Detect and Prevent: Diagnostics-Driven Virtual Care from Everly Health, with Dr. Liz Kwo

Meg welcomes Liz Kwo, MD, MBA, and Masters in Public Health (all from Harvard). Dr. Kwo is the Chief Commercial Officer at Everly Health, a personalized diagnostic-driven care-at-home solution. She is an experienced healthcare executive specializing in P&L management, B2B/B2C marketing and sales, strategic partnerships, and post-merger integration. Dr. Kwo is an expert at building and scaling digital health products, leveraging predictive and prescriptive analytics to improve outcomes.

In this episode, Liz shares her experience as a healthcare executive, investor, physician, and company builder, and how those can tie the market and community needs together to reach more patients. She discusses her personal inspiration, experience bringing companies to market, getting the right investors, and teaching resilience across generations.

Dr. Kwo’s new book, Digital MD: Revolutionizing the Future of Health Care is available for pre-order now! Link below…

 

Further Reading:

• Digital MD: Revolutionizing the Future of Health Care
• Current state and future potential of AI in occupational respiratory medicine
• The Promise of Liquid Biopsies for Cancer Diagnosis
• Evaluating the Clinical and Cost Effectiveness of Musculoskeletal Digital Health Solutions

Episode Credits: 

The Game-Changing Women of Healthcare is a production of The Krinsky Company. 

Hosted by Meg Escobosa. 

Produced by Meg Escobosa, Calvin Marty, Chelsea Ho, Medina Sabic, Markala Comfort, and Wendy Nielsen.

Edited, engineered, and mixed by Calvin Marty. 

All music composed and performed by Calvin Marty. 

©2024 The Krinsky Company

Creators & Guests

Host

Meg Escobosa

Meg Escobosa has 15 years of innovation consulting experience, focusing on the unique challenges of healthcare since 2012. For The Krinsky Company, Meg leads client engagements overseeing advisory board design, creation and management. She also leads industry research, expert recruitment and trend analysis to support corporate innovation initiatives centered on the future of healthcare. Her background in innovation and strategy consulting began at IdeaScope Associates where she was involved all aspects of strategic innovation initiatives including understanding the voice of the customer, industry research and aligning the executive team to invest in promising strategic growth opportunities. Meg received her BA in Latin American Studies from Trinity College in Hartford and her MBA in sustainable management from the pioneering Master’s degree program, Presidio Graduate School. She is also on the board of a non-profit foundation focused on researching and developing technology to support a sustainable society. She lives in San Francisco with her husband and two teenage daughters.

Producer

Calvin Marty

A man of many hats, Calvin Marty is a Podcast Producer, Editor, Engineer, Voice Actor, Actor, Composer, Singer/Songwriter, Musician, and Tennis Enthusiast. Calvin produces, engineers, edits, mixes, and scores The Game-Changing Women of Healthcare. Calvin is also the creator of the 2020 podcast, irRegular People, among others. Find his music under the names Calvin Marty, Billy Dubbs, Nature Show, and The Sunken Ship. Over his long career as an actor, Calvin's has voiced many Radio and TV commercials for a wide-range of companies and products and has appeared in small on-camera roles on shows such as Chicago Fire and Empire.

What is The Game-Changing Women of Healthcare?

The Game-Changing Women of Healthcare is a podcast featuring exceptional women making an impact in healthcare today. We celebrate our guests’ accomplishments, setbacks, and the lessons they've learned throughout their careers. We dig into the many healthcare issues we face today and how these innovative leaders are working to solve them. Join host Meg Escobosa in conversation with some of the many brilliant, courageous women on the front lines of the future of health.

Dr. Liz Kwo: Unfortunately, for my first pregnancy, I lost a baby at 38 weeks. And as a provider, it was very difficult for me to realize that I didn't see some of the signs, you know, I had a little bit of a headache and some very slight vision changes, but nothing that would be too alarming. But some of the questions that raced through my mind were, “Should I have been able to symptom track? Should I have been monitored more closely? Could I have had a remote patient monitoring to detect the slowing of a heart rate?” And over time, I realized it would be great if we could allow affordable and accessible care at consumer prices that are reasonable. And I feel like over time, you've learned that, you know, you're braver than you believe and stronger than you seem, smarter than you know, and you can find a way through and I tried not to accept sort of the negative self-talk I had like, “Could I have eaten something wrong? Was it my fault?” And I just sort of watched it float in my mind and then warmly kind of let it go.

Meg Escobosa: Welcome to the Game-Changing Women of Healthcare, featuring exceptional women making an impact in healthcare today. Together, we dig into the many healthcare issues we face today and how these innovative leaders are working to solve them. We celebrate our guests’ accomplishments, setbacks, and the lessons they've learned throughout their careers.

I'm Meg Escobosa. Join me in conversation with some of the many brilliant and courageous women on the front lines of the future of health.

Welcome back to The Game-Changing Women of Healthcare. I'm your host, Meg Escobosa. A quick note before we get into today's episode, we are currently looking for sponsors for the podcast. If supporting and encouraging female leadership in healthcare is important to you or your organization, help us do that by becoming a sponsor of the Game-Changing Women of Healthcare, reach our engaged audience with a mention by me in future episodes, or we'll produce a short audio spot for your organization. At The Krinsky Company, we believe in female and diverse leadership in healthcare. If that's important to you too, become a sponsor of the podcast and proudly share your values with the world. Reach out to us at [e-mail] and thank you.

Welcome back to the Game Changing Women of Healthcare. I'm your host Meg Escobosa. Today on the show, we have Dr. Liz Kuo, MD, MBA, and Master's in Public Health, all from Harvard. She is the Chief Commercial Officer at Everly Health, delivering personalized, diagnostic driven care at home. She's also a lecturer and physician at the Harvard Medical School and a board member of several companies, including Walmart de México y Centroamérica.

We will dive into some of the earlier chapters and prescient business ideas of her 20 year career in this conversation, but I also want to mention that next year she is releasing her new book, Digital MD: Revolutionizing the Future of Healthcare.

Hi Liz, welcome to the show.

Dr. Liz Kwo: Hi Meg, thanks so much for having me.

Meg Escobosa: We're so grateful to have you here. So Everly Health is a fully-integrated digital care platform for consumers and businesses with a mission to provide more care to more people. What do you mean by a diagnostics driven care platform, and how are you able to reach more patients?

Dr. Liz Kwo: Well, during the pandemic, we realized that people were very comfortable taking tests at home, self-administered, right? COVID tests, especially. And we've also realized at the time, Everly was one of the first to help employers not only return their employees back to work, but thinking about how do we get patients more self-administered tests where they can be the stewards and also empowered to figure out what's wrong.

Things from food sensitivities, food allergies to things like hormone tests. On top of that, we also do more chronic care management and conditions, such as diabetes, chronic kidney screens and others. And our recent one chronic kidney disease is something I'm really proud of. We've been pushing it for a long time. It just got cleared as a HEDIS measure, which means it's reimbursed now. So we're seeing a lot of payers and insurance companies saying, “You know, chronic kidney disease is underdiagnosed. About 37 million Americans have it. 90 percent don't know they have it. How do we help people become aware so that they can prevent a dialysis requirement down the line?”

Meg Escobosa: Right. That early detection is so important to prevent costs.

Dr. Liz Kwo: Exactly. Focusing on knowing what you don't know and finding out, but also on addressing symptoms that you're feeling and may not have the exact way to access an affordable test, even that you can order just by calling from a website.

Meg Escobosa: So as the chief commercial officer, you're worried about the business model and generating revenue for the business. Can you describe who your primary customer is and what your biggest obstacles to achieving your business aims are?

Dr. Liz Kwo: Absolutely. We have two different business models. One is direct-to-consumer where some typical non reimbursed tests people can order from fertility, to other things we just mentioned about their gut health. I think what we also do and what I lead on the enterprise side is to help patients get covered for specific tests, such as colorectal screens. Colon cancer is pretty predominant. It's the third most prevalent cancer. We're also helping people like we've mentioned know about their cholesterol, know about their heart health, and we sell these to employers and also payers to cover it as a benefit, and we get this all through medical claims, which is really exciting because then it's like we are a 50 state provider, basically helping people treat them in their own homes. And what we're seeing is table stakes of virtual care is now no longer as exciting as being able to actually take a test and know and share that with your provider.

So actual lab values because 90% of what we see is people didn't know that they had certain issues. And on top of that, about 70% of diagnoses just, you know, knowing that you have high cholesterol or diabetes or other things are from lab tests. And providers are much more armed to be able to help patients if they know what your lab values are.

Meg Escobosa: And it sounds like you recently, I don't know how, when it happened, but when you acquired PWN. They have medical doctors who can prescribe or read labs and diagnose so that is the capability that you have acquired to allow you to do this.

Dr. Liz Kwo: Absolutely. So, Meg, you've done a lot of homework already, I guess. So we're very excited about that. We acquired a 50 state licensed medical practice to allow us to also now reimburse for testing and then treating and being able to manage someone if they have an abnormal result. How do we make sure that they can bring down their diabetes numbers or support them in their chronic kidney journey?

And what we really get excited about is now we can also prescribe. If you have a sexually transmitted illness, we can prescribe and we can also, on top of that, help people with weight management, which we're doing a lot right now, as people have talked about GLP ones and drugs that are helping to reduce obesity.

Meg Escobosa: People are catching on and it's what's selling like gangbusters. People are trying to get these medications, right?

Dr. Liz Kwo: Exactly. There's a lot of work right now on the prior offside and to help people get it, but also to try to work with insurance plans and employers to try to get people the right type of management for care.

And so we're very excited to be part of that and to push not only that, but women's health also initiatives ahead with fertility testing and menopause and other things that people may not have direct access to.

Meg Escobosa: Would you say that primary care doctors feel threatened by Everly Health? Is there a resistance in the market among providers or did they see you as a godsend? You know, here you come helping to address all these issues that we just don't have time to deal with.

Dr. Liz Kwo: We see ourselves as collaborators. I think we are now realizing, and we've worked with a lot of primary care doctors, that we can actually send them results that they may not know about. And or it's patients basically helping themselves and empowering them to feel like, “Hey, I got this abnormal result. Can I follow up with you? This is something I'd like to learn more about and be educated on.”

We also, as we test people, we actually send something called PCP letters. So we make sure that the primary care doctors are notified and we do that for all of our clients so that they don't feel like they're out of the loop.

Meg Escobosa: Right, so it's keeping the care kind of where it belongs, keeping everybody on the same page and making sure that the follow-ups happen, that the care gets delivered.

Dr. Liz Kwo: Exactly.

Meg Escobosa: Congrats on this evolution of the business. So your passion for leveraging technology to help patients, no matter where they live, was sparked well before the pandemic in 2015, you co-founded InfiniteMD, an end-to-end tech enabled service platform, for global patients to receive expert medical second opinions, which eventually was acquired by Consumer Medical.

Can you tell us that story? And how did you recognize the opportunity for the business and how did you build support and funding and growth through its eventual acquisition?

Dr. Liz Kwo: Absolutely. We were very excited at the time when I was building a company with my co-founders of this concept of helping people get the care when they most need it, especially in difficult events.

I myself, unfortunately, for my first pregnancy, I lost a baby at 38 weeks. And as a provider it was very difficult for me to realize that I didn't see some of the signs, you know, of, I had a little bit of a headache and some like very slight vision changes, but nothing that would be too alarming. When I was waking up, I just thought I was just waking up from a nap.

Meg Escobosa: I'm so sorry.

Dr. Liz Kwo: Thank you for that, but some of the questions that raced through my mind was, “Should I have been able to symptom track? Should I have been monitored more closely? Could I have had a remote patient monitoring to detect the slowing of a heart rate?”

And over time, I realized it would be great if we could just kind of allow affordable and accessible care at a consumer prices that are reasonable. Which is why I also love working with Walmart and some of these other great companies who are looking a. clinical trials and supporting women's health and thinking through initiatives that would push affordable health care into the 21st century.

I really like also, as we were thinking about InfiniteMD, how do I help people in their difficult time of need find the right specialist? So we had AI models to support and match and then allow people to translate from around the world and be able to find a specialist that could address their concerns. Anyone who gets a new cancer diagnosis or has a rare disease or has a pediatric concern, finding the right specialist was so important for me, and I'm very lucky, you know, I, since then have had three wonderful kids, two from IVF. And I'm very grateful for the right specialists that I found.

Meg Escobosa: That's an incredible story. I'm really moved by what you - you lived through that and then you went on to look to bring the solution to other people. I mean, that's just fabulous. It's you have seriously a strength of character to do that. I can see how just you have a will to make things better for the next person. So congrats on making that happen.

Dr. Liz Kwo: I appreciate that. I had a village of friends. I had mentors, supportive parents, and a great partner. And I feel like over time, you learn that, you know, you're braver than you believe and stronger than you seem, smarter than you know, and you can find a way through. And I tried not to accept sort of the negative self-talk I had of like, “Could I have eaten something wrong? Was it my fault?” And I just sort of watched it float in my mind and then warmly kind of let it go as I was pursuing back this journey that I wanted to hold on tightly to of trying to get pregnant again. And I think it's really important. I think I applied that both in my life journey, but also in my pursuits of entrepreneurship.

Meg Escobosa: Yeah, it seems really relevant because as I talk as a host of the show to a lot of entrepreneurs, there's definitely a common theme. It is a lot of work. It is harder than you can imagine when you set out so if you know all that you're going to have to get through when you start, you may never start because it is, it's such an uphill climb.

So I think that's a lovely, amazing attitude to have when you are a founder. It's going to be tough, but jus be kind to yourself with it, you know, call in the support you need. So I love that. I'm curious about sort of what did you learn about raising capital? Did you have to raise capital for that business?

Dr. Liz Kwo: Absolutely. We raised capital with a few of initially some angels, and then we ended up actually raising a larger series A with some really great people that supported us. I think we spent a ton of time talking to a lot of people thinking about the timing, thinking about the market, thinking about the valuation.

With early stage companies, you don't, you don't have an EBITDA, so you don't have to profit. And usually with public markets, it's just EBITDA times X multiple and so we were pretty focused though on getting the right investors and the right board roles for them. And top of that, creating a dynamic where we felt very comfortable with our ways of decision-making.

And it was great, as I've always learned with a lot of these pitches, you start to learn more and more how to not fail from the last one. And the more often you fail, the less it becomes a process of being afraid and you delve into failure almost like unexpectedly to succeed sometimes even faster because you immunize yourself against the fear of, “Okay, well, this is just going to be another pitch.”

I try to think about it whenever I've pitched things to be cautiously optimistic, right? You hope you'll get a win, but if you don't, it's not going to crush you. And thinking through that was one of the greatest lessons I think I learned too, as I've now become a mom and how do I help teach my kids resilience?

And how do you think about achievement in a way that makes you feel not only worthy, but that you can look back and say, “I did this. And even if I didn't do it perfectly, it was still my best effort. And I am, I'm proud of that.”

Meg Escobosa: That's really cool. The idea of not letting these failures, the decline, the no, the rejection define how you experience what you're doing next. That's really, really important, but I wanted to ask, you said you have, you kind of wanted to have the right investors. Did what your dream investor, how you define them, did that change as you got into that, as you learned talking to different investors, did that shift at all? And how could the next entrepreneur figure out who their ideal investor should be?

Dr. Liz Kwo: I think oftentimes it's someone who just loves your idea, loves the product and has a personal vested interest in seeing you succeed, whether they've encountered something or they want you to succeed along with them. Some investors are more thinking about just financially - how do they win from the situation?

But the ones that I think are tremendously helpful, click with you, they want to spend time with you. They want to help dig into the business model and find the right networks for you, the right advisors and giving you the right, I think, client leads, especially early on when you're all about the sales and the pitch.

I also find when we've had really good investors, they've been the ones who will lean in and say, Hey, you know, I just talked to this company. Is it relevant to you? If not, don't worry. But they're also not too high strung where they need to know about everything that's going on. They're fine with an updated quarterly letter.

And they tend to be, I would say, focused on helping the company grow together. And sometimes actually helping you think about making hard decisions when, you know, especially right now, when we're seeing a downturn in some of the valuations of companies and we're seeing a lot of investors, you know, either come through and say, “I'm going to invest in you,” or also just like holding still on what they're hoping will be a trend upward and we're looking at, you know, two to three years, because there's been a bit of a slowdown in terms of digital health valuations.

Meg Escobosa: Are you essentially saying that they are being more patient? They're seeing their investment with a longer term investment, longer term return.

Dr. Liz Kwo: Yes, and waiting for the market conditions to get better.

Meg Escobosa: Yeah. Okay. The life of an entrepreneur and an executive is really demanding, right? It can be all-consuming, but you seem to have a strong point of view about maintaining a healthy work-life balance. Have you always operated that way, or how did you come to learn this?

Dr. Liz Kwo: I think I have learned some tricks to the trade. You know, there are little things that I do, like writing letters to my kids when I'm gone or giving them cute little Easter, you know, bunny baskets or other things when when I'm gone, so they can find it throughout the house.

Meg Escobosa: That’s so cute!

Dr. Liz Kwo: It originally came out of guilt and now actually I start, I've taken them to one or two trips too and that's been life-changing because I just get to spend time with them while I work on deals. I think what's really great too, is I focused a lot on having mentors over the years. And I've just been very grateful for how they've taught me how to balance everything and to not lose sight of, let's say, your spouse and how your partner's feeling when you're traveling or delving in.

I also see it actually as seasonal. Life is somewhat cyclical, right? There are days or weeks where you're focused on, let's say, if we think about the health chart, you know, just your family. Other times it's really work. Other times it could be health because, you know, you're a little sick or some things and somebody's sick in your family.

I try not to give myself a guilt trip when one ball gets a bit dropped. I over communicate when I'm overwhelmed or even the other day I will really a bit. It wasn't my greatest moment, but out of frustration, you know, I kicked a wall and I made a hole in my wall.

Meg Escobosa: I'm shocked, Liz!

Dr. Liz Kwo: My kids, they were so thrilled to tell my husband and tattle on me that I gave myself a timeout after that. So I find, like, I don't try to guilt trip myself when I, you know, could have been made a better choice. I think it's one of those things I live with a zest for life and for new experiences, but I also try to measure it with how do I deliberately use the time that I have and I think also about, you know, we talked about not feeling guilty, but the idea is, you know, the past is a memory and the future is an imagination. So the only reality is the present. So how do you focus on being in the present when you're with your kids or when you're at work? It's really like 100% time devoted and focused.

And I also find what's incredible now is parents also have these great tech companies that have, that can send anything from diapers to baby wipes to dinner, or helps with a lot of it. I'm grateful that I have the ability to afford these things and I do try to manage it well that way.

Meg Escobosa: So I want to talk about the mentors. You've described a really thoughtful way of thinking about mentors and advisors in your life. Can you just share for our listeners how you came up with this approach or what you think about mentors?

Dr. Liz Kwo: Yes. So I think mentors oftentimes are organic, but sometimes you have to say into the world what your hopes and dreams are so the world can be a steward of your imagination and your dreams. And I think that is true for asking for mentors to come into your life. I've never really asked directly to someone to be a mentor, but I'll just ask, you know, “I really appreciate this time. Do you mind if I could follow up with you in a month and get your advice again?”

And over time, I've also been realizing that you can't be presumptuous, but you should ask. And then also make it quid pro quo, like they have to have and learn something from you. And what it is, is even if it's just energy, it's just a thanks or it's a gift. You're thinking about them or an article you read and you had a discussion with them. It's keeping them in mind and also focusing on, I'll say like what happened with me is I have a mentor named Stephen Oesterle. He was a medical device executive and I'll give you examples. So I went to a conference, this is when I was in medical and business school, and I just looked at the conference list. I said, “Hey, this person looks really interesting. His background is he's an MD, but he went into the executive side on Medtronic. I'd love to meet him.” So I saw him at a networking event right after I was a little bit afraid of approaching him. So I actually grabbed a friend and we walked over to a group that he was talking to.

And I tried to position myself next to him and I just said, “Hey, you know, I would love to learn more from you, you know, what you just spoke on and X, Y, Z was really inspiring and we developed a great conversation,” and I will say that has been life changing for me. A year later, I was doing an internship in Switzerland with Medtronic and he's just been a lifelong mentor of mine. We’ve kept in touch. And I find some of it is just putting yourself out there. But it's also, I've sent him books over the years. I've really like followed his family and that's what I mean about quid pro quo, you know, can't just be take, it's a lot of give and receive and it's a true friendship.

Meg Escobosa: That's great, I mean, you've found somebody that inspired you and let them know it too. I think communicating that means something to them. Yeah.

Dr. Liz Kwo: It does. And some people will receive it at the right time. Some people it's not the right time, you know, they're over, I say overworked or they have other schedules, but some are receptive, and so I create opportunities to try to understand. And then also it's figuring out how I can be supportive of other people. And now I'm starting to think about how I pay it forward. I mentor it back and actually makes me interested and I'm thinking about another book, Digital MD is coming out, but so many people ask me how to transition from being a clinician to an executive. I've started writing a lot about it and I think that's going to be my next book after this.

Meg Escobosa: Oh, very cool. I was going to ask you about, you know, getting your MD is one huge task. Getting your master's in public health is another. Getting an MBA is yet another. Did you always know you wanted to do the business side of healthcare? When did that come together for you?

Dr. Liz Kwo: Sure.I will say I was in debt a lot, so I don't know for everyone, but I also have ADHD and so it was the right thing for me to kind of balance between various things that I find fascinating. I have a thirst for learning. I'm right in like reading right now a lot on private equity and how we think about that, but I would say I did the MD and the MBA together.

It helped shave off time for me and that there are a lot of great joint programs like that. And thenI was doing my residency and part of the residency was an MPH. And I just love the idea of lending public health and population health and again, affordable care, into my own, I would say, knowledge base.

I think all of this was fortuitous, because the goal, I think, at the end of a, I think, a lifespan of career is kind of discovering your gifts, figuring out what you're good at. And then hopefully gifting it away over the course of your life to leave a legacy and to try to support other people.

With that in mind, I feel like that's why I've started talking to different folks about if you're interested in healthcare and you're a clinician or you're a dietitian, that's almost some ways are for you. If you want to delve into startups or entrepreneurship, it's to dabble, it's to keep your day job, but really focus on where can I be an advisor to a startup and how do you build some of that credibility first and the skills and approach because I actually what I also see is when a lot of clinicians who are following protocols now are jumping into the business side, it's harder for them to transition. The jobs are more instead of top down, knowing what the protocols are, you now have to think laterally - how do I cross functionally improve the team dynamic? How do I think about the business model and how much risk am I willing to take in this business model? Certain for not only production of a wide range of tasks from medical affairs to thought leadership to concern about supply chain to the, you know, sales upside to profitability to this idea to really represent the voice of the patient.

I think it's a really nice blend. And I think another fascinating area is healthcare is so regulated and quite complicated that when there are people that really understand their domain and they can really speak to their expertise. It makes a big difference. So that's part of also what helped us with fundraising too, it was to have a level of authority, credibility, and then when you approach that and you refine your own speaking ability, you find your communication and the platform that you want to speak to really resonates with a lot of people over time. So being able to do that, I think as an entrepreneur is key as you refine your pitch.

Meg Escobosa: Very nice. Tell us about your book, Digital MD: Revolutionizing the Future of Healthcare. Where'd you get the idea and what do you think is next for the future of healthcare?

Dr. Liz Kwo: Sure. I'll say the book cover came from my girls who really love unicorns, especially rainbow ones. So I was going to make a unicorn, but then my publisher was like, I don't think that's professional enough. So I moved it to a cross with the rainbow and all the digital ideas that come in. I wanted to write it because I've been at the intersection of sort of five different Ps. I call it five different stakeholders. So the patients, providers, payers, public policy, and then pioneers. So policymakers, kind of regulators, these are all the ways that shape how we decide what kind of business model we create, but also payers and employers kind of reimburse for a lot of healthcare, so how do we learn how they think and how the return on the investment they're expecting if they're going to cover what you do.

As a payer executive, you know, I came from Elevance Anthem as our deputy chief clinical officer, I was looking at Medicare, Medicaid and commercial, and you start to learn different business models of how we cover different tests, especially innovative tests or innovative remote patient monitoring, or how are we thinking about precision genomics and what diagnostics we're willing to cover and why.

And so the book is written to help people demystify the entire ecosystem. As we're thinking about digital health, it's great for a lot of entrepreneurs. It's also for academics to try to understand where we're headed. And it's written for also the lay audience who may be interested in healthcare and just wants to see, which I call also the future of care, which is the three Ps on top of that in predictive modeling, precision genomics, and also personalized medicine. And then ultimately, not only can you predict through data, but then prescribing. And these are all really important next steps because data by itself is not as useful as something that you would use it to change management. So if it's just data, like I get, you know, patients asking me all the time, “So like this sleep monitor tells me to do X, Y, Z,” without it telling them what to do. If it just gives them data, well, their heart rate is today. It's not that relevant.

Meg Escobosa: Right. It's like the Challenger crash, the shuttle, you know, all this data was presented in a table. It didn't indicate there was a risk.

Dr. Liz Kwo: That's exactly it. That's right.

Meg Escobosa: Yeah, serving data in a consumable way. What is your take on Gen AI in healthcare? What are you most excited about and what causes you concern?

Dr. Liz Kwo: Oh, great question. So definitely a few things. When I look at Gen AI, I mean, there's such great stuff out there. I'm so excited about, even the way I've spent, I've lost actually hundreds of hours delving into Chat GPT and how it works.

But I also feel like there is so much excitement around it. So I actually just wrote today, an article on the nine revolutionary ways AI is advancing health care, even in the coming years from medical imaging, identifying tumors, and, you know, all the great things that we can now do to surgical robotics and achieving better outcomes for patients. Medical research and data - I think we're going to see a lot more of this work.

For example, you may not need to work on petri dishes and wait for cells to grow over time. You can actually model out clinical trials and how molecules bind. Just basically like the way that using the same technology as driverless cars, you can figure out how models, different kind of drug targets, can be assessed for drug development.

So there's, there's so much great stuff. I think even early detection of fetal blood diseases, not to mention that we talked earlier about remote patient care, this idea of using algorithms and wearable devices worn by a diabetic patient to detect certain abnormal readings of glucose levels. And we're seeing so much of this just blow up and I think it's going to continue to assist in everything that we do.

And I definitely think it's going to change work culture too, as people are thinking about, you know, I know from engineers to lawyers to others about, I'm even thinking about how I will educate my kids. The skill sets that they're going to need to learn and how it's not rote memorization, but it's going to be leadership and communications and confidence and cross functional team and being creative.

All these things I think are going to be skill sets that are better than what a AI model could generate. Like let's say for accounting or financial model or even in writing. So it's a really interesting time. I think it will save humans tremendous amounts of time. You asked about the risks. I think they aren't small, but I do think a few things I think more about are from the healthcare side are more about data-in versus data-out. And you have to base your AI so that you don't risk kind of all the things that can go wrong with that, and people are using AI for prior auth, for example. I did that back at Anthem, and we realized, you know, we can't model old behavior. If old behavior was bad, you have no idea to detect if you were granting more MRIs for this demographic or another.

But you can use AI in a very objective way. Let's say we don't use old history of data. We actually use data that says, “These are five things that are required for this prior auth,” let's say an MRI of the required physical therapy, pain, unrelenting, you got an x-ray, didn't show anything. It's been five weeks.

Then it checks the box through the medical records, and that's already been documented, and it's fair. So having these things with natural language processing and the ability for us to train algorithms and speed it up, I think is just phenomenal. We're also seeing, by the way, on the prior auth side, we are focusing on making sure it only does approvals, but denials need to have a human hand, at least at this point.

Meg Escobosa: Yeah.

Dr. Liz Kwo: That it doesn't, as you're training the models, it doesn't deny things that you wouldn't have wanted it to deny.

Meg Escobosa: Right. There's more to a story than just what's on a piece of paper. I say paper, but ones and zeros.

Dr. Liz Kwo: Yes, exactly. But the good news is AIs are at least better than faxes, which we're still in some of this medicine.

Meg Escobosa: Yes. So it's cool that you, so, you know, the provider side as a clinician. And you know, the payer side, given your experience. Who is leveraging AI more effectively or who's faster at adopting AI, and where do you see this heading?

Dr. Liz Kwo: Oh, that depends on the type of company. I am seeing a lot of providers using it in their workforce management.

I'm seeing it in startups using it for RFPs, like, you know, when they're bidding for certain things, they just use the same language and they can update it with generative AI, I'm seeing a ton of it also on the payer side, especially with prior authorization, but also workforce management. In payer side, we try to reduce medical costs and so how do we think about length of stay or ER visits and can we leverage certain tools to prevent somebody from bouncing back to the hospital or for home care or what we call CMDMUM. So care management, disease management, and utilization management, all three areas. You can help clinicians work top of license by streamlining the workload. You know, what I talked about earlier prior auth, instead of a nurse chasing these charts, it's the AI being integrated with medical records to pull it out and maybe one thing is missing. So it saves, you know, about 90% of the time that would have been for a clinician to kind of chase charts.

Meg Escobosa: Very cool.

Dr. Liz Kwo: Yeah, so it's a great time to be in healthcare. I really believe that there's so much room to grow and I definitely am very optimistic about the future.

Meg Escobosa: Well, Liz, this has been just such a cool conversation, a great conversation for me. I'm thrilled that we got to have you on the show and looking forward to reading this book and to hearing when your next book is out. I don't know how you do it all.

Dr. Liz Kwo: Thank you, Meg.

Meg Escobosa: Thank you.

Dr. Liz Kwo: Really, really nice to be here and appreciate the time.

Meg Escobosa: Thanks for joining us for the Game Changing Women of Healthcare, a production of The Krinsky Company. Today's episode was produced by Calvin Marty, Chelsea Ho Medina Sabich, Wendy Nielsen, and me, Meg Escobosa. This podcast is engineered, edited, mixed and scored by Calvin Marty. If you enjoy the show, please consider leaving a rating and review wherever you get your podcasts. It really does make a difference and share the show with your friends and colleagues. If you have any questions, comments, or guest suggestions, please email us at [e-mail] and visit us on the web at www.thekrinskyco.com.

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