Warning: "continue" targeting switch is equivalent to "break". Did you mean to use "continue 2"? in /www/wp-content/plugins/revslider/includes/operations.class.php on line 2854 Warning: "continue" targeting switch is equivalent to "break". Did you mean to use "continue 2"? in /www/wp-content/plugins/revslider/includes/operations.class.php on line 2858 Warning: "continue" targeting switch is equivalent to "break". Did you mean to use "continue 2"? in /www/wp-content/plugins/revslider/includes/output.class.php on line 3708 A Second Opinion at emids – A Second Opinion Podcast

A Second Opinion at emids

with Paul Fipps & Gyre Renwick

For today’s episode, we’re doing something a little different. I was recently joined by Paul Fipps, the Chief Digital Officer of Under Armour and Gyre Renwick, Vice President of Lyft Business. We sat down before a live audience in Nashville, at the sixth annual emids, that’s E-M-I-D-S, emids Healthcare Summit, to discuss the topic of Google, Alexa and the future of voice activated healthcare. Our panel was part of a two-day event, focused on maximizing technology to fundamentally alter the business of care delivery. Before we get started, I want to thank our sponsor, MEDHOST, a trusted EHR for healthcare facilities.

Senator Bill Frist, MD:   Each year, emids brings together a highly curated group of healthcare leaders from across the country. Leaders in consumer brands from around not just the country, but around the world, to gather, to engage, to dock up and to talk about how we are making digital doable for healthcare.

Senator Bill Frist, MD:   By doing so, how we can make the experience of healthcare for consumers, look a lot more like we experience everything else in life. Joining me today to talk about how we can lower those barriers to better health, by voice and by voice search.

Senator Bill Frist, MD:   How we can integrate those into our healthcare system are first, Mr. Paul Fipps, Chief Digital Officer for Under Armour, a leading performance apparel and footwear brand, operating in more than 70 countries and Mr. Gyre Renwick, Vice President Lyft Business.

Senator Bill Frist, MD:   Gyre served as Head of Healthcare Partnerships for Lyft, starting in 2016. Prior to that, spent nearly a decade at Google, as part of its healthcare group.

Senator Bill Frist, MD:   I want to welcome too both of you today. The whole discussion that we have today, we can start with some context. Researchers predict that by the year 2021, really 18 months from now, there will be as many voice-activated assistants as there are people in the world. That figure is 7.5 billion.

Senator Bill Frist, MD:   Obviously the proliferation of voice in large part, is driven by the devices that we carry in our pockets. Our smartphones, and increasingly through devices like Alexa and Google Home.

Senator Bill Frist, MD:   As the chief digital officers for each of your respective companies, what I’d like to capture today is the conversations that you are having, each at your own facilities, at your own institutions, exploring how we can incorporate this new technology.

Senator Bill Frist, MD:   Really to make access to health and to healthcare almost a forgettable experience. Let’s talk about, what are those biggest opportunities for voice search from a consumer perspective? Then talk a little bit about the barriers to voice search for healthcare.

Paul Fipps:                    First of all, it’s a real honor to be on this podcast and be with this group today. This is actually the second year I’ve been fortunate to be on a panel here, so it’s been an exciting opportunity. It’s really great to do this with you and with Gyre as well.

Paul Fipps:                    In fact, Gyre and I were on the panel last year together as it turns out, so I’m excited to do this again. I think from an Under Armour standpoint, I would just as you had set the context, we are obviously a large performance apparel and footwear brand.

Paul Fipps:                    We also own the largest digital health and fitness community in the world. For us, what we think about is, “How do we put the consumer at the center of the experience and then build backwards?” We haven’t always done that.

Paul Fipps:                    This has been a real journey and a really learning for us, in terms of, how do you say, “What do our core consumers need, then build that experience around them?” I’ll just give you an example of a story. We do these things in MyFitnessPal called Victory Stories.

Paul Fipps:                    Victory Stories are where we pull out members of the community, who have had transformational impacts on their health and fitness. There is a woman that we use, and we just showed a video of her not too long ago. Her name’s Gabby. She, like many of us, she starts off in high school.

Paul Fipps:                    She is a high school athlete, she’s healthy, she’s fit. She goes to college, she gains 10 pounds. She likes to highlight her freshman year, 10 pounds turns into freshman 10, turns into freshman 15, turns into 20. By the time she is in graduate school, she’s gained 85 pounds.

Paul Fipps:                    Now she’s 23, 24 and she’s looking around going, “I got to make a real change.” What happens at that point when you want to make a real change is, you need tools. You need coaching, you need content, you need community to do that. Along her journey… it took her about 18, 24 months.

Paul Fipps:                    She first started with nutrition. We always say, [inaudible 00:05:54], “Fitness starts with nutrition.” We all know you can’t outwork a bad diet. She started losing the weight, and she started losing the weight.

Paul Fipps:                    She became more and more motivated in the community, while she was consuming content around health and around fitness and around nutrition. She started working out. You fast forward, and she’s in her late 20s now. She’s actually a fitness and nutrition influencer on Instagram.

Paul Fipps:                    The journey has been transformational for her. I use that as just a story, in terms of how people in our community actually make transformational change in their life around health and fitness.

Paul Fipps:                    She could have gone the other way. She could have kept going with the weight gain. She could have led a very unhealthy life over the next 25 or 30 years. We think about that a lot. We think about-

Senator Bill Frist, MD:   In that story, Paul, what is the sort of central organizing levering effect, between actually changing lifestyle, accomplishing results?

Paul Fipps:                    Well, I think it’s your change in behavior.

Senator Bill Frist, MD:   Yeah.

Paul Fipps:                    She started logging her nutrition daily, and understanding what she was eating and what the calorie intake was. Our goal in that community, is to help you achieve your fitness goals. We coached her along the way, both on the nutrition side, but then we also have coaching around our performance apparel.

Paul Fipps:                    We actually have a chip in our shoe, that comes back and engages with you in MapMyRun. We use machine learning to actually coach you into a personal running form, to actually make you a better runner.

Paul Fipps:                    What we found over time is people actually get faster, when we actually coach them to a better run. We use voice for that. I mean, that’s a huge part of it. You get the auditory cues around your running form, around actually what your split times are. It’s a really big part of that.

Paul Fipps:                    The combination of her logging her nutrition, capturing her fitness and bringing those two together. If you think about what your calorie goals are, plus actually how many calories you’re expending when you work out, we then coach you into your goals and help you meet those fitness goals.

Paul Fipps:                    It’s that real interaction there as you’re part of that community, and as you’re engaging those tools. That’s how she was able to make a transformational change in her life.

Senator Bill Frist, MD:   [inaudible 00:07:53].

Paul Fipps:                    Yeah.

Senator Bill Frist, MD:   Gyre, you sort of have a few things that is for us, but one that stands in my mind and it strikes home with me, because behavior clearly is more important than being a heart surgeon or being a doctor, or Romneycare or Obamacare when it comes down to it.

Senator Bill Frist, MD:   Behavior has probably two to three times in impact, as a person such as myself, a doctor or a hospital or a Straight service. What people don’t realize quite as much, is on the transportation world.

Senator Bill Frist, MD:   There’re a lot of statistics out there, but the one that sticks with me is the fact that 3.5 million people today have diminished healthcare, diminished health, because of lack of access to a physician, a facility or a healthcare entity, 3.5 million people.

Senator Bill Frist, MD:   Our audience probably wonders, we’re talking about voice and activation and the role. Here we have a consumer brand, Under Armour and we have Lyft, a transportation company.

Senator Bill Frist, MD:   Five years ago, that simply wouldn’t have happened in a healthcare conference. Transportation, Lyft, voice activation, take it from there.

Gyre Renwick:              Sounds good. Thank you. Thank you for joining the stage with me as well, it’s pleasure to be here. Just for context, so Lyft has been in the healthcare space now for the past four years.

Gyre Renwick:              To Senator Frist’s point there, the whole thesis we had was that, lack of transportation was a key determinant for people to actually get access to healthcare. Interesting enough, I spent over a decade at Google, and leading a lot of the Google Health initiatives there.

Gyre Renwick:              Google Health was always looking at trying to bring technology to the healthcare world, and try to solve really fundamental issues. As inspiring as some of those projects were with Google Home and aspirational views of what Google Glass could do.

Gyre Renwick:              One of the most tangible projects we actually… I worked on at Google, was looking at self-driving vehicles. We were looking at, “How do we help elderly blind individuals that don’t have access to transportation, use self-driving as that vehicle.”

Gyre Renwick:              To me, it was there where it really clicked, where [inaudible] some of the most simple solution to solve a really basic problem, is not decades away from actually being widely adopted.

Gyre Renwick:              It’s taking transportation, building a solution like that to actually help those individuals get to where they need to be. I came to Lyft with this idea, and the stat of 3.5 million Americans missing appointments every year due to lack of transportation, was how I started my pitch to both of our founders.

Gyre Renwick:              I said, “This is an important problem to solve.” Lyft’s mission as a company is improving people’s lives, to the world’s best transportation. If you think about the work that we can do in healthcare, helping Medicaid, Medicare Advantage and low-income individuals have access to healthcare.

Gyre Renwick:              The impact that can have, not only from a financial perspective, from a health well-being perspective, fundamentally changing the lives of those people. That resonated with our founders. That resonated with our team. That is fundamentally the reason we built our healthcare business.

Gyre Renwick:              I think the other interesting piece around it is, if you think about Lyft as a consumer-facing app, you have to have a smartphone, you have to have a credit card, you have to have comfort with technology.

Gyre Renwick:              If you’re talking about Medicaid and Medicare Advantage populations, surely there is a lot of barriers that exist there. My thought is that, “Let’s take transportation.”

Gyre Renwick:              We do transportation incredibly well and we do it at scale, millions of times every single day to help individuals get to where they need to be. How do you take all those barriers out, and build solutions that actually meet users at the point where they need it?

Gyre Renwick:              How do you build solutions for people through speech, through better technology that removes all of that friction? At the end of the day, an income… low-income individual can get access to transportation, without ever opening their Lyft app, without ever paying for the ride themselves.

Gyre Renwick:              Creating that seamless experience that reaches the consumers where they are, and ends up solving those issues. That’s really what we’ve done over the past few years.

Senator Bill Frist, MD:   Explain a little bit further in terms of Under Armour, at a digital health sort of discussion. Why are you here? What do see as the potential for voice over the next four to five years in your brand business?

Paul Fipps:                    Yeah, I mean, if we start with digital… I mean, we think about it as digital fitness versus health or wellness. We say fitness very specifically, because we believe that it’s aspirational, it’s inspirational and at Under Armour our mission is to make you better.

Paul Fipps:                    That’s how we think about that community in that world. We think about how much you eat, how much you sleep, how much you work out. Increasingly mindfulness, and some of the things that have been talked about here are a big part of actually your overall well-being.

Paul Fipps:                    Now, from a voice standpoint, we have traditionally leaned in and gotten very good at quite frankly, using voice to coach you in real time while you’re working out. If you take MapMyRun and some of my examples earlier, while you’re running, we give you your split times, we give your cadence.

Paul Fipps:                    We give you all kinds of metrics, to make sure that you’re meeting your goals while you’re in a run. We’ve also fine-tuned that voice activation, to make sure that it’s not too robotic. To make sure that it’s actually at the timing that it needs to be.

Paul Fipps:                    To make sure that it’s actually not just some robotic robo-type thing, that says, “You’ve run eight many miles,” or whatever your split time is. We’ve tested into that and we have such a large community. I mean, we log 2 million workouts and 30 million foods each day. It’s a massive platform.

Paul Fipps:                    We’ve fine-tuned that with our community to actually figure out, “How do we use voice and activate that, to coach you into actually a better version of you and meet your fitness goals?” On the input side, we’ve done a lot of work, a lot of testing. Some of the testing has not turned out great.

Paul Fipps:                    We’ve actually frustrated some of our community because earlier this year, we launched a voice activation with Alexa, and Alexa Service and Alexa Skill. Where you could actually log water in MyFitnessPal.

Paul Fipps:                    As soon as we launched that, logging water is great. We were just kind of putting it out… it’s like a minimum viable product, and testing and learning to see what our community was-

Senator Bill Frist, MD:   Walk me through that a little bit [crosstalk 00:13:50].

Paul Fipps:                    You could say, “Alexa, log one glass of water in MyFitnessPal.” Alexa would do that, and you’d log one glass of water.

Paul Fipps:                    Very quickly after that, the next thing you want to do is say, “Log 16 ounces of almonds, or 10 ounces of almonds,” or whatever, and that you couldn’t do. Logging food from voice is much more complex than logging water. We frustrated a lot of our community and got some immediate feedback.

Senator Bill Frist, MD:   Well, the fact that you couldn’t do the next step.

Paul Fipps:                    Exactly, yeah.

Senator Bill Frist, MD:   In fact, personally for me, to log foods which I know from the behavioral aspects of my profession-

Paul Fipps:                    Yeah.

Senator Bill Frist, MD:   … is critically important.

Paul Fipps:                    It is.

Senator Bill Frist, MD:   The logging… so being able to do it digitally, and by text is very hard. I’m not complaining, but it’s hard in the sense of doing it for a week. Actually I can do it for about two days. I’d be frustrated too. What’s your next step?

Paul Fipps:                    Yeah.

Senator Bill Frist, MD:   You did water, that’s pretty easy.

Paul Fipps:                    It is. Water, right?

Senator Bill Frist, MD:   Yeah.

Paul Fipps:                    What’s happened is, is that we know from the day that logging is the biggest barrier. I mean, people don’t… I mean, yeah, two days and you can see what happens. Is when you actually log, people lose as much as six pounds on average across the community. It works.

Paul Fipps:                    I mean, it’s definitely a way to drive behavior and actually get you to change and hit your goals. The problem is, is that then people stop. We have these great curves of, people are achieving their goals and then they fall off. Then guess what their next goal is three months later?

Paul Fipps:                    It’s the same goal they had four months ago when they started. Logging is the biggest barrier from a nutrition standpoint. We see voice as a part of an overall experience.

Paul Fipps:                    We actually are working on some very innovative things around computer vision, artificial intelligence, and neural networks at the actual device, that could actually recognize food and portions. We’re really doing a lot of testing there, but we also know that that’s not going to be a perfect science.

Paul Fipps:                    How do you actually activate voice as part of that experience? You’re not going to be able to recognize everything on a person’s plate, every part on the table. If you can actually go right to voice or start with voice as part of that experience, we believe that’s an opportunity for us.

Senator Bill Frist, MD:   With Lyft and transportation, again, I view it from the consumer standpoint, that 3.5 million people who know they need to get to a nurse or to a doctor, but they just simply can’t get there now. How is Lyft approaching that? Do you subsidize it?

Senator Bill Frist, MD:   Do you voice-activate it from a, “Hey Google,” at home? Or is it from the hospital or the clinic who’s making the appointment? How do you envision that? I know Lyft is active here in Tennessee-

Gyre Renwick:              Yeah.

Senator Bill Frist, MD:   … and at least seven other states in the Medicaid programs. Very active, but walk me through it a little bit, the mechanics of how it works. Then also, where you’d like it to work in terms of voice.

Gyre Renwick:              Yeah, so a couple of different ways. Our hypothesis beginning, was that putting it in the hands of the consumers was not going to address that need. All the barriers I spoke about before, was going to be a deterrent for those individuals.

Gyre Renwick:              We said, “Let’s put it in the hands of case managers, caregivers, physicians to actually have them be the one empowering to provide that transportation.” What that means is, we’re actually having health plans and payers, health systems.

Gyre Renwick:              Even now integrated, the EHR’s actually the ones that the vehicle… is actually calling those rides. The point of that is that, at end of the day, the individual isn’t the one actually calling that ride.

Gyre Renwick:              Take an individual that goes to dialysis every three weeks or every three days, every week, every single time that a dialysis appointment is booked, we’re booking transportation as a component towards that. That individual doesn’t need to have the Lyft app. Frankly, doesn’t even have to have a smartphone.

Gyre Renwick:              We’ll do things like robo-calling landlines, to let them know a ride’s been scheduled. Robo-calling landlines, to let them know that their ride is arriving. Giving them information about their driver, the license plate, the vehicle type, all the things you expect from the consumer side through the app.

Gyre Renwick:              Building solutions like that, again, that meets those consumers at that point. We’ve also done things to integrate within certain pieces of technology, using other groups as well. One great example is a company called Aira. Aira is actually a Google Glass product, designed for visually-impaired individuals.

Gyre Renwick:              Aira’s basically augmented reality, so you can connect to an Aira agent through Google Glass for someone who’s visually impaired. Actually have them describe what they see in front of you. They could read a menu, they could tell you when the trains arriving.

Gyre Renwick:              Or they could tell you and actually order Lyfts directly through that. If you think about Aira as a piece of technology, it’s to even all their friction through Lyft. Through voice technology, they’re calling Aira to actually dispatch a Lyft ride.

Gyre Renwick:              Build back either to that individual, or to a plan or a system that’s actually paying or fully paying for that ride. All the work we do in healthcare is not subsidizing rides. This isn’t Lyft trying to market to consumers.

Gyre Renwick:              We’re saying that, “Providing Lyft transportation adds so much value to that consumer, as a health system that’s looking at, “How do you improve throughput of your facilities? How do you not hold a patient for extra hours waiting for a family member to pick them up?

Gyre Renwick:              Or how do you drive better adherence to something like dialysis?” I think I spoke about this previously, but dialysis patients, a single missed appointment will result in over 30% mortality rate increase over the next six months.

Gyre Renwick:              Over $100,000 of expected cost, because that dialysis patient is going to show up to an emergency room with a catastrophic event. It’s also a really interesting indicator for a health plan to understand, this population here is not well-managed.

Gyre Renwick:              Even though them missing that single appointment may just result in one less dialysis treatment, it also is indicative that this patient is actually just not managing their health overall. I think that’s another interesting piece.

Gyre Renwick:              If you think about the data that Lyft has, it’s interesting a lot of the Medicaid populations we work with, health systems and plans don’t have a physical home address for many of these individuals. They’re understanding, where they’re discharging patients, where they’re going.

Gyre Renwick:              That data that we’re collecting across those consumers and around those patients, is really powerful for those health plans. I think it goes back to trying to reach some consumers through voice, is one example, through that company Aira.

Gyre Renwick:              We’re also building solutions directly for drivers, and for our passengers as well even through our app. Again, reaching them at that moment. You mentioned Alexa and Google Home.

Gyre Renwick:              We’ve done voice integrations with those products as well. At my time at Google, I think we thought a lot about Google Home as really a conduit for communication between family members, care managers, physicians, and really continuing that whole life cycle outside the home.

Gyre Renwick:              We talked a lot about it around, if you have a piece of hardware, how can you actually provide care in the home? How you provided reminders about not only appointments, but taking medication?

Gyre Renwick:              Really trying to capture some of that barrier that exists, or remove that barrier that exists across that population as well.

Senator Bill Frist, MD:   Facebook, about three weeks ago, came out with their announcement of preventive… it’s really their first big sort of [inaudible] into health, but preventive health. Doing exactly what you said, sending announcements out.

Senator Bill Frist, MD:   You put your age, put your gender and maybe a little other information you ought into it. Basically with their huge, huge, huge database, can send out a message once a week. “This is the preventive care for you.”

Senator Bill Frist, MD:   Again, they already know, but you tell them whether or not you smoke or not. This announcement, Twitter-like sort of approach, do you see voice adding anything to that approach in the future?

Senator Bill Frist, MD:   Again, listing to both of you, just this integration in what you’re doing in terms of the sort of consumer apparel, exercise, fitness world, and in the transportation world. How important will this projecting out by voice versus text…? What will the difference be?

Paul Fipps:                    I mean, I think we see voice as just one modality of how you’re going to interact with devices and apps in the future. I mean, and I shouldn’t say in the future. Today, we interact with our cars through voice, we interact as humans mostly through voice, unless you’re a teenager.

Paul Fipps:                    It’s kind of the expectation. I think we need to meet our core consumer where they are in that journey. Voice is part of that. I think… and we kind of joke about this.

Paul Fipps:                    I don’t think that… when we get into a great place with MyFitnessPal, I don’t think you’re openly going to say, “Log two cheeseburgers in MyFitnessPal.” Yeah, you probably want text that one. You want type that one out.

Senator Bill Frist, MD:   Yeah.

Paul Fipps:                    I think we may advocate or really proudly say, “Log by carrot sticks and celery sticks.” I don’t know. I think it’s just part of the interaction. For us, it is about reducing friction and eliminating those barriers.

Paul Fipps:                    Certainly, we see entry and we use machine learning now, to actually understand your habits and give you the things that you eat most often and bring those to the surface. I do think there’s this combination of really great experience around computer vision.

Paul Fipps:                    Being able to just highlight over the food, with a voice-integrated experience with, with typing it in. Maybe even some other things that we’re thinking about. With Google and with Alexa, as they actually… those new devices all have screens on them.

Paul Fipps:                    You can imagine a world where in MyFitnessPal, you’re actually getting recipe feedback from the screen. You’re cooking with your hands, and you’re logging as you’re cooking. Or you’re interacting there… really interactive from a plan standpoint, to the recipes that we recommend.

Paul Fipps:                    To how you’re actually doing those things. I think there’s all kinds of opportunities for voice to play a role. I just don’t think it’ll be the only role in that ecosystem.

Senator Bill Frist, MD:   Yeah, Gyre, what do you have?

Gyre Renwick:              Yeah, I would agree. I think it’s an important role. I agree, it’s probably not the only conduit. I think for the right application it makes sense. I’m a father of four little kids. My kids use Alexa and Google Home devices to call family members.

Gyre Renwick:              I also have an elderly grandmother who also saw this first… I think [inaudible] issues. It solves issues for populations, both younger generations and older generations.

Gyre Renwick:              Where technology and today’s pieces of hardware are not always readily available, and comfort with those pieces of technology. I think at Google we talked a lot about, Google’s mission was around organizing the world’s information and making it universally useful for everyone.

Gyre Renwick:              To me, that’s really what voices is, is for certain populations and for certain applications, voice is the right conduit for that. Interesting things with even with my kids, we have voice reminders set up with Google Home to notify them when it’s time to go to school for that day.

Gyre Renwick:              Or remind them to go home and call mom when they got home from school. There’s ways to augment kind of experiences through voice. A lot of times the problem with having a cell phone or having a text-based [inaudible 00:24:26], is that you have to interact with that device.

Gyre Renwick:              Our view at Google was, if you can reach people at the moment, it’s far easier to have an interaction through a device, that is either speaking to you or that you can speak at. Really, it removes that barrier. We talk a lot about… at Lyft we talk about providing transportation for individuals.

Gyre Renwick:              We also provide the transportation for individuals and caregivers. Previously, what was happening is, if you’re taking a loved one to appointment, you’re sitting in the front seat driving your relative. They’re may be in the back seat or next to you. There’s not that human interaction.

Gyre Renwick:              Now, if they’re in the back of a Lyft, there’s actually interaction. You really can be a caregiver and a loved one together there, versus having that hardware or that separation there.

Gyre Renwick:              Same thing with voice, is that, if you can reach the consumers at the point they have the interaction, you’re not sitting there staring into a screen, you’re actually having a real interaction with a person.

Gyre Renwick:              It’s a different experience we found through hardware. When voice is an element of it, it brings a lot more humanity and kind of interaction to it versus-

Senator Bill Frist, MD:   Yeah.

Gyre Renwick:              … setting a screen and texting.

Senator Bill Frist, MD:   That really comes back to the physician in the care. There’re 1.4 billion patient-doctor visits a year, 1.4 billion. Clearly, great advances made in telemedicine and virtual healthcare. In those 1.4 billion visits, the opportunity to have voice and Voice Access become a component part.

Senator Bill Frist, MD:   It improves exactly what you said, the emotional, the intimacy of it. That changes behavior as… Paul as you know as well. Let’s go through… and I’ll be happy to take people’s questions in just a couple of minutes.

Senator Bill Frist, MD:   The barriers, if we just list them today, where we are. Then we’ll talk a little bit more, and we’ll sort of run down a list of opportunities and the upside. What do you see as the barriers? Paul, we’ll start with you and then Gyre.

Paul Fipps:                    The barriers around voice or?

Senator Bill Frist, MD:   Yeah.

Paul Fipps:                    Yeah, so I think the barriers around voice today are… and Gyre highlighted some of them. I think there’re some device barriers, there’re some natural technology barriers around voice, that I think need to be a little more integrated more seamlessly.

Paul Fipps:                    Many of you hopefully got the headphones, the Under Armour JBL headphones on your tables earlier on. For us, those are accessories that we put in our ecosystem to actually encourage voice, both through auditory coaching but also, to actually talk into your device.

Paul Fipps:                    Whether you’re making a phone call or whatever you’re doing there. They do a really great job, because they’re built by athletes for working out and running and training.

Paul Fipps:                    I think there’re some technology opportunities to just make that a little bit more seamless, as you want to talk to your device more or interface there. I think there’re some challenges there.

Paul Fipps:                    I think that the barrier will be less around the direct interaction you have, and more around how do you design the experience to really engage with whatever you’re trying to do?

Paul Fipps:                    I mean, even today with your car, you feel like you’re yelling at it. It’s like, “Call wife.” It just feels unnatural little bit.

Senator Bill Frist, MD:   Yeah.

Paul Fipps:                    Then if anyone else is in the car with you, they think you’re yelling at your wife or whatever. I think there’s probably just some experiential things that we can all do, as we think about voice as a modality and integrating it there.

Senator Bill Frist, MD:   Yeah.

Gyre Renwick:              Yeah, I think I agree with everything Paul mentioned. I think the other piece I’d add to it is, the comfort with the accessibility of what that means for data. People talk all the time about having Alexa or Google home, is it listening to you all the time? Is it capturing data all the time?

Gyre Renwick:              Google, will always struggle with this, is that, there’s really tangible reasons why capturing data all the time actually is incredibly valuable. Google Home used to look at things like fall detection.

Gyre Renwick:              When an elderly individual is in their home, and you don’t hear background noise for a period of time. You know they’re in the home, because their devices next to their product and you’re not hearing interaction.

Gyre Renwick:              We can actually say potentially this person had a fall, and then you need to intervene. The downside of that is people were saying, “Well, then Google Home is listening to me all the time.” That comfort of the privacy and the security, and all of the stuff that Facebook and Google are dealing with all the time.

Gyre Renwick:              It’s comfort with the idea that they are listening all the time, but what are they actually doing with that information? I think to me, I agree the technology needs to get better. I also think as a society, we have to get comfortable with that concept.

Gyre Renwick:              Or not get comfortable with it, and understand that really both security and privacy and policy around that, I think is a really important barrier that needs to be addressed.

Senator Bill Frist, MD:   Now, a quick word from our sponsors that make this podcast possible. For 35 years, MEDHOST has been partnering with the community hospitals and specialty healthcare facilities, to focus on what matters most, effectively taking care of their patients.

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Senator Bill Frist, MD:   Backed by world-class support, MEDHOST solutions are an ideal match for facilities wanting to enhance patient care. To learn more, go to medhost.com. Now, back to the episode. How big of an issue is it today, versus what you think it’ll be three years from now?

Senator Bill Frist, MD:   Obviously a lot of people are more comfortable… younger people today, with sharing their data. Is the privacy issue which is so dominant in Washington DC…? Where I’ve spent so much time today, and among probably older people more than younger.

Senator Bill Frist, MD:   Is it going to become more of a problem or less of a problem? I preface that by saying that, in 1998 in the healthcare world, where many of the people in the room operate, I was part of the government operation in the Health Committee in the Senate that wrote the HIPAA, the whole privacy.

Senator Bill Frist, MD:   Still we’re operating under a 1998 regulation, in spite of the great advances we’ve made, exponential advances we’ve made in technology. It shows how slow government is. Government’s not going to speed up as we know looking at Washington today.

Senator Bill Frist, MD:   How much will the private sector do to relieve the sort of privacy concerns we have? Both of you comment on, where you think we are and where we’re going, trendline in privacy.

Paul Fipps:                    I think from a value standpoint at Under Armour, we believe that we should give the control of the data to the consumer. We work really hard at that. We certainly have more work to do there, in terms of giving you control of every piece of data that you interact with us on.

Paul Fipps:                    We’ve done what I would call GDPR plus compliance, to make sure that we over-index there. Actually gone above and beyond in terms of letting you opt in and opt out in certain data elements. Again, more work to do there. We have a whole team that focuses on it.

Paul Fipps:                    Then you see additional regulation coming. You see the California Privacy Act coming right behind it. That’s actually going to start up here in Q1, and you see other states starting to lineup.

Paul Fipps:                    My worry is that, it’s a state-level issue at this point. It’s not a federal level issue. Unlike GDPR, where I can have one compliance standard for all of Europe, now we have one in California.

Senator Bill Frist, MD:   Yeah.

Paul Fipps:                    That is different than GDPR, and in some cases it’s more stringent, some cases it’s not. I think the government… and as many cases they are, is a little bit behind in this issue. It’s probably prompted by basically all of the data breaches that we’ve had over the past 5 or 10 years.

Senator Bill Frist, MD:   Yeah.

Paul Fipps:                    That forces governments to act, but it’s late. I think that overwhelmingly, consumers are starting to say, “I really care about certain data. I don’t care about other data, because there is other protections out there for me.” I have two teenage daughters who don’t even think about any of this.

Senator Bill Frist, MD:   Yeah.

Paul Fipps:                    I think there’s probably… it’ll become less from a consumer standpoint, in terms of worry. I can’t speak to healthcare data specifically. I would imagine that’s going to be a little different.

Paul Fipps:                    I think that I’m concerned from a commercial side, how much we have to invest in data privacy and follow some of the regulatory requirements.

Senator Bill Frist, MD:   Yeah, we’re going to turn to the audience for questions. If you could raise your hand, we’ll have a microphone going around. I’ve got several questions on the screen as well, we’ll turn to that. Gyre, anything else on the privacy that you’d add?

Gyre Renwick:              Yeah, and I think the only other piece I’d add is that, I think privacy is a really important issue for folks like Under Armour, Lyft and Google in terms of, how do we treat that data? How do we protect it?

Gyre Renwick:              I agree, I think that we really also need to empower people to understand what that data really means, how that data is being used. Google did a lot of work to understand, really, how do you own the data? How can you eliminate the data if you leave a product like Google?

Gyre Renwick:              Then also, “How do we actually empower individuals that want to share that data with other folks as well?” Google tried… I worked on a project, Google Health at the time, was basically trying to build an electronic health record to actually bring in consumer data, as well as physician data.

Gyre Renwick:              We struggled, because this was pre kind of all the interoperability issues we have now with the EHR is, trying to actually solve that issue is really challenging.

Gyre Renwick:              What we did find is that, consumers that were putting data in wanted to share it. They wanted to share it with their loved ones. They wanted to share it with their physicians. To me, it was really around empowering them to understand what this data is, how they can use it.

Gyre Renwick:              I think it’s giving them the control. I don’t think it’s a matter of, any technology company’s responsibility to say, “This is our data and we should leverage it.” Allowing the consumers to own that data, and powering them to do things with that data is meaningful.

Gyre Renwick:              If it’s through data they give to Under Armour or through Lyft, if we can provide that data and provide the insights to that data, I think that becomes a really powerful tool.

Senator Bill Frist, MD:   Well, do you have Alexa and Google Home in your house? Why is that?

Gyre Renwick:              Well, I didn’t own an iPhone until I left Google. I spent 13 years at Google. I started at Google in 2002, when I iPhones and Android devices didn’t exist.

Senator Bill Frist, MD:   Yeah.

Gyre Renwick:              When I left Google, I felt like, “Hey, I can at least try what the competition offered, and get a better sense of it too.” Now we have both in our home, and use both technologies. I have an iPhone today, so I experience the real life.

Senator Bill Frist, MD:   All right, let’s go. First question, so for Lyft, do you have metrics from healthcare providers or health plans, that demonstrate that patients are keeping more appointments, and therefore achieving better outcomes as a result of your involvement? If so, can you share them?

Gyre Renwick:              Yeah, absolutely. I think a lot of the work we’ve done initially, was partnering with what are called transportation brokers. Transportation brokers administer transportation for health plans all across the country today.

Gyre Renwick:              Previously, transportation brokers were actually trying to build kind of fragmented networks of providers all across the country. By working with Lyft, they actually could have one provider that could cover all of the ambulatory curb-to-curb trips. Really cover that across the country there.

Gyre Renwick:              What’s interesting is a couple of things, is one, is we were decreasing wait times. Normally transportation for providers, would measure wait times in matters of hours. They’d give them an hour window before, to be picked up.

Gyre Renwick:              You imagine an elderly patient that’s going through dialysis, waiting out in cold weather like this, waiting for transportation. They have no visibility into that trip whatsoever. It’s a terrible experience.

Gyre Renwick:              What we found is, you could decrease wait times to a matter of minutes, which we’ve experienced on the consumer side. The experience actually in the Lyft was far more accountable, so they could rate their driver, they could evaluate their driver.

Gyre Renwick:              They could say they had a great experience or a poor experience. Then you’re also getting those patients actually show up to their appointments on time, because they’re not waiting an hour, they’re not having a terrible experience.

Gyre Renwick:              Sometimes a lot of transportation providers would group multiple patients together and say, “We’re going to do a small bus with five patients, and go drop them off one by one.”

Gyre Renwick:              What’s sad is, if you’re late to a dialysis appointment, they’re so overly impacted. You basically have less time in the chair, and you’ve less time to receive your treatment.

Gyre Renwick:              We saw a 30% increase in actually attendance to appointments, by taking a transportation provider and adding Lyft in as a solution. You had so much better experience, so much more accountability. Then actually help that patient get to the appointment on time as well.

Senator Bill Frist, MD:   Next question I have is, where should we absolutely not use voice? The question continues, can it actually be more annoying than helpful in some ways? I’ll open that, and I’d love to hear from both of you.

Senator Bill Frist, MD:   The doctor-patient relationship obviously is something that’s built on trust. We talked about privacy. What bothers people most about privacy is the attack on trust.

Senator Bill Frist, MD:   Once trust is lost in terms of changing behavior or changing outcomes, or whether or not you do a heart transplant on somebody, once that trust is broken… so clearly voice, in where it is today in terms of Alexa on the shelf or Google Home on the shelf.

Senator Bill Frist, MD:   That amplification of a question that you want to keep private is a challenge, and probably a technical challenge. I mean, that can be. What other areas would you respond to that question on?

Paul Fipps:                    I think for us at Under Armour, a big part of our focus around health and fitness is around controlling the controllables. Really giving people access, so they can control their nutrition, their fitness, their sleep, those elements that we can all as humans control from a health standpoint.

Paul Fipps:                    You can also imagine some embarrassing moments. I mean, if we say, “Hey Alexa, how am I doing this month?” It responds back and says, “You gained three and a half pounds,” and your whole family’s there. You could start to see some embarrassing moments.

Paul Fipps:                    I think that’s an embarrassing moment. I think that could get really challenging and dangerous, if we then take the controllables and we start to integrate your fitness, your nutrition, your sleep with real medical records. Combine that data to see kind of your overall picture of health.

Paul Fipps:                    Then I don’t think you want that responding, you may not. If you’re 22 and everything looks great, you may want it responding. If it’s not, you may not want that to come out, your high blood pressure or whatever those things are.

Paul Fipps:                    I think that you could get into a situation like that, where it’s not just annoying but it could be embarrassing. Then that does erode trust. That erodes trust in the platform and the community, and how you actually engage in these apps.

Senator Bill Frist, MD:   Next question is, what is your take on Google and the Ascension data sharing? It’s all over the news, and forcing the public to develop an opinion. They should leave off of… the final part of that question is, we need a second opinion.

Senator Bill Frist, MD:   We do actually going forward, because the way it was presented was that in 27 states, your medical data is being shared in a way that you don’t know how it’s going to be used. In response to the question, what would you say?

Paul Fipps:                    You want to start?

Gyre Renwick:              Yeah, I mean, I think it goes back to my point before, is people need to understand how their data is being used. You need to understand what data is being captured. You need to understand how that data is being leveraged.

Gyre Renwick:              At one point Google launched kind of a tool, that actually allowed you to say, “What is all the data that Google has about me?” Maybe people don’t realize that, but you can go to Google and kind of say… it’s almost like, “What does Google know about me?”

Gyre Renwick:              It was interesting it understands all your behavior, because frankly Google, you’re feeding it information all the time. Every time you search for where you’re traveling, or where you’re going or what your hobbies are, it’s understanding all this data about you.

Gyre Renwick:              What’s interesting is, Google will create then the ability to say, “Well, there’re certain parts of my data that I don’t want people to know. I don’t want Google to share this data.”

Gyre Renwick:              You can actually not only understand it, but actually augment and change Google’s kind of knowledge of who you are based on that. Obviously Google was doing it… and the other thing, Google captures data for a lot of different reasons, but many reasons is actually for advertising data.

Gyre Renwick:              They want to be able to actually take the data, show you more target and relevant ads. That’s how Google makes close to 80 to 90% of its revenue. The reality though is that, if you give consumers the ability to say, “Certain parts of my life, I don’t want you to be understanding it.

Gyre Renwick:              I don’t want it to be kind of invasive, kind of understanding of.” that’s kind of what… Google tried to empower consumers to do that. A lot of times healthcare data was the data that helped Google… consumers did not want to be shared. They didn’t want to know that they have diabetes.

Gyre Renwick:              They didn’t want to share that with their employer. I think to me, healthcare was actually some of the reasons why Google started to create some of those privacy, kind of understandings and controls.

Gyre Renwick:              I think it goes back to having controls and having levers to be able to pull, and really empowering the consumer to even understand that. I think a lot of people and a lot of the media today, talks about privacy and data and scares consumers.

Gyre Renwick:              To not really understand what’s actually being captured, and what it’s actually being used for. I think it’s the responsibility of technology companies really to educate people, and give them the power to understand what they can do with that data.

Senator Bill Frist, MD:   Will the rules of the road going forward be more policy and government out of Washington or the state, or will it be more out of the tech companies? There’s no answer to that probably. My comment earlier, about government moves very slow.

Senator Bill Frist, MD:   Once something passes 1998, HIPAA regulations and we’re still living under those 23 years later. That’s the reality, and that’s not going to get better. I think the consumer view… each consumer is going to have to decide.

Senator Bill Frist, MD:   In terms of the regulation, which there will have to be some, is it going to come from the tech companies? Is it going to come from pressure at the state level?

Senator Bill Frist, MD:   Or is it going to come from companies that aren’t really in the healthcare business directly, but understand that health data is different than straight up consumer data.

Paul Fipps:                    Yeah, I-

Gyre Renwick:              I mean… go ahead.

Senator Bill Frist, MD:   All right, Paul. Take [crosstalk 00:42:24].

Paul Fipps:                    Yeah, I would say, I think the consumer will like in most places… an empowered consumer will drive what they want. I think that will then dictate kind of how we regulate these types of things. I mean, I read the Google articles, as did probably most people in this.

Paul Fipps:                    The reality is that the promise of artificial intelligence around healthcare is not a new concept, but it actually hasn’t happened. If we get better outcomes as consumers, if we actually get better healthcare, get better… I mean, an insight for someone… if Google takes my data in healthcare, I would argue.

Paul Fipps:                    Combines it with how much I track around nutrition, fitness and other components. Can put that together and give me insight, into either an issue I have now or one that I’m going to have in the future, and how to avoid that, it’s completely game changing.

Paul Fipps:                    I do understand if you’re a member of Ascension Health and you have all these privacy concerns. At the same time, I mean, how do we move the ball forward outside of companies like big tech companies, who have massive capability?

Paul Fipps:                    Quite frankly, now the technology exists to process the data in a way, that we can learn from it and build on it. I think consumers will demand that over time, in order to get better health outcomes, so-

Senator Bill Frist, MD:   Yeah. No, I think you’re exactly right. The whole field of health and healthcare and well-being, the consumer is where the real power is, and technology empowers that. I still don’t fully understand who is going to regulate.

Senator Bill Frist, MD:   Clearly, huge mistakes had been made. The old Facebook, Cambridge Analytica, the fact that Facebook had chat rooms that were applied for automobiles, and for hobbies and for coin collecting.

Senator Bill Frist, MD:   Appropriately said, “The chat rooms are very powerful for people with a particular disease, and individuals or families along the spectrum. Or a chronic heart disease or COPD, Chronic Obstructive Pulmonary Disease.”

Senator Bill Frist, MD:   Hugely powerful, but then the privacy protections, they just clearly failed in doing it. In large part not realizing, that giving the consumer what they needed and wanted, because the conversation was there.

Senator Bill Frist, MD:   Really failing in guidelines in the healthcare data and the intimacy, the power for abuse, insurance rates going up. You have HIV, you’ve had debilitating things happen that you don’t want your employer to know.

Senator Bill Frist, MD:   I’m still… I don’t know exactly where voice and non-voice, where that ultimate regulatory body control… there is this distrust now of most of the tech companies themselves.

Senator Bill Frist, MD:   Again, the consumer activates a lot by what they feel, and how they can benefit and now they can lose that. Get the feeling there’s something else that’s going to have to take place, before trust is going to be full. Gyre, [crosstalk 00:45:20].

Gyre Renwick:              Yeah. I mean, I believe that the technology companies are going to push that initiative forward, because they’ll obviously have the incentive to do it. To your point, half the consumers are demanding that type of experience.

Gyre Renwick:              I will say any day, I think it’s going to be up to technology companies also, to educate government in policy to actually understand what that means. I mean, the interviews, if… I’m sure everyone saw it with Mark Zuckerberg, when he was interviewed around understanding Facebook and Facebook’s privacy.

Gyre Renwick:              There was clearly a lack of understanding around what Facebook even was, how their technology worked. To me, it’s the responsibility of technology companies hopefully, to push that initiative forward. Then I think working through with policy, it has to be a collaborative effort.

Gyre Renwick:              I would also say though, if you look back probably 20 years ago and that concept of online banking, that I would put all my money into a bank account. I would send money virtually through apps and technology, that would be incredibly fearful for people. People would be very distrusting.

Gyre Renwick:              There’s probably still some individuals that are distressing that, but today online banking has become pretty universally acceptable and adopted by pretty much everyone. People use Venmo or PayPal to wirelessly send money back and forth.

Gyre Renwick:              The idea of currency, even my kids, they use Venmo as a way to send money to each other. To me, it is going to take time. Obviously I think healthcare is… and I think some of the issues here are going to probably even be probably further delayed.

Gyre Renwick:              At the end of the day, I think it will change. I do believe that it has to be technology companies pushing it forward. Then working with policy, and the government actually putting rules and safeguards in place. It shouldn’t be based on just technology company’s willingness to move this forward.

Gyre Renwick:              There should be regulations on them. I think it needs to be a collaborative effort to understand, really what technology companies want with that data and what they’re actually doing with it as well.

Senator Bill Frist, MD:   Good, our conversation very much is looking at voice as hugely powerful coming forward, pretty early in its infancy, which we all know. The more interesting thing to me and just listening to both of you, is the relationship to this larger ecosystem of artificial intelligence, of machine learning.

Senator Bill Frist, MD:   Again, we’ve touched up on the words themselves, but the question that has come from the audience is, can you speak to the most important technologies, artificial intelligence, machine learning, the power of voice?

Senator Bill Frist, MD:   Talk a little bit more on this sort of relationship, because even the title of our period here together is voice. Very quickly you’ve moved to voice in this larger ecosystem of other advancing technologies. Clearly, I think it’s happening in the consumer field, but talk a little bit more about that.

Paul Fipps:                    I think the most… it’s interesting, I think whether it’s most technology related to voice or AI or machine learning, I would say the compute power continues to accelerate at a rate that makes all of this possible. The combination of… and I mean, on your device.

Paul Fipps:                    When I talk about the problem with food recognition right now, you can actually do food recognition on your phone with Google. It’s got to go back to the cloud. It can’t do volume, and there is a bunch of other things it can’t do. it’s because it was programmed to actually do image recognition in the cloud.

Paul Fipps:                    Why? Cloud is cheap, storage is cheap, compute power is cheap, so that’s great. It’s a terrible user experience. When you think about, how do you take artificial intelligence or neural networks, and you put them on the device?

Paul Fipps:                    Well, that’s because all of us have $1000 device in our pocket that’s got enormous compute power in it. I think the advancements of how powerful the devices are that we use, combined with how powerful the cloud compute is, those two things are what are enabling things like artificial intelligence.

Paul Fipps:                    Machine learning, voice and voice capabilities. The way we use that is today, it is machine learning. When we coach you into a better running form, you start with… we start every problem at Under Armour with, what is the problem we’re trying to solve for the consumer?

Paul Fipps:                    In our community, we found people saying, “I don’t know how to run. Teach me how to run.” You say, “Well, how do you not know how to I run? We’re all human beings. Like you just go run.” Well, if he didn’t run track or you weren’t actually trained in a run, typically your stride length is too long.

Paul Fipps:                    Your cadence is too slow. What does that do? That then drives you towards injury and a bad running experience, so you quit. That’s part of fitness, is running. We saw this as an opportunity to then say, “Okay, what are the data points that matter?

Paul Fipps:                    How do we capture individual attributes for each person, and highly personalize basically a run coach in your pocket, so that you actually run into a better running form.” Again, through auditory response, in the right tones, in the right places to actually coach you into a better cadence and straddling.

Paul Fipps:                    We can see when you engage with this feature through machine learning, which we couldn’t do five years ago, because we wouldn’t have the compute power. That you actually get 5% faster, after just five weeks of using this coaching. Now, 5% on a run is substantial.

Paul Fipps:                    I think all of these technologies are becoming enabled by a much lower cost compute power. You know the big players out there that are driving this. To me, those are enabling everything from machine learning to what I always call the next wave of artificial intelligence. Voice will be part of all of that.

Senator Bill Frist, MD:   Then all of this comes back to the integration. I, as I mentioned, do a lot in the virtual healthcare field with the telemedicine and telehealth. I was trained classically as a physician who really believed that, to take care of you.

Senator Bill Frist, MD:   General surgery and primary care in chronic disease, I needed you to come to my office. I needed to take your pulse. I did sit down, and I need to put my hand on your shoulder, get the connection. That’s why my dad practiced medicine for 50 years in this community. Again, not too far from where we’re sitting today.

Senator Bill Frist, MD:   Then I got in the virtual healthcare field, and it was basically video. It was telemedicine, and we add these [inaudible] lines to put in these villages, and communities on tribal reservations, very expensive. Then we moved to inexpensive video today, which is HIPAA protected.

Senator Bill Frist, MD:   Then we moved to… and again, you’re talking and you’re saying… it hurt my feelings a little, because I thought you had to see somebody. That’s the way I was trained. Then what we found in the behavior of the field, that text is preferred over going in person. That hurt my feelings.

Senator Bill Frist, MD:   Then the video conferencing… which is routine, and we all do it and incorporate it. Then most of the video conferencing now is even gravitating to text. Part of it is the behavioral feel, the anonymity of it.

Senator Bill Frist, MD:   The fact, you want a short burst. It’s retrievable at any standpoint. Again, that really hurts my feelings, because then the person aspect is not even there.

Senator Bill Frist, MD:   You have this spectrum, and it really comes with a question, what’s going to win now in the health arena? Is it going to be video? Is it going to be a keyboard? Is it going to be text coming forward? Will voice be the one? Gyre.

Gyre Renwick:              Yeah, I think one thing that’s interesting, I think Google spent a lot of time with this, is that, what can voice give you that text can’t? Google dealt a lot of times with, how can you actually recognize sentiments from someone’s voice?

Gyre Renwick:              How do you look at early sign detection of minor strokes? Because people’s voice or patterns are changing. I think it’s really interesting to understand, does voice give you a different level of insight about a consumer that text actually can’t give you?

Gyre Renwick:              I think that to me is really interesting. You talk about kind of capturing data through different ways, and we talk about… even with Lyft, we look at, how do you use AI to understand even locations of where people live?

Gyre Renwick:              Understand, do they have more severe issues because they live in transportation deserts, and they don’t have access to public transportation? Can AI actually be a tool to allow you to leverage… to understand this population is probably more vulnerable, more likely to miss those appointments?

Gyre Renwick:              You have the insight, and the same thing with voice. Is that, if you actually have devices in the home, how can you actually capture data that otherwise wouldn’t be captured?

Gyre Renwick:              Again, if you’re manually logging… if it’s not just food or exercise or any type of activity, how can voice and voice recognition be another form of capturing data at a passive level? Where the consumer is not making the decision to actually log that.

Gyre Renwick:              How do you actually capture verbal data like that, in a way that provides insights either to caregivers or frankly to the patients or individuals themselves? To me, it’s important to look at, is voice a different channel that captures a different set of data than otherwise it’d be available?

Senator Bill Frist, MD:   Yeah, very well said. We have just a couple of more minutes or so. As you look ahead over the next say one, two or three years, what is most exciting to you about voice? You can answer it either from your own sort of company standpoint, or past companies.

Senator Bill Frist, MD:   Or as you look at… for me, it’s where I started. As a physician who is engaged in a small fraction of the 1.4 billion interactions out there, where you have physician burnout, where you lose in the communication as, Gyre… you just described the intonation of the voice.

Senator Bill Frist, MD:   They’re hesitant to say… the emotional impact of voice. The most exciting thing to me is that interaction with the physician, with the nurse, where you’re not distracted by either typing, looking down, taking information, taking a history, a past medical history, all of which is very important.

Senator Bill Frist, MD:   Where you can connect one-on-one with that particular patient. To me, it’s very exciting. Whether it’s in simple dictation or accessing information, or explaining in a way that is pitch perfect in terms of clarity to the consumer. Capturing it right there in 15 minutes. To me… but Paul, where would you start? Next three years, sort of what has the most value?

Paul Fipps:                    I think it continues the conversation. As you articulate an experience with a physician and patient experience, I think it’s the same thing. It’s how do you actually inject voice, as part of the overall experience in this human machine interaction, that we’re just getting started on this journey?

Paul Fipps:                    I mean, you can see a world in three years, where natural language processing continues to improve. It just becomes this flow of you back and forth with a machine. I mean, the interesting thing about your question earlier is, voice or text is the way out?

Paul Fipps:                    I was in a tech conference a few months ago in Silicon Valley in a room this size, and they asked people to vote> It went 50-50. I thought about it and I thought, “Well, today we now do voice to text.”

Senator Bill Frist, MD:   Yeah.

Paul Fipps:                    You’re actually sending a text, but you’re actually talking into the phone to do it. I think it is part of how these technologies evolve. They will evolve very fast, where you feel very much like it’s a much more human interaction with voice.

Paul Fipps:                    You get more comfortable interacting with devices, whether that’s in food logging, in nutrition, in fitness or in healthcare.

Senator Bill Frist, MD:   Gyre.

Gyre Renwick:              Yeah, I think the other piece I’d add to it is, we talk a lot about transportation. How transportation is going to evolve in the next five years. Lyft has said publicly by the year 2025, we think over half of our trips will be transferring people in autonomous vehicles.

Gyre Renwick:              Where you will not have a driver in your vehicle, and vehicles will be designed differently because of that. Google, we had built vehicles that had no steering wheel, nothing but a solid dashboard with a computer screen there, that had no actual touch typing input.

Gyre Renwick:              The only way to actually interact with Google self-driving vehicles, was through voice technology and through voice recognition. We imagine a world where, not only our car ownership changing… I have four kids all under the age of 12.

Gyre Renwick:              I fundamentally don’t believe I’ll ever buy them their own car, because I’d love today… one day that Lyft and others can solve the problem. How do you help transport individuals like that?

Gyre Renwick:              You’re not worrying about putting a 16-year-old with a license in a vehicle, at that age, making decisions about kind of the long-term impact of their whole lives. I really imagined a day where you look autonomous vehicles, I think will be this amazing conduit for voice recognition.

Gyre Renwick:              Time where you can actually think about, “If I’m taking a Lyft to a physician’s for an appointment, how can I actually create a clinical experience in that vehicle, where I’m interacting? Giving patient information, inputting kind of pre-admission information on the way.

Gyre Renwick:              You have a completely controlled environment without a driver even in there. To me, the technology is farther along than people realize. To me, autonomous is going to be this other version where, it will be an opportunity for voice capture and voice recognition beyond even the hardware we see is today.

Senator Bill Frist, MD:   Gentlemen, thank you. It’s been a real pleasure to be able to explore this whole world of voice and the applications, as we shared today. 99% are hugely exciting and changing behavior, changing the health.

Senator Bill Frist, MD:   Changing not just the health and health care, but the real well-being of 300 million people in this country, and obviously seven and a half billion people around the world.

Senator Bill Frist, MD:   I want to thank both of you for your participation today on this live edition of A Second Opinion. You can all subscribe to A Second Opinion on Apple Podcast, or wherever you are listening right now.

Senator Bill Frist, MD:   Be sure to rate and review A Second Opinion, so we can continue to bringing you great content. You can get more information about the show, our guest and sponsors at asecondopinionpodcast.com. Join me in thanking both you, Paul and Gyre today. Thank you.

Paul Fipps:                    Thank you.

Senator Bill Frist, MD:   Thank you guys.

Paul Fipps:                    Thank you sir.

Senator Bill Frist, MD:   Good. Thanks. Thank you.

Gyre Renwick:              Thank you very much.

Senator Bill Frist, MD:   Right, [crosstalk 00:58:53]. This episode of A Second Opinion, was produced by Todd Schlosser, the Modus Creative Group and SnapShot Interactive. Be sure to join us for our next four-episode series, where we will share healthcare insights and predictions from our nation’s leading health economists.

Senator Bill Frist, MD:   Including from the minds behind the individual mandate, and Massachusetts Romneycare. A Second Opinion broadcast from Nashville, Tennessee, the nation’s Silicon Valley of health services, where we engage at the intersection of policy, medicine, and innovation.