Rae Woods (00:02):
From Advisory Board, we are bringing you a Radio Advisory, your weekly download on how to untangle healthcare's most pressing challenges. My name is Rachel Woods. You can call me Rae. This is not a normal episode of Radio Advisory because we're actually here to celebrate. We're celebrating hitting 1 million downloads. We have had incredible guests, we've had provocative conversations. We have an entire team that I'm incredibly proud of, but ultimately, we couldn't have done this without you, our listeners, and that's why to celebrate we're revisiting some of our most popular and our most favorite episodes even going all the way back to the very beginning.

(00:40):
I want to give you the insider's look on how we made some of these episodes, the good and the bad, and as always, I'm going to try to sneak in a little bit of teaching. I'm not even sure how to quantify how many insights we've shared in four years, 215 episodes and 1 million downloads, but I do think there's a lot we can learn from looking back, understanding what's changed, what's stayed the same, the impact that you, our listeners have made on the healthcare industry along the way. And honestly, I can't do this without bringing in the production team. After all, I always say that we are here to help. So let me start by bringing in my producer Chris Phelps. Chris, where do you want to start?

Chris Phelps (01:23):
Hey Rae, I want to start at the beginning. Let's go back to 2020 where this started. One of our earliest episodes, episode two, actually, it's when we were talking about how COVID-19 is transforming telehealth, right? It seems so commonplace these days.

Rae Woods (01:41):
But it was so new back then.

Chris Phelps (01:43):
It was so new or it felt new or it's just like a lot of interest and people using it for the first time way back in April of 2020. Everybody probably remembers where they were in April of 2020, but to us, we were starting this podcast. That's what we were focused on at that time.

Rae Woods (02:00):
Yeah, I was in this room.

Chris Phelps (02:02):
Let's listen.

Rae Woods (02:07):
From Advisory Board, we're bringing you a Radio Advisory. My name is Rachel Woods. You can call me Rae.

Chris Phelps (02:17):
So first off, that was definitely our old theme music, her old intro music, if you remember that. But Rae, I got to ask, was your home studio literally in the hallway?

Rae Woods (02:26):
Oh my gosh, it was so terrible. So the true insider's look at this episode is I had just moved. I was one of those lucky folks who moved from my one bedroom apartment in Washington DC to a house literally the first week of March, right before the whole world shut down. So I didn't even really have furniture. So I think I was recording this on a folding card table that you would use for a backyard barbecue, and clearly that was not the right vibe for a podcast host. I also remember deeply debating how to introduce myself and landing on using both my full name and my nickname because I just could not pick.

Chris Phelps (03:12):
And the recording quality back then, you sounding like that in the hallway. I brought out my exact producer notes here. I just wrote, "Sounds bad," but we had to fix that going into episode three. But let's continue on with episode two. I think about where healthcare technology overall is right now. Do you remember the interest back then, the questions we were starting to get around telehealth, this telehealth technology? What were we hearing?

Rae Woods (03:41):
Well, back then the question in April of 2020 specifically, the question is how fast could we start something up? Which at Advisory Board, I remember finding that quite frustrating because we were talking to health leaders about implementing telehealth for years. We were talking about it for a long time. I will tell you as a patient, even though I was on the road telling health leaders to build telehealth platforms, I didn't have my first telehealth visit until it was forced upon me and on my provider because of COVID.

Chris Phelps (04:12):
Next clip.

Rae Woods (04:13):
Do you really see this level of change, 90% adoption, 100% adoption? Do you see that happening in more of the status quo practices across the country?

John League (04:23):
Absolutely. There was data from a weekly survey that Primary Care Collaborative is doing that answers this directly. So last week, 60% of practices reported that they weren't doing any video visit, but that number dropped to 39% in one week. So let me put that another way. More than one third of physician practices who didn't have video visits last week have them this week, and that's simply a remarkable change in adoption and it's that way because it has to be. That's the only way.

Chris Phelps (04:58):
So John gives a really outstanding number there that one third of physician practices went from having no virtual visits to having them in a week. So one week of change, he later goes into wanting to see updated data. I guess I assume I didn't look at the data.

Rae Woods (05:16):
That's what I was about to say. That's really funny. I was literally thinking if we had recorded this the second or third or fourth week of April of 2020...

Chris Phelps (05:23):
Right, right. Yeah. The difference one week made back then was huge. Can you think of another time where this much adoption, maybe necessary adoption happened in healthcare that quickly?

Rae Woods (05:35):
I cannot. And you used the word necessity and that's 100% what was that moment in time? In fact, regulations went away. It was do it on Zoom, do it on a phone call, whatever, whatever it takes to get in touch with the patient, fine, we'll let it happen. Which is of course not normal and also not the way that we operate today. I do think that there is some interesting nostalgia about the COVID years, right? When people talk about tech adoption in particular, they think about how quickly they made a decision or how they were able to come together as a leadership team or come together as competing institutions and make something happen because it served their patients, their community, it was out of necessity and I still hear a lot of "Why can't we make decisions faster?" Maybe it's not in a week, but it's not. We're going to take an entire year to decide what we do next in terms of... Especially something like tech adoption.

Chris Phelps (06:34):
Yeah. All right. Last clip, and then I promise we're going to get to some more recent episodes and get you out of that hallway, that recording there. Okay. In this episode, you asked John to make some predictions. Classic. Let's make some predictions about the future, particularly the future of telehealth after the pandemic, it's time to hold John accountable. Let's see what he said.

John League (06:58):
I'm going to cheat on that, Rae and I'm going to answer, I'm give you two answers. A glass half full, glass half empty perspective. The glass half full perspective is so many more patients and clinicians are getting exposure to telehealth for the first time. And on the patient side, all of Advisory Board's consumer research on virtual visits says that patients who do try a virtual visit are satisfied with the care and the interaction with the provider and that they're willing to use it in the future. So we are likely to see far more consumers demanding telehealth services.

Rae Woods (07:34):
So I actually think John is correct in terms of his prediction. So ding ding, good job, John, in that patients love telehealth and it became table stakes for providers. It actually became something that we saw actual medical groups, health systems, hospitals offer as opposed to third party tech vendors being the people who remained Supreme for five years later. There was a downside to what he said, if I remember, which honestly also became true, which is the concern is how do we ensure access to not just virtual visits but all kinds of telehealth and tech platforms to as many people in as equitable a way as possible? Which continues to be a challenge today that everyone needs to keep focused on so that we can make sure that we're providing access to the most vulnerable populations.

Chris Phelps (08:26):
All right, Rae, let's move on to our next episode, but first it's time to bring on another member of the podcast.

Rae Woods (08:32):
Let's do it.

Chris Phelps (08:33):
Kristin, welcome to Radio Advisory.

Kristin Myers (08:35):
Hey everyone. Hey Rae. Hey Chris.

Rae Woods (08:37):
Hey, Kristin.

Chris Phelps (08:38):
Keen listeners of the podcast may recognize your voice during some of our breaks in our episodes, but you do so much more. Can you tell a little bit about what you do for the podcast?

Kristin Myers (08:48):
So I'm responsible for moving an episode from a broad topic idea to the specific and compelling story that we tell on each of our episodes, and that means having planning conversations with our guests and the rest of the content team to identify our insights and build a narrative into an outline that Rae and Abby and the guest can use on recording day. And I also want to give a shout-out here to Atticus Roche, who is our production assistant. I work really closely with him throughout this process and he wasn't able to make the recording today, so just wanted to give him a shout out there.

Chris Phelps (09:20):
I think he's in Europe though. We don't feel too bad, right?

Kristin Myers (09:22):
No, we don't feel... We're actually very jealous of his Scotland vacation right now.

Chris Phelps (09:29):
I promise we'll get away from COVID-19 episodes, but this next episode actually remember really well. We actually planned to take a summer break in August of 2020, did our first batch of episodes. Let's take a break. Let's settle down. But we actually had this opportunity come up to interview Zeke Emanuel particularly to talk to him about developing and distributing a vaccine, the COVID-19 vaccine when it does come. I remember vividly, we were all waiting for it to happen. Is it going to happen when that going to be, when can I get this shot? It was really reassuring at that time to hear Zeke talk so confidently about it.

Rae Woods (10:07):
Yeah.

Zeke Emanuel (10:08):
So do we, because we think, look, even if it's not the AstraZeneca Oxford one or it's not the Pfizer one or it's not, it'll be one of them. We've got so many shots on goal something is going to work unless it's really impossible like HIV, but no one thinks it's impossible, like HIV. Even people who are diehard skeptics like myself don't think it's impossible, so we're going to have something even if it takes a little longer than everyone expected.

Rae Woods (10:34):
That's right.

Zeke Emanuel (10:35):
The issue is, all right, you got it. Then you got to manufacture, and each one of these different types of vaccines requires different manufacturing capacity. Some are fermented, some are, you're just producing the RNA, et cetera.

Chris Phelps (10:52):
I love Zeke's shots on goal phrase.

Kristin Myers (10:56):
It's funny because that went right over my head.

Rae Woods (10:59):
What? You're not a sports person?

Chris Phelps (11:03):
Speaking of sports, Radio Advisory might be coming, a sports podcast. There was an episode a couple of months ago about some sports analogies used. Rae, do you have any other sports analogies to use to describe your interview with Zeke?

Rae Woods (11:13):
Oh, interesting. Well, honestly, thinking back to that moment, it really did feel a little bit like a boxing match, but in the best possible way where we were really sparring with each other, except I was clearly the lightweight in the room who had to learn all of this information about life sciences and drug development and vaccine development, which was really new territory for me to then go toe to toe with an expert and someone as important to the healthcare field as Zeke Emanuel. It was like me being the lightweight, him being the heavyweight and me trying to keep up and I got to say listening back, I think I held my own.

Kristin Myers (11:54):
Right Chris, I do want to ask, because this was before I joined the Radio Advisory team, getting Zeke Emanuel on the podcast must have been a really exciting milestone for Radio Advisory, especially so early. I mean, just a couple of months after the podcast launched. What was it like to get the confirmation that he was coming on the pod?

Rae Woods (12:13):
I remember this very clearly. I remember being amazed, honestly, and this speaks to the history and the legacy of Advisory Board, right? People in the market, even though Radio Advisory, the podcast was new, people knew and respected Advisory Board and knew, "Hey, if I have a message to get out to health leaders, especially in this time where they're not picking up the phone, they're not going to events. I can use the Advisory Board platform to do that." And this was the very, very first proof point of that model that we had bet on when we made a podcast. And there were actually a couple of big name guests in a row that came on, and that summer we had Mark Harrison come on, and I remember having this moment thinking to myself, "Hey, this is going to last. This isn't just going to be a COVID experiment. This is something that we're going to be able to do year after year. If we can deliver our insight, the insight of Advisory Board and get thought leaders like Zeke Emanuel and Mark Harrison on, we can do this."

Chris Phelps (13:16):
So the podcast continued to grow and we've added more and more people to the team, and we're jumping now to 2021. But first, let's bring in Abby Burns, cohost of Radio Advisory. Abby, welcome.

Abby Burns (13:34):
Morning everybody. How are we doing?

Chris Phelps (13:36):
Good. Abby, I looked this up earlier and you've never actually been a guest on the podcast.

Abby Burns (13:41):
This is true. I have not.

Chris Phelps (13:43):
You've only hosted, so first off, I'm sorry we're breaking your streak, but second, what does it feel like to be a six time host and a first time guest?

Abby Burns (13:50):
Oh, a six time host.

Rae Woods (13:52):
And counting baby.

Abby Burns (13:53):
Yeah, you're really keeping track there. It feels great. It's also very fun to be a guest for the first time alongside the whole team, so this is a fun way to do it.

Chris Phelps (14:04):
Yeah. I was going to ask you to say like long time listener, first time caller or something like that, but I won't do that. So back in April of 2021, we did an episode with Warner Thomas, another big name CEO at then Ochsner. Rae talked to Warner about the digital innovation Ochsner's done over the last 20 years.

Abby Burns (14:24):
Yeah, I actually think it made a lot of sense to talk to Warner because Ochsner has been really at the forefront of digital innovation When we think about progressive health systems that invested early in digital, so I love that you were able to bring them on.

Rae Woods (14:36):
And again, it actually goes back to the very first clips that you played with John where we wanted to contrast all of the new rapid singular focus on telehealth that had been happening at that time, with what long-standing deeper in technologies that would frankly support care management and what that looked like, and there was no better organization to bring on than Ochsner to talk about that.

Abby Burns (15:00):
One part I really liked was when Warner evoked other industries and talking about the comparison of healthcare being comparatively behind other industries when it comes to digital innovation, which is a comparison we hear a lot and vice versa. We make that a lot, but I really appreciate it. This was an example of not just admiring other industries but actually emulating them.

Rae Woods (15:24):
Is there a personal spin here though, right? Have you been personally an advocate for this transformation and where does that come from?

Warner Thomas (15:32):
I absolutely have been, and I think one of the things I've always tried to look at is other industries and really comparing healthcare to other industries. I remember talking more than a decade ago with folks about... It's amazing that we can book an airline ticket online. We don't have to go to the counter anymore to check our bags and to get our tickets. That all of that is done electronically, and that has obviously evolved in the last decade, but it was amazing how healthcare was so far behind banking and airlines and other areas. So I've constantly tried to bring those other thinkings about other industries to healthcare and to our team.

Rae Woods (16:11):
Yeah, that speaks to exactly what Abby was just talking about, and it speaks to the leader that Warner is no longer at Ochsner moved on different organization, but it's one of the reasons why we like to feature voices like his on the podcast.

Abby Burns (16:27):
Rae, at the end of that episode, I remember you said you were surprised, but not that surprised that when Warner was talking about what he sees as the future of digital health, he did not limit it to just talking about virtual visits.

Warner Thomas (16:41):
Video visits, virtual visits, whatever nomenclature use. I think as a piece of this solution, I think the question is really around how do you win at patient engagement? Historically, we've thought about patient satisfaction and whatnot as, "Hey, what's your experience when you're in our ER, when you're in our hospital, when you're in our clinics?" To me, that's when folks are in your four walls. That is not where we are today. I mean, the question is how do you engage patients when they're not within your four walls? How do you let them know that you're thinking about them when they're not in your clinics? What is the way you're going to engage them to take better care of themselves and how can you do it in a way that's not intrusive but is more coming alongside them and being a partner?

Abby Burns (17:30):
I love that he immediately ties also their digital strategy to a strategic goal. It's not just we're doing digital strategy because we need to do a digital strategy. It's like, "Here's what we're trying to achieve with it."

Rae Woods (17:39):
Which is still true, which is still advice that we are repeating honestly every single day. Don't be distracted by a shiny object. Have it rooted in a clear business goal, patient engagement, reducing the total cost of care, all of their focus on value-based care is squarely where Ochsner was and is today, and then it's a matter of figuring out what tools, in this case, this technology doesn't have to be, that are going to support that strategic goal. I love that. Stand by it.

Chris Phelps (19:01):
Newest team member Chloe. Welcome to Radio Advisory.

Chloe Bakst (19:07):
Hey everyone, long time guest, first time team member. Yes.

Chris Phelps (19:13):
I love that. Obviously, you're no stranger to Radio Advisory, but in this next episode you are actually on it, so we're going to listen to you listening to you

Rae Woods (19:21):
Now you know how I feel every week, Chloe.

Chloe Bakst (19:25):
I love that. Let's do it.

Chris Phelps (19:27):
In particular, we're going to look at the episode where we started covering Ozempic, Wegovy and other weight management drugs. I believe this was your second appearance. Can you tell us a little bit about trying to plan for this episode in particular?

Chloe Bakst (19:40):
Well, this was such a fun episode because I feel like the first time I came on the pod, we were presenting research that it was tied up with the bow. We already knew what our main talking points were, but this was very much a response to what was happening in the news, the public conversation around these drugs, and so many questions from health systems, from health plans, even from manufacturers about what's happening right now, and are we at this turning point in how we approach weight management, obesity care, or is this just another one of cyclical weight loss fad drugs that come out? And I remember we had... Rae, you might remember this too, just so many long email conversations with so many researchers across different teams and advisory board, just writing paragraphs and paragraphs of, "Here's what we should talk about in this podcast and podcast. Here's what we definitely need to say." And a lot of those things didn't end up making it into, I think it was even still a 40-minute episode, but we had still had so many things left on the cutting room floor.

Rae Woods (20:50):
I remember having this moment of saying to the team, "No, no, we need to say something now because our listeners have questions now, I know that we can be helpful even if we don't have the perfect answers." Let's figure out what helpful looks like at the height of this early conversation about weight loss drugs.

Abby Burns (21:08):
As a lurker on that email chain, it was a really effective way to learn about everything that was happening and everything that was going on. So thank you.

Rae Woods (21:16):
Maybe we missed an opportunity to publish something off of that email chain, Chloe.

Chloe Bakst (21:20):
This a frantic, when I listened back to it recently, I was really struck by... I think almost exactly a year ago, I think we had this conversation last April and this framing of the episode was, "Here's all our questions on Ozempic, Wegovy, these new generation of weight management drugs," and now a year later, after a year of conversations and lit review and talking to stakeholders across the industry, we have not all the answers, but we have a lot of answers or at least recommendations or ways to move forward. I mean, we have an entire resource library now on our website that has a collection of case studies and our takes on ways that leaders can start integrating these medications into their existing weight management programs and just... It's crazy looking back how far we can come in a year when an issue is really important, and we prioritize it and learn as much as we can about it.

Chris Phelps (22:27):
And we'll put all those links in the show notes, Chloe.

Rae Woods (22:31):
You're also doing a very good job of teasing a future episode that you're going to come back on, Chloe, to talk about some of those recommendations, not for just the drugs, but how we think about weight management in general. So Chloe will continue to be both the behind the scenes and a forefront of Radio Advisory episodes.

Chris Phelps (22:49):
Rae, one of the things you asked about or we talked about on that episode was the fears or maybe things we were worried about these drugs could do to disrupt weight management care. Let's take a listen.

Rae Woods (23:02):
I want to make sure we give voice to all of our fears or questions that we have about this alternate scenario where patients are getting it outside of how the FDA necessarily intended for Regal Virus MPEG to be used. What other concerns do you have that you want to put out there for our listeners to know?

Chloe Bakst (23:19):
I'm just concerned about the idea of there being a magic solution to weight management in the United States now, and that maybe putting pressure off of governments or off of other institutions to create more collectivist policy solutions to things that are perpetuating obesity and weight issues in the country, like our food system, having safe spaces to exercise, all of these factors that become like the social determinants of health web that make controlling obesity so complicated. I don't want there to suddenly be a feeling of, "Well, we have this great shot now. You can just take, and maybe it's expensive, but at least you'll be thin."

Chris Phelps (24:04):
And stay tuned. There's more episodes, as Rae alluded to, we're doing many more episodes on this topic.

Rae Woods (24:10):
Chloe, do you stand by that fear? I think I do.

Chloe Bakst (24:13):
I definitely do.

Rae Woods (24:15):
In fact, I actually think there's been some public backlash against these drugs in the year since where people are talking about the negative side effects or things that represent the downside of these drugs. The common way that they're talked about has shifted quite a bit.

Chloe Bakst (24:29):
Where I have seen that fear come to light is how they're discussed in the public and just this persisting, prevailing idea that these drugs are getting used by people who perhaps don't actually need them for weight loss or just again, to achieve a certain aesthetic look. But I'm heartened by the conversations that I have with healthcare leaders who are really trying to actively adjust their existing obesity or pediatric programs to create something that is comprehensive, wraparound model that is aimed at not just weight loss, but at cardiometabolic care and actually improving health metrics and supporting patients where they're at.

Chris Phelps (25:16):
Final segment, Rae and everybody, every good podcast needs a lightning round. Rae, I know one of your favorite podcasts calls theirs the slow round, which is just great. So for ours, I'm going to theme it too. I'm going to keep it in the healthcare theming and call it the heart rate round. Raise your heart rate. First question, Rae, how many times do you think you've said from Advisory Board, we're bringing you a Radio Advisory?

Rae Woods (25:41):
Oh my gosh. Well, what episode is this? 215, at least 215 times. I've gotten pretty good at only having to say it once as I'm recording an episode, so probably somewhere around 300 maybe.

Chris Phelps (25:55):
I say you're very efficient, but I'm going to guess it's more like 500. There's times where you started over and whatnot. The word untangle, that's a word that I think we kind of like around here. Could you tell everyone why we like that word so much, particularly around why we use it in the intro every time?

Rae Woods (26:16):
And I should say we didn't always use that in the intro. It's relatively new and huge shout out to one of our producers, the person who seamlessly edits all of our episodes, Katie Anderson, who actually proposed us using that phrase to talk about our approach to healthcare problems. We've talked about as we've reflected on all of these episodes, we don't always have the perfect solution, probably because the perfect solution doesn't actually exist, but it doesn't mean that you can't pull on different threads of this knot to start to unwind and untangle some of the biggest challenges in healthcare, which I frankly find to be the more helpful conversations that we have, especially when different stakeholders, different people in healthcare represent different threads that ultimately need to be pulled on at the same time. I think it's a really wonderful representation. It's also a wonderful visual word for what we're trying to accomplish on this podcast.

Chris Phelps (27:12):
Abby, who's your podcast host inspiration? Who are you channeling when you're putting on those headphones?

Rae Woods (27:18):
If you don't say me, Abby, you're fired.

Abby Burns (27:22):
Rae, I'm sorry to say, I think my podcast host inspiration is Sabrina Tavernise from The Daily.

Chris Phelps (27:29):
Yes.

Abby Burns (27:31):
And actually for a specific reason, which is I became a huge Daily listener during the pandemic, and Michael Barbaro I thought was just end all, be all, and he is. And then when they brought a new voice onto the podcast, I was so skeptical. And then very quickly, I think Sabrina Tavernise has a really authentic style, and I really like the way that she asks questions and the way that she relates to anybody that she's talking with. I also think it's super cool that she speaks so many languages. So then as I started ramping up on Radio Advisory and came on as co-host, I was trying to channel my inner Sabrina.

Chris Phelps (28:03):
All right. Last question. This is for everybody. Do you remember the first podcast you ever subscribed to?

Kristin Myers (28:09):
I do. And it's a podcast I still listen to today. It's a Stuff You Should Know.

Rae Woods (28:14):
That's a good podcast.

Kristin Myers (28:15):
A classic podcast. I listened to it on long car rides. It's great.

Abby Burns (28:21):
I think I was Serial back in 2014, the story of Adnan.

Kristin Myers (28:26):
That's such a good one. I'm a big true crime podcaster too.

Chloe Bakst (28:31):
Every Album Ever, specifically the Taylor Swift albums.

Rae Woods (28:38):
Yes, I love that podcast.

Chloe Bakst (28:39):
That's great.

Rae Woods (28:42):
Honestly, I think the first podcast I listened to wasn't even on a podcast platform. It was like tuning in on Sundays on NPR to listen to this American Life before I even had a...

Abby Burns (28:56):
That's a new call.

Rae Woods (28:56):
Or before I even had it downloaded to my phone. And then I remember the big podcast wave of 2014, 2015, and really loved Startup, which was a podcast about starting up a podcast.

Kristin Myers (29:07):
You knew you were going to do it one day.

Rae Woods (29:11):
No, and I was a huge podcast fan. I remember walking around DC just for hours listening to different podcasts.

Abby Burns (29:20):
Chris, what about you?

Chris Phelps (29:22):
Oh my gosh, I go way back. I think I was in the NPR sphere, too. It's like I was in college listening to my first podcast. I was like, "I should follow the news." I think it was the NPR daily update and then, Wait, Wait. Don't Tell Me. It's a classic one.

Kristin Myers (29:38):
Wait, Wait, Don't Tell Me. Yes.

Chris Phelps (29:39):
Yeah. Great one. We're at the close everyone. So thank you everybody for joining, and thank you everybody for listening. We're celebrating here today, 1 million download. We've done this across four years, 200 plus episodes. I think our team has grown. The types of guests we have on have been incredible, insights we've generated, so I couldn't ask for a better group to work with. So here's to the next million.

Rae Woods (30:04):
Cheers. To the next million.

(30:42):
If you like Radio Advisory, please share it with your networks, subscribe wherever you get your podcasts and leave a rating and a review. Clearly that helped us get to 1 million and we want to get to the next million. Remember, Radio Advisory is a production of Advisory Board. This episode was produced by me, Rae Woods, as well as Chris Phelps, Abby Burns, Kristin Myers, Atticus Raasch, and Chloe Bakst. The episode was edited by Katy Anderson with technical support provided by Dan Tayag and Joe Shrum. Additional support was provided by Carson Sisk, Leanne Elston, and Erin Collins. We'll see you next week.