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- [00:01]
A
This is Laura Dardo with Abeckers Healthcare and I'm thrilled to welcome you all to our CEO CFO Roundtable speaker series. Today we'll be speaking with Manish Goyal, who is the chief operating officer at Mayo Clinic Platform. Manish, thank you so much for being here today.
- [00:15]
B
Thank you for having me.
- [00:16]
A
Absolutely. Well, I'm excited to have this conversation because I know Mayo Clinic is such an innovative health system. And what you're doing at Mayo Clinic Platform especially has really big implications for healthcare delivery in the future and will be exciting for our broader audience to hear about. But before we do, can you tell me a little bit more about yourself in Mayo Clinic Platform?
- [00:37]
B
Yeah, you bet. First of all, again, thank you for having me. Thank you to listeners out there. So very simply myself, I've been fortunate enough to have some interesting experiences, but I would say I've been a builder of things my entire career. Helped to build a semiconductor company which is Fortune 8 today. Helped him build a venture fund in healthcare technology. Led as an executive at healthcare technology company, which we sold. And I've been at Mayo for about five years, or actually almost six years and helped to write the original strategy for Mayo Clinic Platform with some of my other colleagues. And I've been in the CEO role ever since. At Mayo Clinic, one of the things that we pride ourselves is that we enable, we deliver against many metrics, some of the best care in the world. We've been number one in the world by U.S. news and World Report for seven plus years. But the bigger mission we're on is actually change how healthcare is delivered globally. We recognize that we can take care of millions of patients a year at our three destinations in the US and our health system. But how do we impact billions of lives? That's been at the cornerstone of Mayo for 160 years. But now we're trying to figure out how to do this at scale. And that's where platform comes in. Platform models inherently get stronger the more utilization happens on it. For five plus years we've been on this journey is to say how do we work more scalably with a growing set of health partners our health system. So that means other academic institutions all the way to community health workers across the globe. Because part of healthcare is can you get to the right diagnosis? Can you get there quicker? Part of it is can you get to the right therapeutic pathway and can you get there quicker? Because Mayo has seen tens of thousands of neuro oncology patients because of who we are. But the average community hospital might see one or two or 10 patients in a decade or over a long period of time. And so your experience set is much bigger at Mayo. Now you take that and expand the experience at a global academic institution and you get some really interesting insights that can be gleaned. Those insights can be shared with those community hospitals that don't have the same kind of patient volume and complexity volume. And that's how we impact billions of lives. That's our goal, is that we want to create a partner ecosystem that consists of healthcare organizations that are going to deliver care for their local patients and we're going to help them supercharge them. We're going to help them get to the knowledge base that exists in Mayo so they can make diagnosis and care recommendations faster and better and then have a support structure that really understands care delivery. We're not a technology company or a healthcare organization. At the end of the day.
- [03:48]
A
That'S.
- [03:48]
B
The journey we've been on. Today we have 40% of the top 10 institutions that are part of our network. A total of 73 hospital systems across the globe representing 45 million lives. I think the metric that I'm most proud of as I reflect on the past year is Mayo saw 1.2 million patients in the last year. We impacted 45 million lives through platform. And we're just starting to get, getting going. Right. So I can share specific examples, but that's what we're up to.
- [04:25]
A
Well, that's amazing to hear and what a huge impact that you're having on patients and hospitals and health systems across the country and across the world. I think it's such a unique success story that Mayo Clinic has had and truly innovative in how you're supporting other organizations going forward. So that's amazing to hear and I would like to ask, you know, if there's a project or initiative or one of those examples you want to share with us has been most successful from the last year or so.
- [04:51]
B
Yeah, I'll share how we're rethinking of the very notion of a hospital. So, you know, we recognize that hospitals are very expensive to, to. To build, to maintain. You know, it's expensive equipment, it's maintaining and organiz the infrastructure. Can we rethink and allocate those resources into the things that are necessary for a hospital to do? Five years ago, four years ago, pre pandemic, we had a charge from our CEO who asked the question, can we take 15 to 25% of our patient volume and have them be taken care of in their home? This notion of a Hospital at Home was born and we partnered with Kaiser Permanente to develop that. Today, that model is being used by 21 hospital systems across the country. Some of them are other academic institutions, some of them are local, regional hospitals. But what's interesting about that, that we learned over the course of five years through the pandemic, is that the model is actually better. Patients prefer it, the outcomes are better, because we know what's actually happening with the patient after they leave. Our premise, it's not just you're on your own, which is what happens today. We know it can reduce cost. You can live your entire healthcare career and not have those three things happen at the same offering or solution. We're happy with that. But what I wanted to talk about is really what we learned and how we could apply it. A year ago, we asked the question, what else can we do with this? Mayo has seen tens of thousands of patients under this model. It's now becoming commonplace for us. We said, what else can we do? Our oncology department said, could we deliver chemotherapeutics in the home? That's done in a clinical setting because that is the standard process. There's no reason a patient needs to go for most chemo to a clinical setting. We said, let's leverage this infrastructure and deliver chemotherapeutics in the home environment. We ran a clinical trial, found patients love it, satisfaction was higher, the clinical results were safe and effective. We said, okay, let's expand this. Until we asked our network who wanted to participate in this clinical trial. We're still going through the clinical trial model on this. A regional hospital, Altru in South Dakota, raised their hand and said, we want to participate. We stood them up and now we're able to power their patients to get the same model of care and or a clinical trial model delivered. In this case, ALTRA would never be able to build that on their own or would take a lot of effort and resources. So we're able to help them stand that up. Why is that important? A, we're running a distributed clinical trial, recruiting patients from an academic institution and a community hospital. We're running a new, new model of care and we're doing this in months time versus talking about it for years. We, we stood that up in three months or four months time frame. That's really power. And that's one narrow example amongst many, many other examples. I'll give you a, an INSIGHTS example as well. Right. What could you do if you organize our data? So Mayo has taken our 40 years. We've only digitized 40 years of history. It's about 7 million patients that we've seen. We've organized that all in the cloud and de identified it, which allows us to do pretty novel discovery. When I say data, I want us to imagine everything we know about a patient. That is all the structured and unstructured data that sits in your ehr. Radiology reports, pathology reports, echo reports, all of the radiology images. We've scanned 20 million pathology slides, omics, waveform data, ECG and EEG and other waveform data, put it into the cloud. Now, with all of these modern computation techniques, you can find some really interesting things out. We discovered that we can diagnose asymptomatically certain cardiovascular conditions that you couldn't do before. The way you discovered these things were when the patient exhibited a cardiac arrest, a lot of times the patient died. We're now able to do this in an asymptomatic way. When you come to Mayo Clinic, these algorithms are running in the background, highlighting risk on these patients. These solutions have gone through an FDA process and a reimbursement process. They're pretty mature. But another example. And so, boy, isn't it powerful to think about that you could have these things that analyze all the available data on you as a person and diagnose something well before you exhibit any symptom. It changes how we think about healthcare.
- [10:14]
A
Absolutely. That's such a great point. And really powerful examples of the ways technology can supplement everything that caregivers are doing and make them sharper, provide better outcomes, and as you said, really save lives when it comes right down to it. So that's amazing to hear and think about. Now, I'm curious, what are some of the top two to three issues that you're focused on right now? What's really top of mind for you as you're looking at the evolution of technology? Seeing how healthcare environment is changing as well as I'm sure patient behaviors and demands are changing as well.
- [10:46]
B
Yeah, I think I would say our key area of focus right now is how do we do everything at scale? What do I mean by that? If you look at any hospital, the departments that have resources are oncology, cardiology and radiology. That's where you see all the innovation. But there are a lot of other departments with other complex diseases like immunology, that we don't necessarily fully understand the pathways patients suffer because they go from diagnosis cycle to diagnosis cycle, and it takes years to figure out certain what's actually the root cause. And it's a process of elimination. So one of the things that we're working on is could we use a lot of the lessons learned. If you have 10 million patients and we have 23 million patients across the world that are in this infrastructure, could we learn something around what's actually happening with these diseases? Because we've been diligently capturing data on patients for 30 years now. The promise of the EHR is actually taking hold. Could we discover things and can we do this in the areas that are not well funded? Call it rare diseases, call it diseases that don't have massive biopharma funding or large research grants? Can we do this at scale? That's a focus area of ours, is to really from democratize the clinical areas that would be addressable by what we're, what we're talking about. The second thing that we're really focused on is the other kind of, I would say democratization is can we take these and actually deploy them into parts of the world that don't have the same level of infrastructure or resources that we do in the U.S. i think we oftentimes don't really fully realize how spoiled we are in terms of the availability of great health care. Even though it's somewhat inconsistently allocated, you can get really great health care in the United States. It's not always available or it's rationed. So can we actually plug into parts of the world that's entirely cash based? Parts of Africa are, in India, almost all a cash based system. So when it's cash based, you have to really align with the patient much more tightly than a third party payer system. And so a lot of the things we're working on is infinite scalability. And what that means to us is can we share knowledge? Because that's what we're talking about. Can we share knowledge around decision making rapidly and at a low cost so that we can attach to business models that aren't the same business models that are in the United States or large development part of the world? That's what we're focused on, is really taking everything we're doing and having scalability up and down the economic ladder.
- [14:04]
A
I love that it seems like such an important aspect of bringing all aspects of healthcare into becoming more accessible, providing better outcomes and really sparking that innovation in areas that you mentioned that already, you know, have funding or might have the infrastructure in place and are innovating rapidly in oncology, cardiology and radiology, and then, you know, bringing that to other areas as well. And so this is extremely admirable. Where do you see some of the big opportunities for growth over the next few years or so. What do you see as being really important when you look at growth at Mayo Clinic platform?
- [14:38]
B
So what's interesting is we're starting to see what I'll call network effects, which is our partners are understanding that even though it's called the thing that we're participating is called mail calling platform, we're not trying to supersede their brand. So if we think about healthcare, it's like politics. It is local, you get healthcare locally and even if you use a GPT server that's half a world away your for, for information, when you need care, it will be local. So you really have to elevate and participate in a global model. And so I think the big opportunity and big growth lever for us is going to be continuing to empower local systems so they're able to disseminate in their local geography. I'll give you a specific example. One of our, our community hospital systems raised an interesting point with us and said look, can we leverage what you've built and create our own local affiliations with the critical access hospitals that we're associated with? So great. That is the whole point of this model which is that we're not trying to stand in the way of anything. We want the message to continue to grow out. But what we're saying is whatever is the message on there should have a certain bar for what it's doing. It should be focused on care, quality improvement, it should be focused on earlier diagnosis, it should be focused on the patient. We're not trying to create a new economic engine that's going to be the next trillion dollar company. That is not Mayo Clinic's charge. Our charge is maximal impact on a global healthcare.
- [16:38]
A
That makes a lot of sense. You know, having that center top of mind truly, I can imagine makes a difference. And you're looking at decision making, looking at figuring out what your next step is going to be, your strategy for the future. Before we wrap up, I wanted to get your perspective on what do you think it will take to lead a thriving organization over the next five years or so, Especially given how fast technology is changing. You know, the healthcare ecosystem is changing. Access to care is a huge issue for many organizations. So what do you see as being paramount for the top leaders within healthcare systems today?
- [17:14]
B
No, it's a great question, as you know discussed with many, is that there's a lot of external forces that are forcing each organization to make rapid internal changes. So now you've got a perfect storm of external and internal change. And so I think most organizations or any organization that's going to thrive in this has got to have a couple of things in mind. One, there has to be a maniacal focus on one North Star. One key imperative for Mayo. It's been the same for 150, 160 years, which is the needs of the patient come first. So when anything gets blurry, we say, okay, is this good for the patient or is it not? Because decision making is complex. Strategy evolution is complex. We always focus on what you're trying to do and for each organization, something different. But for us, these words mean a lot. I think the second thing is you need a lot of agility once you have that North Star established, because there's so much rapid, to your point, innovation happening and change happening, whether it's regulatory environments changing and shifting, global landscape and geopolitics changing rapidly, technology innovating more quickly than anyone or most people really gathered. And I think there's almost like a seeming acceleration of socioeconomic changes where you've got population shifts happening, whether it's resourcing for healthcare workers or aging patient population. Two, finally, these macro events, the next pandemic or the advent of a GLP one that completely changes the obesity curve, but it has a macro cost. All those things are going to continue to happen. You have to have maximal agility to maneuver around it, otherwise they're going to be caught in the tide.
- [19:29]
A
Absolutely. That's such an important reminder. Manish, thank you so much for joining us on the podcast today. This has been such a helpful conversation. Really inspiring to think about all the possibilities in the future, but then grounding to also understand the big challenges ahead and how we can really tackle them together. I appreciate your time today and look forward to continuing this conversation at our CEO and CFO roundtable.
- [19:52]
B
Well, thank you Lauren, and thank you for having me and really appreciate everything that Beckers does.