Month: September 2019

Consumers are looking for convenient, price-transparent solutions to manage their healthcare.

Episode #24

Podcast with Giovanni Monti, VP, Director of Healthcare Innovation, Walgreens Boots Alliance

Consumers are looking for convenient, price-transparent solutions to manage their healthcare.
paddy Hosted by Paddy Padmanabhan

In this episode, Giovanni Monti discusses his current role and how the digital healthcare innovation group at Walgreens is focused on bringing new and sustainable innovative solutions to consumers.

Innovation at Walgreens is to have consumers manage their healthcare in a convenient and cost-effective way with great outcomes. It is all about delivering care to consumers when they want it, how they want it, and where they want it. Some eight million customers walk through a Walgreens store every day. Through their recently released Find Care app, Walgreens has started providing a range of personalized and localized healthcare services to consumers. Going well beyond the traditional e-prescription function, the app is a digital front door that delivers services from a curated set of 30 partners that can be accessed anytime anywhere with price transparency.

Giovanni’s current role at Walgreens is to focus on extending these partnerships by working with the right innovators at the right time in their product and market growth.

Welcome to the big unlock podcast where we discuss digital transformation and emerging technologies in healthcare. Here are some of the most innovative thinkers and leaders in healthcare and technology talk about how they are driving change in their organizations.

Paddy: Hello everyone and welcome back to my podcast. This is Paddy and it is my great privilege and honor to introduce my special guest today Giovanni Monti, Vice President and Director of Healthcare Innovation for Walgreens Boots Alliance. It’s very rare for me to actually do a podcast interview in person and this is one of those rare occasions. I am at the Walgreens Boots Alliance corporate headquarters in Deerfield, Illinois. Giovanni, thank you so much for joining us and welcome to the podcast.

Giovanni: Thank you Paddy. Great to be on your podcast and doing it in person.

Paddy: Very good. So, let’s get started. Tell us a little bit about your current role and the digital Healthcare Innovation Group at Walgreens.

Giovanni: Sure absolutely. So, Walgreens and Walgreens Boots Alliance in particular is basically the largest pharmacy networking in the world. And so, in my role I’m really focused on extending the relationship that customers have with their pharmacies and pharmacists from the pharmacy to overall healthcare. And to do that not just in store but where and when they want it with the view of helping the customers better manage their healthcare. We do that by sometimes developing new pharmacy services delivered in store. Other times developing a digital innovation that are then delivered in a nominal channel way and it’s really like all the innovations a great team effort not only my team that which is between Seattle, Chicago, and the U.K. But the overall company from the stores to everyone else as well as partners because through our innovations we also bring lots of partners and innovators to market.

Paddy: And we’ll cover a lot of this as we go along in the conversations. You mentioned a couple of things. Clearly your focus is to take your retail consumer relationships to an online relationship. That’s one of your focus areas and you also mentioned healthcare is all about delivering care to consumers when they want it, how they want it, and where they want it. I know that Walgreens made a big digital splash earlier this summer with your new app you want to share a little bit about the app.

Giovanni: Sure. Absolutely. So, the Walgreens app was already a very successful app that Walgreens customers are utilizing on daily basis to manage their prescriptions. And what we’ve really done is a year ago we started extending that app, as I was saying earlier, enabling consumers to manage their healthcare more broadly. And so, what we’ve launched is – Find Care – which is a new solution available on the Walgreens app and on Walgreens.com and it’s a platform enabling individuals to connect with healthcare solutions based on where they are and based on their healthcare needs. And we’ve designed it in a way that it’s totally customer centric and on Find Care then consumers would find. Of course, all the Walgreens services that we deliver but also a curated selection of partners. And these solutions deliver by these partners. Sometimes in-store other times purely digital in a very consumer friendly way. We launched it a year ago approximately and then we keep adding new partners and new solutions based on what customer needs and based on what we learned from the eight million customers that goes through Walgreens stores or digital on a daily basis.

Paddy: I will come to the partnerships in a minute. Could you tell us what was the need you perceived in the market as you started thinking about this app for the consumers.

Giovanni: Yeah absolutely. So, what is happening in healthcare, as you are covering in so many of your podcasts, is that consumers are looking for convenient solutions they want or sometimes need to be more involved in managing their healthcare costs some time are escalating. So, there was a need to connect individuals to more convenient price inspiring solutions. And we had the opportunity of doing it. Given our great footprint and daily traffic as I say in stores and digitally. And we already had a great starting point because through Walgreens we have lots of partnerships on different customer needs in different regions with different partners whether it’s you know labs, and urgent care, and primary care, or other partners. So, with Find Care, we aim to address these customer needs of a convenient transparent access to their health.

Paddy: Let’s talk about the partnerships right. The Find Care app which by the way is on my phone as well. I’m a Walgreens customer and I pick up my prescriptions using the Walgreens app and now I have Find Care which gives me a whole menu of offerings. I’m going to let you actually talk about the offerings and you mentioned a curated list of partners so tell me about the curation process. Well firstly how did you curate the services that you wanted to offer on the app and then how did you curate the partners who are going to offer it on your behalf on your digital property.

Giovanni: Yeah absolutely. So, we want to make sure that customers have access to proven reliable solutions to manage their healthcare. And we look at what the customer needs are, what the various innovations are, what is available on the market, but maybe not really utilized because of lack of direct access to consumers. And we come up with a prioritization for the Find Care development in terms of adding new services and new partners. As we identify target areas then we aim to start with the leaders in that area. And again, the starting point was really great because when we launched it, we had already 17 partners on board. Starting with who was already working with us in store maybe with co-located clinics, urgent care, online doctors from MDlife to Providence, Narcolepsy, etc. But then quickly Find Care has already become a way to based on the customer needs attract to Walgreens new partners that deliver their solutions. So for instance over the past few months we’ve announced the extension of Find Care to chronic condition management, with now Propeller available on Find Care to manage asthma and COPD or Dexcom in continuous glucose monitors. So, there is a whole stream of solution providers. There are also new care delivery models whether it’s doctor or house calls like Heal. And in the west or tele derma solutions in this case nationally. And then we also look at national versus local in a way because depending on the service and depending on the partners which is what makes sense. So we’ve also added in certain geographies where we didn’t yet have a great local offering through Find Care more partners like Houston Methodist or other national solutions as well. So that’s really the principle of how we develop the partnership on Find Care.

Paddy: And now how many partners are you right now?

Giovanni: Approximately 30 but it’s growing quickly. Yeah. So as of today, 30 but maybe.

Paddy: Maybe the next time when we speak it will be much bigger than that.

Giovanni: Some offer more than one service because they might have urgent care and telehealth through Find Care for instance.

Paddy: So is it fair to say the focus of the offerings is routine primary care but also urgent care. Are these the two main focus areas?

Giovanni: You know it goes all the way to the beauty of a platform like Find Care is that it really enables deep personalization and localization. So, we are adding services that we know will be valuable only for certain segment of our customers. But when they are there would be very valuable. So, we’ve gone all the way to. tele dermatologist I have mentioned earlier or even second opinion is already available on that on Fine Care. So clearly telehealth, urgent care, primary care is some of the focus areas, but we like any internet platforms we can manage the long tail.

Paddy: So, let me switch topics here for a minute and talk about the data that’s powering many of these applications. Now you mention you have a very strong foot traffic in your store so obviously you have a very strong understanding of your retail consumers and retail healthcare consumers. Now to build more of a healthcare relationship you probably need other data sources as well about the clinical and their claims history and so on and so forth. Can you talk a little bit about your data strategy as it relates to building out new products and engaging more with your patients?

Giovanni: Yeah absolutely. So, the way we look at it is that we are totally focused on the customers interests. Walgreens and the other Walgreens Boots Alliance companies in other countries are a very trusted and pharmacies are a very trusted counterparty or healthcare stakeholder. And so, there is a great level of trust that consumers have in interacting daily with us in store and digitally. We with Find Care continue to be totally focused on the customer’s interests. So as Fine Care evolves both from a product perspective as well as partnerships and as a deeper data strategies and opportunities are becoming possible, we prioritize and decide the entire entirely the art of the possible enabled by data centered on the customer interest.

Paddy: And I did notice that the Find Care app all the services that are offered on the app. There’s actually a price indicated as well. So I assume that it was a conscious decision on your part to list all the prices for all of the services so that consumers had price transparency when it came to your store just like they would for anything that they bought at the store even though it’s a digital health offering and that’s kind of a unique and interesting thing as well.

Giovanni: Yeah. No absolutely we believe it’s where we know from customers feedback and insight that it’s something they very much look for and we’re very focused through the Find Care platform on building the necessary transparency together with the convenient access solutions.

Paddy: So the applications like Find Care are what I refer to as digital front doors. This is like a digital storefront for consumers to come in and veil of broad range of health care services. Walgreens is not the only company that is launching these kinds of digital front doors. A lot of traditional healthcare providers as well as non-traditional healthcare providers are getting into the business and so the competitive landscape for primary care, urgent care type of services is evolving. Would you like to comment on what you see as the current state of the market as it relates to the emergence of digital front door type of offerings.

Giovanni: Yeah sure. So, it is absolutely an evolving framework in a way and with non-traditional players as well. And even I would say the traditional players are playing their role in non-traditional ways because it is possible today thanks to the evolution of a technology, data, interoperability, regulation depending on the countries et cetera to connect the customer and patient journeys in different ways. With Find Care and with the Walgreens network we are focused on enabling those new care delivery models and customer journeys without you know the unnecessary barriers between one and the other. So for instance a while ago almost a year ago we in Walgreens we launched a collaboration with Humana opening partners in primary care centers for seniors or with more recently announced one with VillageMD for primary care offering forum for adults and these collaborations. Of course, then as they go live they also go live on Find Care where there are many other evolving offerings as well. I think the principle that we must keep in mind and design to is the integrated journey where it’s possible between the various care delivery stakeholders and pharmacists and primary care and the rest which is what consumers are looking for in addition to price transparency.

Paddy: And you also have partnerships with hospitals I think Advocate Aurora is one of your partners. So, you I am assuming have a referral arrangement in place where your consumers were looking for more acute care type of services. You could refer them to one of your partners in your patient care network. Is that the intent?

Giovanni: So, it’s all built as I said earlier with customers first transparency, and choice, and consumers depending on where they are see different offers. Because in their geographies there might be certain partnerships and those will be different from other geographies like healthcare systems are across different states.

Paddy: How has the response been since. So, the app has been out there for what three months four months now?

Giovanni: The latest services yes leaner version with fewer partners and services now a year. Did the response. Look we’re really pleased with the response I would say. And what we were talking about partner so let’s continue that. We have almost doubled the number of partners and services available on Find Care in the first year which is a great sign of the interest that so many partners and healthcare innovators have in bringing through us proven healthcare innovations to market. Because again we have such a good connection credibility in daily flow of customers that we can truly help our customers partners. But also, the reaction from the stores and from customers has been very good with the colleagues in stores that I’ve learned they’ve gone through training and now have one place to go to find new solutions to recommend to consumers. Customers these stories they liked the most of a customer’s reaction is when they’re actually able to find the end to end solutions on Find Care may be in store where a colleague recommends them for a certain need to access the platform they do a consultation or access any of those services and are able to walk out of the store with their health need. So, which is pretty impressive. Whereas from a more if you on healthcare innovation and digital perspective we’re also quite happy that in less than a year we were already shortlisted as a Webby honoree which is a great start for a new digital.

Paddy: Yeah. Congratulations. Let me take a step back now you’re also the Director of Healthcare Innovation and this is clearly a very innovative new offering from Walgreens. Can you talk to us a little bit about how you define innovation? Every organization has a different definition. What is your definition of innovation? How do you define success metrics and how do you track? How do you measure success with innovation?

Giovanni: Yeah absolutely. So, I’ll repeat what I said earlier a bit because it’s really what we stand for in a way. We want to have consumers manage their healthcare in a convenient and cost-effective way and with great outcomes as much as possible. And so, for any innovations we are introducing we are very focused on that. We’re equally focused given our scale ON MAKING INNOVATIONS sustainable which then means that for all the stakeholders involved whether it’s the digital therapeutics or connected care companies bringing innovations or our networks and scaling them up etc. We want to ensure that we can serve the millions of customers and patients we have. And so, we are very focused on from the beginning designing innovations that have that level of sustainability. So again, given our scale. We also liaise a lot with the rest of the healthcare stakeholders or national healthcare systems. Because we know that when we succeed in innovations there is a profound impact on the local health care system. Just think it. I don’t know immunizations for instance a few years ago before they were available in pharmacy the landscape was totally different. And think of the profound impact it has had on care delivery. The role that we’ve had in adding these services in pharmacy. So, you know sometimes for smaller startups is easier to start because they have to worry a bit less about the implications at scale. We have the luxury of developing innovations in a group that is just in the U.S., 8 million daily customers. So, we feel that responsibility.

Paddy: Now of course Walgreens Boots is now much more than a U.S. Company it’s a global firm. And when you look at your company’s business in a global perspective and when you look at innovation pipeline and prioritizing innovation investments and taking care of customers’ needs in different global markets how do you really manage the tradeoffs and how do you really prioritize when it comes to managing let’s say consumer needs in Europe versus North America. How do you do that as an innovation group that’s responsible at an enterprise level?

Giovanni: Yeah. So, innovation happens everywhere. First of all, like in local communities with local contracting relationships with the local healthcare system and they maybe come up with a new way to deliver a healthcare service et cetera. And that’s fine. Absolutely. We can help scale some of those innovations. What we’re very focused on in my team in a way are the those innovations that are truly scalable across geographies because they build on common customer needs, common platforms et cetera. And I would say for instance the example of Fine Care is probably a good one.

Paddy: Yeah. And in addition to internal innovation do you have a formal program for looking at what’s going on out there in the marketplace. For instance, the startup ecosystem in the United States, digital health innovation ecosystems. Billions and billions in VC money that is going to fund startups that have very interesting ideas but of course they also come with a lot of risks. How do you really harness the external innovation in a way that it doesn’t put you at too much risk? But at the same time gives you the opportunity to tap into the innovation that is available. What are the tradeoffs there? How do you look at that market?

Giovanni: Yes. So, we are very active on the market with lots of different offices across my team and others are constantly speaking with the innovators. Let’s remember that innovations can come from you know startups as well as big leaders in their space. And we again are constantly speaking with innovators. At the same time, we’re very focused on the strategic priorities that we’ve identified based on our road maps and the customer needs because it’s important to work with the right innovators and at the right time to then really help them grow at scale. And sometimes it’s better to wait and touch base again after six months or a year when the product roadmap, marketing roadmap whatever is better aligned in these dialogues and relationship with innovators for instance. I would also add you know we go from having added the propeller. A great example of a relatively new company to actually having introduced services on sleep with Philips which is almost the other scale of the size continuum.

Paddy: One of my earlier guests on my podcast put it this way. They said we look first internally to see whether the solution is available somewhere in the system. If you find a need in the market and if it isn’t available, we ask ourselves can we build it. Those with the resources that we have. And if the answer is no to that then we’ll go out and look whether such a solution is available out there in the market. And they of course do one more thing which is that if they really find it interesting solution then go out and put some venture capital money into the company themselves. Do you have a V.C. fund? Do you look at companies that way?

Giovanni: We’re really focused on bringing new solutions to consumers. That’s our DNA with the network we have, the role that we have in pharmacy and our network. And sometimes innovation is available. And however, they’re not where the customers are, and we can how that happen. So that is really our focus and the way we can create value for consumers as well as for innovators that want to scale up their innovations.

Paddy: That’s where we all said. Well we’re coming up to the end of our time here. Giovanni is there any closing thoughts anything that you would like to share maybe some new innovation that you’re working on that you’d like to share with us?

Giovanni: What I would say is first of all thank you again for the opportunity of being on your podcast. And I would say just go on Walgreens.com and check out Fine Care and see whether there is an opportunity for your company and healthcare system, solution providers, digital therapeutics, whatever it is to connect with our customers in a personalized targeted way. I was mentioning earlier Phillips, it’s the latest addition to the solutions that we offer via Fine Care with their smart sleep analyzer that providers personalized recommendations. There is a there is a lot that innovators can do with Fine Care and the Walgreens scale and network. There is a rich product roadmap and partnership roadmap. And I look forward to sharing other developments maybe in the near future.

Paddy: Yeah. And we’ll be back again, and we should touch base maybe six months to a year from now and I’m sure you’ll have a lot of new updates and lot of new innovations to talk about you on. Giovanni it’s been such a pleasure speaking with you. And once again thank you for hosting me at the Walgreens Boots Alliance global headquarters here in Deerfield, Illinois. And thank you once again. We’ll be in touch.

Giovanni: Thank you. My pleasure. Thank you.

We hope you enjoyed this podcast subscribe to our podcast series at www.thebigunlock.com and write to us at info@thebigunlock.com

About our guest

Giovanni leads healthcare innovation at Walgreens Boots Alliance (WBA), the first global pharmacy-led health and wellbeing enterprise. Prior to leading the healthcare innovation, Giovanni was Director of Corporate Development and M&A at WBA since 2012, with previous experience in corporate development, M&A, and management consulting.

Giovanni is a member of the Advisory Board of the Healthcare and Pharmaceutical Management Program at Columbia Business School, and holds a Degree in Economic and Social Sciences from Bocconi University, Milan, and both a Master in Business Administration (MBA) from Columbia Business School and a Master of International Affairs (MIA) from the School of International and Public Affairs, Columbia University, New York.

About the host

Paddy Padmanabhan is a widely published and quoted thought leader on digital transformation in healthcare. He is the author of The Big Unlock: Harnessing Data and Growing Digital Health Businesses in a Value-Based Care Era, and the CEO of Damo Consulting Inc, a digital transformation and growth advisory firm based in Chicago.

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Digital transformation is not just about digitizing and automating workflows

Episode #23

Podcast with Dr. Sylvia Romm, MD, Chief Innovation Officer, Atlantic Health System

Digital transformation is not just about digitizing and automating workflows
paddy Hosted by Paddy Padmanabhan
In this episode, Sylvia Romm discusses her role as the Chief Innovation Officer at Atlantic Health System and how her prior experience in pioneering telehealth adoption influences her views on digital transformation.

Most healthcare organizations are reactive today as opposed to being proactive. Digital transformation is off to a slow start but disruption will be here before we know it. According to Sylvia, innovation at Atlantic Health System starts with developing internal innovation and standardizing it across the health system. It also means developing external partnerships to build an innovation pipeline. However, she does not believe in investing in “shiny new things” that do not help their health system move forward.Sylvia believes that digital transformation is not simply automating or digitizing all the current workflows. It has to go beyond replacing in-person visits with one-on-one virtual visits and look at reimagining patient and caregiver experiences.

Welcome to the big unlock podcast where we discuss digital transformation and emerging technologies in healthcare. Here are some of the most innovative thinkers and leaders in healthcare and technology talk about how they are driving change in their organizations.

Paddy: Hello again and welcome back to my podcast. This is Paddy and it is my great privilege and honor to introduce my special guest today Sylvia Romm, Chief Innovation officer of the Atlantic Health System. Sylvia thank you so much for coming on our show and welcome.

Sylvia: Thank you so much Paddy. I’m really happy to be here.

Paddy: Thank you. So, let’s get started. Can you maybe just tell us a little bit about the Atlantic Health System and your current role for the benefit of our listeners.

Sylvia: Absolutely. So Atlantic Health System is the health system that’s in northern New Jersey. We are a mid-market sized health system with six hospitals and four ACOs, about 4000 physicians, and between the hospitals we have just around a thousand beds. So that gives you a sense of the size of our health system. We have really a visionary and strong leadership which is actually one of the main reasons that I came here. Our CEO is actually one of the leaders at the American Hospital Association and he’s been really great about bringing Atlantic Health System together really as a health system and thinking about ideas in a broader and more visionary way.

Paddy: I know that you came into your role recently and prior to that you were involved for several years in pioneering telehealth adoption. Do you want to talk a little bit about that and maybe give us your assessment of telehealth adoption today?

Sylvia: Yeah absolutely. I’ll sort of start a little bit back and give a little bit of my background just so your listeners understand how I think about telehealth and what angle I’m coming from. So, I’m a pediatrician by training and I was practicing as a hospitalist when I had my second child and wanted to have a little bit more flexibility in my schedule. I actually came into the telemedicine world as a physician looking to use telemedicine as a way to see patients and as a way to see patients from home. So that was a little over five years ago which doesn’t seem very long, but it is kind of an eternity in the adoption of telemedicine. And I started with a company that was just starting up doing urgent care video visits at the time. Pretty soon after that I started practicing with them and I thought as a pediatrician and as a new mom for the second time that new parents are the ideal target for telemedicine. And you have lots of questions and it’s kind of hard to leave the house. And so, I started a telemedicine company for new parents with breastfeeding support that eventually started offering nutrition support as well. After getting that going, I became a subcontractor of a much larger telemedicine company called American Well providing those clinical services to them. And then eventually came on to American Well full time. And through American well, started off in kind of a medical director role. So initially looking at clinical guidelines and quality but pretty soon thereafter really going into more of an executive role working with health systems to think about how to adopt digital technology. So, my view changed really from a user as a physician of telemedicine technology to truly finding out how digital healthcare delivery can fit into the larger ecosystem. So, when I think about that and I look at telehealth adoption there’s a really wide variety of adoption depending on which population you’re looking at both from the patient side and from the provider side. So, from the patient side you see most of the visits particularly in video visits. And this did take another step back. I’m going to be talking about telemedicine not meaning only live synchronous audio video connection. I actually like the term digital healthcare delivery more because I think that allows people to think about different technologies in the same way. But I know that most people when they talk about telemedicine, they’re talking about video visit and so I’ll try to be clear when I’m talking with one of the about one or the other, but I sometimes will use it interchangeably. But the vast number of video visits or even phone visits that are happening between patients and physicians are really urgent care style visits that are set up by health plans. The adoption by health systems of using telemedicine again the volume still tends to be third party clinical providers. That are providing video or telephone visit but you’re starting to slowly see health systems using telemedicine technology so their own physicians can see own patients. But that’s taking a lot longer to ramp up.

Paddy: That’s still in early stages. So that’s an interesting background. So now you are Chief Innovation officer at Atlantic Health System. How do you define innovation and what is your innovation model at Atlantic Health System?

Sylvia: Yeah that’s really a great question because innovation can be defined in so many different ways. So, when you look at innovation roles and innovation divisions and this is a new role at Atlantic Health System. And so, I am defining a lot of what it means to be Chief Innovation Officer at Atlantic health as we speak. When you think about innovation departments or innovation shops there are a couple of just very large buckets that you can put the shops into. One is taking internal innovation within the health system and developing it maybe standardizing it across the health system especially if you have a very large health system. You can have pockets of innovation and it doesn’t even make it to the other sections of the health system and potentially even taking some of those ideas and commercializing them and spinning them out. Another way to think about innovation is bringing in external partners. This is often done through something like a venture arm where you are seeing the innovation that is happening in the entire ecosystem and trying to bring that innovation into your health system. One to get the innovation that is happening explicitly with that company and with that partnership. But also to bring in some of those ideas and the mentality maybe for example design thinking which has been supported perhaps a little bit more in some of these external companies and just bring that type of thinking within the health system so that it helps you innovate as well. And this position is doing a little bit of both. Our health system has a group called Atlantic Health Care Advancement that has been working as an innovation pipeline to bring innovative ideas from people across the health system and it really is why swath of people that have been submitting ideas to the pipeline anywhere from specific devices that then we support to prototype and look to use internally and externally. But also, in thinking about care model delivery in certain processes. I mean it’s been really great to see people get really engaged in that and really think about how to bring innovation into their day to day. We’ve also started building out thinking about investments. The American Hospital Association for example has an investment fund that we’ve become an LP of and we are working with them to become an active LP and have really a reciprocal relationship where not only are they bringing in pipeline companies for us to look at but we’re also helping them understand which companies would be good for the fund to invest in by looking at the ones that really have clinical applicability within our health system. So, it’s definitely a give and take with learning on both sides. So, it’s exciting that I’m really getting to build up and develop both of these areas.

Paddy: So that’s really interesting. And it seems like you’ve already covered quite a few aspects of innovation models that some of the larger health systems we’ve been at this for much longer under the purview. And in some sense your innovation function seems fairly mature even though you’re the first innovation officer. Come back to a couple of those themes so literally especially on the commercialization models for internal innovation and also harnessing of external innovation. One of the questions that I get asked and I also like to ask is how do you really prioritize your innovation ideas and innovation pipeline in a way that aligns with organizational priorities even though individual initiatives may or may not be the best business cases. So how do you really do the tradeoffs and how do you ensure that the right initiatives are getting funded and nurtured and supported?

Sylvia: Yeah that’s an excellent question because when I think of innovation in general if you don’t know where you’re going with the innovation it’s like you have a vector. You need a direction because if you just have the size of a vector you can really go in any direction and you might not be moving towards where you want to be. And this is an incredibly simplistic thing that I’m about to say but I really think it’s important. One of my friends told me years ago that one of the schools that she went to had them ask themselves every day who am I. Who do I want to become and who I may become with my actions? And obviously that’s an incredibly simplistic rubric. Thinking about the words but it’s so useful when you think about these very large ideas like innovation. You have to understand what your priorities are. And every time you’re investing in something you have to take that step back even if it’s just for a moment even if it’s just beginning. But make sure you’re headed in the right direction with that decision because there are so many shiny things out there and there are many shiny things that get wonderful things done. But if they aren’t helping you become who you want to be. If they aren’t helping Atlantic become the health system that it wants to be then it’s not an innovation that we want to invest time in. You think it’s really important as well because in my role in American Well while I work with a lot of different health systems and it’s very common for organizations to be pretty reactive as opposed to proactive. So that when they’re looking for something there’s this general feeling that they need something new that they need some innovation and then kind of wait and see who approaches them with new ideas or new care models or new ways of doing things and then evaluate each of those ideas on an individual basis. And one of the things that I think is really important is to again take a step back and put the time and energy into understanding what your problems are and what you need solved. And then once you have a much clearer understanding about that then proactively go out and find the people that are trying to solve those problems and work with them to solve the problems that you want as opposed to waiting and seeing kind of who falls in your fishing net and examining each one of those individually.

Paddy: You know the observation that you just made our own research confirms that. We see a lot of health systems that are funding and launching a lot of new innovative solutions. They are kind of standalone ad hoc initiatives. They don’t really fall in line with the broad enterprise strategy and to your point being more proactive about what the enterprise should be looking at as opposed to looking at the interesting ideas that are coming into the pipeline and then funding and implementing the ones that look promising. And those are important distinction that you make there. Switching topics a little bit, you mentioned digital a little earlier on when you talked about telehealth and digital transformation is in early stages for healthcare. At the same time, there’s a lot of innovation, there’s a lot of effort that is going into helping healthcare enterprises get ready for the future. And we all agree that healthcare is a little bit behind other sectors such as retail, or banking, or hospitality for instance. So, when we talk to, in our research on in our work with health systems we hear about digital transformation being all about reimagining patient and caregiver experiences. Do you agree with that definition? First of all, and then can you may be share an example or two of innovation initiatives that really align with the digital transformation of the enterprise at Atlantic Health System?

Sylvia: Yeah. No that’s a really great question as well. So again, I’m going to be pulling a little bit more on my previous role to answer this than my current one since I’m just a few months in at Atlantic. But understanding that digital transformation is not simply automating or digitizing, all of the current workflows is really important. Because if all you think about for telemedicine for example is that you are replacing the in-person visit one-to-one with a video visit for example then you’re not going to fully understand all of the benefits that comes from having a digital transformation. In the way that I think about it that often resonates with health system leadership is around value-based care. And so, if you think of value-based care as simply a different way to pay for the same interactions that everybody was already having in the fee-for-service world then you’re never going to create good value-based care. Because a lot of the way that we practice medicine that we deliver care has been shaped by that. The fee-for-service interaction is actually not best for the patient or for the caregiver. And the same it is true for geography and the activation energy of coming in for a physical visit. A lot of what we do is based upon the idea that is difficult both for the caregiver and for the patient. And so, when you remove that it doesn’t make sense to just keep everything else the same. And then one of the examples they use for this and again coming from a pediatric background when you look at school-based medicine for example or school-based telemedicine programs. When schools are initially thinking about this it’s often because they don’t have enough money to pay for Nurses and so they have a shortage. And so, they initially think oh we can bring nurses in to replace the nurse that we have and that obviously has some benefit. But then you start to think oh well instead of a nurse maybe we can have a physician at this point because of the economies of scale and the efficiency that comes to telemedicine we can actually afford to have a physician that could maybe order and prescribe medication so that it just gives the office more flexibility. And then once you start thinking about that you could start to think about things like well maybe the kid with ADHD that needs to go and see their psychiatrist every month. Well one maybe this kid shouldn’t be missing a day of school because they’re already having problems. And you can have a psychiatrist come into the school. And then if you’re not missing school maybe really the kids should be seen for 10 minutes or five minutes once or twice a week instead of for a longer period of time once a month. And that you’re actually getting better clinical care when you do it that way. And again, that’s just one example of many. But you know I think of that as the evolution of understanding how digital technology can actually provide better care in circumstances. But it really needs to be thought of differently than just replacing what you’re doing one-on-one.

Paddy: If you mention value-based care and I want to touch on that a little bit. Now we all know that the shift from fee-for-service to value-based care is not happening as quickly as many of us would like to see. At the same time the investment in digital technologies which essentially assumes a capitated model of payment has to be justified in some ways. Part of it is justified through a strategic need so telehealth for instance you know you have to have a telehealth program because that is the way of the future whether or not you’re making money today you still have to invest in it. I see the sense I get is that a lot of health systems are making some of these investments to digitally transform them so as to reimagine their patients experience or their caregiver experience in anticipation of the day when you are going to be in the capitated model and value based care environment. Given that what is your sense, since you have come from the outside and you are relatively new to looking at it from the inside of the health system. What is your sense of where health systems are in the journey towards digitally transforming themselves?

Sylvia: Yeah. That’s very interesting because I think what you said is right there. It is so crucial to understand about every set it talks about………. [unclear]. It’s like trying to head towards value-based care but that being in direct competition with the fee-for-service model. And the health systems that have seen really moved forward as in digital transformation and you actually think that even more than I have in your role, you can say your thoughts as well. But are the ones that recognize that healthcare has to have this digital transformation and that it’s been a slow start. But before we know what it’s going to be here. And so, we might not be able to justify it and in fact it’ll probably eat into the fee-for-service revenue for the time being. But we have to do it. Otherwise there will be disruptors that will do it for us. And so, when I think of it in the retail world, I think of gosh how hard must have been to be on the leadership of some of these large retail store chains where having e-commerce as part of their model didn’t exist. And you know for a while there was this divide that you see in healthcare right now of all the old stores, all the old bricks and mortar stores and then you had the e-commerce disruptors and there wasn’t great integration between them. And so there wasn’t a good model, someone called this the other day as clicks and mortar which I think is great which some of these stores have adopted where for example you ordered the items that you want online and then you have a special spot in the store where they get picked up. It’s kind of a combination of e-commerce and the traditional retail. But a few years ago, that model didn’t exist right. Someone had to create that model. And so, your leadership of this big store you see these e-commerce shops opening up and they’re gaining market. But remember they still have a ton of market. You just see them coming and you have to make the decision. Do we change our entire model to try to compete with them or do we stay where we are and hope that something comes up between now and then that saves that? And you see large store chains you could see making both decisions and at the time I think that it was not an unreasonable business decision to say you know what. This is our model, we’re good at it, we’re going to keep it, we’re going to sit and wait and see what happens. But in the end, we know what happened. Lots of these stores closed and the only ones that are surviving are the ones that either have a completely different demographic or are incorporating e-commerce into how they work. And it’s a hard decision but I think the same thing is coming in healthcare. There are many health systems where I get the feeling that the leadership is like we just hold out a few more years until I retire. You know we’re not going to have to deal with this.

Paddy: So you know I hear this of being described as the two-canoe model. You have a leg in two canoes and you’re hoping that you’re going to be able to sail downstream without losing balance. Right. And what you’re describing as a clicks and mortar. You know I think that’s what they’re referring to as a two-canoe model. That’s fascinating. So, you know is the chief innovation officer. You necessarily have to deal with a lot of the risks that come with innovation. You are harnessing internal and external innovation. And by definition many of these ideas will never come to fruition. Some will consume resources and fail, and a small number will make it work. We all know that the digital health startup ecosystem is being fueled by billions and billions in venture capital money, but they have a high mortality rate for reasons not connected to the health system themselves but for their own business reasons or whatever it is. So, as the Chief Information Officer the risk becomes a very big part of your life. How do you look at this and what do you think health systems need to be doing in terms of either changing their mindset to embracing these kinds of risks? And at the same time also facilitating a pathway to success for the more promising ideas. I know it’s a two-part question. But hopefully that was clear.

Sylvia: Yeah. You know it’s funny. Having worked in the digital health world now for a few years. So, starting off as a physician working clinically in a health system and then moving to the digital health world for a few years, and now coming back to the health system faith. It’s been very interesting to see how different parties view the relationship between health systems and companies. And I actually posted something in LinkedIn, probably a week ago that has done such a tremendous response saying that I am retiring the word pilot and vendor. And replacing pilot with phase one which is you have you start something with a company that has a defined outcome that you are looking for and if you make that outcome there’s a trigger that moves on to phase two automatically which is some sort of scaling, and if you don’t meet that outcome then you stop. But it’s this death by pilot phenomenon that I think you hear a lot about in the digital health world that I’m really trying to tackle with that question and just the ideas behind it. And the other one is the word vendor which I think is supposed to be neutral. But I actually find it has implications around it that there is almost a master-servant relationship with that the company they’re working with is there just to serve the needs. You’re the vendor and having worked in a lot in one of these companies and you worked with a lot of other companies. They’re just really smart people obviously on both sides but also in the companies that are working on these problems that have a lot of knowledge of the area that they are working in. And I found this again being on the tech company side. I got to see these technologies being implemented in dozens of health systems. And so, I often had a very good view of the nuts and bolts of how this works. But I found it amazing how often I would offer to health system and leadership to help them think about implementation strategy. I mean how many of the leadership teams wouldn’t take me up on that offer. And now that I’m on the health system side a little bit more. I do think it’s this concept of -there’s a vendor that puts that barrier there because it makes it seem like this isn’t a back and forth relationship where we’re learning from one another. And I think that those types of relationships are really important. One to solve big problems because almost always you’re trying to sell something complicated in healthcare, very rarely that you’re trying to solve simple problems. And so, getting smart people with different experiences in the room working together is really important to get answers for this but it’s also you know as you said there’s a high mortality rate on the startup side. And so, as a health system part of the way that we can be a good partner. It’s not just you know offering a space for four people to implement but really giving that product and design feedback and helping them understand the complexity and value drivers of being in their health system and bring that tons of information that comes from having worked in such a complex environment to the company so that they get better. And in doing that in fact if you can implement and to health systems that puts you way ahead of the curve for most companies and the ability to scale and thrive.

Paddy: As someone who runs an advisory firm, I can’t tell you how much I appreciate just the thought that you want to replace the word vendor to something that suggests much more of a collaborative mindset. And I applaud you for that, and I wish the spirit behind that thought is something that spreads more because I think at the end of the day digital transformation is not going to be accomplished by any health system in a vacuum. This is going to be a sort of collaborative partnerships which are mutually reinforcing and where there are win-win outcomes and for that to happen words matter and once again I applaud you for this. So, you know we’re coming up to the end of our time here and I just wanted to ask you one question. Ultimately as Chief Innovation Officer. You are going to be tasked with certain goals and demonstrating certain results. How do you define and measure success or how do you propose to define and measure success or innovation function at the Atlantic Health System? How do you look at it?

Sylvia: And yet another really good question. So again, I am still just a few months into this position and really these first few months I’m more towards understanding these important meta questions that we were talking about earlier in our conversation. What are our strategic goals? Where are we headed? What do we have right now? And that’s the other thing being in a health system the size of Atlantic. As you said there is already a significant amount of innovation that exists and is developed. And so how do I bring that together. Where are we seeing the innovation? Who are the people that are taking the lead and still doing a lot of the groundwork assessment of what we have and generally where we want to go? And then once I’m able to do that then I’ll be able to look more closely at what success metrics are. In general, we talk about operations improvement and creating an innovative culture and environment, retaining our most innovative clinicians and staff into all of those are going to be a portion of what we look at. But we’re still I’m still creating the larger goals and then we’ll have to break that down into the success metrics as well.

Paddy: Right and I hope to have you back as a guest, maybe a year or so from now when you can maybe talk about some of the successes and how we were able to go about that process. But we look forward to that. So, you know I think you provided some really interesting perspectives by virtue of your having come from a technology provider organization and given your background as a pediatrician. So, it’s going to be really interesting times ahead of you and I wish you all the best in your new role.

Sylvia: Thank you very much. Yeah, look forward to talking to you in the coming years myself as well and comparing notes what was said here.

Paddy: Absolutely. Well once again thank you Sylvia for joining us and I appreciate your thoughts and appreciate your taking the time to talk to us. All the very best and I look forward to being in touch.

Sylvia: Thank you very much.

We hope you enjoyed this podcast subscribe to our podcast series at www.thebigunlock.com and write to us at info@thebigunlock.com

About our guest

Sylvia Romm, MD, MPH, Chief Innovation Officer of Atlantic Health System is driven by a passion for transforming healthcare delivery to patients and communities. She brings her background and expertise as a clinician and an entrepreneur to her role as the Chief Innovation Officer for Atlantic Health System. Firmly believing that a patient-centered focus is vital to healthcare innovation, Dr. Romm works with Atlantic Health System’s team members and physicians to find new ways to improve access to high-quality and affordable care. She also forges relationships with local and national innovation partners and works to expand our organization’s research profile. Dr. Romm is an avid author and speaker in the areas of healthcare, technology, and health information technology (IT) policy. She has written articles for various publications, including NEJM Catalyst, Forbes, KevinMD, and the Huffington Post, and was named one of FierceHealthCare’s 8 Influential Women Reshaping Health IT. A board-certified pediatrician, Dr. Romm has served in a variety of clinical leadership roles throughout her residency and as a hospitalist.

Before joining Atlantic Health System, she was Vice President of Clinical Transformation for American Well, the largest video-based telemedicine company in the United States. In addition, she was the founder of MilkOnTap, the nation’s first telehealth company focused on the needs of nursing mothers and lactation support. Dr. Romm earned her Master of Public Health in Global Health from Harvard TH Chan School of Public Health. She holds a medical degree from the University of Arizona College of Medicine and completed her residency in pediatrics at Massachusetts General Hospital.

About the host

Paddy Padmanabhan is a widely published and quoted thought leader on digital transformation in healthcare. He is the author of The Big Unlock: Harnessing Data and Growing Digital Health Businesses in a Value-Based Care Era, and the CEO of Damo Consulting Inc, a digital transformation and growth advisory firm based in Chicago.

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We need to be cautious in the use of technology to prevent increase in total costs of care

Episode #22

Podcast with Dr. Karen M. Murphy, EVP and Chief Innovation Officer, Geisinger Health

"We need to be cautious in the use of technology to prevent increase in total costs of care"

paddy Hosted by Paddy Padmanabhan
In this episode, Karen Murphy discusses her role as the first Chief Innovation Officer and the Founding Director of the Steele Institute for Health Innovation at Geisinger, and how they are working towards lowering the costs and improving quality for the overall welfare of members and patients.

Innovation at Geisinger means taking a fundamentally different approach to solving a problem that has quantifiable outcomes. According to Karen, focusing on specific problems like price and quality will move the needle in a meaningful way. Currently, the innovation team at Geisinger is developing a new care model that leverages AI and machine learning, along with remote monitoring for a more holistic approach towards patients.Karen also believes intelligent bots will help decrease overall cost of care as they are more efficient. However, while adopting new technologies we need to be careful and prevent increase in the total costs of care due to technology.

Welcome to the big unlock podcast where we discuss digital transformation and emerging technologies in healthcare. Here are some of the most innovative thinkers and leaders in healthcare and technology talk about how they are driving change in their organizations.

Paddy: Hello everyone. This is Paddy and welcome back. It is my great privilege and honor to introduce my special guest today Karen Murphy, Executive Vice President and Chief Innovation Officer of Geisinger Health. Karen, welcome to the show.

Karen: Thank you Paddy and thank you for having me.

Paddy: You’re welcome. Karen as I understand it you are the Founding Director of the Steele Institute for Health Innovation for Geisinger and also, I think the first Chief Innovation Officer. Can you maybe give us a little bit of background for the benefit of our listeners and how it came about and what are the objectives of the Institute?

Karen: Sure, I’d be happy to Paddy. So, I was working as the Secretary of Health with the Commonwealth of Pennsylvania. And I met Dr. David Feinberg and I was working on an innovative payment model called the Pennsylvania Rural Health Initiative and engaged stakeholders across the Commonwealth to work on this payment and delivery model with me. So, when I met Dr. Feinberg shared with me that he had this exciting new role at Geisinger called the Chief Innovation Officer. And just a little bit about my background, I started my career as a registered nurse, I’ve been a President and CEO of a health system. Then I went into public service to the federal public service at the Center for Medicare Medicaid Innovation and then subsequently went to the state as Secretary of Health. So, I have a diverse background in understanding health care delivery plus the policy piece and really a passion for innovation. So, Dr. Feinberg invited me and said would you like to come to Geisinger and talk about the Steel Institute for Health Innovation. So, the Steel Institute for Health Innovation was created by the board of directors really in honor of a previous hospital health system CEO who is Glenn Steele and Glen needs very little introduction. But Glen was the CEO for almost close to 20 years here at Geisinger and really raised the profile in terms of the national stage for Geisinger being recognized as one of the most innovative delivery systems across the country.

Paddy: That’s really interesting. And I do want to spend a few minutes talking about some of the initiatives that you’ve got going on at the Innovation Center. But to start at a high level, for health system today what do you think are the primary competitive forces that you have to deal with and how does an Innovation Group align itself organizational object in that context?

Karen: Thanks Paddy that’s a great question. So, asking the question of a competitive environment how does an innovation team help. So, I think we are competing in all markets in both quality and price. In terms of the quality of the services we deliver the price that we deliver at is certainly under scrutiny and I really don’t think I think we’ve kind of exhausted the toolbox if you will and trying traditional methods of lowering cost and improving quality. I think we’ve made maybe marginal advances in quality but I mean not in the actual delivery of health care but also when I include quality I examined the patient experience of care, the patient’s ability to access services, the need, the way, the patient’s ability to understand what they’re paying for and what cost they’re responsible for. So, when I say we’re marginal I mean we’re marginal whereas an industry really marginal around that very complex ecosystem. So, let me define first innovation at Geisinger, so we define innovation as a fundamentally different approach to solving a problem that has quantifiable outcomes. So, innovation at Geithner means we are going to focus only on problem. We must take a fundamentally different approach to solving that problem and we must have quantifiable outcome to measure for the innovation. So, I think unless we take a fundamentally different approach to price and quality, I don’t believe that we’re going to move the needle sufficiently. So how does the innovation team attack those two very large problems. Certainly, in collaboration with the clinical enterprise and the whole team across the enterprise. But I think our goal is to spike to very specific initiatives that move the needle in a meaningful way.

Paddy: And that’s a really interesting definition for the works you do in fact the notion of fundamentally adopting a different approach to solve an existing problem is what I hear the most when others I talk to about digital health innovation and you also alluded to this today in healthcare which is access, affordability issues for consumers. Do you care to share one or two examples of how you actually rolled out innovation programs that address these challenges at Geisinger?

Karen: Sure. So, I should say Paddy too that the Steele Institute for Health started July 1st of 2018. So, we’re just celebrating our very first anniversary. So, I’ll give you a couple of examples of how we’re using fundamentally different approaches. So, you may have heard of our fresh food pharmacy where we identify food insecure type 2 diabetics and we prescribe the patient to go to the fresh food pharmacy. And when the patient goes to the fresh food pharmacy they’re provided with fresh food. And the way fresh food diet counseling actually monitoring of preventative services all circling this patient to improve the health of the type 2 diabetic. And I can tell you that we just expanded to three sites because our first site was really very successful. The patients that have engaged in the fresh food pharmacy have seen very positive results some more than you would think then even through medication. And they’ve also demonstrated positive outcomes on their health maintenance exams and some of the other health indicators that we ordinarily would coordinate with better healthier lifestyle. So, we’re really excited about that and that is a fundamentally different approach. We’re currently working on developing a new model of care for patients with chronic diseases. So just to Geisinger alone about 30 percent of our patient population has one or more chronic diseases. And as you know Paddy most of them have more than one. But this system that we’re using for chronic disease management right now is extremely labor intensive requiring a one to one intervention in most cases. So, case manager or community health worker and we look at the diseases in a very siloed fashion. So, we develop chronic disease management programs that are for cardiac, chronic disease management programs that are diabetics, chronic disease management programs for COPD. But the fact of the matter is most of these patients are all three so they could have congestive heart failure, COPD, and diabetes. So, we’re looking at developing a more holistic approach and over the next three years we’ll be developing new care model that leverages artificial intelligence and machine learning along with remote patient monitoring and patient reported outcome to number one. As I said before looking at the patient and more holistic fashion. Number two to really slow down the progression of the disease. And number three prevent disease exacerbations that would require a higher level of care such as the emergency room or hospital admission. So, there’s just a couple of examples of where we’re working really hard at lowering cost, improving quality for the overall welfare of the members and patients we serve.

Paddy: That is such a fantastic example. You know when I talk to folks very often the notion of innovation is somewhat conflated with technology and sometimes you see a lot of startups out there and I’ll come to that a little further on in our conversation. They launch solutions that are fundamentally different ways to approach a problem but there’s no validation in terms of the people process and change management aspects of it. It’s sounds like you’ve covered all of that in the fresh food pharmacy. The cold concept that you just described. I think that is just a fantastic case study. Thank you for sharing that. Now you alluded to a couple of other things when when you talked about that case study. One of them was artificial intelligence. Now we’re seeing a lot of new AI enabled solutions to hit the market. More recently I’ve seen lots of announcements about AI enabled chatbots, symptom triaging and things like that. These are not necessarily just traditional health systems there are a lot of non-traditional players also coming into the market. So, I guess switching gears here a little bit, you care to your thoughts on how health systems could be leveraging technology more to drive the primary care experience and to address emerging competition in the context.

Karen: Sure. So, I think that you know others have used Paddy you raised chatbots within the Steele Institute we have a hub for what we’re calling artificial intelligence automation. I think the use of chatbots certainly are appropriate in a couple places I think those that where we have repeated questions. I think it’s perceived by the patients that the bot does a better job in terms of efficiency and information that I think that’s appropriate. I think the other place where bots are going to be very important and are going to be those tasks that humans do repetitively that we really don’t require a human to do that. But I think we have to have our intelligence bots. So not just a robot that can keep doing the process over and over again but one that learns from the activities that they are doing and I think the part that I think is important about them is that it will help us decrease the overall cost of care because obviously the use of bot is much more efficient and those use cases are really infinite and other industries have demonstrated they’ve done that really well. I think the big part we have to remember about when we talk about artificial intelligence, machine learning in any case is one that certainly there are a whole host of ethical issues that we have to be of course cognizant of. There’s a whole host of especially in clinical medicine if we’re changing the way that we practice. So, there’s a whole, there’s certainly a side to that that we have to be very careful of. But really even and the most simplistic side like all technology there is many things the data scientist can do particularly in the predictive arena. But we need to be aware that in particular in the predictive arena that the data is usable so that we don’t increase the total cost of care. In other words, I’ll give an example highlighting people who are predictive first stroke and there are 30000 of them. Very hard to do an intervention with technology with to notify 30000 people that you don’t actually have to hire other individuals to do it. So, I just want to be I know I’m a little bit always cautious about adopting new technology that we don’t end up increasing the total cost of care as opposed going in the other way because as we began this talk it is critically important for us to decrease that total cost of care and increase the quality.

Paddy: Right. And I think you made some very good points there and we’re all aware that the FDA is now looking at how to really understand and offer some level of oversight on how artificial intelligence rhythms are deployed in the context of healthcare and what is the level of regulation that is required or not. And so, I think the debate is still ongoing, but I think you made some very good points. And just to follow up on that I wanted to ask also about the data sources right. So, for AI algorithms to work well, the more the data and the more the data sources, the better they are at accurately predicting let’s say disease progression like stroke that you mentioned. So, can you share a little bit on how are harnessing emerging data sources such as social determinants or genomics for example.

Karen: Sure. So Geisinger currently has we have about 23 years of electronic health records and unified data architecture. We also have other sources of data in that unified data architecture the social determinants of health. We’re actually not only taking in from external services but we’re looking at now not only screening for social determinants of health but also identifying community resources that we could immediately connect the patient to when we recognize what the challenge is, what the social need is.

Paddy: So, let’s talk a little bit about the fact that Geisinger there’s actually a health plan and a health system and you’re unique. And so how does your innovation model balance the need to build the health system and the health plan and prioritizing your innovation investment. How do you pick your big needle movers as an example?

Karen: So, I would say a couple of things to that. So, the first is that as I said long before I got here Geisinger is a very innovative organization. And there are many operators that I would say are truly innovating here at Geisinger. So, the innovation that occurs is not just limited to the Steele Institute. So, when we pick projects or select projects for the Steele Institute, we really try to select like I referenced before a new model of care. We really try to select those initiatives that have perhaps a larger, more far reaching, ROI in both cost and quality that will benefit more broadly the organization.

Paddy: Now switching topics here, lately there have been several announcements about you know large health systems or health plans are turning innovation programs as commercial entities. In other words, an example of that was a recent announcement by Highmark which is looking to commercialize their innovation program and offering up the data to startups and researchers to test out new solutions or products and really creating additional revenue streams. I was just curious. I know its early days yet for your innovation program but is there a long-term goal to sort of maybe try and commercialize some of this?

Karen: We definitely are exploring commercialization in the common development realm and what that really mean is if there is not currently an application on the market to solve the problem that we’re trying to solve that we would open up and invite companies to come in and work with us and we would co-develop. So there definitely is an interest there. I would say the difference Paddy is that our approach is exactly that. Here we have a problem that we want to fix and we want to work with it and this is how we’re going to work as opposed to just opening it up more broadly we just want to be sure that we’re answering for problems of the future, of the present, and the future.

Paddy: So, when we talk about innovation we’re also talking about digital transformation. You actually provided some great examples of how you’re already on that path in many ways. In the way you select projects, in the way you’re rolling out the projects. It’s of course very difficult for a single innovation group to meet the entire needs of an enterprise especially if you want to accelerate digital transformation. There’s a huge ecosystem of startups out there who could potentially help you, they’re funded by billions in VC money. But it’s also hard to determine which ones of them are validated, what’s the risk involved and so on. So, can you maybe share your thoughts on how you harness external innovation today and what do you think are some of the risks that need to be managed.

Karen: Sure. So, I think you’re absolutely right in terms of there just by definition of what they do is they’re unproven. Right. So, by being a startup early in business not a lot of experience all the risk that comes along with that is inherent to that selection. And I would say quite honestly that we’ve experienced both really good experiences and had some experiences that didn’t work out so well. And I would have to say that they didn’t work out the failures were just as important as the successes because we learned. In this new territory of startups we learned what we would do differently and if you call me in a year I’ll probably say the same thing that we worked with a lot of startups that we had some successes and failures because I think that’s the nature of the work.

Paddy: Well I think we are coming up to the end of our time here and I want to ask you about you know you’ve now you’ve been in both public health and in private institutions and most recently before you came to Geisinger as you mentioned. You were Secretary of health for the State of Pennsylvania. How does a public health experience inform and influence your work at a private institution and what is your advice for someone looking to make the transition either into public health or into private sector?

Karen: So I have said this before Paddy when I was interviewed that I spent most of my career in the private sector but just had the magnificent opportunity to work in both the federal and state government. And I always say that I wish I’d found public service much sooner in my career what I would have done is moved in and out of public service and private sector because I think the best public servant is really one that is in touch with the private sector and understand how the private sector operates. But at the same time understands what it is to have the denominator be the federal, or the population of United States, or the population the state you are serving. So, I would advise anyone that had the opportunity to work in either federal or state government or any public health initiatives for really go for it because it’s a tremendous experience and it’s very much unlike the private sector.

Paddy: That’s great. That’s wonderful. So, we are at the end of our time. Any final thoughts before we conclude the podcast Karen. 

Karen: No thanks very much for having me and I really enjoyed talking to you Paddy.

Paddy: Thank you much.

We hope you enjoyed this podcast subscribe to our podcast series at www.thebigunlock.com and write to us at info@thebigunlock.com

About our guest

Dr. Karen Murphy is Executive Vice President, Chief Innovation Officer and Founding Director of the Steele Institute for Health Innovation at Geisinger.

Dr. Murphy has worked to improve and transform healthcare delivery throughout her career in both the public and private sectors. Before joining Geisinger, she served as Pennsylvania’ Secretary of Health addressing the most significant health issues facing the state, including the opioid epidemic. Prior to her role as secretary, Dr. Murphy served as the Director of the State Innovation Models Initiative at the Centers for Medicare and Medicaid Services leading a $990 million CMS investment designed to accelerate healthcare innovation across the United States. She previously served as President and Chief Executive Officer of the Moses Taylor Health Care System in Scranton, and as Founder and Chief Executive Officer of Physicians Health Alliance, Inc., an integrated medical group practice within Moses Taylor.

Dr. Murphy earned her Doctor Of Philosophy in Business Administration from the Temple University Fox School of Business. She holds a Master of Business Administration from Marywood University, a Bachelor of Science in Liberal Arts from the University of Scranton, and a Diploma in Nursing from the Scranton State Hospital School of Nursing.


An author and national speaker on health policy and innovation, Dr. Murphy also serves as a Clinical Faculty Member at Geisinger Commonwealth School of Medicine and as an Associate Faculty member in the Department of Health Policy and Management at Johns Hopkins Bloomberg School of Public Health.

About the host

Paddy Padmanabhan is a widely published and quoted thought leader on digital transformation in healthcare. He is the author of The Big Unlock: Harnessing Data and Growing Digital Health Businesses in a Value-Based Care Era, and the CEO of Damo Consulting Inc, a digital transformation and growth advisory firm based in Chicago.

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Sign up to get Paddy’s Newsletter that is personally curated by Paddy along with analytical notes on the developments for the week.

THE HEALTHCARE DIGITAL TRANSFORMATION LEADER

Sign up to get Paddy’s Newsletter that is personally curated by Paddy along with analytical notes on the developments for the week.