Not many Health IT startups get to the successful exit. This week Charlie Lougheed co-founder of Explorys now an IBM company joins us to discuss technology and the Healthcare Startup space.

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Bill Russell:                   00:01               Hey podcast listeners, thanks for listening. If you’re enjoying this week in health it, we just want to give you some information on how you can support these conversations to keep them going. This weekend. Health. Its goal is to keep you your organization and your employees updated with the emerging thought and trends in the healthcare industry. Through our conversations with healthcare and technology leaders, the best and easiest way you can show your support is to go over to this week in health it on itunes and leave us a review. Also, you can subscribe on Itunes, Google play, or stitcher, or go over to our youtube page and subscribe and hit the notification bell. Again, we really appreciate you spending your valuable time listening to this podcast.

Bill Russell:                   00:49               Welcome to this week in health it where we discussed the news information and emerging thought leaders from across the healthcare industry. This is episode number 20. It’s Friday, May 25th. Today we talked blockchain, what healthcare can take from Fintech and harder and wisdom for your healthcare it startup. This podcast is brought to you by health lyrics. Are your strategies constrained by infrastructure or tied in a knot of applications? Break the bonds, visit health lyrics icon, but schedule your free console. So my name is Bill Russell, recovering covering healthcare cio, writer and consultant with the previously mentioned health lyrics. Before I introduce our guest today, I want to share, uh, share with the audience just an exciting opportunity. Uh, we’ve reached milestones in the show and upon reflection, uh, and, and talking to many of you, we found that the content is relevant and timely, and now what we’d like to do over the next couple months is get that content into as many current and future healthcare leaders as we can.

Bill Russell:                   01:44               That’s why I’m excited to announce that our sponsor has agreed to give $1,000 for every 100, 100 new youtube or podcast subscribers over the next 90 days to hope builders home builders provides orange county’s most disadvantaged youth, the life skills and job training needed to achieve personal and professional success. I’ve hired some of these graduates at my previous employer and, uh, their, their stories are nothing short of amazing. The trajectory of their lives are on as a part of, as being a part of this program is really exciting and that’s why I’m really excited to be a part of it. I hope you’ll join us in sharing the show with your friends and your peers to maximize this opportunity. Okay, so today’s guest is one of the brightest minds in data. Hopefully that won’t go to his head. A successful health it entrepreneur who actually saw an exit, one of those rare occurrences in the, in the health tech startup world. Uh, my good friend Charlie logo is with us today. Good Morning Charlie. Welcome to the show.

Charlie Lougheed:        02:40               Hey, good morning. It’s going be here.

Bill Russell:                   02:43               Wow. You, you, you, you actually got to an exit, um, that, that really isn’t all that common yet within the health tech world, is it?

Charlie Lougheed:        02:53               Not as much as it should be a little surreal. Right? And still, even today it’s still sinking, but, uh, I think we’ll see more of it. I think we’re seeing some maturation in the market,

Bill Russell:                   03:06               so we’re starting to see some things, some. So how long has it been since, since explorer? Since the exit of explorers to IBM,

Charlie Lougheed:        03:17               it’s been just a little over three years. So April of 2015.

Bill Russell:                   03:22               Wow. Yeah, those were exciting times. I think I was with you at a conference either the day of or the day after the announcement and uh, uh, it was really surreal on that day you were just, your eyes were sort of glazed over, like it mean, was that something you were really looking forward to or just something that just came out of the blue and surprise you?

Charlie Lougheed:        03:47               Well, we were growing so fast in 2014 that we recognize that we had either raise more money so that we can get presence on the coasts or either go public or do some something, some kind of acquisition that made sense. And the third wasn’t what we focused on. It was really how do we continue to do the good stuff that we’re doing and grow the business. But a IBM came along and kind of late in the game and we, in about nine days we went from a term sheet to signed agreement, uh, to do the acquisition. And that was, you saw me probably that day before hams or the day of hymns. So all that happened that, that weekend before that Sunday, before that was when they closed happened. And uh, so at that point we were all a little exhausted.

Bill Russell:                   04:42               Yeah. The life of the startup. I mean, when we first started off, I think we were at my employer, we were one of the first customer, so I got to see you a fair amount. That. And then it really ramped up. You were flying all over the country talking to clients a everywhere. So, and, and that’s the point at which you just either need more capital or you need a, you need a bigger partner like IBM, I guess.

Charlie Lougheed:        05:05               Yeah, it worked out great and I’m excited to see how the team has been doing and really proud of him.

Bill Russell:                   05:13               That’s great. So let me, let me give people some of your background. You’re a so cofounder of Exploris, uh, in 2009. He served as the president. And I this, I’m sorry, I pulled the bio off a website. It was probably written in 2009 because it says you’re serving as, so we’ll say he has served as president, a chief strategy officer and chief technology officer, true startup. Uh, you also served as the president of everstream until, uh, 2007, a cofounded everstream in 1999, serves as its chief technology officer, executive vice president, uh, also extensive experience with a financial services industry having lead national city corporations, consumer online banking division as well as position in PNC financial as senior vice president of the online channel for it’s a fluent customer segment. Uh, had been with everstream since 1999. Lead the product strategy development initiatives prior to joining everstream serve as vice president, electronic of electronic consumer marketplace systems at key bank national association.

Bill Russell:                   06:16               Um, and, and it says you’re also, you a very involved in community service chairman and member advisory board of everstream. Uh, also I’m a chairman of Galen Foundation, chairman of Saint and Technology Group, a advisory board member to genesis innovations. Uh, and you have your bachelor’s degree from John Carroll University. That’s probably the most I’ve ever read. If somebody is a bio, so I’m pretty old now. Well, the thing I want to really point out is, I mean, you really are the data and technology person as well as an entrepreneur, so because we’re going to dive into some, uh, we’re going to straddle that line today of talking entrepreneurial venture, but we’re also going to go into a deep dive in some of the technical areas. Um, all right, so one of the things we like to do with all of our guests is to give them a moment to just tell us what you’re excited about or what you’re working on today.

Charlie Lougheed:        07:13               You mentioned being a recovering cio. I think I’m a recovering entrepreneur is probably a good chance. I’ll relapse or fall off the wagon here, uh, at some point because I’ll do one more. But, uh, it’s been. I’ve been taking a break and it’s been kind of Nice, uh, spending a lot of times my family, you know, uh, just try to catch up on some time. Ems to startups is a, is a big commitment and a balanced it. Okay. But, uh, there’s a lot of stuff. I’m, I’m again catching up on my wife, Katie and I are about to be empty nesters in the fall, so that’s a little surreal. Have three in college and we’ll have a little chance to do some traveling going to Europe and Africa later on this year and have a little fun there. But uh, in terms of my professional life, I’m still staying pretty engaged. I’m, uh, I’m doing, uh, uh,

Speaker 3:                    08:13               uh,

Charlie Lougheed:        08:16               yeah. I kind of go towards the stuff that’s disruptive. That’s the things that, you know, generally be the areas that excite me the most,

Bill Russell:                   08:24               most of my, it actually broke up there for a second. You got to be sort of a robot going so it could, could you hit that again? Just what you’re working on?

Charlie Lougheed:        08:34               Yeah. Uh, yeah. I’ll just kind of start from. I’ll start from spending 10. Did you hear the part about recovering entrepreneur

Bill Russell:                   08:42               recovery entrepreneur heard about spending time with the family, which is phenomenal by the way. So you spent five years doing explorers and didn’t see the family, and then three years of being in the house every day. I know how that goes, and the family’s like, okay, dad, why don’t you go back to work?

Charlie Lougheed:        08:58               That’s right. That’s right. They’re like, what are you doing here? Too many trips to Costco, uh, companies that are sort of in traditional spaces, but they’re looking at this from a disruptive approach and that’s been, that’s exciting. But I’d tell you the thing that I’m doing them for spending the most time with, you know, probably 40 to 50 hours a week right now is this nonprofit called unified project. It’s really exciting. It’s kind of like my blues brothers project. We’re getting the band together on a mission from God, etc. It’s, they are some people from my past endeavors. So steve mIkael and sending nixon and cornell, uh, we’re, we’re working together on it. We’ve got some other amazing leaders that I haven’t worked with in the past from healthcare and social services and philanthropy and financial services and education, even government. So, uh, it’s, it’s a really neat, uh, endeavor, uh, our board, we’ve gotten together.

Charlie Lougheed:        09:51               It’s all the ceos from the major organizations about healthcare and education and philanthropy in banking from the cleveland area. And, uh, it’s an interesting mission. It’s essentially, and it’s not an easy one, it’s fixed the economy. Um, you know, the economy’s going to roll it along for a lot of people, uh, but that lot of people really amounts to about the top 10 percent, uh, the rest are still struggling and uh, and the bifurcation of wealth in the us and the bifurcation of income is continued to be a pretty big problem and we think it’s gonna get even worse, not just for them, but for all of us. And, uh, and so, you know, we started looking at the economy and in what seems to be wrong, right? The us spends more than anybody else’s, you know, on healthcare, yet we’re ranked 28th in life expectancy.

Charlie Lougheed:        10:48               We, uh, with, uh, one of the biggest spenders in education, yet we’re 20th and literacy and, uh, you know, urban core of less than 10 or 15 to 10 percent of, of those kids go off to college or secondary education. We’re the most generous country on the planet. Uh, we give more to philanthropy than anybody else by far. Yet we are ranked third in poverty among the nation’S 50 percent of the uS population makes less than 20 bucks an hour and a. If you look at what some of the experts are saying about where they see the economy in 25 years, a project that, well over 50 percent of theM close to 80 percent in some cases we’ll be out of a job because of automation and globalization.

Bill Russell:                   11:38               Depressed. So what are you going to do?

Charlie Lougheed:        11:42               Even more so. So we look at it, the saying, okay, what is happening with charity? What’s happening with all this in one of the other things we, we noticed as we sort of did this walk about, because we did this, remember we distant healthcare back to seamless. Now what can we help with? What was in charity? We also found that there’s about $800, million dollars. They’re literally sitting oN the sidelines in these charitable foundations if you amass all the wealth together. So the bill and melinda gates foundation, ford foundation, cleveland foundation, right? And, and you’re wondering why, why is only seven percent of that money going into the go into the, uh, the people in need and a lot of it has to do the fact that in order to maintain those organizations in perpetuity and have them continue to grow year over year, they need to be able to hold back a lot of that money, invest it in, usually the stock market or wall street, that’s their mechanism for return on investment.

Charlie Lougheed:        12:35               And uh, and, and, and that’s really their only means of, of, of sustenance. So in addition to just continue to get money piled in, we looked at that and said, why can’t there be a return on investment for raising up our population for helping them participate in the economy and participate in the next economy is this rolls around and we believe that I Can look at someone who’s in poverty today, full subsidy spend. It costs the taxpayer close to $50,000 a year, maybe even a little more in some cases. You turn that around and get someone from a position where they don’t have good secondary education and training. You get them into a role in computer science or data science as one of the things and you flip, you flipped the scales pretty significantly. You’ve got someone now who is making a living wage. They’re thrown off tax revenue, and so we think there’s a really big roi and we think that there are mechanisms to return that roi, but it’s going to take an operating system and what unified project is doing is implementing an operating system. We’re building it and it takes visibility and transparency of the data just like it did in healthcare. That’s going to take some ai and machine learning to understand all this big data and trim out the biases and we believe it’s going to take a piece of blockchain as well, particularly around smart

Charlie Lougheed:        14:00               ben and permits and around performance. And ultimately engage those entities that can return estimate, uh, back to those foundations, back to those investors in social good. And, um, and actually bring more money into the system. So once again, What we’re trying to do is bring about an operating system that begins to change the dynamic and bend the curve away from the dangerous position it’s going in right now. So I’m pretty excited about it. The opportunity, and it’s an app, you know, I think it’s an opportunity for healthcare, financial services and technology to really do a good thing, uh, as opposed to a always sort of be blamed for the things of the past and, and be concerned about the things of the future. I think there’s more positivity in front of us than anything and it’s just a matter of grasping that. Wow. Well, that’s exciting. I’m looking forward to a

Bill Russell:                   14:52               following that and seeing how that progresses for, uh, for you guys. I know with the smart people that you’ve put together, the solution is going to be pretty exciting. So let’s, um, let’s jump into the show. So we have three sections in the news soundbites and then social media close and I’ll kick us off. We each have a story. My story is a given your background and, and, and, uh, the show. So why healthcare should study up lessons learned from fintech. Uh, there’s a story from health it analytics that come, uh, let me, let me kick it off here. So, uh, clinical, uh, from the story clinical quality, patient safety and long term outcomes will always be a top priority for healthcare providers and payers, but, uh, but the consumer experience is or should be running very close second for stakeholders across the industry, soaring out of pocket costs for patients are leading to choose your consumers who are considering more than proximity to the local hospital when making decisions about where to seek care.

Bill Russell:                   15:50               A federal efforts around transparency, availability of your data and whatnot are making consumers out of, uh, out of patients and growing expectations that digital services for payments, communications and price comparisons will simply be available, is putting the squeeze on providers who haven’t yet invested in an online consumer relationship tools. So nothing new there. We’re here, we’ve been hearing this for several years. Then they go into some numbers. Uh, 80, 88 percent of patients want to be able to pay their insurance bills digitally. Sixty eight percent would like to be able to clear their balances with their provider by using online tools, yet 77 percent of providers are stIll using paper billing statements to conduct at least some of their financial transactions. In 2017, only four percent of practice leaders expressed any interest in the digital bill pay options according to the survey. This mishmash mismatch doesn’t just indicate an opportunity for digital payment companies to fill or to fill a clear need.

Bill Russell:                   16:46               It also exposes a worrying disconnect between how providers view their existing processes and what their patients really want to experience. Earlier in 2018, a poll by ntt data services pointed out that 59 percent of patients want their healthcare experiences to align with what they’re offered in retail. Half of patients said they would consider leaving their current providers if they found another option that offered more technology schools. Okay, so, so let’s stop there. We’ll come back to the story. But you know, the first question I want to bat around with you is, you know, let’s, let’s just, let’s do this on a scale of one to 10. One being the patient has a, has choice. Oh, actually, one being the patient has no choice. They’re locked in and 10 being the patient has, is a full blown consumer of healthcare with choice. Uh, where do you think we’re at on that continuum today? You know, I think, uh, I think we’re probably closer to zero was the no choice, is that right? One, one is the no choice and what

Charlie Lougheed:        17:49               lizard. No, zero now, and I think we’re probably close to three or four, but I think the attitudes are changing a lot and we see it everywhere and I didn’t say healthcare just takes a little longer to catch up, right? Uh, but I think what’s happening in other spaces is going to begin to have a profound impact on the attitudes people have in healthcare. I mean, clearly the high deductible was a shock to the system for a lot of people as it is. It is it related to costs? Like, wow, I’m paying a lot of my pocket so I’m going to make some different choices about this now. But I think other things, I mean, here’s something that’s completely unrelated, but related bill, uh, take the gig economy, right? Uber and airbnb and other things, people are thinking differently about, uh, things they never would before, right?

Charlie Lougheed:        18:38               You, you’d have some stranger drive you around or you stay in some stranger’s house, uh, that wasn’t something we really considered to you 20 years ago or even 10 years ago in that, in that that’s changing and you’re even beginning to see some interesting innovative companies like nomad and hire a who are bringing some of the ag economy to healthcare, particularly around a $15, billion dollar a year market for local, a temporary physicians or practitioners. So, uh, I, I think, I think the, the age of having a single dimensional channel to healthcare are going to change. I think, uh, you know, you’ve got the other factors of all these baby boomers who have grown up around technology. They’ve been pretty avid adopters. That technology will look at this and say, I paying my bills should be easier to be more straightforward. I’m getting care when I want it, where I wanted at the edge, it should be easier and I think they’ll move towards organizations and provider systems that are progressive in that matter.

Bill Russell:                   19:46               Right. My son had to go to my son’s 20 some years old and works for a large company and he went to, he cut his finger, had to get stitches. He went over to the, uh, emergency care and I happened to be available. So we went over so we could just hang out and whatnot. And as they’re stitching them up and whatnot, they’re handing him stuff like, here’s your gods, here’s your stuff. And he said it. They walk out of the room and he looks at me. He goes, am I paying for this? Because I don’t really want it. I don’t, I don’t think you have a choice. Um, so, you know, as I look at this, I, you know, there’s, there’s really two directions this can go single payer or market driven. And I agree with you today. It’S really neither. You have trends that happen.

Bill Russell:                   20:27               It was heading towards single payer. Now it’s heading a little bit. Um, you know, more towards market driven, but the reality is the consumer still has no idea how much healthcare costs the builders is reflect actual costs. Um, you know, you, you, you then run it through an insurance machine and you get another bill. It, it feels a little bit like playing the slots, you know, you pull the handle hope for the best and you take whatever, whatever comes to you, there’s some choice, but, you know, it’s not based on any facts. We’re, we’re still not looking at price and, and uh, and those kinds of things. But, but I think the trend is, is right. I think you have a pressure from the, the, the retail world in the consumer world and we’re saying, hey, why can’t healthcare be more like this? High deductible plans are making us more discerning.

Bill Russell:                   21:15               Um, and then I think medical interoperability is starting to get there. Some new options, like my insurance carrier has a telehealth option that they want me to go to before I see even see my primary care physician. So I, I find that to be fascinating. I think we are seeing an advent of, you know, of, of really moving, but I would agree with you, I think it’s a, you know, three or four moving in the direction of building out a market, but, um, but you know, that could easily change evan another election in a whatever, two and a half, three years and swings back the other direction. Um, you know, we’ll, we’ll have to see how it plays out. So here’s another area I want to get into with you. So data is it, the article goes on, data is the current is the currency of these new ventures and fintech a is powering a predictive analytics, fraud detection, identity management, security protocols required to compete in this modern environment.

Bill Russell:                   22:11               Customer intelligence will be the most important predictor of revenue growth and profitability in the fintech world. And translating those insights into personalized experience will be a close second without the right technologies to create meaningful, engaging experiences that exceed baseline expectations. They may soon find it challenging to maintain their revenues, especially as value based care alters their cash flow. Um, so data is new currency, customer intelligence will be the most important predictor of revenue and profitability. Um, technology will be central to creating engaging experiences. Um, is this a reality in healthcare or how do a better question would be, how do we make this reality in healthcare where data is actually a beginning to be used to, to make those kinds of changes with either predictive models are new experiences.

Charlie Lougheed:        23:03               I think we’re evolving to a data economy. I mean it’s to be interesting and what is the output of the american economy 20, 30 years from now, data is going to be a big component of that. And we know that those, that work in the data space in many ways have a much brighter economic future that knows that don’t. So I think, you know, it’s, it’s translating to a lot of different areas. When we, when we founded explore us, our whole premise was, was based upon data and how data was the real value in that. It could in many ways bend the cost curve if used appropriately. And, and when I say appropriately, both morally and ethically as, as just financially in a prudent way, but you know, having spent a lot of time in the financial services sector, I tell you that, that’s been around a long time as well, and they’ve seen that they’ve learned some very painful lessons.

Charlie Lougheed:        23:58               The 2008 financial crisis was really all about a recognition that they weren’t leveraging their data as effectively as they should have. And that’s why you see now so much emphasis in fintech around things like kyc or know your customer, uh, the ability to predict and mitigate risk, apply ai to drive those mitigation strategies, address the regulatory requirements that are out there. And I mean, the parallels to healthcare are amazing. I was, I spoke at an event yesterday, a fintech event yesterday, and this is what came up and it’s interesting. They actually used healthcare as an example. What do they need to start thinking in terms of a patient privacy and protection of information and whatnot. So these, these markets are so interconnected. I think, uh, you know, I, again, I think information is absolutely critical. What’s ironic that one of the major reasons why people have health issues is stress, and so they go in front of their doctor and they tell them about it and there’s their doctor prescribes a medication that may be needed for one thing or another that, that physician in in many cases doesn’t know what that’s going to cost the patient a, it seems like a vicious circle, right?

Charlie Lougheed:        25:19               The patient gets home and finds out that their copay or that or that drug’s going to cost them $500 a wind right back up at the, at the doctor’s office again. So we need to think about our data. We need to be put better data in front of our practitioners, better data in front of our, uh, of, of the patients that’s going to be critical to this. And I think the organizations that take that really seriously, again, we’ll get rewarded with a, a new, a new kind of loyalty.

Bill Russell:                   25:48               I go in for stress, I get medication, I go home, I get the bill for the medication, I get stressed, I go back. uh, I, you know, I find that know your customers, the thing to be very, uh, you know, it’s uh, it’s a, it’s a, uh, because we talked about it a lot. It’s a, it’s a interesting balance, right? So when you send that email to the, to the consumer and they realize, oh wow, you know, more about me than I think, you know, you may have crossed the line. So there’s always that balance of we want to provide great care, um, by knowing the customer better and uh, and being a, the patient and the consumer better. Um, but you don’t want to cross that line by having information that you really shouldn’t or acting on information that you really shouldn’t. And there’s that, uh, I guess it’s a, it’s an ethical balance and it’s also sort of a, I don’t know, cultural balance of how much privacy, how much privacy do we really think we have and how much should we be afforded I guess.

Charlie Lougheed:        26:55               Oh, go ahead and in big data creates more big data. One of the things that, that I think is really important is that we have more and more metadata around the appropriate and the allowed use of patient data or consumer data for that matter. Right? So these are the, these are the situations where I permitted being used, here’s where it’s completely off limits or opt in models where it needs to be used and we did, wasn’t anticipated, but it needs to be used in these ways. Am I good with it? And again, we’ll talk about it a little bit later, but that’s one example of where the blockchain can show some promise.

Bill Russell:                   27:36               Yeah. Alright. So we’re going to have to pick up the pace here a little bit. Let’s kick it over to your, uh, to your article. Why don’t you set it up and we’ll talk about it.

Charlie Lougheed:        27:47               Yeah. So, uh, one of the articles I saw this week that sort of caught my eye was an article by brad perrelli in mass device.com. And I’ve seen a number of articles that are similar like this. This was entitled six reasons why we shouldn’t bet on bloCkchain disrupting healthcare. Uh, and you could, you could supplant healthcare for pretty much every other industry and it’s a fair statement. It’s a fair title because the amount of hype that’s around blockchain is pretty deafening right now. Uh, but the Article goes in, in covers these six topics. One is that the development is stricter and slower. I totally get it right. But the reality is in that, in that place, uh, the high stakes coding’s always been this way for a long time. And blockchain blockchains a nascent technology, it should get better as it matures. those are talks about things like maintenance is very costly.

Charlie Lougheed:        28:46               This is an issue with blockchain today. I think what he meant when he said maintenance is operating costs, but man, that is opera definitely the case that public assumptions right now for the standard proof of work consensus models or just absurdly high and frankly they’re, they’re horrific for the environment. And, and we need some changing. Uh, the good news is, is there’s a lot of new technology that’s on the, on the forefront. Things like a proof of stake, consensus models and permission models that should improve this. He also talks about how a users are sovereign, uh, and that, that challenges associated with getting something on a blockchain. you really can’t change it after that. It’s immutable for good reason, but again, that depends to some degree on the blockchain or a architecture that’s being deployed, uh, not as not as much of a factor for permission networks.

Charlie Lougheed:        29:38               Private networks talked about a forced upgrade is not, is not an option a, there’s been a lot of controversy around this. A lot of times people mistakenly think that the ethereum network was hacked last year, uh, with the dla instance. That wasn’t the case. It was actually a, just some bad code, but the bad code had a $50,000,000 implication, uh, in that community had to come together to decide what they wanted to do. And, uh, it was an interesting outcome. And then scaling, I think scaling, he talks about scaling being really hard. Distributed computing is difficult, right? We’ve been doing it, I’ve been doing it for a long time, had been in other environments, and I think it just boils down to the philosophy of, of mpp versus vertical approaches. But I think really bell, I’ve seen so many articles like this, I think it kind of misses the point because despite all the hype, blockchain is really not the elixir for everything and we’ve got to stop treating it like that.

Charlie Lougheed:        30:35               Just like internet banking wasn’t, the alexa was going to change everything about banking in the financial space. It was just another channel. I think we need to think about it in a different terms. I think hybrid models we have on chain and off chain, particularly around big data medical records is going to be really important. And Uh, and I think the real promise around blockchain, as I mentioned a little bit earlier, is, is, is really around three things. It’s around medical record portability and interoperability. Certainly a lot of opportunities there. Identity management, not just in healthcare but in human trafficking, a lot of spaces around that. It’s a big issue today among our underbanked population and probably the biggest is smart contracts. This idea that we can have a multi lateral accountability in an accountable care model, right? Not just make the medical provider accountable, but also have the patients in certain conditions along the way be required and other entities that are involved in controlling those incentives.

Bill Russell:                   31:34               It, that’s a great setup. So a distributed nature of blockchain is distributed, immutable record, smart contracts. So I want to give you five healthcare use use cases and let’s just go through, you know, um, uh, you know, likelihood of happening and impact on healthcare. So here are the five use cases, a provider licensing and credentialing. Do you think blockchain has application there and then what would the impact be?

Charlie Lougheed:        32:02               I think it has incredible potential or high and it would have a big impact. Uh, the process of credentialing is slow, it’s cumbersome, it’s redundant, it’s expensive. If you’re going to get to a gig economy and healthcare, it’s absolutely critical.

Bill Russell:                   32:16               Blockchain based, hie based, even though between what actually between anyone, payers, providers, whatever, but blockchain based hiv, what do you think

Charlie Lougheed:        32:24               it could be the next generation of him and his technology is, has struggled, right? For a lot of business reasons, but some tactical reasons. So I think it’s got a pretty good chance they’re not as high as a as credentialing, but a decent chance,

Bill Russell:                   32:38               a medication supply

Charlie Lougheed:        32:40               chain. A lot of talk about that. What are your thoughts on that? The question is to what degree that the consumers really care. I’ve heard a lot about this in the food industry, but then I talked to people and they say, well, yeah, if I guess a found in general, generally think about it. So, uh, I think it’s really more regulational drive that though.

Bill Russell:                   33:06               Okay. How about revenue revenue cycle and more specifically fraud prevention and auto adjudication of medical claims processing.

Charlie Lougheed:        33:13               That’s another one I think will be a big opportunity. You know, that we all know that process today is fairly broken. It’s extremely expensive. It’s a big part of the cost of healthcare. So I am bullish on that as well.

Bill Russell:                   33:25               Uh, efficient prior authorizations and referrals through smart contracts.

Charlie Lougheed:        33:31               I don’t know, we’ll see. I think we’ve got some pretty good systems in place to do that today. Uh, uh, maybe later. But that one doesn’t come to the forefront for me right now.

Bill Russell:                   33:40               Yeah. And so I, I think I’m telling my clients the same thing that you’re saying here, which is blockchain is going to have a place, a, how it gets implemented, it’s going to be important. We need to keep an eye on it. It does have a potential to be disruptive, but we’re not seeing that yet. Um, and, and some of these areas could be, you know, for some systems, you know, million dollar place. And so that’s why I’m saying, you know, don’t dismiss it because it’s, it is at the peak of the hype cycle. There’s no doubt about that right now. I mean, you know, blockchain, you know, replacing doctors. I’m sure something that’s an article that’s been written, but it’s just craziness how hyped it is right now. And hopefully, uh, you know, hopefully it will come back down to earth. But while it’s doing that whole thing with these emerging technologies, I just always recommend keep an eye on it.

Bill Russell:                   34:29               Think through based on its characteristics where it can be applied. All right, so we have this section called soundbites and the soundbite sections. I’m going to ask you a handful of questions. Uh, you know, one to three minute answers and uh, we’ll just, we’ll just start here. So a lot of people will want to know this answer. So you’ve, you’ve had a successful entrepreneurial venture and health it. Um, so I really have two questions around this. Uh, what was the one thing that surprised you as you got into healthcare and what’s the one thing you would tell someone going into this space today?

Charlie Lougheed:        35:01               Well, I think the one thing that surprised me getting the healthcare, not knowing anything about healthcare was how gracious and helpful the healthcare community was particularly to me and, and steve and others that didn’t have experience with it, uh, about getting up to speed. They knew that we had something offered from data. So you have to bring something to the party. We understood big data, we understood different industries, but it is a good market to be in a lot of really smart people. People that like to teach. and if you, if, if you give him the respect and, and, and be patient, they’ll do that. They’ll coach you, they’ll, they’ll, they’ll tell you what they need. So that is something I really do love about the, the, the market and still do.

Bill Russell:                   35:45               Yeah. So what would you tell somebody who’s just starting off their health tech firm and they’re going into this space? Maybe something you’ve learned as they, as they get started on this, on this path?

Charlie Lougheed:        35:57               Yeah. I think, you know, understand that the economics that’s absolutely critical. You know, you have to follow the money. You have to understand how, how these models work because you can have a great idea, great technology, but if it doesn’t improve the sitUation for the provider, for the payer, for the patient, or at leaSt to two of those three, uh, you know, it’s, it’s, it’s gonna be tough sledding.

Bill Russell:                   36:23               Yeah. A clear message around the economics. And uh, the other thing, I, I do consult with a bunch of startups and one of the things I always tell them is we’ve really got to look at the sales cycle because almost everyone makes this assumption around the sales cycle within healthcare and it’s a, invariably it’s double or even triple it depending on how aggressive they’ve met in their predictions. That’s, that’s. Um, so I’ve asked this before but to other guests, but I was wondering from an entrepreneur’s perspective, you know, what’s the biggest impediment to innovation in healthcare and maybe what can we do to overcome it?

Charlie Lougheed:        37:01               Probably the biggest impediment right now is the fee for service model that just won’t quit, uh, you know, it. And how do we overcome it? I liked some of the things we talked about bill. I think the more we can push this market to a consumer model, the government’s done some right and, and we see how easy and election can swing that once the consumer gears get going. I don’t exerting any stopping them. We won’t, we won’t go back. I, I, I don’t think we’ll even go back from, from value based care. Uh, it’ll continue on. It’s slow journey and progressive journey. But consumerism is gonna is gonna be the key in my opinion.

Bill Russell:                   37:42               Great. So data science is talked about as the hottest job we now most health systems have this canon. Now that we’ve collected all this data, we are a big data platforms. Um, you know, where can data science be applied, where can we point this candidate to do the most good within healthcare today?

Charlie Lougheed:        38:05               I think one of the areas that I think it really is really important is artificial intelligence in the development of machine learning. Data science right now is at a state where, or I should say machine learning is a state right now where the big data that’s out there still isn’t big enough and it isn’t clean enough. So data scientists that understand how to clean and standardize data and then write great models around it, uh, I think are going to be in very high demand. I think that’s a really big opportunity to make a big in the cost of healthcare and, and enable some pretty amazing breakthroughs. But data scientists are going to have to be at the forefront of that. And uh, there is a lot of work to do yet.

Bill Russell:                   38:47               Yeah, I see that. So, um, how will technology change healthcare in the next five years?

Charlie Lougheed:        38:53               Well, I think they’re going to be a move towards consumer, especially as we get more data in front of them. I think the cost of care and making that more transparent at the encounter is going to be critical and in the more patients see that happening, the world, they’ll expect it. Again, I think the gig economy is, it has a big opportunity. Healthcare, particularly as, as many consumers of healthcare as they get, especially as they get older, are going to want to have that care pushed to the edges, whether that’s assisted living facilities or, or the, the commercial population at the place of work. And I think ag is a great a space for that.

Bill Russell:                   39:36               Great. So if you were going to do another startup in healthcare today, so you and I are going to do a venture, uh, what areas might you be looking at?

Charlie Lougheed:        39:45               Well, I think decision support, particularly around analytics and a in cost are going to be continued to be important. Like I mentioned before, I do believe that we need a better operating system, if you will, the coin another term from earlier, uh, for value based care. I think you look at the aco projects that have a, have started out there. some of them have been very successful, others haven’t, a lot of it has to do with the fact that it’s hard, right? You’ve got a lot of competing elements, but I think you start getting some of that, uh, those decision processes onto a blockchain, into that become more transparent and more enforceable from an incentive and performance based payment standpoint. I think that can have a profound effect on the effectiveness of many of those programs.

Bill Russell:                   40:40               YeAh. And that’s where you were going with explorers, right? I mean, it’s, it’s the ability to have a platform, if you will, or you keep referring to it as an operating system, uh, for that, for that today. So, all right, well we’ve gone over time as is usually the case when I get on the show with, with friends who are like talking to about this stuff. Uh, what’s your social media clothes for the week?

Charlie Lougheed:        41:04               Well, I looked at a couple of different things that were out there and one of them was a posting by bill gates on his top five books for the summer. And uh, two of those books I thought were pretty interesting. One was, it’s called an origin story, a big history of everything by David Christian and it’s just interesting because it focuses on societies. A lot of what we’re dealing with with the unified project, how complex they are weaving these insights together using this evidence. There’s a lot of system and social dynamics. I’ve started reading this book and it’s just really fascinating. In the other book was written by hans rosling recently passed away called fact factful. Wellness again, focuses on understanding the truths from a data perspective and how life in some respects it’s gotten a lot better in other respects, has a long ways to improve and in some cases unfortunately gone backwards. But it does give a lot of hope in terms of what technology can do to turn things around.

Bill Russell:                   42:06               Right. So mine is, yeah, see if this one resonates with you. You know, a second grader said they wished cell phones didn’t exist because their parents are on them all the time. so, uh, you know, I know, you know, my, my wife is always saying to the kids, you know, put your phone away at the table and now they just look at her like, do you realize how hypocritical that she doesn’t listen to this show? I’ll get in trouble for that one, but um, but is it, is true that parents are on their phone an awful lot in front of her kids? So charlie, thanks for coming on the show. You’re going to be an empty nester. So is there a good way to, for us to follow you? You’re going To be on social media or something more?

Charlie Lougheed:        42:44               Yeah, always be online. So yoU’ll be able to find me. It waS great being part of this. Uh, thanks for having me on today. A great conversation.

Bill Russell:                   42:52               Well, I appreciate it. So, uh, you can follow me on twitter at the patient cio health website. How system cio.com. I just wrote an article on telehealth and it’s imperative. Uh, I think we’ve reached a tipping point with the va’s announcement to forego the, uh, uh, boundaries on telehealth. now you can see a veteran across the, uh, across the country. I think you could see that happen and cms as well. And if that does, I think you’ll see telehealth become an imperative for every health system that’s on health systems. don’t forget to follow the [email protected] and take, take a moment to, uh, follow the show on a, on our youtube channel. We’re now up to about 130 videos short segments that you can watch, a couple minutes and a great conversations with industry influencers. So please come back every friday for more news commentary from my friends. That’s all for now.

Speaker 4:                    43:56               Thanks.

 

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