Episode 2: Healthtech Innovations in Charlotte with Paula Kranz & Dr. Scott Pope

Scott Pope  00:06 

I tell people take pictures of Charlotte right now put them in sepia tone, and be able to tell people that, you know, five or 10 years ago I was here and look, look how young this space was and how far we've come because there's just, I think Charlotte's gonna be unrecognizable five or 10 years from now. All the things that we've been able to do on both a local and an international level. 

  

Pete Seeber  00:28 

Welcome to the Kingsmen Software Beyond the Build podcast, where we highlight our friends in the software development community. We get to know them, their story, their influence, and their impact at a deeper level. We also have a good bit of fun along the way. I'm your host, Pete Seeber, and among other things, I'm the Chief Strategy Officer here at Kingsmen Software. I'm really excited about today's podcast conversation. I'm excited because to me, it feels like there's a healthtech, medtech evolution going on here in Charlotte, that in all honesty has been going on for the last few years. It reminds me of the banking revolution that took place in the early to mid 90s that really put Charlotte on the national stage from a business perspective. We can all see how Charlotte and the region benefited from that evolution that took place over a 30 plus year period. What started with the expansion of banking begot advancements in technology skill sets, which begot new industries in payments, and fintech. This first evolution in banking catapulted Charlotte onto the national landscape. The second evolution in healthcare, healthtech, medtech, in my opinion, has the opportunity to have twice the impact and half the time. Now, that's obviously a pretty big statement. But think about it. Charlotte is starting this health tech evolution from a much different platform. It's a platform that is much more well positioned to accelerate quickly, up and to the right. Why? Because the industry needs certainly exist. We all see that. The technology talent pool is already here in Charlotte. Thank you banking evolution number one. And much like the first evolution, we have phenomenal support from larger healthcare players in the space that are here in Charlotte, Novant, Atrium, etc. This support extends all the way down to the grassroots level in the health tech innovation and startup space. And the big players are working in coordination with those startups. It's a unique combination with a shared vision. Charlotte also has a much more robust venture capital private equity community, right here in our own backyard that is supporting the evolution. When you really put the pieces together and think about it, twice the impact and half the time may in fact, be an understatement. Thank you for joining us today on Beyond the Build. I hope you enjoy the conversation. Our first guest is a longtime friend, Scott Pope. And Scott, I'm gonna give a little bit of background on you. But you're going to of course correct me when I get half of this wrong. Right. You know, by trade. You're a doctor of pharmacy, by passion, a healthcare and healthtech evangelist. By profession, you're the CEO and founder of Roamd the CEO and founder of Launch Tower Health and generally all around the health tech ecosystem space. Fair enough?  

  

Scott Pope  03:25 

Fair enough.  

  

Pete Seeber  03:26 

Awesome. Congrats on all that, I know you have a family as well. I don't know how you take care of all of it and spend time with them. That's amazing. Thanks for joining us and spending time today. 

  

Scott Pope  03:36 

My mom will say that I'm burning the candle at both ends, spread a little thin. 

  

Pete Seeber  03:39 

Yeah, yeah. So tell us a little bit about that, brag on yourself a little bit. Give us the background tell it your way.  

  

Scott Pope  03:45 

Yeah, so I like breaking my career up into three different decades. So my background is a doctor of pharmacy, I specialize in infectious diseases. So the first decade my career was focused on taking care of patients in hospitals. The second decade of my career I got to spend here in Charlotte, a company called Premier Inc., and got to be an intrapreneur, effectively launching new business lines of the safety net of what would become a publicly traded company in the healthcare performance improvement space. And now in the third decade, my career gets to really focus on helping the companies that don't have their feet dry in the concrete. That is the status quo, they're really trying to create the truly meaningful grassroots disruption in healthcare and Roamd is, as you mentioned, is one of those very large movers and shakers in the primary care space. So briefly, Roamd is the international network of concierge direct primary care practices that's really focused on creating that relationship between a primary care doc and their patients. And it's been very fulfilling to be at the helm. 

  

Pete Seeber  04:50 

That's amazing. And for our guests out there, our listeners, if Scott's voice sounds familiar, he has his very own podcast. Want to talk a little bit about that? 

  

Scott Pope  04:59 

I do yeah, the Roamd podcast hosted by me, Dr. Scott Pope, where we have on a variety of guests in the membership based medicine, the concierge medicine space, kind of sharing some of their their and tribulations. And really what I try to do, Pete I think it's a lot of what you're trying to do here as well is really connect to the human element of what's going on in the healthcare innovation space. It's it's a privilege to get to have each one of those guests on and I try to do it in a disarming way that just allows their personalities to come through. And it's honestly I didn't think I would ever have a podcast. And now that I've got the Roamd podcast, I can't imagine not having it. It brings a lot of personal joy to my professional life getting to host that. 

  

Pete Seeber  05:44 

That's amazing. I love that you do all that and still stay grounded. Our second guest is Paula Kranz. And I think she has a super interesting journey of multi potential I got the only one of your words there. I love it. Paul's background, I can't talk about most of it. She's a graduate of the United States Military Academy at West Point and spent 20 plus years as a military intelligence officer doing all kinds of stuff that we don't need to know about, I would have to assume. Second part of the journey, and I'll let her tell the story. She's gotten deeply into healthcare. She's the Vice President of Innovation Enablement at Novant, and the Executive Director of the Novant Health Innovation Center. Paula, thanks for joining us. 

  

Paula Kranz  06:25 

It's a pleasure to be here Pete. Thank you. 

  

Pete Seeber  06:27 

Absolutely. Tell us a little bit about your journey, how you got to where you are versus where you started, right, you see all these memes of, you know, where it started, how it's going right? 

  

Paula Kranz  06:39 

I like Scott's kind of framing there of the decades. So maybe I'll present my career in the same way. Although I've had a few, I'd say it's a very peripatetic career path, which I've absolutely loved. Everything I've done along the way has formed my position now, so as you mentioned, served in the US military and served with various US government agencies that start with three letters, learned a lot about collaboration and cooperation and try to bring that to the work I do now, really, Novant can't change the ecosystem in the Carolinas alone, I can't change it alone, we've got to work across partner lines, to get towards the solutions we all are seeking. So after leaving the military, I had a brief stint in academia, pursuing doctoral studies, but also serving as a research associate and combat journalist. So focusing on my writing and research skills, I sort of pivoted from there to starting my own consulting firm, which has had various iterations over the years. But really, what I started to focus on about five years ago, was how to influence behavior change. So it's not unlike what I didn't military, right, like I was trying to get people to tell us where the nukes are. Now, I'm trying to get people to tell us where their problems are, and then trying to figure out solutions. And so, you know, when we find those solutions, we have to influence humans to adopt them, right? If we can help you monitor your congestive heart failure through wearing a remote patient monitoring device and reporting it, maybe we can help you have better outcomes. So I thought for a while, like what's the best way to influence behavior change? And something we had done in the military was using visualization and virtual reality training. So I use it for everything from sports optimization, to pre combat rehearsal, like, you know, practicing an environment we're going to be in, in a foreign land having to deal with combatants and non combatants and make those split second decisions. And I got in, I decided to launch a company in partnership with them. A great team here in Charlotte, was focused on using immersive experiences for medical education. So different work environment, right, but high stakes operations, low frequency, difficult to practice, you need to practice till you get it right, not just do one and done. So that led me to founding this company at the beginning of COVID. And Angela Yochem, Novant's Chief Transformation and Digital Officer said, why don't you bring your company inside Novant embeded as an executive in residence here and help us adopt this emerging technology, which we all know is now called the metaverse. So that's what got me to Novant. And I'll save the rest for later. But it's been a fun journey, learn so much, lots of different, you know, experiences and education, probably a master of zero skills that I loved it all. 

  

Pete Seeber  09:08 

That's amazing. I think it's gonna take me another 10 minutes just to process what you said in five, that's fantastic. Congratulations. So, you know, tell us about Novant Innovation Center. Where is it? What is it? What are the goals? What was behind it? What is the organization trying to do under your leadership? Walk us through that. 

  

Paula Kranz  09:28 

Absolutely. Well, we just launched in April but there was about a year's worth of work getting all the efforts lined up and getting ready to launch some programming just after launch. So we spent time applying for grants to fund our operations, we're completely funded by grants and donor dollars, so we didn't distract from operational activity across the healthcare system. We received a couple of grants to fund some big projects. We received some grant funding to basically lease a space for a couple of years, and we found a partner that really helps us advance our goals in this space as well. So we opened one lab in Charlotte it's located in Enventys, which is a product commercialization firm. And that helps Novant get beyond just creating new digital products, we have a cognitive computing team that can create digital products and services, we can change our processes, but we've never been able to create hardware. So putting our innovation lab in a location like this helps us kind of expand our ability to innovate, if you will. Now, the space is used for our team members to come and do design thinking and ideation. But we're heavily focused on the community as well. So you know, we'll get back to the work Scott has done here in Charlotte and laying the groundwork for a health tech ecosystem. We're trying to build upon that and engage startups in our communities and across the Carolinas. We've expanded that now to include partnerships with Enterprise Ireland, Nordic AMPlify, Israel Innovation Authority, so other governments who are trying to get healthtech into the US, they see the Carolinas as a prime spot for adoption, because we've got kind of nimble, forward thinking organizations here. And that's, particularly exciting to me. The other area we're focused on is just general workforce transformation, teaching kids as young as fifth grade about careers in 3D printing, or biomechanical engineering or surgery. So we have a heavy engagement with nonprofits and schools in the community, especially focused on underserved kids. 

  

Pete Seeber  11:15 

That's fantastic. I'm thrilled to have you both here today. Because knowing both of you, I thought putting you two together to just freewheel in a conversation about whatever topic comes up, people won't even need to hear my voice in that. And I think we can easily cover the time and educate some folks. So excited to have this today. So let's really get into the details. Scott, I mentioned something in the kickoff that five years ago, you couldn't even pull a panel together in Charlotte to talk about this topic. And you're the one that attempted that challenge. Right. So talk to us about where it came from and how we progressed to where we are now with healthtech innovation. 

  

Scott Pope  11:52 

Yeah, absolutely. It's an honor to be on the podcast with you and even be included in the same sentences is Paula is a privilege. So thanks. Thanks so much for having me on here, Pete. Yeah, in late 2017, I kind of woke up. And you know, I'd been in Charlotte since 2004. And I had built a really deep network of kind of healthcare innovators, but very few of them were here in Charlotte, they were all over the US just as a function of the work that I had done through Premiere. I said, you know, I really want to connect with the local healthcare entrepreneurs and innovators. And like, there's surely there's meetings, surely there's is a club or a group of these individuals. And I went to look for it and realized that there wasn't. And so I decided to work with my colleague out of Florida Kelli Murray, who had started Florida Health Innovators. And we started NC Health Innovators in the early part of 2018. And the spirit was just to really kind of be a convening network for healthcare entrepreneurs here in the Charlotte area. And we hosted a handful of events. The very first one we did was in June of 18. And Angela Yochem, Karl Hightower, some folks from Novant, were some of the first people there, I think, Karl didn't even have a Novant extension email yet when he came to the meeting. So they were very rapid early adopters of the movement that we were trying to do. Charlotte is most notably known as a banking town. And when you look around, there's plenty of healthcare innovation, that, you know, we I thought we could put a stake in the ground and, you know, really claim an identity and reputation for healthcare innovation. And in 2018, you know, I struggled to find four companies to present for us and, you know, fast forward several years later and NC Health Innovators become became a North Carolina 501 C 3, a nonprofit organization called Launch Tower Health. And if you go to launchtowerhealth.org, you can see that there's almost 40 healthcare technology startups listed in our health tech directory. And so you know, some of that I don't take credit for starting, you know, all the a couple of those companies that are my own, but overwhelming majority of it was just kind of creating this movement of, you know, like minded people who wanted to be in a particular area, I think, you know, some of the things that are coming here with some of the medical schools that are coming in to Charlotte, created a lot of buzz and intention for people be located here, and excited to get to work with the Novant Health Innovation Lab to really create more of a sense of infrastructure for healthcare entrepreneurs that are trying to do really good things in health innovation. It's, you know, Launch Tower Health has been a labor of love for me. It's been a privilege to get to work with some really, really influential people. If I was going to do one shout out to a company, there's an organization based here in Charlotte called CliniSpan Health that focuses on the disparities that exist in clinical trials and really trying to level some of that work up. So Dezbee McDaniel and Dr. David Lipsitz are the co founders of CliniSpan Health. That is just one of those one of a handful of companies. Very few people in Charlotte even know that they exist. But they're doing really strong work to make sure that more and more people of color get enrolled into clinical trials. And they're more equally represented in those so that when drugs do get approved or get new indications, there's more safety data and quality data that exists for people of color in those clinical trials. And they're based here in Charlotte.  

 

Pete Seeber  15:20 

That's fantastic. I love those stories. And I'm so glad that you're deep in the space. And we've achieved some critical mass, in my opinion, from what I see. But you were one of the ones that were there at the beginning when there was no critical mass. And I agree with you with what you said earlier, Charlotte's known as a financial services banking town, but financial services and banking have changed so much in the last few years that it's really become a technology play, right. And those technologists, and that innovation is transferable to different industries. That's what we see a lot of particularly in healthtech. And you know, I talked to my friends up in Winston Salem, where there's a lot going on, I'm familiar with Nordic AMPlify a little bit. Paula, you mentioned them earlier. So it's amazing to see this really second industry of growth in the last 20 years pop up here in Charlotte and start to take over, it's fantastic.  

 

Scott Pope  16:10 

2006 when I started at at Premier, early part of 2007. And, you know, there was a lot going on in the financial banking industry. And Premier was a technology heavy company. And a lot of the people that recruited into our tech services were coming from the banks, you understand zeros and ones, you understand zeros and ones, and there's a lot of very transferable skills into the healthcare space. And for some folks who are in the financial side, you might find it odd to think that, you know, compared to healthcare, the financial services industry is about 30 years older than the technology and healthcare, we've got a long way to go. So you know, I love the fact that people like Angela Yochem, Paula Krantz coming from outside of healthcare and bring some of that fresh new perspective to problems that need to be solved, versus a lot of people who are inside of healthcare and bring a kind of a jaded perspective and mentality, that well, that clearly can't be you know, overcome, because we've been dealing with that for 15 years or so and to bring some of those outside skill sets, I think is an imperative for healthcare to continue to get better. 

  

Pete Seeber  17:15 

You know, so many people would argue that technology really didn't even get into the healthcare space until really the time that you're talking about Scott, like the early 2000s, with electronic records management, and some of the mandates that came down, it was coming out of the dark ages. So if you just start with, you know, I'll just generally say 2005/2006 timeframe, right, to where we are now in 2022. It has come so far so fast. And you know, Paula, I'd love to hear from you, you know, what are some of the, you know, what are some of the mega trends that you're seeing in the space that you deal with? As you look forward? 

  

Paula Kranz  17:51 

Yes. Well, I think it's very exciting. Just to add some granularity to your earlier comment, the region's employment grew 50% this last decade, which is more than double the national average of 24%. We've added 6,600 jobs, which is fantastic. This is from the Charlotte Regional Business Alliance. A lot of those are focused on life sciences. And I've personally seen venture capitals going wild with investment in healthcare, just because there's a need for it right? In the military, we used to say adapt or die on the battlefield if you don't adapt from like traditional old school conventional warfare to the modern warfare at the time counterinsurgency, you're literally gonna die. But it's figuratively too right, we're competing against Amazon and Walgreens and Walmart. So we've got to find ways to innovate within our community to keep these healthcare systems here. So another thing that sort of sparked biopharmaceuticals in the region, just this past decade, there's been an increase of 363% in the regional workforce. And Charlotte is one of the top five markets in the US 50 largest metro cities. So those are kind of some some local trends, if you will. I just returned from an international conference focused on healthtech innovation. And there were leaders from Singapore and Malaysia, and Japan, and South Africa and all over Europe. And we were all facing the kind of same trends. And it was good to get confirmation of that. So not in any particular order, just the advancement of virtual care and care away from home. So you can imagine in Africa, where they don't have access to big hospitals, there's a lot of rural and remote care that needs to happen. Well, now from Charlotte, we can beam in over the shoulder of a rural nurse and help provide care, you know, anywhere in the world, literally. So we're thinking about that in our rural communities, but also trying to democratize healthcare, so providing care around the world. Second, I would say just the adoption of the metaverse, you know, I'm very passionate about that. So immersive technologies, including virtual reality, augmented reality and extended reality. We have dozens of these cases about to launch at Novant Health. I think we're quite ahead of many other healthcare systems, but you know, probably because it's my pet project. And I know it's something that can be transformational, but doesn't require a heavy lift. So you see companies like Facebook now called meta investing billions in this industry, likewise Qualcomm, so many other big corporations for not just healthcare but other industries as well. So stay tuned for evolutions there. And then I'd say there's a heavy focus around the globe on mental health. How do we take innovative approaches to mental health and there's a shortage of psychiatrists and psychologists and therapists. So are there ways we can use artificial intelligence? My kids would rather talk to a chatbot about their feelings than their mom or a therapist. Lots of innovative ways coming out across the across the globe as well. Scott, you probably have some trends to offer as well.  

  

Scott Pope  20:35 

Yeah, it's a focus maybe a little bit more on the Charlotte market specifically, there's some, you know, a couple of exciting things that have happened over the last several years, we had a major exit, here in the Charlotte market. So Healthstat was an onsite wellness company for self insured employers, and they were sold to Paladina Health, about September, October, I think timeline of 2020. Healthstat was started to Hickory, North Carolina relocated here to Charlotte have been around for about 20 years. And you know, those are entrepreneurial success stories that just aren't told far and wide enough. And the interesting thing too to kind of piggyback on to what you and I talked about Pete with on the financial side, AvidXchange, actually announced a few years ago, they were going to finally break through the HIPAA barrier and get into doing revenue cycle management for healthcare companies. And so our local, some of our local unicorns have gotten in that space Red Ventures, and other Charlotte unicorn bought a company called Health Line. And I want to say around 2020/2019, as well, and they kind of broke into the healthcare space. So there's a lot of exciting things happening here in the local market from, you know, our unicorns that you maybe don't associate with healthcare, to some of these startup companies that people don't even know are here that have really taken off. So it's just, it's a super exciting time to be in the healthcare innovation space in the Charlotte market. And, you know, excited to get to work with Paula and team to continue to make this you know, even more and more increasingly fertile ground for companies to start and originate here or to relocate here and find long term growth in survival. One of the fascinating things that I've talked about and been wildly unsuccessful is yet to really bring to fruition, but maybe this podcast will be the straw that breaks the camel's back and gets us over the top. But when you look at all of these, you know, the financial companies that are here in Charlotte, from the Banks of Americas and Wells Fargos, Barings, etc, etc. The one thing that holds them all together is that they're all self insured employers, right, and they're all paying for their health care expenses for all their employees, and they're spending, you know, millions and millions and millions of dollars to pay for that. And I would love for Charlotte to kind of be the, you know, the banking town that decided was going to fix healthcare, and to find a way for those financial institutions to work with our local health care companies, startups and mature companies alike to find ways to start to fix that. And if we fix that here locally, that stuff will spread like wildfire. But you know, from a financial perspective, from a quality outcomes perspective, there's just no, there's no turn and no rock and healthcare that you can't turn up and find an opportunity to make things a little bit better. And I think Charlotte's got a ton of potential to be able to do that. 

  

Paula Kranz  23:22 

Yeah, Pete, if I could just kind of piggyback off that, Scott's alluding to partnerships, right between big bank corporations and not healthcare. We're looking at those types of public private partnerships everywhere. I mean, whether it's a bank or a grocery store, and we're trying to get medically tailored meals for people with chronic disease, who have to shop at gas stations for food, or, you know, partnering with Uber and Lyft to get people rides to their appointments, because they miss their appointments, they end up back in the emergency department it's not good for them. It's not good for us. We're looking at nonprofits that are growing hydroponic and vertical gardens so that we can help communities where they have food deserts, grow their own food, if you will. So I think public private partnerships is another trend that we're really seeing. And I think it's, you know, echoes around the globe as well from this conference that I was just at. Banks can play a tremendous role, big corporations here, the Charlotte Executive Leadership Council is trying to bring corporations together to address many of these problems. It's great to see that at a strategic level as well. 

  

Pete Seeber  24:21 

I love that I'll leverage off of what you said earlier in terms of a banking town, but also healthtech town, right. When I landed here in Charlotte in 1994, there were two banks that were up and coming right. And we had some great corporate citizens that while they competed against each other on Tryon Street, they also helped cooperatively to build the whole region. And I see that continuing, right. And I'd love to see it continue to happen in the healthcare space. Because, you know, you read all the polls, there's really three big cities in the southeast where you know, people say that's where the growth is at. They talk about Charlotte. They talk about Nashville, they talk about Raleigh, and that's where that's where everything is going. That's where innovation is happening. That's where the population and the jobs are. Charlotte has a unique opportunity to take the traditional finance and banking industry and really double down and become a healthtech space as well, I would love to see that happen, and continue the growth here, I think it would do so much for the region and for the population here. And Paula, everything that you're talking about, it's new to me, and Scott, the same thing with what comes out of your mouth and out of your brain, because I'm just a healthcare consumer, right, I have four kids, and I want to make sure they're healthy. So we go to the doctor, and I have some aging inlaws and some aging parents, and I want to make sure that they have what they need. So I just look at healthcare and healthtech, from my narrow perspective of telemedicine, right. And it's easier to make appointments, it's easier to get the data that I need in terms of our doctor visits. And it's easier for us to get, you know, advanced care, prescriptive care and know what we're doing. But so many of the things that you're talking about, Paula, of what you just talked about that blows my mind that healthcare organizations are in that space, helping the community in those ways. 

  

Paula Kranz  26:10 

Well, you know, something you're alluding to is that task automation, right, you get a reminder that you have an appointment, or your pharmaceuticals are ready to be picked up, or whatever it is, we have such a crisis and workforce shortage as everybody knows, it's happening across the globe. It's affecting the bottom lines affecting the care we're giving our patients most importantly, because we're short staffed. So that's one of the most urgent issues I've been tasked to address, we kind of get a list of priorities for the system. And then I send out the bird dogs on my team to see what kind of solutions we can find. So how can we automate you know, vitals collection and intake? How can we automate reminders for you to take your medication and you know, if your home based patient, how can we make sure you're complying with whatever it is, and it gets sent via Bluetooth back to our electronic health record. But then AI is checking to make sure so we don't have you know, a physician having to read literally a million records in a year that's contributing to the burnout. I forgot to mention that as a mega trend, but just adaptation of robotic process automation and automation of tasks in general is a big trend. But we've got this very strong focus on health equity. And so you often think innovation is focused on kind of the glamorous sexy tools. And granted, you know, we're trying to launch a 3D printing program, for example, it's going to take a while until I can actually use that for patient education for people who don't speak English or have low health literacy. But Novant has created this culture where we can experiment and you know, we've done the research to show the outcomes by using 3D printing or virtual reality, for example, or this AI tool for predictive analysis. But I think unlike other healthcare systems, Angela Yochem, again, her name keeps coming up has created this greenfield for us to use experimentation as a service. And if it fails, it's okay. Right? We do our due diligence, we look at desirability, feasibility, scalability. But all of that we are doing through a health equity lens, how can everything we're doing increase access to care and quality of care for everyone? 

  

Pete Seeber  28:07 

I love that experimentation as a service. 

  

Paula Kranz  28:09 

So we offer that to startups as well, you know, and part of what Scott's bringing through Launch Tower Health is its engagement with local CEOs and local startups. I find you know, even myself, when I got to healthcare two years ago, I really didn't. It was like a foreign language, right. And I had to do a lot of research, I had to go on a lot of rounds, I had to go sit in our Supply Logistics Center and go look at the sterilization center for the OR suite. To understand how this system of system and team of team works, I find that a lot of startups don't have that insight or knowledge. And if they're foreign startups, even from England, they come from a very different system, right? They have a single payer, they can go into the doctor anytime they want. And you know, and the startups don't have to worry about figuring out the reimbursement codes and all this stuff that plague innovation here in the US. So I think what Scott and I want to do is create a space where these startups can rapidly learn whether they're US or from Singapore, or wherever, we're going to create a sandbox where they can learn how to integrate into US healthcare systems. And by making it easier for them to adapt and plug in and have a better product market fit. Frankly, we think that's just going to attract more people, you know, and kind of build upon this momentum of, of interest in planning routes here. So come visit, come play in our sandbox. 

  

Pete Seeber  29:21 

I would love to see it, I need to get down there, take a tour and see everything you guys are doing. I think, you know, I'll go back to this comment. I consider myself now to be institutionalized. Right, my my blinders are on because I perceive healthcare, only through the lens in which I've been allowed to experience it. Right. So opening up that lens to what you guys do every day, right in your sandbox and what you're playing with. I think it's incredible. And I'd love to know, where do you think we'll be in, you know, in five to 10 years, assuming that this momentum in Charlotte, we've got some great corporate, you know, organizations here, Novant being one of the largest and everything that they're doing, and great leadership at the ground level with folks like Scott. Where do you see this going in the next few years? And because I see not only Charlotte, I see a connection to Winston Salem and everything that's happening up there. And across the region, how does all that, how do we pull that together? 

  

Paula Kranz  30:13 

Scott, you've probably been thinking about this why don't you um. 

  

Scott Pope  30:15 

Yeah, I was gonna say I can, I can approach that question from two completely different angles. So I'll try to do CliffsNotes on both of them for you, you know, one piece is just on the looking at one segment of the healthcare market, you look at the primary care space, right. And so in what we call traditional fee for service arrangement, where what you typically know is going to see your primary care doctor, the pandemic really put a spotlight on how many things in that traditional model are fragmented and broken, a traditional fee for service primary care physician has to have between 2000 and 3000 patients in his or her panel that they're responsible for over the course of the year. Now, in a non pandemic year, when maybe a third of those actually want to get in to see the physician maybe that kind of works. But in a pandemic scenario where they all want to go see their physician, the model just completely falls apart almost instantaneously. And what you quickly realized as a consumer of healthcare is that, not only do I, man I don't even have a direct phone number for my physician, but if I ran into my physician at the grocery store, they wouldn't be able to pick me out of a lineup. Like they don't know who I am. There's no relationship that's built there. And what you come to quickly discover, when you start to peel away the layers of the onion there is the reason that dynamic exists is because insurance is so heavily involved in that primary care space. And I'll take a quick step back and give you an example. So we have cars, right. And so you have car insurance, your car insurance pays for accidents, car insurance doesn't pay for oil changes, right, it surely doesn't pay for gas fill ups. Imagine how expensive your car insurance would be right now if it also covered your gas fill ups. It would just be insanely off the charts. And yet in the healthcare world, that's exactly the healthcare insurance model we put together. It's one that pays for the accidents, the catastrophic things, but it also pays for the routine maintenance. And it pays for the episodic care that we get that is based on utilization. And that's part of the reason that healthcare expense is so wildly expensive, is because it pays for things that probably shouldn't be covered under the healthcare insurance model. Right. So what Roamd is getting to do is we're kind of disrupting that entire primary care space, and extracting insurance and putting them at arm's length, and allowing the physician and patient to really have that dynamic, the patient pays a membership fee to the physician. In most case scenarios, the physician doesn't charge the insurance, they can help with reimbursement. But what you've created is a dynamic where now instead of a physician having to see between 2000 and 3000 patients a year, they manage panels between 100 and 600 patients, right, so the time that they can spend understanding and knowing that individual patient as a whole, instead of walking in having their hand on the door, like alright, I'm here, but I gotta get going, because I got 45 more of you to see today. But they actually sit down for 45 minutes to an hour and talk to the patients. And so Roamd is really helping that primary care model being disrupted. And I see a huge trend coming, that consumers are asking for more of that type of relationship model with their patients, and to the physicians want that they want to control their autonomy in that relationship to take care of patients in the way that they know it needs to be done. So I apologize, I get a little bit preachy on that there's a lot to kind of unpack, but I see a huge movement coming that Charlotte, you know, as a function of Roamd being that the home for Roamd is going to be at the helm of helping to drive a lot of that forward. So that's one one piece that what I see really for Charlotte though, as you know, as these you know, larger unicorns get more involved in the healthcare space, as we've talked about, as we see, medical schools starting to come in Charlotte was the largest city in the US that didn't have a medical school. And now we're going to have two here in the next couple of years. I think that brings a lot of attention. It brings a lot of access to capital brings a lot of funding, it brings a lot of new thinking mentality to Charlotte. And you see Novant's Health Innovation Center that's really bringing international recognition to what we're doing here in this space. Just I tell people take pictures of Charlotte right now put them in sepia tone, and be able to tell people that you know, 5/10 years ago I was here and look how look how young this space was and how far we've come because there's just I think Charlotte's gonna be unrecognizable five to 10 years from now, all the things that we've been able to do on both a local and and international level.  

  

Paula Kranz  34:51 

I'll jump in as well Pete unless you wanted to react to Scott real quick, but I was going to talk about some some things I see us doing in the next five to 10 years. years. And in general, I see many US healthcare systems moving this way as well. We mentioned the care away from home virtual care outside the hospital. So putting health kiosks in Dollar General Stores in rural communities, using drones to deliver pharmaceuticals to rural communities, because they just can't get access to them, using robots inside our space, because we have a workforce shortage. And well actually maybe like picking up the garbage at night, you don't need a human to do that right? Or deliver a crash cart when the nurses are focused on other tasks. So I see you know, that automation, and that virtual care expanding immensely. I also see consumers demanding more personalized care. Right. So that's the use of pharmacogenomics to determine, well, you know, you think this drug should be given to somebody on depression to help them but in some people, it can actually cause a worse depression or suicidal ideation, we just have a one size fits all for many pharmaceutical interventions that's Scott space, I won't dig too deeply there. But I know we're trying to expand our pharmacogenomics program for everything from treatment and medication assistance to just knowing you know, genetic testing to know like, what's your what foods you should be eating for maximum sports performance, or to lose weight, or, you know, if you've got other chronic illnesses, food is medicine, and we don't understand it well enough. You know, we're even looking down to the molecular level, if you will. So creating digital twins of individuals so that we can test interventions, whether it's pharmaceuticals or physical interventions, to see how their body would react before we actually do it to them. So just that really personalized care is something consumers are demanding. I don't know if you guys have any wearables, but I kind of geek out on that stuff. Just you know, I like to see if my salmon is good for me, and like, what does one bite of ice cream do to my glucose? But I think even you know, older generations are used to it right? My father currently wears a bracelet so we can track and he's got a congestive heart failure, he has no problem with that. He calls me to see what's going on with him. But you know, our family appreciates that, caretakers are appreciating that. So I would say those couple of things are ways I see healthcare going in our region and in the near future. 

  

Scott Pope  36:59 

Well, I agree completely. And you touched on a point that's very near and dear to my heart is the trend of consumerism, in healthcare. You know, when you look back in the 1980s, insurance companies woke up and said, we have all the data and all the money, let us just create HMOs (Health Maintenance Organizations), we'll just tell physicians how to practice medicine, we've got all the data, can point them in the right direction. And so they took on the risk. Fast forward several years later, an insurance company said wait a minute, we have all the data and all the money, why would we take on the risk and then it created the here's the Affordable Care Act, that's putting the risk in the hands of the Novants of the world, to manage those costs to make sure patients don't have readmissions that they don't end up in the hospital, that they remain walking well. And, you know, there's things that have shown that there's been really positive, you know, results coming out of the Affordable Care Act. But when you look at kind of the triad of the individuals, you know, there's insurance companies or healthcare provider, and consumer, the consumers are the only ones who haven't been left holding the bag on the risk. And as you see the rise of High Deductible Health Plans, and all of a sudden, every dollar that gets spent on healthcare is closer to your pocket, right? That your deductible for that visit for your for kids, is, you know, used to be $20 now, it's $55. Right, and next year, it's $65. And that's on top of your deductible going from 5000 a year per individual to 8500 a year per individual, you know, you are getting closer and closer to every one of those dollars spent. And the system needs to get more mature, the ecosystem of healthcare more mature in allowing the consumer to make educated decisions on their own healthcare. Right. And I think there's so much green space to be able to create a model that is consumer centric. And Paula mentioned the thing about ice cream, the information you can get on a quart of ice cream, you know where it was sourced from where the you know, vanilla beans came from where the cows came from, you know, there's no hormones, go try to find, you know, where the best place in town is to get a hip replaced, or a knee replaced, right? I mean, as consumers like you can find a ton of information on everything outside of healthcare. But there's a lot of ground to be covered in creating a consumer centric healthcare market that allows us to shop for it well, to pay for it better, and ultimately, just kind of drive and choose some of our own experiences on how we want to go with that. I think some of the stuff Novant's doing is, as Paula alluded to, is really focused on that consumer centric and I think Charlotte can own a reputation for being a driver of consumerism and healthcare that we've got 15 to 20 years of the market maturing, to get ready for consumers to really be smart in this space. 

  

Pete Seeber  39:35 

Yeah, I think that's amazing Scott. You just said something that hit home with me is educating the healthcare consumers, right. And I had an accident with my son three years ago where he flipped his knee the other way. And without having access to that information. I've literally had to resort to just asking friends. Hey, who's the best knee doc in Charlotte? Right? And that should not be where we are, right, I can go, if I'm buying, you know something for my house, I can go on Amazon and find 5,000 reviews right and narrow down what I'm doing. But when I'm looking for a knee doc specialist for a preteen, I'm going with neighborhood rumors. We shouldn't have to live in that world. So we're moving in that direction, you guys have successfully blown my mind and expanded my viewpoint on what we should be demanding as consumers. And I'm glad this is happening here. I'm really thrilled that I'm interviewing and having you guys here as guests from Charlotte, and not having to go to other places like Nashville to have this kind of intelligent conversation. I think there's a tremendous opportunity here in Charlotte, to continue to grow this space. So I want to thank you for being on the show. But I want to thank you for what you do every day in this community, because I agree with both of you that take a picture now, because what you see in five years will not be recognizable in Charlotte, as far as healthcare is concerned. 

  

Scott Pope  40:56 

Yeah, Pete I agree. The one thing that I'll add on to that is, you know, when you look at where a lot of the investment dollars gelling in early stage companies, not just in healthcare, but in general in this country, they're on the bookends right they're in New York and Boston, there LA, San Francisco, Silicon Valley. And, you know, I firmly believe that the Charlotte, Raleigh, Nashville, Atlanta's of the world need to work better together and collaborate and cooperate, to prevent the hemorrhaging of talent and money to the bookends. And we see a lot of that happening. Some of the stuff that we've done with Launch Tower Health, we've cohosted with, you know, organizations out of Atlanta and Richmond, we've done a lot with folks in Florida, and cohosting events and trying to drive, you know, regional awareness of one another's markets and some of the cool stuff that we're doing. So that people don't feel, you know, there's another really good story Digitize.AI was a startup company here, they were at the corner of Trade and Tryon. And they had grown to a level that they needed outside funding. And they had offers to, you know, from Silicon Valley for more money than what they were asking for. But it came at the cost of having to relocate to the West Coast. And Justin Adams was the cofounder of that organization that just refuse to, to take that kind of money and instead was able to take money from it ended up being from the Midwest. And one of the terms was their organization had to remain in Charlotte, headquartered here for five years, you know, and in kudos to founders and startup companies like that, that are, you know, finding money in the Midwest, that is like-minded and allows them to remain here versus them, poaching all the talent away from here. So I think there's more of those good stories that just don't get told wide enough and far enough. I tend to get a little bit preachy about it. So I'll stop. But you know, it's too easy to look into healthcare and have a really pessimistic attitude. Because there's so many things that are broken, but there's just really, really good things that are happening here in the region that are, leave a an optimistic mindset into what's going on here locally. 

  

Paula Kranz  43:07 

And if I could just say, you know, to listeners, it's such an exciting time to get involved. And I think Scott and I would love to be resources for people who are thinking about starting healthtech focused companies. There are great resources in our community from Venture Prize at UNCC to RevTech Labs and Roselli's crew, and Venture Stiles, there's, you know, we're trying to connect the ideas to the platform, where the seeds can be planted and grow to access to capital. So I would like to say reach out if you've got an idea or want to learn more about how to plug into the ecosystem.  

  

Scott Pope  43:41 

100%, well said. 

  

Pete Seeber  43:42 

I love the collaborative play. So thank you, again, parting shots here. This is the shameless self promotion part of the show. I want to know since we're out and about in the world, right on a regular basis. We're out of our homes, we're interacting, talking to other humans. What's your favorite restaurant in Charlotte? What have you found since the pandemic that you really learned to enjoy to get back out?  

  

Scott Pope  44:03 

Want me to go first? 

  

Paula Kranz  44:03 

Well, the grill by the pool out back. I do I love Steak 48. But I love going to Community Matters Cafe which is right next to our innovation lab because I believe so much in their mission. We're trying to tie into their mission by bringing some of that hydroponic and vertical farming to the service there so different ends of the spectrum, but both great places. 

  

Scott Pope  44:23 

Community Matters is one of my favorite local coffee shops as well. My favorite restaurant is Custom Shop right there out in front of Novant's main campus, just amazing food they do what I would consider kind of a European style dining. Plan on going there for two and a half hours, right. It's not probably not a place you're gonna take your kids because it's a date night. It's kind of an occasion and the food there is amazing, they do a lot of local farm to table and Custom Shop is off the charts in my books. 

  

Paula Kranz  44:53 

Pete, what about you? 

  

Pete Seeber  44:55 

I've got two, so I'm a Lake Norman dweller. I've been up there for 20 years. So I'm a big fan of Kindred right there on Main Street and Davidson, they've done a great job building out that restaurant and just keeping the quality and the personal touch. Again, not necessarily a place where you're gonna take a kid, it's more of a date night type of environment sit out on the front porch and just enjoy Davidson for what it is. But the second place, I've got to check and see if this place is still in business. It's a place called Keaton's Chicken up in Cool Springs, North of Charlotte, when you get to Statesville, go east, and when you think you're lost, go about three more miles, and go to the right. It's a fantastic place for just some fried chicken in a bag. Really, really great spot. So those are my two. My goal here in this is to get some new places for myself to go. So we're going to try those, what you guys mentioned. I'm a big fan of Community Matters. I've got a chair out there reserved that I'm usually at at least once or twice a week for a cup of coffee, to meet some people, or just generally hanging out. But the underlying goal, let's all get out and have fun. Enjoy life again. 

  

Scott Pope  44:55 

Yeah, what about you Pete? Yeah, thank you, both.  

  

Paula Kranz  46:03 

Good to see you. Thanks so much.  

  

Pete Seeber  46:04 

Alright. Thank you again for another great episode of Beyond the Build. Talk soon.