<div class="tagline">Full transcript</div>
[00:00:00] Liat: Welcome back to another episode of Patient Journey Pioneers. Today, we have Tom Bowen Wright, having previously led Baylor Scott and White's digital revolution, Tom is now helping pioneers in the space to reimagine healthcare. Tom, it's great to have you here.
[00:00:13] Tom: Nice to be here. Thank you.
[00:00:14] Liat: I feel like that intro totally justifies you being a guest on this podcast, as we'll be picking your brain on all things digital patient journeys. And before we jump into the questions let's backtrack for a sec. Your parents and grandparents were all medics and their expectation was that you'd follow their footsteps to become a doctor. Which didn't happen, but other things did. Tell us a bit more about that.
[00:00:34] Tom: Yeah, but if there's one thing about me it's, I'm extremely squeamish. So I can't, if you're thinking about a movie, I just can't watch any of those gory type things. And so you can imagine all that pressure to become a doctor. And I can't even look at an open wound. So that was a show stopper for. Medical career, but I did feel like caring for the sick was in my DNA. So luckily there's lots of ways to do that.
[00:01:07] Liat: Yeah. I also get extremely squeamish when I see the needles though. I totally feel you. Let's dive into the questions and, through that, we'll learn about your journey in healthcare. What is the most important thing you're working on today? When it comes to the digital patient experience?
[00:01:57] Tom: I think that just the general theme is around personalization. Super excited about that topic and there's lots of facets to that. So personalized interactions, how do we infuse that into our communication, even call centers, front desk, obviously the care team and the physicians, and that obviously really enhances relationships intimacy, which helps vulnerability, better conversations, better outcomes. But then going on that, is a personalized care plan. So really, being able to look at the whole person really understands the social determinants, the preferences, as well as the clinical markers.
For example, somebody who lives by themselves and you think about it, okay loneliness could be an issue. So how do I think about how to infuse those into a personalized care plan? And then really thinking outside of the office, now personalized navigation, and really helping people adhere to that care plan and navigate the systems and complexities. And then lastly, if you're doing that is really being able to personalize your products and actually starting to design healthcare products around individuals. So that's the general theme. I think it's a very exciting one. I think we're really in the early stages and there's just lots of opportunity there.
[00:03:20] Liat: What is an example you can share with us behind the scenes?
[00:03:25] Tom:Ooh, or that one area I think is very exciting if we think about personalized navigation. This is really like AI and gamification.
Can have an incredible impact. So if you just think about something very simple medication adherence, you can send reminder notes to somebody at the same time every day saying, take your meds and then they're gonna switch off that message like within days. And yet if you can start personalizing it and really start thinking about, okay, the right message, the right person through the right channel, right time.
We've seen examples where people have been on this sort of reminder system for three, four years, and they really appreciate it. And if you start to tick, reducing it, they're like, Hey, where are you going with it? So it just shows the power of AI to really move the needle in healthcare in ways we've never really thought of before.
And really aligning that digital with the physical and then empowering those care teams when you actually do need an intervention to take the right intervention at the right time. And so that's a very exciting little insight for those healthcare executives, leading digital patient journeys.
What are some challenges yourself facing that aren't being talked about enough? One big area that we're starting to see is that Tech technology alone is not going to do this. Like technology might make up 20% of the solution, but it's that other 80% that's so important. And it's hard, right?
That especially health systems are very conservative corporations. They've been, they've done really well by being very conservative for a long time. And that conservatism is deep rooted. It's in the culture it's reinforced. So if you're something coming in and saying we need to do transformation, you guys are doing it all wrong. Hey, here's a pretty cool new tech that can do it. We just need you to change your processes and change your behaviors. That game is lost already because you're trying to do something to the organization, not with the organization. So going from innovation to actual transformation, I think that is for me.
A big theme that people are realizing, gosh, we've gotta be investing in that. And there's different types of skills. You gotta think about leadership skills. You gotta think about change management skills and communication skills. And often these things have been under invested in places like health systems for a long time.
A great example for that. My, my favorite. Product right now. It's so simple. It's e-consult which is an asynchronous specialty consult. Very simple to say, simple to do, but to actually roll it out in your network, or you need all your primary care docs to start thinking about, oh, now if I have this type of question, instead of doing.
You have a referral to a specialist I'm actually going to, get in and write the question through an eConsult at the same time, you've gotta get all your specialists to, so they say, oh I've gotta think. And about answering these asynchronous messages and I've gotta do it in a timely fashion and how do I fit it into my flow?
And so you've gotta transform your whole ecosystem. So just think about it, there's a lot of technology in there, but there's a lot of process. There's a lot of behavior. There's reimbursement implications for a huge number of questions. So something very simple is actually enormously complicated to roll out scale.
But once again, if you can do that at scale, it's incredibly impactful, both for the patient as well as for the care.
[00:06:19] Liat: So you seem like you're doing it very well, creating change and innovation within the organization. What is one piece of advice you could give someone who is new and wants to implement a certain digital patient project ? What is your way of actually making it happen?
[00:06:35] Tom: So I've been at this game for a long time now. And quite honestly, if I look at the first few years, Very successful in innovating around healthcare, apps and websites and stuff, and very unsuccessful in innovating inside of healthcare, like doing transformation pieces. And one of the things, really had to learn about time was around a new innovation model, a transformation model.
And that idea of like, how do you partner with the business to drive change? And so that takes a lot of upfront thought, preparation structure, alignment. The alignment piece is so critical. Starting with their senior executives and getting a top down mandate, but taking the time to really lay out the future and like here's our destination and let's agree on the destination.
Agree on the problem statement. And then. Collectively let's work out how we get from current state to future state and let's do that together. And that the idea that innovation is a team sport is so powerful. And yeah it took a lot of. Getting it wrong to work out. Okay. We gotta do things really differently.
But hopefully that gives you some insight into the things you just over time have started working for us.
[00:08:00] Liat: Tom, we're gonna go from challenges to a fun little game to spice things up, and it's time to place your digital bet. It's gonna name a technology in healthcare. Can you tell me if it's bullish or bearish? Are you ready? I'm ready. All right. First one, Telehealth
[00:08:15] Tom: Bullish. And if you think about when video visits first came out, we were building this new technology and all this old architecture. And so it was really quite painful, but now as people are starting to get used to it. So if you think about my visit types and scheduling templates now, actually starting to redesign those specifically with the idea that consumers actually do want to consume often through video.
It's maybe a little less than we, we maybe had thought at first, like in primary care, maybe it's around 20% demand, but you design your infrastructure for that outcome. And I think we were all really struggling with that. And still many people are in, in the depths of that struggle right today.
But as people get through that and understand that it's gonna create more access and ease of. And I do think the consumer demand is there. So I just think about my allergist. I never wanna see my allergies again, love it a bit. She's great. I just don't need to be there in person. Just let's do it by video, but that's not an option today because of all the things I just mentioned. But so I'm pretty bullish at it, okay.
[00:09:27] Liat: Number two, wearables.
[00:09:30] Tom: Wearables. So wearables is a tricky one because, and once again, I think it depends on the category. So if you are thinking about a lot of those, the Fitbits of this world, I think people who want and enjoy those types of things have largely adopted them.
But then I think there's some, a lot of innovation around, if you think about diabetes management and some of the insulin patches, to the extent you can make these wearables almost in, I think that's powerful, suddenly it becomes so much more convenient for the consumer. And then lastly, I would say the mobile phone as a medical device.
I'm very bullish about that. I see lots and lots of opportunities. See a lot of innovation in that space. I just think it's gonna only grow.
[00:10:17] Liat: Okay. You're being very nice today. We have bullish two outta two, number three, conversational AI.
[00:10:25] Tom: Once again, I'm pretty bullish on conversational AI. I think it's a remarkable time.
And a lot of that, if you think about modernizing healthcare, we're going from an area where healthcare was largely episodic in how we consumed it. We go to the doctor and we go home. We do self care, six months, 12 months, whatever it is later we go back to the doctor. What now is care is moving to more, this longitudinal type approach that messaging the messaging and communication between the care team and the patient suddenly becomes really powerful and not.
You've heard me mention nudging and medication adherence. And so as messaging becomes a lot more prevalent, if you think that demand goes up suddenly. Are we gonna hire what 3 million care managers across, United States to go manage all these messages and look after?
No. They just don't exist. So the idea that AI can actually provide a lot of that bridge deflects about 90.5% or whatever it is of that messaging volume. That's really powerful so that we can create the access that the consumers want, but without the underlying costs, that relates to the more traditional approaches,
[00:11:44] Liat: second to last one, remote patient monitoring.
[00:11:46] Tom: I hate to do that. I'm actually very bullish. Cover away. So for the vendors in this space I think the reimbursement codes massively change things. Now. I think the reimbursement codes are actually very, quite generous in this space. Now it takes a few, a little while for people to work through them, design technologies and platforms.
I think that we're largely there. So now if you think, Hey, I'm a primary care doc and I've got a whole bunch of fees for service. Patients here. Now I can make an extra 10, $20,000 a year doing nothing like nothing. That's a pretty powerful thing as dogs kind of work that out. Like why am I not doing this now?
I would suggest that a lot of that RPM, it's designed for the coding and it's more optimized for the revenue than it maybe is for the outcomes, but as more and more people do it, we're gonna start learning a lot more about what types of messaging actually leads to the better outcomes.
But the other big force here is around direct contracting. And so now Medicare reimburses primary care docs directly for managing total cost of care. Then now we've got a beautiful alignment between, payer, patient and provider. And I question remote patient monitoring is a powerful force in reducing total cost of care.
And so that's where I see a lot of innovation happening. And once again, we get moving away from process metrics and more to like outcomes and also clinical outcomes. That, once again, I've seen some remarkable changes where you take a, mentioned medical medication adherence, a clinically non-adherent population, and then through remote monitoring.
Within six months that is like 95% plus adherent. And you've seen the total cost of care really coming down. H ONEC coming down, weight coming down. It's remarkable. So that is a space where I'm really jazzed. And I think we're gonna see some amazing outcome.
[00:13:57] Liat: Let's see if we get five outta five from you here. The last one is augmented reality.
[00:14:07] Tom: I would love to get excited by almost five outta five contrarians here. I think there's more hype than anything else. And just a little bit of context. I spent three years in my early twenties in 3d visualization, and I got a lot of scars for that time. . So I spoke to a few VCs recently and they're all excited about it, but I dunno, I, I just don't get it.
[00:14:36] Liat: So we're gonna go bearish on this one.
[00:14:38] Tom: I'm gonna be at that.
[00:14:40] Liat: All right. You were almost five outta five, but then right at the last minute. All right. that's okay. Experts gotta say what they feel. Alright Tom. So question number four. Now that we discussed some emerging technologies, what are some technologies that are on your wishlist when it comes to digital patient engagement?
What do you wish to see one day?
[00:14:56] Tom: Rather than reaching too far out in the future, I'm gonna play something in the area that's relevant to you around conversational AI. One of the challenges about delivering a great patient experience is suddenly patients start using a lot of these tools.
And one of the tools I mentioned is like this messaging tool and we've seen, I think it was a McKinsey number in the last couple of years. The use and adoption of Inba messaging has tripled. And I see my wife, she's just oh, I've got all these questions. So rather than calling, doing the traditional thing, let's call the call center.
Let's see where oh, I'm just gonna massage my doc. I get an answer back, but then 20, 30 minutes. Yeah, it's great for the consumer, but now suddenly that care team is suddenly removing a lot of that administrative burden. On to people who are already totally burnt out. And unless you can think proactively about how do we remove that burden from the care team?
Honestly, like in basket messaging will be the death of digital health, because there's just no time or the world takes on all that. I see a lot of innovation going on, on, on the website side, on the IVR side and the call center. I really wanna challenge people.
Productizing a front end to the in basket messaging that can really defer a lot of those burdens and remove it from the care team is also giving a like speed to answer. Yeah. It's great. Getting an answer back in half an hour. It's even better if you get an answer back in 10 seconds, right?
That's a, I'm gonna lay down the gauntlet for the industry there. Because you'll be solving multiple problems
[00:16:39] Liat: 10 years from now, Tom. How do you envision the hallway conversation taking place between two healthcare CIOs? What are they talking about?
[00:16:45] Tom: Oh gosh. The next few years it's around getting the foundations in place and then very quickly I think this personalization piece is going to take up to 10 years.
That's a lot. Of opportunity. So I think if you look at the pace, the areas really around aligning the incentives and the technology. And so it's this whole idea of payers fighting with providers and who owns the patient who gets to navigate the patient. I'm really hoping that will have been solved.
In the next 10 years. And so we can really start saying, oh, this specific type of patient, how do we truly deliver the best care experience that leads to the best outcomes? And once again that brings pharma into that as well. And so all the innovation players have their incentives truly aligned to.
To solve the problems for our communities. That's exciting. I think we can get there in 10 years.
[00:17:56] Liat: So Tom, as we wind down towards end of our interview, we'll go into some, just a few personal question. How do you envision your future self in healthcare specifically?
[00:18:06] Tom: Ooh. I tell you where I'm excited to play is the forefront of where payment innovation meets technology innovation.
Interesting. Interesting. And I'm, I. Really excited about, some of these new payment models come in, we're starting to see, payers give more conscientious providers, more risk. We're starting to see direct contracting or Medicare. I think finally, as we properly align incentives, it empowers all these new business models that in a fee for service world just don't work.
But in a truly value centered environment can be very powerful and great for the patient. And so that is where I want to be innovating myself.
[00:18:53] Liat: I hope to have you here in five years from now telling us some of your success stories. Who would you nominate as a future guest who was a trailblazer in the industry making an impact?
[00:19:04] Tom: Yeah, I do have somebody who he was one of my partners in crime, back at Baylor, a guy by the name of Dr. She and he is now in very he's taken on the chief digital officer role over Allegheny health network. In Pittsburgh. Great little system. And he is a great friend. We got to partner together on that eConsults rollout, where he was like the clinical lead and it was yeah, just a great experience. He is a very interesting character, a very charismatic leader. And I just think you would have a lot of fun with it. I wanna
[00:19:41] Liat: thank you so much for your insights. I really enjoyed this conversation with you.
[00:19:45] Tom: Oh, likewise. You take care. Thank you. Thanks.