Name: Brainstorm Health 2024: America’s Sick Workforce and Building Better Health Systems
Uploaded: 2024-05-21
Duration: 18 min 54 s
Description: Sean Duffy, Co-founder and CEO, Omada Health, Noosheen Hashemi, Founder and CEO, January AI Owen Tripp, Co-founder and Chief Executive Officer, Included Health Moderator: Jennifer Fields, FORTUNE

Sean Duffy, Co-founder and CEO, Omada Health, Noosheen Hashemi, Founder and CEO, January AI Owen Tripp, Co-founder and Chief Executive Officer, Included Health Moderator: Jennifer Fields, FORTUNE

Brainstorm Health 2024: America’s Sick Workforce and Building Better Health Systems

Conferences

I'm just gonna jump right in. I'm gonna start with you Sean. Um We have more awareness of chronic diseases than ever before and more drugs to treat them than ever before and yet we have more sickness than ever before. So, can you talk about how we got here? Why are Americans so sick? Yeah, it's a great starter question. And it's uh something I've experienced in founding a lot. We're uh 13 years old and every couple of years I feel like I read the exact same jam article, uh which is the epidemiology getting worse, the disease burden is getting worse. Uh The data is getting worse. Uh And that has to change. And uh the thesis that we have is you have to support people on a day to day basis, a proactive day to day basis and the entire health care system of supporting people every now and then with visits just doesn't work for chronic disease. Uh And I think that that's a real opportunity for employers and why that they can get engaged in really helping solve the challenge. So I wanna jump over to you. Um There are so many large employers who are paying for workplace wellness programs. But we also know that workplace wellness programs aren't actually working. Um, can you talk a little bit about why they're falling short and where I'm gonna start with why that's such a crucial problem for employers. This is the largest expense. It's the largest thing that they pay after payroll. It is the largest reason why they can't attract workforce and they can't maintain that workforce doing the jobs that they asked them to do. So, it is actually a problem of American competitiveness. I know we're gonna talk about health care over our time together, but let's just actually start with how desperate this is for, for our economy and our country. Now, why does this happen? Well, we invest that money. We expect people to find these things on their portal to know how to use them to engage in health care in ways that we in rooms like this design and it just doesn't work members, patients, whatever you want to call them, they want to be treated like complete individuals. They don't actually want to think in terms of the labels of their diseases, they want to be treated for their minds, for their bodies and their wallets and it's companies that pull all those things together that are offering the solutions that are winning today. That's great. And New Jan, you do a lot of work with A I and I think we all hear a lot about the promise of A I and health care. Can you talk a little bit about how you think A I can help prevent and manage chronic illness? Absolutely. It's addressing exactly what um what they both mentioned. So, um often we're offering generic services to everyone. They're not hyper personalized to each person. People are infinitely interested in their own circumstances, don't listen to generic advice very much. So, I think A I provides that opportunity for personalization and getting hyper personalized. For example, looking at someone's data and dynamically updating based on, let's say blood test data that comes in um wearable data that comes in being able to essentially help people with everything from s symptoms, tracking to mood, tracking to early detection, for example, looking at someone's irregular heart rate or they even develop symptoms or providing uh just in time care to people. So instead of waiting after someone's already eaten something to tell them, it wasn't a great idea. As a nutritionist might do, you may want to actually say, hey, it's Tuesday. I know Tuesdays you're gonna have a burrito, this is A I is doing this. Um And we have this um and maybe you want to consider this other kind of burrito today. Um Maybe you want to have an alternative, another Mexican tasting thing that has more protein, more uh fiber, less fat and sugar for you today. Um So we can be more responsive that way. So we can provide a lot more uh preventative uh information and we can offer a I health coach, someone who knows you. Um 24 7 is with you and is going to know longitudinally everything about you. And it can, it has the capacity to understand your image data, your blood test data, your MRI data that can read your wearable data, things that are not human, interpretable A I can do for you. So I keep reading these grim statistics about the numbers of people with dementia, uh, the numbers of people with diabetes over the next coming decades. Um, Sean, do you think technology is moving fast enough to keep up with this? Well, we are, we are on a remarkable technology curve. So it's, uh, it's really the tech is moving. I think the adoption needs to move faster and I think the innovators up here are all trying to make that happen. I mean, we're the fastest tech has ever moved. I mean, there's a new model every other day. Um, my bedtime routine with my kids is now to talk to A I at night and I keep reminding the letter my four year old that A I didn't exist in the way that it does now a couple of years ago. So I don't think the tech is the issue. Uh, I think it's how you actually put it in practice in a way that lands with a person that really supports them that hits first principles behaviorally, uh, and actually gets outcomes and that's, uh, that's what needs to happen. Nein, I think a lot of people would argue that the American job is incompatible with health. Um, can you talk a little bit about how we can bring these two closer together? Yes. So, um, a lot of our jobs are sitting jobs. So, a lot of us are essentially, um, uh, spending, you know, having a sedentary lifestyle, which is uh as you've heard, sitting is the new smoking. It's extremely, extremely dangerous to sit for a, for a number of reasons, your comorbidities go up dramatically. So I think employers that take an interest in, for example, treadmill desks or standing desks people because now we are working remotely a lot. So it's not like great offer, a lot of gym subscriptions offer a lot of. So we need to be really flexible because people are not necessarily coming, coming to that central location, to all work together and go to the corporate gym. So I think that innovating companies are providing essentially flexible ways for people to find healthy living wherever they are. And then, and then contributing to the ergonomics of people's um work environments wherever they are. And I think we need to be able to, you know, encourage people to take vacation for example, and all of this needs to happen from the leadership down, right? We need to mean that um and we need to not just say it but actually live it as leaders so that our employees can become a lot more healthy. And it goes without saying that we should care about safety as well, which is really a factor in a lot of jobs. I'm going to open it up to questions in a minute to get your questions ready. But Owen I have a question for you. So employees don't want their companies to become Big Brother. So how do we engage them but also protect their data and privacy? They definitely do not want that. So, but they probably want more than we think they want. They do want a company that looks out for them and cares about them and they're willing to have that company actually make some bold decisions on their behalf. Let me actually tell you a pretty positive story from the last year, Walmart, the largest employer, largest private employer that we have in the United States, one of the largest in the world. Now, they over multiple years evaluated the question of whether they could offer zero cost primary care to their associates nationwide 24 by seven scheduled at times that were convenient for their workplace and their environments and what they saw not only was the loyalty and appreciation of their associates, but they saw 37% reduction in hospital utilization in hospital stay. That is a staggering statistic one that would be hard to repeat in almost any context. Now, this was a deliberate choice by Wal Mart on behalf of their associates, they were repaid with appreciation and loyalty in one of the hardest labor markets. My point in telling you this story is it is doable. We can actually have both of those things together. We can achieve a healthier workforce and demonstrate outstanding corporate results. So I'm excited about that. Um Do we have any questions in the audience? I think we have one over here. We have, we have a microphone coming to you. Thank you. Um As a child psychiatrist, I would really appreciate us addressing the fact that the roots of most physical and mental chronic illnesses begin in childhood, not only from a physical point of view, but the impact of trauma and adversity on Children, but we have a healthcare system that isn't focused on prevention, it's focused on uh once the diseases happen and each of the exciting things you addressed do address current chronic illnesses. But I'd love it if you could talk about prevention and the role of working with Children to truly change the trajectory of us health. My answers could be quite radical. So I don't know, I should, I should offer them. But um well, are you thinking of uh technologies to work with Children to sort of help them as they grow or do you mean um I mean your question butts up right against the human condition. So Children are small. Um And by their size and people just assume that they don't know what they, what they want and they make a lot of decisions for Children. There's a lot of things that happen, that's how they develop trauma, but, but in terms of, you know, big answers to trauma, um not necessarily preventing. But, um, certainly, I think a, I can provide mental health 24 7 therapy. I really believe that it can. Um I've seen some really, really interesting um uh and also psychedelics are a big, big thing coming in and they will get FDA approval this year. Um that I think on maths um should be able to in conjunction with a protocol, help people address some of their trauma. What I would offer is when I hear prevention, I tend to equate it with proactivity, which is something our health care system is very bad at. And when we talk to our members and say, well, what did it for you like? Oh, well, you, you, you asked me my goals. It's weird that healthcare doesn't do that and you were just there checking in on a regular basis, you know, a continual basis. Uh And because if you do that, if you get to know someone that does prevent downstream progression of the disease, uh and complications, did we have another question? Yeah. Thanks for then uh co founder and CEO of Nano Air Sean. Good to see you again. Um And nice to meet uh the rest of you to the last question and maybe the specific for you, Sean, um, food and diet obviously come to mind immediately when we think about childhood progression into chronic disease. How much have you tied over 13 years? Now, you've tied your solution, which was first data driven on a day to day basis. But now I'm sure you've brought in a lot with regards to diet and food and the services around that. Just curious on how you're tying those, those things together and maybe the other panelists opinions on that as well. Yeah, I mean, I think the, the one lesson I offer could probably talk for 45 minutes on this. I think the one lesson I'd offer is if you don't really listen to someone and really try to understand what will work in their world. Does it align with their goals, their circumstances, their family, their preferences, it just will not land durably. So that's something that there's, and there's an art to figuring that out and really listening to people and matching their truth with what can be encouraged and, and kind of work, you know, for them over time. So again, that's a distillation. Uh, but again, it could talk for hours on that. Can I jump in on that first? So we have, um, we've been in research seven years and the single most predict, uh most accurate predictor of people's glycemic response when it comes to metabolic health and managing your blood sugar is what you put in your mouth. So food is incredibly important, more important than activity, more important than everything else that involve that, that affects your glucose, like sleep stress. Um What time of day you eat? Et cetera because measured at all. So food has an outsized role in, for example, um chronic diseases like me metabolic disease like diabetes, which then leads to other comorbidities. So food is really big and we're very excited about food as medicine, picking up steam as a movement in the country right now. I think 11 states are Medicaid. Um organizations are now covering food as medicine and there are medical prescriptions being written all over the United States and this movement is only going to grow any other questions? Sure, there's a microphone coming for you. Sure. My name is Harvey Carp. I'm a pediatrician and the CEO of happiest baby. We make a robotic baby bed called Snoo. Um And I wanted to just make a comment about the um the health of young Children and and chronic disease because A I fantastic but there's some like nutrition, there are some more, get back to the basics in terms of improving health care. And one of the things that we're exploring with snu is um number one, if we can improve sleep and reduce crying, which we've demonstrated to reduce the risk of postpartum depression because we know that postpartum depression then leads to long lasting problems for the mother but also affects the child development. But one interesting fact is that rhythmic holding and rocking is deeply soothing for all beings. Uh And there's evidence that kangaroo care, for example, that is doing that with premature babies leads to improved brain architecture 15 years later. And so the opportunity perhaps is to introduce rhythmic stimuli as a way of improving brain's regulatory ability and reducing the normal stress reaction so that we're not as predisposed to stress, which then predisposes us to chronic disease. So um just saying that there are other ways of kind of thinking about it um to, to try to start at the very beginning and, and improve the care and thousands of people now get this for free from their employers. Uh It's a benefit all across the country. I I want an adult version, please make it. Um I have a question for, for you, Owen. Um So many employees aren't uh they're like gig workers, they're freelance workers, they're not. Um you know, you know, salaried employees, how should we be thinking about them in terms of caring for their chronic conditions and preventing them? Yeah, terrific question because ultimately, you know, sort of one just to frame the question up a little bit more broadly. One of the things if you think about the payment architecture and coverage in the United States, um a lot of the problems that we think of as the most expensive and acute, you mentioned dementia earlier really actually present after you're in the active workforce by and large. But the seeds, the preconditions are happening while you're in the commercial workforce. So actually investment and prevention at childhood at baby is really important, but the people who are on the payment end of it don't actually realize that. And I wanna circle back to that in a half second um for the gig workers specifically, um We and other companies provide uh benefits uh for example, to Instacart drivers to make sure that we are providing that care. Now, there's two good things. One, the member gets an amazing service whenever they need it at low or no cost to them to provide high quality virtual care. But two, you are not passing a time bomb along later to whoever ultimately has that full commercial insurance responsibility that is really, really, really important. Um I just wanna briefly remark on this conversation, by the way, Marty, your product is great. I've seen it. Um is that I have an interest, I think a lot all of us have an interest in the pediatric roots of disease and chronic disease in this country. But I wanna be absolutely crystal clear about something that is not actually where the money is. And so the problem is that if you think about it, all of us, we get reward in our businesses probably like many of you uh around where you get acute, acute flare ups and cost. And so that's actually where the dollars go. That's where the digital health innovation goes. It actually takes a founder mindset, like my colleagues up here to stay in it for the long term and say we wanna actually solve this problem a lot more comprehensively. I hope more of you will stay in that fight for a long time because health care does take a while because then you can take that comprehensive view of prevention, but rarely are you rewarded for starting a business that's focused on prevention? All right, I have a rapid fire question for you. Um If you could answer in 30 seconds each of you, what is the one most important thing that we need to do to begin to reverse the situation? I'll start with you, Sean. It sounds silly, but I think we need to enable payment for asynchronous care because if you think about what I shared the operational models needed for proactivity, require billing for asynchronous care. So all the incentive structures, all the regulatory structures, all the billing models in the entire us that created this problem of a visit by visit like system that doesn't work for chronic disease is because you can't bill for async care. So if you don't actually fix that, you're never going to create a better experience that could lead to better results in chronic disease. I would say uh deploying A I responsibly, I would say on a personal level, all the things that we could do for a person to gain agency over their health, on board them, to their health journey and keep them there, keep them interested and engaged. But also for a company to manage uh programs such as challenges and campaigns, um health challenges, especially in the remote uh work uh that decade that we're in right now. It's really important to get people interested in uh in group activities even if they are remote. And there's many, there are many ways that A I can help, it can dynamically even change incentives. It can decide this group is doing great. They're going to raise the bar. A I can do incredible things for engagement and Gamification. And of course, at an even higher metal level uh corporate um America can really look at trends, look at uh claims data, we can look at um risk stratification. We can see who really needs help and who should we help uh preventatively. And we can scale solutions like diabetes um broadly and we can supercharge telemedicine. We can do so many things with A I. So I would say that's my one. Thank you. I'm so sorry. We're out of time. It was gonna be really good. You'll have to ask me later. It's gonna be the best one. Thank you so much for joining us.