Dale Sanders is a leader in the area of applying data to improve outcomes across healthcare, however, he sees a potential to do this in a manner that may become a burden on healthcare practitioners. I always learn from Dale, hope you enjoy.
Carina Edwards just stepped into the role of CEO of Quil Health an exciting startup that is the result of a partnership between Comcast and Independence Blue Cross. We discuss a wide range of topics from digital care journeys to tech stacks to Women in Health Tech leadership. Hope you enjoy.
Bill Russell: 00:00 Welcome to this week in health it influence where we discuss the influence of technology on healthcare with the people who are making it happen. We are the fastest growing podcasts in the health it space. My name is Bill Russell, recovering healthcare CIO and creator of this week in health it, a set of podcasts and videos dedicated to developing the next generation of health it leaders. This podcast is brought to you by health lyrics. Does your health system needs to do more with less? We’ve been in your shoes. Let’s talk visit HealthLryics.com to schedule your free consultation. If, uh, if you’re enjoying the show and want to support our mission to develop the next generation of health it leaders, there’s five really easy things you can do. One, you can share it with a peer. Love that, share, interact with our social media content that’s out there.
Bill Russell: 00:52 You could just follow us on the social media accounts that we have. Linkedin, Twitter, uh, Youtube. Uh, send me feedback [email protected] Love your feedback. Recommendations on stories to follow, uh, recommendations on guests to have on the show, questions, comments, everything. It’s all really appreciated. And you can visit our website and subscribe to the newsletter. All of it helps. Really appreciate all your support so far. Today I’m excited. Uh, we were able to, while we were in Philadelphia visit with a couple of systems and a couple of, uh, a great startups and this is one of the ones I’m really excited about Quil health. And we sat down with the, uh, CEO, one of my favorite people in healthcare Carina Edwards, great show, great conversation. Hope you enjoy. So today I am in Beautiful Philadelphia, hot and sticky, Philadelphia hot and sticky Philadelphia. It’s amazing. You walk around outside. Yes. And uh, but Carina Edwards, CEO of Quil health, a startup organization, I’m looking forward to getting into that. Um, but Philadelphia, we’re in Philadelphia. We are, um, it’s, it’s amazing to me. So this is the second podcast I’ve done live in Philadelphia. I’d like to do this more as I go to cities. It’s kind of fun to just, uh, to just, but there’s a startup scene here.
Carina Edwards: 02:08 There absolutely is a startup scene here. I think what you’re seeing is this space in Philly has been known for biotech for a long time. And that is bridging, right? I think the world’s in health care and we’ll talk about today in the, in the podcast, the world’s and healthcare are the, the walls are falling down. And so you’re seeing these startups emerge. You’re seeing bridging the gap in a lot of technology areas that are coming out of the passion and the amazing academic institutions that are based in Philly.
Bill Russell: 02:31 Well, that’s what I was going to, I mean, so Philadelphia has five academic medical centers, like within a stone’s throw of this building. Um, I can’t think of another city that has five academic medical centers that are competing. Correct. It’s a, I don’t know if that’s a benefit or, I mean it’s throwing off a lot of people. Great Education. I mean, you have Jefferson down the street. Penn is like right over here somewhere.
Carina Edwards: 02:53 The affordability of the city with the access that it gives is amazing. You know, as a, as a Boston transplant I, Boston I was, I was raised in New York, so I’m always going to be in New York City fan first. It’s hard for me being an eagle’s territory. I’ll be on the record to say that I’ll talk, but
Bill Russell: 03:09 well, you’re wearing your green, which is good. That was actually this painting I’m in New York giants fan through and through. I’ll put that out there really. And we’re having the worst season ever, so, hey, well you got sick on a Barclays.
Carina Edwards: 03:19 Phenomenal. So, um, it’s been, it’s been great, but the, it’s an affordable city. It’s a foodie city. It’s, it’s really transforming and a lot of New Yorkers are moving to Philly.
Bill Russell: 03:31 Yeah. The two, the two things I love about Philly. One is people say, you know, what’s your, what’s your favorite restaurant in Philly? And I’ll say the street carts. I mean, you can eat any ethnic food across the, across the country from a street cart,
Carina Edwards: 03:43 but the foodie scene here, the James Beard award winning chefs that are here, the Michelin Stars we’re getting.
Bill Russell: 03:49 Yes. Amazing. Well veterans here and I’ve just, I mean, yeah, that’s phenomenal. And Star restaurants every now and then I come into Philly with a foodie and they’ll, you go to these like back streets and you think there can’t possibly be an a star restaurant here and it’s, and it feels like you just walked into somebody’s home in some cases. It’s amazing. The other thing about Philly and then we’ll get to the podcast, but okay, so I’m setting up for the last podcast and the Av guys are in the room and, and I said, hey, tough. You know, losing the sixers losing. And they said, yeah. Um, so it’s been a long time for you guys. They said, oh yeah, it was 1984 I thought they were gonna like say the exact time. And they said, oh no, it’s 1984. I said, oh yeah, that was like Julius Irving and Darryl Dawkins. I go, oh no, it wasn’t Dawkins. They then proceeded to rattle off all 10 guys that were on the team, like Maurice Cheeks. I mean, they ain’t gonna go through people. I’m like, oh my gosh, you guys are like sports town. It is a sports town.
Carina Edwards: 04:39 It is just like Boston that regard, right? It is a sports town.
Bill Russell: 04:42 Yes. But to rattle off the team from 1984 they’repassionate, they are passionate and nothing more so than their eagles. It’s kind of crazy. Uh, but let’s, uh, you know, let, let’s get to, let’s get to you. I usually start with a pretty open ended question, which is, uh, how did we get here last time we, we talked, we’re in Chicago at the, I think it was the last time we talked to in Chicago at the a Becker’s conference and your, with Impravada pretty happy things are going well and now you’re a CEO for a, a really interesting startup, really interesting partnership. Uh, well funded startup. Give us, give us a little of the story.
Carina Edwards: 05:15 Yeah. So the story, I’m, it was one of those things where, you know, I got a few phone calls. Um, I pushed them to friends, uh, and, and then they kept on coming back. And so I said, all right, I’ll pull the string a little bit. And what I found was a really amazing opportunity. So when I was at Impravada, when I was the most proud of was my seven years spent there. Uh, we rose the NPS score up from 16 to 60. We actually went from customer retention 92% and 99%. And we scaled the organization going public and then going private. And so I that I accredit that that organization is, is doing amazing. And I also had built an organization where I had number twos that could then take on my role. So it seemed to be, you know, an interesting time when I got this opportunity.
Carina Edwards: 05:57 Um, what’s unique about this Quil is the joint venture between Comcast, NBC Universal and Independence Blue Cross, both Philly based, I would call them my parent organizations are right across the street. When this was first showed up in April, 2018, it was called 1819 because independence is on 19th street and Comcast on 18th street. And so 1819 was formed a, we got the name Quil last November so that the, the, the group got together, they, they got branding done. They built a tech stack. And so what we’re here to do is organize and navigate your health life. And there’s a big gap in everything going on with tech right now. We’re that, that being able to answer that question, what happens next? What do I do next? And so that’s where we’re focused. It’s a really broad mission and vision. We’re starting with episodic journeys of care to really make sure that patients and the teams that support them and their loved ones just know how to answer that question then can navigate appropriately.
Bill Russell: 06:57 So it’s a care navigation play. It’s that a patient health companion and a caregiver companion toolset. So based on digital technologies, tech stack and,
Carina Edwards: 07:08 oh yeah, the tech stack. So it’s, it’s um, clinical content. It’s lifestyle content, it’s patient interactivity through quizzes and surveys, et cetera. It’s nudges, it’s wearable integration. And so when we think about what’s unique here, it’s not just the funding mechanism, but it’s also the distribution mechanism. So we are an app or a website and we’re also on the television. And so there are 85 million, um, Comcast viewers every night. And so we now have a Quil, um, x one app on the expense of the platform and now we can, we can get that curated playlist for that, that, that individual, if I need to see these four videos before getting ready to, for my hip replacement, I can now bring in my family to watch them with me or my support team to watch them with me because those aren’t Phi related things. That’s like, how do I set up my home? How do I get organized? What’s going to, can I drive? It’s answering all those questions when you learn about, hey, your, your hips coming out, you’re not thinking in that 20 minutes of the dock. And so it’s, oh, it’s bridging them through all of that. So we have to do this big wave right now to get the lights to go back home.
Bill Russell: 08:15 Oh, we do. We do. We have to do this. Like please. The beautiful thing about a podcast, people are going to be like, what were they doing? But they could always go to the youtube channel and see us running around with our hands up so that the lights could go back up. So, um, you’re, you’re uh, picking certain things like orthopedics at this point. Um, care navigation is such a, an interesting play. Um, so I mean traditionally you have phone care, get navigation or paper based care navigation. And by phone I mean like analog phone. Hey, what should I do next? Um, paper, we’re still, I mean we still get the mail of people are sitting in here. Some stuff. Yep. Get a whole bunch of papers handed to people when they walk out, which are almost indecipherable to the average layman.
Carina Edwards: 09:04 I love the photocopied 17 times. So now it’s not really on the page. Yeah, it’s like that little side page and here’s your patient packet and here you go.
Bill Russell: 09:12 What was I supposed to do? Then you have the smartphone, you have digital navigation, which I’m to be, I mean we’ve seen a fair number, but then now you’re saying set top box,
Carina Edwards: 09:20 a set top box. Also web. You know, when you start thinking about this, you have to have an answer to meet people where they are. Uh, you know, we’re in, we’re in pilot right now at one of the major academic medical centers right around us and what’s amazing is the eligible patient population. And I want that to be 100% and I don’t want to limit, um, oh you have a flip phone so you can participate, right? So right now I have an offering that is 100% eligible because they can get the same content and that same workflow, whether it’s on their television or whether it’s on the web or whether it’s on the phone. And so we can engage them in different ways and we can also just bring it to a, one of the, the, the fun unique things here, the NBC universal tie-ins and, and, and the content, medical content, medical literature.
Carina Edwards: 10:09 I’ve been evidence based for a very long time. Even back. Amazing stays. I think when we first met years and years ago, right? Order sets were evidence based, but everybody puts them into a different workflow. And so bright, bridging that gap between letting a patient go into a system with evidence-based content and teaching them what to do, but also in the workflow of that institution to make sure it navigates their way. Right. That’s a bridge to bring interesting content in short snippet. Lighten the fun. I mean, think about it. We have Al Roker that does our welcome video. We have, um, some fun, right? So we have folks here at access that, uh, they are perfect
Bill Russell: 10:46 familiar. It’s comfortable. It’s,
Carina Edwards: 10:48 yeah. And it’s compelling.
Bill Russell: 10:51 Yeah. Well, you know, one of the things for care navigation that we were trying to do for, for a pilot was start to record the physician talking to you while you’re in the office. Yes. And I’m now caring for 87 year old father-in-law who’s moved in with us and those kinds of things. Uh, and part of the challenge was when he was in Pennsylvania and we’re in California and he would call us up and we’d say, how did the visit go? And he’d say, you know, good, uh, you know, and he wouldn’t remember the medication. He wouldn’t remember the timeline. And it’s one of the reasons he moved in with us cause we just, it was, uh, it was just too hard to navigate. But that’s one of the things, uh, just one of the many ways. What does the future of care navigation look like? I mean, is it,
Carina Edwards: 11:34 so I actually believe right that there’s, um, there’s, there will be a marketplace, right? We will not be the only, and now I think with 21st century cures act and Tefca going to legislation, we have the right as patients to make our data portable. Right? And so that’s step one. And so now that I can get with blue button paving, the way I bring my data into an app when I consent, yeah, I can also consent to share my information with others. And now you have a digital ecosystem with you and your support team. Um, some people call them caregivers, whatever name you want. These are not the clinical professionals that care for you. These are your niece or nephew. The, the, the, the friend that’s gonna take you to the appointment. Now I can see what those feeds. I can see schedules, I can see medications, I can see claims data.
Carina Edwards: 12:19 And from that I can share with you a comprehensive recommendation of what to do next, not just on the journey you’re on. So in the current pilot that we have now, we have some patients that are going in for a hip replacement. Great Full Stop. Now you add to that though their BMI is 40 and they’re a smoker. So before we get them on the table, can we also get them to potentially change some behaviors in the next seven to eight weeks that will make them better for that encounter and get to the better outcome. And I think finally our incentives are aligned because now with value based bundles, right? The risk lies with making sure that patient is well if they, if they get readmitted than I hold the cost for that. So what can I do to drive adherence education and really then get through this, this journey together and get them to the healthiest version of themselves.
Carina Edwards: 13:14 Because it’s not about everyone is to go climb a mountain. And so this has to be innately personal, right? When you think about the content, I had a friend who was going through hip journey. So I say, please use The risk lies with making sure that patient is well if they, if they get readmitted than I hold the cost for that. Quil, give it a shot, give me a ton of feedback. And his best feedback was stop showing me 80 year old women and walkers, I’m going to be back on the golf course soon. And I said, fair point. And so I turned to the team and I said, what can we do for customization and personalization? And so within a month we’ve now tagged all of the content and we’ve actually done a demographic tag. And so literally I can present to you based on your goals, what are you looking to achieve or you’re looking to play with your grandkids. Are you looking to run a five k are you looking to get back to a marathoner? There’s everyone has a place they want to start and where they want to go.
Bill Russell: 14:04 How long have you been CEO? 90 days. Okay. So I say a hundred I think. I think we’ll see. Your tech team might watch this later. And like, so I, so I’m going to drill into this cause it’s the question becomes all right, is it in, is it B2B, B to c? Right now it’s B to B. Eventually we might be B to c. Okay. So where do you get your content? Do you get your content from third parties or do you get it from the partner systems that you’re partnering with who are potentially the orthopedic surgeons who are, who like the orthopedics department. Okay. So you’re getting it from all of the above. Then how do you determine what actually goes out there? Do you have clinicians on staff or are you using a algorithms to try to figure out what’s,
Carina Edwards: 14:41 yeah, so we have clinicians on staff and we also have, um, a clinical advisory board. But more importantly, the way I’m the, these come together. Right. So like I said earlier, there’s evidence-based journeys. Full Stop. Yeah. And now you bring them to an academic institution and they say, okay, well, you know what, I want to, I want to customize the front end of that. I want to change this language here. I want to put in five other steps that are unique to us. And so on the tech stack perspective, we have a CMS, we have a workflow engine and we have multitenant. And so now literally when the, when the, when the individual or care team come in, they put in their code and they get to that institution’s flow the way they want to see it. So now we’re bridging that gap I think between the, the battle of the brands. Right. And then also care because each of these institutions are world renowned in certain things and so they, they want to showcase to the individual and the patient that wow, this is a journey that you’re not going to get anywhere else.
Bill Russell: 15:42 Yeah, that’s interesting. You know, I, I’m trying to figure out where I want to go next in this cause. Um, so talking to Dr Klasko earlier, there’s this week he said, you know, there’s a trillion dollar market for healthcare transformation. Healthcare will not be delivered at the same in five to 10 years. Now he is one of the more forward thinking. And I found that the more forward thinking typically their dates are wrong. You know, it’s like we’re going to change healthcare in three years and you’re like, uh, three times what, three times, two, three times. So is it six years? Is it nine years? Um, but it’s, you’re right in the center of this. So TEFCA, uh, 21st century cures you have a, the work of secretary Azar at and they’re all saying, okay, push that data out. Sure. But that’s still a challenge to, I mean there’s a whole, you want to get that claims data and supposedly based on what were, what’s being proposed, you’re going to get that claims data. We do have blue button. So for a certain population you can get that data. Right. Um, but what is it,
Carina Edwards: 16:43 well I had this discussion with some of the other days. So the one thing I will say is be careful with the, you’re going to get that data, right? Cause I don’t think, I don’t think any of the digital health apps want the onslaught of all of the data. I believe there are things that, that, that we can leverage that can help somebody monitor a condition or monitor a journey or make it personal to them. That is not the entire potential data set of every single blood pressure reading you had during your 15 days to get it correct. And so I think when you, when you go through this process, you have to decide what’s meaningful, what can drive adherence and what could actually be patients self reported or wearable or make it easy, right?
Bill Russell: 17:27 But, but here’s what’s not sustainable. If every time you go into a new market, so you’re, you’re in pilot with a couple of health systems. But if every health system you go to, you gotta, you know, look at their dataset and fix it and bring it across and integrate it. So you’re, you’re in the Philadelphia market. Are you in other markets right now or in Philadelphia? All right, so you go to new, you go to New York, you go to New York Strathspey and they go, well, hey, we’re epic. You’re in an epic shop or you’re in a Cerner shop floor, connect up. No problem. Hey, we’ll use fire. But you know, once you get that data, you’re looking at it going, okay, we gotta do something here. We’ve got to massage. If we got to whatever to get it to be used. I know that like, you know, you just rewind like eight years ago when I was trying to do this. Yup. The difficulty level was like a 10 out of 10. It was really hard to do. Um, is it still hard or is fire? Is all this stuff helpful or is it like it’s still confusing?
Carina Edwards: 18:19 It’s very helpful. I think what it’s doing is it’s giving us a standard, it’s not to your point, it’s not every single piece of data, a blue button also limited it down to specific data types and those are done in a pretty consistent way because the good news is, right, this is now in legislation I believe for 2020 then don’t quote me on that. Um, but I believe it goes into penalty effect somewhere in the 2020 timeframe. Right? So I think healthcare institutions are getting their ducks in a row to say, okay, like great example I had with a conversation with the CIO. He said it’s a double Cedric’s hop to get into my, um, my, my, my, I think it’s using Cerner, my Cerner, uh, instance. Okay, so Cerner has to kind of come to the table here and say, hey, based on the new laws we have to publish this API, this API has to be attainable and it has to, has to basically give this subset of data, 20 elements that make it up. And, and from there it’s industry standard. So now a patient is consenting for those 20 elements. When that comes, clearly you have to protect that Phi. So, so clearly we are, you know, looking at all the HIPAA laws and regulations, but this is where you, you think through, it’s not all of it because there’s show much consumer and patient self reported and Care Support Team reported. You know, it’s like when you go to the doctor and they said, how many glasses of wine do you drink in a week?
Bill Russell: 19:42 Which week? \Two. Two. Yeah, two one, two every five hours.
Carina Edwards: 19:49 And so it’s the, when you start getting their behavior data mixed in. So the EHR’s aren’tthe holy grail. The claim data is off the holy grail. The wearables aren’t The Holy Grail is when you put all of this together in your consumer life and bring it to bear to help you figure out what happens.
Bill Russell: 20:06 I hope you’re enjoying this conversation with Carina Edwards. We’re going to get back to it and just one minute, I want to ask you a question though. Is anyone helping you to advance your career? Your answer is probably no, and that’s really not okay. Every person deserves a chance to learn, but developing people is time consuming and expensive because it’s difficult. Most businesses don’t develop their people at all. This week Health daily was designed to help every professional develop through daily short videos that you can begin to apply today, subscribe to this week, health daily at this week health.com/daily and get a five minute video in your inbox every weekday morning. That gives you insights from industry leaders to advance your career. Think of these videos as graduate school for health it in bite sized chunks except it’s totally free. So start investing in your career. Check out this week health.com/daily to sign up for these insights from industry leaders. And now back to our conversation with Carina Edwards.
Bill Russell: 21:07 Why do we need partners to do this? Why, why can’t health systems do this by themselves? I can answer that question if you’d like.
Carina Edwards: 21:12 Please. Well there’s a lot better than mine.
Bill Russell: 21:16 Well it’s interesting cause it, you know, you have this great team, I wish I could like scan this whole thing right now, but you have this great team of really smart developers who are really focused in on a set of technologies. Yes. So they’re going to be able to patch that when you know Ios is going to have a new version every year and you’re going to have to, there’s gonna be a ton of tech debt like immediately on, on the application. But this team knows how to do it. Okay. All right. So providence has put 200 people in Seattle to do this, but I can’t name another health system that has even remotely close to 200 people who are, who are going to be able to keep these, the version correct and all this other stuff that goes on. Um, so I mean, that’s one of the reasons, just tech.
Carina Edwards: 21:56 I think that’s one of the reasons, but I think the other reason too is you’re bringing different capabilities to bear. You know, we’re in our unique situation, right? I actually have some folks on the team that came from, um, the, the payer side of the world. Yeah. I have some folks on the team that are still employed by NBC universal. I have some folks on the team that I’m right. And so when you start thinking about
Bill Russell: 22:15 what does the envy, NBC Universal, that, that’s unique, so what would that, what would that bring to obviously access to the set top boxes. Well, that’s a, that’s contrast.
Carina Edwards: 22:23 Yes. So NBC universal brings engagement. So think about it, right? Um, they have their theme parks, they have movies, they have television, and whether the television is delivered on the Comcast box or Hulu or prime or whatever, or universal is,
Bill Russell: 22:37 so it’s influence. You can influence health care for a pretty significant population.
Carina Edwards: 22:41 I’ll, I’ll say it differently. It’s actually we know, how do we engage people because we build the content they engage with every night. So it’s taking a content play here and making it engaging content.
Bill Russell: 22:53 Fascinating. Um, what does success for Quil look like?
Carina Edwards: 22:58 I think like any digital health, you know, enterprise, I just left it board meeting. Uh, it is, it’s the series of milestones that get us to viability and scale. And so how do we make sure that, um, as we go out there, uh, it’s not just about the numbers, it’s never been about the numbers for me. Um, this is a value play. If, if I can’t deliver value, then we shouldn’t be in business. Um, it’s one of those pieces where, um, when you look at all of the tech startups that are out there in the landscape, a lot of them, sometimes they’re doing tech for tech’s sake. This is tech for tech’s sake. This is saying, okay, there’s someone trying to navigate. There’s a system moving from fee for service to value that person trying to navigate this is at risk because they don’t know how to navigate it correctly.
Carina Edwards: 23:42 And then the person holding the, that, the value and the risk there is also, now incented. So finally, data’s accessible. Incentives are aligned and we’re just trying to serve up value for the patient and the caregiver. What do I do? How do I do it? Where do I go ask all those questions that the nurse navigators answer every day of the week, um, and, and get that done in a way. And if they have questions, they can chat. AI Chat bots have come a long way, right? We can answer a lot of the things that happen every day. And there’s value in that because now you’re taking a more efficient approach. You’re driving better patient adherence and the holy grail is right information, right time, right place, you’re going to get to the best outcome, right?
Bill Russell: 24:25 Plus 80, 20, I mean, only 20% of health outcomes are related to, you know, research and the hospitals and the stuff that they’re doing. 80% is social determinants. You have a way to reach, I keep coming back to this. It’s a different, that set top boxes interesting to me. Um, I don’t know. It would be interesting. One of the things we’re missing I think in this space is, you know, we have research on, uh, just about everything in healthcare but not digital. The effectiveness of digital tools, uh, in order to make that, so my encouragement to you as a CEO is as soon as you can get those, you know, those published studies that say, Hey, you know, this, this percentage, this is how we’ve moved the needle. Uh, and anyone else I’m talking to in your space are saying the same thing. Cause I think there’s still a, a host of people in healthcare that are saying, hey, prove to me that this is going to move the needle.
Carina Edwards: 25:19 Well, and I think that goes back to you have to go, I think beyond some of the wellness pieces, right? Because I think what the self insured employers have been seeing as a whole is the wellness nation is great, but how do I, they’re having the same problem the health system CEOs are, right. They’re there. They’re looking at a toolset that has, you know, 75 apps that they need to get to their employee base. How do you start going beyond that and thinking, Hey, I’ve jumped into this and now I’m going through a pathway. And so that’s why we’re starting there because yes, of course you want the population to get better and be well. Yeah. But it’s got to start a little bit earlier so they get comfortable with the, the new tooling and the,
Bill Russell: 25:59 will this be a tool that used within the employee population of uh, Comcast, NBC universal are Sorta like a Amazon, Berkshire, whatever. Yeah.
Carina Edwards: 26:09 This is a tool that we will absolutely pilot with both populations. With, I’m with Comcast as well as independence. So yeah, we’re working through the definition of those pilots and when we’re going to start them. But
Bill Russell: 26:19 now we’re going to wave our hands again. I don’t think it’s gonna work because you’re all over to the light. So folks, no, no, we’ll keep them all in the benefits of these are clearly, we’re not waving our hands enough in this podcast. Yes. Have to get, have to get more passionate about the topic. So NBC universal and Amazon, um, you are going to use it with your populations.
Carina Edwards: 26:40 We are, yeah. And I wouldn’t be, I don’t know what haven’s, I don’t. Um, so I don’t, I don’t know if we,
Bill Russell: 26:45 yeah, I know if I, if I knew what haven was doing, that would be as new story in and of itself. I think they’re, they’re trying to figure it out at this point. They’re doing a lot, but they’re doing a lot of research, um, which is sort of the hallmark of a [inaudible].
Carina Edwards: 26:57 All the major players are getting into this. I think so this is not, these are, these are proof points that there’s a need and there is a market and how do we serve that need and deliver value.
Bill Russell: 27:08 Uh, let’s, so let’s get back to your journey. I sort of wanted to do that. So you’ve two things going on here, female CEO and a well funded start up. These are not common terms that, uh, that we hear, but I want to talk about the, uh, uh, being a female CEO, it’s not common. It probably should be more common. Um, you know, how do we, how, what would you say to the next generation of female leaders to say, you know, let’s, let’s, how would we make this more common?
Carina Edwards: 27:37 Yeah, it’s a great question. I think, you know, first and foremost, I, the last study had a rock health published and it was, um, mid 2018 and I think, um, McKinsey just did an update or one of them, one of the big consulting companies, 10 to 13% of digital health CEOs are women. Um, and I think tend to have the, whether they have 30% are diverse candidates. And so I think the whole notion of we have to go back to the studies that show building diverse teams produces better business outcomes and that’s the thing we all have to look at. And so there’s an organization parody.org we just took the parody pledge and all day asking everyone to do is how do you get a slate of diverse candidates for every job you post. And that’s something that’s easy to do. But I will tell you the industry isn’t wired that way.
Carina Edwards: 28:28 I’ve done some hiring here in my first hundred days and it was nothing against the recruiting firm. I love them. I’ve done business with them for a long time. What was interesting to me with this new Lens, when I was presented with the, the the the list of here’s the top 20 candidates they were, it was not a diverse candidate set. So I set them off to get me a panel of full diverse candidates and we will find the best person for the job. This is not a quota based system. We chatted about that earlier.
Bill Russell: 28:55 So is that, was that hard for them to do?
Carina Edwards: 28:58 It took them probably a little, it probably was a little harder, but they produced a great lesson. It was more, it was a direction they hadn’t received from others. And so I think what we can all do as leaders is we can ask the people that recruit for us, whether it’s our own consultants, our own folks, just make sure you’re looking at a diverse slate. Cause it’s eyeopening when you start getting, I’m looking at my diversity. It also is non non-healthcare, right? And so there’s, there’s all different stances for diversity that we just have to think through.
Bill Russell: 29:26 That’s interesting. How, yeah. Outside the house care, um, and diversity in all areas because the diversity of thought is good when you’re trying to solve problems. This is why we have, um, liberal arts educations, right? So you get all this diverse thought and it helps you to solve problems
Carina Edwards: 29:43 and the data shows it all the studies showed 50, 50 is the, the best outcome financially for businesses. So this shouldn’t be an argument that we’re, we’re not convinced about anymore,
Bill Russell: 29:54 but not a quota system. You’re not saying, okay, let’s, nope. Um, I think the best person should get the job. So apple is increased one of their plays to increase diversity, which is really interesting is they’ve taken a college education off of a bunch of their jobs. Yes. Yeah. And the reason is because not everybody has the, uh, economic background and the ability to pay for, Gosh, let’s pay for $200,000 to go to a college. Um, but they have, you know, they have problem solving skills, what not they can, they can actually learn at apple how to be a very effective, uh, how to be an effective leader. Um, you know, what kind of, what kind of things do you think is, is going to help, uh, to build diversity within health It,
Carina Edwards: 30:39 there’s a bunch of, uh, I think s initiatives going on, especially with the, with the younger audiences, right? Getting robotics camps in the summer, getting them involved in stem earlier way, way earlier, like in the, in the mid school, high school years. But there’s also, for those that don’t think college is a path for them. There’s a bunch of great tech schools. They’re teaching mobile app development, uh, web development. And these are skills that, you know, if you’re a creative, if you’ve come from an arts degree, some of the, I have a few folks on my team that don’t have degrees, but they were artists and are UX designers and they look at the world so differently and they bring such a perspective of thought like, Oh, I never thought about that. Cause they study human nature and these are skills that come in and they just make these Aha moments that, that, that I think are priceless. So I would, I would say as you’re, as you’re looking to, to build out your teams, I like the nontraditional routes there. There are a lot of places you can find great talent that’s untapped.
Bill Russell: 31:37 The, so I’d like to brainstorm a little bit with entrepreneurs. Um, so you’re in the space, you’re moving around, you’re seeing things. Let’s assume I’m going to do a new startup. What are, what spaces are an untapped in the digital space that you’re, as you’re, as you’re sort of out there, you’re gone, man. I wish somebody would fill that spot. Or, or, or something would sort of pop up.
Carina Edwards: 31:57 That’s a really good question. Do you have an idea as I think about this one,
Bill Russell: 32:01 I have a bunch of ideas because I keep doing these interviews with asking really smart people. Um, uh, you know, it’s, it’s, it’s interesting cause there’s a lot of different spaces. There’s the engagement space and uh,
Carina Edwards: 32:13 so I’m going to just get the, the, the video conferencing in conference rooms to work. I, I’m just like the most basic level. Like I think of the things I struggle with.
Bill Russell: 32:21 I just, I just, I just had that conversation with uh, uh, uh, gosh, Michigan, a medicine CIO and uh, we, I said, you know, what’s one of the biggest challenges? He goes video conferencing in the room. You know what the biggest problem with that is? It doesn’t report into it. Most Times it’s in the facilities, and you’re like, why is that in the facility? He has no idea. Well, because they build the building and when they build the building and majority of that stuff gets bought and put into a room and then they say, here, here it goes. And then, and then I, for whatever reason, they want to own it.
Carina Edwards: 32:51 Well, so I was just a little, I know it’s tongue in cheek, but it’s true. Every health healthcare organization for with seven, 10 minutes of every meeting, it’s, Oh, hold on. We’re like, we can’t get the x working with, it’s not just one vendor, it’s all of them collectively. So that can be, but I actually, when I, when I look at our space, there’s really interesting change happening with new care models, with new, um, social determinants, with new neighborhood based approaches. And so as more consumer information comes in, I do think there’s going to be some killer apps that come out dealing with the neighborhood effect, the zip code effect, the how do you engage in, in risk sharing to get a neighborhood healthier. And this is going to be in the, and there’s a couple instances that are out there in Tan diamond, the in the Philly market, Gen med down in Florida. There’s a lot of these that are now a city block, um, others that are coming to bear here. And these are really interesting models to look at.
Bill Russell: 33:49 Are they going to address the health disparities by Zip Code? Is that essentially,
Carina Edwards: 33:53 it’s basically, it’s basically bringing care to those neighborhoods in unique ways. And, and a digital platform is one way, but not the only way by far. It really is navigating and getting a sense of what’s happening and trying to solve the problem more holistically, not just through the lens of health. That’s, that’s interesting. It’s really eye opening stuff. It’s, it’s not what we’re not, yeah.
Bill Russell: 34:14 Well I’m, I’m aspiring to be a, you know, a health tech, a see a CEO like you someday. And so if nothing else, I like to spread these ideas around. Oh, they’re great ideas. Um, you know, it’s, it’s, it’s interesting cause I, so I come from the health system background, so I have a little bit of a, um, experienced bias just cause that’s where I come from. I may not understand some of the areas more. Um, and what I’m hearing over and over again is more, you know, we need to do more with less. Every healthcare organization’s running at 110% in the it space. And then somebody goes, hey, let’s bring you Quil health. And they’re like, oh, that’s 115% a because it’s another thing to plug in. And I, I see an opportunity to really change the architecture and how these things are architected. And it’s interesting cause it’s just gonna take a, it’s going to take some courage and it’s going to take some different thinking. It’s almost design thinking around how are we doing things and, and saying, you know, why do we think a platform that was built in the 1980s is going to serve this new, uh, technology world that we’re sort of entering?
Carina Edwards: 35:22 Well and no other industry have those platforms then transitioned as those industries as I have a lot of evolved. So if you think about it, right, no one thinks about hold on before you can, before you can transact with my bank and deposit money. I got to these seven things in three Citrix hops. And, and so when, when we think through this, we have to be able to say, I think the legislation is finally in place. And now the health systems, if they catch up with it, it will make them more efficient because now there should be security based standards. There should be security handshakes, we should agree on protocols. I know I’m speaking in Nirvana, but this can’t be that far away.
Bill Russell: 35:57 It can’t be that far away. How is, but you know, if you put your hat on, how is healthcare going to change in the next five to 10 years? But the most it’s going to change and just about every way. But I was going to change the most,
Carina Edwards: 36:11 I think the consumer wave is here. It’s not coming. I think it’s here. And I think you have a whole generation coming up that is not engaged in traditional health care. And this is where I think the, the big Aha moments are going to happen as the baby boomers age out. Um, and, and they are very expensive and now you have an unengaged majority. And so as you’re thinking about this, they’re, they’re looking at care very differently. They’re in the highest deductible plans. They’re looking for tools that are untraditional. They’re not looking at that, uh, oh, I get my 17 copays and my tip 15 visits. Uh, they’re not doing any of that stuff. And they need to be, they’re trusting their friends.
Bill Russell: 36:48 Do you think they’ll start to pay to be healthy? Do you think they’ll, they’ll look at a, an insurance plan and an insurance one insurance plan will say they will pay for your care. And another one says, hey, we’re going to, we’re going to invest in keeping you healthy. It’s interesting because you know, you go to an employer and they say, here’s our plan. And so my son’s with one of a pretty sizable firm and you know, they give them $150 a year to spend on health in any way they want. So you know, you buy a digital scale or they can buy golf clubs. I mean it’s like, Hey, just get out and do something. But they also have a whole bunch of other things that would say, we are invested in keeping you healthy. What do you think we’re going to start seeing that sort of transition where, because the millennials care about being healthy,
Carina Edwards: 37:32 they do. I think they, yes, they care. And they are also, they’re engaging in their own APPS, right? And so they’re using nontraditional health apps and they’re also selling their data. They’re smart about this. They’re saying, listen, my data’s valuable. There’s a cafe I heard in Florida that literally for exchange for your lunch, you can give them $15 worth of your health data. I’m not kidding. It’s a currency offer. You know, I forget the name of that. I heard about this on another podcast, but I was like, seriously? So think about that model. There’s a, there’s a whole society of, of, of, of folks that are saying, listen, you’re going to get my data anyway. I’m doing everything. Um,
Bill Russell: 38:04 all these people have my data and shouldn’t have my data. Why don’t I get some value? I want lunch.
Carina Edwards: 38:10 And on the flip side, right? Um, as you’re seeing data sets be purchased by big corporations and they’re building billion dollar business office, why shouldn’t people share in that? So there’s an interesting change of value in a shift in the economic model. I think that’s going to happen. Fee from service to value based. And also what is the, how do you participate in this new economy?
Bill Russell: 38:29 Well this is exciting. So how do people follow Quil health? How do they follow you? Well,
Carina Edwards: 38:33 Quilhealth.com and my Twitter handle @cEdwardSki Cause I’m a big ski bum. Uh, and uh, and yeah, just please follow along and it’s been a great conversation
Bill Russell: 38:42 You’re not gonna get to Ski as much as you know, it’s Philly. Well you can go to the Poconos, but that’s more of an ice skating kind of thing. Yeah, I grew up, uh, I grew up skiing in the Poconos and, and it really is ice skating cause there’s so many people on a very small mountain on a very small mountain, but they all love what they’re doing. So at least it is a lot of fun. Uh, well thank you again for coming on the show. I really appreciate it. Um, make sure you check in every Friday for more, uh, news information, emerging thought with leaders from across the health care industry. And thanks for listening. That’s all for now.
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