Healthcare Digital Transformation: How to Drive Consumer Growth & Loyalty

Webinar

Featuring

Tech Mahindra

Description

In 2020, we learned that rapid digital transformation in healthcare is possible. Unfortunately, the catalyst to this change was a pandemic.

In quick order, health systems coordinated to launch telehealth, outdoor vaccination, remote monitoring, and countless other technologies to combat it. As we move against COVID-19, another villain remains: poor consumer experiences in healthcare versus other industries.

How can we move past this? Former Cleveland Clinic CIO, Edward Marx, lays a roadmap and field guide to the culture and technology health systems should adapt in his latest book: Healthcare Digital Transformation: How Consumerism, Technology and Pandemic are Accelerating the Future

Edward’s current role as Chief Digital Officer – Life Sciences at Tech Mahindra has him exposed to the latest customer experience innovations at leading brands like DKNY, Gerber, and Red Bull. In this conversation, he’ll share strategy and learnings that healthcare can adopt:

  • The latest in data-driven customer experiences across industries
  • Healthcare digital transformation
  • Healthcare AI transformation and case studies

Healthcare has a responsibility to deliver excellent consumer experiences, and it goes far beyond revenue. Let’s explore what we can learn from other industries, and how we can leapfrog them.

Edward Marx

Edward Marx

Chief Digital Officer
Tech Mahindra Health & Life Sciences

Tech Mahindra
Joe Schmid

Joe Schmid

CTO
Actium Health

Actium Health
Chris Hemphill

Chris Hemphill

VP, Applied AI & Growth
Actium Health

Actium Health
1

Transcript

Edward Marx: So, I’m not going to read every single bullet point, you’ll have access to these slides and video, so I’m just going to highlight maybe one thing on each. But one key sub theme that underlies several of these is about the millennials and other digital natives that you’ll be interacting with or are interacting with. A lot of them are postponing care due to cost, and many of them don’t even have a primary care physician. So what this really talks about is, you need to come up with different ways and aligning delivery models, understanding digital natives. They do not want a relationship with the PCP, that’s been the traditional model. Right? Baby boomers, we all want to have the same doctor for 30 years. They’re not interested. They are okay, and prefer jumping ahead a little bit here, but to have a mobile app and press a button and talk to whomever can help them at that time at the right price point. So, understand your changing demographics. A lot of times, I think we still design healthcare for baby boomers, and we need to be what I call, bi-modal. Yes, of course. You’ll still do the traditional things that you’ve always done, but you have to realize the major shift that’s taking place. Then, what are the consequences of inaction if we don’t engage? So, you can see, we just pick up on heart disease alone, the costs will triple in the next less than 10 years. So, chronic disease continues to be a major, major issue all around the world, but especially in North America. So we really need to make bolder moves in prevention. Again, a lot of this is obvious, you’re probably thinking, “Well, that’s pretty obvious.” But we don’t do it by and large, but we’re doing it in other industries. So, if you take some of these examples and take the healthcare component out of it, you can tell how we are engaging with consumers in really different ways that gets them to buy in to that particular brand. So, that’s really critical that you’re able to identify these things and then optimize around that. Then, elevating the patient experience or consumer experience. I touched on this already, but it’s really important. You can see the statistics there, 30% of millennials prefer walk-in. Again, remember, as people grow older, more and more will be digital natives. So, you’re going to see that trend continue. So, you really have to think about it and offer new ways of delivery because they’re not interested in getting in a car, driving for 30 minutes, having a five to seven minute consult with a physician, wait in a waiting room for an hour, reading old magazines, and then reversing that process. It’s just not going to work. That’s something to really think about now. So, we made a lot of gains in this area because of the pandemic. So, roughly about 1% of outpatient visits were virtual prior to the pandemic. During the pandemic, it had varied by institutions, but the average of average is about 60%. 60% of outpatient visits were virtualized for a period of two to three months. Since that time, it has gone down to below 20% and continues to contract. Now, I don’t think it’s going to go back to where it was. Certainly it isn’t, but I would resist the temptation to go back to the old model, and that’s what we’re seeing. So I receive emails from my provider saying, “Ed, please come back. We’re ready for you, everything’s clean.” That’s great, but I don’t want to come back. I had this great experience, I had a knee issue. So, I was able to do all my physical therapy remotely. It worked just as well. I mean, it saved me so much time because where I went for my physical therapy, because I loved the therapist there, took me an hour. So I took a … what is a three to four hour time commitment, and I made it basically 30 minutes. I would never go back. So, think about that. That’s the way a lot of your patients think. So you really have to make sure that you make this as convenient as possible, and then the seamlessness. Right? So, we all know that there’s a lot of silos, and Chris talked about it upfront. There’s a lot of silos between our payers and providers and the data gets replicated or data does not transfer over, and so you have to think about how you’re going to work with your primary … If you’re a provider, how are you going to work with your primary payers and vice versa to make that a seamless experience. You do not get that dysfunctional of experience in retail, and who knows behind the scene? One of the companies that I go to, it is made up of five completely different companies, but they all aggregate towards the top. But from an experience point of view, whenever I’m buying something, I could be in one company buying from a different company. But to me, it’s one company, it’s one checkout. But in healthcare, we’re not like that at all. So, it’s very discoordinated. Again, it goes back to the experience which is bad, and then tarnishes the brand. So, preference is really critical in all this. So, that’s a little bit about what we’re seeing, what the reality is. So, how do we shift towards a more futuristic healthcare? So we have to adapt to the evolving consumer demand. So, you see here, and I know this one’s a little bit tougher because there are rules and regulations that we must respect, but we’re finding that more and more patients are willing to share information if it means that there’s more value and that there’s better personalization. So you need to think about this when you work with your patients and how much are you willing to share. So, an example would be with a personal health records. So oftentimes, we, as healthcare organizations, put more rules and regulations around what can be released than actual any rules or regulations that are given to us by federal government. So, we’re like, “No, let’s control this data, and let’s not release this data.” That’s not good thinking, and that hurts the experience, which then hurts your brand. Let patients have their data. So, that’s just an easy example, but I can tell you from my current experience, that over 80% of healthcare organizations, still control beyond what the government regulations are, what data goes out and what data is retained. So, there is an easy fix right then and there. Again, you get your patients more engaged, which tends to better outcomes, tends to a better experience and works to give you a better brand. You’re going to start operating and have the same experiences as other companies like was shown on that one slide, maybe perhaps like a Starbucks as an example. So, how do you get to outcomes? We’re going to talk a little bit about AI. So, I don’t want to spend too much time here, but you really can make for an improved experience. I’ll give you another simple example, this one within healthcare. So, rather if you know me, if you’ve personalized things and you truly know me, you know that … and I’m going to just give you a really simple example, but these things happen every day. You know that I don’t respond well to Tylenol, yet Tylenol is given to about 90% of the patients that come in and complain of a headache as an example. So, you should know me already that Tylenol doesn’t work for me, so it might be Advil. But what we do is we just give everyone the same care pathway. Care pathways are really important and very critical for many, many reasons, but you can personalize these so that it’s a care pathway designed for Ed, not a care pathway designed for a generic 50 year old. So, it’s all about that personalization, and it makes a difference in the outcomes. It’s an amazing how much waste we have, both from actual costs and logistics and supply chain, as well as clinical quality digression, because we don’t personalize. So, it’s really important. Again, convenience is as important to many of our patients as is the cost and quality. So, one more slide about the future, and then I’ll give you a couple of more examples, and remember, just be listening for the authenticity of the brand telling stories and making sure that things are highly personalized. So, this one, you’ve heard three different ways now, and that is patients want care where and when they prefer. And again, for most of them, it’s not in a brick and mortar. So, not only is it about mobile and about voice, but it’s also about the home. So, care is transitioning to the home. You want some evidence, CMS, last fall, launched their hospital at home program for selected DRGs. They’re allowing you to discharge patients earlier. In some cases you won’t even admit these patients, and allowing them to be cared for at home using technology that exists today. It’s still a little bit of a hybrid model, but it’s a step towards a fully automated model, and that’s what people desire. So, we’ve all probably been a patient or have had loved ones that are patient, and as great as any of your local hospitals might be, they are not where you want to be. So, you want to be home, you want to be surrounded by loved ones, people that care for you and have all the amenities of home and not be bothered at 1:00 AM for a needle stick or something like that. So, you really need to make sure that you have these bi-modal capabilities to deliver care in the setting that that patient would like it. That’s really critical, and how do you do that? You have to know me, you have to know the patient. That’s why it’s really important to grasp this. If you think of various companies today that are successful outside of healthcare, that is exactly their model. Let’s just take Walmart as an example. You can go online and have the same Amazon like experience for Walmart, but maybe you like to go … maybe it’s part of a social regimen just to get out. Maybe you like to go to your local Walmart. So, guess what? You can go to that same store and find the same products. That’s a really good example. We should be stressing the same, and again, as I showed you from the statistics, you’re going to see more and more of this shift towards at-home and mobile. If you don’t evolve, you will be completely disintermediated, and it may be too hard to catch up. So it’s really a warning sign. Another point of reference for all of this, is the fact that if you look at what’s happening in retail today, if you look what’s happening in the payers space, they are taking their market share for primary care. And how do they do it? All the things I already shared, convenience, personalization, authenticity, stories, a story, “Hey, I’ve got to go to Walmart anyway, and there’s a clinic right there, and you know what? It’s no hassle. I know it’s $30 for my primary care visit. I can just walk in. I don’t even need an appointment.” That’s what I’m about when I say learning from other industries. Yeah, I already talked about that. Let me finish with two examples and then let me hand it over to Joe. So, this is an example of what I’m talking about when it comes to personalization. This is for Purina. Right? So they make puppy chow, or not puppy chow, but dog food. They know that dogs are really important to people. In fact, for many people, dogs are a full fledged member of the family, and it’s just as important as any other person. So, they’ve created personas and they tell a story. So of course you have the puppy and the smart dog and so forth. So in this example, we pick Danny, Danny’s the small dog, but it’s all about personalization. If I really care about dogs, I don’t want my dog to have some generic dog food. So you go and you have a couple of different choices. “Hey, for puppies, you get this bag, for a senior dog, you get this bag.” No, no, no. My dog is special. My dog is important to me, and I know my dog doesn’t like just vegetables in their food. So, I can simply take this. This is not a clickable model for you, but I could click on, “Hey, my dog loves jerky twist.” That goes into that. What you see in the upper right hand corner, the prime born mixed pack. So I’m going to pick a little bit of jerky and my dog also likes rice, and I’m going to click in some rice, and guess what? I have just created my own dog food at the same price point for my dog, because I love my dog. Now, why can we do that for dogs, but we can’t do it for humans? Right? That’s what we’re talking about when we say personalization. You have to have the systems to enable that, and then you’d get your personalized dog food. It’s brilliant. One last example is about healthy living and fitness. Right? That’s something that we probably all aspire to, like, how do we become the best fit person that we want to be? But we always emphasize one thing, whatever that one thing is, it might be diet, or it might be how much you work out, but that’s really not how people work. So, in this example, you can take some of the same thinking that we just reviewed from other industries, like the Purina example, and give people point value and allow them to reach the points that you set up for them. But maybe for them, it might be a little bit of cardiac, a little bit of cardio exercise, and then maybe with some diet modification. Then maybe for some people it’s really about wellness and mindfulness. So, they create their own mix. Not everyone is built the same, not everyone’s going to respond the same. So it’s really about personalization. So, that’s really the examples that we’re learning from other industries, is this whole concept of personalization, and it’s the telling of the stories. It’s really about customizing their experience and ensuring that it’s holistic and that at the end, that they’ve had a great experience, which then in turn impacts your brand and speaks way louder than any particular marketing campaign. So, Joe, I’ll turn it to you. Joe Schmid: Awesome. Thanks so much, Ed. We really appreciate you being so generous with your time, and you’ve been a leader in the industry for so long. We appreciate all the insights. What we’re going to do next is talk a little bit about how we can connect this important emerging technology at AI to support some of these objectives around digital transformation. I’m just going to bring up our next set of slides here. Chris Hemphill: Thank you very much, Ed. I appreciate it. If you guys haven’t noticed there’s another poll coming out that you’ll be able to take. But when it comes to Joe, Joe has been with us for a very long time, five years with SymphonyRM. In that time he’s built out this data science and AI infrastructure that hits on some of the personalization and tailored experience initiatives that Edward was talking about. So, the poll is, “How are you doing towards these initiatives?” We’re seeing a question that came in from [Reynold Brian 00:16:15] we want to get into that big hairy audacious goals that healthcare systems can or have hit. But we want to hear from you on how you’re doing in the progress down this digital transformation journey. Chris Hemphill: Joe, we’re excited to have him talk about when we’re identifying use cases for using things like machine learning, AI and data science, let’s get specific, let’s get tactical to the different things that we can enable. So Joe is going to provide a good framework, and good research behind that framework around how to take the action driven case towards AI. Joe Schmid: Awesome. Thanks Chris. So, where I want to start, I want to take a look at some high level learnings that we can draw. One of the things that Ed does so well, like you heard is, learn from other industries. There was a great study done with Boston Consulting in conjunction with the Sloan School where they looked at a large number, over 2,500 executives who were involved with AI projects. So, there were some pretty shocking findings that we came across. The first thing that we found from the study is that a whopping 70% did not have payoff from their AI investments. So seven out of 10, pretty abysmal results. Now, it’s not all bad news. On the flip side, there are 30% that had some good results and we can learn from that. So if we dig in and we look at what are some of the key takeaways, there was one that stood out to us, and this is a great quote from the CIO at Roche. What he captured, I think is really powerful. It’s not that AI is some separate kind of siloed agenda, you’re doing technology for technology sake, it’s tooling its capabilities, but it’s in support of objectives, and it’s really got to be viewed in that light. So we’re going to talk a little bit about how we can put that into practice with that in mind. It kind of analogous to just like Ed talked about, it’s really about experience and the technology serving that experience. It’s AI serving that strategic set of objectives, part of which is delivering unexperienced, especially around digital transformation. So, let’s take a look at broadly what were the types of opportunities that people pursued in this study, implementing AI. We could divide them into two simple buckets. The one hand, some of them were around efficiency and cost reduction, the other set of opportunities were more around growth, proactive outreach and being engaged. So, interestingly enough, the results of these two areas were really different. What the study found is that, for the former success rate of those were generally low versus the areas that did see a great payoff were much more around these opportunities for being proactive for driving revenue. Chris Hemphill: Just as a callback to the poll you took earlier, we asked a pretty similar question, and it’s interesting to hear from this audience that … it was pretty aligned with what we saw from the study, which is that, the majority are seeing growth focus initiatives as the path to use AI. So, just thought that was an interesting nugget to share and some real time stuff to collect, but continue on Joe. Joe Schmid: No, no, thanks, Chris. It’s interesting that the poll results lined up with what the study saw, which is great. So, from here in our work with clients over the last many years, we’ve come up with strategy recommendations that go like this. What we do in working with clients is, we start with their objectives and we work backwards on actions and activities that support those. We can take a simple example and just step this through. So let’s say you’ve got some objectives around being proactive in increasing breast health early detection. That’s great. That’s a specific example. You might have a whole broader set of things, but let’s take that as one simple use case. What you want to do then is work backwards from there and talk about what actions would support that. Just like Ed mentioned, personalization is such a big deal to consumers today. How can you put together personalized calls to action that would support this particular objectives? All right, if that’s going to be some of your activity, what’s going to support that? You might need some predictions from AI that are going to give you both clinical predictions, that top area around propensity, for someone to need a breast health services, which women are more at risk, and you would have scores from AI models in that area. But that’s often not enough. You’d also want models that give you predictions around what content is best for Joe versus Ed versus Chris. Now, through the use of AI and training models on outreach and campaign results, we can start to make personalized predictions that said, “You know what? Joe really likes text messages, Ed really likes digital engagement in his mobile app.” And those kinds of personal, both channel outreach, as well as content that’s most effective for your consumers on a personalized basis, are going to get you much better results. Then the last step of the process of course is, you need some data sources to be able to train models and your data scientists, your trusted partners can help you work all the way backwards to say, “What sources do I have?” One of the things that I love about Ed’s book is talking about doing inventories and really laying out your roadmap for where you want to apply digital transformation. So you see all the pieces of the puzzle. So that’s the strategy that we work with, we’ve seen be effective for clients. I think that general methodology is a great way to go. You can dig in and go further, you can refine these, you could dig in a little deeper, you could also cover other objectives and work through that process, cataloging both what you want to achieve and your methods to achieve it. As you go through that, there are some questions that you want to ask, I think for better or worse, our industry has a lot of hype, even across beyond healthcare AI. There’s a lot of hype, there’s a lot of talk and it’s hard to cut through the confusion. I think at the top level, everybody’s going to tell you they have great accurate models. They’re all in production. They’re super effective. Unfortunately, you need to dig a little bit deeper. So what we recommend is asking some specifics, and we do lots of work across different areas in things like breast cancer models, questions that clients and prospects ask us are things like, “What kind of data was the model trained on? What went into it?” Vendors should be able to tell you that detail, how did it perform? Unfortunately, we’ve seen a lot of history where that performance measurement and metrics just aren’t shared, it’s kind of black box secret sauce. They should be able to tell you details about how much lift will it get you, if you’re into lower level details, what’s the area under the curve score? Things like that. Then last but not least, what does the model use? What kind of features go into it? Things like that. That kind of visibility, transparency are things that you should be looking for. Then another critical question is, you should be asking if there’s bias in these models. If vendors are not careful, they’re likely to not only pass along bias, but potentially amplify it. It’s something that we see as a big positive trend, we’re really encouraged. Thanks to Chris and members of our team. We’re trying to take a leadership role in the industry. There have been a lot of high profile cases in other industries around models, unfortunately amplifying bias. There’s a high profile case of a recidivism prediction model, that unfortunately was incredibly biased. There are things around gender bias. Apple got some bad publicity around credit availability for men versus women. And even in our industry, there have been bias, where models start to use costs instead of clinical aspects, and things like that. It’s something that we’ve got a lot of work to do, but that work is happening, we’re encouraged by. Specific questions you want to be thinking about or asking about when approaches have shown racial bias and what was done to mitigate it. You want to ask about internal review processes. Are these one-off things that happen, or are they really baked into products and procedures? Then you want to ask about, are they working with third parties? As an industry, we do a great job of security audits. We expect vendors to have SOC 2s and high-trust reviews from external auditors. We think we’ll see a big trend towards audits around bias and fairness, and that’s really important work that the industry is starting to do. So, we’ve kept this high level for today. That was just a quick overview, a few recommendations around AI strategy. If you want to go a little bit deeper, Chris and I, did this great thing. It was really fun to work on with Chris, that we call Health AI University. It’s a series of four webinars, it’s totally free. It’s just out there on our website, and it really breaks it down. It’s meant for non-technical people, but we do go in depth around understanding AI, how to think about it, how to apply it in healthcare. So it’s a great resource. You can all go check out. Chris Hemphill: I appreciate that Joe, and I appreciate the [inaudible 00:25:41] Health AI University, that was a lot of fun to put together. Hopefully it takes a lot of this stuff as nebulous. Are there questions around, how this stuff is actually executed and gives leaders like you the ability to say, “Okay, well, now I can actually suss out the difference between these particular use cases.” Now, it’s your turn. We’re about to drop the PowerPoint. I don’t think that anybody came here to be PowerPointed to death for 80 minutes. So, we’re going to open up the floor. We got some good questions that already came in. We have a flow that we wanted to go through. One question that came in beforehand, like if you go into our LinkedIn event, Jared Johnson, asked a question around the involvement of marketing in this whole pie. I really love to think about marketing’s role. I know a lot of the people who are joining and conversing, have a stake in that patient engagement, patient outreach view. If you’ve read Ed’s book or seen Ed communicate, he’s about breaking down barriers, and he can talk about patient engagement and consumer strategy alongside the more infrastructure oriented things. So, Ed, just wanted to hear from you about what kind of role marketing should play and the kinds of consumer initiatives they’re trying to push forward. What are some things that they can do to help play that role into this whole digital transformation concept? Edward Marx: Yeah, I think the ultimate is, if the CMO or CIO are speaking, you can’t tell who’s who. So, I was very fortunate at the Cleveland Clinic to have that kind of relationship with Paul Matsen, who was the chief medical officer. He would be up there talking, and you would think that he was the CIO. I took great pride in that. I could speak in the same language that he could as well. So ideally you are partnered at the hip. I often use McCartney and Lennon as example, before Yoko Ono came into the picture, where the two were just working together, writing beautiful, brilliant music, and that’s the way it should be with the chief marketing officer and the chief information officer or chief digital officer, whatever the titles might be. It comes down to, if I get really simple, it comes down to pride and culture. So, you just have to lose your pride, you can’t own everything, just work with other people and learn from them and work together. So it doesn’t matter who gets credit. It doesn’t matter if it’s sponsored primarily by the CTO, CIO, CMO, just make it happen. It’s the right thing for your patients. Chris Hemphill: I have a bit of follow up question based on that. So, I love the partnership that you described at Cleveland Clinic, between CMO and CIO, curious, are there some specific goals? One of our commenters asked about big hairy audacious goals. I’m wondering about, if that kind of partnership cross departmental collaboration has led to any stories around that? Edward Marx: Yeah. For us, it was double the number of lives touched, that was the overarching goal of the organization. Because we knew we had something special and we wanted to share it with others, and everything else falls in place, if you can double the number of lives touched. So in order to do that, you have to work really closely together. So, CRM would be an example. So, when I arrived, there was probably three or four initiatives, everyone getting on CRM, which is crazy to think about, but that’s the direction we were headed, and we just all work together. So that would be one example to get a single CRM, and then we just met regularly. I don’t want to mention vendors, but we both had a relationship with a specific vendor in search engine optimization. Some of the goals that we maybe had in data analytics. Let’s just all work together, let’s not have separate vendor meetings, let’s think about this as a big partnership. So that’s what came out of it, but for a very specific [inaudible 00:29:56] was our patient portal, that would be the best example. So, rather than us going down on IT track and they’re getting frustrated and doing things just on the web, so that’s the way it was. I think in many organizations, you should have someone pursuing an application on a phone, someone else thinking about a web presence. Oh, that’s crazy, it should be done together. Then that’s what we did. So we formed a single method working together how we would reach and double the number of lives touched. Chris Hemphill: There’s a question that came in from [Meda Havnucar 00:30:30] with regards to skills that people should pick up or can pick up to help lead down a digital transformation journey. I wanted to throw that … starting at you, but I want to hear your thoughts too, Joe, on, when it comes to what knowledge, what learnings, people should have before they’re trying to communicate and lead through these initiatives, what can people start doing personally to pick up the skills, to make sure that these are good transformations within the health systems? Edward Marx: Yeah. For me, one of the sayings I have is to be innovative. You must be innovative, and I think it’s the same way with digital. To be digital, you must be digital. You need to experiment. So, this is another offensive thing to some of my peers. It’s like, if you just do what you normally do, you are not going to get it, you’re going to miss the train. So you need to go outside of healthcare, and you need to find out best practices other industries are doing. That’s really key. So, be digital yourself. So force yourself to learn. That’s what I always tell people, like switch your phone every year, try Android phone if you’re always using iOS. Do something to shake things up, try Clubhouse, get on Clubhouse, learn about Clubhouse, be active on LinkedIn, Twitter or whatever. Whatever the latest things are, get engaged and learn from a personal experience. Because then, what’s going to happen, you’re going to start thinking, “Oh, what about this? Oh, we can apply this to healthcare.” That’s one of the reasons I started working in the OR. One day a week, I spent entire shift in the OR once a week. Did I have to for my job? No, but I was there working in the OR, and you can do the same, volunteering. So maybe you can’t work in OR, but you can volunteer. So, go volunteer someplace. That was one of the main reasons I volunteered too, is just to be exposed to new things and to see the patient perspective or a clinician perspective and just say, “Oh, wow, man, I didn’t know it was that hard. That should be easy.” So it gave me new ideas, fresh ideas, but then at the same time, I would spend time with colleagues outside of healthcare. Then the final thing I want to say, Chris, and then I’ll hand it off to Joe. So I don’t mean to be long-winded, but I just want to give you really practical things that anyone can do, and must do if you’re going to have any chance at leading digital successful, is working with people outside of healthcare and bringing them into your team. So, a lot of times what we do in healthcare, we say, “Okay, I’ve got this open role.” And HR says, “Must have 20 years of healthcare experience.” So you’ll never hire anyone from outside of healthcare because we put these made up rules on ourselves. So say, “No, no, I want zero healthcare experience.” Bring in people from other industries onto your team and start transforming the way that you think and the way that you operate and bring in new ideas and give them freedom, take away obstacles and start doing the right thing for the patients, Joe. Joe Schmid: Yeah. I love that advice. Especially the shake things up. I think, humans by nature, we tend to have a little bit of inertia and if we’re stuck in the way that we’ve been thinking it’s hard, but once you get that ball rolling, I think it really opens things up. The other thing that struck me is, digital transformation and leading that is tough. I think it’s less about the technology and more about the collaboration and culture. I think that collaboration is so key. One little thing we’ve done inside our company, it’s so simple, but I think it makes a big difference, is we started doing these random coffee meet and greet, 30 minutes. You get paired with somebody random throughout the company. And it’s great. You get another perspective, you meet new people, and I love to see people inside healthcare do those types of things to understand different perspectives. Ed, you did it by working in the OR, that kind of thing is really eye-opening. Edward Marx: Yeah, Joe. Just piggybacking off of Joe is, I would do the same thing where it was a requirement for everyone that worked in IT to spend one day a year with a clinician. So, we made it really easy. They could pick the hospital or the outpatient clinic and they could pick … do they want to do bedside nursing? Do they want to do surgery? Go to surgery, whatever it is that they might have an interest in, and they were paired up, and they had to write about the experience afterwards. That led to a lot of digital transformation, everything from getting rid of printers, because we didn’t realize how printer reliant we were, to getting better communication systems. That was a game changer. We did that every year. Imagine doing that 10 years. I mean, you’ve got 10 days, otherwise you might sit in a cube or at home now, but you were out there seeing patients and talking to clinicians. Chris Hemphill: Thank you for that feedback. Another question that came in, this time from an anonymous person in the audience, but there’s a flip side like, I don’t like painting, everything is a completely rosy picture because there are digital transformation efforts and digital transformation startups that fail. Ed, maybe want to start by hearing from you on what’s the difference between digital transformation efforts that succeed and what fail and startups, et cetera, your concept on failure in digital transformation? Edward Marx: Yeah. Also, someone put a thing up about call spend time in a call center. I agree. In the example I gave, 25% of my team, was a clinician on purpose. So they already knew what it was like to spend a day with clinician. So they spend time in the call center. So like our CMIO doctors, they would be in the call center for a whole day just learning from that experience. So, I love failure. So got to create an environment where failure is encouraged. Obviously we’re not talking about failure that’s going to harm people or sink a million dollar someplace. Hopefully you catch failure a lot quicker, but I’m really big into agile, where you fail fast. So, start up [inaudible 00:36:10] your product and then see if it works or not and fail fast. So I’ll give you one really quick example, maybe my favorite example, we were really big into innovation, and back then it wasn’t called digital transformation, but that’s what we call it now. There was this thing called circus. This was before the Microsoft surface was a big tabletop. So, with Microsoft, we invented this very cool capability touch and go into the human body and do diagnoses. It was amazing. Six months later, the iPad came out. I mean, so it’s like, who would ever buy this huge desk essentially like a Pac-Man table? If you remember those that you would sit down around and end up … But out of that thinking and out of that creativity and out of that engagement with physicians, we developed an app to the iPad that helped diagnose Alzheimer’s to a much higher degree than had previously existed. It was all paper-based, and for the first time it was automated. So, out of failure comes success. So you just have to breed that culture that says, “Hey, it’s okay.” That’s one example. Chris Hemphill: Excellent. Your thoughts on the same question, Joe? Joe Schmid: Yeah, I think Ed hit the nail on the head with the fail fast. I think if you’re not failing, you’re not taking enough risks, you’re not pushing the envelope. So it’s a great metric to see like, if all my efforts are succeeding, I’m really not pushing things. I think agile is a great way to cut the risks, cut the timing down, deliver in chunks, get that feedback, put it into the hands of users, deliver something usable. Don’t try to boil the ocean. We’ve seen that pay off. There’s a long history of applying that across many industries. I think healthcare, we’re maybe a little bit behind in that, we’re a little bit slower to adopt some of those things, but I’m encouraged that we’re starting to see those types of approaches take root. Chris Hemphill: That’s a great point. So, what you both highlighted was creating an environment where failure is embraced, but also the harm is limited. Especially when you focus on something like an agile rollout versus a waterfall or massive rollout, then you can compartmentalize a failure, learn from a sprint and then learn how to iterate for the next step. So, it’s awesome seeing that language introduced to healthcare, and we’re starting to see some more adoption of that method in healthcare as well. I want to get onto some more questions coming in from the audience. Everybody keep them pouring. If we don’t get to them now we’ll get to them later. So, hit us up with questions. We love them. Question came in from … let’s see, you have failure. What do you see as the future for mobile healthcare with the increase of a digital collaboration and digital transformation happening? That’s a great question that hearkens back to the good experience that you had in a virtual means. Ed, curious about your views on the future of mobile care. Edward Marx: Yeah, yeah. I love mobile. I think there’s no time to go into the story, but except to say, I had this massive heart attack during a big race on national championships for Triathlon, and I finished the race, but I had one of these cardio things. I don’t remember the name of the vendor, but that’s what I would [inaudible 00:39:27] at the Cleveland Clinic. Of course, I had all this stuff and I did this at the medical tent, and sure enough, I was having a LAD or widow maker. So I got shipped off to the hospital, I got cured immediately, but then my followup was all enhanced by both mobile technologies and remote patient monitoring to the point that, 90 days later I was in the world championships racing for team USA. The only reason I tell that story is to answer that question. Oh my gosh, everything is mobile. So it’s all about mobile, and the next emerging technology that you layer with it is voice. So it’s all about voice enablement, it’s all about listening and creating this amazing experience for your patients. Joe or Chris. Joe Schmid: I was going to chime in, I think the voice piece is under appreciated. I think that’s coming, there’s a long history of maybe some stops and starts in voice, but I think now’s the time for that. We know that mobile is probably just a huge channel and it’s only in its infancy right now. I think about it kind of two ways. There’s like, do we have that channel available? Is there a mobile app? That’s step one, but then you want to be feeding content in, you want that personalization that Ed talked about. You want to be proactive, that mobile app should know me, it should be context aware. So I think that’ll be … we’ll take baby steps and get the channels in place, and then we’ll make it more sophisticated as we go. Chris Hemphill: Thank you. We have time for a couple more questions. Alan is going to launch a poll where if you want to get more into conversations later on, we can outreach to you to get to anything deeper that we didn’t discuss here. But, we have a question that came in, another anonymous question, but it was around specific benefits or overlap between CRM, AI, and propensity models. Ed, having evaluated these things, curious what your thoughts are on that, and I’m sure Joe will have some good perspective there as well. Edward Marx: Yeah, I’ll probably defer most of this to Joe. I love what SymphonyRM is doing in this area as CRM is not enough. That’s my comment, CRM is not enough. You got to take it to the next level. Joe. Joe Schmid: Yeah. That matches exactly what we’re seeing. It’s really interesting. Right now the trend that is emerging is that there are some big CRM vendors that have been around for a long time, they’re household names we all know, but I think when you go to put it into practice, it’s missing the intelligence piece. So it’s got the pipes, it’s got the visibility, it’s got the user screens for call center agents, but it doesn’t have that intelligence of how do I make use of all that rich data from EMRs and emerging new systems like sensors and wearables and things like that, and how do I take that rich data and start to make predictions that I can put into practice? I can go to Joe and say, “Not only are you a good candidate for your prostate screening, because you’re behind on that, but also we see you’re an athlete and you’re getting a little bit up there, so here’s some things in terms of sports med and stuff like that.” I think that’s the opportunity to use that data be proactive. I think the trend is really good. We’re seeing there’s a lot more interest in that, both for health systems that are focused on value and preventative care, as well as those that are still in a fee for service world, and we see models on both sides of the equation for that. Chris Hemphill: Gosh, I wish that we had more time to elaborate on that because there’s a lot of education there and a lot of confusion out there that would be fun to discuss. But we got another really fun question, which is from [Matt Weed 00:42:54] Matt, I’m going to give you a precursor. We actually have a webinar coming up on this subject that we’re doing in partnership with HMPS, that’s going to be on April 15th, and we’ve gotten, James Gardner, who is analyst who has done heavy research on Walmart health and Walmart clinics. We have [Sheri de Campbell 00:43:16] from MultiCare who is the leader or director of marketing for MultiCare’s Retail Health Initiatives. So, that is going to be a very exciting one for you to attend, to get that kind of question answered, where when we look at the … Jame calls it the clash of the Titans, Google, Amazon, Best Buy, everybody competing in the healthcare space. The big hairy question for Ed is, what does Amazon’s role in healthcare look like in five years? Edward Marx: I think the provider side, because we haven’t moved quick enough, I think there’s still hope. So it is really a call to action, it’s not a negative, but we’ve succeeded. We’ve given away the whole primary care base, where the largest primary care base now is on the payers, and you’re seeing that growing and you see the entrance of retail and now Amazon and other big tech, and it’s all about the patient experience. That’s where people are going. So, if Amazon, you gave me this great one-click experience for my telemedicine visit and or you’ve got a drone that’s delivering my medicines shortly thereafter, guess where I’m going? So, it is really about creating these experiences for people especially, again, the whole presupposition earlier was, there’s a subset of the population, but they’re growing older, that likes it the old fashioned way, and there’s this huge growing digital native, and that’s the way they want it. They want an Amazon like experience and that’s where they’re going to go. So, it’s a wake up time for those on the provider side to really get moving on a lot of these technologies we’re talking about. Chris Hemphill: All right, Ed, do we have time for one more question? There was a really good one that came in. Edward Marx: As long as Joe answers this. Chris Hemphill: Okay. This one came in from Chris Kelly and it was … The overarching question is, how can AI improve communication within hospitals? But really, I didn’t even look beyond the AI as a way to improve communication. The example that Chris brought up was when family and friends have hospital stays, it’s striking the number of times that a new doctor will walk into a patient’s room and request the same information. So, AI or not? Just overarching thoughts on improving communication between departments and between episodes of care within the hospital. Edward Marx: Yeah, that’s where I think CRM plays a big role because that is the way it is, and that’s why it’s typically a bad experience. You have to repeat everything. There’s very little predictive capability, and I did this quick experiment on Twitter at one time, I think last summer, and I said, “Who knows me?” I copied my healthcare provider and I copied American Airlines and Marriott, and my financial services from USA. All of them responded immediately, and they said something about me that wasn’t too personal, but it was right, except for my provider. They have no clue, no idea who I am, even though I may be an executive within that provider or maybe a ten-year employee, whatever. They don’t know me, and that’s got to change. Joe. Joe Schmid: Yeah, so true. I think this is a great question around, we think of digital transformation focus on patients, but there’s opportunities inside the health system. We can put better information that’s contextually aware for physicians. We do a little bit of this with pre-visit plans and things like that, and we can make that so much smarter. Chris Hemphill: All right. Well, we appreciate everybody’s spinning one minute and 47 seconds additional with us. Again, this is going to be transcribed and recorded, so you’ll have the ability to access and read the conversation later. I’ve plugged to the next webinar that we’re doing. We’re really excited about that with James Gardner, going really deep into that big scary question about what this clash of Titans, Amazon, Google, their involvement in healthcare, what that’s going to mean for traditional providers. The recording will be available on our website or actually through the same link that you used to register here. The same link that you used to register will just take you to a direct recording and transcript. So, all that’s going to be packaged in one place, but again, we appreciate you spending time with us today, and look forward to seeing you in future conversations. Joe Schmid: Thanks, Ed. Thanks, Chris. Chris Hemphill: Thank you. Edward Marx: Thank you.

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