Latest / CareTalk: Healthcare. Unfiltered. / Zeke Emanuel on AI in Healthcare

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Zeke Emanuel on AI in Healthcare · CareTalk: Healthcare. Unfiltered.

• 0:00
  David: Artificial intelligence seems to be taking over everything, including healthcare.
• 0:04
  David: So before chat, g p t or Bard takes us off the air, we're gonna try to squeeze in as much natural intelligence on this show as possible.
• 0:11
  David: Who better than Dr.
• 0:12
  David: Ezekiel, Emmanuel Bioethicist, health policy expert, oncologist, professor, writer, et cetera, to be our guest today?
• 0:20
  David: Welcome to CareTalk America's home for incisive debate about healthcare, business, and policy.
• 0:24
  David: Today's episode is brought to you by MedMastery.com.
• 0:27
  David: If you need to brush up on clinical skills like E C G interpretation, mechanical ventilation, pocus, and more, and wanna do it in a fun way while earning C M E credits, you should check out what they're doing over at MedMastery.com.
• 0:39
  David: I'm David Williams, president of Health Business Group,
• 0:42
  John: and I'm John Driscoll, the president of Walgreens Healthcare.
• 0:44
  John: You neglected to mention that Zeke is a longtime friend of the show.
• 0:48
  John: David, come on!
• 0:49
  David: I did mention it.
• 0:50
  David: I said et cetera.
• 0:52
  David: You know, here's the thing.
• 0:53
  David: You know, it's, it's, you know, Zeke's been on the show three times.
• 0:56
  Zeke: Is that right?
• 0:57
  David: Yeah, that's right.
• 0:58
  David: And, and the question is with artificial intelligence, I mean, is this it, will anybody be a guest on the show?
• 1:03
  David: I mean, is AI going to take over the world?
• 1:06
  David: You know, and how soon, how soon do we need to get you back on the show before that's all done with?
• 1:10
  Zeke: Well, you know, the experts keep telling us that we anticipate it's gonna come faster, but it takes longer and then it's takes a lot.
• 1:21
  Zeke: Um, and the, the, the full flourishing comes faster than we think.
• 1:25
  Zeke: I don't know.
• 1:27
  Zeke: I, I'm a little skeptical, but I, but you got sound creative.
• 1:33
  Zeke: Yet, yet, yet.
• 1:37
  Zeke: Well, look, I think the large language model is a, can be creative because what it does is just rearrange what it already has heard.
• 1:46
  Zeke: And creativity is about bringing things you don't know together.
• 1:51
  David: So we'll be able to deal with that another time.
• 1:52
  David: So it sounds like you do expect to be back for a fourth or a fifth, uh, time, but how about in healthcare?
• 1:57
  David: I mean, there's, you've written something about that, you know, and one, one area that people talked about is just on the, you know, there's, there's nobody that will show up and work, uh, in healthcare.
• 2:05
  David: And then when we do show up, we have 'em do all sorts of tedious things that, that drive 'em out.
• 2:09
  David: I mean, is that, is that the place to take the healthcare convers, the, the AI conversation.
• 2:13
  Zeke: Well, I think there are three things which are really important.
• 2:16
  Zeke: One is definitely automation of repetitive stupid tasks, which we all hate.
• 2:22
  Zeke: Um, and, and that I think has to come, you know, just a lot faster.
• 2:27
  Zeke: And I, I think medicine in this regard is, Kind of like where it was with electronic health records.
• 2:33
  Zeke: Everyone knew there were electronic health records out there.
• 2:35
  Zeke: We had to digitize and uh, health systems didn't invest until the government just gave a lot of money.
• 2:43
  Zeke: Um, I think the sort of labor shortage was gonna drive this a lot more and faster, um, because labor shortage is gonna force them to automate what they can.
• 2:56
  Zeke: Take those people and do something more productive with them.
• 2:59
  Zeke: So you're seeing, you know, prior authorization, go have more ai, you're gonna see billings and claim processing.
• 3:08
  Zeke: Um, so I think those are really important places that's gonna happen.
• 3:12
  Zeke: But in addition, I, I think one of the.
• 3:16
  Zeke: Interesting questions is whether you can use AI and machine learning to make more accurate predictions, uh, both for the clinician, um, and for the system as a whole.
• 3:27
  Zeke: And there I, I've seen some very interesting things that I think we're just not utilizing enough, um, where you can predict.
• 3:35
  Zeke: Sort of adverse, um, uh, drug drug interactions or potential drug, uh, uh, toxicities that would lead to a hospitalization that you can for all by early intervention.
• 3:47
  Zeke: And those are the kinds of things that you really, you know, they improve quality.
• 3:52
  Zeke: People don't have an adverse reaction.
• 3:54
  Zeke: They save money.
• 3:54
  Zeke: And that, that's where we wanna be.
• 3:57
  Zeke: Um, we're working on AI and machine learning.
• 4:00
  Zeke: Improve the risk adjustment for Medicare, and we'll see if we can do that.
• 4:06
  John: Zeke, on on the, on the improving.
• 4:08
  John: Uh, drug drug interaction toxicity, you know, where my, my mind immediately goes to is all of these new and novel oncology therapeutics that, you know, really if you're, you know, a, a community oncologist wouldn't necessarily see every day a, a a, a case where those drugs would be needed.
• 4:27
  John: And they often have lots of, uh, unanticipated, um, You know, non clinical and nonclinical reactions, toxicity would be one of them is, does machine learning give us the ability to kind of take what's going on at the nci, you know, the best cancer hospitals in the, in the country and, and push out best practices and maybe some predictive and, and kind of patient oriented knowledge to, to the community because that, that could be pretty powerful in terms of radically rapidly improving, uh, and supporting, uh, community.
• 5:03
  Zeke: I think you're, you're absolutely right, John.
• 5:06
  Zeke: Um, oncology has become so complex between the genetics, the multiple drugs, um, getting the right combo for this patient, which is updated.
• 5:15
  Zeke: There are lots of people who are thinking about this, and I think a lot of.
• 5:20
  Zeke: We're gonna have something.
• 5:21
  Zeke: And then the big challenge is different, which I think is less the AI and more the uptake in utilization by doctors.
• 5:28
  Zeke: I think that's, um, where these things often fall apart.
• 5:32
  Zeke: You know, we have all of us, all of us, me and a bunch of other people, um, in 2010 when we were, uh, passing and enacting the Affordable Care Act thought, you know, you, you, you have, uh, little reminders or decision supports in the ehr.
• 5:48
  Zeke: Everyone would get, you know, optimal care, the guideline driven care by the professional societies.
• 5:54
  Zeke: Here we are 22 years later, it still hasn't happened.
• 5:56
  Zeke: And why hasn't it happened?
• 5:58
  Zeke: Because you don't really have uptake.
• 6:00
  Zeke: It doesn't work.
• 6:00
  Zeke: Get into the workflow.
• 6:02
  Zeke: We've all learned that these habits that doctors have are hard, hard to break.
• 6:07
  Zeke: And therefore interjecting new information and getting them to behave on it is, is hard that I think, you know, the everyday human problem I think is something we're gonna have to figure out
• 6:20
  John: How much of That's just basic doctor.
• 6:22
  John: Trusting something that, that the doctor doesn't ch self-generate.
• 6:26
  John: I mean, I, I think we've got, you know, it's, it's, it's, I I think that the two, the two facts that, or, or, and, and, and you could tell us whether they're right.
• 6:34
  John: It often takes as long as 17 years between the time something is agreed on as best practice and it is actually populated across a particular specialty.
• 6:43
  John: And the other thing is that, That while there is protocol based medicine, only 40% of medicine is, uh, pro protocol driven.
• 6:52
  John: You know, how, how do you, how, how do we change that?
• 6:54
  John: Cuz the machine can't help a doctor who doesn't want to be helped.
• 6:58
  John: John, I think
• 6:58
  David: you're thinking about the 17 year locust.
• 7:01
  Zeke: No, it's a, it's, it's a, it's a thing cicada.
• 7:03
  John: Mean, how do we crack that?
• 7:04
  Zeke: I think actually, John, you go to, one of the things we really can't forget, uh, is how much behavior is critical in shaping and modifying behavior is really hard and doctors, like all people are resistant to changing their habits.
• 7:23
  Zeke: We get into a groove.
• 7:24
  Zeke: You know, you, you know, this doc doctors have optimized fee for service.
• 7:29
  Zeke: They figured out how many patients they have to, uh, see who gets referred to where, blah blah.
• 7:35
  Zeke: Hard to change that workflow.
• 7:37
  Zeke: And even if you pay them, you need to do a lot of things to get them to change how they're practicing.
• 7:44
  Zeke: And I think AI alone.
• 7:46
  Zeke: And the, here, here's the optimal guideline approved by the American Society of Clinical.
• 7:51
  Zeke: That's one element of a much more complicated change process, and so I think we have to think about the complicated change process.
• 7:59
  Zeke: I am convinced though the combination of what my great mentor and colleague Vic Fuchs used to say.
• 8:08
  Zeke: The three eyes are critical.
• 8:09
  Zeke: You do need incentives, so doctors have to see it's.
• 8:13
  Zeke: Get the money or get the non-financial incentives.
• 8:15
  Zeke: More time, like David began with, uh, through automation.
• 8:19
  Zeke: They have to have information, what's the right thing?
• 8:22
  Zeke: And then they have to have an infrastructure.
• 8:24
  Zeke: And I think we forget the infrastructure a lot, and that turns out to be critical to actual implementation.
• 8:31
  Zeke: And, um, you can't leave it to doctors.
• 8:34
  Zeke: I don't have time to, to, to fix their infrastructure, et cetera.
• 8:37
  Zeke: So what, what is, when you say infrastructure, what does that, what that mean in, in terms of, you know, a classic
• 8:41
  John: doctor's work?
• 8:43
  John: Oh, sometimes it's, it, it, it means the referral to the, uh, right facility, um, easy connection to the facility so that they actually get, maybe it's imaging, they get the report back, uh, or they get a call back.
• 8:58
  John: Easy scheduling for the ambulatory surgery center, knowing who that anesthesiology group is.
• 9:05
  John: Maybe having a personal connection with the specialists they're referring.
• 9:09
  John: Patients too.
• 9:10
  John: So a new specialist comes into town who's better, you know, we have better quality metrics on them, um, but they don't know them.
• 9:16
  John: They don't have their personal cell phone.
• 9:18
  John: It's very often very simple things.
• 9:22
  David: So AI is clearly one of the mega trends.
• 9:24
  David: Do you see any other big trends or does AI overwhelm everything else?
• 9:27
  Zeke: Oh, no, not at all.
• 9:28
  Zeke: I, I, I mean, I think actually one of the biggest trends is pay.
• 9:34
  Zeke: Um, I, I think.
• 9:37
  Zeke: Well, in 2014 when I wrote my book, reinventing American Healthcare, I made six predictions, one of which is that insurance companies, as we know them, would end.
• 9:49
  Zeke: Um, and I thought what would happen is that hospitals would go into the payment side of things and they would sell themselves.
• 9:56
  Zeke: As you know, you can buy Mass General Insurance, you get Mass General Care.
• 10:02
  Zeke: But hospitals didn't do that.
• 10:03
  Zeke: They were, you know, stupid.
• 10:04
  Zeke: I think, uh, they were doing the same old playbook.
• 10:08
  Zeke: Instead, insurance companies decided, oh, that's a real threat, we're we get to buy all those primary care doctors and get into the provision of care.
• 10:16
  Zeke: And that's what's happened.
• 10:17
  Zeke: And I think that's gonna be really successful.
• 10:21
  Zeke: Uh, much more.
• 10:21
  Zeke: I mean, you, you're seeing a lot of it, but it's gonna be much more successful.
• 10:25
  Zeke: You have.
• 10:26
  Zeke: Uh, great primary care groups that have shown that they can lower cost, improve quality, um, and get much better patient experience.
• 10:35
  Zeke: And I think that's gonna be the mechanism.
• 10:38
  Zeke: I will, in my defense, say that I, I, I phrased it as the Kaiser Reification of American Healthcare, and I, by which I meant the unity of payer provider, and.
• 10:50
  Zeke: I think we're gonna get a lot more of that over the next decade.
• 10:54
  Zeke: A lot more of that.
• 10:55
  Zeke: You're already seeing, you know, it's c v s, it's Amazon, Walgreens.
• 11:00
  Zeke: It's Humana, it's Walgreens.
• 11:02
  Zeke: Right.
• 11:03
  Zeke: Um, so I think, I think you're gonna just see a lot more of that.
• 11:08
  Zeke: Uh, and I think it's gonna be good because to make that successful, John, we could trade microphones here, but you know, you have to.
• 11:17
  Zeke: Uh, not fee for service, but alternative payments probably capitation.
• 11:21
  Zeke: And so we're gonna finally see that.
• 11:22
  Zeke: I think the tipping point to where a value-based payment is gonna really entrench itself.
• 11:30
  Zeke: You, Walgreens, and all the other places are gonna work with the doctors to, uh, implement changes in how they see patients.
• 11:37
  John: Well, I think that the, the thing that I, I don't think you missed it, Zeke.
• 11:41
  John: I, I think the one place where you might have overestimated is the ability for hospitals to actually have the capital flexibility to actually move into this in a, in a more meaningful way.
• 11:55
  John: And it requires a ton of money to become an insurance company, but then it gives that they, they've got a lot of captive capital that they can leverage in all kinds of creative ways, whereas hospitals , they've done that.
• 12:08
  Zeke: So John, you tell me why they haven't done that.
• 12:10
  John: Well, no insurance companies, I'm saying insurance companies have a lot of captive capital.
• 12:14
  John: And, and, and United was one of the first to.
• 12:17
  John: A little like buffet and, and, and, uh, and, and, uh, property and casual insurance that in the health insurance business, there was capital they could leverage and invest in novel ways.
• 12:27
  John: And hence, hence now United has about 60,000 doctors.
• 12:31
  John: Um, we're up to probably five or 6,000 doctors.
• 12:34
  John: The, the, you know, uh, c v CVS just jumped in, but we have more capital flexibility.
• 12:40
  John: And I, I just think that's the, that's the big difference and, and obvious.
• 12:43
  John: The folks who end up leading most of these hospitals are fairly conservative.
• 12:48
  John: Um, you know, even, even, even like Johns Hopkins where I'm the board, they, we've got a, a Medicaid plan and a commercial plan, but it's, you know, it's been a, it, it has, it hasn't been easygoing cuz it's sort of a, also organizationally and culturally very different.
• 13:02
  John: But I don't think you've got it wrong and you're seeing it in all of the different private equity.
• 13:07
  John: As well driven investments in rolling up doctors and now, you know, rolling up in, in some cases, very specific specialties.
• 13:16
  John: I'm, I'm not always sure that's great for continuity of care.
• 13:18
  John: It would've been more interesting to have more of the hospitals.
• 13:21
  John: Like the better hospitals like Mayo and Cleveland.
• 13:24
  John: Um, but it's, it's something I I, I, I personally pitched to a, I got a number of healthcare, a number of CEOs of, of, uh, hospitals.
• 13:33
  John: And even if they were interested, often their boards kind of held them back.
• 13:37
  John: So, uh,
• 13:38
  David: Let's talk about, I got, so listen, we're talking about doctors, hospitals, insurance companies, universities.
• 13:43
  David: Let's talk about the patient, Zeke, which you talk about.
• 13:46
  David: A couple things struck me, what you've been commenting on recently.
• 13:50
  David: Maternal mortality in the us and another is about financial toxicity for people with cancer.
• 13:57
  David: What are, what are some of the things that are really happening, you know, at the pa, at the patient level?
• 14:01
  John: Well, let's get at how bad is maternal mortality?
• 14:03
  John: Zeke?
• 14:04
  Zeke: Uh, we're we, we are so far out of the ballpark.
• 14:07
  Zeke: It's pathetic.
• 14:08
  Zeke: I mean, we're not even close to European standards.
• 14:12
  Zeke: Singapore, you know, there are places like Norway where they're basically at zero.
• 14:18
  Zeke: Um, It's like they, they have one or something.
• 14:22
  Zeke: Uh, we are in, you know, I think 15 or 16.
• 14:27
  Zeke: We had a 38% jump during covid in maternal mortal.
• 14:32
  Zeke: Now, it's not a huge number, but we should remember every single mother who dies, destroys the family, destroys the kids.
• 14:39
  Zeke: It's really, really, uh, dam damaging.
• 14:44
  Zeke: Um, and there's.
• 14:45
  Zeke: Reason we have to be that high.
• 14:47
  Zeke: We know we can bring it down.
• 14:48
  Zeke: How do we know we can bring it down?
• 14:50
  Zeke: California did, uh, they had a multi-pronged intervention.
• 14:55
  Zeke: Um, are they, they're still higher than I think France, for example, they're at about seven per hundred thousand.
• 15:03
  Zeke: Um, but that cut in half.
• 15:04
  Zeke: In a handful of years, we can do much, much better.
• 15:10
  Zeke: Uh, we have a lot of problems.
• 15:11
  Zeke: One is hospitals don't control the obstetricians.
• 15:16
  Zeke: They have to begin having, uh, exercises in crisis management.
• 15:21
  Zeke: That's the first thing you need to follow.
• 15:23
  Zeke: The mothers out of the hospital much more vigorously.
• 15:26
  Zeke: Once a birth is done, basically the obstetrician washes their hands of it, and that's a real problem because a lot of the maternity deaths happen afterwards.
• 15:36
  Zeke: I think we forget how traumatic.
• 15:39
  Zeke: Uh, giving birthdays and upsetting to the whole, you know, family life.
• 15:45
  Zeke: You, no one's sleeping.
• 15:47
  Zeke: It's a stress, especially if it's their firstborn.
• 15:50
  Zeke: You have no idea.
• 15:51
  Zeke: Is this normal?
• 15:52
  Zeke: Is this not normal?
• 15:53
  Zeke: We used to have.
• 15:55
  Zeke: You know, grandparents living close by, that's just not realistic today.
• 15:59
  Zeke: So I think we, we need a better system.
• 16:03
  Zeke: Um, I think hospitals have to focus on, be held accountable.
• 16:08
  Zeke: Um, we need obstetricians much more focused on it.
• 16:11
  Zeke: I, I think the fact that the American College of Obstetrician Obstetrics and Gynecology has not created a registry for every single birth in the country is really.
• 16:21
  Zeke: Terrible.
• 16:22
  Zeke: Uh, and then I think we need to have more doulas, especially for, uh, uh, families that don't have good social networks and social supports to help them through this moment.
• 16:34
  Zeke: I think that combination would do a lot of good.
• 16:38
  Zeke: How would you hold hospitals accountable?
• 16:39
  Zeke: That's an interesting idea because obviously they're a public utility, and so you could actually, you know, regulate that.
• 16:47
  Zeke: Oh, I, I think they have to actually provide data on every single birth in the hospital, uh, and detail data, um, uh, and then outcomes up to 90 days.
• 16:57
  Zeke: And you need to invest.
• 17:00
  Zeke: In getting that data, publicizing that data, and again, I, California did a great job on this.
• 17:07
  Zeke: I think almost all their hospitals voluntarily provided the data on their, uh, maternal mortality, uh, et cetera.
• 17:15
  Zeke: What we haven't had, and again, this is where infrastructure's important and information is, you know, if you collect the data, should give performance feedback to the physicians.
• 17:25
  Zeke: How well are you doing, how are you doing compared to.
• 17:29
  Zeke: Uh, neighboring obs obstetricians.
• 17:32
  Zeke: I think that's vitally important.
• 17:35
  Zeke: Let me say one other thing I think is really important, and now I'm gonna get on a hobby horse, um, and I'm gonna, you know, uh, give responsibility to my daughter that she sort of infected me with this, you know, way back when, uh, you know, sort of 1996 to 2008, I wrote a lot about research ethics and one of the things.
• 17:56
  Zeke: I pushed there is, why do we have this, uh, we don't test drugs on pregnant women, and we didn't test the initially test the covid vaccine on pregnant women.
• 18:04
  Zeke: That is an absurdity.
• 18:06
  Zeke: Um, it's, it's a harbinger of, you know, women can't decide whether they're gonna take the risks, uh, from the seventies.
• 18:15
  Zeke: We have to learn more about what drugs are safe and what combinations are safe for pregnant women because they often stop medications not knowing or being told that they haven't been tested in pregnant women.
• 18:27
  Zeke: They have that.
• 18:29
  Zeke: That's, we, we can't do that.
• 18:30
  Zeke: It's nuts.
• 18:31
  Zeke: It's nuts.
• 18:33
  Zeke: Yeah, it is.
• 18:33
  Zeke: It's totally nuts.
• 18:35
  Zeke: And I think it's, uh, the FDA needs to ch change that.
• 18:41
  David: I saw your, uh, your photos from, uh, the Holy Land and you were there waving a flag and getting in the midst of the, of the protest there.
• 18:48
  David: What, what kind of takeaways are there from an American standpoint?
• 18:51
  David: I, I know you, I saw you linked to an article on the Atlantic about, you know, what American liberals can learn from the protests in Israel.
• 18:57
  David: What, what do you take away from, you know, observing things on the ground here, uh, and in Israel, observing and parti.
• 19:04
  Zeke: Well, you take, first thing you take away is that we've got a lot of very divided societies.
• 19:10
  Zeke: Uh, they, we seem to be polarized.
• 19:14
  Zeke: You know, whether it's two camps or more camps, I don't know, but it's certainly at least two.
• 19:20
  Zeke: And they're, I I would phrase it this way, they're, they tend to be polarized between those who know the truth and have a, typically a religious belief that they've got the, you know, word of God in their ear.
• 19:37
  Zeke: And it's hard to negotiate with that.
• 19:38
  Zeke: It's hard to compromise with that.
• 19:40
  Zeke: It's hard to come to a liberal position with people who think they have the word of God in their ear.
• 19:46
  Zeke: Um, and then you have a bunch of liberals who think, well, we need tolerance.
• 19:51
  Zeke: People need to structure their own lives.
• 19:52
  Zeke: Not everyone's gonna have had the word of God in their ear, and that's a very hard place to be because it, you know, hard to negotiate that.
• 20:04
  Zeke: The second is, I would say that what's, what strikes you when you go to a protest in Israel, a pro-democracy protest, is they have all the trappings of patriotism.
• 20:15
  Zeke: They're the ones waving the flag.
• 20:17
  Zeke: They're the ones singing the national anthem.
• 20:21
  Zeke: They're the ones who are believe in the soul of the country.
• 20:24
  Zeke: And I have to say on the left, When I walk around and see who's waving the flag, it tends not to be people from the left.
• 20:31
  Zeke: It tends to be people from the right and the, all the trappings of patriotism in America are on the right, not on the left, not on people who are pro-democracy.
• 20:41
  Zeke: Again, that's a bad place to be.
• 20:44
  Zeke: Uh, what I take to be is we want democracy.
• 20:48
  Zeke: We want checks and balances.
• 20:49
  Zeke: We don't want the Supreme Court politicized.
• 20:51
  Zeke: We want newspapers to report facts, not to report things they know to be lies.
• 20:56
  Zeke: Um, those are all patriotic.
• 20:59
  Zeke: That's part of the heart and soul of America.
• 21:02
  Zeke: And you see that very big difference in Israel.
• 21:05
  Zeke: The similarity you see is.
• 21:08
  Zeke: Uh, we had Trump, who's now obviously an indicted person, um, who's gonna be indicted, uh, probably at least once more, maybe, uh, two or three more times.
• 21:17
  Zeke: Um, Israel said, got the same problem.
• 21:20
  Zeke: Their prime ministers indicted.
• 21:22
  Zeke: Um, and, uh, no one trusts him.
• 21:24
  Zeke: Uh, he's a chronic liar.
• 21:27
  Zeke: Um, very similar in that regard.
• 21:30
  David: John last question to you, or little soapbox speech as you may.
• 21:33
  John: I guess I, I guess, I guess Siq, I, I, I would, uh, is there any megatrend And we're waiting for, we're waiting, we're waiting for your article to come out on the mega trends out here.
• 21:44
  John: Outside of the ones we talked about, things we should be really worried about and organizing that we have solutions for maternal mortality, ai, we're or we're not organized and we don't, and, and it appears to be a solution.
• 21:55
  John: Is there anything else you'd want to.
• 21:58
  John: To the, for the trend followers in healthcare that we should be carefully sort of thinking about before it, it emerges in health affairs or the New York Times or the Atlantic, or wherever you're publishing soon.
• 22:10
  Zeke: I do think we need to get off this RPM as remote patient monitoring.
• 22:16
  Zeke: Because it's not the monitoring, it's not the getting information that's critical.
• 22:19
  Zeke: And this goes back to what we said before about trying to change doctors with ai.
• 22:24
  Zeke: What we really need is remote patient management.
• 22:27
  Zeke: And that is a lot more complicated than just putting in a bunch of sensors and getting information back.
• 22:32
  Zeke: You need the AI to soup up the signal to noise.
• 22:36
  Zeke: You need the AI to say this, uh, you know, signal needs to be attended to.
• 22:40
  Zeke: That one doesn't, and then you.
• 22:43
  Zeke: Effective mechanism, a way to get to the patient in the right way so you're not wasting a lot of resources every time something goes wrong, sending someone out, or bringing them back to the hospital.
• 22:53
  Zeke: So I think, uh, we need to concentrate on the management side.
• 22:57
  Zeke: Um, can we do tests in the home remotely?
• 23:00
  Zeke: Can we, uh, uh, change therapies remotely?
• 23:04
  Zeke: And that I think is gonna be the big hurdle, and I don't think we have enough people focused on that.
• 23:10
  Zeke: So I, I would say that's another Remo RPM is remote patient management and, uh, focus on the management of the patient.
• 23:19
  David: Well, that's it for yet another episode of CareTalk.
• 23:21
  David: Our guest today has been Dr.
• 23:22
  David: Ezekiel, Emmanuel Bioethicist, health policy expert, oncologist, professor, writer, and as John pointed out, friend of care talk and multi-time guest.
• 23:31
  David: I'm David Williams, president of Health Business Group,
• 23:34
  John: and I'm John Driscoll, the president of Walgreens, Health.
• 23:36
  John: If you liked what you heard or you didn't.
• 23:38
  John: Please subscribe on your favorite service and, and leave us a, uh, a review.
• 23:43
  John: That really helps.
• 23:44
  John: Zeke.
• 23:44
  John: Thank you so much for joining us again.