Health Innovators
Health Innovators

Episode · 2 years ago

The 3 Unspoken Languages of Healthcare Innovation w/ Dr. Paul Markham

ABOUT THIS EPISODE

Many healthcare innovators fail to get any traction because they don’t take the time to learn the unwritten rules and principles of the industry. What are the rules and languages that govern healthcare, and how do we become better skilled at using them to guide our approach? How can you cross the chasm from pilot to mainstream?

 On this episode, I’m joined by President of Health Strategy at V3, Dr. Paul Markham, who talks about the mistakes innovators are making and how we can correct them.

 

3 Things You'll Learn

  • Why some healthcare innovations fail and others succeed
  • The unwritten rules of successful commercialization
  • Three most important unspoken languages in healthcare: data, doctors, and dollars

 

The truth about healthcare is: if there’s no financial benefit or forcing factor, there’ll be no reason for an innovation to happen. This means that as we sell our innovations, we have to tell the right story and get buy-in from the right people. Understand how data, doctors and dollars play into it, and tailor your approach to get the messages through to different people.

If our innovations can generate revenue and change the business of healthcare, we’ll have incredible clinical outcomes, and the quality metrics will go through the roof.

Welcome to Coiq and first of its kindvideo program about health, innovators earlier doctors and influencers andtheyar stories about writing the roller coaster of health care and ovation. I'myour host doctor, Roxy Founder of Legacy, DNA marketing group and it'stime to raise our COIQ welcome on today's show, we're going toexamine the three most important unspoken languages and healthcareenovation, Dr Paul Markham who's been successfully launching andcommercializing new product innovations and healthcare for nearly two decadesis joining us today, he's going to reveal the unwritten rules of healthcare and decipher three unspoken: languages, data, doctors and dollars.Welcome Paul. Thank you very much for inviting me andI'm excited to talk to everybody. Think you so before we get started just incase. Everyone is not familiar with who you are like for you to share a littlebit about your background and what you do sure. So who am I? Well, that's a goodquestion right apart from the paperwork, who I reallyam as somebody who was going to be a rock and role star in the S, I wasgoing to be that guy we payed back up band for the ACDC, then I went on to bean rd electronics engineer, but along the way I found out that I had a reallystrange personality, something called a blink. If anyone wants to look this up,glad weall talked about it as guys are, and girls are actually thin slices. Sowe see the inpoint before others. It's not an IQ thing. It's just a verydifferent perspective on life. I then went on from my Australian heritage.Came over the United States wot a large company called General Electric, we'reinvolved in all twenty eight acquisitions, and wewere going to build. You know the the new future of personalized prouctivehealth care. I was an absolute sucker for the story because I actuallybelieved in it along the LAD, decided to Rin a doctorate remited to itrogenicdeath, not because I'm an academic per se and because I'e got a passion fordoing something about the third biggest killer in America. Anyway, from thereI've been involved in all sorts of things, raising capital acquired acompany involved in some pretty cool stuff organ transplant, Buma stem sellon an advocate for anything. That's futuristic, I'm very closely involvedwith Singularity University, I'm forever involved in anything that lookslike Hat's going to impact on that very important. You know that unreportedsagestic guys, which is ortragenic death. Unfortunately, it's notsomething that gets a lot of publicity. We hear about cardiology and cancer,but not number three too much and frankly, more recently, I have becomean academic because I really want to get to people. I was just talking to DrRoxy Before this started. I want people to understand. They need to know whythey get up in the morning I get up in the morning, because I want to learnstuff. I never realize that until I got a lot older, the second thing is: Owtpeople understand their uniqueness because, as we move forward here,you're going to be somewhat unique, not just from three hundred and sixtymillion Americans, but from six billion around the world, but frankly, I'mpassionate about anything like what we're doing here today. If it makespeople just pick up one golden nugget that they can take with themselvesmoving forward. Thank you. That's exactly why we're here and what acreative diverse background well have to talk more about this ACDC band inthe future very interesting. So you mentioned that you have a doctorate andbusiness administration. How do you think that that's you know shaped theinsights and guidance that you give to the clients and the healthcarecompanies that you're working with in a unique way? So it's an interesting one,Dr Roxy, that...

...the doctort really for me was a mindset,meaning getting myself into a situation where I clearly have to justify and be moreobjective about everything, but what it does for me. I talk about th. The factis, I can barely speak English with this Australian accent, but frankly,people tell me- and I pony speak three languages- data dollars and doctors andhe'll give you a real ward scenario. I was in a Midwest Hospital yesterday wonderful place, butI found that I had to be chomellyonic. Frankly, when I spoke to the financepeople, comelelyolic meaning had to change the whole discussion. When thenurses and doctors walked in the door, then I had to have a differentdiscussion with the the business intelligence, Fok SOCItheres, one challenge in the United States, which I love by the way- and Ihave citizenship here. So what I think is the challenge of the United Statesis the specialization okay. So, where I come from, unfortunately out in theantivities, we have to actually understand the horizonal landscape.That's how I ended up in this country. You have to understand, frankly, datadollars and doctors, because you don't have another fifteen people around youto do anything. However, in the world moving form. It's kind of aninteresting political statement is that you've got almost socialized healthcare,even if it's capital is to we've, got to figure out a way to get everybody othe talk together and understand those free languags and I believe, back theoriginal question. The fact that I I had a defended dissertation and Ireally got inside the minds of physicians, right MDS, for instance, if you want to get aphysician sponsor, my doctor was related to adoption of Supoe and Emrlong time ago. Now what I learned about physicians right, transformational,leadership works, but it works in a different way. If I'm in the CorporateWorld I bring in Mr Richard Branson or others, it's going to work even lik onyou and Singapore. That kind of idea of that charismatic that leader, what Ilearned from my doctor at Dr Oxe was the fact is that it's not that that'snot how it works in health care. The best physician sponsors that I men werepeople that were selfdeprecating. If anyone remembers that all tov seriescalled Colombo, it's those people in the room that seem like they have noidea what's happening, but they're able to get followership. It's called it's adifferent form of leadership. So the point of the fact is, I think, from thedoctorate. What I leant was to get the insight of not only the medicalfratenity, but I got to Klow chief information officers very, very well,but the thiis with the CIOS it's sort of like so logical. But if you don'task them, you don't know this. If you don't interview them and if you don'tinterview them with mixed mess, method, analysis, meaning survey, you knowqualitative and basically bringing it all together. I found out from CIOS weall think they're about the data. They're get the money. It's not becausethat's a bad thing is because most of them report the CF, so wher he's likewow. I wonder why they're not talking to me about you know how this wonderfulinteroperability and it really comes down to you. Gotta, absolutelyunderstand the language of the bat and just a sort of. If you don't mind I'like to load onto that something very interesting here, we are in health care,I'm right now, I'm involved in a bunch of things, a couple really cool, Anto,artificial intelligence companies and blockchiand all the rest of it Hee's.What we know about healthcare we think about, let's put out research a had onfor a minute he's what we know about health care. Nothing happens, inal,healthcare quickly. The second thing we know about health care. When it doeshappen, it happens because people are forced to do it. This is an unpleasantthing, probably for people to listen to, but if we really care about theclinical outcomes. Well, we wouldn't be...

...burying two hundred and fiftyhsandpeople a year. If we really cared about the physician, you know environment, anthe clinical environment. Well, then, we wouldn't be allowing them to haveepisodic eamars and basically, a million different systems that don'tconnect. We wouldn't allow that. So what we've got to do we're GOITG tounderstand those free languages. We Really Edo understand how to get themessages to different people, because if there is no financial benefit, whenI say that I'm going to be really clear on what I mean, if there's no financialbenefit or there's no reason, meaning the bundle payments ar changing or seemas is coming down or meaning for the uses coming in. If there's nothing likethat, a forcing mechanism, it's never going to happen. So what ive found iswe've got to start thinking like the rest of the world we live in. We alllive with EBNB. We all live with twitter. We live with Buba, and yet wecome to Healthca we go well. You know what we're going to do: We're going tokeep selling these application, not going to work right, we're goitg tostart thinking about thinking about software like like an ultrasoundmachine. People have got to see these things as revenue generaters ashorrible as that may sound, because then, what's going to happen, thinkabout turning the pyramid upside down. If we can get these to be revenue,generators and something that's actually really going to change thebusiness of healthware, then we're GOINGTA have inedable clinical outcomswe're going to have quality metrics through the roof, but I think all toooften we get a lot of you know. New SORF CEOS of these small companies areeither MDS or they're, basically very smart, technical people, and then theysay he here look what I've got and what as marketing people know is it'scoincidence I nee's right. We've got to actually look at the market and findout what is going to actually how we going to get this thing into the market.So that's just sort of I gives a long answer to your question m, so you soyou talked about data doctors and dollars yeah. So let's dive into thatjust a little bit more. Give us like a real world example ofhow you would speak to all three of those languages in a specific scenario.So if I'm a healthcare innovator- and I am approaching a health system orhospital system with my innovation, how am I approaching it and being able tospeak those three languages? So you've got to understand Thall th, and it'sreally, this simple, the language of the bit. So imagine this, for instance,and basically I'll talk about what we did yesterday because lially yesterday.So when I sat with the administrators of the hospital, I did my research. Idid my homework. That's the other thing. People don't do this so back to thedoctrate. Education short helps for this. So before I walked in there. Iunderstand where this hospital. Actually, let's talk about the dollarsfom a minute. I understood where this hospital was on margin. The hospital was around about twopercent operating margin. You got to understand this stuff and the point waswhen I talked to this hospital, I talked to them in pure financial terms.I talk them about some of the CMAS bunble payments of the coming in. Italk them about basically how this particular thingthat we're talking about this artificial intelligence application.Never use those words. Oh, no, not never use use the words. I understandthis is a revenue generator. This is a situation that is actually going tochange your operating march and now this all sounds like wait on polyselling, a clinical application or absolutely, but is what happens to mostcompanies? They don't do that story. They pitch to the doctors, a not to say.Oh, that's, wonderful, Dr Roxy! I want one, but then I hit see the financeperson stayd CFO like we were talking to yesterday, I byind. What's nevergoing to happen so wat happened from yesterday. We actually found out thatthis particular institution Hes what...

...people tell us and then we don't listento them. They said you know what Paul the best thing about. What you've toldme is the concept that you're involved in you're interested in coming into apartnership with our organization, meaning we are interested in a revenueshare. Now you might say well, that's interesting! Is that a big deal there'sa comtny called Athener that will actually tell you. That's a big dealback in the old days, the Col that company was basically, I think, I'munnecessarily jeed at by the Bu, the industry saying you're going to startneam Ma CONP leve, good luck with that, but but what he did he spoke dollancs.He went nax. She tolt the people and said here: here's a software Wen osshare in that sharing the prophit. So to speak, and my point to you isbasically that story that I gave these people yesterday in the financial story.I'm still talking about clinical software, okay, but yes, doco was. If Ihadn't gone into these CFS and said: Oh, my God, we've got this artificialintelligence platform. It's going to make the doctors live so so much better.They're GOINGNA GO SO IWAS number one number, two, thedifference with doctors, and this is straight from the doctoror background.What I did was, I talked to MDS and if there's embies on here, please takethis right way. We have set mds up for failure. Society we've got them at thetop of this food chain. We said there a top two percent of society. Now,unfortunately, they are then put into really verthing and they just not, theycan't be the humans. So what I did with these people yus say the docks plase. Iactually asked them to educate me on what I was selling to them to Verenbigdifference. It's a really big, different tri. In other words, beforewe even got out of this place. These people were sort of telling me how thepilots should be developed, and frankly, I'm notkay with that, because I letthem understand. For instance, I don't talk to them about artificialintelligence. I came up with an acronym that is directly related to somethingthat these people know about and they got it in an instant now, then we metwith the it people and normally a two people. Anyone on the line will knowthis. They'R shitting like this focking back like you're, a bunch of salespeople in here we're not going to listen to you. So then what we did weempathize the first thing that ie fin found with a lot of these people. A CIOhas a shelf live for what twelve to eigteen months. These are tough jobsright, yes, sone, looking at epic or Sota implementations that are going toget them fired because they don't know the taile end of this thing. The firstthing I said to these guys. I see I want to understand your architectureagain, it's some of taking the time and the minute you use their wordsarchitecture. That's interesting. Aso You've got actually this particulartopology youv got Ta, not just know the Jagon, but go deep enough to surviveright, because then these guys come back and they ask me questions what itis. It's like, et' seet, this guy knows you stop right. Now, I'm not I'm anelectronics engineer, but I'm not someone. Lha Cang go deep enough to cutcode anymore, but I do not enough to understand what thes situation was andagain really it comes back to research. Before I went to this institution, Iknew this place was an IBM back end. I knew this place had a particular em. Iknew what they were struggling was. I knew what their payin points were youprobably thinking boy. This is simple but think about it. This is on threedifferent levels: People don't do Omwork Englough; in other words, itbecame about them. Dr Rox, you know about me, it wasn't about us and youknow the beauty of the whole thing. Before the end of our discussion therewe were all sitting on the same side of the table and one person from bothsires meeting USTEVENDA and then the organization two of them were up on theWhite Board. I don't know that sounds like a really good situation to me andwe still had the three groups in their...

...data dollars and doctors. This doesn'thappen much and I think that that's one of the things that I feel prettyexcited about do af. I Salt Health Kaet. No, because frankly- and you and I havetalked about this- we're not even doing healthcare yet we're doing sick here weactually do go to a genelics Tonet technician before we even enterhealthcare and we start doing actual proactive. Then I'm going to say I'm inhealthcare, but I feel committed to doing something with what we've got outthere right now. So thank you so much for that. I want to kind of dive deepinto this, so you know you- and I have talked previously about the researchstatistics and the number of health innovators that launch a new innovationinto the market, especially in health care and fail. They fail to reach anylevel of customer acceptance or profitability. So, from yourperspective, why do you think some healthcare innovators succeed and somefail? Yeah and you see, words are important.So if I said to you, it's all about marketing what most people sads areit's all about promotional, absolutely, not son! I'm going to use a definition,it's all about product marketing. So what do I mean by that? If we thinkback to Steve Jobs, okay, what he did, he actually got an IPAD and sat withpeople and said Hey if you swipe thi single write, ers that what you want todo, yeah great, so the people that succeed are the people that actually doa lot of research and absolutely pointwass trying to sell anything tohealth care. It's something that you've got to find that unmet demand, and notonly that you've got to actually park. Your Ego at the door and I've done thisbefore as a consultant I'll tell People II'll mail, ten a card before we havethe meeting you got to park, your Eg t the door, so many founders are probablygot icuse of about two hundred, but what they don't understand, they'regoing to learn: Tol, listen but iiother words, just because you've, just ninvented the great greatest wigit live. It doesn't mean a dam thing and I'llgive you a scenario, one of my due friends, se up a meeting in New Jersey.Some time ago, a we sat with some super power, vocus CIS from the northeast.These are people managing five to seven million dollar organizations. Basicallypart of Product Marketing Research, and if these arther companies did this,they would learn that therethey're going down the wrong track. I just wentto irs Anda that all thes start up said I would say: Ninety nine percent ofthem are going to fail one or two of them, maybe not so anyway. What we didat this meening. We did some really interesting things. We said: Hey, CIOS,we've got this great new thing. It's going to Sov, so many lives, it'sGointa cut cost is going to do all this stuff and they said whait. Do you wantto hear from us from what we do in our lives and we go yeah ta be great, so alike ciing back was very interesting. No we're actually hugging at each other.Frankly and honestly, because I are actually being appauted in theirorganizations. Why? Because they had six hundred clinical applications, theygot them down to seventy five, a think about the implications of this here outin the market. You got all these new health care in Nevadis sying. Oh my God.Look at this new thing. It's going to be great we're going to bring in yourorganization and the people are actually going to bock. You are sayingthanks, but we're actually getting rid of six. A hundred and fiftyapplications or two hundred and our CES are saying. Thank you for that, becausethen we're getting rid of the cost, tof service cast and all the rest of it. Soagain, it's understanding what the market is. The idea of a good idea comeon. I mean more seriously if things were a good idea, US markeing, tipe, Oknow thirs, for instance, batacord versus VHS is a great example. Batacordback in the day was a much higher quality, but they picked the wrongchannel shock. Horror I'll, tell you another one apple. I teach this stuffand people go Wan Apple, apples, invincible well, not anymore, but inthe early days, what Steve Jobs did he...

...totally thought? Marketing or partMarkit was a big jobe when he first started so he said I do pick educationnow, buill job a Bill Gates got lucky, he picked business. Is that comes backto health care. You've got to really understand what you're looking at,don't assume anything and Park. Your Ego ot the door. If you go into anorganization ik a man. Well you better. Listen to that you',better start! Looking at things like SM ATC. What laws are changing, forinstance, real world example. There's a thing called an IKMO: it's like a hot best way to Siy is like a heart pumpfor people that are waiting to go onto transplant now last year. This had areimversement of a hundred and four thousand dollars. That sounds prettygood this year. That could go down to seventy five hundred. What tmight be anopportunity for artificial intelligence, not because of artificial intelligence.Remember the big problem out: There is not selling the future, butunderstanding. What is the benefit and does anyone care I mean who cares if Icome up with this little technology? I saw some great things again. A tradeshows, and I see them- and I honestly look at him. I think they're going toget the two million bucks. Maybe I'll have the six, what I call pilotsyndromes, where they basically could jole and get some of these big medicalcenters to run their software for a bit butit's whether they can move over thatacross the chasm in the mainstream Ali. That's that's my answer. IOU questionexcellent. Thank you! So much so much RCH information in that. So so we talked before about theunwritten rules of health care and you touched on them a little bit, but ifyou had to identify them specifically, what do you think some of the unwrittenwoles are that you're encountering in day today? Yeah? I think, because I'mI'm this old man of the sea, some of the stuff I'm talking about is notanitdetal. I guess t what I talk about as factual, it's after being involved in many slam,doors and incredible amounts of wasted money on try to basically tell peoplethat this is a great idea. His is the unwritten laws as far as I'm concernedand healthcare in the United States, but it's similarly around the war fordifferent reasons. If there's no forcing factor it's not going to happen,I mean you know the people are, don't o use nose. Let's just say the peoplethat arn the Emr compnies did very very well, but in a funny way they got lucky traditionally in our companies gotlucky with meaning for use the forty four thousand dollars et Cetra yeah. Ilook at that and I think, as anyone ever thought, what the actual forcingfactor, if that forcing factor wasn't there with these epiepisodic revenuecycle, sort of centric, meaning the wrong model, and they know they builtthe wrong model, they absolutely do. Will they even be in existence withthese? WOULD CERTAIN INDIVIDUALS BE WORTH THREE POINT: Nine Billion Dollars?No, they wouldn't so one of the youngwritten waws is as far as I'mconcerned, based on fact, if there's no forcing Facthar, that's basically apointless situation that youre involved in good luck. People are going to lookat it, Dr Axsy they're, going to say oh my gosh you're, so strategic and I ravethe accent and thanks for the Khuala and then they'll like that and you'll,be on your way. What's rain, the next Houregina that, if you're going to tryand market or sell something in health care,if there is no budget, they don't just invent money right, it's just there's,no additional, maybe some large medical serc sendershave things like benevolence funds. Some information departments havethings like an integration fun, but the...

...reality is if you're going to try andsell something, it's going to change everything, and then you find out thereis no actual there's no money for it. Well, you've got to actually thinkharder. You do think like that. Guy Was the EMR company that people sort ofsaid it's never going to work what he did. He listened to the market, so themarket says I have no money, HMM, maybe what I'll do ther I'll sell up like arevenue share on the back end? That was a very, very smart thing that meantthat he was listening to the market. So basically you know if there's noforcing mechanism, I mean honestly good luck with it. The idea of getting stuffthats make the doctors wivs easier. I heard a really interesting story from afriend of mine and he said Ir standing in a large medical center and we justfinished a presentation where we said and we are going to save you, seventeenmillion dollars and honestly, you would have thought it was the Academy Awardswe would have. Everybody would have received Anlaska and essentiallyeverybody was yawning, so the reality is don't assume anything so you're inan organization- and you say things like Oh and it'll- replace all theseftes that's great, but that's on how hospitals work again understand thebuyer might be that its never going to get into a situation like that. Thethird thing about it is as far as I'm concerned think Harda he's an unwrittenrule, be smarter than the other guys and give you an idea of what that is.You might have a platform that is really good for clinical assist. No one's going to buy it right,the doctors are going to jump up and down, but unfortunately the goodotidays of the doctors and these yoknocking on the CS door say twentyyears ago we go ond talk to the doctors and they goan force to Seeo to buysomething. Excuse me that that's not there anymore. It's Gote, however,imagine if we're able to basically dig depr and think harder and arepositioner, so he's he's an example of that. Just so, we've got a platform.That's going to make the the world easier for doctors is that going tosell, is thatgoin a market. Well, somebody might tell me they've done itand and have happy happy happy to you. For the most part, people are going toYo on again how out we goansee the Chief Council of the hospital. This issomething I've been involved in. We start positioning this as a riskmitigation platform wow. What are you talking about? Well, we start lookingat the MDS in the world. We find out that neurosurgeons are the number oneSu doctor, followed by cardiac surgeons and and then you start thinking, moulpractices now the good old days it didn't matter the organization, butthese days many doctors. I think it's fifty two percent now work for TFEhospital. So all of a sudden, you may be able to throgh thinking harder andtalking to different people in the organization. If you start talking withChuth Council or chief quality officer, I cant of Qalt this Vendiagram of ofclinical fiscal and quality. I'm not going down the triple ame thing again,that's another marketing pitch pot. The point is, the point is the third ruleis you've got to think Har that you cannot assume that whatever you've got?In my humble opinion and factually that anyone's going to listen to everybody,everybody out, there is going to take the meeting they're going to do thepitch, but you've got to also understand what is the motive of them?Taking the meeting you've got to actually think to yourself. Is thisactually an end Goa? So for me, some of the unwritten rules in this country,leas Ar essentially understandirs, are ae forcing factor. Secondly, ereactually awhait. Is there actually a financial way to get this done? Andthirdly, are you actually talking? Are you really talking about the benefit ofyour product, meaning hey? We can...

...actually cut down on Ol practice suitthat has a different ring to it than all we got an inter interoperabilityengine, that's Goingna, it's going to be great. The ducks are going to loveit all this type of stuff. It sounds like the right idea, but we might haveto go outside and cameleonitlly go to a different department and have a verydifferent impact. So that's my tyme ome. I think Hou touched on a bunch ofdifferent things that like positioning strategies, messaging strategies, pomecmarket, fit really, you know focusing on the the buyers needs and solvingtheir real problems. Instead of about your wigit and how awesome it is, youknow these things are just fundamental to marketing, no matter what no matter what industry you're in inthere's, so many additional complexities to commercializing an innovation andhealthcare. Let's tall, you touched on pilots alittle bit and I think that's one of those additional complexities to heatcare. You know it's a real challenge. I hear els health innevadors talkingabout this all the time. They've got this innovation. They get reallyexcited when they get this pilot opportunity, but many miny innovators get stuck inwhat I call pilot purgatory right. They just never come out of this pilot fhasedescribe for us your experience with that phenomenon, and you know how can health innovatorsavoid that getting stunt in the so and this? This is just coming from real worldexperience. So many many years ago I got a phone call and somebody said: Hey:can you come in and look at this company and tell us whether we shouldkeep it or shut it down? Yea Sound like an interesting thing to do at the timenow most little companies I'm not going to name the organizations, buteverybody knows what what little cupies think is. The right thing to do is tofind the big brands out there in certain name Rightmedical MedicalCenter, and it seems like a great idea because then you put it on your website.You know you've got these six accounts, itwoneful Wat. Frankly guys they'renever going to pay you. It doesn't work like that and I'm notsaying they should pay. You they've got this. They build up brand equity inthese massive medical cemmers and frankly, it is a good idea to work withthose organizations. They're, wonderful work for, but over here you've got a thing called abusiness with cashfil Etca. So anyway, this organizations I got involved inthey had all that right. It was a midworst company. They were flyingaround the country to all those medical centers burning cash, enormous amounts o sales,not any anywhere likely, because, frankly, it's kind of a privilege to bein some of these medical centers. I mean that quite honestly, som of it, but most people like this organization.I said how thout we hunt close o the home, but what what so? We literally anthis is true story. We physically walked across the road from where thislittle office mcane Medical Center- I'm not making this stufup and we walked inand said, hey we're doing ABC. What do you think so after we got through thewhole, you know discussion about the local footballteam and all this type of stuff. We started but t what I did with thoseguys. I know the pilot syndrome honestly. I was just down to JP Morganand when you talk tot some of these guys, everybody knows the game right,Sedo, everything in your power and I'm not saying it's easy. If you got to doeverything in your power that, if you do a pilot- if you really have to dothat, because unfortunately healthcare has been idiotically set up into this thing,where everything's free- it's just not free, really right contracts, I like todo a nondisciser agreement around a...

...contract that will then actually moveinto something and what I say to the people in there and I never just talkethe CII. I talked to data dollars, doctors, I'll actuallytalk to these people say: Look we want. We really want to do this, but we'rebusiness and for our successors. You know your success, you can't you can'trun a business on nothing and let's say that's the number one thing I hear at least trade chows and people gowe're in that and they go abcde and, of course, those organizations love to seeyou tec. Some of them might get through some now a I say this in a nice way goto the boring places that are actually doing helkid the Donho. You know, let'sjust pick some. I don't want to pick cities because I don't know to u'setanyone, but the maybe you go to a particular place in Georgia. You mightgo to a different place in North Carolina. You might go to Nevada rather than California. I mean Ilove all these places, but so uny is what I say to people just you're hereright, if you're in New York City, why are you? Why are you flying out Tinnermountain health? Again, you know if you're, a company that sellup in Houston, Texas and Y you're trying to go after Mao clinic what Yeho,hup locally and te really smart about it and just understand somebody sayingto you that they want be technology and all the restmint it doesn't doesn'tnecessarily mean that it's going to pay the next check so anywoy with thatcompany within handed likely, we got got to know the CIOS latre Cosero. Hethen told us where the next CIO was. We then set up a CII dinner at Tom himns.This is a long time ago, O New Orleans Wen, I all came along and the absolutejustification for the dinner. Was this we're talking about artwork and golfmeaning no pitching bit. Andt sounds like footall and we went this dinnerand we got to know these people and we built report and relationships. Thepeople happen to come from all the five sectors of the United States O. I waskind of helpful for the point was then we diffused out from there and we neverhad one nickel, a free pilot and I'm not saying it wasn't. It was S, it wastough, shlisten, hyoo pilot, Welwi, say Lo and we bring the statistics up. Imean pilots don't work, they done' they the kind of look good for saclinicalresearch paper or something like that. But if you can get into a situation,look at like come onwe're in the world right. Anything you get for free isworth exactly what you get. If there's. No, if there's no exchange between Aa,it really means that there's no, it's not a real relationship, but I knowthat very, very well so anyway, I hopefully I'l e NSE. Youquestion absolutely that's fantastic feedback, so the last question th t Ihave before we open it up to Qand a is you know: We've got several healthinevadors that are in the trenches right now. So what advice do you have for them? So if I sould give you one piece of advice,loan financers, if you don't know them, loanf them, learn them really wellstart to understand. This sounds like what is he talking about, but seriouslyI understand you're running an business. You might be passionate about whatyou've got you might be in the clinical sense or the technical sense whatever,but the be a leader in a way that youunderstand when it's time to step aside, I saw some different leaders along theway. One of my favorite companies is life is good. Why? Because I make a tshirt that is actually high quality and, frankly I love two shirts. This is whatI'm doing right now. This is all part of personal branding,...

...but suriously yea. The point of it is,I would say, Tho innovators, don't assume anything question things thinkharder but think beyond. Okay, so I think when I hear a a lot of this stuffabout artificial intelligence, I hear about blockchain. Don't just listen tothat! Do you research, Rin, so o you think about Blockchin wokchain in itself, as just a storythat normally is followed by a you mean big coin, so people completely missingpoint: What chain in itself will change the world? There's a statement. There'sno there's no doubt about it. thes technology right now is too early, butlet's think about health care for a minute. If I'm an innovator and I'm notthinking about other technology, so that's my point, think do more research,don't assume your business is going to be there for another five minutes lotlong. Five years you got to be absolutely thinking ahead. You don'tWan to be ses or Boston store where you're sitting there after it's allhappened, go what happened like W. where did Amazon come from? Likewise, with Amazon she'll be lookingat Jack Marin, Ali Barbara and say wothey buy stuff in Ali Baber andselling it n Amazon. Some of my voice pack intovitence is you're not nearlyas small as you think you are. You might have an ir of two hundred, but Ico is not what's going to win this battle, it's really doing di Esearchback to blockchain. So when I first looked at that, I thought I'm atechnical Guy Soso. It looks interesting, it's a good story, and nowI thought wait on there's three things that botchain could do for health, KikGi on now: Younique identify yea, that's interesting, smart contract forall thejudication, a mutable database. That's not a bad start, but that's notreally the point. Let's think harder on that for a minute. Dor obhe does sayreal hard on that in health care. Today there is nopatient centric approach there just isn't. If I got a don use, the name but the EA in certainname. This is episode of care. I'm a doctor. I need to look at the longTitudin Al View T, but it hasn't been built that way. 'To Ronmo, it's Ben Bil,Bein built around the Revenue Cycle. So here's the thing: People MissinLocktran, part from the fact it's going to be. You know: here's the here's, theproducer, here's, the user, that's going to take everything out of themiddle meaning all of the layers of healthcare assurance blah blah blah,but it is the more important thing what they miss on block chaines. They hethung up. On the token blot crain is like a racetrack of the future. It'slike the Internet turned inwar database, but right now what people don't talkabout is if I have a blotchain wallet right all of a sudden. My Wallet is right. Now, it's for a token. It's finefor a financial thing. There's no reason that can't be a patient, centric,electronic medical record, patient centry identification of everything forgenomics there we go. We might do some healthcare sometime. The point is, ifI'm an innovator- and I feel like I'm just about to get over there- lhet'snumber one number two for the innovators. Stop trying to sell dhereguys it's just too hard, yeah go to the Big Med centers. Why don't you say toyourself? Hey, maybe there's a company out there that I can make smarter,meaning that there's a company in the divice market there could be a companyin the farmer world ther could be. Did you know if there's one thing, that'sgoing to make Yo successful, he's a clear real world example. I wasinvolved with the company and, I said: Hey. We need to Oem our software shrinkrapid and put it in this other companies portfolio. Now we're onlygoing to get seventy five hundred dollars every time someone touches it,I'm not going to go into what it was. It doesn't matter and I bought I foughtwith the Bord of directors on this I said: You're underselling the product,it's a million dollar platform, Blah Blah Blah. I said: okay, fine, so notlong after that weere getting three hundred and fiftysand olar cashpermonth, but and it kept the company Flot somuch stupid an that when IIpeople think that theyrthey're able to...

...an the United States of America whane O,we got think fifty eight hundred hospitals start to understand how people buystuff start to understand. You know I don't Wat o work in supply chain wherepeople will come to me with this new little thing and like Oh, it's going tochange. You know this new cutethip. It's going to be great because I do alot of stuff with people in China. The reality is think Harla look at beyondyeah the direct channel. That would be the second thing. I'd say to innovatorsand I'd also say this question and then question again and when you finishquestioning it's a little bit like when you do your doctorit right proof, ree,proverit and prove free it again because guess what it changes fromDatoday, okay, it's like I'm in the back of that over in San Francisco, andI said to this guy. What are you guys thinking about the blockchain and whenI told him about the idea that the the hidden message behind Blok chain is isI is going to take out the Middle Mat and he goes wait on? Are you kidding?That means it takes out ober? I said absolutely what thet can't be right. So that'swhat I'd say to healthcare inabou this. You know I'm not saying take the easy Rod, butif you find out there's a divice, fender or a farmer or biotech orsomething that's got a gap, and you can sell a little baby piece of whateveryou're doing a thousand times and you're going to be in business and thenyou can go on, then you can go and you might be able to afford to do yourpilot syndrome. If you really have to do that, but you might find wait aminute all of a sudden, I don't need to be paying a hundred and fifty grandayear, tor a sales rap and by the way, I'm a sales guy. So I'm not againstsales people, but I'm just saying a business to business model is a reallysmart way to go for a small company and often often small copnies, for MEM istwo things: poduct the first play of marketing, meaning they're building.Something then trying to sell it yep the last one is channels they do alltheir work on basically trying to just stay alive. Their websites awesome ArOy. They got a great website. You got agood website, no doubt but I'd say I'dspend more time on getting the message that someone understand noassum manyone understands while we're actually using neuron network machine liningpeop liating we're actually going to go to reasoning computing and what do youthink and the people on the other end, especially if they're em dosing te,goten yeah, that's interesting, a d they're, probably thinking o themself.I wonder where I'm going for dinner to night. How are you talking about you know? SOWHAT, we're doing is goingto take fifteen minutes off that stupid report. You do at the end of the day.They say what we just what yeah. So, thank you so much for sharing.What's the best way for people to connect with you, I've got about eleven thousand datapoints. I my probably I've got. It doesn't matter text message linkedin Whatsup, a d. You know you know come on, Dr Ox, you know, thes SOM mean oI'm connected so and I'm happy to talk to people anytime. I'm not the Oracle, but I might justmake you do. One thing is thin Hardo just do that for me just think harderbefore you do anything question yourself. I mean honestly Il do it allthe time. I even question what I'm talking to you about, because I go backand I want to test. I want to see. Does this make sense and I'm always here's athing. I'm always talking to the customer. Like yeah yeahwe talked all these differentpeople, datad dollars, doctors. I ask them. I said w before we start thisdiscussion. What's go on in your life right, we found out what what theycared about. Frankly, we then sculpdat how we were talking them. An didn'tchange that much that did a little bit theres some star stuff there that Ididn't understand, like here's, a classic and we'll just close out onthis, we're talking about artificial intelligence and healthcare. So firstthing is stop using that word, because...

...it's it's onlly relevant to bunch ofIto, people and everybody else. It's like it's Goin to it's crazy. It'sgoing to take my job and all the rest of it. It's it's just not right talking thewrong people, but you know I said to this guy. You know unders! I unders! I understandyou know your workfor, but I'd like to understand a little bit more and he'sexactly what he said. He said You know what Paul! No one ever asks us this,but he's what I'll till at happens. He said I'm in a nice. U, and withoutdoubt everything goes wrong when I'm not there think about how powerful thatstatement is, if you really listen to it, artificial intelligence caninstantly help that, but no one's ever asked him that before so essentiallyeverybody's trying to fix the problem, while all the people are there- and hesaid if I could just pick up a little alert on my pan saying: Hey bed sixneeds to come off it venilator. He said my God it'd be great, but it neverhappens like that. I get in the next day and I got a whole bunch of stuff. Igot to deal with so mabsolutely great closing words for us.Thank you. What's the difference between wauchingand commercializing, a health care Novation, many people will watch a newproduct. Few will commercialize it to learn the difference between launchand commercialization and to watch past episodes of the show head to our videoshow page at Dr Roxycom thanks so much for watching and listening to the showyou can subscribe to the latest episodes on your favorite podcast APPlike apple podcasts and spotify, or subscribe to the video episodes on ourYoutube Channel, no matter the platform just search Coyq with Dr Roxiy untilnext time. LET'S RAISE OUR COIQ.

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