We are undeniably experiencing the profound effects of digital transformation; but in the midst of this phenomenon, we should always remember the human side. This is how Howard Rosen imagines the future of healthcare delivery should be. He is the CEO of Nova Insights, where he helps major healthcare industry companies in North America to create and deliver digital products that enhance their value proposition and market penetration. In this episode, he talks about how they are humanizing digital transformation, tying the strongest in automation, digital tools and access, and remote patient monitoring with the clinical side. Howard shares the exciting things they are doing at Nova Insights as they expand around the world. Looking ahead, Howard then talks about the science fiction works that continue to inspire him and why we are at a particularly exciting time as human beings.

#future, #futureisbright, #healthcare, #digitaltransformation

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The Future Of Healthcare Delivery – A Conversation With Howard Rosen

In this episode, we have Howard Rosen, who is an interesting guy. He has been working in the healthcare space and doing a lot of innovation, but he’s got a very rich and diverse background pushing new technologies and futurism. Howard, why don’t you start by giving your history? You’ve had a history in the television business and the defense department contracting business. Now you’re pushing the future forward. Tell us a little bit about how you got into the healthcare industry and all the different things that you’re doing.

That’d be great. Thank you so much. It’s an honor to be part of this show. It’s a lot of fun to tune into and insightful. I hope this fits that bullet as well. The quick story, because there’s a bit longer one, is by education. I have an MBA in International Finance and Marketing, so it’s trained to run a Fortune 500 company. I have to admit I didn’t attend all my classes, particularly one that said you don’t go from graduation to running a Fortune 500 company. With my profound disappointment, naturally, my next move was to go into a career producing film and television for about twenty years with a number of productions, both as a TV and film. With that background, I would fall into an idea that I came up with in around 2005.

This helped in terms of healthcare and how to better engage patients and clinicians. There is a story on that bridge with any question, but I seemed to have ended up inventing a cloud-based communication platform for engaging patients and providers for which I now hold seven patents. That led to me building a company as a solopreneur to entrepreneur. It was working in an international organization. I worked with both the Federal and commercial businesses, and military and civilian as you mentioned. The pandemic came and I went, “Now what do I do?” As we’re building and frankly getting a little tired of being pestered by my investors and my board, I said, “It’s time to kick in succession.”

I stepped back and I still remained on the board. I decided to build up my consultancy to do the things I wanted to do and what I had learned over the previous years. I’m zeroing in on what I call humanizing digital transformation. There’s a lot of technology and I was involved in a lot of technology. What I also saw is technology is building by taking up the human factor. Everyone thought, “The solution is technology, and the reality is technology is an enabler to enable the human side.” That’s where I’ve been playing up to now.

That’s the way that I look at the future and digitization. I do think that we’re going to revert back to the mean and that human interaction is going to become more valuable. It’s a pendulum where it’s swung in a direction with social media and all of these other things that have distanced us from each other and then we’re swinging back in the opposite direction. That’s one of the things, especially in healthcare. I found it has been a defining factor for doctors who are popular versus doctors who are not. It’s the ability for them to concentrate on their patients and not focus too much on what’s on a computer screen.

FSP - DFY | Healthcare Delivery

It’s interesting because all these tools, and some of them are cool, but part of our nature is to go to the shiny object as opposed to digging behind what’s in it. What’s all these shiny objects have done is they talk at us. They don’t talk to us and to your exact point, using the doctors, those physicians talk to their patients. I have a completely different experience, particularly for the patient, than being talked at and going, “You’re just another number.” They’re digits on the system.

Since we swung so far in the opposite direction, technology is increasingly being used for human adjuncts in regards to, “AI might make my note-taking easier so that I can focus more on having conversations with my patients.” I don’t think it’s exclusive to healthcare. It’s every single organization. Everybody realizes that face-to-face interaction is much more valuable than any digital things. That’s not true. I do feel that, from a macro perspective, there is a lot of value and observing trends and giving that data, but there’s another component of it where you also have to have this face-to-face interaction.

To your point, you can have the data collections who look at the trends, the insights, and where things are going to go, but the data collection number is crunching. That’s not the core of where’s the data coming from. In order to get good data, you have to make sure that your data source, for lack of a better term, is in a mode that can give you real data as opposed to bad data. You mentioned AI. I’ve got a whole soapbox on AI that I’ve written about. Particularly, where AI is going is terrific. It’s also been around for a long time. It’s been under different names. The calling of AI now is great and phenomenal for marketing and branding, but now, it’s still number-crunching. All it is big machines crunching numbers and going, “Here’s the probability of the best response.” There’s no insight into it.

That’s the big danger of it. People are thinking, “Look at all this insight we’re getting.” No. It’s just number-crunching working in probabilities. It doesn’t have the human side. Eventually, there’s no question those elements should be built into it, but we’re still years away from that. We were talking earlier about AI in terms of note-taking. It does note-taking, but you need the human side to review it because it doesn’t know what it’s doing. It knows the math and the boring algorithms. It knows this word next to this word next to this word, but it doesn’t know what those three words mean.

I agree. Insight is something that human beings will always have a monopoly on. Call me optimistic. Artificial general intelligence and things like that will not be as capable as human beings. I might be wrong, but I tend to think that I’m right. I think about the numbers crunching. Honestly, a lot of our life is numbers crunching. There’s so much work and being a human being in 2023 that an AI should do. I look at that as a good future, especially in healthcare. What are you doing now? I know that you’re consulting. What are the issues that you’re trying to tackle now?

The reality is we’re days away from launching my new adventure. Basically, we’re building a virtual healthcare stack, but the thing is it’s not virtual health because reality is virtual office is good, numbers are good, and automating things is good. From my experience over the years, 93% of the time, it’s all routine or you can use different tools to do it all, but 7% of the time, those patients need human interactions. What this does is it ties in the strongest automation, digital tools, access, and remote patient monitoring, but it ties in the clinical side. We have call centers and clinicians who can visit you as it is an adjunct to working with the providers.

We’re specializing in the multi-chronic condition population in the states. It is we’re going to be starting. We will be launching with a couple of states, depending on the timing of this. We will have announced that we’re still about to announce. We have that one component work from the states in doing that. Similarly, we’ve signed the first few contracts in the developing world in Africa.

We’re helping to accelerate them to where we are, the 5G for lack of a better term, from when they’re a much simpler system. The beauty of working in Africa is they don’t have the problems of legacy systems that we do and have to work around legacy systems. We’re going in and building brand-new, clean, and efficient systems from the start. There are no bad habits. It’s going straight to being able to outreach the patients.

When you say completely virtual, how’s the care delivered?

The care starts with other remote patient monitoring or interactions on communication platforms, checking in to see how patients are doing. Depending on the responses, you can do regular assessments, or depending on how the algorithms work, it ties them directly into a clinician or they can always ask to speak to a clinician.

Your annual wellness is one thing. If it’s a particular condition, it’s another, but what it does is it uses to discern the need to bring in human interaction. It’s not eliminating it. It brings it in when it’s needed so everyone is working at the top of their lenses. At the same time, for the population that prefers to deal with human interaction, you go straight into human interaction, whether address the individualness of it all or not put everything into a cookie cutter. We’re not looking at a big piece. Each one is an individual.

I certainly think that the convenience aspect of healthcare has not been addressed the way that it needs to be. To go to a physician’s appointment, you have to call. Oftentimes, it’s booked out for months. The appointment might change from now until then. Make sure you get all this paperwork done, even getting to the clinic. There’s a whole segment of the population. Transportation is a real issue. After that, you go to the clinic and then everything is well but then they might ask that you need to do labs, imaging, and all this other stuff. Coordinate all that is not convenient whatsoever, especially if you do have not your basic running mill physical.

If you have a chronic condition, it becomes so inconvenient. That is what I feel right for innovation. I look at it as the goal should be something like Star Trek where you have the ability to do a complete scan and have a consultation with a doctor that’s able to do it virtually and you don’t need to leave the comfort of your own room. It’s something that you can automatically link up to with whatever internet service that you have but obviously, we’re waiting on that.

In variations, we’re closer than you think. Quite honest, that was part of the driver that gave me the inspiration for the idea of the communication platform that it came up with.

Star Trek or what else?

Star Trek, without any question, it’s the original series onward. The quick tie between film production and healthcare is expanding a company from doing traditional film and education training. My first clients were continuing medical education and a class of Smith Klein dealing with type 2 diabetes. That’s where I learned about chronic conditions and the issues associated with chronic conditions. The difficulties, as you mentioned, travel being one of the big ones. This is again 2005 when reading with this. I said, “Instead of telling patients how to communicate and you’ve got to do this, what if you have put control in the hands of the patients? Let them determine how they want to communicate, text, email, interactive voice chat, or whatever they want to do and also from the comfort of their home.”

My thesis statement of what built my company and got me into healthcare was doing all that. The inspiration that supercharged it all was working with the VA. It’s one of my first clients. We had this amazing group where we worked with the women’s health group in Sacramento, California and it was combat-trained female vets suffering from post-traumatic stress who were pregnant. They get to tell 1,000 women in that circumstance every day. At that time, there was a 78% probability of a suicidal event, not to success necessarily but a suicidal event. The results of my goofy idea and my team built in this program were prior to using our system.

It basically had 25 vets to each clinician to manage them. Once the program is up and running, the clinician was managing 150 women. Each one thought they were getting better care and the biggest honor is during the time everyone was on my program, there was not one successful suicidal event during that time. The key to it was we’re automating a lot of the assessments that you’re talking about, but they didn’t have to come to the office. They could stay when they’re 150 miles away, 100 miles away, or 50 miles away and then have the capability of going in with kids all ready to go to the facility.

It works well with mental health and therapy. I wonder how well it would work for other more specific analyses. You can get a good pulse on the sensor technology. You can get a good EKG, but I don’t know if we don’t have a full body scan or if it’s going to replace a physical exam.

No. To your point, it’s a long time before you have a full body scan.

A CT scan and an MRI may not be equivalent to a physical exam.

I was taking it to the hologram world. All the tools are absolutely there like the CT scans. Advisors are amazingly pulled up in 3D imaging of different body parts. It is phenomenal. The toys are there but they’re big. At some point, you got it straightened now and it does come down to the algorithms. It’s all inputting information and it goes down to the fundamentals of all these things. Technology is how good the data is because that’s what it all comes down to. I’m certainly not a data geek at all but I do know what you need is good data. Unless you have good data to start with, it’s not going to help. Good data is not how the pulse oximeter is, for example, getting stuff off of that, and probably 99.6% of the time, you can get good data on there.

Unless you have the good data to start with, that technology is not going to help.

What you’ve got half the solution is the toys when you hook people up. The other half is you’ve got to ask the patient-generated data, which becomes more the holy grail because it’s not standardized in any real form. You need both pieces to get the whole person. You can get the full body scan at home in the hologram, but also you have to know how the person feels because that becomes a whole different parameter. We did early work with wearables in terms of collecting data with that. Everyone said, “Wearables, how reliable are they?”

This was obviously a few years ago, but many of the wearables, even though they’re 15% off or 22% off, or whatever the case may be, were good at being off the same amount all the time. Let’s say it was early Fitbit, and I’m making the number up. Let’s say it was off 10% of the time. It was always off 10% of the time. The valuable data is not how many steps they took. Valuable data is how much change was there in the number of steps that they took. It’s valuable information.

I agree with you. That’s something that the data doesn’t necessarily need to be precise but it does need to be accurate. I would be remiss. We touched on it a little bit. I don’t get to talk to people very often who have this interesting trajectory. Usually, it’s to get into this field, the science, and futurism. You have to have a very dogmatic path. You touched on your time in film and television. We also touched on science fiction. One of the biggest inspirations for me in what I do and honestly most of my interests and futurism have come from science fiction. I was wondering. Number one, is that also the case for you or is this something that you have gotten to from another pathway?

As I think about it, as I said, there’s no question that that was an element because I’ve always watched science fiction. I enjoyed it. I read it. I wasn’t a voracious reader but science fiction films were one of interest me. Depending on how science fiction you think it may be, I was also involved in the production of a small thing called Robocop.

Get out of here. I love Robocop.

I danced in some of that world but it was always fascinating to me. I was always interested in all those things. Though overtly never looked at, there’s no question played into what I do in terms of reading. I do a lot of online but I still get Discover magazine and Smithsonian. I still get the actual magazines and I’m a very proper mechanic. Think of a voracious reader of what all these things are.

Small tangent on Robocop. Frank Miller was the one who developed the intellectual property. I like him a lot because he oftentimes shows a dystopian future. Underneath the dystopian future is this element of, as a human being, we’re going to make it better. There’s so much dystopia that’s out there in science fiction, but there’s a lot of utopia too. Star Trek being one of them, which is one of the things that I highlighted. There’s always an element of the best that we could achieve also. That’s one of the things that I like. I do like Robocop a lot, especially the idea of bringing cyborgs to the mainstream. I can’t think of anybody else that did it better or did it earlier.

That was the interface that made it the most human for obvious reasons and how they did that but it brought it to, “It’s not my favorite robot going from lost in space in terms of how, which is the other side or the direct.”

Same thing. Stanley Kubrick had this dystopian version of this AI that went crazy. The future was so beautiful in that. One of the things that I love as an art piece is retro-futurism. What did the people in the ‘60s think that the future was going to look like? It’s always sleek and beautiful. I feel like now, there’s a lot of people that are trying to make that happen. For better or for worse, the cyber truck is Elon Musk’s attempt to do that.

It was an answer to a conversation that he had with his kid saying, “Why do the cars not look the cars in the future from the movies?” That trend is happening, which is exciting. It’s an exciting time to be a human being. Everybody knows that we’re on this exponential growth curve. The changes are happening unlike anything that we’ve ever experienced before. You’ve experienced it, too, especially with your non-traditional path.

FSP - DFY | Healthcare Delivery

What’s Moore’s Law on steroids in terms of exponentially increasing interactive in terms of how this comes together? It is interesting in terms of the past influencing the future. Using the example of Elon Musk. In the past, he said trucks are going to look like this so that’s what it’s going to look like now. The inspiration for me is when everyone always thought the future looked like was a movie called Logan’s Run. Every hair is white and bald. For some reason, everyone thought that was going to be the future and that hair was a real problem.

Composition can also be fascinated by history. We go through all the things that we’re doing. This is all cool and going. No one has ever experienced it but the reality is every moment in history, many cases over the past 200 years let’s say, we look at all those technologies that we have. We look at all these things and how things are changing. No question that the speed at which that’s happening is dramatic, which is the utopian side. The dystopian side is it can be co-sideways so easily because, as a human animal, a lot of this is almost too much to comprehend unless it’s fit properly. Let’s use ChatGPT as an example. AI and all the approaches to that brand of doing that are great and it’s a tremendous amount of value it has it’s going to have for us but you’ve got to know what you need.

For ChatGPT for example. Part of the programming was you always have to have an answer regardless of whether he knows the answer or not. He’s programmed to make up answers. Unless you know when you’re using ChatGPT in your browser or whatever the case may be, the answer you get may or may not be the right answer. You have to ask it to get sources. You guys know what those guard wheels are. It’s a blanket acceptance of things going. Obviously, very much of the future looks great with a lot of opportunity but it has also gone with a cynical look. We got to be careful because it can go sideways.

We have to be careful accepting technology because it can go sideways.

What’s interesting about the ChatGPT when you ask it to give sources, it makes up the sources too. That’s very interesting to me. The hallucinations of giving you something that wants me to hear or feels that I want to hear. For example, if I were to say, “Write me a research article with sources about X,” it would write that research article with totally makeup sources. It’s it looks so great that it has fooled lawyers where it is inputted that and put it into their cases and have got called out for that. What’s funny to me is the hallucination thing. It’s such a weird byproduct. Who would have thought that that would be a problem?

Exactly. That’s why the tough part is knowing what you can’t do. We don’t know how the coup is the coder. What coding did they do? What were the parameters in the coding that they had? This is the way. If you go online, how many chat AI bots are out there? I’d say it’s probably about 300 now. How do you know how it’s all programmed and everything else? Look at it as an innate, not as a solution. All of these things are enablers, not solutions. This gives you some parameters. We touched on it earlier. It gives you a good first draft of all sorts of things, but then our job as a human animal side is now, we got to build on that. Let’s check this out but it’s a great start on some pieces.

Someone was telling me in another session that was an expert in AI that the biggest thing for him that he’s seeing is the ability to code, in general, drop down significantly. I know that you’re building something out yourself now. I’m sure that you probably are in it with that whole software stack. Has that translated to a real difference now or is that something that’s coming down the pipeline?

It’s happening now. If you haven’t read it already about the gaming industry, hundreds of thousands of coders are being fired. Which one is it? Is it ChatGTP design? It was insane. It is shown in a picture. Here’s the diagram of what I want and say, “This is what I want. Here’s the output and I want it in Python,” one of the computer languages. In seconds, it gave the entire coding for the entire interaction set that you showed as your sketch.

Again, you need to have somebody to check all the coding. It’s now taking the work of five people in three weeks or whatever the case may be. That is real-time. Depending on what you want, you can go, “I want to go from Python to C++,” another computer language and it’ll change it for you. The reality is everything is going to Python. It’s a swift shift that way.

It’s a systems engineer and he’s telling me some of it all. My programmers are telling me what’s going on. It’s amazing what it’s doing but it’s having real time effect now. Coding and programmer used to be a high-priced area. Salaries are dropping. We need senior people now and we’ve got machines that can take care of it quickly for us.

I don’t think it is necessarily a bad thing, especially for a lot of the applications that I feel like I want to have. The barrier to entry to coding is so significant. It’s disheartening. If I said, “I want an app that is able to connect my education courses so that I can distribute them online,” I have to go out and find a developer. They might make a stack. It might take me 3 or 4 months. The idea of democratizing it is interesting.

That would allow for a whole other sector of the population to get into entrepreneurship with coding, whereas now, they look at it as this democratic field and open to everybody but it’s also very difficult. It’s not like the early 2000s where I could learn how to build a website and then all of a sudden, that transition into a Fortune 500 company. You have to learn a lot to get through that. Not everybody has a time for that. I certainly don’t have the time for that.

I completely agree. It’s analogous completely to the film-television business. It’s all digital. Anybody with a phone can make whatever they want to make. You have a tool on your laptop to do all the editing and it changed it all. A great example is this. Have you ever known a show It’s Always Sunny In Philadelphia?


The pilot was done on an iPhone.

I didn’t know that.

They use an iPhone. It was a four. They literally shot it on an iPhone. They edited on with the tools that existed on their computer and submitted it. To your point, you can’t get more democratization than that. Now, the fundamental issue is a lot of garbage gets created but the reality is democracy is messy. In terms of democratization, that sits it all perfectly but it’s a way for people to find things. These gems are hitting that don’t have acts. It goes back to the early discussion in terms of access. It’s allowing access to things that you had access to before.

The reality is democracy is messy.

I’d love to hear your insight considering your background on everything that’s going on with the film and television industry now, how they’re trying to push back against AI, number one, but also the decrease of legacy media, and how it’s not important. With all of the different technological advances, it makes less sense for us to have these large organizations that are the arbiters of all the content that comes out. I might be wrong. How do you feel about it?

When I was very young, the TV we had had three channels. That was two to start with. It was a good thing because you had a shared consciousness of the population. All of them were on CBS on Sunday night, to date me and everybody, who’s tuning into this. I was very young when the Beatles came on but the Beatles are on before my time and Elvis. It was a very shared consciousness and there’s something to that as a society. The fragmentation problem is in destination television or destination programming now. It’s certainly changed how you don’t have that shared consciousness anymore, which is the value in terms of something that is an experience.

It’s having it all out there. The problem is when you’ve got the media stacks that exist now, a perfect example, it can be used for good or very specific purposes. They have the ability with mass media to control certain things. They have considered less control than they used to in that for the same reason. Whether it’s good or not, it’s a tough call. If you producing something that’s a value, sure. For example, I’m a big BBC person for the news. I watched the BBC for the news. It’s a great source of the news so that’s my new stack. For TV, it’s picking and choosing those of that stuff. On Hulu, I’ll watch some stuff. On Apple, it becomes more of a shopping but it’s going to Wegmans. That shelf is a little bit on this shelf.

It changed the nature so it changed the economics. To your point, it’s changed a lot in how production has been done. The solution that the studios have done production to look at film is events. Everything is an event. We’re going to go through the entire DC catalog. Everyone is going to be a superhero. The problem is people are tired of it now.

It’s gone a little sale.

A film like Oppenheimer and Barbie got tremendous because it was different. It wasn’t this big superhero thing and they got great ratings. A lot of people showed up for them because they wanted that change. The problem is the big machines and those big conglomerates of media, it’s run like my alma mater out by the NBA. It’s looking at the numbers, not looking at the human side of it. Statistically, this is okay. The mathematics of film is very simple. For every 10 films that are made, 8 are going to lose a stupid amount of money. One is going to break even and one would be a massive hit. The problem is they have no idea which ones. It’s throwing the stuff at the wall. What they’re trying to do is narrow it. These big superhero movies make more money than the smaller ones so we’ll do that.

It’s interesting now how a lot of these companies are becoming much more lifestyle brands. If you have Disney+, you’re a Disney family, or Apple is an identity now. That’s an interesting trend for companies in general.

Everything is brand management. Everything has become a brand. News has become a brand but the old networks are that way. NBC had its own brand. ABC had some brand. It was different. It was much more esoteric, whereas now, it’s much more specific. The biggest problem is you throwing so much immediate people as so many things. You’re getting everyone overwhelmed.

Everything is brand management. Everything has become a brand.

The bigger problem is you’re overwhelming people and everything. If you’re going to every news station on TV, everything is breaking news. Shows are called breaking news. The difficulty is to be able to discern. I use this example a lot. I’m not the only one with Google. Whenever something is going wrong, Dr. Google would tell you what’s wrong. What people don’t realize is when they go to Google, 95% of people looked at the first research items and that was it and took them for gospel without trying to figure out why are those the first three items and what’s behind those first three items. They didn’t care. They say that’s the answer to my problem.

People are manipulating search engine algorithms to sell snake oil and, in a lot of cases, with healthcare.

It almost drives you crazy as a doctor if patients come in going, “I googled this and I’ve got arrhythmia or I’ve got this problem. I saw this drug on late-night TV. I think I have that problem. I’ve got male pattern baldness. I take this and shake it in my head so I can grow up with an afro tomorrow.”

My biggest thing now is that people are getting into this idea that titanium, which is a very common metal that we use in surgical fixation is not good for them. That’s something that is a recent thing that I’ve heard.

Along with many crazy things, I’ve heard that one.

I don’t think it’s real but, every now and then, you get an idea that permeates through from multiple different sources. We’ve had 2 or 3 patients in the past six months who have asked me about either removing their titanium or that they didn’t want to get titanium. That was something that was interesting to me. I didn’t replace them.

Is that a change for hip replacement? Do they want wood or something?

There are ceramic hip replacements. Overwhelmingly, titanium has been used for decades but my point is that it’s interesting to have this other view where you’re not exposed to something. You have this normal protocol that you follow and then all of a sudden, an idea comes from Google or some snake oil and then it permeates into your little bubble. That’s an interesting concept for me. You wouldn’t expect it. I wouldn’t expect someone to try to convince me that the Earth is flat. Over the past few years, I’ve met people who have this idea that the Earth is flat. Very few people and they’re not close personal friends but I definitely met people in the community who believe that. I don’t think that that existed a few years ago.

It goes to your point in terms of a social issue back to the dystopian side. There are two things. All these technologies find like-minded people is what social media has done. At the extreme, it’s this whack-job idea and all said, “There’s another person with the same whack-job thought.” They start building on each other. It could be a thought but they are going, “This must be real because these ten other people have the same idea so they build upon themselves.” Years from now, psychologists will look back and will explain some of it, but it’s this bizarre desire to bond with somebody and bond with these ideas. To your point about the flat Earth. I won’t go into it, but I agree with you. It’s not flat. I don’t know if they believe it or not. It’s they want to believe it.

It becomes a mini religion. My religion is there’s a flat Earth and there’s a result of the flat Earth, X, Y, and Z. It’s a weird phenomenon, but social media and technology have enabled that. It amped it up obviously to the stories, but again, the algorithms in the social media programs and platforms. That pushed that further and it became an interesting phenomenon. I’m not sure but it’s a good one because you accelerating non-fat-based or scientifically fact-based ideas and letting it fester. It is benign like that. Let’s say Joe over there believes that the Earth is flat. We’re talking about the environment we’re in now, you can go, “How wrong can it go?”

One of the conversations that I had with somebody was an interesting point. They were saying that this was the next round of evolution. For such a long time, genetics were an issue. If you were born with some random genetic disease, then you would be weeded out of the gene pool and your progeny would not propagate. Now, we have a lot of tools that help those people succeed as they should. They have a right to life the same way that we do.

The likelihood that that person is going to convince somebody else that the Earth is flat and so much so that they’ll get married and have children is unlike. I was like, “That’s so interesting.” I wonder if that’s the case that 100 years we’re looking for, the idea of evolution will be coming from ideas. The people who have the most correct ideas, which are natural physics and science and everything like that, will be the people who will be most likely to succeed. It’s a new version of natural selection. Anyway, it’s something that I thought about.

You’re absolutely right. It is fascinating. We’re so early days in what that means. You see now a bit of a divide in society between those who believe certain things and don’t believe certain things. I’ll go bold to say those that believe in fact-based or provable scientifically based products, I don’t think that’s right. That must be my fact.

The 2016 era, when people were introduced to the idea of alternative facts, is when we made a break with how accurate you had to be with what you were saying is correct. That’s an interesting thing. Politics aside, I did want to talk with you a little bit about your military work, which is something that is super interesting. I didn’t get an opportunity to talk with you about it. Tell me a little bit more about your time with the VA, the defense department, and all that other stuff.

We started with my first trial of the technology or the platform I talked about. It was with an NGO. I was working with a gentleman who is suffering from post-traumatic stress and mild traumatic brain injury at a convalescent group called Pathway Homes out of Sacramento in Napa Valley. It was fascinating work to work with them because they had short-term memory issues and everything else. We’re helping them to use technology to help interact with them. That trial was successful. In fact, literally, two weeks into the first trial, I got a call at midnight. I was in the Eastern Time Zone and it was 9:00 their time. A friend Guzman called me up and said, “I called to let you know your technology helped save a life tonight.”

He hung up the phone. Of course, I called him right back and I was wearing Adam. It must be a half an hour. Every word you can do because I’m still producing film at the time, this is a side piece. He said, “Why you’re so mad?” I said, “It’s because you don’t understand, Fred. I thought this was a cool technology and a neat idea. Certainly, business is good. I thought this was a social good but never that they would be something that could help save somebody or help support them. Now I have to find a way to do this again. I got to see if I can help one more person or those who won’t sleep nights and quit the film business to do this all the time.” I became evangelical about it. Some of the clinicians who work there went to other VA facilities and they started talking about these VA facilities.

That’s how I got into the VA. It was through that. At our main center, we worked in Sacramento with Women’s Health, but also at North Chicago at the James Lovell Facility. There, we had all kinds of work and papers that came out of working with high-risk suicidal and traumatic brain injury. To your point earlier, I’m huge and mental health and behavioral health. I’m working with gentlemen and women in terms of dealing with it all and pushing the envelope in terms of what we can do because it was not the traditional care process.

The head office was looking at us at scans whereas the facilities are going on, let’s keep on going. While we did that, we had an opportunity to work with the Department of Defense when we got asked to work with their program called Military OneSource, which is the wellness ongoing care management for active duty personnel. When the VA retired, that was active duty. To be working with them was more catch-all associated.

Let’s make sure you’re being taken care of. What it was used to do was if somebody said, “I have a problem,” whatever the problem could be, they used our system to automate follow-up and to make sure that they were getting followed up if they weren’t created an outreach to make sure it was taken care of. We had a front-line taking care of people. This took to your earlier point. This did all the follow-up side, which is amazingly administratively heavy, which is what got me interested in creating rudimentary versions of what’s now called Robotic Process Automation or RPA, if you’ve heard of that yet.

I have.

It’s something I’m very much involved in which is where you have ChatGPT as an example of where a patient can get information through an automated assistant. RPA is the behind-the-scenes assistant working with physicians and clinicians.

It’s admin work that’s putting in insurance and stuff like that.

It has your schedule for tomorrow or for Monday. It knows you’re seeing Sarah James. Based on the programming, it’ll go search out for any updates and Sarah James’s history throughout the entire health system. They had any tests or blood, if they’ve done prescriptions, or whatever the case may be, they update the record and do an analysis based on her parameters to say, “Based on this change or these elevated levels, you should look at this and this.” When you have your fifteen minutes with Sarah, it’s not asking all the questions and it’s not even you querying about, “What are these? It could be this or this.” It’s already done that work to help trigger your discussion. In terms of efficiency and effectiveness, it’s phenomenal.

How do you measure efficiency and effectiveness?

Efficiency is the information that’s there and the ability to track that information down. If it’s not there to figure ways, it’s alerting to be able to track the information down. If something is wrong, it’ll highlight that right away. Efficiency is all the information is there and it turns the FTEs and the full-time staff. It allows the administration to do things much more productively than some of these much more rudimentary tasks of following information. We’re going on searching different databases all the time and sitting at the keyboard trying to track things down. It automatically does all the systems.

That’s pretty interesting. I do think it’s going to be very important in the healthcare field because there’s so much admin work. I’d love to talk to you more but we’re coming towards the end of our time. At the end of our time, I always ask all of my guests three questions that I haven’t been able to ask them that I was thinking about. A lot of them are similar to other questions that I’ve asked other guests in the past. The first of which is where do you see healthcare in the future? What do you hope that would happen such that it’s a future that you’re excited about?

Two things. One is you’ve heard about digital health, eHealth, and mobile health. To get out of that, we call it health. You don’t have to give a name to it. You don’t give a name to apiece to it. It’s healthcare. It’s how we’re helping people. It is the first part. The second part is, and we touched on earlier, more into what I call precision medicine. The care I’m getting today now is not like, “Here’s a checklist of things.” It’s tuned to my needs, body chemistry, genomics, or what is happening to me. If I’m sleeping four hours a night, it’s not considered a problem because that’s better than the three hours I had for 50 years. It’s normal as opposed to somebody else to be considered I’m normal.

FSP - DFY | Healthcare Delivery

You’re on sleep three hours a night? Is that a real deal?

Yes. Now I’m up the four and a half.

You have so much energy.

I’m exhausted. A friend of mine who slept ten hours a day. It’s a joke I’ve lived twice his life. That’s where I think it’s all going to be going in those areas in terms of being much more specific or in tune with our particular needs. That’s how you get real care. Frustration is my personal example. Something weird showed up in one of my X-rays. The main reason I thought was because it had better X-ray systems than before. It was a concern about years’ worth of tests and at the end of the day, 51% were negative and 49% were positive. It’s like, “I guess you’re negative. Let us know if it hurts and then come in again.” You’ll get us out of that healthcare and into knowing much more in-depth information as opposed to the art of health versus the science of health.

That’s the trouble with too many tests. There are so many false negatives, false positives, artifacts, and all sorts of different things. Until we get accuracy and precision that’s on the atomic level almost, I feel it’s going to be a lot of that for a long time.

There’s no question, but part of the problem is because the testing is getting so accurate and so clean. For example, digital X-rays or 3D digital X-rays are so much better than even a few years ago. Things are showing up and they never showed up before. For those things showing up or raising flags, it may have existed my entire life. The good thing is you’re getting more accurate pieces of information. The bad news is it’s raising all kinds of flags. I’m not the only person that’s happened to say, “Something showing up that didn’t show up before.” This is why it didn’t show up.

We talked a little bit about science fiction and its impact on your life. What would you say is some significant impactful science fiction that has affected us as a species?

That’s interesting. Maybe it’s because it shows age. I do think Star Trek was probably one of the biggest influences on a lot of people. Certainly, now it looks quaint. It was the whole idea when you went crack, you would go through the door, and the door automatically open and close. It was mind-boggling. People went, “How does this happen?”

The reason it was so relatable to a lot of people, which is why it’s so valuable, is because Gene Roddenberry spoke with NASA scientists and all scientists around the world. He goes up to the show to say, “What’s coming up in the next 20 to 30 years?” He built all those things in knowing what was coming. To me, it opened up ideas of this is not violent near-term but these things are approachable and reachable. Provided a vision of the future that wasn’t mad max is very hopeful.

It’s post scarcity society. We’ve moved past money as a denomination of value. A lot of great things that I hope come to fruition. Touching on that, my last question is healthcare aside. What is the technology that you want to have happen that you’re looking forward to? I’ll tell you mine. Mine is robots. I can’t wait until I have a robot butler that waters my plants and folds my laundry. I can’t wait until all of the menial tasks of being a parent to be quite honest because I have a two-year-old. I can’t wait until those are taking care of for me.

You got fun ahead still.

It’s fun.

It’s great. I’ve had four.

Good for you. That’s my perfect number. Me and my wife are in negotiations now about numbers.

It was a fool’s eye to find that out.

What would you say is the technology that you’re most looking forward to?

That’s interesting. It is the amped-up version of the digital systems. We’re using Alexa, Google, or whatever the case may be, but to gather information and put it together or to impart to do what you want, I said, “I forgot to water the lawn. Can you set sprinklers on?” It’s to have that extra support system to go to do some of the things and gather the information where we’re able to do or whatever the case may be to do what I want to do. It is an automated driverless car because that scares me.

Wait until we have automated drivers. That’s pretty thirty minutes of free time.

It can’t happen until it’s all driverless cars. You can’t be a hybrid. Hybrids have humans. You got to be kidding me. The idea of thinking of an algorithm that can figure out who’s going to do a whack job turn, it’s not going to happen. If it’s all driverless, without question, that’ll be the coolest thing. As long as you get humans driving, you’re going to have accidents.

Certainly, a lot more safety and efficiency when everything is connected in general. I totally agree with you. I can’t wait until I have an assistant who I can say, “Book me a flight for this time or for this day.” It already knows my schedule.

It knows the schedule, what you like, that window or whatever, and if you want to have certain seat preference. It’d be very cool and it can do it.

It was so nice speaking with you, Howard. All the best of luck in your new venture. To all of our readers, please like and subscribe. We will see you in the future. Thanks, everybody. Have a good day.

Thank you so much.


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About Howard Rosen

FSP - DFY | Healthcare DeliveryAs the CEO of Nova Insights, I direct a consulting business that helps major healthcare industry companies in North America to create and deliver digital products that enhance their value proposition and market penetration. I have over 20 years of experience honing skills in engagement as a film/TV producer and in my second career as an inventor (awarded 7 utility patents) and founding/ operating international businesses that develops innovative health technology products and services for various sectors, including military, pharmaceutical, education, clinical health, and insurance.
My core competencies include advising cross-functional stakeholders, promoting clinical product and service offerings, coordinating customer-facing business and technology analysis, and managing product development and delivery processes. I am also a distinguished thought leader and mentor in the healthcare and technology domains, contributing to Forbes , a senior Fellow Columbia University (HITLAB), Global Affairs Canada, UofT Hatchery, and Emerging Leaders Forum to name a few. My mission is to leverage my expertise and network to drive improved clinical efficiencies and patient experiences.


By: The Futurist Society