Equity, AI, and Pens: A Weird Combination at a Healthcare Conference
Written by Dr Nick on April 10, 2023
Vive Wrap Up
This week I am talking to Gautam Gulati, MD (aka DrG @drgautamgulati) and HealthcareNowRadio’s very own Editor in Chief Roberta Mullin (@mssoftware) to take a look back at the Vive event that took place in Nashville at the end of March.
Vive Presentation Stage – Dr Nick
There were some well-received presentations and stand-out content and direction from Micky Tripathi, the National Coordinator for HealthIT at the ONC, and Aneesh Chopra who had a candid conversation with Liz Fowler (Center for Medicare and Medicaid Innovation (CMS Innovation Center) on Value Based Care and how things are not working that Roberta. Gautam took a longer perspective looking for patterns and trends over the years finding the number of companies at the conference unexpected. As usual old buzzwords have disappeared (Web 3.0 and blockchain) but have not been replaced with a splash on AI. We were all surprised by the lack of any promotion around generative AI and ChatGPT – recall the advent of meaningful use or AI in the past and those buzzwords were splashed across every booth and it was hard to find a company not doing “Fill in the Blank buzzword”.
ChatGPT – nada!
And the show certainly had a lot of HealthEquity but our views were different on what that might or might not mean for the reality of healthcare.
Listen in to hear our thoughts on signage for companies, and the struggle with food (as a proof point I lost three pounds while attending this conference for 4 days!) and hear our suggestion for conference organizers to take on the waste of giveaways with an innovative idea – thinking along the lines of a program for hotel soaps: Clean the World
Listen live at 4:00 AM, 12:00 Noon, or 8:00 PM ET, Monday through Friday for the next week at HealthcareNOW Radio. After that, you can listen on demand (See podcast information below.) Join the conversation on Twitter at #TheIncrementalist.
Listen along on HealthcareNowRadio or on SoundCloud
Raw Transcript
Nick van Terheyden
I’m Roberta I’m saying editor in chief answers media network and healthcare radio now yes
Roberta Mullin
healthcare now radio
Nick van Terheyden
you think I know it after that it’s time but and I got you. I’m going to call you gotten through this. I’ll introduce you as Dr. G as well, because that’s your brand.
Roberta Mullin
Okay, conduct. I’m with Dr. Nick and Dr. G.
Nick van Terheyden
Yes, you are. You’re in hallowed company. That’s all right. Ready, guys ready. And today I’m delighted to be joined by Roberta Mullen. She is the editor in chief of answers Media Network, and also for healthcare now radio, and Dr. Gautham Gulati, also known as Dr. G. He’s the founder and CEO of well, the well home and founder of well played media. Thanks to both of you for joining me today.
Gautam Gulati
Thanks for having us.
Roberta Mullin
Great to be here.
Nick van Terheyden
So we’re at Vive, we’re doing a wrap up, this is our opportunity to analyze what we’ve seen what we’ve heard what we think about the show. I’d like to start by asking, What are your highlights? What have you seen, that we’ve experienced in the past and you go, wow, that was a good opportunity for either some insight or some innovation in the show space.
Roberta Mullin
So naturally, I come to these conventions as as press. So I’m always looking around and I have like an agenda as far as like, who to go see and everything else. This vibe, we were asked to bring our radio station. So we I spent a lot of time in that booth. But I did get to venture out because I’m my beat. I say in health IT is interoperability, which I think will keep me employed for like the rest of my life. Because I’m not sure because
Nick van Terheyden
there’s never gonna be any. That’s correct. So
Roberta Mullin
I’m here to talk
Nick van Terheyden
about your emoji if you like.
Roberta Mullin
Here’s my emoji, that’s not going to happen. But I always I always make time to see Mickey Tripathi, the head of the O and C. And he of course, was a headliner on Tuesday morning, laying out the plans of the O and C, which I think, you know, through all of the government turmoil and everything else, I think the O and C has been steady and not political and kept to kept to their, to their vision. So I always like to see him his his big news was that we all thought he was going to have the the rules that they’ve been reviewing for some time now. They were going to be out, but he said no. So there’s that rule. And then
Nick van Terheyden
there’s your job security, right.
Roberta Mullin
And the other person I like to keep in watch is a nice Chopra. Everybody knows it nice Chopra. He’s the you know, the first CTO of the US and he always he’s into value based care. He’s he thinks that’s gonna happen to
Gautam Gulati
you also brings the energy he does
Roberta Mullin
always say a nice is in the house. You know, when he had a great he had a great panel, because he’s so into value based care. He brought Liz Liz Fowler. She’s the current director of CMMI, which is the Innovation Center for CMS. They’ve changed all that acronyms. But anyway, CMMI. And what he did is he actually invited Liz and the one that she just replaced and a consultant from one that just there and they talked really candidly how like most of the stuff doesn’t work there. And that they really had to retool, you know, innovate, just throwing out a model. What is that doing a model delivery, you’ve got to we they really have to look at, like how they’re going to be coming to value based care. That’s a really passion of niches. And it was, it was enlightening to see that it was you know, it wasn’t like the rah rah rah rah, let us all you hear here. Like this so much energy so much, you know, graffiti art. There.
Gautam Gulati
Right, the signature branding five, right, the graffiti. Yeah. You know, from my perspective, as someone who’s been at the forefront of innovation for a couple of decades, I tend to view these types of conferences through that lens. And I look for patterns have been coming to these events for a number of years. I tried to look for patterns over the course of the years. And and looking for patterns. Typically I try to see what surprises me from year after year. And so from that lens in terms of identifying what are the trends versus the fads, and what’s surprising me. I’m really surprised, to be honest that they’re actually this many companies here this year, just given the way the markets are. For one, right that the dollars are going down. Right, right is this, you know, this is how people are spending their money. So I was I was pretty surprised by that. I’m sure they’re getting some value out of that. The other the other surprise that I think has stuck, I think we had a louder voice. And maybe it’s just because of the tweets and just the way Ross who does things, but the carrot home model being threaded throughout a number of different companies and organizations, and what that means and what health at home means and how it’s getting reimbursed and getting a lot of attention there. So that’s had some staying power over the past couple of years. I think what’s notable in absence is we don’t see web three stuff. We don’t see blockchain stuff. We don’t see any of that those those sorts of buzzwords that have been floating around healthcare for the past couple of years. So another important thing to sort of notice, notice there, and quite surprisingly, Nick at you and I talked about this a little bit, there’s some, only a moderation level of of talk around the generative AI and chat up to me, it’s here. But it’s not the dominating conversation, which was a little bit surprising to me. Not everyone will say that they think it’s going to have significant impact, but maybe, you know, as we come to health or we go to vive next year, maybe we’ll see more of that.
Nick van Terheyden
Yeah, I agree. I mean, I think that was my expectation. I thought I I’m trying to think I think maybe it was telehealth, post. You know, the pandemic, everybody was telehealth. That was telehealth, banners, telehealth this, and I thought for sure the marketing teams would go into overdrive and it would be chat GBT large language models, we’ve been doing this. I haven’t seen a word. I mean, as as you said, a little bit of conversation. And it is I mean, there’s no question that this is going to revolutionize, but somebody was asleep at the wheel, that was an opportunity for some hype and buzz and they missed it.
Gautam Gulati
We can talk about some specifics. I mean, there were some companies that incorporated it in a very smart way. But I think also people were careful about not overhyping it in certain ways. But you know, not putting the marketing before the science is I like to say like, you gotta Well,
Nick van Terheyden
why would they do that now, they’ve never done it before.
Gautam Gulati
But I just want to fit into other things, which I think are notable and really refreshing to see, I think we’re starting to get a lot of recognition of seeing women in healthcare, and some of the, you know, leaders around organizations like folks health and, you know, parsley health and so forth that are that are running some interesting organizations, and also the Diversity Equity inclusion and seeing, you know, some of the health equity conversations really at the forefront. So really enlightening see that?
Roberta Mullin
Yeah, unfortunately, that’s on my not gonna happen list.
Nick van Terheyden
The diversity and inclusion,
Roberta Mullin
equity. Oh, because I just don’t believe unless you have one payer that you can really be equitable. I don’t see it happening. I see. I see a lot of people talking, we had a whole hour of it on on the stage here. And we understand the problem. I think we understand it more than we did. I think that it was, I think that the people in the industry knew that it was going on, they just didn’t want to bring it to the forefront. Right. You know, why, why. And now that we have now that COVID has really exposed a lot of it. They have to say it, but so now, but what’s the solution to that? So
Gautam Gulati
do you think it’s just lip service at this point is because of the way
Roberta Mullin
I think that everybody’s like, Oh, they’re shocked that it’s happening? I’m not I’m not shocked that it’s happening. But what’s the solution? How do you get how do you get Dr. Nash was on the show with you the other day? He said, The Five there’s five top medical institutions in Philadelphia, right, right. Yep. Philadelphia and he says the county so Philadelphia, the city of Philadelphia is in the county of Philadelphia. And he said that that county was that has that that much of the best medical whatever they can get right. And he says certain percentage of medicine people even run through Philadelphia at one time of their right, right, right. Yeah, it is on the bottom. It is so low on on the health outcomes of the country of the country. That same county has three of the top five now that particular county has three of the top they can’t even do it there. Okay. That, that to me, that whole thing was like yeah, that’s not going to happen.
Nick van Terheyden
I in many respects, I agree with you. I mean, I want it to be I’ll play the dumb immigrant, because that’s what I am. I came into this country and I truly didn’t have the insight it. And it wasn’t a complete revelation. But I will say that the pandemic opened my eyes in ways that I absolutely had not. I don’t know why I was blind, I’m blind to because I’m white in part, and I’m privileged. And I’m lucky. And I recognize all of that. And it wasn’t for not wanting to look, I just didn’t see it. And yet, I feel like many of these things, we just keep talking about it. And we’re not doing it. I mean,
Gautam Gulati
I think there’s different pieces. I mean, we have to define equity. Right? Like, what is, is it? Is it just minority populations, underserved populations, is it you know, because I, for me, inclusive of equity is also accessibility and affordability, access. And so but but seeing things, for example, like I would just had a conversation with Vin, Vin Gupta, who runs Amazon pharmacy, and they’re introducing generic drugs. I mean, they’re all about the convenience and accessibility to try to get, you know, coupon in which 85% of the population doesn’t utilize, and they just announced that this morning. So, I mean, is it massive progress in terms of is going to solve all the issues? No. But is it an important one and a small piece to move the needle? I think so.
Roberta Mullin
In the United States, your care is directly related to the insurance and how you pay. That statement came from Mickey Tourette Tripathi at health. It’s a it’s a statement that I think is horrible. But true. Your care in the United States is directly related to how you pay. So if you have good, a good pay meant if you have good insurance, you get better care.
Nick van Terheyden
I’m sorry. I’m just I’m no big the truck up. No, that’s not true. And I’ve a case study of that. You don’t get great care. Even if you have a fantastic insurance. I got that. And they denied it. I don’t care. I’m teasing. I’m teasing a
Roberta Mullin
little bit. I get that. But I’m just saying you’re that’s we’re not talking apples. No, no,
Nick van Terheyden
no, I know. I know. i Yes. That’s that’s part of it. But I mean, to your point, I would say Amazon, I haven’t seen what they’ve done, I still relatively new. The person I would call out that is trying and maybe this doesn’t satisfy the equity, but its cost plus Mark Cuban’s piece, and he’s not solving the actual problem. He’s just pulling everything out that he can he took 100. Now he’s extended it. That’s a huge deal in my mind. And I think that does start to answer it, although maybe that’s not even drink. But I mean, even my comparisons, I’m seeing the numbers, and I’m going, How is this even possible? I’m hoping that the numbers he’s coming up with are affordable for people that don’t ordinarily have, and it’s all cash. So in that sense, it’s those so those that don’t have access that don’t have a plan, because of course, we wrapped drugs up into the health insurance.
Gautam Gulati
And even in conversations with the leaders of folks health, which for those who aren’t familiar with it provides sort of a hyper specialized clinic care for the LGBTQ community. That mean they’re taking, they’re taking their model and going from direct to consumer to an enterprise based approach. So they’re utilizing it as a member benefit in organizations, which we all know, our insurance typically comes from employer base or sponsored insurance big, big bee in my bonnet about that, but, I mean, that’s a separate issue itself. But if if that’s how we are getting covered, and we get our services offering that type of service to that, you know, underserved population I think is a move it’s a it’s a move forward, I think it’s a plus. Again, I don’t think it’s a massive massive issue. Sure, but at least seeing micro innovations around certain areas I think are interesting to it, I mean it’s refreshing to see
Roberta Mullin
but it’s insurance and those who have money can you can utilize it Sure. Right. And but even step back to wellness Alright, so what are we doing about wellness? I mean, if we had wellness in this country and that was a priority then we would have less problems on the other side I mean people are you know,
Gautam Gulati
well Food Food as Medicine has now stepped forward as a that’s great as popular conversation.
Nick van Terheyden
But again, that feels an awful lot of lip service, although there is one group that’s I figured
Gautam Gulati
Instacart was here and representing significant Yeah, but
Nick van Terheyden
there’s I think farm box is the one that’s actually trying to deliver food but you know, incorporating i I’d love to talk about this but I do want to sort of get back to some of the show and you know, the good and the bad I’m gonna pick something a little bit trivial but you know, it’s a bit like you know, hospital if you if you mess up the entryway and the the, you know, the first inter reaction that people have, you’re gonna get people patients that are really unhappy. And I would say the same about conferences. This particular instance, they got the food wrong here. I just I never got any food for the last three days I’ve been starving because I couldn’t stand in that light. I partly I got stabbed for that extended period of time and, you know, the little pop ups. I couldn’t bloody find them what the hell was wrong with
Roberta Mullin
and here’s the thing that some people were like saying was a great deal. And I thought it was pretty good too, that they actually had the menu in their, on their sight and in the app, and you could I knew everything that they were serving, so I knew
Nick van Terheyden
I wouldn’t find that. Oh, well, that was my failure. Sure. It was in the app and there were
Gautam Gulati
a couple of signs floating around tell you
Roberta Mullin
that was your
Nick van Terheyden
your wetsuit all Okay, so the good
Roberta Mullin
food was
Nick van Terheyden
there was no problem with booze you can get plenty of that. It was just the hot food seemed to be
Roberta Mullin
a good job with it. Was advertising what they were gonna have like a week ago. I was looking at it.
Gautam Gulati
Whether it was good or bad. I mean, that’s personal preference. You’re not gonna you’re not gonna please everyone. No,
Nick van Terheyden
no, I’m no commentary on the food because I didn’t taste any of it.
Roberta Mullin
I saw you eaten sushi. Oh,
Nick van Terheyden
that was not bad. That’s not
Gautam Gulati
bad. But they were offering sushi here. Yeah.
Nick van Terheyden
So you didn’t find it. You said I was bad.
Gautam Gulati
But to the point of could there be healthier options at a health conference? Yes. I mean, there. I didn’t see a lot of it. I mean, that’s a bunch of cookies chips. Yeah,
Roberta Mullin
the in betweens they when they brought out the desserts after you didn’t see them. No, I
Nick van Terheyden
didn’t know. I saw somebody posted a red velvet cake that kept scrolling on the screen all the time. I missed that one.
Roberta Mullin
There. Yeah. Oh, yeah. They had ballclub by yesterday. They had? Yeah.
Nick van Terheyden
You you clearly found it all.
Roberta Mullin
I bet. This is like we have to remember health and vibe. They’re the same conference and by the same people and everything’s and I’ve been going now for like six or seven years. It’s they don’t stray from their, from their patterns. Right? All right,
Nick van Terheyden
so low lights for you guys.
Gautam Gulati
Low lights,
Nick van Terheyden
what could they do better what
Gautam Gulati
as a conference or as
Nick van Terheyden
even companies companies that got it wrong in
Gautam Gulati
I mean, I think we’re gonna, there’s gonna be a massive attrition between now and the next Oh, got to be there has there has to be it’s gonna be a little shakeout, the cost of capital is near zero for the past decade, a lot of lot of noise entering the market, not saying that they’re bad products is probably bad execution for a lot of them. But we’ll start to see a shakeout and I think it’s needed.
Nick van Terheyden
It definitely is needed, not least of all, because I can’t keep track of all the names. We’ve run out of names for all this stuff for me to know what’s going on, at least I. And if I’m going to pick on the companies, not a lot of companies do good on signage, I thought, I mean, this is a FedEx society, you need instant bullet points. And I’m not seeing those. And that’s what I’m walking around. And, and most of the time I see people on their phones, and I’ve you know, lots of people talk about this, they’re not engaging. There’s the odd person that says, Hi, Nick, and I’m do I
Gautam Gulati
help companies don’t know how to be creative and don’t know how to tell stories. And it’s just the nature of the beast. And if one company can figure that out, I could probably stand out on that floor.
Roberta Mullin
But yeah, exactly. Because when I walk through my my two things, it’s exactly like I get probably 150 to 200 emails a day in my from PR people, okay, that are pitching me something to do in the news. And if I first of all, if I don’t recognize your name, you’re, you’re down. And the second thing is, I will read the subject line, if I don’t know what you’re talking about, and why would I open the thing that goes right to the trash? I walk through here, and I literally am walking very slowly walking, reading that reading. I know a lot of the company’s names, but when I don’t look and I’ll say, I walked by, I’ll read what they have. I don’t know what they’re not even I don’t know what they do. I just walked by, I read.
Gautam Gulati
Those are the ones I’ll tell you where I struggle as a doctor. I’m addicted to pens, right? And so when you walk when you walk by when you walk by a booth I’m staring at the pen is like is that a pen I want but I don’t want to make eye contact. Right, exactly. Because if I do then I have to stop and talk.
Nick van Terheyden
I’m gonna Fess up. So I’ve broken that habit I used to collect. But I one of the very early conferences I went to and one of the things that happened at the work. The company I was at a lot of people didn’t get to go and we’re quite envious, you know, these heydays of and there was some Fanta, so my first day was dedicated to running the floor and just picking up everything and I literally packaged it up fast Next to the the company had causes for distribution. And I kept a few things and you know, I scored or you know what? I think it was about 510 years later, I’m looking in my basement, we’re doing a clear out everything was there all this junk? So I collect nothing. I don’t even have a pen. Actually, I may have a pen. But that was no, it’s whiskey society. So that definitely wasn’t here. So I know, I didn’t
Roberta Mullin
have a sister who was a teacher in the Philadelphia School District. And she always wants pens. I picked them up for her. And then he’s telling me that Yeah, and I’ve also talked to some of these people. Because when if you’re here, and afterwards, they throw most Yeah, that’s a lot away. And I say, why don’t you get with the, with the local schools, and at least drop the pens off? You know, because she gives them out all year, I always bring her you know, what
Nick van Terheyden
a great idea. I mean, I just recently read or listen to a whole story about hotels, so which has always bothered me. Yeah. And there’s actually a company that takes that and has created a financial track to allow it they they get the hotels to pay to take it away, and then they mash it all up, and then send it out to all the countries that need it, where the kids are dying from diarrhea because they couldn’t wash their hands. We could do the same thing with all that stuff in schools, backpacks to send all the backpacks, hey, vive listening to this, you could set this up and actually do this or health. I know that’s,
Roberta Mullin
and you just need to do the local one, you just tell the local school that right? I’ve got six, you know, cases of pens coming over. And they will gladly
Nick van Terheyden
teach, using their own money to buy
Roberta Mullin
supplies. We’re in a city every every city has like the you know, brilliant idea, financial problems, just like the hospitals and everything. So we’re
Gautam Gulati
going to be promoting ozempic on pens to kids. I think we’ll probably have to be careful about what’s on the pen.
Nick van Terheyden
Unfortunately, chat GP at this point. Okay, so thinking about next vibe, what would you be hope? Well, I’ve heard you I agree with you. I think, you know, attrition rate, I want to say it certainly used to be 50%. I think it’s going to be at least 50% won’t see of companies that are here. There’s nowhere it’s
Roberta Mullin
gonna be LA. The next five, the next five is in LA, and in February, and it will be at the Los Angeles Convention Center. So I think that’s going to be constrained right there. Right.
Nick van Terheyden
Because of money. Well,
Roberta Mullin
I think, well, going out everybody going out to eat? Yeah, I think so.
Nick van Terheyden
Okay, well, I mean, I think they’re going to be lost because they’re not, you know, they haven’t focused on the funds, they don’t have an actual solution that people are going to buy. So I think we’ll see. We’ll see a loss. So I don’t know shrinkage necessarily. But what do we think’s going to emerge? I’ll take the easy one chat. GPT is going to be absolutely front and center, not as maybe chat GPT. But some variants of all of that.
Roberta Mullin
I think the only person I talked to about that subject. I had lunch with the first day. And it was a it was an AI company and the guy that was in there. And so of course we said what do you think and he goes, that’s not gonna happen. It’s not it’s not
Gautam Gulati
it. What’s the what are you mean? That’s like, what like, what,
Roberta Mullin
like, what to Minister he said that that, that that technology is not going to be what everybody’s saying it’s going to be
Gautam Gulati
alright. With that. I think it’ll be that and more.
Nick van Terheyden
Oh, absolutely. It’s gonna be that more. What was he smoking?
Roberta Mullin
He was he was eating.
Gautam Gulati
Well, that’s it that’s like, that’s like back in the mid 90s. Like, what is this thing called the internet? What does it do? That’s right, right. Yeah. She’s ever gonna use that somebody should record him saying that and then track back 20 years,
Nick van Terheyden
you know, didn’t tell us who it was. Right. Well, I’m not asking
Roberta Mullin
never I can’t remember because obviously didn’t make an impression on I just kept looking at it. You know,
Nick van Terheyden
I think that’s absolutely gonna be big. What else? What do you think Home Health clearly, from your perspective? Certainly
Gautam Gulati
home health. Absolutely. I think we’ll see a lot of new models being delivered around. I like to see a lot of policy moves when it comes to home.
Nick van Terheyden
Oh, yes. Yeah, I so I agree with you about Tripathi, you know, phenomenal. And, you know, that’s one of the things about a niche, he’s connected, although he’s outside now. I think that’s part of what he brings not only his connections and his energy, but his ability to navigate that. I mean, I’m clueless when it comes to that, but we need people that really bring the difference. I’ve had some great conversations with some really interesting companies. So policy is essential. Some acceptance that we need policy and government oversight, maybe yes, yeah, yeah.
Gautam Gulati
I I think we’ll see a lot of m&a over the course of next year.
Nick van Terheyden
Oh, yeah, maybe that’s some of the ways they’ll just wrap up some of the technology. I
Gautam Gulati
mean, there’ll be fire sales for a lot of companies. Yeah, sure. Good bargains.
Nick van Terheyden
All right. Well, unfortunately, as we do each and every week, we’ve run out of time. It just remains for me to thank both of you for joining me on the show. Always a pleasure to catch up even better to catch up in person, Roberta Gotham. Thanks for joining me.
Gautam Gulati
Thank you. That’s a lot of fun.
Roberta Mullin
Yes, great conversation.
