Step into the world of cutting-edge healthcare as we explore the incredible impact of artificial intelligence (AI) in this enlightening podcast with Robin Famanfarmaian, professional speaker and healthcare entrepreneur. Join us on a journey through the revolutionary ways AI is shaping the medial landscape, from streamlining the patient care process, to technology advancements. AI is not just the future of healthcare; it’s the present. This discussion shows how it’s changing the way we care for patients worldwide.
Step into the world of cutting-edge healthcare as we explore the incredible impact of artificial intelligence (AI) in this enlightening podcast with Robin Famanfarmaian, professional speaker and healthcare entrepreneur. Join us on a journey through the revolutionary ways AI is shaping the medial landscape, from streamlining the patient care process, to technology advancements. AI is not just the future of healthcare; it’s the present. This discussion shows how it’s changing the way we care for patients worldwide.
Learn more about the show: https://www.amnhealthcare.com/amn-insights/elevate-care-podcast/
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TIMESTAMPS
(0:20) Robin’s Story
(4:44) Artificial Intelligence (AI) Explained
(7:07) Diagnosis Advancements
(8:17) Developments on the Horizon
(11:23) Amazon’s Footprint in Healthcare
(14:44) Generations in Healthcare
(16:27) Data Tracking
(18:42) Future of Home Health
(24:00) Technology Advancements
(26:36) Role of Corporations
(30:00) Evolution of Hospitals
(34:07) Predictions of the Insurance Industry
(36:06) Mark Cuban’s Initiatives
(38:03) Final Remarks
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ABOUT THE GUEST
Robin Famanfarmaian, a professional speaker and healthcare entrepreneur. She’s driven high-level business development for cutting-edge medical and biotech companies. She educates audiences on technology, the future of healthcare, patient empowerment, building thought leadership, and more. She is the author of four books, including How AI Can Democratize Healthcare.
Website: https://www.robinff.com/
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Welcome to Elevate Care, the show where healthcare professionals, visionaries, and thought leaders come together to explore the limitless possibilities of healthcare innovation. I am your host, Jamey Dubke. Welcome to a journey where innovation meets humanity. In today's episode, I interview Robin Famanfarmaian, a professional speaker and healthcare entrepreneur. She's a driven, high-level business development for cutting-edge medical and biotech companies. She educates audiences on technology, the future of healthcare, patient empowerment, building thought leadership, and more. And on top of this, she is the author of four books. Wow, Robin, welcome to the show. Oh, I'm so excited to be here today. I feel like such an underachiever. I don't have four books yet. You know, you're a couple years younger than I am. Oh, thank you for that. I'll take that. Well, Robin, you have such an interesting and unique background. What made you so passionate about getting into health care? Well, I'm not sure. It really goes back to my childhood. So first of all, my mom was a pediatrician and my dad's an MIT guy turned patent attorney and does a lot in the healthcare space. But the reason is because as a teenager, I was misdiagnosed with an autoimmune disease. All told, I've had 43 hospitalizations, six major surgeries, and three organs removed. Oh my gosh. So by the time I was 26, this was seven years after I'd had my entire large intestine surgically removed. It's a total colectomy with J-Pouch. which is considered a cure for ulcerative colitis, but I wasn't cured and I was in pretty extreme pain. So over a period of time, my doctors just kept upping and upping my opioid dose until eventually they decided to switch me over to 80 milligrams a day of methadone. That is an absolutely gigantic dose of medication, right? And I hated it. And so as soon as I could get back into my pain doc, I was like, all right, I need to be off this medication. I think the rebound pain is significantly worse. than the actual original pain that I'm supposed to be on it for. And they said, OK, well, next step could be to surgically implant a morphine pump into your spine. It's like, sorry, what? I was 26. I was essentially a shut-in. I could barely function on a daily basis. Sometimes taking a shower was really the hardest thing that I could do. And what I was hearing was that was the rest of my life. And so I said, absolutely not. And I fired my entire health care team. And this was at 26? 26 years old. I went home that night, and I dropped my own methadone dose by 40%, which is not the smartest thing to do. But I was 26, and this was before we had as much information available as patients. Well, that's kind of what I'm interested in learning about. So how did you have some independence or just trying to figure that out? Because you probably didn't have access to. you know, all of the information on Google that we have today and how we self-diagnose ourselves on Google and all the apps. How did you do that at 26? Well, it wasn't trying to self-diagnose me or anything like that. I just had enough. I said, that's it. I hit rock bottom and decided, I'm just starting from scratch. So I'm going to get off every single thing that I'm on, all of the pain meds. I'm going to find a new team of doctors who could figure out what was wrong, like starting by looking at the beginning, right? not taking under any assumptions that I had ulcerative colitis. That was supposedly cured. And it worked, right? So I went through pretty hardcore opioid withdrawal for about a week, which is extremely painful. I can't even imagine. And then I felt better at the end of the week. And I called a whole bunch of new doctors at my same hospital. I ended up getting diagnosed correctly with Crohn's disease, put on an IV medication called Remicade, and I went into remission overnight. How did you go about even seeking out new doctors in the same hospital? Because there's probably a lot of politics involved and probably some drama involved. How would one go about doing that today? So it was hard in some cases and easier in others. And so I was at a big hospital system. And all I needed to do was kind of move to the other satellite office, which is four miles away or something like that. And so I was able to switch over a lot of my doctors that way. with OBGYN, which I didn't have any problems with anyway, they wouldn't let me. They were like, no, if you wanna stay in the practice, you have to stay with this doctor. And I'm like, okay, so I guess I'm leaving this practice because they wouldn't let me do it. But the rest of my doctors, I was able to do it by just switching medical buildings essentially. Okay, awesome. Yeah. Awesome. Well, hey, I know you have so much interest and passion in healthcare, and I know you are literally speaking to world leaders and talking to them about AI and healthcare. So can you break it down though for some of us that are not so proficient? When we think about AI and large language models, what is the information that we need to know so that at least we can start to all speak some common language? Yes. And that's a really big deal because most of us don't actually have the vocabulary or the foundational concepts to understand the differences between different artificial intelligence. And we use AI as a blanket term, but there is a lot within that. And so with the large language models and generative AI specifically, that's a very specific type of artificial intelligence. It typically uses all of Wikipedia as well as part of the World Wide Web and tons and tons of books. And that's how these large language models are trained. And because they use so much of the internet, It's able to understand context. And that is the big leap when we're talking about the large language models in their understanding of context. Okay. I know I've been hearing a lot about how they've like scraped the webs, they've scraped all the books, but when you think about what we are going to be able to do with AI, can I just go into chat GPT right now, type in some symptoms and somebody can maybe give me some thoughts on a diagnosis or where I should go? Absolutely. So it depends on which one of the large language models you're using. If it's just plain old chat GPT, it's probably not going to give you any sources and it's not going to let you open up the black box and see why it thinks that way. And that's a big deal in health care because you can't just put in a prompt and say, okay, what is the diagnosis for this without being able to follow the money and kind of understand where did the large language model come up with that. Because first of all, it has to do with the prompts. But secondly, if it's trained on a lot of the World Wide Web, I think a little bit of that might be inaccurate. Yeah, you think. You know, you think. Who invented pants? Exactly. Awesome. Well, also too, when you think about using some of those AIs, you said plain old chat GPT. But for some of us, that's kind of what we're even just kind of dipping our toe in. What do you think about? when you think about some of the skills that we're gonna need, right? So prompt engineering is a new skill. It's gonna be a skill of the future. We're gonna need everybody to know how to do it. Even I'm gonna start teaching my five-year-old how to prompt engineer so that by the time he goes to middle school, he can program something, I'm sure, but what are the skills that they're gonna need in order to understand technology or even how to leverage this technology? So we're so early in generative AI, it might actually even become easier to do over time. because all of the giants are getting into it. So when ChatGPT launched, I think it was last November, it really started the race, right? Like everyone had been working on it behind the scenes, but no one was ready to launch. And then all of a sudden, everyone had to launch. And so companies like Amazon have their own large language model. Google, all of these big tech companies. And so it might actually get so easy that it's just basically. the natural language processing, right? So like you just talk to it as if it were a person. Awesome. So basically because that time clock started and then it started the races, right? Like everybody has to now make it easier. Yes. And simplify it, right? So it's the easy button. Exactly. Awesome. Can you share some of the insights and some of the developments that you're seeing that are on the horizon that you're incredibly excited about? So. Thinking about the knowledge graphs or the certification layer of data on top of generative AI is what is really exciting. And so a company that I like to talk about is called Kuehne out of Israel. And what they do is they have thousands of data points that they put on top of the large language model and it filters the answers through that. Now this certified layer of data is clinical grade medical data that is accurate, right? And it's a small subset of data. It only needs to be thousands of data points. It doesn't need to be the trillions that you think about with a large language model. And that way, all of a sudden, the certified layer of data is able to understand context because it's plugged into the LLM. And so... all of a sudden we have that black box where we can open it up and look and it says, okay, well, 85% chance it's a diagnosis of Crohn's disease and this is exactly why I think that. And here are the 17 different sources, the white papers and the actual FDA certifications, you know, of these different reasons why I think that. And so that is a really big development. And Amazon Web Services, they already have launched their AI Medical Scribe. which auto transcribes clinical visits and then summarizes it and does things like pre-authorizations. And so they are launching these types of certified layers of data around subspecialties. And I know one of the earlier ones I think they're launching in is orthopedics. Right? Yeah. What is the advantage to launching it in orthopedics versus some other specialty? They probably just chose a couple of subspecialties to start, right? And I mean, they're probably ready to... Launch in all sub specialties, but they had to pick a couple. So I'm not the internally at Amazon I'm not sure why but there's you know, it's really okay. Let's just see how these people take to it, right? Okay well I just didn't know if it was a benefit from a like what is gonna benefit the patient most or What's gonna benefit Amazon the most right because they are a big provider of a lot of services and they and just as you mentioned They're continuing to ingest even more They're now a pharmacy provider as well too, I believe. So they have Amazon Pharmacy. They have pharmacy licenses in all 50 states. They have a $5 a month subscription model for unlimited number of generics. They have transparent pricing. And they just bought one medical, one medical for $3.9 billion. And right before they bought one medical, One Medical had bought Iora Health, which is the Medicare population. So all of a sudden, with one giant check, Amazon now takes care of people from birth to death. Oh my gosh. Yeah. What are the implications on the rest of kind of the healthcare space when you have an Amazon come in and kind of take that big footprint? So one of the main reasons I decided to go with One Medical as my primary care, and that was about seven years ago, when I switched over to them is because of the digital aspect. It's incredibly easy and efficient to make appointments with my doctor. I can walk in any time to the blood lab, and there's no line, and I can get my blood drawn. And I can easily send uploaded attachments and links through the patient portal. And I mean, those things sound like they should be easy and simple, and everyone's doing it, but they're not. A lot of the big hospital systems, it's just, it's very difficult to make an appointment. Like every time I try and make an appointment with my ophthalmologist, it takes like six tries. Oh yeah. It's crazy. That's if they call you back, right? And then if they call you to reschedule and then, hey, we're gonna see you in four months. Yes, exactly. Because right now it feels very hard to even go see you, just a regular primary care doctor. Yes, yes. Wow, I'm excited for everything that this is gonna do. especially in some of those specialties that it's hard to get referrals into, and then also too when we think about children and just their needs and how prevalent they're becoming into the healthcare space as well. Awesome, thank you for that. Robin, based on all of your insight and information, what are the areas in the industry that stand to benefit the most from AI in the healthcare space? Oh, there's so many. I mean, it really benefits almost every aspect of the patient journey. But thinking about the generative AI and pre-authorizations, that one thing alone, UnitedHealthcare spends 13 million hours every year on pre-authorizations. Can you tell me what pre-authorization means in this context? So for your insurance. So if I want to go get a 3D mammogram and ultrasound. I need to get, of course, pre-authorization from my insurance company before they will do something like an ultrasound in addition to the mammogram. And so just that paperwork back and forth, they spend 13 million hours a year. And so generative AI can do it in milliseconds. Wow. Yep. What is the implication then from the human aspect to that? What is the implication to the patient? Yes. Well, to the patient, they get served much more quickly. Right, because pre-authorizations typically go back and forth, sometimes over a period of weeks, if not months. I know for some of my more complex things, it has taken months to like figure it out. And so all of a sudden, all of that red tape is gone because both sides have generative AI. So the hospital or the doctor's office can use, you know, ChatGPT essentially, for the pre-authorization letter. And it takes seconds. And then UnitedHealthcare will get it. And they're... generative AI programs will look it over and mark it up and send it back. And all of that can be done in milliseconds versus months. Yep. So patients will get help when they need it much sooner. Yes. Awesome. So we've been talking even just internally a lot about the generations and how even with health care and the needs of the younger generations along with the older generations, we're living longer. So we are continuing to need those services much later on in life. So I'm really excited to hear that AI is gonna be able to help us predict a lot of those services also too, right? Exactly. So if you look at some of the early products in the space of aging in place, companies like the LEQ by Intuition Robotics. So the LEQ is this beautiful smart speaker that's like an Amazon Alexa and a smart tablet and a video camera. and it is built in like lots of different apps, easy for people to use, because you get it for aging in place. So I'm expecting grandma to use this. And it will learn grandma's schedule. So not only can grandma say, hey, LEQ, call my son or call my doctor, or you know, LEQ will give her medication reminders and things like that, but it learns her schedule. And it notices when grandma walks past her every single day at 9 a.m. to get a cup of tea in the kitchen. And if grandma doesn't show up one day, LEQ is gonna get worried and it's gonna ping grandma. And if grandma doesn't say, oh yeah, I just slept in today or what have you, you know, and respond in some way, then it can go ahead and like call the son or something like that. And so all of a sudden we have these predictive analytics that have the ability to learn about the individual over time and change the approach. And that is a really big deal when you think about it. No, that's amazing. Are there any downsides or downstream implications that we're not thinking about when you have technology that is tracking patterns or tracking behaviors? What are the things that we should be considering? Well, All of a sudden, people are going to know a lot more about you, right? I mean, we're already allowing Google and Facebook and Twitter. And I mean, all of these companies already are tracking everything we do online, and they know a lot more about us than we might even know about ourselves. And this is just inviting even more in. Right. But we're already doing that with Apple watches and GPS. Like we know where every single American essentially has been. every single second of the day for the past few years, right? Like, because we never leave home without our phones. Absolutely. And so this just brings it in a little bit more, but I'm not too worried about that. Like, no one really cares about my blood pressure or essentially my movements. What people care about is the privacy and security on the financial side, right? And so some of these devices can allow hackers to come in or something like that. So there's always something that we worry about with that. No one cares about the blood pressure, but they do care about the social security number or the credit card number. Absolutely. That's kind of what I was going for, is like, where's the data privacy concern? Yes. And are there implications then from a protection perspective, or what can we do as consumers and patients on our side to even protect us from that? Well, it depends on what you're using. And so if you're using secure devices like the Apple phone, or one of the. the Google phones or what have you, you know that they are pretty secure. And if you're paying for software security and all of that, you're pretty well protected. You don't have to worry about those kinds of things. It's the very, very inexpensive devices that you might plug into your home network that can provide that backdoor entry for a hacker. But again, they don't care about your medical data. They care about your financial data. And the same thing with the big hospitals. They hold the data like hostage, right? But they don't care about the data necessarily. They want the money. Yep. Now that we're starting to think about AI and how it's going to advance us from a patient perspective, there is a lot that's going on in the media right now about taking a lot of health care back into the home. Yes. How does one even conceptualize? Because I'm just so familiar with going to my doctor, like I've got to have labs drawn, I've got to have all these tests done. How do we even think about how we bring that back into the home and what does it do for our experience as patients? Oh, the experience is so much better. I get as much healthcare in my home as absolutely possible. And I only go into the clinic when I absolutely need to. That's amazing. It's amazing. And so I have a nurse that comes in every six weeks to draw my labs and then just go and she drops them off at the nearest lab core or Quest. And so I don't have to go into a blood lab. She comes in and she does my IV Remicade. And so I don't have to worry about going to an infusion clinic. I do a lot of my stuff with virtual care. So if I just need to see my primary care doc and I'm traveling a lot. you know, maybe I will do a virtual care appointment with her if she doesn't need to do any type of an exam. And it's much easier for me to be able to do that kind of thing now because I have a nurse who's typically the same exact nurse time after time, so she knows me over a period of years. But she's coming into my home every six weeks and taking my vital signs and making sure everything is okay. So I feel like I'm getting 10 times better, like, care than I had previously. Because it's focused and it's one-on-one. Yep. But earlier, you were sharing with me a story about the difference of getting those IV injections in the hospital setting versus what happened when you started bringing it in your home. Yes. So I've been on it for over 20 years. And the first 15 years, I got it done in normal hospitals. And I have to say, I love my hospitals. And I love my specialists. But the problem was is that the infusion clinic was kind of an afterthought, right? And so it's in the bowels of the hospital with no windows, 15 other patients all in one giant room with some room dividers, but like you could hear everything. And the alarms on the IV poles, I'm thinking, this is an infusion clinic. So my own IV pole would go off five or six times while I was there. And each time it would go off, it was between two and five minutes long before the nurse could come in and press it to quiet down. And the only reason the alarm was going off for five minutes was because it needed to get sped up. How is that an alarm emergency? Yes. Right? And so the entire three, four, five hours, sometimes I'd be there. All I could hear was just high-pitched alarm bells going off the entire time. So stress and cortisol and everything else that we don't want dripping in our body when we're trying to heal is happening. Exactly. And of course, anytime you go into any kind of a clinic, you're surrounded by infectious disease. And if you're getting something like an anti-TNF alpha drug like Remicade, I'm suppressing my immune system. And so every time I am running the risk of getting some type of low level infection that I don't even realize just by being in an environment where the person who walked in behind me happens to have some kind of contagious disease. And so it was taking me seven or eight days to recover. I mean, in fact, I'd go home and I would be hurting from head to toe, like every cell of my body. And I would just go and I would curl up in bed and I would whimper. And I always thought that it was the Remicade because of course it's a biologic, which means there's proteins. Yep, and it has mouse protein in it. And so it would make sense to me that maybe I was having a reaction to it, but it's a wonderful drug. And so I would go through that seven days of recovery every six weeks. just to be able to have the Remicade. But then about seven years ago, my insurance company, and this has happened across two different insurance companies, said if I wanted to stay on Remicade, I had to get it done in the home. You're like, wait, thanks, I'll take it. Why didn't you tell me this a while ago? Exactly, and so my recovery time went from seven days to zero. Wow. It wasn't the medication, it was the environment that was making me sick. And I'm hearing this across the Crohn's community. people who were getting it in the hospital and they were so sick when they were getting the infusion that they'd slow down the medication to go in over an even longer period of time. And then all of a sudden, all of the side effects went away when they pulled it into the home. So you can be sitting at home watching Netflix with your dog or your cat, and you're in a much happier space. And your own healthy food, right? Everything about it is much more healthy. And the cool thing about it is because it's the same nurse time after time, she can first of all notice if there's black mold. If all of a sudden there's been a big change and if I'm usually pretty neat and all of a sudden it's extremely messy. So from a mental health perspective, we're also able to care for people on a different level instead of just like maybe the one to three minute interactions, we get to care for the whole person again. Exactly. And I love that. It's almost like going back and having doctors visit your home. Yep. Yep. OK. Tell us and really get into this, because I think this is exciting stuff. You've mentioned the Apple Watch a few times. There's a lot of other technologies that are coming in to help us with some of that remote patient monitoring or how we're reusing technology. Tell us just about a few of the ones that you're most excited about. Oh, I mean, first of all, we're just using a lot of old technology, just new applications. So PPG, photo plasmography, is what we've used. to get pulse oximetry since 1982. The same thing with the cuff method for the blood pressure cuff, so moving that down to the wrist, which is much easier for patients to use. In fact, even my nurse has a wrist blood pressure monitor that she brings with her and takes my blood pressure that way sometimes. But then there's entirely new ways to think about vital signs. And so things like counting the number of times someone coughs on a daily basis. What does that do? Think about it. One of the main issues that drives people into primary care and urgent care is coughing. But we have never been able to metrocise coughing. But instead, now companies like HIFE AI, they just use your smartphone or I think they have a watch that will listen. And it's just a microphone and it counts the number of times someone coughs on a daily basis. Not only that, but it categorizes the coughs into things like a whooping cough or a productive cough. which is both an indication of the problem and of a potential treatment for the cough. And so all of a sudden, we can metricize this stuff. It's incredible. Oh my gosh, but it's something like a cough. What are some of the other? Biometric, essentially monitoring. Yes, so what are some of the other biometric monitoring that's happening in this space? So if you think about Sankora, it used to be called Amerisource Bergen. They actually have an Apple Watch app that is available by prescription only. that metricizes Parkinson's involuntary body movements and spasms. Why is that important? Obviously, the disease itself is really highly unknown, I think, in most aspects. Yes. And so what are the implications to a Parkinson's patient? Well, one of the biggest problems when you have Parkinson's is the involuntary body movements. And so being able to metricize that not only can help map out medication efficacy, it can help map out disease trajectory. And whether some type of a treatment, whether it's physical therapy or mind game or whatever the patient is using is working or not. Right? Yeah. Now, Robin, we've also seen some giants or at least in the news where you have Walgreens and CVS, even Best Buy, I just heard is starting to get into the healthcare space. Tell us a little bit about that because that sounds exciting. And also too, we might learn some advice to invest in. So I mean, you've heard the consumerism of healthcare, right? With companies like Amazon, Apple, Google, and Best Buy, these are all consumer facing companies and they know how to treat people and get people to come back to them over and over again, right? And so Best Buy is one of the surprising ones. About, I wanna say about eight years ago, they started getting into the connected consumer and things like aging in place. with the TitoCare device, which is a telemedicine toolkit that has an otoscope for the ears and stethoscope and a temperature monitor and a tongue depressor on a video camera that can be used in the home. And so that launched out of Best Buy. And that was the first time when I was like, all right, that looks like something's going down. That's an indicator that a retailer just purchased something big like that. And all of a sudden, two years ago, they spent $400 million buying a company called Current Health. and that provides hospitalizations at home. It's the data platform and the care coordination of the hospital at home and remote patient monitoring. So all of a sudden, with one $400 million check, Best Buy became a full-on hospital provider. Oh my God. I didn't think 10 years ago when I was buying a TV from Best Buy that they'd be taking care of me in the home. Exactly, right? But they went into it in a big way. Oh my gosh. Tell me about some of the investments that CVS and Walgreens has been making in this space because they're providing a lot more of that in-home patient access as well. Yep, well remember, so CVS is not just the pharmacy, the retail pharmacy, it's a pharmacy benefit manager and it's Aetna, so it's one of the major payers. It is fully vertically integrated. And so yes, they're buying up companies that provide care in the home, like Signify Health. I believe they paid about $8 billion for that. And even for a giant the size of CVS Aetna, $8 billion is still a lot of money. I was gonna ask, what is the billions that CVS is holding onto? Because is eight billion just like a nickel? Is it a dollar? No, it's still a considerable amount. So they've spent about $20 billion between Signify Health and Oak Street Health. So Oak Street Health has clinics all over the United States and it's a primary care style offerings. and then Signify Health actually goes into the home and does home health checkups. Okay. And so those two companies alone, 20 billion is a lot for CVS Aetna. Oh my gosh. Yep. So what are the implications of what they're looking to continue to pursue? So control the entire experience for the entire patient from start to finish. whether they need to see their primary care doctor, whether they want to go into CVS or have it be done in home or a freestanding clinic, if they need their medications, what OTC medications they need in addition to the specialty drugs and the regular prescriptions. I mean, they are owning the patient from start to finish. Right, well, and they've been doing a lot more, I think, over the last year or so about trying to almost mandate that, hey, we're gonna deliver these drugs to you. So it's almost like, the pandemic has helped us fast forward what that looks like. What is the implications then in the hospital setting? What is this going to do for hospitals if we're drawing patients from a physical hospital into the patient's home? Exactly. So hospitals need to start to think about themselves as no longer constrained by the four walls. The hospital now needs to completely go into the home. And so thinking about it without walls whatsoever. And so I'd love to see the hospitals partnering up with companies like Bioformis that provides that data platform to provide the hospitalizations at home. And that way, it's not going to another company. They are still being hospitalized under that doctor, under that health care system. But you're just extending it into the home where they might be able to get actually significantly better care because of the ability to be able to sleep. Right? not be surrounded by infectious disease, and just be able to be in familiar surroundings. I mean, those three things alone are huge when you're a chronic disease or even end of life. Yeah, no, and I think about some of the healthcare teams, right, so once you find that doctor that you connect with, that you've spent years, decades even, they get to know you, they know your family, they know your history, you don't have to repeat that. Like I would hate to have to try to replicate that, but it sounds like even with the advancement in telehealth in all of these remote monitoring devices that we're still gonna be able to have the access to our doctors. And yet we're still gonna be able to have that in-home care in a space where we can truly heal. Exactly, exactly, you've got it. And this is so cool to think about, this is what the future is gonna look like. And you didn't need Skynet to make that happen. It just, it's happening now, which is amazing to think about. All right, so when we think about also to respiratory disease and mental health, I know this is another big thing. When we think about some of the epidemics that are also happening in today's society, the loneliness epidemic, self-harm, and suicide rates continue to increase. And even with some of the Gen Zers, we know that those health markers or the mental health markers are happening earlier on in their teenage years. What are some of the things that... that are happening right now with AI or remote monitoring that are really going to help us be able to care for people from a mental health perspective. Oh, so there's a whole new category called digital therapeutics. And the world of digital therapeutics is maybe 10 years old. Really, we kind of look at 2017 as having the first software apps that have cleared the FDA based on something called CBT, cognitive behavior therapy, which is a gold standard when you're talking about mental health. And so the digital therapeutics world is just starting up, but I think it's gonna have a huge impact because instead of trying to have your mental health breakdown at 2 p.m. on Thursday, right? Like, which is what we end up having to do is seeing a psychiatrist or a therapist. These digital therapeutics are companions by our side 24-7. And so they can work in conjunction with things like medication or therapy. But it gets to know you, just like I was talking with the LEQ, gets to know you over time. Yes. Companies like Twill Health. So Twill has a number of digital therapeutics already on the market, including one that's for medication adherence and medication transition. And what it does is it reminds the patient to take their medication and the way they remind the patient changes over time in response to learning about that patient. And so like two different Twill Health digital therapeutics are not going to be exactly the same after a patient has had them for a month. Wow. Like I'm even just trying to think about how does somebody then start to use that data? Like how do you integrate that into a health care plan? So one of the interesting things is that Elevance Health, which is Anthem, Anthem renamed themselves. they have already distributed five different digital therapeutics to their members for free. And think about that from a couple different levels. First of all, it is a health insurance company that has the ability to change a patient's behavior on a daily basis, has the ability to interact with the patient now on a daily basis, and integrate all of that data into their health plan on the insurance side. which is just incredible to think about. Are there any negative implications though from an insurance company having that type of insight or data, does that somehow down the road prevent somebody from getting care because the insurance can predict that stuff in advance or is it more like, are there concerns that I wanna anticipate or even talk about? So we already know that, right? So just thinking about... Facebook knows our mental health better than, say, our clinic does. Just based on our updates and likes. Exactly. I mean, we are seeing these big tech companies, they understand who we are and how our mental health is. That data is available and potentially even for sale. It's not about that data. It already exists. There's no way to put that horse back in the saddle or back in the stable. What it is the rules and regulations. It's always going to come down to regulations and that's legislative. So it's still about protecting our data, but it's still then about how do we use... How the insurance companies are allowed to use it. Everyone knows that, like say I have a pre-existing condition. There's no way to hide that from an insurance company, but they have to cover it because of legislation. Okay, awesome. So Robin, we're here in Dallas, and so Mark Cuban is a Dallasite, and we absolutely love him. He's been in the news a lot lately though because of his Cost Plus Drugs initiative. Tell us a little bit about your insight, kind of what your thoughts are, and where you see him competing in that space. So it's really cool what he's doing. It's not just basic price transparency, which we are seeing out of Walmart, Walgreens, you know, all of those big guys, Amazon, all of them do price transparency. which is a big deal in general. But Mark Cuban does radical price transparency. So if a patient has to pay $35 for their medication, Mark Cuban will literally break it down. 20 of that goes to manufacturing, five of that goes to shipping, seven of that goes to the markup. Literally every single dollar, we know where it's going. And that's a big deal. And that's... that radical price transparency is not something we've ever really been able to have in healthcare before. And now they already offer over 1,000 generic medications and they offer a number of brand name drugs. Three for Janssen in the diabetes space because it needs to compete with the regular insulin. Well, no, mostly competing with Wigovy and the new blockbuster drugs that are on the market. They also offer a brand-name drug for hypothyroidism, which has about 99 million prescriptions written every year for it. And it just recently came off patent. And so by offering it directly through Mark Humans Cost Plus, that's the way they're kind of extending the life of that particular medication. But the other interesting thing is they just started offering one of the Humira biosimilars. And those of us in the industry who understand the anti-TNF drugs like Humira and who understand what Abbott has really done with this medication, it's incredible to see that we can get it directly now through COS plus drugs. Like, that's incredible. When you think about where we've been at as a society and a culture for the last several years, like there is a lack of trust. When we think about pay transparency, we're really starting to see states also increase pay transparency when it comes to even wages. And so now if you have organizations that are kind of pushing those boundaries and everything's been kind of under the rug, or even as a consumer, as in a patient, you start to not understand how we're charged or how a hospital could charge us $280 for a Band-Aid or a box of Kleenex. And so really... starting to get to see that is really exciting because from a competitive perspective, it really kind of levels the playing field, but then it also gives us control. And I think as humans, having choice is really important to us and our psyche. And that's kind of the autonomy that we're always seeking from a human aspect. Oh my gosh. Exactly. And especially with the younger generations too, if it's like millennials or Gen Z or even Gen X, right? They are expecting not only transparency, but an understanding of where everything is and how it works. That's right. We want to know where our money's going. We want to know that the companies that are taking it value what we are doing. So, man, Robin, we could spend probably another five hours talking about this. Six. Six at least. So we're going to need a break. Oh my gosh, yes. We're going to have you back for sure. But where can our guests find you on social media? Oh, so I am the only Robin Ferman Fermian in the entire universe. So that's amazing. Yeah. Is that your Gmail too? In full. Oh, my gosh. Absolutely. So absolutely. Robinff.com. You can go on my new democratizing health care.ai website. And that's all around the book. Awesome. And I'm on all the major social media channels. Awesome. Well, Robin, thank you so much for everything that you shared today. I know we're all going to go home, go research on chat GPT, go Google a whole bunch of stuff, go think about our investment portfolios. Thank you for everything that you did. Thank you so much for having me. Awesome. Thank you guys for joining us today on Elevate Care. We hope you enjoyed this episode. If you found this podcast valuable, please consider subscribing, liking, and leaving us a review on your favorite podcast platform. Your feedback means the world to us and it helps us to reach even more listeners just like you. 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