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E191: John Fryer | The Healthcare Shift That Will Impact 100 Million Americans · The Advancing Healthcare Innovation Show

0:11
Hello and welcome back to the Advancing
0:12
Healthcare Innovation Show. I am your
0:14
host Michael Stamatinos, and if you're
0:16
new to us, super excited to have you
0:18
here. Welcome. We're bringing some
0:20
really exciting conversations with real
0:22
leaders that are painstakingly reshaping
0:25
the future of healthcare.
0:27
We're really passionate about a few
0:28
different areas. We're really focused on
0:30
improving access,
0:31
leadership, innovation adoption.
0:34
And if it's your first time tuning in,
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0:38
back and give you a little bit more of
0:40
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0:41
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0:43
we're focused on bringing real stories
0:45
of innovation to life, not just the
0:46
stuff that you read about or stuff
0:48
that's actually, you know,
0:50
theoretical. Like, you know, this is
0:52
real stuff, real people that are in the
0:54
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0:56
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0:58
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0:59
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1:01
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1:03
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1:18
So,
1:19
we are in a very fascinating moment in
1:23
healthcare right now.
1:24
Primary care is carrying more weight
1:28
than ever before. The demands of the
1:30
system continue to grow. The workforce
1:35
honestly continues to feel the pressure
1:37
of those demands, and at the same time,
1:39
AI is really
1:42
beginning to to reshape
1:45
what scale can actually look like. And
1:49
in that gap,
1:51
um,
1:52
the very dangerous gap is actually
1:54
in rural America.
1:56
46 million people, Now, more than 90% of
2:00
rural counties facing a shortage of
2:02
primary care physicians. So,
2:05
rural America has lost more than I think
2:07
it was the stat that I had checked was
2:09
more than 10% of its family physicians
2:11
in just
2:13
the last 6 years. And payers who were
2:16
sort of supposed to serve these
2:17
communities are quietly kind of pulling
2:19
out because of uh less profitability
2:22
than I think they would have imagined.
2:23
So, the big question is this, can we use
2:26
technology to
2:27
expand uh human capacity without losing
2:31
the humanity that
2:33
uh really makes
2:35
care work in the first place? And
2:38
our guest today, John Fryer, has been
2:41
standing in that gap and is doing
2:44
something about it. So, he is the chief
2:47
growth and corporate development officer
2:49
at Lumaris. He and his team have helped
2:52
move over
2:53
a million members into value-based
2:55
models with more than 10 billion with a
2:58
B dollars in medical spend under
3:00
management.
3:02
Uh this doesn't happen uh
3:05
overnight. This happens because there
3:06
are a whole host of things that are
3:09
happening, strategic relationships that
3:11
are in place, and
3:13
John's CV is pretty
3:15
freaking ridiculous. Uh he was named
3:17
Modern Healthcare's 40 under 40. He is
3:20
also an active angel investor. Um and
3:23
someone who doesn't just talk about
3:24
transformation, he's proactively
3:26
building it and building it at like
3:28
massive scale. So, today,
3:30
um
3:32
personally, I want to kind of dig into
3:33
all of that stuff and look at what's the
3:36
next generation of primary care going to
3:38
look like, how can AI really be an
3:40
amplifier of that,
3:42
and how can they remove a lot of that
3:43
friction, and you know,
3:46
what do health systems need to get right
3:48
if they want to scale uh care in in a
3:51
way that is really deeply personal. So,
3:55
yeah, we're going to go through all that
3:56
stuff. So, I'm really excited. So, John,
3:57
great to see you.
3:59
Welcome to the show.
4:01
>> Michael, it is a pleasure and I'm super
4:03
excited to be here today. There there
4:05
couldn't be more going on,
4:08
uh, in our world and I think I'm I'm
4:09
looking forward to digging into it, uh,
4:12
today.
4:13
>> Yeah, so we were, uh, kind of jamming
4:15
before
4:17
before the record button went on. Um, I
4:19
kind of want to start our kind of local.
4:21
So, you you you grew up in Kansas City,
4:23
Cerner's hometown, now known as Oracle
4:25
Health. And I think, if I read
4:28
correctly, somewhere along the way you
4:30
ended up, uh, in a in a random
4:33
conversation with, uh, Neil Patterson
4:35
that changed the trajectory, um,
4:40
I think of your career and your life. I
4:41
mean, just
4:43
take me back to that moment. Um, what
4:45
what like what happened?
4:47
>> Yeah, it's, uh, it's a pretty special,
4:51
you know, moment and when you can look
4:52
back on your life, you you can identify
4:54
these in the moment. You oftentimes miss
4:56
miss these opportunities, miss these
4:59
foundational pivots. But but for me,
5:01
this was a big one. I was a junior in
5:03
college. I was back in town. Um,
5:05
happened to get from Neil Patterson the
5:08
question that many juniors in college
5:10
get, which is what are you going to do
5:11
with your life when you graduate?
5:14
Uh, I was super excited
5:16
to give him my answer, you know, I I had
5:18
been in economics and in finance, uh,
5:21
undergrad, uh, focus on
5:23
entrepreneurship. And I was on a very
5:25
traditional,
5:27
uh, investment banking financial
5:28
services track. I had done my
5:30
internships. I was all excited,
5:32
uh, to be going to Charlotte, Boston, or
5:34
New York. And, uh, I really leaned in to
5:37
sharing how excited I was, uh, to Neil,
5:40
uh,
5:41
who responded by saying, "Don't waste
5:43
your life. Uh,
5:44
go into health care,
5:46
uh, and participate in industry that
5:49
that has an opportunity to truly impact
5:52
people at scale
5:54
and you know this was almost 20 years
5:56
ago now
5:57
and and do so then at a time that could
6:00
have an impact and you know that moment
6:02
stuck with me I went into health care
6:04
right out of undergrad I did get closer
6:07
to more of the finance side of the
6:08
equation for a few years but I I stayed
6:11
in health care and it's it's wild how
6:14
those chance encounters
6:17
can have such a broad and lasting impact
6:20
on on your career.
6:22
>> What degree do you sort of attribute
6:25
that to luck? Like how lucky do you see
6:27
yourself like on a scale of 1 to 10 1
6:29
being not so lucky 10 being like just
6:31
ridiculously lucky where you at on that
6:32
scale?
6:33
>> I think the luck is less having the
6:37
encounters it's more
6:40
seeing the signal
6:41
and responding to it.
6:44
I think all of us
6:46
find ourselves in unique situations or
6:49
meet unique people or even have a
6:51
conversation with a loved one
6:53
um
6:55
and we don't always listen to it
6:59
and most often don't act on it.
7:01
And
7:03
I think I was fortunate to have the
7:05
experience but also I have I haven't
7:08
really thought of this as to what was it
7:10
that made me really reflect and make an
7:12
alternative choice. Um but I I made that
7:16
choice with not all the facts in the
7:18
world but I I was watching the digital
7:20
health ecosystem start to establish I'm
7:23
I'm a son of an entrepreneur
7:26
um so I've always loved entrepreneurship
7:28
there's a bunch of
7:29
investment capital coming into health
7:31
care around this time and and
7:34
um
7:35
there was something in that moment that
7:37
said well this is the right the right
7:39
place for me to focus my energy.
7:41
>> Yeah I mean look you've been in you've
7:42
stayed
7:43
throughout your career. You never left.
7:45
I think there's some people um
7:48
with similar profile that would have
7:50
maybe taken money, gone somewhere else
7:52
that's a little bit easier. I I'm I'm
7:53
just sort of curious of what what is
7:56
the thing about this industry
7:59
that that keeps you from from leaving
8:02
even when it's frustrating and you
8:05
you know, want to run your head into the
8:07
wall.
8:08
>> It's only for the foolish. No, I mean
8:11
uh
8:13
I think the thing that um
8:16
Yeah, there's a lot of challenges in
8:17
healthcare. There's a lot of challenges
8:19
um that make um having a long
8:23
established career in healthcare really
8:24
hard and it's not for everybody. Um the
8:27
thing that I love the most is the people
8:29
that gravitate to healthcare, the
8:30
passion,
8:32
uh the ability to wake up every day
8:35
with a north star that you're
8:37
investing in your future, but you have
8:39
an ability to have an impact that can
8:41
actually better the world, better
8:44
communities.
8:45
Um so, I think it's it's part the
8:49
premise of participating in pushing our
8:52
our healthcare ecosystem that we're all
8:54
impacted by forward,
8:57
a large part the people that get
8:58
attracted and do stay in it, they're
9:00
passionate, they're doing it for they've
9:02
got a true purpose, they
9:04
generally feel pretty strongly uh about
9:07
it. And I I think the third thing is is
9:10
it To me, it's the land of opportunity.
9:12
Uh there are lots of ways uh that
9:16
innovators that passionate people can
9:19
have an impact um at large big scale,
9:23
but also at micro scale. I mean, micro
9:26
encounters in healthcare can have real
9:27
impacts on real people every day.
9:30
And I I don't think there's many
9:31
industries that you can step back in,
9:34
you know, go to sleep after a long day
9:36
and know it was you know I'm I'm working
9:38
towards a bigger purpose.
9:40
>> Yeah.
9:41
I love that. I mean
9:43
the metrics earlier were I'm still like
9:46
mind over a million members, 10 billion
9:48
in medical spent. Like that's
9:51
Those are big numbers.
9:53
I want to go behind those numbers.
9:56
Because behind those numbers are
9:59
strategic relationships that need to all
10:01
align. You you talked a little bit about
10:04
that. Uh I want to hear about
10:07
a partnership that was difficult to
10:09
secure
10:11
but you ended up moving it over the
10:12
line. Like what what do those
10:15
opportunities look like initially? What
10:17
does it take
10:19
to get them to
10:21
get over the line?
10:23
Now take me into that room.
10:25
>> Yeah, I think
10:27
the way that I have you know if if you
10:30
had asked
10:32
you know 23-year-old John would you be
10:34
in partnership development and sales? Um
10:39
you know 23-year-old John would have
10:41
said
10:42
no I'd be in finance crunching numbers
10:45
and and maybe doing deals on on the
10:47
other side of the table. Um
10:50
but I I think that um
10:53
partnership development is all about
10:54
trust. It's all about relationships and
10:56
and we are in an AI era that is changing
10:59
uh things very rapidly but um
11:03
I think for me and for the culture that
11:05
I've tried to create on the teams uh
11:07
that I've built um it really is about
11:11
understanding who's on the other side of
11:13
the table and you have to do that across
11:15
the various stakeholders.
11:17
>> Sorry.
11:18
>> There's a lot the one beautiful thing
11:21
about health care is uh it's
11:23
consensus-driven. Um it's it's it
11:27
incorporates leadership, finance,
11:29
clinical, patients, uh consumers,
11:33
payers, providers. It's complicated. Um
11:37
and we uh have a very complicated
11:40
operating model we we organize within.
11:44
And so you really have to understand the
11:47
perspectives of others,
11:49
uh what motivates them, what determines
11:52
how they view success,
11:54
how do you keep their communities that
11:55
are being served um top of mind.
11:58
Um and really being able to
12:01
get way lower than the glitz and
12:05
glamorous sales presentation or
12:08
technology demo.
12:10
>> Right.
12:10
>> Uh there's a value to that and it's fun
12:12
doing a a glitz and a glam show. Um but
12:16
ultimately to scale innovation, you've
12:18
got to really understand both sides
12:21
uh and align
12:24
um at a much deeper level with where am
12:27
I trying to go? Where am I trying to
12:28
take our business? What impact do we
12:30
want to have? Um and does that map
12:34
um with the problems that you need to
12:36
tackle and the communities that you need
12:38
to serve and the priorities that you
12:40
have. And um
12:42
it's also putting
12:45
you know, the one thing that I've always
12:46
leaned into with my teams.
12:49
In business development at any in any
12:52
opportunity, you you have these moments
12:55
where you identify something and you're
12:56
like, "Oh, I want to bury that."
12:59
>> Right.
13:00
>> I want to put it behind me. I want to
13:01
put it underground. I don't ever want to
13:03
bring that up. And that's the wrong way
13:06
to think about it. When you identify
13:08
those hairy objects,
13:10
uh you need to put them on the table and
13:12
you need to put them on the table as
13:14
early as you can
13:15
um because you may be able to get that
13:19
relationship across the line. You may be
13:21
able to get your deal.
13:23
Uh you ultimately won't be successful
13:26
uh because partnerships are built on
13:28
trust, integrity, transparency on both
13:32
sides. Um, and I expect and demand that
13:35
of myself, my teams, but also I expect
13:38
and demand that from those that I'm
13:40
looking to be in business with.
13:42
Partnerships are not easy. Um, and
13:45
there's always moments of friction. And
13:47
if you don't go into a partnership with
13:49
the ability to deal with those moments
13:51
in time,
13:52
you're probably not going to be able to
13:53
deal with them when they inevitably will
13:55
come up
13:56
in the life cycle of your partnership.
13:59
>> Yeah, that just
14:01
reminds me of
14:02
a fellow who has been a really big
14:04
mentor for me, and he always said that,
14:05
you know, if you're going into a
14:06
partnership, pick a fight. How does your
14:09
partner fight? Do they fight fair?
14:10
Do they get really nasty? See how they
14:13
See how they respond, how they react.
14:15
Curious, when you're working with health
14:17
system leaders at this type of scale,
14:20
what's usually their readiness to
14:22
change?
14:23
Um, because it just seems as though the
14:24
like within the last few years, there's
14:26
been sort of this Yes, value-based care.
14:28
We talk about it a lot.
14:30
Not as many are doing it as as we're
14:32
talking about it.
14:34
What's the readiness to change?
14:37
Where do you see their
14:40
um aperture for wanting to make a move?
14:43
Like what has to happen in order for
14:45
them to really consider this?
14:48
>> I I think that um
14:50
we're at a pivotal moment in time in
14:53
health care. There is change coming at
14:54
us in all directions, and I think, you
14:56
know, value-based care is one mechanism,
14:58
the transformation of AI is another. Um,
15:02
the reality that
15:05
we don't have an innovation problem in
15:07
health care. We have a deployment,
15:09
execution, and operating model problem.
15:12
And I think when you think about
15:15
how ready are we, the answer is it
15:18
depends. I think by and large, most of
15:22
the leaders that I engage with in a
15:24
one-on-one setting
15:26
understand they want to drive change.
15:28
They believe in the future. They're
15:29
optimistic.
15:31
The difference is and what I seek to
15:34
find
15:36
is those that have the fortitude
15:38
um to not only identify the need for
15:42
change, the desire for change
15:45
but they've got
15:47
the innate
15:48
ambition and belief that they have to
15:51
change
15:52
that they can lead cultural change. Uh
15:55
change management
15:57
is not for the faintest heart. Um
16:00
you know, moving people from the status
16:02
quo, even moving people um you know, to
16:05
think differently about an individual
16:07
task in their daily job is very
16:09
difficult. To think about whole-scale
16:11
redesigning
16:13
how our patients experience care. Now
16:16
that Now you're
16:18
blowing people's minds. And it it takes
16:21
um
16:23
a leadership profile, a leadership
16:26
commitment and also an organizational
16:30
culture
16:31
to be successful in that. And I think
16:35
my optimistic side does believe
16:38
that more of those cultures exist today
16:40
than existed last year, than existed 2
16:42
years ago.
16:44
>> Yeah.
16:45
>> But as I look back over a decade
16:48
those cultures are really hard to find
16:50
cuz they're very hard to create. They
16:51
take years to create those cultures.
16:53
And we don't have years
16:55
uh to solve the challenges that are in
16:58
front of us. And I am a big believer
17:00
that the
17:02
the way the winds are blowing right now,
17:04
whether it's
17:05
the demands that our aging population
17:08
is putting on our health care delivery
17:09
system
17:10
uh the rise um of chronic diseases and
17:14
the prevalence of chronic disease
17:16
uh across our populations. Um the state
17:19
of our our funding models. Um you know,
17:22
as more people age, they're moving into
17:24
government programs. Government programs
17:26
pay our providers less.
17:28
Uh employers are
17:30
um
17:31
you know, facing 10%
17:33
year-over-year year-over-year increases
17:35
in in offsets for costs.
17:39
Um and so I think
17:41
you know, all that
17:43
being said, I I think change must
17:44
happen. Change can happen.
17:47
And
17:48
those that
17:50
will themselves and their organizations
17:53
to find good partners to help them in a
17:54
transformational journey
17:56
will ultimately be the sustainable, the
17:59
successful, those that'll be able to
18:01
carry on their their missions
18:04
um that in many cases in health care
18:05
have been around for a hundred plus
18:07
years. There are providers
18:10
um you know, you brought up the
18:13
the
18:14
payer segment of our industry and their
18:16
ability to come in and out of markets.
18:19
Um
18:20
from a business perspective, they have
18:21
an ultimate advantage. They can come in
18:23
and out of a market on an annual basis.
18:25
>> Mhm.
18:26
>> They can
18:28
um
18:28
choose the employers they partner with.
18:30
They can uh choose the counties they
18:31
offer government programs within.
18:34
And they can pull the plug on a
18:35
year-over-year basis.
18:38
Providers are entrenched in our
18:39
communities. And in many cases, again,
18:41
they have been there for in some cases
18:43
hundreds of years.
18:45
Uh with a mission and a vision
18:47
of caring for the people around them.
18:49
Um
18:51
and it is increasingly tough
18:54
uh for them uh to continue to see what
18:57
does three years from now now look like.
18:59
What does five years from now? How does
19:01
my mission and my vision
19:03
continue to
19:05
um sustain with all the the potential
19:08
headwinds that that face folks.
19:11
>> Yeah, I mean, if you think about from a
19:12
provider perspective,
19:15
there's certain things that we know
19:16
aren't going to be changing anytime
19:17
soon.
19:18
I mean, from a patient's perspective,
19:21
when they want to go in to see a
19:22
provider, they want to go in and they
19:24
want to be seen pretty quickly. They're
19:26
not going to want to be seen like, "Hey,
19:27
I want to go see Dr. So-and-so and see
19:29
them in 6 weeks from now." Like, they
19:31
want to go in like tomorrow,
19:33
if not sooner, whether that's virtual or
19:35
in person.
19:37
They always want are going to want to be
19:39
treated nicely.
19:40
They're not going to be like, "You know
19:41
what? I wish I would have gone there and
19:43
gotten treated
19:44
like like shit." Just to say that.
19:46
>> very good at that, though. We're not
19:47
very good at that.
19:50
>> And and then and then clinicians want to
19:53
work
19:54
at top of license, and they want to work
19:55
at a place where they feel valued and
19:57
they feel respected. Like, those things
19:59
aren't going to be changing.
20:01
Does Lumarys, you know, operate off of,
20:04
you know, specific principles catering
20:07
to that? And if so, what what is that
20:09
What does that dynamic look like?
20:12
>> Yeah, it's a really interesting
20:13
question. So, Lumarys is a company
20:15
founded by physicians 20 years ago
20:17
um that were fed up with their status
20:20
quo um and really leaned in as physician
20:24
entrepreneurs to do something about it,
20:26
and that led to the journey um that
20:29
became Lumarys
20:30
uh and became this incredible
20:32
organization I've had the pleasure of of
20:34
serving for more than 9 years now.
20:36
Um
20:37
and when I think about that history, you
20:39
know, originally
20:41
company really had designed around
20:43
enabling the physician. And from the
20:45
physician's perspective and the
20:47
physician and the care team's
20:48
perspective, building tools
20:50
uh to better enable the physician and
20:52
the the care team.
20:54
And I think a lot of our history was
20:56
very focused from that lens.
20:58
Um
20:59
but I would say as as we've endeavored
21:02
to tackle an even bigger problem
21:04
in solving access
21:07
and expanding access to care.
21:10
Um
21:12
You know, probably 2 and 1/2 3 years ago
21:15
we did step back and say, "For us to do
21:18
this the right way, we need as an
21:21
enterprise, as a as an organization,
21:24
to make our commitment be to build the
21:26
model around the patient."
21:28
And start with the patient
21:31
and then go to the
21:33
the physician and the care team and then
21:35
go to all the other components around
21:37
the equation.
21:39
And I think it changed our perspective.
21:41
And we've come into our conversations
21:44
and it's not
21:44
>> How so? How so did it initially mean
21:47
completely change it or
21:49
>> You know, we come in to conversations
21:52
today, we are a clinically driven
21:55
organization. We have strong clinical
21:57
leadership throughout the company,
21:58
strong clinical leadership in our core
22:00
product and in our engineering teams and
22:03
what we are building the clinical rigor
22:05
is is of the utmost importance to us. Um
22:08
but I got a good chuckle the first time
22:09
I heard this. Our chief clinical
22:10
officer, Dr. David Carmouche,
22:12
in a room full of physicians says, "I
22:14
just want to be clear. We've built this
22:16
product from the patient's perspective,
22:19
not from
22:21
my perspective or your perspective."
22:23
Obviously, we've
22:25
been very intentional with the design
22:27
that it it has to um
22:31
absolutely
22:33
enhance the quality of life for
22:34
clinicians, give them more control, give
22:36
them more visibility, allow them to
22:38
believe that their patients are getting
22:40
better care. Um
22:42
but when you design a system
22:45
>> Mhm.
22:45
>> around the It's not the end consumer cuz
22:48
they're not buying my my solutions.
22:52
Um but they are the ultimate, if we are
22:55
successful, who wins.
22:58
It's the individual people
23:01
that have better
23:04
and a more coordinated experience and
23:06
they identify,
23:08
you know, symptoms earlier and they've
23:10
got access to care quicker and their
23:13
care is more coordinated. Um
23:16
and so that's another interesting part
23:17
about health care is like many times
23:19
like that is the end user I want to
23:23
impact the most, not my customer. It's
23:25
not who It's not who pays
23:28
uh the bills.
23:29
Um
23:30
>> Mhm.
23:31
>> But that's who we've designed around
23:33
um
23:34
with a focus on the care teams, but
23:36
really putting that patient experience
23:38
in the center um because that's going to
23:40
be the only way I think we achieve our
23:42
our objectives of scaling access
23:45
uh to provide primary and preventive
23:47
health services.
23:48
>> Actually, look, I mean, the entire
23:50
industry is
23:51
like
23:52
talking about AI right now.
23:55
Um
23:56
>> A lot of talk.
23:57
>> Yeah, but but most of the conversations
23:59
are around like efficiency and cost.
24:03
And it just sounds as though like you're
24:05
operating in a world where the
24:08
relationship between the patient and the
24:10
physician
24:11
is the whole product.
24:13
So
24:15
I kind of want to ask you something
24:16
different. I mean, where where have you
24:19
actually seen
24:21
AI
24:22
um
24:23
make care feel more
24:26
human
24:27
rather than less?
24:30
>> I got a couple of uh early
24:34
we saw these early on. One one of which
24:36
I think
24:37
we went into it expecting, the other we
24:40
had a major aha moment.
24:43
When you think about
24:45
getting ready to go to the doctor, we
24:47
all do it, you know, we like you
24:48
mentioned may wait weeks to even go see
24:51
them and we've kind of got our laundry
24:53
list of things we want to get we got
24:55
finite time.
24:57
>> Yeah.
24:57
>> And now
24:58
>> want to make value out of this driving
25:00
and parking and waiting and getting that
25:03
time. I've got my list of questions.
25:06
Uh nine out of 10 times we definitely
25:09
forget most of what
25:11
we wanted to bring up in that
25:12
conversation.
25:13
>> Yeah.
25:14
>> In the moment cuz it's like time
25:16
pressured and maybe a you know
25:18
clinician says something and we you know
25:20
forget to ask and so what happens is we
25:22
go home and then we have to call the
25:23
office and then we're asking our
25:24
questions and then we're waiting to get
25:25
responses.
25:27
Um really low-hanging fruit
25:29
was understanding
25:31
what a patient wants to discuss
25:34
before they're in the room and surfacing
25:36
that to the provider.
25:38
And so AI doesn't forget things. It can
25:41
have conversational experiences with you
25:44
very much like a human, listen,
25:46
understand, notate, and then put it in
25:49
front of that clinician. So actually our
25:51
clinicians are seeing
25:53
patients coming in here the four things
25:55
they're really interested in
25:56
understanding. Um and that gives the
25:59
provider a perspective uh as to what's
26:03
what's top of mind for this patient
26:04
right now.
26:05
Um because in the old model they're
26:07
looking back at charts, they're digging
26:09
through, you know, last conversation. Uh
26:12
you know, Dr. David Carmouche again
26:14
another story about him is he used to
26:15
write down the first time he met someone
26:17
what's their dog's name, what's their
26:18
kids' name. They're trying to
26:19
personalize it but he's
26:21
>> Right.
26:22
>> They're looking back at their file
26:23
before they walk in. They're seeing 30
26:25
patients a day.
26:26
Uh you know, they're writing it down and
26:28
trying to
26:29
bring those human components into it. Um
26:32
and so the models and and and AI can can
26:35
actually deliver a more personalized
26:37
human experience. I'm still focused on
26:39
the human the the physician and the
26:41
patient in-person visit but it's it's
26:45
humanized, it's tailored, it's
26:47
personalized leveraging AI. I think the
26:50
the other
26:52
um
26:53
you know, when we first started rolling
26:55
out AI
26:57
to consumers and patients.
26:59
>> Mhm.
27:00
>> Big scary moment. I said, "Oh boy,
27:03
are people going to interact with these
27:04
things? Are they going to reject them?
27:05
Are they going to hang up? Are they
27:06
going to, you know, write a newspaper
27:09
article about how horrible this
27:10
experience was?"
27:12
Um
27:13
it was an existential moment for me,
27:16
uh you know, waiting to see this kind of
27:18
play out. And one of the first um
27:20
you know, individuals that um our
27:23
platform interacted with was a
27:25
90-year-old woman, Medicare Advantage
27:27
patient.
27:28
>> Mhm.
27:28
>> Um
27:30
and we noticed in, you know, we're doing
27:32
constantly looking across surveillance
27:35
and and we've got products that we've
27:36
built to make sure that the experiences
27:38
patients are having are both clinically
27:40
relevant, clinically safe, uh
27:42
experiential, and and understanding how
27:44
people respond. And we noticed that this
27:47
lady was spending a lot of time on the
27:48
phone with an agent. Um our our
27:52
conversational agents announce
27:54
I'm an AI assistant calling on behalf of
27:56
their provider.
27:57
Um so we are very upfront that you are
28:01
talking to software. Um
28:04
and this individual was spending 40-plus
28:06
minutes on the phone with the agent. And
28:09
um this was early on in our journey, and
28:10
so we were having care team members call
28:13
these patients after they were
28:15
interacting with the AI to ask, you
28:16
know, "How was it? What did you like?
28:18
What did you not like?" And um in this
28:20
case, uh when we called, we got a hold
28:23
of her daughter. Picked up the phone.
28:24
Her daughter did not live in the same
28:26
city
28:27
>> Okay.
28:28
>> as her mother. She was actually in town
28:30
ferrying her mother to doctor's
28:32
appointments.
28:33
And uh she said, "What what you don't
28:36
have visibility into is that that phone
28:38
call may have been the only interaction
28:41
my mother had that week."
28:43
Um and so for us, at that point, this
28:47
was, I don't know, 18 months almost 2
28:49
years ago,
28:51
we hadn't even thought through the
28:52
loneliness component.
28:54
>> Yeah, I mean, just isolation in general.
28:56
>> The isolation, the loneliness,
28:58
uh
28:59
a bit of a sad,
29:02
you know, experience that that we took
29:04
in there, but at the same time, really
29:06
exciting.
29:08
Uh but also it it ins you know, it
29:10
really made clear to me like the
29:12
responsibility we bear.
29:14
Um
29:16
and the impact these technical tools
29:18
will have on all of us,
29:20
um
29:22
is really powerful. And and we've got uh
29:25
not
29:26
um take that lightly.
29:29
Um and I say we as an industry.
29:32
>> Right. Right.
29:34
>> Um because I I think the pace at which
29:37
the market
29:38
solutions,
29:40
the hyperscalers, you name it, is
29:42
moving,
29:43
um
29:45
is really, really fast. And the
29:46
downstream implications, like these are
29:48
just micro examples of um you know, big
29:52
downstream implications and big
29:53
responsibility I think we as an industry
29:55
have to bear.
29:57
>> So, what does that look like when you're
29:58
doing that at scale and you're managing,
30:01
helping manage
30:03
populations,
30:05
what does a
30:06
what does a great year look like
30:09
if you've done this
30:11
and things are going really, really
30:12
well. Because obviously there's a huge
30:15
shortage conditions, especially primary
30:17
care we're talking about uh on the rural
30:19
side. I know that you have been doing
30:20
quite a bit of work on rural health
30:22
transformation. Just maybe comment
30:24
around that and where you see this thing
30:26
going and what what great looks like.
30:29
Yeah, I mean,
30:32
great is solving for the fact that we
30:35
live in one of the most developed
30:36
countries in the world where a third of
30:38
our um core population has no access to
30:41
primary care.
30:43
100 million Americans.
30:46
And I think when we uncovered the data
30:48
behind that, it was a bit depressing.
30:51
Um
30:51
>> Yeah.
30:52
>> because the fact that a third of our
30:55
country does not have access to primary
30:56
care should be a way bigger
30:59
uh societal problem that we're heavily
31:01
investing in, way more so than we are
31:03
today.
31:05
Um and so a great year to us
31:08
is we're
31:10
lowering that number
31:12
uh of Americans that lack access to
31:14
primary and preventative health
31:15
services.
31:16
Um and I think that is going to be a
31:19
journey.
31:20
Um we're not going to get to 100
31:21
million. We will not as a company be the
31:23
one that maybe closes that full gap, but
31:26
we believe we can participate, create
31:28
ecosystem, create competition, and
31:31
create focus that we can massively
31:34
shrink the the number of Americans that
31:36
lack access to primary and preventative
31:39
health services. It's no more acute than
31:42
in a rural health setting.
31:44
>> Yeah.
31:44
>> Um
31:46
and I think it's uh
31:48
you know, there's been a lot of changes
31:50
that have impacted rural
31:52
uh over the last several years, lots of
31:53
closure, um looming Medicaid cuts,
31:58
um and and you do have the rural health
32:00
transformation program that will inject
32:02
$50 billion over 5 years,
32:05
um
32:06
anchored around states and states'
32:08
desire to create their own initiatives
32:10
for how they want uh to think
32:12
differently about rural health.
32:15
Um
32:17
and it it's a it's a massive
32:18
opportunity.
32:21
The 50 billion is not going to replace
32:23
what's lost from the Medicaid uh
32:26
shortfalls.
32:28
And so
32:30
how I hope states and organizations that
32:32
operate in rural health communities in
32:34
these states think about it is what
32:37
could the system look like
32:39
and how do we put ourselves on a journey
32:42
to design
32:44
a totally different model
32:46
uh
32:47
in these rural communities
32:49
uh leveraging seed capital
32:52
um from the government. Um
32:55
>> Yeah.
32:56
>> And that's going to be hard. Um and
32:59
>> like a large-scale startup.
33:02
>> I hope that some think about it rather
33:06
than just trying to put Band-Aids
33:09
>> Mhm.
33:09
>> on what's been broken.
33:12
Um actually getting to redesigning how
33:15
it could be experienced. How do we
33:17
leverage technology? How do we leverage
33:20
more ubiquitous access to broadband?
33:23
Um how do we leverage the fact that most
33:25
people have a smartphone in their
33:28
pocket?
33:29
Um
33:30
how do we better connect those patients
33:36
to specialty care?
33:38
Um
33:38
>> Mhm.
33:39
>> Whether that's an hour away, two hours
33:41
away, five hours away, 10 hours away.
33:44
Um I do believe we have still some of
33:46
the best clinicians in the world that
33:48
practice in the country. I think we have
33:51
leading institutions and I hope that
33:53
they step up to also acknowledge the
33:56
role that they can play.
33:58
Um
34:01
in bringing
34:04
a new model of care to rural America.
34:08
>> Yeah, I mean it just seems like I don't
34:10
know, just kind of following your
34:11
journey. You've been really
34:14
voicetrous about this. You've been
34:15
spending a lot of time, expending a lot
34:18
of energy in this.
34:20
So you've
34:21
you've sat across
34:24
from probably some of the most powerful
34:26
executives, leaders in American health
34:28
care.
34:30
Um
34:31
I guess who's who's the person that
34:33
you've learned
34:34
the most from? You know, in in a in a in
34:38
a single conversation and
34:41
like what did they teach you?
34:45
>> Maybe two people.
34:46
>> Okay.
34:48
>> Um
34:51
I think that
34:54
Dr. Mosier,
34:56
who is a rural family practice physician
34:59
from rural Kansas,
35:01
who committed himself years ago
35:05
to the betterment of rural health care
35:09
and has been doing everything in his
35:10
power uh to help organize, to help
35:13
coalesce, to bring best practice
35:16
um to the rural communities in in the
35:19
state of Kansas,
35:20
um
35:21
has had an eye-opening perspective
35:24
to me from someone who's born, raised in
35:28
rural America, a clinician in rural
35:30
America, someone who has committed their
35:32
life to rural America to understanding
35:36
the unique challenges that exist in
35:38
rural America. Um
35:42
in rural America, there is a skepticism
35:45
and a lack of trust
35:47
uh in a lot of the the big players. Uh
35:51
and that could be big players in health
35:52
care, that could be the big institutions
35:54
in their particular state, it could be
35:56
the big companies that exist in the
35:58
country, but um it's a very local and a
36:02
very community-oriented and organized
36:04
and they build trust on relationships
36:06
and they're um it's not to say they
36:09
don't uh value help from outsiders, but
36:12
there is a bit of that,
36:14
you know, who's this person coming from
36:16
the outside to my community to tell me
36:18
what to do.
36:19
Um and so that has shaped my perspective
36:22
in this model to say in everything that
36:24
we we do out in the rural health
36:26
transformation program.
36:28
Uh we will bring in be bringing those
36:30
that are both
36:32
patients, consumers, but also the care
36:34
teams, the physicians into the mix to
36:36
design
36:38
what does this need to look like? Uh
36:40
they need to be part of building the
36:43
solution versus somebody comes and
36:44
brings the solution to the market. Uh I
36:48
don't think that's going to work uh in
36:50
rural America.
36:51
Um
36:52
and then I I think um
36:55
you know, the there's been several
36:57
others along the way that um
36:59
you know, I've had some interesting
37:01
encounters with um
37:03
you know, Dr. Mehmet Oz uh
37:07
over CMS. I've spent a good bit of time
37:09
with him in the last 6-9 months.
37:12
Um
37:13
and I do believe he's built a strong
37:15
team. I think he is enabling his team. I
37:18
think he is leading uh
37:21
with a North Star of improving care, of
37:26
improving how patients experience
37:28
healthcare, uh and of trying to tackle
37:32
some of the biggest structural
37:35
challenges that we've created in our
37:38
healthcare ecosystem.
37:40
I do not envy that job. Um
37:43
>> Yeah.
37:45
>> Uh politic politics
37:48
um and policy is a bit of a new world
37:51
uh for me.
37:52
Um
37:53
but I do think he's
37:55
um
37:56
trying to take feedback from
37:59
constituents
38:01
um
38:01
and more broadly being out there and
38:05
accessible to constituents than I've
38:06
seen uh others before. And I think he's
38:10
got a a North Star of of actually
38:12
influencing care at an N of 1 patient
38:14
level, um which excites me. Um so I I
38:18
get some energy that
38:21
I think there's a a lot of complicated
38:23
policy
38:24
um and leading in in times like we've
38:29
got right now is very challenging. It's
38:31
a very polarized environment that that
38:34
we collectively live in.
38:36
Um
38:37
but I I do think that we are going to
38:40
continue to need uh folks that step into
38:44
government leadership in this
38:46
administration and beyond that are going
38:48
to be willing to tackle
38:50
uh the hairy underlying systemic
38:53
uh challenges that have kind of led to
38:56
the problems that we've talked about
38:57
trying to solve today.
38:59
>> And before before I forget
39:01
um
39:03
tell people like where they can follow
39:05
you, your work, the work of Lumera,
39:07
so make sure that we kind of give you
39:09
guys that that opportunity to share a
39:11
bit of your commercial.
39:13
>> Well, uh anybody who's interested in in
39:16
joining our journey, we're always
39:17
looking for good folks that want to
39:19
provide input uh and or officially join
39:23
us on this journey, you can find us
39:25
uh at Lumera l u m e r i s dot com. Uh I
39:30
love to write and engage uh individuals
39:33
on LinkedIn and you can find me on
39:35
LinkedIn. I've got a very simple handle.
39:37
It's just linkedin.com/johnbfryer.
39:43
Uh
39:43
>> Awesome.
39:44
>> And that's where you can find me, but I
39:47
appreciate this forum, Michael. I think
39:49
it's amazing work that you do um
39:52
bringing experiences. I've always loved
39:54
listening to your
39:56
uh interviews.
39:57
Um I would encourage anybody that's
39:59
listening to this to reach out. Um I
40:01
think the the value that community
40:04
broadly can provide as we all try and
40:06
solve problems in healthcare that's
40:08
really where the the sweet spot happens
40:10
is collaboration.
40:12
>> Right.
40:12
That's right. That's right. I appreciate
40:15
you saying that. And last question
40:16
because
40:17
we started off by
40:19
you started your career because of one
40:21
conversation with one person who changed
40:24
the trajectory and asked you a simple
40:25
question,
40:27
you know, why not healthcare?
40:29
And if you could ask that same question,
40:33
um maybe to every young person coming
40:35
out of university right now considering
40:37
this industry,
40:39
what is the version
40:41
of that question that you would ask
40:42
them?
40:46
>> What is the version of that question I
40:48
would ask them?
40:50
Um
40:52
I think
40:53
the way that I, you know, I I'm
40:55
fortunate to be engaged with the Johns
40:57
John Hopkins and the Bloomberg School of
41:00
of Public Health.
41:01
And um
41:03
some of the brightest minds. Now, many
41:04
of those folks have already kind of seen
41:06
the light and they're they're in
41:07
healthcare. I think the one question
41:09
that I ask young people is
41:12
uh what the world needs right now is
41:14
creative strategic thinkers.
41:17
Um that want to tackle big problems.
41:21
And there is nothing more personal than
41:25
our health.
41:26
And there is nothing more impactful than
41:29
being able to be creative, be strategic,
41:32
be disruptive, be innovative, um be a
41:36
solutionist mindset
41:39
in an industry like healthcare.
41:41
And I think there are enough
41:44
avenues
41:46
in healthcare, whether you like
41:48
technology or clinical or finance
41:52
um or supply chain
41:55
um or patient experience
41:57
um or patient education.
42:00
There's so many different ways
42:04
uh to participate in the industry.
42:06
>> Mhm.
42:07
>> And there's not a one of them that
42:08
wouldn't benefit from
42:11
a creative, strategic, innovative,
42:14
solutionist mindset individual
42:17
uh that wants to build, grow, learn in
42:20
an industry that is healthcare.
42:23
>> Yeah.
42:25
Yeah, I think after this conversation,
42:26
I'm more convinced
42:28
that none of this ever gets solved with
42:31
tech alone. I think we all kind of knew
42:33
that. It gets solved
42:35
by people that are proactive
42:37
that are willing to sit across the table
42:40
um
42:41
from whoever that might be. Maybe it's
42:43
across the table from a health system or
42:45
payer or maybe even it's a
42:47
it's a rural
42:48
provider.
42:50
And
42:52
you're going to be in that conversation
42:55
and you're not leaving until you figure
42:57
something out. Or at least sketch a
42:59
solution of, all right, what are we
43:00
going to deploy, by when, and let's come
43:03
back again, let's have this cadence.
43:05
So,
43:06
that that's kind of what I'm
43:08
leaving from this conversation is this
43:10
is just a whole string of things that
43:13
need to happen in order for something to
43:15
really get done at scale and it's never
43:19
as easy as
43:21
um or as nice as it sounds when it comes
43:23
off of the press release. There's a lot
43:25
of sweat equity that goes into the
43:27
behind the scenes that no one ever sees.
43:30
Difficult conversations that have to
43:31
happen. You can
43:34
you can still disagree and still be
43:35
friends, still be nice, and both want to
43:38
move towards something that everyone
43:40
wants.
43:41
So, um that's super interesting. So, for
43:44
those if you've listened to this and you
43:46
got value from it, number one,
43:48
the best thing, you know, if you're
43:50
thinking about, well, what what can I do
43:51
to be helpful? Number one is
43:53
share this.
43:54
Uh like it, comment on it. Tell us what
43:58
resonated with you. What are some of the
43:59
things that you're working on? We want
44:01
to know.
44:02
And if there is a topic that you want us
44:03
to explore
44:05
or even a leader that you want to hear
44:06
from, um drop us a note, leave a
44:08
comment. We do read, we do listen to
44:10
them. This is a platform that is isn't
44:13
just about content, it's about
44:15
community. A community is a living,
44:17
breathing ecosystem and sometimes you
44:19
got to feed it more than what you take
44:21
from it. And that's the way of doing it.
44:22
So, thank you for listening, John. It's
44:25
great to have you come on.
44:27
Keep building with purpose and I guess
44:29
folks will see you next time on the
44:31
Advancing Healthcare Innovation Show.
44:33
>> Thanks, Michael. It's been a pleasure.