The show is here.

The show is here.

Yo, Our mission is clear. It's time to change healthcare. Have no fear. Today is the day. This is the hour together. You know, we've got the power drop, the silos. We're all the same team experience. This is tech and marketing. How can anyone be satisfied with the way things have always been? Yeah, we tried. So join us now. Join the Revolution. Consumer First Health Is the revolution status quo or like status?

Yo, Our mission is clear. It's time to change healthcare. Have no fear. Today is the day. This is the hour together. You know, we've got the power drop, the silos. We're all the same team experience. This is tech and marketing. How can anyone be satisfied with the way things have always been? Yeah, we tried. So join us now. Join the Revolution. Consumer First Health Is the revolution status quo or like status?

No. Yeah. This is the health rep, y'all.

No. Yeah. This is the health rep, y'all.

New choices, new platforms, new care models and the health care of tomorrow, consumers win. But who will design it? What will it look like and how long will it take? We are here to answer those questions with some provocative thinking about how to create the health care that people actually want. Ready to roll up your sleeves, Look at the world a little differently and explore the frontiers of consumer health together. Join us. This is the health care wrap. Welcome back. I'm your host, Jared Johnson. And here's what's going to go down today. We have the flavor of the week about new data from epic research on how telehealth visits don't require in-person visits. How can we use this data to support the creation of consumer first products and services? I'll talk about that. Then we continue our 2023 Predictions series, where we're inviting pairs of all star guests to share their predictions for consumer transformation in the coming year and beyond. This week, we welcome author, blogger, consultant and Trend Weaver, Jane Sarazen Khan and Amy Heymans, Chief Design Officer for UnitedHealthCare. How are health systems, health plans and disruptors addressing the calls to become more consumer centric? And where should you be looking next? It's time to dive right in. Are you ready? Let's go. Flavor of the Week Epix Latest research on telehealth visits can help you champion Consumer First Health in your organization. On December 13th, Epic Research published a study titled Telehealth Visits are unlikely to require in-person follow up within 90 days. It was a large scale study of more than 35 million telehealth visits conducted between March 1st, 2020 and May 31st, 2022, to determine the overall rates of telehealth visits by specialty and to identify how often these visits require in-person follow up within the same specialty. Their conclusion they found that high follow up rates were present only in specialties that unavoidably require regular visits with an in-person component for hands on care, such as obstetrics and surgery. Here are their key findings. In nearly every specialty studied, most patients who had a telehealth visit did not require an in-person follow up appointment in that specialty in the next three months for specialties that required follow up, the additional visits were likely related to needing additional care, not duplicative care. For example, obstetrics or geriatrics, Mental health and psychiatry had the largest volume of telehealth utilization and some of the lowest rates of needing in-person follow up. Only 15% of the time did a patient who had a psychiatry or mental health telehealth visit need an in-person follow up visit in the next three months? And in specialties that could be consultations, for example, genetics or nutrition in telehealth visits might even replace the need for in-person visits. Genetics telehealth visits required in-person follow up 4% of the time, nutrition telehealth visits required in-person follow up only 10% of the time. Epic research had two recommended actions as a result. First, health care providers should continue to educate policymakers and administrators on the function that telehealth plays as an alternative rather than duplicative and counter. And second, health care payers should extend telehealth visit coverage beyond the current waiver to support this method of care delivery and increased health care access. What do I think? This type of research is tremendously useful in crafting consumer first services. I've heard people point to post-pandemic drops in usage and question whether they should keep offering virtual visits at all. So when that happens to you now you have more data points to share. Not to mention these are by far the biggest data points that I have seen 35 million telehealth visits from 1063 hospitals and more than 22,000 clinics. The study was completed by two teams that worked independently, each composed of a clinician and research scientists, and the two teams came to similar conclusions. Why does this matter? We're in the midst of a time when consumer transformation could be discarded by the wayside if we don't champion it and stay vigilant about continually connecting a better consumer experience with better business and better outcomes, how might you bring a more informed view to the table and become a consumer transformation champion? For starters, you can find a link to the study in the show notes. In the meantime, let's seek out more validated data to support our calls for building and designing consumer first products and services. That's another way that we'll build to the health care of tomorrow, and that's the flavor of the week.

New choices, new platforms, new care models and the health care of tomorrow, consumers win. But who will design it? What will it look like and how long will it take? We are here to answer those questions with some provocative thinking about how to create the health care that people actually want. Ready to roll up your sleeves, Look at the world a little differently and explore the frontiers of consumer health together. Join us. This is the health care wrap. Welcome back. I'm your host, Jared Johnson. And here's what's going to go down today. We have the flavor of the week about new data from epic research on how telehealth visits don't require in-person visits. How can we use this data to support the creation of consumer first products and services? I'll talk about that. Then we continue our 2023 Predictions series, where we're inviting pairs of all star guests to share their predictions for consumer transformation in the coming year and beyond. This week, we welcome author, blogger, consultant and Trend Weaver, Jane Sarazen Khan and Amy Heymans, Chief Design Officer for UnitedHealthCare. How are health systems, health plans and disruptors addressing the calls to become more consumer centric? And where should you be looking next? It's time to dive right in. Are you ready? Let's go. Flavor of the Week Epix Latest research on telehealth visits can help you champion Consumer First Health in your organization. On December 13th, Epic Research published a study titled Telehealth Visits are unlikely to require in-person follow up within 90 days. It was a large scale study of more than 35 million telehealth visits conducted between March 1st, 2020 and May 31st, 2022, to determine the overall rates of telehealth visits by specialty and to identify how often these visits require in-person follow up within the same specialty. Their conclusion they found that high follow up rates were present only in specialties that unavoidably require regular visits with an in-person component for hands on care, such as obstetrics and surgery. Here are their key findings. In nearly every specialty studied, most patients who had a telehealth visit did not require an in-person follow up appointment in that specialty in the next three months for specialties that required follow up, the additional visits were likely related to needing additional care, not duplicative care. For example, obstetrics or geriatrics, Mental health and psychiatry had the largest volume of telehealth utilization and some of the lowest rates of needing in-person follow up. Only 15% of the time did a patient who had a psychiatry or mental health telehealth visit need an in-person follow up visit in the next three months? And in specialties that could be consultations, for example, genetics or nutrition in telehealth visits might even replace the need for in-person visits. Genetics telehealth visits required in-person follow up 4% of the time, nutrition telehealth visits required in-person follow up only 10% of the time. Epic research had two recommended actions as a result. First, health care providers should continue to educate policymakers and administrators on the function that telehealth plays as an alternative rather than duplicative and counter. And second, health care payers should extend telehealth visit coverage beyond the current waiver to support this method of care delivery and increased health care access. What do I think? This type of research is tremendously useful in crafting consumer first services. I've heard people point to post-pandemic drops in usage and question whether they should keep offering virtual visits at all. So when that happens to you now you have more data points to share. Not to mention these are by far the biggest data points that I have seen 35 million telehealth visits from 1063 hospitals and more than 22,000 clinics. The study was completed by two teams that worked independently, each composed of a clinician and research scientists, and the two teams came to similar conclusions. Why does this matter? We're in the midst of a time when consumer transformation could be discarded by the wayside if we don't champion it and stay vigilant about continually connecting a better consumer experience with better business and better outcomes, how might you bring a more informed view to the table and become a consumer transformation champion? For starters, you can find a link to the study in the show notes. In the meantime, let's seek out more validated data to support our calls for building and designing consumer first products and services. That's another way that we'll build to the health care of tomorrow, and that's the flavor of the week.

The flow. The flow. The flow.

The flow. The flow. The flow.

All right, everyone, let's get into the flow. Today we continue our Predictions series to wrap up the year, and I am doubly excited today. I really am. I'm going to try not to geek out in my fandom here that our first guest is Jane Saracen Khan. Jane, welcome to the Health Care wrap.

All right, everyone, let's get into the flow. Today we continue our Predictions series to wrap up the year, and I am doubly excited today. I really am. I'm going to try not to geek out in my fandom here that our first guest is Jane Saracen Khan. Jane, welcome to the Health Care wrap.

Thanks, Jared. Happy to be here.

Thanks, Jared. Happy to be here.

My goodness. And you were calling in across the pond, as they say, correct?

My goodness. And you were calling in across the pond, as they say, correct?

I'm in Brussels, Belgium right now. So it's a lovely time to be here.

I'm in Brussels, Belgium right now. So it's a lovely time to be here.

You were just speaking about some of the time you've gotten to spend in the Christmas markets around there. It just sounds like a lovely time of year to be there.

You were just speaking about some of the time you've gotten to spend in the Christmas markets around there. It just sounds like a lovely time of year to be there.

It's fantastic, which is why I wanted to stay here through the new year at least, to experience all this wonderful holiday. Splendor, lights and great food.

It's fantastic, which is why I wanted to stay here through the new year at least, to experience all this wonderful holiday. Splendor, lights and great food.

Does sound lovely in in many different ways. That sounds fantastic. I'm also pleased to welcome Amy Heyman's back to the podcast. Amy, how are you?

Does sound lovely in in many different ways. That sounds fantastic. I'm also pleased to welcome Amy Heyman's back to the podcast. Amy, how are you?

Oh God, I'm good, but not as good as Jane. I was in Brugge once near the holidays and it was so, so lovely. So wish I could be there with you. Jane I'm in New Hampshire, an hour north of Boston, so you can have that lovely country holiday vibe. But but yeah, I'd love to be over in Belgium.

Oh God, I'm good, but not as good as Jane. I was in Brugge once near the holidays and it was so, so lovely. So wish I could be there with you. Jane I'm in New Hampshire, an hour north of Boston, so you can have that lovely country holiday vibe. But but yeah, I'd love to be over in Belgium.

What a great time of year. I mean, all around. I want to dig right in here because I want to make the most of our time. I wanted to give you both a chance to share anything you'd like to our listeners to know about you and your background. I feel like listeners know you both pretty well. But Jane, let's start with you. What would you like our listeners to know about what you're working on right now?

What a great time of year. I mean, all around. I want to dig right in here because I want to make the most of our time. I wanted to give you both a chance to share anything you'd like to our listeners to know about you and your background. I feel like listeners know you both pretty well. But Jane, let's start with you. What would you like our listeners to know about what you're working on right now?

Sure. So my background's in health economics, but I've only ever been an advisor to the health systems of the US and many in Europe as well. What I'm working on now is the growing ecosystem of what I call retail health, which is not only with retail pharmacy, but it's anything consumer facing in health where people can take on more self care, health care and actually stay away from acute care as long as possible, from a health economics point of view, that's what can conserve costs, greater patient engagement. So I'm doing a lot of work across the whole ecosystem, whether it's looking at big food and retail or with traditional health systems who want to do more of that. So that's where I'm at right now.

Sure. So my background's in health economics, but I've only ever been an advisor to the health systems of the US and many in Europe as well. What I'm working on now is the growing ecosystem of what I call retail health, which is not only with retail pharmacy, but it's anything consumer facing in health where people can take on more self care, health care and actually stay away from acute care as long as possible, from a health economics point of view, that's what can conserve costs, greater patient engagement. So I'm doing a lot of work across the whole ecosystem, whether it's looking at big food and retail or with traditional health systems who want to do more of that. So that's where I'm at right now.

That's amazing work and I'm so thrilled that you're doing it. Amy, what about you? You have a new gig since the last time we had you on the podcast.

That's amazing work and I'm so thrilled that you're doing it. Amy, what about you? You have a new gig since the last time we had you on the podcast.

Yeah, absolutely. So I am a designer born and bred and for 20 years led a design consultancy called Mad Cow, where we brought purpose driven design, human centered design into health and finance. And of course, the organizations in the middle of those two industries, insurance companies. So we worked with health organizations across the ecosystem payer provider, government, nonprofit. I really enjoyed the work we did with our insurance company clients because I felt that you know, in a system where folks are left in the middle of a big mess trying to figure things out on their own, that health insurance companies actually have a great opportunity to help bridge some of the gaps and be there for folks when people need someone to kind of guide them through things. So I left mad Cow after 20 years and still going strong, but I wanted to pivot my career and start to untangle some of these wicked problems, some of the systemic problems from the inside and make a big impact at scale. So I chose to join UnitedHealthCare as chief design officer. I oversee an amazing team of designers. We're looking to make insurance easier to understand and navigate, but also really show up for people, as I mentioned, when they need us most during their health journey, during the moments that matter in their lives. And I should say that that my opinions are my own and do not reflect UnitedHealthCare. I've worked in insurance and in health and in design for years and years and years, so I'm bringing to bear those collective experiences in my in my views and insights.

Yeah, absolutely. So I am a designer born and bred and for 20 years led a design consultancy called Mad Cow, where we brought purpose driven design, human centered design into health and finance. And of course, the organizations in the middle of those two industries, insurance companies. So we worked with health organizations across the ecosystem payer provider, government, nonprofit. I really enjoyed the work we did with our insurance company clients because I felt that you know, in a system where folks are left in the middle of a big mess trying to figure things out on their own, that health insurance companies actually have a great opportunity to help bridge some of the gaps and be there for folks when people need someone to kind of guide them through things. So I left mad Cow after 20 years and still going strong, but I wanted to pivot my career and start to untangle some of these wicked problems, some of the systemic problems from the inside and make a big impact at scale. So I chose to join UnitedHealthCare as chief design officer. I oversee an amazing team of designers. We're looking to make insurance easier to understand and navigate, but also really show up for people, as I mentioned, when they need us most during their health journey, during the moments that matter in their lives. And I should say that that my opinions are my own and do not reflect UnitedHealthCare. I've worked in insurance and in health and in design for years and years and years, so I'm bringing to bear those collective experiences in my in my views and insights.

Yeah, more incredibly meaningful work. And I will double down on what you said just there in terms of these being your own opinions here and appreciate that because yeah, what it brings is that entire scope of your career in this field and the insights you've gained. So fantastic. Tell you what, let's get right into this because I'm really excited to hear what the two of you think here. And I will make it very clear to our listeners we're just want to have some fun today. We just want to offer some predictions. Again, these are just things that are based on what we're seeing, where we'd like to see the industry go regarding consumer transformation. And I'd like to start with traditional providers, so our incumbent providers, if you will, hospitals and health systems for the most part, looking at what trends we might expect to see there. I'm also curious how the two of you define consumer transformation. So maybe, Jane, we can start with you there and tell us how you define it and what trends do you think we might see with providers?

Yeah, more incredibly meaningful work. And I will double down on what you said just there in terms of these being your own opinions here and appreciate that because yeah, what it brings is that entire scope of your career in this field and the insights you've gained. So fantastic. Tell you what, let's get right into this because I'm really excited to hear what the two of you think here. And I will make it very clear to our listeners we're just want to have some fun today. We just want to offer some predictions. Again, these are just things that are based on what we're seeing, where we'd like to see the industry go regarding consumer transformation. And I'd like to start with traditional providers, so our incumbent providers, if you will, hospitals and health systems for the most part, looking at what trends we might expect to see there. I'm also curious how the two of you define consumer transformation. So maybe, Jane, we can start with you there and tell us how you define it and what trends do you think we might see with providers?

Well, I mean, if we're talking consumer transformation versus digital transformation, consumer transformation is really what we saw accelerated in the pandemic, which is digital transformation of the individual people working at home schooling at home, praying from home, exercising at home and making sourdough bread at home, putting it on Instagram. ET cetera. So we saw people who could do those things at home, who had broadband connectivity and platforms for. On ramping to the online world take on more digital tasks, whether it was e-commerce or self care, health care through telehealth or peer to peer health care, networking on social social media. So that now is pressuring. I will shift to your question grassroots from the bottom demand, pushing up to traditional providers, hospitals and health systems for people demanding more digitally enhanced digitally enchanting services, which is where Amy comes into play. But speaking of the trends facing these hospitals and the biggest challenge facing hospitals and health systems is that we know from Kauffman Hall's monthly hospital reports that hospitals are entering 2023 in financially unwell ways. Around half of US hospitals will start the new year with negative margins. And we have to think about hospital finances. If we're talking about digital transformation and what's available in terms of resourcing to invest in addressing patients, demand for enchanting design and digital front doors, quote unquote. I'm also looking at 2023 and hospitals engaging in this. What I've been writing about the battle royale for primary care. Primary care is where you get patients to enter your system. So we have traditional legacy players, hospitals and health systems needing to get more ambulatory patients through the door because margins are down in those places. And this is the sweet spot. But on the other hand, the new entrants will talk about later are also entering the primary care space. So we have this competition in the middle for that digital first primary care patient. And that's what I see as a key trend entering 2023 for these legacy systems downward spiraling profits or flat at best. And then consumers demanding greater digital experiences that are in Amy's world, enchanting experiences.

Well, I mean, if we're talking consumer transformation versus digital transformation, consumer transformation is really what we saw accelerated in the pandemic, which is digital transformation of the individual people working at home schooling at home, praying from home, exercising at home and making sourdough bread at home, putting it on Instagram. ET cetera. So we saw people who could do those things at home, who had broadband connectivity and platforms for. On ramping to the online world take on more digital tasks, whether it was e-commerce or self care, health care through telehealth or peer to peer health care, networking on social social media. So that now is pressuring. I will shift to your question grassroots from the bottom demand, pushing up to traditional providers, hospitals and health systems for people demanding more digitally enhanced digitally enchanting services, which is where Amy comes into play. But speaking of the trends facing these hospitals and the biggest challenge facing hospitals and health systems is that we know from Kauffman Hall's monthly hospital reports that hospitals are entering 2023 in financially unwell ways. Around half of US hospitals will start the new year with negative margins. And we have to think about hospital finances. If we're talking about digital transformation and what's available in terms of resourcing to invest in addressing patients, demand for enchanting design and digital front doors, quote unquote. I'm also looking at 2023 and hospitals engaging in this. What I've been writing about the battle royale for primary care. Primary care is where you get patients to enter your system. So we have traditional legacy players, hospitals and health systems needing to get more ambulatory patients through the door because margins are down in those places. And this is the sweet spot. But on the other hand, the new entrants will talk about later are also entering the primary care space. So we have this competition in the middle for that digital first primary care patient. And that's what I see as a key trend entering 2023 for these legacy systems downward spiraling profits or flat at best. And then consumers demanding greater digital experiences that are in Amy's world, enchanting experiences.

I'm really latching onto that term. Enhanced. Yeah. Yeah. Amy, what do you think? Yeah, I love.

I'm really latching onto that term. Enhanced. Yeah. Yeah. Amy, what do you think? Yeah, I love.

I love the enchanting. I mean, it really speaks to kind of an intuitive engagement and just fluidity and sort of delight. I mean, think, you know, when looking to to 2023 and this is sort of the eternal challenge that we're up against. There's so much pain to heal, right? There's so much hurt. There are people who are in pain. There are people who are suffering. There are people who are managing chronic conditions. And there's so much work that we need to do to connect folks with the resources, the care, the community, the other human beings, the activity, the understanding that's going to help them to to heal, to feel better. But then also, you know, health is interesting because when health isn't present, when you're struggling, you know, it's a number one priority. Right? But when your health is okay, quote unquote, it can kind of fade into the background. But we know that, you know, prevention and lifestyle behavior change and looking at sort of how do we manage stress, how do we improve our relationships, how do we ensure that we're getting enough activity that we're eating, you know, nutritious foods? All of these things are so important and they and they shape our health, right? So what Jane's working on, she's always working on what's next. So if you ever want to know what's going to happen in health care, you just look at what Jane is working on. What she's talking about is so important because it really gets to the clinical experiences that we deliver need to improve, right? Both from a easy to do business with perspective like seamless experiences and journeys where things are connected and they there as you would expect them to be modern consumer grade digital experiences. Right? But also outside of the clinical realm, how are people managing their health, their conditions, but also their well-being? How are they, you know, making a commitment to meditate or to go get that physical therapy or to walk with a friend or to maybe, you know, eat more vegetables and manage their weight. All of these things people are doing outside of the clinical. And so how do we be conscious of that and sort of connect it up so that we're approaching it from a more holistic perspective? Because think sometimes the system can be a little bit, a little bit tone deaf, right? We'll only pay attention to 25 to 30% of the things that you care about or the things that you're thinking about or the ways that you go about managing your health. How do we connect it all up? And I think it's really important what she said, too, about primary care. Primary care is, again, in two ways. You're the sort of center point for how I'm managing my condition and I'm interacting with primary care in that way. Or primary care is a means to prevention and primary care as a means to prevention only works if somebody shows up. So that opportunity comes into play. How do we help people to achieve their best health in alternative ways that are engaging and enchanting to to Jayne's point and digital health is is still a huge opportunity. So I see all this innovation happening in pockets. But the question becomes, how do we connect the people who could benefit with the solutions that from an evidence and evidence perspective are effective?

I love the enchanting. I mean, it really speaks to kind of an intuitive engagement and just fluidity and sort of delight. I mean, think, you know, when looking to to 2023 and this is sort of the eternal challenge that we're up against. There's so much pain to heal, right? There's so much hurt. There are people who are in pain. There are people who are suffering. There are people who are managing chronic conditions. And there's so much work that we need to do to connect folks with the resources, the care, the community, the other human beings, the activity, the understanding that's going to help them to to heal, to feel better. But then also, you know, health is interesting because when health isn't present, when you're struggling, you know, it's a number one priority. Right? But when your health is okay, quote unquote, it can kind of fade into the background. But we know that, you know, prevention and lifestyle behavior change and looking at sort of how do we manage stress, how do we improve our relationships, how do we ensure that we're getting enough activity that we're eating, you know, nutritious foods? All of these things are so important and they and they shape our health, right? So what Jane's working on, she's always working on what's next. So if you ever want to know what's going to happen in health care, you just look at what Jane is working on. What she's talking about is so important because it really gets to the clinical experiences that we deliver need to improve, right? Both from a easy to do business with perspective like seamless experiences and journeys where things are connected and they there as you would expect them to be modern consumer grade digital experiences. Right? But also outside of the clinical realm, how are people managing their health, their conditions, but also their well-being? How are they, you know, making a commitment to meditate or to go get that physical therapy or to walk with a friend or to maybe, you know, eat more vegetables and manage their weight. All of these things people are doing outside of the clinical. And so how do we be conscious of that and sort of connect it up so that we're approaching it from a more holistic perspective? Because think sometimes the system can be a little bit, a little bit tone deaf, right? We'll only pay attention to 25 to 30% of the things that you care about or the things that you're thinking about or the ways that you go about managing your health. How do we connect it all up? And I think it's really important what she said, too, about primary care. Primary care is, again, in two ways. You're the sort of center point for how I'm managing my condition and I'm interacting with primary care in that way. Or primary care is a means to prevention and primary care as a means to prevention only works if somebody shows up. So that opportunity comes into play. How do we help people to achieve their best health in alternative ways that are engaging and enchanting to to Jayne's point and digital health is is still a huge opportunity. So I see all this innovation happening in pockets. But the question becomes, how do we connect the people who could benefit with the solutions that from an evidence and evidence perspective are effective?

There's a lot to that, isn't there? There are a lot of different players involved in those trends you just mentioned. Then we add like another facet or another layer to it, which is all these disruptors and new entrants and all the other terms we use to describe those non-traditional providers who are coming in and just looking at part of that health care value chain and saying we don't have to figure out acute care, we're just going to come in and provide that that very specific part of primary care, for instance. And we're going to rock at that and bring that better customer experience. And that's just another another layer here. So, Jane, walk us through that. Like, what do you expect to see from these new entrants who are who have come in and have made a dent and they have said like, we're going to address just this part?

There's a lot to that, isn't there? There are a lot of different players involved in those trends you just mentioned. Then we add like another facet or another layer to it, which is all these disruptors and new entrants and all the other terms we use to describe those non-traditional providers who are coming in and just looking at part of that health care value chain and saying we don't have to figure out acute care, we're just going to come in and provide that that very specific part of primary care, for instance. And we're going to rock at that and bring that better customer experience. And that's just another another layer here. So, Jane, walk us through that. Like, what do you expect to see from these new entrants who are who have come in and have made a dent and they have said like, we're going to address just this part?

Well, first, let me respond to Amy by saying one, Now we know why I'm president of the Amy Heyman's fan Club. And two, now we know why UnitedHealthCare wanted to bring her in because she really she brings the empathy. Whichever, you know, before the last few years people thought was an airy fairy, as the Brits say, a soft skill, which is actually a very hard skill. There's a hard ROI on empathy, which I have written about, and there's there's evidence about that. When we look at the new entrants to segue from empathy and Amy's wonderful discussion there, which I could just listen to for another 30 minutes, the disruptors, quote unquote, are these new entrants. Some of them are actually not so new, but expanding and integrating. So if we think about Walmart as a disruptor, I mean, they've been doing health and beauty for years. And when I looked at some of their numbers, what their numbers are to get right for Walmart, but I mean, it's a huge chunk of their business, health and beauty aisles alone in retail. And then we think about health services and the opportunity for a Walmart or a dollar General, which is growing in health with a new CMO hired last year and a board of advisors, we're going to see some traction in 2023 with people reaching out to folks who've been underserved in health care, people with lower incomes, people with health literacy, challenges in terms of language or just, you know, understanding how to read a drug facts label. I will point out that the Consumer Health Care Products Association announced a collaboration last week with Dollar General. And by the way, these are not clients. When I work with somebody, I will tell you if somebody pays me, but a CHP and Dollar General have a pilot for eight weeks in Dollar General stores using a QR code connecting people through their smartphones to really easy to understand drug facts labeling to help you figure out what over-the-counter pain medications you should buy, which is a tough area to crack because, you know, you can go go crazy looking at the choices of pain medications in the store. And if you have high blood pressure, some of these medications could raise your blood pressure. So I love the these applications from, quote, disruptors like a dollar General and Consumer Health Care Products Association or or Walgreens looking at 23 and the disruption in the entrance. Some of these organizations have huge cash reserves to play with going forward. We've seen big purchases being done in the last few months by CVS Health, by Walgreens, who are really going to resemble more and more what Amy's organization, that UnitedHealth Group with Optum looks like, where data become a huge asset, understanding the patient and the way Amy was talking about in terms of nutrition, transportation, the drivers of health or what we used, what I used to call social determinants now. Shifting to the phrase drivers of health with the good counsel of Sandro Galea. But in Boston, because the drivers go beyond social determinants, there are things like broadband and access to connectivity and such. So I think we're going to see more health and wellness growth coming out of traditional providers. As I said, moving toward the digital health companies, you're mentioning, Jared, those fragmenting tool innovators, some of which are proving out and will we'll need more points of proof in 23, many analysts are saying, but also from companies like big grocery stores that have co-located pharmacy chains. And again, we have the retail data and the pharmacy data, which together can be very powerful. So think of someone taking a step and who goes to buy grapefruit juice and we know that's contraindicated. How can we get that information in the the hand of that grocery shopper, which could avert a health incident or an adverse event. So I see this food as medicine issue coming into play as well in 2023 with disruptors and incumbents coming together.

Well, first, let me respond to Amy by saying one, Now we know why I'm president of the Amy Heyman's fan Club. And two, now we know why UnitedHealthCare wanted to bring her in because she really she brings the empathy. Whichever, you know, before the last few years people thought was an airy fairy, as the Brits say, a soft skill, which is actually a very hard skill. There's a hard ROI on empathy, which I have written about, and there's there's evidence about that. When we look at the new entrants to segue from empathy and Amy's wonderful discussion there, which I could just listen to for another 30 minutes, the disruptors, quote unquote, are these new entrants. Some of them are actually not so new, but expanding and integrating. So if we think about Walmart as a disruptor, I mean, they've been doing health and beauty for years. And when I looked at some of their numbers, what their numbers are to get right for Walmart, but I mean, it's a huge chunk of their business, health and beauty aisles alone in retail. And then we think about health services and the opportunity for a Walmart or a dollar General, which is growing in health with a new CMO hired last year and a board of advisors, we're going to see some traction in 2023 with people reaching out to folks who've been underserved in health care, people with lower incomes, people with health literacy, challenges in terms of language or just, you know, understanding how to read a drug facts label. I will point out that the Consumer Health Care Products Association announced a collaboration last week with Dollar General. And by the way, these are not clients. When I work with somebody, I will tell you if somebody pays me, but a CHP and Dollar General have a pilot for eight weeks in Dollar General stores using a QR code connecting people through their smartphones to really easy to understand drug facts labeling to help you figure out what over-the-counter pain medications you should buy, which is a tough area to crack because, you know, you can go go crazy looking at the choices of pain medications in the store. And if you have high blood pressure, some of these medications could raise your blood pressure. So I love the these applications from, quote, disruptors like a dollar General and Consumer Health Care Products Association or or Walgreens looking at 23 and the disruption in the entrance. Some of these organizations have huge cash reserves to play with going forward. We've seen big purchases being done in the last few months by CVS Health, by Walgreens, who are really going to resemble more and more what Amy's organization, that UnitedHealth Group with Optum looks like, where data become a huge asset, understanding the patient and the way Amy was talking about in terms of nutrition, transportation, the drivers of health or what we used, what I used to call social determinants now. Shifting to the phrase drivers of health with the good counsel of Sandro Galea. But in Boston, because the drivers go beyond social determinants, there are things like broadband and access to connectivity and such. So I think we're going to see more health and wellness growth coming out of traditional providers. As I said, moving toward the digital health companies, you're mentioning, Jared, those fragmenting tool innovators, some of which are proving out and will we'll need more points of proof in 23, many analysts are saying, but also from companies like big grocery stores that have co-located pharmacy chains. And again, we have the retail data and the pharmacy data, which together can be very powerful. So think of someone taking a step and who goes to buy grapefruit juice and we know that's contraindicated. How can we get that information in the the hand of that grocery shopper, which could avert a health incident or an adverse event. So I see this food as medicine issue coming into play as well in 2023 with disruptors and incumbents coming together.

Fantastic. Amy, what do you think? Yeah, 1 or 2.

Fantastic. Amy, what do you think? Yeah, 1 or 2.

I mean, just the whole concept of neighborhood health. I think the pendulum has swung in the direction of technology, you know, and people, you know, wonder and worry about the singularity. I mean, is technology going to take control? It already has. And that's a good debate topic. And it's like, who's in charge here? Right? So the pendulum has swung all the way in the direction of technology. And you could argue that it will continue to and in many ways that it will. But I think the operating principle of the technology should help us to be more human, not less human. And as technology accelerates, quote unquote, productivity, it enables us to do more things faster. We come to grips with the sheer limits of our humanity in terms of how much can we see, how much can we do, how much can we be. And so I think that this pendulum swinging back in in a in a period where we have the proliferation of technology, but yet an epidemic of loneliness and isolation and depression. So we're going to see that pendulum start to swing back in the direction of relationships and humanity and the companies who are able to leverage technology to be able to show up to people with people in a very human way are the ones that feel will win moving forward. And so when they have a brick and mortar footprint, you know, when you hear folks in the retiree segment saying, I just want to go to a place to see people and to talk with them. Right. To get out of the house. Right. These are some things that technology can help with in some ways. You know, Amazon, Alexa and the caregiver market folks are installing Amazon. Alexa with their aging parents to like drop in and say hello and you know check in So technology can help in a way. But but it doesn't sort of give us, you know, from a fulfillment perspective and from a complete opportunity perspective what these human to human relationships do. Right. And so I think we need to be very conscious of that and design for it. And so to Jane's point, retail health, neighborhood health, human connection, getting to the heart of the matter, right? So enough with operating on the superficial level, getting to the core of what people are really struggling with and showing up for them there, That's prevention, right? I love the quote by Desmond Tutu, and we spent a lot of time pulling people out of the river instead of going upstream and trying to figure out why they fell in and stopping them from falling in. Right. I'm probably butchering the quote, but the premise is let's focus on what people truly need, that the people, the human at the end of it and so yeah I plus one and by the way, Gene I am also I'm the president of your fan club. So I'm there.

I mean, just the whole concept of neighborhood health. I think the pendulum has swung in the direction of technology, you know, and people, you know, wonder and worry about the singularity. I mean, is technology going to take control? It already has. And that's a good debate topic. And it's like, who's in charge here? Right? So the pendulum has swung all the way in the direction of technology. And you could argue that it will continue to and in many ways that it will. But I think the operating principle of the technology should help us to be more human, not less human. And as technology accelerates, quote unquote, productivity, it enables us to do more things faster. We come to grips with the sheer limits of our humanity in terms of how much can we see, how much can we do, how much can we be. And so I think that this pendulum swinging back in in a in a period where we have the proliferation of technology, but yet an epidemic of loneliness and isolation and depression. So we're going to see that pendulum start to swing back in the direction of relationships and humanity and the companies who are able to leverage technology to be able to show up to people with people in a very human way are the ones that feel will win moving forward. And so when they have a brick and mortar footprint, you know, when you hear folks in the retiree segment saying, I just want to go to a place to see people and to talk with them. Right. To get out of the house. Right. These are some things that technology can help with in some ways. You know, Amazon, Alexa and the caregiver market folks are installing Amazon. Alexa with their aging parents to like drop in and say hello and you know check in So technology can help in a way. But but it doesn't sort of give us, you know, from a fulfillment perspective and from a complete opportunity perspective what these human to human relationships do. Right. And so I think we need to be very conscious of that and design for it. And so to Jane's point, retail health, neighborhood health, human connection, getting to the heart of the matter, right? So enough with operating on the superficial level, getting to the core of what people are really struggling with and showing up for them there, That's prevention, right? I love the quote by Desmond Tutu, and we spent a lot of time pulling people out of the river instead of going upstream and trying to figure out why they fell in and stopping them from falling in. Right. I'm probably butchering the quote, but the premise is let's focus on what people truly need, that the people, the human at the end of it and so yeah I plus one and by the way, Gene I am also I'm the president of your fan club. So I'm there.

So let's see, let's add one more layer here yet. And Amy, we can start with you on this one. That's health plans. What can we expect there? And again, we'll reinforce fact. You know, this is Amy speaking not on behalf of United or anything, but just anything that's that's come up or anything that that you expect that we'll see.

So let's see, let's add one more layer here yet. And Amy, we can start with you on this one. That's health plans. What can we expect there? And again, we'll reinforce fact. You know, this is Amy speaking not on behalf of United or anything, but just anything that's that's come up or anything that that you expect that we'll see.

From again some major trends. Right. That the connectivity connecting people with other people, connecting people with information, connecting people with resources and starting to delve, expand the purview outside of outside of the clinical. So mastering sort of what folks expect out of us clearly. But then, you know, stepping beyond that to really extend the relationship in the social social contract that we have with people. So I think there's enormous opportunity to help people navigate the health system and to. Achieve better health by really catering to what they what they really want and need. And that's, you know, philosophical by nature. But, you know, that's one thing that I'm thinking really deeply about, actually, is ethics in moral philosophy. You know, our clinicians and caregivers take the Hippocratic Oath. What's our oath as people who are working in the health system as designers, as engineers, as marketers? What's what's our commitment and how do we translate ethics and more moral philosophy? Do no harm treating people with dignity? How do we translate those things into principles that can guide us so that we can say, okay, let's reduce harm? What harm are we doing? Okay, What harm? What harm could this decision, this solution actually have downstream? What are the cascading impacts? I've been getting a lot more into futures thinking and speculative foresight. Now that is imagining a future, right? What are the positive futures? The aspirational futures? The preferred futures? The possible futures? The plausible futures? The dark futures that could happen. How do we anticipate negative downstream consequences and designed to prevent them? But also how do we get really influential People said about the work of thinking about what kind of world do we actually want to create? What is a positive health experience, a positive health system? What does that actually look like? Right? Because it's really easy to imagine the apocalypse, but it's more difficult to set about the creative work of imagining everything working, actually, as we would hope it could. Or it should.

From again some major trends. Right. That the connectivity connecting people with other people, connecting people with information, connecting people with resources and starting to delve, expand the purview outside of outside of the clinical. So mastering sort of what folks expect out of us clearly. But then, you know, stepping beyond that to really extend the relationship in the social social contract that we have with people. So I think there's enormous opportunity to help people navigate the health system and to. Achieve better health by really catering to what they what they really want and need. And that's, you know, philosophical by nature. But, you know, that's one thing that I'm thinking really deeply about, actually, is ethics in moral philosophy. You know, our clinicians and caregivers take the Hippocratic Oath. What's our oath as people who are working in the health system as designers, as engineers, as marketers? What's what's our commitment and how do we translate ethics and more moral philosophy? Do no harm treating people with dignity? How do we translate those things into principles that can guide us so that we can say, okay, let's reduce harm? What harm are we doing? Okay, What harm? What harm could this decision, this solution actually have downstream? What are the cascading impacts? I've been getting a lot more into futures thinking and speculative foresight. Now that is imagining a future, right? What are the positive futures? The aspirational futures? The preferred futures? The possible futures? The plausible futures? The dark futures that could happen. How do we anticipate negative downstream consequences and designed to prevent them? But also how do we get really influential People said about the work of thinking about what kind of world do we actually want to create? What is a positive health experience, a positive health system? What does that actually look like? Right? Because it's really easy to imagine the apocalypse, but it's more difficult to set about the creative work of imagining everything working, actually, as we would hope it could. Or it should.

Yeah. Yeah. Jane, any comments on that?

Yeah. Yeah. Jane, any comments on that?

Oh, gosh, yes, I love it. First upstream, upstream. Desmond Tutu. I mean, upstream is what we're talking about. That's prevention. That's education. That's transportation. That's clean air. Clean water so that kids don't develop asthma and end up in the E.R., you know, circular door in and out with asthma exacerbations because air is dirty, clean water. Flint In my home state of Michigan and in London, where I spent last week working, there are concerns about dirty water spawning polio again in London today, 2022 we're entering 2023 with great knowledge post-pandemic and now about public health. But to Amy's point, do we really believe and I'll put my US lens back on, does the US really believe in public health? Because public health is a real thing with a capital P of capital H and concerns the things that Amy's talking about, the collective, the social contract. Now, thinking about the health plan role here, I'm encouraged that many health plans are looking at the role of ESG in their mission and vision. So that's environmental, social and governance goals that come out of the UN sustainability objectives. ESG is important in banking and in lending. Now, where we're looking at the likes of Wall Street, Standard and Poor's who are starting to evaluate big hospitals, pharmaceutical companies and other and health insurance companies coming to do financing, where Standard Poor's, as an example, rates their credit worthiness. And ESG is now part of rating those companies credit worthiness. Those are publicly traded companies. So for the for profit sector. So it's exciting because we're seeing ESG reports coming out of these big companies looking at environmental and climate goals, looking at social, social, looking at inclusion, diversity and how neighborhoods are being treated, where these headquarters operations are. So I think Amy's point about neighborhood care or accountable community of care, not just accountable health care, but accountable communities for care is emerging and many health plans. That was your question, Jared, are addressing things like housing, investing in local housing or housing in places where they have big operations, looking at mental health for both workers and insureds. And then the employers who contract with these health plans are also looking to do more in terms of mental and behavioral health for 2023. As we look at employee benefits next year. And many of those reports are coming out now that I've been combing through. So we're seeing more attention to mental and behavioral health for both insureds and their families, young people whose mental health has been devastated in many cohorts of young people around the US and around the world, in fact, and then attending more to sleep asleep, which is getting more. Attention by insurance companies and employers alike as part of our overall well-being. So I'm encouraged by what I'm seeing with health plans regarding the drivers of health and going upstream.

Oh, gosh, yes, I love it. First upstream, upstream. Desmond Tutu. I mean, upstream is what we're talking about. That's prevention. That's education. That's transportation. That's clean air. Clean water so that kids don't develop asthma and end up in the E.R., you know, circular door in and out with asthma exacerbations because air is dirty, clean water. Flint In my home state of Michigan and in London, where I spent last week working, there are concerns about dirty water spawning polio again in London today, 2022 we're entering 2023 with great knowledge post-pandemic and now about public health. But to Amy's point, do we really believe and I'll put my US lens back on, does the US really believe in public health? Because public health is a real thing with a capital P of capital H and concerns the things that Amy's talking about, the collective, the social contract. Now, thinking about the health plan role here, I'm encouraged that many health plans are looking at the role of ESG in their mission and vision. So that's environmental, social and governance goals that come out of the UN sustainability objectives. ESG is important in banking and in lending. Now, where we're looking at the likes of Wall Street, Standard and Poor's who are starting to evaluate big hospitals, pharmaceutical companies and other and health insurance companies coming to do financing, where Standard Poor's, as an example, rates their credit worthiness. And ESG is now part of rating those companies credit worthiness. Those are publicly traded companies. So for the for profit sector. So it's exciting because we're seeing ESG reports coming out of these big companies looking at environmental and climate goals, looking at social, social, looking at inclusion, diversity and how neighborhoods are being treated, where these headquarters operations are. So I think Amy's point about neighborhood care or accountable community of care, not just accountable health care, but accountable communities for care is emerging and many health plans. That was your question, Jared, are addressing things like housing, investing in local housing or housing in places where they have big operations, looking at mental health for both workers and insureds. And then the employers who contract with these health plans are also looking to do more in terms of mental and behavioral health for 2023. As we look at employee benefits next year. And many of those reports are coming out now that I've been combing through. So we're seeing more attention to mental and behavioral health for both insureds and their families, young people whose mental health has been devastated in many cohorts of young people around the US and around the world, in fact, and then attending more to sleep asleep, which is getting more. Attention by insurance companies and employers alike as part of our overall well-being. So I'm encouraged by what I'm seeing with health plans regarding the drivers of health and going upstream.

See, I told you this is going to be a well rounded discussion. I mean, we're we're able to take a lot of just between the two of you, take so many different facets and take so many different audiences, I guess is the easiest way to say it and weave this together. I mean, this is really where where this is compounding and just there are going to be some overall trends. And that's the big picture that we're painting here. So maybe I can go the opposite way and look at a couple of individual players. I wonder if could we just have a little fun on this one and have you each predict a brand that will be talking about the most in 2023? Jane, you want to start with this one?

See, I told you this is going to be a well rounded discussion. I mean, we're we're able to take a lot of just between the two of you, take so many different facets and take so many different audiences, I guess is the easiest way to say it and weave this together. I mean, this is really where where this is compounding and just there are going to be some overall trends. And that's the big picture that we're painting here. So maybe I can go the opposite way and look at a couple of individual players. I wonder if could we just have a little fun on this one and have you each predict a brand that will be talking about the most in 2023? Jane, you want to start with this one?

Well, I'm just going to go for the obvious one. The big A Amazon who everybody likes to trash when they close down one part of an Amazon health product, but then the next week announce a new one. When you have a lot of cash around, you can fast fail and reenter and learn. And we should all be lifelong learners, right, as individuals or as organizations. So I would not count Amazon out at all looking forward for 2023 for big tech in general, though, my proviso in this includes Amazon is issue of privacy and trust. So living in Europe much of the time now I track what's going on with the EU and a lot of lawsuits against big tech in terms of the GDPR, which is the privacy regulation that's much more overarching than HIPAA or any other privacy regulation in the US. But privacy is a huge area now and trust is a precursor for engagement. So if a consumer does not trust an organization to share their data with, they're not going to share their data. And we saw that during Covid, where Americans on masks said they didn't even want to share temperature data with the government in terms of tracking and tracing for contact tracing for Covid. So I'm not optimistic about people sharing data where there's no trust, nor do I endorse people sharing data where there's no trust. And this gets back to Amy's point about empathy and really currying loyalty and earning loyalty. Hard to earn, easy to lose. So that's my proviso on big tech and health data for 23 actually.

Well, I'm just going to go for the obvious one. The big A Amazon who everybody likes to trash when they close down one part of an Amazon health product, but then the next week announce a new one. When you have a lot of cash around, you can fast fail and reenter and learn. And we should all be lifelong learners, right, as individuals or as organizations. So I would not count Amazon out at all looking forward for 2023 for big tech in general, though, my proviso in this includes Amazon is issue of privacy and trust. So living in Europe much of the time now I track what's going on with the EU and a lot of lawsuits against big tech in terms of the GDPR, which is the privacy regulation that's much more overarching than HIPAA or any other privacy regulation in the US. But privacy is a huge area now and trust is a precursor for engagement. So if a consumer does not trust an organization to share their data with, they're not going to share their data. And we saw that during Covid, where Americans on masks said they didn't even want to share temperature data with the government in terms of tracking and tracing for contact tracing for Covid. So I'm not optimistic about people sharing data where there's no trust, nor do I endorse people sharing data where there's no trust. And this gets back to Amy's point about empathy and really currying loyalty and earning loyalty. Hard to earn, easy to lose. So that's my proviso on big tech and health data for 23 actually.

I love that angle. Jane. I've seen some recent studies in the United States that say folks already assume they have no privacy. And in the context of asking me for more personal data, yeah, sure, I'll give it to you. Hope that you don't use it for bad intent, but give me something out of it. Right? So if you're going to take at least help me better understand myself or connect me with better information or, you know, let there be some sort of payoff, I'm actually interested in, you know, every time I hear from Jane, I learned from her and just thinking, I'd love to just ask one question if that's okay. Jared to Jane about value based care and monetizing prevention as opposed to health. Think all the trends we're talking about are kind of pointed in that direction. But I'm wondering from a health economics perspective, is the picture becoming so blatantly obvious that it gives you hope that we could we could truly start to move in that direction? What are you seeing there?

I love that angle. Jane. I've seen some recent studies in the United States that say folks already assume they have no privacy. And in the context of asking me for more personal data, yeah, sure, I'll give it to you. Hope that you don't use it for bad intent, but give me something out of it. Right? So if you're going to take at least help me better understand myself or connect me with better information or, you know, let there be some sort of payoff, I'm actually interested in, you know, every time I hear from Jane, I learned from her and just thinking, I'd love to just ask one question if that's okay. Jared to Jane about value based care and monetizing prevention as opposed to health. Think all the trends we're talking about are kind of pointed in that direction. But I'm wondering from a health economics perspective, is the picture becoming so blatantly obvious that it gives you hope that we could we could truly start to move in that direction? What are you seeing there?

Yeah, I think we are.

Yeah, I think we are.

At this pivot point for value based care, which, you know, we've been forecasting for 20 years probably. But the fact is, in a downward economy, even though for some people the economy's pretty good, when people perceive it's not the economy isn't good, then they won't buy more expensive healthy food, for example, which is counter to what we really want to happen in households. I'm hopeful value based care is getting traction and we're seeing more more going beyond pilots for it in certain metropolitan markets in the US, a lot of this depends on the employer markets. We're looking at in very specific areas of the country like Seattle or Miami, where markets where there's an active managed Medicaid population or Medicare Advantage, which has incentives to prescribe healthy food, right? Vegetable and fruit prescriptions in Medicaid, where people will also maybe qualify for SNAP benefits for food. So we're seeing that when there's a value based plan in place, there's an incentive to adopt evidence based digital health tools, food programs, transportation programs, mental health programs, etcetera. There's an article I am urging everyone to read which is not new from Jama, which may be behind a paywall. So people should get in touch with me to get a hold of this article. If you can't get it, it was written in. I think 2015 or 16 October, but it was called value based payments require valuing what matters to patients. And Amy hinted at this a moment ago when she said, what are the values of people? We have to know if you're a person from the Hispanic community that you may be cooking with certain kinds of fats, which some people at the cardiology association might not want us to eat, well, that's too bad. People are going to cook the way they cook. So how can we adapt recipes that are still tasty and culturally relevant to us and enjoyable and still healthy? And that is doable. I've worked with a clinic in my hometown and outside of Philadelphia with a Latina physician to work with local folks who didn't know how to grow vegetables in the garden and herbs and things. And she's reversed potentially type two diabetes for many patients. So this stuff is doable with the value based payment and promise in mind. And Amy, I am hopeful that in 23 we're going to see more of that traction because there isn't enough money to sustain the way we do things, the way we have in in volume based payment anymore.

At this pivot point for value based care, which, you know, we've been forecasting for 20 years probably. But the fact is, in a downward economy, even though for some people the economy's pretty good, when people perceive it's not the economy isn't good, then they won't buy more expensive healthy food, for example, which is counter to what we really want to happen in households. I'm hopeful value based care is getting traction and we're seeing more more going beyond pilots for it in certain metropolitan markets in the US, a lot of this depends on the employer markets. We're looking at in very specific areas of the country like Seattle or Miami, where markets where there's an active managed Medicaid population or Medicare Advantage, which has incentives to prescribe healthy food, right? Vegetable and fruit prescriptions in Medicaid, where people will also maybe qualify for SNAP benefits for food. So we're seeing that when there's a value based plan in place, there's an incentive to adopt evidence based digital health tools, food programs, transportation programs, mental health programs, etcetera. There's an article I am urging everyone to read which is not new from Jama, which may be behind a paywall. So people should get in touch with me to get a hold of this article. If you can't get it, it was written in. I think 2015 or 16 October, but it was called value based payments require valuing what matters to patients. And Amy hinted at this a moment ago when she said, what are the values of people? We have to know if you're a person from the Hispanic community that you may be cooking with certain kinds of fats, which some people at the cardiology association might not want us to eat, well, that's too bad. People are going to cook the way they cook. So how can we adapt recipes that are still tasty and culturally relevant to us and enjoyable and still healthy? And that is doable. I've worked with a clinic in my hometown and outside of Philadelphia with a Latina physician to work with local folks who didn't know how to grow vegetables in the garden and herbs and things. And she's reversed potentially type two diabetes for many patients. So this stuff is doable with the value based payment and promise in mind. And Amy, I am hopeful that in 23 we're going to see more of that traction because there isn't enough money to sustain the way we do things, the way we have in in volume based payment anymore.

This has been amazing. I'm going to wrap up with one question because I think it gets us to the heart of kind of what of all what does all this for, right? If I take a step back and say, how can some of these trends lead to a different place, a better place for for a majority of people? And that's just thinking like, what is the net result of these trends? You know, where do we hope it gets us as an industry and broader as a society? So I'm thinking in a short term window like the next 12 months, but maybe we also think about beyond that. So, Amy, let's start with you and then Jane, you can wrap us up on this one.

This has been amazing. I'm going to wrap up with one question because I think it gets us to the heart of kind of what of all what does all this for, right? If I take a step back and say, how can some of these trends lead to a different place, a better place for for a majority of people? And that's just thinking like, what is the net result of these trends? You know, where do we hope it gets us as an industry and broader as a society? So I'm thinking in a short term window like the next 12 months, but maybe we also think about beyond that. So, Amy, let's start with you and then Jane, you can wrap us up on this one.

I love the question, Jared. I mean, I've been working with health insurance companies for the past 15 years and some of the problems that we were trying to solve back then, you know, we still haven't solved. We we've made big strides. But these are eternal challenges mean just the labeling of the the US Department of Health and Human Services, the desire to have health, to care for oneself, to care for one's family. It's part of the human quest. So it's a problem, quote unquote, that's never solved. It's an opportunity that's that's never truly reached. It's it's a it's an eternal quest that we get better and better at. And I think in the desire for solutions, sometimes we can miss that. The real solution is how we do things, the process, the people in that that how which I believe fundamentally should be human centered, participatory, inclusive, designing with people as opposed to for people that approach will yield us myriad, wonderful, enchanting solutions as we move into the future. But, you know, our work here is never done. And I do marvel, though, at at the things that that we are seeing and the the achievements that we have made mean we sort of need to to celebrate our wins in order to not go crazy right. In the health health system because it can feel like, oh my gosh, there's so much work to be done. It's overwhelming. It's daunting. But but but through process and inclusion, I think we can we can make a big dent. In the universe.

I love the question, Jared. I mean, I've been working with health insurance companies for the past 15 years and some of the problems that we were trying to solve back then, you know, we still haven't solved. We we've made big strides. But these are eternal challenges mean just the labeling of the the US Department of Health and Human Services, the desire to have health, to care for oneself, to care for one's family. It's part of the human quest. So it's a problem, quote unquote, that's never solved. It's an opportunity that's that's never truly reached. It's it's a it's an eternal quest that we get better and better at. And I think in the desire for solutions, sometimes we can miss that. The real solution is how we do things, the process, the people in that that how which I believe fundamentally should be human centered, participatory, inclusive, designing with people as opposed to for people that approach will yield us myriad, wonderful, enchanting solutions as we move into the future. But, you know, our work here is never done. And I do marvel, though, at at the things that that we are seeing and the the achievements that we have made mean we sort of need to to celebrate our wins in order to not go crazy right. In the health health system because it can feel like, oh my gosh, there's so much work to be done. It's overwhelming. It's daunting. But but but through process and inclusion, I think we can we can make a big dent. In the universe.

Yeah, I'll tag onto that because I live this by continental life between the US and Europe. When I'm in Europe, I'm considered what's called a health citizen. I have a passport from Italy, which means I'm a citizen of the European Union, which doesn't include the UK anymore, of course, post Brexit, but it does include lots of other countries. And in Europe they call people who live in the EU health citizens for a reason. People have universal access to health care at a level everybody has access to it. Also, every citizen in the EU is covered by the GDPR privacy law. When I think about the concept of health citizenship in the US, which is something I've been spending a lot of time on as well looking at how do we scale health access to everyone? Interestingly enough, the latest survey from UPMC Center for Connected Health Class and Nokia, which I just wrote about in my blog, that survey of health system leaders found that the number one challenge they believe these are health system leaders believe digital health can help solve is patient access. We can scale care to where people live, work, play, pray, learn and shop. I've extended the live, work, play and pray to learn and shop because people are accessing care and retail formats closer to home and at home. So I'm really hopeful that digital health can help us scale these things, but I fear that we're putting too much pressure on the health care system to provide what is really public sector policy for food, for transportation, for, as I talked about earlier, clean air, clean water. And I think as health citizens, we all have the responsibility to vote when we can vote in elections, but we also must vote for health being baked into all policies across the board. And I am hopeful that in the post-pandemic era, more people understand and are connecting the dots between public health and personal health and the power of the collective, because what affects one person affects everybody. As it turns out, that's how viruses work. So I'm hopeful we have learnings that we can leverage to move forward for everybody's health, citizenship, all included, not just most Jared, but everybody. So that's my Holy Grail.

Yeah, I'll tag onto that because I live this by continental life between the US and Europe. When I'm in Europe, I'm considered what's called a health citizen. I have a passport from Italy, which means I'm a citizen of the European Union, which doesn't include the UK anymore, of course, post Brexit, but it does include lots of other countries. And in Europe they call people who live in the EU health citizens for a reason. People have universal access to health care at a level everybody has access to it. Also, every citizen in the EU is covered by the GDPR privacy law. When I think about the concept of health citizenship in the US, which is something I've been spending a lot of time on as well looking at how do we scale health access to everyone? Interestingly enough, the latest survey from UPMC Center for Connected Health Class and Nokia, which I just wrote about in my blog, that survey of health system leaders found that the number one challenge they believe these are health system leaders believe digital health can help solve is patient access. We can scale care to where people live, work, play, pray, learn and shop. I've extended the live, work, play and pray to learn and shop because people are accessing care and retail formats closer to home and at home. So I'm really hopeful that digital health can help us scale these things, but I fear that we're putting too much pressure on the health care system to provide what is really public sector policy for food, for transportation, for, as I talked about earlier, clean air, clean water. And I think as health citizens, we all have the responsibility to vote when we can vote in elections, but we also must vote for health being baked into all policies across the board. And I am hopeful that in the post-pandemic era, more people understand and are connecting the dots between public health and personal health and the power of the collective, because what affects one person affects everybody. As it turns out, that's how viruses work. So I'm hopeful we have learnings that we can leverage to move forward for everybody's health, citizenship, all included, not just most Jared, but everybody. So that's my Holy Grail.

Well, thanks so much for giving us so much to think about and that will do it for this episode. We're going to keep an eye on these trends and we'll see how everything plays out this coming year. But you've given us so much to keep an eye on. I've had the pleasure of speaking with Jane Sarasin Khan and Amy Heymans. Thank you both so much for joining us today.

Well, thanks so much for giving us so much to think about and that will do it for this episode. We're going to keep an eye on these trends and we'll see how everything plays out this coming year. But you've given us so much to keep an eye on. I've had the pleasure of speaking with Jane Sarasin Khan and Amy Heymans. Thank you both so much for joining us today.

Thank you.

Thank you.

Thanks for tuning in. If you like what you heard, please spread the word. Tell your colleagues to tune in for all the awesomeness, then leave a review on Apple, Spotify or wherever you listen. This show is produced by Shift Forward Health The Channel for Change Makers. Subscribe to Shift Forward Health on your favorite podcast app and you'll be subscribed to our entire library of shows. See our full lineup at Shift Forward Health one subscription all the podcasts you need and it's all for free. And remember, we might have a lot of work to do in health care, but we'll get there faster together. Thanks again.

Thanks for tuning in. If you like what you heard, please spread the word. Tell your colleagues to tune in for all the awesomeness, then leave a review on Apple, Spotify or wherever you listen. This show is produced by Shift Forward Health The Channel for Change Makers. Subscribe to Shift Forward Health on your favorite podcast app and you'll be subscribed to our entire library of shows. See our full lineup at Shift Forward Health one subscription all the podcasts you need and it's all for free. And remember, we might have a lot of work to do in health care, but we'll get there faster together. Thanks again.