Health Innovators
Health Innovators

Episode · 2 years ago

Telemedicine is here to stay. What to expect the day after w/ Joe Kvedar


After nearly 30 years of chasing a dream to connect technology and healthcare, when COVID-19 invaded our everyday lives, Dr. Joseph Kvedar witnessed more movement in his field of expertise over the last month than he has in years. But what does that really mean for the telemedicine industry?


Whether you’re an innovator new to the field or an established player in the telemedicine industry, you’re going to want to hear Dr. Kvedar’s take on how today’s pandemic has thrust telemedicine into the spotlight and how that momentum may play out as we inevitably move into a post-COVID economy.


In this episode, Dr. Kvedar discusses the impacts, implications, and possible outcomes healthcare and health innovator industries may experience due to covid, and offers his own insights and tips on:

  • Why telemedicine is taking hold right now and how the technology that enables telemedicine can reach further into our everyday lives via education, finance, and other industries
  • The past obstacles to the telemedicine industry and why/how that has changed within the COVID-19 economy
  • The challenges telemedicine may face post-covid and the importance of advocating for processes within the telemedicine industry that are being proven as beneficial 
  • Opportunities and challenges health innovators may face due to COVID-19
  • Tips and insights for telemedicine and health innovators as we move forward - and beyond - the current pandemic crisis


Guest Bio

Joseph C. Kvedar, MD is a professor of dermatology, Co-Chair on digital reimbursement for the AMA, incoming President of the American Telemedicine Association, and Editor in Chief for npj Digital Medicine. 


A 27-year believer in the idea that there could be a better model of health care delivery with the ability to provide care outside of a hospital or physician setting, Dr. Kvedar has had the privilege of leading the advance toward a more connected health experience while working at Partners Health.  


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, by email at, or by visiting

Welcome to Coiq, where you learn how health innovators maximize their success. I'm your host, Dr Roxy, founder of Legacy DNA and international bestselling author of how health innovators maximize market success. Through candid conversations with health innovators, earlier doctors and influencers, you'll learn how to bring your innovation from idea to start ups to market domination. And now let's jump into the latest episode of Coiq. Welcome back to the show coiq listeners. On today's episode, I am very excited to have Dr Joseph Cavador on with us again today. Welcome to the show. Hey, thanks, roxy, it's great to be with you and your listeners. Thank you. So, before we get started, I know that your roles have changed quite a bit over the last few months. So kind of give our listeners just a little beef brief background on your experience with connected health and then kind of touch on what are some of the new roles you're taking on these days. Well, thanks so much for asking. So I in the early s had a bit of an epiphany on a dermatologist by training, as you know, and at that time I was studying as a research project the role of digital imaging and dermatology and it fell into my consciousness, or lap, or however you want to say it, that we gosh, we were missing an opportunity to not have to always expect patients to come and see us in the office, that we could do things by technology, and I've chased that twenty something years ago, yeah, almost thirty wow, and it and I chase that, that dream ever since. And for about twenty five of those years I had the privilege of leading those efforts at partner Southcare, the delivery system I work in, which frankly, largely meant a lot of proof of concept work, a lot of working with innovative companies to help bring their products into the marketplace. We had a variety of things we did and then a couple of years ago, two folks around me, the senior executives and I, decided that it was time to scale and I probably wasn't the right leader to scale it, but I was much more comfortable on the front end. So I'm now an adviser to that process and it's going well and I'm on call for them when they need me. They pull me into various discussions from time to time, but what's taking up my time now, which is incredibly exciting for me, is this opportunity and it's it's three or four things that I'm doing. I'll I'll delineate them in a moment, but they all have what the common theme of influencing adoption at the national level, which is like a gift for me. So the the first one I've been doing for some time now, that this is our fourth year, but it's been very, very productive as co chairing the AMA's committee on digital reimbursement. A second one is working with the Association of American Medical Colleges to get telehealth baked into the training curriculum for medical students and residence so that people who come out of training have some facility with this tool set. Yep. The third one is incoming president of the American Tele Medicine Association. So that starts in just about a month. So that's a we're changing our by laws and it's probably going to be a two year commitment, so that'll be a lot of fun. And then the fourth is I just took on the role of editor in chief at Nature's Digital Medicine Journal, and that's about building the evidence base, which is of course important as well. So that's a portfolio of fun things. It does give me and they definitely overlap and people will call me about one and I refer them to the other. So it feels a great way for me to spend my time these days. So your board... what you're trying to say. You have nothing to do, nothing to do. Yeah, and all of it can be done from home, which is right, right, a fine. So, obviously we have this absolutely horrific global pandemic that is happening before our very eyes and that's really changed a lot of things for us. You and I spoke I think it was probably about seven or eight weeks ago when I first got the email from you where you were, you know, just letting your network know what were some of the new and exciting things on the horizon, and I remember being peppered in there was some of the things that you just mentioned about being dedicated to the adoption of tell a health, and we talked about having you on the show again and, you know, just really kind of for our listeners, kind of encapsulating what's this? What was the state of tell a health? And I can tell you that a lot of the things that I would have asked you and that we would have talked about seven weeks. Seven weeks ago are very different, and so you know, I wonder, I mean, obviously there's still a lot of work to do, but I wonder how the covid crisis has served, in the silver lining of this, as a catalyst. And so I envisioned that you probably were thinking that this new mission of, you know, national adoption of telehealth and, you know, all things digital, would take you five, seven years to kind of start to make some progress. Do you feel like your missions accomplished? Already know, but but you're right, and you're a marketing person, so you know the value of getting a word into the lexicon, and the word tell health is now in the lexicon in the US and that that is extraordinary, that it just can't be said enough. How that what seems to be little thing. I I mean I don't have to go to and never have to go to a cocktail party again. When we start to go to them again and tell people what that is, they will know and and that alone is has been huge. But it is those of us that are evangelists or leaders or whatever term you want. It is ours to lose now. Yeah, we can lose it, and you and I can talk more about that if you like. But no, it's been extraordinary and and for good reason. Not Not that I would have ever invented this awful, awful, awful crisis, but the fact that people, and it's interesting to the other thing I'll just quickly mentioned, is it's not just our industry. I hear little ads on the radio for financial planners saying we can do it by video conferencing. So, yeah, everyone's sort of coming around to the fact that these tools exist. We again, we still have it's you said, what it takes five to seven years. Are we done? We're not done, but it's a different, different set of deliverables now than we had for sure two months ago. So, you know, let's talk about that. You know, in my mind there were, you know, in you probably have a much deeper and broader perspective than I do, but in my mind they were three things that were kind of acting as obstacles to tell a health adoption, and one of them was, you know, legislature and regulatory you know, just physicians saying that, you know, I want to see my patients in person, and patients saying that they wanted to see their doctors in person, and a lot of that has changed. So just kind of update us from your perspective. How has those three things changed? And in some fashion? Well, the legal the easiest one to talk about as illegal and regulatory piece. And so the the government. Now, I can't speak to everyone's all fifty states. It's it's state by state. Things doing be different, but the federal government is now paying us at equal value of an office visit to do a phone visit,... do something that we would call it a synchronous visit, meaning you send me some information over the patient portal and I report back to you, or a video visit. So Medicare went that way. The Governor of Massachusetts demanded at all pairs do the same. That was about three weeks ago. So so there's all of that, which is for the most part and and again I'm so pleased. Most most times I'm proud of my profession and this is one of those times. Most doctors that aren't on the front lines are happily taking care of the patients and whatever way they can and we'll figure out the building later, right. But Yep, we have we have the green light to do this. One of the things you and I might want to talk about is whether that will stick and how much of it will stick. So maybe we'll come back to that. But the other parts I think you're race are really fast out. I should mention, sorry before I go on, is that state ledged licensure laws are also loosening up in most states, not all, and in many states governors have said, you know what, we're going to not worry about that. And then the third piece that bears mentioning is the end it in. People will want to know about this, but the use of tools like facetime and skype is now allowed, which it wasn't. It's some time ago, and the reason that that's worth mentioning, excuse me, is two fold. One is that it does make it so much easier for you and I to have any kind of interaction because we can choose the platform that suits us both. We don't have to make you sign up for something in download something. If you've already got facetime, you can use it. But the other part that comes up, and I want to just address this again. We can come back to any of this, but I want to address this as the privacy side all this talk about zoom bombing and so forth, it turns out that for a healthcare interaction, it is extraordinarily rare that you would have your video hacked. Yeah, the the the the part that we're still doing, and of course we care a lot about a privacy, but the part that we're still doing in the way we always did is recording it in electronic record and that's very secure. So anyway, just to recap those, those three things that their new reimbursement lap relaxed reimbursement restrictions, relax licensure restrictions and relax technology restriction. So that just helps everyone not think too hard about it and loose reduces friction, as they say in the industry. Yeah, so our company is virtual and has been for day one. So we've kind of in a lot of ways we're operating business as usual and I've used zoom. That's just been our, you know, tool of choice for at least five to seven years, probably about eight hours a day. And I'm not saying it doesn't happen, but I've never had anything happen. You know, maybe a little unstable Internet connection here and there, but nothing like you know, what you're hearing about with the zoom bombing. So just to finish that one off and not not to again, I want to make sure that I don't that nobody who's listening to US thinks that. I take it's slightly known in the industry takes privacy likely. We take it incredibly seriously. Yep, but when you have something like an a meeting and you publicize on facebook the link, that means anyone can dial in. That's that's really not hacking. That's just someone saw the link and they were nefarious in their intent. That's that's really not acking. So just just want to turn to put a good face on that. Yeah, that's important. When you talk about pay patients wanting to see doctor in person and doctors want to see patients in person. That's those are really insightful comments in your part. It...

...speaks to the sociology of our culture. It speaks to our industry and I would say a few things about that. One is that no one that I know of is suggesting that the office physic go away anytime soon, that the facetoface interaction with a doctor disappears after this is all over. And I think one of the things again, we could come back to is what what is the what is the likelihood that will all this tell a health will just phase out? Right, we can. We can come back to that. What it will all the all those restrictions get restricted again? Yeah, but with that caveat, people are the answer to your question is people are finding out, and that's mostly doctors. I have to say. Most patients are pretty comfortable with this tool, but a lot of doctors are finding out that you can conduct care this way. Not all care. Right, it has to be high quality. We can't be sloppy. We can't say, oh well, it's kind of like you have a sore throat there, maybe we'll give you some zpack. We can't. We can't mess up. But so much of and what I've asked doctors to do when we talk about this, as I've said, think about and that this. Patients can do the same. But it's just as a doctor, you kind of know what information you need to make a decision. Think about those interactions you had with patients where you didn't need to touch the patient. Uh Huh. Sometimes we touch people because it's part of our therapeutic armentary. Right. And again, that's great, and we mustn't want, we mustn't suggest that that goes away. But there are a lot of times and a lot of examples where it's really mostly about talking mental health. Of course, can all be done this way and and check, you know, like reviewing a lab test. So many of the conditions that we treat our related to lifestyle. High Blood Pressure, obesity, hype, diabetes, those can all be checked and with with sensors remotely and reported out. So a lot of stuff we can do. We don't do procedures. Right, yeah, probably won't in my lifetime, but and you think about it, it's really what I think is most exciting about this, to just finish off your long winded answer to your question, is that it's required people to think differently. Yeah, we used to ask them to think differently. I got up in front of somebody audiences in the twenty seven years I've been doing it. And so please, just think differently. Just think differently and people would go off and they and doctors rightfully go back to a waiting room full of patients and a sixmonth Lait. Why do they need to think differently? Right, right, this is force them to and I dare say we won't go back all the way to just facetoface. I'm almost certain of that. You know how far back and what of those are worth talking about, but we won't go back all the FACETO place. Yeah, yeah, I definitely agree. I think. I think that from what I'm hearing, anyone in my circle, and these are not physicians, these are, you know, more friends and family that have had no virtual visits and some former fashion over the last few weeks, they love it and and they're like it was so convenient, it was so easy, and again it's kind of like that's what you've been saying for twenty seven years. Well, we have a nice, I think, analogy. There's a program we've been doing for a couple years out of partners where I work, called partner so affterre on demand. It's a virtual urgent care program again, existed long before the virus and for for a smallest of things. What Sore Throatier, a UN complicated...

...arnary tract infection? There's a list of about a dozen things. We can get you a doctor on the phone on the video within about five minutes and eighty percent of the time your problem gets answered. What's not to like about that? Right. It's so again, I think, of course, there will always be, probably always be, some patients who just want to come in. Yep, it should be able to and we shouldn't. I mean again, in this time, this crisis, we can't. But in general we should just bring them in. Right. There's nothing wrong with that. I enjoy seeing people in the office. Never never faltered on that. But there's going to be a whole bunch more who were like just what you said, like man, give me the convenience. Hmmm yeah, well, after that. So from an adoption standpoint, you know, I'm curious your perspective when we think about the technology adoption curve and how that market is typically sliced right the innovators, early adopters, early majority, late majority. You know, it seems as though that for years we have still been teetering in this innovator, early adoptor market and we really hadn't crossed that threshold, cross that chasm into the early or late majority market. And it seems as though that the unfortunate circumstance of the virus has been the catalyst to help cross the chasm. I agree, push a really large segment of to the market into adoption and I think, to your point, I think that there's going to be beside the lacquards, I think there's going to a lot of people that are going to be like, yeah, this is great. Why did we do this before? Yeah, yeah, no, I think we have. We've moved in my opinion. I used to say we were somewhere between early a doctrine early majority for years and I think how pushed over again sat said that it took a crisis to do it, but never waste a good crisis, I guess so. Right, right, exactly. That's a great quote. So let's talk about what's temporary versus permanent. And you know, it can be through the lens of Tell Ahalth, but it can also be through the Lens of, you know, any type of virtual care or remote monitoring or anything like that. You know, we're definitely seeing a increase in adoption and a lot of those different areas or sub areas within digital health. You know, what do you think is going to stick and and what do we need to do as an industry to help facilitate that more permanence once this is behind us, because we all know this, we will get past this. Right what no win but we know this will be behind us, and so I wonder if there's anything that we need to do now, kind of as a health innovation consortium, to try to assist that so we don't just really unwind everything that we kind of accomplished during this window from an adopt standpoint. Well, it's that's this. That could be a whole nother show. So we'll see if you think. I think so. Organizations. I mentioned that I'm incoming President of American telementic and Association. Organizations like that have the platform to help bring together providers, vendors, policy makers, etcetera, and really speak with a common voice, and we're doing that now. It's going quite well. We've just had a very weak for instance, we're in the conversations directly with the White House Task Force. We've been very, I think, effective, our policy people have in getting some of these things done quickly. So,...

...not not to sound self serving, but joint join the ATA because that's a really good organization to help move this stuff forward. We think we have a unique opportunity there. But but also whatever capacity you as a participant in the ecosystem, have to lobby your congressman, to speak to your senator, to talk to your local health plans. One of the things that I really want to see, and you mentioned. I'm so thankful to hear you say that your family and friends are pleased with their service level. I worry that, because we're bringing so many new people on both sides of the platform, that will see service levels suffer. Okay, so those those of you who had a good service level, tell your employer, tell your health plan. Yeah, you don't want this to go away. Employers listen to their employees, especially benefits people, and they in turn speak to health plan. So there's a very natural communication channel there. That's like lobbying the government, but on the private side. So I think people should be very vocal about that. And so again, I think our dangers zone here is that because we're being so many people on, as you point out, some of them reluctant, that that will see some dips. I mean it's great that your experience with zoom has been so positive. I think during this crisis all of the companies have had some lapses in their in their ability to get the technology to be perfect. So and all the telehealth providers. I just saw a piece yesterday. I think it was published on Friday and I was believe, as in beckers on, every single telehealth service providers seen a big spike in demand. Uh Huh, well, guess what? Their their networks don't grow exponentially overnight. So that means if you have something and you dial into one of them, tell health American well and belive, you might get a little longer wait, and that's, you know, unfortunate, but it is. It is because we're seeing this spike. So I think consumers, I'm telling everyone in the industry lean and hard to give everyone a good experience. Yeah, and and that they should feel cared for. It is health care, it's it's different. So if you're anywhere in that care provider or service provider ecosystem, just make sure the person feels cared for. You know, maybe they have to wait, maybe this, maybe that, but take go out of the way to care for them. That'll help. And then at the end of it people will say, like your family members, I don't want to go back and and so then they in turn have to go to the various payers and regulators and sort of say that hey, this is nonsense, we're not going back. Uh Huh, yeah, Yep, great wisdom and I think that, you know, to your point, really, no matter what role we have, we all have a role to play. We can some former fashion. Yeah, that makes sense and that's right, because what was once a sort of curiosity or people would say, yeah, you know, and I used again, I was saying this to off camera, that I look I'm giving a couple of virtual talks coming up and looking at my slides from six weeks ago, they all seem kind of me there. But there's things like saying that that we as an industry need to get to a point. This was a quote. I would say. We need to go to a point where this is like your stethoscope. It isn't something that you look... as a curiosity or option. Well, we've got to that point now, so now what? Right? So I think the idea is making sure that we perfect the triage points. A lot of people, for instance, here's an interesting, I think, analogy. A lot of people are, in at least I'm told anecdotally, hospital systems are implementing a lot of these chat bots on the front end, because so much of screening for this virus is very algorithmic in nature, and you can do that with software. So making sure when you implement something like that, that the person interacting with that software can get to a person right, that not trapping them in some God awful loop when you're like on, I want to meet do a human right right, and we can't. We can't do it that way. So it's thinking through things like that that we all think have a role that. And if we do that, if we band together and make it again it's healthcare, make it feel that way, then I think we have an enormous opportunity to success. Hey, it's Dr Roxy here with a quick break from the conversation. Do you want your innovation to succeed, to change lives, to shape the future of healthcare? I want that for every health innovator, which is why I invented Coyq and evidence based framework to take your innovation from an idea to start up to full market adoption. If you're not sure where you are in the commercialization process, take the free assessment now at Dr Roxycom. backslash score. Don't miss out on impacting more lives just because you have a low coiq score. The Free Assessment is at Dr Roxycom backslash score. That's Dr Roxiecom backslash score and now let's jump back into the conversation. So let's talk about, you know again just kind of the broader scope of connected health, digital health, remote monitoring. You know, in all of the health innovators that are out there right now. You know there's definitely some obvious things, but how do you think that health innovators are being impacted by Covid what are some of the opportunities and what are some of the the challenges that they're facing? Yeah, great, no, that's a wonderful question because I do hear from from a lot of them and then I hear from because, as I said at the top of our conversation, I'm no longer directly involved in day to day decisionmaking around purchasing. I can refer people and so I would say a couple things. There's a theme. This is just sort of advice for take it or leave it right. Yeah, Guy who's done this for almost three years, I hear a lot, including companies that I advise, and I'm not so sure that that's the wisest so I hear a lot from people. We want to do something, we're going to create a COVID X Y and Z and everyone in their heart of hearts wants to be part of the solution, and that's great. Yep, and it does bring out, you know, people who are in business that are kind of especially on the investor side, can be cold heart. It's bringing out the best in them. But was that said, if that thing that you want to create is a pivot for your company, that's not a good idea because you're going to burn through capital, you're going to distract yourself, you're I think you're better off now. If, for instance, Booie health is a company that's local here that does symptom checking. So for them to do a covid symptom Checker, it's right right down the fairway, Yep, right, so something like...

...that great. Thank you. Pivot. Yeah, thank you for that and we appreciate it. And but for a lot of people come in and say, you know, I think we could do x. If it's not within your normal project business plan, I wouldn't recommend it. It's it might make you feel good today, but boy, I'll take you off kilter. And as you know, and you've done so many of these sessions with so many interesting people, it takes a lot of effort to get this stuff right. So that's that's one thing. I think. The other thing that is frustrating is that so many people. Now and again, I get a lot of incoming, which I'm grateful for. I love to be something I didn't mention when you were asking me about my hats that I wear, as I'm a board member and adviser to a number of companies, so I love the commercial side. Yeah, so I do end up hearing from a lot of people, and what I have to say to them is, yes, you're right, you have the perfect x, but the people where I work, for instance, and I can really only speak most thoughtfully about them, they've already made the decision to ask why to do that, even though your x is perfect. They've already decided to hire why? Yeah, they can't stop what they're doing and vet what you have. They just can't, and that's sad, but it don't, you know, think that you're going to make the usual eighteen month sales cycle go down to two weeks it. It's not. It's the opposite, like they're shutting out people because they're focused on okay, well, we made a decision to implement x and you know, in the remote monitoring space that's probably the hardest because there's so many interesting new patches or rings to wear or sensors or things like that, or things where you can hang up a sheet of what looks like a sheet of paper in the House and monitor people. Most of that's not getting any traction whatsoever. was either doesn't have FDA clearance or, you know, it doesn't have a clear marketing path here. You're the expert on that, the path to market. So I hear from a lot of those people and they're frustrated and I'm sorry and I don't blame them because a lot of those innovations are exactly what we need. But it just in a crisis they're not going to go anywhere. Unfortunate. So you know, in my experience over the last few weeks and working with innovators is it's been there hasn't been really kind of in a you're alluding to this like if there isn't been really like a cookie cutter response that really analyzing that current strategy and what those different scenarios could be is where I think there's a lot of value and I'm seeing anyone that can pivot like the booty example that you gave, can pivot really within a couple of days and it's really more of a micro pivot right changing their business model. They're not changing their innovation, they're not going out and starting something new from scratch. It's just kind of reframing or retooling the solution into the highest priority and unmet need at that time. But what I'm seeing is that if there was a pipeline of relationships that those customers are there's a certain a segment of the customers that are reaching out and going hey, could could you do this? Yes, that is in that is really flourishing. So it because it was an existing kind of warm in my customer yet, but it was some kind of warm relationship that I'm seeing something that can come to fruition. But yeah, old relationships, like you said, just doors closed. Reach me after covid and really give me a thirty day window to recover its so to you. Really... that that's that's perfect. Yeah, if if you have a good relationship with someone, then yes, they're probably going to call you and say, I know you're innovative. Are you working on this at that? Yeah, it's not, though, just to reinforce kind of another way of looking at this, not the usual RFP process. No, those kind of things just aren't happening. It's like, yeah, we know Sam, Sam does this interesting patch that you can slap on people and monitor them in their home. Let's order, you know, a thousand of those from Sam. Yeah, you know, that's that's but there's some thought that goes into it. It's not completely random. But it's not like let's do an RP that takes six weeks and then we we're not working now, right, right now, not at all. Yeah. So what about the financing piece? What you know? What insights are exposure do you have to this? You know, what about those health innovators that were, you know, planning to participate in all those pitch competitions at the conferences, you know, the last month or so, and it just got canceled right, and you know, they just had high hopes of raising getting a bunch of, you know, infusion of capital. And you know, what do they do now? Yeah, I wish, I so. Maybe you can help me with that. I'll give you some just thoughts. Yeah, my own savings depleted by about twenty percent in two weeks. Yeah, so I'm I'm you know, I'm I'm not been a prolific angel investor. I've made a couple of investments here and there. Not Probably going to do that for a while. Yeah, so you know, and that I'm you know, most people in my in that network of angels are probably feeling the same way that whatever their end was, it's and twenty percent now and that just feels small. Yeah, well, we you know, it could be that it's hundreds of millions, but if it's a hundred million less, that's still feel small. So that's that's just a psychological thing. I think in that space, the VC's, I think, for the most part, are looking at their portfolio companies and wanting to make sure that they help them get through it. So again, that means less new investment. They all, as you know, they leave money aside for people invest in for things like this. So unless you're tanking and they were trying to get rid of you anyway, they're probably going to help you along. Yep. Yeah, but again, that that's that's not good news for someone's looking for new funding. I think it's really challenging and I don't really know Pe. I'm on the Board of one Pew Company and I don't have a good sense for that world whether it's whether it's grinding to a halt or not. I assume, like everyone else, are seeing contracture their capital and therefore they're being a little more careful. But yeah, and so my experience with that is is again kind of that it varies. Right, it depends on what what niche what solution, you know, what what pivot like, what opportunities they have, and then also some just the psychological profile of that situation and those team members involved. You know, some people, I think, are really risk averse in general and so they're just like we need to just stop what we're doing in wait and see. Yeah, and then there's other people that are like opportunity and there, you know, alone cell high, right, right, right, exactly. So I'm definitely seeing a mixture of the two. I think it's some I'm a bylow cell high type, but but I don't have a lot right now of cash to buy things with unless I sell stuff. So so it's just I mean it's a it's a, and this is the term that's overused and I'm going to use it anyways, unprecedented. But we just don't know how this, this this market's going to turn out. It's just so extraordinary. Yeah, Yep, I don't think any of us can really predict how long or the end result of this.

But I did hear something from this is a second hand so if I get it wrong and someone listening knows, they can write us an email correct me. Yeah, I heard about a conference board prediction that we would see, and I won't probably get the numbers exactly right, but next quarter, so q two, will see about an eight percent braw. We already seen a big drop in que of course, and then it's going to rebound pretty quickly in the fall. That's what I'm told. So I love that. That's great. So, yeah, I vote for that path to right. I'm all about that. So we'll see. Yeah, thank God we're not in the hospitality industry, right. I mean racious? Yeah, yeah, absolutely. So. So as we think about you know those companies, remote monitoring companies, you know all of these different health innovators, do you have any you know, wisdom or guidance for them? is they just try to survive this season? Any you? It could be I don't know where you know? Huh? It's it is so depends on how you run your company and how you how you what you do with your capital. Right, if you're capital efficient and you have capital, then there perhaps this is an obvious thing, but I'd say work on your product right this, I mean one of the things that I've always criticized that industry for is that the products and never easy enough for anybody, never easy enough for the consumer, the patient or the provider. So make something that's so easy that I don't want to think about it. Make it as easy as an ipad or as easy as that interface, right, that I can just pick it up and do it. Nobody's done that that I'm aware of, and so I would say everyone should be working on that. WHO has if they have capital and resources. Yeah, maybe you're not outselling, but let's let's get the products better, because they're a lot of them are are designed by engineers for engineers, right. They need to be designed for people who are not who are afraid of technology. Yeah, definitely thought. Yeah. So the other thing that comes to mind is, you know, cultivating relationships right now. So there's definitely going to be those those, you know, hospital administrators and frontline staff that we are just not getting in front of and we shouldn't be getting in front of right. We don't need to add one more burden or interruption to them. But I think, you know, cultivating relationships of just championing them and supporting them and encouraging them and just being human really right, because at the end of the day, we're just all people, just being human with other people and not selling anything. Right now. Yea, and can tell you how many offensive emails I get where people are like, Hey, I saw your piece in the Boston Globe. We are selling this right, right, kidding me? Really? Yeah, those so the the the tyranny of the mass email tear inbox is even worse now and it's almost offensive. So, yeah, I know you advise a lot of people on how to do marketing, but this is not the time to send everyone in your inbox. said, dear ex email. That's Oh my goodness. I mean I went from, you know, let's say five hundred emails a day to one thus five hundred emails a day, and every company that I didn't even know had my email address is emailing me to tell me what they're doing to keep your employees safe, and it's just really it's yeah, yeah, kind of amazing. So is there you know, as we talk about this, is there anything else on your harder, on your mind in the context of this discussion that we should talk about? Well, I think we've covered a lot of it.

But just to review, I think anyone in the sub plot, what I call a supplier side, meaning the tech companies or the telehealth companies or the remote monitoring companies or behavior change through APPS, as I said, use the time to make your stuff more easy to use. Yeah, it's none of it is easy enough and you know well the other things. I'll digress for a second, but one of the other things that was in my lexicon six weeks ago when I would give a talk, and for some reason for the last couple of months I was giving talks to doctor groups. I don't know why I just worked out that way, but was people would come up to me and say, okay, I'm all set. Now what do I do? What can I do as a practitioner if you're not part of a big system uses epic, or you're not part of well? The answers it's hard because you can either sign up for American well, which is not really what you had in mind because you're going to do their cases. Yeah, you know it's there's there's a I don't know a lot about it, but there's a platform called do XY, dot me, doc, see me not. It looks like it's not bad right. Our Docs are using it, some of them, and during the crisis, so we'll get a sense of it. But something like that where I can just go in and sign up and let my patients know that I've got this. So we don't have enough of those. Yeah, I don't have enough of those. So those are things out on the supplier side that people can be working on. As a patient, just keep taking notes of what you like and what you don't, because that that should be we should follow that. We are, you know, when we peel it all back, where a service provider industry and we don't do enough of that. I've said that for years. But but we should be listening to what people want and if if what you want is you say I want an in person experience, we should peel back that on you say, will about what? What is it about that makes you feel that way? And maybe you had to wait a long time or you a jagged video or things that we can fix and as a clinician, keep thinking about when do I actually need to have the person in front of you? What are those decision points where it really doesn't make sense for me to do it by technology? So those are three things I would say. Yeah, so you touched on something that you know we've had a conversations. I actually did a session on this at the Connected Health Conference last year on Co Creation. Yes, Lou as, I think about the the Tele Medicine associations role. You know, if I'm a consumer and I have some perspective on what I like and what I don't like, you know I'm probably going to tell my friends and family, but it's but how do we get that in your hands or your organizations hands, so that way you guys could aggregate that feedback? And I see companies like starbucks and Lego land and proctor and gamble that do really incredible jobs on setting up web pages for that type of data collection to continue with ideation. Very like what you didn't like, but what would you like to see next? Kind of thing, and so maybe that's something that we can do as an industry to help facilitate that more permanent nature, is to create that collection mechanism for all of that feedback and then kind of Prac packaging it in a some kind of way where we know what to do with it next so we can continue to serve and meet the the industries needs. Now that's very insightful. I mean, I just reviewed a paper I ended up suggesting, the editors rejected, but it was on using yelp reviews and so...

...forth. I think is I would say this as doctors. We've been largely passive there, with one exception, which is the the the notion of page you reported outcome. So we're getting a lot of practices that will hand you a tablet when you walk in the waiting room and you tell them some things about your experience. And of course there's the age caps and on those standard surveys which a lot of people have. Can are convinced your kind of not very meaningful. At any rate, I think you're you're, you're, you're onto something not Ata. We are grappling at this point with how best to reach patients and consumers, recognizing, as you well know, that that's an enormously expensive proposition. And we're not we're we're not an organization that has the kinds of resources at an American heart or one of those bigger organizations has. So we have to think that through and but I think you're onto something in terms of their repository and if it especially if we could somehow use some natural language processing technology to codify at all completely. Yeah, and you know, as a as a whole, if we really want to shape the future of healthcare and we want there to be some permanence behind these, you know, small adoption increases that we've experienced here recently, then we kind of have a responsibility to come together, providers, vendors as a whole and kind of ponty up for this solution, because it will serve as well as a whole we come together and try to figure that out, you know, it will be better suited than if one entity try to take it on on it. Yeah, now one way to sort of summarize what we've been talking about as we as an industry, because of this crisis, we threw a lot of spaghetti against the wall at once and so as we see what sticks, we have to re find it, make sure that it's professionalize, make sure that it's not chaotic, make sure that's well organized, make sure that it's thoughtful. Yeah, and then it will stick long term. Yeah, absolutely so, Joe. How do folks get a hold of you if anyone has any questions for you after watching and listening to you today? So I'm I'm on Linkedin Joe cadd a KVEEDR. I'm on twitter at JKVID are. You can email me. It's my first initial last name, Jak v Evare at Partnersorg. I also have a website, Joeke of tercom. That has a lot about me on my website. Excellent. Well, thank you so much for your time today. I'm totally enjoyed our conversation. Likewise, look forward to spreading the work with you. Thank you. 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 your attention. To save time and 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's been sharing the show with friends and colleagues. See You on the next episode of Coiq.

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