Relentless Health Value

Kathy Lokay is general manager, as well as chief cheerleader and idea generator, for Via Oncology. Kathy joined UPMC in 2008 to launch the Via Oncology product that UPMC CancerCenter started in 2004. Her background as a CPA combined with her 20 years of experience in oncology have been a great foundation to help her lead Via's overall strategy and execution. She is passionate about driving the volume to value transition in oncology and has made clinical pathways her personal mission for the past 11 years. Kathy was previously senior vice president at US Oncology with responsibility for several business units. She received her Bachelor of Business Administration in accounting from the University of Texas.

If I was going to sum up the summaries, I might put it this way, liberally co-opting the words and sentiments of my articulate guests: The intent here is to help doctors care for patients, patients care for themselves, and all of us care for each other (thanks for that concise statement, Jim Barr). If we want to do this well, we want to and need to standardize the way that digital medicine suppliers express their value so that providers and other purchasers can make informed choices not derailed by who has better marketing. And health systems and other large stakeholders are starting to come around to the inevitability of digital medicine and also the need for evidence to separate the winners from the not-so-greats in a field of literally thousands of health tech options. You can learn more at nodehealth.org or by emailing [email protected]. Megan Coder, PharmD, MBA, is executive director of the Digital Therapeutics Alliance (DTA), whose mission is to broaden the understanding, adoption, and integration of clinically validated digital therapeutic solutions into mainstream health care through education, advocacy, and research. With more than a decade of experience in the health care industry, Megan's expertise extends from strategic growth and partnership development within the digital health sector to the direct delivery of patient care. James E. Barr, MD, is vice president of clinical intelligence at Atlantic Health System and medical director for the Optimus Healthcare Partners and Atlantic Health System Accountable Care Organizations. He is a board-certified family physician with an active clinical practice. He is an assistant clinical professor at Robert Wood Johnson Medical School and has worked with Aveta Health Solutions (North American Medical Management) as vice president of medical services. Katie D. McMillan, MPH, has dedicated her career to imagining and building technology to improve health care for patients and providers. Her experience spans multinational global health organizations, lean software start-up companies, and large academic medical centers. Katie's latest venture is the creation of the Mobile App Gateway (MAG) at Duke University Health System. The MAG serves as the hub for digital health at Duke and provides product consulting services to clinicians and researchers, monthly events and workshops, and content exploring the many facets of the health tech industry. Naomi Fried, PhD, is an innovative and digital health thought leader and founder and CEO of the boutique advisory firm, Health Innovation Strategies, which focuses on innovation program design and digital health strategy. Naomi was the first vice president of innovation and external partnerships at Biogen, the first chief innovation officer at Boston Children's Hospital, and vice president of innovation and advanced technology at Kaiser Permanente. She served on the board of directors of the American Telemedicine Association and the Governor of Massachusetts' Innovation Council. Louis Morrow is regional director of sales for Intelligent Retinal Imaging Systems (IRIS), the leading comprehensive solution provider of diagnostic telemedicine services committed to ending preventable blindness due to diabetic eye disease. Louis was one of the earliest builders at IRIS and has played a major role in saving the eyesight of over 55,000 patients (so far) through the partnerships built with major health systems and integrated delivery networks across the country. He's an award-winning consultative sales team leader with more than 20 years of successful experience in the eye care space and has held senior sales leadership positions across multiple companies. Adnan Iqbal is the cofounder and CEO of Luma Health, a digital health company solving the biggest challenge in health care: getting patients in front of the right provider and to the best health care outcome quickly. Adnan previously held leadership roles at Genentech across research and development, finance, operations, and market analysis and strategy. Prior to Genentech, Adnan cofounded a medical device start-up working to develop an inexpensive diagnostic test for tuberculosis and several other infectious diseases. Roylyn Fernandez, RN, has more than 15 years of combined experience in clinical and informatics roles integrating technologies such as electronic health records (EHRs), virtual desktop infrastructure (VDIs), and mobile applications into system processes. Her passion for nursing and health care enable her to leverage her clinical, operational, and informatics knowledge to design and execute technology adoption strategies that support organizational goals related to quality, patient safety, and revenue capture initiatives. In 2016, Roylyn joined DeLappe Consulting after leading enterprise-wide technology implementation and optimization projects for Kaiser Permanente, Sutter Health, and Cottage Health Systems. Jay Fischer, MBA, as an executive, management consultant,

Brian Van Winkle, MBA, focuses on transforming health care by accelerating the adoption of digital technologies throughout the ecosystem. He is the executive director for NODE.Health, a nonprofit with a mission to combine the rigor of evidence-based medicine with emerging health care technologies to help create evidence-based digital medicine. Brian also runs an innovation center for Johns Hopkins focused on connecting physicians with promising technologies and solutions to solve real problems. Brian has spent 10 years in health care consulting with expertise in strategy design, process improvement implementation, and complex transformation at some of the biggest health care systems in the world. Jay Erickson is a founding partner and Health and Wellness lead at Modus, a digital product studio, and serves on the executive board of NODE.Health. As a cancer survivor and lifelong technologist, he works at the intersection of patient advocacy and digital health, using human-centered design methods to improve experiences and outcomes. Shahid N. Shah is an internationally recognized and influential health care IT thought leader who is known as "The Healthcare IT Guy" across the internet. He is a technology strategy consultant to many federal agencies and winner of Federal Computer Week's coveted "Fed 100" award given to IT experts that have made a big impact in the government. Shahid has architected and built multiple clinical solutions over his almost 24-year career. He helped design and deploy the American Red Cross's electronic health record solution across thousands of sites; he's built several Web-based electronic medical records now in use by hundreds of physicians; he's designed large groupware and collaboration sites in use by thousands; and, as an ex-CTO for a billion-dollar division of Cardinal Health, he helped design advanced clinical interfaces for medical devices and hospitals. Shahid also serves as a senior technology strategy adviser, helping small businesses commercialize their health care applications.

Today, I talk to Jonathan Singer, host of The Social Work Podcast as well as associate professor at Loyola University Chicago School of Social Work. I asked Jonathan to come on the podcast today because I've had this growing sense of disconnect between all the talk about social determinants of health, all the talk about how clinical care has a relatively small impact on patient outcomes compared to environmental factors, how the most important number in health care is someone's zip code. All this talk swirling around, and rarely do social workers come up in the conversation—at least at the level that you'd think they would, given the number of years of education they have in addressing the environmental factors in question. You can learn more at socialworkpodcast.com. Jonathan B. Singer, PhD, LCSW, is associate professor of social work at Loyola University Chicago, secretary of the American Association of Suicidology, and an award-winning author and podcaster. His research on youth suicide and cyberbullying has been featured on NPR and Fox, and in Time magazine and The Guardian. He is the founder and host of the award-winning Social Work Podcast, with over 5 million episode downloads and 30,000 followers on social media. He lives in Evanston, Illinois, with his wife and 3 children and can be found on Twitter as @socworkpodcast and Facebook at facebook.com/swpodcast.

Jed Constantz, DBA As a Healthcare Finance and Delivery Strategic Consultant, Dr. Constantz ensures existing and prospective clients receive maximum value from current and future strategies and initiatives. In previous roles, Jed advised employers on measures to develop regional and community-based physician accountability and commitment through means of enhanced benefits and reduced costs; with the significant benefit of creating sustained loyalty between providers, patients and payers. He has successfully offered strategies that built on four pillars: actionable data, physician alignment, high-risk member targeting and network re-engineering. Having begun his career on the payor's side of healthcare (Blue Cross/Blue Shield of Central New York), Dr. Constantz has served in several positions for hospitals, home health agencies, physician organizations and physician/hospital organizations. Over his 30 plus years in healthcare, Jed has developed tools and resources for primary care providers and employers seeking to reduce costs, drive greater efficiency and quality outcomes and thereby create a "featured-and-favored" network in their regions and community. This process includes a deep focus on the selection of the right community of primary care physicians and specialists, a thorough audit of existing patient and population data, commitment to accountable care standards and improved compensation for the physician. The end-objective is a better healthcare delivery model with an alignment of "enlightened self-interests" and a balance between rewards and value for the employer, employee and provider. For the employer, the financial benefits are immediate with on-going healthcare savings, a healthy workforce, and improved physician relationships. The provider can see greater patient volumes, improved care standards and compensation tied to performance. The employee will feel an improvement in care and attention, benefit with reduced out-of-pocket expenses and sense a higher level of satisfaction. You can learn more by visiting Jed on his LinkedIn page.

Today's episode features the following guests: Ross Bjella, MBA, is the founder and CEO of Alithias, a patient advocacy and population health analytics company serving self-insured employers, insurance companies, networks, and third-party administrators. (EP163) John Lynn is the founder of the HealthcareScene.com network, which currently consists of 10 blogs containing over 11,000 articles, with John having written over half of the articles himself. These EMR and health care IT-related articles have been viewed over 18 million times. (EP124/171) Gary Frazier is a disrupter and founder of OM Healthcare, Inc., a health care technology start-up established in 2015. He has over 18 years of business development experience and over 13 years of executive-level hospital and health system strategy expertise. (EP168) David Smith is from Avia and founder of Third Horizon Solutions. He is chief development officer, where he is responsible for expanding the firm's influence in the health care market. (EP135) Alex Jung is global strategist at Ernst and Young. She is a partner/managing director in Parthenon-EY, where she works primarily on growth strategy projects. (EP189) Joe Murad is president and CEO at Pokitdoc. He most recently served as managing director and head of individual exchange solutions for Willis Towers Watson, where he was responsible for the largest private health insurance exchange. (EP183) Frazer Buntin is president of value-based services from Evolent Health. He has worked in strategic and operations leadership positions for the past 17 years. He is responsible for managing the operational performance of Evolent Health's partners. (EP202) A.G. Breitenstein is a partner at Optum Ventures. She was most recently the co-founder and chief product officer at Humedica, one of the earliest big-data analytics companies in health care. (EP207) 02:21 Ross Bjella's short list—5 action items—for employers to get the most for their money out of the health care system. 03:05 Take control of employer health care costs by gaining access to their health care data. 03:18 Offer an incentive-based plan design. 03:32 Create virtual narrow networks. 03:46 Offer live care navigators. 04:10 The importance of controlling health care costs. 04:43 The emotional component behind what an employer must do to maximize the value of their health care. 05:10 Disruptive vs incremental change, and what's really happening in health care. 06:17 John Lynn of HealthcareScene.com, and why it's so tough for disrupters to break into the health care system. 07:26 The weird dynamic of the false market that is health care. 08:46 Health care regulations making it difficult to disrupt the market. 13:15 Gary Frazier's opinion on connecting value-based care and empowered patients. 15:20 What value-based care is really about. 16:17 David Smith elaborates on the problem with assuming empowered patients change health care. 18:21 Rational decision making and how that isn't always present in health care. 19:19 Alex Jung and the "messy middle" of the economic side of health care. 19:44 How the economic model, not the business model, of health care is broken. 21:36 "Is [this] necessary?" 22:13 Joe Murad and the "messy middle" in medical services pricing. 23:11 Frazier Buntin and where we are in the transition from fee for service to value-based care. 24:09 Is this change driven from the health system or major employers? 25:00 A.G. Breitenstein and the power of consumers en masse to move markets.

Eric Weaver, DHA, MHA, is nationally recognized for his work in primary care transformation and value-based care. As a corporate vice president for Innovista Health Solutions, he oversees enterprise strategy and technology adoption for a fast-growing population health management services organization. Dr. Weaver has been recognized for his contribution to the health care industry by receiving the ACHE Robert S. Hudgens Award for Young Healthcare Executive of the Year and the Modern Healthcare "Up & Comers" Award in 2016. Prior to joining the Innovista leadership team in 2015, he was the president and CEO of Austin, Texas–based Integrated ACO—one of the more successful physician-led accountable care organizations in the country.

A.G. is a partner at Optum Ventures. She was most recently the co-founder and chief product officer at Humedica, one of the earliest big-data analytics companies in health care. Following its acquisition by Optum, she became chief product officer at Optum Analytics. She began her career as an attorney, founding a non-profit aimed at helping homeless youth at high-risk for HIV infection. A.G. expanded her mission by obtaining a degree in public health from Harvard. She is a mission-driven leader focused on transforming the health care system into a health system.

Ashok founded Centivo in 2017 after observing the inefficiency in the health care system and the pain that has resulted for employers and employees. Prior to Centivo, Ashok co-founded Liazon, operator of the nation's industry-leading private benefits exchange for active employees. Liazon was acquired by Willis Towers Watson in 2013, and after the acquisition, Ashok served as managing director for Willis Towers Watson's Group Exchange business. Prior to Liazon, Ashok was an associate principal at McKinsey and Co., where he served as a leader in the firm's health care and private equity practices. ​In addition to his role at Centivo, Ashok serves as an independent Board director at Artemis Health as well as a senior adviser to Silversmith Capital, a growth equity firm. Ashok received his undergraduate degree from Princeton University, a master's degree from Stanford University, and an MBA from the Stanford Graduate School of Business.

TJ is a designer at heart and a pharmacist by training. He started his career at his family's long-term care pharmacy in 2004 and has worked at Target pharmacy, a local community pharmacy, and Massive Health (acquired by Jawbone). He holds a doctor of pharmacy (PharmD) degree from Massachusetts College of Pharmacy and Health Sciences. In 2015, Forbes named TJ to its 30 under 30 List in Healthcare. In 2018, PillPack was acquired by Amazon. 02:20 TJ talks about his origin story with PillPack. 04:16 TJ explains what PillPack is and how it works as a full-service pharmacy. 06:57 One of the biggest challenges is getting across to patients that there is a better option to approaching their health. 10:06 How the customer experience is different between PillPack and a retail pharmacy, and how PillPack is working toward eliminating the frustration that comes with a normal retail pharmacy. 11:13 PillPack's average customer age is 49. 12:42 How PillPack addresses the issue of customer loyalty and the personalized experience that might be offered by retail pharmacies. 15:01 Providers and prescribers often spend somewhere around 30% of their time prescribing medication, when a more efficient solution can be to implement a start and end order. 20:16 The illogic behind using expirations on prescriptions to entice patients to remain accountable at doctor visits. 22:47 How PillPack steps in to be the medication coordinator for individuals. 26:32 The complicated issue of nonadherence and what this means. 27:57 How PillPack reminds the patient about being proactive about refilling prescriptions. 33:29 How patients pay to use PillPack. (Hint: It's the same cost as going to a traditional pharmacy.)

When not hosting the show, Stacey is co-president of Aventria Health Group, a marketing agency and consultancy. Aventria specializes in helping pharmaceutical, employer, pharmacy, and health system clients improve patient outcomes by creating and leveraging collaborations with other health care organizations. For more than 20 years, Stacey has innovated better-coordinated health solutions benefiting all stakeholders and, most of all, the patient. Dave is a 30-year veteran of managed-markets marketing. After working in consumer marketing with AT&T and health care publishing with Elsevier, Dave made the move to medical advertising and communications at KI Lipton, Inc. Subsequently, he became a cofounder of Pinnacle Health Communications. Dave is an accomplished strategist, providing innovative customer marketing, access, quality, and health intervention solutions for large clients and has directed the development of numerous industry-leading campaigns in primary care and specialty markets. He has supported clients in disease areas that include oncology (Bristol Myers Squibb [BMS], Novartis, Eisai), virology (BMS, Merck & Co.), pharmacy (American Pharmacists Association, Merck, Novartis), and blood disorders (Novo Nordisk), to name a few. Dave has helped more than 15 clients achieve top rankings in their respective categories. He is also an active member of the Pharmacy Quality Alliance. 00:30 Collaborating with "large organized customer groups" aka IDNs and health care stakeholders. 01:36 Pharmaceutical companies working with IDNs. 04:58 "Historically, Pharma trained ... their representatives on the brand; secondly ... on [their] selling skills." 05:17 "What they don't do well ... is training them on understanding customer objectives and needs." 05:56 "What a customer wants to buy is impact." 07:57 "It's basically Pharma meeting on a level playing field with peers." 08:42 The more stakeholders take on risk, the more they will demand seeing outcomes from Pharma. 09:09 "Pharma can't ... prove its value in the absence of having collaborative relationships." 09:30 One of the most important roles that Pharma can play. 10:42 The barrier with market share. 13:13 Enabling a brand to be successful. 13:39 Solving the customer's problems. 13:50 Creating a near-term and a long-term plan. 16:00 How Pharma can be a collaborative partner throughout the entire patient journey. 16:58 Pharma's barrier in not striving for the ideal. 22:39 Barriers in pharma collaboration with IDNs. 24:28 "Consider these plans a living document." 24:45 "It's a commitment to invest the time, invest the energy." 27:24 "The much more valuable brands are [the ones] that build upon their successes." 29:44 "How can we work together to find a solution that is approvable?" 31:03 How Aventria might be able to help mitigate some of these challenges.

Maya Dusenbery is a journalist, editor, and the author of Doing Harm: The Truth About How Bad Medicine and Lazy Science Leave Women Dismissed, Misdiagnosed, and Sick. She is editorial director of Feministing.com and has previously been a fellow at Mother Jones magazine and a columnist at Pacific Standard. Her work has appeared in publications like Slate, Cosmopolitan.com, HuffPost, TheAtlantic.com, Popular Science, and Teen Vogue, among others.

Virginia Gurley, MD, MPH, is the senior vice president and chief medical officer at AxisPoint Health, responsible for leading all clinical content development and analytics activities for the company, as well as providing strategic clinical oversight for delivery of population health management services. Dr. Gurley brings with her more than 30 years of experience in preventive medicine, clinical programs and systems design, analytics, and health education. Prior to this role, Dr. Gurley held leadership positions at managed care organizations and care management vendors, including Healthways, Blue Cross Blue Shield of Michigan, McKesson, and Henry Ford Health System. Dr. Gurley earned her MD from the University of California at Davis School of Medicine and completed her residency training at George Washington University and Johns Hopkins University, where she also completed her MPH in epidemiology.

Gregory Makoul, PhD, MS Greg is founder and CEO of PatientWisdom, Inc. He is internationally recognized for expertise in physician-patient communication and shared decision making as well as a radical commonsense, person-centered approach to health care innovation. He started PatientWisdom because professional and personal experience made it clear that listening to patients—individually and at scale—is the real key to improving health and care.

Frazer Buntin has worked in strategic and operations leadership positions for the past 17 years and currently serves as the president of value-based services for Evolent Health. Evolent Health partners with leading provider organizations to achieve superior clinical and financial results in value-based care, actively managing care across Medicare, Medicaid, and commercial and self-funded adult and pediatric populations. Frazer is responsible for managing the operational performance of Evolent Health's partners. Prior to Evolent, Frazer served as CEO for WhiteGlove Health, a population health management firm providing primary health care services to self-insured employers and health plans. Previously, Frazer was co-founder, president, and CEO for Silvercare Solutions, one of the largest providers of primary care and health care management services to the senior population in the United States. Prior to Silvercare, he served in several senior-level roles for Healthways Inc. and Dollar General Corporation. Frazer currently serves on the board of Leadership Health Care and holds an MBA from Vanderbilt University and a BS degree from The University of the South.

Clinton Phillips is the founder of Medici, a platform that allows doctors and patients to connect securely from their mobile phones. He launched the company in early 2017 with a vision to create technology that would revolutionize the way doctors provide care to their patients. As a serial-entrepreneur, Clinton previously founded 2nd.MD in response to frustrations he had experienced when seeking medical care for his daughter, Gabi, who had suffered a stroke shortly after birth. 2nd.MD has since helped thousands of people in over 45 countries gain access to high-quality second opinions with outcomes that has saved lives and lowered health care and recovery costs for patients, providers and carriers. Before this, Clinton served as a consultant to The Vitality Group working to lower health care spending through employee education and engagement programs. He is also a certified Chiropractor and founded the successful Colorado-based Aspen Back & Body, a non-surgical rehabilitation clinic for people with back problems. Originally from South Africa, Clinton and his family now reside in Austin, Texas. 02:14 Clint explains the need for a virtual second opinion. 03:21 The need for virtual second opinions in rural environments vs. urban environments. 04:41 The number of diagnosis that are incorrect, or treatment plans that are not ideal, and how getting a second opinion can improve these stats. 06:09 The need for physicians and health care professionals to become more self-aware. 06:39 Balancing revenue with compliance and quality outcomes. 07:13 Why getting rid of misdiagnosis isn't higher on the priority list for health systems. 08:00 Clint's advice to help mitigate misdiagnosis. 08:20 "The expectation that every hospital can treat everything well is very flawed." 08:30 "Specialize in what you can do well…" 09:35 "Health care these days is a team sport." - Stacey 10:55 How this works from a cost perspective. 11:40 Fixing primary care as the only solution. 14:28 The need for the patient to fully understand their care needs. 15:30 The reality that patients face today in health care, and the responsibility that they carry. 18:28 Clint's insight about patient education and understanding their care and communication. 19:15 The cost of managing billing, and how this differs in health care vs. other industries. 21:18 Quantifying the layer of cost and burden between doctors and their assistants. 22:24 The opportunity physicians have through Medici to solve some of these issues. 22:51 "...There is a massive shift coming in health care." 23:12 How health care is moving more towards virtual care. 24:26 How Medici solves for the changing landscape in health care. 27:00 "When communication gets easier, a lot of these conditions just start to improve…" 28:20 You can learn more at 2nd.MD, or by reaching out to [email protected], to find out more about getting a second opinion and avoiding the expense behind misdiagnosis and misguided treatment plans.

Stacey L. Worthy, Esq, is a partner at DCBA Law & Policy, where she counsels members of the health care industry, including nonprofit patient advocacy organizations, treatment programs and providers, recovery residences, urine drug testing laboratories, and pharmaceutical companies. As counsel to the nonprofit Aimed Alliance, Stacey provides legal insights that drive the organization's education, advocacy, and policy initiatives. Based on her extensive research and analysis of federal and state laws, regulations, and legislation affecting access to quality health care, Stacey authors scholarly articles for publication, drafts model legislation, develops policy positions, and assists with coalition-building efforts of allied organizations focused on advancing common goals. She is also a featured speaker at national conferences and contributes commentary that addresses important issues impacting patients with serious chronic diseases and rare conditions. She earned her Juris Doctorate degree from the George Mason University School of Law and graduated magna cum laude from Boston's Suffolk University.

James is the founder and managing director of Fitzroy Health, a leading international health care investment and commercialization firm. He has served as an executive, entrepreneur, and investor in health care firms across numerous international markets. James sits on the boards of RJ Health Systems, DosedDaily, Salute Safety, and Flex Health. He was awarded Entrepreneur of the Year at The Wharton School 2009 WEC Expo and has been profiled by the Financial Times. James holds a BA from The University of Melbourne and an MBA from Columbia Business School.

James is the founder and managing director of Fitzroy Health, a leading international health care investment and commercialization firm. He has served as an executive, entrepreneur, and investor in health care firms across numerous international markets. James sits on the boards of RJ Health Systems, DosedDaily, Salute Safety, and Flex Health. He was awarded Entrepreneur of the Year at The Wharton School 2009 WEC Expo and has been profiled by the Financial Times. James holds a BA from The University of Melbourne and an MBA from Columbia Business School.

Eric is established as a national expert on the impact of health care reform on health care providers and is a respected thought leader in the hospital health system industry. A consultant with deep experience in health plan strategy, design, prevention care, and productivity and behavioral economics, Eric serves as the national leader of direct provider solutions for Collective Health. A former executive at Evolent Health and principal with Towers Watson, he has worked in the employee benefits business for 30-plus years as an advisor to hospital and health system clients, developing health benefit and prevention care strategies that align with the health system's population health business. Eric focuses on improving the poor health of health care workers and professionals as a first step to improving patient satisfaction and quality outcomes. He frequently speaks about the direct link between improving health care workers' health and boosting patient satisfaction and quality outcomes. Eric is a published author, including the book STOP!: 21 Stops to Reduce Stress and Enhance Joy, and has authored more than 20 articles on employee benefit topics, including "Fixing the Broken Triangle," "The Healthcare Benefit Crisis—Ten Years Later" in 2015, "Choice Architecture—A Tool for Ratcheting Up Benefit and Wellness Results," "eACOs—The Health Plan of the Future," and "The Healthcare Benefit Crisis." A member of several "Who's Who" lists for business executives, Eric graduated from the University of Illinois with a BA in psychology and earned his MBA from the University of Chicago Booth School of Business.

Brian is an innovator in digital life science technology, launching 15 brands across biotech, pharmaceuticals, and technology. Most recently he was the vice president of strategy at Alere, where he led efforts in point-of-care commercial implementation and business process design. In his current role, Brian leads the effort to create and launch cutting-edge VR and AR experiences in health care as well as the evolution of MediSolutions into an industry game changer. You can learn more at medisolutions.healthcare.

Kelly Close founded Close Concerns in 2002; its mission is to make everyone smarter about diabetes. At Close Concerns, Kelly and her team write approximately three million words each year on diabetes, prediabetes, obesity, and digital health for Closer Look, a highly praised service covering the goings-on in the field. Kelly's passion for the field comes from her extensive professional work as well as from her personal experience, having had diabetes for over 30 years. Kelly is the author of more than 30 peer-reviewed manuscripts as well as Targeting a Cure for Type 1 Diabetes: How Long Do We Have to Wait?, a widely praised book published by the American Diabetes Association (ADA) in 2013. She also wrote the foreword for the widely praised Bright Spots & Landmines by Adam Brown, published in 2017. Kelly is an associate editor of Clinical Diabetes, a journal focused on diabetes for primary care physicians published quarterly by the ADA. Close Concerns is a winner of the ADA's "Excellence in Health Communications" Award, and Kelly and her team write a quarterly column in Journal of Diabetes, a peer-reviewed journal based in Shanghai. Kelly chairs the diaTribe Foundation, a nonprofit established in 2013 to improve the lives of people with diabetes and prediabetes and to advocate for action. She is also the founder of diaTribe.org, begun in 2006 as an educational resource for people with diabetes; diaTribe.org's free educational mailers go to over 100,000 people every 2 weeks. Before starting Close Concerns and the diaTribe Foundation, Kelly's work focused on life sciences more broadly. Over nearly a dozen years, she worked on Wall Street (investment banking at Goldman Sachs, equity research at Merrill Lynch) and at McKinsey & Company, where her work centered on life science, managed care, and nonprofit organizations. You can learn more by going to diatribe.org, follow diaTribe on Facebook and Twitter, and check out diatribe.org/foundation and diatribe.org/brightspots.

I'm a creative and detail-oriented professional gardener with many years of hands-on experience in addition to attending ongoing college courses at Edmonds Community College in their highly regarded Horticulture program. In my previous career, I spent a lot of time working with clients on innovative ways to deliver the results they wanted while keeping an eye on the big picture. Oddly, garden design is quite similar. I always have to keep a budget and overall objectives in mind while developing strategies and tactics, and managing external resources. Specialties: Garden design; excel at delivering innovative solutions to garden challenges. Precision Pruning of specimen trees including Japanese maples and flowering trees. College level and professional training in pruning. 02:30 Why Crane pays out of pocket for his exam. 03:15 The chain of events that Crane, as an average patient, went through to find out the cost for his hernia surgery. 04:20 Why Crane thought to ask for the price of the procedure in the first place. 05:15 What Crane did next when he found out how much the cost of the procedure was going to be. 06:40 David Contorno's price shopping video - check out his episode, EP186. 09:10 Online services patients can go to get a sense of cash prices for certain procedures. 09:45 Why discovering price breakdowns for patients with insurance is so difficult. 13:50 "Generally speaking, the lower the cost, the higher the quality." 15:50 What Crane found out from his research on guroo.com. 18:15 The inconsistency with negotiated insurance prices. 20:20 "Most care provided in this country is not acute." 21:10 Resources to check the quality of the care you are receiving: healthgrades.com, leapfroggroup.org, and medicare.gov/hospitalcompare. 25:50 "Give me more information that I can make a decision on."

Seth PainterSeth is a senior-level business development, sales, and marketing professional at IQVIA, a leading global provider of information, innovative technology solutions, and contract research services focused on using data and science to help health care clients find better solutions for their patients. Seth's background is unique, having sold for and to pharmaceutical companies in addition to having extensive hospital sales experience. As a health care and marketing expert who specializes in consumer insights, marketing effectiveness, and media innovation, Seth works with pharmaceutical, agency, and media organizations to provide targeting, optimization, and measurement for patient/health care provider campaigns. Anton Yarovoy A science nerd turned marketing creative, Anton is behind numerous innovative campaigns, including "Color for the Kids!" and "Be Heard!" With over 18 years of experience across academia and industry, his unique and unexpected multichannel projects empower health care providers to be advocates for the products they use. He has a degree in biochemistry, biology, and neuroscience from Brandeis University and an MBA from Montclair State University, and speaks on the role of digital marketing in the health care space. Alec Pettifer Alec consults with pharmaceutical and life science industry clients to deliver actionable insights to drive business performance. With hundreds of successful projects completed, Alec joined suAzio Consulting in 2017 as senior business consultant to use direct stakeholder engagement to optimize co-creation of patient support programs and digital health solutions. Alec is passionate about patient centricity and is an active member of and volunteer for The Aurora Project. He leverages 20+ years' experience with traditional and cutting-edge methods to support patient-focused drug development. Alec earned a bachelor's degree in sociology from Rowan University and has lived and worked in Europe, Asia, and North America throughout his career. Joe Shields As an Emmy Award–winning filmmaker and digital pioneer, Joe infuses storytelling with technology to systematically move audiences to action. Applying his unique perspective to business, he has led global marketing, new product development, digital strategy, and enterprise innovation for Fortune 100 companies in specialty chemicals, telecommunications, biopharmaceuticals, medical devices, and diagnostics. He is currently president and cofounder of Health Accelerators, a business-to-business marketing services agency supporting suppliers to life sciences companies. You can learn more at healthaccelerators.com.

Dyan is the owner of a patient-focused consultancy, Inspired Health Strategies, LLC (IHS). After spending 20+ years in Big Pharma in traditional sales and marketing roles, in 2007 Dyan began working as a contractor with Sanofi. She was brought in to develop a multi-cultural marketing initiative and Dyan had little hope of making much of an impact until she realized that Sanofi was serious as evidenced by their commitment to a hefty budget and an enterprise-wide effort. She knew that, given her past experience combined with a non-traditional approach to market research, she could help Sanofi develop a groundbreaking program. What was developed was a program that incorporated the patient's ecosystem into a branded and non-branded initiative that resulted in documented behavior change and significant contribution to the bottom-line. The Community Health Partnership (CHP) changed her brain – she now understood the opportunity the industry was missing by not understanding the value of the patient. Since that Sanofi initiative Dyan has been an evangelist for patient engagement. But after years of trying to push the industry in this patient-focused direction she was ready to give up…until she attended the March 19, 2018 FDA meeting regarding the Patient-Focused Drug Development (PFDD) initiative. The FDA was going to actually issue guidance that echoes Dyan's mantra – that patients should be involved in drug development, in a meaningful way, from pre-Investigative New Drug Application (IND) through commercial. This has rejuvenated Dyan's efforts as she watches and helps the industry sort out how to comply with this guidance. Compliance will demand a change in thinking in the industry and will produce great results for patients. Dyan's efforts have been recognized by her being included in the PharmaVoice 100 Innovators in Life Sciences. Dyan has been published in several industry journals including Pharmaceutical Commerce and The Journal of Patient Adherence and is a frequent speaker at industry meetings. You can learn more about PFDD and see case studies on the work of IHS at Dyan's website www.inspiredhealthstrategies.com, follow Dyan @InspiredHealth_

Edith Peterson Mitchell, MD, FACP, FCCP, is board certified in internal medicine and medical oncology and is clinical professor, Department of Medicine and Medical Oncology, at Sidney Kimmel Medical College at Thomas Jefferson University and associate director for diversity programs and director of the Center to Eliminate Cancer Disparities for the Sidney Kimmel Cancer Center at Thomas Jefferson University. Dr. Mitchell's research in breast, colorectal, and pancreatic cancers and other GI malignancies involves new drug evaluation and chemotherapy, development of new therapeutic regimens, chemoradiation strategies for combined modality therapy, patient selection criteria, and supportive care for patients with gastrointestinal cancer. She has spent her medical career assisting individuals in medically underserved areas realize that changes in lifestyle can dramatically impact cancer care. Through her work, Dr. Mitchell has demonstrated the importance of community service and outreach, especially to individuals unable to obtain more conventional medical advice. Dr. Mitchell holds leadership positions in the American Society of Clinical Oncology (ASCO), serves on the National Cancer Institute (NCI) Review Panel, the Cancer Investigations Review Committee, the Clinical Trials and Translational Research Advisory Committee, and the National Institutes of Health (NIH) Council of Councils; is co-chair of the NCI Disparities Committee; and served on the NCI's Blue Ribbon Panel. She was the 116th president of the National Medical Association. Dr. Mitchell is also a retired United States Air Force Brigadier General, having served in the Air National Guard. You can learn more by going to joinallofus.org, or visit their Twitter profile @allofusresearch, #joinallofus.

Alex is a partner/managing director in Parthenon-EY, where she works primarily on growth strategy projects. She helps clients define and implement their strategy and build organizational capabilities to deliver sustainable business results through both organic and inorganic approaches. She is a thought leader in the industry and specializes in asset repurposing and optimizing value propositions. Prior to joining EY, she was the senior vice president of Walgreens Corporate Strategy. Alex has over 30 years of experience working on strategic growth and risk mitigation engagements. She began her career with Arthur Andersen and after 10 years moved into consulting with Mercer as the leader of the National Health Care Analysis Unit, helping to architect one of the first health data analytics platforms. Alex has worked globally with Fortune 500 companies and has developed and implemented large-scale strategy, operations, and financial projects. Her domain expertise in health care and life sciences includes hospital operations, pharmacy and drug manufacturing, patient clinical intervention programs, employer benefit plan designs and funding, commercialization, and growth strategies, including mergers and acquisitions. Alex has been quoted in numerous articles in Forbes, the Chicago Tribune, Business Insurance, Workforce Management magazine, Crain's Chicago Business, and other industry publications. She is on the editorial board of Inside Patient Care magazine. 01:00 Why change is coming. 01:30 More convergence coming to the industry. 02:20 The interlopers—private equity firms. 02:35 Challenging perverse incentives. 04:20 What HMOs used to be, and why they were the dominant health insurance policy design. 05:45 Why so many HMOs went bankrupt. 06:20 How we might see social advocacy change health care yet again.

Don is an accomplished Health IT expert with a 20-year track record of driving value with technology. Don began his career as a custom software developer and eventually built and lead a team of more than 30 engineers. Later he was a subject matter expert, product manager and head of sales and marketing for a digital health startup that launched a SaaS-platform focused on administrative simplification in health care. Today, Don is president of Glide Health IT, LLC, a consulting firm that helps forward-looking organizations align their health IT and business strategies. The firm specializes in business and product development with a focus on data aggregation, interop, analytics and quality measurement. Don is also the founder, co-host and executive producer of The #HCBiz Show!, a podcast dedicated to unraveling the business of health care. When not hosting the show, Stacey is co-president of Aventria Health Group, a marketing agency and consultancy. Aventria specializes in helping pharmaceutical, employer, pharmacy, and health system clients improve patient outcomes by creating and leveraging collaborations with other health care organizations. For more than 20 years, Stacey has innovated better-coordinated health solutions benefiting all stakeholders, and, most of all, the patient. Learn more about Don Lee and The #HCBiz Show!, a podcast at thehcbiz.com or by following Don on twitter @dflee30.

John Gorman is founder and executive chairman at Gorman Health Group (GHG). In this role, he has led the development of the industry's leading consulting practice and several entrepreneurial ventures in government health programs. John's work focuses on Medicare, Medicaid, and Affordable Care Act strategy, governance, and turnaround of distressed health plans. Prior to founding the firm, John served as assistant to the director of Health Care Financing Administration's Office of Managed Care, where he provided day-to-day management and served as the external liaison for the Medicare and Medicaid managed care programs. During the 1993 debate on national health care reform, John was chief lobbyist on health care financing issues for the National Association of Community Health Centers, an organization of federally funded primary care clinics for the medically underserved. John's career in Washington began as press secretary and staff director for US Representative John Conyers, Jr (D-MI), then chairman of the Government Operations Committee. 00:19 How Pharma and suppliers to providers are being impacted by needing to produce outcomes. 00:31 Future huge sources of revenue for manufacturers. 00:37 Cutting out the PBM. 01:28 "They are basically rebate machines."—John 02:23 "How far do you want to push the disruption of your biggest customers?"—Stacey 02:36 "All they're going to have to do is wait a couple years."—John 04:03 Getting away from rebates and into a different business model altogether. 05:13 "It's not skin in the game, and it's not a game—this is people's health care."—John 06:40 EP189 with Alex Jung of Ernst & Young.

Nathaniel (Nate) Lacktman is a partner with the law firm Foley & Lardner LLP, where he is the chair of the firm's Telemedicine Industry Team. He advises health care providers and technology companies on business arrangements, compliance, and corporate matters, with particular attention to telehealth, digital health, virtual care, and health innovation. Working with hospitals, entrepreneurs, and start-ups to build telemedicine arrangements across the United States and internationally, his practice emphasizes strategic counseling, creative business modeling, and fresh approaches to realize clients' ambitious and innovative goals. Go to foley.com/telemedicine or healthcarelawtoday.com to learn more.

John Gorman is founder and executive chairman at Gorman Health Group (GHG). In this role, he has led the development of the industry's leading consulting practice and several entrepreneurial ventures in government health programs. John's work focuses on Medicare, Medicaid, and Affordable Care Act strategy, governance, and turnaround of distressed health plans. Prior to founding the firm, John served as assistant to the director of Health Care Financing Administration's Office of Managed Care where he provided day-to-day management and served as the external liaison for the Medicare and Medicaid managed care programs. During the 1993 debate on national health care reform, John was chief lobbyist on health care financing issues for the National Association of Community Health Centers, an organization of federally-funded primary care clinics for the medically underserved. John's career in Washington began as press secretary and staff director for US Representative John Conyers, Jr (D-MI), then chairman of the Government Operations Committee. Find out more information at gormanhealthgroup.com, or follow John Gorman on LinkedIn and Twitter.

Alex is a partner/managing director in Parthenon-EY, where she works primarily on growth strategy projects. She helps clients define and implement their strategy and build organizational capabilities to deliver sustainable business results through both organic and inorganic approaches. She is a thought leader in the industry and specializes in asset repurposing and optimizing value propositions. Prior to joining EY, she was the senior vice president of Walgreens Corporate Strategy. Alex has over 30 years of experience working on strategic growth and risk mitigation engagements. She began her career with Arthur Andersen and after 10 years moved into consulting with Mercer as the leader of the National Health Care Analysis Unit, helping to architect one of the first health data analytics platforms. Alex has worked globally with Fortune 500 companies and has developed and implemented large-scale strategy, operations, and financial projects. Her domain expertise in health care and life sciences includes hospital operations, pharmacy and drug manufacturing, patient clinical intervention programs, employer benefit plan designs and funding, commercialization, and growth strategies, including mergers and acquisitions. Alex has been quoted in numerous articles in Forbes, the Chicago Tribune, Business Insurance, Workforce Management magazine, Crain's Chicago Business, and other industry publications. She is on the editorial board of Inside Patient Care magazine. Read Alex's list of employer actions to reduce pharmacy costs here. You can learn more by emailing Alex directly at [email protected].

Sean Erreger is a Licensed Clinical Social Worker (LCSW, MSW) in New York State with an undergraduate degree in psychology. Sean has over a decade of practice experience in a variety of settings, including foster care prevention, psychiatric emergency room, adolescent day treatment, and adult inpatient. Currently, he is a clinical case manager for children and adolescents at risk of inpatient psychiatric hospitalization and/or out-of-home placement. Alex Akers is vice president for business development with Health Catalyst, a Utah-based, next-generation data, analytics, and decision-support company. He has been with Health Catalyst since 2015. Alex began his career in health care consulting, working for KPMG and Accenture in their health care strategy practices, and then shifting to revenue cycle reengineering with Stockamp & Associates. His passion for technology in health care really took off after he joined Microsoft and was responsible for health care strategy in their payer segment. After a stint with Grand Rounds in San Francisco, Alex landed at Health Catalyst. 00:00 The purpose of podcasts. 01:40 Industry-specific podcasts as a great way to absorb information and make unproductive time productive. 05:15 Getting context through podcasts. 05:40 Podcasts helping with work-life balance. 06:00 "It's a way to get creative." 06:35 Finding new podcasts through keyword searches and apps like Pocket Casts and Overcast. 10:50 What it means to subscribe to a podcast. 11:20 Following timelines to seek out specific information vs being a casual listener. 12:10 Alex's podcast recommendations. 13:35 Sean's blog, stuckonsocialwork.com, and his self-guided course on social media ethics for social workers. 14:15 Using podcasts as a way to help make the workday less mundane while gaining a better sense of various topics. 16:30 How Sean gets most of his podcasts—through Google Play or iTunes. 20:30 Sean's podcast recommendations for social work.

An experienced senior executive with several years of experience in the pharmaceutical and biotechnology industry, Will has held key positions where he was instrumental in launching a variety of innovative platforms in medical affairs. He speaks frequently regarding the ever-changing role of medical affairs at most major medical affairs conferences and is currently president and CEO of the ACMA, whose primary mission is to create industry standards and goals for medical affairs professionals. Will has held key management roles across the industry within medical affairs, such as at Eisai, Retrophin, Gilead Sciences, Abbott Laboratories, Boehringer Ingelheim, and Merck. Will previously also served as vice president of medical and scientific affairs at CME LLC, a leading provider of continuing medical education to health care providers nationwide. He also has worked on the strategic management consulting side with companies such as Veeva Systems and often provides medical affairs consultancy services for Bain, McKinsey, BCG, Atheneum Partners, and Alpha Insights. He has published extensively and led a number of initiatives focusing in the areas of ischemic heart disease, dyslipidemia, diastolic heart failure, type 2 diabetes, and obesity, where he has collaborated with some of the nation's top research institutions, such as the Pennington Biomedical Research Center, the Washington Center for Weight Management & Research, the Yale School of Medicine Digestive Diseases Program, and the University of Pennsylvania's Center for Weight & Eating Disorders. Will was most recently invited to speak at the Center for Medical Technology Policy's (CMTP) conference on Comparative Effectiveness Research to help inform payers, health care policy makers, physicians, and patients on the most effective ways to design clinical trials to better address gaps in medicine. He also presented at the 2014 annual American Diabetes Association (ADA) Conference on preventing the progression of type 2 diabetes among prediabetic overweight and obese individuals. In 2008, Will published a book entitled The Rise of Chemistry: Implications for Industry and Education. You can learn more at medicalaffairsspecialist.org.

Sandra is the chief operating officer at SinfoníaRx. SinfoníaRx is a leading provider of MTM services. Through a comprehensive suite of innovative health care solutions, SinfoníaRx provides direct support to health plans, health systems, provider organizations, and pharmacies. SinfoníaRx's team works directly with patients, caregivers, and providers to ensure the most effective and safest medication therapy possible. Todd started his professional career in telecommunications and spent 8 years in the field of business development until entering the pharmacy technology sector in 2004. Todd helped to build a small software systems design company into the most recognized long-term care pharmacy management system in the pharmacy industry, SoftWriters, developers of FrameworkLTC. He then launched his own company, Pharmacy Technology Resource, which started from a small popular blog about pharmacy operators leveraging technology better to gain efficiency and maximize profitability. In 2009, Todd launched the pharmacy industry's first podcast about the business of pharmacy dedicated to health care professionals called the "Pharmacy Podcast Show." In the fall of 2014, several pharmacists joined Todd, and the "Pharmacy Podcast Show" was transformed into the Pharmacy Podcast Network. Today the audio-blog is the US health care system's largest network of podcasts dedicated to the profession of pharmacy. After several successful years in the world of pharmacy software and health care tech consulting, Todd found a new career in the field of opioid addiction recovery in business development and strategic marketing with national leader New Season, headquartered in Orlando, Florida. He has been with New Season since June 2016.

David is a nationally recognized thought leader, speaker, and author on disrupting health care and delivering better care at lower costs for employers and their employees. He spends much of his time educating the industry, including his competition, on how to bring these powerful solutions to the masses. The rest of his time is working directly with employers to improve benefits and improve overall company profitability. You can learn more by finding David on LinkedIn.

Since 2010, under Pablo's leadership, Antidote has raised $26 million in venture capital and grown to become a leading player within the digital health sector, empowering thousands of patients worldwide to discover and access potential new treatment options through clinical trials. Pablo is a seasoned entrepreneur and manager of internet companies. He's been building high-scale businesses in online retail, travel, mobile, media, and now health sectors since the late 1990s, including firms such as NetJuice, DondeComprar.com, Kelkoo (acquired by Yahoo!), Kayak (acquired by Priceline), and ValueClick (acquired by Conversant). Pablo has spoken about technology, health care, and innovation at Harvard Medical School, DIA, Disruptive Innovations, Health 2.0, Digital Health Forum, and many others. He has been included in the "100 Club" by SVC2UK and the "Ones to Watch" list by The Sunday Times's Tech Track 100 and was recently named one of MM&M's Healthcare Transformers of 2018. He's also been featured in Wired, the Financial Times, and Forbes; on CNBC, TechCrunch, and Re/code; and more. Tou can sign up for the Antidote platform by going to antidote.me. You can also learn more by emailing [email protected].

Alex Lickerman, MD is a primary care physician, author, speaker, entrepreneur, and founder of ImagineMD, a direct primary care medical practice headquartered in Chicago. ImagineMD works with self-insured and fully-insured businesses and their benefits consultants to help lower health care costs and improve the access to—and quality of—health care for their employees. This enables businesses to attract and retain top talent, as well as increase productivity and reduce absenteeism—all to increase the value of the business itself. You can learn more about DPC and ImagineMD at www.imaginemd.net.

This podcast inbetweenisode is mostly dedicated to Pharma teams who have determined that EHRs and Health Information Technologies are here to stay, and that it's a business imperative to develop initiatives that suit a digitized health care ecosystem. However, this info also has relevance to startups or other entrepreneurs looking to work with Pharma. Take this as a word of advice... if you are working with a Pharma team and you're noticing that they are not doing the things that I'm going to talk about... get the check up front, if you know what I mean. When not hosting the show, Stacey is co-president of Aventria Health Group, a marketing agency and consultancy. Aventria specializes in helping pharmaceutical, employer, pharmacy, and health system clients improve patient outcomes by creating and leveraging collaborations with other health care organizations. For more than 20 years, Stacey has innovated better-coordinated health solutions benefiting all stakeholders, and, most of all, the patient. 00:00 Integrating and digitizing in Pharma. 02:00 EHR Strategies—Now what? 02:15 Finding a sufficient process to achieve an EHR strategy. 03:00 The symptoms a team experiences when lacking a process model for EHR-related efforts. 04:30 Symptom #2: The business objective is not a business objective. 08:50 "Technology in itself has no value. Business models have value." 10:00 Four major technology archetypes of customers. 10:25 Stage 3: Solution Construction. 11:10 Technology selection. 14:15 "Pharma tends to be risk averse." 15:20 The answer to choosing the right solution. 16:00 Learn more at aventriahealth.com

I was thinking about this when reading that Forbes article that came out the other day that 44% of Americans skip doctor visits or medical care due to cost. Here's my point: There could be 2 prongs to this. One of them is that the costs are too high. And yep, they are. Even more distressing when you consider that only a dime on every dollar spent on health care goes to the physician or nurse or person actually providing the care. So much is chewed up by invisible middle people adding questionable value to patient care. But here's another prong that you might not have thought of. I remember in one of my marketing classes ages ago the case study about classified ads. Classified ads that listed the price were something like 50% more successful than those that did not. If there's no price, consumers just assume the price is too high. Consumers are consumers whether they're buying a used lawnmower or medical care, and they simply assume the cost is too high when the price tag is turned under. Buying something and being obligated to pay for it even if you don't know what you're getting yourself into... that's a risk that might be a factor in that 44% not bothering to show up for care they need. Today, I speak about the hidden costs and frictions in health care with Joe Murad, President and CEO of PokitDok. Costs and frictions that make being a health care consumer a less than optimal experience. Joe most recently served as Managing Director and Head of Individual Exchange Solutions for Willis Towers Watson where he was responsible for the largest private health insurance exchange. Prior to WTW, Joe was the COO and a founding team member of Extend Health, Inc. from its inception until its $435MM sale to Towers Watson in 2012. Before Extend Health, Joe was part of the initial team at eHealth (IPO: EHTH) where he served as the Director of Business Development and was instrumental in building the company's early overall success. Before eHealth, Joe held numerous market facing roles at Informix Software, Inc. (acquired by IBM in 2001) by way of its acquisition of Illustra Information Technologies in 1995. You can learn more at pokitdok.com

Renya is a Partner in the New York City office of Mercer Health & Benefits and leads the Center for Health Innovation (CHI). CHI is a national team, which includes Mercer LABS, focused on driving market change via collaboration with our clients, our colleagues, and thought leaders across the ecosystem to generate unbiased solutions that translate health innovations into relevant and actionable opportunities for employers. In addition, Renya continues to actively participate and lead consulting engagements that focus on strategic planning, population health management, and health innovation. Prior to joining CHI, Renya served as the Total Health Management Practice Leader for the Central Market where she focused on creating health management and well-being strategies for multinational employers. She led efforts focused on designing high performing care management programs, assessing next generation advocacy models, and developing new approaches to drive optimized health engagement through digital solutions. These projects resulted in industry-leading health outcomes—and more importantly—supported her client's broader workforce goals like optimizing productivity and retaining talent. This work spanned many industries including pharma, manufacturing, technology, and academia. You can learn more at mercer.com.

Dr. Lipi Roy is an internal medicine physician board certified in addiction medicine as well as clinical assistant professor at the NYU School of Medicine, Department of Population Health. She is currently the medical director of an addiction treatment center in New York City. In her previous role as Chief of Addiction Medicine for NYC jails including Rikers Island, Dr. Roy oversaw substance use treatment and recovery efforts for nearly 10,000 incarcerated men and women at the nation's second-largest jail. Previously, she was a primary care doctor to Boston's vulnerable homeless population among whom the leading cause of death was drug overdose. She also served as an attending physician at Massachusetts General Hospital and an instructor of medicine at Harvard Medical School. Dr. Roy completed her medical degree and master's in public health degree at Tulane University in New Orleans, followed by residency training in internal medicine at Duke University Medical Center. Dr. Roy is a strong advocate for public service. In addition to caring for incarcerated and homeless men and women, she has worked with the underserved in Nicaragua and India as well as New Orleans residents affected by Hurricane Katrina. Dr. Roy has also provided medical relief to earthquake victims in Haiti and volunteered in the medical tent at the Boston Marathon. She currently volunteers with the New York City Medical Reserve Corps. You find out more information at lipiroy.com.

Tatyana Kanzaveli has gone from a programmer to senior executive at Big 5 to founder and CEO of a startup company along her 20-year career. She is recognized as a thought leader and mentor for her ability to guide Fortune 500 and startup companies through business challenges. She's worked for major companies like PricewaterhouseCoopers and Fujitsu and startups in the early days of the Web. Tatyana has personally helped companies jump from 0 to millions in revenue, even during the toughest economic times. She has also opened new verticals and markets. Today, she is the founder and CEO of Open Health Network, a startup in a big data/artificial intelligence health care space. She is a mentor at 500Startups and Richard Branson Entrepreneurs Centre and serves on boards for private companies. She also is licensee and organizer of highly notable TEDxBayArea conferences and is a frequent speaker at United States and international conferences on innovation, entrepreneurship and digital health. Tatyana has been featured in the White House blog , spoke at the United Nations, and presented at the first White House Demo Day hosted by President Obama. She was recognized as 1 of the Top 10 Influential Women in Health IT 2015. Tatyana was USSR chess champion an played in the same team with Gary Kasparov. She loves to cook and kayak. You can learn more by emailing [email protected] or by going to www.openhealth.cc

Anne C. Beal, MD, MPH, is dedicated to improving health care in the United States, particularly for vulnerable patient groups. Her career is devoted to providing access to high quality health care and has included delivering health care services, teaching, research, public health, and philanthropy. Dr. Beal is Senior Vice President and Head of Global Patient Solutions for Sanofi, an integrated, global health care company focused on patient needs and engaged in the research, development, manufacturing, and marketing of health care products. In that role, she is supporting a culture of patient-centeredness that ensures patients, their needs and priorities, come first in all of the work of Sanofi. Prior to that, she was the Deputy Executive Director and Chief Engagement Officer for the Patient-Centered Outcomes Research Institute (PCORI) in the US, which was created by the Affordable Care Act to improve health care delivery and outcomes by helping people make informed health care decisions based on research that is guided by patients, caregivers, and the broader health care community. As PCORI's first Chief Officer for Engagement, Dr. Beal was charged with ensuring that the voices of patients and other stakeholders are reflected in their research portfolio. In her role as Deputy Executive Director, she helped to see that PCORI worked efficiently and effectively to carry out its mission as the nation's largest research institute focused on patient-centered outcomes research.

Chief Information Officers (CIOs) are not just "the computer people" anymore. Technology is no longer relegated to the category of operational overhead. Technology is a strategic imperative. It's a competitive differentiator, it's a driver of success in today's connected era, an era increasingly dependent on outcomes-based revenue. On the other hand, when something goes wrong, technology gets blamed even if the real problem is a shabby process or insufficient training. Today, I have a candid conversation with Sue Schade from StarBridge Advisors about the what and how of being a CIO. Sue is the perfect person to have this conversation because she's had the opportunity to serve in the role of CIO or interim CIO at 4 health systems in 4 geographies with 4 different cultures and levels of sophistication and leadership teams. Sue is a Principal at StarBridge Advisors, LLC. A nationally recognized health IT leader, she recently served as interim CIO at Stony Brook Medicine on Long Island and at University Hospitals in Cleveland, Ohio. Prior to joining StarBridge Advisors, she was a founding advisor at Next Wave Health Advisors. Sue has more than 30 years' experience in health care information technology management, and was recognized as the CHIME-HIMSS John E. Gall, Jr. CIO of the Year in 2014. You can learn more at starbridgeadvisors.com or at sueschade.com.

Cyrus Maaghul is a serial entrepreneur currently applying distributed systems, blockchain, and cryptocurrency technology to the health care industry as founder and CEO of HealthCombix and Co-founder/Board Member at PointNurse. Cyrus' health care blockchain thought-leadership has appeared in articles on CoinDesk, Nasdaq, Distributed, and other media outlets. His experience as a payments technology entrepreneur and working inside world-class organizations like Fidelity Investments' Blockchain Incubator and Deloitte Consulting give him a unique perspective to advise, develop strategy, and build decentralized networks. HealthCombix is currently developing new foundational infrastructure and custom applications for decentralized health care, including identity, consent, privacy, smart health trusts, governance, and asset management capabilities. PointNurse is a digital decentralized autonomous-based peer-to-peer virtual health platform seeking to drive down the cost of primary care, streamline clinical trials, and nursing by displacing various intermediaries. Cyrus' interest in blockchain technology began in 2013 after investing in Bitcoin. This led to his investigating how to use blockchain to solve problems related to privacy, peer-to-peer data sharing, security, administration costs, and virtual community governance. You can learn more at healthcombix.com.

Roy is Chief Innovation Officer at Penn Medicine, working to rapidly design, test and implement high impact health care delivery practices. His team crafts interventions to achieve dramatically improved patient outcomes, experience, and high value care. In the past 4 years, they have driven measurable progress in readmission rates, frequent use of the ER, medication adherence, screening rates, antibiotic stewardship, and making a population normotensive, among other advances. Previously, Roy served as the first VP of Innovation for Intuit, a leading software company best known for Quicken and TurboTax. In this role, he led changes in how Intuit managed new business creation, allowing teams to experiment quickly at low cost. Intuit now consistently appears on Forbes' list of the most innovative companies in the world. Prior to leading innovation, Roy's Quicken team achieved record profitability and product leadership while growing to 14 million consumers. Roy's 18 years with Intuit spanned the early years in software to their emergence as a leading SaaS provider. Outside of his Penn role, Roy advises startups and Fortune 100 companies building new technology businesses focused on making a meaningful difference in people's lives. Roy received his MBA from Stanford and graduated with honors from Harvard College. 00:00 Article by Paul Graham "Do Things That Don't Scale." 01:30 Video from Alberto Savoia at Stanford about pretotyping. 02:15 Chris Trimble How Stella Saved the Farm. 03:15 Stories off of University of Penn's Web site, www.pennmedicine.org

Dr. Robert Pearl is the former CEO of the Permanente Medical Group (1999-2017), the nation's largest medical group, and former president of the Mid-Atlantic Permanente Medical Group (2009-2017). In these roles, he led 9,000 physicians, 35,000 staff, and was responsible for the nationally recognized medical care of 4 million Kaiser Permanente members on the west and east coasts. Recently named one of Modern Healthcare's 50 most influential physician leaders, Robert is an advocate for the power of integrated, prepaid, technologically advanced, and physician-led health care delivery. He serves as a clinical professor of plastic surgery at Stanford University School of Medicine and is on the faculty of the Stanford Graduate School of Business, where he teaches courses on strategy and leadership, and lectures on information technology and health care policy. In 2017, he authored Mistreated: Why We think We're Getting Good Health Care—And Why We're Usually Wrong, a Washington Post bestseller that offers a road map for transforming American health care. All proceeds from the book benefit Doctors Without Borders. As a regular contributor to Forbes, Robert covers the business of health care and the culture of medicine. He has been featured on CBS This Morning, CNBC, NPR, and in TIME, USA Today and Bloomberg News. He has published more than 100 articles in various medical journals and contributed to numerous books. He is a frequent keynote speaker at health care and medical technology conferences, Robert has addressed the Commonwealth Club, the World Health Care Congress, and the Institute for Health Care Improvement's National Quality Forum. Board certified in plastic and reconstructive surgery, Robert received his medical degree from the Yale University School of Medicine, followed by a residency in plastic and reconstructive surgery at Stanford University. From 2012 to 2017, he served as chairman of the Council of Accountable Physician Practices (CAPP), which includes the nation's largest and best multispecialty medical groups, and participated in the Bipartisan Congressional Task Force on Delivery System Reform and Health IT in Washington, DC. Stacey Richter is Co-President of Aventria Health Group, a marketing agency specializing in helping pharmaceutical, device, and pharmacy clients gain access to patients by creating and leveraging partnerships with other health care organizations. For 20 years, Stacey has innovated better-coordinated health solutions benefiting all stakeholders, and, most of all, the patient. Alex Akers is Vice President for Business Development with Health Catalyst, a Utah-based, next-generation data, analytics, and decision-support company. He has been with Health Catalyst since 2015. Alex began his career in health care consulting, working for KPMG and Accenture in their health care strategy practices, and then shifting to revenue cycle reengineering with Stockamp & Associates. His passion for technology in health care really took off after he joined Microsoft and was responsible for health care strategy in their payer segment. After a stint with Grand Rounds in San Francisco, Alex landed at Health Catalyst. 00:00 Dr. Robert Pearl, author of Mistreated: Why We think We're Getting Good Health Care—And Why We're Usually Wrong. 01:30 How bad is the problem in American health care? 04:35 How our health system lags in overall health, according to third-party, objective data analysis. 05:20 Rampant overtreatment, and how this adds to the problem. 08:30 How can context improve health care? 09:00 The 4 pillars of improving health care outcomes. 12:40 Integration as a crucial step to maximizing quality. 13:00 Pay-for-value as the second pillar of improving health outcomes. 17:20 Technology as the third pillar. 17:45 How current health care tech being utilized is 50+ years old. 19:30 Why video isn't utilized more in health care, despite being relatively inexpensive. 21:20 Do doctors hate technology? 22:30 "All of medicine is probability." 24:50 "We fail to do the things that we know we should do." 27:00 Physician and clinician-led as the fourth pillar. 28:45 "We don't have a system; we don't have a structure." 29:35 "To do that is going to require leadership." 30:00 Dr. Pearl's advice for actionable change. 31:00 "This is the time to change; don't wait for disruption to occur."

Prior to Aventria, David held several commercial leadership roles, including Head of Oncology Marketing at Genentech and VP Strategic Marketing at Schering AG, specializing in commercializing oncology and specialty products. He was also instrumental in the commercialization of Taxotere, Fludara, Herceptin, and Rituxan. Paul has extensive experience leading successful market access commercialization strategies of specialty pharmaceuticals throughout their life cycles, including several landmark oncology products and other specialty therapeutics. Paul is a former Vice President of Payer Marketing with Bayer and former Vice President and Head of Oncology Managed Markets and Market Access at Novartis Pharmaceuticals. He is an RPh and a graduate of Rutgers University's Ernest Mario College of Pharmacy.

Julie is an executive pharmaceutical leader with over 20 years of experience across all phases of development both on the commercial and research sides of the organization. She leverages her Masters in Business Administration and Doctorate of Pharmacy to develop and deliver strategic patient-centric value propositions to optimize patient access and improve outcomes in patients with difficult to treat diseases leading to longer, healthier, and more productive lives. Her years of experience in global and US payer markets provides Julie with intimate knowledge of the current and evolving payer and market access landscape in the United States and around the globe. She has led the development and execution of several outcomes-based contracts with 3 of the largest national payer organizations in the US. Julie is well published, having authored more than 30 publications in peer-reviewed journals and more than 60 peer-reviewed abstracts presented as posters at major scientific congresses.