Latest / Becker’s Healthcare Digital Health + Health IT / Tom Andriola, Vice Chancellor of Information, Technology, and Data & Chief Digital Officer at UC Irvine

Transcript

Tom Andriola, Vice Chancellor of Information, Technology, and Data & Chief Digital Officer at UC Irvine · Becker’s Healthcare Digital Health + Health IT

• 0:00
  - This is Laura Dedo with the Becker's Healthcare Podcast.
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  I'm thrilled today to be joined by Tom Ola, vice Chancellor
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  of Information Technology
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  and Data, as well as Chief Digital Officer for uc, Irvine.
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  Tom, it's a pleasure to have you on the podcast today,
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  - Laura.
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  It's wonderful to be back on the podcast. Thank you.
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  - Absolutely. You know, and I'm always fascinated
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  by our conversations, you know, we,
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  we really dig into some media and interesting topics,
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  and so I'm excited to do the same today as well.
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  And first off, you know, I was wondering,
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  how did you become interested in health tech
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  for keeping people healthy?
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  Is there a personal story here,
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  or how does that connect to your career?
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  - Yeah, there, there is a personal story, and,
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  and exactly as you said,
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  it connects, it connects to my career.
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  It's like an intersection of your personal life
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  and your professional life in a way
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  that I wouldn't have anticipated.
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  Uh, so, you know, as, as you know,
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  I've been in the healthcare industry
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  most of my professional career.
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  You know, I've been involved in
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  how technology has impacted healthcare.
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  You know, over a couple of decades, uh, you know,
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  when software became, uh, a very important part of the way
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  that healthcare organizations work
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  and patient care works, how the data from, you know,
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  that's generated through technology
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  and software became the value proposition.
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  I always say it's like the MRI is tech,
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  but the image is data
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  and the diagnosis comes from the data, right?
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  So the data value proposition started
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  to become a much more important thing
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  for anyone in the healthcare ecosystem.
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  And then it's been about big data and multimodal data,
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  and now we're talking about AI all the time.
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  So, yeah, so I've been a part of that.
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  But, you know, as, as we as, uh, you know, my, my colleague,
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  uh, Jeff Margoles always says, when it comes
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  to the health system, you are sometimes a patient,
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  but you're also a consumer.
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  And that's no different for me, right?
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  So, you know, as I was getting older
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  and I started seeing changes in my health situation,
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  you know, I started to take more of an interest,
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  like from a professional perspective.
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  I know how this goes for patients,
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  and I started to see some of those changes in my own life.
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  And so, you know, trying to be an empowered health consumer,
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  I started taking more active interest, uh, in, you know,
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  I knew what the right decisions were, most of us do,
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  but how do I know that I'm making the right decisions?
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  And of course, since I'm a data person, how am I using data
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  to inform my health decisions that I'm making going forward?
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  And so that, you know, created this kind of educate myself,
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  how do I find the evidence, you know, to know the things
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  that I'm doing or working.
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  It led me to understand the difference
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  between really the sick care market
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  and the healthcare market
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  and concepts like the difference between lifespan
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  and healthspan, right?
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  So this journey, uh, of really going, uh,
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  deeper into understanding and to be very, very data driven
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  and asking questions like, well, how valuable is it
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  for my one annual visit
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  to see my primary care physician versus data
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  that I might collect on myself every day
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  and have 365 days worth of, of data
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  and trends to understand what's going on around am I
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  the healthiest person that I could be?
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  Do I own this data or is the health
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  system, uh, own this data?
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  Can I take that data and give it to another doctor
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  or to a research team?
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  And so that led me to do kind
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  of novel things like wave my HIPAA rights so I could
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  actually port my data more freely
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  and give it to whoever I wanted to.
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  And for example, research teams
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  around the country have my data sets
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  and are doing things with them.
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  I started participating in clinical trials,
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  but saying, look, I'll participate if you'll give the data
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  you collect on me back into me for my kind
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  of personal health data store.
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  And so, you know, kind
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  of what's happened over time is I've kind
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  of become this empowered health consumer.
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  And, you know, that's kind of a new thing in our society
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  through people who've bought
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  wearables and those types of things.
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  Uh, my wife thinks I take it a little bit
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  farther than normal, right?
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  Because, you know, it's the aura ring, it's the smart scale,
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  it's the blood blood pressure cuff, it's the nutrition app.
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  And so I've got about a hundred data points
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  every day about my health situations I've been collecting
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  for a number of years now
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  that really have informed my health journey in a very,
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  very data-driven way that I can talk about,
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  but I also can share with others
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  and give them kind of perspectives of what happened,
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  how do I know, um, in ways
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  that people find very interesting.
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  - That is definitely fascinating to hear.
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  And certainly, you know, what a,
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  a great opportunity you have to, um, collect all that data
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  and that information and,
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  and really see how it works together to, um,
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  build the picture of your health
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  and inform your decision making going forwards.
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  So, you know, in thinking about everything
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  that you take a look at every day and are measure
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  and tracking, what are some of the specific trends
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  that you're keeping your eye on right now and, and tracking?
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  - Yeah, so there's having data and then there's using data
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  and, and using data means, you know,
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  am I making more informed decisions?
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  And, you know, I'm a big fan of, uh, Peter Atia, you know,
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  and, and you know, he recently put out a book talking about
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  was book was called Outlive,
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  and it's the Science and Art of Longevity.
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  I, I was really a big fan of that book when it came out,
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  you know, and he talks about the four horsemen and,
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  and the horsemen are the four disease categories
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  that usually kind of take away our health span, you know,
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  uh, metabolic disease, cardiovascular disease, you know, uh,
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  cancer and now neurodegenerative disease,
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  you know, in that category.
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  And so I really try to, you know,
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  think about it from a risk management perspective in terms
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  of, am I doing the things?
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  Am I, the things that I'm tracking are kind of tied
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  to keeping those things out, right?
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  So food and nutrition, really making sure
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  that from a metabolic health perspective, uh,
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  I've got a pretty good view on what's going on.
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  Cardiovascular, kind of, you know,
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  exercise and those types of things.
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  Neurogenerative disease, sleep, sleep is
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  so important from the standpoint
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  of giving your body a chance to clear out all those,
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  you know, all those bad substances that are floating around
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  and especially in the brain.
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  And so, you know, I use kind of, you know, kind of these,
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  these models, again, evidence-based models that
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  that medical professionals come out.
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  And I say, how can I incorporate that into way
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  that I'm managing my personal health situation?
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  And then how do I, can I collect data
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  and look at that data over time to tell me, you know,
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  are, are things changing?
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  Right? Are things changing? 'cause as we, as we age,
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  we start to see changes,
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  but we can be surprised by them if we're not actually kind
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  of monitoring them.
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  And that's kind of how, you know, I've started then using,
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  um, you know, kinda using the data myself
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  and then also trying to use the, the, the medical, uh,
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  profession to help inform my choices
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  or the way that I think about problems.
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  I, I, one of the jokes I like to tell people,
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  I just like give people like, well, gimme an example Tom.
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  It's like, well, you know, I am one
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  of those annoying patients, you know,
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  who might be sitting with their doctor.
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  And the doctor says like, well, you know, you know,
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  you should really worry about heart disease.
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  It's like, how much red meat do you eat?
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  You know, and the average patient will say it's like, oh,
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  I don't know, maybe, you know, four or five times a month.
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  And it's based on kind of, you know,
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  recalling into your brain and thinking about it.
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  You know, I'm the annoying patient
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  who, who will say something.
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  It's like, well, um, over the last two years, you know,
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  I've averaged, you know,
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  2.4 times per month eating red meat on an average
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  of about three ounces per sitting.
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  You know? And I'm like, I've got the data
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  to back that number up.
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  Right. You know, and it's kind of funny
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  because for some people it's like way over the top.
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  But for me it's just about being informed, uh,
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  to make the best decisions that are right for me.
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  - Well, that's fascinating.
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  And, you know, truly, truly amazing that you can collect
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  that information, as you said, have the data to back that up
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  and really, um, be precise about what you're doing
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  and what you're, um, you know, talking through
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  with your clinicians, Laura,
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  - On per, you know, that, that kind of precise, you know,
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  sometimes people say it's like, Tom,
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  I could never be that disciplined .
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  And I, and I, and I said, well, what if I told you
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  that you could kind of, you know, to the 90% level,
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  track your day, track what you eat for Nutri.
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  I I don't track food or calories.
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  I, I I track for nutrition achievement.
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  I'm like, what if I said you could do that in five
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  to seven minutes per day?
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  Does that sound like an overly
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  disciplined thing to ask of you?
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  And people are like, no, that doesn't sound bad at all.
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  I'm like, well, that's really all it takes, right?
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  It's little, it's little things.
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  It's not, you know, we're not talking about something
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  that is gonna change your entire lifestyle to be able to do.
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  And I think that's the balance I've found, is it's
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  so incorporated in that it's almost happening just as part
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  of life rather than it looks like I'm doing something overly
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  disciplined that's not sustainable.
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  - Absolutely. That makes a ton of sense.
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  You know, and certainly, um, is easy
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  to devote just a few minutes a day to really, um,
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  becoming more conscientious about how, uh,
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  we're treating our bodies, what we're putting in, and,
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  and how we really are looking at our health.
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  And, you know, I, I understand that you're also working
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  with some companies, um, along these lines.
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  What are the companies that you're working with
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  and how are they leaning into the consumer wellness market?
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  - Yeah, certainly this market has gotten huge, right?
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  Certainly the wearable movement
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  and, you know, apple Watch and Fitbits.
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  And so, you know, there are, there are millions
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  of people now walking around with these, and, and,
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  and some of those, you know,
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  some of those things I work with.
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  The other thing I'll say about kind of this space is not
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  that I'm in this category, right?
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  But if you had the money and you bought a Lamborghini,
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  then all of a sudden you kind of find the other people
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  who also own Lamborghinis,
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  and you find these things in common.
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  And so, you know, you find individuals who are kind
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  of into this space.
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  Um, you know, people like Larry Smar who used
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  to be a professor at uc, San Diego, who might be the most,
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  you know, the most measured, you know, individual in terms
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  of some of the data that he has around himself.
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  Uh, I think of Mike Snyder, who's at Stanford, you know,
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  who's done research on this,
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  but is also kind of a personal, uh, you know,
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  personal health and personal measurement person.
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  But some of the companies that, you know, worked with,
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  you know, kind of beyond kind of the device companies.
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  Um, and, you know, thinking about Apple,
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  and you've got the Apple, apple Health app is,
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  you know, this is a great one.
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  It's called Measured Wellness.
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  And it's a very, very early stage company.
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  But think of it as, you know, um, a,
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  a data science consultation around your data in the same way
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  that your medical image is sent to a radiologist
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  for a read and a report.
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  So think about your wearable data going to a specialist,
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  a combination of medical profession
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  and data scientist, uh, service that basically says,
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  well, you know, you know, looking at your data over time,
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  your cardiovascular patient,
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  'cause they might be working with the patient directly
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  or they might be working with the primary care physician
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  who ordered the quote unquote consultation.
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  It's like, you know, here's some things
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  that we see in their data
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  that might be valuable when you kind of sit down with them
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  and help them manage their cardiovascular state.
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  Um, also, you know, uh, the, the doctors
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  that measure wellness also work directly
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  with patients in a primary care fashion
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  and use that data as a conversation piece
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  to change the nature of the doctor patient discussion.
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  'cause you're now just not just talking about generalities
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  or what do you recall, but you're saying, look, we,
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  you know, we've been looking at your data over the last six
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  months, you know, there are things going on in your life.
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  'cause your, your, your quote unquote, your stress levels
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  and your resiliency factors look
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  to have changed over the last six months.
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  Is there something that we should talk about?
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  And so, measured Wellness is one of those companies.
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  Um, uh, there's a company called Engage Three I work
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  with in, in a new initiative.
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  It's kind of a spinoff of their core business, uh, working
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  with retailers called Project Health,
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  where they've had a very successful business working
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  with retailers, really driving price optimization
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  to help retailers to price their products,
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  to optimize the balance between price, margin, and volume.
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  Right? Because, you know, when you're a retailer like a
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  grocer, it's all about volume of, of churn
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  and how much revenue you get for a shelf space.
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  But now they're saying, look, we could take this model,
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  we could apply it to help people make better food choices.
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  And if you think about what, you know, the Walmarts
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  of the world and the CVSs of the world are doing in terms
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  of, you know, generating a a, a place
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  where the health consumer is gonna interact, you know,
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  and that concept of you, you know, prime, uh,
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  Walmart's become your primary care physician
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  and they might write your prescription,
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  but they also might be able to point you towards food
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  that's in that store
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  that quote unquote might be the equivalent healthy decisions
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  to manage, let's say high blood pressure.
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  This type of optimization engine could become very valuable
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  to quote unquote manage the, the incentives associated
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  with getting, um, patients to make better decisions
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  for themselves through food,
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  which they're gonna go by anyway.
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  Um, and then I've got a couple of research teams that,
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  you know, are working on things
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  that might become spin out opportunities, uh, you know,
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  in things like personal health navigators
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  that really look at personalization and proactive care
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  and pulling your data together, allowing you
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  to put multimodal data together, right?
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  Because it's, you know, you've got waveforms,
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  you've got alphanumeric data,
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  you might have medical imaging, uh, lab test results.
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  And so, you know, how do you start to get that data together
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  and find insights across different data types
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  through different types of, uh, AI techniques?
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  And then, you know, this company's also, these,
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  this team is also now pivoting with kind
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  of generative AI tools
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  and the concept of health agents, right?
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  So you may have read some things recently about people
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  talking about, you know, generative AI
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  and evolving to agents, so, you know, not just
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  generating content,
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  but actually helping in decision making,
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  task completion and those types of things.
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  And so, uh, uh, open CHA, uh, which stands
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  for Conversational Health Agents is a personalized l large
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  language model, um, age, uh, agent platform
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  where it's not just how you're having a conversation
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  with you about your data and the right decisions,
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  but it's also looking to connect you to the right resources.
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  And, you know, today as an example,
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  I look at my nutrition achievement maybe
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  before I go to dinner, and it might inform what I plan
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  to eat if I'm, my wife and I are eating out that night,
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  but what if the agent were to actually be,
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  here are the best places for you
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  to eat given the nutritional achievement
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  that you still haven't gotten today.
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  And so it's kind of, you know, given me the recommendation
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  and someday might even make that, you know, if I click yes,
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  makes that, uh, you know, that reservation for us.
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  So, you know, there's lots of things in this new world
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  that's gonna be powered through ai.
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  It's not just gonna be about analyzing data,
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  but it's gonna be about connecting what comes out of that,
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  those insights and helping you take the next step
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  or get to the right step.
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  And so these companies I think are very exciting.
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  They're very early stage,
• 14:46
  but I think these are the types of companies
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  that you're gonna read about, you know,
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  1, 2, 3 years from now that are going to impact the,
• 14:54
  the healthcare, uh, um, the healthcare space.
• 15:01
  - Well, that's great to hear
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  and just fascinating to see
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  how quickly these things are evolving in, you know, uh,
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  just really as you were talking through the different ways
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  that AI is playing a part in this, the different, um,
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  opportunities to really connect people
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  with the right resources
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  and, um, develop a deeper understanding
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  is, is really so cool.
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  Where do you see some of the big opportunities
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  for physicians and health systems to use this data
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  for more targeted wellness plans as well? Yeah,
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  - I, I, I think this movement, uh,
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  really provides an opportunity,
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  and I've learned this from, uh, Dr.
• 15:34
  Mike car, uh, Carrizo, who, you know, who's the CEO
• 15:37
  and really founder of, of measured wellness.
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  It provides this opportunity to really change the nature
• 15:42
  of the conversation between the patient and, and the,
• 15:45
  and the medical professional.
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  Let, let, let's, in this case,
• 15:47
  let's just call it the doctor, your primary
• 15:49
  care physician, right?
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  Because, uh, instead of this kind of searching to try
• 15:53
  to find the right question, find the right answer,
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  you're now talking, you're looking at an evidence based
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  through data, and you can actually target the conversations
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  and have a different type of conversation.
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  You know, I've always said,
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  or at least I've been on this journey, you know, I,
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  I've started to think about, it's like, you know, um,
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  I have a, um, a financial person who I talk
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  through my long-term financial goals for have
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  for my adult life, whether it's what, you know, they have
• 16:18
  for my family to send my kids to college,
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  why isn't my primary care physician
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  interaction similar to that?
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  I want to be a healthy person.
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  I wanna live into my later years
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  and to be able to do the things that I wanna do
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  to climb a flight of stairs, to be able
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  to go on a five mile hike to run around
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  with my grandkids someday, right?
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  Why is my conversation about not about what are the things
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  that I need to do?
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  Why is it not a consultation rather than this kind
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  of just kind of back
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  and forth where I don't really feel a lot
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  of value other than it's been a touch point
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  that happens once a year.
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  Why can't it be a different conversation?
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  Why can't it be an ongoing conversation
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  where technology is touching base
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  with me on a very regular basis,
• 17:01
  nudging me in the right direction?
• 17:02
  And then, you know, the, the, the conversation
• 17:06
  that we have once a year is a much more informed
• 17:08
  conversation about, I can see the decisions
• 17:10
  that you're making for the other 6,364 days of your life,
• 17:15
  and I think you need to really think about
• 17:16
  some additional changes here.
• 17:18
  You gotta get up from that chair
• 17:19
  and out from that computer more.
• 17:21
  Why don't you take more zoom calls via walks, right?
• 17:24
  Why are we not talking about those things through data?
• 17:27
  And so I think the doctor patient, um,
• 17:29
  conversation has an opportunity to really deepen a change
• 17:34
  and deepen, uh, through what we see coming
• 17:36
  through technology and data.
• 17:40
  - That definitely makes a lot of sense, you know,
• 17:42
  and certainly is a reality that you can imagine in terms
• 17:45
  of having those, um, really intelligent conversations,
• 17:48
  data-driven, um, talking points and,
• 17:51
  and really action items that you can take back.
• 17:53
  And patients really are able to then be empowered
• 17:56
  to stay healthy and live healthier lives.
• 17:59
  How do you see this work evolving over the next
• 18:01
  two to three years or so?
• 18:02
  - Yeah, I, I, I think like we're seeing in a lot
• 18:05
  of ways in our society right now through this, you know,
• 18:09
  phenomenon of ai, I think it's gonna move very fast, right?
• 18:13
  I mean, I think we're gonna see new types of services
• 18:16
  and touch points become available to us, uh, you know,
• 18:21
  at rapid paces, uh,
• 18:22
  faster than we bought, probably able to consume it.
• 18:25
  Um, you know, one of the, you know, one
• 18:27
  of my mentors once taught me it's like, look,
• 18:29
  the future's already here.
• 18:30
  It's just unevenly distributed.
• 18:32
  He used to say, and I think that's exactly
• 18:34
  what we're seeing now, is that, you know,
• 18:36
  these advances are happening very fast.
• 18:37
  They're becoming available certain, you know, uh,
• 18:41
  certain people who, you know, you know, who can,
• 18:44
  like myself, I get a chance to kind of follow the space.
• 18:46
  So I see things earlier than let's say the, you know, the,
• 18:49
  you know, the large population does.
• 18:51
  So I think we're gonna see these things, um,
• 18:54
  come about very fast.
• 18:55
  I think the adoption of them
• 18:56
  and then the equity around the adoption of them is the thing
• 18:59
  that we really need to come back
• 19:00
  and think, uh, think, uh, um, broadly about,
• 19:04
  because, you know, these things also are advances
• 19:08
  and they, they benefit people,
• 19:09
  but if they benefit only small parts of the population,
• 19:13
  or let's say, um, pa parts of the population who, um,
• 19:17
  who are more privileged, it doesn't
• 19:20
  address the larger challenges that we have
• 19:23
  as a society, right?
• 19:24
  So I think we're gonna see fast evolution.
• 19:27
  I think the focus point needs to, how do we bring this to
• 19:30
  large percentages of our population,
• 19:33
  or as is becoming more popular, how do we bring AI to all
• 19:37
  and not just a select few?
• 19:38
  So that's my hope for the next two to three years.
• 19:43
  - That's amazing to hear.
• 19:44
  And, and certainly, you know, so important to keep those,
• 19:47
  uh, gaps in mind.
• 19:48
  Tom, thank you so much for joining us on the podcast today.
• 19:51
  This has been a fascinating discussion.
• 19:53
  It really, you know, cutting edge things
• 19:54
  that we're talking about today that are a reality
• 19:57
  and continue, will continue to grow and develop and evolve.
• 20:00
  I appreciate your time here
• 20:01
  and look forward to connecting with you again very soon,
• 20:04
  - Laura.
• 20:05
  Thanks for having me.