Philip Lieberman of Analog Informatics Corporation On 5 Things We Must Do To Improve Patient Outcomes for Underrepresented Populations
…The greatest challenge I have seen in healthcare is the allowance of patients’ condition to degrade in silence, with no one responsible for their outcome. Patients with chronic conditions like diabetes, mental health or addiction generally don’t have assigned case workers to evaluate their condition and provide transportation and appointments to keep them from dying or ending up in the ER. This can be solved via the technology we are working on, helping them stay healthy and caring for their well being no matter where they sit on the social ladder. We trademarked the term “Technology Heals” to start a movement to use technology to help take care of our fellow human beings…
Healthcare disparities continue to affect underrepresented populations, leading to unequal patient outcomes. Social, economic, and cultural barriers often hinder access to care, appropriate treatments, and equitable health services. How can we bridge these gaps and ensure that all patients, regardless of background, receive the highest standard of care? In this interview series, we are talking to healthcare providers, policy makers, community leaders, researchers, and anyone who is an authority about “How We Can Improve Patient Outcomes for Underrepresented Populations”. As a part of this series, I had the pleasure of interviewing Philip Lieberman.
Philip Lieberman is a physicist, serial-entrepreneur, and philanthropist. He has over 40 years of experience in technology, cybersecurity/cyberwarfare. His products and services are used worldwide and have affected billions of people’s lives. He has written many books on technology, wrote and taught computer science courses for over 20 years, written an uncountable number of articles, and appeared on most TV networks as a subject matter expert on cybersecurity and technology.
Thank you so much for joining us in this interview series! Before we dive into our interview, our readers would like to get to know you a bit. Can you tell us a story about what brought you to this specific career path?
Like so many times in my life, the inspiration for creativity has come from personal pain and/or laziness (software developers hate repetition and wasting time). Before starting this healthcare company, I built a multinational cybersecurity software company where we worked with the largest companies in the world and governments. In that world, we used best practices for customer engagement and partnered with these large organizations to solve big security and IT infrastructure management problems at a planet-wide scale. I sold my company in 2018 and began looking for a new way to change the world again.
In 2020 my mother-in-law, Doris, who was 103, had medical problems, and as a family we found ourselves engaged in her healthcare with providers and her hospital. In 2020, I encountered a world of only faxes, telephones and paper, with little to no engagement of families or caregivers, and literally no guidance or help in navigating the system. When we had to take her to the ER, we waited for hours on end with no updates and we saw a community of non-English speakers in that same waiting room living there for days for an update on their loved ones.
The epiphany that came to me was the disconnect from reality in healthcare. I knew where my Amazon packages and Uber driver were, but there was no information for patients and families in the healthcare system — even though I noted that everyone behind the glass was working on computers. I then went on a journey, taking courses at Stanford Medical Center, UC Davis and other institutions to learn how I could get real-time data updates out of the hospital and practitioner systems and into the hands of families and caregivers. Part of extracting the data also required that I take courses — a lot of computer programming in Artificial Intelligence, cloud software development, linguistics, and more. Fortunately in the era of COVID, all of the courses I needed were available online and I could binge them. I was working seven days a week with 10- to 16-hour days taking courses online for over a year to try to solve this communication and coordination problem for everyone in the world.
During my training, I also learned that an inflection point in healthcare data sharing had occurred with the Cures Act that forced Electronic Medical Record companies to share their data electronically with the permission of the patients and doctors.
Just like I saw the Internet changing the world of IT, I saw the Cures Act as the impetus that could provide a more humane and interactive experience in healthcare. Combined with AI, the cloud, mobile devices, and new linguistic translation services, it could democratize access to healthcare information and provide a concierge experience to all income levels, especially marginalized groups who don’t have the resources or knowledge to directly interface with healthcare providers.
Can you share the most interesting story that happened to you since you began your career?
As a person who builds solutions, I assumed that once our platform was created, that doctors and hospitals would immediately embrace it because I “assumed” that healthcare was filled with humanitarians. My thoughts were that those who went into healthcare were motivated by helping others. Since I had an amazing platform that really changes the paradigm which patients and families would embrace, the providers should be similarly excited.
As it turned out during clinical trials, the patients and families absolutely loved the constant communication and updates. Many responded back to our AI system with “God bless you doctor for caring about me,” but the medical community was singularly focused on something completely different — money and only money. If our solution did not make more money for the practice, it was of no interest.
That was a bracing bit of feedback for both me and my team. In 2021, we then started another year of development to create the business value needed to sell our technology as a profit generator. Two years later, we finally had a solution that not only took care of patients and their families, but also demonstrably generated a lot of growth and profitability for those that deployed it.
Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?
Just because something is useful to you and others, does not mean that people will pay for it. Creating a product is the beginning of the journey to find out what customers really want and are willing to pay for.
How would you define an “excellent healthcare provider”?
Great question and the answer revolves around the question of whether you are focused on outcomes or how you feel emotionally after the interaction. In healthcare, the rule of thumb is that the more a practitioner does the same procedure, the fewer the complications and the greater the success. Unfortunately, sometimes those that do the same procedure thousands of times may not have a good or any bedside manner. Okay, they can really be jerks but if you are seeking the best outcome, you may prefer an arrogant provider to do the work. Then there are those with great bedside manner who visit their patients in the graveyard.
Assuming two practitioners are equally competent: One may work at a facility with a great culture, filled with compassionate staff. This organization is focused on patient engagement, communicates constantly, and cares for not only the patient but also the family and caregivers equally. It is generally located in wealthy demographic areas. A few miles away, you may see the exact opposite at general hospitals and in trauma centers. The outcomes data is the same for both, but for the concierge experience, high end practices can dedicate staff to patient engagement.
My idea was to create an AI patient concierge that would treat everyone — no matter their location or socioeconomic situation — as a first class patient with compassion and care, using technology to achieve these outcomes for pennies per person.
What are your favorite books, podcasts, or resources that inspire you to be a better healthcare leader? Can you explain why you like them?
There are a lot of sites and organizations I follow. In the US, there is an HHS organization called ONC that has created a movement called HealthIT to use technology to improve healthcare. There is an EU group. o that is focused on improving the patient engagement experience that I also follow.
Are you working on any exciting new projects now? How do you think that will help people?
The latest project we are working on is something that sounds simple, but it is incredibly hard to do: multilingual patient scheduling. Interestingly enough, handling the language issues is something we already know how to do well. However, scheduling patients turns out to be a PhD level computer science problem because scheduling involves alignment of physician skill sets, work styles, equipment availability, facility availability, and more. We have learned that it can take six months to a year to properly train a person on scheduling patients due to the rules involved.
Developing groundbreaking technology is needed because patients require around the clock scheduling in their preferred language and device. By empowering the patient, we are breaking the paradigm that patients must be flexible to the needs of the doctor, delivering better outcomes and customer experience.
Ok, thank you for that. Let’s now jump to the main focus of our interview. What are the primary barriers that underrepresented populations face when seeking healthcare?
In my opinion, obsolete 1970s technology and a set of laws that have gone wrong are the primary areas I see. In the case of laws, the US government mandated that anyone who needs medical care, regardless of insurance, is entitled to healthcare at ER. This is part of what is known as EMTALA — Emergency Medical Treatment and Active Labor Act. This has led to a perverse condition where ERs are filled with non-emergency cases. Many patients who cannot afford to treat conditions before they become life-threatening, have no options other than showing up at the ER. Many die needlessly because they are not provided with a non-acute option or urgent care.
Interestingly, under EMTALA there is no need for the hospital to communicate with those waiting. In fact, telling them how long it might be before they are seen can lead to litigation. This is based on trying to incentivize them to leave and not provide the mandatory services required by the US government.
How can healthcare providers build trust with patients from diverse backgrounds, especially in communities that have historically experienced medical neglect or discrimination?
I truly believe that only technology can bridge the gap because there is no funding or staffing on the horizon to fix this situation. During COVID, the US government allowed the use of remote conferencing systems to address quarantine. Currently the government and providers are at odds about whether telemedicine will still be compensated by the US government and insurance companies. Clearly, greater use of mobile devices, telemedicine and the use of AI to analyze patient records and their behavior can deliver targeted services to marginalized groups much more economically and expediently.
Unfortunately, the US government and insurance companies are not incentivized to introduce innovation, and there are no rewards for helping stop medical neglect or discrimination. This is where private, technology companies can step in to address these historic and continuing inequities.
What role does cultural competence play in improving patient outcomes, and how can medical professionals be better trained to meet the needs of underrepresented groups?
Cultural competence is at the center of what we are trying to do in modernizing patient engagement. Existing electronic medical record systems do capture some demographic information, such as outdated race identification, but practices and hospitals don’t do a DNA deep dive, nor do they capture family contact and relationship information needed to bring the entire support community of a patient to bear.
In our technology stack, we specifically capture the patient’s entire support network and communicate the entire healthcare journey, including care information for optimal outcomes.
It is a daily uphill battle to get practitioners and their staff to capture the patient’s social network to educate them on patient care. Because this additional information captured is not paid for by the US government or insurance, there is resistance to do work that is not remunerated.
Can you share any successful strategies or programs that have been implemented to reduce health disparities and improve outcomes for underserved communities?
We previously talked about the inclusion of the entire social network as unpaid extra work, however we realized that these persons, if treated with decency and respect, have a secondary value in leaving reviews on Google and other sites to share how they were treated. This represents a new type of currency and value — marketing value. As noted earlier, healthcare is very primitive when it comes to the customer experience. It is also in the Dark Ages on marketing and its value in bringing in high value patients.
We found ourselves not only being technologists, but also educators and influencers to show providers the marketing value of treating patients well, which makes all the difference in their practice viability.
How can technology and telemedicine be leveraged to reach underrepresented populations who may face geographic or financial barriers to traditional healthcare services?
It is clear that technology and telemedicine are here to stay, but more practitioners need to be educated in its use. The general population must also be educated in its availability and usefulness. More importantly, the US government should expand EMTALA to allow patients to present themselves online rather than traveling to an ER only to wait for hours or days to be seen.
There are a lot of doctors rightfully resistant to change and new technology because they are concerned about litigation. It is up to US legislators to incentivize technology advancement to engage underrepresented groups and provide legal safe harbor.
As a “healthcare insider,” if you had the power to make a change, can you share 5 changes that need to be made to improve patient outcomes for underrepresented populations? Please share a story or example for each.
1. Provide a guaranteed service level agreement to all patients, in which providers must provide status updates no more than every 30 minutes. As in aviation, if a travel delay exceeds a certain threshold, the hospital will compensate the patient and their family for lack of communication.
2. Revise EMTALA to provide US government reimbursement for urgent care and other non-emergency services so that ERs will have capacity to handle real emergencies more quickly.
3. Require that all persons responsible for the care of a patient be included in every medical record, including all of their contact information. Require all communication and updates to all those parties during the interactions with the patient. All communications must be in the preferred language of the person.
4. Prohibit no-show fees and provide free transportation vouchers for those that cannot afford to get to a healthcare provider. All hospitals and clinics must provide a telemedicine option with self-scheduling in the language of their choice.
5. Currently, most electronic medical system providers in the US have blocked small and large companies from developing innovative solutions that could address the current healthcare crisis which is particularly acute for marginalized groups. We would like the US government to provide clear guidance on the Cures Act to immediately stop blocking data access and allow innovators to help every patient no matter what their situation.
The greatest challenge I have seen in healthcare is the allowance of patients’ condition to degrade in silence, with no one responsible for their outcome. Patients with chronic conditions like diabetes, mental health or addiction generally don’t have assigned case workers to evaluate their condition and provide transportation and appointments to keep them from dying or ending up in the ER.
This can be solved via the technology we are working on, helping them stay healthy and caring for their well being no matter where they sit on the social ladder. We trademarked the term “Technology Heals” to start a movement to use technology to help take care of our fellow human beings.
What specific steps can be taken to ensure that medical research and clinical trials are more inclusive of underrepresented groups, and why is this important for improving. overall patient outcomes.
There are no incentives in place to be inclusive when it comes to medical research and clinical trials. There are also no automated communication systems that can be used to engage the entire population in a geographic region in these efforts. Today, everything in healthcare is phones, fax machines, and paper.
You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. 
I believe that Technology Heals is a movement to modernize healthcare and use technology to help scale existing healthcare professionals. I would like the US government to unlock all data to healthcare innovators (data access to be granted by patients and their doctors) and stop all data blockage by electronic medical record companies. I would like a reform of litigation rules to provide safe harbors to healthcare providers that move to new and innovative technologies and electronic medical records.
For what it is worth, all of the innovation in healthcare IT is happening in Europe with their project called OpenEHR. In Africa, clinics are attuned to population genetics and dispense drugs at the clinics to ensure their patients comply with doctors’ orders.
That being said, the US has the most innovative tech community in the world that just needs to be unleashed to provide the best healthcare system in the world — driven by technology.
How can our readers further follow your work online?
Go to https://technologyheals.com to see what we are doing to open up data for innovation.
Visit our website at https://analoginformatics.com to see the technology we offer to help every person, no matter their situation, with a concierge experience in the language of their choice.
If they want to help in my mission to improve healthcare via innovation, contact me via LinkedIn: https://www.linkedin.com/in/phlieberman/
Thank you so much for these insights! This was very inspirational and we wish you continued success in your great work.
Philip Lieberman of Analog Informatics Corporation On 5 Things We Must Do To Improve Patient… was originally published in Authority Magazine on Medium, where people are continuing the conversation by highlighting and responding to this story.