Health Innovators
Health Innovators

Episode · 3 years ago

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


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 kind video program about health innovators, earlier doctors and influencers and their stories about writing the roller coaster of healthcare innovation. I'm your host, Dr Roxy, founder of Legacy DNA marketing group, and it's time to raise our COIQ. Welcome. On today's show, we're going to examine the three most important unspoken languages and healthcare innovation. Dr Paul Markham, who's been successfully launching and commercializing new product innovations and healthcare for nearly two decades, is 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 invoting me and I'm excited to talk to everybody. Thank you. So, before we get started, just in case everyone is not familiar with who you are, like for you to share a little bit about your background and what you do. Sure. So, who am I? Well, it's a good question. Rot Apart from the pipe work, who I really am as somebody who was going to be a rock and roll star in the S. I was going to be that we played back up band for the ICY DC. Then I went on to be an rd electronics engineer, but along the while found out that I had a really strange personality, something called a blink. If anyone wants to look this up, glad well, talked about it. US guys are and girls are actually thin slices, so we see the endpoint before others. It's not an IQ thing, it's just a very different perspective on life. I then went on from my Australian heritage came over the United States with a large company called General Electric. We're involved in all twenty eight acquisitions and we are going to build, you know, the the new future of personalized, proactive healthcare. You know, I was an absolute sucker for the story because I actually believed in it. Along the way, I decided to write a doctorate related to hydrogenic death, not because I'm an academic per se because I've got a passion for doing something about the third biggest killer in America. Anyway. From there I've been involved in all sorts of things, raising capital, acquired a company involved in some pretty cool stuff, organ transplant, bumbarrow stem cell on an advocate for anything that's futuristic, I'm very closely involved with singularity university, forever involved in anything that looks like it's going to impact on that very important. You know that unreported statistic, guys, which is I trogenic death. Unfortunately it's not something that gets a lot of publicity. We hear about cardiology and cancer, but not number three too much. And frankly, more recently I have become an academic because I really want to get to people. I was just talking to Doctor Roxy before this started. I want people to understand. They need to know why they get up in the morning. I get up in the morning because I want to learn stuff. I never realized that until I got a lot older. The second thing is I want people understand their uniqueness because as we move forward here, you got to be somewhat unique, not just from three hundred sixty million Americans, but from six billion around the world. But frankly, I'm passionate about anything like what we're doing here today if it makes people just pick up one golden nugget that they can take with themselves moving forward. Thank you. That's exactly why we're here and what a creative, diverse background. Will have to talk more about this. ACDC band in the future. Very interesting. So you mentioned that you have a doctorate in business administration. How do you think that that's, you know, shaped the insights and guidance that you give to the clients and the healthcare companies that you're working with in a unique way? So it's an interesting one. Doctor.

Roxy that the doctor really for me was a mindset, meaning getting myself into a situation where I clearly have to justify and be more objective about everything. But what it does for me, I talk about the fact is I can barely speak English with this Australian accent, but frankly, people tell me, you know, pout, you speak three languages. Data dollar was some doctors. I'll give you a real will scenario. I was in a Midwest Hospital yesterday, Wonderful Place, but I found that I had to be cameleonic, frankly, when I spoke to the finance people, cameleonic, meaning had to change the whole discussion when the nurses and doctors walked in the door. Then I had to have a different discussion with the business intelligence folks also say that's one challenge in the United States, which I love, by the way, and I have citizenship here so what I think is the challenge of the United States is the specialization. Okay, so where I come from, unfortunately, out in the antipoties, we have to actually understand the horizontal landscape. That's how I ended up in this country. You have to understand, frankly, data, dollars and doctors, because you don't have another fifteen people around you to do anything. However, in the world moving forward, it's kind of an interesting political statement is that you've got to almost socialized healthcare, even if it's capital is too. We've got to figure out a way to get everybody to talk together, to understand those free languages. And I believe, like the original question, the fact that I had to defend a dissertation and I really got inside the minds of physicians. Right, MDS, for instance, if you want to get a physician sponsor, my doctor was related to adoption of CPOE and emrs long time ago now. Or I learn about physicians. Right, transformational leadership works, but it works in a different way. If I'm in the corporate world, I bring in with the Richard Branson or others, it's going to work even Lee Kuan You and Singapore. That kind of idea of that charismatic, that leader. What I learned from my doctor and Doctor Roxy was the fact is that it's not that. That's not how it works in healthcare. The best physician sponsors that I met were people that were selfdeprecating. If anyone remembers that old TV series called Colombo, it's those people in the room that seem like they have no idea what's happening, but they're able to get followership. It's called it's a different form of leadership. So the point of the fact is, I think from the doctorate, what I learnt was to get the insights of not only the medical fraternity, but I got to know chief information office. Is Very, very well right. And the thing is with the CIOS it's sort of like so logical, but if you don't ask them, you don't know this, if you don't interview them, and if you done interview them, with mixed Messi method analysis, meaning survey, you know, qualitative and basically bring it all together. I found out from CIOS. We all think they're about the data, there about the money. It's not because that's a bad things, because most of them report the CFI. So we're here like wow, wonder why they're not talking to me about. You know, how this wonderful interoperability and it really comes down to you gotta absolutely understand the language of the bar and just to sort of if you don't mind, and I'd like to load onto that, something very interesting. Here we are in healthcare. I'm right now. I'm involved in a bunch of things, a couple really cool and to artificial intelligence companies and Batcha and all the rest of it. He's what we know about healthcare. We think about let's put our research a hat on for a minute. He's what we know about healthcare. Nothing happens in a healthcare quickly. The second thing we know about healthcare. When it does happen, it happens because people are forced to do it. This is an unpleasant thing probably for people to listen to, but if we really cared about the clinical outcomes, well,...

...we wouldn't be burying two hundred and Fiftyzero people a year. If we really cared about the physician, you know, environment and the clinical environment, well then we wouldn't be allowing them to have episodic emrs and basically a million different systems that don't connect. We wouldn't allow that. So what we've got to do? We're got to understand those three languages. We really need to understand how to get the messages to different people, because if there is no financial benefit, when I say that, I'm going to be really clear on what I mean, because no financial benefit or there's no reason, meaning the bundle payments are changing or cms is coming down or meaning for us is coming in. If there's nothing like that, a forcing mechanism, it's never going to happen. So what I found is we've got to start thinking like the rest of the world we live in. We all live with air being be we all live with twitter, we live with Uba, and yet we come to health, can we go? Well, you know what we're going to do. We're going to keep selling these application not going to work right. We got to start thinking about thinking about software like like an ultrasound machine. People have got to see these things as revenue generators, is as horrible as that may sound, because then what's going to happen? Think about turning the pyramid upside down. If we can get these to be revenue generators and something that's actually really going to change the business of health, then we're going to have incredible clinical outcomes. We're going to have quality metrics through the roof. But I think all too often we get a lot of you know, new sort of CEOS of these small companies are either MDS or their basically very smart technical people, and then I say here, look what I've got, and what US marketing people know is it's coincidence and the try. We've got to actually look at the market and find out what is going to actually how we going to get this thing into the market. So that's just sort of gifts a long answer to your question. HMM. So you so you talked about data, doctors and dollars. So yeah, so let's dive into that just a little bit more. Give us like a real world example of how 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 or hospital system with my innovation, how when my approaching it and being able to speak those three languages? So you've got to understand they and it's really this simple, the language of the buyer. So imagine this for instance, and basically I'll talk about what we did yesterday, because literally yesterday. So when I sat with the administrators of the hospital, I did my research, I did my homework. That's the other thing people don't do this. So back to the doctor and education, I sure helps for this. So before I walked in there, I understand where this hospital actually let's talk about the dollars for a minute. I understood where this hospital was on margin. The hospital was around about two percent operating margin. You got to understand this stuff. And the point was when I talked to this hospital, I talked to them in pure financial terms. I taught them about some of the CMS, bundle payments of the coming in. I talked to them about basically how this particular thing that we're talking about, this artificial intelligence application. Never use those words, oh no, no, never use the words. I understand this is a revenue generated. This is a situation that is actually going to change your operating march. And now this soul sounds like, wait on, Pauli's selling a clinical application or absolutely. But here's what happens with most companies. They don't do that story. They pitched to the doctors. The Doctor Say oh, that's wonderful, Doctor Roxy, I want one. But then it hits the finance persons. They see if I, like we were talking to you yesterday, is that buy into it's never going to happen. So what happened? From yesterday? We actually found out that this particular institution, he's what people tell us...

...and then we don't listen to them. They said. You know what, Paul, the best thing about what you've told me is the concept that you're involved in, or you're interested in coming into a partnership with our organization, meaning we are interested in a revenue share. Now you might say, well, that's interesting. Is that a big deal? There's a company called Athena that will actually tell you that's a big deal. Back in the old days, the CEO of that company was basically, I think I'm unnecessarily jeter by the but the industry, saying you're going to start in the of our company, good luck with that. But what he did he spoke dollars. He went and actually talked to people said here, here's a software we'll just share in the share in the profits, so to speak. And my point view is basically that story that I gave these people yesterday, the financial story. I'm still talking about clinical software. Okay, but yes, doctor was if I hadn't gone into these CFOs and said, Oh my God, we've got this artificial intelligence platform, it's going to make the doctor's lives so, so much better, they're going to go. So that was number one. Number two the difference with doctors, and this is straight from the doctor or background. What I did was I talked to MD's, and if they're as MD's on here, please take this right way. WE HAVE SET MD's up for failure society. We've got them at the top of this food chain. We've said that, the top two percent of society. Now, unfortunately, they are then put into a really for thing and they just not, they can't be the humans. So what I did with these people just say the DOCSIC pose. I actually asked them to educate me on what I was selling to them. Two very spect difference. It's a really big difference. Right in other words, before we even got out of this place, these people were sort of telling me how the pilot should be developed and frankly, I'm okay with that because I let them understand. For instance, I don't talk to them about artificial intelligence. I came up with an acronym that is directly related to something that these people know about and they got it in an instant. Now, then we met with the it people, and normally it people, anyone on the line, will know this, sitting like this, looking back like you're a bunch of sales people in here, when I can all listen to you. So then what we did we empathize. The first thing that I've found with a lot of these people. A CIO has a shelf life of what twelve to eighteen months? These are tough jobs. Right once the we're looking at epic or Cerner implementations that are going to get them fired because they don't know the tail end of this thing. The first thing I said to these guys I said I want to understand your architecture. Again, it's sort of taking the time and the minute you use their words architecture, that's interesting. I'll so you've got actually this particular topology. You've got to not just know the jargon but go deep enough to survive. Right, because then these guys come back and they ask me questions. What it is it's like sleep? This guy knows. He stopped right now. I'm not I'm an electronics engineer, but I'm not someone that can go deep enough to cut code anymore, but I do know enough to understand what their situation was. And again, really it comes back to research. Before I went to this institution, I knew this place was an IBM back end. I knew this place had a particular Emar. I knew what they were struggling with. I knew what their pain points were. You probably thinking, boy, this is simple, but think about it. This is on three different levels. People don't do I'm work enough. In other words, it became about them, Doctor Roxy not about me. Wasn't about us. And you know the beauty of the whole thing. Before the end of our discussion, there we were all sitting on the same side of the table and one person from both sides meeting us. The vendor and then the organization. Two of them were up on the White Board. I don't know, that sounds like a really good situation to me. And we still have the three groups in their data, doll...

...was and doctors. This doesn't happen much and I think that that's one of the things that I feel pretty excited about. Do it by soult healthcare, you know, because frankly, and you and I've talked about this. We're not even doing healthcare yet. We're doing sickcare. When we actually do go to a genetics, to name technician, before we even enter healthcare and we start doing actual, proactive then I'm going to sign them in healthcare. But I feel committed to doing something with what we've got out there right now. So thank you so much for that. I want to kind of dive deep into this. So you know, you and I have talked previously about the research statistics and the number of health innovators that launch a new innovation into the market, especially in healthcare, and fail. They fail to reach any level of customer acceptance or profitability. So, from your perspective, why do you think some healthcare innovators succeed and some fail? Yeah, and you see, words are important. So if I said to you it's all about marketing, what most people siyes are, it's all about promotional absolutely not. So I'm going to use a definition. It's all about product marketing. So what do I mean by that? If we think back to Steve Jobs, okay, what he did? He actually got an IPAD and sat with people and said how, if you swap the single right, is that what you want to do. Yuh Huh, great. So the people that succeed are the people that actually do a lot of research and absolutely pointless trying to sell anything to healthcare. It's something that you've got to find that I met demand. And not only that, you've got to actually park your ego at the door, and I've done this before as a consultant. I'll tell people I'll mail them a card before we have the meeting. You got to park your ego out the door. So many founders are probably got IQ's of about two hundred. But what they done understand. They've got to learn to listen. But in other words, just because you've just invented the great, greatest widget live, it doesn't mean a damn thing. And I'll give you a scenario. One of my dear friends set up a meeting in New Jersey some time ago and we sat with some superpower boker Cios from the northeast. These are people managing five to seven billion dollar organizations. MMM basically part of product marketing, research and if these other companies did this they would learn that they're they're going down the on track. I just went to rs and I that's all these startups there. I would say ninety nine percent of them are going to fail. One or two of them maybe not so. Anyway, what we did at this meeting we did some really interesting things. We said, Hey, see, iows we've got this great new thing. It's going to say so many lives, it's going to cut costs, is going to do all this stuff. And they said, wait, do you want to hear from us and what we do in our lives? And we go yeah, that'd be great. So what they came back was very interesting. They were actually hugging each other, frankly and honestly, because they are actually being applauded in their organizations. Why? Because I had six hundred clinical applications. They got them down to seventy five. And think about the implications of this. Here out in the market, you've got all these new healthcare innovators saying, Oh my God, look at this new thing, it's going to be great, we're going to bring in your organization and the people are actually going to block you are saying thanks, but we're actually getting rid of six a hundred and fifty applications or two hundred, and our CEOS are saying thank you for that. Because then we're getting rid of the cost, the service costs and all the rest of it. So again it's understanding what the market is. The idea of a good idea common. I mean more seriously, if things were a good idea. US marketing types know this. For instance, Beta chord versus VHS is a great example. Beta Chord back in the day was a much higher quality. But they pick the wrong channel. Shock Horror. I'll tell you another one. Apple. I teach this stuff and people go what apple? Apples invincible. Will know anymore. But in the early days, what Steve...

Jobs did? He totally thought marketing or product marketing was a big joke when he first started. So he said I'm going to pick education, now build job A. Bill Gates got lucky. He picked business is that comes back to healthcare. You've got to really understand what you look at. Don't assume anything and Park your ego at the door. If you go into an organization and they go man, well, you better listen to that. You better start looking at things like ce MS, what laws are changing, for instance, real world example, there's a thing called an ECHMO. It's like a heart. Best Way to say it's like a heart pump for people that are waiting to go on to transplant. Now, last year the just had to reimbursement of a hundred and four thousand dollars. That sounds pretty good. This year that could go down to seventy five hundred. What. Wow. What you an opportunity for artificial intelligence. Not because of artificial intelligence. Remember, the big problem out there is not selling the feature but understanding what is the benefit and does anyone care? I mean, who cares if I come up with this little technology? I saw some great things again at trade shows and I see them and I honestly look at them. I think they're going to get the two million bucks. Maybe I'll have the six what I call pilot syndromes where I basically could jole and get some of these big medical centers to run this software for a bit, but it's whether they can move out of the across the chasm in the mainstream alley. That's that's my answer view question. Excellent. Thank you so much. So much rich information in that. So we talked before about the unwritten rules of healthcare and you touched on them a little bit, but if you had to identify them specifically, what do you think some of the unwritten rules are that you're encountering in Daytoday? Yeah, I think because I'm on this, you know, old man of the sea, some of the stuff I'm talking about, it is not anecdotal. I guess what I talk about is factual. It's after being involved in many slam doors and incredible amounts of waste of money on try to basically tell people that this is a great idea. He is the unwritten laws as far as I'm concerned, and healthcare it in the United States, but there's similarly around the world for different reasons. If there's no forcing factor, it's not going to happen. I mean, you know the people are doing to use noise. Let's just say the people that own the EMR companies did very, very well, but in a funny way they got lucky. Traditionally Mr Companies got lucky with meaningful use, the forty Fourzeros, etc. Yeah, I look at that and I think, as anyone ever thought, what the actual forcing factor? If that forcing factor wasn't there, would these episodic revenue cycle sort of centric meaning the wrong model, and they know they built the wrong model. They absolutely do. Will they even be in existence would these would certain individuals be worth three point nine billion dollars? Now they wouldn't. So one of the unwritten laws is, as far as I'm concerned, based on fact. If there's no forcing factor, that's basically a pointless situation that you involved in. Good luck. People are going to look at it, doctor, Roxy they're going to say, oh my gosh, you're so strategic and I love the accent and thanks for the Koala, and then they'll go like that and you'll be on your way. What're right. The next unwritten rule that if you're going to try and market or sell something in healthcare, if they're is no budget you. They don't just invent money, right. It's just there's no additional maybe some large medical service centers have things like benevolence funds, some information departments have things like an integration fund, but the reality is if...'re going to try and sell something it's going to change everything, and then you find out there is no actual there's no money for it. Well, you've got to actually think harder. You got to think like that guy with the Emar company that people sort of said it's never going to work. What he did? He listened to the market. So the market says, I have no money. HMM, maybe what I'll do there? I'll set up like a revenue share on the back end. That was a very, very smart thing. That meant that he was listening to the market. So basically, you know, if there's no forcing mechanism, I mean honestly, good luck with it. The idea of getting stuff that's make the doctor's lives easier. I heard a really interesting story from a friend of mine and he said I was standing in a large medical center and we just finished a presentation where we said and we are going to save you seventeen million dollars. and honestly, you would have thought it was the Academy Awards. We would have everybody would have received an Oscar and essentially everybody was yawning. So the reality is, don't assume anything. So you're in an organization and you say things like Oh, and it'll replace all these fts. That's great, but that's not how hospitals work. Again, understand the buyer might be that it's never going to get into a situation like that. The third thing about it is, as far as I'm concerned, think harder. Here's an unwritten rule be smarter than the other guys, and I'll 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 good old days of the doctors MD's knocking on the CEOS door, say twenty years ago. We go and talk to the doctors and they go on force the CEEO to buy something. Excuse me that that's not there anymore. It's gone. However, imagine if we're able to basically dig deeper and think harder and reposition it. So he's an example of that. Just say we've got a platform is going to make the world easier for doctors. Is that going to sell? Is that going to market? Well, somebody might tell me they've done it and and happy, happy, happy to you. For the most part people are going to want again. But how about if we go and see the Chief Council of the hospital? This is something I've been involved in. We start positioning this is a risk mitigation platform. Wow, what are you talking about? Well, we start looking at the MD's in the world. We find out the neurosurgeons are the number one sue doctor, followed by cardiac surgeons and and then you start thinking malpractice suits. Now, the good old days it didn't matter the organization, but these days many doctors, I think it's fifty two percent, now work for the hospital. So all of a sudden you may be able to through thinking harder and talking to different people in the organization, if you start talking with Chief Council or a chief quality officer. I kind of call it this Venn Diagram of clinical, fiscal and quality. I'm not going down the triple a thing again. That's another marketing pitch. But the point is. The point is. The third rule is you've got to think harder. You cannot assume that whatever you've got, in my humble opinion and factually, that anyone's going to listen to it. Everybody, everybody out there, is going to take the meeting, they going to do the pitch, 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 this actually an end goal? So for me some of the young rotten rules, in this country at least, are essentially understand is are a forcing factor secondly, they're actually away? Is there actually a financial way to get this done? And thirdly, are you actually talking? Are you really talking about the benefit of your product, meaning, Hey,...

...we can actually cut down on Ma'll practice suits? That has a different ring to it than are we got an inner interoperability engine. That's going to it's going to be great. The ducks are going to love it right all list top US off. It sounds like Larad idea, but we might have to go outside and camearly on it, like go to a different depot and have a very different impact. So that's my tip on it. I think he touched on a bunch of different things that like positioning strategies, messaging strategies, product market fit really, you know, focusing on the buyers needs and solving their real problems instead of about your widget and how awesome it is. You know, these things are just fundamental to marketing, no matter what to no matter what industry you're in and in. There's so many additional complexities to commercializing and innovation, and healthcare, let's talk. You touched on pilots a little bit and I think that's one of those additional complexities to healthcare. You know, it's a real challenge. I hear else health innovators talking about this all the time. They've got this innovation, they get really excited when they get this pilot opportunity. But many, many innovators get stuck in what I call pilot purgatory, right, they just never come out of this pilot phase. Describe for US your experience with that phenomenon and you know, how can health innovators avoid that getting stuck in there? So, and this this is just coming from real world experience. So many, many years go about a phone call and somebody said, how can you come in and look at this comp me and tell us whether we should keep it or shut it down? Yeah, sound like an interesting thing to do at the time. Now, most little companies, I'm not going to name the organizations, but everybody knows what. What little companies think is the right thing to do is to find the big brands out there in certain name right, M medicals, medical center, and it seems like a great idea because then you put it on your website. You know you've got these six accounts. It's wonderful. Look frankly, guys, they're never going to pay you. It doesn't work. Like that, and I'm not saying they should pay you. They've got this. They're built up brand equity in these massive medical centers and frankly, it is a good idea to work with those organizations. They're wonderful to work for. But over here you've got a thing called a business with cash, file etc. So, anyway, this organizationals I've got involved in, they had all that right. It was a midwest company. They were flying around the country to all those medical centers, burning cash, enormous amounts of sales. Not any anywhere likely, because frankly, it's kind of a privilege to be in some of these medical centers. I mean that quite honestly. Sy It, but most people like this organization. I said, how about we hunt closer to home, right? What? What? So we literally, and this is true story, we physically walked across the road from where this little office I could net medical center. I'm not making this stuff up, and we walked in and said, hey, we're doing ABC. What do you think? So after we got through the whole, you know, discussion about the local football team and all this type of stuff, we started. But what I did with those guys, I know the pilot syndrome. Honestly, I was just out of JP Morgan, and when you talk with some of these guys that everybody knows the game, might see you everything in your power, and I'm not saying it's easy, you got to do everything in your power that if you do a pilot, if you really have to do that, because unfortunately healthcare has been idiotically set up into this thing where everything's free. It's just not free. HMM. Really Right, contracts. I like to do a nondisclosure agreement around a contract that will then actually move into something.

And what I say to the people in there, and I never just talked to see io, I talked to dated dollars doctors. I'll actually talk to these people say look, we want, we really want to do this, but we're a business and for our successes. You know your success. You can't. You can't run a business on nothing. And I'd say that's the number one thing I hear at least trade shows and people go home. We're in at and they go abcde and of course those organizations love to see you tech. Some of them might get through some how. Do I say this in a nice way? Go to the boring places that are actually doing here that don't have. You know, let's just pick some. I don't want to pick cities because I don't want I've said anyone, but that maybe you go to a particular place in Georgia, you might go to a different place in North Carolina, you might go to Nevada rather than California. I mean, I love all these places, but sure, company. It's what I say to people. Just you're here, right, if you're in New York City, why are you? Why are you flying out the inner mountain health again? You know, if you're a company that's set up in Houston Texas and yet you're trying to go after Mayo Clinic, what right you're not? Hunt locally and be really smart about it and just understand somebody saying to you that they love you. Technology and all the rest of it. It doesn't doesn't necessarily mean that it's going to pay the next check. So anyway, with that company, with then hunted locally. We got got to know the CIOS Latreuecross road. He then told us whether the next CII was. We then set up a CIO dinner at Hymn's. This is the long time ago. In New Orleans when I all came along, and the absolute justification for the dinner was this. We're talking about artwork and golf, meaning no pitching, right, I'm sounds like. And we went to this dinner and we got to know these people and we built rapport and relationships. The people happen to come from all of the five sectors of the United States, so it's kind of helpful. For the point was, then we diffused out from there and we never had one nickel of free pilot and I'm not sorry. It wasn't it was easy. It was tough. So listen, why are you do a pilot will? I saw look and we bring the statistics up. I mean pilots don't work. They don't they the kind of look good for pite clinical research paper or something like that. But if you can get into a situation, look, it's like, come on, we're in the world, right. Anything you get for free is worth exactly what you get. If there's no if there's no exchange between not it really means that there's no it's not a real relationship, and I know that very, very well. Though. Anyway, I hopefully I've answered your question absolutely. That's fantastic feedback. So the last question I have before we open it up to q and a is, you know, we've got several health innovators that are in the trenches right now. So what advice do you have for them? So if I, if I was to give you one piece of advice, learn finances. If you don't know them, learn them, learn them really well, start to understand the sounds like, what is he talking about? But seriously understand you're running a business. You might be passionate about what you've got, you might be in the clinical sense or the technical sense whatever, but the a being leader in a way that you understand when it's time to step aside. I saw some different leaders along the way. One of my favorite companies is life is good. Why? Because I make a tshirt that is actually high quality and frankly, I love t shirts. This that I'm doing right now, this is all part of personal branding right now. But seriously,... the point of it is I would say to innovators don't assume anything, question things, think harder, but think beyond okay, so I think when I hear a lot of this stuff about artificial intelligence, I hear about blockchain, don't just listen to that. Do you research right. So if you think about blockchain, what chaining itself is just a story that normally is followed by are you mean bitcoin? So people completely missing point. What chain in itself will change the world? There's a statement. There's no there's no doubt about it. The technology right now is too early. But let's think about healthcare for a minute. If I'm an innovator and I'm not thinking about other technology. So that's my point. Think harder, do more research. Don't assume your business is going to be there for another five minutes, low one, five years. You've got to be absolutely thinking ahead. You don't want be seers or Boston store, where you're sitting there after it's all happened, go what happened, like Whoo, where did Amazon come from? Likewise, with Amazon, HMM, should be looking at Jack Marn Ali bar and saying well, hang on there buying stuff and Ali Barber and selling it at Amazon. Some of my vice back to innovators is you're not nearly as smile as you think you are. You might have an Iq of two hundred, but Iq is not what's going to win this battle. It's really doing deep research back to block chain. So when I first looked at that I thought now I'm a technical guy, so I thought it looks interesting, it's good story, and then I thought weight on. There's three things that blockchain could do for healthcare. To I don't know, unique identify, now that's interesting. Smart Contract for all the Judication, immutable database. That's not a bad start. But that's not really the point. Let's think harder on that for a minute, Doctor Rock so you let's think real hard on that. In healthcare today there is no patient centric approach. There just isn't. If I got to, going to use the name, but an Mr Insert name. This is an episode of care. I'm a doctor, I need to look at the longitude and all view. But but it hasn't been built that way. It's a wrong model. It's been being built around the revenue circle. So here's the thing. People missing. blockchain part from the fact it's going to be, you know, here is the here's the producer, here's the user. There's going to take everything out of the middle, meaning all of the layers of healthcare assurance, blah, Blah Blah. But he's the more important thing. What they miss on blockchain is. They get hung up on the token. Blockchain is like a race track of the future. It's like the Internet turned inward database. But right now what people don't talk about is if I have a blockchain wallet right all of a sudden my wallet is right now. It's for a token. It's fine for a financial thing. There's no reason that can't be a patient centric electronic medical record, patient centric identification of everything for genomics. There we go. We might do some healthcare sometime. The point is, if I'm an innovator and I feel like I'm just about to get over there, that's number one. Number two for the innovators, stop trying to sell direct guys. It's just too hard. Yeah, go to the big medcenters. Why don't you say to yourself, Hey, maybe there's a company out there that I can make smarter, meaning that there's a company in the device market. There could be a company in the farm or world that could be. Do you know, if there's one thing that's going to make you successful, he's a clear real world example. I was involved with a company and I said, Hey, we need to oem our software shrink wrapper and put it in this other companies portfolio. Now we're only going 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 fought with the Bord of directors on this. They said you are under selling the product. It's a million dollar platform, blah, Blah Blah. I said, okay, fine. So not long after that we're getting three hundred and FIFTYZERO dollars cash per month. Right, and it kept the company of flight so stupid in that when it is people think that they're they're able... and United States of America. What do we got? I thinks fifty eight hundred hospitals. Start to understand how people buy stuff. Start to understand. You know, I've done a lot of work in supply chain where people will come to me with this new little thing and say, Oh, it's going to change, you know, this new que chip, it's going to be great, because I do a lot of stuff with people in China. Reality is, think, Harla, look at beyond. Yeah, the direct channel. That would be the second thing I'd say to innovators and I'd also say this question and then question again and when you finish questioning. It's a little bit like when you do your doctorate right, proof for it, to prove for it, and proof for it again, because, guess what, it changes from day to day. Okay, it's like I'm in the back of that Uber and San Francisco and I said to this guy, what are you guys thinking about with block chain? And when I told him about the idea that the hidden message behind blockchain is is that it's going to take out the middleman and he goes weight on. Are you kidding? That means it takes out of Uber and I said absolutely what they can't be right. So that's what I'd say to healthcare innovators. You know, I'm not saying take the easy road, but if you find out there's a device vendor or a farmer or biotech or something that's got a gap and you can sell a little baby piece of whatever you're doing, a thousand times are you're going to be in business and then you can go on. Then you can go and you might be able to afford to do your pilot syndrome if you really have to do that. But you might find wait a minute, all the I'm not don't need to be paying a hundred and fifty grand a year to a sales rep and, by the way, I'm a sales guy, so I'm not against sales people, but I'm just saying a business to business model is a really smart way to go for a small company, and often, often small companies for me missed two things. Product. The first period marketing, meaning they're building something then trying to sell it. Yep. The last one is channels. They do all their work on basically trying to just stay alive. Their websites awesome. Or why? They're got a great website. You got a good website, no doubt, but I'd say I'd spend more time on getting the message someone understand. Don't assume anyone understands. While we're actually using neural networks, machine learning, deep learning, were actually going to go to reasoning, computing, and what do you think? And the people on the other end, especially if they're MDUZING thegn yeah, that's interesting and they're probably thinking of themselves. I wonder where I'm going for dinner to, not knowing how you're talking about you know. So, yeah, what we're doing is going to take fifteen minutes off that stupid report you do at the end of the day that, I say, what'll just what? Yeah, that's so thank you so much for sharing. What's the best way for people to connect with you? I've got about Elevenzero data points. I might probably, I've got it doesn't matter. Text Message Linkedin WHATSAPP. You know, you know. Come on, Doctor Rock. So you know this. I mean, I'm connected, so and I'm happy to talk to people anytime. I'm not the Oracle, but I might just make you do one thing. It's think harder. Just do that for me. Just think harder before you do anything. Question Yourself. I mean honestly, I do it all the time. I even question what I'm talking to you about because I go back and I want to test. I want to see does this make sense? And I'm always here's a thing. I'm always talking to the customer like. Yeah, we talked all these different people, data, dollars, doctors. I asked them, I said, look, before we start this discussion, what's going on in your life? Right? We found out what what they cared about. Frankly, we then sculpt that how we were talking them. It didn't change that much. That did a little bit. There's some style stuff there that I didn't understand. Like he's a classic. And we'll just close out on this. We're talking about artificial intelligence and healthcare. So first thing is stop using that word, because it's it's only relevant to a bunch of I...

...people and everybody else it's like it's going to it's crazy. He's going to take my job and all the rest of it. It's it's just not right talking to the wrong people. But you know, I said this guy, you know, understand, I understand, I understand, you know your workflow, but I'd like to understand a little bit more. And he's exactly what he said. He said, you know what, Paul, no one ever asks us this, but he's what. I'll tell you happens. He said, I'm in a nice you and without doubt, everything goes wrong when I'm not there. Think about how powerful that statement is if you really listen to it. Artificial intelligence can instantly help that, but no one's ever at Austin that before. So essentially everybody's trying to fix the problem while all the people are there. And he said, if I could just pick up a little a look on my phone, sign hi, bed six needs to come up for vent alida. He said my brother would be quiet, but it never happens like that. I'll get in the next day. I'm going a whole bunch of stuff I'm going to deal with. So thank MMM, absolutely great closing words for us. Thank you. What's the difference between launching and commercializing a healthcare in avation? Many people will launch a new product, few will commercialize it. To learn the difference between launch and commercialization and to watch past episodes of the show, head to our video show page at Dr Roxycom. Thanks so much for watching and listening to the show. You can subscribe to the latest episodes on your favorite podcast APP like apple podcasts and spotify, or subscribe to the video episodes on our youtube channel. No matter the platform, just search coiq with Dr Roxy. Until next time, LET'S RAISE OUR COIQ.

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