Disrupting health care with Joe Rubinsztain
CEO for ChronWell
Thank you for joining us for this interview series, we’ve been talking to experts in aging, mobility, technology, policy to uncover the business and social opportunities that inclusive and accessible products, services and experiences deliver.
Q. Tell us about your own story and the great work that you do at ChronWell and beyond?
I'm a physician by training from Venezuela, but an entrepreneur and computer programmer at heart. I graduated from Central University of Venezuela around 1992, and started a business while in medical school to do electronic health records, which operated until 1996, and then moved into the United States. Here I worked for an electronic health record company for about a year to learn the Americanway.
Then I started a company called gMed, which did electronic health records for gastroenterologists; the company grew, slowly but surely, to take over about 30% of the American gastroenterology market. Eventually we sold it to Modernizing Medicine in 2015, and worked with them for about a period of six months to transition. Afterwards we started a company to help injured workers called ChronWell.
From a background perspective, I went from understanding computers as a hobby and medicine as a profession, to loving programming and technical work, and then making my way through sales management. After that general corporate management, and then eventually leadership and selling the company, which changed my career. I also completed an executive course at Harvard Business School, and co-founded this new company with your help.
Q. Tell us about ChronWell and its vision.ChronWell is a new company that was designed to put a little bit more empathy into the American healthcare system.
I am originally from Venezuela, where the healthcare philosophy is very different; the doctor-patient relationship was a critical part of the equation. That seems to have been somewhat lost in the highly procedural and litigious US system, and particularly in the workers compensation space, which deals with work-related injuries. We thought it was time to bring back what should be common sense: that a little bit of kindness and good science can actually make a big difference in resolving cases that are otherwise expensive and litigious.
ChronWell is all about applying kindness and intelligence, both human and artificial, to solving these problems.
Q. When did this concept of being inclusive, being kind and accomplishing results by connecting with human beings become important to you?
I don't think it was something that became important, it was always there. When I was younger I was exposed to many cultures as a doctor; In gMed we were also exposed to many cultures from our buyers, their patients, and the employees we hired. With that cultural diversity we were able to see different points of view, which actually enriched our designs, leading to smarter solutions.
As we come into workers’ compensation, with humans and artificial intelligence, we become exposed to multiple races, nationalities and levels of education, as well as multiple social and economic layers. And now we have to consider artificial intelligence as an additional layer for inclusion.
Q. How to make sure that AI ends up being inclusive? Can you describe in more detail the role that ChronWell has with the injured workers and with the companies it serves?
ChronWell is a company designed to change the way we deliver care to the injured worker, and that starts at the moment an incident occurs. Our platform is called ChronWell Recovry? and the interaction begins with an injury hotline that allows injured workers and their managers to describe their incident; we can then make recommendations for the best level of care; in many cases injured workers can take care of themselves with minor help and bypass a very cumbersome process. In others you have to go to the right facility or call an ambulance. We immediately follow up with a care assistant that is a mix between humans and artificial intelligence. It’s designed to establish a line of communication between the injured worker, the employer and the insurance.
Today that’s a relationship that starts off wrong, because the injured worker has no one to talk to when the incident happens. They don't understand how to navigate the healthcare system, and don't know if they're going to continue getting paid as they're recovering from their injury. Recovry? acts as that intermediary that answers questions, organizes appointments, communicates achievements and recovery milestones, and keeps everyone engaged in the recovery of that injured worker.
Artificial intelligence can't fix everything, the human touch is critical as well. That’s why we're creating a very dynamic interplay between the live person and the computer to allow live people to be more efficient and more effective in their job, and really creating a true partnership between workers and artificial intelligence to establish a better outcome.
Q. Can you describe what that means to the employers? Why is it good for companies to create an inclusive experience for the injured workers?
When an employee gets injured he’s no longer productive, and workers should be a high-value asset to all employers. On the one hand, you have this person that can’t fulfill their role in the company; on the other, employers are also humans, and humans care one for another. The need to offer a lending hand should be innate. Employers are truly interested in three things: number one is to make sure injured workers recover as fast as possible and become productive again; number two is making sure the company doesn't get harmed, because lawsuits are expensive and hinder growth. The third is they want employees to perceive them as a good and caring place to work, so they can attract better talent.
That's a critical area from an inclusion perspective. Most employers today are looking to attract the best talent possible, to keep the talent they already have, and to make sure they don't waste time or resources on lawyers.
Q. What do you think are the biggest obstacles, or the biggest critics of creating an experience like this one?
The first obstacle is the innate believe by employers that a large majority of the employees are fraudulent and they want to trick the system. According to mainstream publications, employers believe that 18 to 50% of workers compensation cases are fraudulent. Other publications state that 85% of employees want to get better, but they may not have a good path, and they pay the price of the fraudulent 15%. So barrier number one is the innate believe that it’s the employees’ fault when things don't go well.
The second one is clearly artificial intelligence; it’s still unclear how much of it is hype and how much is reality, but it’s still in the early stages. It's available today, but the marketing version of artificial intelligence is always much bigger than the reality itself. So, people really can't put their finger on what it means; there’s resistance to the concept of a computer taking care of a person because people really don't understand what the computer is, and many think the computer can be evil.
And obviously, there are natural barriers to new companies and ideas: “we've done it this way forever, why do we need to change today?” But we should be able to solve that with some track records and results.
Q. Do you think this resistance comes especially from the workers, or also from the employers?
There’s a mix between a healthy skepticism that comes from deceptive marketing, and reasonable disappointments caused by companies making promises they can't deliver. That skepticism is all around. We find healthy skepticism in management when they’re trying to understand what AI brings to the table; and some are highly skeptical because many companies have come out with products that are touted as being AI driven, and have either unproven or marginal value compared to their price.To include AI in future products one has to understand the tangible benefits AI provides, and few people are really capable of articulating that. It's too ethereal at this point, and we're going to have an interesting time including AI into the care process. It's a challenge and an opportunity at the same time.
Q. Do you see something new or innovative in your field that excites you and it’s tied to inclusion?
I'm very excited about the creative uses of artificial intelligence, and the use of particularly mobile technology to create widespread communities where information flows more freely. You no longer need to be a TV producer to publish content that anybody can consume, and you can view content from anywhere in the world, not just in the United States, just by having a mobile phone. This means you can easily create global communities with technologies that eliminate distance and language as a barrier to inclusion.
What excites me is twofold: our newfound ability to automate, enabling humans to do what they're best at, creating new solutions and building relationships; and how we bridge the gap in distance, time and culture by using artificial intelligence and technology to communicate, regardless of your location, the language you speak and your availability.
One additional item about inclusion is that artificial intelligence is going beyond just recognizing spoken words, and towards truly understanding emotional inflection. Different cultures have different intonations, and analyzing emotional content as much as the spoken word is critical: what does their body language really say, what does that intonation mean in Nigeria versus the United States, etc. It will certainly help us bridge that gap in communication.
Q. Do you think that it will also be possible to recognize, for example, the body language of a very stressed person versus a relaxed one?
I have no doubt. If computers can see micro gestures, body positions, or emotional spoken inflections; if they can perform context analysis and understand social profiles, their ability to truly understand who you are, what you feel and what you're trying to say can be much deeper than that of a human being: we have a skewed vision of the world that’s shaped by our own experience.
That's a great point. It could be much more neutral and inclusive.
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About Joe
Joe Rubinsztain is CEO for Chronwell, a new company disrupting the Workers Compensation with Artificial Intelligence to coordinate care, improve outcomes and reduce costs. He is founder and former CEO for gMed, which was sold Modernizing Medicine in 2015. He is passionate about strategy, innovation and leadership and often helps companies and entrepreneurs conceive new products, motivate employees and drive change, with particular interest in patient outcomes. Joe is a physician with over 20 years of experience in healthcare information technology and services. Under his guidance gMed became the leader in healthcare information systems and services for gastroenterologists in the United States. He served previously as President of R&R Comed, a pioneer in Electronic Medical Records from 1990 to 1995, and was Clinical Product Manager in charge of NextGen for Quality Systems Inc. in 1996. He has been involved in healthcare information technology since 1981, graduated as a medical doctor from Universidad Central de Venezuela and the OPM program at Harvard Business School. Joe serves on various public and private boards.
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