Is the Boom of Digital Health Really Booming?

Announcer

Rethinking Healthcare takes more than disruption. It takes more than thought leaders. It takes change makers and doers. That's who we'll be speaking to on the Healthcare Rethink podcast, giving you, our dedicated listeners a rich body of insights to make your own change. This is the Healthcare Rethink podcast.

Brian Urban:

[00:00:30]

Yes, this is the Healthcare Rethink podcast. I'm your host, Brian Urban, and today we're so thankful to be having a futurist and also a chief medical officer on our show here today, Dr. Jessica Schlicher, the Chief Medical Officer in Digital Health Virtual Care at Providence. Thank you for joining our show here today.

Dr. Jessica Schlicher:

Thank you so much, Brian. Super happy to be here.

Brian Urban:

[00:01:00]

This is going to be a lot of fun. We've already had a small adventure coming into our recording, so maybe some of those challenges are out of the way and we're into it now. With every episode, Dr. Schlicher, we love to have our guests share a little bit about who they are and how they've come to be. You obviously didn't wake up and become chief medical officer of Providence. You had a journey, and I think a lot of modern chief medical officers have a very tech futuristic journey toward the end of their practicing and into their new maybe executive roles, but I don't want to assume things. So take us through your journey. How did you come to be chief medical officer in our modern times?

[00:01:30]

Dr. Jessica Schlicher:

[00:02:00]

Well, mostly a lot of really good luck, but I can tell you the story. I'm a family physician. I love caring for patients. I like to start with where my heart really is, and that is in making sure that we care for absolutely everyone in our communities. I started in urgent care for about 10 years, and then I had the great fortune to be leading a clinic that was for the folks in our community who are most in need, folks who are likely to end up in the hospital over and over, and I loved that work, and then ended up realizing that I needed a whole new skill set. I needed to understand the business of medicine if I was going to really advocate for my patients.

[00:02:30]

[00:03:00]

So I went and got my MBA, ended up being the medical director over a virtual hospital, and then over a command center doing hospital operations during COVID, which was an incredible blessing to work with that team. And then ended up doing some work with Providence and getting to become their chief medical officer, as well as the head of content for MedPearl, which is a very exciting clinical decision support engine that I ended up getting to be involved with as well. I have an incredible team of 14 medical directors, and my main job is to grow and promote and help them to do what they do best, which is the direct patient care that we provide across eight states on any given day, including today.

Brian Urban:

[00:03:30]

[00:04:00]

You have a big footprint that you cover, thousands of people that deliver healthcare and a lot of different service needs related to health. And it's fascinating that you commented on having to learn the business side of health. I think that's very specific to the United States, as it is to the rest of the world. And it's fascinating because you touched so many different components of healthcare delivery. So it makes sense that you still have a strong tie to virtual care as well. So a lot of trends happening in terms of digital virtual care, a lot of point solutions, a lot of throughput solutions, in-home technology, aging well in place, mobile care, of course, TeleMed now a staple. What are you seeing in terms of trends that are sticking really well with the lives you serve, and that maybe you're starting to investigate what the next innovation could be at Providence? I'm curious of what you're seeing these days.

Dr. Jessica Schlicher:

[00:04:30]

The most important care for patients is to make a human connection with every single patient we serve, and virtual care, TeleMedicine, it's all just care. So it's getting the care to every patient who needs it, whether they're in Kodiak, Alaska or in Los Angeles, and making it possible for everyone to get the same high-quality, excellent care. So that's what we do at Providence Virtual Care and Digital Health. We have one of the largest virtual care footprints in the country today. We'll provide stroke services at 93 hospitals. We'll provide psychiatry at 43. We have 14 service lines that serve all across the care continuum, and really it's just care. Care is done person-to-person, human-to-human, and we just use tools to deliver that.

[00:05:00]

[00:05:30]

We have some automation tools. We're working a lot with pushing the edge of what AI is capable of and all of that. But it comes down to the very first thing that I read in medical school, which is the most powerful thing for predicting whether a patient will feel better a month after they first come to the doctor, is whether they feel the doctor actually listened to what they had to say. Though, all of our services do that, and MedPearl is about allowing the clinical decision-making to be easier so that I can spend more time looking you in the eye and understanding what you're actually going through.

Brian Urban:

Wow, that right there, I don't know if we can beat that in the rest of our conversation today, Jessica.

Dr. Jessica Schlicher:

I'll try. I'll try.

Brian Urban:

[00:06:00]

[00:06:30]

[00:07:00]

That is fascinating because I think in a lot of the healthcare ecosystem, we've lost our way. We've really gone so tech-heavy and so virtual care-heavy that we forget about the interpersonal relationship that must exist through simply having eye contact and hearing someone and addressing their needs. And you talked about that in terms of addressing the needs of those that have the highest social health challenges in life. And if we can start to meet their needs, we can really start to right size healthcare and gain good traction into what innovation could be for the next leap in our healthcare society. You've taken a lot of really cool leaps and I think probably a lot of your work will start to wrap more around AI or AI enabled technologies or services. You mentioned MedPearl, great plug for MedPearl. Another Pearl that we're probably both familiar with, Dr. Robert Pearl came out with a book called, ChatGPT, MD. So a lot of AI floating in our universe these days in the healthcare. How do you see AI starting to, in the near term, impact the patient provider relationship?

Announcer:

Rethinking Healthcare takes more than disruption. It takes more than thought leaders. It takes change makers and doers. That's who we'll be speaking to on the Healthcare Rethink podcast, giving you, our dedicated listeners a rich body of insights to make your own change. This is the Healthcare Rethink podcast.

Brian Urban:

[00:00:30]

Yes, this is the Healthcare Rethink podcast. I'm your host, Brian Urban, and today we're so thankful to be having a futurist and also a chief medical officer on our show here today, Dr. Jessica Schlicher, the Chief Medical Officer in Digital Health Virtual Care at Providence. Thank you for joining our show here today.

Dr. Jessica Schlicher:

Thank you so much, Brian. Super happy to be here.

Brian Urban:

[00:01:00]

This is going to be a lot of fun. We've already had a small adventure coming into our recording, so maybe some of those challenges are out of the way and we're into it now. With every episode, Dr. Schlicher, we love to have our guests share a little bit about who they are and how they've come to be. You obviously didn't wake up and become chief medical officer of Providence. You had a journey, and I think a lot of modern chief medical officers have a very tech futuristic journey toward the end of their practicing and into their new maybe executive roles, but I don't want to assume things. So take us through your journey. How did you come to be chief medical officer in our modern times?

[00:01:30]

Dr. Jessica Schlicher:

[00:02:00]

Well, mostly a lot of really good luck, but I can tell you the story. I'm a family physician. I love caring for patients. I like to start with where my heart really is, and that is in making sure that we care for absolutely everyone in our communities. I started in urgent care for about 10 years, and then I had the great fortune to be leading a clinic that was for the folks in our community who are most in need, folks who are likely to end up in the hospital over and over, and I loved that work, and then ended up realizing that I needed a whole new skill set. I needed to understand the business of medicine if I was going to really advocate for my patients.

[00:02:30]

[00:03:00]

So I went and got my MBA, ended up being the medical director over a virtual hospital, and then over a command center doing hospital operations during COVID, which was an incredible blessing to work with that team. And then ended up doing some work with Providence and getting to become their chief medical officer, as well as the head of content for MedPearl, which is a very exciting clinical decision support engine that I ended up getting to be involved with as well. I have an incredible team of 14 medical directors, and my main job is to grow and promote and help them to do what they do best, which is the direct patient care that we provide across eight states on any given day, including today.

Brian Urban:

[00:03:30]

[00:04:00]

You have a big footprint that you cover, thousands of people that deliver healthcare and a lot of different service needs related to health. And it's fascinating that you commented on having to learn the business side of health. I think that's very specific to the United States, as it is to the rest of the world. And it's fascinating because you touched so many different components of healthcare delivery. So it makes sense that you still have a strong tie to virtual care as well. So a lot of trends happening in terms of digital virtual care, a lot of point solutions, a lot of throughput solutions, in-home technology, aging well in place, mobile care, of course, TeleMed now a staple. What are you seeing in terms of trends that are sticking really well with the lives you serve, and that maybe you're starting to investigate what the next innovation could be at Providence? I'm curious of what you're seeing these days.

Dr. Jessica Schlicher:

[00:04:30]

The most important care for patients is to make a human connection with every single patient we serve, and virtual care, TeleMedicine, it's all just care. So it's getting the care to every patient who needs it, whether they're in Kodiak, Alaska or in Los Angeles, and making it possible for everyone to get the same high-quality, excellent care. So that's what we do at Providence Virtual Care and Digital Health. We have one of the largest virtual care footprints in the country today. We'll provide stroke services at 93 hospitals. We'll provide psychiatry at 43. We have 14 service lines that serve all across the care continuum, and really it's just care. Care is done person-to-person, human-to-human, and we just use tools to deliver that.

[00:05:00]

[00:05:30]

We have some automation tools. We're working a lot with pushing the edge of what AI is capable of and all of that. But it comes down to the very first thing that I read in medical school, which is the most powerful thing for predicting whether a patient will feel better a month after they first come to the doctor, is whether they feel the doctor actually listened to what they had to say. Though, all of our services do that, and MedPearl is about allowing the clinical decision-making to be easier so that I can spend more time looking you in the eye and understanding what you're actually going through.

Brian Urban:

Wow, that right there, I don't know if we can beat that in the rest of our conversation today, Jessica.

Dr. Jessica Schlicher:

I'll try. I'll try.

Brian Urban:

[00:06:00]

[00:06:30]

[00:07:00]

That is fascinating because I think in a lot of the healthcare ecosystem, we've lost our way. We've really gone so tech-heavy and so virtual care-heavy that we forget about the interpersonal relationship that must exist through simply having eye contact and hearing someone and addressing their needs. And you talked about that in terms of addressing the needs of those that have the highest social health challenges in life. And if we can start to meet their needs, we can really start to right size healthcare and gain good traction into what innovation could be for the next leap in our healthcare society. You've taken a lot of really cool leaps and I think probably a lot of your work will start to wrap more around AI or AI enabled technologies or services. You mentioned MedPearl, great plug for MedPearl. Another Pearl that we're probably both familiar with, Dr. Robert Pearl came out with a book called, ChatGPT, MD. So a lot of AI floating in our universe these days in the healthcare. How do you see AI starting to, in the near term, impact the patient provider relationship?

Dr. Jessica Schlicher:

[00:07:30]

[00:08:00]

I play with AI every day. I'm a huge enthusiast. At this point, it's kind of like a more curated internet search, a faster internet search. There are some tools I really like that help me find clinical studies that I might've otherwise missed. That's really cool. For administrative tasks, it works really well. The thing is, for acute undifferentiated suffering, that's what patients have when they come to see us, right? An unknown reason for something that's impacting their life. The AI can't do that yet. It might be able to do it someday, and I hope so, because I think that would lead to great democratization. At this moment, the AI can tell me, what's the management of an inflamed gallbladder? It can do that.

[00:08:30]

But if I say, "What's the best way to treat this patient's menopausal symptoms, confounded by depression when she's had chronic pain and a history of cancer?" And also, she's a human, so there's some things that she is interested in and not interested in, and AI can't deeply understand your patient, right? That's why we go to 12 years of training. And what MedPearl is cool for, is we've actually algorithmatized the way that physicians actually think is the best one.

Brian Urban:

Interesting.

Dr. Jessica Schlicher:

And then put it with the medical evidence and presented that at the point of care. It's really cool. But I'm going to let you ask your next question because otherwise we'll never get through them because I get too excited about it.

Brian Urban:

[00:09:00]

[00:09:30]

Well, my next question kind of wraps around that. You're talking about clinical decision-making, and I think knowing more about what's happening in a person's life, let alone clinical needs, is extremely important and fits together. So talking about MedPearl and how that can help alter or maybe right fit the next best decision a physician can make for a patient, for a life that they're serving. What do you see the role in non-clinical data being in the future of healthcare? And we're talking everything from socioeconomic data to behavioral data, purchasing behaviors, where someone lives, assets they own, jobs they've lost, jobs they just got, arrests, criminal activities, all kinds of stuff. Do you see that stuff being meaningful for physicians, or just being maybe more noise in the short-term?

Dr. Jessica Schlicher:

[00:10:00]

[00:10:30]

Boy, I would be really careful about some of that, Brian, honestly, because the thing that creates healing is trust and an expression of care. And I would want the patient to know and to consent to the sharing of that information with the provider. I actually think it's really important to walk into a room and say to that human being, "What is most important for me to understand about what you're going through?" And then stop talking. Our problem with decision-making is really not about a lack of data. Our problem with decision-making is a lack of listening. I saw a patient who was living in a halfway house, struggling with addiction, had just gotten out of jail, and when I walk into that room, that room is filled with shame. My job is to express care so that he can tell me what's really going on.

[00:11:00]

[00:11:30]

Doesn't matter. I could have all the data in the world, but if I don't make a human connection with him, what's the chance that he's going to really listen to anything I have to say? So I guess I would say that technology can allow us to have more time for making a profound human connection, but I don't think we're going to algorithmatize our way out of these problems. I think care is person-to-person. With that particular patient, he couldn't figure out why he was so anxious, and we talked and talked and talked, and finally it turned out that when he was incarcerated, he was able to exercise and now he wasn't.

[00:12:00]

[00:12:30]

And you can say to someone, "Hey, I don't know if this fits for you or not, but you're a big muscly dude. Maybe that's part of this." I think it's important to know that humans are not a pointillistic painting of their data points. And if we're really going to get people to do... 90% of their health is not healthcare. So if we're going to have any impact on that, then we have to actually have a partnership with our patients. "A doctor is not a sage on a stage, but a guide on the side," is what one of my people likes to say. It's like, "How can I be helpful to you?" And then stop talking and hear them.

[00:13:00]

Now, the cool thing about something like MedPearl is, you have to... I'll give you an example. I have to figure out whether the abdominal pain this patient is having is an emergency or not, and I have to figure it out really quickly, and I have to know the right thing to do medically. So if that part can be made easier, then I can spend more time actually connecting with the human, so that if there is a decision to be made, we're making it together, not me making the decision, twisting your arm, telling you what to do. That doesn't work. That never works.

Brian Urban:

[00:13:30]

[00:14:00]

No. I love where you're going because a lot of what I'm hearing is, technology can only enable physicians to go so far, and there's a component that has to remain human-to-human. I'm also hearing that patient-led healthcare decision-making has to be brought more to the forefront. And with that, you can't simply just have a flood of data to inform what that communication or relationship should be like. That can be there to maybe validate things, but it can't be there to blur the relationship. And it's a great example that you gave us, someone coming from a halfway house that might have substance abuse, has a criminal background, has a lot of economic challenges in front of them. How do you meet the person where they are and start to begin progress, whatever that progress might mean? Technology can only take you so far. So, interesting.

[00:14:30]

Let me take you to the other side of the coin here. Remote patient monitoring. This is something that we're looking at, very big waves of aging populations across the US. We look out maybe five plus years from now, we're going to have over 90 million US citizens being 65 to 85 years of age, having needs that go beyond the normal connectivity of in-person and even TeleMed. So there's a lot of applications to remote patient monitoring. I want to have an understanding of what you feel that's going to be in healthcare going forward, regardless of population perhaps, and what that means maybe to Providence and how that's integrated into MedPearl. So big question for you there, but I want to get your take on RPM.

Dr. Jessica Schlicher:

[00:15:00]

I think there's several parts. Providence has a partnership with a company called Cadence, and I'm an enormous fan. Here's what they do. Well, let me contrast the way my practice normally would be, versus with Cadence. Normally, I'd see a patient with high blood pressure. Do you know what the number one preventable cause of early death was 40 years ago? High blood pressure. And spoiler alert, it's still high blood pressure. So we have to do something different. So normally if I see a patient and their blood pressure is really high, we're going to do the normal care pathway, lifestyle, exercise, stopping smoking, limiting alcohol, maybe medicine down the road, right?

Brian Urban:

Lifestyle.

[00:15:30]

Dr. Jessica Schlicher:

And they're going to come back and see me and we're going to titrate it and we're going to work on it. We're going to flip it over and do a little something. Doesn't work very well. Doesn't work very well for a lot of people because the snapshot I get in the clinic, it does not actually allow me to impact all of the choices and things that the patient is walking through in their daily life. So I can see them every three months. That works for some people, it doesn't work for a lot of people.

[00:16:00]

[00:16:30]

With a company that can do RPM, like Cadence, what they do is, they actually say, "Okay, we're going to have text base, we're going to have regular video chat. We're going to talk about all the things that are difficult to change," like that I mentioned. "We're going to follow that patient and then we're going to make it so that the physician, the provider can see on a daily or multiple times a day, what is their blood pressure actually doing?" They can show that by having a high touch, very low barrier kind of approach that we can control and decrease that early death from hypertension in the most difficult populations, just by having some technology that sort of has a basic level of intelligence, and that connects us.

[00:17:00]

So basically, they've automated what I used to do in residency. In residency, when somebody had bad blood pressure, I actually wrote it on a piece of paper and I put it on my desk and then I would call them every week. Or this person isn't going to lose their home because they have some dementia, and their family needs to be involved and this is going to be really hard and I didn't have a lot of support service. Great, I'm going to call them every week.

[00:17:30]

Well, that's not scalable. So there are places where we really do need technology to surface that information over time. But when you give a patient the ability to feel in control of this thing, then the thing can become something that they are able to actually sort of triumph over or live with or mitigate the effects of, right? But anyway, I could go on forever. But I love RPM. We do RPM for diabetes, heart failure, and hypertension right now. But you can imagine a day where there's RPM for a lot of other things.

Brian Urban:

Yeah, absolutely.

[00:18:00]

Dr. Jessica Schlicher:

Depression, lack of exercise. That would be the one I'd be on for, acute too many doughnuts, then that would be mine. So there's lots of things. And I think RPM, it's just part of the ecosystem of needing to democratize healthcare, bring down the cost and make it accessible to everyone. Yeah, we're super excited about RPM. Very bullish on it.

Brian Urban:

[00:18:30]

[00:19:00]

That is awesome. And I am as well. And I think good note for Cadence. They sound very cool, very good partnership you have there. And looking across retail is something that I thought was a huge miss looking at what Walmart had done, and Amazon in some regard. But Best Buy Health, what they're doing with RPM, it seems like everyone else in retail kind of forgot that you have to enable the physician, not replace it or anything close to that degree. And it goes in a large part of what you were saying there, is RPM is a way to enable technology and healthcare professionals, not replace it. So I love that adoption.

[00:19:30]

Looking ahead, Dr. Schlicher, we're thinking about all these different technologies. You see the whole landscape. You've experienced it in different parts of your growing career. So when you look ahead over the next, I'll make it 10 years, we'll go deep into the crystal ball, what do you see in terms of technology being more sticky in the market that are going to stay with us, and some that might fall out? Because we have so many tech vendors out there, it's crazy how many platforms exist. Mental health apps alone are well into the hundreds. What do you see sticking and what do you see falling out?

Dr. Jessica Schlicher:

[00:20:00]

[00:20:30]

Well, value is defined by the customer, right? So when I go around these big technology conferences and I ask them, "Okay, show me what it does." "My AI can tell from this whole conversation that you have ankle pain." "Great. What decision is made that would've not been made based on that tool?" There are a lot of things that are of interest, but where is the actionability? Where is the democratization of the knowledge and the action steps so that patients can care for themselves for things that don't require a doctor visit, so we drive down the cost of care for everyone? And then, I think the solutions that are going to stay are the solutions that bring back the joy to caring for people, and joy to receiving that care.

Brian Urban:

I love it.

Dr. Jessica Schlicher:

And that that's all because nobody has an acute lack of enough devices in their home, right? I guess I would just go back to that. The value is defined by the patient and they still see value in the trust with the provider that they can actually talk to. So I think that's going to remain the heart.

[00:21:00]

Brian Urban:

Just when I thought we couldn't get any better, you drop another beautiful nugget of a quote that the joy of receiving a type of care and the joy of giving care will be a part of what sticks around for certain technologies today, looking into tomorrow. I didn't think it could get better, but it got even better. That was a beautiful sentiment.

Dr. Jessica Schlicher:

[inaudible 00:21:24], I don't know.

[00:21:30]

Brian Urban:

It was the extra push-ups and maybe coffee that you had prior to the show. That's probably what it was. But I'm so thankful to have had your voice on the show here today, Jessica, and I just am so excited for the future that you're bringing Providence into. And thank you so much for being on our show here today.

Dr. Jessica Schlicher:

Of course, anytime. Thanks so much for having me.

Brian Urban:

And for more exciting insights and excerpts, please visit us at finthrive.com

[00:07:30]

[00:08:00]

I play with AI every day. I'm a huge enthusiast. At this point, it's kind of like a more curated internet search, a faster internet search. There are some tools I really like that help me find clinical studies that I might've otherwise missed. That's really cool. For administrative tasks, it works really well. The thing is, for acute undifferentiated suffering, that's what patients have when they come to see us, right? An unknown reason for something that's impacting their life. The AI can't do that yet. It might be able to do it someday, and I hope so, because I think that would lead to great democratization. At this moment, the AI can tell me, what's the management of an inflamed gallbladder? It can do that.

[00:08:30]

But if I say, "What's the best way to treat this patient's menopausal symptoms, confounded by depression when she's had chronic pain and a history of cancer?" And also, she's a human, so there's some things that she is interested in and not interested in, and AI can't deeply understand your patient, right? That's why we go to 12 years of training. And what MedPearl is cool for, is we've actually algorithmatized the way that physicians actually think is the best one.

Brian Urban:

Interesting.

Dr. Jessica Schlicher:

And then put it with the medical evidence and presented that at the point of care. It's really cool. But I'm going to let you ask your next question because otherwise we'll never get through them because I get too excited about it.

Brian Urban:

[00:09:00]

[00:09:30]

Well, my next question kind of wraps around that. You're talking about clinical decision-making, and I think knowing more about what's happening in a person's life, let alone clinical needs, is extremely important and fits together. So talking about MedPearl and how that can help alter or maybe right fit the next best decision a physician can make for a patient, for a life that they're serving. What do you see the role in non-clinical data being in the future of healthcare? And we're talking everything from socioeconomic data to behavioral data, purchasing behaviors, where someone lives, assets they own, jobs they've lost, jobs they just got, arrests, criminal activities, all kinds of stuff. Do you see that stuff being meaningful for physicians, or just being maybe more noise in the short-term?

Dr. Jessica Schlicher:

[00:10:00]

[00:10:30]

Boy, I would be really careful about some of that, Brian, honestly, because the thing that creates healing is trust and an expression of care. And I would want the patient to know and to consent to the sharing of that information with the provider. I actually think it's really important to walk into a room and say to that human being, "What is most important for me to understand about what you're going through?" And then stop talking. Our problem with decision-making is really not about a lack of data. Our problem with decision-making is a lack of listening. I saw a patient who was living in a halfway house, struggling with addiction, had just gotten out of jail, and when I walk into that room, that room is filled with shame. My job is to express care so that he can tell me what's really going on.

[00:11:00]

[00:11:30]

Doesn't matter. I could have all the data in the world, but if I don't make a human connection with him, what's the chance that he's going to really listen to anything I have to say? So I guess I would say that technology can allow us to have more time for making a profound human connection, but I don't think we're going to algorithmatize our way out of these problems. I think care is person-to-person. With that particular patient, he couldn't figure out why he was so anxious, and we talked and talked and talked, and finally it turned out that when he was incarcerated, he was able to exercise and now he wasn't.

[00:12:00]

[00:12:30]

And you can say to someone, "Hey, I don't know if this fits for you or not, but you're a big muscly dude. Maybe that's part of this." I think it's important to know that humans are not a pointillistic painting of their data points. And if we're really going to get people to do... 90% of their health is not healthcare. So if we're going to have any impact on that, then we have to actually have a partnership with our patients. "A doctor is not a sage on a stage, but a guide on the side," is what one of my people likes to say. It's like, "How can I be helpful to you?" And then stop talking and hear them.

[00:13:00]

Now, the cool thing about something like MedPearl is, you have to... I'll give you an example. I have to figure out whether the abdominal pain this patient is having is an emergency or not, and I have to figure it out really quickly, and I have to know the right thing to do medically. So if that part can be made easier, then I can spend more time actually connecting with the human, so that if there is a decision to be made, we're making it together, not me making the decision, twisting your arm, telling you what to do. That doesn't work. That never works.

Brian Urban:

[00:13:30]

[00:14:00]

No. I love where you're going because a lot of what I'm hearing is, technology can only enable physicians to go so far, and there's a component that has to remain human-to-human. I'm also hearing that patient-led healthcare decision-making has to be brought more to the forefront. And with that, you can't simply just have a flood of data to inform what that communication or relationship should be like. That can be there to maybe validate things, but it can't be there to blur the relationship. And it's a great example that you gave us, someone coming from a halfway house that might have substance abuse, has a criminal background, has a lot of economic challenges in front of them. How do you meet the person where they are and start to begin progress, whatever that progress might mean? Technology can only take you so far. So, interesting.

[00:14:30]

Let me take you to the other side of the coin here. Remote patient monitoring. This is something that we're looking at, very big waves of aging populations across the US. We look out maybe five plus years from now, we're going to have over 90 million US citizens being 65 to 85 years of age, having needs that go beyond the normal connectivity of in-person and even TeleMed. So there's a lot of applications to remote patient monitoring. I want to have an understanding of what you feel that's going to be in healthcare going forward, regardless of population perhaps, and what that means maybe to Providence and how that's integrated into MedPearl. So big question for you there, but I want to get your take on RPM.

Dr. Jessica Schlicher:

[00:15:00]

I think there's several parts. Providence has a partnership with a company called Cadence, and I'm an enormous fan. Here's what they do. Well, let me contrast the way my practice normally would be, versus with Cadence. Normally, I'd see a patient with high blood pressure. Do you know what the number one preventable cause of early death was 40 years ago? High blood pressure. And spoiler alert, it's still high blood pressure. So we have to do something different. So normally if I see a patient and their blood pressure is really high, we're going to do the normal care pathway, lifestyle, exercise, stopping smoking, limiting alcohol, maybe medicine down the road, right?

Brian Urban:

Lifestyle.

[00:15:30]

Dr. Jessica Schlicher:

And they're going to come back and see me and we're going to titrate it and we're going to work on it. We're going to flip it over and do a little something. Doesn't work very well. Doesn't work very well for a lot of people because the snapshot I get in the clinic, it does not actually allow me to impact all of the choices and things that the patient is walking through in their daily life. So I can see them every three months. That works for some people, it doesn't work for a lot of people.

[00:16:00]

[00:16:30]

With a company that can do RPM, like Cadence, what they do is, they actually say, "Okay, we're going to have text base, we're going to have regular video chat. We're going to talk about all the things that are difficult to change," like that I mentioned. "We're going to follow that patient and then we're going to make it so that the physician, the provider can see on a daily or multiple times a day, what is their blood pressure actually doing?" They can show that by having a high touch, very low barrier kind of approach that we can control and decrease that early death from hypertension in the most difficult populations, just by having some technology that sort of has a basic level of intelligence, and that connects us.

[00:17:00]

So basically, they've automated what I used to do in residency. In residency, when somebody had bad blood pressure, I actually wrote it on a piece of paper and I put it on my desk and then I would call them every week. Or this person isn't going to lose their home because they have some dementia, and their family needs to be involved and this is going to be really hard and I didn't have a lot of support service. Great, I'm going to call them every week.

[00:17:30]

Well, that's not scalable. So there are places where we really do need technology to surface that information over time. But when you give a patient the ability to feel in control of this thing, then the thing can become something that they are able to actually sort of triumph over or live with or mitigate the effects of, right? But anyway, I could go on forever. But I love RPM. We do RPM for diabetes, heart failure, and hypertension right now. But you can imagine a day where there's RPM for a lot of other things.

Brian Urban:

Yeah, absolutely.

[00:18:00]

Dr. Jessica Schlicher:

Depression, lack of exercise. That would be the one I'd be on for, acute too many doughnuts, then that would be mine. So there's lots of things. And I think RPM, it's just part of the ecosystem of needing to democratize healthcare, bring down the cost and make it accessible to everyone. Yeah, we're super excited about RPM. Very bullish on it.

Brian Urban:

[00:18:30]

[00:19:00]

That is awesome. And I am as well. And I think good note for Cadence. They sound very cool, very good partnership you have there. And looking across retail is something that I thought was a huge miss looking at what Walmart had done, and Amazon in some regard. But Best Buy Health, what they're doing with RPM, it seems like everyone else in retail kind of forgot that you have to enable the physician, not replace it or anything close to that degree. And it goes in a large part of what you were saying there, is RPM is a way to enable technology and healthcare professionals, not replace it. So I love that adoption.

[00:19:30]

Looking ahead, Dr. Schlicher, we're thinking about all these different technologies. You see the whole landscape. You've experienced it in different parts of your growing career. So when you look ahead over the next, I'll make it 10 years, we'll go deep into the crystal ball, what do you see in terms of technology being more sticky in the market that are going to stay with us, and some that might fall out? Because we have so many tech vendors out there, it's crazy how many platforms exist. Mental health apps alone are well into the hundreds. What do you see sticking and what do you see falling out?

Dr. Jessica Schlicher:

[00:20:00]

[00:20:30]

Well, value is defined by the customer, right? So when I go around these big technology conferences and I ask them, "Okay, show me what it does." "My AI can tell from this whole conversation that you have ankle pain." "Great. What decision is made that would've not been made based on that tool?" There are a lot of things that are of interest, but where is the actionability? Where is the democratization of the knowledge and the action steps so that patients can care for themselves for things that don't require a doctor visit, so we drive down the cost of care for everyone? And then, I think the solutions that are going to stay are the solutions that bring back the joy to caring for people, and joy to receiving that care.

Brian Urban:

I love it.

Dr. Jessica Schlicher:

And that that's all because nobody has an acute lack of enough devices in their home, right? I guess I would just go back to that. The value is defined by the patient and they still see value in the trust with the provider that they can actually talk to. So I think that's going to remain the heart.

[00:21:00]

Brian Urban:

Just when I thought we couldn't get any better, you drop another beautiful nugget of a quote that the joy of receiving a type of care and the joy of giving care will be a part of what sticks around for certain technologies today, looking into tomorrow. I didn't think it could get better, but it got even better. That was a beautiful sentiment.

Dr. Jessica Schlicher:

[inaudible 00:21:24], I don't know.

[00:21:30]

Brian Urban:

It was the extra push-ups and maybe coffee that you had prior to the show. That's probably what it was. But I'm so thankful to have had your voice on the show here today, Jessica, and I just am so excited for the future that you're bringing Providence into. And thank you so much for being on our show here today.

Dr. Jessica Schlicher:

Of course, anytime. Thanks so much for having me.

Brian Urban:

And for more exciting insights and excerpts, please visit us at finthrive.com