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- This is Laura Dedo with the
Becker's Healthcare Podcast.

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I'm thrilled today to be joined by Dr.

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Tarun Kaur, senior Vice President

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and Chief Transformation
Officer at Virtual Health.

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Dr. Kaur, it's a pleasure to
have you on the podcast today.

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- Hi. Thank you very much, Laura.

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A pleasure to be here with
you and with the audience.

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- Now, I know we've got
a lot to talk about,

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and I'm excited to learn more about your

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transformation portfolio at vir.

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But before we dive into my questions,

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can you tell me a little bit more

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about yourself and your background?

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- Absolutely. So to Kaur tk for short,

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I'm an internal medicine
hospitalist by training.

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Um, and, uh, I'll just say it's,
it's, if I had probably had

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to look back 20 years ago
when I started this journey,

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I would've never planned this
journey out, uh, on purpose.

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It's one of those things where

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wherever you go, there you are.

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So I, um, I've had opportunities to,

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to be a working hospitalist.

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I've, uh, had roles inside
of our informatics team.

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I was actually the chief medical officer

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of our, our medical group.

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I had a stint in population health.

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And then in 2019, I was asked
to take on digital health

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as a stretch assignment.

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And, uh, the best career
advice I can give to anyone is,

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it's always better to be lucky than good

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because March, 2020 comes along, uh,

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covid pandemic accelerates
digital health in a way we could

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have never even fathom.

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So, um, as such, uh, we at ua,
which is in the southern part

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of New Jersey, just right
on that same latitude

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as Philadelphia, uh, uh, we, um,

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we created a digital
transformation office right,

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coming out of the second wave of covid.

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And, um, glad to share
more about our, our,

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our office and our portfolio.

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- Well, fantastic. That's great to hear it

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and absolutely looking forward to it.

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So, will you tell me a little bit about

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that transformation portfolio?

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What's unique about it in
your program at Virtua?

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- So, the reason we created a
digital transformation office

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was to,

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because we, we were recognizing,
my goodness, look at this

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astounding rate of change that occurred

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during the first couple
ways of, of the pandemic.

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I remember there was this headline in,

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in the New York Times
talking about the adoption

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of telehealth in the United Kingdom,

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and they said 10 years
of change in one week.

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And that's exactly what we saw.

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And I, I think a lot of
organizations were seeing levels

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of change that they had
never anticipated before.

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And the question we, we knew that the pen,

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so the pendulum never
swings back to the middle.

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It always tends to swing
back to the other direction.

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So we knew that once
the, some of the urgency

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of the pandemic were starting
to would, would ease.

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We knew some of those
transformative energies

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would start to ease as well.

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And people potentially could go

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back to doing it the old way.

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And we as such created a digital
transformation office and,

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and took a model off of Silicon Valley

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incubator accelerator model,

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what we believe transformative things,

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especially digital
transformative things can happen

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organically inside of an organization.

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But what would normally take two

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or three years to happen,
we try to help accelerate

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that process and do it in six months.

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And, and the reason is, is

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'cause the operators are
constantly having to put out fires.

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Uh, you know, today we're,
we're recording this

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and there's a pretty,

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there's a pretty big breach
happening at Change Healthcare.

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Well, if I'm running a transformation off

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or if I'm an operator, I gotta
take care of that breach.

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And, and so there's always an opportunity

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for a fire to take over.

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A transformation office lets
a group of people continue

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to move the transformation
forward even when immediate

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emergencies come up, uh, and could

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otherwise distract people.

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And that's what we did. So, uh,

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that's the idea behind the office.

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The office does not own any form

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of transformation by itself.

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It always partners with an operating unit.

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We have a deep partnership

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with our information technology team.

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'cause we need, we need the digital

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underpinnings to get it done.

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And then the other piece of
the transformation portfolio,

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which, you know, we think is
a little bit different than

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typical projects in a health system,

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is we don't rebalance
it on an annual basis.

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We rebalance the portfolio two, three,

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sometimes four times a year

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because the needs of healthcare are

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changing faster than ever before.

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You can't be on annual
planning cycles for this stuff.

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So I think that's where
there's been some adaptability.

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- Absolutely. That's just so fascinating.

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And certainly as you mentioned, the pace

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and rate of change in
healthcare sped up so much

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during the pandemic and it
continues to seem like, you know,

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there is a, a pretty fast rate of change

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with new digital technologies

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and artificial intelligence
and so many other things.

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And like you mentioned, needing
to be nimble if there is a,

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a cybersecurity incident

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or something else impacting the system

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or a, a business partner,
um, I can imagine

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that's just such a challenge
when you look at, um, you know,

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being able to make that pivot and,

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and have teams go from what
it used to be in or, and,

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and now into a space where you can

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be more nimble, make changes quickly.

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What does that take culturally

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and how do you make sure you keep

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that momentum going even if there's not a

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global pandemic going on?

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- Yeah, so, uh, boy, I wish I had a, uh,

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a simple answer for that.

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And I don't because I'm
constantly learning.

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I think one of the
important pieces though,

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that we've learned here is,

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and even though the word
transformation is in my title,

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not everything can nor
should be transformative

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and learning how to iterate,
even if it's relatively simple

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iterations and, you know, say, well this,

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there's nothing transformative about that.

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There are learnings
that come along the way.

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Uh, so I, you know, I'm, I'm
a, a big, uh, believer in,

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in reader of Hendrick Berg's
work from his time back at, uh,

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Spotify and Lego.

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And, you know, he, he
talks about not building

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in a waterfall mechanism, but
truly an agile methodology.

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And what we try to do here is someone

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says, I think I need a car.

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And we go back to them and say, for what?

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And that's a awkward question sometimes

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to ask in healthcare,
especially if you're talking

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to other professionals, like physicians

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who are extremely well trained.

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Why do you need a car?
I say, well, I want it

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to get from point A to point B.

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And you say, okay, well
here's a skateboard.

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Give that a try for a week.

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And that's just a
different way of thinking.

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But a couple things happen along the way.

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You learn sometimes that, well,

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maybe a skateboard isn't good enough,

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but maybe you can stop at a bicycle.

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And you know, what we say is, well,

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if you're designing transportation
in, in the Netherlands,

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in Amsterdam specifically,

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you would always stop at a bicycle

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'cause there's nowhere to park the car.

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And it's just a different mindset

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because in in healthcare, you know,

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when we take the Hippocratic
oath, we say premium numb,

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necessary, first of all, do no harm.

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That doesn't really sit well
with a transformative mindset.

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It's only if you're making mistakes

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that you learn something.

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And so what we had to find in balance is

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we do make mistakes, but we
will make sure we are safe.

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Safety and, and learning

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or making mistakes are
two different things.

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We can be safe and still
make mistakes as we learn.

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And I think that that's the mindset

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and the cultureship change that,

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that we we're still going
under here at Virtual.

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- That makes a lot of sense.

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And you know, I love that analogy

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and the way you explained
it in thinking about

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transformation and understanding,
you know, what needs

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to be iterative and how you
can really approach some

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of those things versus some

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of the bigger transformation as well.

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What are some of your top priorities

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over the next 12 months?

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What do you have top of mind
and what are you focused on?

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- We manage our portfolio in, in domains.

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So we have consumer financial
journey, digital doors,

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uh, alternative term
is digital front doors.

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I'm not a big fan of the
term digital front door.

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When's the last time you went to the

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front door of your own house?

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Uh, so I think you have
multiple doors into a,

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in a house you should have multiple

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doors into your health system.

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What I would say if, you
know, with all of our,

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and I would, I be careful
here, I sometimes say projects,

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but in reality it's products.

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And that's an entire mindset
shift in, in healthcare.

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But within our products,

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if I just talk about three global themes,

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we are talking about digital resiliency,

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digital outcomes.

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And perhaps most important
right now is digital access.

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Uh, there is an access
crisis in the United States

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and uh, it's not gonna go
away for the next 10 years.

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And so if we do not come
up with alternative ways

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of thinking about this, it's
gonna be a rough 10 years.

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- I think that's such a great point.

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And definitely, you know,
looking at, as you mentioned,

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trying to solve some of those
big problems, big challenges,

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whether it's access

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or other issues using some of
the digital technologies in,

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in places available, um, I
really, you know, like you said,

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think that it's so paramount

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and can certainly make a
big difference, difference

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for the communities that you serve.

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Is there anything that you're
doing now looking ahead that,

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um, you really feel like
is going to be helpful

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and beneficial, um, as
you're making that transition

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and really ensuring that you've
got digital health access

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and, and can improve that for

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the whole community that you serve?

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- Well, you know, I think
this is one of those, uh,

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an opportunity, one of those learnings.

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We, um, we came along the way

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and you remember I asked,
I said about you asked,

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someone says, I want a car.

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It's like, to do what I,

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I think a lesson we've
learned along the way.

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We've, we've had a lot of
success with online scheduling.

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We have really substantial numbers

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of online scheduling appointments

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that occur in the organization.

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And if you think about all the
phone calls that are saved,

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both from the convenience
to the patient, consumer,

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but also to the operators,
uh, the operations team, that

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that can be avoided because
of digital scheduling.

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But I actually looking back

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and kind of realizing, you
know what, maybe we are,

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we didn't ask enough of to do
what I didn't ask enough of

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what do you want the
online schedule to do?

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And so for example, way we've
been thinking about it is

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patients, do they really
want an appointment?

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Does anyone really want an appointment?

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And I think, yes, there are some people

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who absolutely just want an appointment,

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but most people actually just want an

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answer to their problem.

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They're willing to make an appointment

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as a mechanism to get the answer.

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Are there other ways we can
get them their answer without

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them having to have an appointment?

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And if we are talking
about scarcity of resources

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and our clinicians are probably
our most scarce and, and,

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and, and precious resource,

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does every question need an
appointment to get answered

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or are there other ways we can do that?

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And that's where we were
talking, we're thinking

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through some of the
digital tools, et cetera.

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You know, the reality though
is, is that the structure of

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how billing works is going to have

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to be looked at differently.

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What are, you know, what
are consumers comfort levels

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of getting their answers
through digital means?

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When is something appropriate
for a digital answer

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and when is something appropriate
for an analog answer when,

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you know, meaning in
person with your clinician?

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I think those are all the things
we're trying to solve for.

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And uh, you know,

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I think we just recognize
if you look at the numbers,

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the population numbers
in the United States,

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you're not gonna recruit
your way out of this problem.

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We're all competing to have clinicians

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and the pipeline will
just not come fast enough.

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So we're going to have

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to think about other ways of doing this.

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- That's a really excellent
point. Thank you so much.

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Now before we wrap up here, I'm wondering,

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given everything we've
talked about looking at

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transformation, digital
technologies, access to care,

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how do you anticipate your
role in teams will change

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in the next year and beyond?

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- Yeah, we think about this a lot.

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I, um, you know, I, I think
we we're spending a lot

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of time here as mentioned we
were a digital transformation

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office, so it's a little bit
more of a centralized function

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function when we started,
what I'd love to see is more

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of a federated model or approach.

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And, and that meaning like for example,

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when Excel first came out, yeah,

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the finance people use it a lot.

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You, everyone uses Excel
across an organization.

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You don't say, well, only
finance gets to use Excel. Right?

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It's just, it's just not
the way the world works.

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I think similarly around
digital, while there have

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to be guardrails around digital guardrails

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around artificial intelligence,
how do you get these tools

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into the hands of the front end users?

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Because that's where the
true innovation occurs. Yes.

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You know, we have innovation
labs where we experiment

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saying, I, you know, I put out there is

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that innovation without
adoption is experimentation,

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but innovation with adoption
is true transformation.

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And we have to spend a lot of
time, we are spending a lot

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of time around literacy,
digital literacy, AI literacy,

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explaining to our, our
colleagues, our employees, these

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what these tools can do.

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These is what these
tools can't currently do

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and this is how these tools can be abused.

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And, uh, so I'm spending a lot

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of time on the education front

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because, you know, these
tools are not gonna be able

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to be kept in a, in a
bottle, the genie's out.

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So we want to educate the people

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around us in our organization how to

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effectively use the tools,

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but also be aware of where,

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where there could be shortcomings.

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- That makes a lot of sense. Dr.

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Kaur, thank you so much for
joining us on the podcast today.

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This has been such a
fascinating conversation

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and really covered a lot of ground,

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so I appreciate your time here

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and looking forward to
connecting with you again soon.

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00:13:42,765 --> 00:13:44,795
- Appreciate your time
and uh, the questions

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and, uh, thank you to the audience

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for giving the opportunity
to share of some

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of the things we're thinking
about here at Virtua.

