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Episode: 516 |
John Driscoll:
John Driscoll, President U.S. Healthcare at Walgreens and Host of CareTalk:
Episode
516

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John Driscoll

John Driscoll, President U.S. Healthcare at Walgreens and Host of CareTalk

Show Notes

John Driscoll is the President of Walgreens Boots Alliance and the co-host of the second largest healthcare podcast on YouTube, CareTalk. In this episode, host Will Bachman welcomed John to the show. John has extensive experience in the healthcare industry, having played a leading role in creating successful companies like MedCo, Surescripts, Oxford Health Plans, and Care Centrix. John discusses topics such as monkeypox, mask mandates, baby formula shortages, Silicon Valley Bank’s failure, and healthcare related topics. He also shares his  opinions on a variety of healthcare issues. 

 

The Future of Pharmacies 

John started his career in health care after being influenced by his mother, a nurse. After college, he developed housing programs for homeless and mentally ill people. He then became a management consultant, before moving to Asheville Health Plan. He has worked in multiple parts of the health industry spectrum, gaining experience in Medicare and Medicaid. 

He has found his career to be full of big and challenging problems, but is motivated to improve the world and create successful businesses. His main initiatives involve investing in Village MD, Summit, and Espadin Shield Specialty Pharmacy to show how an integrated pharmacy and clinical model can improve outcomes at lower cost. Walgreens is also working with health plans and has 9000 stores and 90,000 clinicians to provide access and convenience, trust, and traffic. Their goal is to become essential in healthcare by leveraging their expertise in retail and pharmacy services.

He discusses how pharmacies can become better partners to health plans by taking advantage of their advantages in brand marketing, trust, convenience, and patient specificity.

He shares  a specific example of how a large regional health plan achieved a return rate of three times greater on colorectal screenings than before they partnered with the pharmacy. The pharmacy was also able to increase the rate of colorectal screenings up to 51% in underserved areas due to the support of non-clinical personnel in their stores. Additionally, the pharmacy is partnering with health plans to reduce admissions to nursing homes by 20% through nurse visits, follow-ups, and care navigation. The system leads to better patient and contact information.  Overall, the pharmacy is providing an invaluable service in helping health plans lower costs while improving outcomes. He explains how his company invests in bespoke automation machines to allow pharmacists to spend more face-to-face time with patients, and how pharmacists could be more involved and take on more responsibility in the treatment of patients and how this would expand access to more care in an overburdened health system.

 

Pharmaceutical Healthcare,  the Pandemic, and Value-based Care

John reflects on  health regulations and restrictions and also the risk taking and flexibility that came into place under the COVID pandemic. He confirms how important it is to prepare for pandemics in terms of vaccine supplies, communication, and pre-deploying and integrating national and state employees in operations. He also notes the critical role of pharmacies in crisis situations. He tackles the issue of employee burnout and the current pharmacist shortage and the steps Walgreens is taking to solve the problem across states.

On value-based care, he explains how it is the future, especially in the U.S. where healthcare is more expensive than any country in the world, how this is unacceptable, and how this should be approached to address health issues earlier to avoid hospitalization. 

 

The CareTalk Podcast 

John talks about the inspiration and intention of his podcast, what the content is and what has surprised him throughout the conversations. Guests that have been on his podcast include Andy Slavitt, Zeke Emanuel, Tony Cosgrove, and Amy Abernathy. When asked what he learned from his guests,  John shares that he was surprised to find out that even though healthcare is very complicated and people are in silos, there is still room for novel and provocative opinions that can be explained. He also found out that everybody knows that drug costs are too high, but there are practical ways to bring them down without destroying the biotechnology industry that is creating new drugs to cure aging and extend lifespans.  The podcast explores various issues surrounding health care and how to best address them. Toby Cosgrove from the Cleveland Clinic brought up the importance of creating heart-centered care in a large inner city hospital. It was noted that there are a lot of people working on solutions to healthcare problems, such as telehealth and AI to solve labor shortages. He also touches on the potential for AI and Chat GPT to be used in health care. While it is still early days, he mentions that there have been some companies experimenting with using these tools.

 

Health Care and AI

John talks about the impact of artificial intelligence on healthcare. He believes that AI has the potential to reduce administrative costs and waste in healthcare by simplifying billing and reconciliation processes. He also believes that AI can help in drug discovery, clinical pathways, and personalized care.  He is looking forward to having guests on CareTalk with whom he can discuss the economy, healthcare costs, and the pandemic’s effect on inflation.

He wants to discuss  the current chaotic economic landscape that is impacting healthcare, and the labor industry in particular. He mentions the growth of traveling nurses who are paid by private equity firms and how hospitals have had the worst six months financially in US history.

He sources his information from HealthTech Nerds,  the Washington Post, New York Times, LA Times, Wall Street Journal, Health Affairs, and Jim and Science,  the MIT Tech Review, Science and Cell, all as good sources of information. He suggests Kaiser Family Foundation and Kaiser Health News as exceptional sources, as well as government sources such as CMS for basic data.

 

Timestamps

03:20 Walgreens Boots Alliance’s Healthcare Initiatives

06:35 Partnering with Health Plans to Improve Outcomes and Lower Costs

09:52 Improving Patient Care Through Pharmacist Interaction

10:48 Automated Fulfillment Centers and Patient Care at Walgreens

28:45 Healthcare Innovations 

31:54 Exploring Solutions to Healthcare Challenges

32:15 The Impact of Artificial Intelligence on Healthcare 

36:49 Exploring the Impact of the Changing Labor Industry on Healthcare 

 

Links:

https://www.caretalkpodcast.com/

https://www.walgreens.com/

 

One weekly email with bonus materials and summaries of each new episode:

 

Ep. 516. John Driscoll

SPEAKERS

John Driscoll, Will Bachman

 

Will Bachman  00:02

Hello and welcome to Unleashed. I’m your host will Bachman and I am so excited to be here today with John Driscoll. John has played a leading role in creating many of the successful companies that you are familiar with med co Surescripts Oxford health plans, care Centrix. He’s currently the president of Walgreens boots Alliance, and he’s also a fellow podcaster. He’s the host, co host, I should say, along with David Williams of the second largest healthcare podcast on YouTube care talk. And they cover a wide range of topics. You can learn about monkey pox and mask mandates and the baby formula shortage and how the failure of Silicon Valley Bank affects healthcare, insulin, all sorts of topics, anything healthcare related on his podcast, John, welcome to the show.

 

John Driscoll  00:54

Well, thank you so much. I mean, and yeah, we’ve got opinions on everything. And hopefully some of them are informed care talking just one slight change. I am actually the president of Walgreens health. The there’s plenty of other parts of, of Walgreens, but I am I’m just delighted to be on the show.

 

Will Bachman  01:13

Fantastic. Oh, thank you for that correction. So, John, I was wondering if you could start by giving us a bit about your journey. In your career, you’ve gone through multiple different places within the health industry spectrum and wonder if you could give us a bit of a tour?

 

John Driscoll  01:31

Well, I think it’s it starts with my mom’s a nurse. And I think early on, I had this notion that health care was sort of special because my mom was or is a nurse, even at 90 years old. And I rather than I ended up as a management consultant, like you did it at LTK earlier in my career, but before I did that, after college, I actually developed housing programs for homeless families and mentally ill people. And I realized just the disconnect between resources and end results. And as an young consultant, I was working on a health plan reorganization among a bunch of other projects. And I realized that what I loved about being mission driven organizations and having an impact on the world, could be combined with sort of some business expertise to make a change in people’s lives through health care. And so I after that I migrated to Asheville health plan, Dr. was an entry level employee and met the first leader in Medicare and Medicaid. And like most situations, you’d rather be lucky than smart we we grew very, very quickly from about 100 million to four and a half billion in five years and then went through a bit of crash and a turnaround and then I got to the that sort of launched me Well, honestly into healthcare technology and PBM and everything else, I found the career to be just absolutely full of big gnarly problems where if you get them right you can, you can help improve the world and build great organizations and create some some some business success as well. So it’s just been a ball.

 

Will Bachman  03:20

Let’s talk about your current role at leading health at Walgreens boots Alliance. Talk to us about some of the key initiatives that you have going on that are public, and some of the major trends that we should be looking at in the kind of pharmacy world in the US.

 

John Driscoll  03:40

I think I think the most exciting things we have going on right now are our investments in village MD and Summit, which is a one of the largest employed doctor of practice management businesses, that’s working very closely with us to optimize them show the impact of how a combined integrated pharmacy and clinical model and value based ending fee for service can be powerful and effective at improving outcomes. espadin shield Specialty Pharmacy which is doing the same thing, just in the Specialty Pharmacy world for health systems, better outcomes at lower cost and care centers. We own all three care centers involved with working with health plans to improve the last mile of health care again, delivering client measurable, better outcomes at lower costs. And what’s your we’re working with doctors, we’re working with health systems or with health plans. And then you combine that with Walgreens 9000 stores and 90,000 clinicians that are tuning themselves not just to become a be a better retailer and better at pharmacy services, but a better partner to health plans. Providers. I think we’ve got a really interest same set of assets, all of which are focused on creating, either leveraging the low cost access and convenience, trust and traffic we have in the stores, or are working towards building more of an integrated pharmacy and clinical care experience, they’ll deliver a better outcome they were really investing in in leveraging some of the fastest growing markets in health care, to play in places where we’ve got a right to participate, because we’re good, or great at pharmacy services, and we’re good at retail. And our goal is to be as essential in healthcare as we are currently in retail and pharmacy services. And part of that is investing in the reserve where the puck is going in healthcare. And part of it is really showing that as an integrated team, through all of our expertise, and retail, all of our expertise in pharmacy, and what we have in our building in healthcare, that we can really be a great partner to help doctors, hospitals and health plans, do a better job here. What we’re good at is not what legacy healthcare is good at. Brand Marketing, trust, convenience, really getting very customer and patient specific. And we think we provide lots of attractive alternatives to partner to help extend the work while lowering costs and improving outcomes for health plans and providers. Yeah,

 

Will Bachman  06:35

share some specific examples of how that what that means in practice of being a better partner to health plans. So, you know, some people might think, Oh, the pharmacy, you go there, they just give you the pills and you go home like so what are what’s the ways that the pharmacy can really add value?

 

John Driscoll  06:54

Yeah. So think think about, like, what are our advantages you get brand convenience, trust and traffic? What does that turn into? Well, for one of the large regional health plans, our return rate for colorectal screenings, is three times what their colorectal screenings were beforehand. Yeah, north of 20% return rate 3x what they could do on their own. We have, we tested the same screenings. When we asked when we can offer the support of a of a non clinical person or a clinical person in the store that goes up to over 51% in colorectal cancer is a very serious risk and a major, an unnecessarily high source of mortality, particularly in underserved areas. 40% of our stores over 9000 stores are in medically underserved areas. So we can play a direct role in screening care and navigation for that particular condition. These care Centrix we’re partnering with health plans and lowering their number of unnecessary readmissions and admissions to nursing homes by 20%. We can we can provide that care, navigation and support to caregivers and their families to prevent those by either sending nurses to the home, following up with folks centrally by giving them helping them do care, navigation dealing with all the things outside of traditional healthcare that affect or obstruct patients from getting the care they need. And we can make sure that as they see pharmacists, and you’re gonna see your pharmacist typically, particularly for chronically ill patients a lot more than you’re going to see your doctor to provide those care nudges and care support and care information that will help patients stay aligned with the care that they’re on or change it. Because they’re something show something’s driving. Whether it’s a social determinant barrier, or an unexpected side effect, it’s keeps people from either getting care or staying on the care path that they need to be on. So what what what proximity gives you and repeated content give you is more of an ability to connect and influence and frankly, get better data for patients mean one one simple example is that we have better contact information because we’re seeing the patients more frequently so we know where they live. We know how to what their what their telephone numbers are, and that seems rather small, but it’s pretty significant when you’re trying to do follow up care and just try to help families navigate the the the the the difficult for us that often getting the right care is for patients who are ill.

 

Will Bachman  09:52

Now, many years ago when I was at McKinsey, I worked on a project for eight different pharmacy chain and it was about out, one of the things that we worked on was increasing the patient customer satisfaction by increasing the amount of time that the pharmacists spent actually counseling patients. You know, at that place, they were spending so much time kind of counting and verifying the pills that they weren’t doing as much face to FaceTime. And when we increased that the patient satisfaction went way up. And I think a lot of people weren’t even aware that they should ask the pharmacist how to take the you know, medications and so forth. What are some ways that you work at Walgreens to make sure that or to you know, to measure encourage and cent allow the pharmacist to be giving that kind of patient care that they’re trying to give?

 

John Driscoll  10:48

Well, we’re investing in we Walgreens are investing in automated fulfillment centers that are centralized and regional. And the goal is to take a lot of busy work that is a necessary part of what a pharmacist does, to make sure that the right bills get to the right patient at the right time in the right dosage. As the more we can leverage robotic automation, the more we’re going to free up that time. Most pharmacists go to pharmacy school, farm techs get involved with it, because they do really care about the patients and they want to spend more time with them, that we’ve we’ve overwhelmed them with complexity and tasks that have kept them away from reduced the exposure to the patients. And you’re absolutely right, the more time we’re clinician is going human to human, the happier they are. So it’s not just the MPs for the patient in the family. But it also is for the pharmacist. And so we’ve invested a pretty significant amount of money to build bespoke automation machines that will drive and permit pharmacists to really spend probably 20 or 30% more of their time, eyeball to eyeball with patients in their in their caregivers to help them navigate care. And I think it’s going to be a positive not just for our net promoter scores, but also for the farm for our own employees.

 

12:11

How do you

 

Will Bachman  12:13

alert the pharmacist or maybe prioritize like which patients they should really speak with? Is there is there kind of some kind of system in place that would help them say this,

 

John Driscoll  12:23

we do have systems in place, but honestly, a lot of this is common sense. Think about it, you’ve got someone on multiple maps, they have that information. And someone shows up at the pharmacy desk, when depending on the type of medication you can kind of tell whether and by the look of that patient for the look of fear or concern or uncertainty in the person picking up the pills. You know, this is a lot of this is common sense and the data in front of them. But we do have the ability to message in queue, physician workflow. But honestly, we just have to I believe we just have to create more room and in pharmacists schedule for them to do the work they want to do and leverage their common sense because pharmacists are again, these are people who are who are highly observant, well trained who are dealing with patients every day. But we do have the ability to message them. But a lot of this is common sense.

 

Will Bachman  13:18

What regulatory barriers exist, if any, that currently prevent pharmacists, or the people in the pharmacy pharmacy techs for that matter, from providing certain types of services that they really have the training to do, but perhaps aren’t allowed in certain jurisdictions.

 

John Driscoll  13:37

Oh, it’s it’s a it’s a crazy quilt patchwork of regulations. It’s one of these things where the industry grew up with the clinical rules being passed to through state pharmacy boards that individually have to approve work roles, particularly around scope of practice, the work rules have are standardized around it right for the right person, right dosage, but and the oversight there. But whether you can for whether pharmacy techs, which they are in the UK, in England, nationally, can check blood pressures is really easy, is it can only be done in certain states in the US. And there are a number of other examples where the pharmacists can if they had the the if they were approved by the State pharmacy boards, they could provide a lot more care support and care navigation. You see it in in limits of scope of practice around testing. And we did probably 40 or 50 million tests in in stores but we tended to have to lease that space out to a LabCorp or an Aegis or others. You know the pharmacies during the public health emergency were the public were the With a front door to the public health system that doesn’t exist. Now two thirds of all vaccines in arms came through pharmacies. And that’s because the healthcare system was not set up for that kind of entry level care follow up and support. So we proved during the public health emergency that pharmacists can do the screening, counsel, the patient’s provide the care, but it’s but it really is a patchwork of individual restrictions or opportunities. And we’re working at the state level on the federal level, to educate healthcare leaders and regulators on the value of expanding the scope of practice, which is just the rules that permit you to do more or less as a pharmacist, because the health care system is bursting at the seams with tasks that need to be done. patients that need care, and not enough clinicians available nurses and doctors conventionally, to provide it. So I think that’s a big opportunity to expand access and provide more care and follow up if we can get that we can expand the scope of practice for pharmacists.

 

Will Bachman  16:12

I’ve seen some articles recently saying that we are not really we haven’t taken all the lessons of COVID to heart and in terms of preparing for the next public health emergency or the next pandemic. Tell me your perspective of what are some things that in terms of you know, from the in the pharmacy world that you know, should still be done? Or maybe you’d say no, no, we’re we’re much better prepared because of because of x. But are there are they’re sort of on steps that still should be taken to be better prepared for the next pandemic.

 

John Driscoll  16:47

Let’s build on that mean, for sure. Let me break it into pieces. So there are a number of legacy restrictions on things like telehealth, or pharmacy scope of practice, and others that were just dropped during the public health emergency. And it turned out that the healthcare system can adapt pretty well, even in its regulated way to new technologies, novel approaches for care and follow up. And one of the things that will hurt us is from lowering the cost of living and linemate that kind of follow up and make it harder in a public health emergency, if all those restrictions return. So I think that’s the that’s the first thing is the flexibility in the terms that we got, we shouldn’t go back. The second thing is it taught us a lesson that if we can adapt that we should be the healthcare system in general, can responsibly take risks on novel approaches to care and follow up, which is the lesson that we really need. We’re trying to drive through the Cares Act and care and through the regulate the regulations and laws, we’re trying to expand to allow pharmacists to expand their scope of practice. But the third thing, I guess, is more of a government thing versus a Walgreens health or pharmacist thing, which is that you look the as a country. We are extraordinary once the crisis starts, but not always focused on preparing, before the balloon goes up for the fire starts or however whatever metaphor you want to use. And I think what, what we’ve what we’ve saved hundreds of 1000s of more people, if we were as good at the beginning of the public health emergency in terms of stockpiles of medicine, availability of training, vaccine availability and public communication. And those muscles, which got really strong as a country, later in the pandemic, I think are ones that we’ve got to be really careful, careful, don’t atrophy, whether that’s purchasing and pre pre pre planning, or pre deploying materials around the country, or really integrating our national and local public health authorities to come up with solutions that are appropriate, not just for downtown Manhattan, but better available in kind of rural Iowa. We did a really great job. But it required the entire system to move faster. Expand in novel ways leverage low cost access to talent labor that was already clinically engaged pharmacists and local pharmacies. But we were playing a lot of catch up and I don’t want to be there again, because because it’s sort of like a hurricane. That won’t be you don’t you don’t necessarily like hurricanes, not necessarily gonna hit you tomorrow. But if you’re in a hurricane area, eventually it’ll hit you want to be prepared for it. And that’s the way we’ve got to think about our public health risks. But one of the things again to cheers for all of our pharmacists who really delivered and the pharmacies that stayed open throughout Have the entire pandemic as an essential access point for supply support for vulnerable our vulnerable citizens. So, I think we proved that we, prior to the pandemic, I think if you think about retail pharmacy, people think of it as more retail and less pharmacy. I think if we proved during the pandemic, that we can be a great partner to the healthcare system, low cost access everywhere, nearly always available and obviously failed. There’s a lot of a lot of our pharmacists and pharmacies are a little bit whipped from the public health emergency but we proved we can deliver for healthcare. And so what I’m excited about go looking forward is how do we play continue to play a bigger role in the healthcare industry?

 

Will Bachman  20:44

I’ve heard there’s a shortage of pharmacists. I’m not sure about pharmacist Tech’s talking about that. And about, you know, how are you leading Walgreens health are addressing it.

 

John Driscoll  20:56

I think there’s the the there’s the challenge of clinician burnout is a problem across the entire spectrum. So the way we at Walgreens are are dealing with it is we are we are improving working conditions, we’re also trying to reduce the number of unnecessary work roles. We’re increasing pay, we are engaging more directly with pharmacy schools to help provide easier access to, to work in pharmacies, which pharmacist, young young pharmacy students really like. We’re expanding what they can do clinically. And we are through our investments in central Phil and robotics, trying to add an even different layer, reduce the number not just the rules, but of the tasks that are closer to routine and busy work to allow pharmacists to practice closer to the top of their license. But it’s it’s one of those challenges, given the demographics of the country with 10,000 people turning Medicare eligible every day that you fight to stay ahead of, because we are coming out of a public health emergency where we’re hitting kind of the graying of, of the country. But it’s a you’ve got to have a kind of a multitrack defense to get on offense to turn this to solve our labor problems in healthcare in general.

 

Will Bachman  22:18

You mentioned value based care earlier. Could you talk a little bit more about that, and about how value based care is now you know, showing up in kind of the pharmacy health world?

 

John Driscoll  22:30

Well, I think, you know, really value based care is simply healthcare on a budget. And healthcare should be on a budget, you just realized that the budget is after you realize the bills are going up, we have the most expensive healthcare and the system in the country system in the industrialized world, on a on an expense per man per per per person. And we’re not where we are not top 20. And probably any of the mortality statistics and performance statistics other than cancer care where we do an exceptionally good job at screening and care. That’s unacceptable. And one approach to that is to really give doctors and health plans. Health is often giving health systems and groups of doctors performance based compensation where the either the capitate any, or all of the cares is paid for with one payment, or it’s performance based either one of them could be considered value based. And I think it’s a really good thing. We should be measuring our healthcare system, we should force it on a to have a reasonable budget. And then when you’ve got that budget, then what happens is the clinicians themselves can through a different mix. have nurses do play at the top of their license, doctors play at the top of their license, maybe have a social worker or a dietitian, talk about folks diet, you can provide it’s a it’s a much more doctors and groups like village take a much more comprehensive view of the members that they cover in a value based arrangement because they’re paid to the better job they do. And avoiding unnecessary care or care breakdowns, the more they can dress the whole person needs social emotional, physical food that can often directly lead to an unnecessary hospitalization to any unwarranted visits to the emergency room. You’re paying the doctors to perform and to engage members more upstream before they get into the hospital in the emergency room. And so I think value based care is is is the future and we’ve made a big investment in that with village and D which is a group of employed doctors that are high performing that are highly focused on their their their men. care patients. Somebody’s doing what other other one of our assets company we invested in, in New York that does a great job on performance based payments with commercial patients, their admissions per 1000, the number of ambitions they have for the, the, the, the commercially covered members, the younger patient faces 20% below their their peers and care center, it’s we’re doing the same thing, we’re managing your budget to lower unnecessary visits to the hot hospital or the or the nursing home. So I think that performance based payment and, and healthcare sort of payment on looking at it for more of a conventional budgetary view, is the future. And it’s the only way we’re going to get under around the inflation that you know that healthcare costs are really an excess tax on every American.

 

Will Bachman  26:01

Let’s talk about your podcast for a minute care talk. Among the top 10, podcasts and healthcare on Apple and Spotify. It’s not that usual to have a senior executive at a major Fortune 500 company running a podcast, I’d love to hear the story behind it. Like if,

 

26:25

like if Joe Biden is like a politics, podcast or something.

 

John Driscoll  26:29

Well, the great thing about a podcast, your health, like health care is really complicated. And it’s unnecessarily complicated, but it’s connected to everything in our lives. And my friend, David Williams, who’s my, my partner in this, and I believe there’s a space in the landscape for us to take topics that we felt strongly about or had some opinions about, and kick it around to help our colleagues, our friends, the people, we work with the people who work for us, in some cases, the people we work for, to understand and get aligned with or provoke the right conversations. And I think what what what we like what, too much of what is in the podcast landscape is oriented towards who’s paying the bills on the adverts, or a particular perspective. And we thought there was a lane in healthcare for, you know, an honest, unfiltered look at some of the harder questions from to, you know, somewhat opinionated, or perhaps overly opinionated executives who had some opinions. And we’re kind of happily surprised that it’s taken off, we’re averaging it over 40,000 streams per episode we do we record weekly, we’ve had episodes that get up to over 100 and 100 plus 1000 streams. And that speaks to me of a real need in the marketplace. Just how do you get your medical record? Why should you care? I think it was over 80,000 streams. So it’s not just the grand epic episodes around drug pricing, which got, you know, a fair amount of streams but but even more conventional or mundane issues. I mean, healthcare is complicated, and we try to make it simpler, clearer, hopefully, sometimes a little bit funny. And, and then then express an opinion, which gives people sort of an X. Hopefully, our goal is to give our audience to inform, entertain, and get anything out of our complicated topic, stroke, bring folks up to date, within 20 minutes. And it’s been a ball to do and I think we get a little bit of following. So it’s been it’s been fun. We’re serving the accidental success that we continue to invest in.

 

Will Bachman  28:45

Well, not accidental. That’s congratulations. That’s amazing. Now you’ve had some really incredible guests. You know, Andy Slavitt, Zeke Emanuel, Tony Cosgrove, Amy Abernathy, and many others. Tell me about a couple things that you’ve learned on the show that have surprised you or that you found enlightening that you’ve learned from your guests.

 

John Driscoll  29:06

You know, I think I think what the most striking thing about you know, whether it’s Zeke or Toby Cosgrove, or is that there’s still room, again, we’re healthcare so complicated, and people are in silos. If there’s still room for novel provocative opinions that are simply explained, you know, I can what we find is with our like, everybody knows that drug costs are too high, but to break down the practical ways of how you would get at bringing drug costs down without screwing up and undermining this amazing An industry of biotechnology that’s creating novel novel drugs that will literally cure diseases of aging or extend our lifespan. How do you unpack those issues? That there is that there? There are really good people working on these issues. And there are really interesting solutions, which for Toby Cosgrove, the challenges of how do you run a complicated big, successful hospital, it’s one of the best hospitals in the world for health care for hearts, but also a deeply important local institution, for Cleveland with the Cleveland Clinic, and how do you do it while enhancing and really create a leading role and in creating heart centered care and a massive inner city hospital with hundreds of proud with 1000 employees? You know, I just I suppose it’s less, I learned from every we learned from every guest. And it reminds us that we got to stay humble, because of all the stuff we don’t know. But there are a lot of people out there working on really great solutions to our, our heart or normally healthcare problems, just just to hear how excited and how much opportunity there is in telehealth, and I think we’re gonna we’re gonna start to dig into chat GPT and AI to solve the labor shortage problem you raised earlier to bring folks in who can who can create kind of map out a path where through a combination of technology and improved work rules, we can actually get the capacity and support we need for clinicians to take care of all these people who are getting older and who are chronically ill, while also extending lifespan. It’s just It’s thrilling, I guess, it’s less I learned something new every week, I It’s hard to pull one or two things out, it keeps us humble.

 

Will Bachman  31:54

You mentioned AI and Chad GPT. It’s early days, but what have you seen so far in terms of you know, any, any health company in the whole spectrum, using those sorts of tools, or even experimenting with using those sorts of tools?

 

John Driscoll  32:15

Well, I think the the last chat GPT specifically, because it’s really it appears to me at least to be really focused on his son being the extended personal assistant and researcher, and allowing you to write essays and emails and quickly do research. And it’s very early days, what’s what, what’s what we need to watch, there’s, it’s learning at a faster pace than any form of data driven machine learning has ever. And so what you see today is going to rapidly increase in into what will truly be fully automated digital assistants that are gonna learn faster than then than humans. They’ll I think, allow people that again, do more higher level work. Where I see the impact on artificial intelligence is the third, we spend probably 15 to 20% of all costs on administrative costs in the US, it’s just it’s just something that number may be high, but that it’s out of a $4 trillion economy. I think there’s easily two or 300 basis points in hundreds of billions of dollars, that just simply simply learning what goes right and wrong administrative before you even get into drug discovery, or better clinical pathways for understanding social determinants of health. The perfect example is one of those I’m involved with waystar. It’s a revenue cycle software business that sells that software to hospitals to simplify and make the billing more efficient, as they are investing in AI and intelligent algorithms. They’re going to simplify and automate a lot of the tasks that are quite wondering the hospitals who just around reconciliation to get paid and get a bailout. Those are those are those are very machine learnable. And will reduce costs dramatically over time. And then you move to the the amount of complexity, but how much data we have for all the drugs we’ve tried and all the drugs we’ve abandoned as we learn more about profiling individuals to really personalize your pharmacy related drug related care. I think we’re gonna we’re going to the the artificial intelligence now. Models, large language models, just massive amounts of data. And in healthcare, we got a lot of that and I think drug discovery, and then finally care pathways and we work off of averages everyone’s individual. I think the the, the opportunity in healthcare is pretty dramatic. The first place you’re gonna see it, I think is reduction of unnecessary costs. and waste just spent in sort of cutting out administrative costs. And then over time, I think you’re gonna see it in drug discovery and novel care care, novel approaches to care. It’s really exciting. And I think it’s hard to overestimate how fast these these models and these technologies are going to learn how to do things better, where they’ve got the data to train the models.

 

Will Bachman  35:23

Amazing. Who is a guest that you’re looking forward to getting on care talk that you have not yet?

 

John Driscoll  35:32

I would love today, I would love to get Larry Summers, the former Secretary of Treasury to tell him to test our assumptions on Iraqi economy, how does how to help out his health care fair, costs are still going up of the pandemic, there’s a inflation kicked up because a lot of physicians and nurses are purged out. And there’s some structural changes in the labor industry. Traveling nurses be nurses who are paid by private equity firms to charge at the effort for moving around to different hospitals. They’re charging two, three times as much as a conventional nurse. We’ve got hospitals having the worst last six months of their economic financially that they’ve ever had in the US. So how does the convergence or divergence of sort of calm low cost, interest and smooth, relatively smooth economy translating to our currently chaotic times? And what’s the knock on the impact on healthcare? I think he’d be an interesting guest to have on because I just think that you can’t divorce what goes on in healthcare from new cons, and particularly when it’s going sideways.

 

Will Bachman  36:49

I am sure that you are just swimming in an ocean of information about the world of Cal healthcare. I’m curious, what are the sources of information that you use to keep up to date? Are there other podcasts you listen to? Or newsletters or substack? Or websites? Or is it primarily conferences or journals? What’s your information diet?

 

John Driscoll  37:15

Well, I think you know health tech nerds is a really good, good, good group to join. I watch you know, read the journals, Health Affairs and others check out Jim and science for sure. And then I am constantly scanning. You know, the MIT he’s got a tech review that’s really going on future stuff. But just the Washington Post New York Times, LA Times, Wall Street Journal are all really good sources for current news. For farther out, I think you’ve got to you’ve got to look at some of the journals like science and cell but it’s I’ve got to say that the health tech nerds is one that probably comes into my, the one that I jumps out in, and I will serve different podcasts for more by topic than by person. Right now I’m hunting for good insights on AI and, and healthcare because I just don’t think it’s well covered. And that those are some of the sources that I that I go to, and, and I honestly pay a lot of attention to the people we’ve had on the show and Zeke Emanuel, he’s not always right. But he’s always interesting. And he’s always super thoughtful. And, and then obviously conferences and simply conferences aren’t aren’t as helpful in terms of data. And then honestly, the the other thing that that’s really worth, you know, hunting down and paying attention to is, you know, the Kaiser Family Foundation Kaiser Health News is exceptional. And a lot of the basic government sources. You know, CMS has a ton of information on basic data. You know, the reality is you can on any topic, if you’re going after core data on on health care industry, you often go to CMS first and then work out from there. But again, the challenge of a $4 trillion economy that encompasses everything in healthcare, she got to bounce around a lot but I guess the core health care diet on interested information would be health, health tech nerds, Health Affairs, Kaiser Health News, and then the conventional news, magazines and newspapers.

 

Will Bachman  39:30

Fantastic. John Driscoll we will include a link to care talk in the show notes awesome any other links that you would like us to include for listeners to follow up find out what your work

 

John Driscoll  39:43

I think I’ve laid laid out a bicycle but keep watching keep an eye out for what we’re gonna do at Walgreens South I’m really excited about where we started and I think we Yes, Walgreens Walmart are all going to have a big impact on the future state of bringing down health care costs, improving outcomes, so I’m delighted to be at LogMeIn so

 

Will Bachman  40:01

fantastic thanks so much for coming on the show and sharing that perspective it’s been great speaking with you and congrats on care talk

 

John Driscoll  40:10

cheers thanks so much thanks for having us

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