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foreign TF Health what's the future health I am talking to the who's who of Health Tech and Healthcare Innovation and today I've got some good friends from Salesforce here to talk through all of the exciting things that I learned about Salesforce and their business at dreamforce 2022 which was a couple weeks ago so at dreamforest for those of you who didn't see my coverage there was a lot of new product features launched namely this product called Healthcare 360 which brings in real-time data let Salesforce do virtual care straight from their application uh Health scoring what else longitudinal patient record like all sorts of really exciting stuff and so we are going to unpack that as well as some of the healthcare thought leadership that's happening at Salesforce to help move the needle in terms of Health Equity in healthcare consumerism so without further Ado please join me in welcoming our guests we have Dr Gita nayar she is the senior vice president and chief medical officer for Salesforce and also joining us we have Amit Khanna he's senior vice president and general manager of Life Sciences and health at Salesforce so thanks you guys for joining us thanks for having us Jess thanks so much so happy to have you here I'm like dying to talk to you more about this specifically around all the the thinking that needs to kind of shift for us to really start to embrace this consumerism and Healthcare idea and then the way that you guys are helping Advance this using Salesforce expertise as a CRM so the thing that struck me the most at dreamforce right off the bat is this whole concept that we need to start as Healthcare rethinking the relationship between the EHR and the CRM and that this is an and both thing not an either or and that the EHR should be for you know keeping track and knowing the patient but the CRM is for knowing the customer so I can't wait to dive into this but before we get into the specifics Dr G I'm hoping that you can just start us off by talking about high level some of the thinking around Healthcare consumerism that Salesforce is operating under the premise of so you know what is what is Healthcare consumer mean to Salesforce well first of all just thanks so much for having me and thank you for your excitement your passion is is very contagious I can I can feel it through the zoom so thank you for that and for letting us host your dream for us you know in a nutshell we have seen the acceleration of digital transformation primarily because of the pandemic so we feel that CRM is here to stay and it couldn't be more relevant right if you look at where the consumer is which is in their home in their car in their office and in the doctor's office it's about the complement of CRM with EHR and I think the Futures is uh bricks and clicks right you still need that brick and mortar uh hospital system just like you need that EHR baby's got to be born surgery has got to be done but you also need those clicks you need the ability to meet your consumer where they're at wherever that might be and we are living in an age where the consumer is in charge they are interested in their health number one but they're also in charge of it and if you as a provider Pharma company payer are not able to provide these efficiencies they're going to go somewhere else and that somewhere else might be the retailer down the street so the digital transformation is is here to say as the number one CRM on the planet we've done it before and travel Hospitality manufacturing Finance you name it we've done it and we're doing it in healthcare and we see that as the future of healthcare that's awesome I love that and I love seeing all the different Industries represented at dreamforce that was really cool because I felt like I learned a lot even just seeing the way other other Industries are integrating your technology so I'm gonna chime in here because this whole idea of EHR and CRM this is kind of like the the big thought paradigm shift that I think we need to to start to you know really Embrace in healthcare you know but why is now the right time for this conversation because I feel like this whole concept of healthcare consumerism not new this has been around for a while CRM has been around for a while but like why is now the time to start rethinking the relationship between the EHR and the Sierra yeah I think uh I'll say a couple of things why is the right time is because as you look at we as consumers as I mentioned in our previous conversation uh we should talk about as consumers not patients our expectations have been coming and changing a lot whether you want care anywhere whether you want to care in the retail side of the house whether you want Care at home so now if you look at it that relationship with the doctor is changing it is coming across every time every channel it's Omni channel so that's where CRM part comes in if you look at em ehrs they have in the space but they are more transactional but health is not transactional so we have realized over this last few years as how we look at it it's longitudinal it is outside the hospital system it is a retail Clinic it is home so that's where CRM comes into play because you need to know the consumer not when they come to you but also when they're outside of your hospital how do you connect that information how do you know them that's why it's critical timing for us to start thinking of these two together as bringing the right let's say right Health outcomes for us as consumers all right I'm sticking with you because I want to dive into some of the sexy things that I mentioned at the top of the interview that came out with the healthcare 360 product launch and so this is you know this whole idea of integrating real-time data but there were a lot of other things that came out with this some really sexy product features like I said so I mean some of the the Integrations with slack with mulesoft the whole idea of a longitudinal patient record the health scoring so I'm hoping that you can keep going because I know there was a lot more than that hit us with the highlights of healthcare 360 and then my question too is if you can speak to it you know it seems like a lot of these features are much more careforward than I had anticipated seeing coming from a company like Salesforce coming from a CRM so what what made the what really prompted the decision to move in this more careforward Direction with some of these features yeah great great questions yes okay so one thing I'll say is that from our perspective when we look at some of the key things that we announced at dreamforce it goes back to our overall strategy as we call it as holistic care whether it's at home outside Hospital knowing the patient knowing the consumer with that thought if we apply what Innovations we have come to for example you talked about risk scoring it's not about risk scoring as a clinical risk scoring for us the idea is again the holistic care which means can I understand the social aspect can I understand the demographic aspect can I understand the financial and then marry that information at the clinical data so that now I can understand to the point that I'll take a specific example Bay Area had two years ago a lot of fires and there was a lot of smoke can you predict that from an environmental factor and reach out to a consumer who is like eight-year-old kid who has asthma problems before that hits can you understand and act that's the CRM part that's bringing clinical knowledge that's bringing environmental knowledge scoring that and reaching out so that's our thesis around it how can we more preventive and bring this data sets together in real time to act on it now what if you take the same thesis we applied virtual care you asked about and you mentioned about virtual care we brought virtual care with the same thinking here is delivered in multiple channels whether it's at home it's outside home virtually and also when we look at virtual care it's not just about the doctor there are a lot of areas tertiary part of healthcare that needs video channel an example could be care manager reaching out at chronic disease consumer who needs to be connected or a pharmacist in a Health Plan who is doing medication therapy management needs to reach out to or if you go outside us for example there are a lot of places where you end up with so this thinking around how can I engage with the consumer across all channels brought us to this idea of scoring virtual care and then also we talked about and reinforce as not just focus on traditional therapies but as we look at more non-conventional therapies like cell and gene therapy platform we also launched that bringing all these together makes us let's say Forward Thinking if we think so but hopefully we can also bring our customers along that church all right Dr GA I want to kind of pick your brain on this specifically on the virtual care side of things because that was I think of all the things I saw the thing that surprised me the most is like Salesforce virtual care wait a minute what so I'm hoping that maybe you can give us a little bit of an Insight on the why behind this move into virtual care sure so first of all I mean look at how we're doing this this Zoom right this has become the way that we see patients and CRM is the natural extension in which to do virtual care we believe virtual care is here to stay we believe the Paradigm of of Health Care and delivery has really shifted as I said the bricks and clicks and who better than Salesforce should be positioned to own that patient relationship um manage it but be able to do it the way that the the patient wants it and also the provider wants it right we talk a lot about uh patient relationship patient engagement but the truth is when you do physician engagement correctly you're then doing patient engagement correctly and the reality of so much of the workforce is we've gone through this physician burnout decision shortage all of this continues we are able to offer better access to Care by having the virtual option because many providers need to have that many providers need to have that or they're forced to actually deliver less services and so we see this as the future of the physician Workforce the care team Workforce and we see this as a partnership to opening up access for patients the way that they want to again the promise of virtual care it's not a silver bullet there are things that have to be done in a hospital like delivering babies having surgeries you heard me say it earlier but the truth is so much of medicine can be done virtually and we see we've seen that because of the pandemic we do have to be mindful I said on the board for the American telemedicine Association we need to be mindful that this is all locked up with regulation because these regulations opened up during during the pandemic we were able to unleash the power of virtual medicine our hypothesis is that it is here to stay that will get pulled back uh reimbursement and regulation pending but again this is the future there's really no question about it and more care in the home we know for a fact brings down costs improves quality and I'll just give you a quick anecdote I mean patients that I saw during the pandemic being able to see their home being able for them to to show me it's remember one patient she said when I take this step up my stairs this is what happens and there was a question in my mind over which joint it was the knee or the hip but it was so clear it was her hip because I saw her hold her home environment and there are there are umpteen examples of like that in every specialty so inviting your provider into your home can also make a difference in your diagnosis as well as your treatment I love that I think Health in the home is is definitely where we're headed in the future um and I want to come back to you and have you fill in some of the product questions about the virtual care piece because you know as I'm sitting there and I'm watching you know the demo of this at dreamforce and I'm thinking to myself I'm like so wait wait a minute does Salesforce have its own doctors now or is this just a platform that you're you're providing to your customers the providers the plans the life sciences companies Pharma you know in order to to enable them to provide virtual care so clear that up for me and then maybe tell me a little bit more about the ritual care offering yeah so we are just as you said offering the platform to our customers we don't have clinician means we have clinicians Dr G like Dr G who are advisors chief medical officer but we don't have practicing we don't offer as like teledocs or other vendors on the market that you see probably have so we don't have uh that but we are providing the platform and under the platform I think there are a couple of important points from a product perspective that we thought are important one is this this idea is not about just video video if you look at it is a commodity in that sense but the idea that video is embedded in the patient 360. you can see all the timeline you can see the medication you can see their household members you can see their care plans all that embedded in that console was our fundamental thesis to bring these together so that was one second for us is an important aspect is multi-party party participants so can I bring if I'm uh if can I have if I'm a son or daughter can I sit in the same conversation with my dad with the mom with the doctor so that multi-party participant is important same thing is on the other side can a doctor invite somebody in the conversation like hey I want a nutritionist to be in this call together so this idea of multi-participant is important third for us is focus on this idea of Health Equity so we have option of closed captioning we all know that that is available but also we want to make sure that it's not just a video you can also call the doctors with the same so there is a number that you can call so that in areas where the bandwidth and the Broadband is not there enough you can still do that and so it is you're not at a disadvantage and lastly we offer this capability as you rightly mentioned at the beginning not just in the provider sector but it's more about provider like sciences and patient Services Program health plans for doing medication therapy management care coordinators all these areas are we looking at and that's where we come and it is our partnership with uh AWS that we bring the video stream so we embed it together and for our customers it is all tied together they don't have to do anything when they open the box it is up and working that's so impressive all right I have to ask you one more question I'm in about the product launch the health scoring I want to double click on this too to get into some of the the weeds with you um so for those who are not aware of like exactly what this looks like who may not have seen the demo and you didn't have the lucky lucky privilege to a trend dream for us like I did explain what the health scoring is in more detail and tell me like you know everything about it what contributes to a health score what data are you pulling in because real-time data integration was Central to this so what data is coming in how do we arrive at a score who is meant to look at the score a nurse a doctor I mean who how are they meant to use it and how real time is the real-time data that's contributing to the score so tell us everything about it yeah makes sense so I think a lot of good questions so I'll start with what is fundamentally the product idea go into a little bit of details how it works and then why and who are the users basically we are thinking about so the fundamentally the idea started where as I right at least uh in the beginning of the call said that marrying clinical and non-clinical data so that's First Fundamental thing we had a lot of data coming social demographic economic then we say we marry this and buy different providers pairs health plans they might have different form of understanding that population or even trying weightage of that population so you might say Okay I want to build my own algorithms the ideas that you're collecting the data we're giving the toolkit and our provider pair customers are bringing their own models on top so they are marrying this data it could be a device data it could be environmental clinical data and then creating a score score could be think of it as a population Health score we have talked about but here we're marrying all of it bringing and calculating that score so to answer first question real time it is completely depending on the data source you're feeding if you feed every one minute you'll calculate it every minute there's nothing preventing us from that what is important for us is we take that score and it is that's where the power of CRM comes into play because there are a lot of companies you have seen in health who have done scoring that's one part of population health is typically there but we take the score and publish it in the transactional side which means when you open up a patient's record see their score and their Trends over a period of time and not only that we have defined Rules by which you can say if a score in environmental category in the clinical score in the social Falls by 10 automatically do X so that ability to have the score publish it in real time and act on it is important and it's automated and finally if you can look at it with our toolkit on marketing Cloud we say you can also automate saying okay if a score Falls or goes up by a certain point put them on a certain Journey think of it now you know that the patient is diabetic has two chronic conditions their adherent score they missed last two appointments fell by five percent I want to put a task out for the care manager to call them or to put them on a journey which means every week somebody will call him or her that's the power we are trying to bring together it's not just the score scoring segmentation and actionability is the key part of it and the last question you asked is about what who are the users so we look at the users in the Care Management side of the house most of the time time in the health plan side both on Commercial and Medicare Advantage side providers who are at risk which means that this is not addressed providers who take risk basically for the population so they are not the so that's one thing so those are the areas and finally on the clinical trial side we saw a lot of Pharma companies interested in that because they want to see at the population level what the scoring is bring those data points and then act on it so that's where we look at these use cases also that's incredible I think that's just it's it's the ability to bring in that level of data and then make it actionable I think is is really game changing as far as you know our ability to really make an impact on patient outcomes so Dr G I want to ask you because I think underpinning like some of these these examples that um it gave us in in this conversation about health scoring and definitely in that conversation about virtual care is this whole idea of Health Equity which was a central theme at dreamforce it was actually the theme of the keynote for the health and Life Sciences group so I'm wondering if you can talk a little bit about the higher level thinking that's going on at Salesforce about Health Equity and you know how you really feel that you guys can make a big difference in terms of moving the needle and improving access to care and you know improving outcomes for all sure so first I won't pretend that we have all the answers Health Equity is perhaps one of the biggest issues of Our Generation and we saw that again play out during the pandemic but we we remain very interested in taking a leadership position on that and we have done several things in that regard number one the Investments we're making in Virtual care speak for themselves virtual care without a doubt improves access not to everyone but improves access across the board to folks who don't have it sometimes in rural areas sometimes even in big cities where transportation is an issue part of the scoring um I've mentioned is basically social determinants of Health right so there's a recognition that there are barriers related to socioeconomic status that hinder people number two we're living in an era of misinformation and disinformation again we saw this play out during the pandemic not that it's new to healthcare if you come from the south Asia Community like I do everything can be cured with ginger and garlic right so being able to activate CRM technology specifically marketing Cloud not marketing but it's really patient education right scaling that patient after relationship is a big part of what we do with our with our technology and so being able to empower that with the facts and the knowledge and the trust that is really needed in healthcare now more than ever and that we know primarily affect black and brown communities in particular we find continue to be important lastly we've made investments in the space I sit on the board personally for same Sky Health which is one of our investments by sales Ventures they're fantastic afternoon their CEO their whole business model their entire product Suite is dedicated to Health Equity and how to reach those populations so we've also put our money uh where our mouth is in that regard and certainly in our own hiring practices as a company as an organization we continue to invest in that space so we are very serious about being part of the solution I wish we were the Silver Bullet but it will certainly take much more than technology to solve the Health Equity issue but we we believe we're making strides and we continue to keep it as a focus for us for us as a business it's fantastic and chime in here because I know that there are some ways that you're out even helping enable your clients to to make inroads on Health Equity and so to Dr G's point I mean you guys may not be able to solve it yourselves with a magic Silver Bullet of Technology but the more broadly the technology can be made available to others in healthcare to help tackle this it really empowers everyone we need to make a difference so share with us maybe some examples of how Salesforce clients are starting to look at using your Tech to help improve Health Equity yeah so I think uh more and the step that we as we build product I'll give an example we also go through our internal team of ethical uh and team that make sure that we are not putting out any biases in our algorithm and making sure that we are bringing out products that do address some of the health inequal equalities an example I'll say is that a big problem in healthcare is missed appointments or uh no shows as we call them that's both a problem for help better health outcome and a problem on the provider offices so when we brought out our no show which is predicting the idea that when a consumer is trying to book an appointment we tell them uh we even though 8 AM is available we end up giving them only the 10 amp slot because from our prediction we think that that will be a better and they will be better with a 10 a.m and not do 8 AM and when we first went to our ethical team and we presented our algorithm they said you have an inherent bias in this one this algorithm is not right it will put more the more inequality so then we went through that process we removed certain parameters in the algorithm we made sure there's no inherent bias or inequality in so that's one example of we consciously do it same thing with virtual care when we started we said okay we have to make sure that not everybody might have the greatest Broadband we should allow them to have directly dialed in so things like that are automatically built in and have the idea that every team member starts thinking about this when they build the product all right you guys let's wrap up this conversation by talking about buzzwords I love buzzwords and I kept track of some that I heard at dreamforce because it was like just after so many days of sitting in these sessions it's like you start to you start to you hear hear words over and over again and they start to Bubble Up in my mind and so I'm going to ask each of you about a buzzword that I wanted to I get a little bit more input and explanation around just because they seem like they might be indicative of trends that might really shape the healthcare and Life Sciences industry moving forward so I'm going to want to start with you over and over again I kept hearing self-service at scale so what exactly does that mean and if it means what I hope it means when can we start to see this like unfold in a big way in healthcare what do you think yeah so I'll give you two examples and one of them is live in our Healthcare product can you book an appointment with your wealth advisor and your home mortgage person online self-service yes can you book an appointment with the doctor no but we can with health with our product we launched six months ago it's self-service I can go find the slot it will automatically provide connecting to an EMR as we normally said that we have to stand up both parallely so real time connect with EMR find the right slot and I can book an appointment and I can submit my assessment so I don't have to be with paper when I come into the office so this idea of self-service making an appointment at scale avoids the cost in the system and also has a better outcome because I can book it I don't have to be in the call for half an hour so that's one example second example is from a provider pair interaction a prior auth approval so we all know that priority faxes calls we are looking at in that idea that can we have a real-time connection between a health plan and a provider so so as soon as you see it you can submit you don't have to wait you are submitting from the provider real-time answer comes back to you within Health Cloud saying you don't need a prior or you are missing this document so make it all so seamless that the machine can do it you have self-service and remove the cost so that we can have more time with the patient ultimately all right Dr Dover look it's like baked into the rhetoric even part of omelette's answer so I mean tell me Dr G you know from the from the high level Salesforce what a seamless experiences mean and if you can like bring us full circle and connect it to the idea of healthcare consumer that we started this whole conversation out with you know I mean I think that we all want the friction to be removed but I think positioning it as seamless is is slightly different so tell us what Salesforce means by that and when we as Healthcare consumers can start to perhaps enjoy some of those seamless experiences from our payers and providers and the Pharma companies that we all are engaged with so it really goes back to everything that we've talked about right how does the front end complement with what's happening in the back end the back end primarily being the EHR so a lot of what I must described very similar to what you might experience with your airline right that you're able to check in you're able to acknowledge who you are perhaps answer some questions even get some information like we talked about hey don't bring batteries hey don't bring um guns aboard right there's all kinds of things that happen in healthcare that often is the opposite of seamless right when you go to your average doctor's office today you're still giving that clipboard right and you're asked the same four or five things that you filled out last time or you filled out before but somehow never made it into the into the back end so we're we're cutting that out right we're saying look a lot of this can be done do it yourself and a lot of it can be automated and let's let's ask the things let's leave the time for the things that don't require automation or should not be automated like the high how are you the chief complaint Etc and same for the discharge process right so much of the compliance issues that we see in healthcare related to not picking up a prescription not not knowing that you were supposed to schedule an appointment so a lot of what Amit is talking about is taking those pieces which are the most uh most filled with friction and often it's the the check-in and the checkout those are really the points to care where we can offer a lot more value and in addition to all the things that we're doing to complement the EHR but the idea is take out take out the take out the friction and really lead the consumer available to do what they need to do to confirm their data edit their data and also send it back to the doctor in real time so they can actually action and make better diagnosis and treatments well thank you so much I mean this is so exciting I love hearing the the picture of the future of health and Life Sciences as painted by Salesforce because I do think you have such a tech forward and more importantly customer forward approach than we do right now in healthcare broadly speaking broadly speaking but I think we're working on it and so it's great to hear you know how you guys are thinking about it and some of the strategy and and definitely the product features that are coming together to help Advance this idea of moving forward and health so thank you both so much um Dr D I really appreciate you stopping by to chat with me no problem all right to find more interviews with the who's who of Health Tech as they are changing the way that we do Healthcare head on over to my YouTube channel it is youtube.com WTF Health thanks again to the two of you and to Salesforce for hosting me at dreamforest it was a pleasure hope to be there again next year talk to you guys soon take care