Moving from Patient Engagement to Patient Enablement, ft. Brian Mullen

Intro (00:03):
Consumer demands, disruptive technologies, and AI are shaping healthcare for years to come. On Hello Healthcare, we dive deep on these issues with leaders who are driving change. We hope that these stories will inspire you to create and demand a better future in healthcare. Please welcome your hosts, Alan Tam, chief marketing officer at Actium Health.

Alan Tam (00:26):
Our first two seasons of Hello Healthcare are available on Apple, Spotify, Google, or wherever you listen to podcasts. Check out our conversations with some of healthcare’s most well-respected leaders in marketing, business strategy, data science, and much more. If you like what you hear, please share with your friends and leave us a review. Thanks for tuning in.

(00:47):
Hello Healthcare. Over the past few years, healthcare entities have significantly transformed patient and consumer access to care. While retail health organizations like CVS, Walgreens, Dollar General, Walmart and the likes continue to lead the way, traditional health systems have also invested heavily in their own digital transformation, enabling services like telehealth, online scheduling, and other digital front door services. How has this made an impact on the healthcare consumers journey? Has access to care really improved? Are healthcare consumers adopting these latest innovations? And how are health systems continuing to move and drive these digital experiences forward?

(01:24):
Joining me today is Brian Mullen, head of innovation and product at The Clinic by Cleveland Clinic. The Clinic is a visionary joint venture that combines the clinical expertise of Cleveland Clinic with that of Amwell’s telehealth platform. They provide solutions like virtual second opinions to deliver easy, secure access to high quality medical expertise.

(01:45):
Brian, I can’t think of a better thought leader to join us on today’s conversation topic. I’m delighted to have you. Welcome to Hello Healthcare. Thank you for taking the time today.

Brian Mullen (01:55):
Yeah, thank you for having me. I’m sure there’s many, many out there that have been on your podcast that are also great thought leaders and better than me on some of these areas. Happy to be part of the conversation and part of the community that you’re building here.

Alan Tam (02:07):
Absolutely. I look forward to our conversation and getting your perspective from your role. Let’s start with that. What is your role at The Clinic as the head of innovation and product? What are some of the things that you’re doing and what are some of your areas of focus?

Brian Mullen (02:24):
As head of innovation and product, it covers a broad spectrum. Innovation’s always vague. Product, I think, also can be vague, but it really covers the tech enabled side of a service, right? How do we marry that? A lot of my focus is how do we provide the tech enabled experience to enable the service that we deliver, which is virtual second opinions as our primary product and service? How do we get those two things singing together between the human interaction element that is so critical in healthcare, as well as the experience that is provided digitally from a platform, experience for really the key players here, which are the patient and the providers. We need to make it easy, usable, accessible for the people who are working to serve and that they’re delivering the care and so critical to that part.

Alan Tam (03:13):
Right. Obviously, patient engagement is key to the success of what you’re doing and also to the business model at The Clinic. What are you seeing and experiencing today in terms of patient engagement at The Clinic and how is that evolving?

Brian Mullen (03:28):
Patient engagement is an interesting concept and idea. We focus a lot on engagement. I think the question becomes: “Why engagement?” There’s a bit of engagement that we look at, because when digital health starts to emerge, there’s a lot of people looking at social media platforms and engagement and video games and the digital movement that happened. Before, on the software side, an engagement is a key metric there. Sometimes I want to hear if it’s the right thing. We need an experience that is engaging so that people want to interact with it, that they can find it easy to connect and get the service that they’re looking for. I think a lot of more about enablement. How do we enable somebody to get a virtual second opinion in an easy patient-centered quick way that allows them to have the peace of mind that second opinions can provide?

Alan Tam (04:17):
Do these health systems have the wrong mindset then? I think that’s a really good nuance that you pointed out between enablement and engagement, which leads me to ask the question of: Are health systems today measuring incorrectly to drive enablement and ultimately patients to care?

Brian Mullen (04:37):
I think this is a great question. I think this is a great area of probably conversation because I don’t know if it’s the health systems that are measuring the wrong things sometimes. I think there’s a disconnect between what the health systems are being sold by digital companies. Previously, I was also at Brigham and Women’s Digital Innovation Hub, where we got a lot of inbound requests and a lot of startups start with engagement will increase engagement. The next question, I think, anybody in healthcare asks is: “What’s the outcome?”

(05:06):
Health systems, providers, doctors, nurses across the board looking, “How does this help my patient achieve the thing that we’re helping them to work with them to achieve?” Is this going to make them better in some way, shape, or form? Keep them healthier, keep them out of the emergency room? Engagement is part of that experience, because if somebody’s not using the thing you give them to help them, then it’s not worth anything. It needs to be engaging enough and usable for somebody to use that, but I think engagement is too heavy of a metric that historically, I think, has been brought more from the digital health startup space.

(05:48):
To your question, I think enablement is there. How do we enable somebody to achieve the thing that the doctor has told them is really, I think, the opportunity that… If you look at [inaudible 00:06:02] examples, that’s where things happen. Engagement could be part of the thing that enables, but really it’s about enabling somebody, I think, is the metric that we should start to look at. Did it help somebody do the thing that they’re being told to do? I think that gets more aligned with what healthcare providers, hospitals, institutions look for. What is that outcome? Did it help them achieve the outcome?

Alan Tam (06:25):
Right. I like how you’re describing it because I see enablement as more, “Did they convert right?” Did they convert on the particular action that you sought the consumer to achieve? I wholeheartedly agree with you that enablement is a better metric and measurement of outcome, especially for healthcare consumers and patients than engagement. If I read a newsletter, if I read an article but don’t take action, was that successful? Maybe, maybe not. But if I book an appointment, if I seek that second opinion, to me, that is enablement, that is a conversion, and that is what I want to do.

Brian Mullen (07:04):
Yeah. I think it goes a step further than that, too, right? It’s not just book it. Could I actually then show up for that second opinion? Can I get the second opinion that somebody told me to get? There’s that whole chain all the way through to final result, which is, from a second opinion standpoint all the way through, the person was able to book it, have it, and have the outcome of that second opinion where they can bring it back to their care team.

(07:29):
To your question at the start, what do I do? That is what I worry about. How do we enable people domestically and internationally to have access to some of the world’s best physicians in an easy way, where they’re enabled to get a second opinion, which sometimes can be hard? It’s really hard if you don’t live in the right geographic location to get it from the right specialist or sub-specialist that really would make the difference in your care.

Alan Tam (07:57):
Right. I want to dive deeper in that, because I find what you guys are doing to be very unique. A lot of health systems and a lot of healthcare organizations aren’t really focused on doing that. I’d love to have a better understanding in terms of how is The Clinic helping patients get the care they need? How are you driving and encouraging and enabling those patients to arrive at that second opinion, to take that meeting, to schedule that appointment?

Brian Mullen (08:28):
First and foremost is we offer it virtually. If we look at challenges in healthcare, [inaudible 00:08:34] on the theme of enablement, a lot of people can’t make an appointment because they don’t have transportation or they can’t take a day off from work. There is challenging just to show up to a visit. By providing the ability to give access virtually allows somebody to engage at a time that works for them, ideally as best as we can accommodate, as well as allows them to take it from home or wherever they can. I mean, there you could take it from your car in a parking lot, wherever it’s best for them to take that visit in their interaction. That’s the first kind of step is making sure that that is possible and it is reliable to have that virtual visit and interaction.

(09:17):
Another key step in that engagement enablement is having a nurse intake visit. Healthcare is human. Having the right human connection in that is critical. The first thing that happens once you signed up and you schedule a visit with one of our nurse care managers… That allows to bring clinical insight into why you’re seeking a second opinion. They ask a set of questions, they bring their clinical insight knowledge, which allows us to help match you with the best specialist or subspecialist for you.

(09:48):
I worked in healthcare for a while. I didn’t really know the nuances of specialty versus sub-specialists until you start working in these hospitals and how much of a difference that can make. Most people might not feel confident or sure which specialist is the best fit for them for their condition and their symptoms and the questions that they have, why they’re seeking a second opinion. That’s another key step, which I think is an engaging one, because it’s human and you provide empathy in that moment where people are oftentimes very stressed out.

(10:18):
When you need a second opinion, it’s because you got a cancer diagnosis, you have a heart condition, you have a significant surgery that’s coming along your way. You already had this chronic condition for a long period of time and now something’s changed in your care, your symptoms or whatever else that you need more insight, and it’s stressful.

(10:35):
Those are two key things. And then the nurse is enabling that, matching in the scheduling with the physician so that we go out and collect the medical records. It’s all enabling the work, so it’s taking burden off the patient who’s already stressed, enabling those things, providing the right oversight. Even simple things seemingly simple or minor, but they’re really important, we double check the medical records that get sent to us to make sure that all 10 pages are there. And that if page seven’s critically relevant to the second opinion, that we make sure we track down page seven of that medical record, because it might not have gotten scanned when it sent over, and then it’s about the physician.

(11:17):
Helping coordinate schedule and get the right physician at a time that works for you is critical. It’s an enablement, it’s an engagement opportunity. Again, real time interaction with that physician to ask your questions, to engage with them, for them to understand, and then we deliver a report back out so that you can then take that report and bring that to your local care team, and then you can make your decisions with your care team about what the appropriate actions are for you based off of the recommendations and the information you have.

(11:49):
At each step, it’s all about engagement and enablement, engaging you in a human way with empathy. Our team, our nurses are fantastic at this. Our care coordinators… It’s a main focus on that. The physicians are really… I mean, Cleveland Clinic’s known for this in their empathy training that they go through, and then the enablement and the whole process that we do so that you can get that second opinion in a timely fashion in a lower stress way, so you can take action quickly for your care.

Alan Tam (12:22):
I do think you may bring up some good points and I really think the concept of subspecialties really comes into play for many folks, especially for those folks that are seeking that second opinion. What would you say is the percentage of folks who engage with you who are not exposed to subspecialties when they start talking with your staff?

Brian Mullen (12:46):
If you look at most of America, most of America is not in a short drive from a top academic medical institution. We can together name those top five. Cleveland Clinic is obviously one of them. How far would you drive for that visit? A big thing of what we do is we untether somebody from their geographic expertise. Let me re-say that one. I think one thing that we do and work a lot on is, how do we untether somebody from their geographic limitations? They have probably great physicians that are doing their best, but they don’t have the volume of cases that warrant specialists and subspecialists to be there. That’s really where Cleveland Clinic provides that capability and most of the country doesn’t have that aggregation of specialty and subspecialty.

Alan Tam (13:40):
I think what I’ve learned personally as a healthcare consumer myself is, oftentimes as the patient, I have to create and guide my own journey, especially if I live in an area where I don’t have access to the experts. I may not know that orthopedic surgeon… There’s folks that specialize in ankles versus knees versus hips versus shoulders, et cetera. I think that becomes really critical. As a healthcare consumer myself, fully appreciate what you guys are doing.

(14:11):
I think a lot has changed within healthcare in the past few years. I think the pandemic has definitely accelerated digital transformation in healthcare. It has brought up around great technologies, some of the work that y’all are doing. In terms of engagement and enablement, a lot of folks have initially focused on building those digital front doors very much like you all have been doing on your website as well. My question to you there is, how are organizations today driving the right traffic to those digital front doors that you’ve built and how are they addressing enablement such that their investments in digital front door are actually being used and paying off?

Brian Mullen (14:59):
Great question. I think one area where that happens is having high quality services that, when somebody walks through that door, that person can access like The Clinic by Cleveland Clinic. That is where a part of our focus and attention is to have business to business partnerships and be part of payer benefits and part of benefits as part of those digital front door offerings, so that we are there, so that when somebody walks through the door, they’re seeing quality. Again, maybe it’s too much of the product [inaudible 00:15:33], it’s too much of the engineering needs. What is the outcome that we deliver? And at the end, you have to have something, I think, when you walk through those doors that the person wants to buy or access. We use the [inaudible 00:15:46] markets stuff of people want to walk through a door… If it’s a retail shop, hopefully have things that people want to buy or else they’re not going to walk through your door.

(15:55):
I think, similarly high quality value add benefits when you walk through that door is the draw. I think that’s why people find us. It’s high quality, trusted service that is enabled, that’s going to deliver on what they’re looking for, versus uncertainty and not sure what to do, where to go, or how to get it or the quality that’s going to be delivered once they… Even if it’s dollars, but it’s their time. Time really matters in these opportunities in healthcare.

(16:29):
You talked about it yourself, the amount of time you spend quarterbacking your own healthcare. So, how do we help achieve those goals when somebody walks through that door and makes the door more enticing?

Alan Tam (16:40):
Can you share an example of a challenge there that you recognized and how you went about solving that?

Brian Mullen (16:48):
Yeah. I mean, we work on this a lot. We work on this because we’re a direct-to-consumer product offering as well, so you can find us. I think a lot of healthcare is related to knowledge. How do we help people understand what a second opinion is, why is it helpful to them, why should they access it? And then how can we be helpful compared to the other options they have for a second opinion, like going in person, their local geographic expert, or flying directly to Cleveland Clinic or somewhere else to be the in-person experience. That communication we spend a lot of time with. There’s always some education in that.

(17:30):
You want somebody to help them learn and understand and help them be able to make the right decision for them, given where they are in their care journey. We spend a lot of time on helping make sure we communicate the value, but also expectation setting of what the experience will be, how we can help, and what the outcome can be. Sometimes, the outcome is you’re on the best plan for you, and that is as good, I think, as knowing that you’re not on the right plan, because it gives you the peace of mind and confidence to move forward.

Audio (18:05):
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Alan Tam (18:26):
What are some things that you see health systems and other healthcare organizations doing right today? What are some good examples that you can share in terms of driving that enablement? Obviously, you guys have done a lot of great things and I’m sure motivation and inspiration comes from what you see out there, whether it’s within healthcare or outside of healthcare. What are some good examples?

Brian Mullen (18:48):
Yeah. I mean, of course, I think these novel partnerships that you’re seeing with institutions to work with partners like Amwell to help enable where health institutions aren’t trying to build everything internal. But trying to be strategic in their relationships and partnerships with digital health providers, I think, is where the leading institutions are. If you look at all of them, they all have some sort of digital innovation hub. Now, those leading institutions, they all have some other type of partnership and engagement with the partners to stay focused and deliver on those and increase their ability to provide access, while at the same time… What I think about a lot in our team [inaudible 00:19:29] not causing additional burden to the health system, their providers… Let’s be very specific, to providers and the care providers, the team, the nurses that have to be involved. So, how do we do that so that we’re not burning people out either? I’m not sure if that fully answers your question. If you can ask it again, I might be able to add more to that as well.

Alan Tam (19:48):
I think it does. I think there’s considerations that have to be taken into account before you open the floodgates, if you will. I think it’s equally important that the healthcare organizations focus on attracting the right audience so that the overburdened staff doesn’t… I don’t want to say waste their time, but there should be, given the lack of supply and the overwhelming demand, focus on those that are, quote, unquote, “most valuable,” whatever valuable may mean. Valuable can mean highest risk, most in need. How can we maximize those patient outcomes? But I also see a lot of bad examples out there that healthcare organizations are doing, where it may not be focused or targeted to the right patient audience. But I’d be interested to hear from you and what you’re doing at The Clinic, areas where you focused on and where you’ve drawn some of the inspiration and best practices to make The Clinic as amazing as it is.

Brian Mullen (20:53):
Yeah. What I focus on… This is probably later in the podcast for a reason because you never started off with this. I actually focus on logistics. To your point and some of the things, Alan, that you were talking about in leading in is: What are the logistical burdens we can take off of the patient and the providers and the humans in this process so that… If we can get the logistics right, I think this is where digital is actually, from a lot of hospitals, having impact is enabling the logistics of helping people do the work or getting access.

(21:29):
Partly, I get inspiration everywhere, but I recently got an oil change done at a dealership. I take my car to the dealership all the time. It’s the first new car I ever bought. It’s five years old. Whenever you make that expense, I was like, “Okay, great. I’m going to take care of this car instead of the beaters that I’ve had most of my life.” I was an entrepreneur for a long time and I was in grad school, so this was a big splurge when I bought a car. They asked me if I needed a ride back to home while it was being service because it’s going to take a couple hours and I said, “Sure.” They just pushed a button and a Lyft showed up. I didn’t have to pay for it. The guy got there, I got a text message to my phone of who… I didn’t have to download the Lyft app.

(22:06):
It was a text message, Johnny’s going to show up and it’s license plate X. Got in the car, drove me home, I texted them. I think I texted the dealership. When they told me it was ready, they asked me if I needed another Lyft sent. I texted back, “Yes,” and a Lyft showed up. The logistics of getting… That is stuff that I do think about and look at and take inspiration from, because if we can do the logistics and if you listen to a lot of the steps we do, like getting medical records, helping do the assignment, those are all logistical things.

(22:43):
We all know how to get a Lyft done for the most part. A lot of people don’t who might be older and aren’t as accustomed to that, but when you go through a second opinion in a lot of your medical care, it’s the first time you’re navigating that. There is no experience. You don’t know what the next step is. You don’t know what the logistics are, you don’t know the shortcuts, you don’t know the back roads. Even though Google Maps is telling you to take you somewhere, you’re like, “No, I’m a local.” So, how do we get the logistics right at that for the patient and the provider?

(23:11):
One of the great things about our experience is, if you look at the provider feedback, the physicians, and specialists who are incredibly busy, there’s a line at their door every day. They really enjoy participating in our program because they can impact the people who wouldn’t have had access to their level of quality and knowledge and has really made major changes in their treatment plans or their diagnoses that are huge. That’s why providers show up to work. I mean, I’ve talked to a lot of them over my life. They’re all there to help have an impact in patients’ lives. And if we can make that easier for them and they can help more patients easily, they’re in and they enjoy it and they love it, but we take away a lot of the headaches for them.

(24:05):
They show up, they click a link, they start an engagement. They have everything that they need in front of them. They have the interaction, they can listen to the patient in a quick timely phase. Hopefully, the patient’s more relaxed because they’re at home and then they deliver. And then we deliver it, make sure the patient gets the report. These are the things that… I think about the logistics of healthcare in a very different way, not just transportation. I know I give that example, but it is the logistics of getting somebody from point A to point B in the easiest possible way for them, as well as the others involved on that ride.

Alan Tam (24:42):
I love the example that you shared. I really do. That is how healthcare should be. It should be as easy, as streamlined as that. Personally, I believe that is the biggest challenge for a lot of healthcare organizations today. Typically, patients probably have a really good relationship with their physicians, but if we go back to the patient navigating that experience, I don’t know what I don’t know. My poor experiences, if you go and read reviews, the poor experiences are actually around the logistics: helping me find the right doctors, getting that second opinion, getting lost trying to arrive on time, and all these other logistical nightmares that I as a healthcare consumer have to deal with.

(25:26):
But when I’m sitting in front of the doctor, all is good. Rarely and very seldom do people complain about the actual experience when they’re in front of the physician. I think that’s a phenomenal experience that you shared. My question then is, are we as healthcare consumers and patients expecting too much from healthcare? And how come healthcare can’t be like that? Why can’t the health system just send me that Lyft if I need one and give me a ride home? Why can’t the experiences be as seamless as booking a flight, making a hotel reservation, or my favorite restaurant? Why is that not happening in healthcare today?

Brian Mullen (26:04):
Healthcare is one of the most innovative industries in the world right now. It is also the most complex industry there is in the world. Tour journey in healthcare is like booking a whole 10-week vacation and planning every step of the way. It’s not just booking a flight. That’s why there’s so many point solutions. The number of point solutions, the number of steps you have to take in a highly regulated… And we talk about high regulations, I think, too often than negative. We forget how important those regulations are to protect us as patients. I know it can be frustrating.

(26:43):
My startup is a medical device company, and if you read the history of the FDA and why it exists, you’re very happy that the FDA now exists. Snake oil salesmen were literally real things. Those regulations and protections are there for us. The regulations and protections and being thoughtful about what data to share to whom and when is there. It makes it hard. It doesn’t mean we should not strive for better, but we are doing the hard things. There is not a harder industry to do it in, because it is complicated and we need to get it right.

(27:17):
One of the things I used to say when I was a medical device startup is… It was during the fad of “move fast and break things,” Mark Zuckerberg’s famous quote. In healthcare, we need to move fast and get it right is the goal, but the getting right is not negotiable. My device had to work, or any medical device you get or drug has to work the first time every time safely or people die. Same with a lot of digital health experiences. They have to be reliable and dependable and they have to work, because people are dependent upon them for high quality care and services and medical device, where they’re making decisions about their health that could be significantly impactful.

(28:01):
Why as a consumer… I don’t think we’re expecting too much. I think we always have to strive the best, I think, hospitals and many people are rowing in that direction, but there is a need to make sure we get it right. The steps that are required to get it right are hard, because you actually think about your airplane experience. You talk about booking the airplane is easy, booking the reservation at the restaurant within the airport is easy. You didn’t talk about… You also have to book the Uber to get to the airport or plan your traffic and plan your trip. The question becomes: do you expect the airline to do that for you?

(28:38):
In healthcare, the assumption in your question is we expect the hospital to also make it easy for you to get there and make the appointment. But to get to the appointment, not just have appointments available for you to get to. We can have that conversation. I think that’s a different conversation, but these are the things that we expect from healthcare that we don’t expect. I think the analogies to other industries can often fall short very quickly.

Alan Tam (29:05):
That’s a great point and I’m happy you called that out. If you’re at a certain level of status, I suppose, with the airline or with a hotel, they do offer that, but for most people that is something that, you’re absolutely right, we have to plan for ourselves. How do I get to the airport and so forth?

(29:23):
As we talk about logistics, as we talk about that particular experience, I want to dive into the role that technology plays in terms of helping the healthcare industry move forward. There’s a lot of discussions around AI at the moment within healthcare, and quite honestly AI in the clinical setting has been around forever. I think health systems and providers have invested heavily in that for a very long time. But in the nonclinical setting, I think it’s fairly newer. I’d love to get your perspective on what is the role of AI in healthcare moving forward in the nonclinical setting?

Brian Mullen (30:05):
It’s a really good question. I’ve been trying to think about this a lot, because one, I don’t want to give an answer like everyone else like, “It’s going to be the best thing or it’s going to be a nightmare.” I was trying to think of where’s a true spot in a more genuine practical answer in that. I want to go back to something that you said earlier about the knowledge. We’ve been dancing around this like, “People won’t necessarily have knowledge in healthcare.” I think where AI can be from some of the things I’ve seen along my journey, not just in healthcare but beyond in working in the disability space… I actually went to grad school to look more at how do we help people with mental and cognitive disabilities? One of the startup I mentored is actually using AI to help make it easier for people with cognitive disabilities to consume text.

(30:49):
Basically, take your PhD and write it down, get it down to a sixth grade reading level without losing the content so that somebody can read that and understand that and access that information without having the challenges with a complicated [inaudible 00:31:05] looking at this for webpages. I think that’s where AI can have a lot of value is helping us in that knowledge gap, support us as users to understand what it means further, what the doctor or the care team’s telling us, so that the doctors can speak more in their language and be more detailed and provide us better information, but then have something to be with me and help interpret that and understand that and condense it down.

(31:33):
ChatGPT is doing this for a lot of us. You can write in the prompt, “Please write me an executive summary of this three-page email that I wrote so that I can send it to my boss and I need it in three bullets.” It’s the equivalent. Can we use a tool like that in healthcare to help me as a patient better understand and guide me and basically educate me so that we’re not relying on the subspecialist says it once and then I get supported in taking that report and dissecting it? I think that’s an area of opportunity.

(32:02):
I think the flip side of that is me… How can I be a better patient to that care team? I used to ask this question a lot in my startup. I used to ask consultants all the time. How can I be a better, basically, partner to them? If I hire somebody to do branding, I knew nothing about it. How could I be better? What do you need from me? When do I call you if I have a question to my lawyer? I think that’s where AI can help us. I don’t necessarily know what things might be symptoms I should track before I call my doctor. What questions should I be thinking about? What is normal for [inaudible 00:32:34] to be the only thing? What is a normal bowel movement? Is it once a day? Is it 27 times a day?

(32:41):
When we live with our conditions, we don’t know what normal is. Sometimes what is normal for me isn’t. How do we get informed so we can be a better partner to the care team? I think this is where I would be excited. I think there’s a lot of opportunity there. I do worry a lot about AI, because like any technology, it’s always a double-edged sword. If you only get enamored by what it can do, you overlook the consequences and the risk and the harm it can do as well. I think that there’s been plenty of studies already out there to know that the AI tools that have been applied in healthcare and across the board are very biased and get a lot of challenge with the biases in our culture, our society, that have been there for hundreds of years, because they’re trained on that historical data.

(33:29):
How do we move out those biases? How do we understand the risk of using AI so we’re not… Because of my race, gender, ethnicity, where I live, my income, I’m not getting bad healthcare advice or I’m getting second tier healthcare advice because they don’t think I can afford it. AI doesn’t think I can afford that service even though that’s the service I actually should get. I think, those are the things I think about a lot. I do think there’s probably a large opportunity with AI to help improve social determinants of health and the logistics of that.

(34:02):
To your point, I think you said earlier, “Who gets what, when, where, how, and really move that?” And that’s probably where… I mean, FedEx does this, UPS does this. That’s where you’re seeing in other industries where it’s the delivery of that service. Netflix, what show to show you, when, and how. Spotify… That’s where the AI can, I think, also help us in healthcare: the right provider, right time, right place, right service, right time, right place, right enablement tool to allow you to do that right time, right place.

Alan Tam (34:34):
Yeah, I liked your example using generative AI almost like a translator, but also you said it is a double-edged sword. In order to get that personalized experience, you need access to that data. If we want to use some symptoms, if you and I both had the same symptom, let’s just say a headache, it could be different things for you than it is for me based on the conditions that I have versus the conditions that you have. Unless AI has access to that personalized data, I don’t think it could make the right recommendation, if you can call it that, or educational content for that particular person.

(35:13):
We all know as healthcare consumers that when we do have symptoms and we do worry, we go on Google and we start looking and we dive into the nether regions of the internet and diagnose ourselves with the worst possible condition. I have a headache, must be a brain tumor. You come across all these rare diseases, which is seldom the case but it can happen. I think that you’re right in the double-edged sword is I need more context.

(35:40):
That is one of the major things with AI and we see… I’ll use traffic as an example. I don’t know if you use the application Waze versus Google Maps versus Apple Maps, and they always tell you the best direction given current traffic conditions. Sometimes, I follow blindly and sometimes I don’t. The reason why I don’t is because I have context. I know that, by the time I reach a certain area, the traffic may not be there, but the data that’s powering these applications don’t know because they’re using real-time data. I think AI oftentimes… If you don’t have access to the right data, you’re missing context, and context plays a really important role in helping the consumer understand and find that particular application in those technologies valuable.

(36:30):
I appreciate what you said and I think it is definitely a major area of exploration for a lot of health systems as they explore these technologies.

Brian Mullen (36:40):
Well , I think there’s a in-between there. I agree with the context, but let’s go back to ChatGPT, which is probably inspiring this conversation a lot. I think there’s a lot of opportunity for the code interpreter equivalent. Anybody can start to become a data scientist where there actually is a check. You put data in, it’s math, it’s structured, it’s there. It doesn’t have to have the guesses and whatever you’re using, the insight of applying knowledge, equations, structure, techniques that are pretty rigorous. It shows the code that it writes essentially for you to do that data analysis. Unlike the black box part of a lot of AI, there’s so much knowledge that is known that no human or specialist or subspecialist or I can understand that.

(37:25):
I think that’s where AI can identify which knowledge to grab that is scientifically the standards. Just the standard questions, best practices, PROs, and present that to me in a dynamic way based off of my responses to help me understand or articulate those questions or even from the side of the provider. Show me not all papers written on condition X, but the subset that’s most relevant based off of the report the physician gave. I think there’s a middle there before we jump to the personalization, where all that data might be needed and personalized. Then there’s also that opportunity where, with AI, because it is learning and has that dynamicness, ask me some personal questions to help it refine its search so we can provide the context, which is ChatGPT is going that way where you can provide context in there and give it that little extra direction and say, “What will the traffic be like in an hour from now based off of this?” Because you’re going to stop at lunch with a friend before you go.

(38:36):
I think that there’s an interesting middle ground before we jump to full personalization. Just like you see the progression of personalization of medicine as a whole, there are really value add opportunities because there is so much knowledge. How to just get the right knowledge that is known in the right paper that’s close enough in front of me versus having to wander Google search, which isn’t smart enough… We even give Google search that context, too, for personalization. I think that partnership between human and AI is going to be really fascinating, especially in the foreseeable feature. I was going to say the next 20 years, but who knows how fast this stuff will move? But it is a tool right now that is a human machine interaction, I think, for a period of time where we can deliver that context because it’s not smart enough.

Alan Tam (39:23):
Yeah, nowhere close. Well, on that note, what would you like to see healthcare, say, three to five years from now? What’s possible?

Brian Mullen (39:31):
Well, what’s possible is, I think, we just talked about with the AI part of it. I think where I’d like to see healthcare from three to five years from now is, I think, it’s the hope that everyone says, where we just have more clarity in the regulatory aspects of it, align on the capabilities that are there so we can deliver the services to people in this country. An imaginary state line shouldn’t cause so much pain and headache and extra work. There’s reasons for some of these things, but let’s get aligned on it. Let’s move forward. Let’s understand where our tools and our technology are now and that the care is.

(40:08):
I also think, from a regulatory standpoint, laws, systems dynamics, everyone… It goes back to this enablement. The key things that every doctor will tell you is eat healthy, move, exercise, but just move at this point and sleep well. And if you do the first two, you tend to do the last one, but this is where I look at enablement so much. We don’t have systems processes as a society that enable that stuff well. From our food programs, how do we have food deserts? How do we start to move towards truly preventative medicine that accounts for that social determinants of health in combination with programs like the second opinion program where those escalations happen and we have interactions that require access to ER or specialists or subspecialists or direct care.

(40:58):
It’ll be easier for everyone to treat patients because they are healthier walking into that surgery. These are the things that I hope… I think that there’s movement there and will make big risks. My background was also mental health, so I’m just a big champion of seeing the changes we are and understanding where mental health fits and the importance and impact that has on our physical health and how much cost it could save if we actually really put systems and processes in place to take care of our brains and our mental wellness as much as we focus on our physical wellness.

Alan Tam (41:29):
Right. I’m going to keep my fingers crossed, Brian, that some of these can be resolved the next few years. I think there’s definitely a lot of challenges ahead, but at the same time, folks like yourself are moving and pushing things forward. Hopeful for the future. Thank you so much for your time today, Brian. Really enjoyed the conversation and thank you for sharing those fascinating insights.

(41:52):
For the folks that are listening to this podcast who would like to continue the conversation with you, what’s the best way for them to reach you?

Brian Mullen (41:59):
LinkedIn is always good, but write a note with it. Not just random ones. Write a note, say that you listen to me on the podcast, have a question. I definitely reply to those more often. It’s www.linkedin.com/in/brianmullen. It’s pretty easy to find. I’m always looking to engage with other innovative thought leaders in the space.

Alan Tam (42:20):
Awesome. Thanks again for everything today, Brian. It was truly a pleasure learning more about what you are doing to help push the boundaries forward to help healthcare consumers be enabled to get access to the care they need faster. To those in the audience, we hope you enjoy today’s episode. Thank you for listening and until next time, hello.

Outro (42:41):
Thanks again for tuning into Hello Healthcare. If you like what you heard, we appreciate a review on Apple, Spotify, or wherever you’re listening. You and your feedback fuel us. This conversation is brought to you by Actium Health. To get the latest on what these healthcare leaders are saying, subscribe on hellohealthcare.com. Thanks. And when we see you next time, hello.