Health Innovators
Health Innovators

Episode 113 · 4 months ago

What’s happening in digital health w/ Dr. Joseph Kvedar


The digital health space is changing so fast, it can sometimes feel like your head is going to spin right off trying to keep track of what’s coming and going.

And with all those moving parts, if you’re not paying attention - and I mean close attention - you could miss out on some huge opportunities, or fall into some epic traps.

Dr. Joseph Kvedar has had his finger on the pulse of digital health and telehealth for over 30 years - so, when it comes to hyper shifting technology and business models, or even stalled out progress, he’s the man you want on your team.

That’s why I was thrilled when he agreed to come onto the show, again, and share his expertise and thoughts on all those moving parts.

Only this time, instead of discussing the possible changes to digital health and telehealth, we’re going to pick apart the massive shifts caused by COVID, and what those shifts may mean to the future of healthcare.

Here are the show highlights:

  • Looking at digital healthcare through the eyes of patients or caregivers. (9:52)
  • Who’s at risk of being the next Kodak? (12:45)
  • Successful healthcare disruptors will want to do this (15:39)
  • Which healthcare innovations are further along than others (22:04)
  • The risks and rewards of AI (24:25)
  • The fastest growing trend of entrepreneurship (33:31) 

Guest Bio

Joseph C. Kvedar, MD is a practicing dermatologist, Chairman of the Board at the ATA, Editor at the npj Digital Medicine, a senior advisor at Harvard Medical School and an advisor to many healthcare startups, and the author of two books, The Internet of Healthy Things and The New Mobile Age: How Technology Will Extend the Healthspan and Optimize the Lifespan.

If you have additional questions or insights you’d like to discuss with Dr. Kvedar, you can reach out to him on LinkedIn at Joe Kvedar, Twitter at @jkvedar, or by visiting

You are listening to health innovators, a podcast and video show about the leaders, influencers and early adopters who are shaping the future of healthcare. I'm your host, Dr Roxy Mooney. I have a very special episode for you all. Today I'm sitting down with Dr Joseph Cavator, a man who I am very fond of and have a lot of admiration for. Most of you know Dr Cavator, but if you don't, here's a quick overview. He's a practicing dermatologist, a senior advisor at Harvard Medical School and an advisor to many, many healthcare startups. He's an editor for the Journal of Digital Medicine and he's authored two books, the Internet of healthy things and the new mobile age, how technology will extend the health span and optimize the lifespan. It's a true honor to have him on the show again. So, without further ADO, here's my interview with Dr Cavator. Welcome to the show. Hey, thank you, roxy's. I'm so delighted to be with you today. Yeah, so, so much has changed and healthcare and connected health and digital health since we first met, probably about seven years ago. Yeah, re markable. It really is incredible and I think the last time we spoke we were talking about we were probably hypothesizing on how the pandemic would affect digital health. And so maybe just kind of start off by sharing with our audience, you know, what's new, what's from your perspective, what's new and what's what are some of the big trends happening in healthcare innovation these days? Well, new is relative, but but let's maybe maybe to choose our anchor point is as right around early twenty, just because I know one thing I'll talk about is tell a health and you know that's not new anymore, and that's good. I'm glad to hear that, because what I usually start off saying is it. I can mention to any patient in my office practice now, would you like to have your followup by Tele a health, and they know what I'm talking about and that's amazing and it just I don't take that for granted at all. So the words out there. We know what it means. It's part of a lexicon. Everyone's almost everyone's experienced it. That's by no means a tree. It creates a floor, it's not a ceiling and frankly, it's not that innovative, because all we've done is taken what you and I might do in the office and moved it to a video. Mean, if Amazon did that, think about how unsuccessful they would have done then. So so we had a long way to go, but but we have a conversation now and I think the reason that there's been so much up draft in the space is because people of all walks of life now sense that that innovation is possible right. They can see the vision of Oh well, yeah, we could do this virtually and having all those virtual visits beget the enthusiasm, for instance, for virtual first primary care. It's just a huge thing now and and threatening, you know, the businesses of major health systems all of the country, and again in a good way, because we have to up our game. And so that's another innovation that's really exciting to watch. Lots going on in the remote patient monitoring space because there's new reimbursement codes, and not just for sort of the old fashioned devices like weight scales and blood pressure cuffs, although they're certainly growing, but some software as a server tools for things like muscul skill and respiratory now being reimbursed through that process. So those...

...are a few highlights. Home testing going bonkers again because, because when you take advantage of having a virtual interaction with your doctor, wouldn't it be nice to go to the lab? Well, that's coming your way, home devices so that you can do more, collect more data for that doctor, so that she doesn't have to say, well, Roxy, you got a sore throat, but we need to bring in because I can't see the back of your throat. Right, right, you really need to listen to your lungs. Right. We have tools now that that kind of thing can be done on the spot. So lots going on. Those are some of the highlights. So is that you know from your perspective? Is that a lot of talk? Is it? Is it a lot of, you know, new entrants into the market? Are we starting to have some type of penetration, market penetration over the last year and a half or two years, or we really just scratching the surface in some of those areas well? I think in digital medicine is always a lot of hype. That's one of the challenges that we face as that for some reason people feel compelled to to overstate their outcomes. So that's just always there and it's one of my grain of salt, you know, commentaries for folks. But with caveat, there is a lot happen and it's both partly because, as I said, this environment of whether you call it on me, channel healthcare delivery or hybrid or Yep, these days tell them medicine is now about four to five percent of healthcare claims, whereas in the early part of two thousand and nineteen it was zero one nine percent of healthcare claims. So more than almost a hundredfold more, you know, and and that may or may not be the right Amout, but it's there in that and so people just have now this sense that they don't have to travel somewhere to get something done, and with that there's more money coming from. This coincides with a, I think, historic time for having a lot of cash out there looking for investments. So if you're a founding CEO, it's I think you tell me, because you're you're involved, maybe a lot more than I am in this, but it seems like it's easier than ever to get founding capital and fair amount of it, and that's because you do. There's always a group that's still struggling. Sure, maybe there's a reason why they're struggling. Work to be done on their business model, maybe, yeah, but I but then I see so yeah, so I think the venture capital industry is pouring a lot in. There's a lot of MNA going on, as you know. So, yes, there's a lot and it I'll just come back to, not not to beat a dead horse, but virtual first, primary care, Amazon, CVS, best buy, United Health Group. Often they're all launching these products. For most of them the premium cost for the end user is less, HMM, and the service is more like being Amazon than a corner book store. So what's not to like about that? Right? So, yeah, you know, really really starting to see some transformation and healthcare as opposed to you know. So I think that there's probably still a lot of hype and probably always will be to certain degree. But you know, I think one of the biggest things that we talked about as one of the big pain points, and probably still is to certain degree, was just adoption. And I don't think we struggle with adoption to the same degree that we did two years ago. No, no, no, and so I mentioned a couple times now patients or I forget which...

...when I was a kid that was a I forget what lays potato gives. Maybe try it priamial, like them something. But people have had an experience with this. Now. Yeah, and I do might tell a health clinic on Tuesday afternoons and at least one per week. Someone says to me, you mean, that's it, I don't have to that's all I have to do. And their thrill accomplish whatever it is that they needed without them leaving their home like it's like well, and it just sinks in. So they are peoples. They've had that. They want more of it, and so that's going to lead to transformational change on the patient side. On the doctor side, we still have a bell shape curve. Yeah, and there's still are people who are I often mentioned, you know, there were so many, not so many, but a bunch of doctors retired. They didn't want to use electronic records. I just said I'm done. Yep. So people that are aging out will look at this and say I'm done. That's fine, but for the most of ourt most of the physicians had more tell oath experience. They figured out things that they could do that were relevant to their practice. As long as there's an income stream they'll continue to do it. So yeah, yeah, there's a lot and as I said that there's all these adjacencies, whether it's the home testing adjacency, the home devices, other things, different kinds of software that enable the processes. Those people are all going to make money alongside the transformation, you know. So as a physician or as a health system that's just being bombarded by all of these innovations, all these widgets, you know, you know a thousand things that are going to save you time and improve outcomes and improve the patient experience. How in the world do you keep up with all of it? What's that? You're going to ask a different question about how we make choices, but keeping up with it is impossible, and you just I mean I'm on one of the hats I wears. I'm an editor at mature digital medicine, editor in chief, so I get to see. It's not quite the same because that's all really early stage research, but it does at least give me a window into what is going on in the very early stage innovation in terms of the startup world. I just do as much as I can. I'm on some boards and advising and read a few newsletters and talk to people like you. I mean it's just it's a constant goal of trying to keep up because there's no easy way around it. So so I've been in the industry for a while. Haven't been in in the industry as long as you, but you know, I've had hundreds of conversations with so many incredible people on the show and I still haven't found this one thing that I'm looking for. So I'm a caregiver for my ninety three years, soon toobe ninety three year old grandmother and you know, you've rattled off all of the innovations of you know wearables and you know digital medicine and tell a health and you know virtual care at home, remote patient monitoring. And I'm looking for the Digital Health Amazon where I'm to sort through Amazon to find it, where I can just go in and go, okay, this is what's going on with my grandmother. What tools can I buy, purchase and bring home to optimize her care? And I'm really frustrated because I feel like if anyone should know that, it would be me because I'm so immersed in the industry. But I still don't even know where to begin because I don't know what are all? What all are the rarebles that we have to choose from and all of the different devices, which kind of goes back to where your thought I was going to ask you. The question is choices. It's I'm where's the store, whether it's a digital store or physical store, for me to be able to be exposed to all...

...the choices and figure out what I need, especially as a caregiver? Yeah, that's a really thoughtful question. We tend to list we kind of view the answer to that question to the lens of either a health system executive or a health provider, but sadly not enough throw the patient, of the caregiver so so that that's a real need that you're defining. I mean there are, for instance, there's a firm in the UK called or co, or Ceja that does APP libraries. HMM, you know, they're a couple of examples out there people that are trying to curate, but you're right, it should be just as easy as going to Doncom and searching. I agree with it doesn't exist. Maybe maybe the reason it doesn't exist as there there are many people in your shoes, but there aren't many who would put their own money and they're waiting for insurance to pay for things, and could be that tense tends to hold up, I think some business models. I had heard at one point years ago that best buy was considering, you know, throwing out all their geek squads and and you know, making these health, health kiosks, if you will. Yeah, really excited about that, but I think that they change their strategy. Yeah, that's a company that you you know, always is in the headlines of the next thing they're going to do and then often it doesn't get the right right. So I've got an interesting question, or at least I think it's an interesting question. So blockbuster and Kodak are just these classic examples of these behemoth companies where the writing was on the wall. All the big trends were there and they just completely ignored it. Right and in it was there. It was their demise. And in who? Maybe you don't, maybe you don't have to name any brands, but who are the peat the brands or the companies that are at greatest risk of being the next blockbuster and Kodak, because they're still ignoring what's happening and thinking kind of holding tight to their all traditional or old business model and and not moving fast enough to leverage the trends that are happening today. I think it's the hospital systems for sure, and and I appreciate their dilemma, and I mentioned that because I'm part of one, so I have an inside view and I appreciate the dilemma. So it starts with the uncertain reimbursement future for just tell the medicine, but digital health. Learn if I'm a hospital executive, and remember we go on with like on three percent margins and we're mostly on profits. So, Yep, dollars are precious. So far. Ask A CFFO if you'd rather buy a m Mari magnet or invest in telehealth. They look at that and they say, well, the MRI magnet people are going to eat m our eyes. I can amortize. It's easy the tell a health. Well, we don't know when the public health emergency is going to end. One of the private payers going to do to the doctors like it, and that's our it's too much thinking. Let's buy the magnet. So so there's there's that, and then they're on the other hand, as we mentioned now a couple times, there are all these innovative companies that are coming in to basically eat our lunch. Yeah, so the fear that I have is that the hospital will end up being a place where you can get an emergency room, operating room or an ICEEU bed, which is a really small footprint, and then the rest of the stuff will be decentralized in a network and you'll get it through again through an Amazon or through a one medical or firefly, or pick your favorite example. And that show they'll contract was...

...with cup, you know, like my mass general where I work. Yeah, for thank those things, for the ICEEU, the emergency room, etcetera. That's a pretty weird view of the future of healthcare, but I think it's a possibility. I do too, probably more than any of US realize or one admit pretty fast. So so who do you think are the biggest disruptors? And maybe it's equal, but you know, are should we be more concerned about the apples, facebook Amazons, or more of the you know, hundred thousand mom pop startups that are out there right now? Well, concerned is an interesting turn of phrase. I think of the ones you mentioned and all of them, I think Amazon has the biggest chance of being successful in healthcare. Because they're relentless focus on the customer and in my own experience as a doctor, whether it's in the office or online or I find that when I take care of people, and I mean that exactly what I said, that they like that they're you know, people want to be cared for and Amazon will do that. So I can't say whether facebook will be successful in the space or, you know, others, but yeah, you know, apart from that, I think the the startups and and and I would you know there's certain categories that I think are more likely to be disruptive than others, and a lot of it has to do with the real and this is going to take a few years, but they're real mix between having software interact with you and having a human being and went to make that position. So if I often will remind people that I'm not particularly good futurist, but I interact with all their services beyond healthcare, and there ten years ahead of us. So it's easy to make some predictions right. And so if you now need something on a website customer service of some sort, you will almost always interact with the bought first. Yep, the ones that do a good job can sense if you are. You really need a human being and they'll get you to one. MMM, the ones that don't do a good job. You feel trapped in this nonsense with a body nine and ninety nine. Can I speak to a human please. You know, we've all had the experience and and I won't name names, but certain companies are known for this. Yeah, if we don't do that right in healthcare will fail. But we have the opportunity for it's not just virtual first, but it's really software first. MM. So, when you need when you need something that has to do with your health, Roxy You now? I don't think. Maybe you do, because you're pretty far out of the curve, but most of us don't immediately go to our mobile device as a first choice. Right, everything else you do. Yeah, yeah, right, you're more you're more likely to call my office, leave a voicemail, someone calls you back. I mean, how twenty a century is that right? So we've got to make that leap that you're comfortable picking up your phone and saying I need x from my healthcare provider and start working with in that. And then again you're going to get an APP or, sorry, software symptom checker or chat bought. Yeah, fine, right, if you really need a person, it should sense that and get you to a human being. And then again escalated up all the way to God forbid, you need to go to the Er, you need to go in right away. So funny. Thank you. That's the journey will be on. Yeah, because actually, not too long ago I had a very, very minor health condition and I did not pick up my phone to look for a provider, but I picked up my phone...

...first thing to get some answers, right from Dr Google. Yeah, the Dr Google thought, but good our rex, everyone here at brilliant marketing right, so that it was a piece of content to answer the questions that I had. But the content led to an ad that said, Hey, if you've got this issue, you can get your prescription today without leaving your house. And I was like that sounds like a plan. And so I ended up doing, and I don't know if you would even call it a tele a health visit because I never got on camera. It's I mean it was literally the chat bought. I answered, yeah, yeah, answered some questions and then I did a text with a physician or nurse practitioner and you know, they just made sure a you know, just verified and confirmed a couple of things. So within about twenty five minutes I picked up my phone to Google a question, but I'd all already had my doctor's visit and my prescription that I could have either had delivered at my house or picked up, and I just chose a wonderful story, great story, and and I know good our acts there there on their medical a biased reboard. I know them quite well. Yeah, but I think the other thing that's important about your story to just sort of emphasize is is that what we at the ATA would call it a synchronous tell a health where you're filling out forms or what have you and you're getting responses, and I don't know what enage of it is. I should but I don't. This some percentage of healthcare that is really, as you describe, quite algorithmic in nature. I need x, maybe it's a you're an attract infection or birth control, or there's a variety of services that are just yeah, you know, patients come to me all the time. I just need my medory filled doctor, right, feel like right. But so for that slice of healthcare, filling out a form and tracing lot and and as you say everyone's happy and then they'll deliver it by drone. Right. So I was like this doctor's visit I've ever had. But now, to contrast that, if you were worried about something really, really serious and it was complicated and Yep, you would feel you wouldn't want interrect of the box completely one hundred. So so that's why I say we, that's we need to thread that needle in a way that makes you feel cared for. The experience you had, you felt cared for because, again, you knew what you needed pretty much, you got it. It was straightforward. But again, if it was Ambi, if us, and you were worried about, God forbid, your life, for your health, you want to person completely, one hundred percent. Yeah, Hey, it's Dr Roxy here with a quick break from the conversation. Are you trying to figure out what moves you need to make to survive and thrive in the new covid economy? I want every health innovator to find their most viable and profitable pivot strategy, which is why I created the covid proof your business pivot kit. The pivot kit is a step by step framework that helps you find your best pivot strategy. It walks you through six categories you need to examine for a three hundred and sixty degree view of your business. I call them the six critical pivot lenses. As you make your way through this comprehensive kit, you'll be armed with the tools, tips and strategies you need to make sure you can pivot with speed without missing out on critical details and opportunities. Learn more at legacy and DNACOM backslash kit. So you mentioned categories and and I kind of wanted to get your perspective on that because there are so many different segments or categories within, you know, healthcare innovation. So which one of those are maybe...

...further along then maybe some others? Tell a health I think definitely is one of them. Yeah, but we'll put that one aside. Is that that's like an almost like being a dead horse. Yea, well, I you know, it's funny because I spent almost thirty years predicting things that were took longer than I predicted. So there's a there's a point in your I would just say, you know, throw a little Kudo's you away. You're an expert at disruptive innovation, so you probably have a better sense of when some of these things are going to get the top of the Gardener hipe cycle or whatever analogy you want. Yep, but I think home testing is really ready for its coming out party. So that's one that I just so it's it's like simmering water. It's about to boil. Yeah, and I just hear about it all the time all over the place. And again, covid helped a lot because everyone wants home testing for Covid, but that's just one use case, right, right, I think my contrast, I think the home device is when is harder. You know, when I was a kid growing up in the early S, if we got sick, my mom would pull out the mercury thermometer, right, just always take a temperature. Yep, and I mentioned that story because we need to make like the tidal care device, the Mercury for mom. Everyone has one. It's in them and I don't know how we do that, right, do there's your health plan finance them? You just have to go out and cough up to cash yourself. We, I'm sure we bought our homeworkery thermometer and we never thought twice about it. Right. How consumers aren't ready to invest in those kinds of home devices. Yeah, so that home device thing is getting tremendous power, but it's still sort of stuck in limbo. MMM. So those are two examples of one that's a little more farther along than another, I think. So let's talk about Ai. What are the risks and rewards of AI? What should we be mindful of and what should we be really excited about? Well, first thing to say is it's not magic. It is the idea that you have large data sets, very large data sets, and these days there are everyone has a lot of data about everything, right, so that that's just too much data, maybe. I mean there's a lot. So then the second is you apply computer to it and the computer will pull out trends, and that's phase two. When? So there are these these algorithms. Yes, there's algorithm innovation, but a lot of them are just off the shelf. Right, you pull them off of a place called GITHUB and put them on a database and see what happens and we find out that it's the same the same way that ten or fifteen years ago it was novel and Amazon could predict what books you want, or at Flix could predict what movies you want right. So that's that's quite at its core. That's what a I does. So apply that to healthcare and there are many different applications. But if I as a doctor, you know someone come in to me, I'm a dermatologist with a really puzzling rash and it would be great to have the computer say, okay, of Tenzero people around the world just like this, this is what happened, and a I could do that for me. But the downside's there's a couple of downsides. Will probably many, but want a couple of highlight. One is the they're all the computers only as good as the day feed into it. There's a wonderful, amusing blog called AI weirdness hmm, and the woman who's written at her name is Jenel Shane. She's...

...also written a book and she does things like trained algorithm. Like she trained an algorithm to use pickup lines in a bar and the stuff that comes out is just it's just crazy and it's stilly and the computer doesn't have any of that knowledge. Right. It's Alwaly as good as one. And she has wonderful like she trent trained an algorithm. Put she had people Um to try trying to train the album to recognize dogs versus cats, and it turns out that most people hold their cats. So the album fought arms were cats. It's that's you know. You have to understand that about computers. They are not smart at all. HMM. And so that means that this idea of bias creeps in right you. You take a database that's all about white people. I mean there's a famous woman, I think she's faculty at might now, but she did this Ted talk and she's a Grad student how she wanted to study facial recognition and the software would not recognize her face because she was coming. Wow. So that's that's the problem with a eyes. We really don't and so that the latest sort of phrase is called explainability. We hear. You hear about that a lot. It's like people now. They don't just publish their outcomes of how predictive the Algorithm is, but they have to do something to explain a little bit about how and why it works. MMM. So it's a journey. Fascinating is this isn't really a healthcare situation, but it just really was kind of like a lightbulb going off for me. I Love Tick Tock like on doing my favorite favorite program and I just came across this video the other day and it's probably a probably a three or four year old little kid. You can't even see the kid's under the blankets. What, of course, with its device and it is having a full on conversation with Sirie as if Sirie is their friend or person. And so it's like come on, Sirie, you know, put my game or my show back on, and in the kid gets frustrated and so kind of has an attitude with Sirie, Siri says something back and then the kids apologizing to Sirie. I mean it's just and I just thought, wow, how remarkable that that generation is growing up having conversations with computers. They are human being, right. Yeah, I mean I think you're and you're you know that. The Nice thing about that story, or more than just a musing I guess, is that is thirty years out we will be doing that. Yeah, when they're when they're, you know, young adults, they will be doing exactly them. Yeah, definitely. So I just want to talk about another trend, is the just an aging trend with the population. So we've been talking for a long time now about you know the growing boomer population and you know there's a couple of different things that are happening with, you know, the sixty plus, the gray market right, getting bigger and bigger and bigger, and you know the trends of millennials not having as many babies. So there's a lot of conversation of WHO's taking care of those folks and and so how, you know, from your perspective, you know, for all of the innovators that are listening and watching the show, you know, what are just some of the things that come to mind with this aging trend and man kind of marrying that trend with like some of the trends in healthcare. Yeah, so that it's fun to talk about. This is really was the subject matter of this book that I wrote five years ago now, right, the new mobile age, I think you were helping me promoted at one. Yeah.

So a couple things. One is is that you you, you. I'll just underscore because you really hit the nail on the head. We are literally literally running out of young people that take care of old people. It's a fact and it's not news. That's been happening since about two thousand and ten. Yeah, the demand for as we get older, we all need more healthcare services. It's just a fact. Even very healthy fit you just have more touches to the system. You just do. And so the demand for healthcare services continues to to skyrocket relative to the supply of people who can provide those services. And the only way out. This is how it ties back to what we were just talking about. The only way out is to automate some of them. And so the reason that we talked not the reason, but one of the things that could be very exciting about this vision of talking to Syri or having a botby your first interaction is if, or even even probably more or less what you did with your story about getting something done in twenty five minutes. Most of that was not it was it was efficient for the provider right. They had very little to do. They could spread themselves across many more people with your need then they could if they saw you in the office. So everyone works wins out. So the more we ought to be made the more we use what I call one too many care models. Yeah, the more we enable, you know from in employee software, Sim check symptom checkers, bonds, etc. And the things like remote monitoring or homebase services. That's where we need to head for that. And then the other half of it's it's not the other half. There's many, many nuances to this interesting topic you brought up. But another thing that I was like to point out is I just actually the other day turned sixty five. So now this is me actually part of the club. Yeah, exactly. Like I'm waiting for all those old timer discounts to rolls. Not much has happened. But anyway, the notion that we and I'm in nowhere near retirement mentally. So that's again that's just interesting. But we don't really know what to do with people when they get older. That's a society we kind of don't know with. So it that that comes as again, people like me. So so far I'm not like breaking China and ruining things, but at some point maybe my my brain will be far ahead of my abilities and some will have to come to me and say maybe, you know, there's that, or there's the whole death and dying part of it. That's enormously challenging. How we handle those last few days of life. Yeah, so those are, I think, really important challenges and again for your audience, any anything? I just mentioned in the last few minutes is is right for any kind of entrepreneurship and innovation, because there were they're all broken, frankly. Yeah, you know, it's funny. I just read recently that the fastest growing segment for entrepreneurship is like the five thousand and sixty in us. Yeah, isn't that thing is that? Well, because people have a little bit more wisdom, I guess, after having made all their mistakes. I don't know, but well, they're just you know, what I was reading was that, you know, the quality of life for that age group today and tomorrow is just very different than, you know, years past, and so, you know, we're maybe expecting more, that that population is wanting to having more to give and we're open to receiving that from that. Yeah, yeah, exactly. We now just say it because, yeah, I mean I there's there's still a lot of ages, I'm for sure, but it's...

...getting better. I like to remind people that when social security was created and they decided that sixty five was the age you could get social security payments, the average life expectancy was sixty two. So, wow, I don't think I knew that right. So so think about it. So they, the government people, weren't this maybe stupid? They brought this thing together. Sounds Great. If you live that long, will give you a few bucks. And of course, every all people a small group. Now I with life expensing. We just took a dip because of other things, but it's in the late s etc. Yeah, I met with a friend the other day WHO's my age and then he said, well, I'm making my twenty year plan because my this longevity in my family and I figure I got another twenty years and at least and and if I think back to what I was doing when I was forty five and what's happened to me, and it's pretty exciting to think what might happen the next twenty year. So you have to have that kind of new point, I think, to tackle this thing, as opposed to saying having someone on Pat me on the head and say go pick play pickle ball, right, right, exactly. I mean I think that that applies to so many different people. But when you know what I know about you, is like you know you're the guy that's standing on the beach watch the waves and now you finally just seen the big Kahuna come out right you got. You want to ride this big Ahuna wave as long as you can. Yes, you're absolutely right. Right. Yeah, our time has come. Yeah, yeah, so, you know, as we kind of just start to wrap up here, I'd love to end on you're involved in so many different companies. Maybe this is an opportunity to give a shout out to some of those that you're a part of or maybe just some that you've observed and admired. But I'd love to just kind of hear from your perspective a few of those, either leaders or companies that are really just doing some incredible things and having a some real impact to communities into the ecosystem of healthcare. Well, thank you for that and I I would say a couple things. One is that I tend to because people ask me what I care about or what's and I think in categories. So really the companies done I'm involved with all in a way strategic for me because I need to learn more about or I think something's going to be big. So I am involved with a Dermatology Computer Vision Company called piction health, using artificial intelligence to help primary care doctors to make better creosh decisions for for dermatal that's one fun one and and they're these are all early stage. Yeah, with one explained June mention the other. Another category that I really like is Aiy edriven beer. Change in health. So two companies that I'm working with. One is called Sweech, swetc. It's Israeli company and they have a what's called it in time at adaptive intervention rategy for chronic illness management that takes all these data streams in about you and then creates a facial environment to help movee to a healthier state. Likewise, another one that's earlier, stay just forming, just getting funded, called Julie Joli, based out of Switzerland. Similar concept, more applied to mental health than a couple of other things. So that category industry a lot. I'm always up for new devices. I'm advising. Another is really firm...

...that's doing wrist warm blood pressure check. If we could ever get blood pressure to be easier than pumping something up and that would be a big breakthrough. So I'm helping them where I can. Yeah, and then I'm on the board. That the the one that I'm working with. It has some level of scale. Is called mobile help and they have two main product lines. One is a personal emergency response units, so people can easily call an ambulance if they feel sick, and their other subsidiary as their remote monitoring subsidiary, called clear our shelth, where I'm involved as well, and that's more of a remote patient monitoring play. And they're they're big enough, they're private, equally own. They're big enough that they have some pretty significant scale. If anyone out there is is being advised by me, and I didn't mention you, I apologize, but I'm just setting the highlights. So he loves you, I promise he does. I also know that you are the president of the ATA and want to give you an opportunity to promote the upcoming events. Thank you. Thank you, Roxy. So we change that role to chairman of the board, and that the reason is when I originally saw this is my second time in the role, for whatever insanity that presents, but first time around two thousand and five ish, we had it was common for associations to have a president elected for a year or two and an executive director. And of course, nowadays you would appreciate this most. There's no more executive directors are they're rare. It's more CEOS. So with ATA, having put in a CEO just confused people. So we change that title to Chairman of the Board. But our upcoming annual meeting is in Boston this year. It's May one through three. It's really going to be I mean it's because they're so we're just starting, as you know, to do in person again. So by that time I'm sure the virus log we wait in. It'll be a fun I hope you can come. Yeah, we yeah, so that that's may one through three. The content. I'm helping with the content for that. It's going to be a fabulous program great networking, great opportunity for people to see what's in the vendor space and etc. So highly recommend that show. We do a policy conference in the fall. We just did early December last year, so that we will come up sometime in the fall. But the the ATA is special interest groups, is all kinds of ways we engage with people outside of those meetings. So if you're involved in, and I really mean this, if you're involved in tell a health of tell medicine, you must be part of it. We're advocating to move the industry forward. We have a huge policy emphasis. We just created a five, hundred and one, see six to do advocacy. So it's the organization is very much on the on the move and on the growth phase and it's exciting to be part of it. It's great. Well, it's always a pleasure to have you here with me. I always say we're going to do it more often and we just get so busy. So thank you. Yeah, harving out some time for us today. Thank you for having me and I look forward to promoting this and getting the word out as you as you are awesome. Thank you so much. Thank you so much for listening. I know you're busy working to bring your life changing innovation to market and I value your time and attention. To get the latest episodes on your mobile device, automatically subscribe to the show on your favorite podcast APP like apple podcast, spotify and stitcher. Thank you for listening and I appreciate everyone who shared the show with friends and colleagues. See You on the next episode of Health Innovators.

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