From Tech to Trust: Redefining Population Health for a Healthier Future

[0:00]  I think the Long View of having a healthier Society in a in a global view is being more collaborative and and still maintaining our capitalistic Innovative structure not having it become this huge bubble that's going to collapse and I think we're at a Tipping Point it almost feels like we can't go back from relative to healthcare spending and all the things that fall underneath that so that I think is a money conversation I think it's a traditionalist legacy leadership conversation I think if we start to change it there's better longevity for us as a society and then a global leader and competitor as well so I think Eyes Are Always On Us in terms of healthcare and what's so wrong but a lot of good things that are also coming out that are

[0:47]  progressively better all right guys welcome back to a brand new episode of the heart and hustle podcast now today is going to be an incredibly special episode because I'm sitting across from an incredible leader here now I've got Brian Urban on the show who is the head of population health and Community commercial strategy for Best Buy Health if you're watching you can see his black vest that he's got on Brian is going to be leading us through what does population Health actually mean has it changed since the pandemic with somebody in his strategic seat what is he prioritizing as we go

[1:34]  through the next couple years and What needs to change for them overall population of our communities man but Brian welcome to the show brother oh thank you this is Keenan so much fun and by the way I love the way you uh you have heart inserted as not only part of your last name but as a part of the podcast uh theme and brand itself but what an honor to be talking to you across the country so very cool well brother how's your heart doing today let's kind of get into it good I uh I think I'm challenged dayto day with just generally juggling things in my little world but uh heart's good brain's good family's good uh just need to spread out travel and be be more home as much as I can but otherwise life Life's good it is man

[2:23]  when we think about you know something that's as important as the health of our communities I feel like a lot of people have a miscon conception that nobody strategically is thinking about the mass populations of people when we talk about population health I think a lot of people who are tuning into the podcast today have no idea what that even means so what is population Health can you kind of give us a definition so the audience can understand what we're going to be talking about here today yeah I'll give you some historical context and then I'll I'll take you into the definition that I'm trying to have as a part of the evolution that needs to happen with population Health from my perspective so if your uh listeners are familiar with the origin of population Health really the nomenclature came to stick as a discipline in the early 90s and it was really rooted in clinical application and research so the practice

[3:13]  of delivering care to different populations relative to socio economics Geographics and also cultures of Health that was really where it's been for a long time and that tree growing really out of academic medical centers and and continuous there across the country in the US took another arm to the to the growth in the early 2000s and started having a focus more on top of the discipline that I just mentioned of now data analytic social determinance of Health policy as well so it started to get a little bit broader and even more interdisciplinary kind of like what we we know as a modern day Public Health practice now is you see a lot of those practitioners across the ecosystem now and really it's been for me kind of

[4:02]  stagnant there for a while and I'm hoping in my work in Best Buy Health that the third iteration or continued evolution of population health will have more of a consumer Behavior lens with technology being the focal point in this View and that's really important because in the developing and even developed communities across the US technology plays a critical day-to-day role in understanding our health as a journey not just as outcomes in an episodic manner but as a journey throughout different parts of our life individuals close to Kin family community technology is one of the biggest bridges that we all find some sort of common ground on that connects us on a daily basis so

[4:51]  with Best Buy Health having more of a a strategy to the populations we serve Aging in place uh Wellness and Care at home it makes a lot of sense that we're having this type of purview and it's just it's just where we're going in our Evolution right now it's not even really the whole story of Best Buy health I mean I think it's really interesting for us to kind of take a step back and talk about your background to be somebody who is the head of population Health right and strategy for an organization like best bu Health how do you get this role like are you a doctor who then wants to deal with population I know that you had a BS in uh what you got your business administration and management uh Bachelor's in science you also got your Sports and Fitness Administration and management Bachelor's in science and got

[5:39]  multiple Masters after that so what has your journey been like to kind of be this individual who sits with me here today I'll tell you this is the cool thing about best by Health uh I am an oddball uh I I I guess you could classify me as but really like a utility player I think best by health is comprised of a variety of utility players and you can think about a sports team uh I I don't root for the Patriots but good example of their Dynasty that they had is a a variety of really athletic teammates that could play different roles and could be almost like a Lego piece and I think that takes a really interesting background to be able to be applicable across so many different segments relative to Health Care today and that's how I think I was so attracted to best bu health and vice versa so my background if you look at it

[6:27]  uh I I I'm still in school I'm at brown right now uh I I just finished a public health degree at Dartmouth and then before that private Christian School lburg MBA um California of Pennsylvania Indiana of Pennsylvania some State schools here and all those Journeys uh I'll say them Journeys separately have led me to believe that I have to continue to learn and adapt to our everchanging environment relative to healthcare where my interest lies so I don't think I was ever a thoroughbred for population Health in particular but I'm absolutely an individual that can contribute to where population Health needs to go so it stays alive and relative to my work in uh Health tech services and Best Buy health and population and health in in its its

[7:17]  Nature has gone through so many changes so I think I kind of uh I'm defined with that story as well so my background is a mix of a variety of things and even professionally I've worked for large private payers Blue Cross with Shield license Walgreens specialty drug rare orphan disease uh from an analytic product focus and then even some work I had done in nonprofit in revenue cycle in a private Equity Firm so I've kind of gone around the ecosystem to gather different experiences professionally and academically to get me ready to do a really Dynamic role that I find myself blessed to find myself in today I mean with all that experience that you've had did you ever have like an aha moment or was there a Eureka moment where you realize like wow there's a real good opportunity for me to apply myself to

[8:05]  this pop health model and have a real impact did you ever kind of have that aha time I did it was probably coming out of my time with siga I was there for about almost eight years did a variety of roles I found myself wanting to do things that they weren't ready to do at the time at a local market level and a corporate level as well not to say anything bad but just they weren't thinking in the way that I feel I could have added extraordinary value to individuals lives and also business groups so I just thought all right I might go back to school again uh but I want to change course I went into nonprofit I was with the Alzheimer's Association out of Chicago for almost two and a half years when the pan Global pandemic covid-19 hit they

[8:54]  lost a ton of funding resources I had the opportunity then to take the skills I was doing uh with Alzheimer's and health systems work over into Walgreens Specialty rare disease and what was really cool at that time was I I finally found my FIT I was in a product role but I wasn't being defined as hey you're Building Products your job is to be able to create new things that we haven't done before pressure test them quickly to find new Partnerships and stick something in the market that people can actually get value from and I was put on this project to build an sdoh analytic engine using uh a bunch of desperate data sources credit bureau uh raw data sources from there uh claims Banks

[9:42]  chargemaster data demographic uh the social variance index that's publicly available putting all these different uh data sources together to show more of a whole view of what's impacting an individual's medication journey and their adherence to it the e y of the drug uh and also education literacy alongside that that was a critical project for me to say wow there's such a deeper thing that I could do and public health might be it because at that time population Health there were a few really good programs more residential in nature me not willing to move at the time with a young family just didn't work out so I found a great hybrid program uh Dartmouth clinical practice uh the The Institute there and spent the next two plus years really finding my

[10:33]  discipline within Public Health that took me to population Health as a subset of the education I received there and that aha moment wasn't like a moment it was it was like a multi-year ah o oh ah like that it took me a while to be able to pingpong a little bit to land me in the right place but leaving signno was critical because it took me out of uh a Market management role of simply just uh designing a high performing network of providers and underwriting policies for insurance to a accelerating impact level and actually helping people not to say they don't but it wasn't a fit for me and what my skills were going toward so it was a aha

[11:23]  multi-year experience for me hopefully that helps resonate with some of your listeners man does but the thing that's surprising to me is talking about how many disparate data centers or data sets you were pulling data from to get a better visualization of the overall population which is really crazy because a lot of people think that my health data right is tied to me going into the doctor's office an Urgent Care being able to you know get a prescription or have a diagnosis about me being sick or something like that and that is my healthc care data but there's so much more that is in the overall population picture by pulling from Cur credit bureaus and everything else like that which is really interesting to me yeah it's it's fantastic I'm not a fan of the construct of credit bureaus I I think uh my opinion there's a lot more they should be uh forced to do that they're

[12:11]  not maybe regulated to do today so I think they could add more societal value if uh we have some pretty creative uh leaders in government kind of enforcing that but the data is so rich because uh for for good and bad it's showing the behavior uh from consumption but also really challenging things things are happening to someone's life so if there's been arrest or foreclosures on homes job loss deaths moves uh and and then also the specific zip code plus a kind of designation to someone's built environment access they have to care to food to transportation to education so zip code plus4 is a lot of of the

[12:59]  analysis that I was working through the latter part of my time with Walgreens and then also into my world in fin Thrive where i' come prior to Best Buy health and it kind of all came to actually a really cool all moment as I was in it was standing up a thing that we had called the data Humanity lab which unfortunately I I left to come to be a part of Best Buy health and I think it's still alive in some fashion with fin Thrive but it was to gift these very privatized and sometimes hard to get data sets to research institutions to healthcare institutions and it would help show a bigger view like we're talking about of a person and what you as a healthcare organization or you as a Health Plan

[13:48]  could start to address with high confidence that you can rightsize health care or improve engagement or improve access Etc and that was a really fantastic initiative that I I hope continues in some fashion but that was probably the another benefactor of that long aha multi-year aha moment but uh this fantastic data is UN unbelievable and the maintenance of it it's almost near real time because these these things are happening on a daily basis as claims I always think of that as a faucet you know claims data is episodic point in time like it's on and off people aren't always in a hospital but consumer Behavior Uh socioeconomic data it that

[14:36]  fit's always on and it's it's wider and it's it's always telling you different things about individual choices where they are the phone num they have the what type of data they're using on their phones text voice voice over internet paid minutes where they're buying things how they're using uh C certain things uh um in in their home to be able to have whatever they want whether it's consumer goods or food or Transportation or energy so it's just an unbelievable set of information I mean we're are data machines right everything that you're talking about it seems like we're kind of in The Matrix there's data flowing all around us and we've got leaders like Brian on the other side who are trying to analyze those ones and zeros to help us be healthier in our populations here's a question for you you know we've

[15:22]  seen the explosion of Technology right let's say over the last decade in healthcare we've seen the emergence of t Health emrs Data all the type of things that we're talking about wearables RPM everything else that comes along with that with all the access to this new data how are our leaders supposed to change and morph to be able to take advantage of this wealth of information now to have bigger impacts are we trying to shift the way that our leaders are thinking about population Health you are somewh of from my perspective an outsider who didn't come up through the healthcare system as an MD or something else like that so how are we going to redefine the leadership role of Pop Health with all the day to now that's probably the one degree I think I'll never strive for as an MD I uh broken bones blood that's fine it happens to me I don't want to be able to treat or have

[16:09]  care for that that's just not my thing plus I don't speak Latin very well everything from a biology standpoint is labeled with a 200 plus year old uh dead language it just doesn't you know it doesn't work for me but uh the Technologies I think are going to continue to always change whether it's Hardware software it's always going to evolve what we need to evolve front end is the people and the processes and that's going to be able to have us become more adaptive to what will come ahead whether it's new startups or Legacy manufacturing coming out with different Technologies at the individual consumer level or group population level so the way that I'm starting to talk to my partners across the ecosystem is saying

[16:58]  that that again the third iteration of population Health technology is the bridge that we all share a common ground daily whether we are in a developed or developing Community to some degree and regardless of race ethnicity gender language like those barriers usually are kind of blurred and if not cleared when we're talking use of tech especially if it's relative to health or communication uh finances things like that so the way that I'm trying to talk to my partners is saying like this is not going anywhere so we need to invest in how we're pulling data from it what are we gleaming from these insights that we can put into an actual program or Initiative for us taking care home makes the most sense because you're creating more

[17:46]  efficiency in healthcare you can create more efficacy toward drug development in terms of what we do in life science you can create more High touch Care at home when you're do doing it from remote patient monitoring or for us having Geek Squad not only come to the doorstep but cross the threshold and go into the home to actually activate these devices maintain them and service the individual so it's kind of a completely different way of thinking about how a retailer is involved in someone's life and is now coming into someone's health and how they're influencing in a positive way so it's taking the world of health and looking at it at an individual perspective of what are they doing in their lives because going to a health

[18:34]  center is a need if it's a complex case or if it's of a terminal disease as well but that can also be managed in certain regards at home so it's taking what an individual is experiencing and understanding it more and and really for us I mean we're leading with our best strength which is not our footprint necessarily it's our people Force but it's enabling technology to enrich and save lives it's like it's our sweet spot and I think you've seen maybe some failures of that in other retail organizations that have tried to provide care and I providing care in the US is extremely complicated and the payment methodologies let alone reimbursement pathways are extremely complicated and

[19:22]  have a lot of risk associated with all parties mostly so uh that's a lot of information but that's the way that we're starting these conversations and saying what can we use to help change the care experience and health Improvement through technology and services and that's the way we have to start thinking about is we don't have enough gerontologists Primary Care oncologists it's it's it's a huge gap that we're going to see happen in the US let alone globally so how do we fill that it's not just Tech but it's blending Tech and Human Services that can be done remotely well I'm also really interested in the I want say the intersection if you will between consumer Behavior and the Catalyst of the pandemic everybody before the pandemic normally thought that you had to go into the clinical

[20:08]  environment doctor's office hospital urgent care whatever that is in order to receive Services then overnight everybody became very good at video chat tele medicine exploded at the same time we saw a lot of consumer technology in the selfs serve modality of you can get technology in your home you can use it yourself get the results without having to have the labor or the you know sacrifice of traveling different places do you ever think about what an amazing time this is for us to be here in 2024 2025 where all of these systems have kind of converged Upon Our timeline to be able to make this type of offering even more possible but people accept it as well it's insane to think about this even and you know this because you're entrepreneur you started a tele Health company yourself even when I think about the start of Medicaid Medicare in the

[20:57]  50s and really the strong establishment in the mid-60s like what they were trying to do was just trying to do a good thing support the economy get people access to health care and at that time things were affordable and now looking at it for gross domestic product it's it's taken up so much money we're talking just under four trillion and the way that things are changing with access it's almost like we have a lot of access points but now we were trying to cross the threshold of improving digital literacy to really fix any gaps that we have remaining in Access and that is challenging because you could be Urban you could be Hinterland you could be rural there are still a lot of populations that have high needs relative to accessing uh Technologies

[21:47]  and Hardware or software and then the people that help them on the other side like tele Med like like remote patient monitoring there's also a trust component there too that's a that's a very tough to acquire currency for healthare and health plans especially health plans right now when you look across MPA MPS scores year-over-year in Industries there's a lot of utility companies that still rank higher than health insurance plans relative to experience and engagement and Desiring to communicate with that says a lot and it's it's a really interesting time we're in now that we have these emerging Technologies I think we'll see a lot of them Fade Out the strong ones stick in in terms of popularity ease of use and adoption for payment to and reimbursement from

[22:34]  government to private and to Blue Cross withes Health Care uh for for utilization and coordinating care so we're at this just crazy time and and I think I if you would have told me hey one day Brian you're gonna work for Best Buy I would have said huh that an interesting turn of my career but everyone now has I think an idea of what they want to do in health I think every industry across the US in particular has an obligation to help the health side of their consumers so it's just it's finally just more of an Awakening for a lot of people in the US a lot of employer groups a lot of businesses it's interesting because I had an amazing individual um Dr J Sanders who is actually the founder and president of the American tele medicine

[23:21]  Association on the podcast and we had a conversation which is really interesting I talked about my journey of starting my tele Health company in 2014 because assembly Bill 292 is passed a bill in Nevada that says you can have a virtual interaction doctor can be paid is if you're in the office I say have you ever seen anything like this he said Keenan back in the 60s I was having these conversations when I was a resident at John Hopkins and we thought that the intersection of Technology was going to be happening in the 70s but we're still pushing this out decades and decades and decades in time he said one of the biggest challenges that we came across was the leadership in healthcare didn't want to adopt technology we've seen that the space itself is like kind of turning a cruise ship takes a long time to get advant or get ahead of like technological waves so do you ever find yourself frustrated Brian with any type of healthc care leadership or maybe just

[24:09]  saying we need to move a little bit quicker to take advantage of these things while they're right in front of us yeah and for me uh because most of my career has been inside the payer realm I've always had frustration with us adopting and changing aside from just simply acquiring Ing and my old firms in in my health plan world that was the kind of the especially the private plan like siga it was to kind of stack on top of your your Revenue new generating Revenue opportunities which is usually merger and Acquisitions if you can't do something in house so they went through a few at the time MD live was one of them among some other you know smaller Tech firms to create more access and adding more you know streams of revenue

[24:56]  for themselves so that that was really the peak of innovation that I saw at my time there which was frustrating because for me it was like well that's you know that's easy but to for us to build something new a movement that means something that could create a legacy that spans Generations that is so rare to find I think you find that across certain organizations I think Kaiser has done that really well for a long time I think you're starting to see some other health Tech firms do that in their early days here is create generational spans of value for people having new things in their life to create them more healthy and uh more happy and quality of life as well and understanding health so I think

[25:44]  my frustration has always been on the health plan side to be able to say you know there's better ways that we can Contract Services with providers other than just rate sheet negotiations or pushing them to Value based care but they still want to stay in fee for service is there's a better way to share data I think back in the early 90s you can just as a quick example providers got burned for for capitated payments they just didn't have any support from the payers at the time to say here's data on people's behavior that is affecting their health care utilization that's affecting your ability to actually get paid and and be profitable so I think now we have the ability to do that and the collaboration just still not there and and that's my frustration is the collaboration on both parties

[26:33]  particular health plans and providers it just needs to be uh even if it's an idn integrated delivery Network sometimes those sides don't talk well to each other some of them some of them do but most of them not too great so I think the collaboration silos need to really break down come together and that's the biggest frustration but through what you're saying and even the emergence of now technology and health I think RPM service models that go in homes that is going to continue to break down those walls and really Bridge a lot of the collaboration that we've been hearing about for like really the last decade in particular payer provider collaboration I think that's a that's a solve to it or it's a a big progress to having Solutions in pockets for certain payer

[27:24]  and provider organizations so I'm really hopeful of that that's been my frustration is true collaboration off balance sheet like people first not patients or members but just people first if we can just get that down we'll be all right everyone will make their money but like that's the shift and focus that I'm really hoping will happen through Technologies like RPM Etc is is this a is this a money conversation you know what I mean if you got an 800 or two 800lb gorillas in the room you know what I mean each of them is going to take their resources often they're probably not going to share do you think that that's kind of what's Happening across our communities is why we're not getting the data share why we're not getting the collaboration because it's coming from a scarcity mindset that's a great question I think I think a lot of the existing leadership in these really

[28:11]  large organizations is still very traditional in nature and and to the point that they have owners they have boards and those boards are still very traditional in nature of improving margins and improving volume and I think that's one way to go about dominating a market it's very traditional I think the Long View of having a healthier Society in a in a global view is being more collaborative in in still maintaining our capitalistic Innovative structure not having it become this huge bubble that's going to collapse and I think we're at a Tipping Point it almost feels like we can't go back from relative to healthc care spending and all the things that fall underneath that so that I think is a F conversation I think it's a

[28:59]  traditionalist legacy leadership conversation I think if we start to change it there's better longevity for us as a society and then a global leader and competitor as well so I think Eyes Are Always On Us in terms of healthc care and what's so wrong but a lot of good things that are also coming out that are progressively better I mean how are we going to fix the the state of our pop Health right in the United States as an example you know one things that I saw as I was doing a little bit of research for this was 74% of Americans today are being identified as being overweight 40% of them being over o obese 74% of our population being overweight seems like there's a lot of catalyst that happen when it comes to managing our own health

[29:45]  but also the costs that come into the Health Care system so why do you think we're in such a Negative place like that like having a population of your country that's dealing with some of those health challenges seems like it's a really tough place to kind of navigate from your guys perspective yeah I think uh context to the origin is important here and then also comparison to the rest of the world too so contextually even some comments I made back uh about the 1960s really Medicaid Medicare looking to solve public health problems in terms of access and insurance and coverage and like that it was developed to to be a good thing not to be abused or necessarily um expanded to the degree it has now in terms of spend so Us in terms of growth population growth other countries have

[30:33]  seen a lot of healthcare utilizations but they've probably stopped in terms of their total GDP around the low double digits like 10% 9% 8% and we've contined to increase almost now to about 20% relative to cost associated with our total gross domes product and and Healthcare spend so it's insane how we've continued to go this way and I think the variables in our equation that's different from the rest of the world not only the reimbursement and payment methodologies that exist in our ecosystem but also the variables that are of our food that are of our gaps in education and access to health care and understanding health care and all the divisions that we have on the socioeconomic runs and even back to the 30s the uh approach of redlining areas in which certain areas were designated

[31:22]  for low socioeconomic at the time and still today African-American uh Asian Latin the populations where highways were intentionally run through to avoid higher income areas the traditionally Caucasian uh population so that still is a scar and a horrible fissure in our society in the US and we haven't even begun to fix things like that in terms of population health so we have Band-Aids now we have RPM it's a Band-Aid it's a really good Band-Aid we have teleah health it's a good Band-Aid but Society we haven't fixed these things and created any kind of means of increasing quality so the the the the path that we're on is just so incredibly dangerous so just looking at our

[32:09]  country's variables especially with food to your point being overweight I saw an ad the other day just as a kind of anecdotal thought here it was it was like five roast beef sandwiches for $10 and I was like what and I was like what's the quality of that meat uh it's affordable uh but you know who are you affording it to and how is their health being impact on a consistent basis so from I think the FDA perspective we need some Heavy Hitters to actually fix stuff food dies as well but it's the food and the access to these horrible foods that are becoming our way of life as a as a whole storyline for Americans and and

[32:57]  that's really sad because you think about those that can afford those Foods that's what they're going after and it also impacts their literacy of how are they able to do uh more Dynamic healthy cooking at home relative to maybe the medications they're on so pounding roast beef sandwiches is probably not going to help your diabetic to medication that you're on and help you stay on it just as an example it's scary it's for me as an individual not a Best Buy Health guy it's the scariest thing in the world when and I see in my area Farms being knocked down in plazas of fast food places being put up we place the wrong value on things in our society Pockets by Pockets across the country and I think that's the biggest contributor toward this continued metabolic syndrome

[33:45]  that we have in the US that's a different variable in our equation than other countries by far long way of saying we have a ton of behavior change and food change that needs to happen as a foundation of how we meet our basic needs and ourselves and I think that comes with the start of a prioritization of Education right because we've seen education around the food pyramid and things change in our lifetime which has been dynamically different um you know taking your your Best Buy vest and hat off in this instance your opinion what do you kind of think about the new Administration with somebody like you know um RFK Jr right who's coming in or Bobby right um talking about how he's going to work with the FDA he's going to help us get healthier foods not going to have us having all this additive stuff into our food in the Americas like what do you think about that do you think

[34:32]  that's a a message or you think that's a sustainable strategy we're going to be able to do that kind of stuff because it's on the front of Mind of a lot of people I think food as an underlying component of how health is maintained and improved over time is critical for the us to start to change and I referenced food dies and and also uh synthetic sugars alongside that too it's amazing that we've been able to make these types of foods in this country that are predicated on the model of almost being addicted to it and it has this pleasure pain cycle and one of my earlier degrees that we were talking about earlier was a study in bioenergetics is like basically food energy properties relative to exercise and and reducing metabolic syndrome and my work back in the day was very basic

[35:21]  it was looking at the fat salt sugar triangle that a lot of food scientists use in these huge companies to be able to create the right balance to keep you coming back for more and it's not just a flavor thing but it's also a macro micro uh kind of view at what a food digestible product is made of and that there shows relative to healthcare ecosystem we're putting profit first not people and I think if we would have more of a Long Range View if you have consumers living longer they'll be buying more makes sense to me just basic math so if you're having healthier things to improve and increase their life and their quality of

[36:09]  well-being then they'll probably keep coming back as consumers long term where we have this weird sense of addiction to certain products relative to food and beverage in this country and it's really scary and I hope we have leaders that are going to start to put new changes on that because we're at a health Tipping Point in this country and no matter what RPM tele Med uh like dispatch health model in home care model you you do it's you're still feeding into the sick model of healthcare it it has to be a Breaking Point and it can't be the behavior just on the individual consumer it has to come from these huge organizations down and and that's a hope for me and maybe I

[36:56]  think a lot of lot of people in the field of healthcare I mean here here's a question for you with all the knowledge that you have and your background and all the degrees that you have what is your diet personally look like oh you know what I used to be this is a good look in the mirror thanks for doing this Keenan uh I I used to be extremely strict uh so for a span of about six years no meat uh I I was vegetarian at had some egg egg products and Honeys things like that not a true vegan and I had no candies no sugars I only drank water and some coffee that radically changed I think with baby one baby two and then more school and pushing myself harder that I had a ton of coffee I'm

[37:44]  recently a month in on zero coffee per day I had so much I was Downing 40 hour how's it going better now that I'm at this point than like day one but like I was having 40 ounces plus of coffee day uh two to three double espressos a day and I just wasn't I was just keeping the engine running hard and I wasn't really well hydrated and that led into um just other bad dietary choices high sugar high fat content Foods so I think once you do one addictive thing relative to food it's definitely a snowball I've experienced it but now I'm on a much better kick I've started to put my time into more valuable stuff and that has helped my other choices with just daily diet so I am still quite

[38:33]  strict I really only have water uh and an at um water in particular is extremely important to me the last several years I've been focusing on high value waterers so those with a high content of total dissolved solids so I not a plug in any way but you know I go with the French Alps when I can and some other waters that uh are pulled from a natural source and aren't aren't distilled or have reverse osmosis or anything like that so I've been really focusing on like the source of my water hydration so sugar's way down caffeine's gone hopefully I don't get back on those kicks but yeah it it can get anybody even the people that are you know the chief medical officers of huge organizations they can still pound

[39:20]  coffee and twinkies and snacks all day it's almost a uh a blind consumption endless uh endless eating is it's a it's a real thing I mean in some of those stressful environments right when we kind of cope with the emotions and the emotional toll and the stress that we have and going to work every single day as a healthcare provider health care professional right often we don't have the healthiest habits if you're working a 12-h hour shift it's not easy to go home and make all your meals from limited ingredients as well so I totally understand where you're coming from in uh 2017 I actually went raw vegan for a couple months for like two and a half months raw vegan uncooked veggies I lost like nine pounds didn't need to drink coffee anymore because my energy levels were so good every single day I woke up my digestive system was on point but I lost a ton of weight in that element and

[40:08]  it was a really cool experience to see how much your diet can impact not only your energy levels your mood but also the way in which you kind of move throughout the world on a daily basis with your energy it's really cool um one of the things I think is a real opportunity i' love to get your perspective on this one of the biggest flaws that we've seen or the trends in healthcare when whenever somebody feels sick they feel like they have a personal diagnosis or something's going on what do people do often they hop on the internet they go to WebMD they go down that dark hole they end up freaking themselves out is there a position for healthc Care organizations and institutions to be a trusted source of information by leveraging tools like AI or conversational AI tools to be able to curate data information and have their community members come to them as a trusted resource which only builds the

[40:56]  relationship and reciprocity in the community instead of expecting people to go to all these desperate sources of health information yeah I I think um for me the adoption of this is on the rise in a relatively cautious slow pace advoc groups like American Cancer Society uh Dr Arif there I think I had a conversation with him several months ago and he was talking about his AI Baseline tool that is available to all caregivers that is showing them ways that they can take care of themselves oxygen mask first care for the other person as you can and that I think is really helpful for individuals to know their place as a caregiver to a patient so patient

[41:43]  advocacy education literacy insights that space I think it has more of a uh a safe adoption rate than some of the other players in healthcare only because it's doing in a non-invasive non-influential way it's just completely providing actionable information relevant to the questions that are building its intelligence so I think that space is going to continue to grow and I think it's GNA be very valuable because we have a huge wave of individuals that live in this sandwich generation I'm of that I have uh older parents I have an older mother-in-law who has a lot of needs at home and she depends on her 9-year-old father to get her groceries and drive her around so

[42:29]  like that is a real economic challenge for our family let alone a community health challenge for where she is so patient advocacy tools developing AI whether it's a bot or if it's a navigation tool is extremely applicable and real right now and I hope others can see these use cases are boundless and they can really apply across different Industries different uh points of care points of service and healthare so I very confident that that it'll keep growing that way and we do need to put safeguards and this is a little bit outside of my brain but safeguards in terms of how these tools continue to be intelligent and servicing a a person authentically so that is always going to be in combination of a person helping retool and keep the intuition of AI

[43:20]  tools going in the right way yeah I just think that we're coming up to a unique time I'm very observant about these consumer Trends and I've been looking at some studies that talk about the percentage of people when they're looking for information on the internet today who go to Google which we grew up on or go to things like chat GPT a good percentage of people are starting to go towards chat GPT because the answers that are coming out of these systems are a little bit more accurate based on the context of what they're looking for rather than giving 50 pages of information right that is kind of broad through Google and I feel like and when consumers are looking for good trusted information they should go to the source of good trusted information and that gives a real opportunity for your local health system or trusted resource to be that individual but by leveraging technology as that kind of first AI digital touch it seems like it would be

[44:07]  a win-win for an augmentation of the support that we give in person but it takes curiosity from a leadership perspective to see that future as well yeah it does curiosity I think uh good scars bruises failures uh along the way as well I think AI has been around for a long time it has only become more uh attractive because of the applications it's had chap GPT perplexity a bunch of other platforms and sourcing their data not just uh search engine optimization that people can pay into so you pop up as the first thing that comes up based on the words you type in so that's the danger that I think Google has kind of went into with there but you know that's their business model and and some capacity but I think for some of the other AI search engines

[44:54]  or tools that are out there it's uh it's it's so it's so crazy to use them I think it's really helpful and uh sa safe cards are gonna be half have to be a must on all kinds of things AI as we we keep going forward my my perspective on that one yeah so Brian where where we going in 2025 2026 I want to give you your opportunity like Babe Ruth to kind of call your shot here so what's going to be happen over the next couple years yeah uh so I can give you a couple couple good predictions here maybe some bold ones but I think uh the work that I'm in uh the acute Hospital home program that's been extended I think that's going to be a staple in the US that's not going anywhere I feel like that's going to be put into place mainly because of all of the folks we have in

[45:43]  our country that are aging deeper into their Medicare lives so you think about the cut from 65 to 85 you think about 85 plus 10 years out 90 million plus individuals across our country country that is a huge percent of the total population of about 330 million so that's a huge economic challenge that can't be shifted solely on the lap of Health Care Systems as physical centers but it has to be shifted over into other points of care and that's a trend that that's been going on for easily the last five six years even pre Global pandemic and for sure post so I see that program driving more value for technology Innovations service model Innovations

[46:31]  food as medicine as service programs things that will couple traditional therapies for people that are chronically ill and that are or even terminally ill so I think that's a big thing that I see on the horizon 25 plus the other big thing that I see is is more unique collaborations I think we'll still see a lot of merger Acquisitions but I think we'll see more unique collaborations using AI that will tell healthc care what individuals are doing on social media and how they're influenced as part of their mental Behavioral Health and what healthy choices they can make to be able to offset some of the content that they might be either vulnerable to or continually exposed to I think we'll

[47:18]  start to see a hard play into how health plans will adopt certain AI tools that will help people become healthier in their social media interactions because there's a Tipping Point there that I think we've we've Definitely Maybe surpassed let alone reached Last Prediction I think I'll make for you is I think we're gonna see some really cool not like we have and like there's Farm box RX mom's meals they've been around for a while but I think we're going to see some really cool food as medicine programs be developed through grocer payer healthc care Partnerships I mean there theyve there have been a few out there Albertson's Kroger's Walgreens CVS I think to a certain degree but I think you're going to see more of those collaborations on how can we get better

[48:07]  access to better foods not like snack foods like Twizzlers and stuff like that but real food that has high macronutrient content to help people stay on medication improve their condition get off medication stay out of Healthcare systems and age well and and live in their community and home so I think those programs are going to just be lit on fire the next few years and uh starting in 25 I think they'll continue to Trend upward if we had an opportunity to hop in a time machine and go back 10 years and you had an opportunity to sit across the table from a younger version of Brian and give him some bold advice to navigate the future what would you tell him to do uh honestly uh I would say be with your family and the place

[48:57]  you love and don't spend money don't spend money on stupid stuff that uh I think a lot of e-commerce is uh kind of Praise uh on people to do as a continual you know pleasure pain cycle so I think that's what I would give as a simple advice and say man love your family don't travel as much as you know travel if you need to uh and just don't spend money on junk well Brian man it's it's been an absolute pleasure and it's easy to understand why you're the definition of heart and hustle brother I can't thank you enough for coming on the show and sharing your expertise your perspective but also what your vision looks like for the future man can't thank you enough for coming on the show thank you Keenan I'm just um giving it my best shot here as an oddball and hopefully this influences other odd balls to to never

[49:45]  give up keep working hard and there we go guys we'll catch you in the next one