Connecting Care: Cherry Health's Mission Unfolded with Cherry Health's Co-Founders

About the Episode

It all began with a backyard conversation about healthcare challenges and job difficulties at the start of the pandemic. Leading to an innovative idea to connect healthcare professionals through a unique medical network, brainstormed over an elaborate spreadsheet; came the evolution of the Cherry Health mission.

In this episode, join Cherry Health co-founders Dr. Jordan Vollrath and Dr. Maximilian Kerz as they recount the transformation of a simple idea into a groundbreaking healthcare platform. They share their journey through challenges and their dedication to revolutionizing healthcare connectivity and job opportunities. Dive into a compelling conversation about healthcare's complexities, from fragmentation to financial incentives and interoperability. Discover how Cherry Health is reshaping the healthcare landscape.

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Objectives and Discussions

• Addressing Healthcare Fragmentation
• Challenges and Realizations
• Gaining Traction
• Financial Incentives and Healthcare
• Interoperability in Healthcare
• Looking Forward

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More Resources:

LinkedIn: https://cherryhealth.co/linkedin

Facebook: https://www.facebook.com/cherryhealthinc/

Instagram: @cherry.health

Twitter: @cherryhealthinc

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Have questions? We want to hear them!

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Transcript

Speaker Identification:

[Speaker]: Dr. Jordan Vollrath

[Speaker]: Dr. Maximilian Kerz

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How did it start off? I think we had a conversation in the backyard where we were talking about healthcare in general. You were welcoming at the time. That was just where the pandemic started. And we were talking about how challenging it is to find jobs. No, it started off because you had a way cooler job than me and I was jealous. Because you were working at Harvest, the venture studio, doing the startup company consulting building thing, which I thought was pretty neat. And then we were talking about, is there anything in healthcare?

and then you're like, well, let's come up with something, let's brainstorm something. That's where it really started. That was the beginning. Yeah, yeah, you're right. And then you were working for Tells at the time. Yeah. And you've been responsible for the Alberta Telehealth delivery, and then we put our heads together, put it together as a spreadsheet.

Maximilian Kerz (01:59.188)
Oh yeah, we brainstormed some ideas and then you came back the next week with the most outrageous looking spreadsheet I'd ever seen. It had like eight tabs on it and a whole bunch of math happening. You changed one variable and you're like, look, we'll be billionaires. The graph went up. I think the main motivation behind it was realizing that just healthcare is so fragmented. And I mean, you were clearly having an issue finding the right opportunity.

while also being involved in the community. And in fact, you're not the only one. This is an issue throughout experiences for physicians. I'm not necessarily, I guess, what people coming out of school or med school expect. And so finding the right place to work is a real challenge. And that's how we got started. What was the combo of two things? There was the jobs problem, which I was experiencing. But then while I was working at Intellis, they used Slack. That was their business and education tool. And it blew my mind.

I'd never seen anything like this in healthcare. There's just like a group community chat forum for all the people that are working on the same thing. And then it was just super helpful. All the doctors would be talking to each other, asking each other questions. How do we set this up? How do we do that? What do we do with this patient? And it was just like, why did we not just have this in general? And so that was where the original idea for building the medical network came out of. We're like, okay, well, we'll start with the jobs thing and it'll look like.

in, but the goal is to have that connection, the community actually like bring together the healthcare practitioners. Yeah, exactly. Building the healthcare connected and then building tools on top of network that provide true value. So it's not just a fad in terms of like connecting people to look at cat pictures, but rather like disseminating valuable information to them. Exactly, exactly. Like a pragmatic business tool. Not like the Facebook for doctors where you're just like, it's kind of like a

kind of superficial and recreational, but more of like just a actual, this thing solves business operations challenges and is useful on a day to day. Yeah. How do you think we're doing so far? And I thought it takes a lot longer to do things than initially you imagined, like just like how long it takes to like.

Maximilian Kerz (04:20.528)
build the actual platform, like just coding and creating things. And then there's the actual like testing. Like you remember the early phase of the whole network was just like so buggy. It was really testing. It was crazy. So like, I think we had the idea in May, 2020 and two months later we went live. We actually went live with the first app. So I think we were like super fast and like trying to test it. Um, and like, obviously you were having like user, um, interviews,

making sure that we're sort of hitting the nail on the head with that initial delivery of the network, but then also the job function essentially. Initially we focused on just locums, and then we very quickly expanded to other jobs as well. Yeah, and we realized that after going live after like one month, like, you know, my background is mostly in business development, but also some of it.

biotechnology and coding was so secondary. And yeah, for some reason, the entire database of the app was duplicated onto our users' phones, which is not only insecure, but just not scalable. So we had to rebuild the entire thing and release a new version, I think, like an unthousand.

Yeah, it was fun. It was fun. So yeah, it took a lot longer to actually build the stuff, and it takes a lot longer to get people to use the things. We figured, okay, there's a doctor shortage, we're doing this whole thing, it's free, it doesn't cost anything, we're giving away water in the desert, people will be flocking to it en masse. But it definitely took a lot longer to actually get the awareness and the visibility within the medical community. It's just a very closed, locked down.

conservative sector and so that definitely was also quite challenging didn't expect that upfront and then like anything external anything you're waiting on for like a third party to do obviously they've got their own priorities and things going on whatever other like side project kind of thing coming from another company or another organization like us is like you often low priority so it takes a lot of time to actually like any of these external

Maximilian Kerz (06:31.242)
with the clients, like everything just takes a lot longer than I initially thought. Especially in healthcare, because you're right, it's super regulated. But then on the other hand, I think there are also a lot of champions early on. We talked to the PCNs who started to promote us here in Alberta, the Canadian Medical Association gave us the Innovation Grant within a few months of us releasing, which was incredible. And actually it was kick-started. It was to kind of do full-time work and then really pursue charity help to where it is now, which is really incredible. Well, yeah, and you took the plunge.

quit your job. Yeah, yeah, that was a big step. Like, the winter of 2021 went like, full time. What were you thinking when that happened? Were you like, oh good God. I was like, let's go. Let's go. Let's build something massive. Let's build something really cool that solves real problems. Yeah. So at the time, what were you working on at Heartbath?

Was that at Harvest or what was the other one called? Yeah, I was involved in like two venture studios at the time. One more focused on agriculture and the other one more on fintech. But my background prior to that was always in healthcare. So I used to work for Bayer Pharmaceuticals, also in the venture investment side. And then prior to that, worked in academia and did my PhD also mostly on focusing on building products for patients and healthcare professionals. And so, you know, like so that

that lack of adoption in healthcare was always very pervasive and the challenges with that as well. And I think one of the interesting things that we're also doing with Cherry is we're connecting healthcare, but healthcare is when you think of the physician and the healthcare practitioner as the main delivery provider, which is totally true. But then you have the subset of demographics that help.

Maximilian Kerz (08:23.846)
your clinic effectively. You have the nurses and everyone else that essentially help the physicians and then you have product and therapeutic providers that also play a fundamental part in the delivery of care. And that always struck me as really interesting, is there's no really easy way to connect with physicians effectively.

I think that is also one of the allures of Cherry Health that we're building some of this digital distribution challenge between healthcare practitioners, but also for industry to access healthcare practitioners in a meaningful way, not just in an exploratory, in an appetizing way. Exactly, that gateway for things that actually get disseminated, because that's the biggest problem right now, right? Like we use Facebook for everything.

jobs, patient care, logistics, like vetting companies and vendors, service providers. And so it's just very helter skelter, like it's all over the place. You don't really have any like organization or superstructure to it. You don't know where these pockets of doctor groups are unless you stumble across it by accident or you're like really searching specifically hoping something exists or somebody else invites you to it and you're like, oh cool. And so it's again very fragmented just like with many other things.

in the digital health space. Yeah, I should make some notes of that actually, in terms of trends within Canadian healthcare. And I think one really interesting piece that I thought was technology adoption within healthcare. What do you think around how it's currently going, where it should be going within that? Because I mean, there's always, it's a double-edged sword, I feel like.

It's slower than we would like, for sure. I mean, you can see right now, like, the entire system is just plagued with slowness and inefficiency. The CMA, the Canadian Medical Association, they've got their big $10 million grant callout for proposals right now for reducing the admin burden. So it's like the number one, I don't know if it's the number one, but it's like the top couple things just like impacting the system right now.

Maximilian Kerz (10:24.584)
There's just not enough tech and adoption and tools to make it speed up, automate the mundane and the redundant and all these things. So everything is still like one-to-one, manually done. You know, it's like you're 100% sure that it's getting done correctly and the human is looking at every single step. But anytime a lab gets ordered, an image gets ordered, I mean, there's like five different places that this internet fax gets processed through and categorized and tagged and assigned to people.

All the different like everything you do with the patient has to get documented and charted like just for Your own like legal protection just so they're the good record if somebody else takes over care So like the more charting more actual like note-taking you do the better But of course that takes a lot of time. So that's where these like AI Ambient scribes look really promising like you just completely focus on patient care You don't have to like write anything now There's tools coming out that actually like layer on to the

to actually do functions. So before we would have macros. That was like the best thing we'd have if you're using an EMR. You'd type like... Like an Excel macro, basically. Exactly, you'd type like slash back pane and then it would like pre-pull up like some copy pasted text and then you'd fill it in. But now they have like actual function macros layering onto your EMR. So you would tell it like, write a prescription for this and it would like pull up the prescription writer and like fill in the drug and the dose

You still assign it off and okay it, but it saves you a bunch of clicks, the typing. They're starting to be this extra layer of tech added on to the tech now. And so there's just like no shortage of things to speed up and improve. So access to care, one of the biggest problems we have right now. And so making all the healthcare providers more efficient, that's the goal. Yeah. I couldn't agree with you more. And I think like, it's really interesting. I spoke to one of the sponsors that we had.

recent Cherry networking event, physician networking event. And I think he was talking about his company that was doing very similar things, so like trying to support the MOA with AI to the point where they could become much more effective and also alleviate a lot of the administrative burdens for the physician. And then I think, I don't know who it was, it was a must have been a doctor, you must know whether the name comes probably back up. She was saying that...

Maximilian Kerz (12:53.148)
We've been disappointed so many times with technology. They've over-promised so much and never really delivered in the past decade when tech really took off and helped tech. But I think there is a natural suspicion with everything that comes out nowadays. But it feels like with AI and generative AI, there's this shift change in terms of capability.

Partly out of necessity because you have to. The system is so strained right now that you have no choice but to optimistically hope that all these things coming out are the secret tool to unlocking that productivity, but also because it's just so much more mainstream now. Chat GPT 3.5 hit the market a couple months ago and it just blew up everywhere. Now AI is a household name. Your grandpa knows what AI is and might even have it on his phone.

There was a lot of that suspicion in medicine just forever anyways. Show me the evidence, what's the data say? When it comes to patient care and treatments, what's the actual number needed to treat? How many patients am I going to harm by using this versus how many am I going to help? That same level of suspicion has transitioned over to the tech and the tools. Everybody's just skeptical of everything. What's the actual downside? What's going on behind?

And so it's just been very much more slow and conservative. There's more privacy, there's more security laws, the protocols needing to be followed. Anytime you adopt it, like here in Alberta, at least legally with the Health Information Act, anytime you adopt a new technology, you are supposed to submit a new privacy impact assessment, which is a whole giant monstrous process of documents and policies and have that approved on. So anytime you do anything other than

add a new user to your existing software. You are supposed to jump through all these hoops, which obviously keeps people's data more secure, but it doesn't really pose a barrier to actually improving things, trying new things, right? And then just that barrier to entry. If you wanna switch electronic health records, like let's say you're not 100% happy with this one, and you wanna try out a new one, it's not just like you download a different antivirus program, pay your 20 bucks, and then eight minutes later, the whole thing is fully set up.

Maximilian Kerz (15:15.758)
and it takes months and months and months and thousands of dollars to like migrate your patient data from one system to another. Everything's gotta get ported over, every field, every individual piece of data gets mapped over to the appropriate spot in the new software. You're reconciling manually all the discrepancies in the areas and obviously you gotta like pay the electronic health record vendors to do all this. So it's not like it's easily switchable for some of these things. And the EMR is like the main

software tool that physicians have in their clinics. That's pretty much the thing. I don't even know what else you have. Everything revolves around that particular piece. Yeah, that's like your operating system, almost, for healthcare or EHR. And so just that huge switching cost really slows down things. Because all the new innovation and everything is getting layered into those EMRs or the crosstalk connectivity between EMRs. Or not. Yeah. And so there's that big barrier to entry

upgrading their core tech. Yeah. I think the EMR business is such an interesting area to be in. And we've had the pleasure of talking to, or you had the pleasure to talk to, multiple new EMRs, like companies that are starting up in BC and Alberta, and kind of like trying to solve that incumbent that you were describing, which is like, companies have been around for decades, didn't really have a need to innovate because once you're in a clinic, it is very challenging for the actual physicians and health providers to switch.

And the initial setup is expensive, but once you're in the clinic, it's probably there for life. It's sticky. Yeah, it's a very sticky product. But I think there's some really exciting changes happening. And EMUproyser seeing the benefit of interoperability and trying to move into that space, it's also very much a shift from the existing business model.

It is. And so hopefully that process just gets more and more smooth. People get more accustomed to upgrading their tech, trying new things. But I mean, like people are still using the software and the technology until it gets sunset by the manufacturer. There are people out there still just using paper charts. They're like, tell them, they're not going to bother. Like, this is too much. It's changing all the time. It's crazy, actually. That's still the case. And I think they have

Maximilian Kerz (17:42.182)
I think there are over 700 EMRs in Canada.

What? Yeah. I mean, some of them must be really small in terms of market share or extremely specialized. Yeah. Super proprietary. And then you obviously have some larger players, but there's a lot. Yeah. And I think that doesn't stop, right? If you start with EMRs, you go for administrative solutions as well. Then you go into hospitals and you have more sophisticated softwares, very specific things. So I think, so if the burden of having to vet...

which technology best fits my workflow. It's only gonna become bigger. You just need a way to compare. It's easy to see what's out there. It's tough. There should be a speed dating for EMRs setup. You just log on and go check them all out all at once.

something to keep in mind. It's not something to keep in mind. It's a slight topic because we talk a lot about AI. I think something interesting, and we'd like to go a little bit more into actual care provision, or tell health. What about it? I find that especially in kind of like, provinces take a very different stance on it. And like...

how they value it in the overall pathway of providing care. In Ontario, there have been massive shifts in billing codes which actually render telehealth being less useful to use, or from an operating clinic perspective. And so a lot of physicians go back to normal care, or care within the clinic, where you can see a lot of benefits, but at the same time, from a convenience factor for the patient, telehealth is great.

Maximilian Kerz (19:30.532)
So I know from a physician perspective, how do you feel telehealth, telehealth's role should evolve within the delivery of care, especially continuing care?

I mean, I think telehealth is great. Like just customer experience is something largely overlooked in healthcare from the get-go. Like doctors not getting paid by the patient, doctors getting paid by the province. There isn't that direct like financial incentive to like have a good experience. The patient can go and poop on you, un-rate my MD, but nobody really cares. And it just writes it off as like, ah, it's just whiny patients. So like, it's just like not something that's been paid.

a lot of attention to. I mean, like, does a patient need to come into your clinic, book half a day off of work, and sit there to get a refill on their prescription every three months or whatever it's been set up to, right? So there's just like a lot of like dogmatic kind of silliness that we've been practicing that way for decades upon decades, right? Versus, could we not have just done a lot of this through the phone a long time ago? Probably. So I think like telehealth really has a lot of potential to bring that care out to

underserved, rural, remote, northern communities, places that just don't have access to physicians. So it really will equalize that access to care quite a bit more distributed across the country. I mean, in Ontario, it is interesting because they kind of like chopped the legs off of those virtual care billing codes. So I think the intent of that was mostly to prevent like telehealth companies from taking over because you can still bill and it can be a lucrative venture like for a doctor who

his own or her own patients virtually. So like I was just saying, if they need a prescription refill, they don't have to actually come in and book a day off work to do so. So if you still have your own panel or roster, you can see those patients virtually as well. It's more like new coming ones and solely seen and watched. Exactly. So like having a company start up a telehealth operation and then have a doctor meet a new patient digitally across the province, like that basically doesn't work. Nobody's going

Maximilian Kerz (21:44.51)
financially disincentivized. You couldn't do it. You're like pretty much volunteering your time at that point. So not many people I think are going to do it. But if you want to keep in touch with your existing patients in Ontario, it's definitely feasible. Here in Alberta, it's a little bit more loose. It's a lot more open and you can see patients start new patient engagements from Gistin. So the rules here are definitely more conducive to that virtualization of care.

I have a self-pay side where if you want to provide that value, then you'd ask the consumer to pay personally, which is I think, especially a public pay system, something that we're not used to. And yeah, it's met with a lot of, I think, challenges.

Well, the rules on that are different too, right? Like a doctor can't charge privately for something that they're also charging publicly for. I think you have to like fully opt out of the billing system if you want to do that. So like for example, if you want to have like a private knee surgery or something like that, which is publicly available in Canada, surgeons will fly to a different province, work at a clinic for a couple weeks, and then fly back to their home province and then they're billing publicly on the public system for that one.

know how that would actually work if you were like a family doctor seeing patients virtually. Maybe if you were on like a salaried ARP contract from like a benefits company and part of the benefits package for employees is you have access to a telehealth provider. Maybe that's how you would get paid privately for stuff that you're also billing publicly. I don't know, I'm not 100% sure I've ever done anything in that space, but I definitely think you can't be doing both at the same time.

Very interesting. Do you feel like it's going to move in that direction? Like more to like self-paying or like private? I have no idea. I've heard that the Alberta government is trying to push things that way. Like there's never been anything published, I don't think, by the Alberta government that makes that claim. But there's been a lot of actions by the Alberta government that people are interpreting as that's the direction they're trying to push things, is towards a two-tier system. So it very well could happen. Wouldn't be surprised.

Maximilian Kerz (24:03.47)
I think this is where technology is a really interesting play as well. Technology in general is deflationary, trying to improve an existing process and hopefully thereby increase efficiency. That could be a really interesting way if you make a concerted effort in terms of adoption to keep the public player system as more effective and keep it around as long as possible.

Because I mean, there's a lot to be said for public health care systems that can provide care. I think it's really important. Well, the virtual side, I think it's interesting because the doctors, there needs to be the financial incentive. So that's why there's been the big push here in Alberta lately for getting onto the team-based care model with complexity factored into the billing codes. Because as the doctors argue that all the easy patients go to virtual care. I need a refill. I have a runny nose.

the simple things that are going to take five minutes versus half an hour to figure out. If the billing code remains the same regardless of what the underlying problem was, then the doctors who are doing the more complex patients, like the older person with multiple comorbidities, they're going to take a lot longer to sort things out. So then they're feeling disenfranchised and left behind because they're like, well, why wouldn't everybody just go towards the easier side?

made about walk-in clinics for decades, right? People are like, well, the easy patients just go to the walk-in and then I'm stuck here dealing with grandma Smith's heart failure and COPD, kidneys falling apart, and everything all at once. So then it's like, OK, we've got to make sure the incentives align.

But this is where the complex cases are. So tough conversations, longer time that you spend with the patient probably as well. So yeah, it makes complete sense. Complexity factor, very interesting.

Maximilian Kerz (26:01.288)
We'll see. So there's a lot of potential there. I think there's like a lot of different ways that technology can help and virtual care platforms can bring that equitable access to care, but the government needs to respond by making the financial incentives proportional depending on the situations so there aren't some people left behind.

Maximilian Kerz (26:22.564)
What's it like in Germany? How does their system work? It's a two tiered system. Yeah. So you've got the public, but then if you, um, you can switch to a private health care insurer, if you have an income of a certain amount. The very interesting thing is that the, if you switched your private payer system when you're young to the private payer insurance, uh, you get great access for like faster access to care, use, utilizing the public. Um.

hospitals and resources.

So you can essentially access them faster. And it comes at a cheaper cost than the public payment system. How does that work? Because as soon as you choose that you want to go private, you cannot go back. And then they get you when you get older. So as you get older and your bills start increasing, you start paying significant amounts. And a multitude more, usually like a factor of one

had to more linear increase that you see in the public sector. I can see that. I remember hearing a statistic, I don't remember the exact numbers, but it was something like you use 90% of your entire life's health care spend budget in the last, I can't remember if it was 10% or five years of your life or something. It was massively disproportionate towards one year. Makes complete sense. I feel like when you look at the rapid decline of health overall, I think the goal is to always try and stay in that.

high quality of life health region as long as possible and at some point it just starts dropping off. So what was the critique then of the hybrid private public system in Germany? Not everyone can like it, or do they? Is it widely acclaimed as being incredible? I think that initially it was like seen as a great solution to being able to provide great care for everyone but if you wanted to access that care you could.

Maximilian Kerz (28:24.24)
by now because it's not that they're just like fully primary clinics in the end when you have complex surgeries, you're still using the public system. You're running into very similar issues that you see here. It's all stretched. You have a physician shortage, you have a nursing shortage, general provider shortage, and people are working overtime and are not really compensating for it. Very similar issue to me. Sounds familiar.

Maximilian Kerz (29:02.032)
I have some interesting pieces to that actually with the inter-provincial license. There's a lot of conversations around people moving around or potentially being around, moving around. What are your thoughts on that?

I think it's a good idea. I think it'll help more than it'll harm. A lot of people are worried that you know soon as they move. Yeah I don't know personally I doubt that a few forms and a thousand dollars of registration fee are locking in the doctor to a community that you or she otherwise think is not a great place to live and they're just itching to get out of there So I don't know that argument to me sounds a little bit ridiculous I mean when you look at it at a population level

I'm sure that will happen once or twice, but I can't picture that being a common thing to occur So I mean somewhere somebody is gonna be like look I was right But I think on the whole it'll just make it more portable again easier for doctors to travel up north Try to go to the East Coast for a working vacation go check things out for a month or two

and work while you're there. So I think it would be an antipositive overall. Yeah. It's a very interesting mindset, so that's a scasty mindset around physician resources and health care provider resources, which is completely understandable, given that we are working on a physician shortage, generally speaking. But so the ability to, I think, have that free flow of resources, like you said, can also be a net positive, where you give people the opportunity to be there for a short period of time.

That's a lot of the feedback and a lot of the stigma that we've been working against with Cherry Health as well. Connecting healthcare is not always viewed as positive because you're making it easier or you're providing an insight into something that you may not want people to have a look inside it. In the end, people want to work at great clinics where they have a good working environment and potentially an interesting patient demographic to work with.

Maximilian Kerz (31:15.55)
challenging sometimes, but I think it is a great incentive also to then as a clinic and employer to raise the bar and see what's up there. Yep, exactly. So yeah, we've heard the same feedback from a lot of people using our network of like, well we don't want our doctors to see this platform, like okay it'll help my clinic's jobs get more visibility with our locums and our temps, but then they'll see other jobs. And we're not very confident that our clinic is...

going to retain them. And so, again, looking at it from the individual person's perspective, you follow the incentives and they're worried. That scarcity mindset, just like you mentioned, right, that really changes behavior. You know, okay, something might be in the best interest of the system as a whole, but if there's a little bit of potential blowback on the individual, they're not going to do it. Yeah. Very interesting. And I think what that actually shifts to, and I think

Maximilian Kerz (32:15.81)
the rate limiting step within healthcare, the key limiting factor, which is the provider. And so trying to ease their life will make them appreciate the place they work at more. And so the risk of them leaving goes down. And so I think that is like a key indicator, right? Like if you can create a great working environment, make their life easier using.

administrative solutions, support staff such as N.Y.A.s to kind of help them practice as best as they can and really focus on the patients. That is a great indicator for, I think, a good working environment.

Yep, exactly. Make the doctors happy or I guess it's a plus to any employee. Make them happy and they'll stick around. I mean, I've seen lots of places that do it well and lots of places that do it poorly. Like one clinic I would look them at, they had a different front-end office team pretty much every time I'd get there. And so you never really got that flow, that rapport with the staff members. I remember there was always one like really good.

who stuck it out somehow for a bizarrely long time compared to everybody else. But yeah, it just like, it rips the clinic apart. Like I don't know what it was that they were doing, but without that stability between the team members, it's very difficult to like have a well-run organization. Yeah, taking care of your staff and employees is the key. Like in the end, your business can only run with people. Like you can only do so much as a single person. Yeah.

Our generation and the Gen Zs, I think they're a little bit more fickle when it comes to careers and jobs though. Like, versus our grandparents, they'd work at the same company for 40 years and retire on their pension. Versus now, I think the average is like definitely in the single, low single digits for how long a job lasts. Yep, yep. Longitude is like a challenging thing. I think like what in the end matters is like mission and personal fulfillment. And if you can make those two things aligned, then people stay. Yep.

Maximilian Kerz (34:19.577)
Yeah. Amazing.

Maximilian Kerz (34:24.399)
What are your thoughts for 2024? What about it? Healthcare trends, what excites you currently in the scene?

I'm trying to think. I mean a lot of stuff on the digital side I find very enticing. I think there's a lot of like really cool new tech companies coming out now. Like the AI is just so pervasive everywhere. There's like a lot of innovation coming out there. Every time we go to a conference there's more and more of these different tech companies with like really cool promising looking products. Even like seeing some of the older tech companies are not necessarily old but like the ones that we saw last year. Just how things have developed over the last 12 months.

is incredible. So I think there's like a lot of really, really innovative stuff coming out. And I think like now that the healthcare system is sort of getting to that breaking point and everything's falling apart publicly and it's hard to like sweep it under the rug anymore. People are like, okay, we've got to change, you know, that like slow moving conservative skeptical mindset is starting to shift. So now you're starting to see those people that would have typically been the late

Maximilian Kerz (35:34.954)
there will be a lot of good coming out of it. I don't know in terms of like the primary care system, there's just been a lot of doom and gloom about the whole system's crumbling and falling apart. And it's hard to say like really where that rock bottom is. Are we there? Are we there now? Or can it get an order of magnitude worse? It's hard to say, but I mean, there's a lot of unrest and people are starting to like be more open-minded. So I think that'll really influence how the next couple of years go.

Maximilian Kerz (36:04.894)
specifically, I think the NHS just broke into four different sectors. So acute, continuous care, mental health, and what was the other one? Primary care. So yeah, it'll be really interesting to see how that break up actually, hopefully, has a positive effect. I think there's like a lot of people also thinking it's a crazy move. We'll see, it'll change also, there's a lot of possibility.

I respect that they're trying things, right? They're like, okay, we have a problem, we gotta do something, and we can't just continue to do the same thing again and again and think things will get better. So, I don't know. Everyone's always skeptical any time anything happens, but I like to try and be optimistic and hope it'll help. I mean, their thinking was that it'll remove some layers of mental management and they'll be able to run a leader operation by breaking the organization down into the four. So, Alberta Health Services,

Maybe it will be leader now. Time without. I mean, small organizations, it means you have more capability to like, look into the various policies and what's going on. Like it's very easy to get bloated when you're not seeing the forest from the tree, so that might actually work in their favor.

Then again, I don't know, that was part of like what they touted as the benefits previously, was Alberta Health Services was the largest health system across the entire country. And so they're like, well, we can be quicker. You know, there's less red tape. We can just make decisions more swiftly because there's one central decision signing authority. And they certainly have done a lot of like innovative things over the years, like Netcare was pretty ahead of its time. So that was like the provincial system where all your labs, your blood tests, your images.

is your consultant reports for a patient who show up. Sort of that one patient, one record philosophy. And everywhere else didn't really have that. That was like pretty revolutionary for Alberta to have this platform. You know, you go somewhere else and you get discharged and then you get readmitted to the hospital later that day at a different location. The ambulance drove somewhere else and they're like, what just happened? We have no record of any of this. And so that was pretty cool. Connect Care. So now this is Provincial Y.

Maximilian Kerz (38:24.106)
electronic health record system for the hospitals which plugs in with all the EMRs in the clinic. One person I've talked to so far is liking it. Growing pains. They're still very much in that like initial adoption period and a lot of people are frustrated and burdened by a lot of the inefficiencies and things there but...

Perhaps it will be, again, ahead of its time and revolutionary by the time it's all settled in. Right now, the vibe on the street is not particularly positive, other than the one doctor. But I don't know, we'll see.

It's a power move, right? That's one of the things that's nice about having that central health system. That they can do things like that. Very true. It goes along the way of interoperability and connecting healthcare. Like in the end, I think that is the play. And then the question is more on the execution and operational side of is it set up in a way where it truly accelerates healthcare? And like you said, Medicare can lead it.

very positive thing there. So we'll see. The verdict is still out. Maybe this whole challenge weighed into why they decided to split back up and separating the acute from the primary care. So we'll see. Very true.

Maximilian Kerz (39:51.128)
Some thoughts on Urient? I've never used it. I've never actually logged on or seen it, so it's hard for me to comment there. Sounds like a great idea. Yeah, we'll have to talk to some people next year, next year, and see how the integration has gone. Pretty cool. Nice. All right. Yeah, I think this is an interesting sort of wrap, from a J perspective, I think.

interesting moves this year like around terms of like re-solidifying sort of ability to connect people and like hopefully still help from that.

of connectivity and job opportunity perspective, you know, looking to support universities as well. So we'll see what that takes us. But yeah. What are you the most excited about for 2024 coming up at Cherry? I think, you know, like the initial vision was to connect healthcare. We started off with jobs and job opportunities and we tried to address the physician bill and all that and we saw some shortage problem.

And then the vision was always to go further, to not just stick it out in that area, but actually provide value in other areas as well. To, in the end, empower physicians and healthcare providers. We have some interesting areas that we want to focus on in the new year that go beyond job and job opportunities and really help serve more on the administrative side and the actual delivery of care. So I think there's a lot of exciting things that we can.

talk more about in the coming quarter and that I think I will use and actually start experiencing as well. A big expansion, new function coming out.

Maximilian Kerz (41:42.056)
I think it would be nice having all the allied health professionals on there. That really ties things together quite nicely, like in terms of all the outpatient clinics that are multidisciplinary, in terms of all the hospital teams that are running multiple facets. We've talked to a lot of different professions already and the same problem exists everywhere in terms of their jobs, in terms of their locums. It's just like not often a very central platform or system for coordinating.

Maximilian Kerz (42:12.01)
backbone for a lot of what they need to collaborate on. So it'd be really nice having them on there. Yeah, it'd be really interesting to see that and then also how they could potentially be used not just from a core connecting perspective but also from a referral standpoint, especially with allied health, which is very much underserved at the moment. I think patients are very much.

left alone in finding the right provider and by giving essentially sort of prior care the ability to actually look who's actually around, who's got time, you know beyond specialists but actually within the allied health care sector is really something that we want to work on and hopefully that also being an efficiency gain within the entire system. Yep, exactly. I mean again, the team-based care model, right, there's just not enough doctors to go around.

let's distribute the work, right? If everyone's working at the top of their scope as efficiently as possible, that will definitely help with the access to care. It's just gonna be a matter of creating those collaborations and those lines of communication. I think starting off with referrals, how do we actually find each other, who's capable of doing what, and just getting that information more freely out there. I think that'll make a big difference. Yeah, more than we can. Sometimes, I mean, I think that right now, we very much rely on our personal network

we've referred to in the past because our patient had a great experience, which makes complete sense, but doesn't necessarily look at the availability and wait lists of how quickly a patient could potentially receive care. And so I think that's a very interesting opportunity that we'll be looking at actually pretty soon.

Exactly, exactly. Collecting the hive mind to start putting some of this data together, the wait times, the experience. Was it positive, was it negative? Was it sub-specialized enough, right? Because doing it independently by trial and error for all these different practitioners in your area, you can imagine the cycle of sending out a patient versus getting information back, right? Like how was that psychologist? Did they, you know, versus look at any other digital marketplace?

Maximilian Kerz (44:21.178)
right now, there's always a system for accountability on there, the insights, the data, right? Uber's got ratings, Amazon's got ratings, right? And then you look at the healthcare space, again, it's very much closed off, you don't have these insights as to anything. And so by making that more visible, more transparent, it'll just be much, much easier for practitioners to navigate, you know, who should I be sending this patient to, not just for referrals, but for things that the patient can seek out themselves, helping to direct.

them and put things in the hands of the patients. Yep, they have 100% efficiency gain but also hopefully powering the physician to see what's out there and raising the bar of care in general. I think lots of exciting things. I think we can close out, we're really proud. In the way we've come to, we're super thankful for all the users that have started adopting Cherry Health and using it on a regular basis.