Latest / CareTalk: Healthcare. Unfiltered. / 2023 Digital Health Trends & Challenges with Jess DaMassa

Transcript

2023 Digital Health Trends & Challenges with Jess DaMassa · CareTalk: Healthcare. Unfiltered.

• 0:00
  After incredible growth during the pandemic, digital health is adjusting to its own kind of new normal.
• 0:06
  Interest remains strong, deals are flowing, and artificial intelligence is making its mark.
• 0:11
  But the market is less frothy or maybe it's even overreacted.
• 0:15
  Co host Jess Damassa is filling in for John today.
• 0:18
  She has her finger on the throbbing pulse of the market from up top to down under.
• 0:23
  I can't wait to dive in.
• 0:33
  Welcome to CareTalk, America's home for incisive debate about healthcare business and policy.
• 0:38
  I'm David Williams, president of Health Business Group.
• 0:42
  Hi David, I'm Jessica DeMassa, I'm the executive producer and host of WTF Health, What's the Future Health.
• 0:47
  Happy to be here, subbing in for John.
• 0:50
  Outstanding.
• 0:51
  Now, Jess, the last time we caught up, you've been in some, uh, some helicopters, as I recall, flying over the Las Vegas Strip, making various lifetime vows.
• 0:58
  Have you been in any helicopters recently?
• 1:00
  No, I, I, the one helicopter trip was enough to last a lifetime for me.
• 1:04
  So still, still living, um, the fairytale romance with my new husband.
• 1:09
  Um, and I actually, I just took him.
• 1:11
  With me to Australia.
• 1:12
  So you mentioned down under, um, we just got back from a trip down there.
• 1:15
  I spoke at a conference there called Medinfo.
• 1:18
  It was put on by the Australasian Institute of Digital Health.
• 1:21
  And Medinfo is actually an international conference that bounces around from location to location.
• 1:26
  So it was a big coup for them to get it down there.
• 1:28
  It's really one of the largest global health informatics conferences.
• 1:32
  And so I got to talk on stage, uh, during the opening plenary about some of the health tech trends that are shaping healthcare here in the States.
• 1:39
  And then I got to interview a bunch of people and catch up on the gossip about what's happening not only in Australia, but elsewhere in the world.
• 1:46
  So had a couple of chats with folks from Dubai, um, the director of digital health and innovation at the World Health Organization, and then like a slew of other people.
• 1:55
  That's awesome.
• 1:56
  I saw some of your videos and I was thinking a couple things.
• 1:58
  One was I saw it said Australia and it said Dubai so I figured just hopping around but actually the Dubai guys were over there and in Australia and then The other thing, you know I've been on Cape Cod over the summer and I did a show where I was talking about sharks as part of the new normal here Any sharks in Australia?
• 2:12
  I think they're known for being hanging around there, but maybe not in the wintertime.
• 2:16
  Are you talking about like investor kind of sharks, like the ones on shark tank?
• 2:18
  Or are you talking about like actual legitimate?
• 2:20
  I was talking about the legitimate animal sharks, but maybe you saw both types.
• 2:26
  No, I, we just did no, no sharky investors down there.
• 2:29
  Their investment, um, atmosphere is a little bit different than ours.
• 2:32
  And then as far as like real life animals, the coolest thing that I saw was, uh, like, I guess, I don't know, what's a group of kangaroo, like, A smack of kangaroos, a flock of them, I don't know, a bunch of kangaroos.
• 2:43
  We'll have to look, we'll have to look it up.
• 2:44
  I don't think they call it a roost of roos, but uh, we'll, we'll find out, we'll find out for our next, our next time.
• 2:49
  A jump of kangaroos.
• 2:50
  I think, I know the babies are called joeys.
• 2:52
  You see any joeys?
• 2:53
  Yeah, I did.
• 2:54
  I saw a couple little joeys bopping around.
• 2:56
  It was really cool.
• 2:57
  That's cool.
• 2:57
  All right.
• 2:58
  So there were a couple of things that I saw that you did there.
• 2:59
  One was you were talking to outcomes health, which was like a primary care general practitioner thing.
• 3:04
  And, and they were talking about what they were doing.
• 3:06
  You had a couple of guys that are very eagerly like leaning into to explain what was what, how did you find the sort of primary care?
• 3:12
  Like, what was the approach down there compared to what we're used to?
• 3:14
  Oh, it's so cool.
• 3:15
  So, um, so this is funny too.
• 3:17
  I have to say this because at first I was like, I'm going to be interviewing these guys from Outcome Health and there's the American Outcome Health like was embroiled in scandal.
• 3:24
  And so I freaked out the conference organizer when I was like, this is Australian Outcome Health, right?
• 3:28
  Because look at this news story.
• 3:30
  And so it was pretty, it was like a funny moment, but, um, these guys are doing something really cool.
• 3:34
  They're actually a nonprofit organization.
• 3:36
  They're the largest practice of primary care docs in Australia.
• 3:41
  Um, among the top three largest mental health care providers, and they also are selling, like, practice management software now so that they can help, like, GPs there, um, aggregate data better and get not only, like, a per doctor point of view of, of how care delivery is going and outcomes and, you know, tracking of revenue and things like that because they're all independently operated businesses, um, but also roll it up to the practice level and then multiple practices.
• 4:05
  So, the way things are going down there with primary care, I mean, their system is different, obviously.
• 4:09
  So, it's.
• 4:10
  You know, central government system.
• 4:12
  Um, and really the GPS have like a longer term relationship with their patients.
• 4:16
  So for them to have like a really cool practice management, you know, software that looks at data.
• 4:22
  What I understand currently the status of their software down there is that the GPS operate independent.
• 4:28
  From the EMRs that are in the hospitals or that are in ambulatory centers.
• 4:32
  And so their, their data is their data.
• 4:34
  And so they have the ability to create these longitudinal views of patients because they have the relationship, they have their own EMR system, and they can do like kind of the thing we wish we could do here in the States.
• 4:45
  Um, but they still need to plug that into what happens at, you know, higher, uh, more acute.
• 4:49
  points of care.
• 4:50
  But, um, they're basically in the same spot we are, uh, with with primary care, I would say a little bit more maybe leaning into preventative medicine.
• 4:59
  I think those guys from outcome health are really talking about, you know, population preventative health and they really have, you know, the incentives are aligned there to make sure that the population is taken care of, you know, all the way through before things get worse.
• 5:12
  They really do have more of a health care system there than they do a sick care system.
• 5:16
  I believe that was the vibe that I got from those guys.
• 5:19
  No, it was good.
• 5:19
  They seem to be having a good time.
• 5:21
  I always like the accent.
• 5:22
  Anyway, whatever they do, it sounds very, you know, earnest and like a good time.
• 5:26
  And I do think that, that, you know, these systems that are more primary care oriented, they have a little bit better time, like being an actual system.
• 5:33
  Because primary care is dealing with prevention and the whole person, whereas specialist is often dealing with, okay, what happened?
• 5:39
  You know that now they have to have to deal with it.
• 5:41
  So I'm always fascinated to see the systems that are like that You know, you also had I saw they've got some sort of a health care Digital agency and you uh, you were interviewing the head of that.
• 5:50
  She seemed interesting I mean, is that their mickey tripathi or is it some sort of kind of a role?
• 5:54
  She didn't look like it is kind of their mickey tripathi.
• 5:57
  Like so it is that person And only less on the day.
• 5:59
  Like there is no office of the national coordinator for, um, health IT, but they're kind of that, yeah, they, they play that role of convening on standards.
• 6:08
  So fire, for those of you who are big fire fans of the, the, the data sharing standards, they were actually founded by an Australian.
• 6:14
  And so the father of fire Graham Grieve is always at these events.
• 6:17
  And this is not my first time at an Austral, Australasian Institute of digital health event.
• 6:22
  So he's there and, and they're obviously very hot on those.
• 6:25
  Standards and the fact that they really are like the international leader in terms of data sharing.
• 6:29
  And so the gossip from her was all about, you know, how their, my health record, they have a centralized government owned.
• 6:37
  Patient record and that was launched.
• 6:39
  I think 3 or 4 years ago before the pandemic.
• 6:42
  Maybe let's call it 2018 ish.
• 6:45
  And, um, it was like controversial when it was first announced because people were concerned about the government being in their private health data, blah, blah, but I guess since then and the pandemic now it's like looked at as this really great thing.
• 6:58
  And there's a lot more information than was available in it.
• 7:01
  Previously now available as a result of, you know, the data sharing that has gone on past the pandemic and the systems are put in place.
• 7:08
  So really exciting news there about that.
• 7:10
  You know, when you talk about the father of fire, I'm picturing like Zeus on the mountaintop or some caveman or something like that.
• 7:15
  But this guy says quality.
• 7:17
  I mean, he's like the nicest man, but he's just like, he's like international health.
• 7:22
  I.
• 7:22
  T.
• 7:22
  Superstar.
• 7:23
  Yeah, Yeah, yeah, yeah.
• 7:26
  Well, the gods are sometimes understated, you know, until they got to have to pull some firebolt out or something in order to toss.
• 7:31
  Well, from a couple years ago, I did get a chance to interview him.
• 7:33
  So if anybody's curious in this story, again, his name is Graham Greaves.
• 7:35
  So go find that on my, on my YouTube channel.
• 7:38
  We just have to figure out how to spell it.
• 7:39
  I mean, Graham is relatively easy to spell.
• 7:42
  Yeah.
• 7:42
  It's got an E at the end of it.
• 7:44
  All right.
• 7:45
  Okay.
• 7:46
  So now Bax, I think you were backstage side.
• 7:48
  You're phoning it in from over and, and I saw you, you did an interview with the CEO of Flatiron.
• 7:53
  And I thought on the one hand you were saying, Hey, great stuff in 10 years.
• 7:56
  But then on the other hand, it's sort of like.
• 7:57
  It's been a decade.
• 7:58
  Do you have anything to show for it?
• 8:00
  Well, yeah, and that's a big question, right?
• 8:02
  I think of all of all of our friends who have been at it for about a decade, which I feel like is like pretty, pretty standard for healthcare technology companies, no matter where they're at, if they're in digital health or if they're in health IT or if they're in.
• 8:14
  Pharma and clinical trials like Flatiron is.
• 8:17
  So it sounds like they've found, um, their, well, it's their new CEO who's been around now, I think for two years.
• 8:23
  And, you know, she's just talking about, you know, all the business that they're doing with big pharma organizations since they've been bought by Roche.
• 8:30
  Remember that?
• 8:31
  Um, so they've got a lot of contracts with a lot of different players and they're doing a lot of great work in terms of helping, you know, diversify clinical trials, helping bring drugs to market faster.
• 8:40
  And, and.
• 8:41
  You know, she put it beautifully in that interview.
• 8:43
  They've proven the case for, you know, what big data and large language moms can do in this space.
• 8:49
  And now it's just like, let's go get it.
• 8:51
  The market is right.
• 8:53
  You know, RWE is a term that's been talked about a lot, a lot of excitement about that.
• 8:57
  There's another term that doesn't get a lot of excitement, but I've started to see more about it recently.
• 9:01
  And that's menopause.
• 9:03
  And in fact, I saw that you, you know, you were.
• 9:06
  Yeah, there's male menopause too.
• 9:07
  I, I heard, I heard, but I don't think it's the real thing.
• 9:10
  Is there something you wanna tell us here?
• 9:11
  I don't think I was ever, that John's not around . I don't, I don't think I was ever capable of carrying a, a baby to term, just to be, just to be clear on that.
• 9:18
  Okay.
• 9:18
  John May be.
• 9:19
  John May.
• 9:19
  In fact, now that you mention it, male menopause.
• 9:21
  That does explain a lot about John, but we'll let him defend himself later.
• 9:25
  But I saw, you know, I actually saw a couple articles about this recently that this is an area where employers in particular mm-hmm.
• 9:31
  are starting to realize, hey, this is, this is an issue.
• 9:33
  And what happens is that women that are.
• 9:35
  You know, in menopause age, a lot of them, more of the focus has been, you know, they're caring for their kids, they're caring for their older parents.
• 9:41
  And even though, you know, it's funny to think about women's health'cause most patients are women.
• 9:46
  This, it's kind of an under, you know, an an underutilized and underlooked area and it's getting a lot of attention now.
• 9:52
  And you interviewed somebody, uh, from me, health.
• 9:55
  Uh, and it seemed like pretty interesting.
• 9:57
  Seems like a big topic.
• 9:59
  Yeah.
• 9:59
  So this is really cool.
• 10:00
  I love this space.
• 10:01
  This, um, it's like a couple spaces at one time for me.
• 10:05
  I love the women's health space.
• 10:06
  I love the menopause space because we actually spend more time as women, um, in our non reproductive years than we do in our reproductive years.
• 10:14
  And so there's a whole lot of different things that happen to your body when it stops, you know, naturally producing the hormones that it's used to.
• 10:20
  And it can affect everything from, you know, your mental health to your bone density and muscle tone and you know everything.
• 10:27
  So I think that's an interesting space.
• 10:29
  And then I also think that this is a really cool example of, broadly speaking, how virtual care as a category online is just expanding.
• 10:39
  And I think that this kind of specialty medicine is like 100% indicative of the next wave, I think, of the new startups that are going to be really making a difference in terms of, um, what's happening with telehealth and with virtual care models.
• 10:54
  And, you know, kind of that whole idea of, you know, omni channel care delivery.
• 10:58
  I think that specialty medicine, we haven't even started to see virtual really take hold there.
• 11:03
  And this is a perfect example of that.
• 11:04
  So, you know, to your point, David, it's like, this is a huge, um, Yeah, productivity issue if you want to put it in dollars and cents from an employer standpoint.
• 11:12
  And so having support for women who are, you know, really struggling, you know, during like really the peak of their careers, a lot of them are in leadership positions, you know, and a lot of them have teams that report to them.
• 11:22
  A lot of them are doing fantastic work and to have to suffer through hot flashes or, you know, some of the other changes that happen, difficulty sleeping at night, whether it's a hot flash or not, or, you know, just even differences in appetite, just changes.
• 11:33
  And, you know, there's a lot going on there.
• 11:35
  And so if there's.
• 11:36
  So if there is more targeted, specialized solutions that really appeal to the diverse needs, you know, the whole picture, holistic health for a woman during that period of time, you know, and then afterward, I think, you know, great.
• 11:49
  I mean, that's like a no brainer as far as I'm concerned.
• 11:52
  Yeah, I mean, there were a couple of things that struck me in that interview.
• 11:55
  One of them was that, as the CEO was pointing out, like.
• 11:57
  All these things really are conducive for virtual care.
• 12:01
  You don't need, you know, it's omni channel in a sense, but it can be, um, you know, really being virtual makes sense.
• 12:06
  And then there's the question about fragmentation.
• 12:08
  And you're saying, well, how do you coordinate with primary care?
• 12:10
  And she said something like, you know, 40% of women in this age group like hadn't been to a doctor in some time anyway, so we're probably their primary care anyway.
• 12:18
  And then the other thing I think, and this was, this is why I believe it hasn't gotten that much attention, that, you know, care for this kind of segment has been Kind of synonymous with hormone replacement therapy, which is now it's and it's much broader, you know than than that That's what I learned.
• 12:32
  So I I found that was probably of all the different things Uh that I saw that you've done recently.
• 12:36
  That was the most eye opening one.
• 12:38
  Thank you Thanks for watching that david.
• 12:40
  That's really that's really awesome.
• 12:41
  Thank you Appreciate that more men need to get familiar with that category and I always say like watching an easy little video Having somebody explain, like, those kinds of categories is really important because you can do it in the safety and privacy of your own little home.
• 12:54
  Exactly.
• 12:55
  And tell the whole world about it here.
• 12:56
  Tell the whole world about it.
• 12:57
  Like, listen to this! Yeah.
• 12:58
  Casually send it to your wife, you know, whatever.
• 13:02
  Exactly.
• 13:02
  I'll do that.
• 13:03
  I don't think she watches CareTalk anyway, but, uh, she knows.
• 13:06
  She should be more of a WTFHawk fan.
• 13:09
  Probably.
• 13:09
  I'll let her know about that.
• 13:11
  You know, so Las Vegas, we're talking about that before.
• 13:13
  So I was, I'm planning to go out there for the, the HLTH health conference, however you want to call it.
• 13:19
  And I understand that maybe I won't get the helicopter ride this time, but are you going to go, what are you expecting to see out there?
• 13:26
  Yeah.
• 13:26
  You know, I mean, this is the biggest show for us.
• 13:28
  For the year.
• 13:29
  I mean, so you gotta go, right?
• 13:30
  And, um, I think that, you know, what I'm optimistic about is that I hope we're going to see some late year deals here.
• 13:37
  Like, I mean, if we've been quiet, you know, I mean, the first half of the year ended up like, I think rock health had the total around 6.
• 13:44
  3 billion for the first half of 2023 funding.
• 13:47
  Everybody's tracking the, the, the, the projections are that will hit about 15, which will be either At or below, depending on the what's after the decimal point of where we were last year.
• 13:58
  And I think like, you know, I feel like a lot of folks are down on that, but I think it's kind of encouraging that we haven't dipped.
• 14:05
  You know what I mean?
• 14:05
  That we've kind of maintained.
• 14:07
  And so I think we're holding our own and I expect at health that there's going to be, there's always announcements.
• 14:12
  And so I think we'll see some of that.
• 14:14
  What's been surprising to me, I think so far.
• 14:17
  And I'd be curious to hear what you think too, David is like at the beginning of the year, I remember saying myself like, Oh, there'll be so many mergers and acquisitions.
• 14:24
  And like, I really feel like I haven't seen that.
• 14:27
  And, and it's been a little bit.
• 14:30
  Disconcerting because I'm like, are these companies, are some of these companies just disappearing quietly?
• 14:35
  And I just don't know, like I, or what's going on?
• 14:38
  I mean, like, it's, it's difficult to tell right now.
• 14:40
  And so I think that at health, it's going to be a good time, at least for me to just double check that everybody that I was, that was there last year that I want to see accounted for is there again.
• 14:50
  I mean, what are your thoughts on that?
• 14:51
  Is the amount of M& A activity or lack thereof surprised you for this year?
• 14:57
  So, you know, like the last couple of years, the big stories have been like about big deals and then about big deals gone bad.
• 15:03
  So I think I want to have that be the, you know, have that be the big story.
• 15:07
  It is interesting when, uh, when there's sort of good news and deals, people are trumpeting that and they don't sort of make a quiet thing to say, Hey, you know, we went out of business or, or whatever.
• 15:15
  What I think has happened is a couple of things.
• 15:17
  One is you've got companies that, you know, had these.
• 15:20
  Big valuations in prior years, and then they're hitting their milestones, but they find that they hit their milestones and they go out for their next funding round that, gay, the valuations have gone down.
• 15:29
  So they're trying, even though they hit their milestone, so they're, they're trying to sort of stretch out what they can do, you know, on a dollar.
• 15:35
  And then the same thing, I think, for some of these acquisitions, it's like, hey, you know, if I was worth 500 million last year, I don't want to sell for 300 million this year.
• 15:43
  And so I think that's sort of slowed things down.
• 15:45
  Now, eventually things happen, you know, because you still have to raise money.
• 15:49
  So if you don't raise money.
• 15:50
  Then they're going to either quietly or loudly go away or have a forced sale.
• 15:54
  So I think you're seeing some of that.
• 15:56
  And I do believe that, um, you know, maybe we are, maybe we're seeing an uptick of deals in general across healthcare and the economy.
• 16:03
  And maybe we are going to see a big one, uh, by the time of health, and we'll be able to talk about that.
• 16:08
  I'm pretty excited about some of the stuff I've been seeing lately.
• 16:11
  I don't know about you.
• 16:12
  All that Amazon stuff is really cool.
• 16:14
  Amazon clinic with wheel and study MD.
• 16:16
  And then now I feel like for a second, can we just say about the blue shield of California?
• 16:23
  Killing the relationship with CVS Caremark after 15 long years.
• 16:27
  It's like a divorce.
• 16:28
  And now they're like dating Merck Cuban, the cost plus drug company and Amazon pharmacy.
• 16:34
  I'm like, Oh my gosh.
• 16:35
  So yeah, I think there's, we're right for a little bit of shaking up here and it's exciting to see some of these.
• 16:41
  Those are the deals that I've been excited about lately, or to see kind of like what's been coming together in terms of partnership, um, not necessarily M& A, but, you know, just what's been unfolding.
• 16:51
  I'm like, who's dating who these days?
• 16:54
  Yeah, exactly.
• 16:55
  Well, you know, when you talk about the Blue Shield deal, there's been a lot of talk over many years about pharmacy benefit managers and what are you going to transparent PBM or start our own or do something different.
• 17:06
  And there has not actually been.
• 17:08
  All that much movement.
• 17:09
  So now you see something pretty radical, right?
• 17:11
  When you've got Blue Shield, which likes to be innovative and do something new, working with some players that actually have the heft to do something.
• 17:18
  Amazon on the one side, Mark Cuban, a cost plus drug company, you know, on the other, and they've got a couple of other partners in there and we'll have to see what, you know, what occurs.
• 17:28
  It definitely took a whack out of the CVS stock.
• 17:31
  You know, when they, when they announced that, so you can see the shield, they've got to be an ozempic shot somehow.
• 17:37
  Right.
• 17:39
  Exactly.
• 17:39
  I mean, some people say the, you know, that's going to be the year.
• 17:42
  I saw the term the other day, peak obesity, and we may have reached peak obesity.
• 17:46
  And now it's going to go down there.
• 17:47
  I don't, I'm.
• 17:49
  A skeptic on that one, but I think the payers are smart on this is like everything I've been hearing is like the buck literally stops here like that.
• 17:57
  Everybody's going to be everybody's plan is going to be recalibrated next year.
• 18:01
  And then that is not going to be covered the way that it is right now.
• 18:05
  Now, Jess, I would say around maybe not at the very beginning of the year, but maybe yeah, the first quarter there was incredible talk about AI And in fact, when it comes to digital health, people were saying, I just made all of these investments in digital health and now is AI chat GPT and others going to come along and.
• 18:23
  Blow everything up that hasn't quite happened.
• 18:26
  Wait, what do you what do you think is going on?
• 18:27
  Yeah I don't know we should you know Go talk to the folks at a haven or IBM Watson or find out about blockchain and all that other We have like love to glom on to you, right?
• 18:38
  Like it's kind of it feels like that's there for me in terms of our own.
• 18:42
  I know there's the Gartner hype Cycle, but like on the, in the Jessica DeMasa worldview hype cycle, I feel like like chat AI is kind of there for me right now.
• 18:52
  No, but I did hear some interesting stuff at that conference in Australia.
• 18:55
  Not to kind of bring it back full circle.
• 18:57
  Um, it was a big topic of conversation there.
• 18:59
  There was actually an international policy forum I was part of with the, you know, some folks from around the world who like, you know, people who were talking about data standards and sharing.
• 19:07
  And it was, it was interesting.
• 19:08
  One of my favorite, um.
• 19:10
  Moments is actually I've captured it on interview in an interview as well.
• 19:13
  It's an AI policy person from the UK who works with the, the, the UK government.
• 19:18
  You know, she's like, you know, we're talking about policy for generative AI and we haven't even figured out policy for regular old AI.
• 19:25
  Like we were just like, we're so far back here.
• 19:27
  And so I think everybody's, what I got is everybody is blown away by the technology.
• 19:32
  Not sure if it will, it'll be.
• 19:34
  Years before it's good enough to put into a clinical situation, I think admin type stuff is where they're looking at right now, but I think that, you know, she put it so well.
• 19:44
  It's like, we haven't even figured out what we're doing with good old AI.
• 19:49
  And now we're going to just layer on top of this.
• 19:51
  Like, there's, there's kind of have to be a stop and an assess your moment in terms of the frameworks for that with a lot of concern being put on.
• 20:00
  Yeah.
• 20:00
  Um, how the models are trained.
• 20:02
  So I was hearing even talk of kind of like a food label.
• 20:05
  Like we have like the nutrition labels on food, knowing like what ingredients went into whatever it is you're eating.
• 20:10
  Well, like what ingredients went into training the algorithm for the AI that is now giving you whatever it's giving you.
• 20:16
  So I, it's a lot of interesting conversation about it, man, like.
• 20:20
  So early to me so early my next hot area to watch if you're really interested in what I think is, um, that whole infrastructure space.
• 20:29
  I really think that right now.
• 20:31
  1 of the things that this whole generative AI conversation is bringing up is the fact that.
• 20:36
  are, you know, is it, is it Coke or is it Pepsi EMR system that we have around the world, which is not interoperable at all is like really going to be like where the rubber meets the road in terms of any type of data, intelligence, analytics, anything.
• 20:51
  And, you know, those systems were built to be a medical record and to help with billing.
• 20:55
  They were not designed to do, you know, complex algorithmic modeling and preventative.
• 21:00
  population health and all that other sexy stuff we wish they could do.
• 21:04
  So I think that there's going to be that space to me is exciting to watch as the stuff that is going to come up to kind of bridge that gap between where we're at right now and what is next.
• 21:12
  But I don't, as far as, you know, chat GPT, you know, passing medical boards and whatever, uh, that's going to be a long time in my opinion.
• 21:21
  So Jess, there's so much more to talk about and I'm going to tell John to go take more vacations so that you can come and co host the show again and we can continue to talk.
• 21:29
  But for now, I'm going to say that's it for yet another episode of care talk.
• 21:33
  I'm David Williams, president of health business group.
• 21:36
  And I'm Jess DeMossa, executive producer and host of WTF Health.
• 21:39
  Thanks for having me here, David.