Latest / CareTalk: Healthcare. Unfiltered. / Making Mental Health More Accessible w/ Dr. Tom Milam

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Making Mental Health More Accessible w/ Dr. Tom Milam · CareTalk: Healthcare. Unfiltered.

• 0:07
  John: Welcome to Care Talk America's home for incisive debate on healthcare, business, and politics.
• 0:12
  John: This morning we have as our special guest, Dr. Tom Milam, chief Medical Officer of Iris Telehealth.
• 0:20
  John: Welcome Tom.
• 0:21
  Dr. Tom: Thank you.
• 0:22
  Dr. Tom: Great to be with you, John.
• 0:23
  John: So Tom, maybe before we get into Iris and kind of all the cool things you're doing and your perspectives on AI and mental health, how did you get, what was your healthcare journey like?
• 0:33
  John: How did you end up as the chief medical officer?
• 0:36
  John: What were your ambitions, kind of, how did you get here?
• 0:39
  Dr. Tom: Yeah, great question.
• 0:40
  Dr. Tom: It's, it's, uh, been an interesting journey.
• 0:43
  Dr. Tom: I've been on fa, I've been a psychiatrist for 25 years.
• 0:46
  Dr. Tom: I've been on faculty at Virginia Tech Carilion in Roanoke, Virginia for the last 16 years.
• 0:51
  Dr. Tom: And during, um, about 2016, a little bit earlier, I began to see how so much of Virginia, like many states, has a very rural population and was looking at how my patients were having to drive hours and hours to come to our hub hospital to get care.
• 1:11
  Dr. Tom: I began doing some pilots with, uh, various clinics in rural areas, uh, family medicine clinics, pediatricians, seeing patients on site, um, there through telehealth.
• 1:22
  Dr. Tom: Um, and developed a network where providers could just call me and say, Hey Tom, I've got a patient here.
• 1:26
  Dr. Tom: Can you help us?
• 1:27
  Dr. Tom: Salaries, kind of challenging mental health issue or addictions issue.
• 1:30
  Dr. Tom: Started doing that.
• 1:32
  Dr. Tom: That turned into getting some grant money to expand it.
• 1:35
  Dr. Tom: Expanded it to a number of our, uh, emergency rooms at, uh, at Virginia Tech and the five hospitals that we serve.
• 1:43
  Dr. Tom: And from that got really interested in, in telehealth and the need to provide high quality mental health care, mental health care, where it's needed, when it's needed.
• 1:53
  Dr. Tom: And ultimately in 2018, I was invited to join a. Telehealth.
• 1:58
  Dr. Tom: Um, as I said, the, it was small.
• 2:01
  Dr. Tom: When we started we had about 20 or 30 providers, and now we have about 650 throughout the country and it's been a wonderful journey.
• 2:07
  John: Well maybe double down on, you know, with your background as a psychiatrist, how many people do you think who need access to mental health services are getting it just in general?
• 2:22
  Dr. Tom: Sure.
• 2:22
  Dr. Tom: Um.
• 2:24
  Dr. Tom: Two parts to that question, are they getting any access at all?
• 2:28
  Dr. Tom: And I would say that probably close to 50% of people that could benefit from access to it, whether they have mild to moderate stress or need help with coping strategies to those who are really struggling with depression or anxiety or addiction.
• 2:44
  Dr. Tom: Are simply not getting it.
• 2:45
  Dr. Tom: They don't know who to turn to.
• 2:46
  Dr. Tom: They don't know the mechanisms through which they could seek care.
• 2:50
  Dr. Tom: They don't know what the expense or whether the insurance is available.
• 2:53
  Dr. Tom: So that's a huge part of our population.
• 2:56
  Dr. Tom: And I think one of the things we learned during COVID is how many pockets of people there are who have very limited access to any healthcare, let alone mental healthcare.
• 3:06
  Dr. Tom: So, um, there are a number of other, um, folks that.
• 3:10
  Dr. Tom: Need it.
• 3:10
  Dr. Tom: They may not know that they need it.
• 3:12
  Dr. Tom: Um, the key is with mental healthcare is that sometimes you don't know that you need it until things get really bad.
• 3:20
  John: I think that's true.
• 3:21
  John: Most of us, Tom, let's just be honest.
• 3:23
  Dr. Tom: Yeah.
• 3:25
  Dr. Tom: Absolutely.
• 3:25
  Dr. Tom: So that's the second part to it, that once you need it, there has been such a long wait to get it and to get directed to the kind of care you need, whether you need therapy, whether you need some psychiatry or psychiatric medication management.
• 3:42
  Dr. Tom: So helping patients with that journey.
• 3:45
  Dr. Tom: Wherever they are is, uh, what we do at our telehealth.
• 3:49
  John: Well, I, I think the other, you know, interesting problem, you're, you're solving and you have a unique perspective being in Virginia, which as people think about it as a, you know, the urban centers and, you know, Metro DC and Charlottesville.
• 4:03
  John: But there's a ton of, I mean, it's, it's a great example of a lot of the states in the US where.
• 4:09
  John: There is pretty limited access to general healthcare in rural areas, and I think it's hard for folks in suburban and urban locations to understand how complicated it is if you're working full-time in a rural area to then schlep and get care unless it's in an absolute crisis.
• 4:27
  John: And I think that's one of the interesting.
• 4:29
  John: Avenues that you've opened up with, you know, access to mental health.
• 4:34
  John: But maybe you could talk a little bit about, given your perspective as a psychiatrist and being in Virginia and what the cha some of the challenges are for accessing healthcare in rural health.
• 4:45
  John: In in rural areas where.
• 4:48
  John: You know, most hospitals that are closing are closing there.
• 4:51
  John: Most practices that are closing are closing there.
• 4:54
  John: Just kind of what's the everyday challenges of folks who are working in rural areas to get access to care?
• 5:01
  Dr. Tom: Yeah.
• 5:02
  Dr. Tom: Well, Gianna, I'm glad you raised this point because people need to have access and they need it when they need it.
• 5:09
  Dr. Tom: Um, when you're struggling with a severe bout of panic attacks or severe depression or going through withdrawal from abuse, uh, substance or alcohol or something that you want help getting off of, to me that's a medical emergency.
• 5:24
  Dr. Tom: So.
• 5:26
  Dr. Tom: People want care quickly.
• 5:28
  Dr. Tom: For physical health, you're having chest pain or severe headaches or something strange going on.
• 5:33
  Dr. Tom: You go to the emergency room.
• 5:34
  Dr. Tom: But for behavioral health, sometimes people think, well, this is behavioral health.
• 5:38
  Dr. Tom: It's not that urgent.
• 5:39
  Dr. Tom: But I tell people, it is urgent.
• 5:41
  Dr. Tom: You need to have health.
• 5:44
  Dr. Tom: Um, there are in rural areas very, as you said, very limited access to physical health, but I, I really admire my family medicine and pediatrician colleagues.
• 5:55
  Dr. Tom: They are on front lines in these communities across the country, in these rural areas.
• 6:00
  Dr. Tom: But with the increasing shortage of psychiatrists and mental health professionals, coupled with.
• 6:06
  Dr. Tom: Getting them into the areas where they're needed most.
• 6:09
  Dr. Tom: And you're right, it's, it's not just urban.
• 6:11
  Dr. Tom: There are urban areas that need us where we serve, but a lot of rural areas across the country.
• 6:17
  Dr. Tom: Getting you in there and getting you in front of patients quickly, that's what we work on.
• 6:22
  Dr. Tom: It's a challenge.
• 6:23
  Dr. Tom: People have to work.
• 6:24
  Dr. Tom: Their kids are in school, they have to have babysitters or things while they go to appointment, and those are financial challenges, transportation challenges, the car breaks down that day and then your appointment is pushed back three months.
• 6:37
  Dr. Tom: These are the real sort of what we call social determinants of health.
• 6:41
  Dr. Tom: The factors that are real things in people's lives that impede them getting the care.
• 6:46
  Dr. Tom: Um, so what we have to do is keep trying, keep being on the front lines with folks, keep being respectful of them and their need and being available as best that we can.
• 6:56
  John: I, I just think what you're talking about is so important given what I've, we've observed as the acute kind of growth of loneliness and, and, and the real, the real isolation that often goes with being in a rural community.
• 7:10
  John: And get those issues of access where I think that mental health, some sort of mental health support, if not intervention, would be kind of essential to kind of navigating the challenges that, that, that are exposed, I think, to everyone during COVID when during lockdown and that sense of being isolated or disconnected.
• 7:28
  John: That's kind of the every day reality for folks who are living at a, a pretty great distance to, to urban and suburban centers.
• 7:36
  Dr. Tom: Absolutely.
• 7:37
  Dr. Tom: And we can't blame patients for not getting access to the care that we, that they need and that we can offer.
• 7:44
  Dr. Tom: Telehealth has created it.
• 7:47
  Dr. Tom: It's not a new technology.
• 7:49
  Dr. Tom: The VA and other systems throughout the country have been doing telehealth for many years, but the changes that were implemented by.
• 7:56
  Dr. Tom: CMS.
• 7:57
  Dr. Tom: So Medicaid, Medicare, during the pandemic allowed us to reach into communities and clinics that we wouldn't have been able to before.
• 8:07
  Dr. Tom: And the growth of telehealth going from.
• 8:11
  Dr. Tom: Really expensive cameras and all this digital equipment that people said you need to working with.
• 8:17
  Dr. Tom: Like we are with a simple camera or working on your phone, uh, on a tablet, whatever people have, wherever they can get access to data or wifi, making it simple so that we're breaking down those very real barriers that people have to getting care.
• 8:33
  Dr. Tom: Loneliness is real.
• 8:34
  Dr. Tom: It, it really is.
• 8:35
  Dr. Tom: And so.
• 8:36
  Dr. Tom: Uh, and particularly with mental health, you hold a lot inside.
• 8:39
  Dr. Tom: You're scared to get help.
• 8:40
  Dr. Tom: So creating avenues where people can break through that loneliness and get the help they need in a timely manner through a, through a, a portal, through a connection, that that's
• 8:50
  John: the great thing about telehealth is you start, for all of us, I think it's a challenge to admit that there may be an emotional thing going on, or you might have be upset about the loss of a spouse or a child, or a dog, whatever, that things are difficult.
• 9:05
  John: To be able to provide real time access through the avenues of communication that we otherwise use.
• 9:11
  John: That's a major breakthrough that I think that to your point, CMS is allowed with telehealth.
• 9:16
  John: Is there, do you think you can provide the, the, the, the, I I don't think we've got much of a, an a, a choice given how many people have the have needs and there aren't enough of Tom, sorry.
• 9:30
  John: But, but, but how, how successful can you be in connecting over an iPhone or a tablet?
• 9:38
  John: Do you feel that you and your colleagues at Iris are, are, are breaking through and, and really making a difference in people's lives and lifting them up?
• 9:46
  Dr. Tom: Yeah, absolutely.
• 9:48
  Dr. Tom: John, I mean.
• 9:49
  Dr. Tom: It's something I learned early on in psychiatry.
• 9:52
  Dr. Tom: Um, six months into my own private practice in North Carolina.
• 9:56
  Dr. Tom: Came home and said to my wife, I could create 10 more of me because the need was tremendous and I had a lot of colleagues working around me.
• 10:03
  Dr. Tom: But, um, particularly when you're working with underserved populations and children.
• 10:09
  Dr. Tom: The elderly, uh, people that are often disenfranchised, uh, people who are, uh, incarcerated, homeless populations, folks that, uh, a lot of folks that really struggle with, um, additional social determinants of health.
• 10:22
  Dr. Tom: The need to connect to them and find creative ways that that work for them.
• 10:27
  Dr. Tom: It's imperative because what we learned during COVID is we can't just wait for people to come into our buildings, to our bricks and mortar, to our clinic and say, Hey, I'm here.
• 10:37
  Dr. Tom: I need help.
• 10:38
  Dr. Tom: We have to go to them.
• 10:40
  Dr. Tom: And, uh, CMS, the DEA, created avenues to make that easier and better and safer with less restrictions.
• 10:48
  Dr. Tom: And what the data has shown is that it works incredibly well, and certainly who doesn't like going in person and seeing a therapist or whatever, seeing a doctor.
• 10:58
  Dr. Tom: But say you're in an area where you have to drive an hour each way, uh, and you're a physician or a nurse or a therapist that has to drive an hour each way or two hours, um, it is just amazing the burden that's on people.
• 11:12
  Dr. Tom: So it's really a no-brainer to make telehealth.
• 11:16
  Dr. Tom: Avenue where people can, um, access care more quickly.
• 11:19
  Dr. Tom: Patients are in the driver's seat.
• 11:21
  Dr. Tom: They get to choose.
• 11:22
  Dr. Tom: So if they wanna drive and go literally in the driver's seat and go to a, a doctor's office, that's great.
• 11:27
  Dr. Tom: Like, I don't know if you've had experiences recently, but many primary care docs and and mental health professionals will say, do you wanna come in person?
• 11:34
  Dr. Tom: Do you wanna do through tally what works best for you?
• 11:37
  John: It's a game changer.
• 11:38
  John: Although I will say that the healthcare, uh, establishment took a long time to actually make it easy, and it was only a crisis that made it available.
• 11:47
  John: So, so tell me a little bit about, tell, tell, tell our listeners a little bit about Iris and kind of what you guys are doing to kind of expand access and reach and what kind of impact do you having in people's lives.
• 11:59
  Dr. Tom: Yeah.
• 11:59
  Dr. Tom: I appreciate you asking that because, um.
• 12:03
  Dr. Tom: You know, people say, how can you be a psychiatrist?
• 12:05
  Dr. Tom: And sometimes they say, how can you not be one?
• 12:08
  Dr. Tom: Um, and they say, what do you mean?
• 12:10
  Dr. Tom: And it's like every day.
• 12:12
  Dr. Tom: Myself, others, my colleagues were invited into the intimate parts of people's lives where they're really struggling, really hurting, dealing with issues with their children or with sick loved ones or their own mental health issues, really struggling.
• 12:25
  Dr. Tom: And to be able to provide that kind of care.
• 12:28
  Dr. Tom: Yes, it can be exhausting.
• 12:29
  Dr. Tom: It can be draining, like many things people do for work.
• 12:34
  Dr. Tom: At the end of the day, I can say to myself and our colleagues do that.
• 12:38
  Dr. Tom: We're trying our best to help people.
• 12:39
  Dr. Tom: We're trying, and that's meaningful.
• 12:42
  Dr. Tom: Iris started in 2013, really as a response to community mental health needs in Virginia.
• 12:48
  Dr. Tom: A colleague, Dr. Shaheen, a great psychiatrist, just um.
• 12:52
  Dr. Tom: Helping out community mental health centers that needed it.
• 12:54
  Dr. Tom: And then more needed it, more needed it.
• 12:56
  Dr. Tom: So he began this business and started off small, grew it from there, um, just in Virginia to now we're in, uh, 44 states across the country.
• 13:06
  Dr. Tom: The same model is there that you respect the dignity of every person you.
• 13:12
  Dr. Tom: Share their journey.
• 13:14
  Dr. Tom: Where are they, what are their needs are?
• 13:16
  Dr. Tom: And then you try to guide them to the right level of care.
• 13:18
  Dr. Tom: As I said, some talk therapy, cognitive therapy.
• 13:21
  Dr. Tom: And
• 13:21
  John: is it, is it, and is it a bus?
• 13:23
  John: Is, is Iris more of a business to business provider that, that an employer would hire Iris to take care of its employees?
• 13:32
  John: Or is it, does it do, do health plans hire you guys?
• 13:35
  John: I mean, yeah.
• 13:36
  John: Uh,
• 13:37
  Dr. Tom: uh, it's a, it is a really interesting question because there were some concrete decisions we made.
• 13:41
  Dr. Tom: We don't have our own hardware that you have to buy to access us.
• 13:46
  Dr. Tom: So we work in community mental health.
• 13:49
  Dr. Tom: We work with, uh, FQHCs, so federally, qualitative healthcare centers that are serving folks with physical and mental health and addictions, residential treatment.
• 13:57
  Dr. Tom: So we make connections with those organizations.
• 14:00
  Dr. Tom: Our providers get.
• 14:02
  Dr. Tom: On their credentialing panels, on their insurance.
• 14:06
  Dr. Tom: So they're working for Iris, but they're also working for our health partners.
• 14:09
  Dr. Tom: Some what?
• 14:10
  Dr. Tom: Iris.
• 14:11
  Dr. Tom: So you're provi,
• 14:11
  John: you're, but you're basically creating infrastructure that those in those healthcare institutions don't have to extend mental health access.
• 14:20
  Dr. Tom: Absolutely.
• 14:20
  Dr. Tom: And it's so cool because they might need one psychiatrist or one therapist.
• 14:24
  Dr. Tom: Some places we have 30 of us working there.
• 14:27
  Dr. Tom: Some places where the entire department of behavioral health for a healthcare organization or health system.
• 14:33
  Dr. Tom: Um, so to be able to come in and not just say, this is the way you have to do it.
• 14:38
  Dr. Tom: With Iris, we listen to our partners, large health systems, hospitals, clinics, what do you need?
• 14:44
  Dr. Tom: We talk about how they're serving their community, what the unique challenges are there, and work with them to design something that's good for the patients, good for the clinic, but you also have to take reimbursement seriously these days and, and factor that in.
• 15:00
  John: So, so let, let me roll the tape back.
• 15:03
  John: So you're, Iris is available through, uh, these systems.
• 15:08
  John: You're creating the muscle, the psychiatric muscles that a lot of these institutions lack to provide the resources, the.
• 15:16
  John: Turn it around to the patient level.
• 15:17
  John: A lot of patients have a hard time taking that first step.
• 15:21
  John: What, what's your advice to a patient that may be bothered by something going on in their lives emotionally or that, that, that, that isn't quite sure that they want to take the first step to, to go into an institution and or, or make a phone call, or make a video call and ask for help?
• 15:38
  John: What do you say to a patient who may be on the bubble, may be concerned about any stigma?
• 15:43
  John: Or concern that maybe they don't fit in the system or their problems aren't ones that a normal doctor can solve.
• 15:50
  John: What do you say to that patient?
• 15:52
  Dr. Tom: Yeah, I, it's, um, a wonderful question because that's where a lot of people are.
• 15:57
  Dr. Tom: They're thinking about.
• 15:59
  Dr. Tom: Do I take that leap and talk to somebody?
• 16:01
  Dr. Tom: Do I open my heart?
• 16:02
  Dr. Tom: Do I open my mind to a professional and invite them in to help me?
• 16:07
  Dr. Tom: That's, um, it's a challenging thing to do just to take that initial leap.
• 16:12
  Dr. Tom: And what if you take it and then you say, okay, we'll get you in with somebody either three hours away and there's a six month wait list.
• 16:19
  Dr. Tom: It's really disappointing.
• 16:21
  Dr. Tom: So you feel like you opened yourself and then there wasn't access, or the only access is to go to the emergency room or, or you, you have a cry for help.
• 16:29
  Dr. Tom: You say, I'm, I'm having some suicidal thoughts.
• 16:31
  Dr. Tom: And then you have police at your door taking you sometimes and handcuffs into the hospital.
• 16:36
  Dr. Tom: Uh, things that communities do to try to prevent to.
• 16:39
  Dr. Tom: Prevent people from self-harming.
• 16:41
  Dr. Tom: Um, the first step is creating these networks, working with health systems so that they can advertise to their patients so that the payers that those patients are working with, whether they're Medicaid and Medicare or Blue Cross, whatever, they can reach out to those patients, send them texts, send them emails, saying there are mental health providers there that are available to you.
• 17:03
  Dr. Tom: Iris is partnering with us.
• 17:05
  Dr. Tom: We can provide this service.
• 17:07
  Dr. Tom: There is not a long wait time.
• 17:09
  Dr. Tom: We can get a, a diagnostic evaluation done, usually within three to seven days.
• 17:14
  Dr. Tom: After that, we can get you plugged in with a therapist or a psychiatrist or nurse practitioner within three to seven days.
• 17:21
  John: So, Tom, so Tom, that's amazing, but what do you say to the patient who's afraid to take the first step?
• 17:26
  Dr. Tom: Yeah.
• 17:27
  Dr. Tom: To
• 17:27
  John: get help.
• 17:29
  Dr. Tom: You know, it, it's, um.
• 17:32
  Dr. Tom: I tell patients a lot that I'm treating in the hospital, particularly when they're really unwell, that I'm proud that they came in because I know it's hard to make that decision.
• 17:42
  Dr. Tom: Um, and so through people like that, I think word of mouth, if you can tell someone I'm proud of you for, for crying for help.
• 17:52
  Dr. Tom: I'm proud of you for making this step to call 9 1 1 and come in here.
• 17:56
  Dr. Tom: I'm proud of you for making this appointment today.
• 17:59
  Dr. Tom: I think that's where you begin is tell, is acknowledging how hard it is to reach out and just make that first step.
• 18:07
  Dr. Tom: I think there's a lot of people waiting.
• 18:09
  Dr. Tom: So we can't make that step for them.
• 18:11
  Dr. Tom: But the more that we can connect with communities at the community level, um, whether it's faith organizations or community mental health or, or, uh, community health centers or homeless shelters that they can say to their folks that are there, Hey, if any of you are struggling with addiction or mental health or some issues, there is help for you.
• 18:33
  Dr. Tom: People store that in their mind, and so when something comes up, instead of saying, no one will help me.
• 18:39
  Dr. Tom: You're, you're,
• 18:40
  John: you're, you're making sure that door's available for someone when they need it.
• 18:43
  Dr. Tom: Absolutely.
• 18:44
  Dr. Tom: Absolutely.
• 18:45
  Dr. Tom: And it, it wasn't as available.
• 18:47
  Dr. Tom: COVID has really, uh, created some scenarios where more doors are available, and I do find, I'll tell you, John, it's exciting 'cause I, I.
• 18:55
  Dr. Tom: More people are willing to get help than before, which
• 18:59
  John: is, which is just amazing'cause we do have an epidemic of, you know, of mental health challenges and suicide self-harm with VI veterans.
• 19:08
  John: We've got an epidemic of self-harm and suicide among young people, particularly young women.
• 19:13
  John: And I think it's e even more essential right now.
• 19:17
  John: The services that you, Tom and Iris and are providing Yes.
• 19:21
  John: What's, what's your point of view?
• 19:23
  John: What, what's your view of AI chatbots that are, that some organizations are using to extend access to folks leveraging, you know, technology effectively on its own to help people with quite mental health challenges?
• 19:38
  John: Are, are you for or against those chat bots?
• 19:42
  Dr. Tom: You know, I'll tell you, I'm, I'm for good chat box and I've been studying them for about the last 15 years.
• 19:48
  Dr. Tom: The technology.
• 19:50
  Dr. Tom: How they communicate.
• 19:52
  Dr. Tom: Um, because as I said before, when I was first in practice, I told my wife I could produce 10 more of me.
• 19:59
  Dr. Tom: Um, I, I love what I do.
• 20:01
  Dr. Tom: I love the work I do.
• 20:02
  Dr. Tom: I'm glad to have colleagues around me that love the work we do.
• 20:04
  Dr. Tom: We could all make 10 more of us, but that's not going to happen.
• 20:07
  Dr. Tom: What's the next best thing?
• 20:09
  Dr. Tom: Next best thing is, um, having patients feel held.
• 20:13
  Dr. Tom: You talked about loneliness.
• 20:15
  Dr. Tom: Can you make a connection potentially through a bot, and sometimes just calling and making an appointment with someone and you've made an appointment on the phone and you talk to a scheduler.
• 20:25
  Dr. Tom: Well, you've made a connection.
• 20:26
  Dr. Tom: Someone has listened, someone has put me in a queue, in a schedule, and so something has happened.
• 20:34
  Dr. Tom: That's the first step.
• 20:35
  Dr. Tom: So I don't fear.
• 20:37
  Dr. Tom: Bots that can help with basic things like scheduling and, and not just press one for a schedule, press two for billing.
• 20:46
  Dr. Tom: It's like we find with like chat GBT and others where they're conversational.
• 20:51
  Dr. Tom: Tell me why you're calling today.
• 20:53
  Dr. Tom: Um, it's been interesting.
• 20:54
  Dr. Tom: I'll tell you interesting story.
• 20:55
  Dr. Tom: I was on a, like doing a training for my hospital.
• 20:59
  Dr. Tom: And talking to this person at the end of it for 30 minutes, they said, by the way, maybe some of you have realized I'm a bot.
• 21:07
  Dr. Tom: I'm not a real person.
• 21:08
  Dr. Tom: And I, I did not, I could not tell, except that the guy was much younger and much smarter than I thought a young person.
• 21:15
  Dr. Tom: Uh, he was like, like 18 or something.
• 21:19
  Dr. Tom: But, um, I think that's the thing is that.
• 21:22
  Dr. Tom: It's the type of bot, and I don't fear it.
• 21:26
  Dr. Tom: I was at American Hospital Association in Nashville earlier this week and everybody's talking about how to implement it into the work queue to create efficiencies and what do efficiencies do?
• 21:36
  Dr. Tom: It allows providers, doctors like me to spend more time with patients.
• 21:42
  Dr. Tom: Less time having to gather a lot of records and data and labs, but have that information come in, be someplace.
• 21:48
  Dr. Tom: Oh,
• 21:48
  John: every doctor would be happy to be done with it in a distribute.
• 21:52
  John: But, but effectively what you're saying, Dr. Tom is you're, you're good with artificial intelligence and chatbot as long as they meet a standard of connection and competence.
• 22:05
  Dr. Tom: Absolutely.
• 22:06
  Dr. Tom: I, I, I see the data and I see people have fear about it, fear of trust, but.
• 22:11
  Dr. Tom: You have to show people that a bot or some type of interaction with an AI can be trustworthy.
• 22:18
  Dr. Tom: And I think that's the journey we're on right now is it's showing that it's not just going to, you know, spit out things or, or make, you know.
• 22:27
  Dr. Tom: You ask if for how to commit suicide or things like that, and it's gonna tell you it's, there's going to be smarter and smarter bots.
• 22:34
  Dr. Tom: So there's some caution around the data that's behind them.
• 22:39
  Dr. Tom: But in terms of things like AI companions that you can talk to and interact with, that they know you, they know everything about you in terms of what they see it, there's.
• 22:48
  Dr. Tom: Not as much to fear there.
• 22:50
  Dr. Tom: I think there's a lot to celebrate.
• 22:52
  John: That's, that's le let's, let's finish then on that, that, that, that those, those two components of the three components of hope, access, connection, and the possibilities of technology.
• 23:04
  John: Um, Dr. Tom, thanks for joining us.
• 23:06
  John: Uh, really appreciate you joining Care Talk today and for our listeners, if you like what you heard or you didn't, we'd love you to subscribe on your favorite service.
• 23:14
  John: Dr. Tom, thank you so much and congratulations on everything you guys have accomplished at Iris.
• 23:19
  John: Thank you, John.
• 23:20
  John: Good to be with you.
• 23:21
  John: Cheers.