Talking HealthTech

Peter Birch speaks with Pete Williams, the co-founder of Medipass, a digital healthcare claiming and payments platform for providers and insurers. 

Before starting Medipass in 2016, Pete co-founded Localz, a VC backed startup that powers last mile delivery experiences for major retailers and service companies. 

Prior to joining the startup world, Pete led consumer and high-value payments technology - including HICAPS - at National Australia Bank. 

He was also employed by KPMG where he worked on financial service and payment projects around the world

In this episode, Pete and Pete chat about the complexities of healthcare payments in Australia, how we stack up to other parts of the world, the importance of partnerships with practice management systems and payors for HealthTech vendors, and many more.

Bringing in 2020 with a bang, this is a mammoth show to see in the new year!

Back in November at the Medical Software Industry Association (MSIA) 2019 Annual Summit and AGM in Sydney Australia, Talking HealthTech recorded interviews with different speakers throughout the day.  This episode features 5 of these conversations covering a broad spectrum of issues that are pertinent to Australia’s health technology scene today.  

The theme for the summit was “Limitless - Health Software Transforming Australia’s Healthcare”.  The event was attended by over 100 members of the MSIA, and had guests speakers from all over the country, as well as a special international guest.  

This episode features interviews with: 

• Iman Ghodosi, Vice President of Asia Pacific at Zuora
• Igor Zvezdakoski, Chief Product Officer at Message Media Group
• Dr Ruth Webster, Global Head of Medicine at the George Health Technologies
• Dr Harry Nespolon, President of the Royal Australian College of General Practitioners (RACGP)
• Steven Posnack, Deputy National Coordinator for the Office of the National Coordinator for Health Information Technology, at the US Department of Health and Human Services. 
• Robert Best, President of the MSIA and CEO of MIMS AU&NZ.  

David Dahm is a driven, motivated and dedicated individual with a raft of qualifications and experience, and an amazing life story. He is currently the CEO and Founder of Health and Life, the CEO of One Moment Foundation and is actively involved in industry associations across the Medical and Accounting professions. David is passionate about creating a sustainable and socially responsible healthcare system by promoting health and financial literacy in the community.  

Most recently David is on a journey to establish the IHSEB - the International Health Standards & Ethics Board - in an effort to implement standards of healthcare delivery across the globe.

Listen in to this episode of Talking HealthTech to hear more about the IHSEB, as well as David's story, what Doctors can learn from Accountants, and all about the concept of patient advocacy.  

Dr Femida Gwadry-Sridhar is the Founder and CEO of PulseInfoFrame; a company that builds collaborative communities to enable the best value healthcare and cures for cancer and rare diseases. 

As founder and CEO of PulseInfoframe, Femida has an extensive background as a pharmacist, epidemiologist and methodologist with over 25 years of experience in clinical trials, disease registries, knowledge translation, health analytics and clinical disease outcomes.

Femida’s brain child is a cloud-based healthcare data insights solution called Healthie which is a state of the art analytics and visualisation platform built on the backbone of a dynamic registry. Healthie enables the integration of clinical, imaging and histopathology data as well as patient reported outcomes and natural histories.  

Over her 25 year career, Femida has obtained more than 10 million dollars in funding for research, has published in top tier journals, and worked along-side the best in the world of medicine and business. 

During this conversation, Femida chats with Pete about patient reported outcome measures, patient reported experience measures (PROMS and PREMS), clinical trials, and the use of health data.  

Dr Louise Schaper is an expert in health informatics, and is passionate about transforming the health sector by leveraging technology to provide sustainable and better health for everyone.

Louise is the CEO of HISA: Australia’s digital health community. In this role she brings together world-class clinicians, researchers, innovators and organisations from across biomedical, health and technology who are committed to the improvement of health outcomes enabled through innovative uses of technology and information.

In this episode Louise talks to Pete about HISA and it’s role in the health community as well as the evolution of Digital Health.  Louise also delves into the importance of events to bring together the healthtech community, and the big themes in Health IT today.

Overview

[02:00] The background of HISA: Back in 1992 HISA was founded when computer technology adoption generally was low.  They became Australia digital health community.  Bringing the tribe of digital health ecosystem together 

[03:40] HISA is putting out a paper about where they see digital health.  Sneak peak: before we spoke about health it, ehealth, digital health is interchangeable Digital Health is different to the application of IT in healthcare.  In 2019 they are leading that conversation - health in the digital age.  How does health transform to the fact world is digital these days.  Hard to implement.

[05:50] The Australian healthcare system isn’t screwed, we deliver high quality healthcare to many people, but generally it needs to be fixed.  Not broken but could be better.  Not a fault of clinicians, technology doesn’t give them the right tools to do their job in the more effective way possible.  Work to do to change that situation

[06:50] In America, $4.2 billion invested in digital health in first half of 2019.  A lot of money invested globally, especially in Silicon Valley. Since 2011, in US, $29.4 billion invested in digital health. 

[08:00] Investing in healthcare is riskier investment, it’s not like other industries.  In healthcare, focus needs to be on the workforce.  No matter how much you invest and how great the tech is, the workforce needs to understand why we need to change in healthcare.  Need to change the business models of healthcare.  Need to be critical on how we look at technology while we embrace it.  This is not taught in uni for doctors.  Can’t just put devices infant of clinicians and expect them to embrace it.  Investing in upskilling workforce in digital health is growing area.  Seeing increasing momentum in dollars spent on this area.  

[11:15] HISA is Independent but partners with many organisations including ADHA Australian Digital Health Agency.  Run events, forums, connect people who feel they are alone in digital health world.  Also working with nurses and midwives to build a digital health capability framweeworl for nurses, and ADHA is sponsoring that.  Will be launched next year - worlds digital health nuses and midwives coming to Brisbane next year, launching there.  Individual nurses and midwives, employers and educators to see what does a nurse need to know about digital health to be the best nurse they can be.  Upskill workforce, educators can plan curriculum, and nurses and midwives look to improve their career.  

Workarounds are inevitable if training and onboarding in 

[16:00] When we nail it, we can just go back to calling it health.  It’s not health IT, healthtech. E-commerce just became commerce and became the norm / they became redundant.  Eventually technology will be the norm and how we do things.  

[18:00] The way we manage healthcare information hasn’t really changed  in couple hundreds of years.  Since Florence nightingale’s time.  She complained about the lack of information she could use for comparative purposes to help patients.  Things move slowly.  We will get to a point where Florence wanted where clinicians have real time info, live dashboards, helpful info to make best decisions about patients, and consumers can have access to our healthcare information, in a useful way.  

[20:00] We share common passions and frustrations in healthcare - it’s slow to change.  HISA events bring up to date and relevant info at events.  Events are important to bring community together and share what we’re doing.  In healthcare we are so busy.  Walk up and down isles of hospital or GP clinic and people are busy delivering health . Taking time to network, learn, share and question to then collaborate and build a better future.  It’s happening.  For start ups the pace of change can be frustrating.  Technology evolving at rapid pace with artificial intelligence, quantum computing, but they aren’t well applied in healthcare yet.  Things move at a slow pace but anything worthwhile has to be done properly.  If you’re a VC, occ health physician or start up, make sure you’re in it for the long haul because it’s a complex system to change.

[24:00] FHIR - Graham Grieve did a lecture for Louise, and its the most downloaded podcast.  Legend, even would be proud of it if if wasn’t Australian, and taking world by storm, is exciting.  Very excited that Apple Health is using FHIR to build their stuff, fabulous they aren’t creating their own data silo and using FHIR.  Small thing as well - CliniCloud who invested the digital stethoscope.  Originally doctors in Melbourne who said they can build new and Digital selling to mums with babies. 

[27:30] HIC conference will have more of an international audience.  In 2021, Medinfo conference 3,000 people, global health informatics leaders coming to Australia.  Opportunity to show off what you’re doing, start working on extracts now.  White paper on how we see Digital health as a conversational starter.  To upskill in digital health, over 700 people certified in health informatics.  

Matiu Bush is both a clinician and a designer who founded One Good Street, a social impact platform to encourage neighbour initiated care for older residents at risk of social isolation and loneliness. 

Matiu is the Deputy Director of the Health Transformation Lab at RMIT, designing cultures of innovation and creativity in healthcare. 

He has a Master's degree in Public Health and broad clinical experience as an emergency, oncology and intensive care nurse and he is also a sexual health Nurse Practitioner.

He’s a board member of Better Care Victoria and the Emerging Leaders Clinical Advisory Committee.  He is a super active member of HISA, a Rotarian, and a mentor for undergraduates and post graduate science students.

Overview

[01:30] Neighbour initiated care lifts the social capital in neighbourhoods, it improves house prices and creates an alternative value economy.  The One Good Street is a platform to enable and scale those initiatives.

[05:00] Salutogenic Design can be used to avoid building tech that is beautifully useless.  It is about design that focuses on reducing stress levels and promoting wellbeing. Opposing the pathologising of humanity when you walk into hospital.

[07:30] Guerilla information provisioning uses nudge theory to teach people about their health condition in the peripheries.

[08:30] Citizen driven science looks at how to get citizens to help solve complex problems 

[10:15] The RMIT Health Transformation Lab uses “The Treatment” as their design mythology, which involves ‘deep hanging out’, or anthropology (the study of humans).  Just shutting up and watching.  

[10:30] They also use the Causatory reasoning method, which calls for ‘descending into the particular’ and ignoring generalisations. 

[11:30] The saluto-technical approach marries salutogenic design principles with new technology, in an effort to stop the fetishisation of technology in healthcare.  Otherwise we are so close to data but so far from the truth. There is a need to provoke the sector to do better so we don’t design technology that is beautifully useless.

[15:30] Technology needs to be designed while keeping the readiness of the health ecosystem in mind.  

[17:50] The Cisco Digital Maturity Index helps you determine the level of work that will be required to implement new technology in a health organisation, depending on its appetite and ability to adopt technology. 

[22:21] Matiu had a falling out with Mother Teresa in Tijuana…

[24:00] Sanctuary trauma is what happens when you go into healthcare and they are meant to look after you and they don’t.  This can be avoided by involving the third sector of healthcare - those groups like schools, volunteers, rotary, Australia Post etc that have a legitimate place at the table with clinicians.  

[25:00] Doing tech better in health will enable relational health - where doctors will ask more about your relationships to see a better ‘return on investment’ on your treatment, to help you stay healthier for longer.

Links

Talking HealthTech Podcast

Talking HealthTech Community

One Good Street

One Good Street Facebook Community

Health Transformation Lab

Rotary

Transpire’s Vodafone Dreamlab

Cisco Digital Maturity Scaling 

Transcript

[00:00:00] Pete: [00:00:00] Welcome to Talking HealthTech. My name is Peter Birch, and this is a podcast of conversations with doctors, developers, and decision makers that are playing in the Australian HealthTech scene today. 

Here with me today's is Matiu Bush.  Matiu is both a clinician and a designer who founded One Good Street, a social impact platform to encourage neighbour initiated care for older residents at risk of social isolation and loneliness. He's the Deputy Director for the health transformation lab at RMIT, designing cultures of innovation and creativity in healthcare. He has a master's degree in public health and broad clinical experience as an emergency oncology and intensive care nurse, and he's also a sexual health nurse practitioner.

[00:00:40] He's a board member of Better Care Victoria and the Emerging Clinical Advisory Committee. He's a super active member of HISA. a Rotarian, a mentor for undergraduates and postgraduate students and he's here sitting in front of me now.  Matiu thanks so much for joining.

[00:00:53] Matiu: [00:00:53] Pleasure, when you read that out I sound exhausting.

[00:00:57] Pete: [00:00:57] It's comprehensive and it's, and it's well learnt and it's [00:01:00] exciting to have you in front of me. I've actually, you've, come here after going to event. I saw you at an event a couple of months ago now, and it's taken this long to get you into the studio.

[00:01:10] Matiu: [00:01:10] Good to be here.

[00:01:10] Pete: [00:01:10] Thanks for coming in. Look, we've got so much to  cover as well, but look, we'll, start with something that I first heard about when,  I saw your talk, which was about the concept of neighbour initiated care. Tell us more about about that platform that you founded, The One Good Street and why it exists.

[00:01:28] Matiu: [00:01:28] So there's a GP who lives on my street. He's retired, he's 84 and when he falls out of bed, I go and pick him up. And that active neighbour initiated care saves an ambulance fee as well as an ambulance trip, as well as an admission into ED. And for someone who's 84 often they are triaged as a category three or four.

[00:01:47] So he probably deteriorates and doesn't have a tea or any food or anything fluids whilst he's there, cause EDs can be quite ageist. So for an 84 year old, that's a pretty scary experience. So that act of his daughter calling me and me going to [00:02:00] do that,  I reckon we save around $3,000 for the state budget in healthcare. It also helps the ED meet their four hour target, which is important because they want to get people in and out within four hours.

[00:02:11] Pete: [00:02:11] It's such a  simple thing to do

[00:02:13] Matiu: [00:02:13] Correct and I do joyfully because what it does, it lifts the street capital, the social capital in my street. My street's a great street to live in. That impacts property prices. When new people move in, they're like, gee, everyone's so friendly and everyone helps each other out. So there's an alternate kind of value economy happening when you do those sorts of things. And so I started to talk about that, and more and more people would say, I do the same thing. So I developed a platform that enables people who want to do great things for older people in the neighbourhood for that to occur. And that's called One Good Street.

[00:02:45] Pete: [00:02:45] Wow. What about Health Transformation Lab, what does that do?

[00:02:49] Matiu: [00:02:49] Yeah, so we're a newly formed lab that's anchor funded by Cisco, and it's part of RMIT's new vision of how to integrate with society [00:03:00] and industry and industry partnership. And so we're pretty radical. We'd call ourselves anti-disciplinary. Okay, so leave your specialisation and come on a creative journey with creative bravery and creative leadership, as we attack and approach and tease apart and grapple with the thorniest and most wicked problems in healthcare. So we're all hybrids. We're either a clinician plus something else. I'm a clinician designer. We've got an architect who's become an anthropologist, who's become a project worker and human centered design, an indigenous consultant and now works for us. We've got immunologists that are expertise in loneliness and isolation. So if you're a hybrid and you don't fit in anywhere else, you fit in in the lab because we actively seek a neuro diverse group where contestability is the hallmark. We don't want echo chambers. And so people come to us with healthcare problems. So a hospital might come and say, we've got a problem with discharge planning and getting [00:04:00] letters to GPs, and we'll tease that apart and map the ecosystem of the problem and then suggest very radical solutions to that. Looking at the latent capacity that exists in our neighbourhoods. So for example, thinking about discharging to rotary. So an 84 year old's discharge automatically a letter goes to GP, but it also goes to the local rotary. So they're there to catch them. Make sure there's food in the fridge. Make sure they take their meds that they get to their outpatient appointments.

[00:04:32] These are ways that we can tap into this network of support. Because in healthcare, we see people in tertiary hospitals, we discharge them, and if we discharge them to nothingness, loneliness, isolation, no support, no family, there's no return on investment, we're immediately failing and they'll end up back in.

[00:04:50] So that's the kind of solutions we bring. We think about, we use the cybernetics lens, which is really kind of radical, which I'll go through in a minute. We also think about [00:05:00] salutogenic design. When we're designing technologies, we don't want to make stuff that's beautifully useless.

[00:05:07] There is plenty of beautifully useless tech out there. That quantifies everything about you.

[00:05:14] Pete: [00:05:14] Beautifully useless, I can think of about a few different examples of that.  Okay salutogenic design. That's a cool name for something I don't know about so I'm going to get you to tell me you about it!

[00:05:26] Matiu: [00:05:26] Based on the Italian root word for Saluto or Saluto is health. Okay. Janet has generation or the genesis of the beginnings of, and it's all about design that focuses on reducing your stress levels and promoting your wellbeing. So it's kind of anti, it stands opposed to the pathologising of your humanity when you walk into hospital.

[00:05:49] So a salutogenic design, will focus on designing towards things and services and processes that help you manage your condition better, make it more [00:06:00] comprehensible so you understand what's going on, and also make it meaningful for you. And that can be from built form, interior design, lighting, collateral development, wearable sensors, technology, AI, machine learning, system design, even comms design with how your staff talk,  admin staff, for example, talk to patients. It can be wayfinding. Everything we do should be increasing a patient's manageability of their condition. Can we make this more manageable for them?

[00:06:31] Can we make it more comprehensible? The letters they receive a clear, they can understand what they're doing there in that outpatient department, and we invite meaning, how do they feel in that moment? And that I think delivers a much better patient experience.

[00:06:44] Pete: [00:06:44] So at the labs, some of those, are they, are there, are there been solutions that, an example of a solution that you can talk about? So something that has come out of it ? So two questions then, what does it look like when it goes into the lab, you know, a problem comes in, do people just draw on a [00:07:00] whiteboard  and then what's been some of the outcomes and the benefits of that.

[00:07:02] Matiu: [00:07:02] So for example, a cancer hospital came in and said, Hey, we want to build some kind of curriculum or university or school where people can learn about cancer. And we took that problem and we teased it apart. And on reflection, we were able to demonstrate that people want to spend as little time as possible learning about their cancer because cancer is a thief for them, just robs them of everything.

[00:07:26] So the last thing we want to do is allow cancer to rob more time for someone who's got a time limited illness. So we worked on a something called guerilla information provision. That is using a whole lot of nudge theory where you can inform and teach people about a health condition, but in the peripheries, and that can be with augmented reality. it can be with fridge magnets, it can be with decks of cards. It can be a whole range of other ways that subtly inform people that it's always at the periphery and when they need it, they can grab it, but it's not [00:08:00] forcing into them a whole lot of, collateral around cancer. And that's what came out with a whole lot of students who have developed all these great little prototypes of board games which built health literacy, but not intentionally doing so, of using augmented reality that allows you to observe from a really high level your entire cancer journey. But you don't have to engage with any of them. You can just marvel at how beautiful and how cool it is and share it with family and friends and say, hey, check this out.

[00:08:27] In doing so, you're exposing people to a range of things and you can nudge them in the direction of that. That's one example. Health, citizen driven science is another one. So for example, in the UK, they have trained  normal everyday people to look at mammograms and detect cancer And they get like 96% accuracy after awhile. Yep. So it gives you an idea of when someone comes to us and says, hey, we've got a problem, we'll look at it in different lenses. For example. a provider came and said, well help us understand citizen [00:09:00] science. How do we get citizens to help us out? And then we're able to expose them to a range of things. For example, there is a great company in Melbourne called Transpire who've developed an app where you can donate your phone data or phone processing overnight, and it runs computations from cancer research overnight. And in doing so, they reduce the overall time of producing the data that's required for the research.

[00:09:25] So latent capacity, they are the sorts of things that we expose people to and provoke. These are provocations to the sector. So you might come in and say, Hey, I've, here's our problem and we might take you to a completely different destination and more likely with a really unusual partnership where you didn't think of. So for example, we might say Australia Post is going to be the best person to partner in loneliness and isolation because who visits your house every day all around Australia. There's this capability. that's what we're doing. We're grafting in the solutions because the solutions aren't with those that are the [00:10:00] problem custodians. And most healthcare try and solve their own problems. And they marinade in it for years and years. And if you've been to enough health conferences in your time, you'll hear the same stuff repeated over and over again. So that's what we do. Come into the lab. They tell us their problem.

[00:10:15] We've got something called the treatment, and the treatment is our design methodology. And it's really unusual. We do, a lot of anthropology deep hanging out. That's how we found out about why you should never give a cancer patient anymore to read because, we mapped a lady, who was 84, and in her home she had 186 pages worth of patient information she had to get through. And we knew that whatever you do, whatever you design, you can't make that pile. So we use anthropology.  Deep hanging out. It's where you shut up and just watch. We also do a, use a Jesuit reasoning method called Causatory, where you descend into the particular, you ignore all of the generalisations that come before and you descend into the [00:11:00] particular, and a good example of that is using chatbots in health.

[00:11:04] And lots of people say you've got to be specifically trained, these as highly specialised, you could never push this to code. But all of those generalised principles occurred before chatbots developed. So we need to delve into what chatbots can do and then generalise out from that new beginning. A word for a chat bots, a world full of AI, machine learning.

[00:11:25] Pete: [00:11:25] That's going to lead onto my next point because, you're focused on transforming health,  and technology is often seen as the solution to do that. How should we be designing technology to transform health?

[00:11:39] Matiu: [00:11:39] We've got to stop fetishising it. There's an absolute fetish for technology and people believe that technology will solve so much of healthcare, but you can have great tech grafted into a crap system that's a crappy outcome and patient experience and our systems aren't ready for the technology. That that's way ahead. [00:12:00] We've developed something called saluto-technical and the soluto-technical approach really marries that salutogenic design principles with new technology. So that's where whatever you design, is it more meaningful for the individual? Does it also respect the ecosystem? And I'll give you an example.

[00:12:17]There's mattresses now that can measure your heart rate, and if your heart rate changes, they can send an SMS off to family.  It won't be going to the GP cause he's he or she's never gonna look. So to family, and then family can respond. The tech is beautiful, but if your Chihuahua hops on the bed, you're going to be tachycardia and your family's going to get an SMS saying, hell, what's going on? And it's the Chihuahua.

[00:12:38] Pete: [00:12:38] See I get excited by these things and then I think about the practicality.

[00:12:41] Matiu: [00:12:41] That's right. So they're for people developed in isolation who don't have dogs. Also, they don't have partners. So if granddad or grandma decided to bring home someone to entertain one evening, and they're having sex you're going to get an SMS saying the heart rates are regular, right? So what they haven't done is had a real [00:13:00] human perspective. Actually they haven't had a life perspective of what it's like to live in somebody's house. And when you introduce technology into a house, it changes the relationships. So what we think is that saluto-technical approach is really mindful of the human, really mindful of the ecosystem. So I wouldn't put any tech that monitors anything into someone house unless its has a purpose for health outcomes.

[00:13:24] Otherwise we are so close to data so far from the truth. So I can have everything about you knowing about you, but there's, but then you're isolated and lonely. So we know you're using the fridge. So you're eating, you're drinking, your heart rate's regular, but you're not speaking, for example, cause you've got no friends and you're 84 and your life is miserable.

[00:13:44] So they are the sorts of things we try and provoke the sector to do better so that you don't design technology that is beautifully useless.

[00:13:53] Pete: [00:13:53] The, concept of so close to data and so far from truth that's almost like this [00:14:00] big mind blowing moment  from my side , I'm, extremely curious about that. We're collecting all this data. and, so much values placed on like, thinking from a health company or a vendor's perspective, it's all about the data play at the moment. How are we going to, extract more data of value from this data or collect more data? What do we do with it all? It sounds like we're not doing enough or the right thing.

[00:14:28] Matiu: [00:14:28] You've got ecosystems, health models of care that are really impermeable to it. So for example, at home, let's say with your grandparents, if we put tech in the house, it's giving us a lot of information. Some of it's incredibly useful, but it meets a model of care that's resistant and hasn't transformed itself. So that data doesn't go to the community nurses. It doesn't go to the care workers. So it's all the responsibilities put back on families to manage that data. When you've got data about your grandparent's house and their activity. Then you've, you've changed the power dynamic.

[00:15:00] [00:14:59] How much of that do you share when you see that they've been watching TV all day and done no exercise and  your mother phones them and she says, Hey, they're fine. They've had a great day, they'd been doing lots of things and you see the data and they'd been on the, on the couch day.

[00:15:12] You changing family dynamics and that's not addressed in the technology that is going into people's homes. So first of all, it, it pushes more responsibility on families. It also meets a care system that doesn't know what to do with it because it hasn't changed its model of care.

[00:15:28] There's no tech prescriptions. So if you came to see me with congestive heart failure, I don't prescribe for you a range of, bluetoothed blood pressure machine, scales, some apps, whatever it is, some sensors in the house, none of that goes out with you as the first line. What we do is send a community nurse out to, so you've got this, this model of care that just  hasn't caught up with what the possibilities they haven't transformed itself.

[00:15:55] So these, there's that. We're collecting a lot of data and now normally in a hospital, [00:16:00] a clinician will decide and if you like, prescribe or dictate what data should be collected and when. So for example, four, hourly two hourly, 15 minute obs, you know, we are used to doing observations within a particular context. When you put a whole data on people's homes and make them all smart and connected on the person, but also in their environment, there's no way of turning that up and down. So we can, I can imagine getting to a stage where people are palliative, people are dying and you're still recording heart rate and doing all this other stuff that it doesn't matter anymore. And that's where you can be so close to data so far from the truth.

[00:16:35] Pete: [00:16:35] Wow. That's pretty crazy. I mean, it changes then. You know, how technology is  developed, how it's solving problems, then we've got so many tech vendors in Australia, and growing globally, everyone trying to solve problems in healthcare, and at least in Australia, then well, you know, it hasn't caught up yet. And a lot of them are backed by private equity or backed by anyone that [00:17:00] that is looking for return on their investment. What do you, what are they doing until then? Do they just keep. developing and hope for the best?

[00:17:08] Matiu: [00:17:08] I mean, it's a marathon, it's a marathon journey. Lots of people in tech, vendors and startups in healthcare. I think they jump in and because they can see it. But then they made a system that can't see it because there's lenses and dare I say cataracts in the way of seeing  a future. So I think there's two things there is they their respect for the ecosystem and understanding the maturity of the ecosystem and almost benchmarking the organisations you're working with to understand the maturity. One thing a lot of startups come to me and say is, Hey, we thought we could just deploy and go. But three months later, we're still training staff. We do, we're doing the training, I'm doing the videos, I'm doing the PDF.

[00:17:48] Pete: [00:17:48] I've got to go there in person,

[00:17:50] Matiu: [00:17:50] Correct. And that's because they haven't understood the digital maturity of that organisation. And Cisco do a great maturity scaling, where you can benchmark, and I [00:18:00] would encourage startups when they go and they get their customer. Before the high fives and the beers, benchmark them on their digital maturity. Go to Cisco's website, find it out and see about benchmarking because you'll get a sense of how much more you're going to do because you're most likely gonna have to recruit a project manager to help with the integration of the technology.

[00:18:19] I rolled out virtual reality in a major, major hospital five years ago, and if I did not constantly manage those devices, they would always end up out of battery in the cupboard. So when we walk away, our technology can completely fall over. The one thing also is really work on user experience.  Because clinicians, often will have different ways of working and so it's always worth spending time on the UX of it, but understand that from a procurement point of view, hospitals don't pay for UX. If you're a major hospital and you're purchasing a whole lot of tech, you're going for the cheapest. You're not going for the one that clinicians love the [00:19:00] most because the UX is the best. So that's also about a UX maturity within the sector.

[00:19:06] So it's an absolute hard slog. You can either run away now, which I encourage you to just run away and go and work somewhere else. Cause it cause it's hell on earth. It's a blood sport. Or if you're going to hang in there, and watch Game Of Thrones and House Of Cards as professional development because all of those skill sets will come in hand.

[00:19:24] Pete: [00:19:24] Nice one. That's so true about onboarding and UX. I mean it's just two areas of such pain that, 9 times out of 10, that's where I'd see most HealthTech or any tech really, but predominantly HealthTech would fall over.

[00:19:38] I was reading your bio. As complete kind of left field... You worked with Mother Teresa?

[00:19:45] Matiu: [00:19:45] Correct.

[00:19:46] Pete: [00:19:46] Really? Like THE Mother Teresa not someone with the same name

[00:19:48] Matiu: [00:19:48] When I was 19 I was studying design in Sydney and the Somalian famine was happening. So I'd finished design school and then headed home, and all these starving [00:20:00] people were on TV and I was 19 so it had rather an impact. And I was in a bookshop and I saw this nun on the cover of this book. Anyway, I brought it read it and I wrote her a letter at 19 she wrote back to me and said, come and work with me. So I bought a one way ticket to Calcutta and started working with her in their home for the dying. And also there was, a whole range of stuff like orphanages and soup kitchens and medical dispensarys.  A whole range of things.

[00:20:28]I then went to Mexico into Tijuana and lived in the slums and Tijuana and worked with her there. And we ran a soup kitchen and, a feeding dispel like food dispensary, where we had lots of great benefactors in the U S that would donate a lot of, food. And we were supporting hundreds and hundreds of families per week in that environment.

[00:20:48] So she taught me a lot about what's very practical, but she also taught me a valuable lesson. She actually made a mistake. She made the mistake of using the poor people as the raw [00:21:00] materials for her expression and her philosophy on life. She robbed them of autonomy because she needed them to be poor and grateful because that fitted into her worldview. And I have always taken that away with me, that wherever I work with marginalised people, that the most ethical thing to do is provide choice. And lots of quality choice. But Mother Teresa didn't provide quality choice. It was either curl up and die in one of our homes with minimal medications, certainly know pain relief because of the belief that suffering is somehow worthy in the Christian philosophy. So therefore she robbed them of choice. And I dare say that's unethical.

[00:21:45] Pete: [00:21:45] Sure, wow.  And to go through that at,19-20 years of age, like to go through that learning experience...

[00:21:52] Matiu: [00:21:52] It's great, so four and a half years later came back to Australia and, and it was a great formation. I mean, plenty of practical things [00:22:00] just to start. So for example, I run air-con clubs, so when it's hot in Melbourne, then we open up our home to older people in our suburbs so they can come and spend time with our air conditioning. And we have solar panels that works well. What it does is simply reduces heat exhaustion for those people that wouldn't turn on the air-con because they have limited pensions and they're also really concerned about electricity prices.

[00:22:21] So when I ran the first air-con club, somebody brought a rabbit because they needed a rabbit cooled in the heat. And so from a Mother Teresa perspective, you just start, you start small, like the micro ambition of her where she just started, picked up poor person that was dying on the street. Found a house to store them so they could at least die with some dignity, and off she went.  And I think she knows scale up better than most startups, because I think she was in like 160 countries by the end of it. But what she did, she scaled up that Calcutta model everywhere. And so when I was in Tijuana, I remember writing a letter saying, you can't take your model from Calcutta and introduce it all over the world when they surrounded by [00:23:00] medicines that could support them. These people shouldn't be dying because you should be giving them antibiotics, or taking them to a hospital sooner. And that's where I came unstuck with Mother Teresa.

[00:23:10] Pete: [00:23:10] Oh, damn that's awesome. so what is, as we're winding to the end of this conversation then, looking to the future, say we say we nail it Matiu, what does healthcare look like in 5 or 10 years?

[00:23:26] Matiu: [00:23:26] If we nail it, it will be radically democratic. And it will include the third sector. And the third sector is Rotary. It is schools, it is volunteers, it is corporates. It is unexpected people involved. And that includes people like CommBank, Australia, Australia Post, so that they have a legitimate place at the table along with clinicians. So if you had. Stage four colon cancer. That part of your support team would include the community and that would be digitally enabled so [00:24:00] that there are platforms that all of the tech is just a tool for connection. So you would be well connected and it would be really meaningful for you. You'd enter a system that would not traumatize you. Sanctuary trauma is what happens when you go into health care and they're meant to look after you and they don't. You get traumatized. If we nail it, that won't be there. And it's more than just soft furnishing and lighting and some leafery. It's about a whole system transformation that's very, very deeply focused on the individual and their experience.

[00:24:31] But that scaled up, so it can not just deliver it for one person, but deliver it for ten. And that it's so ingrained in the model that it can do it for a hundred people every single day. And that's where we need to evolve. And it is organic. It's not just structures getting different parts right and then sticking them together. Healthcare is organic, as we are, and it should be relational. I think there'll be a much greater focus on relational health. So when I [00:25:00] see you as a patient, I'll be asking, talk to me about your relationships, because if I spent all this time fixing your knee, fixing your diabetes, and then I discharge you out into the community, I want a return on investment. And that only works if you've got really healthy relationships. So I see a much stronger swing to relationships and then enabling those around you to support you. And the tech just enables that. And I think with tech, the best way to think about it is we are the artists and the tech is the brush. And we're painting great futures for ourselves, but that we paint what we desire. We code what we desire. And so the tech never runs away. And then we can avoid this ridiculous malignant prophecy around technology and what it will do in health care in regards to everyone's losing their jobs, we'll have these stupid robots saying hello to us, stuff like that. You know, it's, the future will be far more, organically evolving and we will never ever make it. It will be constantly [00:26:00] evolving, and that's the beauty of it. And I think that's why a lot of people stay in healthcare because of the turbulence and the mess of it all, and also the brilliant outcomes.

[00:26:07] What we want is to reduce that heroic effort of clinicians who stay over time. There are people now who will stay, so it's  3:30 now. There'll be clinicians who will do three to four hours overtime to get the job done today. We want a healthcare system where they don’t have to do that, and if tech helps, great.

[00:26:27]Pete: [00:26:27] The challenge I think as well from,  what you were saying, you're talking about starting small and doing something that that's meaningful in a, in a neighbourhood or like back, to those  Initiatives, and the things that are really meaningful in a relationship perspective, are usually one or quite a small, a little impact. It's, it's then making that scalable is probably where a lot of people get unstuck too. Cause there's all these little pockets of, really good stuff,   and, if technology can enable that scaling, then that's when we start to really, It's some big wins.

[00:26:53] So, to close out then, how do people find out more about or get involved with, some of those initiatives?

[00:26:58] Matiu: [00:26:58] Brilliant.  So if you [00:27:00] look up onegoodstreet.com.au, that gives you a rundown.  Join our Facebook group, One Good street, and you'll see all the kind of stuff that we do. And some of it is just acknowledging what you already do. So there's nothing new because some of you are out there doing amazing things for older people. You look after a Nona, you do the gardening, you do all this stuff already.

[00:27:17] Australia does this in a flood, in a fire and a fun run. We just designing ways to do it more regularly and Australia needs help in scaffolding that; both ways. Patients, we as Australians find it difficult to ask for help. Which is why we end up with lots of lasagna in our fridge when we unwell.And we're like, can someone just change the sheets on my bed because I have broken my shoulder. So we've got to scaffold it.

[00:27:44] And so, join One Good Street and check out the Health Transformation Lab. our website we've got, it's fresh. It's very radical. when I look at it, I've been in design for quite some time and normally you get this double diamond kind of shape of [00:28:00] exploratory iteration on that kind of stuff, prototyping... We're way off script. So what I would say, if you're a clinician or a designer or somebody where you never fit in because of the way you thought, then we are going to be in new home.

[00:28:13] Pete: [00:28:13] Wow. That's awesome. There's so much to follow up on. It's been, it's been a fascinating chat Matiu, and I look forward to having many more like that in the future. Thanks so much for your time.

[00:28:21] Matiu: [00:28:21] Pleasure.

[00:28:22] Pete: [00:28:22] Thanks for listening to talking HealthTech. My name is Peter Birch. Go do some stuff on our socials and website. Share it with some people and give us a nice review and a five star rating because it all helps to spread the word and get people talking. Until next time I'm out of here.