Latest / The Advancing Healthcare Innovation Show / E172 | Why Healthcare Breaks at the Handoffs with Effie Carlson

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E172 | Why Healthcare Breaks at the Handoffs with Effie Carlson · 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 Samantinos, and if you're
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new to us, we are super excited to have
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ultimately with with the world. So we've
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got an amazing action-packed year. If
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you haven't had an opportunity to check
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out any of the historical interviews,
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button now. So any of the new episodes
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come directly to you. So look, within
1:18
healthcare, we talk a lot about
1:19
coordination, but most of the time, I
1:21
mean, it still feels like everyone's
1:24
rowing in a different direction, and
1:26
today's guest lives in that tension. So
1:30
Effie Carlson is the CEO of Watershed
1:34
Health. She has spent her entire career
1:36
working at the intersection of payers,
1:39
providers, employers, helping them move
1:40
from good intentions to actually getting
1:43
alignment. So, we're not going to be
1:44
talking about dashboards for the sake of
1:46
dashboards, but really um talk about the
1:49
infrastructure
1:50
that makes collaboration possible when
1:54
incentives are aligned um and trust is
1:58
actually in place. And I think what I
2:00
respect most about Effie is that she
2:02
doesn't romanticize healthcare. She's
2:04
rigorously honest, tells you the truth.
2:07
She understands how hard it is to get
2:09
organizations to actually move together,
2:12
especially when risk, money, and
2:15
accountability um are on the line. So,
2:18
watershed health was really built uh
2:21
from a space where when things break,
2:24
handoffs fail, watershed steps within
2:28
that gap. So this conversation is really
2:30
going to be around what it what does it
2:31
take to align systems, why most efforts
2:36
sort of stall and what leaders
2:39
underestimate, you know, when it comes
2:41
to trying to scale collaboration. So
2:44
Effie, great to see you. Welcome to the
2:47
show.
2:48
>> Thanks, Michael. It's good to see you,
2:49
too. Can't believe it's December.
2:52
>> I know, I know, I know, I know. So, I I
2:55
kind of want to start maybe way back
2:58
when earlier in your career. Um, I just
3:01
get the sense that you're the type of
3:03
person that had a hard time not saying
3:07
things when things were very apparent.
3:09
Um, when you didn't have real I don't
3:12
even know how to say this, but like we
3:14
didn't have like a title or you didn't
3:15
have that quote unquote like authority.
3:18
How did you kind of decide when to push
3:22
and when to sort of sit back and
3:24
observe?
3:26
>> Oh wow. Um I don't know if I ever really
3:30
realized there was a time to push or
3:32
not.
3:34
Um I think I think professionally and
3:37
personally I'm a person who cares about
3:40
the outcome being right or doing the the
3:43
thing we set out to do. So um early in
3:47
my career I was lucky lucky enough to
3:49
have a lot of people around me who had
3:51
patience with my uh what about nature um
3:55
and to allow me a lot of latitude in
3:57
being able to help solve problems cuz I
3:59
that's really what I was focused on is
4:01
if I saw something that was broken or it
4:04
could be better or you could help
4:05
somebody win, you know, I was the first
4:07
person to raise my hand and say, "Have
4:08
you ever thought about this?" or you
4:09
know I always tell people you could sum
4:10
my whole career up to me being in rooms
4:12
with strangers and me saying like huh
4:16
you know what you could do with that and
4:17
then the next thing happening.
4:19
>> Yeah.
4:20
>> Yeah. I just remember like our first
4:22
conversation when we first met years ago
4:24
and I walked in I was like wow that was
4:26
that was awesome. So before you were um
4:30
we have a cool history because Chip was
4:33
actually uh the former CEO was a guest
4:35
on the show and then that was when you
4:37
were chief strategy officer but before
4:38
you were CEO like was there a moment
4:41
early on in your career where you were
4:43
just like man healthcare is not just
4:45
complicated it's it's just fundamentally
4:47
misaligned like what's your viewpoint on
4:49
that? Yeah, I mean I think like a lot of
4:51
people who are in healthcare, it's
4:52
personal, right? So I think my first um
4:56
experience with the tactical realities
4:59
of what goes wrong and right um was back
5:02
when I had my first kids. So I had twins
5:04
who were born at 28 weeks. So we spent a
5:07
lot of time in the hospital um both
5:10
before they were born and then several
5:12
months at Phoenix Children's Hospital.
5:14
And you know sort of really young age I
5:16
got a crash course in the importance of
5:18
advocacy, the importance of
5:20
understanding how the ecosystem works,
5:22
the importance of paying a lot of
5:24
attention, how to read an EOB, um how to
5:27
um advocate on the payment side and on
5:30
the clinical side and you know in that
5:32
experience really seeing firsthand what
5:35
goes right and wrong. And then again
5:37
being a person if something if I see
5:39
something I say something. When I was at
5:40
Phoenix Children's Hospital watching the
5:42
other parents
5:43
>> in the NICU navigate that and ended up
5:45
starting a support group while I was in
5:47
in there to help parents do the same
5:49
thing because it's just we could
5:50
collectively um traverse like a
5:52
challenging life experience that's
5:54
really unique. You know not a lot of
5:56
people have
5:58
>> understand what that feels like.
6:00
>> Yeah. You know, I think your your
6:04
superpower is you can just see how all
6:07
the pieces align and fit together. And
6:10
I'll never forget when you first shared
6:13
with me about watershed. Can for those
6:16
that don't know about sort of the origin
6:18
of watershed, can you maybe share a
6:20
little bit of that story
6:21
>> when kind of Chip was mentioning some of
6:23
the things that he was working on and
6:25
what you saw and then kind of fast
6:27
forward today where you guys are at in
6:29
that in that whole
6:31
>> in the vision.
6:32
>> Well, when I first met Chip, so Chip is
6:35
Dr. Dr. Grant is an interventional
6:36
cardiologist and I think one of the
6:39
things that attracted me to watershed
6:40
first and foremost was it was built by a
6:42
clinician for clinical people which
6:45
means it was rooted in reality from day
6:47
one. Um he was solving a problem for
6:50
himself versus solving for a TAM or
6:52
solving for a great market opportunity.
6:55
He was looking to figure out how to
6:58
better care for his patients when they
7:00
left the hospital. And um I would say he
7:03
did it kind of like a doctor does. He
7:04
went to the committees. he participated
7:06
in all the research projects and the
7:08
different ways to find the journals and
7:10
such. So when I met him, he was several
7:12
years into having um launched in his
7:15
community, having scaled it in the lower
7:17
part of southern Alabama and it had
7:19
grown organically because when he
7:20
launched it, he launched it like a
7:21
clinical trial and when it worked, other
7:23
people joined. So what caught my
7:25
attention with what he was doing at the
7:27
time, he was very focused on post-accute
7:29
transitions and that was really where
7:30
which makes sense like given where he
7:32
started. Um but what caught my attention
7:34
was um again that practical and tactical
7:37
aspect and he had he had thought about
7:40
some things that other people wouldn't
7:41
have considered had they been only
7:43
solving for a post accute transition. So
7:45
when I met him I said you've kind of
7:47
done something I'm really interested in
7:49
because I've sat in a bunch of seats
7:50
like I've been on the you know I I ran a
7:54
and built and ran a practice management
7:56
company in my late 20s. I was the I did
7:58
network contracting market analytics
8:00
credentiing for a payer nationally. I
8:02
was the COO of a clinical organization
8:04
and then you know owned my own growth
8:06
consultancy business um focused on
8:08
health healthcare digital health
8:09
companies and the thing that always came
8:13
that was always there when we were
8:14
solutioning something was the fact that
8:16
nothing was ever built with the concept
8:18
of ecosystems right and really
8:20
understanding that humans aren't moment
8:22
it's moments in time they're not
8:23
episodes of care they're not just you
8:26
know a data point on a spreadsheet
8:28
>> they're a thing and that's traversing
8:30
all of these different moving parts all
8:32
the time. And um so that was really what
8:34
caught my attention with what Chip had
8:36
done um was that it had the building
8:39
blocks to be the thing that I always
8:40
wanted. And so now 5 years later
8:45
um you know because it'll be 5 years in
8:47
January which is craziness uh you know
8:49
we've we've accomplished a lot of what
8:51
we saw that day and turned it into a
8:55
scalable actionable ecosystem between
8:58
you know health plans and clinical
9:00
providers nonclinical providers. So they
9:01
all can work together. Um so they
9:03
actually get to work across systems and
9:05
settings and and patients. Um as opposed
9:08
to fighting fax machines and text
9:10
messages and um siloed thought processes
9:13
and a belief that you're the only thing
9:15
that matters, right? I think I I tell
9:17
people at least once in every
9:19
conversation, it's not all about you.
9:22
You know, um and I think healthcare
9:24
healthc care is one of those places
9:26
where it is best illustrated that it's
9:28
not all about you. Um, you can be
9:30
brilliant,
9:32
>> uh, but the second you're done being
9:33
brilliant, you're passing the ball to
9:35
someone else.
9:36
>> Um, you're sending a person into an
9:37
unmanaged community, you're sending to
9:39
someone who maybe doesn't have the same
9:41
worldview or the same technological
9:42
capability or clinical capability.
9:44
>> And so, you have to care more than just
9:47
the moment in time of time the patient
9:49
sitting in front of you.
9:52
So when so when leaders say they want
9:55
alignment like what are they what are
9:58
they usually asking for and I guess what
10:02
are they usually hoping that they won't
10:04
have to change
10:06
>> what are they usually asking for opex
10:08
reduction
10:11
no but I think that like I think that
10:13
from an organizational perspective
10:15
generally people again it's reasonable
10:17
to solve for yourself um and a lot of
10:20
times And when people are are looking at
10:21
coordination, they're looking at how
10:24
coordination impacts their own internal
10:26
organization, like their success
10:27
metrics.
10:28
>> And I think that we're finally entering
10:30
an era where people are starting to
10:33
understand that you can't you have to do
10:35
more
10:36
>> and that you don't need to do
10:37
everything, but you have to do more. And
10:39
we have to be able to operationalize it,
10:41
not just talk about it at conferences.
10:43
Um, and I think that we're finally
10:45
wrapping our minds around it both
10:47
technologically and then I think
10:49
emotionally, which is kind of a funny
10:51
thing to say.
10:54
>> Yeah. Because when it just sounds as
10:55
though that you're refusing to
10:57
compromise on certain things, like what
10:59
do you guys refuse to compromise on in
11:01
terms of being best-in-class in this
11:03
particular space and addressing this
11:05
issue?
11:06
>> Uh, that details matter. I think that um
11:10
a lot of health tech companies I I think
11:12
technology companies in general think
11:14
that they're going to find silver
11:15
bullets
11:16
>> and they're going to do one smart thing
11:18
really really well and that's going to
11:19
be the thing that is the magic thing
11:20
that solves all the problems. Um I think
11:23
in understanding the details in a way
11:25
that I think is that I know is very
11:27
unique. um we're able to solution from a
11:30
point of view that allows us to scale
11:32
across all of those different um
11:34
verticals which are traditionally,
11:36
you know, the nuance of it all makes
11:38
people overwhelmed and they stop they
11:41
stop trying, right? And so, but in
11:42
understanding the details, we've been
11:44
able to take those details and scale up
11:46
so that we can look at it both from a
11:48
100,000 point of point of view, but then
11:50
down understanding how that impacts the
11:52
person who does the work. Because the
11:54
other thing about healthcare and
11:55
coordination, it's not all about the
11:57
people at the top. They're the least
11:59
important people in the entire equation.
12:01
You know, the people who are looking at
12:03
dashboards because ultimately most of
12:06
the folks that are making the decisions
12:07
don't do the work. They just they report
12:09
the work and and we have a ruthless
12:12
pursuit in making the world a better
12:14
place for the people who do the work.
12:15
And that's really impacted how um we've
12:18
gone to market, how we've engaged users
12:21
um and why we see user adoption, you
12:23
know, doubling quarter over quarter.
12:28
When you talk about that type of growth,
12:30
were there things that you and just kind
12:33
of given you're you're a growth person,
12:35
growthminded, have there been decisions
12:37
that you've had to make that kind of
12:40
slowed things down short term but sort
12:44
of protected the the trust in sort of
12:48
the long term because it just seems as
12:49
though that this ecosystem is really
12:53
precious and if you put things into it
12:56
too soon, it could kind of put it off
12:58
balance. So, I'm just trying to think,
12:59
are are there is it counterintuitive to
13:03
slow down, but really slowing down
13:05
really means speeding things up later
13:06
down the line?
13:09
>> Yeah. I mean, I'm trying to think of a
13:11
really good example. I feel like that's
13:12
me every day, right? Is is your
13:14
balancing when to hit the brake and when
13:16
to hit the gas and then knowing when you
13:18
find that moment of inflection to just
13:21
go whole hog. I think I think anyone
13:24
who's ever done network builds um
13:26
understands that really well like when
13:28
do you hit critical mass and density and
13:30
sometimes you make investments in things
13:33
that on paper or spreadsheets look
13:35
stupid but you understand the dynamics
13:37
of the personalities in that community
13:39
of the the players that that drive
13:41
change because the other thing about
13:42
healthcare that's unique is is it's like
13:44
all things healthcare edges of the curve
13:46
right so it's the edges of the curve the
13:48
patients that drive all the costs and
13:50
the headaches are trying to figure out
13:51
how to solve for them it's the edges of
13:52
the curve in the leadership context
13:54
because in every community there's like
13:56
a hundred people who have who have since
13:58
the beginning of time been holding
14:00
things together with duct tape and spit
14:02
and knowing who those hundred people are
14:04
is the difference between success and
14:05
failure. And so sometimes when you're
14:07
entering a new market, taking the time
14:09
to understand those more human dynamics
14:12
has been um something that business
14:14
people are confused by because it
14:16
doesn't show up in a spreadsheet. it
14:17
doesn't show up in a KPI in your HubSpot
14:20
instance around pipeline development,
14:21
right? But you understand that these are
14:23
lynch pins for being able to move the
14:26
work and move things in a way that it
14:28
allows for growth. And we've seen that
14:29
work really well for us. I think that's
14:31
an example I think in understanding the
14:33
order in which that you develop
14:35
technology is another one. Um people
14:37
like to like I think right now is a
14:38
great example like everyone wants to add
14:40
AI to everything. Um I think it's great
14:43
on a slide. I think in practicality it
14:45
doesn't drive any result because you
14:47
have to do things in a logical order to
14:49
build the right infrastructure in order
14:50
to make AI useful. Um it's like it's
14:54
like throwing headcount on a problem
14:55
before you have a system in place,
14:57
right? So you go and hire 100 people,
14:58
but your system isn't ready or your
15:00
growth isn't there and you're just
15:01
burning calories on on the the ad
15:04
because it made you feel good to have a
15:06
bigger staff.
15:07
>> Um patience and fundamentals are
15:09
important in all things and and business
15:11
and healthcare aren't exceptions.
15:13
Yeah, you know, you said something
15:15
earlier and I just noticed a pattern.
15:17
So, I just had a little aha moment. You
15:19
mentioned about how you had gone through
15:20
your twins and you had set up sort of a
15:23
support group sort of advocacy. Now,
15:25
you've done similar in terms of bringing
15:27
all the right people to the table. Can
15:29
you talk about some of that
15:30
collaborative work that you're doing in
15:32
Texas and some of the successes you've
15:33
been having because I I see parallels in
15:36
both of those.
15:37
>> Oh, yeah. No, if you look at my life, it
15:38
it there are so many repeat stories. Um
15:42
the it's not all about you thing has
15:44
popped up a lot.
15:46
The um take your time and do it the
15:48
right way. Understand core problems like
15:51
get to the root cause before you start
15:53
solutioning those kinds of things and
15:55
then not being afraid to run at
15:56
something um that other people are
15:58
afraid of. Austin has been a great
16:01
example of this and it wasn't us and I'm
16:03
not going to take credit for it. So,
16:04
there was something going on in Austin
16:07
>> um as a result of the pandemic where the
16:09
community had come together and were
16:11
working together to just deal with a
16:13
public health emergency
16:14
>> and they were dealing with it like a lot
16:16
of people in the country were with
16:17
spreadsheets and daily phone calls and
16:19
who's got beds and who doesn't and how
16:21
many people died today and the awfulness
16:23
of of having to face the reality that
16:25
there is no infrastructure in healthcare
16:28
for data exchange for collaborative work
16:30
for despite the hundreds of billions of
16:32
dollars we've spent co allowed um didn't
16:36
allow anybody anymore to pretend that we
16:38
lived in an interconnected community. So
16:41
that community had come together and
16:42
built relationships. I think talking
16:43
about relationships, they had built
16:44
relationships with one another that they
16:46
hadn't historically had, right? Everyone
16:48
working in their own business silos and
16:50
they very cleverly really being
16:52
spearheaded by um Dr. Walks at the
16:54
Travis County Public Health Department
16:57
and um they came together and decided
17:00
they could do better. And so before they
17:02
met us, they were working on creating an
17:05
environment where they could do the
17:06
basics better, right?
17:08
>> And we got brought to the community um
17:10
through an entity that works with us in
17:12
a different market and we were lucky
17:14
enough to work alongside that group and
17:16
eventually that group choose us to be
17:18
the people that help connect this
17:19
community.
17:20
>> And the best part about Austin is it's
17:22
not happening through some sort of grant
17:24
program or government funded something.
17:26
This is truly community deciding. And I
17:28
mean, and I don't mean community, I mean
17:30
literally the geography. Sometimes when
17:32
I say community, people think I'm
17:33
talking about the community, but I mean
17:34
like the geography coming together.
17:37
>> Um, and them choosing because you can
17:40
sometimes just choose to do things
17:41
better even when no one forces you to.
17:44
And I give them so many props for um for
17:48
not only having the the for the
17:51
foresight to do it, but the driving the
17:53
political will to make it happen in an
17:55
environment that um is not typical.
17:58
Do do you think that that's just is it
18:01
just Austin because it's a unique place
18:03
that has those ingredients like what are
18:05
those ingredients that would need to be
18:07
necessary for it to happen in other
18:08
markets?
18:09
>> It can happen anywhere. That's the best
18:11
part about what I do every day is this
18:13
is not about oh because you know most
18:15
things are built for one reason right
18:17
this is for Medicare this is for
18:18
Medicaid this is for hospitals this is
18:20
for postaccute this is for whatever this
18:21
is for public health this is for
18:23
government. Um, I think one of the
18:25
things that we helped the Austin
18:26
community see is they have the same
18:28
patients in common.
18:29
>> They see the same humans.
18:31
>> And um, and so this can happen anywhere
18:34
with those people I was talking about,
18:36
those duct tape and spit people, right?
18:38
Because what Watershed does is we
18:41
technologically enable those folks. Um,
18:44
we help them scale and realize the
18:46
vision of the thing that they're already
18:48
doing just having to do it with a lot
18:50
more effort and a lot more work. And and
18:52
again that's one of the most exciting
18:54
parts about what we do is because we
18:56
don't leave anybody out. Um and that's
18:59
another feeism is like there are no
19:02
unimportant people in healthcare and um
19:05
and I and I know that really well having
19:07
spent a lot of time in the ancillary
19:08
space right so in the post accute and
19:10
ancillary and not in social terms of
19:12
health space. Um, you know, we saw every
19:15
day in the very tactical reality that
19:17
like it doesn't matter how how great you
19:20
are as a hospital or even a physician
19:22
group. Like I said, you're you're
19:23
passing the ball off to someone who has
19:25
no margin and no tech and no resources
19:28
and no clue what you signed up for. And
19:31
but on the positive side, you see those
19:33
people drive amazing outcomes with none
19:35
of the resources that everybody else
19:37
has. And I think us being able to give
19:40
infrastructure to that has also been
19:42
really exciting because you're now able
19:44
to see in numbers the impact of things
19:45
that we all sort of anecdotally knew
19:47
were important
19:49
>> because because you touch so many
19:51
different
19:52
>> entities, you know, and to me incentives
19:55
tell the truth. um you know when
19:58
incentives
19:59
maybe conflict with patient outcomes I
20:01
guess what have you what have you
20:04
learned about how organizations like
20:07
actually behave
20:09
>> well first of all I don't think good
20:11
human outcome and good business outcome
20:13
are misaligned I think that's one of the
20:15
biggest misconceptions is that you're
20:16
either a good human or you're a good
20:18
business person and I think healthcare
20:20
is a great example where you if you're
20:21
clever and you take time you can
20:23
actually be both um and I think you have
20:26
to be both. Uh because we don't have
20:28
enough time or bodies anymore to
20:31
continue to just be whatever about
20:33
stuff.
20:34
>> Yeah.
20:35
>> Um
20:36
so yeah, I think I think that's that's
20:39
the big the big takeaway for me is that
20:41
and then I think like what people have
20:43
to do differently is or not differently
20:46
is sort of learn from one another is
20:48
that also we build good we orient good
20:50
human outcomes to selfishness. Like
20:53
running a good business and making more
20:56
margin doesn't mean that you're
20:57
sacrificing patient care. It's about
20:59
knowing where you can automate and
21:01
knowing where you don't need to. So that
21:03
technology should be something that
21:05
enhances humanity, not replaces it.
21:09
>> Definitely. Definitely. Definitely. And
21:11
you know, you said something earlier
21:13
also about it was like, you know, hey,
21:14
it's been five years and there's in
21:17
society, we're really quick to just want
21:19
to get to the next step better, faster,
21:22
like everything's, hey, it needs to
21:24
happen today. But there's something to
21:25
be said about like taking your time and
21:28
building the right infrastructure. Do
21:31
you feel like knowing what you know now,
21:33
could you have really sped up that
21:35
process or do you feel like it just it
21:37
it unfolded the way that it was supposed
21:39
to unfold?
21:41
I'm a big believer in things happening
21:42
the way they're supposed to happen. So,
21:44
I think on a cosmic level, the people
21:46
who know me will say that like the the
21:48
universe will take care of that stuff.
21:50
Um, I think there's always learning
21:52
though, and I think that learning isn't
21:54
an annual process. It's an everyday
21:56
process, right? So, we're constantly
21:58
evaluating the things that we can do
21:59
better, faster, cheaper, smarter. Um,
22:04
but I think that like the taking your
22:06
time piece is I think the hardest part
22:09
about taking your time when you do this
22:10
kind of work is not losing track of what
22:12
you're trying to accomplish. Because I
22:15
think the biggest problem that um
22:17
innovation people have is we're
22:20
impatient by nature, right? We like
22:22
risk. We're impatient. We all have ADD.
22:25
We all over you have to be a little
22:27
delusional. like you have to have some
22:28
part of yourself that's a little
22:30
delusional because you got to look at
22:32
the world in a complex problem go
22:33
totally I can fix that
22:35
>> um to stay sustained in that headsp
22:38
space uh without getting all the big
22:41
exciting things that having not solved
22:43
the world's problems all at once I think
22:45
is another thing that is very unique
22:46
about you know people who have an
22:48
entrepreneurial bent so I I think could
22:50
we have done things faster sure I think
22:52
you can always look back but as long as
22:54
you're looking back you're learning and
22:55
you're implementing those learnings
22:56
going forward you're
22:58
Um, the other thing about what we do,
23:00
the world had to be ready. Um, because
23:03
when I first started telling the story
23:05
that we tell today,
23:07
>> I got a lot of like, huh? Like, wait,
23:10
what? I don't understand what you're
23:12
talking about. And um, you know, because
23:14
we we think about things so differently
23:16
than other people
23:18
>> and have been in lots of conversations
23:20
with folks who have been doing this way
23:22
longer than I have, who have stared at
23:24
me, blink slowly, and said, "This is
23:25
novel." like what you're doing is novel.
23:27
I I've never I' I I need a minute to
23:29
even process what's happening right now.
23:32
>> Um and so I think what's exciting about
23:34
2026 is I think that the you know the
23:37
world is also ready and and we are. So
23:40
while everyone else is going to be I
23:42
think trying to pivot their tech, their
23:45
strategy, their approach, their
23:47
worldview to meet where the world is
23:49
now,
23:50
>> this is what we were architected to do.
23:53
And so I think um I think that part's
23:56
the thing I'm the most excited about. Um
23:59
so I think it's a little bit of both. I
24:01
think you can always be better, but I
24:03
think we're right where we're supposed
24:04
to be right right now.
24:06
>> Yeah.
24:07
>> Where I mean you mentioned about like
24:09
opportunity as a CEO. There's obviously
24:11
lots of highs, lots of lows. um
24:15
any setbacks that you um kind of look
24:18
back and you're like, "All right, that
24:20
sucked going through it, but now I'm
24:22
glad we went through it." Anything that
24:23
you can maybe a story that you can
24:25
share, maybe a founder that's in sort of
24:28
a difficult space, difficult time that's
24:30
going through something, maybe uh
24:32
something that could be possibly
24:33
inspiring for them or motivational.
24:36
>> Yeah. Well, I think I think so. I'm kind
24:38
of weird because while I'm a CEO now at
24:40
Watershed, when I was doing my
24:41
consulting thing, I was like the co-CEO
24:44
of a bunch of different companies,
24:45
right? Like helping people work through
24:47
these moments in time. Mhm.
24:49
>> And I think the thing, and I was talking
24:51
to someone about this recently, I think
24:52
the thing that I encourage people to do
24:54
is don't don't forget your fundamentals
24:59
around business, like your business
25:01
fundamentals, like running a good
25:04
business, like for sustainability, for
25:07
cash management, for because even when
25:09
times are high and you're riding the
25:11
wave and you're feeling like you're God
25:12
and like you're the most amazing smart
25:14
human that's ever existed, that's part
25:15
of the process. You're going to have
25:16
moments where you're like, I'm the best
25:18
thing that's ever happened to humanity.
25:19
And then 20 minutes later, you're like,
25:20
I'm the worst thing that's ever happened
25:22
to humanity. Um, and that's just the
25:24
life is when you have a strong
25:27
foundation and you've done your
25:28
fundamentals well. When the low hits,
25:30
because it will. I don't care how great
25:32
you are, how smart you are, how amazing
25:34
you are, you will hit a part where
25:35
you're wrong, where you will have
25:37
calculated wrong, where you will have
25:38
made a misstep. And that doesn't mean
25:40
you're bad. It just means you made a
25:42
misstep and and you you're going to
25:44
pivot. When you have strong
25:45
fundamentals, when those things happen,
25:47
the level of crisis that you feel is
25:50
mitigated because you're you have a
25:51
strong sustainable organization and
25:53
you're building towards that. It also
25:56
keeps you in control of what the future
25:58
looks like, which is also important
26:00
because ultimately as a CEO, it's your
26:03
job to execute on the vision. Um, so
26:05
trust yourself. Don't lose track of what
26:07
you're trying to do and and sometimes
26:09
the basics protect you from a lot of
26:12
nonsense.
26:14
Yeah. Has the vision changed? Has it
26:16
altered or is it still constant?
26:20
>> I told Chip, I said the first day I met
26:22
him, I told him what this company was
26:25
the first meeting within the first 15
26:27
minutes. I said, "This is this." And we
26:29
were talking about the other day and I
26:30
said, "And here we are, and it's exactly
26:32
what I thought at the first time I met
26:34
him." Um, and that was what brought me.
26:37
It's like I told my board recently, you
26:39
know, I came to do the things we're
26:41
doing now. I'm not I I'm not interested
26:43
in these other things if I'm going to
26:44
wake up because and I know I told you
26:47
the story before, Michael, but I'll tell
26:48
you I'll say it again for the listeners,
26:50
but like what you do in your everyday is
26:53
a literal exchange of your existence.
26:56
The only thing that matters is time. And
26:58
when you wake up every day and you give
27:00
your time to something, um it better be
27:03
worth your existence because that's what
27:05
you're exchanging.
27:06
>> And so every day I wake up and that's
27:08
the bar I hold myself to. Is this worth
27:10
my existence? And I think when I met
27:14
Watershed and as I got more involved in
27:16
it, as I um you know really understood
27:19
and started to architect what we could
27:21
become, it's absolutely worth my
27:24
existence to do the things that we do.
27:25
And I hope that everybody has the
27:27
privilege to be able to say that about
27:29
themselves. And it doesn't have to be
27:30
your job. Could be your family. It could
27:32
be your hobbies. It could be your
27:34
friends. Um, but that you're you're not
27:37
squandering the thing that matters the
27:38
most, which is the fact that for this
27:40
two and a half seconds, you get to exist
27:42
and hopefully it's meaningful.
27:46
>> Pretty damn deep.
27:49
>> I wasn't sure.
27:50
>> That's true though, right? Like it helps
27:52
it helps keep you focused cuz I think
27:54
when when the noise starts when
27:56
everybody's got an opinion about how
27:58
stupid or smart you are, which happens
27:59
about every 5 seconds and they all
28:00
contradict each other. Um if you don't
28:03
have a true sense of what you're trying
28:05
to do and it doesn't mean tactically
28:07
like down to the button click of what it
28:08
is, but if you don't know the problem
28:10
you're solving, why you're solving it
28:12
and it doesn't light you up. If you're
28:14
doing startup work or innovation work,
28:17
do something else because this is hard
28:21
and it's stressful and as much as it's
28:24
brilliant and amazing, you have the same
28:26
days that are equally like, holy cow.
28:28
And um and also there's a lot of noise
28:31
and if you don't remember the core of
28:34
the reason you're ch exchanging your
28:36
existence, then you're going to burn out
28:38
and that you can't you can't sustain it.
28:41
So, it's heavy, but it's also really
28:43
exciting because when you find it, dude,
28:46
it's such a it's such a blast. It's such
28:48
a blast.
28:49
>> Yeah, it is a blast. I mean, who do you
28:51
share those moments with? Do you have
28:53
like aside from your board? I mean, can
28:55
we talk about just having the realness
28:58
of folks that actually understand what
29:00
it is that you're trying to do, how
29:01
difficult it is? Is it hard to find
29:04
common ground with people that aren't,
29:06
you know, growth companies, CEOs? How do
29:08
you how do you communicate with normal
29:10
people
29:12
>> when you're doing something that's
29:13
really difficult?
29:15
>> Yeah. No, I think it's kind of like the
29:16
niku, right? Like there's a small number
29:19
of people who have ever done that. And
29:21
when you try to talk to parents who've
29:23
never been through something like that,
29:24
they go, "Oh, yeah. There's one time my
29:25
kid was in the ER and you're just like,
29:28
"Yeah, cool. That's not even remotely
29:30
the same thing." But you also recognize
29:33
they're trying to be relatable and kind
29:34
in the moment. I think business works
29:36
the same way. Um, and I think that you
29:40
also have to have people who, whether
29:42
they understand the words you're saying
29:43
or not, will at least share in the
29:45
feelings of the things that you're doing
29:46
with you, whether it's excitement or
29:48
distress.
29:49
>> Um, especially when you do something
29:51
hyper nuanced or if you, anybody who
29:52
hangs out with me long enough knows I
29:54
love details and I have to ask you um,
29:56
upfront like, how much do you want to
29:58
know? Cuz I'll go back to the beginning
30:00
of time and bring you all the way to the
30:01
present and then we can go 100 years
30:02
into the future or you really are just
30:04
interested in the next two minutes. Um,
30:07
so for me it's having some really great,
30:09
smart, capable friends, many of which
30:11
that I' I'm luring to watershed to work
30:14
alongside so we build things together.
30:16
Um, it's having, you know, people like
30:18
Chip who understand and share the common
30:20
vision. And I'm really lucky with my
30:22
board and investors and I don't think
30:24
that that's something that people get to
30:25
say a lot. Um, you know, my board is
30:29
really supportive and and really, you
30:31
know, excited about what we're doing and
30:34
you have to have all of those things
30:35
around you. Um, but I think it's just
30:38
like and it's maybe two people. It's not
30:40
a hundred people. It's like there's a
30:42
couple people who get to be part of it
30:44
and
30:45
>> um that's the part that matters.
30:48
So before we wrap, tell tell people what
30:52
is the best way to follow the work that
30:55
Watershed is doing and just sort of
30:57
staying up to date and tuned in on the
30:59
cool things that you and the team are
31:00
doing and building.
31:02
>> Yeah, we've been trying to do well I've
31:03
been doing a lot of like op-ed work
31:05
lately like writing a lot um and you
31:08
know so you see a lot of things on
31:09
LinkedIn press releases and others.
31:11
We're also going to be in quarter one
31:13
publishing a bunch of white papers and
31:14
different sort of results from customers
31:16
because our favorite thing to do is let
31:18
other people tell their stories. Um
31:19
because again it's not about us. Uh I
31:22
think you know that would be the way is
31:25
just like the social media environment
31:27
you know it's kind of where we're
31:29
keeping people posted.
31:31
>> Yeah. I mean and even just not you
31:34
saying how awesome you are although
31:36
because we know that you're awesome.
31:38
It's wonderful to hear others that are
31:41
leveraging Watershed and sharing
31:44
>> their experiences. Case in point, we
31:46
were in Austin together and in a room
31:49
full of high capacity leaders and
31:51
Watershed gets honestly the most
31:54
probably one of the most incredible
31:55
shout outs I've ever heard and I was
31:57
just like blown away. And how does that
32:00
make you feel as CEO knowing that you've
32:02
built something that people are finding
32:04
to be really useful and appreciated and
32:07
are doing it in a public forum like
32:08
that?
32:10
>> I I'm honored to have the opportunity
32:12
honestly and I'm I'm really and this is
32:14
going to sound kind of paternalistic,
32:15
but I am a mom. Um I'm really proud of
32:18
what people do with it. Like watching
32:20
people do stuff with it is is the best.
32:25
um because it takes guts and I know that
32:28
like anytime you're doing something
32:30
different. So as much as I have pride in
32:32
what team does and what we get to do and
32:35
feel you know excited to that I'm also
32:37
just constantly proud and amazed at what
32:40
people choose to do with it. Um and how
32:42
people have leveraged that uh because
32:45
again you know it's the none of this
32:49
stuff is like impossible. One of our FAQ
32:51
cues is um someone asked when we first
32:53
came to Austin actually it was um what's
32:55
the barrier to adoption and I said
32:58
belief and and it's because health pe
33:02
healthcare people have been lied to a
33:03
lot like a lot um or who who have bought
33:08
into something and it wasn't quite what
33:10
we thought it would be right and
33:12
>> and when you work in healthcare you know
33:14
in operations or clinical or whatever
33:16
like your life is fast-paced and
33:18
overwhelming and every five minutes,
33:20
someone has a great idea that's about to
33:22
ruin your life, right? And so we just
33:24
our tolerance for things is so low. And
33:28
so when someone comes in and goes, "No,
33:30
wait. It's amazing. It's going to be
33:31
great." You're just like, "Oh my god."
33:33
And and I think that as we've watched
33:35
people not only believe, but participate
33:38
and then, you know, procilitize
33:42
um has been just the coolest thing ever
33:45
because when you get to be a catalyst
33:46
for communities doing the things they
33:48
believe in.
33:49
>> Yes. I mean, that is like top tier
33:52
existence exchange business right there.
33:55
Like, when you get to like
33:57
>> just be the person that sparks something
33:59
and then they run with it and it sparks
34:01
something and it sparks something. And
34:02
we've finally finally hit that critical
34:04
mass where now it's starting to build
34:06
itself. And again, I'm just really proud
34:09
of that and I'm proud of the communities
34:11
and I'm proud of the team. And I tell
34:13
the team every day like if you're lucky
34:15
enough to have even the opportunity to
34:17
be in the room where people have the
34:19
opportunity to do the kinds of things we
34:21
get to do, you're one in a million
34:22
people. And to be at the tip of the
34:26
spear of that is freaking insane. And
34:28
every day we should be just like
34:30
pinching ourselves and saying, "Okay,
34:32
don't screw it up."
34:36
>> Yeah.
34:38
>> Yeah. I so appreciate you and just this
34:40
this conversation, the work that you're
34:42
doing, the work that the team is doing
34:45
and to see folks leveraging a tool in
34:49
such a way where maybe they're using it
34:50
in a way where you're like, "Wow, that
34:51
was like really surprising." And you
34:53
know what that that created an outcome
34:56
that was exceptional because look,
34:58
healthcare doesn't suffer from a lack of
35:01
smart people. We've got a lot of smart
35:02
people. I think it suffers from systems
35:05
that make it hard for good people to do
35:10
the thing that they want to do
35:11
consistently. And it's like you said,
35:13
just do the right thing. So today,
35:16
>> you sharing some of those stories and
35:17
highlights just validated the fact that
35:21
it anything worth doing takes time.
35:25
>> It's it's not an overnight thing. It's a
35:27
>> yeah,
35:27
>> you know, in your case, a five plus year
35:30
thing in the making. So to the audience
35:32
that's tuning in, if you happen to find
35:34
this conversation useful, if you found
35:36
it helpful, the best way to share that
35:40
would be to engage with it, you know,
35:42
comment like. We do read them. And if
35:44
there is a topic that you want us to
35:46
explore or even a leader that you know,
35:49
you'd like to hear from, yeah, drop me a
35:51
note. I read them. Um, this platform is
35:54
absolutely not just about content. It is
35:56
actually a living, breathing ecosystem.
35:58
It is a community. It's not just
36:00
onedirectional. So, thanks for
36:02
listening. Keep building with purpose
36:04
and uh we'll see you next time on the
36:06
Advancing Health Innovation Show.