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Sumit Chauhan, Corporate Vice President, Office Product Group, Microsoft 
Dr. Lisa Costa, Chief Technology and Innovation Officer, US Space Force 
Moderator: Amber Burton, FORTUNE 

MPW Next Gen 2023 - Generative A.I. And The Promise Of Productivity 

Conferences

Sumit Chauhan, Corporate Vice President, Office Product Group, Microsoft 
Dr. Lisa Costa, Chief Technology and Innovation Officer, US Space Force 

Generative A.I. And The Promise Of Productivity

Sumit Chauhan, Corporate Vice President, Office Product Group, Microsoft 
Dr. Lisa Costa, Chief Technology and Innovation Officer, US Space Force 
Moderator: Amber Burton, FORTUNE 


Paxton Maeder-York, Founder and CEO, Alife Health
Dr. Dina Radenkovic, Chief Executive Officer, Gameto, Inc.
Leslie Schrock, Author, Investor, Entrepreneur
Moderator: Deena Shakir, Lux Capital

Brainstorm Health 2023 - How Men Can Play a Role in Fertility 

Paxton Maeder-York, Alife Health
Dr. Dina Radenkovic, Gameto, Inc.
Leslie Schrock, Entrepreneur
Deena Shakir, Lux Capital

How Men Can Play a Role in Fertility 

Guy Friedman, Co-founder and CEO, SteadyMD
Rich Roth, Chief Strategic Innovation Officer, CommonSpirit Health 

Brainstorm Health 2023 - Addressing the Healthcare Staffing Shortage 

Addressing the Healthcare Staffing Shortage

Guy Friedman, Co-founder and CEO, SteadyMD
Rich Roth, Chief Strategic Innovation Officer, CommonSpirit Health

Right. How was everybody's afternoon? Hopefully good. Um I've been like incredibly impressed so far with all the content. Um I think this is the first conference I've been to where I just wanted to sit through absolutely everything. So um really means a lot that you're all here. Um So next up, we are having a panel on the crisis in care, the health care staffing shortage, which I think is just such an important topic, not nearly talked about enough. Um It's been called a public health crisis and it absolutely is one, this problem began before the outbreak of COVID. But the pressures and the demands of the pandemic led to so many nurses, doctors, other providers just leaving the industry in record numbers. And even now we're, we're continuing to see this trend. According to the Association of American Medical Colleges, the US will face a shortfall of 124,000 doctors by 2034. Um And this statistic doesn't even take into account the lack of nurses, dentists, mental health professionals, and just so many other providers across other professionals as well. And in addition to this burnout, there's also this rising aging population that we've talked about. Karen Lynch mentioned this, we have more seniors now than kids and the rising demand for care and problems in the education pipeline as well. Um So how do we even get people to want to be doctors these days? Um Big question that we're facing. None of this bodes well for any of us. Um So joining us today to talk about this is our fortune. Well reporter Alexa Mchale, who will be diving deeper into these challenges and potential solutions. Um With a panel that includes we Deng, the CE C O and founder of quit board health Guy Friedman, um co-founder and CEO of Study MD Rich Ross, um who is the Chief Strategic Strategic Innovation Officer at Common Spirit Health. Please welcome all of them to the stage. Well, first, thank you all for joining us and I want to jump right in as we heard in the introduction, the causes of the staffing shortage range from the education pipeline to burn out to this growing demand for care, which I wanted to start with you. Common Spirit Health operates over 2200 care sites across 23 states. I mean, do you agree with these causes? And what for you has been most top of mind in addressing right now? Yeah. Well, I mean, first of all, I remember, you know, during the pandemic when my dad unfortunately has cancer and you know, it was a time where you couldn't visit. And he lives in rural Pennsylvania. And, you know, I, I was calling nurse, you know, all the time checking in on him and, you know, one time I checked in on her and I said, hey, how are you doing? And, you know, literally we talked for 10 minutes and she cried for most of it. And you think about, you know, how caregivers went from heroes at the beginning of the pandemic to kind of villains with mass mandates and vaccines. And then all of the things that they, they do each day, you know, gun violence that we see in the news, you know, fentaNYL abuse and all these other types of things, they can never turn that off. And so ultimately, I think burnout and mental health is the largest challenge that we have and all innovations that we need to focus on really have to center there because I don't think we're going to have a stable workforce unless we're able to do that, right? And, and you bring up burnout. And we, I wanted to turn to you, your platform. Clipboard Health gives primarily nurses, nursing assistant and medical assistance the ability to uh grab shifts at health care facilities at an a need basis. And so I'm curious, you know, from your work and your perspective, you know, how has that increase in flexibility, addressed the burnout epidemic that, that rich brought up and um and, and really kind of address the ability for people and, and clinics just to stay and, and stay in the workforce. Yeah, thank you. So, the way that we've approached the problem is to offer the health care workers more flexibility in both their schedule in terms of when they want to work or if it's an AM shift or shift PM shift. You know, there are quite a few parents on the platform, a lot of single moms who have to deal with constant changing child care. And then the other uh way that we're addressing is by providing for the health care facilities, they have their own full time staff, staff, some of whom are burnt out because they have so many patients come in that they have to treat. So giving them more staff to help just more hands around the table so that the patients get better care, but the actual workforce in the facility themselves get more relief as well. Definitely. And guy I wanted to bring you into the conversation. Uh you now manage a national Digital Health Network that allows other digital health care companies is to use those clinicians across all 50 states. I mean, we've been talking a lot already about tech and virtual medicine and you know, I'm curious from your perspective, what are some of the hurdles and obstacles you know about seamlessly integrating telehealth into this care continuum and thinking about retaining clinicians as we move forward. Yeah, I mean, since we're national and we're taking appointments from all different types of lot um users from the systems to payers to self insured employers and the types of appointments can be different as well. So it could be synchronous or asynchronous. Um I think if you think about supply and demand, you wanna create a more efficient appointment uh to create more hours and more capacity for the whole industry. So in digital health, we have an advantage where we can take in all that appointment data kind of um uh like itemize it and then allow the supply to be really scaled across all the different uh all the different appointments coming in from all over the country. Um I think that's, that's like the kind of the biggest lever that can unlock it um in terms of barriers, um I think the biggest one is state licensing. So um most people know this now, but it was really not really well known, but uh the clinician, if they're prescribing needs to be licensed in the state where the patient lives. So we have a big licensing operation where we're licensing clinicians all over the country. But that's probably the biggest like regulatory hurdle that gets in the way of really, really scaling definitely and, and rich from your perspective, you know, thinking about on the ground and, and in the hospitals and clinics, I mean, how are you thinking about digital innovation? I mean, do you have examples of how that, how that looks on a daily basis, you know, say I'm going into, you know, an appointment. Yeah, I mean, I'll give a perfect example. So when you think about patients going to physicians and they're worried about their physical health and then they also may disclose, oh, my gosh, I actually have a mental challenge. I'm depressed. I am, am anxious. I'm something along those lines and the typical world is, you know, provide that you say, ok, well, that's mental, it's different. So here's a binder. Good luck, you know, you know, finding an insurance, finding a practitioner. So we've actually transformed that a bit where, you know, telephonically through an outsourced group, similar to what they're talking about, we can provide behavioral health assistance over 90 days immediately with any insurance to, to those patients. So if they're asking for help, we get them help in 24 hours versus the current system, a historic system where they may or may not ever ask for help again. And so our real goal is how do you, you know, expand that access through innovation and technology? Definitely, definitely. And after this next question, I, I wanna go to the audience. So if you have anything top of mind, um keep, keep a look out for that. Um But yeah, we I'll turn back to you. Um You know, I want to think about also addressing this crisis in the long term, right? We've, we've talked a lot today already about, you know, the aging population and um the number of Americans aged 65 older will reach 80 million by 20 40 more than doubling over the next 40 years. And so I'm I'm curious how are you also thinking about what your either platform or, you know, just having adequate staffing for seniors, especially um thinking about the next 20 to 30 years. Yeah, for sure. So I think there are a few ways worth thinking about it. Um The first is, you know, the missions of companies very much to lift people up the socioeconomic ladder. And with that in mind, we over time want to partner with other educational institutions so that we can really move up a CNA to become an and to become a nurse and really actually address some of the shortage problems from the root. So on the educational front and then the other one is a lot of careers only moving to home. So working with home health agencies and partnering with them to give the nurses who sometimes they want access to patients one on one. They like having that long term relationship, giving them more opportunities because right now we mostly serve long term facilities, some community hospitals, but not as much in the home. And so bringing some of that care in the home to, to address those seniors who want to stay home and have care delivered at home. Yeah. And guy How are you thinking about that the next 20 to 30 years? Um Yeah, I, I think um I think uh a few different levers you can pull. Um 11 big example is just moving from synchronous care to asynchronous. I think um that's a big lever that almost, you know, people ask me like sometimes for advice and how to scale. I think that's probably one of the biggest things you can do is try and move as much of the experience to an asynchronous uh model and then really save the synchronous part for like the true care and skip kind of the um intake and then on the back end trying to minimize the paperwork. Um to that, that's a real piece of the burnout is the amount of time clinicians spend documenting. So actually in a digital situation or a digital ecosystem, you can really, really fine tune that so that the the um the care is maximized and the documentation is minimized. So if you're controlling things end to end, you can really open up a lot more capacity for like true care versus um the stuff that really burns doctors out uh which is like, isn't really the time they're spending with the patients, the other stuff, right? And, and that's nearly 25% of, of their time in, in certain that's a, that's a low, I think it's even higher. Yeah, great. Um I wanted to turn to the audience does anyone have a question? Oh, I see over here. Great tim, with the association of schools and programs of public health. It, it occurs to me that we're not going to have enough people to do this work you're talking about and we need to think more about prevention. How are we going to add prevention to this? So we avoid too many people going to the hospital or having to get care. Yeah, go ahead. You know, um uh you know, I think most systems are working towards more value based care. I think it's a very, a very large question, but I would also take prevention in terms of the workforce burning out. So as an example, we um it costs us $40,000 to replace a nurse. So training bonus uh and we have to replace 10,000 nurses every single year. So that's $400 million right? Uh These are huge opportunities um to create more sustainable um professions for individuals where education is provided along the way where peer mentoring is, you know, part of the standard process, we've created something called a nurse residency where we're adopting 5000 nurses a year and providing them with this education, peer mentoring and support. We've actually spun that out and formed a company and we're doing it for Kaiser and a few others. But our hope is that prevention of the workforce is through their ability to have a healthy and well respected profession. Right. And, and you mentioned burnout again, I mean, symptoms of burnout is that really like emotional exhaustion and, and not feeling good about, about the work that you do? I mean, is that what you're integrating into these mentoring and coaching opportunities? How do you actually address that emotional mental health piece? Absolutely. All of our caregivers now have mental health. We have programs dealing with conflict resolution dealing, you know, again, all the social strains that we see, you know, in society and maybe we can turn off our Twitter feed and maybe we can turn off the news. They can't, you know, and so they're bombarded with these things. And how do you deal with that conflict resolution and how do you deal with? I would say the other piece we're working on is really trying to get new individuals from different sources and have historically come into the health care. So we've partnered with more health school of medicine where their residency site here locally, we partnered with Charles Drew, bringing in new doctors, new nurses of the community that may have a better ability to understand some of these issues and resonate. And so it's a multi pronged approach, but that is exactly the burnout. People are feeling definitely. And guy thinking about prevention and partnerships, I mean, do you have anything to add on to it? Which I would just say I'm not an expert. I think rich is more of an expert in the topic. But I would say in, in digital health, you have a lot more data more quickly. So if you're tracking the frequency of interactions and um maybe uh there is this like place where you can go, where you can theoretically see, burn out earlier and then intervene earlier. Um So I think uh in digital health, it's a, it's a, I see MD as we're a leader in this space. So I see it the responsibility of our company to really make sure we don't replicate a lot of the things that have happened in the past where clinicians like really don't like their job or their um you know, very high rates of burnout. Um So we work really hard on creating a good culture as well as preventing that with data. I'm not an expert in the topic, but I know like we can track things much more quickly. Definitely, definitely. And yeah, and I wanted to ask another question of, of each of you. We, I can start with you. Um you know, thinking about this on more of a broad scale as well. I'm, I'm curious, you know, if you can talk a little about what you have learned in the last few years, you know, during the pandemic that has changed the way you think about health care and your vision for the future of your business and the future of addressing addressing this crisis, which has had multi faceted layers as we've talked about so far today. Yeah, I think the thing that I don't know if it's a new learning but um actually many of the health care workers, they went into the job because they really do want to interact with patients, they want to provide care. And I think the condition, we've made the conditions harder for them to do that. And during the pandemic, it was highlighted that these health care workers, you know, were watching colleagues suffer or watching many patients die from COVID. And, and so I think actually the um you know, back to what you're saying about the administrative work, like many doctors went into the field because they want to care for patients, not be saddled with, you know, administrative uh just all this paperwork and similarly, with the nursing assistants of that, we work with many of them still at the end of the day, wanna have interactions with patients. So if you enable them to do that on a um work with better nurse patient ratios so they can give each patient the care they they deserve. Um I I actually think that that does help them um prevent from burn out. I mean, we hear from the providers on our platform that, you know, when they have other, other people from our platform go to the facility or they have people that they know who are there, they actually feel energized by the mission of, you know, by sort of the purpose of their work. Great. Yeah, I'll go down the line guys. You want to answer the question? Yeah. Thinking about, you know, the last few years during the pandemic and, and, and what you've learned that's maybe changed the way that you think about, about health care and the future of your business and addressing this crisis. Um Yeah, I mean, I think um how, how do you increase capacity? You can increase the number of hours available or you can increase uh decrease the amount of time it takes to see a patient like efficiency or um and I think um if you're trying to do the second one, you can't ignore like the clinician culture and uh burn out and feeling around that. You have to really build a product that takes that into account from the get go. Um So I think uh that's something like you can't just uh build the most optimal optimal system because that, that, that might not be the, the best for the doctors long term and clinicians long term. I think uh we've learned to really try and build our product with that in mind. I think the role of workforce and what people want to do is changing so dramatically. You know, I'll give two examples. One is millennial caregivers, you know, like they don't want the same job. They want to be a nurse, wants to be an ICU nurse. Next week. I want to be a cardiac nurse. Next week, I want to be, you know, on the rehab floor and like the system is not built to like transform that model of practice so quickly. And then on the other side, you know, there are more 10 staff, the traveling is so before the pandemic, about 3% of our nurses were travelers right now. It's about 25% maybe even higher. And it's fascinating when you talk to these individuals, I was talking to one nurse and she was from Iowa and she loves to hike and her partners are tired and they're basically just hiking across the country by doing three week stints here and there. Meanwhile, she's renting place in Iowa to other nurses that want to transfer that want to work there for, you know, their personal reasons. And so there's this entire network that's been created. I think it's going to be really hard to dismantle in terms of, you know, nurses preferring different types of workforce than they ever had in the past. And obviously, it's social workers and physicians, it's others. But the dynamic of what his work is changing interestingly and what is, oh, sorry, I don't wanna, I was just gonna say, and we actually see the same data where the uh over 80% of the workers on our platform work at two or more facilities and like 60% work at three or more facilities. So that choice of today, I wanna go to this rehab center tomorrow. I wanna do home health tomorrow. I wanna go to community hospital is, is real too. That's interesting and just, and just changing the way we think about work to kind of even potentially to, to help with that education pipeline and, and explaining that this industry might look different, it might look different, different to work there. Um Great. Well, that is all, all the time we have. so going to wrap up, but thank you all so much for joining on this important conversation and looking forward to continuing it. Thank you.

Bakul Patel, Senior Director, Global Digital Health Strategy and Regulatory, Google
Dr. Monique Smith, Director, Design and Innovation, RockHealth.org
Moderator: Chrissy Farr, Principal Investor, Health Tech Lead, OMERS Ventures; Co-chair, Fortune Brainstorm Health

Brainstorm Health 2023 - The Role of Regulators On Responsible Health A.I. 

Bakul Patel, Google
Dr. Monique Smith, RockHealth.org
Chrissy Farr, Fortune Brainstorm Health

The Role of Regulators On Responsible Health A.I. 

Bakul Patel, Senior Director, Global Digital Health Strategy and Regulatory, Google
Dr. Monique Smith, Director, Design and Innovation, RockHealth.org
Chrissy Farr, Principal Investor, Health Tech Lead, OMERS Ventures; Co-chair, Fortune Brainstorm Health

I am so excited to get to moderate this particular panel because I have been on maternity leave the past few months and reading nonstop about generative A I um because I am a total weirdo. Um But now I get to talk about it with these two um who know, honestly, everything there is to know about this, this space um even as it rapidly evolves. So I'm gonna start by picking on you. Um And I would love for you just to give us like a quick 32nd intro to where we are at right now with uh regulating A I, what is FDA doing? What's AJ S doing just like a snapshot? Yeah. So before I left FDA, which is about a year ago, um we had put out an AI regulatory framework that sort of proposed a couple, couple of unique ideas about how do you allow algorithms to evolve and change over time without actually going back or back to FDA for approval. So those, those things are now, well, one of those things which is called a predetermined change control plan is now in law that FDA has in the toolkit now. So that's a good advancement that allows people to sort of iterate their models and, and, and not go to FDA like more frequently. So that's one thing, Nis put out a framework and then the White House put out a principle to document, I think when you start looking at where things are and I believe there's an R out from NTI A to ask like, how should we think about regulating? So those are, those are sort of where things are in the government today. HHS is obviously thinking about health and what should be done. And I think one of the key principles in, in health, like people are like gravitating towards is transparency, like explaining in layman's term to the users, what the algorithm does, how it got to what it got to and what its recommendation really means. I think that's one of the fundamental principals how to get there, what to do. I think still work in progress. Um Yeah, that's definitely helpful and a lot of confusion I think still around which agencies specifically should even be regulating this space that um we will definitely be be watching because it's, it's unfolding as we speak. OK. So um I recently put out a poll on my account which I, I do sometimes um question was in the US, we will regulate A I not nearly enough thoughtfully or with over caution. Can anybody here guess what the answer was? 40 to nice people. I'm gonna go with a caution. You know what, when I see patients in the emergency department, there's this tendency to think that anything that we're doing and decisions that we make don't have enough, um, rigor around them. But I think actually our government tries to do well with that and it's actually gonna go over the bar that as providers, we probably will have less latitude, um, to kind of play with clinical decision, support tools and everything else that we do. We do right now. Um Yeah, I would, I would agree, but I would also hope there's with enough caution, people regulate because there is the, the thinking around how do you sort of push technology to be useful to the benefits part and then the risk part. But if you can, if you were to like, transpose exactly what we do today, it's a lot of the risk sort of angle, right. So I think so, I think there's going to be a balance and it's gonna be a struggle for regulators to think about that. Um So most people disagreed with the both of you. Um, 78% of people thought that the exact opposite actually, of what you thought, um, not nearly enough was the, was the response of touch. So, um, any thoughts on, on why, um, the public or at least, um, however many, uh, folks answered my poll, uh, think this way, I, I think, um, I started to enter I guess, I think if I talk to my friends and family, I think people are really, really cautious about, like, using technology for the sake of using technology. And also you're reading news articles that sort of talks about how, you know, we can ask a question to general and gives you something that you should not be getting or you would be afraid that somebody else, like your, your child should not be getting. So I think that I think there's a lot of that fear built into it. Um As, as, as I imagine it is an emergency doctor, I always think first do no harm, right? And I think a lot of folks are worried about harm and that's the idea of under regulation. The elephant in the room is that there's this idea that what we're doing in medicine might be codified to the extent that there's less choice, there's less autonomy. You know, a lot of our health care system and the beauty of it is built on the fact that we can do what's best for the patient in front of us. And when you layer algorithms on top of that, that might not be on the best data. Um You certainly have challenges. Um Quick reminder, everyone that if you have a question, um look for one of the, the lovely ladies with a mic and ask at any time. Um So, you know, along these lines, you're both doctors, um how do you? Well, are you? You're not, I'm not a doctor. Oh my God. OK. So you are a doctor. Um So I'll direct this question to you, Monique. But um there is definitely some evidence now that these A I algorithms can sometimes outperform physicians, especially, you know, not, not all doctors are the top 1% of the profession. So how do you think the physician community copes with that knowledge? Especially as these algorithms get more and more small over time. So the question is outperform for whom? Right. So each of these algorithms are built on a specific training data set and that data set is a set of people like people in this room and the people who came here today in this room are different than the people who came to another location today in this room. And so the ability to outperform, you have to ask that again on an individual basis, you also have to ask that over time, right? So as our world changes, algorithms don't mix in, that's why as we mentioned, the FDA is thinking about how do we actually allow algorithms to evolve. So I don't worry about my job stability one because I resuscitate patients and no algorithm is going to do chest compressions for you. But also because there's this element of human interaction that matters, right? I don't think anyone's talking about replacing physicians and the role of that knowledge, they're actually just talking about how can we have let you work top of license. How do we make this more efficient, less, painful, less burnt out? And there's a lot to be figured out in that mix, particularly because medicine in and of itself is already a little bit flawed. The data that we have to work on on the baseline already has biases that are embedded within it. You mentioned bias, which I think is, is a key point here. Um Humans are obviously biased. So are the algorithms that we create and we're seeing more and more evidence of this now. Um So as we kind of move these technologies into health care and it may be slower than other sectors, quite frankly, but it will happen. How do we ensure that we don't have all of that kind of bias baked in? So I'll give you an example during early pandemic, our emergency department partnered with our Bioinformatics Corp and we were really trying to solve the problem of, we don't have enough personal protective equipment, we don't have enough doctors, but we need to screen patients. We need to know who's sick and who's not sick. We want to use very well known facial recognition technology to do some very simple vital signs. Do you have a fever? Are you turning blue because you can't breathe and you're short of breath and use that to differentiate where people should go and that's, you know, something that looks at your face and decides, I mean, we had a great group that really put together technology and they said, hey, we're an academic center. This is as far as we can take it based on our training data set. And this is a training data set based on the population in Atlanta, which is reasonably diverse but still didn't have a wide variety of melanin in the facial recognition software which causes problems. When you're thinking about thinking about blueness around the mouth, even for the element of sensing temperatures for facial recognition, you know, much to my chagrin about, you know, four months later, I had a well known and established technology vendor come with me to a company that they had acquired and this company, they were doing facial recognition for vital signs. And I was like, this is great, you know, we're doing really great things in telemedicine. Maybe this can be incorporated. I'm so glad you've solved this problem. Tell me about your training data set. Absolute crickets. I never heard back from them. I had to ask a few months later when they were telling me about another technology and said, you know what that training data set has zero diversity in it. That's the problem, right? So it's a level of accountability that spends all the way from local decision makers, all the way to the FDA. It's an ecosystem, right? I as a purchaser have to make the decision that is this appropriate for my population and not just appropriate at the point of purchase, but also it, six weeks from now, from year, six years from now it's six decades from now. We can't just have a one and done policy and then it stands up to the way you think about, you know, how you actually build for it and whether or not the FDA said it's ok. I think it's a very broad problem that has many, many actors that have to take part to make sure they're all safe. Yeah, I absolutely agree. So, bias, we know huge risk. Another one which we already mentioned is that we might actually not do enough to regulate A I, how do you think all of this plays out as we see other countries globally? Like China and Russia move ahead and start to do quite amazing things. But, you know, potentially things that require more caution, more thoughtfulness, more regulation even. Um Do you think that the States will look at examples like that and think we need to keep up um without kind of doing the work to keep people safe? I, I just have some, some positive hopes that, you know, countries like ours would probably be more responsible and not just followed suit with all the other countries that do. I think there's a lot of, a lot of harm that can be done and for long periods of time. And I think that's the, that's the key risk here. And if you're not responsible in terms of how do you develop technology, how do you sort of make sure that you have the bias thought process in the, in the, in by design and, and not, and not only that, but also like thinking about how do you make sure there are the right filters in place as you can see, like Geneva, like the chap and bars of the world are, are now not giving you answers that they used to give before. Right? And, and that's sort of the evolution that needs to happen. And I I know there is going to be this is kind of in other scenarios that we have seen in the past, in the future that people will race down this path. But I think people who do it properly will probably be succeed in succeeding in the long term. So I feel like the industry, the technologies, the users and states would have to be responsible in terms of how do you sort of get to the next level of using and realizing this potential for A I to be actually be useful for us in health, especially when it's more important. Um You know, along these lines, I was reading about kind of all these technologies like I mentioned on my maternity leave and then my mom actually fell and broke her wrist and we ended up in several different urgent cares that same evening. And of course, given imaging on a disk drive that we then had to take between the two urgent cares and then get a PC P referral and then take the disc drive imaging over to the surgeon. And the whole thing just reminded me of what it is actually like to be a patient in health care today. And that we still live in this era of fax machines, which is a very long winded way of asking, you know, we've got A I, on the one hand, on the other hand, we still use fax machines. Um How do we square both of those things? And um can, can I believe sincerely that um in the next kind of, you know, 1 to 3 years, we true health care will truly be disrupted by this technology when there is clearly so much invested in the status quo. So there's a company that I'm super interested in um that we've, you know, deeply partnered with at Emory in this space to enable us to have, enable your mom to have a much better experience, right? There's this element of meeting patients exactly where they need to be met, that there's a I that can help with that triage. There's an element of being able to use the technology that allows us to communicate in a way that makes sense based on where you are to be able to have a result on the other side that you don't have to carry a CD 1000 places that information travels where it needs to be. And maybe your mom has someone come, if it's her foot that's broken and she can't walk, she have to do that X ray as opposed to having to get up and go to an urgent care. Right. You've got to think about all those different things. There's an emergency doctor. You know, we often are like catching the rest of the health care system. Something we firmly believe in is how do we work upstream of that? And technology enables that right? The ability to catch people before they have like last result, I'm going to wait in the emergency department forever. And I think there's a beauty of A I in terms of the way we triage folks, there's the beauty of like the way technology platforms now engage and appropriately diagnose and care for patients that are appropriate for the platform. And I think there's a lot that's going on in that space and I'm excited to see more happen there. I could you guys remember and probably in the audience when he used to fax things you would just call and and said, did you get my fax? And this is exactly the scenario, right. I'm sure that the image went over the electronic system. But in order to make sure that the patient does carry it with them, the CD was given. So I'm hopeful there's a positive lining into all this that down the road. We'll probably not think about this. Like carrying a CD is a burden, but carrying a CD is like more of that phone call. Like, did you get my facts kind of thing? Although I did, I did call Urgent Kara and he said, well, you just bring back the disk drive and then you take a photo on your phone of us use it like it was just like insane. Like what or you could just use Box or Dropbox. Like haven't those existed for like a decade? The best part is when you fill up in the emergency department by ambulance with the disc and you've got the entire care team saying where's the disc for like 20 minutes and like, oh forget it. Let's just send her an X ray. Yeah, I mean, yeah, anyway, um but I think you're hitting up on something which is near and dear to my heart is in, right? I think a I can only help when the data is there in front of you. It can operate, it can sort of operate on that data on the disk, right? But it does not do the transfer of the disk to point A to point B I think when we, when we start talking about interoperable solutions, I think they're getting there. I think this journey has been there for a very long time. You and I chatted what at least 10 years ago about this? And we are we are still working on this, right? I think c is actually pushing this agenda on inter ability further and we need to continue to push that and it needs, it will probably take all of us the health care systems, the technology vendors, etcetera, who's in, who's in for the challenge? And are these people in the room that might be? So A I, we talk often about the clinical applications, we've already talked about that on stage. Um What about all the back office on sexy stuff? Um It seems like it's probably gonna revolutionize claims in some fashion. Look at all the waste that we see in the health care system. Could A I do anything about that? Um How exciting, how near term do you think these applications are? I I, one of the key, one of the most exciting things that I'm really thrilled about is education. You know, if you think about generative A I and you know, Google's Met product that is, that is basically A I literally like scored 80% in their A S M L E exam sort of test. And that to me is phenomenal. I mean, can you get a machine to like pass the exam that's hard and, and to me that just opens up doors for many other things down the road, right? I mean, you can, can you just imagine a place where you're not supplementing medical training with generative A I I think to me, those are even fundamental changes that you can, you can see and I'm excited about this. I think there's a really interesting space here of what the A I does, right? When you talk about adjudicating administrative items, whether it's a pre authorization or figuring out, you know, should this person be able to, you know, get physical therapy, you have to have this element again of the interaction, right? Because there are personalized pieces might not fit across the algorithm and you're only going to discover that if you're looking for it. So when I think about a I think of it as the assist, right? As like the assistant that no one in medicine has, like you pull together the pieces of information really quickly for you to be able to make a game time decision as opposed to having the backlog, it reduces that down so that people are still making decisions that are relevant to other people and that technology is the assist. Um So I love to kind of leave it on the note of giving people ideas and something optimistic to think through. So if there are any potential founders in this room, what would be an idea that you'd love to have them work on in say 20 seconds or less in this space, to further kind of health care in a in a more positive direction, hopefully get rid of the fax machine too. Uh You know, one of the things that I find most painful. Um, is that when I'm seeing a patient real time really locked into them, there's something that I need for their plan. Right. Like I need them to be able to get this medicine and also have this diet plan and for that to be neatly packaged and appropriate for where they live and their zip code and all those things to be figured out and the ability to offload that thought to make sure that my well thought out plan that gets lost in execution is actually delivered. Yeah, that sounds great. I'd buy that. I would actually go back to your original question. I was like, what all the back end applications that create inefficiencies in health care? Like getting to a doctor getting that care. I think once the, once the patient is in front of the doctor, you get phenomenal care, but getting there and sort of following through, I think that's where all the work is necessary and needed. And I think if we can use technology to sort of remove some of that friction will be great. Amazing. Well, we, we managed to end on time um without the A I so really appreciate you both being here and sharing your thoughts, your perspectives. Um Thank you. Thank you.

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