Name: Brainstorm Health 2024: The Health Care AI Reality
Uploaded: 2024-05-21
Duration: 17 min 51 s
Description: Dr. Rebecca Mitchell, Executive Vice President, Investment Team, Vive Collective Kevin Spain, General Partner, Emergence Capital Jeff Tangney, Co-founder and CEO, Doximity Moderator: Chrissy Farr, Second Opinion Media

Dr. Rebecca Mitchell, Executive Vice President, Investment Team, Vive Collective  Kevin Spain, General Partner, Emergence Capital Jeff Tangney, Co-founder and CEO, Doximity Moderator: Chrissy Farr, Second Opinion Media

Brainstorm Health 2024: The Health Care AI Reality

Conferences

Dr. Rebecca Mitchell, Investment Team, Vive Collective, Kevin Spain, Emergence Capital, Jeff Tangney, Doximity, Chrissy Farr, Second Opinion Media

So good to be with you all. Again, I'm gonna dive right in with the question for Jeff. So you and I have known each other. I would say going on almost 15 years. Um And I've seen you through a few different iterations, Hippocrates, which I would say was a standout in the mobile health area and then doximity, which really came along around the time that digital health was taking off. So I'd love to hear from you what you think the next wave might be today? Do you think it's a, I, do you think we're that like, how, how do you think about that as somebody who's been involved with both cycles? Yeah, that's a great question, Chrissy. So doc I think folks know we make medicine mobile for doctors. We have over 80% of all us physicians who use our app, they call their patients, they sign their digital paperwork, they check their calendars and we have over um all of the top 20 Pharma companies and hospitals as clients. Uh 475 million in revenue last year, 230 million in profit. All right. So what's the next wave. Uh We do think it's, it's a I, so we stood up a product, we call doximity GPT. 14 months ago, we've had thousands and thousands of doctors using it and using it very consistently. So we've done millions of prompts now and looking back across the 14 months of millions of prompts, I think what we've seen is it helps with letters with notes and with answers. So letters with the first use case, it was helping with insurance appeal letters, the residency recommendations, I have to write the, you know, the service animal letter for the patient who wants to bring their puppy on a plane. Doctors have to do a lot of letter writing and it really helped out a lot with that notes was the next kind of surprise feature though. That got a lot of use. Doctors have to write a lot of notes to patients and they have to write it in a language that patients can understand and they're taught in medical school how to speak in medical Latin, but they're not taught, taught how to speak to 1/4 grade, you know, patient, right? So it's really been helpful with that and then the last area is answers. So we've seen a lot of doctors just asking clinical complex questions that need to go into the literature. And we recently announced a partnership with perplexity to add the citations and sources and make that part easier. So listen in the grand scheme of things. Physician burnout is a real issue in this country. The doctors who've used their GP T say that they can save 13 hours a week on average using A I, which is a major improvement I think in being a physician in this country. And Kevin, that kind of dovetails very nicely into a question that I had in mind for you, which was really about this kind of in health care. We, we sort of struggle between, do we invest in, in software or do we invest in services and doximity? You, you more think of as a software company? It's now a public company, one of your investments. How do you think about that in light of A I? Because your firm has been doing a lot of writing on this, that A I could change the services side of a lot of different industries. So as you look at where the need is in health care, are you a software or, or services? Sure. And why? Well, I think it's a, it's a really interesting question, you know, for us at emergence, we have been software investors for the last 20 years. I mean, we've been lucky to work with companies like doximity and sales force and Zoom and others. Uh ser uh software businesses are phenomenal businesses. They're very high gross margin, they're very scalable. Uh And ultimately, they can become very profitable like doximity once they reach meaningful scale. So I think for us, we will continue to be primarily software investors. But one of the really interesting things that I think A I enables that I don't think technology has necessarily been able to enable in quite the same way is we can now build soft companies that actually can in many ways replace certain kinds of services businesses. You know, many ways software has been really good at improving productivity, right, making companies that do things maybe produce services more efficient at doing them. But now you can actually see the opportunity to build technology companies, software companies that can supplant services. Now this will not apply to all services. I think there will be lots of areas, for example, with health care, where people are going to still play a very important role in providing services, for example, to patients. But when you think about all of the outsource services in health care, like all the third parties that do work for health care services organizations that themselves are services companies, we see an opportunity to build technology companies that can actually now for the first time, actually supplant those services with software. And so in some ways like what we're, what we're talking about and writing about is the opportunity for A I as a venture investor is more interesting in services than it is in software. But in the way that you know that I just described Rebecca, where do you land on that specific debate? Because you've been involved, you know, both as an advisor to companies like doximity. You've been at, at the VGO, which ultimately sold to Teladoc more on the services side. You're also a physician. What, where do you stand in that, in that conundrum? And what do you think is actually going to make life better for everyday clinicians? Is it going to be more services or more software? Hm. Um, so I'd actually love to answer this question by pulling forward beyond how do you make the day to day life better for clinicians? Because I think if you really talk to clinicians, one of the reasons they are the bigger reason they are so burnt out and demoralized across the board right now. Yes, it is so much note, writing pajama time writing notes um feeling like they can't do the right things for patients because it's not covered. But the bigger moral injury I hear from many of them that they're experiencing is feeling more and more distanced from having a meaningful impact on the health of individuals and communities and it getting better over the years of their career and being part of shaping how to make it better. So a lot of the clinicians that I work with as an investor and I worked with for the last 15 years and product isn't as an operator in digital health companies. What made their life most better was actually sitting alongside ceos like Jeff sitting in product teams being clinical leaders and thinking about how to combine the best of medicine and science and technology to solve clinical problems in completely different ways where you could invent new medicine and bring the best existing medicine to far more people in the world than it does today. I grew up in rural, pretty like blue collar, like no good hospital in sight, Wisconsin. And I mean, my family are some of the most aggressive adopters of digital health tools and it is absolutely changed like their health care experience as like infrastructure that we think of as like typical health care has moved further and further away over that same period of time. So I'm a big fan of what people like Morgan Cheam are saying we have to get beyond the faster horse problem both in digital health and using generative A I and pull people together who can re invent the way we deliver care. And Jeff, I, I think a lot of that speaks to you especially, I mean, we sort of lost over this, but more than 80% of all physicians are using your service. That's an enormous number. I think you said 900,000 or something along these lines, use it all the time. So how do you, you, you must interface with just so many physicians every day? You see the inside of this culture, you see the burnout. What do you think is finally going to move the needle and give the clinician the right to live this entrepreneurial community and lifestyle that they thought they were signing up for. Well, I guess I'd say two things on this. We, we just completed a survey we do every year 7000 physician respondents asking, would they encourage their child to go into medicine? And the answer is as low as it's ever been. Uh, 62% of us physicians would not encourage their Children to become doctors today. And that's down from 40% or so 56 years ago. So it's gotten worse. I do see, hope, I do see an opportunity here where that pajama time everyone gets a scribe, everyone gets a helper and they're able to focus more on the patient experience and less on the keyboard. Right. So I do hope that that turns around specifically as I look back. I think there's this misnomer out there. A lot of people think that doctors are afraid of A I because it's going to start competing with their diagnosis. Well, that's already been happening with Google for a decade, right? And the reality is in the United States, we don't pay doctors to diagnose patients. You can make $50 for a visit trying to get a complex diagnosis or you can make $150 cleaning your ear wax, right. It's amazing how that isn't really supported by a reimbursement system. So I think physicians actually can look forward to better diagnoses higher quality care. Again, using A I using tools that the patient could do maybe pre visit to help them out. So again, I'm I'm hopeful that this will really change what has become really just uh an untenable job for a lot of doctors just reminded the audience that we will, we will be taking a question. So stop thinking about it. Um Kevin, one of my favorite memes on Twitter right now is um this people doing this side by side between the the most amazing technology that you see in other industries and then what you see in healthcare. So like one headline is like this incredible, you know, A I robotics and it's related to another industry. And then at health care we get, you know, oh this new product that's gonna make a fax machine work more seamlessly. So as you look across health care and your firm invests in other industries as well, like how do you even make the case internally for? Like we should just continue to invest in this area when you see it be so far behind so many other areas? Well, I think it's a great question and I mean to be fair, it's not just in health care, there are a lot of industries, a lot of what we would call kind of rusty dusty industries, industrial sort of parts of the market where this is also true. They have the same means they have the same uh you should follow those accounts. They're kind of fun too. But um but I do think that there's still, it's sort of interesting as an investor and I think also for founders too, it's so interesting to me that here we are in 2024 and we still see so many places in the economy, so many industries where there is still so much opportunity to build better technology, to enable businesses to operate more effectively and efficiently. Uh It is a shame that health care is one of these industries, right? Uh We all obviously in uh interface with health care and we all deserve a better experience and I firmly believe as a technology investor, uh that technology is a key part of the equation to make that experience better. Um But why has this happened? Why has this happened in health care? Why are we here today? Um I think, you know, a lot of it has been uh fear, right? I think fear of change, right has been, you know, something that we have seen in the health care industry, you know, for a while. Um and as a result of, you know, some of that fear of change, uh we've seen less adoption of new and innovative things, not everywhere. I mean, certainly, I think in the clinical realm, we've seen a lot of adoption of new and innovative things, but we're now only starting to get to a place I think where health care is starting to realize that the technological innovations um that we've seen adopted in other industries are really necessary to be adopted here. Think A I is one of these things where, you know, we see this, you know, through doximity, you know, physicians are picking this stuff up and they are using it. Right. And that is the signal, right. I think that everyone in healthcare should be paying attention to that. The time is now to start adopting this stuff in ways that they haven't before. Totally agree. And I think Rebecca and I would have both experienced this, but we, we sit in these rooms talking about A I and meanwhile, every physician out there is already using it. Um I'm gonna throw the question on to the audience if anybody has one. Ok. Hi. Uh Muir Kusa, co founder of Vital Bio. Thank you all very much for being on the panel today. Um I'm just wondering if I could hear from each of you what the goal is of A I? And are we trying to get to a place where we get A I? Good enough that A I will never be the cause of harm? Or is it just to get it to a place where on average A I is reducing overall uh harm or pain or um uh inefficiency in health care? Ok. Sure. Um So I wouldn't answer this question the same for any new wave of technology. I, I think the goal is to create a better health care system and bring more of the best medicine to as many people as possible as quickly as possible. And we are utterly lying to ourselves. If we don't pretend the status quo doesn't have many people being left out. It's delivered imperfectly all the time. And one of the things that has drove me the most bananas, whether we're talking about M health, digital health, like ML like now generative A I is holding all of these two technologies, these new technologies to a completely different standard than the status quo of medicine. I mean, I mentioned Wisconsin, the other first five years of my career were spent in global health contexts. Other countries are not waiting around for like the gold standard to be evenly distributed like even 20 years ago, right? They were using community health workers and S MS based health care delivery in really rural environments. And it was extraordinary seeing what was possible when you unleashed a bit of that creativity even though it wasn't perfect. So I am fully in the second category of your question. Yeah, but I think this is an interesting question. I mean, if I can put it well, like with any new technology, they're going to be upsides and they're going to be risks, right? And this is no different. Uh I think there are a lot of people speculating that the risks around this new technology may be greater than technologies that we've seen in the past. I don't think we really know yet. Um And the other thing I would, I would offer is that when a new technology emerges like this, it is kind of unstoppable, right? You can't put the genie back in the bottle. So the, the thing I think that we need to focus on uh more than trying to tamp down the risks uh because I think the risks are just, there is trying to get the most out of it that we possibly can, right? How do we get the most value out of a new technology that is the best way for us to ultimately deal with the fact that there will inevitably be risk. So, you know, you know, I would love to see A I adopted in health care as broadly as possible. And along the way, we'll identify some risks. But I think the benefits if we do this, the right way are going to greatly outweigh them. Yeah, real quick, I'll just say better care. That's the goal. And I would look at radiologists as an example of a, of a specialty that's had A I image reading now for well over a decade. And at first, there were fewer physicians going into radiology residencies because they were worried that we wouldn't need radiologists anymore. And of course, that didn't happen. What happened is people started getting better care, more people get more ct scans and more Mris than ever before and were able to spot things earlier. So I think that's an example of where technology has led to greater efficiency, has led to better patient care. And I think there's a lot more areas that we can go there, Jeff, I'm gonna throw the final question out to you and, and perhaps, you know, just hear what you think and what I really appreciated what you did with the doc. Somebody it is that you invited some of the physicians who had been involved with your business for a long time on the product side to get in on it and be part of it. And some of them made great returns. And so I'd love to hear from you a little bit more about that. How do you think physicians should be getting skin in the game when it comes to digital health and the technologies that they use every day beyond just being customers and evangelists? Yeah. No great question. So, you know, it's our goal to be the most physician owned public tech company. I think we are. It's hard to prove it. But I believe that we are today, we have tens of thousands of physicians as shareholders. And you know, each year Rebecca has come, we do these deep dive physician Summits for a whole weekend. We're really all of our best ideas, including automating the facts early on. That was one of our early hits and we joked, we had posters in the office fax to the future. You know, it's hard to get engineer excited about working on FAX technology. But it is what doctors need because it's what insurance companies require. And that's the nature of our world. So you brought the engineers to those events too, which is exactly how you, and they could hear the excitement of facts to the future and all the time it would save. I agree. So, yeah, it's our goal to continue to be the most physician owned tech company. And I do think that, yeah, there's just a lot of pride we take in serving. What we think is one of the most noble professions, which is caring for caregivers, caring for people who spend their days dealing with honestly, the hardest, the poorest, the sickest people in society and trying to help them with better tools. I hope more companies adopt this. The reality is medicine has become more corporate, not more clinical in the last decade or two. And in some ways, my hope is that technology can, can change that, make it more about that patient relationship. Excellent. Well, thank you so much to the panel. Really appreciate all of you for joining us today. This is wonderful. Thanks for having us.