Things You’ll Learn: 

• Understanding patient experiences through direct observation can reveal critical opportunities for improvement in healthcare services. 
• Identifying and articulating significant healthcare problems is essential for sourcing effective solutions rather than merely adopting existing technologies or methods. 
• Partnerships with external companies and industries can lead to innovative solutions, as demonstrated by successful collaborations during the COVID-19 pandemic and in maternal and fetal health.  
• Utilizing AI and other technologies can enhance operational efficiency, predict outcomes, and improve both patient and provider experiences in healthcare settings. 
• The healthcare industry must be open to disruption and innovative thinking, learning from other sectors to drive positive change and improve care delivery. 

Resources: 

• Connect with and follow David Sylvan on LinkedIn. 
• Follow University Hospitals on LinkedIn and explore their website! 

Transcript:

Rachel Schreiber: 

Hello and welcome to the Spark, a view of innovation in healthcare. I’m Rachel Schreiber, your co-host, and in this episode, we’re speaking with David Sylvan, chief strategy, innovation and marketing officer of University Hospitals, a renowned academic medical center and community hospital network with locations across northeast Ohio. He’s also president of University Hospital Ventures. I’m looking forward to speaking with David about innovation and healthcare, words of wisdom for startup organizations and his perspectives on priorities for improving the healthcare experience. I’m also joined by Stuart Hansen, the CEO of Avaneer Health. 

Stuart Hanson: 

All thanks Rachel. Hey, good morning David. Welcome to the Spark. Really glad to have you here. Thanks for kicking us off, Rachel. It’s been a minute since we did our last one of these. We’ll dust off our cobwebs here, but really excited to start a discussion with you this morning. I think your title is extremely interesting to our listeners, president of Ventures, part of the organization, but also chief strategy and innovation officer and that puts you in a really interesting position, not only in Ohio but in the national healthcare innovation scene. So what we’re really looking forward to hearing about is all the exciting stuff.  

I view Cleveland as another up and coming Nashville, if you will, in terms of the density of healthcare innovation and thought leadership and innovation between university and Cleveland Clinic and all the great stuff going on. I think getting an innovation center started there years ago created a really exciting center for innovation. So we’re really looking forward to talking about that. Before we jump into any of the specifics of things that you’ve got going on, insights that you’d like to share with our listeners or things specifically going on with your team, we’d love to hear, first of all, your personal source of passion or what is your spark, if you will, to put the pun on the name of our podcast. But what is your spark for driving you to tackle the really tough challenges that our healthcare industry faces? 

David Sylvan: 

Well first of all, good day Stuart. Rachel, great to see you both and appreciate the opportunity to chat. Tremendous question. As you both know, no one steps into healthcare because they think it’s a fun thing to do. This is difficult work. There are probably easier ways to make a living and there are probably ways to make a more candidly lucrative living, but certainly don’t want anyone to feel sorry for me. I’m not starving.  

The passion comes from the observation of the human condition, if you will. I came out of investment banking and capital markets. Prior to that I worked in professional sports, both righteous and laudable pathways from a career perspective, but I always found myself somewhat separated from the human being and the human condition. I joined University Hospitals about nine years ago as a consultant only intended to stay for about six months. 

And I’ve told this element of the story before, I didn’t have an office as a consultant, so I spent my time working, sitting in lobbies and waiting rooms and exam rooms. And if you really truly want to spectate the problems to be solved in healthcare, one great way to gain those insights is through observation. And for me to watch the experience of the individual when they crossed the proverbial threshold for me was not only fascinating, but very revealing from the standpoint of opportunities to fix things. And I found passion candidly, Stuart.  

I think what the spark for me is this notion that I can make an impact as a non-clinician, I can impact people’s families, populations, individuals. And it’s a very humbling place to be and the mission component has kept me hooked. 

Stuart Hanson: 

I think that’s really well said and inspiring. I think a lot of us recognize that caregivers themselves, the source of their passion is usually something very similar. But I think there’s a lot of us, and I’ve got an investment banking and financial services background as well. But you fall in love with the complexity combined with the ability to help impact people in a positive way without being a trained physician or a professional caregiver. And that resonates with me because it’s very similar to my passion for what we’re all trying to tackle.  

Why don’t we start with maybe some examples of some of the challenges that your team and you are tackling at University of Hospitals health system and how you’re going about trying to change the status quo. Because the hardest thing is really the momentum, the complexity of this industry combined to make it really, really difficult to make an impact and to really make a change. So maybe you can elaborate on that. Yeah, 

David Sylvan: 

Very insightful question. I think healthcare generally suffers from a series of own goals. We are lumbering, we’re inefficient, we tend to place reliance on, well, that’s the way we’ve always done it. And those belief systems become ingrained and difficult to break through. The challenges that we tackle are really the opportunity to source high value problems. We don’t merely look to fairy or shepherd or be the conduit for fascinating solutions. We start with problems. Once we’ve really defined the problem and we’ve got to the point of articulation where it’s as tight as it’s going to be, it becomes far easier for us to source solutions against that. Now certainly we don’t close our minds nor eyes, nor doors to what might happen organically. What Stuart Hanson introduces us to in terms of an interesting startup for example, or one of our prolific inventors or researchers generates creates some IP that looks like it might have some legs from an out license or commercial pathway perspective. 

Obviously those doors are always open, but our primary goal is to look at a problem set, look at the potential magnitude if ameliorated if sold for so to speak. There are lots of little point solutions that can be fixed. We should be doing some of those. But really our focus as a team is to look for those large, hairy and audacious problems which are not dissimilar from any other health system candidly. And to try and knock those off one at a time, some through process, re-imagination, re-engineering, some through technology enablement, some through partnering, and the notion of build by borrow comes into play as well. 

Stuart Hanson: 

Makes sense. Any recent example? Even old examples in terms of where you’ve taken something that you or someone on your team or someone that you’ve worked with has learned something in another industry and applied it successfully into the healthcare segment. Because there’s a lot of try and quick die efforts where people think things are way simpler and they can just apply something from the hospitality industry into healthcare and it fizzles because of any number of reasons. But those unique examples where you can actually take a learning from financial services from any other, even the manufacturing industry and change the game. Anything along those lines spark a thought that you’d like to share? 

David Sylvan: 

If we had seven hours, we would still be talking. A few examples come to mind. We’re blessed to have a number of Fortune 500, 2 50, 100 companies here in our region, very agile notwithstanding their size, deep balance sheets, capacities and large engineering teams. During Covid for example, we came across a dramatic shortage of face masks. There was a lot of open source design available, which was great. If you’re making one, two or three and you’re stamping those out or your 3D printing. But when the governor of the state calls and indicates that they love your design and they want 3 million of those as soon as possible, you turn to your industry partners who are able then to spool up their mechanisms and their machinery to partner with you. That is an example. Another example would be a company that’s been a longtime collaborator and the notion of screen rolled flexible small batteries for an industrial application with a renewed use case in continuous temperature monitoring. And that company is known as tempra and we’ve been partnering with them for years. So an application from potentially another industry cross walking to ours. I could keep going. I think the biggest lesson we should consistently heed from the perspective of what we can learn from other industries is speed to execution and not letting fear and resiliency and complacency stand in our way. 

Stuart Hanson: 

How do you, it’s really interesting and I think a really unique example there are there, and I don’t know that much about all of the portfolio companies and innovations that University Hospitals health system has invested in or incubated, but anything specifically that’s really directly impacted the patients or the physicians more so than you even expected that you’d like to highlight? 

David Sylvan: 

Yes, we have, again, we have a number, but I’ll highlight one maybe too quickly in the interest of time. In the maternal and fetal space, when there are exacerbations, there are two patients potentially at risk. The problem is to date, when we monitor mother and child in it’s at points in time, it’s sporadic, it’s not continuous. And when they have been negative outcomes, there’s always been the assessment of if only we would have known, well we created an algorithm, our system did, and it’s been digitized. That enables for both remote and continuous assessment of mother and child and the opportunity to use algorithm and machine learning to predict and preempt when there might be an exacerbation that we need to intervene, where we might need to intervene. And in so doing in the first few years of go live, we went from a certain number of negative outcomes with a result need to actually financially reserve for those. We actually went to zero Stuart. Now you can never be at zero forever, but that means that IP generated by IS system absolutely saved, lives saved and changed lives because of the concentric circle impact that those bad outcomes have. That’s an example. I have many, but that’s a very visceral, real example that’s still live as we speak. The company is known as risk ld, the LD standing for labor and delivery, 

Stuart Hanson: 

Check that out. That’s really amazing. Congrats on that. I guess the other thing that we often talk about with some of our guests here on the podcast and we get a lot of questions from our listeners around some of the more boring stuff that’s got the ability to still impact a physician in a really positive way. We all know how complicated it is to manage our healthcare, to interact with the healthcare system as patients. Unfortunately, we’ve all got either a direct bad experience or a family member who’s gone through just a paperwork nightmare or whatever it is, prior authorization debacle, tons of use cases there. And I’m not trying to prompt any, but there’s also, we’ve seen some really interesting companies impact the way healthcare is administered. Are there any big challenges that UHHS is tackling around either data flow, data availability, paperwork reduction, consumer experience improvement, revenue cycle, like any of the nitty gritty stuff kind of behind the scenes that also has a really negative impact in a lot of cases on your patients? 

David Sylvan: 

A hundred percent. And non-sexy is correct. It’s back office work that changes the paradigm from the standpoint of efficiencies. Bottom line impacts the ability to reinvest, et cetera, patient and provider experience because we don’t want to leave the provider out because the two obviously in lockstep is one of our strategic, one of the pillars of our strategic focus. How can we use not only the notion of empathy and training for individuals, but how might we use highly trained chat bots, large language models that will enable us to interact with a patient in a virtual manner, but to do so seamlessly une, emotionally efficiently as you look to ferry the patient along their journey towards getting the needed assistance that they’re seeking. And sometimes, as you well know, patients aren’t always quite sure what they’re seeking. And so how do we use tools and technologies to prompt and elicit the enough information to create that kind of appropriate guidance. 

That is an example. How do we use algorithms? How do we use AI to the point that you made earlier, predict and preempt prior auth implications or denials? What does that do from the perspective of then beginning to intervene early in the process and not waiting to try to react post denial or post event. What does that do for us from the standpoint of more accurate budgeting and forecasting, which then in turn implies how do we resource appropriately as we generate our issues. Heat map, myriads of examples. But I think working with RevCycle or supply chain or procurement or physical clients and infrastructure from say an energy perspective, all of those things are critical and technology comes into play consistently. 

Stuart Hanson: 

Great. Thanks for that. Sorry Rachel, I’ve been hogging all the air time here with David. It’s really fascinating. 

Rachel Schreiber: 

It really is. So one of the things I was hearing is that a lot of those processes around prior auth and some of those backend processes require collaboration. And I’m sure there’s some good examples of how you’ve worked with payers or how you’ve worked with other community partners or other types of providers because that collaboration, I think in healthcare we can really tend to look really narrowly, but there’s so many opportunities when we collaborate and I think your story about the masks was also an example of when you’ve had to collaborate in order to make that innovation happen. But are there some other ways that you’ve seen work really well in the collaboration? 

David Sylvan: 

Yeah, myopia is debilitating. This notion that we can do be all things for ourselves and we can solve for all of our problems. I think that those are Thelma and Louise moments if we’re not careful. And being receptive to collaboration beyond healthcare as we’ve alluded to earlier, is equally as important. We have a very robust independent physician partnership mechanism. Oh, 

Rachel Schreiber: 

Interesting. 

David Sylvan: 

And I think that’s an example of how we look to extend our reach and brand primarily from a community focused perspective to plant seeds and plant flags, if you will, beyond the traditional confines of our jurisdiction. That of course enables us to perhaps be able to offer that tertiary quarternary specialty care to those patients who might be community might be rural who are in need. And this becomes the glue, the connectivity from the hinterlands to the academic medical center, if you will. So that’s an example of collaboration with physicians who don’t necessarily wear our badge, wear our team jersey, if you will. Beyond that, that you mentioned payers critical that we don’t view our payers as the enemy. We have to view them as our partners. And whether that’s we think about vertical integration, whether we think about how we continue to move towards value and what does that imply from the perspective of shared savings or risk adoption. That doesn’t happen in a vacuum either. You have to do that through collaboration, negotiation, and alignment with your payer partners. Plenty of examples. Those are two that come to mind. 

Rachel Schreiber: 

That’s really interesting. What are some of the challenges of those collaborations or just innovating in general? 

David Sylvan: 

Well, the challenge of collaborations are this notion that you have to not only dispel mythology around why we’re special and different, but you do have to underscore differentiation. Why? Because there is choice. Why should we be a partner of choice? One of the things that we actively taught Rachel is this notion of being a living lab, given that we can offer your patient population or sample from rural to academic and from primary care or rural care all the way to transplant, for example, implies that we could partner with the early stage community in a way that offers them the ability to affirm their offering, their value proposition in a live fire setting, in collaboration with subject matter experts potentially in addition to perhaps some strategic funding in the sort of co-development model with this notion of if you can make it here, that’s probably a good proxy that you could make it work elsewhere. So that’s an example of how we sort have an open view finder and a warm home, if you will, for collaborators from the outside in. 

Rachel Schreiber: 

That’s interesting. So then when you’re looking at the vision for innovation at university hospitals was one either phrase or picture of what you’re trying to create. 

David Sylvan: 

A number of phrases, canned phrases come to mind and we bandy those around pretty liberally. We’re looking for the positivity, we’re looking for those people that don’t want to just do their job the way it’s always been done or the way in which they’ve been trained and are receptive to re-Imagining the day in the life of disruptive collaboration would be a phrase that we would use. We do disruptive can be seen as pejorative and negative perhaps. It is in some settings, any healthcare system worth its fact right now that claims that we’re not ripe for appropriate disruption. And disintermediation is naive and there are certain systems that have the brand reach and they have the band sheet and they have the international reputation where perhaps they can afford to remain a little bit more of a closed circuit for now, but the disruptors are coming hard and whether it’s Mark Cuban or Apple and everyone in between, we will be and should be disruptive, so disrupted. So why not be receptive to that and why not collaborate around that disruption for a greater good. 

Rachel Schreiber: 

That’s a really good perspective on that collaboration of Go ahead. Yeah. 

Rachel Schreiber: 

So that wraps up our time together. We’re really excited about what you’re doing at university hospitals and that perspective of disruptive collaboration and how that’s going to happen in healthcare. So if listeners want to keep up with your thought leadership, they can follow David Sylvan on LinkedIn and we want to thank you today for joining us and continue that inspiring transformation healthcare. 

Stuart Hanson: 

I really enjoyed having you would love to have you back. I held myself back from diving a little bit deeper into some of the AI stuff. Would love to talk to you further about that. But thanks so much for the time. 

David Sylvan: 

Fabulous. Look forward to the next opportunity and look forward to connecting with your listeners.