Latest / The Advancing Healthcare Innovation Show / E176 | Justin Brueck on Why Healthcare Innovation Fails Inside Health Systems

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E176 | Justin Brueck on Why Healthcare Innovation Fails Inside Health Systems · The Advancing Healthcare Innovation Show

• 0:11
  Hello and welcome back to the Advancing
• 0:13
  Healthcare Innovation Show. I am your
• 0:15
  host, Michael Stamatinos, and if you're
• 0:17
  new to us, we are super excited to have
• 0:20
  you here. Welcome. We're having some
• 0:22
  just incredible conversations with real
• 0:24
  leaders that are really painstakingly
• 0:27
  reshaping the future of healthcare and
• 0:29
  we're very focused and passionate about
• 0:31
  a few different areas. We're passionate
• 0:32
  about healthcare innovation, about
• 0:34
  leadership, about the adoption of that
• 0:36
  innovation and access. So, if it's your
• 0:39
  first time tuning in, let me just sort
• 0:41
  of peel back some layers of the onion
• 0:43
  here and just kind of give you a little
• 0:44
  bit more detail about what we're trying
• 0:46
  to get done here. So our our focus is is
• 0:49
  bringing real stories of innovation to
• 0:51
  life. Not just stuff that you read in a
• 0:53
  book or read in an article. Like these
• 0:55
  are these are real things that are
• 0:56
  happening in the real world. Real
• 0:58
  learnings that are happening and giving
• 0:59
  these folks the opportunity to share
• 1:02
  their story with our community and
• 1:04
  ultimately with the world. So wherever
• 1:06
  you are, if you're watching this, if
• 1:08
  you're listening to this, please hit the
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  subscribe button now so that any new
• 1:13
  interviews come directly to you. So
• 1:17
  look, most people they talk about
• 1:18
  innovation. Uh very few people have made
• 1:22
  it work inside of a real health system.
• 1:25
  Um and and this is why today's
• 1:28
  conversation really matters. So on the
• 1:30
  show I'm joined by Justin Brewick.
• 1:32
  Justin is the
• 1:35
  system VP uh of innovation and research
• 1:38
  at Endeavor Health. But what matters
• 1:41
  more than his title and how he is really
• 1:44
  sort of how he got there. It's really
• 1:45
  interesting story. So he didn't show up
• 1:47
  with a big idea and a big slide deck. He
• 1:49
  started as a fellow. Uh he learned the
• 1:51
  system from the inside, how decisions
• 1:54
  get made, where things slow down, and
• 1:56
  why good ideas often stall out. So today
• 2:00
  he helps lead work across genomics,
• 2:03
  research, simulation, and innovation.
• 2:06
  I'm probably missing a few things,
• 2:08
  Justin, but you'll fill that in just in
• 2:09
  a moment. But he's not here just sort of
• 2:11
  chasing shiny objects. He's focusing on
• 2:14
  what actually helps doctors, um,
• 2:17
  clinicians and patients, you know, do
• 2:21
  their things and jobs better. So,
• 2:24
  interestingly enough, Justin grew up in
• 2:25
  a small town in rural Iowa. We'll kind
• 2:28
  of bring why that matters in this. I
• 2:30
  think his background shapes sort of how
• 2:32
  he thinks and how he processes and makes
• 2:34
  decisions. He cares about access. He
• 2:37
  cares about practicality and he cares
• 2:39
  about whether something works when
• 2:42
  resources are tight and the stakes are
• 2:43
  high. So in today's conversation, we're
• 2:46
  going to talk about what innovation
• 2:49
  really looks like um once the door
• 2:51
  closes and the work begins, where it
• 2:54
  breaks, where it surprises him, uh and
• 2:58
  what it truly takes to earn trust inside
• 3:02
  of a larger health system. So Justin,
• 3:05
  great to see you. Welcome to the show.
• 3:09
  >> Thanks, Michael. And I I think we should
• 3:10
  just end now because you've said so much
• 3:12
  great stuff. I don't want to ruin it.
• 3:15
  >> Well, we are recording this. It is your
• 3:17
  episode, so you could just, you know,
• 3:19
  loop it and play it to your kids. You
• 3:22
  know what I mean? So, you'll kind of
• 3:23
  That'll be your entrance song. Kind of
• 3:25
  like, you know, the the Chicago Bulls
• 3:27
  theme song. Yeah. That'll be your walk
• 3:28
  out music.
• 3:30
  >> All right. So before we kind of dive in,
• 3:32
  I'm just thinking, take me to a random
• 3:35
  Thursday from the last month. Where were
• 3:38
  you? Who were you with? And what problem
• 3:42
  were you actually dealing with?
• 3:45
  >> So if I in the last month, I think uh
• 3:49
  Christmas fell on a Thursday and I have
• 3:50
  six kids. So I will tell you trying to
• 3:52
  keep them ordered relative to who gets
• 3:54
  the present first. Uh that that actually
• 3:57
  was a real but but I will tell you uh
• 4:00
  there's something really refreshing when
• 4:02
  your kids start to realize that they get
• 4:04
  to presents faster if they get along. So
• 4:06
  I I'll take that as a win.
• 4:08
  >> Um you know a normal day uh for me at
• 4:11
  Endeavor it it's it's partly because of
• 4:13
  the unique nature of my role and the
• 4:16
  fact that I kind of can jump from
• 4:18
  different things. So I may start my day,
• 4:20
  you know, at Evston Hospital working on
• 4:22
  things with some physicians around
• 4:24
  research ideas or even meeting with our
• 4:27
  sim lab team to try to understand like
• 4:28
  what are they working on.
• 4:30
  >> Um start at the research institute uh
• 4:32
  where we have a very large team that's
• 4:34
  kind of helping us administer research.
• 4:37
  Um but also we have our wet labs there
• 4:38
  so I get a chance to actually interact
• 4:40
  with the scientists which is phenomenal
• 4:41
  when you're actually trying to think
• 4:42
  about bridging the discovery um from
• 4:45
  bench to bedside. Um, on the innovation
• 4:47
  side, could be having conversations with
• 4:50
  startups, with founders, with venture
• 4:51
  groups, just trying to figure out like
• 4:53
  where we're at. But my favorite thing to
• 4:54
  do is to talk to the clinicians and the
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  frontline staff because that's really
• 4:57
  where you start to hear like what are
• 4:59
  the true pain points that they have. And
• 5:00
  I think as we talk through this
• 5:02
  interview and conversation, a lot of the
• 5:04
  things that I'm going to reiterate are
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  we have to be focused on solving today's
• 5:08
  problems. And if you're not focused on
• 5:10
  solving today's problems, you're never
• 5:11
  going to build the trust that's going to
• 5:13
  give to you the ability to jump two to
• 5:15
  three years out in advance because
• 5:17
  people need to have that confidence that
• 5:19
  you're there to support them and you're
• 5:21
  not here just to try to, you know, bring
• 5:23
  the new AI tool in that's going to take
• 5:24
  something from them.
• 5:26
  >> Yeah. I mean, when you first stepped
• 5:29
  into this role, um, what did you
• 5:33
  underestimate?
• 5:36
  But, you know, I I I I'll say that I
• 5:39
  probably underestimated the amount of
• 5:42
  time that it takes to move things
• 5:44
  through a system.
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  >> Um, and and I think that's an important
• 5:49
  thing for startups. I think it's for
• 5:50
  anybody that's working with health
• 5:52
  systems to realize it's not that we
• 5:54
  don't want to move quickly. It's just
• 5:55
  that there are a lot of priorities going
• 5:57
  on at any given moment. And you have to
• 5:59
  be able to flex with those priorities
• 6:02
  and recognizing that you may have the
• 6:04
  greatest idea ever. Um, yeah, but if you
• 6:06
  don't have other people that are aligned
• 6:08
  with you, it's going to be, you know,
• 6:10
  moved down the priority list. And I I
• 6:12
  will say that I have worked with several
• 6:13
  companies um that came in hot shot CEO
• 6:16
  said, "We're going to get this thing
• 6:17
  through in two weeks." And, you know,
• 6:20
  let's get it done. And yeah, they find
• 6:21
  out very quickly, six months later that
• 6:23
  you have your first red lines.
• 6:26
  >> Yeah. Yeah.
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  >> I think I think that would be my biggest
• 6:28
  >> Six months is fast, by the way. Six
• 6:29
  months is fast. I was thinking like two
• 6:31
  years later,
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  >> we have we set Yeah. We set high goals.
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  Um but yeah, I mean I think that that's
• 6:35
  that's a major one for me, but I also
• 6:37
  think it's the number of players that
• 6:39
  have to be engaged to move an innovation
• 6:41
  along. Um we we've we started out with
• 6:44
  something that we were looking at with
• 6:45
  remote cardiac rehab at one point in
• 6:47
  time and we thought we'll get some
• 6:49
  cardiologists, we'll get it and we'll
• 6:50
  turn it on. Well, pretty soon you
• 6:52
  realize you have to have the credentiing
• 6:54
  team, you have to have rep cycle, you
• 6:55
  have to have, you know, legal involved,
• 6:57
  of course, and you have to have quality
• 6:58
  so that they're double-checking and make
• 6:59
  sure that the quality outcomes are
• 7:01
  comparable, and then you have to have
• 7:02
  the finance team there that's validating
• 7:04
  all these things along the way. And so,
• 7:06
  it takes a village to really make this
• 7:08
  stuff happen. Um, so not for the weak of
• 7:11
  heart, but I think once you start to
• 7:13
  understand those and and you kind of get
• 7:15
  that process in play, it creates a
• 7:17
  flywheel effect that allows you to move
• 7:18
  forward. We're not perfect first to tell
• 7:21
  you. Um, but I think we've we've got a a
• 7:24
  good process in play um and are looking
• 7:26
  forward to the next couple years as
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  we've become this one large system
• 7:30
  spreading innovation across all corners.
• 7:32
  >> Well, before we kind of dig even
• 7:35
  further, I'm just because I love your
• 7:37
  origin story. I I think it's phenomenal.
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  Like you didn't one day just wake up
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  thinking like, hey, I'm going to be this
• 7:43
  this innovation leader. like talk talk
• 7:46
  about the the series of events in terms
• 7:48
  of how you how you really stumbled
• 7:51
  across healthcare and then started
• 7:54
  really kind of digging in and digging in
• 7:55
  and uh and now you're kind of you are
• 7:57
  where you are. Obviously there's there's
• 7:59
  a few tours of duty and stops in there
• 8:01
  in between. But would you mind maybe
• 8:02
  just sharing a little bit of that? I
• 8:04
  think it adds a little bit more richness
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  and color.
• 8:07
  >> Yeah, I mean I so if you asked me what I
• 8:09
  wanted to be when I grew up I literally
• 8:11
  said this to my parents. It was either a
• 8:12
  UPS driver or a pilot. I I don't know
• 8:14
  where those two came from.
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  >> So I said no I was never the one that
• 8:19
  said I want to be a doctor. Um
• 8:22
  in in school I did I did fine in school
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  was small school though. So I mean like
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  I I was first generation college
• 8:27
  student. My parents didn't know Ivy
• 8:29
  League schools. They didn't even think
• 8:30
  about that. Um and I don't even know if
• 8:32
  I would have gotten in. But I did I was
• 8:33
  fortunate to get a a scholarship from
• 8:36
  Pella Corporation to go to Central
• 8:38
  College in Pella Iowa. Um, and that was
• 8:40
  my first foray into understanding like
• 8:42
  what liberal arts education means
• 8:44
  because I got uh I had a biology degree,
• 8:47
  a chemistry minor. Um, but during that
• 8:50
  time I also started to get engaged with
• 8:52
  music. I had my family has a love of
• 8:54
  music. Uh, my father sang, you know, my
• 8:57
  mother was a floutist. Floutist. There
• 8:59
  you go. Flute player. Um, and and so
• 9:02
  we've always had music in our lives. Um,
• 9:04
  and I played the piano. Um, fortunately
• 9:07
  I I had to take an elective in music and
• 9:10
  they had a very beautiful pipe organ and
• 9:12
  I said, "I'd love to learn more about
• 9:13
  pipe organ and things like that." And
• 9:15
  uh, a professor by the name of Mark
• 9:17
  Babcock decided to take me on even
• 9:20
  though he had no obligation to and
• 9:22
  probably wishes he wouldn't have at some
• 9:23
  point in time.
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  >> But the long and short of it is through
• 9:26
  that I ended up graduating not knowing
• 9:29
  what I wanted to do and that was okay.
• 9:33
  But I ended up somehow getting a music
• 9:34
  degree after healthcare or after sorry
• 9:37
  after my bio uh biochem degree and there
• 9:41
  was a journey through there of thinking
• 9:42
  about being a priest and sacred music
• 9:44
  and so it all makes sense right? No it
• 9:46
  doesn't make any sense and I think
• 9:47
  that's part of the moral of the story
• 9:49
  here. Um but long and short is I got
• 9:52
  into healthcare because I had people who
• 9:54
  gave me an opportunity and I think
• 9:57
  that's really my story and I think
• 9:59
  that's something that it's the pay it
• 10:00
  forward to others. Um, so again, I'm,
• 10:04
  you know, I graduate with my master's
• 10:07
  degree in music. I'm like, what am I
• 10:08
  going to do? I'm working at a bank. I
• 10:10
  have a part-time bank teller. I'm
• 10:12
  playing a church on the weekend. Like,
• 10:14
  how did I get to this point? There was a
• 10:16
  guy that came into the bank and I got to
• 10:18
  know him and because he also went to the
• 10:19
  church um that I I was playing at. And
• 10:22
  he said, "What are you doing with your
• 10:24
  life? What do you want to do?" And I was
• 10:25
  like, "I don't know." He's like, "Come
• 10:26
  to my office." So, me being, you know,
• 10:29
  naive, I'm like, "Sure, why not?" Lo and
• 10:31
  behold, he was uh one of the executives
• 10:33
  at University of Iowa hospitals and
• 10:35
  clinics. And that chance encounter and
• 10:37
  that relationship that we developed, he
• 10:40
  said, "Come to my office." We sat there.
• 10:41
  We talked. He walked me to the grad
• 10:43
  admissions person for my MHA program and
• 10:46
  said, "I'll vouch for him. Let's go."
• 10:48
  And from there, he helped me, you know,
• 10:51
  with fellowships. He got he helped
• 10:52
  secure my internship in Japan. I mean,
• 10:54
  like all these things from this one
• 10:55
  person. Um, and then I got here and and
• 11:00
  I think this is just one of those
• 11:01
  stories where
• 11:02
  >> do you ever like ask him like why did
• 11:04
  why did you do that? Like like
• 11:06
  >> you know what's interesting for others
• 11:07
  and
• 11:08
  >> I so so this is this is a a fascinating
• 11:11
  things about this individual. Um he has
• 11:13
  actually done this for others
• 11:15
  >> and he has
• 11:17
  >> kind of plucked people from what I would
• 11:19
  say obscurity and has really developed
• 11:24
  an eye for how to do that. Well, um I
• 11:27
  personally I I would have never picked
• 11:29
  me at the time given what what I was
• 11:31
  doing and saying, "Oh, yeah, you're
• 11:32
  right for healthcare." But I think
• 11:34
  that's kind of what Pass Forward brings
• 11:36
  a unique vantage point because I am a
• 11:40
  little bit more renaissance potentially.
• 11:42
  Um as you said, like chasing shiny
• 11:44
  objects. I I think I use the expression
• 11:46
  80 o like 80 oo shiny. And I think that
• 11:49
  works for me because I have the ability
• 11:50
  to look at different things and try to
• 11:52
  create those connections. But at the end
• 11:54
  of the day, um, my story is because
• 11:57
  someone gave me a chance, right? And I
• 11:59
  think you you have that ability and I
• 12:02
  and I I I look forward to doing it to
• 12:04
  others. I actually mentor different
• 12:06
  groups um, working here in Chicago with
• 12:08
  startups. Um, and I think sometimes it
• 12:11
  it you got to start looking out for
• 12:13
  others, right? And and I think I'm at a
• 12:15
  point now um, where I'm excited to do
• 12:16
  that for the next generation.
• 12:19
  >> That's awesome. Is there I'm curious. I
• 12:21
  mean, what's something that you did
• 12:23
  early on in your career that uh maybe
• 12:27
  makes you cringe now, but but really
• 12:30
  helped you grow?
• 12:31
  >> Uh, you know, um, I'll give you two. One
• 12:34
  is a very practical one that just is
• 12:36
  like human behavior 101.
• 12:38
  >> Um, and the second one is actually one
• 12:40
  that I I still carry with me. Um so the
• 12:43
  first one is honestly I was overseeing
• 12:45
  an outpatient radiology location and you
• 12:48
  know we had these we had MRS we had CTS
• 12:51
  and we had mammogram we had standard
• 12:53
  X-ray.
• 12:54
  >> Yeah.
• 12:54
  >> And it was during the middle of winter
• 12:57
  this was early before pandemic and we
• 12:59
  had several staff that called out
• 13:01
  because they were sick. I mean they work
• 13:03
  together of course they're going to
• 13:04
  potentially spread. Um, and I remember
• 13:07
  that I because an MR that sits empty is
• 13:11
  significant revenue loss. I went out of
• 13:13
  my way. I ordered like I delivered
• 13:16
  orange juice to this person's house. I
• 13:18
  was like, "Come on, man. We need you
• 13:19
  back. Like, can you get there back by
• 13:21
  tomorrow?" I didn't do it for one of the
• 13:23
  X-ray texts
• 13:25
  and they found out.
• 13:28
  >> I will tell you, they didn't say
• 13:29
  anything to me for a very long time, but
• 13:31
  I could tell there was something there.
• 13:34
  And you know the lesson in all of that
• 13:35
  is I think I was looking at it as a
• 13:39
  revenue play like we need to get our MRS
• 13:41
  running. I wasn't thinking about the
• 13:42
  people side of it. And I think that was
• 13:44
  an eye opening kind of experience for me
• 13:47
  that really taught me the the importance
• 13:48
  of making sure that rise elbows right.
• 13:51
  You got to you got to support the entire
• 13:53
  team. And the whole expression of like
• 13:56
  the janitor is just as important to
• 13:58
  delivering great healthcare as the
• 14:01
  neurosurgeon as a CEO. So I think that's
• 14:04
  an important lesson. Uh the one that I
• 14:06
  learned a little bit later in my career
• 14:08
  actually was a result of um given my
• 14:12
  personality. I our chief human resource
• 14:15
  officer actually became my mentor which
• 14:17
  just tells you how close to being in
• 14:19
  trouble I was. Um but you know it was a
• 14:23
  period of time where I was just really
• 14:25
  excited. I wanted to do all these cool
• 14:27
  things. And the challenge was is I
• 14:29
  didn't recognize that. He said, "You're
• 14:32
  running. You're you're you're seeing
• 14:33
  green lights. You're just a guy that's
• 14:35
  like the eternal optimist. You're just
• 14:36
  going to see green lights wherever you
• 14:37
  go."
• 14:38
  >> The problem is you're blowing blowing.
• 14:41
  >> Exactly. You're blowing through these
• 14:43
  intersections and sometimes a green
• 14:45
  light is actually your signal. So you
• 14:47
  have right of way, but he goes, "You are
• 14:50
  running into more red lights and you're
• 14:52
  just blowing through them." And the
• 14:54
  problem is often times people around you
• 14:57
  are stopping and protecting you, but
• 15:00
  they're not forgetting about it. And so
• 15:03
  the life lesson that you know, and I
• 15:05
  still have this little squishy like
• 15:06
  stress uh stoplight on my desk, it's you
• 15:09
  got to realize that every time you're
• 15:11
  encountering a relationship, it is an
• 15:13
  intersection. And if you blow through
• 15:15
  it, you may get lucky and not get hit.
• 15:18
  But the reality is the people that are
• 15:20
  there on the sides, you you've seen
• 15:21
  them, they honk, they may throw some
• 15:23
  some fingers places, right? You know,
• 15:26
  um, but that was the life lesson I think
• 15:28
  for me that really resonated and still
• 15:30
  stays with me is that there are
• 15:32
  intersections throughout your day and
• 15:35
  you have to understand that sometimes
• 15:37
  people need to get, you know, yield the
• 15:39
  right of way. Um, but you got to make
• 15:40
  sure that you're not blowing through
• 15:42
  signals.
• 15:43
  >> That's super fascinating. Along those
• 15:46
  same lines, right? So there are signals
• 15:48
  around good ideas and there's probably
• 15:51
  no shortage of good ideas that come
• 15:55
  across your desk. Tell me about a good
• 15:59
  idea that everyone agreed was smart
• 16:04
  that still died.
• 16:09
  No, I I would say that
• 16:14
  I I'll actually use that example with
• 16:16
  the the cardiac rehab. Um
• 16:18
  >> yeah,
• 16:19
  >> here's a situation where
• 16:22
  I didn't even appreciate what cardiac
• 16:24
  rehab was when we got started with this,
• 16:26
  but it is the single most important
• 16:29
  thing to do after a cardiac event to
• 16:31
  ensure it doesn't happen again.
• 16:33
  >> And it makes total sense. You got to get
• 16:34
  your heart healthy again. You got to get
• 16:36
  it where it needs to be. Um, and right
• 16:39
  now in healthcare, we don't have enough
• 16:41
  slots to be able to see the number of
• 16:42
  patients that actually need it. And
• 16:45
  patients don't necessarily want to do it
• 16:47
  because let's call it for what it is.
• 16:49
  Um, you go to a hospital and you work
• 16:51
  out and it's not
• 16:53
  >> super nice. It's like the 1970s YMCA and
• 16:56
  this probably the smell that goes with
• 16:58
  it. Um, but it's it's really hard to get
• 17:01
  patients to do that. Plus, you have to
• 17:03
  be able to take time off work and and so
• 17:06
  there was this component here where it's
• 17:08
  like nobody could actually do this
• 17:09
  unless you're a retiree and you really,
• 17:12
  you know, wanted to get that next uh
• 17:14
  opportunity at life.
• 17:15
  >> So there was a use case and a problem
• 17:18
  statement there. And what ultimately
• 17:20
  happened is we launched this and the
• 17:21
  company was very successful in terms of
• 17:24
  the outcomes, but we couldn't get over
• 17:26
  the change that it meant for those that
• 17:28
  were the incumbents. And I don't mean an
• 17:30
  incumbent in a bad way because it was
• 17:32
  the cardiac rehab teams. They they were
• 17:34
  very committed to doing what they needed
• 17:36
  to do to take care of patients. And I
• 17:38
  think as we talk about technology, we
• 17:40
  talk about all these different things.
• 17:42
  It's so important that those frontline
• 17:44
  staff are there from the onset because
• 17:46
  we were viewed as an outside threat when
• 17:49
  in fact what we could have been viewed
• 17:50
  at is we're actually taking the patients
• 17:54
  that don't necessarily need to be there
• 17:55
  because they may be less acute. So you
• 17:58
  could actually maximize what you have
• 17:59
  trained your entire life to be able to
• 18:01
  do.
• 18:02
  >> I mean often times people say no because
• 18:04
  you know they they're trying to protect
• 18:06
  their turf.
• 18:07
  >> Knowing what you know now would you
• 18:10
  frame it any differently where it it
• 18:12
  actually could have could have possibly
• 18:14
  made it.
• 18:16
  >> Um I still think there's a chance for
• 18:18
  this and and it comes back to the
• 18:20
  question of timing. I think it's the the
• 18:23
  optimist in me that it'll always survive
• 18:24
  and I think in healthcare we have that
• 18:26
  problem. Um, if you bring people along
• 18:29
  from the very beginning and you help
• 18:32
  them, as my boss says, don't don't bake
• 18:35
  a cake and bring it to me and expect me
• 18:38
  to frost it.
• 18:40
  You need to be part of the ingredients.
• 18:42
  You need to have them helping to knead
• 18:44
  the dough or whatever it is if you
• 18:46
  really want them to have that shared
• 18:47
  ownership. And that requires time. And I
• 18:51
  think what's the challenge in innovation
• 18:53
  and to a a fault potentially with even
• 18:56
  some of these companies, they push so
• 18:59
  hard because they are so passionate
• 19:00
  about what they're doing. And sometimes
• 19:03
  it pushes us if we're not paying
• 19:05
  attention to bypass some of those steps
• 19:08
  in order to become more efficient. But I
• 19:12
  think if you asked several of these
• 19:13
  companies and even that company,
• 19:15
  >> I think they would said would have said
• 19:16
  we would have done spent much longer at
• 19:19
  the beginning doing stakeholder
• 19:21
  engagement because as opposed to it
• 19:23
  taking potentially 9 months to launch a
• 19:26
  pilot,
• 19:27
  >> it took 18.
• 19:29
  >> It was 18 that could have been
• 19:30
  shortchanged by simply making time at
• 19:33
  the beginning to get more bakers, you
• 19:35
  know, help them with the cake.
• 19:37
  >> Yeah. relationships are made or broken
• 19:41
  in the beginning, not at the end.
• 19:44
  >> So that's uh makes a ton of sense
• 19:47
  >> because you like
• 19:50
  green lights and you like to say yes. Um
• 19:55
  what is the hardest no that you've had
• 19:59
  to give to a team that cared deeply
• 20:03
  about something?
• 20:05
  Well, I I will say that no is I I always
• 20:10
  try to be honest with my teams and say
• 20:13
  want to be a no butt kind of person and
• 20:16
  and I it's it's just again like part of
• 20:18
  this there's a way we will find a way.
• 20:21
  Um, but yeah, there are times when you
• 20:23
  have to say no. And I I will tell you
• 20:26
  there are more often times than not
• 20:29
  where it's it's it's a no because it
• 20:31
  hasn't been framed correctly.
• 20:33
  >> And I think that to me becomes one of
• 20:36
  the clear mistakes that happens with
• 20:39
  ideas and people bringing ideas forward.
• 20:41
  They're so focused on the what and the
• 20:44
  thing that they forget about the why.
• 20:46
  And so for me, that's the kind of
• 20:48
  connection point that I'm always looking
• 20:50
  for is like, so why is it that this this
• 20:52
  founder has come to me with an idea? Is
• 20:55
  it because they were handpicked by a
• 20:58
  really great venture firm to say they
• 21:01
  have a track record of spitting off
• 21:02
  companies and they're going to do the
• 21:04
  next one? Or is it because they're a
• 21:06
  founder that has a personal story,
• 21:09
  >> that has a passion behind it? Um, so I
• 21:11
  would say oftentimes I say no because I
• 21:13
  don't necessarily see that we have
• 21:16
  alignment in terms of our interest.
• 21:18
  >> Yeah. Yeah. Does it does it make it more
• 21:22
  uh alignment ready when there is a
• 21:26
  personal story that level not to say
• 21:29
  that someone who doesn't have personal
• 21:30
  story doesn't have conviction but does
• 21:32
  that make it more
• 21:35
  does it make it more believable that I
• 21:37
  mean because to me belief having belief
• 21:39
  having that conviction combining is um
• 21:42
  to me it's a superpower when someone is
• 21:44
  really passionate about something it's
• 21:45
  it's incredible
• 21:47
  >> you're you're right on and what I say
• 21:49
  that that we turn down companies that
• 21:51
  don't have that the story because I'
• 21:52
  I've heard enough of those stories that
• 21:54
  have been uh I think ChatGP wrote some
• 21:57
  of them. Um we're not going to
• 21:59
  >> 95% of them.
• 22:00
  >> Yeah, I'm not going to turn them down by
• 22:03
  by by default and I'm not going to
• 22:05
  accept someone who has a great story if
• 22:08
  they don't have context. But what I have
• 22:10
  seen in working with leaders and many of
• 22:12
  the companies that we have long-standing
• 22:14
  partnerships with, they are not they are
• 22:18
  founder CEOs and and actually I bet if I
• 22:21
  looked at our portfolio right now, the
• 22:24
  majority of things that we have are
• 22:25
  founder CEOs.
• 22:28
  >> Those CEOs often are still actively
• 22:31
  engaged with the company. And again,
• 22:32
  that's partly because it's it's a
• 22:34
  growing and evolving space with all the
• 22:36
  new technologies. Um, and no one's had
• 22:38
  the ma the the big exit, but um, you
• 22:42
  know, there's something to be said about
• 22:43
  that founder CEO.
• 22:46
  >> Talk about um, some of the work that you
• 22:48
  and the team are doing around genomics
• 22:50
  because every time I've heard you speak
• 22:53
  about it, you uh, you kind of light up
• 22:56
  about it. There's a level of pride
• 22:57
  around it and I'd be remissed if I
• 22:59
  didn't uh, ask you to sort of share some
• 23:02
  of the amazing work that you and the
• 23:03
  team have been doing.
• 23:04
  >> Yeah, I it is it's a point of pride for
• 23:06
  me. me it's a point of pride for the
• 23:08
  organization but I am fortunate to be
• 23:10
  standing on the shoulders of giants on
• 23:12
  this one and I truly mean that we have
• 23:14
  been at this for since the 1980s um
• 23:16
  Henry Lynch of Lynch Syndrome was one of
• 23:19
  our first medical directors so like we
• 23:21
  were in it even before we probably knew
• 23:24
  what we were in
• 23:25
  >> um and we have an amazing team our um we
• 23:29
  have pharmaccogenomist Mark Dunenberger
• 23:31
  is a great guy Peter Hulick our
• 23:33
  geneticist counselors Kristen Hughes all
• 23:35
  these different individuals that show up
• 23:37
  every day because they see the potential
• 23:40
  for us to move genetics from this
• 23:42
  genomic exceptionalism into something
• 23:44
  that's actually part of every patient's
• 23:46
  care. And I think that's what I get
• 23:48
  really excited about to be honest with
• 23:49
  you is like I don't know one half of my
• 23:52
  family history because my mother was
• 23:54
  adopted.
• 23:55
  >> So when you think about that and you
• 23:57
  look at how much of the screening and
• 23:59
  guidelines are based off of your family
• 24:02
  history, I don't have one on that side.
• 24:04
  And so for me, genetics provides this
• 24:07
  quantitative family history that is not
• 24:10
  well, I think aunt Sue died of was it
• 24:13
  colorectal cancer or was it breast
• 24:15
  cancer, right?
• 24:17
  >> It actually gets you the ability to
• 24:18
  understand quantitatively. um as a
• 24:20
  community-based hospital and a community
• 24:22
  based health system, I think we are
• 24:24
  uniquely positioned to be able to
• 24:26
  deliver on genomics because the thing
• 24:27
  about genomics is yes, it's expensive
• 24:30
  doing whole genome sequencing and all
• 24:31
  these things are not for the wearded and
• 24:33
  payers aren't necessarily paying for it.
• 24:36
  But what we have the ability to do is
• 24:38
  start thinking holistically and
• 24:39
  longitudinally about how you use
• 24:41
  genomics as a a test with lifetime
• 24:44
  value. you go back and query the
• 24:46
  information based off of what clinical
• 24:48
  presentation you have or different risk
• 24:51
  factors that that evolve with your age.
• 24:53
  Um, genomics is not a crystal ball. Like
• 24:56
  it doesn't tell you everything, but it's
• 24:57
  a really important signal that helps you
• 25:00
  better understand your destiny and you
• 25:02
  can do something about it. So, I mean, I
• 25:04
  I think genetics has a tremendous uh
• 25:06
  potential. The costs are coming down.
• 25:08
  Um, we've been now fortunate to sequence
• 25:11
  over 50,000 patients or not sequence,
• 25:14
  we've had 50,000 patients complete some
• 25:16
  sort of a genetic test. Um, and and that
• 25:18
  is just a drop in the bucket. You know,
• 25:20
  we're our patient geography is 1.4
• 25:22
  million and growing. At 50,000 is a
• 25:25
  great testament of what we can do when
• 25:28
  we put our mind to it. But I want to see
• 25:29
  a zero on that in the next couple years.
• 25:32
  And that's going to take us being able
• 25:34
  to truly prove out the business case as
• 25:37
  well as the clinical case so that we get
• 25:38
  folks uh to embrace it.
• 25:41
  >> When you think about innovating, you
• 25:43
  know, you mentioned the business case.
• 25:46
  How do you frame up some of these ideas
• 25:50
  and problems that you're trying to solve
• 25:52
  today? Like you're marrying, hey, we
• 25:54
  need to solve this problem, but we also
• 25:56
  need to come up with a business case.
• 25:57
  Like walk me through your thinking. what
• 25:59
  happens internally to to the degree that
• 26:01
  you're actually able to share because
• 26:05
  I'm just going to say this from from
• 26:06
  from from a founders's perspective
• 26:09
  they're just like well they only see
• 26:10
  they only are seeing it from their
• 26:12
  perspective but they don't see what
• 26:15
  needs to happen and the inner workings
• 26:16
  of an organization that's multifaceted
• 26:19
  lots of different priorities that are
• 26:20
  happening give them just a snapshot to
• 26:23
  see because it's kind of like you're
• 26:25
  going through a gauntlet and there's a
• 26:28
  lot of things that can get you off
• 26:29
  course or get you killed. Um, so if if
• 26:32
  if if you're able to share, would love
• 26:35
  to hear more of that.
• 26:37
  >> Yeah, I I think that as the organization
• 26:40
  has gotten larger,
• 26:43
  I'll be honest with you that the impact
• 26:45
  is going to have to be greater.
• 26:48
  >> Um, definitely. So the days of and
• 26:50
  again, we're a five and a half, six
• 26:52
  billion dollar organization. for me to
• 26:54
  come back and say I need everybody to
• 26:56
  get excited and I have the ability to
• 26:58
  deliver a million dollars of value.
• 27:01
  I hate to say it but a million dollars
• 27:03
  while it's a it's a million dollars.
• 27:04
  It's a rounding.
• 27:06
  >> Yeah. And
• 27:07
  >> so for me it's really really becoming
• 27:09
  important for us to not focus only on
• 27:12
  the dollars and cents but to really
• 27:14
  understand the holistic value that you
• 27:16
  can get out of that. And so we talk a
• 27:18
  lot about workforce empowerment, we talk
• 27:20
  about care differentiation, we talk
• 27:22
  about our institutes, we talk about US
• 27:25
  news and world report like how do you
• 27:27
  start to leverage innovation to be an
• 27:29
  unlock with multipliers surrounding it.
• 27:32
  >> Um so I I I would say that we don't we
• 27:35
  don't anchor specifically to the
• 27:36
  financials. Of course it's a critically
• 27:38
  important one particularly it's going to
• 27:40
  require a lot of capital or additional
• 27:42
  resourcing behind it. Um, but it has to
• 27:45
  be a, you know, the whole solution in
• 27:47
  search of a problem. It's got to be a
• 27:48
  problem that we have or it's got to be a
• 27:49
  really unique opportunity that we think
• 27:51
  we're well positioned to to win in. And
• 27:53
  then we put together kind of the
• 27:55
  overarching what is the value prop
• 27:56
  across multiple dimensions.
• 27:59
  Nice. So now you're in this leadership
• 28:01
  role. Um, your team is
• 28:06
  quite big.
• 28:08
  talk about that and the dynamics of that
• 28:10
  because I mean I want to know that you
• 28:11
  know when you've now that you're you've
• 28:13
  been in leadership. Um maybe what's
• 28:16
  something about leadership that has kind
• 28:18
  of surprised you once you've kind of
• 28:20
  been in it for a bit?
• 28:22
  >> Uh the thing that surprises me is
• 28:25
  nothing surprises me in leadership. Um
• 28:29
  but uh you know I it's it's very
• 28:32
  interesting because you work with
• 28:33
  different teams and and it's it's
• 28:35
  grounding for me because remember I have
• 28:38
  the innovation side where it's like go
• 28:40
  go go and then I have the research side
• 28:42
  which is the regulatory says this and
• 28:45
  this says this and this and the IRB and
• 28:46
  all these things and so it's really
• 28:48
  interesting to try to sit in the
• 28:50
  dynamics between that. My meetings that
• 28:52
  I have with the teams are vastly
• 28:54
  different. One of them is called like
• 28:57
  the research cabinet. The other one is
• 28:59
  like the innovation collab, right? And
• 29:01
  these kind of things and and I mean
• 29:03
  there's just dynamics you have to
• 29:04
  understand and appreciate. I try to
• 29:06
  bring some fun stuff over to the
• 29:07
  research team. Um and I think they're
• 29:10
  coming along for the journey, but I
• 29:11
  think in leadership it it it's
• 29:14
  relationships. It's recognizing that uh
• 29:19
  when it's you you I've had several
• 29:22
  experiences actually this year where the
• 29:24
  most important points that I've
• 29:26
  reflected on are when it gets tough do
• 29:29
  you still show up and are you there for
• 29:31
  your teams because that matters more
• 29:34
  than you could ever imagine when it
• 29:36
  comes to retention relationships they
• 29:39
  they are the most important thing. So,
• 29:42
  um, we're a people business and that is
• 29:45
  our biggest asset that we have and so we
• 29:47
  have to nurture it.
• 29:51
  Um, I'd be remiss if I didn't ask like I
• 29:53
  mean what is the best way for people to
• 29:55
  follow your work? Um, the work of the
• 29:58
  teams that you get to that you get to
• 30:00
  that you get to guide that you get to
• 30:01
  lead. How how do people follow Endeavor
• 30:04
  Health and all the awesome things that
• 30:05
  you and and the teams are doing?
• 30:07
  >> I mean, I think you said like hit
• 30:08
  subscribe or something, you know, and
• 30:09
  they'll come back.
• 30:10
  >> I told them to hit subscribe, but we
• 30:11
  want to put it, you know, but I'll let
• 30:12
  you I'll give you the mic.
• 30:16
  So, so we um are are actually in the
• 30:19
  process of developing a pretty robust
• 30:21
  intake process and I'm happy to include
• 30:23
  um in followup to this a link to our
• 30:25
  intake process um so that people can
• 30:27
  share ideas with us and that's um really
• 30:30
  I think a way for us to begin
• 30:32
  understanding what are the different
• 30:34
  ideas that really makes sense for us.
• 30:35
  We're very clear up front in the intake
• 30:37
  process like these are the things that
• 30:38
  are our number one 2 three and four
• 30:40
  priorities. Um, so definitely there. And
• 30:42
  then, um, LinkedIn is pretty pretty
• 30:45
  phenomenal. I haven't gotten on to X or
• 30:48
  or any of those things yet. My wife
• 30:49
  actually got me off of Facebook like 10
• 30:51
  years ago, which now looking back, I'm
• 30:53
  like, greatest decision that she ever
• 30:55
  did is, you know, keeping me off that.
• 30:57
  Um,
• 30:57
  >> smart woman.
• 30:58
  >> Yeah. Follow uh follow that. And
• 31:01
  honestly, I I think in the coming years,
• 31:04
  um, you're going to see Endeavor really
• 31:07
  double down on promoting innovation
• 31:09
  because in such a competitive geography,
• 31:12
  both for talent, but also for patients,
• 31:15
  you have to be able to demonstrate that
• 31:16
  what you're doing is actually providing
• 31:19
  differentiated care. And I do look at
• 31:21
  healthcare. It's it's pretty much the
• 31:23
  more things change, the more they stay
• 31:25
  the same. I think we need to be able to
• 31:27
  break that mold. And I'm hoping that
• 31:29
  given this new system coming together,
• 31:31
  unified medical group, single epic
• 31:34
  platform, once we get something figured
• 31:36
  out, we can scale it immediately.
• 31:38
  Hopefully, you'll see us in the
• 31:39
  headlines. For good reasons.
• 31:41
  >> For good, as I say, for good reasons,
• 31:43
  right? All right, let's do a little
• 31:45
  quickfire before we before we wrap. Um,
• 31:49
  I'm going to ask these quickly. No
• 31:51
  follow-ups. Just tell me what you think.
• 31:53
  Uh, a meeting that you always prepare
• 31:56
  for,
• 32:00
  >> one-on-one,
• 32:03
  >> something that looks easy from the
• 32:05
  outside but isn't
• 32:08
  >> revenue cycle.
• 32:12
  >> Most overrated idea in healthcare
• 32:15
  innovation.
• 32:23
  No.
• 32:25
  >> What about most
• 32:28
  underrated constraint?
• 32:32
  >> Underrated constraint. This is like a
• 32:34
  double negative I have to work through.
• 32:35
  So the underrated constraint
• 32:38
  with
• 32:42
  >> What about
• 32:44
  one thing that you would not fund right
• 32:48
  now?
• 32:53
  huge AI project
• 32:57
  >> without very clearly understanding the
• 33:00
  value prop.
• 33:01
  >> Okay. What about um a habit that you
• 33:06
  protect
• 33:08
  >> with money?
• 33:13
  >> Um what about a habit you're trying to
• 33:15
  break?
• 33:18
  scheduling uh back-to-back meetings that
• 33:22
  have now become 30 minute meetings
• 33:24
  because we couldn't get them in.
• 33:27
  >> All right. And last question. I mean, if
• 33:28
  if someone listened to this uh
• 33:30
  conversation five years from now, what
• 33:33
  would you hope that they feel?
• 33:38
  >> At the end of the day, healthc care is a
• 33:41
  it's a people business. It's people we
• 33:44
  care for. It's people we work with.
• 33:45
  Relationships matter. And and more than
• 33:48
  anything, technology is going to bring
• 33:50
  some amazing things, but at the end, as
• 33:53
  we talk to our nurses about virtual
• 33:56
  nursing and all these things, they want
• 33:58
  less noise, less toys, they want to be
• 34:01
  able to bring joy back to the bedside.
• 34:04
  And as opposed to having a computer
• 34:06
  screen blocking their view to the
• 34:08
  patient, they want to be able to sit on
• 34:09
  the side of the patient's bed and talk
• 34:11
  to him.
• 34:14
  >> This has been awesome, Justin. I
• 34:16
  appreciate just your um you just have a
• 34:19
  good sense of humor, good energy. You
• 34:23
  clearly have
• 34:26
  you want to do the right thing. You want
• 34:27
  to make things better, which is why I my
• 34:29
  gut was like, you'd be a great guest for
• 34:31
  the show. And um
• 34:33
  >> well, you're very
• 34:36
  and and I I will say that this is not
• 34:38
  something that is come together
• 34:41
  overnight and it's still a work in
• 34:43
  progress as we all are. Yeah. Yeah. But
• 34:46
  even something that you said about, hey,
• 34:48
  someone gave you an opportunity. So I
• 34:52
  would say if there's if you're listening
• 34:55
  and you're in a position where you can
• 34:59
  grant someone access,
• 35:02
  give it
• 35:04
  because it might just be something that
• 35:06
  could change the trajectory of someone's
• 35:07
  future. And Justin, in your case, it
• 35:09
  sounds like that was the case. like you
• 35:12
  might not be here
• 35:14
  >> had you not been able to jam out um the
• 35:18
  organ and that gave you the opportunity
• 35:21
  to meet someone at their office and they
• 35:24
  poured into you. So that that that that
• 35:26
  to me is is there's forms of innovation
• 35:28
  that happen because of
• 35:32
  a series of events but you but you were
• 35:34
  in the building and you put yourself out
• 35:35
  there and you poured yourself into that.
• 35:37
  So that that just showcased something
• 35:38
  and like you mentioned the the human
• 35:40
  side of leadership about change and and
• 35:43
  adapting to that change all that matter.
• 35:44
  So um for those that are listening,
• 35:48
  thank you. And if there is a topic that
• 35:50
  you want us to explore or maybe even a
• 35:53
  leader that you want to hear from, drop
• 35:56
  me a note, leave a comment. We do read
• 35:58
  them. And if you really love this
• 36:00
  episode, would you mind sharing it? like
• 36:03
  let someone that is in your network let
• 36:06
  them know about it. So this is a
• 36:07
  platform that is absolutely about
• 36:09
  authentic community. So thanks for
• 36:11
  listening, keep building with purpose
• 36:13
  and uh we'll see you next time on the
• 36:15
  Advancing Healthcare Innovation Show.
• 36:17
  Thanks for joining us.
• 36:19
  >> Thanks Michael.