April 5, 2023 • 33 mins
In this episode of Healthcare Changemakers, our guest is Jodi Rosen, VP of Innovation and Digital Strategy at City of Hope. Join Jodi and host Jeff Gourdji as they discuss the foundations of City of Hope, and how innovation and human-centered design are practiced at the organization today.
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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):
Hello everybody. This is Jeff Gorgie with this week's podcast.
I'm very pleased to have with us Jody Rosen, who
is the vice president of innovation and Digital strategy at
City of Hope. Jody, welcome to the podcast.
Jodi (01:02):
Hello, Jeff, and thanks so much for having me on today.
Delighted to be here.
Jeff (01:06):
Good, good, good. It's a pleasure. So let's start and
we'll talk about your your current role and some of
your thoughts about health care. And I'm really excited to
get there. But I want to start with you. Tell
us about your career path and all the things that
led up to your current role and whether you start
(01:26):
here or whether you kind of wrap your answer. Make
sure you include at least one fun personal tidbit that
those that perhaps know you professionally don't necessarily know about you. Okay.
Jodi (01:38):
All right. Well, I'll try to do the last tidbit justice. Okay, cool.
But I think the thing to know about me, Jeff,
is that I'm a public health girl at heart and
I'm really motivated by what used to be the triple aim.
And today folks would talk about is the quadruple aim
of improving health of populations, improving patient experience, improving value
(02:04):
and reducing cost of care, and improving the work life
of health care providers. And those are really the core
values that I bring to the work that I lead.
I grew up in health care operations. I spent a
lot of my early career in federally qualified health centers,
community hospitals, Large and AMCs. And so I'm really I
(02:26):
deeply understand how care is delivered. And I'll date myself
a bit for for you and the audience. But growing
up in health care operations in the 90s, I was
really part of a lot of practices moving from paper
to an EMR or even 90s and into 2000, one
EMR to another and meaningful use and kind of adding
(02:48):
technology to how care is delivered. And that was really
formative for me. And so later in my career I
added in more user centered design from an engineering lens
to my public health and business skills. And I would
say throughout my health care career, I've spent time across
sort of the main healthcare ecosystem PS payer, pharmacy patient
(03:11):
and provider. But it really is that intersection of the
patient and the provider is kind of my sweet spot and,
and the place I love to work. And as my
career evolved, I moved more into health care strategy and
business development roles. I worked for a top ten academic
medical center in those in many of those roles and
(03:34):
really saw again, the first hand opportunity as well as
challenges that technology and digital can bring to care delivery,
patient experience, research and a growing workforce. And I had
the privilege to work on writing a strategic plan for
setting up an innovation department at Northwestern Medicine, where I
worked for almost nine years. And and then I had
(03:56):
the honor to be tapped to lead that department along
with a physician dyad leader, which I did. And we
focused on digital health innovation, clinical innovation system innovation. And
today I am leading digital innovation work at City of Hope.
And in that capacity and growing from all of my
(04:17):
years of experience. And we're really working to leverage digital
innovation at City of Hope to create new or enhanced
business processes and experiences or solutions to meet the needs
of our patients, our providers, our workforce and the larger
oncology community. And it's a very, very exciting time, as
(04:37):
we'll talk about to be at City of Hope is
we're delivering on a one city of Hope experience to
patients now across the country, which is super exciting. And
I'm not forgetting your fun question.
Jeff (04:51):
Good. I wasn't going to let you off the hook.
Jodi (04:53):
Don't let me off the hook. And so I think
maybe the fact that people don't know in my professional
life that maybe my personal friends would know is that
I'm a proud mama of five kids. And our our
very busy life spans kids five, 15 to 27 years
of age. My husband and I are super blessed with
(05:15):
a very, very full life and terrific kids. Sometimes that
when you go to bed with that many, you kind
of exhale and say like, Who did you text talk to?
What in-person conversation did you have? Like, is everyone doing okay?
And and I'll share this for you and for the
viewers as it's because I do think it's hard today
to kind of show up only professionally. I think, you know,
(05:37):
your personal life, your professional life, where we all are,
technology is all intersecting. And I think, you know, my
my husband and I are also managing. Sort of aging parents.
And so we're also at this sort of sandwich generation
at the moment. And it's very interesting to think about
across our sort of multigenerational crew, sort of that interesting
(06:00):
experience of how we are all accessing the health care
delivery system, but sort of the points in which our
family is accessing it is is very interesting. And I
just think that kind of working in health care, that
intersection of of the span of our ages, of our family,
including aging parents and showing up to work, it's it's
(06:21):
a very interesting time to think about that intersection of
both personal and professional.
Jeff (06:28):
Yeah, it's certainly one of those things that makes working
in health care real, right? Is that you talk about
it at work and then you experience it, right? And
that brings a lot of humanity, I think, to the
work that we do. And it's what drew a lot
of us, certainly including myself, to be excited about this
part of the of the of the world and the
world of business, which is where I entered from. And
(06:50):
I chose it for many of the reasons that you
talk about. Well, thank you for sharing that. So this
is this we call this podcast about the health care changemakers, right?
We're obviously trying to bring learnings and lessons about what
it takes to drive innovation and change. So now to
your point, you've done it at different types of health
care organizations, payers and otherwise. I'd love just to hear
(07:13):
your reflections around, you know, clearly you've learned some stuff, right?
We all have. But if there were some lessons about
driving innovation and driving change in health care that you
wish you knew back when fax machines and paper to
EMR was all the was all was new.
Jodi (07:32):
Yeah. Well, obviously I gave myself away because I said
growing up in health care operations in the 90s so
I know the wounds are pouring. Sultan But I'll think
some of the advice I'd tell, you know maybe my
my younger self and health care and definitely in the
innovation space is it's a team sport and that innovation
(07:55):
work by definition is multidisciplinary and knowing how to innovate
and transform in highly matrix systems is so, so, so important.
And especially in health care, where oftentimes our systems are
highly siloed and inner innovation really can be fostered at
(08:15):
higher speeds with greater agility to this kind of product
development program development aspect of design. Develop test, iterate when
cross-functional teams get pulled together. And and I also think
along those lines of interdisciplinary team engagement is really bringing
end users and stakeholders into the process early on. They
(08:37):
can add so much value related to to user centered design.
And so I think those very novel transformative approaches to
complex health care delivery challenges really can be solutions through
that sort of team mentality. I think another lesson I've
(08:58):
learned with age and a couple gray hairs would be
I think about kind of Aaron Burr saying to Hamilton,
Talk less, smile more. And really I think that is
like that. The emphasis is listen more. And I do
believe your patients, your workforce tells you what they want.
And listening is a great place to begin with innovation.
(09:22):
And I briefly mentioned in my intro, but later in
my career, about maybe ten, 12 years ago, I had
the privilege of doing some executive education and learning in
the design innovation space with roots in engineering and business.
And my training allowed me to more formally grow my
skills in applying human centered approaches to problem solving and
expanding my product design and development skills, and also kind
(09:45):
of leading with research methodology around innovation to ensure health
care products and programs I was building, leading were being
developed with those users in mind. And so I think
it is this listening more and leveraging user centered design
really does allow organizations to ensure the needs of their
users are front and center in the solutions in the
(10:06):
product development and the new program offering space.
Jeff (10:09):
Well, I think that's our first Hamilton reference on this podcast.
I thank you for that. But addition to that, thank
you for those lessons. So my observation, Jody, and I
think it's consistent with what you're saying is that I
have the privilege of working with a lot of different
health systems, and sometimes I see their plans and sometimes
I'm involved in creating the plans. But there's a lot
of commonality, right? Things that sound obvious, right? If we
(10:31):
can reduce these friction points in the journey and create
online scheduling and physician reviews and there's some greatest hits, right,
that tend to come up over and over again and
it begs the question. Is that innovation. And for me,
the answer is it's innovation. If you haven't done it yet, right.
It doesn't have to be a new, fresh idea that
no one's ever thought of. The game is is not
(10:51):
necessarily that. It's how do you do it? Is that
consistent with the lessons you shared? I think it is.
Jodi (10:56):
It is. It is. And I sometimes think about innovation.
And.
Specifically digital.
Innovation is like a Maslow's hierarchy of need pyramid. Yeah.
Whereas by the bottom.
Foundation of that pyramid, which is wider right and steadier.
You've got some.
Of the core functionality of growing maturity. And so again,
(11:18):
back to kind of basics for adoption, sometimes one instance
of an EMR interoperability across sites of care kind of basics,
and then systems begin to especially through a provider lens,
I'm going to say in kind of a patient journey lens,
they digitize the basic processes. So you mentioned things like
online scheduling and bill pay and messaging your doctor, like
(11:40):
the real kind of digitization of the basic processes. And
then from a.
More stable core, you can move up and do digitize
some of the clinical processes. We've seen explosion with the.
Pandemic of virtual care, asynchronous and synchronous modalities, remote patient monitoring,
and then from.
Kind of some of those clinical decision support tools. But
then really at the top, you get to really have
(12:03):
more of that.
Kind of transformative design, patient centered.
Tools, proactive intelligence.
Solutions that leverage big data, AI interactions and platforms.
And so we think to your point, Jeff, I'd.
Say.
Sometimes it's very hard for.
Organizations to do that top of the pyramid when their
bottom structure still has a lot of growth. And so we.
(12:25):
Think it's I think it's both.
I think it's you can have sort of both pieces,
one in each hand, you can work on continuing to
grow the.
Core.
And strengthen some of those basics that for some are
core innovations, but.
But really vital. And they are innovative in their own way.
But then finding a way to carve out a path
for for more, you know.
(12:46):
Adjacent transformational type innovations really and key to.
Jeff (12:50):
So that's interesting. Jody, your pyramid, if you will, or
your step changes in ambition as you go from the
online scheduling to the proactive intelligence. And some of the
things you talked about is clear. But I hadn't thought
about it as a as a pyramid in that the
base is required. Is that just from like a confidence
building we talked about people and overcoming fears is do
(13:12):
you really need to do the basic stuff first because
it builds internal confidence and builds a case for change?
Or is there another reason you describe it as necessary
to come before you get to the top of the pyramid?
Jodi (13:23):
I think it's a little bit of both. I think for.
Me, intersection innovation really happens.
At that intersection of people process technology.
So from a pure technical lens.
Not even digital, I think of digital is like how
people use the technology. But from a.
Pure technical.
Some of that base in core is needed.
So that your main infrastructure.
Is there, that you have, you know, more advanced.
(13:46):
Whether it's security.
Cloud.
Core, you know, one instance.
Interoperability to talk to your sites of care.
So some of it is you really need it from
a technical perspective and a digital perspective. The other piece
is really organization culture.
I think, Jeff, some of the work that you've really
led and kind of builds confidence amongst the workforce, if again,
(14:09):
it's the people in the process.
Sometimes and that three legged stool of people process.
Technology, that's the hard stuff. Sometimes the technology is the
super easy piece.
Jeff (14:18):
Right? Right. With the right budget.
Jodi (14:20):
Right. So true.
Jeff (14:22):
That's right. Okay. So let's pivot to talking about City
of Hope. So first, tell us what led you there?
What made you say, wow, there's something really cool that
I can affect and I can change? And then I'm curious. Obviously,
as much as you're willing and comfortable to share about
what's the change agenda look like and where is City
of Hope going, going to bring some of that digital
(14:44):
and innovation in the next 2 or 3 years? Those
of us that read the headlines know about the recent
not so recent, perhaps acquisition of cancer Treatment Centers of
America and the rebranding. So I assume that's part of
the story, but I'd love to, but maybe it's not.
I'd love to hear from you. What led you there
and what's the change agenda now for sure?
Jodi (15:04):
Well, I'm excited. Let me let me kind of take
you back a little.
Because it'll it'll lay the groundwork for what.
Excited me about the opportunity.
And so the City of Hope story really began.
In.
1913 when a group of volunteers, spurred by.
Compassion.
For helping those who had tuberculosis, established what at the.
(15:25):
Time was known as the Jewish.
Consumptive.
Relief Association.
And they raise money to start a free.
Non-sectarian tuberculosis sanitarium, which is in Duarte, which today is
where our main hospital campus is located. And.
Really that launched a.
Century now journey that is placed City of Hope at
(15:46):
the forefront of our nation's leading medical and research institutions.
And by the mid 1940s or so, thanks to the
discovery of.
Antibiotics.
Tuberculosis was on the.
Decline in the US. And so City of.
Hope really rose to the next.
Challenge and tackled the disease of cancer as well as
(16:09):
diabetes and later HIV and AIDS and other rare diseases.
And so.
City of Hope has always been.
An innovative institution and has led significant advances in modern medicine,
including the first synthetic human.
Insulin.
Technology behind widely used cancer.
Fighting drugs. And today, City of Hope's a designated.
(16:31):
Comprehensive cancer.
Center, which is.
The highest ranking.
Bestowed.
By the NCI, the National Cancer Institute.
And we're a founding.
Member of the National Comprehensive Cancer Network. And so I
share all of that with you, because this was an
opportunity to be at a growing health care organization that
(16:55):
is nearly singularly focused on one disease state. And that
was very, very attractive to me. Innovation requires.
Significant strategic focus.
And direction and culture. We're just talking a little bit
about that and the opportunity to innovate deeply in a
focused disease state through a lens of equity and access
(17:17):
and best patient experience and provider experience was was very,
very exciting to me. And you did mentioned that a
recent acquisition of Cancer Treatment Centers of America, you know,
City of Hope is now able to share that expertise century,
a century of expertise to benefit a greater number of
(17:39):
patients in even more communities. And we did recently announced
just a bit over a week ago, the transition of
our locations to our City of Hope brand as we
hit the one year integration milestone as a national cancer
research and treatment health system. And it really allows us
(18:01):
to continue.
To commit.
To democratizing cancer care. And and I think that was
a third thing that really spoke to me. Again, back
to my public health training. It lends itself very well.
To all of.
Those quadrupling kind of core values that I have.
And even a lot.
Of what's happening now in discussion of adding kind of
(18:23):
a fifth theme around health equity and and City of
Hope is is very passionately working in that space, which
is exciting. Um, and I can, I can speak to
that a little bit more just to kind of maybe
do a bit of a double click on that because when.
You look at.
Where the challenges are in health care outcomes and experience
and cost of care and where the workforce suffers most,
(18:46):
Jeff it really is often and under resourced communities and,
you know, oftentimes communities that have been oppressed. And so that.
Inclusion.
Of equity and democratization is is so important and City
of Hope, in addition to its clinical care and research,
(19:07):
we have led many successful efforts to advocate for equity,
including our involvement in passing the California Cancer Care Equity Act.
Which really enables.
The most vulnerable populations in California to seek optimal cancer
care services and access.
To subspecialists.
(19:27):
And clinical trials.
And while the.
Impact of cancer care innovation has been very positive, cancer
care advancements are resulting in rapidly improved patient outcomes. Cancer
death rates in the US have decreased about 33% over
the past 30 years, since a peak in the early 90s.
(19:48):
Yet access to that optimal care is is still an issue.
And this is.
Concerning because over 80% of cancer care is delivered out
in the community and so there's lots of of health
equity implications and being able to address that is so important.
(20:09):
And and at the roots of sort of who we
always have been and as part of the work we
have ahead of us. So it's a very exciting time
to be part of the organization.
Jeff (20:20):
Yeah, for sure. So what's, what's what's coming?
Jodi (20:24):
So a lot of strategic.
Effort in a multi-pronged approach to address some of the
the disparities. You know, cancer death rates are higher among
people with lower socioeconomic status compared to people with higher
we know. African American men have over 110% and African
(20:49):
American women have 39% higher risk of dying from sequentially.
First prostate cancer. Second, breast cancer for women compared to
their white counterparts. We know Hispanic women experienced stomach cancer
incidents and deaths almost twice as often as white women.
So our approach to begin to transition to.
(21:12):
Locations that are City of Hope begins to have standard of.
Care.
Democratization and access to clinical trials and.
Begins to to break.
Down some of these siloed experiences with with access to
subspecialty expertise.
And ability to partner in communities where more.
(21:33):
Sort of generalized oncology care is delivered. So it's.
A it's a very exciting.
Time and we have.
A workforce of over 11,000 team members, over 600 physicians.
More than a thousand scientists and.
Research that are.
Kind of spanning now not just California, but Arizona, Georgia
(21:54):
and Illinois. So yeah, yeah, lots ahead, lots happening and
couldn't be couldn't be more proud to be part of
the organization right now.
Jeff (22:03):
Yeah. So much of what is known in clinical care
is based on codifying and pattern recognition of the past. Right.
But to your point, the limitation on that is a
lot of the pattern recognition has been based on, you know,
white men, right? To put it most, most bluntly and
most simply. And I think part of what a lot
(22:25):
of organizations are doing and the benefit of scale is
sometimes so you can arm wrestle with with with Blue
Cross Blue Shield better. But but really, it's around getting
to these solutions. And what I think I'm hearing is
for City of Hope, expanding its footprint is part and parcel,
not just to delivering the great value you already provide
to the communities in Los Angeles, but to build to
(22:47):
a step change increase in how you add value. How
do you get to these answers requires the scale to
be able to get at some of these health inequities
that you addressed.
Jodi (22:54):
Absolutely. Absolutely. I mean.
We both know that, you know.
Sadly, care and in the case of oncology, survival is
often directly dictated by your zip code. Right? It's the
work that the CDC has been doing on their 500
cities project, which uses health data, I think from over
100 million people. And those statistics really show where you
(23:19):
live affects your health and ecology, but across a whole
host of other disease states. You know, I alluded to before,
I really think about innovation happening at that intersection of people,
process and technology and kind of viewing it as like
a three legged stool. And so I.
Think leading with people allows us to build empathy and
(23:42):
deeply understand.
The needs of our patients.
It allows us to better.
More effectively, efficiently connect people and collapse barriers. And again,
back to kind of what would you have told your
younger self. You know.
Multidisciplinary teams are so important and so that people piece
of that the opportunity to work together.
(24:05):
To incubate ideas.
Solve problems, build, bring clinical.
Practitioners together with researchers, together with the community.
Leading with people. So important.
I think.
You know, the second leg of that stool leading with.
Process. So allowing us to optimize.
Workflow with human centered design approaches, right as we are.
(24:26):
Creating a fabric across the country of a national cancer
research and.
Treatment center, being able to really.
Deeply understand the.
Workflows and.
Approaches.
Ensure cross department.
Collaborate.
And then I think part of the process too is,
is a bit of the culture piece.
(24:47):
And having a safe space to.
Test, to.
Iterate. And, and sometimes it's part of innovation, right? To
fail forward and build on those learnings and experiences. What
worked in one community may not work in another.
Or what works in one community is is incredible to
be replicated in another. So I think that process piece
is huge.
And then.
The third leg of the stool I.
(25:08):
Think is really leading with technology because the technology is
the enabler. It allows us to enable the people in
the process and that's some of your your human centric
model as well, and that we can ensure we can
integrate and automate the processes so.
That solutions are.
Data driven. They allow us to.
Accelerate a.
Rapid rate and.
Reach more, more.
People and break down some of those siloed experiences of
(25:31):
oncology care and other rare disease care that that we
were talking about.
So I think that's that's really, really important.
And so.
Hope is going to continue to lead with our people.
It's our greatest asset.
But as we become a national cancer research and treatment system,
(25:51):
a treatment center and system, we, like many health care providers,
have to continue to build those digital experiences using our technology.
To meet those.
Unique needs of our patients and our workforce and the
larger oncology community and and to reach them where they are.
And digital provides that opportunity to do it. And, you know, think.
(26:16):
I love the work that Eric Topol.
Talks about in terms of like the value of leveraging technology,
not to.
Replace people. And I think that's so important. I think
that we need to think.
About leveraging new technology, new AI, new solutions.
To ensure we can make medicine better, and.
(26:39):
That we can also, in addition to using some of
these digital technology experiences, we can free doctors and clinicians
from the the tasks that.
Interfere with human connection.
And we can actually use the technology to give clinicians
back the gift of time and restore the care and
(27:00):
health care. So I continue to see that as part
of building on the framework that you all have around
kind of your your human centric model and and how
that that aligns with a lot of the work we're
doing to.
Jeff (27:14):
Yeah. Yeah. It strikes me that since the beginning of
probably going back to the Industrial Revolution or beyond, right,
there's been this fear of technology replacing humans or machines,
replacing humans, and maybe those fears are still legit now
for different reasons. But boy, it just seems like the
demographics suggest that we don't have to worry so much
(27:34):
about being replaced. There are not enough. As one of
our one of my clients said to me once, there's
not enough humans being born to take care of the
humans that have already been born. Right.
Jodi (27:42):
As we have an enormous amount of our population entering
into their 65 plus years of age and living longer.
And again, I think while it worries me.
That we need to be able to.
Compete with the rapid evolution of changing models of care,
(28:03):
whether it's care at home, ensure that the.
Workforce is working at top of.
License, right? Not eliminating anybody, but getting everyone to work
at top of license and that.
We won't be as bold as we need to.
About driving some of those changes to meet the ever
(28:24):
growing needs of truly an aging population. So I think
that would be a worry, but also a great challenge
and opportunity. And I can then add to the the
worry with the excitement because I'm that's sort of how
I roll. I want to look at things in a
in a in a better lens. And I am very
(28:44):
excited by the growth of omnichannel care delivery that we
are seeing up and down the healthcare ecosystem. We're seeing
new models of partnership between folks who used to not
talk to each other, right, whether that's payer, provider.
Provider.
Digital health, startup.
Research and advocacy.
Groups. It's very exciting. And, you know, we have to.
(29:06):
Remember that.
Our patients, our.
Workforce.
Our providers are.
Digital.
Consumers in every other part of their lives. And so
we must as a health care industry, be giving them
the tools.
To manage their care that they.
Have been used to managing in every other part of
their lives. And so we can no longer have them,
(29:29):
you know, continuing to do analog ways of business where
every other part of their business life, they have gone digital.
So I think that's that's the exciting opportunity and I
will share that. I think another very exciting opportunity for
me has been that COVID actually.
Brought to the.
Forefront a lot of conversations around clinical trials that maybe
(29:55):
hadn't existed before. So, you know, the vast majority of.
The world was.
Talking about clinical trials and when we'd have a vaccine, right.
And and those became dinnertime conversations, conversations on Zoom, right
when we weren't gathering with people. And the vast majority
of families pre March of 2020 never talked about a
(30:18):
clinical trial. And so.
That begins.
To build on democratizing access to macro awareness in this
convergence of this health care delivery ecosystem that sometimes has
been a.
Laggard to.
The digital party and to the disruption party. And I'll
(30:38):
end kind of with a personal story on this one.
And for me.
My first friend in life.
Was Felicia, and she lived three houses away from me.
We were born five days apart and our moms were
best friends. And Felicia and I grew up together. And
(31:01):
just as Felicia's life was launching, she.
Had graduated from law.
School. She had gotten married. She was giving back to
her community. She was diagnosed with breast cancer.
And this was back in the early 90s.
And she had an aggressive form. And when standard protocol
therapies were not working, she did participate in a clinical trial.
(31:24):
And I remember learning about clinical trials throughout the course
of my public health, schooling and in research.
Articles, maybe reviewed as.
I was getting my MPH. But I never knew anyone
who was part of a clinical trial. And I don't
even think I'd ever spoken about a clinical trial with
friends or family. And sadly, the clinical trial came too
(31:47):
late for Felicia, and we lost her far too young.
At 26, my first friend in life was gone. And
I share this story with you because although.
Clinical trials.
Conversations have become mainstream at dinner tables on Instagram.
And TikTok, not everyone has.
(32:09):
Access to trials or the awareness. And this democratization of
oncology care that we are leading at City of Hope.
This is the work around education best in class National
Cancer Institute and CI Designated care, holistic care.
Supportive.
(32:29):
Care that we are leading now across the country. And
that fuels me each and every day.
Jeff (32:40):
Well, I think we are all I think I can
speak for everyone who will listen here. We're all rooting
for you personally and we're rooting for the City of
Hope because what you talk about is important and it's inspiring.
Jody Rosen, vice president of innovation and digital Strategy City
of Hope. Thank you for being on the podcast.
Jodi (32:58):
Thanks so much for having me. Really appreciate it.
Anna (33:09):
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 profit slash thinking. I'm Anna Kuno,
(33:29):
the senior 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):
Hello everybody. This is Jeff Gorgie with this week's podcast.
I'm very pleased to have with us Jody Rosen, who
is the vice president of innovation and Digital strategy at
City of Hope. Jody, welcome to the podcast.
Jodi (01:02):
Hello, Jeff, and thanks so much for having me on today.
Delighted to be here.
Jeff (01:06):
Good, good, good. It's a pleasure. So let's start and
we'll talk about your your current role and some of
your thoughts about health care. And I'm really excited to
get there. But I want to start with you. Tell
us about your career path and all the things that
led up to your current role and whether you start
(01:26):
here or whether you kind of wrap your answer. Make
sure you include at least one fun personal tidbit that
those that perhaps know you professionally don't necessarily know about you. Okay.
Jodi (01:38):
All right. Well, I'll try to do the last tidbit justice. Okay, cool.
But I think the thing to know about me, Jeff,
is that I'm a public health girl at heart and
I'm really motivated by what used to be the triple aim.
And today folks would talk about is the quadruple aim
of improving health of populations, improving patient experience, improving value
(02:04):
and reducing cost of care, and improving the work life
of health care providers. And those are really the core
values that I bring to the work that I lead.
I grew up in health care operations. I spent a
lot of my early career in federally qualified health centers,
community hospitals, Large and AMCs. And so I'm really I
(02:26):
deeply understand how care is delivered. And I'll date myself
a bit for for you and the audience. But growing
up in health care operations in the 90s, I was
really part of a lot of practices moving from paper
to an EMR or even 90s and into 2000, one
EMR to another and meaningful use and kind of adding
(02:48):
technology to how care is delivered. And that was really
formative for me. And so later in my career I
added in more user centered design from an engineering lens
to my public health and business skills. And I would
say throughout my health care career, I've spent time across
sort of the main healthcare ecosystem PS payer, pharmacy patient
(03:11):
and provider. But it really is that intersection of the
patient and the provider is kind of my sweet spot and,
and the place I love to work. And as my
career evolved, I moved more into health care strategy and
business development roles. I worked for a top ten academic
medical center in those in many of those roles and
(03:34):
really saw again, the first hand opportunity as well as
challenges that technology and digital can bring to care delivery,
patient experience, research and a growing workforce. And I had
the privilege to work on writing a strategic plan for
setting up an innovation department at Northwestern Medicine, where I
worked for almost nine years. And and then I had
(03:56):
the honor to be tapped to lead that department along
with a physician dyad leader, which I did. And we
focused on digital health innovation, clinical innovation system innovation. And
today I am leading digital innovation work at City of Hope.
And in that capacity and growing from all of my
(04:17):
years of experience. And we're really working to leverage digital
innovation at City of Hope to create new or enhanced
business processes and experiences or solutions to meet the needs
of our patients, our providers, our workforce and the larger
oncology community. And it's a very, very exciting time, as
(04:37):
we'll talk about to be at City of Hope is
we're delivering on a one city of Hope experience to
patients now across the country, which is super exciting. And
I'm not forgetting your fun question.
Jeff (04:51):
Good. I wasn't going to let you off the hook.
Jodi (04:53):
Don't let me off the hook. And so I think
maybe the fact that people don't know in my professional
life that maybe my personal friends would know is that
I'm a proud mama of five kids. And our our
very busy life spans kids five, 15 to 27 years
of age. My husband and I are super blessed with
(05:15):
a very, very full life and terrific kids. Sometimes that
when you go to bed with that many, you kind
of exhale and say like, Who did you text talk to?
What in-person conversation did you have? Like, is everyone doing okay?
And and I'll share this for you and for the
viewers as it's because I do think it's hard today
to kind of show up only professionally. I think, you know,
(05:37):
your personal life, your professional life, where we all are,
technology is all intersecting. And I think, you know, my
my husband and I are also managing. Sort of aging parents.
And so we're also at this sort of sandwich generation
at the moment. And it's very interesting to think about
across our sort of multigenerational crew, sort of that interesting
(06:00):
experience of how we are all accessing the health care
delivery system, but sort of the points in which our
family is accessing it is is very interesting. And I
just think that kind of working in health care, that
intersection of of the span of our ages, of our family,
including aging parents and showing up to work, it's it's
(06:21):
a very interesting time to think about that intersection of
both personal and professional.
Jeff (06:28):
Yeah, it's certainly one of those things that makes working
in health care real, right? Is that you talk about
it at work and then you experience it, right? And
that brings a lot of humanity, I think, to the
work that we do. And it's what drew a lot
of us, certainly including myself, to be excited about this
part of the of the of the world and the
world of business, which is where I entered from. And
(06:50):
I chose it for many of the reasons that you
talk about. Well, thank you for sharing that. So this
is this we call this podcast about the health care changemakers, right?
We're obviously trying to bring learnings and lessons about what
it takes to drive innovation and change. So now to
your point, you've done it at different types of health
care organizations, payers and otherwise. I'd love just to hear
(07:13):
your reflections around, you know, clearly you've learned some stuff, right?
We all have. But if there were some lessons about
driving innovation and driving change in health care that you
wish you knew back when fax machines and paper to
EMR was all the was all was new.
Jodi (07:32):
Yeah. Well, obviously I gave myself away because I said
growing up in health care operations in the 90s so
I know the wounds are pouring. Sultan But I'll think
some of the advice I'd tell, you know maybe my
my younger self and health care and definitely in the
innovation space is it's a team sport and that innovation
(07:55):
work by definition is multidisciplinary and knowing how to innovate
and transform in highly matrix systems is so, so, so important.
And especially in health care, where oftentimes our systems are
highly siloed and inner innovation really can be fostered at
(08:15):
higher speeds with greater agility to this kind of product
development program development aspect of design. Develop test, iterate when
cross-functional teams get pulled together. And and I also think
along those lines of interdisciplinary team engagement is really bringing
end users and stakeholders into the process early on. They
(08:37):
can add so much value related to to user centered design.
And so I think those very novel transformative approaches to
complex health care delivery challenges really can be solutions through
that sort of team mentality. I think another lesson I've
(08:58):
learned with age and a couple gray hairs would be
I think about kind of Aaron Burr saying to Hamilton,
Talk less, smile more. And really I think that is
like that. The emphasis is listen more. And I do
believe your patients, your workforce tells you what they want.
And listening is a great place to begin with innovation.
(09:22):
And I briefly mentioned in my intro, but later in
my career, about maybe ten, 12 years ago, I had
the privilege of doing some executive education and learning in
the design innovation space with roots in engineering and business.
And my training allowed me to more formally grow my
skills in applying human centered approaches to problem solving and
expanding my product design and development skills, and also kind
(09:45):
of leading with research methodology around innovation to ensure health
care products and programs I was building, leading were being
developed with those users in mind. And so I think
it is this listening more and leveraging user centered design
really does allow organizations to ensure the needs of their
users are front and center in the solutions in the
(10:06):
product development and the new program offering space.
Jeff (10:09):
Well, I think that's our first Hamilton reference on this podcast.
I thank you for that. But addition to that, thank
you for those lessons. So my observation, Jody, and I
think it's consistent with what you're saying is that I
have the privilege of working with a lot of different
health systems, and sometimes I see their plans and sometimes
I'm involved in creating the plans. But there's a lot
of commonality, right? Things that sound obvious, right? If we
(10:31):
can reduce these friction points in the journey and create
online scheduling and physician reviews and there's some greatest hits, right,
that tend to come up over and over again and
it begs the question. Is that innovation. And for me,
the answer is it's innovation. If you haven't done it yet, right.
It doesn't have to be a new, fresh idea that
no one's ever thought of. The game is is not
(10:51):
necessarily that. It's how do you do it? Is that
consistent with the lessons you shared? I think it is.
Jodi (10:56):
It is. It is. And I sometimes think about innovation.
And.
Specifically digital.
Innovation is like a Maslow's hierarchy of need pyramid. Yeah.
Whereas by the bottom.
Foundation of that pyramid, which is wider right and steadier.
You've got some.
Of the core functionality of growing maturity. And so again,
(11:18):
back to kind of basics for adoption, sometimes one instance
of an EMR interoperability across sites of care kind of basics,
and then systems begin to especially through a provider lens,
I'm going to say in kind of a patient journey lens,
they digitize the basic processes. So you mentioned things like
online scheduling and bill pay and messaging your doctor, like
(11:40):
the real kind of digitization of the basic processes. And
then from a.
More stable core, you can move up and do digitize
some of the clinical processes. We've seen explosion with the.
Pandemic of virtual care, asynchronous and synchronous modalities, remote patient monitoring,
and then from.
Kind of some of those clinical decision support tools. But
then really at the top, you get to really have
(12:03):
more of that.
Kind of transformative design, patient centered.
Tools, proactive intelligence.
Solutions that leverage big data, AI interactions and platforms.
And so we think to your point, Jeff, I'd.
Say.
Sometimes it's very hard for.
Organizations to do that top of the pyramid when their
bottom structure still has a lot of growth. And so we.
(12:25):
Think it's I think it's both.
I think it's you can have sort of both pieces,
one in each hand, you can work on continuing to
grow the.
Core.
And strengthen some of those basics that for some are
core innovations, but.
But really vital. And they are innovative in their own way.
But then finding a way to carve out a path
for for more, you know.
(12:46):
Adjacent transformational type innovations really and key to.
Jeff (12:50):
So that's interesting. Jody, your pyramid, if you will, or
your step changes in ambition as you go from the
online scheduling to the proactive intelligence. And some of the
things you talked about is clear. But I hadn't thought
about it as a as a pyramid in that the
base is required. Is that just from like a confidence
building we talked about people and overcoming fears is do
(13:12):
you really need to do the basic stuff first because
it builds internal confidence and builds a case for change?
Or is there another reason you describe it as necessary
to come before you get to the top of the pyramid?
Jodi (13:23):
I think it's a little bit of both. I think for.
Me, intersection innovation really happens.
At that intersection of people process technology.
So from a pure technical lens.
Not even digital, I think of digital is like how
people use the technology. But from a.
Pure technical.
Some of that base in core is needed.
So that your main infrastructure.
Is there, that you have, you know, more advanced.
(13:46):
Whether it's security.
Cloud.
Core, you know, one instance.
Interoperability to talk to your sites of care.
So some of it is you really need it from
a technical perspective and a digital perspective. The other piece
is really organization culture.
I think, Jeff, some of the work that you've really
led and kind of builds confidence amongst the workforce, if again,
(14:09):
it's the people in the process.
Sometimes and that three legged stool of people process.
Technology, that's the hard stuff. Sometimes the technology is the
super easy piece.
Jeff (14:18):
Right? Right. With the right budget.
Jodi (14:20):
Right. So true.
Jeff (14:22):
That's right. Okay. So let's pivot to talking about City
of Hope. So first, tell us what led you there?
What made you say, wow, there's something really cool that
I can affect and I can change? And then I'm curious. Obviously,
as much as you're willing and comfortable to share about
what's the change agenda look like and where is City
of Hope going, going to bring some of that digital
(14:44):
and innovation in the next 2 or 3 years? Those
of us that read the headlines know about the recent
not so recent, perhaps acquisition of cancer Treatment Centers of
America and the rebranding. So I assume that's part of
the story, but I'd love to, but maybe it's not.
I'd love to hear from you. What led you there
and what's the change agenda now for sure?
Jodi (15:04):
Well, I'm excited. Let me let me kind of take
you back a little.
Because it'll it'll lay the groundwork for what.
Excited me about the opportunity.
And so the City of Hope story really began.
In.
1913 when a group of volunteers, spurred by.
Compassion.
For helping those who had tuberculosis, established what at the.
(15:25):
Time was known as the Jewish.
Consumptive.
Relief Association.
And they raise money to start a free.
Non-sectarian tuberculosis sanitarium, which is in Duarte, which today is
where our main hospital campus is located. And.
Really that launched a.
Century now journey that is placed City of Hope at
(15:46):
the forefront of our nation's leading medical and research institutions.
And by the mid 1940s or so, thanks to the
discovery of.
Antibiotics.
Tuberculosis was on the.
Decline in the US. And so City of.
Hope really rose to the next.
Challenge and tackled the disease of cancer as well as
(16:09):
diabetes and later HIV and AIDS and other rare diseases.
And so.
City of Hope has always been.
An innovative institution and has led significant advances in modern medicine,
including the first synthetic human.
Insulin.
Technology behind widely used cancer.
Fighting drugs. And today, City of Hope's a designated.
(16:31):
Comprehensive cancer.
Center, which is.
The highest ranking.
Bestowed.
By the NCI, the National Cancer Institute.
And we're a founding.
Member of the National Comprehensive Cancer Network. And so I
share all of that with you, because this was an
opportunity to be at a growing health care organization that
(16:55):
is nearly singularly focused on one disease state. And that
was very, very attractive to me. Innovation requires.
Significant strategic focus.
And direction and culture. We're just talking a little bit
about that and the opportunity to innovate deeply in a
focused disease state through a lens of equity and access
(17:17):
and best patient experience and provider experience was was very,
very exciting to me. And you did mentioned that a
recent acquisition of Cancer Treatment Centers of America, you know,
City of Hope is now able to share that expertise century,
a century of expertise to benefit a greater number of
(17:39):
patients in even more communities. And we did recently announced
just a bit over a week ago, the transition of
our locations to our City of Hope brand as we
hit the one year integration milestone as a national cancer
research and treatment health system. And it really allows us
(18:01):
to continue.
To commit.
To democratizing cancer care. And and I think that was
a third thing that really spoke to me. Again, back
to my public health training. It lends itself very well.
To all of.
Those quadrupling kind of core values that I have.
And even a lot.
Of what's happening now in discussion of adding kind of
(18:23):
a fifth theme around health equity and and City of
Hope is is very passionately working in that space, which
is exciting. Um, and I can, I can speak to
that a little bit more just to kind of maybe
do a bit of a double click on that because when.
You look at.
Where the challenges are in health care outcomes and experience
and cost of care and where the workforce suffers most,
(18:46):
Jeff it really is often and under resourced communities and,
you know, oftentimes communities that have been oppressed. And so that.
Inclusion.
Of equity and democratization is is so important and City
of Hope, in addition to its clinical care and research,
(19:07):
we have led many successful efforts to advocate for equity,
including our involvement in passing the California Cancer Care Equity Act.
Which really enables.
The most vulnerable populations in California to seek optimal cancer
care services and access.
To subspecialists.
(19:27):
And clinical trials.
And while the.
Impact of cancer care innovation has been very positive, cancer
care advancements are resulting in rapidly improved patient outcomes. Cancer
death rates in the US have decreased about 33% over
the past 30 years, since a peak in the early 90s.
(19:48):
Yet access to that optimal care is is still an issue.
And this is.
Concerning because over 80% of cancer care is delivered out
in the community and so there's lots of of health
equity implications and being able to address that is so important.
(20:09):
And and at the roots of sort of who we
always have been and as part of the work we
have ahead of us. So it's a very exciting time
to be part of the organization.
Jeff (20:20):
Yeah, for sure. So what's, what's what's coming?
Jodi (20:24):
So a lot of strategic.
Effort in a multi-pronged approach to address some of the
the disparities. You know, cancer death rates are higher among
people with lower socioeconomic status compared to people with higher
we know. African American men have over 110% and African
(20:49):
American women have 39% higher risk of dying from sequentially.
First prostate cancer. Second, breast cancer for women compared to
their white counterparts. We know Hispanic women experienced stomach cancer
incidents and deaths almost twice as often as white women.
So our approach to begin to transition to.
(21:12):
Locations that are City of Hope begins to have standard of.
Care.
Democratization and access to clinical trials and.
Begins to to break.
Down some of these siloed experiences with with access to
subspecialty expertise.
And ability to partner in communities where more.
(21:33):
Sort of generalized oncology care is delivered. So it's.
A it's a very exciting.
Time and we have.
A workforce of over 11,000 team members, over 600 physicians.
More than a thousand scientists and.
Research that are.
Kind of spanning now not just California, but Arizona, Georgia
(21:54):
and Illinois. So yeah, yeah, lots ahead, lots happening and
couldn't be couldn't be more proud to be part of
the organization right now.
Jeff (22:03):
Yeah. So much of what is known in clinical care
is based on codifying and pattern recognition of the past. Right.
But to your point, the limitation on that is a
lot of the pattern recognition has been based on, you know,
white men, right? To put it most, most bluntly and
most simply. And I think part of what a lot
(22:25):
of organizations are doing and the benefit of scale is
sometimes so you can arm wrestle with with with Blue
Cross Blue Shield better. But but really, it's around getting
to these solutions. And what I think I'm hearing is
for City of Hope, expanding its footprint is part and parcel,
not just to delivering the great value you already provide
to the communities in Los Angeles, but to build to
(22:47):
a step change increase in how you add value. How
do you get to these answers requires the scale to
be able to get at some of these health inequities
that you addressed.
Jodi (22:54):
Absolutely. Absolutely. I mean.
We both know that, you know.
Sadly, care and in the case of oncology, survival is
often directly dictated by your zip code. Right? It's the
work that the CDC has been doing on their 500
cities project, which uses health data, I think from over
100 million people. And those statistics really show where you
(23:19):
live affects your health and ecology, but across a whole
host of other disease states. You know, I alluded to before,
I really think about innovation happening at that intersection of people,
process and technology and kind of viewing it as like
a three legged stool. And so I.
Think leading with people allows us to build empathy and
(23:42):
deeply understand.
The needs of our patients.
It allows us to better.
More effectively, efficiently connect people and collapse barriers. And again,
back to kind of what would you have told your
younger self. You know.
Multidisciplinary teams are so important and so that people piece
of that the opportunity to work together.
(24:05):
To incubate ideas.
Solve problems, build, bring clinical.
Practitioners together with researchers, together with the community.
Leading with people. So important.
I think.
You know, the second leg of that stool leading with.
Process. So allowing us to optimize.
Workflow with human centered design approaches, right as we are.
(24:26):
Creating a fabric across the country of a national cancer
research and.
Treatment center, being able to really.
Deeply understand the.
Workflows and.
Approaches.
Ensure cross department.
Collaborate.
And then I think part of the process too is,
is a bit of the culture piece.
(24:47):
And having a safe space to.
Test, to.
Iterate. And, and sometimes it's part of innovation, right? To
fail forward and build on those learnings and experiences. What
worked in one community may not work in another.
Or what works in one community is is incredible to
be replicated in another. So I think that process piece
is huge.
And then.
The third leg of the stool I.
(25:08):
Think is really leading with technology because the technology is
the enabler. It allows us to enable the people in
the process and that's some of your your human centric
model as well, and that we can ensure we can
integrate and automate the processes so.
That solutions are.
Data driven. They allow us to.
Accelerate a.
Rapid rate and.
Reach more, more.
People and break down some of those siloed experiences of
(25:31):
oncology care and other rare disease care that that we
were talking about.
So I think that's that's really, really important.
And so.
Hope is going to continue to lead with our people.
It's our greatest asset.
But as we become a national cancer research and treatment system,
(25:51):
a treatment center and system, we, like many health care providers,
have to continue to build those digital experiences using our technology.
To meet those.
Unique needs of our patients and our workforce and the
larger oncology community and and to reach them where they are.
And digital provides that opportunity to do it. And, you know, think.
(26:16):
I love the work that Eric Topol.
Talks about in terms of like the value of leveraging technology,
not to.
Replace people. And I think that's so important. I think
that we need to think.
About leveraging new technology, new AI, new solutions.
To ensure we can make medicine better, and.
(26:39):
That we can also, in addition to using some of
these digital technology experiences, we can free doctors and clinicians
from the the tasks that.
Interfere with human connection.
And we can actually use the technology to give clinicians
back the gift of time and restore the care and
(27:00):
health care. So I continue to see that as part
of building on the framework that you all have around
kind of your your human centric model and and how
that that aligns with a lot of the work we're
doing to.
Jeff (27:14):
Yeah. Yeah. It strikes me that since the beginning of
probably going back to the Industrial Revolution or beyond, right,
there's been this fear of technology replacing humans or machines,
replacing humans, and maybe those fears are still legit now
for different reasons. But boy, it just seems like the
demographics suggest that we don't have to worry so much
(27:34):
about being replaced. There are not enough. As one of
our one of my clients said to me once, there's
not enough humans being born to take care of the
humans that have already been born. Right.
Jodi (27:42):
As we have an enormous amount of our population entering
into their 65 plus years of age and living longer.
And again, I think while it worries me.
That we need to be able to.
Compete with the rapid evolution of changing models of care,
(28:03):
whether it's care at home, ensure that the.
Workforce is working at top of.
License, right? Not eliminating anybody, but getting everyone to work
at top of license and that.
We won't be as bold as we need to.
About driving some of those changes to meet the ever
(28:24):
growing needs of truly an aging population. So I think
that would be a worry, but also a great challenge
and opportunity. And I can then add to the the
worry with the excitement because I'm that's sort of how
I roll. I want to look at things in a
in a in a better lens. And I am very
(28:44):
excited by the growth of omnichannel care delivery that we
are seeing up and down the healthcare ecosystem. We're seeing
new models of partnership between folks who used to not
talk to each other, right, whether that's payer, provider.
Provider.
Digital health, startup.
Research and advocacy.
Groups. It's very exciting. And, you know, we have to.
(29:06):
Remember that.
Our patients, our.
Workforce.
Our providers are.
Digital.
Consumers in every other part of their lives. And so
we must as a health care industry, be giving them
the tools.
To manage their care that they.
Have been used to managing in every other part of
their lives. And so we can no longer have them,
(29:29):
you know, continuing to do analog ways of business where
every other part of their business life, they have gone digital.
So I think that's that's the exciting opportunity and I
will share that. I think another very exciting opportunity for
me has been that COVID actually.
Brought to the.
Forefront a lot of conversations around clinical trials that maybe
(29:55):
hadn't existed before. So, you know, the vast majority of.
The world was.
Talking about clinical trials and when we'd have a vaccine, right.
And and those became dinnertime conversations, conversations on Zoom, right
when we weren't gathering with people. And the vast majority
of families pre March of 2020 never talked about a
(30:18):
clinical trial. And so.
That begins.
To build on democratizing access to macro awareness in this
convergence of this health care delivery ecosystem that sometimes has
been a.
Laggard to.
The digital party and to the disruption party. And I'll
(30:38):
end kind of with a personal story on this one.
And for me.
My first friend in life.
Was Felicia, and she lived three houses away from me.
We were born five days apart and our moms were
best friends. And Felicia and I grew up together. And
(31:01):
just as Felicia's life was launching, she.
Had graduated from law.
School. She had gotten married. She was giving back to
her community. She was diagnosed with breast cancer.
And this was back in the early 90s.
And she had an aggressive form. And when standard protocol
therapies were not working, she did participate in a clinical trial.
(31:24):
And I remember learning about clinical trials throughout the course
of my public health, schooling and in research.
Articles, maybe reviewed as.
I was getting my MPH. But I never knew anyone
who was part of a clinical trial. And I don't
even think I'd ever spoken about a clinical trial with
friends or family. And sadly, the clinical trial came too
(31:47):
late for Felicia, and we lost her far too young.
At 26, my first friend in life was gone. And
I share this story with you because although.
Clinical trials.
Conversations have become mainstream at dinner tables on Instagram.
And TikTok, not everyone has.
(32:09):
Access to trials or the awareness. And this democratization of
oncology care that we are leading at City of Hope.
This is the work around education best in class National
Cancer Institute and CI Designated care, holistic care.
Supportive.
(32:29):
Care that we are leading now across the country. And
that fuels me each and every day.
Jeff (32:40):
Well, I think we are all I think I can
speak for everyone who will listen here. We're all rooting
for you personally and we're rooting for the City of
Hope because what you talk about is important and it's inspiring.
Jody Rosen, vice president of innovation and digital Strategy City
of Hope. Thank you for being on the podcast.
Jodi (32:58):
Thanks so much for having me. Really appreciate it.
Anna (33:09):
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 profit slash thinking. I'm Anna Kuno,
(33:29):
the senior editor of this podcast. Thank you for listening.
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