March 15, 2023 • 19 mins
In this episode, we speak with David Grandy, FACHE, CMPE, who leads Kaiser Permanente’s Delivery System Design and Innovation practice. Join David and host Jeff Gourdji as they discuss the benefits – and complexities – of expanding an integrated model of care, growing care outside the four walls of the hospital, and…roller coasters!
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Episode Transcript
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Anna (00:07):
Hello and welcome to Prophets Healthcare Changemakers podcast, where we'll
be talking to leaders in healthcare who are focused on
transforming their organizations to drive the next level of growth
for their business and for healthcare at profit. We believe
that the organizations that thrive in healthcare are those that
dare to change the game, striving to improve human health,
create better experiences and make the best of care and
(00:27):
enduring and sustainable reality for all. Those that will transform
health care are the changemakers. And for this podcast we
want to focus on them. Our podcast dials into and
recognizes the people behind the transformation and their journeys and
changing the game one story at a time. Are you
ready to dive in?
Jeff (00:47):
All right. This is Jeff Gorgie here with the Profit
Health Care Changemakers podcast. I'll be hosting this week's conversation,
and I'm very pleased to have with us David Grandy. David,
welcome to the podcast.
David (00:59):
Thanks, Jeff. Great to be here.
Jeff (01:01):
So, David, tell us a little bit about yourself and
take us back to your career path and what led
you to where you are, and then we'll get into
your current role next. But take us back to where
you've come from and where you've gotten to now and
give us one fun fact that maybe is on your
Facebook page, but not your LinkedIn page or maybe isn't
on social media at all if you're willing to share.
David (01:22):
So my career in healthcare started a couple decades ago. Now,
my first job out of college, I was the intern
for the chief medical officer of a multi hospital health system,
and it was a fascinating view of a lot of
layers of an organization. I think both the sort of
executive leadership layer as well as the physician relations layer as.
Jeff (01:46):
You do, you always know you wanted to work in
health care. How did you start there?
David (01:50):
It did. From the time I was very young, I
actually had some health issues, some pretty serious health issues
when I was a younger adult. And so I was
exposed to hospital life. And it was fascinating to me,
despite all the things that I was going through personally,
it was just interesting to me how all the different
parts and pieces and disciplines came together. And so I
(02:10):
think I knew from a pretty young age that I
wanted to go into a helping profession. And medicine initially
was where I thought I was was headed.
Jeff (02:19):
So to ask, did you think about what med school did?
David (02:22):
I did I actually one of my undergrad minors was
in biomedical sciences, so I checked all the boxes to
go to medical school, took the Mcat and ultimately decided
against in part because at that time. Physicians were very
unhappy people. And so in my day to day internship,
this is what I heard over and over again. You
(02:44):
have to really want to get into something that you'll
devote your life to and go into an amazing amount
of debt and come out of that on the other
side and maybe not be happy. So it was a
pretty strong disincentive for me. Yeah. So that was sort
of my initial foray into the, the sort of traditional
side of healthcare. And I decided that that was going
(03:08):
to be my life's work in a lot of respect
at the time. You know, when I looked around the table,
there weren't many young people who were going into healthcare administration.
The route was often you were a clinician of some
kind and were a really great clinician, and you got
promoted into a management position and you went on from
there were very few that sort of had leadership as
(03:29):
their focus. And so I thought this could be interesting.
And I went on with the same system for about
a decade. I did a lot of work in operations
and strategy and ended up running a variety of clinical
and non-clinical ops as part of that system. This particular
health system was interesting in the fact that now, 20
(03:53):
some odd years ago they hired a chief innovation officer.
They may have been one of the first health systems
in North America to do so. Pretty progressive CEO at
the time. This was a gentleman that came out of
the Silicon Valley. His focus was largely on business model
innovation and really helped the system to structure in a
(04:14):
very matrixed way service lines, which were the strategy and
innovation arm of the organization, and then hospitals which were
the operating arm. So I had this interesting role where
I was working in operations, looked at this innovation group
and raised my hand and say, Hey, I want to
be a part of that. That looks like something interesting.
My brain kind of works in that way, and so
(04:37):
made some promises that, you know, I would work nights
and weekends to be part of this group, but was
then exposed to very different ways of thinking and learning
and developing ideas, innovations that would stick and ultimately move
from strategy into operations, sort of uniquely positioned to see
both ends of it. And I think a light bulb
(04:59):
went off. Me at that point in my career, I said,
this is this is really where I belong. It's where
my healthcare innovation is. Yeah, I have something maybe unique
to contribute here. I've made that my life's work.
Jeff (05:11):
I'm not going to let you off the hook on
the fun personal tidbit, and we'll pivot to Kaiser Permanente.
David (05:16):
Roller coasters. I am a roller coaster junkie. In fact,
I have been on roller coasters on several continents. Often
when I go to a new place, a new destination
for travel, I will seek out a theme park and
look for the biggest, baddest roller coaster, Cedar Point in Sandusky, Ohio.
(05:37):
The roller coaster Mecca of North America is a place
I have spent hundreds and hundreds of hours. I love them.
All right.
Jeff (05:45):
Well, that is a fun fact. Okay. So your consulting
role led you to working with Kaiser Permanente as a consultant.
Tell us about that and how that kind of, I assume,
directly led you into this opportunity that you've taken now.
David (05:56):
Yeah, no, that's exactly right. So Kaiser Permanente had at
one point in time put out a design challenge, and
it was called the Small Hospital Big Idea competition. And
it was effectively an open source design competition to reimagine
the inpatient facility. And it was wildly successful. On the
(06:19):
heels of that, they decided that they wanted to do
something similar for their ambulatory facilities. That's how things were,
at least initially, defined. What is the mob of the future?
And so they invited a small number of firms, so
quasi open source to compete again around some very specific
innovation challenges. And my team and my firm were fortunate
(06:43):
enough to win that competition. And so that was my
first introduction to KP. And as we got into that
work that went on for many years with the organization,
and eventually they said, Why don't you come in-house and
build something here? And it's been that ever since.
Jeff (07:00):
That's great. Well, okay, so let's pivot. Let's pivot to
your change agenda. As vice president of innovation at Kaiser Permanente,
tell us about the kind of human problems you're solving,
whether they're consumer experience problems or physician workflow problems or
whatever the case may be?
David (07:17):
Yeah, it's really all of those things. You know, our
broad mandate is what we call delivery system modernization. And
that isn't to imply that what we have isn't modern
and forward leaning, but it's it's simply a North Star,
if you will, for us to dig in to opportunity,
where are the places where our members, our providers run
(07:39):
into dead ends, where the experience for them isn't optimal,
where there are pain points. Alternatively it's where is there
latent value that exists in the marketplace? Are there areas
that Kaiser Permanente should be looking at that we maybe
haven't looked historically that could add value to our business?
(08:00):
So those broadly are the things that we help the
organization look at its delivery system, modernization and how do
we create really new forms of value in service of
those different constituents?
Jeff (08:14):
Are there 1 or 2 that are either public or
close to becoming public or that you can kind of
hone in and tell us about the specific challenge, how
you're tackling and what we're going to see. And again,
not sure what you can share, but I'd love to
know what you can.
David (08:30):
Well, as you can imagine, a lot of the work
that we do is held pretty tightly to the vest
because our charge, again, under that sort of umbrella of
delivery system modernization, is to help the organization think about
where it goes next. If you think about a strategic plan,
our work may be 3 to 5 years out from
(08:51):
that plan, right? Testing, looking at opportunities, working future or
market back. How do we solve human need business needs
simultaneously kind of testing core assumptions around some of those
possibilities and ultimately whittling them down to 1 or 2
solutions which in a couple of years become core to
the business. So that's a general answer. I'll say. I
(09:16):
think part of what we and many organizations are looking
at now broadly is how do we really effectively take
care of populations? How do we extend evidence based care
and population health to more people in more places? The benefit,
(09:36):
of course, of Kaiser Permanente historically is that our business
model had these has these really well aligned incentives, right?
We're a payer and we're a provider. And so we
are incentivized to do things that others are not like
to invest in prevention and screening and and so forth.
When you get out of that sort of integrated or
(09:58):
closed model into a multi. Payer environment, things become instantly
more complex. And so if we want to extend our influence,
we've got to think about how do we do that
and how do we do that well. And so generally,
those are the kinds of things that, you know, we're
starting to dig into. How do you extend the benefits
(10:18):
of the integrated model to more people and more places?
Sounds like it might be an easy thing to do,
but it's actually quite complicated as you get into it.
Jeff (10:29):
Even for Kaiser Permanente.
What are some of the barriers, the biggest barriers still
to be solved and enabled to deliver true health care
value and reduce waste in the system and improve the
outcomes and all the things that go with it.
David (10:43):
It's multifactorial, Jeff, as you would imagine. So I'll give
you some perspective on this. But it's it's complex, right?
I think, you know, one is increasingly, even within an
integrated system like KP, increasingly, if you want to cater
to a member's preference for choice, things become very complex
(11:07):
very quickly because they have options of where they go.
So as an example of that, Kaiser Permanente today operates
in only a handful of states, mostly on the West Coast, Hawaii, Colorado,
Georgia and the mid-Atlantic states. People go on vacation and
(11:27):
they vacation in places that are not in our geographic footprint.
Sometimes they need health care services.
Jeff (11:34):
Right? Right.
David (11:34):
So we have recently implemented what we call a 50
state solution, which allows Kaiser Permanente members to get care
that is quote unquote, in-network, if you will, irrespective of
where they may be geographically. Now consider that a Kaiser
Permanente member, when they interface with us within our geographic footprint,
(11:59):
they get a certain type of care and service and
experience which they likely want replicated elsewhere as a member.
That is a core difficulty to solve for right in
the context of value based care. So now the member
patient consumer has choice. They've gone to a place that
(12:20):
is in this use case outside of our four walls.
How do we solve for that? Well, you've got to
have a pretty sophisticated data capability to be able to say, okay, well,
somebody has gotten service at a place that's outside of
our system, but I still need visibility to what's gone
on there because that is part of their holistic health record,
(12:43):
if you will. Yeah, I need some way of saying, look,
the Kaiser Permanente standard of care looks like this. How
do I ensure that that member gets it through somebody else?
So I think these are some of the core challenges.
And then of course, you get into some of the
human components which are I can develop a pretty elegant
(13:06):
system to achieve those goals, but then I have to
get others to adopt those capabilities, those solutions, and I've
got to incentivize them in the right way. And so
if you just take that one use case and extract,
you can start to see that these are the same
challenges of value based care writ large. Yeah.
Jeff (13:28):
Scale incentives, adoption, adoption, all kinds of things. Yeah. Okay.
That's great. Let me ask you about one specific thing.
I'll ask you to futurecast a little bit. How successful
or how pervasive or how much use will there be
of kind of hospital at home? If you were to guess,
where is it going to be three years from now
and why are you excited about it? And maybe what
(13:48):
are some of the barriers there as well?
David (13:50):
Yeah, well, as a good innovator would do well, reframe
the question slightly and say, I think hospital at home
is a very specific component of care in the home,
and that is a specific component of care outside of
the four walls of ability. And I think that is
absolutely the direction that the industry is headed and needs
(14:11):
to head three years on. You know, I think that
part of the industry will continue to evolve. I think
if you say, look, we want to do more in
the home. That's the core objective. What are the difficulties
that we have to solve to be able to do that? Well,
and I think one of the core difficulties is around
(14:33):
last mile logistics. This is a thing that this part
of the industry is going to have to figure out.
And it's not historically been in our wheelhouse to do so.
So you think about Amazon's ability to get really just
about any packaged good, any consumer good to you relatively
quickly in some instances, even same day. They do that
(14:54):
because they have a combination of a technology platform that
integrates with physical warehouses. Right. They've got a whole distribution
strategy that puts those two things together. That hasn't really
been how the health care industry has thought historically. We
haven't had that need. But if you're going to start
doing more and more in the home environment. You now
(15:18):
have to think about problems like that. That is a
core difficulty to solve. Remote workforce management. Where do I
have specific people specific expertise at any given point in time,
and where are they relative to a patient that needs
them at that same moment in time? The technical infrastructure
many of us probably take for granted that in our
(15:40):
homes we have reasonable Wi-Fi and good broadband. But many
of our members, many communities across the US are broadband
deserts for a variety of reasons. Either good broadband isn't
available or it's available at a price that's unreasonable. So
that becomes another core difficulty to solve if we're going to,
(16:03):
you know, sort of allow for hospital and health care
at home models to be equitable, which is a core
principle for us. So I'm absolutely optimistic about where that
part of the industry will go. It is the right
place for us to move for a variety of reasons.
I also think we have to get real about some
of the core difficulties that must be solved to really
(16:25):
unlock that model at scale.
Jeff (16:27):
That's great. David We call this podcast the Health Care
Changemakers Podcast, so it's been great to have you on.
My parting question for you is what lessons would you
give for the aspiring changemaker or changemaker wannabe?
David (16:40):
It's a great question. There is a technology futurist in
the Silicon Valley, Paul Saffo. And Paul has this quote
that I use quite often. It's, I think, part of
my innovation DNA, if you will, and the quote is
never mistake, a clear view for a short distance. And
(17:02):
my interpretation of that is this. I think we get
to a place in innovation where the idea, the solution
is clear. It may be a good one, a really
good one. It may be, in fact transformational, or at
least we have that belief. But innovation, particularly in complex organizations,
(17:26):
is as much about social connection, relationships, politics, how you
get things done. How you rally people around a change agenda.
It's as much or more about all of that than
it is about the idea itself. It's understanding the complexities
(17:49):
of the organization that are required to actually drive innovation,
not just the whiz bang idea.
Jeff (17:57):
It's a great insight and explains why. The thing we
tried 3 or 4 years ago and gave up on
doesn't mean it was a bad idea then and doesn't
mean we shouldn't reconsider it now. Right. Because so many
of those other things could have changed. The politics, the relationships,
the connections, the macro environment all could have changed since
we last considered it, right?
David (18:17):
That's right. That's right.
Jeff (18:19):
Well, that was very well said, David. Thank you. It
was a pleasure to have you on. David Grandy, vice
president of innovation at Kaiser Permanente.
Anna (18:33):
Thanks for listening to Prophets Healthcare Transformers Podcast. This podcast
is produced by Jared Johnson and his wonderful team at
Shift Forward Health and a big thank you to our
hosts Priya Nasir, Lindsey Mosby, Paul Shrimp and Jeff Gordy.
If you like today's episode, you can find more great
content like this at prophet.com/thinking. I'm Anna Kuno, the senior
(18:54):
editor of this podcast. Thank you for listening.
Hello and welcome to Prophets Healthcare Changemakers podcast, where we'll
be talking to leaders in healthcare who are focused on
transforming their organizations to drive the next level of growth
for their business and for healthcare at profit. We believe
that the organizations that thrive in healthcare are those that
dare to change the game, striving to improve human health,
create better experiences and make the best of care and
(00:27):
enduring and sustainable reality for all. Those that will transform
health care are the changemakers. And for this podcast we
want to focus on them. Our podcast dials into and
recognizes the people behind the transformation and their journeys and
changing the game one story at a time. Are you
ready to dive in?
Jeff (00:47):
All right. This is Jeff Gorgie here with the Profit
Health Care Changemakers podcast. I'll be hosting this week's conversation,
and I'm very pleased to have with us David Grandy. David,
welcome to the podcast.
David (00:59):
Thanks, Jeff. Great to be here.
Jeff (01:01):
So, David, tell us a little bit about yourself and
take us back to your career path and what led
you to where you are, and then we'll get into
your current role next. But take us back to where
you've come from and where you've gotten to now and
give us one fun fact that maybe is on your
Facebook page, but not your LinkedIn page or maybe isn't
on social media at all if you're willing to share.
David (01:22):
So my career in healthcare started a couple decades ago. Now,
my first job out of college, I was the intern
for the chief medical officer of a multi hospital health system,
and it was a fascinating view of a lot of
layers of an organization. I think both the sort of
executive leadership layer as well as the physician relations layer as.
Jeff (01:46):
You do, you always know you wanted to work in
health care. How did you start there?
David (01:50):
It did. From the time I was very young, I
actually had some health issues, some pretty serious health issues
when I was a younger adult. And so I was
exposed to hospital life. And it was fascinating to me,
despite all the things that I was going through personally,
it was just interesting to me how all the different
parts and pieces and disciplines came together. And so I
(02:10):
think I knew from a pretty young age that I
wanted to go into a helping profession. And medicine initially
was where I thought I was was headed.
Jeff (02:19):
So to ask, did you think about what med school did?
David (02:22):
I did I actually one of my undergrad minors was
in biomedical sciences, so I checked all the boxes to
go to medical school, took the Mcat and ultimately decided
against in part because at that time. Physicians were very
unhappy people. And so in my day to day internship,
this is what I heard over and over again. You
(02:44):
have to really want to get into something that you'll
devote your life to and go into an amazing amount
of debt and come out of that on the other
side and maybe not be happy. So it was a
pretty strong disincentive for me. Yeah. So that was sort
of my initial foray into the, the sort of traditional
side of healthcare. And I decided that that was going
(03:08):
to be my life's work in a lot of respect
at the time. You know, when I looked around the table,
there weren't many young people who were going into healthcare administration.
The route was often you were a clinician of some
kind and were a really great clinician, and you got
promoted into a management position and you went on from
there were very few that sort of had leadership as
(03:29):
their focus. And so I thought this could be interesting.
And I went on with the same system for about
a decade. I did a lot of work in operations
and strategy and ended up running a variety of clinical
and non-clinical ops as part of that system. This particular
health system was interesting in the fact that now, 20
(03:53):
some odd years ago they hired a chief innovation officer.
They may have been one of the first health systems
in North America to do so. Pretty progressive CEO at
the time. This was a gentleman that came out of
the Silicon Valley. His focus was largely on business model
innovation and really helped the system to structure in a
(04:14):
very matrixed way service lines, which were the strategy and
innovation arm of the organization, and then hospitals which were
the operating arm. So I had this interesting role where
I was working in operations, looked at this innovation group
and raised my hand and say, Hey, I want to
be a part of that. That looks like something interesting.
My brain kind of works in that way, and so
(04:37):
made some promises that, you know, I would work nights
and weekends to be part of this group, but was
then exposed to very different ways of thinking and learning
and developing ideas, innovations that would stick and ultimately move
from strategy into operations, sort of uniquely positioned to see
both ends of it. And I think a light bulb
(04:59):
went off. Me at that point in my career, I said,
this is this is really where I belong. It's where
my healthcare innovation is. Yeah, I have something maybe unique
to contribute here. I've made that my life's work.
Jeff (05:11):
I'm not going to let you off the hook on
the fun personal tidbit, and we'll pivot to Kaiser Permanente.
David (05:16):
Roller coasters. I am a roller coaster junkie. In fact,
I have been on roller coasters on several continents. Often
when I go to a new place, a new destination
for travel, I will seek out a theme park and
look for the biggest, baddest roller coaster, Cedar Point in Sandusky, Ohio.
(05:37):
The roller coaster Mecca of North America is a place
I have spent hundreds and hundreds of hours. I love them.
All right.
Jeff (05:45):
Well, that is a fun fact. Okay. So your consulting
role led you to working with Kaiser Permanente as a consultant.
Tell us about that and how that kind of, I assume,
directly led you into this opportunity that you've taken now.
David (05:56):
Yeah, no, that's exactly right. So Kaiser Permanente had at
one point in time put out a design challenge, and
it was called the Small Hospital Big Idea competition. And
it was effectively an open source design competition to reimagine
the inpatient facility. And it was wildly successful. On the
(06:19):
heels of that, they decided that they wanted to do
something similar for their ambulatory facilities. That's how things were,
at least initially, defined. What is the mob of the future?
And so they invited a small number of firms, so
quasi open source to compete again around some very specific
innovation challenges. And my team and my firm were fortunate
(06:43):
enough to win that competition. And so that was my
first introduction to KP. And as we got into that
work that went on for many years with the organization,
and eventually they said, Why don't you come in-house and
build something here? And it's been that ever since.
Jeff (07:00):
That's great. Well, okay, so let's pivot. Let's pivot to
your change agenda. As vice president of innovation at Kaiser Permanente,
tell us about the kind of human problems you're solving,
whether they're consumer experience problems or physician workflow problems or
whatever the case may be?
David (07:17):
Yeah, it's really all of those things. You know, our
broad mandate is what we call delivery system modernization. And
that isn't to imply that what we have isn't modern
and forward leaning, but it's it's simply a North Star,
if you will, for us to dig in to opportunity,
where are the places where our members, our providers run
(07:39):
into dead ends, where the experience for them isn't optimal,
where there are pain points. Alternatively it's where is there
latent value that exists in the marketplace? Are there areas
that Kaiser Permanente should be looking at that we maybe
haven't looked historically that could add value to our business?
(08:00):
So those broadly are the things that we help the
organization look at its delivery system, modernization and how do
we create really new forms of value in service of
those different constituents?
Jeff (08:14):
Are there 1 or 2 that are either public or
close to becoming public or that you can kind of
hone in and tell us about the specific challenge, how
you're tackling and what we're going to see. And again,
not sure what you can share, but I'd love to
know what you can.
David (08:30):
Well, as you can imagine, a lot of the work
that we do is held pretty tightly to the vest
because our charge, again, under that sort of umbrella of
delivery system modernization, is to help the organization think about
where it goes next. If you think about a strategic plan,
our work may be 3 to 5 years out from
(08:51):
that plan, right? Testing, looking at opportunities, working future or
market back. How do we solve human need business needs
simultaneously kind of testing core assumptions around some of those
possibilities and ultimately whittling them down to 1 or 2
solutions which in a couple of years become core to
the business. So that's a general answer. I'll say. I
(09:16):
think part of what we and many organizations are looking
at now broadly is how do we really effectively take
care of populations? How do we extend evidence based care
and population health to more people in more places? The benefit,
(09:36):
of course, of Kaiser Permanente historically is that our business
model had these has these really well aligned incentives, right?
We're a payer and we're a provider. And so we
are incentivized to do things that others are not like
to invest in prevention and screening and and so forth.
When you get out of that sort of integrated or
(09:58):
closed model into a multi. Payer environment, things become instantly
more complex. And so if we want to extend our influence,
we've got to think about how do we do that
and how do we do that well. And so generally,
those are the kinds of things that, you know, we're
starting to dig into. How do you extend the benefits
(10:18):
of the integrated model to more people and more places?
Sounds like it might be an easy thing to do,
but it's actually quite complicated as you get into it.
Jeff (10:29):
Even for Kaiser Permanente.
What are some of the barriers, the biggest barriers still
to be solved and enabled to deliver true health care
value and reduce waste in the system and improve the
outcomes and all the things that go with it.
David (10:43):
It's multifactorial, Jeff, as you would imagine. So I'll give
you some perspective on this. But it's it's complex, right?
I think, you know, one is increasingly, even within an
integrated system like KP, increasingly, if you want to cater
to a member's preference for choice, things become very complex
(11:07):
very quickly because they have options of where they go.
So as an example of that, Kaiser Permanente today operates
in only a handful of states, mostly on the West Coast, Hawaii, Colorado,
Georgia and the mid-Atlantic states. People go on vacation and
(11:27):
they vacation in places that are not in our geographic footprint.
Sometimes they need health care services.
Jeff (11:34):
Right? Right.
David (11:34):
So we have recently implemented what we call a 50
state solution, which allows Kaiser Permanente members to get care
that is quote unquote, in-network, if you will, irrespective of
where they may be geographically. Now consider that a Kaiser
Permanente member, when they interface with us within our geographic footprint,
(11:59):
they get a certain type of care and service and
experience which they likely want replicated elsewhere as a member.
That is a core difficulty to solve for right in
the context of value based care. So now the member
patient consumer has choice. They've gone to a place that
(12:20):
is in this use case outside of our four walls.
How do we solve for that? Well, you've got to
have a pretty sophisticated data capability to be able to say, okay, well,
somebody has gotten service at a place that's outside of
our system, but I still need visibility to what's gone
on there because that is part of their holistic health record,
(12:43):
if you will. Yeah, I need some way of saying, look,
the Kaiser Permanente standard of care looks like this. How
do I ensure that that member gets it through somebody else?
So I think these are some of the core challenges.
And then of course, you get into some of the
human components which are I can develop a pretty elegant
(13:06):
system to achieve those goals, but then I have to
get others to adopt those capabilities, those solutions, and I've
got to incentivize them in the right way. And so
if you just take that one use case and extract,
you can start to see that these are the same
challenges of value based care writ large. Yeah.
Jeff (13:28):
Scale incentives, adoption, adoption, all kinds of things. Yeah. Okay.
That's great. Let me ask you about one specific thing.
I'll ask you to futurecast a little bit. How successful
or how pervasive or how much use will there be
of kind of hospital at home? If you were to guess,
where is it going to be three years from now
and why are you excited about it? And maybe what
(13:48):
are some of the barriers there as well?
David (13:50):
Yeah, well, as a good innovator would do well, reframe
the question slightly and say, I think hospital at home
is a very specific component of care in the home,
and that is a specific component of care outside of
the four walls of ability. And I think that is
absolutely the direction that the industry is headed and needs
(14:11):
to head three years on. You know, I think that
part of the industry will continue to evolve. I think
if you say, look, we want to do more in
the home. That's the core objective. What are the difficulties
that we have to solve to be able to do that? Well,
and I think one of the core difficulties is around
(14:33):
last mile logistics. This is a thing that this part
of the industry is going to have to figure out.
And it's not historically been in our wheelhouse to do so.
So you think about Amazon's ability to get really just
about any packaged good, any consumer good to you relatively
quickly in some instances, even same day. They do that
(14:54):
because they have a combination of a technology platform that
integrates with physical warehouses. Right. They've got a whole distribution
strategy that puts those two things together. That hasn't really
been how the health care industry has thought historically. We
haven't had that need. But if you're going to start
doing more and more in the home environment. You now
(15:18):
have to think about problems like that. That is a
core difficulty to solve. Remote workforce management. Where do I
have specific people specific expertise at any given point in time,
and where are they relative to a patient that needs
them at that same moment in time? The technical infrastructure
many of us probably take for granted that in our
(15:40):
homes we have reasonable Wi-Fi and good broadband. But many
of our members, many communities across the US are broadband
deserts for a variety of reasons. Either good broadband isn't
available or it's available at a price that's unreasonable. So
that becomes another core difficulty to solve if we're going to,
(16:03):
you know, sort of allow for hospital and health care
at home models to be equitable, which is a core
principle for us. So I'm absolutely optimistic about where that
part of the industry will go. It is the right
place for us to move for a variety of reasons.
I also think we have to get real about some
of the core difficulties that must be solved to really
(16:25):
unlock that model at scale.
Jeff (16:27):
That's great. David We call this podcast the Health Care
Changemakers Podcast, so it's been great to have you on.
My parting question for you is what lessons would you
give for the aspiring changemaker or changemaker wannabe?
David (16:40):
It's a great question. There is a technology futurist in
the Silicon Valley, Paul Saffo. And Paul has this quote
that I use quite often. It's, I think, part of
my innovation DNA, if you will, and the quote is
never mistake, a clear view for a short distance. And
(17:02):
my interpretation of that is this. I think we get
to a place in innovation where the idea, the solution
is clear. It may be a good one, a really
good one. It may be, in fact transformational, or at
least we have that belief. But innovation, particularly in complex organizations,
(17:26):
is as much about social connection, relationships, politics, how you
get things done. How you rally people around a change agenda.
It's as much or more about all of that than
it is about the idea itself. It's understanding the complexities
(17:49):
of the organization that are required to actually drive innovation,
not just the whiz bang idea.
Jeff (17:57):
It's a great insight and explains why. The thing we
tried 3 or 4 years ago and gave up on
doesn't mean it was a bad idea then and doesn't
mean we shouldn't reconsider it now. Right. Because so many
of those other things could have changed. The politics, the relationships,
the connections, the macro environment all could have changed since
we last considered it, right?
David (18:17):
That's right. That's right.
Jeff (18:19):
Well, that was very well said, David. Thank you. It
was a pleasure to have you on. David Grandy, vice
president of innovation at Kaiser Permanente.
Anna (18:33):
Thanks for listening to Prophets Healthcare Transformers Podcast. This podcast
is produced by Jared Johnson and his wonderful team at
Shift Forward Health and a big thank you to our
hosts Priya Nasir, Lindsey Mosby, Paul Shrimp and Jeff Gordy.
If you like today's episode, you can find more great
content like this at prophet.com/thinking. I'm Anna Kuno, the senior
(18:54):
editor of this podcast. Thank you for listening.
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