Good morning everyone. Happy that you guys are joining Signal and Symptoms podcast. We have an amazing guest today Dr. Khayat and she's going to be talking about with us what we always been discussing and the beautiful word called applied. Again there's always our intention that we want to make sure that we remove the noise and that is why this is called Signal and Symptoms podcast, and symptoms takes us back to the patient itself. I'm going to go ahead and let Dr. Zayna Khayat, Dr. Khayat introduce herself. I'm just going to give two cents. I mean, she is an amazing person. She has actually done so many things. As a matter of fact, if you go through the website, you're going to see that she has done so many gigs. She's currently been involved with so many people in terms of CVS, Phillips and then right now she is um uh part of uh I'm sorry where AMS uh as the principal for that. Dr. Khayat chief program officer for uh advancing innovative healthcare with connected core. She has been associated with Deloitte, Teladoc. Uh again uh thank you so much to Dr. Khayat for joining us. Uh, and then I would let you introduce yourself first so that I'm not gonna butcher it and then we'll start chatting.

Good morning, afternoon, hello guys. Great to spend time with you. That was an amazing overview, Junaid, I got to do this every week and get my state of the state. I think I only read three of those articles in the last. So, just quick background. I'm an applied health futurist. I don't quantificate about the future. I don't predict about the future. I keep a working picture based on all these trends and signals not just technology. There's a lot also going in other domains of society that are going to affect the future of health. Uh and to guide people, organizations, health systems on making much smarter bets today that are at least consistent with the future that's unfolding. And hopefully for some more pioneering people and organizations, the bets they're going to make today will shape the future they want. That's what an applied health futurist does.

Amazing. Thank you so much. Uh, beautifully done. Um, I will open it up to Harvey and Ed to start the discussion. Uh, and then go from there. Ed, go ahead.

No, it's it's super exciting and yeah, amazing background. Thank you for joining us. Yeah. Where do you see us sort of uh I know you're not predicting the future. We're not asking that, but kind of like what have you seen in the last couple years that gets you excited about what might happen with healthcare given all the progress with AI?

Yeah, I think for sure, you know, some shifts towards the future have been underway for a while. Harvey, you talk about a lot of them. I do. And they've been moving at, let's call it a glacial pace in general everywhere. Of course, in some jurisdictions, like it's already standard of care . some of the things that in other jurisdictions they're still stuck in the past. Maybe for certain populations were already there. So there's a deveraging of these shifts to the future around of course not just proactive but predictive around um care anywhere versus facility based care around much more intelligent precise kind of N of one versus segment of one much more continuous versus intermittent much more driven by patients and their families versus you know the cognitive uh training of the most responsible clinician and then the shift to we can actually start to pay for the results instead of the inputs. So that's this future health in a nutshell.

Well said. And then I have a question for you. Uh great to see you again . um in general, you know, the tide changes all the time and um you know, and our goals of what we're saying out there changes as well. Uh for me, I'm, you know, I'm really really pushing because it's like a bell curve when we speak to people. Some people are early adopters, some are late, and so it's kind of hard to talk to everybody. So out of your top topics, what are some themes that you're really out there saying, "Hey, I'm talking about X." I'm just curious what because when I heard you speak in Dubai, I loved your talk, by the way.

So that was like the whole future of health in Dubai in 20 minutes. That's my signature talk. I'm sure you have one too, Harvey. People kind of want to just make sense of all the shifts, all the trends, all the signals, the for just put it together so they can see. So that's my working narrative and you know I kind of just summarized it now but I'd say um the new thing that I'm finding is in high demand u like so if I'd say I do 10 or 15 workshops keynotes whatever a week probably half have to have a theme of AI there's no question which is like a year ago and it wasn't even like that but then more and more I'd say almost all of them are about futurism so they don't really want to know the what you can read that you know it's not that hard or there's a conference every minute of the day. It's more the how do I reorganize myself for the future? So just a couple quotes and I put some of these on my LinkedIn yesterday and I got like some of my highest impressions. I'm like I got to do this more often. You know I just I reposted what a I think an interventional radiologist named Dr. Sebastian Mafeld. I don't know him. I don't know if you guys know him but he posted a great thing. said he said, "We practice with yesterday's evidence on today's patient for tomorrow's outcome." So, he's kind of lamenting about this time cycle disparity, you know, and then, you know, in in our work, you know, the past teaches the present tests and the future reveals what we got right. And so, it's like that's kind of what I'm finding is in demand . this this this need to understand what multiple futures may unfold in my specific domain my context whatever whoever I am

so beautifully said um so I resonate with exactly what it is so my problem I am actually a founder so the whole idea is to apply, apply, apply, so I met with an amazing group of uh GI physicians I'm just going to be very simple getting all of these C-suite people to get together to meet with me took two months. Just that meeting. I mean I'm not everything is done like there 15 providers have piloted it. Everything is done. Everyone's ready. are like can we please get this and there's a huge amount of pressure but the organizations doesn't seem to be you know moving at this stupid glacial pace and how do we communicate this extremely important transition and the transition was from paper charts to digital charts which is the digital transformation, and we're moving from digital charts to AI charts which is AI transformation, so you said one of the key phrases is that the patient is also going to be a very key pusher of this. So can you explore on both these problems? How do healthcare organizations improve a process, and how do patients actually improve the process in getting these done?

Zayna Khayat, Ph.D.:

Yeah. Couple things. So I did do sales in health techs. I wanted to know what that's like to understand ‘cause I was the buyer. I was that glacial molasses C-suite uh in home care of all areas. And this is what I realized if you're truly doing entrepreneurship that is making something new that the world's never seen before that should unlock new value which in my view should be the only thing we do when we're doing startups and tech versus all the metos. By default, you're creating a market that doesn't exist. So you need to not only do amazing at your product Junaid but you need to write the AI policy do all the plumbing of all the technology educate the st like ‘cause that infrastructure doesn't exist, and we have a massive technical debt. So I think just give yourself some grace that that is the market and you're going to you know as you know certain customers have that infrastructure. Then the second point I'd make is maybe another customer of yours went through a workshop with Zayna on futurism has decided that what I find normally with the C-suite I work with and their board of directors, ‘cause we don't do it without the board cuz ultimately they're the boss or the CEO . They take a point of view of what percent of the choices they're going to make today, whether that's their strategic plan, their operating plan, whatever, whatever. What percent do they want it to be anchored in the future that they want, versus today? All the problems of today, wait lists. And so if if you your other client did that work and already knew their point of view on what they want the GI experience to be in the 21st century, you'd have no problem. So to me that's the answer in terms of when you're out there with your different customers understanding is that C-suite like are you already helping them achieve the vision that they've all agreed that they want and if they haven't done that that future visioning yeah it's going to be really, really hard.

Perfect, Ed I want you to explore this with your I love Ed because he's actually at CIO of Cleveland Clinic he's in multiple boards FYI if you don't know Ed . Do you want to expand on from your experience on that and then bring back the patient advocacy, how do I explode patient advocacy for AI but however the product is for clinicians?

Edward Marx:

Yeah I've taken copious notes here on the side because Zane is a rockstar hitting uh all these really key points for everyone. And she's right about the fact that when we're coming with new solutions and especially the brave new world of AI, no one has policies, no one has governance, all that kind of stuff. So, if you come with a package for them, you can really help them be successful. And I always tell people that like the vendors, partners that I loved the most as I was, you know, in a variety of roles as a CIO were the ones that helped me uh and shape me who I am today because I was clueless. And so, if I go back, you know, 20 I'm still a little bit clueless. I'm always learning but like 20 some years ago I remember I was given a task I had no idea it was a partner a vendor that came and taught me these basic things that I didn't know and made me look really good and it can be the same thing right you have this this AI product that's going to change the world you know it's going to you know help patients going to help the clinician and we get you know befuddled because we have all these obstacles because right we don't have policy we don't have governments whatever. But if you came and said, Look here is a set of you know practices that we've seen work in other organizations that will help them like look good, and they'll take that forward and hopefully that'll speed up the blockades that we all experience especially when it comes to innovation. So I think I think that was a really good point and something that people should really embrace and take to heart. The whole thing about yeah empowering the patients and that's the big difference right I I run into it you know ironically it's it's uh and I understand why and I'm not picking on physicians but I love physicians I love all of you

So another quick story and I want your opinion u so Israel Korea are the highest ChatGPT users and the highest Claude users not for just healthcare right in general the population itself not to mention the content speed is the highest in the world. So just understanding sort of the baseline and now we you know and same thing, Dubai infrastructure is very different. The second thing is of course uh I want to ask you is that the whole healthcare economics works through the health government right? like 70% even in Saudi Mina Qatar etc you're going to see that that u it is it is a national healthcare system and then of course, alignment it can be either great like you know as she suggested if the if the whole country is moving towards AI in general which is the minar region massive explosive investment going into it. I get calls from Soie all the time. I just don't know how to find a partner. What I'm saying is that what you're looking at is essentially how do you square the circle that I can't make sense of it because the whole population is being provided essentially through national healthcare. However, still, AI concierge medicine is going to be going into these countries in my opinion unless you advise me better. So how how do you square the circle when economics are different from a public as compared to AI, healthcare, tourism? I think that's the word we should use.

Yeah, I I'll throw another country at you. And of course, think about most of these countries with the exception of China that was just mentioned uh are smaller countries and a little bit easier to kind of do like uh something big on a national scale , but I just returned from Bermuda and that they're very aggressively uh pursuing and it's small, right? 62,000 citizens. So, so it's a little bit easier than, you know, 375 million or what have you. And I was talking also with uh CIO for Swiss for the Swiss medical system as well and we were talking about about this specifically like how how even though there is socialis sort of like a enterprise in Switzerland there's enterprise medical healthcare but there's still a lot of private like we find in in in most in many countries .and so when when he modeled what we're talking about this concierge AI concept you know they would be bankrupt uh and and so would most health systems here in the United States if we said oh look uh primary care will be pretty much uh dissolved the way we know it today and and and so forth. So how do we make the economics work? Obviously if we did value-based care if you were in VBC type of arrangements this would be sort of a no-brainer but we know how that works. It's not you know enterprise, and it's very selective and all that kind of stuff. So what I'm recommending is that you adopt a hybrid approach. So hospitals should be aware that if they don't move this direction, someone else will and it could be from outside the country. It could be someone very entrepreneurial like yourselves inside the country, but the patients are going to move there. I'm ready. You all know my story already. I've already moved there on my own. I don't even need I. I just made it happen on my own. So I think people can do it on their own. But I think I think there's an opportunity now for health care systems to say yes, this is going to happen. We can't hold this one back. It's going to happen anyways.

There was a great post one a GP in the US I forget his name posted that I've been kind of playing around with and Harvey I actually wanted that to be the topic of today was let's play with some what if scenarios of 2035 and his what if and he you know again as a futurist you can put the put the building blocks and see a scenario where this plays out. Yeah, that traditional family doctor-based primary care it goes away because of what you said the combination of physician extenders, nurse practitioners, nurses, physiootherapists, chiropractors and of course pharmacists um plus patients being the CEO of their own healthcare 80% of the time plus AI that do you like is there even a role for this you know five or 10 year trained highly highly uh uh you know uh knowledgebased uh specialist specialist in family medicine, if you will. There's a path we're not. And then you take all your specialists, which at the end of the day, every specialist was based on knowledge and expertise that's now just been commoditized. So, you can just start to see how both of those professions, there's a scenario where they could collapse. However, what the the other side is actually,

You're scaring the [ __ ] out of me today.

No, but you have to have a talk about these things. That's what we do in futurism. So our team futurism because we're just playing with stories. like I'm not so I we create a scenario of a collapse scenario. If every possible trend that's negative for your community goes happens. What does the world look like? We play it out. I use a lot of speculative fiction, design fiction. Biologically, when you hear that Junaid what I just said something in your neurosircuitry changes, right? And then you might make a different choice today because that's all we do.