Episode #10 - Mike Gleichman, VP of Product at knownwell and Former Executive Director of Product at CVS Health
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Description
Mike Gleichman is the VP of Product at knownwell, a pioneering post-Series A company transforming healthcare with its weight-inclusive care model. Mike brings a unique blend of creativity and analytical thinking, with a background in quantitative economics from Tufts and jazz performance from the New England Conservatory of Music. He has honed his skills in product management through roles at athenahealth and CVS's Aetna. In our conversation, Mike talks about:
His journey from professional services to product management
His thoughts on product operations and effective use of OKRs
knownwell's comprehensive care model and strategies for addressing weight stigma
Achieving product-market fit and building a written culture
Feedback and user testing processes at knownwell
Strategic use of AI in their technology stack
The recent acquisition of Alfie to enhance clinical decision support
Balancing operational efficiency and user-centered design
Continuous adaptation to meet evolving patient needs
Mike’s insights underscore the necessity of integrating technology with empathetic care to drive healthcare innovation.
Some takeaways:
The Journey to Product Leadership: Mike Gleichman's career journey is a testament to the power of transferable skills and strategic career moves. Starting at athenahealth in a professional services role, Mike was on the front lines, working closely with healthcare providers and understanding their challenges. This experience was pivotal in shaping his understanding of healthcare workflows and user needs. Over time, he transitioned to various product roles, including product operations, strategy, and management. Mike detailed his transition into product management, highlighting several key steps:
Identifying Transferable Skills: Mike realized that his skills in professional services—such as understanding user workflows and managing stakeholder relationships—were highly transferable to product management.
Building a Network: He networked within athenahealth, seeking mentors and learning from colleagues who had already made the transition to product roles.
Continuous Learning: Mike invested time in learning about product management through resources like the book "Cracking the PM Interview," which helped him understand the expectations and prepare for the role.
Strategic Moves: He methodically planned his career steps, moving from professional services to product operations, then to product strategy, and finally to product management.
The Role of Product Operations: At Athena Health, Mike was part of a pioneering effort to establish product operations, working alongside Melissa Perri. He provided a comprehensive definition and vision for product operations:
Definition: Product operations, as defined by Mike, involves taking on some of the more administrative work from product managers, such as recruiting clients for alpha or beta testing, gathering feedback, documenting processes, and internal communication.
Purpose: The primary goal of product operations is to enable product managers to focus on strategic decisions and user interactions by offloading administrative and operational tasks.
Implementation: Mike emphasized that product operations should work closely with product managers to avoid creating a disconnect between them and the end-users. It's crucial for product operations to support product managers without becoming a barrier to user insights.
Risk Mitigation: He highlighted the risk of inadvertently creating distance between product managers and users, stressing the importance of maintaining direct lines of communication to ensure that product decisions remain well-informed and user-centered. He also shared alternative ways to reduce the administrative burden on product managers, like using software to solicit user feedback and curating a pool of users from which to recruit for testing.
Practice of Product Management: Mike shared his viewpoints on the practice of product management, emphasizing the importance of using frameworks and tools to drive effective decision-making and alignment:
Frameworks: Mike uses frameworks like OKRs (Objectives and Key Results) to align company strategy with actionable goals. He particularly values OKRs for their simplicity and power in providing clarity and cross-functional alignment. He recommends the book "Measure What Matters" by John Doerr for anyone interested in understanding and implementing OKRs effectively.
Tooling: knownwell leverages a suite of tools to gather user insights and streamline processes. Tools like Datadog and Mixpanel are used for tracking user behavior and analyzing data, while user panels and surveys help gather targeted feedback from specific demographics.
Why It Matters: Using frameworks and tools ensures that product management decisions are data-driven and aligned with user needs. This approach helps prioritize features and improvements that will have the most significant impact on users, leading to higher satisfaction and better product-market fit.
knownwell’s Comprehensive Care Model: knownwell’s care model provides a comprehensive, personalized approach to treating patients with obesity. knownwell offers both in-person and virtual care and their care teams are multidisciplinary, including physicians and advanced practice clinicians, dietitians, health coaches, and behavioral health specialists. This model ensures that patients receive continuous, integrated care that addresses both medical and psychological needs. By incorporating lifestyle factors into their treatment plans, knownwell aims to provide a more effective and sustainable solution for patients. Mike explained that this holistic approach helps ensure long-term success for patients by focusing on personalized, ongoing care rather than just short-term treatment options.
Addressing Weight Stigma in Healthcare: knownwell is proactive in addressing weight-related stigma, a significant barrier for many patients with obesity. Mike emphasized several tactical steps that knownwell has implemented to create a more inclusive and respectful environment:
Training Staff: All staff undergo training to foster empathy and non-judgmental communication. This ensures that every patient interaction is supportive and respectful.
Designing for Comfort: The physical environment at knownwell clinics is designed to be welcoming and accommodating for patients of all body types. This includes comfortable chairs in waiting rooms and specialized exam tables that can discreetly weigh patients.
Patient-Centered Policies: knownwell has implemented policies that prioritize patient dignity and comfort. This includes having procedures that respect patient privacy and reduce any potential for embarrassment or discomfort.
Consistent Feedback Loops: Regular feedback from patients is sought to continuously improve the environment and interactions. This ensures that knownwell can adapt and address any concerns promptly.
Effective use of OKRs at knownwell: OKRs are a critical tool for aligning company strategy with actionable goals. Mike described a thorough process for setting OKRs that involves input from all levels of the organization. Here are some key steps for implementing OKRs effectively:
Annual Planning: The OKR planning process typically takes about a month and is done towards the end of the year for the upcoming year. It involves gathering input from all levels of the organization to ensure comprehensive alignment.
Layered Approach: Start with top-level company OKRs and then develop OKRs for each department (technology, operations, clinical, etc.) that ladder up to the company objectives. This ensures that all teams are working towards the same strategic goals.
Cross-Functional Alignment: Engage with leaders from different departments to ensure their goals do not conflict. For example, technology and operations goals should complement each other rather than compete for resources.
Team Involvement: Review the proposed OKRs with the respective teams to get their input on feasibility and any missing elements. This collaboration ensures that the goals are realistic and supported by those responsible for achieving them.
Regular Check-ins: Throughout the year, conduct regular check-ins to track progress, address any misalignments, and adjust as necessary. This ongoing alignment helps keep everyone focused and working efficiently towards the goals.
Achieving Product-Market Fit at knownwell: knownwell has achieved product-market fit with its care model, as evidenced by exceptionally high Net Promoter Scores (NPS) in the 90s and rapid patient growth driven primarily by referrals and word-of-mouth. These indicators reflect strong patient satisfaction and trust in knownwell's services. However, from a technology standpoint, Mike acknowledged that there is still work to be done. The company is continuously evolving its digital tools and internal systems to better support both patients and care teams, striving to enhance the overall user experience and operational efficiency. Mike explained that the focus on continuous improvement and adaptation is key to maintaining product-market fit over time. knownwell plans to invest in:
Customized Digital Tools: Building more customized and integrated digital tools that cater specifically to their operational workflows and patient interactions, rather than relying solely on standard off-the-shelf solutions.
Seamless Experience: Creating a seamless experience for both patients and care teams, ensuring that the technology supports the high standards of care that knownwell is committed to providing.
Building a written culture: Mike advocates for a written culture within organizations, emphasizing that documenting strategies, decisions, and processes ensures clarity and consistency. Written documents serve as a lasting reference that can be revisited and refined over time, unlike presentations that capture only a moment. This practice fosters thoroughness in decision-making and helps new team members understand the rationale behind strategic choices. At knownwell, this approach helps maintain alignment and continuity, particularly as the company scales and evolves.
User Testing at knownwell: knownwell employs rigorous user testing not just for their software but also for the overall patient experience. Mike described their comprehensive approach:
Gathering User Insights: Utilizing tools like Datadog and Mixpanel to track user behavior and analyze data.
Concept Testing: Putting wireframes in front of users to gather feedback and ensure intuitive design.
Clinical Operations Standpoint: Evaluating the entire patient journey, from the registration process on the website to follow-up interactions, to identify improvement opportunities.
Targeted Feedback: Conducting user research to understand pain points and preferences, ensuring that every aspect of the patient experience meets high standards.
Technology Stack and AI at knownwell: Mike provided insights into the technology stack at knownwell, emphasizing the importance of integrating various tools to support comprehensive patient care. The technology includes patient apps, internal tools for care teams, and optimized off-the-shelf solutions.
When it comes to AI, knownwell follows guiding principles that balance the decision to build versus buy. Key points include:
Strategic Use of AI: AI is used to enhance clinical decision support, automate repetitive tasks, and standardize processes like clinician headshots.
Build vs. Buy Decisions: knownwell evaluates whether existing solutions can meet their needs effectively. For example, they acquired Alfie to leverage its AI capabilities for clinical decision support, rather than building a new solution from scratch.
Integration Strategy: Ensuring that all tools work seamlessly together through robust API support, making integration with existing systems like athenahealth smooth and efficient.
Show Notes
Where to find Mike Gleichman:
—
Where to find Angela and Omar:
Angela Suthrave
Omar Mousa
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Referenced:
knownwell: https://www.knownwell.co/
Alfie: https://www.joinalfie.com/
athenahealth: https://www.athenahealth.com/
Cracking the PM Interview: https://www.crackingthepminterview.com/
Product Operations by Melissa Perri and Denise Tilles: https://www.productoperations.com/
Measure what Matters by John Doerr: https://www.whatmatters.com/
MoSCoW to define MVP: https://medium.com/@cjjharries/using-the-moscow-method-to-design-an-mvp-c683f3de48a7
Tradeoff decision between 2 MVPs or between non-MVP items: RICE Method: https://www.productplan.com/glossary/rice-scoring-model/
Software methodologies: Scrum: https://www.atlassian.com/agile/scrum
Gathering user insights: Datadog: https://www.datadoghq.com/
Dashboards: Mixpanel: https://mixpanel.com/
Check out our website: https://www.concepttocare.com
Subscribe to our newsletter: https://concepttocare.substack.com/p/episode-10-mike-gliechman
Transcript
[00:00:00] Mike Gleichman: What do I care about or what do I need to care about over the next year to get us from where we are to a little closer to delivering on that overall strategy? If where that takes you is I have a spreadsheet or a giant backlog of features that I'm trying to prioritize. To me, that's typically a signal that it's not super clear.
[00:00:19] Mike Gleichman: What is important right now. And so whatever you can do upfront to limit the universe of things you're trying to prioritize between, I think is really helpful.
[00:00:29] Angela Suthrave: Welcome to concept to care, where we hear candid stories of success and failure, discuss strategy and dive into the details that offer advice on what to do and what not to do in health tech,
[00:00:41] Omar Mousa: whether you're a seasoned pro.
[00:00:42] Omar Mousa: Growing your career or just starting out. Our aim for this podcast is to be relevant, real world, and tactical. We're dedicated to not only entertaining you all, but also empowering you with actionable insights that can be applied beyond the podcast, one concept at a time.
[00:00:56] Angela Suthrave: This is Angela
[00:00:57] Omar Mousa: and this is Omar.
[00:00:58] Angela Suthrave: Welcome to concept to care. Hi everyone. I'm thrilled to introduce our guest for today, Mike Fleischman. The VP of product at known. Well, Mike is really cool. He brings a unique blend of creativity and analytical thinking having studied both quantitative economics at Tufts. and jazz performance at the New England Conservatory of Music.
[00:01:19] Angela Suthrave: With a career spanning roles at Athena Health and CVS's Aetna, Mike has honed his skills in product management. In this episode, we're going to delve into Mike's insights on product strategy and his learnings from Gamification in health tech. We're also going to explore the company that he's at now.
[00:01:36] Angela Suthrave: known. Well, a pioneering post series a company that's transforming healthcare with its weight inclusive care model known. Well, as redefining the delivery of metabolic health services, providing compassionate and comprehensive care for patients of all sizes. We hope you enjoy this episode.
[00:02:00] Omar Mousa: Mike, welcome to the show. Thank you. Glad to be here. Thanks for having me. Yeah, it's our pleasure real quick. for the audience. Can you just tell us a little bit about yourself?
[00:02:08] Mike Gleichman: Sure. So I lead technology at known. Well, um, that is product design analytics and engineering. Uh, I've been at known well for about nine months, but before this, I've been in health tech for a long time.
[00:02:22] Mike Gleichman: Uh, I started first at Athena house kind of by accident. I was working at enterprise rent a car has nothing to do with healthcare, but living with someone who was working at Athena health and absolutely loved it. And with lobbying for everyone in the house to apply to Athena, I think, in part, because he would get referral bonuses if we all applied and got hired.
[00:02:42] Mike Gleichman: And so he said, look, you don't need any health care experience. It's a great company. It's a great place to work. You'll love it. All you have to do is apply to this team called professional services. They'll take anyone, even if they don't have health care experience, and they'll teach you. And so without knowing a whole lot about the role or even the company, I took his word for it.
[00:03:01] Mike Gleichman: And I applied and ended up getting hired into a professional services project manager job, uh, and did that for a while. So I was at Athena health for seven and a half years in total, in part, uh, in professional services for a few years. And then through a series of product roles, uh, product operations, product strategy, and product management, before I finally felt like I needed to go outside of Athena to keep learning and keep growing.
[00:03:27] Mike Gleichman: Um, and then went over to Aetna before it was acquired by CVS Health, um, first to work on a product called the Tane and eventually the Aetna Member Portal. So at Aetna, I was in a couple of different product leadership roles, and that brought me to Dunwell after that. So, from a personal standpoint, I live just outside Boston with my wife, my five and a half year old son, Tyler, and my three year old daughter.
[00:03:52] Mike Gleichman: And um, when I'm not working, you can find me cooking, being outside or playing the drums.
[00:03:58] Angela Suthrave: Thanks for sharing, Mike. Like you were saying, you started working in healthcare in an implementation role. And so if I'm someone in implementation, what would you say to me in how you were able to make the case that, hey, these are very transferable skills?
[00:04:13] Angela Suthrave: And it seemed like you wanted to get into product. And so tell us a little bit more about how you made that happen.
[00:04:19] Mike Gleichman: Yeah. So when I started at Athena in professional services, there were some things that I really liked about the role. Uh, in particular, the team was great. I was out in the field learning about healthcare, working hip to hip with all sorts of people from healthcare, um, providers, administrative folks, practice managers, and really just learned a ton.
[00:04:39] Mike Gleichman: But what I started to feel is the travel was getting to me for starters. Uh, it was a lot of travel and then I felt like I was encountering similar workflow issues over and over again And instead of just implementing workarounds and teaching one client after another how to do certain things to work around the limitations I really wanted to understand better why the product was designed the way it was and Maybe was there a way to make the product more aligned to how our clients seemed to want to use it?
[00:05:07] Mike Gleichman: And so I wasn't sure exactly how to break into it, but what I knew is that Athena had a really strong culture of moving between teams and departments. And it was a very quickly growing company at the time. And fortunately for me, one of the people who trained me in professional services had moved into the product org.
[00:05:26] Mike Gleichman: And so I started asking her questions about what the job was like and how she liked it. And through her, I learned about what the job was and also met a bunch of other people from the product org. And realize that was really what I wanted to do. And so then I started thinking kind of methodically, how can I get from where I am right now into that role?
[00:05:46] Mike Gleichman: And some things really, so one, watching them do the work, I could then step back and say, okay, what have I done? That's similar to what they're doing right now. So that in an interview, I could explain how I already have some of the skills that would help me be successful. Second, I got a recommendation to read the book, Cracking the PM Interview, and I found that really helpful for understanding kind of what the kinds of questions would be and how I could frame my experience into that.
[00:06:12] Mike Gleichman: And from there, just started looking at what I could do to gradually get closer and closer to being in a formal product management role so that when an opportunity presented itself, I could be well equipped for it. But I would say the biggest things for moving from professional services or implementation into a product role that really transfer well is you have a lot of empathy for your end users and for your customers.
[00:06:37] Mike Gleichman: Uh, you have a deep understanding of the client base and your end users, what their goals are, what their pain points are, how they use the software. You definitely need to have good organization and time management skills. And then in terms of communication and stakeholder management. You know, I think we all understand that's one of the most important pieces of the role for product management.
[00:06:58] Mike Gleichman: It's also really important to be a good project manager because you're finding yourself regularly in complicated, often tense situations. And you have to figure out how to get everyone to rally together and get from point A to point B as a unit, which I found to be very transferable into product management.
[00:07:16] Omar Mousa: You mentioned early on in the journey there was a product operations role. Can you tell us what the current thinking on that is and Which types of companies would want that role versus which companies it wouldn't quite make sense Yeah,
[00:07:31] Mike Gleichman: so just to preface. I haven't read the product ops books that came out relatively recently and you know my experience is from a sample size of one, so Hopefully i'm not going to overly generalize from my experience.
[00:07:44] Mike Gleichman: But Athena Health was one of the first places that Melissa Perry worked to stand up product operations. I was part of the team that did that with her. And it was really interesting. So Athena originally had one, what they called product innovation org that was responsible to really end to end all things product.
[00:08:03] Mike Gleichman: Whether it was pulling data to figure out where the next opportunity is to tackle writing tickets and managing the backlog, working with engineers, figuring out how to test things with clients and eventually realized that there was just too much on a product manager's plate. And so their solution, which was informed by Melissa and another consultant were let's 4 pieces.
[00:08:27] Mike Gleichman: So they had distinct teams for product strategy, product operations, product management and product analytics. And I was on the product operations team at that point. And so, you know, where product operations, I think, is trying to solve problems is at really large organizations, especially in B2B software.
[00:08:46] Mike Gleichman: There's a lot on the PM's plate, and I think that is probably not up for debate. But I think there are a couple of different ways that you could go about solving it. So one is. Let's split the job and have the product manager not responsible for all of those pieces anymore. And so you, the idea is you partner with someone from product operations and that product operations person would help take on some of the more administrative work, whether that's recruiting clients for your alpha or beta, gathering feedback from them, documenting process, maybe communicating within the enterprise.
[00:09:20] Mike Gleichman: In some organizations, I think it includes public data. If you don't have an analytics team that's doing that. And I think all of that could work, or you could use software that makes it easier to collect feedback from your end users. You could be judicious about what actually needs an alpha or beta or have narrower slices of the product per product manager.
[00:09:42] Mike Gleichman: And for me, I think that's probably the path that I would choose to go in most cases, because what I found in practice is not intentionally, but. Having the product operations team going out and working with your end users and customers and doing some of these things. It could create distance between the product manager and your customer or end user.
[00:10:03] Mike Gleichman: And ultimately, the product manager to make the best decisions possible needs as rich a perspective on how your end users are using the product, what the pain points are. You know, all of the things that you get really from talking to your customers and your users. And if you're not really careful and it's not reiterated over and over again, the product operations person can end up just being a go between and inadvertently creating distance between the product manager and your end users or customers.
[00:10:32] Mike Gleichman: So to me, that is a big risk and not something that I would want to risk happening at product org that I'm leading. And so my perspective is if you can try to wick away some of that work, use software that makes it easier to do that. Um, and only as a last resort, put another team that's kind of working in between product and your end
[00:10:54] Omar Mousa: user.
[00:10:55] Omar Mousa: Mike, that's an interesting risk you call out. And, and, you know, for, for some product managers, some of those activities are the things that like, this is, this is what makes me valuable at my job. This is helps me be better. And so I'm wondering, you mentioned some use cases. Can you just highlight a couple?
[00:11:12] Omar Mousa: You said software could be the answer to kind of reduce. The need for like assisting hands in in that administrative work we called it. What, what are some softwares for specific use cases that come to mind?
[00:11:24] Mike Gleichman: Sure. So for gathering user insights, I think Pendo is one of the leaders for that. Uh, I haven't used it personally, but looked pretty deeply at it for when we, when I joined Nowell.
[00:11:35] Mike Gleichman: I think there are a lot of good no code analytics tools out there. Or even if you do have an analytics resource, maybe they could build a dashboard that makes it easy for all of the PMs to go in and look up their specific pieces that they care about. Or you instrument your product with something like Mixpanel, a tool that has a dashboard, a UI where you can go in and kind of figure out what's happening in the product on your own.
[00:11:57] Mike Gleichman: Another thing that's not really a software solution, but kind of scalable, we did this at a team. We recognized we needed to be able to get feedback from our end users, but the process of finding end users that fit a specific thing we were interested in understanding better was really time consuming.
[00:12:16] Mike Gleichman: And so what we did is we sent out a survey to all of our users and said, if you're interested in being in a user panel where we could just periodically reach out to you to understand how would you use this feature? How do you feel about this? What's your biggest pain point right now? Those sorts of things.
[00:12:32] Mike Gleichman: Just give us your email address and we'll contact you if we have an opportunity that fits. And when we were sending out that survey, we made sure to tie it back to user IDs so that later we could say, I'm looking for an end user who's between the ages of 40 and 60 and lives in our rural area. And without needing to go and do a bunch of legwork to find those people.
[00:12:54] Mike Gleichman: We cross referenced our user panel with all of the other data that we had to identify who might be a good fit. And then a product manager could just send an email or a survey or, uh, whatever the specific tactic was that we were trying to use to get feedback out to that group of people. Um, often we did the same from a UX design standpoint to get feedback from them.
[00:13:16] Mike Gleichman: So not rocket science, not any fancy system to do it. You could even use Microsoft Forms if you really had to, to collect those users. But something that I found was really scalable, really worked well. It took away a lot of that administrative work,
[00:13:32] Omar Mousa: not rocket science, but honestly, like really good feedback on that.
[00:13:36] Omar Mousa: Cause I, I think in healthcare, it's really hard to get market insights or customer insights. A couple of companies ago, we used usertesting. com for COPD population. And I always, like, I always wondered like, who on the other end actually has COPD and is like in this population or this panel. So I just questioned those results.
[00:13:53] Omar Mousa: So I think your, your approach is a lot better than, Probably that, right?
[00:13:58] Mike Gleichman: I mean, like any feedback is better than no feedback. So I would say if you're getting feedback, that's good.
[00:14:04] Angela Suthrave: Your background is really cool in that you've worked really with really large companies like Aetna and CVS, and now you're at a startup.
[00:14:11] Angela Suthrave: And so we'd love it if you could share any viewpoints on the practice of product management and frameworks that have worked well for you and, you know, other tools that you have in your toolkit.
[00:14:22] Mike Gleichman: I think the common thread I've seen across all of the places that I've worked in product. Is it's really important to have a really strong product strategy before you start getting into the weeds of what features should I prioritize or how should I prioritize the spreadsheet of features that I have?
[00:14:38] Mike Gleichman: And I think for that, you know, that should come down from the company strategy. So first there's, who is the company trying to serve? What does the company do? How do we think that We can uniquely serve it. And then from that, it's okay, well, I'm, I'm responsible for the product and software specifically. So how is the software that we're delivering going to further the company and its goals?
[00:15:05] Mike Gleichman: And what I like to do once you have a strategy is break it down into some annual goals. Like, uh, okay. Ours is a framework that I really love because it's just so simple, but very powerful in driving clarity and cross functional alignment. So if anyone is interested, uh, the book measure what matters by John Doerr is a really good and pretty brief read that hopefully will convince you also that OKRs are great.
[00:15:30] Mike Gleichman: Uh, I read that maybe four or five years ago and have just been referring back to what I learned in it all the time. I think it is so useful. The thing that I would say is once you have a good strategy, then your OKR should guide you on what matters right now. So the strategy is what matters in a long term or from a long term standpoint, and then the OKR should say, what do I care about?
[00:15:55] Mike Gleichman: Or what do I need to care about over the next year to get us from where we are to a little closer to delivering on that overall strategy? If where that takes you is I have a spreadsheet or a giant backlog of features that I'm trying to prioritize. To me, that's typically a signal that it's not super clear what is important right now, because there's no way that an entire spreadsheet full of features could all be important right now.
[00:16:20] Mike Gleichman: They might be important in the long run, but there are always going to be more good ideas than time or resources to deliver on them. And so whatever you can do, Upfront to limit the universe of things you're trying to prioritize between I think is really helpful when it comes into getting a little bit deeper.
[00:16:40] Mike Gleichman: I really like Moscow as a framework for defining an MVP of something. It what I like about Moscow is you don't try to say. This requirement is more important than that requirement that are both must haves. It doesn't matter. All that matters is what is a must? What is the should? What is it could? What is it won't?
[00:16:58] Mike Gleichman: And then if you really need to get into a deeper trade off decision between two of those things, or if you're not in an MVP scenario anymore, and you're trying to figure out between two initiatives or features, what is more important right now? I like Rice for that. I think Rice is also pretty simple, manages to capture what is the value, how much effort would it be, and how confident are we in our assumptions and that this would actually make a difference.
[00:17:24] Mike Gleichman: Thanks. In a way that doesn't become really complex and, you know, you end up spending days or weeks just trying to prioritize between those things. The other thing that I would say is I've tried a lot of different software methodologies across the different companies. I tend to prefer scrum, but I think we tend to be too holy about what methodology is right and wrong.
[00:17:46] Mike Gleichman: And, you know, one is always the answer and one is not, and you must practice it exactly this way. And to me, that kind of misses the point. I really like the values of Agile, of staying nimble, of teams feeling bought in on the work that they're doing. But, I think when it comes down to the practices and what ceremonies you're going to do and how long your sprints should be if you're using sprints.
[00:18:09] Mike Gleichman: You really need to adapt it to the situation and what's going on in the company and in your org and not just, you know, look back at a book that you read that says you must have two week sprints and say, well, we must always have two week sprints and we must have a retro at the end of every sprint that's an hour long.
[00:18:27] Mike Gleichman: And just don't find that especially useful.
[00:18:29] Angela Suthrave: That's super helpful. You know, you talked about ceremonies and rituals. When you think about your timeline are, and I completely agree that it starts with a product strategy. Right. And so maybe we start there. How frequently are you revisiting the strategy and then how frequently are you doing the cascade of activities from there?
[00:18:48] Mike Gleichman: I like to look at the product strategy every three to six months just to make sure that it still reflects our understanding of the market, of our customers, of our users, based on everything we've learned since the last time I've read it. It hopefully doesn't change significantly from when you look at it to when you look at it the next time three or six months later.
[00:19:07] Mike Gleichman: Okay. But there might be little tweaks that you want to make, and I find that if you, if you look back at it pretty regularly, not only will it make sure that you're staying adherent to your strategy, but also that your strategy doesn't have a wild shift, unless you really learned something surprising.
[00:19:24] Mike Gleichman: That makes you want to change your strategy in a very significant way, but I would say, if you do the work up front to have a pretty strong, clear strategy, that's well informed by a bunch of research. then you shouldn't need to change it significantly, but you'll still want to take a look at it every three to six months.
[00:19:41] Mike Gleichman: OKRs for me, I think are best done on an annual basis. Not that you shouldn't have goals in between, but the OKRs are meant to be fairly high level and large. And so to really deliver some value against that, they probably need to have a long enough time frame that you could do meaningful work, but you could still have goals within the year.
[00:20:04] Mike Gleichman: Now, your OKRs could be spaced out, so some of them you expect to do by the end of Q1, some you expect to do by the end of Q2, Q3, halves of the year. But I think setting goals too often, at least at that level of goal, you, They just, you end up spending a lot of time on the work of setting goals and not as much work on delivering and adding value for your users and your business.
[00:20:30] Mike Gleichman: Uh, in terms of how you go about creating that product strategy and cascading it down, um, you know, timelines aside, I think the first thing to ask is who am I trying to serve? What problem are we trying to solve? How do I think that we can solve it? And so that informs the strategy itself. I think it's really important to layer in business needs.
[00:20:51] Mike Gleichman: So what is it, what is important for us as context right now? What are the realities of our business, whether it's financial, regulatory, culture, or brand, and what are the competing pressures internally and externally? If you don't think about those things up front, your strategy is just going to get whipped around later because those realities exist even if you're ignoring them.
[00:21:14] Mike Gleichman: And to end up delivering something against your strategy, you're going to need allies internally. And so the competing pressures become really important. You're going to need to comply with any regulations. You'll have to have funding to be able to do interesting things. And so all of those become really important to make sure your strategy can eventually be manifested into real, real work, rather than just a nice piece of paper that you can read.
[00:21:42] Mike Gleichman: And then from there, once you've said, all right, who are we trying to solve? Solve for? What do we think we can do and what's the reality of our business? Do the research. So look at market research or your competitors. Understand your users and create rich personas, not caricatures of your users. Uh, and then understand who are your internal stakeholders that you'll either have to partner with or Or whose support you'll need to bring something to life.
[00:22:10] Mike Gleichman: And it can feel like that research part takes a lot of time and slows you down. But what I've found is if you don't do all of the work up front, you'll end up just having to do a bunch of extra work later. So it's more like you're front loading the work to make sure that your strategy can see the light of day rather than it just.
[00:22:30] Mike Gleichman: being held up later because you didn't expect some of those things to be true. I think it's really important also that when you're coming up with a strategy, you think at a high level, not really granularly, but what is technically and operationally feasible, roughly how long is it going to take? Because the market is going to change around you.
[00:22:51] Mike Gleichman: Technology will change. And if you don't think about those things up front, your strategy might not be relevant anymore by the time that you could really bring it to life. Similarly, I mentioned the stakeholders that you have to partner with. It's really important that you get their support. So rather than just waiting to unveil the strategy and some dramatic reveal it, you should have allies along the way who are giving you input, not only to make the strategy better, but so that they feel bought in.
[00:23:20] Mike Gleichman: If down the road, there's some competing priority, and you need their support to make sure that you're able to continue executing on the strategy that you had put together. I think that works best in conversations, but it's also really useful and important to make sure that your strategy is coherent.
[00:23:38] Mike Gleichman: And I found that writing it down in a memo or document format is better than a PowerPoint presentation. You will probably need to present your strategy at some point, but there are a lot of people who are really good presenters and can make a not fully formed strategy sound really great in the moment.
[00:23:58] Mike Gleichman: It's really hard to do that if you're writing something down. If someone else could read a document and understand why have you made the decisions that you've made, what are the assumptions that are baked into it? How do you think you're going to solve it? What are the milestones? All of the pieces of an effective strategy, then it's probably pretty coherent.
[00:24:18] Mike Gleichman: And going back to revisiting your strategy periodically, you know, I think what you learn along the way will then influence the way your strategy manifests in later work. And to give you an example from attain. One of the things that we expected about that product is our users would really value choice and preference.
[00:24:38] Mike Gleichman: I think especially for, uh, American apps in general, I think we have this idea that choice is always good. And besides that, there's a bunch of behavioral economics research out there that says you can actually overload people with choice. We found that to even be true at a more basic level. So one of the things that we had in Attain, we had educational content about sleep, nutrition, exercise, and a few other things.
[00:25:07] Mike Gleichman: And we expected that from week to week, our users might want to choose And say, I'd like to go deeper on sleep this week, or I'd like to go deeper on nutrition this week. And what we actually found is our users felt like because we were personalizing the app in other ways, and we had a lot of data to understand how they were using the app, what they were doing from an exercise standpoint with Apple Watch data, what was happening from a health standpoint with claims data.
[00:25:33] Mike Gleichman: They actually wanted us to personalize and choose for them. And we heard from our users and user testing that they actually would prefer if we would look at all the data that we had about them and choose the right thing based on what would make that healthier. That was a really surprising insight that we didn't expect at all, but we baked that into our product strategy.
[00:25:54] Mike Gleichman: So then our product strategy became that we only among other things, we only ask our users for input. When we don't have other information about them to inform that specific question. And so from there, our future features, um, they included getting additional data or using the data in a way that we hadn't before to further personalize the experience.
[00:26:18] Mike Gleichman: And if we had just stuck with our original product strategy. The end result of the product might not have actually suited the users as much as it did after we refined it a little bit.
[00:26:29] Omar Mousa: I love a written culture, as common as I wish it was. I think the beauty of a written document is it kind of lives forever and it is a forcing mechanism of fully formed thoughts.
[00:26:41] Omar Mousa: And it requires people to read it to actually engage with it. And it can live forever. And have multiple versions of it longer long after it was written, whereas a deck sort of like captures a moment of time in the spirit of the room or the presentation or the talk track often like it doesn't live with that artifact.
[00:27:03] Omar Mousa: And so I'm. big fan of written cultures.
[00:27:05] Mike Gleichman: I totally agree. One of my pet peeves speaking of decks is a slide that's just a picture with nothing on it. If you weren't in that presentation and you get the deck after you have no idea what they're talking about. It's just so unhelpful.
[00:27:17] Omar Mousa: Yeah, I agree. You mentioned, you know, that insight of figuring out that they want to be told your users want to be told with the information that you have about what decisions or choices to make, I think is pretty interesting.
[00:27:29] Omar Mousa: And you changed the strategy ultimately around that. What were the, you mentioned it drove outcomes. So like, what were those outcomes and were those the original metrics that you guys aim to solve or even in the product strategy change? Like there was like, Oh, we actually care about this particular outcome more than the previous.
[00:27:46] Mike Gleichman: Yeah. I would say the outcomes didn't change. From the outset, the whole premise of attain is if you can use gamification and incentives to get people over the hump to make the healthy choice, then in the end, you will see lower medical costs, improve health, improve loyalty, because you're, you're being more proactive and preventative with your patients or members as they were to us at the time.
[00:28:09] Mike Gleichman: And so the metrics themselves. didn't change. Um, but the specific tactics we used to get to those metrics did change. So from the beginning, we knew that the holy grail would be med cost savings. We also knew that to get to med cost savings, looking at retention of your users and daily and monthly active usership would be really important because if you can't first get them to pay attention to what you're asking them to do, you're probably not going to get them to make those healthy choices in the end.
[00:28:38] Mike Gleichman: And so those were pretty consistent and stable. But the specific ways that we've got to those did get more more nuanced as we learned more about our users
[00:28:48] Angela Suthrave: I think your story illustrates the importance of user research because I think that what you found is maybe counterintuitive Where you think that people don't want you to use the information because it's very big brother And what you found is that people want that friction removed and it's sort of like, well, you figure out what is best for me.
[00:29:07] Angela Suthrave: I'd love to hear more about what your learnings were on gamification because I think one of the challenges that we have in healthcare is that It's not like a social app where people just log in all the time. And so how are you able to make the app sticky so that people could actually make those positive behavior changes?
[00:29:26] Mike Gleichman: It was definitely a journey for us to figure it out. And I think in some ways. We stumbled into it. We originally, there were three big pieces of the app. So there's an activity goal that we tracked based on wearable data to see if people were hitting it. And those goals were specific to each user based on a few different criteria.
[00:29:46] Mike Gleichman: Then there was what we called healthy actions, which is, again, that kind of educational content that was originally created just to drive engagement, just to have something there for the users to see because the activity goals. We're really longer time frame. So a typical user's goal would be week long, and maybe it would change from week to week, but typically it would be the same goal for 2 weeks.
[00:30:07] Mike Gleichman: And so just in an effort to have some content, we realized that actually the healthy actions content was really useful for driving sticky engagement and for both of those pieces, activity goals and healthy actions. There was a rewards piece that was attached to it. So if you would do the thing we asked you to do, you would get some rewards.
[00:30:27] Mike Gleichman: That reward would manifest either in gift card or payments toward an Apple Watch. And so I would say the other learning is if you have an incentive that people are excited by, even if it's small monetary value, you're more likely to get them to do something than if it's something kind of nebulous, like a contribution to an HSA account, which I think is, tends to be more of the incentives used in healthcare Probably it feels a little better if you're a health care leader to say we're going to get people contributions in their HSA account, then I'm going to give them an Amazon gift card.
[00:31:00] Mike Gleichman: But if you want someone to be excited enough to take the action, you need the goal or the reward to be something that they care about, not something that you care about as a company. And so I would say that was a really important learning that we then took forward. The other thing that was useful is that we realized the way that you structure the incentive drove the activity from the user.
[00:31:23] Mike Gleichman: So, for example, our activity goals, you would get a very small amount of money for completing one day's goal. You would get most of the money from completing your week goal. So what we would ask you to do is exercise A certain amount each day, at least 3 times or 5 times or whatever times per week. And rather than saying, as long as you hit it over the course of the week, you can spread it out however you want.
[00:31:48] Mike Gleichman: What we were trying to achieve is consistent, stable exercise habits. And the way to get that is make them do a little bit each day. Consistently, and we realized that over time that did show and how our users were using the app and what they were doing even outside of the app, because it was based on their Apple watch or eventually Fitbit data.
[00:32:08] Mike Gleichman: And so I would say, if you're doing some sort of gamification or incentives. Think about whether the way you've structured your game will get the outcome that you want from your users because the little mechanics of how you spread it out really does matter.
[00:32:22] Angela Suthrave: Yeah, that's so interesting. We had reach on who worked on Apple Watch and she, you know, really established a lot of those health plan partnerships.
[00:32:31] Angela Suthrave: So it's really cool to hear your perspective from the health plan side and how you're trying to incorporate the Apple Watch into your strategy. All right, so now what we would like to do is go pretty deep into known well. And so known well is the company that you've been at now for nine months. And so tell us a little bit more about the organization.
[00:32:49] Angela Suthrave: What problem are you trying to solve and how do you ensure that? weight inclusivity.
[00:32:55] Mike Gleichman: So known well itself was founded in late 2022. We saw our first patient in March of 2023. Uh, and the company is now series a, it was seed round when I joined. So still a fairly young company. The problem that we're trying to solve is to be the medical home for any patients living with obesity, whether or not their goal is to actively lose weight right now.
[00:33:18] Mike Gleichman: And so we really think of it more as a comprehensive primary care that we can also do specialized care for people who have a PCP that they really like, but not specifically a GLP 1 prescribing shop. Not a short term kind of diet fad app or anything like that. We really want to be long term care delivery for patients.
[00:33:41] Mike Gleichman: It's comprehensive care. So your care team includes not only physicians or apps, but also dietitians, health coaches, behavioral health. We've got a big team of people that are doing things like prior authorizations. It's a lot of these medications do require some hoops to jump through. And it's really coming from recognizing there weren't good options out in market.
[00:34:03] Mike Gleichman: So our founder and CEO, Brooke Boyarsky Pratt, she had lived this as a patient for years and years, and was really frustrated that she couldn't find a place that she felt comfortable going where she could get that kind of comprehensive care and she ended up meeting Dr. Angela Fitch, who is our chief medical officer.
[00:34:22] Mike Gleichman: She was running the Mass General Brigham Weight Center at the time, and also president of the Obesity Medicine Association. So definitely one of the foremost experts on treating obesity in the country, if not in the world. And together, they just said, look, there must be a better way we can build this because it doesn't seem like it already exists.
[00:34:39] Mike Gleichman: And the 1st clinic was in Needham, Massachusetts, just outside Boston. 2nd clinic in the works right now and more clinics to come. In terms of the problem that it's solving, as I mentioned, there weren't great options for patients living with obesity. And that generally is still true today. So there were really 3 big categories.
[00:35:00] Mike Gleichman: There's academic medical centers that have, uh, a wait clinic. And, you know, mass general program is 1 of those. Those are great. If you live in a big city, and if you're willing to wait, usually at least a year long waiting list, in some cases, more than 1 year, and it can take a long time. If you eventually ever get in to see a clinician.
[00:35:22] Mike Gleichman: You've also got primary care physicians who are definitely doing their best, but they're spread really thin and they're often doing 10 or 15 minute appointments. And so to really understand a patient and to end and all the things that they've tried for obesity, it's just really tough for them to do it.
[00:35:39] Mike Gleichman: They also haven't generally gotten a ton of training on how to treat obesity. It's a relatively new. The topic in med school is to look at it as a disease and not just a moral failing. And even if they do understand all of the ways to treat obesity, they're not, the structure around them is not really set up to deliver great comprehensive obesity care.
[00:36:01] Mike Gleichman: So I mentioned we have dietitians and health coaches, behavioral health, bunch of other things. Your typical primary care office just doesn't have access to those sorts of things. The 3rd category, these are generally newer companies, but virtual only, usually asynchronous care focused on prescribing GLP 1s.
[00:36:21] Mike Gleichman: And, you know, there are some others out there that aren't necessarily focused on GLP 1s, but these are digital health companies that are really looking at you from a narrow standpoint. If you're a patient with obesity, they typically don't do a lot of high touch support.
[00:36:39] Mike Gleichman: And so they're very complex from a clinical standpoint, and these solutions just aren't really great for that. Plus, a lot of them charges subscription fee, which we just think it is not great in terms of accessing care, whether you have money or not. And then finally, if they're virtual only some things that you're going to need care for do require in person care, and they just won't be able to do it.
[00:37:01] Mike Gleichman: They're not equipped to do it. They will say, go see your PCP. So back to the PCP, if you do go to the doctor, there are a lot of issues in the sort of legacy healthcare system for patients who have obesity. So I'm going to hit you with some stats here. 69 percent of patients who have obesity have experienced weight related stigma from their doctor.
[00:37:21] Mike Gleichman: That is really high and really unfortunate. So more than two thirds of patients with obesity have felt stigmatized from going to the doctor that results in them not wanting to go to the doctor. So 55 percent of people with obesity have canceled an appointment due to anxiety about being weighed. And all of these things together mean you probably don't have a strong relationship with your PCP, and that on its own has bad impact also.
[00:37:47] Mike Gleichman: So among patients who have obesity, those without a PCP are 80 percent more likely to go to the emergency room, but they're not any more likely to end up hospitalized. They're just going to the emergency room because they don't have a PCP that they trust that they would go to instead. And so the bad outcome for everyone, it's bad for the patients for obvious reason.
[00:38:08] Mike Gleichman: It's also bad for the employer and for the insurance company, because you get this unnecessary ER utilization. They end up with a bunch of health issues that aren't being treated well. And so that results in increased absenteeism. And there have been a lot of studies out there about wasted drug spend.
[00:38:25] Mike Gleichman: When, say, a primary care physician does prescribe a GLP 1, but they don't know how to prep the patient for what they should expect in terms of side effects, or how to titrate the medication up or down based on their symptoms. And so you see a lot of people going off of the GLP 1s, and now that's wasted spend, which is, again, not really good for anyone involved.
[00:38:46] Mike Gleichman: So what we're trying to do is be the home for anyone living with obesity for really best in class medical care, where we won't judge them, we won't make them feel bad about themselves, and whether they're trying to lose weight or not, they feel comfortable.
[00:39:01] Omar Mousa: I mean, there's so many takeaways there. Just anecdotally, I think it's like, we should have a primary care physician, like, uh, appreciation day.
[00:39:10] Omar Mousa: Cause I, I mean, we see this in specialty care all the time. Like they do so much and they, you know, they take on a lot of the brunt of the care that might need to be referred out or, you know, they only have so much time. So it's like.
[00:39:22] Mike Gleichman: They're all doing their best out there. It's a very tough setup, especially if you're affiliated with a health system.
[00:39:28] Mike Gleichman: Usually primary care is viewed as a loss leader, get patients in the door so that you can funnel them to procedures or specialists where you do make more money. And it's really hard if you're a PCP who wants to do great work, deliver great care. You're just not really set up for success to be able to do that in a lot of these systems.
[00:39:45] Omar Mousa: Right. And I think the known well service is so important and the comprehensive nature of it. I think the eyeopening statistic that you shared is like, I did not realize how many people were just afraid of healthcare utilization because of That topic like that actually is. A huge problem. And I'm glad you guys are out there solving that kind of a tangent.
[00:40:06] Omar Mousa: I'm curious. Like, how do you is that part of the training? I know it's not like part of product, but I'm wondering, like, in the offering, like, is that everyone's very well equipped to kind of solve that kind of challenge? And is that in Provider training that's going on at the org.
[00:40:23] Mike Gleichman: It's a great question.
[00:40:24] Mike Gleichman: It is. Um, it's also part of the hiring profile. So we look for people who are pretty empathetic and not judgmental, but yeah, it is part of what we train new clinicians, but also admin clerical workers, clinical staff, everyone kind of gets trained on the way that we like to talk to our patients, talk about our patients, all the things that really contribute to that.
[00:40:45] Mike Gleichman: But there are also really little things that you don't necessarily think about. That do make a patient feel comfortable or not. So when I walk in and I sit down in the chair in the waiting room, does the chair fit me? Do I feel comfortable in it or is it too narrow? And, you know, now I'm already uncomfortable just from sitting in the waiting room.
[00:41:04] Mike Gleichman: We've got special exam room tables that will take patients wait. So if they don't feel comfortable getting on the scale or they don't want to see the number, that's okay. They can just sit down on the exam table and we're able to see the number. So it is important from a clinical standpoint. Um, but without the patient seeing it and feeling bad about themselves that are involved.
[00:41:22] Mike Gleichman: So it's really just a lot of very small, deliberate things that we're thinking about that maybe typical doctor's office hasn't been.
[00:41:29] Angela Suthrave: And what about one of the challenges that you said is that typical primary care physicians have 10 to 15 minute slots. We've all seen this and it's really not enough time if you want to be thorough.
[00:41:40] Angela Suthrave: And so is your model different in that way as well?
[00:41:43] Mike Gleichman: It is. Yeah. So especially for the first appointment, we spend a long time with our patients. Some of it is because we're still getting more efficient from an operations and technology standpoint. So they could get shorter over time, but I don't expect our new patient visit to ever be shorter than 30 to probably 45 minutes.
[00:42:01] Mike Gleichman: Cause there's a lot to understand from the patients that we're serving. Many of them have been living with obesity their entire life. They've tried just about everything under the sun to lose weight. And if you're their provider, you really need to understand what have they done before so that you don't recommend something that they've already tried and they don't feel like you really understand that.
[00:42:19] Mike Gleichman: And so the name known well is really that we want to understand our patients fully and that does take time. So those initial visits, especially tend to be very long.
[00:42:29] Omar Mousa: You mentioned the subscription model does not. Either does not work or isn't conducive for this population. Tell us a little bit about the go to market strategy.
[00:42:38] Omar Mousa: What's the business model? How do you guys generate revenue?
[00:42:42] Mike Gleichman: So we are pretty much operating in direct to consumer right now. Uh, imagine that we're a new doctor's office that just opened in town and now we're trying to find patients to come see us. A lot of our patients do come to us from referrals. So whether it's their PCP that wants to do well by the patient, but recognizes they're not an expert in treating obesity or an OBGYN, cardiologist, orthopedic surgeon, various specialists will refer to us because for different reasons, it's important for their patient to make headway on their weight.
[00:43:14] Mike Gleichman: Um, we are long term open to partners with employers or payers, but I think for right now, we're more focused on just directly recruiting patients to come see us as if we're any other doctor's office. We are fee for service for the moment. Long term, we definitely want to be in value based care. I think a lot of companies are feeling this way where the incentives are better aligned for us to deliver the kind of preventative, holistic, long term care that we really strive for.
[00:43:40] Mike Gleichman: But we had to start somewhere. It's a lot easier to get rolling in fee for service. And it's really important to us not to have a subscription fee and to take really all of the major insurances that includes Medicare and Medicaid. Um, which makes us pretty unique, but because our mission is to treat obesity, not just for the wealthy, but for everybody, we think that's really important.
[00:44:01] Angela Suthrave: And so if I'm a patient, what am I signing up for? Is it, I think of it just like a primary care, it's brick and mortar only, or is there a digital component? How many visits do you want per patient? Like how do the followups work if it's not subscription?
[00:44:21] Mike Gleichman: Yeah. Uh, it is both. In person and virtual. So in general, most of our patients come to see us at least once a year, but many of the visits in between that annual visit where we're taking measurements and really talking to them face to face in person, the rest of them are virtual.
[00:44:38] Mike Gleichman: And so because of that, we have patients driving from as far as New York to see us in the clinic so that they can get this kind of care because they haven't found someone closer to them that can do it. And it's not a huge deal because we'll be doing virtual visits in between. And so that's, I think, a big important part of the model is the mix of in person and virtual care.
[00:45:00] Mike Gleichman: Virtual care alone, you know, you can treat a lot of things, but to be someone's PCP I think you will occasionally at least need to see them in person. And so our footprint does have small clinics that are kind of regionally based. And then we expect to see patients around. In terms of how often our patients see us in person.
[00:45:17] Mike Gleichman: Um, again, with this population, there tend to be pretty complex health needs, and so a typical patient sees us a number of times per year. On average, I think we're at about 6 visits per year, and that's not all with an M. D. Some of those are with an A. P. P. in their care team, some of them are with a dietitian or health coach.
[00:45:36] Mike Gleichman: But we generally have a pretty frequent touch point with these patients. And what we strive for is to give them the kind of experience that you would get from a direct, you know, primary care concierge sort of clinic, but maybe not with quite the same level of high touch that you're able to do if you're charging a hefty subscription fee.
[00:45:55] Mike Gleichman: But we want people to feel like they're special and they're important. They're not just a number and someone that we're shuttling through the clinic very quickly when they come in.
[00:46:04] Omar Mousa: You know, I love the comprehensive nature of the care model and I think it's very important and I think it's actually far more sustainable than what's out there.
[00:46:13] Omar Mousa: Um, but just thinking about results and what people want and so they so desperately want to be look healthy, feel healthy, et cetera. There is a low effort solution out there. The GLP ones are top of mind right now. Big market. How do you guys think about competing against the GLP ones and, you know, brand and market and message and segment against that?
[00:46:38] Mike Gleichman: I think the short answer is we don't. So I don't think we look at them as a competitor because we're not trying to serve the same population. We're not trying to do the same thing. I think the calibrates of the world would be pretty direct that they don't actually want to be someone's doctor that they're seeing multiple times a year.
[00:46:56] Mike Gleichman: And I think that's fine if that's what they're trying to do. What we believe is that in the long run, to deliver great care and to really make an impact, it has to be more than just prescribing. And by the way, a lot of patients don't have access to GLP 1s. It's not in their formulary. They don't have 1, 000 a month to pay cash.
[00:47:15] Mike Gleichman: And so there are a lot of other treatments out there besides just GLP 1s. And again, your typical primary care physician doesn't know all of them, and it's very hard for them to know all of them. And so that's one of the things that we pride ourselves on being able to do. We do prescribe GLP 1s. So they are a part of the, you know, the toolbox that we will, uh, for some patients, prescribe them if they have coverage and if they're clinically appropriate.
[00:47:42] Mike Gleichman: But I guess to take a bit of issue with the framing of the question.
[00:47:47] Omar Mousa: Please do. I
[00:47:48] Mike Gleichman: don't know that I would say that they're an easy way out. So, for 1, there are some unpleasant side effects, especially as you ramp up on the drug. I think some of those have been overblown in the media, but. You know, it's not like it's without risk or side effect.
[00:48:03] Mike Gleichman: So that's one piece of it. The other piece that I think is more important is most of the patients who are trying GLP 1s now have been trying to find an effective treatment for decades. And they have tried everything. They've tried diet and exercise. They've tried all of the other kinds of drugs. And they just haven't made a dent for them.
[00:48:21] Mike Gleichman: And so to say, oh, they're taking a shortcut now because they're on a GLP just ignores all of the things that they've tried before that. And I think it's, it's a mistake to say that, uh, it's the easy way out. I don't think we would say that about a stat for someone with high cholesterol.
[00:48:39] Omar Mousa: That's a good point.
[00:48:40] Omar Mousa: And I appreciate that perspective and the challenge on that. So I apologize for the framing. No, I'm glad you asked
[00:48:46] Mike Gleichman: it.
[00:48:47] Omar Mousa: Yeah, it's a good one. Let's, let's talk about OKRs here for a bit. So known wells in the, is a care delivery organization. How do you view OKRs? In general, and how do you build OKRs for your product org?
[00:49:02] Mike Gleichman: So OKRs, I think are the, or at least the way I view them is the near term manifestation of your strategy. So I like to look at them again for a year at a time. It should say, how do we get a little bit closer to our strategy a year from now? What are the things that we need to do? What are the meaningful results that we need to show that tell us that we were objectively closer to that and delivering on that strategy than we were?
[00:49:26] Mike Gleichman: For a tech enabled services company like Nutwell, they're not all software goals. They're not all clinical goals. They're company goals. And the company collectively, whether it's clinical teams, operations teams, product teams, or other, you're all working together to deliver on the company strategy. And so, I think where a lot of organizations get into trouble is they try to have a set of OKRs at the corporate level, but Uh, we're at the executive level that are each owned by one person, and I just don't think that's realistic at a tech enabled services company.
[00:50:03] Mike Gleichman: So the way that we look at them is at the top level, what are the things that we need to achieve as a company? And then you get a layer down and say, all right, from a technology standpoint, what can I do? What can my team do that will get us closer to achieving those top level outcomes? From an operations standpoint, what are the things that our COO and his team can do that would get us closer?
[00:50:26] Mike Gleichman: And we each come up with a set of OKRs that should hopefully ladder up to those company OKRs. If you then say, all right, leaders, COO, product leader, et cetera, you're OKRs that you said, they should eventually deliver that top level OKR. And you can hold each of the leaders accountable. For them delivering on their own team's goals.
[00:50:50] Mike Gleichman: And you keep doing that further and further down the org until everyone knows what's important, what they should be prioritizing and can deliver against it. The process of getting there, I think it can be a little tricky. It is time consuming to make sure that you have alignment across those, but it's a lot more time consuming to get halfway through the year and realize that your technology goal is in conflict with your operations goal, and there's not enough time or resources to do both.
[00:51:17] Mike Gleichman: And so the way that I like to go about creating those product OKRs is to start with understanding the company strategy and the company OKRs and then saying, okay, what are the things that I think technology can do to achieve those outcomes and I'll create some and hopefully it's, you know, 5 to 7 in total that should very clearly ladder up to the next level of the company objectives.
[00:51:45] Mike Gleichman: Then I'll review it with my team and say, here's what I think we should be doing. Here's the bigger picture, you know, the company strategy and the company. Okay. Ours. Did I miss anything? Can you think of something that I wasn't thinking about? Is there something that needs to be on here that I wasn't thinking about, et cetera.
[00:52:02] Mike Gleichman: And so the team will weigh in. They'll also give you feedback on feasibility. And eventually the team itself will feel pretty good about what you're setting out to achieve. Then you have to look across and say, okay. So, from a technology standpoint, we feel good about this. Now, I'm going to go talk to the clinical team.
[00:52:19] Mike Gleichman: I'm going to go talk to the operations team. I'm going to talk to anyone else, either on whom I rely. So, over the course of the year, I'm going to need their support to do some of this work, or whose goals might actually be in conflict with mine. So, there might be a sales target that has a A countervailing sort of incentive to the one that I'm trying to work on.
[00:52:41] Mike Gleichman: That's important to iron out up front so that over the course of the year You're not paddling against each other in different directions And once across the functions, then you know that you have alignment then you go back up and say hey ceo Here's what I think i'm going to achieve. I already talked to my team.
[00:52:58] Mike Gleichman: I already talked to my peers And this is what I think we can do and I think it should get us to those company okrs. Does everyone feel good about this? And then once everyone says, yep, those look good, then you figure out how to go and execute on them. But that alignment sort of down, across and up is a really important part of creating the OKRs upfront because otherwise you're just going to run into issues later.
[00:53:20] Angela Suthrave: Real quick, Mike, for the OKRs, you, I really like this idea of not having a single name. Um, so I think that's a common practice and so for you to get, go take the OKRs, go down, go up, go, you know, side to side, how long does that exercise take every year?
[00:53:41] Mike Gleichman: I would say it typically takes a month or so. And so you're generally doing it toward the end of the year for the next year.
[00:53:48] Angela Suthrave: Yeah.
[00:53:48] Mike Gleichman: It can be as fast as the team can really make time to have those conversations. It's often the limiting factors. Finding time with all the people you need to discuss or with whom you need to discuss, but, you know, it, it does take some time to get through those conversations. But like I said, I think of it as an investment so that over the course of the year, you have less churn and less rework.
[00:54:09] Angela Suthrave: And so we talked about how at known well, it's a combination of brick and mortar. and virtual. And so tell us a little bit about how you use user testing at known. Well,
[00:54:20] Mike Gleichman: so we think of user testing, not just for the software. So what my team is delivering is technology that helps us deliver world class clinical care, whether it's for patients in the form of a patient app or for our care teams in software that we're building internally, or kind of optimizing off the shelf things that we've put together.
[00:54:41] Mike Gleichman: In terms of user testing, I think for that, it's a little bit more typical. You know, we, you might get user research to figure out what feature is more important than another feature based on understanding their pain points. You might get some concept testing feedback where you put a wireframe in front of them and say, what do you think of this?
[00:54:59] Mike Gleichman: Let me see you tap through this and figure out if what we've designed actually makes sense intuitively. But we also think about it more from a clinical operations standpoint. Of what is the experience like at known? Well, and to end and not just about the technology specifically, but how is the experience becoming a patient, whether it's the actual registration form that you filled out on the website or the follow up that happens after with a person so that we can understand where are the opportunities for us to improve overall.
[00:55:31] Mike Gleichman: And not just look narrowly at the software or the checking process or any of the other kind of very specific pieces because to a patient known well as the entire package. It's not just. The app that they're using or the experience when they're in the clinic or the experience when they're on a visit virtually It's all of the things together.
[00:55:51] Omar Mousa: Let's talk about product market fit and well has known Well achieved product market fit and if so, how do you know?
[00:55:59] Mike Gleichman: I think as a company in terms of the service We're delivering which is great clinical care for patients with obesity. I would say yes, we have hit product market fit We look at Our NPS scores and say, all right, well, NPS in the 90s, pretty good, actually exceptional.
[00:56:19] Mike Gleichman: So that would be a signal that we've got something going on correctly there. And then we also look at our patient base, which is growing really quickly, mostly from referrals and word of mouth. We're not doing a lot of marketing today. So I think those are signals that in terms of the care we're delivering as a company, yes, we have hit product market fit from a technology standpoint, I think unequivocally, the answer is no, we are just getting started.
[00:56:43] Mike Gleichman: So there's a lot to do and really. It's not just for the patients. It's also internal, because my team is responsible for not only what is our digital experience for patients, but also what are the tools and resources that our care teams have to be able to deliver this kind of great clinical care.
[00:57:02] Mike Gleichman: Efficiently at scale in a repeatable way. And so, you know, I, I'm all, I've only been here nine months. We've only been building things since January from a homegrown technology standpoint. So we're really just getting started.
[00:57:16] Omar Mousa: It's interesting. So like you split product market fit from a care model and then the technology product, what would you say is Either getting in the way or like, what is product market fit from the technology standpoint look like at a health care tech enabled services perspective?
[00:57:38] Mike Gleichman: Yeah, I look at it as the technology that we have in place is really well aligned and tailored to the kinds of clinical care that we're delivering in the way we're delivering it. And, you know, right now we're using a standard EHR with standard EHR workflow capabilities. We've got an EHR portal that we're using to see patients and it works well enough.
[00:58:03] Mike Gleichman: We're seeing patients and we're giving great clinical care and they seem to be happy with the care that they're getting. But it is far from optimized to the way that we want to service our patients. So I look at it that way.
[00:58:14] Angela Suthrave: Tell us more about that. So I like that you think about product as the end to end experience.
[00:58:19] Angela Suthrave: It sounds like your users are the patients themselves. And then it sounds like the other group that you're serving are your care teams. The physicians, the dietitians, others in your team. And so can you tell us more about what products you're building and for whom and what use case and what problem you're trying to solve for them?
[00:58:42] Angela Suthrave: And then maybe go into a little bit about your tech stack.
[00:58:47] Mike Gleichman: So the problems that we're solving, I would say boiled down into three buckets for right now. So the first is I'm a known well patient. I want a really seamless way to engage with known well. You could think of this as a better version of a patient portal, but in the long run, especially in value based care, it's broader than just transactional messaging, scheduling, all of the sort of basic functions that I think we're used to from patient portals today.
[00:59:16] Mike Gleichman: I'm really interested in, can we make it so our patients have a constant touch point with us, whether it's asynchronous messaging or us pulling data to know what's happening in between visits? You know, all of these things are going to be really important in the long run for the patients to get comprehensive longitudinal care and for us to make sure that we're doing it in a cost effective way.
[00:59:38] Mike Gleichman: So that's the patient standpoint. I think that's the most obvious from the outside. The second use case is I'm part of the normal care team, whether I'm a clinician actually seeing patients or I'm working behind the scenes. And doing prior offs or calling insurance companies to find out what happened with the claim that I submitted and why I didn't get paid.
[01:00:00] Mike Gleichman: There's a lot of repeated, tedious work that happens in health care, especially with insurance billing, and it just doesn't all need to be done by a person. A lot of it can be fully automated. And so that's another use case that we're solving for is to really let people practice at the top of their license and not feel like a robot.
[01:00:20] Mike Gleichman: And so I, I've challenged everyone within known. Well, to say, what are all the things that you feel like a robot when you have to do every day and send me an email when you identify 1 of these, and we'll look at whether we can just automate it. So you never have to do it anymore. And then the 3rd is, if I'm a known, well, clinician specifically.
[01:00:38] Mike Gleichman: I want to make sure that I'm giving the right care plan to the patient who's in front of me. And that's not just based on their medical history, but also what is their insurance company going to pay for? And where do they live and a whole bunch of other things that factor in that really increase the cognitive load for a clinician that's trying to see a patient just do the right thing by them.
[01:00:58] Mike Gleichman: And so, especially as known well scales, the question is, can we make it easy for the known well clinicians to deliver the best treatment plan for each patient specific to each patient without sort of burning them out over the course of the day or week.
[01:01:14] Omar Mousa: It brings me to AI hot topic. Are you. Or are there any sort of guiding principles about AI in the framework that you just described?
[01:01:25] Mike Gleichman: Yes, I would say AI, at least from my perspective, is a tool in the tool belt. It is not the answer to every question that you have. But it is really useful. And so when we're thinking about AI, there's a spectrum from AI doesn't belong in healthcare all the way through the Ford, you know, box that you walk into at a mall that will diagnose you and decide what your treatment plan should be.
[01:01:50] Mike Gleichman: I think we're somewhere in between the 2 and probably closer to the AI doesn't belong in healthcare side of it than the walk into a box that diagnoses you side. But we view it as a useful tool to help the clinicians and the other members of the normal team be more effective in delivering care for that patient, whether it's automating away things that don't need to be done by a human.
[01:02:14] Mike Gleichman: Or presenting them with a summary of information or the right information in the moment for that specific patient based on what they're doing right now. We're really interested in it also, in terms of a bunch of really. Sort of boring back office things, so as we're building our app. 1 of the things that we want to do is show headshots of our clinicians.
[01:02:33] Mike Gleichman: So our patients. Have a face to put against the person that they're going to be meeting with. Our headshots are not all exactly standardized. We've got some with 1 background, some with. Someone wearing a blazer and others not. And so we're even looking at can we use built in AI in Photoshop and just make these headshots all look standardized so that we present them to the patient in a way that looks, you know, intentional.
[01:02:57] Mike Gleichman: And so I think AI can be used to solve a lot of problems, but I would caution anyone that thinks they can solve every problem that You're probably doing work you don't need to do because not every situation warrants using AI.
[01:03:10] Omar Mousa: That's funny. It's cerebral. Everyone during the onboarding process, they had to find, like, I don't know, like, personally, mine was like, I found a white poster board from the dollar store and took a photo in front of it.
[01:03:21] Omar Mousa: And then they handed that to a designer and it was a designer's time and. Resources to like make that a photo and they made the clinician or do the same and it turned out alright, but that's very expensive. So I applaud the use of a I or the consideration of a I in that in that use case. I often think that executive teams say I when they're really just describing software.
[01:03:46] Omar Mousa: Maybe that's a bad thing to say, but I'm glad that it's focused on a use case and not just like we need a I. So yeah, I
[01:03:54] Mike Gleichman: would say if you're looking at a problem, it is good right now, especially to ask the question, could AI help us solve this problem? But you shouldn't go in thinking, what can I do with AI?
[01:04:08] Mike Gleichman: Because you're probably going to build something that isn't what you really needed in the end.
[01:04:12] Angela Suthrave: So Mike, tell us a little bit more about the tech stack.
[01:04:15] Mike Gleichman: So we are not building everything ourselves, and that was a really intentional decision. In particular, I think a lot of companies, digital health companies.
[01:04:25] Mike Gleichman: Maybe not so much anymore, but certainly a few years ago went into it, saying, how hard could it be to build our own HR? And the answer is actually quite difficult, especially if you want to comply with all of the regulations around meaningful use a high tech act. If you want to build Medicare, you're going to eventually need to comply with that.
[01:04:42] Mike Gleichman: And so I was really happy when I was interviewing for known well, to find out that they had no intention of building their own HR and they were using 1. Um, That is one of the leaders in the field, especially for ambulatory. I've seen a health coincidentally where I came from. I happen to know it really well.
[01:04:57] Mike Gleichman: And so that was a bonus is, you know, I already know how it works. And I knew that they had good API support. Similarly, I'm not interested in the near term, at least in building a bunch of operational tools. If we could find something that. Uh, our care teams could effectively use without us needing to do the work simply because as I said earlier, there are a lot of really important problems for us to solve with technology and we're trying to be scrappy.
[01:05:24] Mike Gleichman: I don't have a hundred person team to build all of these things at once. And so if we can find something off the shelf that lets us do what we need to do from an operations standpoint, then we can prioritize the engineering resources we do have against building. Uh, the patient app that I think, at least in my head, is different than anything that's, uh, existing out in market.
[01:05:44] Mike Gleichman: And so when we're looking at a need, certainly the first question I ask is, is there something out in market that already would do this pretty effectively? And if the answer to that question is yes, we're certainly going to look deeply at it. So some examples of that, I mentioned we're using Athena Health as our EHR and RevCycle product.
[01:06:04] Mike Gleichman: We've got another operations tool called DocHealth that we use just for tracking all of the work that doesn't neatly fit into the EHR. So, for example, tracking prior auth work from end to end with a patient, that is not necessarily something the EHRs are designed to do today. But DocHealth is a tool that you can customize pretty heavily, I guess, to fit whatever operational workflow you're trying to design.
[01:06:31] Mike Gleichman: And so that's one that we've used pretty well. Uh, we also, uh, do remote patient monitoring with our patients. I'm not interested in being in the business of device logistics, and so we found a company that is responsible for shipping out the scales to the patients, making sure the data is flowing in correctly.
[01:06:49] Mike Gleichman: But the thing that ties all of these together is they all have robust API support, and they all work well with each other. So when a reading comes in through a remote patient monitoring platform, it goes straight into the EHR. If we want to go into a patient's record in the HR and then pop into DocHealth to see what's going on with that patient from the administrative task side, I can click one thing and now I'm in that tool direct to the patient.
[01:07:13] Mike Gleichman: And so it was really important for us, even though we're not building all of these tools ourselves, to make sure that it's not a totally disjointed experience for end users, that they'll work pretty well together. And that we're not asking any one type of user at known well to use seven different tools on daily basis.
[01:07:29] Mike Gleichman: Each of our people, uh, our employees are generally using 1, maybe 2 of these tools, uh, on a regular basis. And so that's more the buy standpoint from a build standpoint. I think the 1st thing that we looked at was, is there a patient app out there that would meet our needs and quickly decided? No, there wasn't.
[01:07:48] Mike Gleichman: There are patient portals out there that are associated with the jars, but. The way that they're built, they have to work across 10, 000 different clients that all have slightly unique needs. None of them are going to be exactly well tailored to our operational workflows and the way that we want to interact with our patients, both in feel and sound.
[01:08:05] Mike Gleichman: You know, in substance. And so we quickly started building that we're using flutter as our front end. So trying to be lean and build cross platform flutter works across native mobile, uh, native tablet, and also web. And so rather than having different teams building each one of those, we're using flutter, and then we just have to make tweaks to adapt it to each one of the platforms.
[01:08:28] Mike Gleichman: We're also not hosting our own infrastructure. So we're using AWS behind the scenes, like many, many other people out there. And then for components of it, like logging and monitoring, we went and found a tool that would do what we wanted to do rather than us having to instrument and build everything ourselves from scratch.
[01:08:45] Mike Gleichman: So we're using data dog for that for the automations again, building a lot of that just in AWS. And then the 3rd piece that I mentioned earlier, clinical decision support, this is a mix of build and buy. And so. We very recently, I think by the time this airs, press release will have just gone live. We acquired a company called Alfie that had been also in the obesity space.
[01:09:11] Mike Gleichman: It built some really interesting technology from a clinical decision support standpoint, and rather than having to build everything ourselves from scratch or just trying to find something that maybe wasn't well suited to obesity, we ended up sort of happening into a really great acquisition opportunity for them that we're now continuing to build ourselves in house.
[01:09:34] Mike Gleichman: And so that is actually an AI use case that makes a lot of sense. It's using a large language model to. Digest, you know, what are the right ways to practice obesity medicine specifically, rather than having a really lengthy rule set, like a traditional clinical decision support platform would use. We didn't build their own large language model, or I guess I should say they, because it preceded known well, but they did not build their own large language model.
[01:10:01] Mike Gleichman: They just fine tuned 1 that existed to make sure it worked well. And it's a really clever stuff so that it can serve our obesity use case, and we have enough control over it. Without having to build everything from the ground up.
[01:10:12] Angela Suthrave: That's super interesting. And the problem that you were trying to solve is to find an analytics tool that could help with the clinical decision support.
[01:10:22] Angela Suthrave: When you were doing that evaluation, how were you able to find suitable organizations and what was the due diligence process like? And ultimately, how did you figure out that Alphie was the right person? Company and then ultimately was an acquisition. So we'd love to hear more about that.
[01:10:39] Mike Gleichman: We actually didn't go into it looking for a company to acquire, uh, Alfie approached us.
[01:10:45] Mike Gleichman: And so we started talking to them, I think, December of last year and had some great conversations with their founder and CEO, Alexander Singh, uh, who actually joined known well as part of the acquisition and has been a tremendous resource to us. So. I'm really glad that he's here, but what we were originally planning to do is that we would build our own clinical decision support because we didn't expect there was anything out there in market.
[01:11:11] Mike Gleichman: That was really tailored to obesity because again, obesity treatment is relatively niche. There aren't that many providers out there, and so we didn't expect that. There were, you know, good obesity treatment, clinical decision support software available out there, the way that there is for typical primary care or cardiology or something like that.
[01:11:31] Mike Gleichman: And so I was not an expert in how to build clinical decision support tools, brought in a consultant who helped me learn. How do you build and maintain these clinical decision support tools long term? What platforms exist in market that you could use as a starting point rather than building every piece of it from scratch and realize fairly quickly that standing up your own clinical decision support software platform is a big effort up front and a big effort ongoing because you need to make sure that as clinical guidelines change or as new treatment options come out, that you're constantly updating your recommendation engine and the rules underneath it.
[01:12:11] Mike Gleichman: to deliver the right recommendation based on what's current. And between learning, you know, the scary side of having to build it ourselves and talking to Alfie about what they had built as they were trying to figure out, do we raise another round or do we look for a suitor? We realized that it actually made a lot of sense for us to try to acquire them because of how clever the technology that they had built is.
[01:12:36] Mike Gleichman: And that From a clinical standpoint, we felt really good about the recommendations that they were making. And so for the process that we went through, I think the first piece was going back to our strategy and saying, do we feel like it's the right time for us to invest the time, the focus, the money in delivering against our clinical decision support vision right now?
[01:13:01] Mike Gleichman: I think there was no question that at some point as normal grew, it would be important to prioritize that. But it didn't mean that that was the right timing for us to do it then, as we were one clinic going to multiple clinics and trying to do a lot of other things at once. It does make sense to do this, and there aren't a lot of alternatives out there in market, and so it just made sense to proceed down that path.
[01:13:22] Mike Gleichman: Then we started having conversations about, from a clinical standpoint, do we feel like the recommendations that it's making are good? And so we, Brooke registered as a patient, put in some info, had it generate a recommendation, and then Dr. Fitch looked at the recommendation and said, you know, based on the input, this is actually a sound clinical recommendation.
[01:13:42] Mike Gleichman: I agree with this. And we looked at, you know, in general, what was it using to make its clinical recommendations? From a technology standpoint, do we feel like it would be easy for us to integrate into our tech stack? Or is it going to become, you know, a really huge effort just to make it kind of work with it known well.
[01:14:00] Mike Gleichman: And then of course, there are the financial pieces that I think people generally understand about doing due diligence on a company. But what we ultimately came to believe is, you know, a lot of shared values made sense from a strategy standpoint, good tech made sense from a clinical standpoint in the way that we like to practice obesity medicine.
[01:14:18] Mike Gleichman: And it would allow us to deliver the kinds of care that, in the long run, that Dr. Fitch can do for her patients with, you know, years and years and years of expertise, and as the president of the Obesity Medicine Association. Well, it'll allow our known well clinicians to deliver that level of care, even if they are not 20 year veterans of practicing obesity medicine with the pedigree to be the president of the Obesity Medicine Association.
[01:14:44] Mike Gleichman: So we're super excited about it.
[01:14:46] Omar Mousa: You mentioned, um, cost to integrate and like how long would it take and would it require a lot of resources? Can you just describe integration strategy? Like how did, how are you guys bringing this into the fold?
[01:14:59] Mike Gleichman: Sure. Uh, there were some pieces I think that made sort of the tactical integration easier.
[01:15:04] Mike Gleichman: So for one, they were also using Amazon web services and GitHub. So transferring everything over was pretty easy in both of those tools, you've changed the organization that it's sitting underneath and suddenly it's now part of known as Amazon Web Services account or Amazon's GitHub account. And so that made that piece easy in terms of how we connect it to all our other tools and bring it live again, that comes down to the technology that they were using, which is part of why we were so drawn to it.
[01:15:34] Mike Gleichman: It's very API driven using fire as the clinical data format that it was expecting to receive data in, which, of course, Athena supports, because all of the HRS are required to support fire at this point. And so we felt pretty confident that it wasn't going to take a ton of custom engineering work to be able to get data into this engine and have it spit out recommendations that were specific to notable as patients.
[01:15:58] Mike Gleichman: But we are using the opportunity. to step back and look at what we're asking our patients from a clinical standpoint. So one of the things that it considers is the patient history that they answer in some sort of new patient forms that they fill out. And we've been asking our patients some of those questions also in different forms.
[01:16:15] Mike Gleichman: There's some discrepancies between the two, and rather than just saying, we're going to use everything Alfie was asking, or we're going to use everything Nonal is asking, we're stepping back and saying, let's look at both. Let's see, you know, where the overlap is and where there's not overlap. And for the things that don't overlap, Are they meaningful from a clinical standpoint?
[01:16:33] Mike Gleichman: And actually, we should be asking them, even irrespective of clinical decision support software, or do we feel like we don't actually need that? And let's update the model to look for something else that we do think is more meaningful. And so that, again, is a partnership between not just technology, but.
[01:16:49] Mike Gleichman: Clinical technology. So Dr. Fitch is going to weigh in heavily on that and say, you know, if I were trying to treat a patient, I think it's pretty important to understand this piece of it. That's not on either questionnaire. Maybe we add that and then we make sure that the model does take it into account.
[01:17:13] Omar Mousa: All right, Mike, we got here. We are at the very fun concept closing call portion of the pod. Angela and I will take turns asking you a couple of questions meant to be quick and fun. You ready?
[01:17:26] Mike Gleichman: Sure.
[01:17:26] Omar Mousa: Let's have fun. What is a tool that is highly valuable to you that you think others may not be using?
[01:17:32] Mike Gleichman: Sure.
[01:17:33] Mike Gleichman: Many others are using this. I'm actually surprised by how big the community has grown, but HealthTechNerds, it is a super rich Slack community. They have a great newsletter. Also, they have really great webinars. This is not a sponsored post. Uh, it's just a great, really rich source of information. I use it all the time.
[01:17:54] Mike Gleichman: I've used it to learn about, you know, tools that are out there that we could use, approaches that people have used to solve problems, just understanding different aspects of healthcare from a regulatory standpoint or anything else. It is truly wonderful and well worth the subscription fee.
[01:18:11] Angela Suthrave: We agree with you.
[01:18:13] Angela Suthrave: Number two, what are concepts in health care that excite you right now?
[01:18:17] Mike Gleichman: So I'll give you two the first value based care not alone and being excited about that But to me it really it incentivizes doing the right things, especially for providers Who want to be treating patients in a preventative longitudinal way?
[01:18:33] Mike Gleichman: I think fee for service really just incentivizes sick care, so I'm going to wait until the patient is sick, and then they'll come in for a visit, and I can bill for that visit, because, you know, there's a CPT code for that. And traditionally, you haven't been able to do the kinds of things like check in with the patient in between.
[01:18:51] Mike Gleichman: There are some ways to do it, like chronic care management, but Value based care is really just going to, I think, enable a lot of organizations to do the things that they already wanted to do, but couldn't from a financial standpoint. So, I'm really excited about that. The other I would say is consumer grade digital experiences for patients.
[01:19:09] Mike Gleichman: So, health care is pretty dated. I think faxes are still responsible for a lot of transactional data going back and forth in health care. And you kind of saw that in the health care apps that were out there for patients to use also. You know, again, not to knock the EHRs for their portals, they serve an important purpose, but they're not really on par with the kinds of apps that we're used to using on a daily basis as consumers.
[01:19:34] Mike Gleichman: And so I think we can thank the digital health companies for really pushing the envelope and what's possible from a digital experience standpoint with that. And that's certainly something that we want to do for our patients.
[01:19:45] Omar Mousa: I think the iconography and some of the apps I've seen are pretty bad. Do you think product management is a science or an art?
[01:19:56] Mike Gleichman: I would say it's definitely more of an art. I think it's hard to say it's a science with how much variability there is from company to company, or even role to role within a company. But, like any art form, there are specific techniques that you can learn to get better at it. So I don't want people to take away that I think it's truly an art that is bespoke and can never be learned.
[01:20:17] Mike Gleichman: I think it can be learned. But I think there's a lot more art to it than science.
[01:20:21] Angela Suthrave: And lastly, where can people get in touch with you? And do you have any shameless plugs?
[01:20:25] Mike Gleichman: Yes. So they can get in touch either on LinkedIn or hopefully they join health tech nerds and they can find me in that Slack channel or Slack community.
[01:20:33] Mike Gleichman: I guess shameless plug this job market is really brutal. So be kind. If you're a hiring manager, don't ghost people, prioritize getting back to people quickly and don't make the process drag out. And especially look at the steps in your process and whether you really need 7 rounds of interviews. You probably don't.
[01:20:53] Mike Gleichman: And then if you're not a hiring manager, just try to help someone out. This is a really tight job market, especially for technology. And so if there's someone asking for a referral. Or just an introduction. Take the time to do it. It's, it's going to pay off in the long run. I
[01:21:09] Angela Suthrave: love that. That warms my heart.
[01:21:10] Omar Mousa: All right, Mike, thank you for coming on to the show. It's been a blast having you here. Thanks so much. Thanks so much for having me.
[01:21:20] Omar Mousa: Hey, thanks so much for listening to the show. If you liked this episode, don't forget to leave us a rating and a review on your podcast app of choice, and make sure to click the follow button. So you never miss a new episode. This episode was produced and edited by Marvin Yue. With research help from Aditi Atreya.
[01:21:37] Omar Mousa: We're Angela and Omar, and you've been listening to Concept2Care.