November 19, 2025 • 27 mins
AI is quietly rewiring healthcare—and in this episode of Conversations with Zena, My AI Colleague, digital health leader RJ Kedziora, co-founder and COO of Estenda Solutions, joins David and Zena to explore what a truly intelligent, human-centered health system could look like.
Starting from RJ’s personal goal of living “100+ with good quality of life,” the conversation moves from simple habits—eating like your grandparents, moving more, sleeping deeply, staying social—to the ways AI and wearables can turn those intentions into real, data-driven change. You’ll hear vivid examples of AI already at work in clinics today, from ambient listening tools that free doctors from their keyboards to rigorously validated digital therapeutics that can be prescribed and reimbursed like drugs. The three also wrestle with the hard questions: self-diagnosis and mental health chatbots, privacy and HIPAA, “sick care” economics, and RJ’s provocative claim that it will soon be irresponsible not to use AI in healthcare.
Listen in, and consider: how might you use AI—as a partner, not a replacement—to prepare better for your next doctor visit, take more ownership of your health data, and push our system from reactive sick care toward proactive, longevity-focused care?
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Episode Transcript
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SPEAKER_00 (00:22):
Our guest today is RJ Kesiora, co-founder and COO
of Estenda Solutions.
RJ has over 25 years ofexperience in software, product
design, development, andmanagement.
At Estenda, he provides digitalhealth solutions that help
people live longer and healthierlives.
(00:43):
RJ has won multiple awards,including the HIMSS Davies Award
and recently the Health 2.0Outstanding Leadership Award.
Hi, RJ.
Welcome to the show.
SPEAKER_01 (00:56):
Thanks for having me.
Looking forward to theconversation.
I can also announce that we madeit uh the Philly 100 list.
We were the 38th fastest growingcompany in Philadelphia this
year.
And we also made the Inc.
5000 list, which is alsoexciting.
But for that, we were like 3,000something or other.
But it just means we're doinggood.
So really exciting.
SPEAKER_00 (01:16):
Fantastic.
Congratulations on all yoursuccess.
Also, joining us today is myco-host, Xina.
Zina is trained as an expert inhuman AI collaboration.
Hi, Zina.
Thank you for co-hosting anotherepisode of our podcast.
SPEAKER_02 (01:35):
Absolutely.
Happy to be here.
SPEAKER_00 (01:38):
Let's jump right in.
And I want to ask you a personalquestion, RJ.
In your LinkedIn profile, youstate that your life goal is 100
plus with good quality of life.
Wow, what a fantastic goal.
Tell us how you plan on gettingthere.
SPEAKER_01 (01:58):
It is, and it's funny because for the longest
time I said I wanted to live to100 with a good quality of life,
and someone challenged me, whyonly 100?
So it is now 100 plus.
But it it's about very simplebehaviors.
It is not complicated to be ableto live to that 100 plus.
Genetics do play into it, buteating better.
(02:22):
Um, you know, I think of eatinglike your grandmother, or even
maybe your great-grandparentsnow, if you're you're of a
younger generation, but eat foodthat you recognize.
Um, don't try and avoid theultra-processed food.
Move more.
Um, it's a key.
You know, I sit at a desk foreight, 10 hours a day, but I I
also train for triathlons.
(02:44):
So it's getting me out there,raising my heart rate, actively
competing.
But you don't have to do that.
It is about moving more,stretching.
Those are keys, keys to beingable to hit to that 100 plus
threshold.
Getting sleep.
Sleep is a huge component, andnot just sleep, rest.
Um, you know, it is a go, go,go, go world, but uh getting
(03:06):
that rest is just as importantand not overtaxing your systems.
Uh, recent research shows thatyou need to main be social um
and get out there.
And there's a huge socialcomponent that if you are more
social, have a good set offriends out there that's going
to get you to you know thoseextended years with a good
(03:27):
quality of life.
So, you know, I I do partake inin that alcoholic drink every
now and then.
Tequila is my my option.
Um, love a nice little glass oftequila, but in moderation.
Um, and what's interesting, alot of the research around
alcohol is sort of swingingwhere it has negative impacts.
(03:47):
But for me personally, it helpsbalance that.
That's a it's a social lubricantkind of thing.
So, how does you know thenegative impacts of the alcohol
balance out with like thatsocial component of it?
So there's a lot of research yetto be done around that.
Um, but it is fascinating.
I'm working on my first book,actually, as you asked that
(04:08):
question called ProductiveHarmony, which is scheduled to
come out next March, March of2026, which is all about this:
how to optimize productivitywithout burning out.
And it really is about needing ahealthier life.
SPEAKER_00 (04:21):
Yeah, absolutely.
All of those components that youmentioned are so important as we
think about longevity.
And I think one of the excitingthings that we're seeing as well
is the science of longevity isadvancing at incredible speed.
And AI is a big component ofthat.
So, how do you think about AIrevolutionizing healthcare in
(04:44):
general, longevity, and just thescience of living well?
SPEAKER_01 (04:49):
I think the biggest thing that AI is going to do for
us in those terms is helpeducate us and let us better
understand when we do talk toour doctor or medical
professionals or look at thatresearch to better understand
that research.
And we combine that capabilitieswith the proliferation of
(05:10):
wearable devices now, thevarious different rings,
smartwatches on, you know, uhcontinuous glucose monitoring
devices to understand your bloodglucose, what's going on within
the body.
The AI is enabling capturingthat information and generating
actionable advice.
Here in America, we do not havea healthcare system.
We have a sick care system.
(05:32):
If you get sick, you go to thedoctor.
The doctor, the healthcaresystems get paid.
They're not getting paid orincentivized enough to make sure
that you are well.
It's really about, again, thatgoal of living to 100 plus.
What we do individually is goingto get there.
AI is a great enabler for that.
You're not sure where to getstarted, ask AI.
(05:53):
And if it gives you an answer orresponse that you don't
understand, you can ask it tobreak it down, make it more
simple for you.
And like I said, it's I do dotriathlons, but it's about
moving.
Get out there and move, go for awalk.
And it's one of thosefascinating experiments I did
where it's, you know, justtaking a 10-minute walk after
(06:15):
dinner makes a difference interms of how your body processes
that food.
It's a it's a powerful moment.
But AI is going to be the keyenabler for that and
understanding that.
But you know, think of thedoctors.
You know, you go to the doctorand you're lucky if you have
seven, 10 minutes, and Godforbid you get a you know, a
diagnosis of cancer, you're notgonna hear anything beyond that.
(06:38):
Like your mind is just gonnashut down, like it's a natural
human reaction.
But you can talk to that AIanytime you want to better
understand what that is gonnalook like.
You absolutely cannot rely onthe AI today for good medical
answers.
You should consult with yourdoctor, but it is a good
(06:59):
opportunity to start exploringthe options.
SPEAKER_00 (07:03):
Yeah.
So, you know, recently I waswatching uh an episode featuring
Mustafa Sullivan, who is thehead of AI at Microsoft, and
they were discussing Co-Pilotfor Health.
He believes healthcare is themost promising market for AI,
and he provided just somestunning statistics.
(07:24):
He said 40% of their queries arehealthcare related.
Copilot provides answers thatare grounded on citations from
Harvard Medical School, which isreally remarkable.
It's a great way for people tobecome more educated and do
exactly what you just said.
You know, sometimes you get adiagnosis and you really want to
(07:45):
understand a little bit betterwhat those terms mean, and you
know, what you can do to helpyourself and and and enrich your
dialogue with your doctor, andAI can be a great help in doing
that.
So I think healthcare isdefinitely a huge opportunity, a
huge market.
And I think we're gonna see justtremendous advances in that
(08:07):
market with the help of AI.
And given your experience, I waswondering if you could provide
our audience with just somereal-world examples of where
you're seeing the successfulimplementation of AI in
healthcare.
SPEAKER_01 (08:21):
Absolutely.
Just quickly from a patientperspective, a great use of AI.
If you are going to a doctor'sappointment, ask it how to
prepare for that appointment.
Ask it what questions you shouldask.
Again, a powerful quick momentto work with that AI to better
(08:42):
engage with your healthcareprovider.
What's interesting in healthcareAI, it is adopting it very
quickly, which is nice to see uhacross the board.
Biggest use cases today inhealthcare around the idea of
ambient listening.
And so when you go into yourdoctor and they have to document
(09:05):
what you are talking about,instead of them sitting there in
front of a keyboard and typingand not interacting with you,
the technology ambient listeningtechnology can listen to the
conversation in the room andtake the notes around that and
can create the information thatgoes into the EMR.
So that allows the doctor, thenurses to get back to doing what
(09:28):
they want to do and interactwith the patient, provide
patient care instead of being atypist at the keyboard.
So that is the quickest,earliest use case that's being
adopted across the board.
And what's interesting andwhat's coming out of this is
then you marry the capabilitiesof the AI to understand the
research data that's out thereand what's going on inside that
(09:52):
patient encounter, that systemsare gradually being developed
now that can surface questionsto the provider to be able to
drive into things.
There's a reason for secondopinions.
Uh, you know, everybody we'rehuman, doctors included.
You know, they're very capable,go through extensive amounts of
training, well-intentioned.
But, you know, you ask aboutsecond opinions because it's
(10:15):
good to have different differentideas and explore possibilities.
And that's what the AI is buyingyou very quickly in today's
today's market.
SPEAKER_00 (10:24):
Absolutely.
I'd like to bring Xina in onthis conversation.
Zina, uh can you share yourthoughts on how you see AI
revolutionizing healthcare?
SPEAKER_02 (10:39):
Certainly.
Let's set the stage this way.
AI is poised to be atransformative force in
healthcare.
Picture a world where diagnosis,treatment plans, and even
patient care become moreintuitive and personalized
thanks to AI's capabilities.
For example, imagine an AI thatcan sift through vast medical
data and offer insights thathelp doctors catch issues
earlier.
Reflecting on that, we see it'snot just about technology, it's
(11:00):
about how we use it to enhancehuman well-being.
So let's consider how we canguide these innovations to truly
uplift healthcare for everyone.
SPEAKER_00 (11:08):
Absolutely.
I think AI has many promises inthe field of healthcare, one of
which is just better diagnosisand the ability to discover new
cures for diseases.
We are seeing AI being appliedtoday in helping us better test
possible drug uh combinationsthat may be effective.
(11:32):
We've seen that with even COVID.
Uh, you know, three years ago,we we went through a process
where AI was very helpful inhelping us make new uh
repurposing of drugs.
And I think this would justcontinue to accelerate at
incredible speeds.
SPEAKER_01 (11:50):
And it's opening up new avenues as well.
The AI is capable of analyzingyour voice or what your tongue
looks like, your typingpatterns, things we don't
typically think of when we talkabout healthcare or diagnosing a
condition.
It it's capable of doing thatanalysis and pulling out
(12:12):
interesting patterns and trendsthat could be early warnings of
potential issues to look into.
Absolutely.
SPEAKER_00 (12:18):
RJ, you talk about a term digital therapeutics.
Can you tell our audience whatthat is?
SPEAKER_01 (12:27):
Yes, I I liken the idea.
So you have digital health,which is just the idea of using
technology to enhance our healthand well-being.
And if you look at theapplications on the marketplace,
there's probably 300,000 or soin the various app stores.
And they do, you know, gothrough evidence generation.
(12:48):
You know, the providers of thosedigital health applications do
make sure that you know thatthey work properly.
The idea of a digitaltherapeutic is that you are
taking it through an extra levelof rigor around making sure that
it works.
Think of the difference betweenvitamins and minerals that are
on market versus drugs andmedications that are prescribed.
(13:09):
And that's the differencebetween digital health
applications in general and thedigital therapeutic ones.
So digital health applicationsmay actually work, may have
evidence around them.
But as you'll see a lot ofadvertisements on TV, they're
not intended to diagnose ortreat a particular condition
where that prescribed medicationis that digital therapeutic is
(13:34):
the digital health app that canbe prescribed by a provider.
There's just another layer ofevidence around the efficacy of
that solution.
Does it actually work?
And from a commercialperspective, what's interesting
is you and I might pick up adigital health application and
use it.
And you know, we're we may pay acouple dollars for it.
(13:56):
But in the digital therapeuticworld, it's going to be
prescribed by a provider andpaid for by an insurance
company.
So that reimbursement will besignificantly higher in that,
opening up many moreopportunities in terms of
creating these applicationsbecause it does take quite a bit
to build a digital therapeuticapplication.
SPEAKER_00 (14:18):
Yeah, so it's a broader ecosystem of healthcare.
It's just the patient, it's thedoctors, it's the insurance
companies, it's this digitalapplication providers all
working together to improvehealthcare for the patient.
And I think that's that's veryexciting.
Now, one of the trends thatwe're seeing these days is
(14:41):
people using AI forself-diagnosis and as a
substitute sometimes for mentalhealth therapy.
Give me your thoughts on that.
SPEAKER_01 (14:54):
I think it's worth exploring, but you have to be
very cautious with it.
They are not designed.
The general, the chat be teas,the demonine, the claws of the
world, the general ones that areavailable for public.
We are seeing this use case forcompanionship, for advice and
guidance in terms of mentalhealth.
(15:15):
They are not designed for it,and that's the key.
So you can get into dangerousterritories.
If you think you have an issue,seek out ones that are designed
for this and talk to yourhealthcare provider about it.
Because there is a mental healthchallenge here in America, and
there are not enoughprofessionals to provide that
(15:35):
service.
I'm lucky and I live in thegreater Philadelphia area.
There are lots of professionalshere.
But if you go out into evenrural Pennsylvania, it gets much
more challenging to find thosequalified healthcare
professionals.
The digital technology, the AIs,they scale.
They're always available.
You know, if if you you you havean issue, you know, an emergent
(15:59):
issue, I would definitely callthe mental health professionals
kind of thing.
But it's also there 24-7available for you to explore in
IDA around different things.
So useful, yes, huge potential,um, but also a strong cautionary
note, particularly if if you'vealready been diagnosed with
(16:20):
mental health issues.
I would not rely on it.
SPEAKER_00 (16:23):
Yeah, so I think you hit on two very important
points.
One is the availability.
I think one of the beauties ofhaving AI as an assistant, as a
therapist, as a co-worker, isthe fact that it's always
available to you.
And that can be very helpful.
But by the same token, we needto be cautious because we know
(16:44):
that these systems are notperfect, we know that they
hallucinate sometimes.
And so it's important to doublecheck their sources, double
check with your doctor, and makesure you're doing a combination
of the two to improve theoutcomes of your uh healthcare
search.
SPEAKER_01 (17:04):
Yeah, the other aspect, sorry, the other aspect
to that, which is important tocall out, is sort of the why.
So, yes, they do tend tohallucinate and make up stuff,
but the way they've beencreated, they're designed to
make you happy.
It's designed to please you.
And that's the driving reasonaround those hallucinations, is
(17:25):
that they want to answer thatquestion.
So, particularly in that mentalhealth condition, you know,
pleasing you is maybe not alwaysthe best approach.
And that's why it's it's useful,it's available, but please seek
out your mental healthprofessionals.
SPEAKER_00 (17:41):
Yeah, absolutely.
That's a really good point.
Now, I want to go back tosomething that you said earlier.
You you alluded to the fact thatthe healthcare system in the US
is broken.
In fact, the data suggests that17 to 19% of our GDP is spent on
healthcare in the US.
And yet, you know, we're notseeing the quality of service
(18:03):
that you may find in othercountries like Canada and even
in some of the Scandinaviancountries.
So, what are your thoughts onhow we turn this whole situation
around?
SPEAKER_01 (18:15):
It's a combination of factors.
It's one, moving to avalue-based healthcare model
where doctors, nurses,healthcare systems are more
incentivized, if notincentivized exclusively, for
health and not sickness.
That's a wholesale change, sothat's gonna be really difficult
(18:36):
to do.
But there are there are earlymovement in the in that
direction, which is good.
I think where we're actuallygoing to see it is in personal
accountability.
And as wearable devices becomeeasier to access and sort of
fade into the background.
You know, I've I've worn theApple Watches, I wear a couple
of the different rings that areon the market.
(18:57):
You know, I love playing withthis this technology.
I learn so much about what'sgoing on inside of me.
That's what's going to make thedifference.
It's it's my personalaccountability for my own health
that I do eat better, move more,and get the sleep that I need.
You know, it was interesting.
I did unfortunately, you know,just get over a pretty bad cold
(19:22):
thing.
And my ring was like, hey,you're not doing well, which was
interesting.
I'm like, I knew I wasn'thealthy.
Um, but it's also as I've beenrecovering from that, it's been
helping me balance out my levelof activity.
So instead of going out andrunning the usual, you know,
five or six miles that I mighthave done this morning, it's
like, okay, you're stillrecovering.
You should, you know, take iteasy.
(19:43):
And that that'll help me recovermuch more quickly, which is
nice.
But that's how we're going toget to a healthier America, a
healthier world.
It's that personalaccountability that's going to
be enabled through wearables andthat data in the AI to help
interpret it and provide morepersonalized information.
SPEAKER_00 (20:03):
I'm also hoping that just the deflationary forces of
exponential technologies ingeneral, which I believe, you
know, we we know the technologyis deflationary in nature.
And as these technologiesadvance exponentially, the hope
is that the cost will start tolower exponentially as well.
And I'm hoping that AI will helpus reduce the cost of healthcare
(20:27):
in general.
But you know, I think that's yetto be seen.
There's a lot of unknowns ahead.
But I I do tend to lean towardsthe optimistic view of that
equation.
Zina, given RJ's rich backgroundin digital technology in
(20:47):
healthcare, what question do youhave for him?
SPEAKER_02 (20:51):
I'd ask RJ to reflect on one core idea.
How does he see AI not just as atool, but as a partner in
reshaping patient care?
For instance, could he share astory or an example where AI
made a tangible difference in ahealthcare setting?
And then let's invite him toconsider how we can thoughtfully
guide that collaboration toensure it stays human-centered
and ethically grounded.
SPEAKER_01 (21:09):
Great, great question.
I I definitely see AI in manypeople as artificial
intelligence.
You know, it is that augmentedintelligence.
It is very much that we shouldcollaborate with it to enable
ourselves to be better humans.
You know, how do how do we useit?
How do we explore ideas is justa powerful moment from that
(21:33):
perspective.
And just thinking of anecdotalstories, you know, in terms of
AI, you see a lot of storieswhere the human has been
challenged and has a particularcondition and hasn't been able
to figure out what it is.
You know, my mother-in-law manyyears ago passed away from
lupus.
Today, so it's been close to 30years now.
(21:55):
Today, still, it takes six toseven years to diagnose lupus.
You know, I've seen thosestories where you know you're
you're asking AI about theseparticular conditions, and it
surfaces that as a possibility.
You know, I alluded to the ideaof you're going to a doctor's
appointment, use it to prep.
There's a great augmentedintelligence capability there.
(22:16):
You know, you working with theAI to have a better,
well-informed doctor's officewith with the uh with your
doctor.
So lots of attention on bothsides, the the patient side and
the physician side to diagnosemuch more quickly, create
better, more personalizedhealthcare plans, just lots of
(22:37):
possibilities.
unknown (22:39):
Yeah.
SPEAKER_00 (22:39):
So Zina brought up something that I think is
important for us to talk about,which is the ethics behind AI
and the use of AI in general,but in particular in healthcare.
And in one of the previousepisodes, one of the
conversations that came up wasaround privacy.
So, how do we deal with theprivacy of patients and making
(23:01):
sure that that data remainsprivate and yet using that data
to be able to benefit withdiagnostics and just the overall
capability of the system shouldbe able to do a better job in
helping us with healthcare?
SPEAKER_01 (23:20):
So if you look at the various companies, and I'll
generically use OpenAI andChatGPT, they are not bound by
the HIPAA privacy laws andregulations.
So if you know you're puttinginformation in there, they can
use it how they may choose.
If you are going to yourhealthcare provider and they are
(23:41):
using it, then they should bedoing their due diligence and
signing what are called businessassociate agreements with the
OpenAI and other companies likethat, which then makes them
accountable for protecting thatdata.
So, you know, when you do go toyour doctor, ask them about it.
How are they using these systemsand have they signed the
(24:03):
business associate agreements?
Are they bound by HIPAA?
That's your first and andprobably most trustworthy step
in terms of understanding, okay,the hospital, the health system
is using it responsibly.
It should be noted that youknow, when you are using the
system, you don't have to tellit who you are to get good value
out of it.
So, you know, if you are fearfulof your information being out
(24:24):
there, just you know, don't tellit who you are.
You know, you don't have to dropyour name, your social security
number in there, your telephonenumber, um, or even your
specific age.
You know, say you're you're inyour you know 50s um kind of
thing to be able to give it lessspecific information around
identity, that it's a powerfulopportunity to learn more.
SPEAKER_00 (24:46):
Yeah, absolutely.
I think it's important forpeople to realize that they
shouldn't be sharing anypersonally identifiable
information with these systemsbecause that information is
potentially being used to trainthose systems, and you don't
want your social security numberor other types of private
information to be out there inthe open.
(25:07):
With that, RJ, please share yourfinal thoughts for our audience
and also let them know wherethey can find you.
SPEAKER_01 (25:15):
Yeah, absolutely.
I'll actually flip the ethicsquestion.
At some point in the very nearfuture, it will be irresponsible
to not use AI in healthcare.
And so we're all sort ofcautionary about it, but very
quickly, yeah, I think it'sgoing to be required to use it
and provide value and betterunderstand what's happening and
(25:37):
going on and a safety check.
Uh, to find me, estenda.com.
That's my company that I workwith day to day.
Uh, LinkedIn is a greatresource.
I'm always out there trying topost and share information that
I find fascinating.
Um, and very quickly, um, I'm onInstagram, Productive Harmony is
(25:57):
the uh upcoming book looking forfor uh March of 2026 when the
final editing phases.
It's it's wonderful working withwith my editors kind of thing.
And we have this constant giveand take around AI.
I don't want to clearly use itfor my book.
I want to you know be mycontent, but I do talk about AI
(26:18):
and and use examples of how touse AI in it, and and that has
really challenged them, whichhas been an interesting journey.
Um, but yeah, looking forward tothat coming out in the near
future.
SPEAKER_00 (26:29):
Yeah, congratulations again on the
launch of the book, and thankyou so much for being a guest on
the show today.
I also want to take a minute tothank Zina for her thoughtful
comments and questions.
SPEAKER_02 (26:44):
Of course.
And thank you for inviting thosereflections.
It's always a pleasure to bringthat thoughtful strategic lens
to the conversation.
Let's keep exploring these bigideas together.
SPEAKER_00 (26:54):
Very good.
Thank you so much, RJ.
Thank you, David.
Thank you, Zina.
Have a great day.
Our guest today is RJ Kesiora, co-founder and COO
of Estenda Solutions.
RJ has over 25 years ofexperience in software, product
design, development, andmanagement.
At Estenda, he provides digitalhealth solutions that help
people live longer and healthierlives.
(00:43):
RJ has won multiple awards,including the HIMSS Davies Award
and recently the Health 2.0Outstanding Leadership Award.
Hi, RJ.
Welcome to the show.
SPEAKER_01 (00:56):
Thanks for having me.
Looking forward to theconversation.
I can also announce that we madeit uh the Philly 100 list.
We were the 38th fastest growingcompany in Philadelphia this
year.
And we also made the Inc.
5000 list, which is alsoexciting.
But for that, we were like 3,000something or other.
But it just means we're doinggood.
So really exciting.
SPEAKER_00 (01:16):
Fantastic.
Congratulations on all yoursuccess.
Also, joining us today is myco-host, Xina.
Zina is trained as an expert inhuman AI collaboration.
Hi, Zina.
Thank you for co-hosting anotherepisode of our podcast.
SPEAKER_02 (01:35):
Absolutely.
Happy to be here.
SPEAKER_00 (01:38):
Let's jump right in.
And I want to ask you a personalquestion, RJ.
In your LinkedIn profile, youstate that your life goal is 100
plus with good quality of life.
Wow, what a fantastic goal.
Tell us how you plan on gettingthere.
SPEAKER_01 (01:58):
It is, and it's funny because for the longest
time I said I wanted to live to100 with a good quality of life,
and someone challenged me, whyonly 100?
So it is now 100 plus.
But it it's about very simplebehaviors.
It is not complicated to be ableto live to that 100 plus.
Genetics do play into it, buteating better.
(02:22):
Um, you know, I think of eatinglike your grandmother, or even
maybe your great-grandparentsnow, if you're you're of a
younger generation, but eat foodthat you recognize.
Um, don't try and avoid theultra-processed food.
Move more.
Um, it's a key.
You know, I sit at a desk foreight, 10 hours a day, but I I
also train for triathlons.
(02:44):
So it's getting me out there,raising my heart rate, actively
competing.
But you don't have to do that.
It is about moving more,stretching.
Those are keys, keys to beingable to hit to that 100 plus
threshold.
Getting sleep.
Sleep is a huge component, andnot just sleep, rest.
Um, you know, it is a go, go,go, go world, but uh getting
(03:06):
that rest is just as importantand not overtaxing your systems.
Uh, recent research shows thatyou need to main be social um
and get out there.
And there's a huge socialcomponent that if you are more
social, have a good set offriends out there that's going
to get you to you know thoseextended years with a good
(03:27):
quality of life.
So, you know, I I do partake inin that alcoholic drink every
now and then.
Tequila is my my option.
Um, love a nice little glass oftequila, but in moderation.
Um, and what's interesting, alot of the research around
alcohol is sort of swingingwhere it has negative impacts.
(03:47):
But for me personally, it helpsbalance that.
That's a it's a social lubricantkind of thing.
So, how does you know thenegative impacts of the alcohol
balance out with like thatsocial component of it?
So there's a lot of research yetto be done around that.
Um, but it is fascinating.
I'm working on my first book,actually, as you asked that
(04:08):
question called ProductiveHarmony, which is scheduled to
come out next March, March of2026, which is all about this:
how to optimize productivitywithout burning out.
And it really is about needing ahealthier life.
SPEAKER_00 (04:21):
Yeah, absolutely.
All of those components that youmentioned are so important as we
think about longevity.
And I think one of the excitingthings that we're seeing as well
is the science of longevity isadvancing at incredible speed.
And AI is a big component ofthat.
So, how do you think about AIrevolutionizing healthcare in
(04:44):
general, longevity, and just thescience of living well?
SPEAKER_01 (04:49):
I think the biggest thing that AI is going to do for
us in those terms is helpeducate us and let us better
understand when we do talk toour doctor or medical
professionals or look at thatresearch to better understand
that research.
And we combine that capabilitieswith the proliferation of
(05:10):
wearable devices now, thevarious different rings,
smartwatches on, you know, uhcontinuous glucose monitoring
devices to understand your bloodglucose, what's going on within
the body.
The AI is enabling capturingthat information and generating
actionable advice.
Here in America, we do not havea healthcare system.
We have a sick care system.
(05:32):
If you get sick, you go to thedoctor.
The doctor, the healthcaresystems get paid.
They're not getting paid orincentivized enough to make sure
that you are well.
It's really about, again, thatgoal of living to 100 plus.
What we do individually is goingto get there.
AI is a great enabler for that.
You're not sure where to getstarted, ask AI.
(05:53):
And if it gives you an answer orresponse that you don't
understand, you can ask it tobreak it down, make it more
simple for you.
And like I said, it's I do dotriathlons, but it's about
moving.
Get out there and move, go for awalk.
And it's one of thosefascinating experiments I did
where it's, you know, justtaking a 10-minute walk after
(06:15):
dinner makes a difference interms of how your body processes
that food.
It's a it's a powerful moment.
But AI is going to be the keyenabler for that and
understanding that.
But you know, think of thedoctors.
You know, you go to the doctorand you're lucky if you have
seven, 10 minutes, and Godforbid you get a you know, a
diagnosis of cancer, you're notgonna hear anything beyond that.
(06:38):
Like your mind is just gonnashut down, like it's a natural
human reaction.
But you can talk to that AIanytime you want to better
understand what that is gonnalook like.
You absolutely cannot rely onthe AI today for good medical
answers.
You should consult with yourdoctor, but it is a good
(06:59):
opportunity to start exploringthe options.
SPEAKER_00 (07:03):
Yeah.
So, you know, recently I waswatching uh an episode featuring
Mustafa Sullivan, who is thehead of AI at Microsoft, and
they were discussing Co-Pilotfor Health.
He believes healthcare is themost promising market for AI,
and he provided just somestunning statistics.
(07:24):
He said 40% of their queries arehealthcare related.
Copilot provides answers thatare grounded on citations from
Harvard Medical School, which isreally remarkable.
It's a great way for people tobecome more educated and do
exactly what you just said.
You know, sometimes you get adiagnosis and you really want to
(07:45):
understand a little bit betterwhat those terms mean, and you
know, what you can do to helpyourself and and and enrich your
dialogue with your doctor, andAI can be a great help in doing
that.
So I think healthcare isdefinitely a huge opportunity, a
huge market.
And I think we're gonna see justtremendous advances in that
(08:07):
market with the help of AI.
And given your experience, I waswondering if you could provide
our audience with just somereal-world examples of where
you're seeing the successfulimplementation of AI in
healthcare.
SPEAKER_01 (08:21):
Absolutely.
Just quickly from a patientperspective, a great use of AI.
If you are going to a doctor'sappointment, ask it how to
prepare for that appointment.
Ask it what questions you shouldask.
Again, a powerful quick momentto work with that AI to better
(08:42):
engage with your healthcareprovider.
What's interesting in healthcareAI, it is adopting it very
quickly, which is nice to see uhacross the board.
Biggest use cases today inhealthcare around the idea of
ambient listening.
And so when you go into yourdoctor and they have to document
(09:05):
what you are talking about,instead of them sitting there in
front of a keyboard and typingand not interacting with you,
the technology ambient listeningtechnology can listen to the
conversation in the room andtake the notes around that and
can create the information thatgoes into the EMR.
So that allows the doctor, thenurses to get back to doing what
(09:28):
they want to do and interactwith the patient, provide
patient care instead of being atypist at the keyboard.
So that is the quickest,earliest use case that's being
adopted across the board.
And what's interesting andwhat's coming out of this is
then you marry the capabilitiesof the AI to understand the
research data that's out thereand what's going on inside that
(09:52):
patient encounter, that systemsare gradually being developed
now that can surface questionsto the provider to be able to
drive into things.
There's a reason for secondopinions.
Uh, you know, everybody we'rehuman, doctors included.
You know, they're very capable,go through extensive amounts of
training, well-intentioned.
But, you know, you ask aboutsecond opinions because it's
(10:15):
good to have different differentideas and explore possibilities.
And that's what the AI is buyingyou very quickly in today's
today's market.
SPEAKER_00 (10:24):
Absolutely.
I'd like to bring Xina in onthis conversation.
Zina, uh can you share yourthoughts on how you see AI
revolutionizing healthcare?
SPEAKER_02 (10:39):
Certainly.
Let's set the stage this way.
AI is poised to be atransformative force in
healthcare.
Picture a world where diagnosis,treatment plans, and even
patient care become moreintuitive and personalized
thanks to AI's capabilities.
For example, imagine an AI thatcan sift through vast medical
data and offer insights thathelp doctors catch issues
earlier.
Reflecting on that, we see it'snot just about technology, it's
(11:00):
about how we use it to enhancehuman well-being.
So let's consider how we canguide these innovations to truly
uplift healthcare for everyone.
SPEAKER_00 (11:08):
Absolutely.
I think AI has many promises inthe field of healthcare, one of
which is just better diagnosisand the ability to discover new
cures for diseases.
We are seeing AI being appliedtoday in helping us better test
possible drug uh combinationsthat may be effective.
(11:32):
We've seen that with even COVID.
Uh, you know, three years ago,we we went through a process
where AI was very helpful inhelping us make new uh
repurposing of drugs.
And I think this would justcontinue to accelerate at
incredible speeds.
SPEAKER_01 (11:50):
And it's opening up new avenues as well.
The AI is capable of analyzingyour voice or what your tongue
looks like, your typingpatterns, things we don't
typically think of when we talkabout healthcare or diagnosing a
condition.
It it's capable of doing thatanalysis and pulling out
(12:12):
interesting patterns and trendsthat could be early warnings of
potential issues to look into.
Absolutely.
SPEAKER_00 (12:18):
RJ, you talk about a term digital therapeutics.
Can you tell our audience whatthat is?
SPEAKER_01 (12:27):
Yes, I I liken the idea.
So you have digital health,which is just the idea of using
technology to enhance our healthand well-being.
And if you look at theapplications on the marketplace,
there's probably 300,000 or soin the various app stores.
And they do, you know, gothrough evidence generation.
(12:48):
You know, the providers of thosedigital health applications do
make sure that you know thatthey work properly.
The idea of a digitaltherapeutic is that you are
taking it through an extra levelof rigor around making sure that
it works.
Think of the difference betweenvitamins and minerals that are
on market versus drugs andmedications that are prescribed.
(13:09):
And that's the differencebetween digital health
applications in general and thedigital therapeutic ones.
So digital health applicationsmay actually work, may have
evidence around them.
But as you'll see a lot ofadvertisements on TV, they're
not intended to diagnose ortreat a particular condition
where that prescribed medicationis that digital therapeutic is
(13:34):
the digital health app that canbe prescribed by a provider.
There's just another layer ofevidence around the efficacy of
that solution.
Does it actually work?
And from a commercialperspective, what's interesting
is you and I might pick up adigital health application and
use it.
And you know, we're we may pay acouple dollars for it.
(13:56):
But in the digital therapeuticworld, it's going to be
prescribed by a provider andpaid for by an insurance
company.
So that reimbursement will besignificantly higher in that,
opening up many moreopportunities in terms of
creating these applicationsbecause it does take quite a bit
to build a digital therapeuticapplication.
SPEAKER_00 (14:18):
Yeah, so it's a broader ecosystem of healthcare.
It's just the patient, it's thedoctors, it's the insurance
companies, it's this digitalapplication providers all
working together to improvehealthcare for the patient.
And I think that's that's veryexciting.
Now, one of the trends thatwe're seeing these days is
(14:41):
people using AI forself-diagnosis and as a
substitute sometimes for mentalhealth therapy.
Give me your thoughts on that.
SPEAKER_01 (14:54):
I think it's worth exploring, but you have to be
very cautious with it.
They are not designed.
The general, the chat be teas,the demonine, the claws of the
world, the general ones that areavailable for public.
We are seeing this use case forcompanionship, for advice and
guidance in terms of mentalhealth.
(15:15):
They are not designed for it,and that's the key.
So you can get into dangerousterritories.
If you think you have an issue,seek out ones that are designed
for this and talk to yourhealthcare provider about it.
Because there is a mental healthchallenge here in America, and
there are not enoughprofessionals to provide that
(15:35):
service.
I'm lucky and I live in thegreater Philadelphia area.
There are lots of professionalshere.
But if you go out into evenrural Pennsylvania, it gets much
more challenging to find thosequalified healthcare
professionals.
The digital technology, the AIs,they scale.
They're always available.
You know, if if you you you havean issue, you know, an emergent
(15:59):
issue, I would definitely callthe mental health professionals
kind of thing.
But it's also there 24-7available for you to explore in
IDA around different things.
So useful, yes, huge potential,um, but also a strong cautionary
note, particularly if if you'vealready been diagnosed with
(16:20):
mental health issues.
I would not rely on it.
SPEAKER_00 (16:23):
Yeah, so I think you hit on two very important
points.
One is the availability.
I think one of the beauties ofhaving AI as an assistant, as a
therapist, as a co-worker, isthe fact that it's always
available to you.
And that can be very helpful.
But by the same token, we needto be cautious because we know
(16:44):
that these systems are notperfect, we know that they
hallucinate sometimes.
And so it's important to doublecheck their sources, double
check with your doctor, and makesure you're doing a combination
of the two to improve theoutcomes of your uh healthcare
search.
SPEAKER_01 (17:04):
Yeah, the other aspect, sorry, the other aspect
to that, which is important tocall out, is sort of the why.
So, yes, they do tend tohallucinate and make up stuff,
but the way they've beencreated, they're designed to
make you happy.
It's designed to please you.
And that's the driving reasonaround those hallucinations, is
(17:25):
that they want to answer thatquestion.
So, particularly in that mentalhealth condition, you know,
pleasing you is maybe not alwaysthe best approach.
And that's why it's it's useful,it's available, but please seek
out your mental healthprofessionals.
SPEAKER_00 (17:41):
Yeah, absolutely.
That's a really good point.
Now, I want to go back tosomething that you said earlier.
You you alluded to the fact thatthe healthcare system in the US
is broken.
In fact, the data suggests that17 to 19% of our GDP is spent on
healthcare in the US.
And yet, you know, we're notseeing the quality of service
(18:03):
that you may find in othercountries like Canada and even
in some of the Scandinaviancountries.
So, what are your thoughts onhow we turn this whole situation
around?
SPEAKER_01 (18:15):
It's a combination of factors.
It's one, moving to avalue-based healthcare model
where doctors, nurses,healthcare systems are more
incentivized, if notincentivized exclusively, for
health and not sickness.
That's a wholesale change, sothat's gonna be really difficult
(18:36):
to do.
But there are there are earlymovement in the in that
direction, which is good.
I think where we're actuallygoing to see it is in personal
accountability.
And as wearable devices becomeeasier to access and sort of
fade into the background.
You know, I've I've worn theApple Watches, I wear a couple
of the different rings that areon the market.
(18:57):
You know, I love playing withthis this technology.
I learn so much about what'sgoing on inside of me.
That's what's going to make thedifference.
It's it's my personalaccountability for my own health
that I do eat better, move more,and get the sleep that I need.
You know, it was interesting.
I did unfortunately, you know,just get over a pretty bad cold
(19:22):
thing.
And my ring was like, hey,you're not doing well, which was
interesting.
I'm like, I knew I wasn'thealthy.
Um, but it's also as I've beenrecovering from that, it's been
helping me balance out my levelof activity.
So instead of going out andrunning the usual, you know,
five or six miles that I mighthave done this morning, it's
like, okay, you're stillrecovering.
You should, you know, take iteasy.
(19:43):
And that that'll help me recovermuch more quickly, which is
nice.
But that's how we're going toget to a healthier America, a
healthier world.
It's that personalaccountability that's going to
be enabled through wearables andthat data in the AI to help
interpret it and provide morepersonalized information.
SPEAKER_00 (20:03):
I'm also hoping that just the deflationary forces of
exponential technologies ingeneral, which I believe, you
know, we we know the technologyis deflationary in nature.
And as these technologiesadvance exponentially, the hope
is that the cost will start tolower exponentially as well.
And I'm hoping that AI will helpus reduce the cost of healthcare
(20:27):
in general.
But you know, I think that's yetto be seen.
There's a lot of unknowns ahead.
But I I do tend to lean towardsthe optimistic view of that
equation.
Zina, given RJ's rich backgroundin digital technology in
(20:47):
healthcare, what question do youhave for him?
SPEAKER_02 (20:51):
I'd ask RJ to reflect on one core idea.
How does he see AI not just as atool, but as a partner in
reshaping patient care?
For instance, could he share astory or an example where AI
made a tangible difference in ahealthcare setting?
And then let's invite him toconsider how we can thoughtfully
guide that collaboration toensure it stays human-centered
and ethically grounded.
SPEAKER_01 (21:09):
Great, great question.
I I definitely see AI in manypeople as artificial
intelligence.
You know, it is that augmentedintelligence.
It is very much that we shouldcollaborate with it to enable
ourselves to be better humans.
You know, how do how do we useit?
How do we explore ideas is justa powerful moment from that
(21:33):
perspective.
And just thinking of anecdotalstories, you know, in terms of
AI, you see a lot of storieswhere the human has been
challenged and has a particularcondition and hasn't been able
to figure out what it is.
You know, my mother-in-law manyyears ago passed away from
lupus.
Today, so it's been close to 30years now.
(21:55):
Today, still, it takes six toseven years to diagnose lupus.
You know, I've seen thosestories where you know you're
you're asking AI about theseparticular conditions, and it
surfaces that as a possibility.
You know, I alluded to the ideaof you're going to a doctor's
appointment, use it to prep.
There's a great augmentedintelligence capability there.
(22:16):
You know, you working with theAI to have a better,
well-informed doctor's officewith with the uh with your
doctor.
So lots of attention on bothsides, the the patient side and
the physician side to diagnosemuch more quickly, create
better, more personalizedhealthcare plans, just lots of
(22:37):
possibilities.
unknown (22:39):
Yeah.
SPEAKER_00 (22:39):
So Zina brought up something that I think is
important for us to talk about,which is the ethics behind AI
and the use of AI in general,but in particular in healthcare.
And in one of the previousepisodes, one of the
conversations that came up wasaround privacy.
So, how do we deal with theprivacy of patients and making
(23:01):
sure that that data remainsprivate and yet using that data
to be able to benefit withdiagnostics and just the overall
capability of the system shouldbe able to do a better job in
helping us with healthcare?
SPEAKER_01 (23:20):
So if you look at the various companies, and I'll
generically use OpenAI andChatGPT, they are not bound by
the HIPAA privacy laws andregulations.
So if you know you're puttinginformation in there, they can
use it how they may choose.
If you are going to yourhealthcare provider and they are
(23:41):
using it, then they should bedoing their due diligence and
signing what are called businessassociate agreements with the
OpenAI and other companies likethat, which then makes them
accountable for protecting thatdata.
So, you know, when you do go toyour doctor, ask them about it.
How are they using these systemsand have they signed the
(24:03):
business associate agreements?
Are they bound by HIPAA?
That's your first and andprobably most trustworthy step
in terms of understanding, okay,the hospital, the health system
is using it responsibly.
It should be noted that youknow, when you are using the
system, you don't have to tellit who you are to get good value
out of it.
So, you know, if you are fearfulof your information being out
(24:24):
there, just you know, don't tellit who you are.
You know, you don't have to dropyour name, your social security
number in there, your telephonenumber, um, or even your
specific age.
You know, say you're you're inyour you know 50s um kind of
thing to be able to give it lessspecific information around
identity, that it's a powerfulopportunity to learn more.
SPEAKER_00 (24:46):
Yeah, absolutely.
I think it's important forpeople to realize that they
shouldn't be sharing anypersonally identifiable
information with these systemsbecause that information is
potentially being used to trainthose systems, and you don't
want your social security numberor other types of private
information to be out there inthe open.
(25:07):
With that, RJ, please share yourfinal thoughts for our audience
and also let them know wherethey can find you.
SPEAKER_01 (25:15):
Yeah, absolutely.
I'll actually flip the ethicsquestion.
At some point in the very nearfuture, it will be irresponsible
to not use AI in healthcare.
And so we're all sort ofcautionary about it, but very
quickly, yeah, I think it'sgoing to be required to use it
and provide value and betterunderstand what's happening and
(25:37):
going on and a safety check.
Uh, to find me, estenda.com.
That's my company that I workwith day to day.
Uh, LinkedIn is a greatresource.
I'm always out there trying topost and share information that
I find fascinating.
Um, and very quickly, um, I'm onInstagram, Productive Harmony is
(25:57):
the uh upcoming book looking forfor uh March of 2026 when the
final editing phases.
It's it's wonderful working withwith my editors kind of thing.
And we have this constant giveand take around AI.
I don't want to clearly use itfor my book.
I want to you know be mycontent, but I do talk about AI
(26:18):
and and use examples of how touse AI in it, and and that has
really challenged them, whichhas been an interesting journey.
Um, but yeah, looking forward tothat coming out in the near
future.
SPEAKER_00 (26:29):
Yeah, congratulations again on the
launch of the book, and thankyou so much for being a guest on
the show today.
I also want to take a minute tothank Zina for her thoughtful
comments and questions.
SPEAKER_02 (26:44):
Of course.
And thank you for inviting thosereflections.
It's always a pleasure to bringthat thoughtful strategic lens
to the conversation.
Let's keep exploring these bigideas together.
SPEAKER_00 (26:54):
Very good.
Thank you so much, RJ.
Thank you, David.
Thank you, Zina.
Have a great day.
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