Newsday - Leveraging Tech to Care for Patients, Staff, and Under Reached Populations
April 12, 2021

 – Episode #

389

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April 12, 2021: The US has the best healthcare in the world in terms of doctors, hospitals and pharmaceutical and medical device companies but certainly not the best outcomes. 30 million Americans do not have any insurance. Anne Weiler joins Bill to discuss US medical costs, Haven, remote work, work-life balance, cybersecurity, equities and the JP Morgan Chase Annual Report. Banks are facing competitive threats from Fintech, startups and other digital companies.­­­ Will the same thing happen in healthcare? Will providers trying to hire doctors not be able to get them because they’ve all gone to alternative companies with a better quality of life? What about the amount of time and money the healthcare industry spends on the EHR? No other industry does that. How can we shift the focus to the patient, the community and efficiency? Is remote working making us more healthy or less healthy? Are we paying enough attention to women’s health? Is Femtech the next big thing? Can we build the financial models to support the large and diverse population that is female startups? 

Key Points:

  • I got into healthcare because I saw inefficiencies and things that could be so much better for patients [00:05:30] 
  • Think of the infrastructure to build a hospital and all the tech that goes into it. All of those devices that are connected can potentially be security risks. [00:06:17]
  • 30 million Americans do not have any insurance [00:13:35] 
  • Obesity, high blood pressure, asthma, diabetes and other conditions are rampant; and costs are far too high with little transparency into their calculation [00:13:38] 
  • What are the weaknesses of the virtual world? [00:26:30] 
  • Invisible Women: Exposing Data Bias in a World Designed for Men” Book by Caroline Criado-Perez [00:32:50] 

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Newsday – Leveraging Tech to Care for Patients, Staff, and Under Reached Populations

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Newsday – Leveraging Tech to Care for Patients, Staff, and Under Reached Populations

Episode 389: Transcript – April 12, 2021

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

[00:00:00] Bill Russell: [00:00:00] Welcome to This Week in Health IT. It’s Newsday. My name is Bill Russell, former healthcare CIO for a 16 hospital system and creator of This Week in Health IT, a channel dedicated to keeping health IT staff current and engaged.

[00:00:17] Special thanks to Sirius Healthcare, Health Lyrics and Worldwide Technology who are Newsday show sponsors for investing in our mission to develop the next generation of health IT leaders. We set a goal for our show. And one of those goals [00:00:30] for this year is to grow our YouTube followers. We have about 600 plus followers today on our YouTube channel. Why you might ask? Because not only do we produce this show in video format but we also produce four short video clips from each show that we do. If you subscribe, you’ll be notified when they go live. We produced those clips just for you the busy health IT professionals. So go ahead and check that out. We also launched Today in Health IT. A weekday daily show that is on [00:01:00] todayinhealth it.com. We look at one story each day and try to keep it to about 10 minutes or less. So it’s really digestible. This is a great way for you to stay current. It’s a great way for your team to stay current. In fact, if I were a CIO today, I would have all my staff listening to Today in Health IT so we could discuss it. You know, agree with the content, disagree with the content it is still a great way to get the conversation started. So check that out as well. 

[00:01:24]Common question I get is how do we determine who comes on this week in health? It, to be honest, it started [00:01:30] organically. It was just me inviting my peer network. And after he show I’d asked them, is there anyone else I should talk to? And then the group, obviously the network group larger and larger, and it helped us to expand our community of thought leaders and practitioners who could just share their wisdom and expertise with the community.

[00:01:46] But another way is that we receive emails from you saying, Hey, cover this topic, have this person on the show. And we really appreciate those submissions as well. You can go ahead and shoot an email to [email protected] It will go to the, to the entire team. [00:02:00] We’ll take a look at it, reach out to these people and see if there’s a good fit to, to bring their knowledge and wisdom to the community as well. Now onto today’s show. 

[00:02:09] All right. Today we have a lot of topics to cover and not that many stories but a lot of topics. And so I welcome Anne Weiler. Anne welcome back to the show. 

[00:02:19] Anne Weiler: [00:02:19] Sorry. Just about to take a sip of coffee as you’re welcoming me. Thank you. 

[00:02:23] Bill Russell: [00:02:23] It was a, it was a short welcome.

[00:02:25] Anne Weiler: [00:02:25] Yeah, I thought you were going to intro more topics. 

[00:02:30] [00:02:30] Bill Russell: [00:02:30] It’s interesting. Each one of the guests that I have recurring guests, I have back on the Newsday show has a different perspective. And your perspective is one where I like to go in a lot of different directions. Your perspective is as a former founder for a health tech startup and you sold that startup.

[00:02:47] And there’s just a lot of stuff going on these days. I mean Transcarent and those guys have come forward and that’s exciting. You have a story, [00:03:00] several stories that you’re going to share, which I think lead us into a different direction. And I have, I have one story. It’s kind of odd. I don’t usually do this but I read the annual report from JP Morgan Chase.

[00:03:17] And this is where I’d love to start because it had so many good things in here for from the, from the founder, from not the Founder. Gosh, the founder of thE founder of JP Morgan would be JP [00:03:30] Morgan. But Jamie Diamond the CEO. Yeah he had he had a lot of good stuff to say, and I think it gives us a lot of different topics we can jump off on. Did you have a chance to read this?

[00:03:43]Anne Weiler: [00:03:43] I skimmed it. I was actually kind of hoping that you. 

[00:03:47] Bill Russell: [00:03:47] Oh you know why that’s great. Cause I skimmed the articles that you sent.

[00:03:52] Anne Weiler: [00:03:52] The audience has. You can talk to me like 

[00:03:57] Bill Russell: [00:03:57] And actually what this shows is we are [00:04:00] two extremely busy people. I skimmed your articles. And I thought well I hope you’re going to lead me through them.

[00:04:04] I’m going to lead you through this one a little bit. So you know, Jamie Diamond is one of those people when he talks the world listens. HE’s one of. Maybe two or three annual reports that I read every year. Obviously his and Berkshire Hathaway and actually two or three others.

[00:04:22] This one was interesting. It was, it was longer than most. He touched on a couple of healthcare topics. He touches on Haven. He touches on remote [00:04:30] work. he, And he touches on the competitive threats that are now facing banks from these from Fintech and from other startups and digital companies.

[00:04:43] And it’s really interesting because he makes the statement in there that that it’s full on competition now. That they have matured. That their technology in some cases is better. It gives a better experience all around for [00:05:00] banking or lending than even JP Morgan what their size and scale can give.

[00:05:06] And when I was reading some of these things, I thought that’s an interesting perspective. CEO of JP Morgan saying look they’re not nipping at our heels anymore. They’re actually stepping into our backyards. And they are actually making an impact. Are we, do you think we’re going to start or are we already starting to see that in healthcare or do you think that dynamic is going to play out in healthcare?

[00:05:30] [00:05:30] Anne Weiler: [00:05:30] I hope it does. You know, I got into healthcare cause I saw inefficiencies and things that could be so much better for patients. And well, I don’t know if we’ve had this conversation before but I tend to, and I’m not saying this to brag because it’s actually not a brag. I tend to see things like, you know 10 to 15 years before they happen and I go this is going to happen.

[00:05:54] And I get all excited and then it’s like we yeah but wait. Yes it will happen. But wait. And that’s why you know, with [00:06:00] healthcare it will happen but I still think it’s going to be it’s going to be awhile. And then it, to me, like the infrastructure costs are so high and the tech stays around so long.

[00:06:17] So if you think of the infrastructure to build a hospital and how long you have all of the tech that’s in that hospital and you know think about, I was reading an article again yesterday about IoT, and I was thinking so much about all those devices in [00:06:30] hospitals that are either connected or disconnected and potentially security risks and things stick around so long that I think it’s going to be while it’s still going to be awhile. And, you know, we’re also seeing hospitals, you know, they’ve been on this innovation bandwagon and we can talk about innovation as you know, some people talk about innovation theater and it’s just to try and look innovative.

[00:06:56] But I think that first wave of innovation was. Oh, my gosh, [00:07:00] you know, there’s all this stuff happening with the you know initial digital health and it was innovation theater. And now though, they were questioning the ROI of that. And actually looking at how do we do different things? How do we partner with different types of organizations?

[00:07:15] So the pressure’s there. The change is coming, and I think we’ll end up in more of a hybrid. That’s my that’s my prediction but it’s going to be a long time. There was a Forbes. I didn’t give you this one, but there was a Forbes article on [00:07:30] Epic yesterday that I was reading and you know, it was just reminding me just how big they are and how many hospitals they run and how that it’s not going anywhere quickly.

[00:07:44] Bill Russell: [00:07:44] No it’s not going anywhere quickly. And that’s one of the things that sorta, you know, having been in the CIO chair and having looked at it. The amount of money we spend on the EHR and the maintenance of the EHR. And the time we spent on the EHR is huge. [00:08:00] And now a lot of people would be listening to this and saying, well, of course it is Bill.

[00:08:03] It’s the most important system we have. It runs so much of the hospital. I’m like, yeah but no other industry does that. No other industry spends that portion of their IT budget and their staffing and their time on maintaining a system like that. It’s almost serving the system. Rather than really focused on, you know, what it can do for the community or the patient or the efficiency.

[00:08:28] And so we’re just [00:08:30] constantly feeding that animal. But I don’t really want to go down that path too much. I what’s that 

[00:08:38] Anne Weiler: [00:08:38] I said me neither. You know, I had another thought, but I, this was a thought I had a little while ago, which is that there’s change that has to happen at all levels. But doctors are actually all trained in the system.

[00:08:53] Like they’re trained in hospital systems. And you meet doctors especially younger doctors okay it’s terrible. I shouldn’t say that. It’s not. You meet [00:09:00] doctors of all ages who believe that things should change, but they’re trained a certain way. And so they’re coming into the system being trained by the system that they’re going to work in.

[00:09:10] Which is different than I think any other industry, you know, you may be trained at a university, but then you go out in the world and the business is very different than. You know, you learned the theory at the university, not the practice, but doctors are actually raised in that system. And so they have to be [00:09:30] part of the change and some of them will be because there they see, you know things that aren’t working and some won’t because that was the path that they went through.

[00:09:39] So I think that’s another tricky thing in shifting healthcare, is that you cannot have healthcare without doctors. I mean, you can, we have all these examples of like, yes, you can have practitioners with different levels, but it’s almost like it’s, I don’t know the way to say it, you know, like a path or a pipe that is kind of [00:10:00] reinforcing some of the ways that things are done. 

[00:10:02] Bill Russell: [00:10:02] But isn’t that part of the point that the doctors are realigning. They’re aligned to, some are aligning with tech startups. I see a lot of tech startups, hiring doctors away. Some building full teams I see United health care is actually, you know, through Optum, just buying doctors practices all over the place. And so they are realigning. And as that realignment happens, doesn’t that, I think that [00:10:30] will be one of the things that will sort of give us an indication that the change has taken hold and it’s starting to pick up steam. When doctors are looking at the where I’m sorry when providers are trying to hire doctors and they can’t get them because they’ve all gone to these alternative methods where they have a better quality of life potentially.

[00:10:54] Anne Weiler: [00:10:54] Yeah. I, yes, that you’re right. That might tip the balance. It’s just a question of [00:11:00] I dunno, you go talk to, you know some of the doctors at the top teaching hospitals and whether they’re really excited about joining a startup. And you know, as a startup, we had a couple doctors come through on rotation and they were incredible and they were unusual.

[00:11:18] And even with being incredible and unusual, you know, there was, there was the theory and the practice where. you know, we would be designing these care plans and they’d be like, well, you have to do this. And we’re like, you know what, if you do that, no, one’s going to [00:11:30] use this care plan. Like there’s people at the end of this and you have to understand what they are and aren’t going to do so.

[00:11:36] And those were, you know, exceptional folks who sought us out who said, I want to go see what’s going on in startup. And they both ended up in, well, one of them ended up in Kaiser. I’m trying to remember where the other one did, but you know, they, they, but still, you know, Kaiser still, you know, massive. Massive health system. 

[00:11:55] So I don’t know about the Optum example either because [00:12:00] I just saw something recently where, you know, some small, I wouldn’t say small, but, you know anesthesiologist practice was suing Optum for something related to in a network of network pricing. So I don’t know, but how much doctors want to be owned by Optum either?

[00:12:19] Bill Russell: [00:12:19] Yeah I’m not saying that they do or want to, but I’m saying that when we see more doctors outside of the provider world lining with Health tech [00:12:30] it’ll be interesting. This story goes on, you know, the. It talks about one of the things that these FinTech companies have over the bank, since they have a lower regulatory burden and they have a lower cost structure.

[00:12:41] And both of those things aren’t advantage going in to the new market. In fact Jamie diamond actually calls for a review of the regulatory environment that these people the FinTech companies operate in because it does create an unfair playing field. And, you know you could see that as of course he’s going to say [00:13:00] that.

[00:13:00] Or you could also look at it and say, well, there’s a certain amount of truth to that. So it’ll be interesting to see how the startup world plays out. He goes on to say a couple of other interesting things you said we need to make healthcare. The healthcare system work better, better health drives, both productivity and labor force participation.

[00:13:17] He spends a lot of time on labor force participation in this, especially around equities and those kinds of things. We have the best health care in the world and. In terms of doctors, hospitals, and [00:13:30] pharmaceutical and medical device companies, but we certainly do not have the best outcomes as I discussed earlier.

[00:13:35] 30 million Americans do not have any insurance. Obesity, high blood pressure, asthma, diabetes, and other conditions are rampant and costs are far too high with little discussed earlier 30 million Americans do not have any with little transparency into their calculation.

[00:13:50] And that’s something we talked about a lot little transparency. We don’t know what we’re getting. When we walk in that front door at a hospital annual medical costs per person in United [00:14:00] States are now 11,000 versus 4,000. In other developed nations, there are ways we can make significant improvements.

[00:14:06] Here are a few allow, bigger incentives for becoming and staying healthy. Eliminate bureaucracy and waste in the healthcare system include administered, including administrative complexity and fraud. Which is about 25% of healthcare costs, according to his findings empower employees to make better choices through more transparent employer plan, pricing and options that include the [00:14:30] actual cost of medical procedures, eliminate surprise bills, and a couple of other things.

[00:14:34] He goes on a couple of other good things in this. And you know, it’s interesting. That’s the perspective of a large employer who essentially just looking at this saying, look my benefits meeting is contentious. Every year. We raising the cost of delivering care. It’s becoming harder and harder to give people what they want.

[00:14:56] Given the options I have from the insurance carriers and whatnot, [00:15:00] there aren’t really good options. I’m hiring a younger crowd in metropolitan areas who want to stay healthy and they want a different looking kind of plan. And we’re not seeing that emergent. We want, they want a plan where somebody is monitoring them seven by 24 with the devices that they have put on the wrist and other things they’re willing to share that information.

[00:15:20] But very few doctors and health systems are willing to track that information and take responsibility. So that information to say, Hey, I’m tracking that information for you. And this is what it looks like by the way. If you have a [00:15:30] question, go ahead and text me. And then when you text them, they actually get back to you and say, you know, Hey, I’m recommending that you talk to a nutritionist and the nutritionist as part of that, you know, when we’re talking about this, this up coming group of people entering, they, they, there is a propensity to want to stay healthy.

[00:15:49] But the plans are still designed around sick care, much more than they are around health and wellness, even, some of the corporate wellness [00:16:00] programs are just okay. With regard to that a lot of interesting things. What have you seen with regard the, the the corporate world in terms of care and the expectations and the challenges that they’re facing?

[00:16:15] Anne Weiler: [00:16:15] Yeah. I mean, there’s so much in there about so much. It’s an interesting thing. I would say, certainly pandemic related. I’ve seen a lot of focus on mental health and mental health programs, [00:16:30] which is great. And I think, you know, that’s kind of the start of it like that. There’s so much relation between your mental health and your physical health.

[00:16:39] Like if you are really stressed that. This is affecting things that also made, you know, that’s when you don’t eat well, that’s when you might not exercise. So I think that’s a really interesting place to start. My, when you were describing this though, my first thought I was once JP Morgan and doing for the health of the [00:17:00] employees, because it’s not about the health plan.

[00:17:02] I was thinking about this as, okay. I live in Seattle. And we all know what Seattle’s like. You know, people are outdoorsy and, you know, running all the time and, and, but it is, it is since the pandemic has started every time you go to the wilderness and there’s so many people there because there’s nothing else to do.

[00:17:21] And also because people have more time, they’re not commuting to work. And so, you know, I thought about this like lifestyle change that. I mean, it’s, [00:17:30] it’s. Not a complete change because we were already pretty healthy and active out here. But work has shifted to allow people to live more healthfully, you know, and they’re also eating at home.

[00:17:44] So they’re not eating, eating out as much. So I have this question around, you know, it’s one thing for the employers to say the health plans, aren’t giving us what we need, but what are the employers doing to start with? To encourage a more active lifestyle for people. I was thinking back, you know, years [00:18:00] ago, years and years and years ago.

[00:18:01] Now, when I used to work at Microsoft we moved into a brand new building and the building had gigantic stairwells, like, like I can’t describe like they were this wide as a whole room and they were painted with murals and the whole point was, don’t take the elevator. And it was a five story building.

[00:18:21] And most people took the stairs because the stairs were actually pleasant. And I have gotten myself into trouble so many times in office buildings where I tried to take the stairs and then I’m [00:18:30] like, you know, getting spit out into a parking garage cause all the, the doors are locked. So that’s my first question.

[00:18:36] Like what is the work environment doing to encourage people to be healthy and not, you know, necessarily sitting in front of a computer all day and more time to get out and even just, you know, Walking up the stairs in the building. And then the second is this question around, do doctors really need all that data, especially if somebody is, is healthy.

[00:19:00] [00:18:59] So, you know, I go in and go back and forth on this, on the, we need tech from a tech standpoint, we need to make sense of the data. We can’t just be. You know, I remember you know, when I first started in digital health and Fitbits were all hot and people, especially in Seattle, cause we’re all fit.

[00:19:16] We’re walking into their doctor’s office, going, here’s all my Fitbit data. And the doctor’s like, that’s nice, you know, like what do I do with this data? And I think that’s where the things become interesting is, you know what are your [00:19:30] goals and what are the anomalies in this data? Or what can we learn from this data?

[00:19:34] And not just like here’s all this data you’re tracking 24 seven and then what? And then, you know, going back to my previous point yeah. Medical schools, aren’t training doctors to do wellness care. So there’s a whole bunch of stuff that has to, it has to shift. And then there’s this question of like, you know, I I’ve seen the data as well about do wellness plans and employers work.

[00:19:59] So [00:20:00] there’s so many components and I do agree that the. You know the offerings, first of all, when you’re choosing a health plan, like you can’t even tell, like, you just want to be able to say, this is me and this is what’s important. And there no plan that enables you to do that. So that might be the first step.

[00:20:18] That would be really interesting. And certainly employers can drive that. But I’ve never, you know, I’m working at Amazon now. I’ve worked at Microsoft. I’ve never had an experience where someone [00:20:30] has asked me what I need in a health plan. That might be first step. Maybe they’re over buying because they’re not actually asking some people only want kind of strapped catastrophic. Right. 

[00:20:40] Bill Russell: [00:20:40] Great. You know, it’s interesting. I’m going to violently agree with you on the first one. I mean that, I mean, that’s such a great point. You know, we, we can stand there and say, you know, this doesn’t work and helps us with our Friday pairs. Aren’t providing this and whatnot, but you could just do a tour of the facilities that these organizations have and [00:21:00] say, all right what have you done for your employees?

[00:21:03] And you could do a, you know, just a, a pre survey of the employees to talk about, you know, the, the work-life balance  and those kinds of things, and just determine. Are, are they creating an environment where people can be well that is an excellent point and I’m glad you made it. The second one is and you sort of came around to it at first.

[00:21:27] What I heard you saying is, you know, the [00:21:30] people would walk in with their Fitbit data and, and the doctor would say, yeah, what do you want me to do with this? And the point being, we’ve never asked the consumer what they want and. And you know, I tell a bunch of different stories around this and I’ll spare the audience I’ve told some of them several times, but there were several times in my CIO career where we got pretty far down into a project and finally said, Hey, what do the patients want? And when we finally asked that question, we [00:22:00] realized, Hey, we just wasted six months. Cause we didn’t take the time to understand what people want.

[00:22:06] And you know, as, as an employee of a major organization or just an employee in general as an employer, I’m an employee now, you know, what I want is I want a plan that is going to take that information and have it if somebody monitoring and it doesn’t have to be a doctor, I don’t expect it to be a doctor.

[00:22:27] I just expect it to be somebody who is [00:22:30] trained medically, who can look at it and say, yeah, there’s no anomalies. Now we can talk about what needs to be done on the backend, you know, AI machine learning, those kinds of things. So we just don’t dump a bunch of data in front of that clinician. But I that I do want that.

[00:22:45] I want to offer that to my employees because I think my employees are saying, you know, I, I got this device because I want to be healthy. And that’s the first indication I just sent. I mean, yes, it’s a fashion statement and yes, it’s cool to have the fill in the blank [00:23:00] watch or cool thing, or track your steps and, you know, track your hiking and different workouts and that kind of stuff.

[00:23:07] But at the end of the day, what that’s saying to me is I want to be healthy. All right. Let’s design the plan that works for the employer. Let’s design the plan that works for the employee, where they’re at and where they’re trying to engage us. And yes, you have to offer all the other. Things around sick care and those kinds of things.

[00:23:24] I also don’t want to be locked in to the health system. That’s down the street from me. [00:23:30] I can get on an airplane. I can go somewhere else and I want to go somewhere else. If I live in a place where the health system down the street doesn’t make the us news and world report rankings. And I want to go to somewhere where they do make those rankings.

[00:23:45] I want to go to an academic medical center that’s really going to provide. You know, a certain level of care around cardiac or cancer. I want to be able to do that as well. So I, I want, I want more [00:24:00] options than what I, what I’m currently seeing. And by the way, I just signed up yesterday for Mike companies you know, what we’re going to offer to our employees.

[00:24:08] And I’m just telling you it’s just weak at best. 

[00:24:12] Anne Weiler: [00:24:12] Yeah. Well, I also, it’s funny, you know many hats I had also was an employer with a health plan. And then, so that’s another interesting thing. Like, you know we had, well, first of all, we needed help. We needed a broker to help us figure out, you [00:24:30] know, what the heck do we offer to employees?

[00:24:33] But it was very interesting to monitor it as well because I have very healthy employees. With almost no claims. So I didn’t do you know, it was nothing let’s say actually I don’t wanna say it was nothing to do with me. We did actually put the office in a place where most of the people, we had one person who drove and everybody else.

[00:24:58] Well, no, so it’s not true. We [00:25:00] had two people who drove, but everybody else walked or bite. For most of the time. And so, and we’ve made that decision when we were, you know, moving to a permanent office from a coworking space of where should we be so that people can be, you know, having a nice commute and, and be healthy and all of those things.

[00:25:19] So that was an interesting thing to watch that you know, our premiums actually stayed flat or went down because we had this. [00:25:30] Healthy how they work for. So, you know, it’s a very, very small model, but I think the employer can have a lot to do with it in facilitating and listening to the employees about what they want.

[00:25:43] Bill Russell: [00:25:43] It’s interesting as you’re talking about that, I’m scanning this and it’s like a 60 page report that annual report that they put out for JP Morgan. And he talks about work from home. And here’s what, here’s some of the things he said, generally speaking, we envision a model that we’ll find many employees [00:26:00] working in a location full-time that would include nearly all the employees in our retail branch locations, as well as jobs and check processing volts, lockboxes sales, and trading.

[00:26:10] Official operations functions and facilities, amenities, security, medical staff, and many others. Some employees will be working under a hybrid model some days per week and a location, et cetera, and a small percentage of employees, maybe 10% will possibly be working full-time from home for very specific roles he has. He goes on to talk [00:26:30] about the virtual world also presented some serious weaknesses. For example, as for weaknesses that have presented at least for JP Morgan. Performer performing jobs remotely is more successful when people know one another and already have a large body of existing work to do.

[00:26:48] It does not work as well when people don’t know one, another second thing was most professionals learn their job through an apprenticeship model, which is almost impossible [00:27:00] to replicate in the zoom world. And I’m really curious what your thoughts cause you’ve, you’ve worked in these models, a heavy reliance on zoom meetings actually slows down decision-making because there’s little immediate follow-up and the fourth thing is remote work virtually eliminates spontaneous learning and creativity because they don’t run into people at the coffee machine, talk with clients, et cetera.

[00:27:22] So he, he noticed that there’s those four challenges. And it sounds like for the most part, he’s saying a majority of their workforce is going [00:27:30] back to the office. 

[00:27:31]Anne Weiler: [00:27:31] Yeah, that’s a, hot topic these days. You know, I am fully remote right now, joined the company fully remote. I’m doing work right now that I know how to do.

[00:27:45] And I think that, you know, I don’t know the company, but if I didn’t know exactly what I was doing, I think it could be really challenging. Especially that apprenticeship moment. I think that was a good. Like a call out at the same [00:28:00] time, you know, you commutes are one of those things that really hurt people’s health.

[00:28:06] You know, people who have long drive in commutes in particular. And so, you know, a lot of I’ve seen since pandemic people talking that they miss their commute because it was this break between office and work, but that they would actually be like going for a walk during their commute. Like they get up.

[00:28:24] Go for a walk, come back, start working to sort of, you know, mimic that [00:28:30] commute. So I think there’s also this, like you know, there’s a difference of energy that you get when you see somebody in person we’re missing a lot of the nonverbal cues. You know, you’re having a meeting, you can’t see everybody’s space at once.

[00:28:44] You don’t know who’s not bought into what you’re trying to decide on. So I think a hybrid model is it’s going to be. Possibly the best. I think this, this going into the office all day, every day, you know, that there’s a lot of [00:29:00] quiet thinking work that is very hard to do in an office. So, but I don’t know. It’s gonna be interesting. 

[00:29:06] Bill Russell: [00:29:06] Yeah. I’ll agree with you. The last two points he makes, and then I want to hear about your story. So while we disbanded Haman, we will continue to build on what we learned. What did we learn from them to spanning David? Do you think,

[00:29:18]Do you have to be careful to answer this? 

[00:29:20] Anne Weiler: [00:29:20] No. I mean, yeah, I wanted to say be careful. I I was always puzzled, but my, this is my main [00:29:30] point with Haven. I was puzzled about how you could be a CEO of a startup, a full-time doctor, professor at Harvard and a correspondent for a bank as you know, taught magazine.

[00:29:46] That was my, my query was like each one of those seems like a full-time job. That’s my only comment about Haven. 

[00:29:53] Bill Russell: [00:29:53] Yes. Speaking, speaking of a tool go on days. Yeah, it didn’t seem like he got all [00:30:00] into the boat. It seemed like he was doing a lot of other things. 

[00:30:03] Anne Weiler: [00:30:03] My takeaway from that was like, Oh, it’s not very hard to be a doctor or a professor at Harvard because you can also run a startup at the same time 

[00:30:11] Bill Russell: [00:30:11] And be active on social media and publishing articles and stuff.

[00:30:14]Yeah. I mean, I’ve talked about that a bunch and I think we’re going to see, we’re going to continue to see innovation mostly from Amazon, because they’re the most innovative company of those three. And it just in the way that innovation will need to happen in [00:30:30] healthcare. I don’t think we’re gonna see Berkshire and JP Morgan chase do a lot of innovative.

[00:30:33] They’ll invest in innovation in healthcare, but not, not much in the way, but you know, we’ll keep it on Amazon care and other things. The last point he makes is cyber risk remains one of the most significant threats to our economy. And I, I think that’s really true. And I had a a meeting yesterday with a client and and we were talking about cyber security and they [00:31:00] They were sort of pushing on me a little bit and saying, you know, why don’t the CIO see how much of a threat this is?

[00:31:05] And my pushback was, they absolutely see how big of a threat of this. I mean, for the first time in our history, we saw entire hospitals shut down. We saw medical images just go up and smoke. Essentially and health systems had to start over with zero images and zero information in their EHR.

[00:31:23] And try to rebuild from scratch. So this is definitely caught the attention of the CIO. The thing that’s [00:31:30] interesting to me is I think it’s caught the attention of CEOs across the country, and I think it’s called the interest of our federal government and and other agencies. It’ll be interesting to see how we progress here.

[00:31:45] I think we’re going to see a lot more public private partnerships around this. I think we’re going to see a lot more. Meetings like I’ve seen within healthcare where you essentially have the FBI coming in and briefing CEOs for [00:32:00] healthcare organizations. This is a, there’s a serious threat to our economy.

[00:32:04] It’s a serious threat to healthcare. This is the first time healthcare has been targeted as an industry. It’s really it’s really interesting. So that’s the last throw out point. I want to hear your story. You have some interesting stuff here. 

[00:32:15]Anne Weiler: [00:32:15] Yeah. So I sent you three stories on similar topics talking about health tech for women particularly,  you know, middle-aged women.

[00:32:27] And then one of the one was an opinion piece [00:32:30] from a doctor that was about data and. After I sent you these three articles, I realized that they were reminding me a bit of a book that I wanted to recommend. And I know I come on here. It’s supposed to be news. I’m always recommending books. But there’s this book that I read. I think our listeners read books as well. 

[00:32:50] I would recommend that they read a book called invisible women data bias in a world designed for men. If there’s especially in healthcare, because there’s a couple of [00:33:00] chapters on healthcare and particularly the health implications of not having the right data.

[00:33:06] And I think for anybody who’s in, you know, a CIO should be really thinking about the data that they have. And that’s what sort of got me thinking about it was. The one article, the opinion piece from the doctor who was saying you know how basically, so some of what we’re saying is, you know, people are not paying any attention to women’s health.

[00:33:25] So let’s just start with that. There’s a New York times article that says [00:33:30] the title is, is fem tech. The next big thing in healthcare. Now let’s replace that with ManTech. Is ManTech the next big thing in healthcare. And you can see how ridiculous the question that is. So we’re talking about a technology that might be geared to the health issues of 51% percent of the population.

[00:33:52] And yet, you know, in 2019 it received 592 million in [00:34:00] venture capital investment. Which, you know, on the one hand, if you don’t know much about venture, that seems like a lot. On the other hand, you know, we have companies that do, I dunno what it’s just marketing tools. I don’t have a good example right now, but you know, these companies valued at a billion dollars individual companies and less than a billion dollars was put into all of this technology. So that’s one, one sort of piece of it. And so there’s this idea of [00:34:30] like, you know, this is actually a business opportunity. It’s also a, a healthcare need. And that you know, at the, this article is talking about how you know, women are represented in medical research. There was concerns about whether women could be pregnant and so they’re not represented in medical research.

[00:34:49] And then there’s just like the, you know, all of the systems. You know, if you think about the EHR and you think about the kinds of questions that get asked, like things that are just not even appropriate. [00:35:00] You know, I’ve had P you know, my mom being, filling out a form, being asked if, you know, is there any chance she’s pregnant? Like, come on.

[00:35:10] So the, the data is incorrect. And there’s not enough of it is one of the challenges. And then I started to question, you know, like these apps are coming up because of this issue of like, there’s nothing. Tailored towards different stages of woman’s life, whether that’s you [00:35:30] know, the fertility side of it, which was the first one, the first area that’s really started to see this traction.

[00:35:36] And then I think in the last three days, I’ve seen a number of companies focused on menopause, which is another one where this opinion piece, the doctor is saying, you know, I asked a bunch of residents, whether they had any patients in men, a cup and a menopause, and they all said, no, And it was like, that’s not actually possible. Given the demographics of the patients that youre caring for. 

[00:35:58] Bill Russell: [00:35:58] Sheer numbers does not [00:36:00] support your statement. 

[00:36:00] Anne Weiler: [00:36:00] Sheer numbers do not support your statement. So the point I wanted to make was, well, first of all, you know, there’s still this sort of condescending, you know, like, is this an opportunity? Yes. Yes. It’s an opportunity. Anything is an opportunity, not just for technology that is specifically aimed at.

[00:36:17] You know, women’s health, but it’s an opportunity for the EHRs for example, to think about like, how are we collecting data on women’s health? It’s absolutely an opportunity for clinical trials to make [00:36:30] sure that they are representing a diverse population. So there’s also, you know, there, are other diversity issues in clinical trials as well.

[00:36:39] But it did sort of take me back to this book, you know, which I think when you read this book, or if you read this book, you would see the answer to these questions is yes. Like we’re missing a ton of data that could improve health. It could improve all kinds of products. And so, you know, one of the things I was remembering from the book was, you know, crash test dummies were tested on [00:37:00] the average male and medical medical textbooks were based on the average male.

[00:37:06] And so it’s like we could be doing so like low hanging fruit from a, so much of a better job of, of both collecting the data and caring for diverse population. 

[00:37:16] Bill Russell: [00:37:16] Yeah. It’s interesting. And I have a hard stop in two minutes, so I apologize for this. I wish I had given this more time. Cause I agree with you, you know, I won’t pick up the book, I’ll read the book.

[00:37:28] I’d like to get [00:37:30] more educated on that, but I will say from the, from the investment side, you know how investments work right there, there has to be an economic model on the other side of it. And part of the vodka, there really wasn’t anything for diabetes because it was hard to build the financial model based on the weird incentives that exist within healthcare.

[00:37:48] And I think that’s where the question of is Femtech the next thing? Can we build the financial models to support you know,the large and diverse population that is [00:38:00] women with startups? It’ll be interesting to see. 

[00:38:03] Anne Weiler: [00:38:03] Yeah, it will be. I think that they’re right now filling a niche, or I want to say niche because it’s not a niche but they’re filling a gap that the larger players are not looking at.

[00:38:13] So there’s always an opportunity when someone’s ignoring something and then eventually, hopefully it should become. Yeah. More integrated. 

[00:38:20] Bill Russell: [00:38:20] Yeah, absolutely. And thank you for your time. We had trouble scheduling this this week. That’s why we have a shortened session. And  I apologize for that. We’re both, [00:38:30] we’re both running around a lot, so thanks for your time. I appreciate it. And look forward to the next time we get together. 

[00:38:36]Anne Weiler: [00:38:36] That’s good. Good to see you. 

[00:38:38] Bill Russell: [00:38:38] Take care.

[00:38:39]What a great discussion. If you know someone that might benefit from our channel, from these kinds of discussions, please forward them a note, perhaps your team, your staff. I know if I were a CIO today, I would have every one of my team members listening to this show. It’s conference level value every week. They can subscribe on our website thisweekhealth.com or they can go wherever you listen to [00:39:00] podcasts, Apple, Google, Overcast, which is what I use, Spotify, Stitcher. You name it. We’re out there. They can find us. Go ahead. Subscribe today. Send a note to someone and have them subscribe as well. We want to thank our channel sponsors who are investing in our mission to develop the next generation of health IT leaders. Those are VMware, Hill-Rom, StarBridge Advisers, Aruba and McAfee. Thanks for listening. That’s all for now.

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