EP 20: Virtual Care: How IT Supports a Digital Healthcare Experience w/ Claus Torp Jensen

ABOUT THIS EPISODE

The advent of virtual care is changing the way healthcare is delivered, bringing a more holistic model to the fore. By connecting data points and services, healthcare providers are now able to make more meaningful contributions to the overall health journey of their patients.

In this episode, host André Christ speaks with Claus Torp Jensen , Chief Innovation Officer at Teladoc Health , about how IT is enabling this revolutionary digital healthcare experience.

They also talk about the different types of virtual care, the four ingredients of IT enablement, how IT can create more consumer-centric solutions, and bringing the same care to building products for internal users.

To hear this interview and many more like it, subscribe to the Unleash IT Podcast on Apple Podcasts, Spotify, or our website.

Listening on a desktop and can’t see the links? Just search for Unleash IT in your favorite podcast player.

Instead of thinking of it as the end part of a long process that starts with let me define some requirements, thinking about as a fundamental participant in the definition of the problem. Welcome to unleash it, a podcast where we discuss the experiences and ideas behind what's working in enterprise architecture and digital transformation within the IT landscape. Unlock Your Business has digital capabilities. Transform your enterprise architecture. Unleash it. Let's get into the show. Welcome to this episode of the unleash it podcast. My guests today is Klaus top Jensen, the chief information officer for Tele ADOC health, a multinational talent medicine and virtual healthcare company based in the United States. As a senior executive with a strong product focus and twenty plus years experience leading large scale transformation efforts, Klaus has seen the best and worst of how organizations approach change. He believes that product focus, design thinking and time to value are key ingredients of a modern customer obsessed organization. COUSTRAK records demonstrates how he combines people, business and technology skills to drive technology and able business transformation. Among many others, his specialities include synthesizing organizational needs and tackling the most challenging transformational problems, turning vision into action, apply ying structural thinking too complex problem sets and leading the creation of breakthrough integrated digital experience and ecosystems. Welcome to unleash I t class. Thanks and a mouthful. So we've heard a bit of explanation about your background, but I'm curious to hear it from yourself what your responsibilities as cio at till the DOC health are. So the I can stand or information or innovation. In my case it stands for innovation. It's interesting because the sort of title of chief innovation officer...

...has been used for different things. It's all O helpits a new role and it basically means that alter knowledgy, all product or product engineering, all the data analytics and the clinical design for the things we do all rose up to me. In some ways, you can say that the gist of the rows to be the chief storyteller. What sure, health care? So I tell stories and have the organizations do the stories into reality. Yeah, maybe you can explain our listeners a bit deeper. What exactly is virtual care and in what ways master tradition, rules of it and technology be actively like rethought to support a more digital and integrated healthcare experience. So what's like your primary task of a chief Innovation Officer in this process? So virtual care is an interesting concept and you have to ask you. So what is the purpose innovation in the context of what you could call the next normal, or the even the new normal for care? We've been talking about virtual care for a lot. I tell the health is is more than that, they ca told. So it's not like we haven't done virtual care before. Over the last two years, maybe year and a half, and we've had some stuff going on in the world that led people to seek more virtual care. So it's sort of exploded and people have talked a lot about it and there are a lot of players out of virtual care now. In some ways, asking as you can do a visit on video is actually the wrong question. I mean audio video carebuilties to talk. We're using what do we do? Could builties to record this podcast? They've existed for a long time. It's not you, but using it in the context that health care is more difficult. There's sort of psychological component to no longer associating proper care with going to a brig and mortor facility. So the first paradigm shift towards a different care model is that it's breaking the ties between us getting an interaction with a clinician and not necessarily being...

...in a physical building. That doesn't actually solve the whole problem, by the way, because all you did was you replaced one system where the parts don't understand each other with a different system where the pots don't necessarily talk. You think about what people want. They want something that combines modern healthcare and the advance capabilities with the intimacy of, let's say, a village doctor. So you want to convenience, the intimacy to context your understanding, and even the shift to having a video based of film based encounter or consultation doesn't change them. So there's a second paradigm shift, and that's my answer to what does achieve innovation officer actually do is reimagine you have the possible, because in today's world we build great solutions for lots of independent things, but it's like a city full of buildings where if you want to use something another building, you have to go down to the street, you have to go next door to another building, you have to go into door and then you got to go up ten smits. ME. So, and that's all on you. You orchestrated in your own experience. The real question is it possible to do better and help people make better decisions and in some ways power up Ampli try, if you will, the larger health care ecosystem, instead of trying to replaced at the ander. Isn't to replace it is to make it better and connected better in a way. That's the innovation happens on top of this sort of city escape of the independent buildings. That's one way is saying what does achieve innovation? Officer to do under the headline of imagining in different future, let's talk a bit about the virtual care or the types of virtual care which exists today and and maybe get some opinion from you. Which of those different types do work better in a virtual way and all like, which which are still complicated, maybe due to like social topics, also maybe due to technology constraints.

Maybe you can like break it down a bit then. And Yeah, let us have more insight into what different types of which you care. Can you imagine? Right? So, the most of his one is having a visit immliter. I need to see a doctor needs a doctor. Now you can call the acute episodic care, where you have a fever, you're not feeling well. Instead of going somewhere, you have an interaction with someone that's got and to degree that you don't require tests, etc. That works everyone and in many case, if you go ask physicians that have been out there for a long time, they will tell you that if I know what people's temperature is, if I know a lot about about what their pauses and what most people can do their in positive they really have to, if I can get decent information about how they're feeling, I can do a pretty good job of saying it's something we can deal with, or do you have to go somewhere so that we are I should figure out what I do with an acute scenario. Very amenable a virtual set and we've been doing that for a long time. There's a whole other category of care which is not about a visit, because of how do you manor manage chronic condition? So think about diabetes, hypertension, recity. You can add mental health, make because that's it. That's a condition that lasts for a long time. These are our conditions where it's sort of a combination of the healthcare system and you manage in your journey of hopefully health and managing that candition well. So there's a whole different category where we're talking about a stepcam. All that reaches from self help all the way up to slotting in specialists that you can have a visit with from time to time. So that's a totally different kind of virtual or digital encounter. But also very meanable to a virtual site because again, these are scenarios where we may send you a device, might to do this, may send you a device to hell, you manage your blood pressure or you wait or you blood sugar, and that then becomes data points that roll in a managed...

...care for so very meanable to virtual care, but you have to think about how you removed to friction, whether things just work out of the box. So you have to jump to loops. Matters a lot for adoption. A third category of care that we're beginning to see and merge and we certainly you know, I work for a hospital. Before joint tell of our health and one of the big questions was what you do when you discharge people from hospital. So this whole notion of remote patient uniting, especially after an acute episode is a third sort of category of virtual care. Again, you can get basic biometrics and you can do that with pretty simple devices, whether these are wearables or to send people home, with what's called a pole simator, or measure your bolts on the option and level in your blood. You can get those data points, you can be pretty confident you're going to manage people who after they become discharge and you can catch whatever is happening as it starts. Right. So they those three things are becoming mainstream pretty rapidly. The fourth one, which is to say we all go to our primary care physician every year. It's supposed to that. That's how you're supposed to stay on top and we go in person because you need a blood draw and you need to have your blood pressure checked and as a whole bunch of stuff. That's a good person, but you know, I necessarily have a meaningful interaction over time with that person. It is like it happens once a year and you get really physical check out. What it was possible to change that one so you could get that physical check out virtually, but it was woven into all these other cauduilties that are talked about. So it becomes a more connected ecosystem where you can blend the different kinds of interactions under one single integrated experience. Wouldn't that be a better month? And probably also it would be much more continuous than just like time stamp based right. So what I wonder is how much of the devices we have right now, let's let's pick the very simple example, how much an apple watch or those any other like fitbit devices and so...

...on, how much do they play into a more continuous delivery or capturing of data? So that is it actually serious enough, serious enough for virtual care? Or is this like would like from your perspective, like our okay, no, we we are like on the different level and need different devices than that. and Or is there any like interplay between the like those more commodity the vices, and then what you what you put in place? I think it's a good question. In my opinion, is still emerging. I have no doubt that we will have the issuture, and it not that far out, where our personal devices become a meaningful data point collection. They're not a replacement for professional grade devices that give you a different quality, but to the degree that you're okay with having a ten of twenty percent sort of variability in how close to the reality is the data point. There's certainly good did it points to have and they give you, as you said, a more continuous kind of way of addressing people's health, if you want to label it. What we're talking about this whole health, but we're talking about whole health that's a little more realistic than the traditional models for population health management, and we're climat work in a way where is not trying to disintermediate or replace the existing system. That's not the point. It's trying to make the existing system better by filling out the gaps, by giving people choices in terms of the motive care, by connecting the data point better and by also giving the providers side of the equation better too, because this is not just about what Eldt can do as a clinical company. Yes, we have clinically buildings, but it was about the technology we can give to other people in health care to make their interaction or the system around them more powerful work. If you think about like the different categories you explain now and translate that into requirements and challenges towards like also the infrastructure and and it and ablement for that. The holly would...

...to describe the challenges are they? We're as complexity in where it's more like straightforward to to provide that, and so maybe you could give us some some view on like the underlying architecture. Almost it's a big question and is multidimensional. I think that's the first thing you have to realize. It is not a UNI dimensional problem. If it was a uni dimension problem, we would have solved. I think it requires for ingredients treat it attendable. One of the intent to send you ingredients is you actually need clinical expertise. You actually need to have clinical programs that work it. What we're talking about is not based on proven clinically efficacy, AK clinical effectiveness. It's just another you know, toy or two. We actually need to know what works on with us and we need to base that on actual observations in the real world, actual data points and actual proven outcome based reporting that says this is where you get out of doing it. So that's the one thing, and there's a technology component underneas that, but it requires clinical expertise. The second thing you need is you need the technology that allows us to do all this stuff, whether that is having a virtual visit, whether it's putting data together where it's collecting data points from devices, whether it's putting robots and hospitals as one of the things we do, so that a, let's say, a specialist can actually remotely connect to an I see you to monitor patients. There's a lot of technology just allow you to do what we talked about and not just do it for us as a company but, as I said, do it for others as well. The third thing you need you need to have the ability to do that skill. Think about it. Every day you have picked a number ten times with people that want in acute virtual care visit and you've got a network, a position that could consivably do that visit. How do you manage the adjustice and Mary APP who gets to talk to what position, on what...

...cadence, with what prioritization and at what time does that actually mean that they get to talk? That's a complex logistical effort and it requires partnerships and support services to operate that kind of thing and scale. It's not as easy people think. So the whole logistical part of this, the partnership to support services, is part of doing it. At scale. Do you know where in a corners on interest it actually want to have a better K model. You're talking national, global skin and that's a happen. So those are the three tangible. The intangible is a choice. You have to choose that you want to make the system better, not replace it. When I talked about amplifiers, that's the choice. Yes, there's going to be things we supplement with. We're not trying to replace a hospital. We're not trying to replace what the hells in chance company does. We're not trying to replace what the benefit team at a lot of employer does. We're trying to make it all better. So I give your long list of things that we can deploy as choices on how we can amplify what you do already and the things we can do to supplement what you're deployed in the health care a system already. And that's an important distinction, because now we're talking about how you disaggregate the silos a kid guilties and how we can show up with think of it as a menu card, but different capabilities that we can apply depending on what situation of working into. That's a true nature a platform strategy. That's aimed at making the system better. Not like very interesting. Maybe, as we're talking and as it talked about scale, can you give us some numbers which are like probably available on what's the scale of the company, of the Organization today? So how many, how you call it into actions or care events, I don't know what's the right term for it, happened today and and and how much is that growing? Does the does that's the company share that somewhere as well? So that's an interesting question as well. So let's start with some simple numbers and then we'll get into some of the more complete a simple number is,...

...in the US, seventy two million people, individuals. Those are the number of people that we have as members, Aka they had access to US services. Everybody uses it every day or every week. But seventy two million people have access to our to the tone set of our services. Some people have access to more than one type, other people only had access to one type. Quite a good share already. That's a good share. That's twenty percent of the American population that had acts reservices. If you think in terms of family had said, ours actually look like seventy two. So then even add international but if we just stick to the US, seventy two to two million. Now you get to so. So how Manny Care Interactions? I think that's a good work. That was the word you use. How many Care Interactions Do we have? Well, if you're talking about the actual visits, you're getting into millions. If you're talking about all care interactions, including I do my blood pressure a couple of times a week just because I'm trying out our program and I don't actually have hypertension, but it's a good thing to buy your own services. So I'm on the program to manage my blood pressure. I do that a couple of times a week. I weigh myself a couple of times a week on the scale that's tied to out program. So if you count those care interactions, you talking tens of hundreds of millions actions. And that's the whole point, because not about how many visits you can manage, is about how present you can be and how much of the white space you can fill out in people's journey of health. So if you're look at the growth or tell Abo health as a company, it's actually not just about members because, as you said, we already have a large fraction of the population. There's a limit to how much of the population you can address, but you can address a lot more of what. We help that population with B cross combining all these services, we've come a more meaningful contribution to their old journey and the healthcares. It's two different ways of looking at side. It's the number you judge and how much you touched, of course,...

...and I mean it's obviously interesting. I mean a lot of what you're saying is like if I if I think about a totally different area, in mechanics or in the industry, you have this concept of the Internet of things, right, so where you where you gather a lot of like data points from machines and then and then correlate that. So it almost feels like it's like the the Internet of the body or the Internet of like the like. How much like same or and also what is different if you would compare it to Iot, because there are sign some patterns. We would say like sounds to me very familiar. But then there are other areas with say like well, look, it's not machine data, it's human data, so you need intern you need in the action, you need like and we're coming to this point in a second to consumer centric, user centric topic, which is like, I don't know how the Internet of things is so, so super user centric all the time, but maybe let you, let you speak. You're so. I mean there are similarities in terms of the amount of data that the velocity of data as it moves. There are other similarities to how do you build the orchestration logic of an Uger or a lift or an air be in the there are some aspects of what Netflix, I. Amazon did to build a platform that exposes multiple different kinds of things. or in Netflix's case it's its content from different sources. In Amazon's case it's goods from different vendors, including themselves in terms of what they're so on Amazoncom. But perhaps the best in niology in terms of what we should strive for, is unswer me this question. What is the Disney of healthcare? That's a very interesting question, because what Disney did was to build a fully connected, immersive universe where you get the Disney experience, and we will tried. It doesn't exist in healthcare today and I'm not saying it's a perfect analogy, but it's not a bad one, because they actually put all the pieces together and build a you...

...know, multidimensional, multi channel candom experience, when feels like it's connected and your inside universe if we do something like that. So health care, I think that's the new nom and we're the ones right now pursuing I love that like analogy, like becoming like the definitely the Disney of healthcare, and so makes it very, very appealing. I sometimes say like our mission at Lena x is to become the Google maps for it right, so it's like, so that's that's kind of the way we try to put this up. But yeah, so maybe as as a SEC way. In one of the recent tweets, if I'm not mistaken, you said pivoting people is the new strategic party for many organizations are raising the bar of achievement on a continuous basis. My personal recipe begins with change what we do in order to change how we think and change how we influens. So what ask myself is what specific ideas of practices, in your view, must then be changed to help it create more consumer centric solutions as it's going from doing to thinking, to to influencing. So maybe you can give some some insights from your work. I think in some ways perhaps in the most meaningful way. It requires redefining what the purpose of your team is, that the purpose of it historically has been built to requirements. The purpose of the business historically has been defined the requirements. We have talked about alignment business. In I t go the Ligne, that basically equated to this was a thing. When you go back at the kid we need to align business, and I basically means I agree. We agree on the requirement that's alignment. If you think that that is in the context that we just talked about, that doesn't change the equation, does it? Because what we just talked about is a blend of business products, clinical expertise and technology saviness and capabilities that you can deploy. So you actually have to redefine the problem. So how can we jointly, across clinical expertise, product...

...expertise and engineering expertise, try to first understand what's the problem with trying to solve then what is the human centric design that will make that a delightful solution so people actually use it and then we can build it. So instead of thinking of it as the in part of a long process that starts with let me define some requirements, thinking about as a fundamental participant in the definition of the problem and the other possible that can address the problem. If you actually want to solve that the build doctor paradox that I talked about, where I want the closeness, that the release doctor, where I want the advancedness and modern health care, you really have to think out of the box and not just pursue requirements, you know, isolation, but take a morbolistic view as to what will modern health scare look like five years? Is that a meaning for answer? Absolutely, and I mean it's a bit for me the SEC with what you said before, the split between like business and it, and I'm also I mean I'm looking back to like a couple of years working and a larger corporate and, like you had like the demand it and the supply it right. So that's that was like this traditional concept of describing the one party is working on requirements and the other is working on standardizing, making it efficients and so on, so which is, I think, in that world, difficult and and that's why I think and and and we believe that I went to challenge that with your thoughts that product it t and corporate it are converging to right so there's no longer just like the internal l t landscape and then the products you built, but it becomes more integrated journey. So is that true from your view as well, for for the business model you're seeing, and what should companies consider when establishing like effective and resilient digital platforms, which require actually both parties to to work together? I think the essence of...

...it is true, right, and it's an it's nascent to digital transformation, which does require showing up differently, a different mindset and thinking about problems differently, tearing down barriers, disaggregating towers or solutions and putting them back together the better, giving people choice. That I think the premier thing we can do is to build solutions a way where you have a choice. Having said that, there's still are different types of products. I think that's important to internalize. So applying product thinking, product management, to sign thinking, product engineering to a problem applies most of the things that you sell on the outside as an organization. Whether you're for profit or not for profit doesn't really matter. You still have products and services that you bring to MINC, but you have an internal audience that you owe the same care in terms of how you build those products and the compariances and especially as we have an increasingly hydwood workforce, we need to spend much more energy and figuring out what are the right products. But that the internal workforce. So every organization that I know of has two sets of products, the outbound products and then the product that you use internally to basically run yourself as an organization. And then, if you're in healthcare, actually have three. That's cares very peculiar. So you still have the internal set of products, but on the outbound side you have two. People describe healthcare as be to be to see. It isn't really, because most of the payments come from a B tob construct. Whether the pair is an insurance company or government doesn't actually matter. You have a contract with, let's say the government, with the last House Insurance Organization, and that's how you pay the fees and how the money flows into system. But the whole different set of products, which is about how you generate adoption for the end user, and the end user is it helps consumer or provider or a office coordinator or research as system, and what they want is something that aimed at...

...their needs, not something that's crafted according to what is it that we sell as a benefit? So the reality is two sets of products and it's really not a traditional B Tob Toc. It is a be to be combined with a business to d user kind of construct. And if you don't actively internalize that, you're really building two sets of products and you organize your teams accordingly so that you can blend the two perspectives. Made Flexible and measurable on the B Tob Side but make it delightful and easy to adopt on frictionless on the D Juss side, you're probably not going to succeed the scale. You've written best setting books on the subject of digital transformation. In one of your books you compiled a list of ten lessons for digital transformation. Can you share what's the core theme of these ten lessons? And or maybe we just that that question first, like what's like the what's like the theme? And of those questions, perhaps a more meaningful way of answering that is is where we just left off, which is, you know, the the underlying premise for succeeding in digital transformation. That's my belief. Is Change Your understanding of the problem. If you're not actually willing to go after your problems willistically and with a blend that business science, in healthcare, clinical science and digital technology signs approach. I don't think you can drive digital transformation. You can drive digital solutions, but that's not actually what the word means. Digital Transformation, by the definition of the word, is an actual transformation. So it's changing not just how a thing is done in isolation, but it's changing what we do and what that means realistically problemization and for the people that we serve on the outside. So as a synthesis of all those things in that book, I think that's why I would start. Yeah, if if I hear you speak,...

...actually that like one of the thoughts which comes to my mind is a fundamental shift of how you organize product teams, including engineers, so not have them like work on top of like epics, which sound agile, or like what work on stories and so on, but allow them talk more to customers directly and understand the problem firsthand. So so I don't know if you're aware of it, I think some essence of that concept is in those two books like inspired and empowered. I don't know you know those books too, so I do. I mean it. There's a big dose of belief in design thinking and what we're talking about now. I mean the whole idea with design thinking is that it is the team as a whole the designs to an understanding of the problem that the in Jewser actually wants to solve. Sometimes it's an acknowledge need. Other Times you're talking about the UNMADE, unrealized need. Those are the hard ones. If you ask someone in healthcare today what they want for a better experience, you're probably not going to get an answer that you can actually do anything meaningful with me, because it is like, you know, Henry Ford aldially said in yourly nine hundred, if I'd ask people what they wanted, they would have said fast to horses. Is You act people what they want today or say short a weight times. What we're talking about is maybe that's not the ends. Maybe the anger is to innovate into a different cameo and that's a team problem. What do you think? How does how does the story go on? So I'm always curious what kind of innovations technologies you have on your like radar or list, which will become relevant in the next like five to ten years. I mean, I know, apart from us changing the habits of using technology, building it by man. I'm always curious, like what's what's if you look into like the future, what's out there on the horizon? We already sort about a couple that are really important. I mean the whole notion of nudges and understanding last amounts of data and...

...using that for a meaning interaction with people. We talked about devices, the in and other things of the data point collectors. We've talked about virtual interaction models. I'm going to add a couple voice. Voice as a primary mode of interaction because, look, we've got off phones and our laptops and whatever else we use that text based. I could imagine a future where we're moving to having ambient technology, now environment that you can talk to. We're beginning to see some of it, but it's just nasty. So shifted back to voice as an interaction model, to the meaningful, because stick spoken word. The science behind this, apparently you know these spoken word. A good story in an oral interaction impacts our brains and our behavior patterns twenty two times more powerfully than thing you read. That's one day of the point and I think government. So voice is a big deal. The other thing that's a big deal, I think, emotionally intelligent technology solutions. We now have the technology calubilities to, in real time, on the fly, actually analyzed the emotional overtone of an interaction and by doing that we can make the solutions smarter, not necessarily nicolatum problem guy or on playing doctor. That's not the point. I'm joring out giving the professionals and the patients better chools to help themselves and, to give you one example, just in the Ey space. We can debate forever whether a position or any I'm model is better at diagnosis, but it's pointless because we've proven conclusively that two of them together is better on either in isolation. It is back to the same notion of amplification, not trying to replace something, making so voice and emotional intelligent and goes to the Great Claus. My emotion, I can clearly say, is I'm thrilled that like people like you, and you're like teams, are working with that mindset on pushing forward how care is done in the future and how it's like rethought, how the problems I actually questions, questioned and and maybe even challenged to come...

...to better solutions, so I really learned a lot today about virtual care. I'd like to say a big thank you for sharing those insights and I'm very optimistic that the future of care will actually become much better than what we have today. So I'm really looking forward to that. So thanks so much for being a guest on the show here today. Thank you. Thanks for invitation. You've been listening to unleash. I T to ensure that you never miss an episode. Subscribe to the show in your favorite podcast player. If you'd like to learn more about enterprise architecture and tools to help unleash your businesses digital capabilities, visit lean ix dotnet. Thank you so much for listening. Until next time.

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