Latest / StartUp Health NOW Podcast / The Future of Virtual Health, with Amwell’s Dr. Roy Schoenberg & Murray Brozinsky

Transcript

The Future of Virtual Health, with Amwell’s Dr. Roy Schoenberg & Murray Brozinsky · StartUp Health NOW Podcast

• 0:00
  [ on-hold music] One of the lessons learned, you know, is that it-- whatever you wanna do and be successful in healthcare, capabilities don't cut it.
• 0:14
  It's understanding, understanding how they mesh into the value model of the people that you sell to.
• 0:22
  Your-- the success of whatever products you have depends maybe thirty percent or forty percent on how good you are, another thirty or forty percent on how the other people are, and twenty percent on circumstances and legislation.
• 0:37
  [upbeat music] Welcome to StartUp Health NOW, the podcast where we celebrate the entrepreneurs and innovators reimagining the future of health. I'm your host, Logan Plaster.
• 0:48
  We've talked extensively on this podcast about how COVID ushered in a period of rapid adoption of telemedicine.
• 0:54
  According to McKinsey, we went from around eleven percent of people using telehealth to around forty-six percent during the pandemic.
• 1:01
  Few companies in the world were better poised to capitalize on this moment than Amwell.
• 1:05
  But what's so interesting about Amwell is that they weren't created to meet this moment, they've been patiently and persistently ringing this telemedicine bell since two thousand and six.
• 1:14
  Back then, seeing your doctor over your computer seemed like a pipe dream, or worse, some dystopian future. Now, well, things look a bit different.
• 1:24
  Building the infrastructure to deliver healthcare virtually is an idea whose time has come, and Amwell's persistence has made them a world leader in the market.
• 1:33
  Now Amwell is expanding the definition of virtual care through acquisitions, and last year they acquired start-up health company Conversa Health, which uses chatbot functionality to automate care in between visits to improve efficiency and outcomes for patients.
• 1:48
  This episode of the podcast is pulled from a fireside chat where we sat down with Roy Schoenberg, the CEO and co-founder of Amwell, and Murray Brezinski, the CEO of Conversa Health.
• 1:58
  The chat, which was moderated by Steven Krein, CEO and co-founder here at StartUp Health, pulls back the curtain on how these two companies came together, the lessons learned from the process, and what it all means for the future of virtual care.
• 2:11
  Roy and Murray are a wealth of wisdom and experience when it comes to digital health, so it was a powerful conversation. And I hope you enjoy. [upbeat music] My name is Steven Krein.
• 2:23
  I'm the CEO and co-founder of StartUp Health.
• 2:26
  I am thrilled to be here with actually some old friends, uh, Roy Schoenberg, the co-CEO of Amwell, and Murray Brezinski, who's now the Chief Strategy Officer of Amwell, the former CEO of, of Conversa Health, uh, a StartUp Health company, uh, that goes back many years from the founding of, of, uh, of Conversa.
• 2:46
  And what I'm really excited about doing today is digging in, not just to,
• 2:51
  uh, the story of Amwell and Conversa and the combination of the two last year, but really getting inside a little bit of the, the, the, the belly of the beast, so to speak, and learning a little bit about, from the entrepreneur's perspective, how
• 3:09
  you navigated, uh, the ups, the downs, the obstacles, the opportunities in a way that I think will shed light for entrepreneurs, inve-innovators, and investors at how to really build a, a sustainable long-term health innovation company and continually making sure that you stay on mission for what it is that you're working on.
• 3:30
  So I am thrilled to be here.
• 3:32
  I'm gonna ask you-- ask you-- uh, actually ask you both to do quick intros and tell your story both about the, the, the company, uh, the company and the founding of the company, but more importantly, your own personal backgrounds a little bit as we bring these together.
• 3:44
  I'm gonna start with you, Roy, and give you a chance to introduce yourself.
• 3:48
  I always find that people doing their own introductions always nets the most interesting facts versus the narrative that the team gives me to read off. Roy, Murray, welcome. Well. Well, thank you.
• 4:00
  Thank you for having us. It's always, you know, always end up we're having such fun conversation, so it's really good to, to be back here.
• 4:07
  Um, introduction-wise, so I think you can, you can judge from my kind of a little bit funny accent that I wasn't born here. I was born in Israel many, many, many years ago, last century.
• 4:17
  Uh, [chuckles] took my time in Israel, trained as a physician there, um, and then came to Boston for a little bit of an academic stint here.
• 4:26
  Um, and then, you know, through two other previous companies that I founded with my brother, uh, over the years, then go to Amwell back in two thousand and six, um, with the idea that we can, we can actually deliver healthcare over technology.
• 4:42
  Uh, this is [chuckles] at the time to remind everybody before the iPhone was invented, so it was a leap.
• 4:50
  And then I would say probably spent the first ten years of, of building Amwell trying to convince clinicians and the forces of nature in, in healthcare that it is safe for clinicians and patients to interact over technology rather than put their hands on the patient chest and abdomen.
• 5:09
  Um, and then the last ten years or so, I would say, are all about growth, are all about, you know, essentially surfing the wave of recognition that of course kind of peaked in, in, uh, in COVID, that healthcare, like other industries, can actually have a digital arm for its operation.
• 5:29
  Uh, and of course, everything trickles down from that. So [chuckles] that's in a very brief way the life story. Excellent.
• 5:38
  And, um, and I'm gonna ask-- We're gonna come back and, and talk a little bit about the mission when you launched, uh, as American Well back in, in two thousand and, I wanna say six-ish, um, and, and hear about that journey.
• 5:52
  But before we do, I'm gonna give Murray a chance to introduce himself as well. Sure. [clears throat] Steve, great to be here with you, and Roy, of course. Um, uhIntroduction.
• 6:02
  I mean, I, I've always thought of myself as a creator, so I've thought of ideas that need to be manifest in the world, and some of them should be through, you know, creating something through writing, a lot of it is through entrepreneurialship and creating companies, technology.
• 6:16
  So I got into technology years ago in different industries, and like a lot of people, I got into healthcare through a personal, uh, family health situation with my wife.
• 6:26
  And it just put into high relief, you know, the problems with the healthcare system that we're still grappling with, and this was fifteen years ago, and we had great access, and it was still very difficult to understand, to navigate, to make decisions, lack of visibility, lack of data.
• 6:41
  Um, and so I said, "I'm gonna take my experience in technology and data and get into healthcare."
• 6:46
  When that opportunity presented itself, I, I got into healthcare and helped to found a number of companies, Healthline and Talex, different parts of healthcare. Conversa is one I didn't found.
• 6:56
  Good friends of mine, Wes Schell and Phil Marshall, who I've worked with at other, uh, ventures, founded it. We'll talk about the founding vision and mission in a bit.
• 7:04
  But, um, I was involved very early on because I was there when we were conceiving the company, and I was the first reference for their, uh, initial investors.
• 7:13
  So I was there from the beginning in a, in a way while I was busy building other companies, and then had the opportunity to join and take over the company right in the teeth of COVID.
• 7:23
  Um, and, uh, we had a really great, uh, vision and mission, all of which was blown up by, by COVID, and we had to make some pivots, which we'll talk about.
• 7:32
  And, uh, we were lucky enough to, uh, meet with Amwell at the right time, and, uh, it's been a, a really great marriage.
• 7:39
  As you mentioned, it, it, uh, consummated in August of '21, so we're going on just about a year now.
• 7:44
  And we're past the honeymoon phase, so I can say definitively that it's been, uh, the right decision on every dimension, and it's been a wonderful experience. Excellent.
• 7:53
  Like, on, on that, on that note actually, let's talk a little bit about the acquisition. We know, uh, about American Well and Amwell. We know about Conversa and its journey.
• 8:02
  What were some of the reasons, Roy, behind why Conversa was so interesting to you?
• 8:08
  And, um, given that we're coming up on the one-year anniversary, how true some of those initial thoughts were, uh, from your, from your perspective now seeing inside the first year of, uh, of what you called the marriage, uh, uh, Murray.
• 8:22
  Yeah. I think the, um... You know, first of all, I wanna say that I think the years following the honeymoon year are actually better. You know, they're getting better and better over time.
• 8:30
  That's the aspiration, right, in all relationships that they get built, and that is the case here.
• 8:36
  I would say that, you know, the coming together period was, you know, not only meaningful on its own, but it was in the context of really a completely change of perception by the industry of what the various technologies can do for healthcare.
• 8:53
  This is COVID. Um, you know, like it or not like it, clinicians and patients were introduced to telehealth because that was the only way for clinicians to practice their art.
• 9:03
  It was the only way for hospitals to sustain itsel- themselves with patient care. And patients, especially those that were, you know, that, that needed a lot of healthcare, didn't have any other alternative.
• 9:16
  There's a lot of stories around what that meant, but I wanna highlight one that brought us together with Conversa, which is, like it or not, the receptivity
• 9:28
  in the audiences of healthcare on the delivery on the clinician side and the patient side to the notion that a bigger part of your healthcare experience is going to happen over technology,
• 9:41
  that embrace literally opened up in COVID. And it is--
• 9:49
  When you think about it, it isn't just receptivity to telehealth, to live video visits like what we're doing, what we're doing now, but it is receptivity to the fact that technology can play a role.
• 10:01
  And what that means is that we can expand the notion of how we can create companionship to patients for their healthcare journey with technology.
• 10:15
  When you kind of peel the onion to that kind of, you know, pithy statement, it's the understanding that at the end of the day, most of people's healthcare experience is actually not with clinicians.
• 10:26
  We spend, I don't know, ten minutes with clinicians when we see them if they're not too busy and not on their EHR typing stuff, and that's a whole other conversation. But we spend very little time in front of clinicians.
• 10:37
  Most of the time that we live with the realities of healthcare, with our living with chemotherapy if we're a cancer patient, or living with pain, or living with recovering from surgery or whatever it is, you know, that journey is spent on our own.
• 10:51
  Now, healthcare has a lot to say and a lot to do to help us through that journey.
• 10:57
  It can guide us, it can reassure us, it can ask us question, it can modify the way we get treated, it can modify the titrate our medications, and do a lot of other things.
• 11:07
  And sometimes say, "Hey, listen, you gotta go to the ER because this is not going the right way."
• 11:11
  The problem is that healthcare isn't there, because to put a clinician next to the patient during that journey would break the bank. So that is where the magic of Conversa came in.
• 11:25
  It is the understanding that if we do it right, there is a role for the digital presence of healthcare next to patients at all times, and that the beauty of it is that if that companionship with that patient
• 11:41
  can not only be there for them during that time, but also if, for whatever reason, things are not going well with the patient, it can raise its hand and bring in the cavalry, get that patient in front of real clinicians,
• 11:55
  then we are really moving the needle on people's healthcare experience.
• 11:59
  I think that the, the beauty of that, you know, joining forces is that we re- we really didn't try to change what either company was doing.Amwell, American Well of, you know, of, of prior to the merger, is all about telehealth.
• 12:16
  You know, we, we bring patients and clinicians together to see one another and interact.
• 12:21
  Conversa, and Murray will tell the story way better than I do, Conversa is all about that digital automated companionship next to patients that's very, very sensitive and discerning.
• 12:32
  It's the binding of the companies, but it's also the binding of the visions that allows us to really say, we can surround patients differently with technology. Um,
• 12:44
  that's why that honeymoon is continuing to get better and better. Yeah, I love that, and I wanna pick up on, on, on some recent announcements related to that convergence.
• 12:53
  But I wanna turn, uh, to Murray a- and ask, you know, for a lot of entrepreneurs who build companies or take on the role of CEO and, and leading a company, um, it's easy to see why, uh, no, I shouldn't say easy, but it's obviously why Roy felt it was so important to add another component to their already existing footprint and success in the, in the telemedicine, in, in the tele- televisits.
• 13:16
  But from your perspective as a, as an up-and-comer company coming from where you were, why, what, what made it so obvious to you to do the same thing?
• 13:25
  In other words, it, it sounds like what, what, what American Well, um, Amwell was missing was clear and could be added and complemented and accelerated, but how do you think about it from the Conversa side?
• 13:36
  Yeah, our, our mission really hasn't changed much from the beginning, right?
• 13:39
  Which was basically how do we incorporate the, the wisdom of the patient, all the information you can capture from a patient, and utilize that to help improve care and improve health.
• 13:49
  But the vision for how we achieve that mission or how we, uh, pursue that mission changed over time, and COVID was a big catalyst for changing it.
• 13:58
  So when COVID hit, we, um, first of all we had this very elaborate strategy, and I remember walking into the first board meeting after I became CEO and put this together, and I took all the slides out and had a picture of Mike Tyson who said, "Everybody's got a strategy till they get punched in the face."
• 14:15
  And so we had to rethink everything, and initially it was a lot of headwinds, um, and we had to pivot and figure out how do we get into the tailwinds.
• 14:22
  And so the vision for the company kind of moved from, we're gonna be the leader in automated care, and is even though at our size, uh, we have a long way to go, we, we really took that mantle and became in, in, in our view, the lead there.
• 14:35
  But that vision changed from a leader in automated care to how do we become a complementary, uh, care delivery model in the new hybrid care world that was emerging.
• 14:45
  And it became clearer what that hybrid care world emergence might look like because everybody moved to virtual visits, right?
• 14:50
  We can talk about the utilization going up dramatically and a lot more, um, skipping of pilots and moving to, hey, we, we just need to use technology because we need to deal with COVID, and that became this sort of forcing function.
• 15:03
  And so we had a number of our customers come to us, and in different ways were asking the question, um, how, how can we get more out of you? We're gonna go from working with sixty vendors down to six.
• 15:16
  We want you to be one of them. What's a natural other things that we should be thinking about from Conversa? Which forced us
• 15:23
  probably sooner than we wanted to, to think about raising a lot of money and potentially acquiring, becoming part of other platforms.
• 15:30
  And so it got us thinking a little bit ahead of where we normally would have been around what is our role in this hybrid care world, and we started to have discussions. There was a lot of interest.
• 15:39
  We were doing very well. And initially the screen was, are you a platform? That was the first kind of screen. And Amwell came through with this vision around hybrid care platform. They were further along than us.
• 15:51
  We, it became clear that we were a piece in a broader platform more logically than trying to build that platform ourselves given the speed at which, um, platforms were scaling. Um,
• 16:02
  and a number of companies came through that screen, but then it became very clear when we started to compare our actual mission, our commitment to that mission, the values, the people, the DNA of the companies, and, uh, we didn't go through a process.
• 16:15
  So once we started to have that discussion, it became clear that Amwell was the right partner for us, and, uh, we only, we only engaged with Amwell at the end of the day in doing the deal. Excellent.
• 16:25
  Well, you know, uh, we were thrilled. We'd known, um, you and West and, and Roy and Ido for, for, for a long time, and so of course as both a startup health company, as a friend of you both, we were thrilled.
• 16:36
  Um, but we know a year later what's really worked and what's working well.
• 16:41
  Just to get, bring some reality to it, what were some of the challenges, maybe unexpected or, or, or, or otherwise, that you kinda dealt with in the first year of integration?
• 16:51
  And, uh, either one, you know, I think has a different pers- each of you obviously has different perspectives of that, but I'd love to hear some of that for the entrepreneurs who are listening today.
• 17:00
  You know, I can take a stab at it if Murray can, can, can add his perspective, and we're probably not synchronized here, so [laughs] probably have different, different views of this. But
• 17:08
  I think that the biggest challenge is that you're coming in as two companies and, you know, especially if you're coming in as two, two strong companies that have, you know, a very, very lively agenda,
• 17:22
  the, the kind of the default is that you continue working in parallel, right?
• 17:28
  We have a tremendous world of things that on the Amwell side prior to the, prior to the merger and, you know, we had to deliver, and we wanted to continue to live up to all the things that we promised the market.
• 17:41
  And the same, you know, was the reality on the Conversa side. They have a world of customers that wanna grow and add capabilities and so on.
• 17:50
  And somewhine- somehow in the midst of all of this, you have to say, "Hang on, I need to somehow squeeze this aside and create another capacity in the middle
• 18:01
  that would not only integrate the two, but will," the, that, you know, statement, take one plus one and make it three.
• 18:09
  And that is always a challenge if you have two companies that have-Very, very active commitments in the market because the market is driving forward. That's, you know, the blessing and the curse of COVID.
• 18:25
  The blessing is the fact that we were able to come together, that both companies were, you know, were doing really well on the day of, of the merger.
• 18:32
  The curse is that we were all tasked already prior to the merger, and then we had to squeeze something out of nothing.
• 18:41
  I think that's partly the reality of, of any two companies that come together, but it was especially true, you know, because these technologies were, were so much at center stage during the, the years of COVID.
• 18:53
  Um, j- just to double-click on that, um, there was a question that came in that you answered in the Q&A from, uh, Dr. Alex Greenhill, who asked you, you could conceivably have tried to build the Conversa capabilities.
• 19:05
  Conceivably, I say, uh, she says, uh, but using your funding and dev teams, what made you buy instead of build? Yeah. So I think the, you know, the answer is, is somewhat simplistic.
• 19:16
  I said we, we could potentially throw money at the problem and try to build capabilities. I think, you know, we probably could. What you can't build is the art,
• 19:27
  and we've learned, you know, we all or some of us have gray hair and, [chuckles] you know, scars from working in healthcare for many years. You, you don't seem to have any gray hair, but that's- Oh, I do. I do...
• 19:36
  a whole different conversation. [laughs] It's, it's the camera. It's the camera that's... Uh, but one of the lessons learned, you know, is that it- whatever you wanna do and be successful in healthcare,
• 19:46
  capabilities don't cut it. It's understanding, understanding how they mesh into the value model of the people that you sell to.
• 19:56
  Your-- the success of whatever products you have depends maybe thirty percent or forty percent on how good you are, another thirty or forty percent on how the other people are, and twenty percent on circumstances and legislation.
• 20:11
  So I think that the, the, the one wonderful thing about Conversa is that they made it work already. Not the features and functions, they made the value come to life in the hands of customers.
• 20:25
  No matter how much capabilities we build, it will take us a decade to get there. I love that.
• 20:30
  I think it's a really important reminder, especially as other companies go through, whether it's M&A discussions or fundraising discussions about- Yeah... answering that.
• 20:38
  The, the, the ultimate question almost every entrepreneur gets, which is why do they, you know, why would they buy you when they can build it, or why
• 20:45
  are you gonna add the kind of value you're adding, um, just around those capabilities. So I appreciate that. Murray, your, your thoughts? Yeah. I'll, I'll just pick up on that last point 'cause, um,
• 20:56
  you know, from the other side of, of the, you know, of the table, I think that's exactly right. Y- the it that you're buying, to Roy's point, is in capabilities. It's a successful business.
• 21:06
  So unless you have the domain knowledge and you're focused in a particular area, there's just a lot that goes into it when you think about build, buy.
• 21:13
  Um, but as far as challenges, again, I agree with everything Roy said. We came in... The, the challenge was really too much opportunity. So how do you prioritize?
• 21:21
  Which I would argue is still the challenge for the company today. And if you wanna have a challenge, that's the right... it's the challenge you hope for.
• 21:28
  But it's still, uh, problematic, and you have to, you know, really deal with it. I am a big fan of, you know, quantifying and statistics and everything else.
• 21:36
  I'll, I'll give you a stat that suggested how we rose to the challenge, and, and this is a testament to, to Amwell and, and what Roy said before, which was recognizing that there's art, that there's magic, um, and, you know, how do you bring two companies together that are successful, that already have customers and have a strong mission and vision and make it one?
• 21:56
  We lost no employees through the process, no, no employees that, that we didn't wanna lose through this process to da- to date. Um, and that's an enor- that doesn't happen in my experience in M&A. Yeah.
• 22:09
  And it's because people really bought in very strongly to the Conversa mission and vision.
• 22:14
  And when we did this, it was very, very clear that we were now becoming part of a larger, uh, longer term mission and vision, and we always built this, again, as I said before, we had the mission, but the vision just got expanded very naturally to we're really a care delivery model, and it needs to be used seamlessly with other care delivery models that exist.
• 22:32
  Amwell was starting to build the other capabilities to support those business models. And when I say, um, um, delivery models, we're-- we both looked at it as support, right?
• 22:41
  So Amwell's been very, very consistent that it's an infrastructure in support of the, uh, the health delivery organizations and the payer organizations and life science organizations, and that was our philosophy as well.
• 22:53
  So although we had challenges, um, I think they were relatively, um, expected, and now it's all about prioritization.
• 23:03
  How do we make sure we deliver on promises that we made previously, while looking forward and, and really focusing on those things that are gonna have the biggest impact in the shortest period of time from, for the most patients?
• 23:14
  Uh, you know, I, I, I think, you know, from what we see, even having a, a, a, a, a CEO as a part of the company a year later, let alone all the employees still there, is a, is a testament really to the culture that you and the team built over the last, uh, uh, fifteen years.
• 23:30
  H- how would you like...
• 23:31
  If you were to, if you were to kinda write the framework for the next decade of the company, how, how would you describe the, the, you know, ten-year vision today of what you want to accomplish, um, so that when you look back, you're gonna be really happy with the progress you made from twenty twenty-two to twenty thirty-two?
• 23:52
  So funnily enough, and I think, uh, I think it's a, it's a privilege to be part of a company that, that has that reality. The mission statement of Amwell hasn't changed from two thousand and six.
• 24:04
  I don't know if it was whatever we were, you know, thinking when we wrote it, but it, it [chuckles] kind of survived the test of time in a way that
• 24:13
  the mission statement doesn't speak to a functionIt doesn't speak to we're going to build that capability that will be embraced by X, Y, or Z.
• 24:25
  It speaks to the evolution of technologies that are going to change and advance people's healthcare experience. And as such, those technologies are useful if they serve the traditional operators of healthcare.
• 24:43
  We're not trying to create a shadow world of telehealth that people will go to that will live, you know, side by side with the rest of their healthcare.
• 24:53
  We're trying to, to blend into their experience that they consume from, you know, from the hospitals they work with or the, the, the Blue Cross Blue Shields that cover them or whatever it is.
• 25:06
  That statement actually works today. I think that the, you know, the, the, the joining of Conversa and Amwell is an example of that because what it really changes is it changes the experience.
• 25:19
  It, it allows people to go home from whatever healthcare building they were in, whether it's an outpatient clinic or a hospital or whatever it is, and feel that healthcare continues around them.
• 25:31
  I think that if you ask me about where that needs to be ten years from now, I would actually say it's a continuation of the same. I think that the reality is that there is going to be a shift
• 25:44
  further and further of healthcare to where we as patients want to be, which is not in a hospital, not in an exam room, not in a waiting room, but rather in our own reality.
• 25:56
  And that's going to be true not only for, for, you know, people that have an anecdotal healthcare experience, but mainly for people that require a lot of healthcare, elder care, graceful aging, you know, people that have polychronic conditions and so on.
• 26:12
  More and more of their healthcare surrounding is gonna be done via technology inside their environment. Now, that can be broken into a lot of different things. That is where conversational AI comes in.
• 26:28
  That is where biosensors and, you know, biometrics are coming in. That is where monitoring of the data that's coming from those devices comes in.
• 26:35
  That's where the ability for someone to walk through your television set at home to check up on you for a couple of minutes, your nurse from the hospital, click, click, come in. "How are you?"
• 26:45
  You know, "Did you take your medication?" That kind of stuff. A lot of complimentary services that can actually come into your home occasionally to make sure that you're eating well or draw your blood or whatever it is.
• 26:56
  There is a whole world of elements, some of which Amwell is part of, and some of which we work with, in order to create a healthcare reality around patients that this is where, where they wanna be. Um,
• 27:11
  and I think it's a, it's, it's just a, a long journey that will constantly continue. There's not gonna be a we have arrived kind of a, you know, a period, um, but that's what makes it nice, right?
• 27:22
  I mean, that's what makes us get up in the morning and continue to innovate. Yeah.
• 27:26
  Well, I, I, I wanna use that as a jumping off point for Murray because clearly you've been living in this world of automating the care experience.
• 27:33
  Um, give me an example or two of what kind of automation, uh, what, what has automation done to change that experience?
• 27:42
  And I'd love an example today, but then I'd love an example in the future that is not possible today, but will be because of, of what you're doing together, uh, at Amwell. Sure. No, it's a great question.
• 27:55
  You know, so when people think about automation, they think-- your head immediately goes to back office, administrative, offloading activities. We actually-- And that's, and it's huge. A lot of value there.
• 28:06
  But we, we chose automating the care delivery. So we, we chose a really hard problem at the beginning, which was, you know, right in the clinical workflow. You gotta get it right.
• 28:17
  And, um, you know, we've talked a lot, we've already talked a lot about experience. It all starts with the experience because if you don't have the experience that works for patients, they won't stay engaged.
• 28:27
  If you don't have experience with providers where they feel it works in their workflow, they won't stay engaged, and therefore you can't... That's the first step.
• 28:34
  But, you know, there was a time, and Steve, you know this, at all these conferences where, you know, you have themes, and patient engagement for years was a theme.
• 28:41
  And I was, was-- I was befuddled by it because it's not an end, it's a means to an end, right? You're getting them engaged for some reason. People wanna get healthy, they wanna stay healthy, they want improved care.
• 28:50
  And so in, in automation, we started with, let's improve the experience, but our whole purpose for doing that was let's get engagement so we have permission to collect the wisdom from the patient.
• 29:00
  They'll give us information because they're having a good experience. They know it's good for them. They know it's being used to improve their care.
• 29:06
  And we've done a really good job, and we've evolved, and now we're very focused on leveraging that data to help make decisions that change behaviors that are predictably and reliably moving the needle on outcomes.
• 29:17
  And that's ultimately the business that we're in. And so I'll give you some examples. We, we, um, announced this recently, uh, on the last earnings call. Ido talked about it. Spectrum Health is a,
• 29:29
  a, a large healthcare system in Michigan,
• 29:31
  one of our long-standing customers, and they're using lots of different programs, our automated programs, but one of them is for the, um, dis-- patients that are discharged or released from the emergency department.
• 29:43
  Thousands upon thousands, twenty thousand patients over the last year. They did a study on those patients, and changing the experience, it was enormous. So ninety percent satisfaction, patients loved it.
• 29:54
  Basically, it's a program when you leave the emergency department, you get enrolled in it as a patient. It's following up to make sure that you understand those discharge instructions.
• 30:02
  Usually ten minutes later, you forget ninety percent of what you're supposed to do. It's confusing. It creates stress. So it checks in, makes sure you understand that, continually reinforces it.
• 30:11
  It makes sure that you're going to your follow-up appointments. It makes sure that you're cl- getting your scripts, if you had a prescription written.
• 30:16
  It's making sure that when you run into problems, you don't change your pain meds and do something dangerous that results in you getting back to the emergency department. And so-Very good experience.
• 30:26
  Patients gave it very high marks. The providers and the care teams that were using it were making on average thirty calls a day to patients to follow up when they were being released.
• 30:34
  It reduced the number of calls they were making by seventy percent. So the burden and burnout on those care teams went down. Satisfaction rates went s- through the roof. They started using it as a recruiting tool.
• 30:45
  People were lining up to be in this emergency department because of this platform that they were able to use to provide better care for patients.
• 30:53
  And then the actual outcomes, uh, it reduced total cost of care, utilization of the emergency department and admission to the hospital to the point where Spectrum went to their health plans and said, "This one program is saving you, for the patients that are on value-based programs with us, over a million dollars a year."
• 31:11
  So about eighty-five dollars per enrolled patient savings from reduced utilization, more savings from care teams and providers being able to focus and practice at the top of their license and not make all these unnecessary calls.
• 31:25
  So that's an example of right now in the moment being able to check with a patient, take their perspective of how they're doing, answers to questions, validated answers to questions in the form of PROs, biometric readings, and in the moment make a decision as to what the status is of that patient, and based on that status, decide what the next best action for the patient could be.
• 31:45
  That's what we're doing today. Love that. What is gonna be done or what should we expect from the, the, the capabilities and the experience five or ten years from now?
• 31:58
  And while what you just described I know would be a big leap forward from today, um, what, what, what does it look like where more data's available, more of the experience has been improved upon and you've already accomplished that?
• 32:12
  Is there, is there kind of a set of things that you'll be able to do five or ten years from now that we can't do today? Yeah, absolutely. So, you know, as Roy talked about, again, the experience, talked about TVs.
• 32:23
  And so, one, different modalities, different ways of being able to engage patients. So right now we're doing it on, you know, devices with browsers, but that could be extended to TVs and voice devices and other things.
• 32:35
  So the idea is a companion wherever you are, right? And you can access it as a patient, as a, a caregiver, as a family member, wherever you might be.
• 32:44
  Um, and then the other thing is I talked about all the data that we have making decisions in the moment for the next best action.
• 32:51
  The next vista there is using that information, you might look good right now, your status might be fine, but we can predict that you're gonna decompensate tomorrow, next week, in a month.
• 33:01
  Or we can predict that the probability, the likelihood of a readmission based on a risk score just increased, and so we can recommend an intervention when things look good.
• 33:11
  And that really fulfills this promise of moving from reactive to proactive care.
• 33:16
  So the whole idea right now is we've automated and virtualized the ability for someone effectively to sit with you as a patient every day in your home and ask you the right questions, take the right readings, and make the right recommendation.
• 33:28
  The next step is that person that we virtualized and automated is gonna be able to be more omniscient and predict what may happen next, so we can provide guidance for the care teams to intervene at the appropriate time.
• 33:41
  Love that. And, and I'm assuming, and I'm gonna turn it back to Roy, re-related to the announcement I saw recently about, um, Amwell powering the CVS Health rollout of their, uh, virtual primary care service.
• 33:55
  How, how does that play a role?
• 33:56
  'Cause I'm assuming that what you just described, Mary, and what you outlined, uh, Roy, uh, is one thing to offer it, but it's another thing to actually reach the patients and the families where they are.
• 34:07
  And clearly, CVS brings you right into, you know, communities all around the country that, um, enables you to put that into action.
• 34:14
  So r- maybe elaborate a little bit on how meaningful that is, Roy, and what the expectation there is. Yeah.
• 34:20
  I think funnily enough, and I really haven't thought about it until you asked it that way, um, it ties to the first, the first question that we had today, or the, the, the first conversation part where we talked about people's openness
• 34:34
  to changing the model by which traditional healthcare has been delivered. I think that the conversation about virtual primary care is, is actually an earthquake.
• 34:46
  It means that your first line of defense for your healthcare issues, your primary care, is gonna start with this.
• 34:55
  And then recognizing that just putting it on the phone is not gonna be enough, you actually have to tie it into the kind of escalation path of care.
• 35:08
  Sometimes it can be solved over the phone, even when you talk to a clinician, and then you have to go into a physical location.
• 35:14
  And sometime someone has to put a stethoscope on your chest, and sometimes blood needs to be drawn, and that needs to be escalated to a physician office, and that goes into an outpatient clinic, in a hospital, in admission, in acute care, and all of that kind of stuff.
• 35:27
  The understanding that there is an opportunity for us to rewrite care settings completely and how they work with one another, kind of the chain of transmission of electrons, to anybody that remem-remembers chemistry.
• 35:43
  The ability to rewrite those care settings and tie them together differently is at the core of introducing virtual primary care. Now, it really helps that you have the technology in place.
• 35:58
  It really helps that you know how clinicians wanna work with that technology, because virtual primary care still allows you to see a real physician, to be clear. It's not-- That part is not automated.
• 36:09
  You actually have a relationship with a PCP. So you understand how PCPs work, but you change the consumption of healthcare to something that is much more compatible with how people wanna be.
• 36:23
  You know, come to them, try to bring it into their reality.
• 36:27
  The notion that they have to queue up in front of healthcare is kind of gone, it's outdated.Um, so, and, and of course, I, I don't have to, you know, speak for, for CVS. They, [laughs] they do a good job doing that.
• 36:40
  But they do have a presence that's very close to a lot, a lot of where people live.
• 36:45
  So that is an opportunity for them to really think about merging all of these things together to rewrite the way people experience the consumption of healthcare. Um, and,
• 36:58
  you know, I would say that the, the fact that that is happening right in front of our eyes is, is unbelievable.
• 37:04
  If you asked me that question five years ago, I would, I would have not predicted that this would happen that fast.
• 37:11
  But, uh, I don't know if you wanna talk about virtual primary care or not, but I would say that I think that is...
• 37:17
  People, I think, are underestimating how dramatic the effect of this is going to be on the entire industry. So let, let's, uh... Y- you're teasing me here. Let's dig into that.
• 37:29
  I mean, I think, um, I think what you're describing, and it's a little bit like, um, people talking about a cure for certain dis- you know, things like Type 1 diabetes. It's always right around the corner.
• 37:41
  It's always right there, but it, then it's, you know, it- it's inevitably like the horizon. You know, when you get there, it's just- Yep. It's another mountain... a little further, a little further. Um, let...
• 37:49
  You know, I, I, I recall not that long ago it was a big deal just to be able to, you know, go see a, a, you know, a, a urgent care at a CVS or a Walgreens, and that was gonna herald in a whole new, a whole new era.
• 38:02
  Um, what you're describing is exciting.
• 38:04
  Why is this different, a different moment for, for, for the emergence of and the actual i- implementation of and acceptance of that impact being felt at, you know, the, the, the home in a, a particular part of the country which might not have even good for [laughs] good primary care in their, in their community?
• 38:24
  So I think, I think the, the reason... [clears throat] I mean, we can talk about technology all day long. I think that the... People hate the term paradigm shift, but sometimes it's appropriate to use it.
• 38:36
  For the most part, telehealth technologies have been used in a variety of transactional ways. Urgent care is a very good reality, right? I mean, please don't quote me on that.
• 38:49
  It, it's an instrument of blind dating, right? I mean, it's a, it's a, it's a patient who has a need right now. They're going into a system that matches them with an available clinician.
• 38:58
  They come together, good healthcare happens. But for the most part, they part ways very likely never to see each other again. Transactional. Very transactional, which is a blessing when you need transactions.
• 39:09
  I mean, [laughs] there's nothing wrong with transactions. But inevitably, a lot of healthcare requires more than transactions. The, the term inside the industry is the notion of longitudinal care.
• 39:24
  When you have a chronic condition or when you...
• 39:26
  even when you have an, an, an episode of care that, that extends over a period of time, like recovery from something or, you know, or something that extends, that is when you need relationships.
• 39:38
  Short-term, long-term, but relationships.
• 39:42
  One of the elements that is so profoundly different about virtual primary care is that these technologies are now built together and brought together in a way that allows you to essentially establish a primary care relationship with all of the services associated with it
• 40:00
  that starts in technology. It sounds subtle, but it spells a complete rewrite of the journey of patients and the consumption of services in healthcare.
• 40:13
  There are a lot of other elements to it which I think are, you know, are, are, are lost on a lot of people. It's not just that you can get a PCP on your phone and have a PCP relationship.
• 40:25
  It's because those early steps, you know, when you raise your hand as a patient to your PCP and say, "Hey, something is wrong with me," in many cases spells out a journey of acquisition of, you know, imaging studies and labs and fifty million other things that happen following that.
• 40:42
  The ability for us, because this is happening, the scene of the crime is now digital, happening on a digital platform, we have an open door to inject into that experience a lot of things like analytics, like best to...
• 40:57
  you know, next action, um, preferential formulary for the patient that makes it less, you know, more affordable for them to take certain medication versus others. There's a world of smarts
• 41:12
  that is associated with technology that springs into life when healthcare encounters happen o- over a digital platform. So this is a much bigger, you know, earthquake
• 41:28
  than, than people think at first. I, I, I love that. Maru, you wanna a- add anything to that?
• 41:35
  'Cause I wanna shift gears a little bit from the business to the back, the, the, the what happens backstage, um, with, with, uh, navigating, uh, the years, or in the case of Roy, you know, decade plus, uh, of building a company.
• 41:49
  But Maru, you wanna add anything to what Roy just articulated about the earthquake that- Yeah. I would just, um, I know we started with pr- uh, you know, primary care, which I think in and of itself is an earthquake.
• 42:00
  I think,
• 42:02
  you know, just the time, if you think about what's happening in primary care, everything Roy just said, if you think about, you know, the elephant in the room with, you know, Amazon, One Medical, I think that's a shot across the bow of the incumbents to invest in virtual first, invest in hybrid care in a real serious way.
• 42:16
  Mm-hmm. Because as Roy said, if you wanna move to a relationship from transactional, and you want to avoid...
• 42:22
  I mean, let's be real, urgent care was really a, a, a solution to a problem where you couldn't get an appointment in the incumbent, right?
• 42:30
  You couldn't get an appointment with a primary care physician at your health system or at a practice. And so it became a convenience, and it became a transactional. And-You know, the systems have, I think, have learned.
• 42:41
  And so the fact that, you know, big tech is getting into and, you know, this alternative shadow world is really an opportunity for the whole industry to move forward. So I think that's a big deal.
• 42:50
  And I think if I, it-- abstract what we're really doing, we're looking at time, place, and people, and we're saying, "How do we optimize all of those things?"
• 42:58
  In healthcare, time, place, and people, it's costing, you know, twenty percent of GDP, it's to Roy's point, people don't wanna be in the hospital. There's a lot of friction.
• 43:07
  There's a lot more conversation now on access and equity than there ever has been to the point where, you know, people are putting it on their, you know, their OKRs and health systems.
• 43:15
  People are being, uh, compensated and measured against those things. And we really have a platform that's helping those systems optimize time, place, and people for the benefit of driving outcomes for patients.
• 43:27
  And I just think that's a complete paradigm shift from where we were pre-COVID. I think that's- Yeah. You know, COVID was a panic. It was investment. It was deal with COVID.
• 43:35
  Then everything settled in, and it was we're losing fifty billion dollars a month in the health system side, uh, we need to do something about it, to now this notion that it's not, you know, putting Band-Aids on it, but it's a fundamental reimagination of how we're gonna deliver care in the future.
• 43:48
  So that's the point we're at now. Yeah. Yeah. I mean, I, I...
• 43:51
  We could spend hours talking about this, this topic, but, um, you, you talked about transactional to transformational in terms of how the healthcare experience ha- occur-- you know, r-really moves and maybe exponentially not only gets better, but, you know, and, and improves, but, but, but is transformed.
• 44:09
  I wanna use that same metaphor to talk a little bit about mindset. And Murray, you know this from being in startup health a, a, as a portfolio company and community member for so many years.
• 44:19
  The power of mindset is so impactful. It can attract, um, especially coming from a leader, it can attract investors and customers and partners and team members, but can al- it can also repel them, right?
• 44:31
  H-how important, um, is, is and was, uh, and continues to be mindset in getting up every day and enabling us to have that transformational experience you're talking about?
• 44:45
  I know we've talked about mission, we've talked about your business, but I, I, I, I can see it every day how, how, how pivotal mindset is and how it plays a role in everything that we do as entrepreneurs and everything we do as humans.
• 44:59
  But as entrepreneurs leading companies, it's the thing that matters most. You want me to go first? [laughs] Go ahead. I think it's, it is...
• 45:11
  I mean, it's not only critical, Steve, but I mean, obviously you're leading the witness, but I think it's, it is the, it's the most important thing, right? Because it, it, it's about people, as, as Roy said before.
• 45:20
  I mean, we could have the best technology, the best product, but all that's built by people as well. And, you know, as a, from the startup perspective, it's hard enough in any environment, right?
• 45:30
  Most startups fail, the odds are against you. Um, so mindset is critical. And then, you know, with COVID, it became, you know, exhausting on top of all the uncertainty and everything else.
• 45:40
  And so as a leader, to be able to show up, you can't have all the answers. You can't, y-y-you can't fake, you know, you're, you're in it with your, your team.
• 45:48
  And so, you know, sharing how you really feel, being vulnerable, um, crowdsourcing, you know, we're a team, the solutions. There's no one person that's gonna solve the problems.
• 45:58
  Recognizing that, uh, we're gonna have setbacks. How do you deal with setbacks and failures is way more important than successes.
• 46:04
  It's great to celebrate the successes, but, um, you know, what do you do when, when you get the punch in the face, which we got over and over and over again as a startup, and then compound that with, with COVID.
• 46:15
  So, you know, I... You always hear people say, "It's not a sprint, it's a marathon." I think you're in a different race at different times.
• 46:20
  Sometimes it is a sprint, sometimes it's a series of sprints, sometimes it's a marathon, sometimes it's a relay race.
• 46:25
  We-- and we have discussions about this with our teams throughout the whole, uh, life cycle of Conversa.
• 46:31
  When, when do we need to have which mindset to make sure that we're gonna be successful to be in the next race, right? It's always about getting to the next race. To Roy's point before, there's no end game.
• 46:42
  It's not like we're gonna get to a point and we're gonna be done, right? We get to a point, we might take a breath and look back and say, "Look how far we've come."
• 46:48
  And then we look up and we say, "We're at base camp," to use Roy's [chuckles] analogy that he uses all the time. "Wow, we made it to base camp. That's great.
• 46:54
  Let's celebrate, but we have a long way to go to get to the peak." And, uh, to your point about the horizon, you know, that peak or that horizon keeps moving. So I think mindset is absolutely critical because mindset
• 47:06
  is really, uh, the determinant of culture, right?
• 47:09
  And culture is all about how you're gonna motivate the team you have and attract, uh, continue to attract the best people so you can actually, uh, deliver on your, your mission.
• 47:20
  I just wanna add, because it's such a critical question, and thank you for asking it. The...
• 47:27
  When you get to the point that you have a product and you wanna sell it to customers and customer, large customers in healthcare, I think what eventually they sign up for is not your features and functions.
• 47:40
  They sign up for a partnership with you, and that is driven by your mindset, and that is driven by your honesty, and that is driven by your problem-solving. And it's good that you have a good product.
• 47:54
  It means that it's worked in the past and grew, but it is the mindset that they partner with. So, you know,
• 48:04
  more than anything, I think that that is the distinction between people that succeed in this industry and people that don't. So thank you for asking that question. No, I, I mean, I, I think I...
• 48:16
  It, it must be obvious that, um, mindset played a role in both of you filtering this tran-- this, the transaction, um, that, that was consummated a year ago to it being a transformational partnership.
• 48:28
  But really that, that, that framework of mindset playing such a big role is often mistaken for fluffy stuff that's kinda out there because people focus on the capabilities of the technologies.Um, from, from your standpoint, what do you do, uh...
• 48:44
  And I'm, I'm gonna ask Roy, 'cause I, I, I probably know the answer on Barry, but what do you do to kind of recalibrate your mindset, your mindset, when you're feeling it either slip or in the wrong zone?
• 48:58
  Who feels in the wrong zone ever? You. No. You. With your own, with your own mind. Look, we all, we all, we all love- We do...
• 49:04
  to believe that we're always in that transformational zone, we're always thinking that way, but when... By the way, this could be personal or professional. Some things happen in life and days, and- No question...
• 49:15
  certain days are harder than others. What are you doing to recalibrate your mindset? Listen to others. I mean, the, the...
• 49:22
  This is only gonna work when there are checks and balances, when people give you a mental or an, an intellectual kind of checkpoint where you see you've gone too far left or right, up or down in your mindset, in your emotions, in your aspiration, in whatever it is, in your innovation.
• 49:41
  Doesn't really matter. The contextualization of everything that you go through
• 49:47
  with the understanding of what's happening through the minds of the people around you is such a healthy grounding effect that it needs to become a regular part of what you do.
• 49:57
  The moment that you start thinking or [laughs] drinking your own Kool-Aid and going too much alone on any dimension of, of your life, I think you get disconnected, and I think that leads to a lot of bad places.
• 50:10
  So just talk to the people around you. Yeah. And surround yourself with the right people. Yeah. The, um... I, I wanna shift gears to, to brand because both,
• 50:22
  uh, uh, the original American Well and now Amwell was a brand at first just because it was the first and the most... You know, I remember, it was in Hawaii was your first, uh, place you launched.
• 50:32
  Like, I remember the promise of it, and American Well, you know, as a brand was cemented around telemedicine.
• 50:38
  When Conversa came on the s- uh, on the scene, I think the same thing happened around the conversational AI a- and that. But how important is brand from the very beginning as a role?
• 50:50
  Uh, you know, how, how big of a role did it play in fundraising, customer development, team recruitment?
• 50:56
  'Cause a lot of entrepreneurs think that comes with success, but for some reason, and I know with both of your organizations, 'cause you both had companies before that built brands, you recognized that from day one.
• 51:07
  But I wanna underscore that here, and if you could elaborate a little bit how important it was, is, and will be to the success of, of, of scaling what you've built and what you've done.
• 51:19
  I'll be very brief in saying that I think that the brand is the chassis on which you brid- you build credibility. And as people, people have to hone in the credibility and then pass it to others.
• 51:32
  They need to have a token by which they pass their respect to what you do or their appreciation of what you do, and that needs to be the, the, the purpose of the brand.
• 51:44
  By the way, whether it is to a buyer or whether it is to the end consumer. But the, the biggest deal is to build that credibility on top of the brand.
• 51:53
  It's not about the name that you find for yourself, it's about whether you position it so it becomes such a good container of that passage of credibility.
• 52:02
  Barry, I don't know if you could- Yeah, I was gonna say the same thing. I mean, I think brand is, is certainly not name.
• 52:09
  I, I think brand is trust, brand is credibility, and so from that perspective it's, it's extremely important.
• 52:14
  And, you know, for Conversa, you know, our brand, our credibility and our trust in the market was way bigger than the company. We grew into the brand. So I think it bec- it was very important in our, our success.
• 52:24
  I think Amwell, uh, would probably say the... Roy would probably say the same thing. I know right now a- as... You know, we went through a process around what do we do with the brands of Conversa and Silvercloud?
• 52:36
  They're powerful, they're strong, they have meaning, uh, convey trust and credibility in the minds of the customers that use them, and so we've, we have product brands that still carry those names.
• 52:46
  We wanna have one platform and one brand, uh, for the company.
• 52:50
  But even that brand, you know, Amwell is transitioning from, you know, re- recognized as direct to consumer as well as B2B to being much more of an infrastructure. It's a support.
• 53:00
  So the, what the brand now means is you can rely on this infrastructure to drive the future of hybrid care, whether you're a health system, or a payer, or a life science company, or an innovator that's providing services through the platform.
• 53:13
  So it, it conveys trust and credibility, but what it stands for and what it's signaling is, is constantly evolving.
• 53:21
  You know, it, it, it's, it's interesting 'cause I think, um, whether it was building a brand back in the mid-2000s or building a brand in, in, in the teens like Conversa, companies being born today or built today, especially in our sector and industry in, in, in so many ways, um, have different challenges.
• 53:39
  And, and, and I'd love to hear what you would tell the entrepreneurs, and I, I wanna pick two different groups of entrepreneurs.
• 53:46
  One group of entrepreneurs has been at it for a decade or more still trying to get the scale, the traction, the acceptance, and they have just enough to keep going but not enough to forgi- you know, to be fully, fully scaled.
• 53:59
  Um, and then the other group would be people starting today and what you would tell an entrepreneur building, uh, a, a digital health, a biotech, a life science company today in this industry that has some of the, some of the tailwinds of a post-COVID world, especially with digitization.
• 54:16
  So bo- bo- both, both audiences, and I'd, I'd love you to both to kinda gi- give us answers as we do the wrap-up today. Roy, you wanna start? Okay. Um, I was gonna ask you the same question. Uh [laughs]
• 54:33
  No, I would say, I, I would say this, you know, I think it's, you know, it's a hard world to be successful in healthcare. I don't think that it's harder today than it was 20 years ago or 50 years ago, 100 years ago.
• 54:44
  Just, you know, the, the, the currencies have changed.We come in today equipped with so much more knowledge than we did twenty years ago, and, and yet that means that also the other guy has, right?
• 54:56
  But I would say this, at least, at least, you know, an observation.
• 55:00
  I, I think that there are two very, very indisputable ways to make a representation of the value that you bring with your entrepreneurship, you know, venture. You can show up with numbers
• 55:15
  which prove that you have cured diabetes or [laughs] that you've done, you know, something wonderful, and if the numbers are correct and compelling, you win. It's that simple.
• 55:27
  Um, and that's how a lot of people in biosciences show that their product, their drug, their whatever, something is working really well, and that's fine. The other very side, the other extreme,
• 55:40
  is to come forward with a vision of an experience
• 55:45
  that may already exist, you've already developed, or you're developing in the future, that is indisputably, viscerally affecting the people that listen to you to say, "Yeah, I wanna live in a world that has that.
• 55:57
  That is how I would envision my, you know, aging days," or, or something like that. And
• 56:07
  if you agree on that emotionally and viscerally, then you can peel the onion on how you're gonna get there, and how much funding you're gonna need, and who you need to collaborate with, and all of that kind of stuff, but you start with that.
• 56:19
  In both cases, you're starting with, with something that people are not contesting. I think that there's a lot of people who are trying to go along the way in the middle who are saying,
• 56:33
  "I have something that will have these features and functions which will contribute, hopefully, towards a better future."
• 56:42
  And I think that is where you're gonna find a lot of people in the room who say, "Well, I don't agree with you.
• 56:46
  These other features would do that," or, or, "These features won't work," and that's where it gets challenging. Um, but that is just my observation.
• 56:54
  Uh, very consistent, by the way, with your comment about the experience- Yeah... you know, about a half hour ago with, with the transaction in urgent care versus the experience in- Yep...
• 57:05
  um, uh, the, the everything else but that transaction part of the, of, of, of the world. Murray? Yeah. I think I agree with everything Roy just said.
• 57:15
  I think what's changed in healthcare that makes it even more difficult is, um,
• 57:22
  the organ- the buying organizations, health systems, for example, and plans, have really gotten to the point where they, they're reducing the number of partners they wanna work with, right?
• 57:30
  I, I had a conversation not that long ago where someone said, "I can't even remember the names of the companies I'm talking to, let alone figure out how to partner with them," right?
• 57:37
  So they wanna move from that sixty to six vendor partners that I talked about.
• 57:41
  So if you're starting a company or you're running a company that's trying to scale, you know, I think the bedrock is to have a, a, a mission and values that are gonna serve you well regardless of the path that you need to take to get where you're going, but the days of having point solutions are over, and the challenge with that is you can't just build a platform, right?
• 57:59
  Because it needs to be purpose-built, so you need to start with the problem. I think it's, it's more imperative than ever to really start with a problem that's a real problem for somebody.
• 58:07
  Figure out who it's a problem for, and then, and it's pretty nuanced, but who... What are the other problems you need to solve to give you permission to solve that problem?
• 58:16
  So for example, if you're trying to, you know, help reduce readmissions, that's the problem.
• 58:22
  If you can define it and you can say, "I can build a solution that's better than others out there to do it," that's great, but then you have to solve the workflow problem.
• 58:28
  You have to serve, you know, solve the engagement problem. You have to get all those constituents in healthcare, the patient, the, the frontline provider, the, the organization that's paying for it.
• 58:38
  And as we all know, it's very complicated. So it's always been the case, but I think you gotta get there faster.
• 58:44
  You gotta define the problem, really high relief, build a purpose-built solution, and then put that under a broader, you know, set of, uh, mission, vision, values so that you can position it that it may be a point solution now, but it can fit into someone else's platform, or we can raise money to grow a platform.
• 59:01
  So I, I, I think it's a challenge.
• 59:02
  I think it's exciting because I think those that figure it out, they'll be even a, a, you know, a wider moat more quickly, but the, the bar has gone up considerably since COVID in healthcare.
• 59:13
  Well, I, I, uh, I, I could talk to you both for a long time and would love to. We'll continue this conversation every few months to kinda make sure that we keep un- un p- unpacking, uh, the gems.
• 59:24
  But, um, my biggest insight from, from this call comes from a comment you made, Murray, about the fact that you have, um, everybody on your team still that want...
• 59:34
  that you want to keep on your team, that you're still there, that you guys both talk about each other and each other's capabilities and each other's organizations.
• 59:43
  So, you know, s- so, uh, synchronized is, is a real testament to both of, of your leadership, uh, style, skills, a- and cultures that you've built in your organizations.
• 59:55
  But I think a real, a, a real, um, moment for other entrepreneurs to, to, to really see what is possible.
• 1:00:03
  'Cause there's so many stories about M&A and different transactions where the team leaves, by the way, coming from both sides.
• 1:00:10
  The big, you know, company doesn't do a good cultural integration, or the new company comes in like a bull in a china shop, but it's a beautiful story.
• 1:00:17
  I think the proof of what is to come is in the CBS partnership and this new dis- experience that you're creating to be more of a transformational experience for patients. I'd love to give each of you the last word.
• 1:00:29
  Murray, first you, then Roy, and then, um, hopefully have you back, have you, have you back maybe at the next festival to continue the conversation and dig into the next six months. But Murray, last word. Yeah.
• 1:00:40
  Well, uh, well, first, my last word would be thank you. It's been a pleasure, obviously, talking with you, and I love...
• 1:00:46
  Uh, Roy and I haven't spent, uh, this much time together in a, you know, in a while now, so we're, we're pretty busy. We haven't been able to coordinate. But no, it's been a pleasure.
• 1:00:53
  I think my last word would be, um, kind of about...
• 1:00:55
  I'm, I'm gonna try to-The last we'll end on where I think we're going as a company, but I think it's also instructive for where I think, uh, entrepreneurs in healthcare need to go.
• 1:01:05
  I think increasingly the notion of data, we're becoming more of a data company, um, analytics, but being able to do that in, in, in extending trust.
• 1:01:15
  When you're trying to help healthcare scale, how do you take this very intimate trusted relationship and through data and technology and continue to c- have it be evidence-based, but yet personalized?
• 1:01:25
  Those things are all intention, right? Trust is the intimate relationship, and now you're trying to do it through technology and scale, uh, you know, taking a lot of the activities that people perform out of it.
• 1:01:35
  Well, how do you do that and keep trust? How do you keep things evidence-based, which is reducing variability of care, while you're increasing variability of experience, which is what personalization is?
• 1:01:46
  Um, I think those are gonna be the, the next challenges, and those are gonna be the determinants of success for the, the new crop of entrepreneurs coming out in healthcare. Excellent. Thanks, Murray.
• 1:01:55
  And Roy, thank you also for answering all the questions in the chat in Q&A. I've- Thank you, Roy. Rarely do we have a guest that actually just does it. I don't even have to read them out.
• 1:02:03
  So thank you for answering everybody's questions in the Q&A. The last word is yours, my friend. I'll, I'll, I'll just say this.
• 1:02:09
  I think it's a, it's a privilege to be at a place where, I don't know, we've been doing this for fifteen years or close to twenty years now, and I feel like I'm sitting at the edge of my seat.
• 1:02:20
  And that is such a, such a privilege. It's driven by, by a lot of really amazing people that have joined part of this journey.
• 1:02:28
  Um, and it's driven by the fact that we're looking at a blue ocean in front of us in changing how people experience healthcare.
• 1:02:35
  I don't think there's been ever a time when so much transformation was just around the corner.
• 1:02:41
  Um, and I just wanna thank everybody that's partnering it and a lot of people that joined listening here that are going to be the leaders of the revolution, you know, going forward in a couple of years. Excellent.
• 1:02:52
  Well, thank, thank, thank you both for the front seat journey, uh, to Conversa, now Amwell. Uh, it's great to, it's great to watch and hear and see, um, what great execution looks like, uh, up close.
• 1:03:04
  But congrats on all the success and look forward to having you back soon. Thanks, Roy. Thanks, Murray. Thanks, Steve. [outro music] Thanks for listening to Startup Health Now.
• 1:03:14
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• 1:03:21
  If you wanna learn how you can join this community of entrepreneurs, or if you wanna connect with one of our four hundred companies, go to startuphealth.com.
• 1:03:28
  If you'd like to learn how you can invest in our Health Moonshot Impact Fund, go to healthmoonshots.com. Thanks for listening to Startup Health Now. We'll be back again with another episode next week. [outro music]