of Digital Products and Services at Baxter.

[00:00:31] And he's got a remarkable career journey working in aerospace and oil and gas, driving digital transformation now in healthcare. In this episode, he shares his experience from reengineering healthcare operations at the Cleveland Clinic to leading digital innovation at Highmark Health and now Baxter.

[00:00:49] He offers valuable insights on topics like value-based care, continuous improvement, and how digital health tools are reshaping patient outcomes and healthcare delivery.

[00:00:59] If you're interested in understanding how technology and innovation are transforming the healthcare landscape, then this is the episode you don't want to miss.

[00:01:07] So tell me in the audience a little bit more about yourself.

[00:01:10] Well, thanks Jim for having me. My name is Gerard Odafe. I'm currently Associate Director with Baxter's Digital Products and Services team.

[00:01:19] And currently living in Chicago, originally from Ohio. And my journey through healthcare has been probably a typical one.

[00:01:26] I'm a professional, meaning that I'm not a clinician by trade. I'd actually started out in engineering, working in oil and gas.

[00:01:33] Actually, even before that, defense aerospace, where I got my first internship experience working at the Wright Pedersen Airport based out of Dayton, Ohio.

[00:01:40] Great experience, learned a lot, but wasn't something that I wanted to continue with, similarly with the oil and gas experience as well.

[00:01:47] But the skills that kind of got me through, or that I was able to carry from those experiences were what actually got me into healthcare in the first place.

[00:01:55] And so as an engineer, you focus on a lot of process improvement, project management, problem solving, systems approach type thinking.

[00:02:02] And at the time, very fortunate to grow up in Ohio. There's a very large hospital called Cleaning Clinic that's right down the road.

[00:02:10] And I joined at a time where they were looking for people with a non-traditional background to join their healthcare system shortly after the ACA as a part of the convenience improvement team to essentially re-engineer their healthcare operations across the entire system.

[00:02:24] So there's people from manufacturing, retail, other consultants, other large manufacturing and marketing firms as well.

[00:02:35] People that had joined the team at the time. And I specifically joined in oncology.

[00:02:40] And cancer is a horrible disease. It's fortunate to not have impacted my family yet, but it's a tremendous place to learn how healthcare in a hospital really works because it not only impacts every part of a body,

[00:02:54] it impacts every part of the hospital. And from a process perspective, you have your aid-a-patient, your outpatient, you have pharmacy, your drug delivery.

[00:03:02] You have the complexities of managing chemotherapy oncology schedule. You have all the different specialists and surgical components, radiation treatment.

[00:03:12] It's a very complex group of different levers. And here I am coming in with my bachelor's degree, trying to help these people improve their day-to-day operations, literally people can cure cancer for a living.

[00:03:22] It's a tremendous place to learn. It made a lot of really great friends and people that still rely on this day for good conversation and knowledge sharing.

[00:03:30] But some of the relationships I built there was help get me over to my next role, which is at Highmark Health.

[00:03:36] And so you'll pick up a fee, which is there's knowledge seeking, and then there's the relationships that kind of got me to the next level.

[00:03:42] One of those people that I worked with, he actually became the chief strategy officer at Highmark Health, Mike Bennett.

[00:03:48] And at the time, there was a number of people that made the move right down IA down the turnpike from Cleveland and Pittsburgh.

[00:03:55] I know from a sports perspective, there's a rivalry there, but it's starting to turn a little bit.

[00:04:00] But we'll see how things shake up in season football.

[00:04:03] But yeah, I made the move after staying in Cleveland for four years.

[00:04:08] And by the way, I didn't really get into too much of the work that we did on the oncology side.

[00:04:12] But essentially building care pathways, value-based care, and a lot of process-approved projects from scheduling, using visual management tools, putting in different care models, and essentially changing the way that oncology services are delivered, organized, and effectively managed for the greater Northeast to higher region.

[00:04:29] So can I make this comment?

[00:04:31] I think that learning is all about timing and sequencing, right?

[00:04:34] And I think that one of the benefits of having that big company non-healthcare experience is in terms of the learning curve of just-in-time and sequence management and error detection and pokey oaks and all the different techniques that are out there.

[00:04:52] They're far more advanced than in general healthcare.

[00:04:56] And most of the reason that is true in healthcare is the infrastructure isn't there to support that analysis.

[00:05:05] And so I think since ACA, we've been trying to put that in.

[00:05:08] Applause to Cleveland Clinic for bringing in that talent.

[00:05:12] But when you think about cancer specifically, and unfortunately for me, I've had family members that have had this, quick decision-making, timing, and sequencing needs to be flawless.

[00:05:23] And to your point, it goes across multiple departments, whereas a lot of the disease, for the most part, stays in cardiology or stays in or something like that.

[00:05:32] So what a great learning experience.

[00:05:33] Yeah.

[00:05:34] I'll never forget, Chairman Brian Bolton, one of the main metrics that we were focused on as a team was time to treat, right?

[00:05:41] How can we reduce that time to treat?

[00:05:43] And really, it starts with how we get to that first diagnosis, right?

[00:05:48] From the first time that this person, either there's biopsy is ordered, something looks spotty on a regular mammogram, whatever it is.

[00:05:56] And reducing that tie between signal and decision, because that can cause a lot of anxiety for the families.

[00:06:04] And I think that's another thing that I took away from that experience is the nature of the treatments.

[00:06:09] You would see patients come there every day.

[00:06:12] And you'd also see their families, their other support systems, friends, other caregivers.

[00:06:15] So, again, I think it's just a unique condition from a treating perspective and how it impacts people, but also from how it's managed and run within the hospital system, too.

[00:06:26] Again, a tremendous place to learn and nothing but great things to say about those folks.

[00:06:30] Transitioning over to the experience in Pittsburgh at Highmark Health, the unique thing, and I think this is when you'll definitely be very well versed in,

[00:06:38] just because of the dynamics that were happening in the Pittsburgh market at the top.

[00:06:41] So, considering the historic relationship between Highmark and UPMC, the estate consent decree, Highmark was in a position where they essentially needed to rebuild this acquired hospital network,

[00:06:54] Gallagini Health Network, and change, transform their insurance products today, considering the changes that were enacted by UPMC.

[00:07:02] And this is right around 2016 was when I made this transition.

[00:07:06] Over there, it was a similar approach.

[00:07:10] You could still take the same process, continuous improvement-type thinking, but this time it was broader than just one condition.

[00:07:17] It was looking at your top five service life spends.

[00:07:20] You're looking at chronic care.

[00:07:21] You're looking at diabetes, hypertension, neurology.

[00:07:24] I spent a lot of time working with the stroke, specifically the ischemic stroke folks down at Allegheny Health Network.

[00:07:31] And from that perspective, we could do a lot of the same things that we could do in Cleveland, but because we had both payer and provider at the table,

[00:07:40] now you have the data, you have the funds flow, you have this kind of closed ecosystem where you could control that population to some degree.

[00:07:49] But then also, you had the key decision makers, the providers at the table to help enact and build out some of these pathways in a more sustainable fashion.

[00:08:00] And additionally, you could create, test, and learn these different types of products and care pathways, and everything is all evidence-based, of course.

[00:08:08] But you had these sort of controlled micro markets that you could stand up and really build out based off of quality, based, have more regional specificity, direct patients from an inpatient center to upon discharge to specific post-acute centers,

[00:08:27] which was a big focus of the PILARC at the time, building more value-based care efforts around post-discharge efforts.

[00:08:33] And it was a pretty unique time, just to get there, just to get there, just because of the different transformation.

[00:08:38] Maybe for the audience, a little commentary so they understand the regional stuff.

[00:08:42] And please correct me if I get it wrong, but UPMC was always an insurer and a provider.

[00:08:47] And Highmark was in just solely for years, just insurer.

[00:08:51] And so they would be welcomed in the UPMC system as an insurer.

[00:08:55] And they decided to vertically integrate, and in doing so, they became a competitor to UPMC.

[00:09:02] And so for a period of time, they weren't accepting their insurance.

[00:09:05] And long story short, I think the state intervened, and there's been some form of relationship that has been formed.

[00:09:12] But this vertical integration is a tactic for many to try to be able to get more information and get more profit out of both sides of the product.

[00:09:22] Is that the general gist of why people do that?

[00:09:24] Yeah, I think you got it.

[00:09:26] And I think it's, if you think about it, if you're controlling the funnel and the funds that manage and deliver what people see, right?

[00:09:34] Between reimbursement, the whole ecosystem of you have a patient that, say they get insurance through their employer,

[00:09:40] they show up that they have these three to five options, hopefully more, three to five options to pick their position.

[00:09:47] And they could do all, everything they need within this top closed system.

[00:09:52] But because you would have the, all theoretically, almost all of their data within their experience within the hospital system,

[00:09:59] and you have the providers that are also sitting at the table to help mold and shape that care delivery network.

[00:10:07] That's when you can really start to accelerate some innovations, which was actually the second part of my experience at Highmark.

[00:10:16] And again, even stepping outside of just within the walls of Highmark, Highmark is a Blue Cross with a children's children.

[00:10:22] One of the few at the time that owned its own delivery network.

[00:10:26] And so being an IDN and all the things that you just mentioned about vertical integration,

[00:10:32] that allowed Highmark to do a lot of things, a lot of things more quicker.

[00:10:35] Some of the other Blue is in the area.

[00:10:37] This is years before the second Blue bit that's recently announced.

[00:10:41] So they were and still are significantly ahead in some of that product and market differentiation.

[00:10:46] But from an innovation perspective, one of the teams that I had worked with, our focus was essentially,

[00:10:51] how can we shorten the time for delivering new and innovative care to our member populations?

[00:10:58] How can we get the latest and greatest cutting-edge solutions in the hands of our clinicians?

[00:11:03] And how can we really bend that cost curve or create more, reduce the amount of volatility in the cost curve

[00:11:10] by essentially de-risking these solutions up front?

[00:11:13] And the credit to the leaders that were in place that had the vision,

[00:11:18] I was a part of a team where we were looking to commercialize and partner with external innovators,

[00:11:25] whether it's digital health startups, whether it's med-surg, med-tech companies

[00:11:28] with the new surgical procedure or device, other novel technologies that essentially they were looking for

[00:11:34] broad market adoption.

[00:11:36] But to get to that adoption, they needed real-world evidence.

[00:11:39] And because we were in the position of payer-provider, we had this kind of closed ecosystem,

[00:11:44] we were able to partner with them on a few different ways.

[00:11:49] And one of them was talking about just, again, we have this specific set of claims that depending on

[00:11:56] if it's a, say it's a diabetes company, which I'll get to when it comes to the next step,

[00:12:01] they have a claim that their solution can reduce someone's A1C over a period of two years by,

[00:12:06] I don't know, 5%, 10%, something like that.

[00:12:09] And we would be able to take a look at our claims dataset,

[00:12:14] identifying the target population based off of whether it's benchmark data that the innovator has,

[00:12:20] or maybe they do come in with an identified set of claims codes from their previous,

[00:12:25] if they went through FDA approval or they just recently achieved that.

[00:12:28] If they were able to come to us with that, if not, we were able to help them define that population

[00:12:35] and essentially return, here's an expected population impact.

[00:12:40] Call it like opportunity analysis.

[00:12:42] And that was really where you would start to see some of the initial kind of triple A stuff

[00:12:45] of potential cost savings, cost containment, clinical outcomes.

[00:12:49] And if we were able to get to this level at the early stages,

[00:12:54] what we could expect from a either a patient impact or provider impact.

[00:12:58] So because of that was a valuable paid product that we were able to partner with those innovators on.

[00:13:05] And it was a decision point essentially.

[00:13:07] So depending on how that looks, that gave us enough information to say,

[00:13:10] you know what, this is worth the retrospective says,

[00:13:13] this is worth enough doing it prospective set.

[00:13:16] Question, would that information be coming down from the insurance company to the providers

[00:13:20] or the other way around when you're dealing with the manufacturers?

[00:13:23] How does that information come in?

[00:13:25] Yeah. So because Highmark was the insurance company, we had all the claims data.

[00:13:31] And so we would be able to say, taking a look at, take a historical full year,

[00:13:36] taking a look at these specific patients, if we were to impact or change this by following the claims

[00:13:44] that they have provided we achieve the right on enrollment, onboarding and engagement over the

[00:13:49] course of a defined period of time to be a year and a half, six long bedroom period built in there

[00:13:53] and an additional six months replaced.

[00:13:55] We could project out with a reasonable rate of confidence.

[00:13:58] We could project out a, either a cost impact or a financial impact.

[00:14:03] And if we're really doing well, there was a potential provider or patient satisfaction impact as well.

[00:14:09] Not all our audiences is got all this background.

[00:14:12] So maybe we'll be paused for a second.

[00:14:14] So first of all, the insurance model itself is there's administration of the plan

[00:14:18] and the insurance model takes on population risk, right?

[00:14:22] And so they have to put profit on top of both of those items.

[00:14:25] And obviously the administrative cost plus a profit is much easier to predict than the population risk, right?

[00:14:32] So this year, everyone's healthy.

[00:14:34] Next year, everyone has cancer.

[00:14:35] The cost for running the system that year is dramatically different.

[00:14:39] Yet you've quoted your premiums for the year.

[00:14:41] So your stock, right?

[00:14:42] So that's the insurance model.

[00:14:44] And because in general, they have data from more than one hospital system, that data is, that data has a lot of insight into it.

[00:14:52] I guess would be the best way to describe it.

[00:14:54] Yeah.

[00:14:54] It's a very rich day.

[00:14:56] And I think the unique position that Highmark had is that we were able to fully harness the capability of what could be extracted from that information.

[00:15:06] Because we had the close, we had the hospital was literally Frosted River.

[00:15:11] It's one of the three rivers.

[00:15:12] But because we had a lot of those folks sitting with us at the building, helping us select some of these solutions, we had a number of physician champions.

[00:15:20] We had to buy it.

[00:15:21] When you have those two pieces together, that's when it's like, this goes from more than, this goes from just a physician bed project.

[00:15:29] Because we all know that the doctors, they want to have the latest and greatest.

[00:15:32] And research is definitely what drives the bus and furthers our innovation in our care delivery.

[00:15:37] But if we do have the opportunity to accelerate how quickly we can scale those products, that's when having that healthcare data and then having the real live testing round, proving round, to put these solutions in play.

[00:15:52] And think about it differently.

[00:15:53] It's just post an FDA approval.

[00:15:57] Whereas to me, have your totally, typically control studies, perfect environments.

[00:16:01] You're going through your face, your face board, like all of that kind of stuff.

[00:16:03] This is what it would look like in a real world setting.

[00:16:08] But you still have the administration on the health plan end.

[00:16:12] You have the direct intervention with the providers.

[00:16:15] And you can control which patients actually onboard to those specific solutions.

[00:16:21] I think from the provider side, they would say that data is rolled up mostly from financial data because that's the history of, and that financial data doesn't always represent the other details that go on.

[00:16:33] So, for example, I've told this story before about end-stage renal disease where in the summer when fresh vegetables, tomatoes, and strawberries, and things are available, a lot of times end-stage renal disease patients will eat things that they shouldn't eat.

[00:16:46] And all of a sudden, the data goes south, and it's hard for the insurance company to know what happens.

[00:16:52] And providers have that behavioral data.

[00:16:54] And this is a real story.

[00:16:55] It was a gentleman who was being lectured by his nephrologist on eating too many tomatoes, and his bun rate had gone up.

[00:17:01] And he said, my wife has made this special tomato soup since day one, and for me not to eat it is an insult.

[00:17:08] And he was saying to them in a conversation, the doctor said, but if your wife knew what it's doing to you, do you think it would be an insult?

[00:17:14] So the data doesn't represent the issue there, right?

[00:17:17] That's a behavioral family issue that needs to be put into some sort of program or behavioral protocol.

[00:17:23] So it's important for both groups to work together because I think the insurance companies have insights into a lot of things that people don't have.

[00:17:30] And then at the same time, these little details, like I just told this story, are an important application of programs or behavioral health programs applied, right?

[00:17:40] So I find that to be really interesting.

[00:17:42] But vertical systems allow for that dialogue.

[00:17:45] Is Cleveland Clinic self-insured?

[00:17:47] No, I don't recall their pair mix, but at the time, at least I don't believe today that they are self-insured.

[00:17:54] Yeah, I remember I had into medical mutual way back in the day.

[00:17:58] So then these products and services that get them better.

[00:18:01] And you actually, one of the things that you just touched on with the behavioral health change, that's a piece that carries me, at least gets me into the digital health side.

[00:18:10] So actually, funny enough, within one of the key metrics that we would always look at, whether it's provider adoption, patient adoption, a lot of that is how the solution is presented to the patient, how it's presented, how it's managed, and what is that experience, right?

[00:18:26] There's always this experience component.

[00:18:27] And I think a number of digital health companies definitely lead me to that pre-pandemic.

[00:18:32] One of those, I think, that was at the forefront of that was Lavonger.

[00:18:38] And their team, they actually came to our team at Highmark.

[00:18:42] I think it was either 2017 or 2018.

[00:18:44] And it was very clear at that point that they had a very strong vision.

[00:18:50] They had a diabetes solution market.

[00:18:52] They were talking about launching hypertension products, talked about the roadmap of where they were looking to go on behavioral health and some of the other chronic conditions, weight management, diabetes prevention, et cetera.

[00:19:03] And it was just funny because I saved the business cards from two of the people that came, but I'd always kept them on the radar of these guys are doing something really cool and it's worth following up.

[00:19:14] And so I had the opportunity probably about half a year later to join their team specifically focused on health plants and product and solution activation.

[00:19:23] And so the cool thing about joining a company like that, at this point, they were, I'd say, late stage startup.

[00:19:30] It was still pre-IPO.

[00:19:32] It was like you could see, you could feel the momentum.

[00:19:35] There was a buzz.

[00:19:36] There was energy.

[00:19:37] There was a sense of collective unity towards this goal.

[00:19:42] And a lot of that does come from the founder, Glenn Tolman.

[00:19:45] But there, you could tell that the team's fully aligned and there was a very clear mission.

[00:19:51] We're going to tackle this chronic care market starting with diabetes.

[00:19:55] And what product strategy made sense because think of where your levers are within the industry.

[00:20:00] I don't have stats in front of me, but given how high the cost of insulin is, the impact of someone, A, not being able to access it, but also not being able to access the strips, having a BG to check on a daily basis.

[00:20:14] The problem that they went to solve, it was, yes, there was a cost equation, but they used it by focusing on behavior change.

[00:20:21] And I think that's one of the things going back in terms of how you could build like the stickiness, how you could get people, get patients that, A, have theirs because versus the clinical impact that matters.

[00:20:33] But then also having very high satisfaction ratings after that.

[00:20:39] Having employers renew year after year with those same contracts because their patients love.

[00:20:44] And being able to report out on cost savings as well.

[00:20:47] And specifically how that impacts the payer side as well.

[00:20:51] I think in terms of behavior change, like that was thinking about where digital health was at the time.

[00:20:59] And they weren't the first and only digital health company that was already leading into that.

[00:21:03] But I think they figured out something early and they were able to do it in a way that was effective and positioned themselves as a leading player when it comes to diabetes management, chronic care management.

[00:21:16] And then, of course, the other acquisitions over the years.

[00:21:18] And you were there during COVID, right?

[00:21:20] Yes.

[00:21:21] And that's a critical time when there was so much concern about patient access to get chronic support.

[00:21:28] And having computer systems and apps and different things that could engage in that becomes critically important.

[00:21:34] Yeah.

[00:21:35] Yeah.

[00:21:35] The connected care wave definitely, again, it's you can't really predict a pandemic, although it's there were enough signs that some of this was happening in real time.

[00:21:46] But you can't necessarily predict the response.

[00:21:49] Being positioned there at the time, it was like you already had this sort of remote connected experience that was really built around.

[00:21:57] This is it was really built around how someone moves around in their day to day.

[00:22:01] The name of the company, Lavondo, actually came from Live On The Go.

[00:22:05] So meeting people where they're at was one of the core tenets of how the company approached member satisfaction, customer experience, and really get to that stickiness, which is what leads to course your ARR and all the other metrics that we love to see from our digital company.

[00:22:24] And then I think during that time, some proposed coding from the industry before COVID to pay for these types of services.

[00:22:33] The resistance was dropped and the codes were finally initiated.

[00:22:37] And I remember being part of a health IT company.

[00:22:41] What are directors?

[00:22:42] Where are someone's from the insurance industry said, yeah, these codes are going to go away after COVID.

[00:22:46] And I said, there's no way they're going away.

[00:22:48] They're out.

[00:22:49] People were starting to see the benefits and it takes years to make change to get these codes launched.

[00:22:55] But once the code is launched and the evidence starts flowing in, which it did, it's the new normal.

[00:23:01] Yeah.

[00:23:01] And they always say that it's harder to take something away than to give it to someone.

[00:23:06] And we definitely saw that with what at least what happened with telemedicine and how some of the digital health companies were able to build some sticking power.

[00:23:15] But yeah, I think from a perspective, and it seems like if I recall, I could be wrong on this, Jim.

[00:23:20] I thought there was a recent legislation or at least a ruling that came out that there was, I think it was just two pieces that happened.

[00:23:28] One, I thought there was extension of the telemedicine provisions within the Medicare Advantage space.

[00:23:33] I thought so.

[00:23:34] Maybe I'm wrong on that.

[00:23:35] And then there was a second recent one about, I don't know how they grouped it, but it was still within Medicare Advantage populations.

[00:23:45] I think it was new and innovative technologies.

[00:23:48] I think it was there.

[00:23:49] I think they're making it easier for them to achieve reimbursement.

[00:23:52] I'd have to look it up.

[00:23:53] When you think about it, and we'll move to the medical device in a second, but this sort of ties with the medical device industry is when you launch a new product that's in a different category, you have to create a trial, not a clinical trial to get FDA approval, but a pay-to-trial that basically says this product has some benefit.

[00:24:10] And that takes sample size and time.

[00:24:12] And I think one of the things that COVID did is we had small sample sizes, small time prior to COVID.

[00:24:20] And when we sent everyone home and told them we were going to take care of them virtually, the sample size went up very quickly and the evidence came up very quickly and it was obvious what we needed to do.

[00:24:31] So we could go back five years and say it was obvious what we needed to do, but we just didn't have the data.

[00:24:36] So I think that's what happened there.

[00:24:38] So what brought you into the medical device side?

[00:24:41] I think of every, much older than you, but the medical device industry, wherever you go, there's a Baxter executive in the C-suite.

[00:24:50] It's just been one of those companies that everyone got great management training from.

[00:24:56] How did you get there?

[00:24:58] And tell us that story.

[00:25:00] Yeah, I think some of it is timing.

[00:25:02] Some of it is also one of the things I had mentioned around personal relationships as well.

[00:25:07] But number one, I've been interested in the company just because, A, their legacy, much more and more entrenched players and if not one of the most entrenched players.

[00:25:17] And you can go to any hospital room and you'll see probably a dozen Baxter products between Phil Rodman, Will, Choward, et cetera.

[00:25:24] And it actually come up from our mutual connection, my brother, who we actually worked at Baxter in 2017, 2018 and built up some great relationships there.

[00:25:35] And I had happened to be available.

[00:25:37] I did about two years working at Google within their wearables Fitbit outplanned partnerships team.

[00:25:43] And I made the move to go over to a smaller digital strategy firm.

[00:25:47] But due to mergers acquisition, I was laid off.

[00:25:50] And so the timing of it was really great because, A, Baxter is always looking to grow and transform its digital offerings as well as gradient folks with, I guess I'll say, outside of the medical device now.

[00:26:05] So thinking, going back to where I was almost over a decade ago at Cleveland Clinic, being an outsider as a person who really didn't have a lot of healthcare-specific experience and going in and using those skills to try to improve it to that level.

[00:26:20] Fast forward 12, 13 years later, coming into Baxter, I have that hospital health plan, digital health, and wearables experience coming in as well as digital transformation, but not the specific traditional come up through device side.

[00:26:33] But that's the stuff that, you know, having all those different experiences that can make, it can help you make a different type of impact because you bring a different perspective.

[00:26:43] Being able to pull on the experiences I had at Heimer, the experiences I had at Cleveland Clinic, Google and others, Alibongo and Teladoc.

[00:26:51] Baxter is looking to capture some of that same population.

[00:26:54] And I can't say too much about it, but definitely there's a lot of opportunity within the digital side and that's where it's focused on.

[00:27:01] So for someone who's listening to this, who's saying, how do I get there like you did?

[00:27:08] Is this serendipity?

[00:27:10] How would you plan?

[00:27:11] If you were to go back in time, could you plan what you did?

[00:27:14] Or do you think that it's a, is it a plan or is it a trade?

[00:27:18] Is it an openness?

[00:27:19] Is it a building relationships continuously?

[00:27:22] What's your recommendation to people?

[00:27:23] I think it's a mixture of a, keeping an open mind.

[00:27:27] Also taking risks.

[00:27:29] I think that was important within Cleveland Clinic.

[00:27:32] A lot of people stay there for the duration of their careers.

[00:27:35] There's a lot of people that I've worked with that are still there.

[00:27:38] Similarly with Heimer.

[00:27:39] And, but I either A, it was the relationships or B, the opportunities that you could see where this is going.

[00:27:47] And I don't want to use the term disruption because I think there's a bit of a connotation now than healthcare.

[00:27:54] And just because maybe disruption is not what we should be trying to do.

[00:27:58] We should be trying to improve and transform in certain ways that align with how the care should be delivered.

[00:28:05] But finding these sort of seminal opportunities, some of that just has.

[00:28:09] The high mark thing.

[00:28:10] There was a lot of people that I knew and worked with that, that made the move over there.

[00:28:13] There was a big opportunity to transform, except a much different scale with the payer provider.

[00:28:19] With joining Livongo, it was having had some of that experience and exposure working with startup companies and the commercialization health tech team at Highmark.

[00:28:28] So that was extremely interesting and seeing an under the hood look at where some of those companies are going.

[00:28:34] This is the next phase of my experience.

[00:28:36] And in between there, I did work on my MBA, which did help.

[00:28:40] And from an educational perspective, combining an engineering degree with an MBA, I'll never forget.

[00:28:47] I had one of my professors tell me there's the two most dangerous people at any company.

[00:28:51] It's an engineer with a law degree and an engineer with an MBA.

[00:28:54] Because A, you know how the business operates and now you can actually put this into practice from a sales and partnerships perspective.

[00:29:02] Or you're the person that's writing your language and how are we actually going to make some of these things stick.

[00:29:08] I was pushed into one of those two directions and decided to go the MBA route.

[00:29:12] I think for me, it was also just a curiosity for knowledge.

[00:29:15] I've never been a person who's been afraid to ask questions.

[00:29:19] Always push for that continuous learning.

[00:29:20] And the opportunity to get to Baxter is one being in Chicago, one of the larger employers and more entrenched players in the industry.

[00:29:30] But it's a great team and we're in almost every hospital in America and so many around the world.

[00:29:36] So it's the opportunity to make change is something that has always attracted me.

[00:29:41] Yeah.

[00:29:42] All those things plus a combination of right time, right place and doing the right thing.

[00:29:46] I think so.

[00:29:47] I do a lot of business and executive coaching and when people are looking to make a change, one of the things I share with them is that if I'm applying to a job in LinkedIn, someone's looking for my title to be very vertical, right?

[00:29:59] I was a director of marketing in this medical device space or hospital space and it's very vertical.

[00:30:03] But if you have relationships, you can now express your skills and your process skills, your analytical skills are very transferable.

[00:30:15] And you're a student of the business of healthcare, right?

[00:30:18] And so you've covered all the verticals in healthcare at this point in time.

[00:30:21] And so for the audience that's listening to that, I think the relationship is what allows the person in that company to listen to that story and not just go through the computerized job employer dating programs we have now where we just file something in and the first cut it goes to an AI and it ranks your score from zero to 97.

[00:30:42] And they say of anyone who's not matching at least 90% or 85%, we don't even let them get to the employer.

[00:30:49] And so I think that that's critically important.

[00:30:52] So with all this, how do you keep current on the rapid changes in healthcare?

[00:30:56] Where do you go?

[00:30:57] What resources do you use?

[00:30:59] Yeah, I would be remiss if I did not highlight my MBA program director, Tom Campanel.

[00:31:05] He was a one of the driving forces for getting me to choose Baldwin Wallace, but also super accomplished healthcare executive in his own right.

[00:31:14] And it has his own podcast and does a number of publications.

[00:31:16] So in terms of people, he's definitely one of the people that I continue to follow and read his articles and interviews.

[00:31:23] I think there's a lot of resources that go through LinkedIn.

[00:31:26] I think there's a number of different, whether it's operators, whether it's clinicians, investors.

[00:31:32] Christina Farr is definitely one of the people who over the last five years has been a constant.

[00:31:39] Sarah Cliff, I think she's at the New York Times now, but way back in the early Obamacare days, I think she was at Fox and did a number of really great articles and publications and interviews.

[00:31:50] Dr. Eric Bricker, everyone loves his YouTube videos.

[00:31:52] Those are pretty popular.

[00:31:53] Ben Schwartz, I think he's an ortho surgeon, but posts a lot of very thoughtful content on LinkedIn as well.

[00:32:02] Honestly, I'd say John Singer.

[00:32:04] I think he's Bloomspoon Consulting.

[00:32:06] That's a shout out to those guys.

[00:32:08] And by the way, I haven't met any of these people.

[00:32:09] The only one I know is Tom from back in the day and Jim Jordan here.

[00:32:13] But yeah, in terms of I'm a big fan of Stacey Richter's Relentless Health Value.

[00:32:17] I think they do.

[00:32:19] I think she does a really great job of articulating complex challenges with context and bringing out key issues that may not necessarily rise to the surface.

[00:32:30] But when you really peel back the layers, that's where some of the big opportunities are.

[00:32:34] And then some stuff that's not even healthcare related.

[00:32:36] There's more business and kind of product market stuff.

[00:32:39] Lenny's podcast is a very good.

[00:32:41] That's more like the product market fit side.

[00:32:43] And then A16Z, they have a lot of really good life sciences and bio healthcare content.

[00:32:48] Yeah, there's no different sources.

[00:32:50] So what's your process for taking all this in?

[00:32:53] Do you listen to podcasts while you're at the gym, get up and have a reading program in the morning before or after work?

[00:32:58] What's your...

[00:32:59] Yeah, I usually have a few podcasts queued up to start the day.

[00:33:03] And then the days when I make the drive to Deerfield.

[00:33:06] So I live in the city in Chicago.

[00:33:07] Deerfield's about 45 minutes away.

[00:33:09] On a good day, I can maybe get a couple podcasts in to catch up there.

[00:33:13] But from like a written perspective, I'm very old school.

[00:33:16] I still use RSS feeds and just pick some topics.

[00:33:21] Whether it's I want to get real smart on, see what's happening, rebrand.

[00:33:25] Recent with like value-based care or different AI sparring tools, things like that.

[00:33:29] I've been able to still leverage that as long as Google continues to offer the service.

[00:33:34] I would say that's probably one of my consistent resources.

[00:33:37] Do you have a favorite reader, RSS reader?

[00:33:39] Or do you just have them sent to your inbox?

[00:33:41] It goes to my inbox and then I can sort it.

[00:33:44] I have my timing.

[00:33:45] The timing is usually set to either right before I go to bed or it shows up like first thing in the morning.

[00:33:51] So then I can start the day with some of those.

[00:33:53] And again, I didn't mention too many publications, but there's so many different great publications now.

[00:33:58] How Beckers, Health Leaders Media, Axios, Healthcare Dive, Fierce.

[00:34:03] Those are all great ones.

[00:34:04] I'm going to have to put a very long detailed note on all the things you look at for this, but I will put them.

[00:34:09] I will definitely try to put them all in there.

[00:34:11] When you go through and take an inventory of where you are today, what's the biggest lesson you've learned in your journey in healthcare?

[00:34:18] Yeah, I think it's important to keep the people at the focus.

[00:34:24] Keep the people at the center of the decision making.

[00:34:28] We're all, most of us, if you're moving through different jobs, sometimes it's financially motivated.

[00:34:33] Sometimes it's educational reasons or personal reasons.

[00:34:36] You're moving to a different part of the country or the world.

[00:34:38] But I think I'll always, and this is actually one of the things of why I decided not to move forward to some of the different energy fields was I didn't feel as if the people were at the center of what we were doing.

[00:34:50] And so specifically within healthcare, it's extremely important to have empathy and thinking about who is at the other end of this change or this product that we're helping put in place.

[00:35:02] That's one of the things that I, in terms of themes, that I tend to keep at the forefront for me.

[00:35:08] I think language is important, like how you, A, between written communication, how you communicate with people on a daily basis.

[00:35:17] But again, education to help teaching other people about things that they may not necessarily be exposed to.

[00:35:25] But then exposure is important because we think about giving context to different groups and having an opportunity to act with new knowledge and empathy in different environments.

[00:35:36] I think it's a, that's how we can make change happen.

[00:35:39] And then I think, of course, engagement is important too, going through the four E's.

[00:35:45] But engagement is key because you could put a process in place.

[00:35:49] You can put, whether it's product change, a new way of delivering care, whatever it is, new device.

[00:35:54] If the people that receive it aren't, if it doesn't, if it doesn't work with them, if it doesn't rate with them, and they're not consistently using it, the value doesn't go anywhere.

[00:36:02] So I think with whatever product change, whatever solution, it's important to keep the people at the focus, but make it keep people at the center,

[00:36:09] but make sure that there is that level of engagement and really effort to ensure that, that whatever change or product you're putting in place has a long and lasting value to really help them with others.

[00:36:18] I think it's when I look at people who start in hospitals or have done startups, it's a very, it's a very quick way to get intimacy with patients and empathy for situations for sure.

[00:36:31] As you look out for the next five or 10 years in healthcare, what do you see as the biggest opportunity of growth or the biggest threat?

[00:36:38] Great question.

[00:36:39] I would say a lot of it probably stems from the same thing.

[00:36:42] You probably had a number of people that have talked about artificial intelligence and all the different applications.

[00:36:49] And I'm a huge fan of what we can do from a, from breaking into the clinician mindshare and enabling our clinicians to build more algorithms, directly connect with EMR data feeds.

[00:37:03] And thinking about like stuff like AI scribes and different clinical decision support tools.

[00:37:08] All of those things are important.

[00:37:09] If we were to even take it back to care pathway days, like how can we do that on steroids?

[00:37:14] But now you're, how are you having high part LLMs driving those and pushing forward evidence face continuous improvement within the clinical system?

[00:37:23] Predictive analytics.

[00:37:24] I think that's also another huge piece, but again, empowered with people at the center, right?

[00:37:29] So you're able to pull in claims data, digital health, wearable data, personal data, delivery real time recommendations, health, food, knowledge in the moment.

[00:37:40] And even unlocking further retention with stuff like a real monitoring.

[00:37:44] I think that's a huge potential area in the future.

[00:37:47] The stuff that gives me pause when it comes to AI is, and again, some of this is already happening today within our current EMR systems.

[00:37:57] I think there is a, when it comes to some of the salaries, you make, it could lead to errors and too much kind of copy paste approach.

[00:38:08] You start to lose the specificity.

[00:38:11] And I think within medicine, yes, everything is evidence-based, but it is personalized.

[00:38:15] And again, keeping the people at the center of everything we're doing.

[00:38:19] That's one of my key fees.

[00:38:20] When you start to focus only on the masses and instead of the 20%, the 10% that these core solutions may not necessarily fit for, oftentimes that outside 10, 20%, even maybe it's 5%.

[00:38:35] That's where a bulk of that cost could be coming from within your system.

[00:38:39] So I think it's important for us to not get built too far, build these AI models to only focus on the majority of what we're doing, of how care is delivered.

[00:38:50] And really start to look at how can you solve the problems for the people at the core, the edge cases.

[00:38:56] Those that may not necessarily get as much attention, but oftentimes can be the bigger drops of cost.

[00:39:01] I love that word edge cases because I've worked with a couple of precision medicine companies and their models are really about, hey, I've got a general practitioner who's going to see a thousand patients this month.

[00:39:13] And the people on the tails, there's only several of them.

[00:39:16] And for you and me, I have a certain disease you don't.

[00:39:20] Something that might be minor, dry skin or something like that for you is nothing.

[00:39:25] And for me is a sign I'm on some pathway.

[00:39:27] So I hope the promise is, as you point out, that it allows personalization.

[00:39:33] And for busy physicians, you've got a thousand patients coming in this month.

[00:39:38] I've got 20 minutes with each of them.

[00:39:40] How do I know the five or seven that have this situation and where they are in the continuum?

[00:39:45] It has a lot of value.

[00:39:47] And I don't think that AI, and this is where I think the fear is, AI is never going to, at least in, I think, the next 20 plus years, 50 years.

[00:39:58] Replace physician judgment.

[00:39:59] I think what it's going to do is it's going to bring variance to the physician faster, hopefully, where they can make these kinds of decisions.

[00:40:07] But I think the category of precision medicine is probably the intermediate step.

[00:40:13] Blowing that out would be the way to go and along this journey.

[00:40:17] Very good.

[00:40:18] Anything else you'd like to share with the audience?

[00:40:20] This has been a great conversation.

[00:40:21] I think we've covered most of it.

[00:40:23] I am a person who's always looking to connect with others and learn from others in space.

[00:40:28] And my journey is unique, but there are others that have had even more dynamic experiences in the healthcare industry too.

[00:40:35] Always looking to connect, either if it's on LinkedIn or if people are in Chicago or coming by the area.

[00:40:40] Happy to have a cup of coffee just to talk shop and how we can change the industry.

[00:40:44] Very good.

[00:40:44] I'll put your LinkedIn profile in the show notes so that people can connect.

[00:40:48] Thank you very much for being such an informative guest.

[00:40:52] It's a broad conversation.

[00:40:53] Yeah.

[00:40:54] Yeah.

[00:40:54] Thank you, Jim.

[00:40:54] This is great.

[00:40:55] This is my first podcast, actually.

[00:40:56] Sure.

[00:40:57] Thank you.

[00:40:59] Thanks for tuning into the Chalk Talk Gym podcast.

[00:41:03] For resources, show notes, and ways to get in touch, visit us at chalktalkgym.com.