Datica Podcast

March 3, 2020

Working in Healthcare: Jamey Edwards

In this episode of the 4x4 Health series “Working in Healthcare”, co-hosts Dave Levin, MD and Geeta Nayyar, MD talk with Jamey Edwards, CEO and Co-founder of Cloudbreak Health. Jamey shares how Cloudbreak is using a proven platform, connected to a scalable network, to deliver medical and language expertise in pursuit of his mission to humanize healthcare and make healthcare disparities a thing of the past. Jamie’s had a diverse career leading up to his focus in medicine including serving as CEO of Emergent Medical Associates, as a member of the Investment Banking Division of Lehman Brothers and as a Fund Manager for BR Venture Fund, the seed stage venture capital fund for Cornell University.


Transcript

Dr. Dave Levin: Welcome to 4 x 4 Health sponsored by Datica. Datica, bringing healthcare to the cloud. Check them out at www.datica.com. I'm your host, Dr. Dave Levin.

Dr. Geeta Nayyar: And I'm your cohost, Dr. Geeta Nayyar. Healthcare is one of the largest sectors of the US economy and one of the most intensely personal aspects of our lives. But few of us have insights into what it's really like behind the scenes, who are the people who make healthcare tick? What do they do? And why, what observations and advice do these insiders have?

Dr. Dave Levin: In this special 4 x 4 Health series working at healthcare Geeta and I talk with doctors, nurses, administrators, IT professionals, and others to get insights into their personal journey and the wisdom they've acquired a long ago. Today we're talking to Jamey Edwards, CEO and cofounder of Cloudbreak Health. Jamey says he's on a mission to humanize healthcare and make healthcare disparities a thing of the past. He's had a diverse career, including serving as CEO of emergent medical associates, as a member of the investment banking division of Lehman brothers, and as a fund manager for BR venture fund, the seed stage venture capital fund for Cornell university. Welcome to 4 x 4 health, Jamey.

Jamey Edwards: Thank you, Dave. Happy to be here. Thank you so much for having me.

Dr. Dave Levin: Geeta, Kick us off. 

Dr. Geeta Nayyar: All right. Well, Jamey, thank you so much for being part of our podcast today. So I know our viewers can't see it, but you've got this really interesting thing. This poster behind you that says, “don't give up the ship.” I'm guessing that's a source of inspiration for you in your day to day jobs. So, tell us your story because there's clearly a ship you're driving that we don't know. So tell us about it.

Jamey Edwards: Yeah. One, I love kind of things that have a history and that are authentic. And so we have a number of flags hanging up in our office like an old, 40, 48-star American flag. We've got a flag that was hanging over a ranger station in California. That's the California Republic flag. And I’ve got behind me that “don't give up the ship” flag, which was flying on the back of a sailboat prior to having it framed behind me. And it's a constant reminder of kind of the entrepreneurial journey. So my background initially started off, I'm an East coast guy. Went to Cornell for undergrad, Cornell for grad school. First 10 years of my career was investment banking and private equity work. Worked for a small high yield boutique out in LA and then Lehman brothers in New York. And the reason that I took that path was because my senior year of college, I took an entrepreneurship class from a professor at Cornell named professor David Ben Daniel. And he was this hallowed entrepreneurship professor in our country. And I wrote my first business plan and I was like hooked. I was like, wait, there's an idea that I have in my head and I can plan it out and it'll become a business. And people will like interacting with that business and I can impact people in that way. So this idea of like taking an idea and make it real, really resonated with me. But when I took a look at what I thought I needed to run a company; I was like an English history major growing up. I thought I was going to be a change management consultant. And I realized I didn't have any finance accounting background and growing up in a time of economic crisis with Enron and, even Lehman brothers, right? I realized that that was a skill set that I never wanted a CFO to be able to pull the wool over my eyes. And I really wanted to understand how the numbers worked and how the numbers basically told a business's story. So that I could be really facile with capital raising and all those different types of things. So I pursued a career in investment banking and private equity that allowed me to see a lot of companies do it right and do it wrong. I helped a lot of companies raise capital. I got to work on Google's IPO and follow on, which is a really exciting process and transformative for the capital markets at that time. But I grew up in a family of physicians, my aunts and uncles on both sides were doctors. Neither one of my parents was or were physicians, but my sister and my brother in law are. Over time my favorite uncle, Dr. Irv Edwards, who founded a company called emergent medical associates here on the West coast had, was one of the first guys to kind of come out of an ER residency when it first became a specialty back in the seventies. And so he kind of grew up building emergency medicine as a specialty in our country and eventually built his own company. And I started doing some consulting for him and moved him out of his home office to a real office and started legitimizing a lot of his operations. And as you can imagine Geeta, it was very easy for me to impress my physician uncle with my knowledge of revenue and EBITDA and PowerPoint and excel. Because they don't teach that to you guys in medical schools.

Dr. Geeta Nayyar: That’s right. We were terrible at that stuff. 

Jamey Edwards: And so we just had this very complimentary skill set. And so eventually he asked me to leave Lehman brothers and, yay nepotism for giving me my first CEO opportunity, right after I got that offer, I happened to get another job offer, to run a different company, which I turned down to go work with my uncle. And we ended up growing his company from around a $12 million business to 150 million of revenue over the course of the next eight or nine years. And from just ER, to ER, hospitalist in the anesthesia medicine. So true multispecialty group that would compete with Team Health and Envision and all those types of really great and Apollo MD, those really great big ER, groups that are out there, providing care for, you know, a lot of people across the country. And while I was doing that, I came across a company called the language access network. My chief medical officer at EMA came to me and said, Hey, I sit on the board of this company. Can you help it raise capital? And so I said absolutely. And I met Andy Panos who was the original founder of language access network and language access network created the video medical interpreting market in our country. So he was the first person to bring an interpreter to the point of care over a telemedicine platform in our nation, company was originally founded in 2003. And what I ended up doing was spinning his company out of a public shell, cause they were publicly traded at that point in time and took over the role of CEO and worked with Andy, to grow a language access network over the course of the next six years. So for six years I sat side by side and kind of ran EMA and language access network. And then language access network is reaching escape velocity. I felt like I had done what I could do with EMA at that point in time. And so I raised a series a round with Kane partners, who is our private equity fund. We ended up rebranding the company as Cloudbreak Health and refounding it. And realizing that the market was evolving and changing that this first use case that we had created in telemedicine, bringing language interpreters to the point of care that our platform could be used to do more. And now we sit here today at over 1,200 hospitals across the country, doing over 85,000 encounters a month and over 10,000 video endpoints. And we now have hospitals who are saying, Hey, can you help us with our tele-psychiatry initiative? We already have you, which is a telemedicine platform in our hospital. Can we expand use cases on the platform? And so Cloudbreak 2.0 is really about doing exactly that it's allowing people to use our service, to resolve more healthcare disparities that might exist within their health systems and communities.

Dr. Geeta Nayyar: So Jamey, you've definitely not given up the ship, my friend hats off. Here's my question. You clearly could have done a bunch of different things. You're clearly a business guy now and an entrepreneur, why healthcare? Like cause I hear it in your voice. You're clearly passionate. You've got the story with your uncle. What is it about healthcare? Cause you could easily be doing this for any kind of company. So tell us a little bit about that story and what driving the ship in that lane is like.

Jamey Edwards: Yeah. Well look, I think to a certain extent healthcare chose me. That might sound a little cliché, but I just really found myself in a situation where I realized the frustration that everyone was having in healthcare. And when I went to work with my uncle in his business, I saw on the front lines of care, these providers. The clinicians themselves, the doctor's, the x-ray techs, the nurses like you see the struggle that they have every day and coming in and working their shifts. And it was me cause I used to be an apprentice, I had all of our employees when I was at EMA shadow our doctors on shifts. They knew when a doctor called up what environment that doctor was in. And what they were facing. 

Dr. Geeta Nayyar: I love that, gosh, I wish our CO would shadow me in the ER. That would be fun.

Jamey Edwards: Yeah. I'm telling you, it was eye-opening and you start to see how electronic health records came in and how doctors had such a struggle with their adoption because it was intermediating their relationship with the patient instead of staring at the patient and having a conversation with them and writing some notes, they were documenting and staring at a computer screen. And I saw my doctors who were struggling to get through their shift every day and suffering really from burnout. And the number one symptom of physician burnout is treating a patient more like an object instead of a person. And so what I dedicated myself to was trying to resolve that problem and restore the joy of calling back to the physician. My whole theory was that if I could do that, they would then intrinsically take better care of the patient because they were having better job satisfaction. They were having tools at their fingertips that would help them connect instead of intermediate or throw up a fence between them and the patient. And so my life's work really became activating that, and everyone talks about being patient centric to these days. And I think that's really critically important, but I think if we're really going to fix the healthcare system today, we really need to talk about being provider centric and we need to make that provider's life and that clinician's life a little bit easier. And as a patient, like we're all patients, right? Every single one of us is a patient at some point in our life, but not all of us got the opportunity to be caregivers. And so it's harder to identify with that. And I think if we could build a little empathy and make sure that that empathy is two ways, not only showing empathy for the patient, but patient showing empathy for their physician, that we'd be in a great environment to practice great medicine.

Dr. Dave Levin: This is such an interesting theme and there's a couple aspects to it that resonate deeply with me. And the first is that your interest in caring for the provider and the second is the way you're relating the provider's experience. And particularly the role of technology in what I think is most widely accepted we we've got a crisis right now often referred to as burnout. I personally prefer to frame that as creating resilience. Cause I think framing it in a positive way is helpful. And the thing that jumps out at me, when you look at the data that's available is a lot of that satisfaction that resilience really does tie directly to how much the clinician has to time to really interact with the patient. And the statistic, I like to say it is some of the most happy, satisfied, and resilient providers are in fields like palliative care, from a first blush you might conclude, well, boy, that's really tough. You're working with patients that are facing really very serious illness and often end of life issues. But what those providers will consistently tell you is, they have the luxury of that time to really connect with the patients and that instills more meaning in the work. And so there's a question in here somewhere, but I think just this shared observation that the technology has an important role to play in that. It can play a positive role; it could also play a negative role. And it sounds like you've seen that and the combination of your personal experience with family members and others is what's driven you this way. Am I making sense here? 

Jamey Edwards: Yeah. You keyed in on something that I think is really important, like the word that you said was meaning. Having meaning to your work. So a lot of studies have shown that the number one job satisfier in our lives is that we're doing something meaningful. It's not pay. And so if a doctor doesn't have the ability to connect with their patient and feel what they're doing is, that they're adding value and actually get that patient's reaction of, "Oh my God. Thank you. Dr. Axe, I'm so grateful for the time that you spent with me today. This has made such a difference for me." If they don't get that, then it starts to be like a manufacturing. Like you're just, you're turning hospital beds the same way a restaurant turns tables and you're desensitizing the physician to the actual amazing work that they're doing on a daily basis. I remember being in the ER, when I was shadowing these physicians and being like, I can't believe you just did X to save that person's life. And they're like, I’ve got to get onto my next patient. And then that was like very, that was, I almost had a very stark reaction to that cause I was like, oh man, like they're operating with a distinctly different mindset than I am sitting here and witnessing their work and how could those viewpoints be so different? And so again, we've dedicated our work to making sure that we're putting technologies in the field that actually enhance the doctor's life. And if we can do that and we can reduce their anxiety while they're on shift and we can help them connect with their patient, they're going to be better doctors. Cause they're going to find that work more meaningful.

Dr. Dave Levin: So be specific and tell us exactly how you see that the technology you're deploying do that, give us a couple of examples. 

Jamey Edwards: Yeah, sure. Geeta I know you were about to ask a question. Do you want me to dive in on that? 

Dr. Geeta Nayyar: Go ahead. Go ahead and dive in full. 

Jamey Edwards: Okay. So the first healthcare disparity that we solved as a company was making sure that limited English proficient and deaf and hard of hearing patients were able to receive the same standard of care as their English-speaking counterparts. Because imagine like being in a hospital emergency department is scary enough when you speak English, but when you don't, it's absolutely terrifying. Imagine being in a foreign country and you've been in a car accident and you end up in an ER and people are running around you speaking French and putting needles in you and you have no idea what is happening to you. I mean, the level of anxiety is through the roof, but by the way, as a patient like that's anxiety driven for you. There's also a ton of anxiety for the doctor because the doctor is sitting there communication is the number one diagnostic tool that a doctor has when treating a patient. If you take a look at a medical chart, it's history of present illness, summary of family history, these are all the data points that a doctor uses to determine whether you're coming in and clutching your chest is a heart attack workup, or whether it's an indigestion workup. Because they can't find out that you went to the buffet and had a jalapeno, or you might be having an allergic reaction to something, all those different types of things. 

Dr. Geeta Nayyar: How do you know Jamey? 

Jamey Edwards: Exactly, exactly. Communication is the number one driver of that. And so for us, being able to, with a push of a button, have a certified medical interpreter available for these doctors. So they don't have to practice a lot of defensive medicine. They can actually practice the type of medicine that they want to, and they can reduce their own anxiety about whatever happens with this outcome, I may not be treating this patient where like most of the time the doctor cares about what they're doing to the point that like the patient doesn't even understand. Like they got into this industry because they wanted to help people. And it's so frustrating for them when they can't. So imagine that kind of cognitive dissonance that happens when, you know, you're kind of like, well, I can't speak to the patients what I'm going to do? I'm going to order both types of workups. I'm going to put this patient through even more than they need to be put through. And so our goal was to say, look, let's get that communication situation figured out. So they could actually focus on caring for the patient. They could build a connection with the patients, they can hear their story because our whole mission at Cloudbreak around humanizing healthcare, it's really about storytelling and allowing patients to tell their stories to the doctor.

Dr. Geeta Nayyar: I love that, Jamey that really resonates with me. Because especially when we think about the opportunity with technology, as well as the limits. And you hit on that very human factor because it's very different when a patient says, "no, I don't smoke." With this face, I know our viewers can't see it, with this face that says I smoke 10 packs a day. So "I don't drink,” and there's real implications to health. And so I love that there are pieces we can solve, but then there are some things that we just got to keep that human factor and the thing about burnout, it's very interesting for me to hear you speak with such passion because you clearly get it. And I'm just wondering if you think, do consumers get it right? Cause there's still this kind of vision of the doctor at the country club, just playing tennis and golfing all day. And it's not the reality, it’s not the reality of the problems you're solving, problems Dave and I are solving in the industry. So I'm just curious if you, where you see the consumer kind of connecting the dots and physician burnout and do people really care. 

Jamey Edwards: I don't feel like we as patients really give the issue, the voice it deserves. And I don't think many patients even understand it. And I think there's a few reasons for that. One, I remember working in the ER, you know, our most grateful patients, ironically, were the ones that were on like Medicaid or the ones who were uninsured. They were always the ones who were most grateful to their doctors for their care. I feel like we as patients, especially once we were covered under some sort of health plan, feel a sense of entitlement and we show up and we're not really paying the doctor for the service or, our insurance company is. And so we treat the doctor like someone who's there to service us as opposed to a teammate or a colleague in our care. And look, I think doctors are equally guilty sometimes of the opposite of, talking down to patients and doing those types of things. And again, just trying to get through their day, as opposed to taking a team collaborative approach in how we're going to treat this person and what they're dealing with. But for me that really, I don't see a lot of patients with a lot of sensitivity and a lot of that is also due to HIPAA. So let's say that you are sitting in a waiting room for your doctor and you're 20 minutes late. All you're thinking about is, why isn't this doctor seeing me? My appointment was at 1:00, it's 1: 20. I've got places to be, like all of our lives kind of take over. But what if the doctor was able to come out and tell you, look, I want to let you know that I'm super sorry to be late, but I was talking to someone who just got a cancer diagnosis and I wanted to spend the time with them to let them know that, everything was going to be okay. And here was their care plan. Would you as a patient take a step back then and be like, oh yeah, that's totally fine, don't worry about it. But doctors aren't allowed to share that information. So I think there's certain constructs that prevent us from really being sensitive to the doctor and what their needs are.

Dr. Geeta Nayyar: Yeah, I liked that. And I think more than that, when we think about a patient or consumer centric world, that healthcare should be right or is becoming more and more, we talk about airline pilots, right. And we always hear the things about airline pilots and they're not getting sleep. They're not being paid appropriately. And they are responsible for all these lives.  I always feel like, why don't we talk about physician burnout in the context of it affects the patient and the consumer, just as much as the physician. We never say that that, well, you haven't slept, you haven't been paid. You haven't been, you got 10 minutes to deal with really heavy diagnoses, like lifesaving or life-threatening issues. And so it's just really interesting to hear that as part of the piece you want to solve, which is just how do we communicate. Cause that's really the fundamental human factor and the story really says it all when we as docs trying to figure things out. So I know Dave's always got something to say, so I'm going to let him take over it out and try it.

Dr. Dave Levin: I want to round this out, cause we've got into a really interesting thread here. And I think the other aspect of this is, our training is, a lot of it is about, being clear about what's subjective and what's objective and trying to kind of remove some of the emotion from it almost Spock like if you will. And the way I thought about this over time is, there was the young Spock who was pure logic, but later in life, elder Spock became wiser and recognized there was a role for emotion and connection too, and so I think that, in addition to other factors we talked about is, physicians have to walk this sort of interesting line between, how much do I share with myself, how much do I connect at that at a personal level, a more intimate level and what's appropriate. And I think those are all things to be thoughtful about. But again my own experiences, the more you connect that way, the more you can be authentic self and connect in a real and an open sort of way, that builds trust with patients. And it's also satisfying to the soul. It's part of building resiliency as well.

Jamey Edwards: Yeah. I think the interesting thing about that, Dave and I thought about this a lot when I used to chat on the doctors in the ER, I'm like, how well are we really handling or training our physicians for the emotional weight of the work that they do? Like if you have a physician who connects with literally every patient and they're a trauma surgeon, and you just know that X number of those patients are going to die. Like that's a tremendous amount of emotional weight for that physician to bear. And do we have the right constructs and mental health and all these different things to support them because you want them connecting in that way so that they feel personally vested in making sure that this person lives as opposed to dies. But when you think about it, the way doctors insulate themselves from that type of emotion is by desensitizing it a little bit. And so that's a constant kind of tug and pull in my view, and we need to find a better way of helping our nation's physicians handle those types of issues.

Dr. Dave Levin: Yeah. I couldn't agree more. And I think it's true of a lot of service professionals. So I think there's a parallel to people who work in law enforcement, to people who serve in the military. This recognition of that, it's maybe more obvious than some than others, but, you know, there's an emotional toll here and there. And it's important to have ways to explore that and ventilate it and get support and people are subject to PTSD and these kinds of roles. And so recognizing that and being able to raise your hand and say, I'm hurting, and I need help too. I think we're doing better over time, but there's still a long way to go with this.

Jamey Edwards: Agreed.

Dr. Dave Levin: So, you sort of bring a very interesting mix of skills and backgrounds, tell us what's a typical day in the life like for you.

Jamey Edwards: Yeah. I mean, I wish there was a typical day. It would really help with my daily planning if there was, but no two are the same, which I'm sure you've heard from people before. Being an entrepreneur on a mission like this is sometimes about being opportunistic. And so I might perfectly plan out my day to be like, I'm going to spend the first two hours doing email, and then I'm going to do this. And then I'm going to make all my phone call backs. And then that gets blown up probably within the first five minutes at 9:05 am If I show up at nine. And so for me, it's a lot of different things. It's one, making sure that from a thought leadership standpoint, and as I’ve evolved into a little bit more of a business leader, I think this has been a little bit of a struggle for me is how do I help move what is a national dialogue on things like physician burnout and telemedicine forward? Because that's not something I was intrinsically trained to do. So, Geeta and I initially met over Twitter. One of my favorite things about conferences by the way is like being able to meet people in real life that I’ve met online, or I’ve had these like amazing discussions and dialogues with, and then show up and make those into real relationships. I think that's when social media actually really works in the right direction,

Dr. Geeta Nayyar: We all look exactly like our picture. I have people that I don't recognize I'm like, who are you? 

Jamey Edwards: Yes. There you go. There you go. And they're like, Oh my God. And they feel like they know you already, right? Because you're sharing so much of yourself. But that was something I wasn't really trained for. And so that's been a learning experience for me is how do you participate in this national dialogue? And it's something that, I’m still learning honestly to this day. So it's things like that mixed with, how am I making sure that the culture of my business is being pushed down to my frontline employees because culture and business, which I kind of consider myself the guardian of at Cloudbreak is a really tough thing to manage. And it's something, it's like a garden. If you don't manage your own culture and the garden starts growing weeds, it kind of takes on a life of its own. And it's much harder to weed the garden than it is to make sure that there are no weeds in the first place. And so that's about things like making sure that our hiring practices and onboarding are tight, making sure that we're hiring people who are cultural fit, making sure that when something, someone does something that doesn't reflect our culture, that we handle that in an inappropriate way in line with it. And so I spent a fair amount of time doing activities around that. And then a lot of it is also in building relationships with our health system clients, and then how we tell our stories as a company. So I’ve always said if I want to be the employer of choice and the partner of choice for hospitals, the employer of choice for people in healthcare, then I need to be telling a company's story that everyone wants to be a part of. And so how do I do that in a way that's really scalable and that's going to resonate with everyone and make sure that the work that they're doing, they feel like is really meaningful. I mean, I stand in some of our language centers as an example, and you hear hundred different languages being spoken and people talking about their cancer and people talking about their sick kid and you just know that great work is being done there. And that's one of the things I do to kind of reinvigorate myself as I’ll go in and close my eyes and sit in the middle of the language center and just be like, right, right, I reconnect myself with that work. And it's kind of funny cause I don't speak any other language than English. I took Latin in high school.

Dr. Geeta Nayyar: Oh, that doesn't count. That doesn't count. 

Jamey Edwards: Six years of Latin. I could still, conjugate verbs. Yeah, exactly. And then I took some years of Mandarin cause I eventually thought I was going to go live in Hong Kong for a little while. I never did that. So I don't really have another language that I speak fluently. And sitting at the center of this is really interesting.

Dr. Geeta Nayyar: Let me ask you this. Cause I'm sort of visualizing you sitting there in the center where you have all these languages. And I think in any number of movies, I forget the one with Brad Pitt where it's like something about dibble, and it's all the languages. Tell me what you have found is universal in all languages. And then what have you found that's like hard to translate. Cause I heard you basically say pain, hurt, love. These are all things that are universal. But what is universal law? It's that human cause you're really in the middle of this, you really are this really cool intersection of the humanity of medicine and the technology and what it can solve. And then what's the piece that you think actually doesn't translate well. Like what's the part that does get missed.

Jamey Edwards: Yeah. It's interesting. So interpretation isn't about wrote translation of one word to another. It's about painting a picture of understanding and in many languages, there aren't direct corollaries for one word to the other. And so you're creating a phrase to basically describe what this word means in another language. And so yeah, I mean pain is something that's universal. I think people will wanting to connect and using communication as a way to do that. I mean that is by far something that's incredibly universal and I'm often amazed when I look even at, the look on the face of someone who is deaf and hard of hearing when one of our ASL interpreters appears and is able to finally get them the care that they need and help them to communicate. All that stuff is incredibly powerful. The stuff that doesn't translate as well or interpret as well as the medical lexicon, like how amazing that we've, there's no plain speak in the physician world. Every specialty has their own lexicon, whether you're an oncologist or an ER doctor, we've created new words to describe things that you could describe them in layman's speak, but sometimes it's hard to describe what a cancer is or how you intubate someone or whatever that might be. And so those tend to be the challenges. And so we do a ton of training on medical lexicon by specialty, how you deal with pediatric situations. We actually have a fair number of clients who are faith-based health systems, the chis of the world and people like Providence, etc. And so we actually developed a pastoral care program so that our interpreters could properly interpret, the prayers and properly interpret last rights and do these types of things. And these are some of the softer things that create a much better experience for patient and provider.

Dr. Geeta Nayyar: That's wonderful. So I do speak, I speak English, I speak Hindi and I would like to say I speak medical Spanish. But it's interesting. Cause even I’ve found that with patients that there's sometimes like there are words in Hindi that I just, there is no other word that I can think of to translate that. And even in Spanish to some regard, but it's interesting to hear you say that because on the medical Spanish, around on the science sort of part, I’ve always been like, Oh, well that's easy. It's just your arm, it’s your leg. I've always thought the science was easy to translate. But I think what you're talking about is a lot of like actions, processes'. 

Jamey Edwards: Correct. Here is what we are going to be doing to you. 

Dr. Geeta Nayyar: And you know, and even who you're talking to, cause like in Latin families, South Asian families, it's the whole family. It's not, here's what we're going to do to you, here's what we're going to do to all of you. Because it's the whole family that comes in. 

Jamey Edwards: So true and a lot of it actually has to do with cultural competency. So it's not enough just be able to translate word for word, our interpreters a lot of times are from the country right.  They're first-generation from the country that they're now interpreting for. And they understand the mindset and the framework that that patient has. And so that cultural competency angle here is important as well.

Dr. Geeta Nayyar: That's right. And sometimes the patient's left out culturally as you're talking to the son or daughter, who's the caretaker for older mom or dad. And actually it's like, okay, we're not going to actually tell mom that this is terminal. We're not going to tell dad, it's interesting, it remains again that human factor. And I love the storytelling piece to it. So I'm going to be using your services. This is awesome. Now I can actually say I speak medical Spanish with a little bit of help. 

Jamey Edwards: We're happy to get you a copy of the app.

Dr. Geeta Nayyar: I'm not giving up the ship. It's not happening.

Dr. Dave Levin: Well, this is terrific. If you just joined us, you're listening to 4 x 4 health. And we're talking with Jamey Edwards, CEO and co-founder of Cloudbreak health. Jamey, I’m going to gently disagree with you on one thing. I don't think this is soft stuff. I think this is, it's essential and I suspect Geeta has had experiences similar to mine in the exam room that, it's the moments when you can connect in that way it's sometimes really unlocked the door to what's really going on. And patients who will say I’ve seen 50 other doctors and, but I want to hear the story in your own words from the beginning and at least in my own practice or more than one occasion, it completely changed the course of my understanding and hopefully the quality of the care that that patient got. 

Jamey Edwards: Yeah. I think that's a great point, Dave. I mean, we take a look at, our willingness to share as people and you and I spoke about this a little bit, pregame here. Like I'm super open. I will tell you, my good times, my bad times, anything about my medical history, but there are other people who aren't like that.  They're super private. And also, its culturally driven. There are a lot of cultures who won't, don't want to share information about their private parts because that's considered to be a front. But you know, we all have these situations that we need to be comfortable relating to, if we're going to receive the proper care to actually help us solve our problem. And that's actually just culturally and societally a little hard for people.

Dr. Dave Levin: Yeah. You've referred to culture several times and you also use the analogy of culture and gardening. So this speaks very, very deeply to me. And I definitely agree with you that managing culture is, there's a lot of parallels between that and gardening. We may have to have you come back for just a deeper discussion about that. 

Jamey Edwards: Happy to, happy to.  You and I could, we all could probably sit here for like a few hours today talking about the healthcare system and these types of things. It is a target rich environment. 

Dr. Dave Levin: Indeed. I'm not sure that our listeners would want to listen for that long. I suspect the three of us would really enjoy it. Now you've offered a lot of wisdom here today. So this question may be a little tough for you, but what's the one thing that you think everyone should know about health or healthcare?

Jamey Edwards: I think the one thing and I’ll focus more on healthcare is, you know, we still have a long way to go and we're living during what I would consider to be very exciting times. I don't think there's ever been an influx of technology in healthcare like we're seeing today. And I think we've discovered that some things that we considered silver bullets aren't, but we're going to be using them in different ways than we thought we would. And as they start to get better, they cease to become technology and they just start to get integrated into what we're doing as medicine. I'm talking about things like AI, I'm talking about things like telemedicine. I think AI, initially people were super fearful of, and, "Oh my God, this is going to replace doctors," all these different types of things. Every Sci-Fi show I’ve ever watched, I'm watching the expanse on Amazon right now. There's someone there who is helping guide the care relate to the patient, etc. So it might mean that our roles evolve, but I don't think it's, anything to be certain that anything to be scared of. But in that same way, it's also not as far along as we thought it would be as of where it sits right now. So I think there's just a ton of opportunity, a ton of areas for improvement. I think, the more human that we can make this healthcare system, it sounds so, I feel almost dumb saying it, cause it sounds so obvious, but the more human we can make this healthcare system, the better we will be. And that's how I feel. And so we've kind of made that the mission of what we're doing every day and it's our way to impact people is, how can we connect people to each other, but do that in a healthcare environment.

Dr. Dave Levin: Well, I don't think it's dumb at all. The putting the care back into healthcare, frankly, putting the health back into healthcare I think that's a lot of what we're struggling to do. My view is we're in a period of great chaos right now that there are some big trends that are converging, whether it's the changing reimbursement models and value based care, the widespread adoption of information technology, particularly clinical information systems and the rise of consumerism and the gap that people experience between how they get healthcare and how they conduct the rest of their lives, whether it's shopping or travel or banking or that that gap has become a chasm. And to your points earlier our clinicians, our providers see that too. And so a lot of them are wondering, it's not that they don't like technology. Cause my gosh, walk into any ICU or surgical suite they're loaded with technology, but they don't like as bad technology. 

Dr. Geeta Nayyar: Or technology with no problem. Cause technology Hey, we could build it, build it and they will come, doesn't work.

Jamey Edwards: Doesn't work, doesn't work. There's a lot of, the roads of healthcare littered with companies on the sidelines there that have tried that approach. I think the one thing that's interesting, which would be an interesting point of discussion here is the concept of how responsible we are for our own care and how technology is kind of making that possible. And I think Geeta has done some pieces on this before, but for me...

Dr. Geeta Nayyar: Don't give up the ship. You got to drive your own ship. That's true. I think people don't realize it. 

Jamey Edwards: I think a lot of people, yeah, a lot of people don't take responsibility for their care. They think health care is something that's done to them or something that they're, why should we be supporting people who are doing bad things to their body, they're drinking a lot, they're smoking a lot, they're doing all this. Like we need to make sure that we're equipping people with the ability to, the knowledge and the programs to make sure that they're not doing those types of things that are actually harmful to them. And those are the things by the way, that costs our healthcare system, the most money. Cause those are the things that ended up becoming acute. And so I think that's really an interesting vein for me as to is how do we get patients to feel more responsible for their own health?

Dr. Dave Levin: Yeah. I may be at a slightly different place than you guys are. Because I think we fall on a spectrum. And so my own view is we've got to get smarter about meeting people where they are, recognizing that when we talk about, I'm going to do a program for diabetics, well, it's probably not going to work. Because diabetics are not a homogeneous group. There's a whole bunch of different characteristics. And so for some people they want more technology and they want to do more self-service and other people, they want to deal with a person. And they want a different balance in their relationship. And so I think part of the journey we're on is to figure out a kind of mass customization, how do we do this in ways that are effective and efficient, but that really meet people where they are and capitalize on their own strengths and acknowledge where their weaknesses are and how do we deal with that as well. 

Dr. Geeta Nayyar: I think we can align; I think both of us can align on that. 

Dr. Dave Levin: We've been talking with Jamey Edwards, CEO and co-founder of Cloudbreak health. Jamey, thanks so much for joining us today. It was just a terrific conversation. 

Jamey Edwards: I'm really grateful for the time. Always a pleasure. And thank you guys so much for the opportunity to kind of share a little bit of our story. This has been a really thought-provoking conversation for me and grateful to be part of it. 

Dr. Dave Levin: You've been listening to 4 x 4 Health sponsored by Datica. Datica, bringing healthcare to the cloud. Check them out at www.datica.com. I hope you'll join us next time for another 4 x 4 discussion with healthcare innovators. Until then I'm your host, Dr. Dave Levin. 

Dr. Geeta Nayyar: And I'm your cohost, Dr. Geeta Nayyar, thanks for listening.


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