Ep 23: How AI Will Transform Healthcare with Teladoc Health Chief Innovation Officer, EVP of R&D and Technology Claus Torp Jensen

Evan Reiser: Hi there and welcome to Enterprise Software Innovators, a show where top technology executives share how they innovate at scale. In each episode, enterprise leaders share how they’re driving digital transformation and what they’ve learned along the way. I’m Evan Reiser, the CEO and Founder of Abnormal Security.

‍Saam Motamedi: And I’m Saam Motamedi, a General Partner at Greylock Partners.

‍Evan Reiser: Today on the show, we’re bringing you a conversation with Claus Torp Jensen, Chief Innovation Officer and Executive Vice President of R&D at Teladoc Health. Teladoc is a leading innovator in virtual healthcare, connecting providers and patients in over 120 countries across the globe. Prior to Teladoc, Claus was the Chief Technology Officer at both CVS Health and Memorial Sloan Kettering Cancer Center. In this conversation, Claus shares his approach to building a culture of innovation, how AI can reinvent healthcare, and the ways Teladoc leverages technology to positively transform patient outcomes. Claus, first of all, thank you so much for taking the time to chat with us. Saam and I were really looking forward to this episode. Maybe just before we dive in, can you share a little more about your background, your career, maybe the role you have at Teladoc Health?

‍Claus Torp Jensen: Absolutely, and thanks for hosting me. So I was born and raised in a different country. I was born and raised in Denmark. I think I would describe myself as an adventurer into the realm of technology innovation. I was born and bred an engineer a long time ago, I have a PhD in computer science, and along the path I went through finance, I worked for a technology company, I worked in healthcare the last number of years. If you look at what I do, when I join an organization, I try to help actually create meaningful change in the world outside whatever organization I work for. I used to say, when someone asks me, what do you use as criteria for why you take a job? I usually say something that lets me leave behind a better team, a better organization, and preferably a better world. So I’ve had the luxury of having a few of those.

‍Saam Motamedi: One of the reasons why I’ve been so excited to have you on the show is you come from the healthcare world and you’ve had a variety of experiences, both on the practitioner and health system side, now on the technology and innovative company side. So there’s a lot to unpack there at the intersection of healthcare and technology. Let’s start with Teladoc, Teladoc is obviously sitting at the very frontier of this next generation of healthcare. Can you share how the company uses technology to transform healthcare and the patient experience?

‍Claus Torp Jensen: So the very company is born on a pretty radical idea. You have to go back 21 years in history, and the idea was, quite simply, you don’t have to go to a provider’s office to get a visit. You can do it virtually. In today’s world, it’s like, yeah, that’s not really novel, it’s not terribly surprising, everybody does that. But you go back in history, it wasn’t that obvious. So you start thinking about it. What do you look for? You look for something that is novel. You look for something that might be obvious in hindsight, but it wasn’t necessarily obvious at the time. And you certainly look for something that’s valuable. Those are the innovations that map. So, the company was started based on that. If you fast forward a little bit in time, now you need to do it at scale. You can’t actually just continue to have people schedule visits with people, even virtually. I mean, that was how practice management has been done historically in healthcare, you have someone who does a schedule somewhere on the calendar, and that becomes the visit. Okay, if you think about doing that at a scale of, I don’t know, pick a number, right now, about 90 million Americans that have access to our services to stay in the US. How many people would you either need to have to do that by having a person schedule?And how many phone lines would you need to have? And how good an experience would that be? So the next stage of transformation based on innovation really is, oh, I now have to do this at large scale. It’s not enough to throw people after it anymore. How do I build technology that can manage the queuing of people that want to get visits, and the intelligent match up to who do we have available in the state of Nebraska? If I’m in Nebraska, I need to get a provider in Nebraska. Who do you have available in the state of Nebraska at 10:30 p.m. in the evening? And how do I make sure that the person that asks for a visit gets correctly matched up? So inside our whole platform sits a pretty sophisticated logistical engine that manages who’s available, what are the credentials? What states are they allowed to practice in? How do we manage all the virtual visit rooms? If you think about it, it’s really about empowering the person that needs care to do the scheduling. There’s just a whole bunch of magic that happens under the covers to make that actually work. So that was sort of a second phase. If you look at the phase we’re in now, it’s really not just about a visit, it’s about the care journey of the whole person. You will find a lot of organizations out there that talk about whole person care. I’d like to coin the term, let’s call it native, because whole person care for us is something that was built, born, bred, made for a whole-person experience pretty much over a lifetime. And you can’t actually do that unless you’re willing to work with the entirety of the existing healthcare system. Lots of people talk about fixing health care, but they think of fixing health care as in, I’ll build something better, and replace it. You know what? I wouldn’t want that. I still want to have access to specialized health care. Look, if I live in New York City, I work for Memorial Sloan Kettering Cancer Center, that’s a great place to go if you ever have the misfortune of getting cancer, and I want that. But I also want the village doctor experience. I want someone who knows me, who knows my history, who can put together all the dots, and who can be my partner in sickness and in health. So whole-person care should be actually person-centric. It should be about the person, not the service. It should be my choices, and it isn’t necessarily binary, because for different people, what my healthiest life is, is actually different. It’s not just what clinical science says, it’s what fits into my life circumstances, my lifestyle, and if you look into the future, I’d like to think that that becomes an embedded, ingrained, let’s call it ambient part of what it means to live your life. The best healthcare services are the ones you don’t have to be consciously aware of. They’re just there when you need them and they’re not in the way when you don’t. So you can sort of look at how the very history of the company is based on the thought that there are just successive waves of innovative thought that leads to a different experience and different outcome.

‍Evan Reiser: I think we all intuitively know that there’s been incredible technology advancements across healthcare, right? If you look at bioengineering or just like even the pandemic we’ve just gone through, there’s evidence of that. However, a lot of that kind of high technology in healthcare is sometimes hidden from the average person. There’s a lot that I think the average patient might take for granted. Do you mind sharing maybe some of the ways you guys use technology that the average patient might not fully  appreciate?

‍Claus Torp Jensen: It’s a great question and it’s actually completely true. I mean, there is a lot of the stuff that makes the health experience great that’s actually very difficult to do and requires a lot of underlying technology innovation, technology development. I gave you one example. We call it the consult queuing service, also called CQS between friends, that’s the logistical engine that matches up millions of people that need visits with a couple of thousands of people that can provide them. Another example would be how do you track identity over time? Think about it. We don’t have the same job for life, we don’t have the same provider for life, we don’t have the same health plan for life. How do you actually leverage statistical analysis, pattern making, algorithms, analytics to say welcome back? When you see someone that comes in from a different provider, a different employer, a different health-, that’s a hard problem. And it’s not something that you see, you just expect that of course Teladoc will recognize me and say welcome back, because I’ve been here before. Why wouldn’t you remember me? Without knowing that the way we see you now, you’re coming in on a different employee ID, you’re coming in under a different health plan member ID, so that’s another example of something that’s hidden under the covers. And then lastly, just how do you nudge people to actually do the right thing in the right moment? And that’s a combination of data science and behavioral science. I mean, that is really the holy grail, where our ability to experiment with exactly what signals matter, at what point in time, and lead people to take meaningful health action will generate a better or not so good outcome. We have a lot of data points, that’s a good thing. So we have a big amount of data to actually train our models with and build out exactly what would be the best possible health action to suggest to someone. And it is highly personalized because it’s not just what the clinical science says, as we talked about, it is very much how you fit into life circumstances and increase the affinity to take action.

‍Saam Motamedi: Yeah, those examples were fantastic, Claus. I was just taking notes on areas I want to double click on. But let’s start on the AI side. Both Evan and I are highly interested in AI. We spend a good part of every week thinking about this new wave of AI we’re in, particularly on some of these generative capabilities and how it’s going to transform the way we work and live, and one of the areas is healthcare, right? You talked about this concept of ambient healthcare, and I really like those two words, and I’m curious, how does that connect to AI?

‍Claus Torp Jensen: The way I always start with the fact that two of you will know, right? There are different classes of AI models and technologies that do different things. Right now, the rage is ChatGPT because it’s the first example of a general AI model that is generative. But there are other kinds. If you look at what healthcare actually needs, we need something that allows us to have a meaningful conversation about what’s going on. So a general generative model is great for learning, for guidance, for trying to just understand what’s going on in my life. It’s great for that. But you also need to say, what can you put into a local environment that gives you the ability to predict that something is about to happen? Now we’re talking predictive models, and those are a different class of machine type intelligence. We use those already. There is the descriptive model that says when such and such happens, it’s likely that there is an adverse event. I’ll give you an example. We actually help people manage conditions like diabetes and if you’re a newly diagnosed diabetic, one of the more dangerous things is that you don’t actually know what it feels like when your blood sugar is out of whack. And it can be quite dangerous both if it’s too high or it’s too low, so we make sure you have a blood glucose meter with you. So let’s say that you’re feeling dizzy, which could mean that your blood sugar is low. You pull out the blood glucose meter, you’re all alone somewhere on the road, there’s nobody out. Look, the US is a big country. You can find places where there isn't anybody really around. You measure your blood sugar and it’s low. Then you can ask yourself, what’s the next thing that happens? Well, what should happen is that there’s an algorithm somewhere that flags the fact that, hey, I just got a data point that said that this individual on our program has dangerously low blood sugar. We know that that person is a newly diagnosed diabetic. Why don’t we call them and see if they need help, which in this case they do, because they’re not sure what to do, and you can help guide them to what they should do. So these are all different classes of what you could call data intelligence that fulfill different aspects of the surround sound environment that I’d like to think is the future of healthcare.

‍Evan Reiser: One of the common frustrations that a lot of the guests for our show have is that there’s a big gap between the promise of AI versus the actual results people see, especially when applied into IT. Can you help us kind of separate the fact from the fiction the aspiring futurists have beliefs about?

‍Claus Torp Jensen: Aspiring futurists, that’s a good term. There’s just a couple of things you have to realize, which is that AI models are basically derived from the data that you give them, and you just have to be very mindful of bias in the data, and look, we have some spectacular examples right now of bias out there that people are talking about. The other thing you have to be aware of is that you don’t always understand why the AI model gave you the answer it did. So we’re not yet at the point where we have general explainable AI. And if you think about healthcare in particular, the reason that’s a challenge is there are a lot of rules and regulations that say you actually need what you would call the standard of care to be understood and explainable. You can’t actually diagnose people, at least in isolation, if you don’t have an ability to explain to the FDA that this is why I did it. By the way, if I was being treated by something, I would actually personally want to make sure it was explainable why it gave me the recommendation it did. So I think it’s very appropriate that that is required. And then finally, people often ask, what is better and what is the future when AI replaces people? I don’t think it’s the right question. The right question is, how can we accelerate and amplify and actually create the combination of people and AI models to deliver a better experience? What’s interesting is when you run the statistics on the quality of answers you get from an AI model or person in isolation, it sort of depends on the problem. But what’s always the case, almost globally, is that if you combine the two and you combine the human inferencing brain with the machine inferencing brain, you always get a better result than from either in isolation. So it’s just fascinating to change the question a little bit and say, look, let’s not talk about what you can replace, let’s talk about how you can make the time that physicians spend more meaningful, how you can make sure that they make even better decisions, and how they can spend more time with the patients and less time with researching data.

‍Evan Reiser: There’s a lot of people out there that have beliefs about what AI can do for healthcare. Is there some area where you feel like AI will be more transformative on patient care in ways that maybe your peers or maybe other people in the industry might feel could be more like science fiction?

‍Claus Torp Jensen: I’ll pick three. I do think our ability to detect in an ambient fashion, in your environment, what might be going on with you is a super important space. Whether that’s when you’re recovering from being admitted to the hospital at home, whether it’s because you’re dealing with chronic conditions, it could simply be because you’re aging and it’s just getting to be more difficult. So simple things like do you follow your normal moving pattern or is there something we shouldn’t do? Can we help you get a healthy diet? Because we can basically wire up your refrigerator and we can start connecting that to some of these modern ordering apps that can make stuff magically appear at your front door. So the whole notion of, if you can call, the smart home I think is a super exciting space when you look at population health in general, and I think it’s underexposed in what you can do with intelligent technology. The other one would be emotional intelligence in an interaction. Whether you have a person to person, if you are a nurse that hasn’t been doing it for 30 years or you are a call center agent or a scheduler of appointments that hasn’t done it for 30 years. When you’ve done it for 30 years, you just get a certain level of experience with what it means to interact with people that are generally in distress. The thing about healthcare is people are not in a good place when they need help, and it’s very emotional and it’s very personal. So our ability to actually help whoever is in contact with you detect the emotional cues. Are we having the right common conversation? Is this person getting increasingly distressed or have they become more comfortable? It’s actually a meaningful power up of a system that’s straining under just not having enough trained people. So I actually believe that adding emotional intelligence to hybrid interactions is a meaningful use case that, again, people aren’t talking about a whole lot and the technology exists. I mean, you can do emotional analysis of sounds, of text, et cetera. So the technology exists to do that kind of thing. And then thirdly, but this one is something people are talking about, I’m just not sure they’re really thinking big enough. One of the areas where you can truly leverage the combination of people and learning algorithms is in the interpretation of images. Whether that’s images from a traditional X ray all the way through to what you would see through a cryoelectron microscope. If you’ve ever seen an image from a cryoelectron microscope, it’s just a blob of white. You literally can’t actually understand it with your human eye. But you can use an algorithm to highlight these structural small, small distinctions in that blob of white. And once you’ve highlighted them, the human can help interpret what it actually means. So the combination of human and machine intelligence on specifically a broad, broad range of images, I think it’s a rich field, but that will be the one where people are talking about it, I’m just not sure they’re dreaming big enough.

‍Evan Reiser: Those are fantastic examples. I really like the second one in particular because you’re right, that’s a technology that already exists today, right? Being able to classify media as the kind of emotional labels, that’s not science fiction,you can do that today, but the application of the doctor watching a video call and getting the cues, hey, like stress is going up or stress is going down, that’s a great example of how AI machine learning can augment existing care to help kind of provide better service or maybe to allow more practitioners that may not be fully qualified, may not have the highest skill in those dimensions to go service more patients with high level qualities. That doesn’t sound very far-fetched, right? It seems like that’s something that’s right around the corner.

‍Claus Torp Jensen: No, I don’t think it’s far-fetched at all. What it requires is imagination. I mean, as I said, the best innovations that matter are the ones that are novel in thought because there’s an element of non-obviousness. But they’re valuable now because they don’t require me to go build this huge thing that might happen sometime in the future. Look, I’d love to have a hyperdrive, but I’m probably not going to get a hyperdrive anytime soon. Whereas if we can find ways of applying either existing or borderline technologies in people’s real lives, that is a meaningful innovation that I think matters to society way more than many of the other things we could do, and it basically comes down to I don’t think innovation comes in one shape, size or form. There are different sorts of modes of mindset you can have. You can be in the mindset of incrementally improving something we’re doing already. You can be in a mindset of more radically changing the way something is done, or you can change the why, which is what I think whole-person care is about and what I’m trying to have a conversation with my team about, in fact that’s our theme for the first half of 2023, is how do you think about innovation as part of your day job? Because innovation isn’t something that happens on the side and companies aren’t innovative, people are. So the best way of continuing to have a rich set of innovations is really to sit down to think about how do I bring my innovative self to work every day and be thoughtful and conscious about the choices I make on the range from we just need to have head to the ground, let’s just get it done, through incremental innovation, radical innovation or, look, we’re right now dreaming about what we can do to transform the world. And I don’t think one is better than the other. I just think it’s a matter of being thoughtful and mindful about what mindset did I bring to this conversation?

‍Evan Reiser: It kind of begs the question, we think about technology leadership as part of the job, right? It’s not really technology, it’s about how do you inspire that culture of innovation? Can you talk a little about how you approach that in kind of leading your team to innovate?

‍Claus Torp Jensen: It’s a great question. Look, my background is a PhD in  computer science, it’s as theoretical as it gets, right? Even in theoretical computer science, it literally is as theoretical as it gets. I would call myself the technologist turned storyteller. Oftentimes I actually introduce myself as, I’m the chief storyteller, because it’s all about how you resonate with people. And look, we go through our careers and we take different things with us. I think the revelation that hit me smack in the head when I had my very first C-level job was actually in the end, it’s all about people. And I can tell you stories about possibly a few mistakes I made in the first year of that job because I didn’t really realize how much it is about people. So ever since then, I’ve actually made a principle out of championing people-centric activities across my organization. Because the biggest amplifier you have for an R&D organization is to get your people to be more effective in driving innovation and transformational change. Now, some of the things we do is we actually lay that out as some of our values. So when you look at the values we have for what it means to be in my organization, it’s in there. We gave the organization a name. It was a naming contest to figure out what we call ourselves, and we ended up in a name that’s actually meaningful in the context of progress. The name is Beacons. So we don’t talk about the R&D organization or the technology organization, we just use the label Beacons, that’s who we are, that’s what we live. And in a more structured fashion, we run learning programs on a six month cycle. Every six months, there’s a theme, and the theme has to do with how you make the world a better place. So I’ve been here for about two years now. The first theme we had was digital transformation. You can really translate that to if you start blending digital capabilities and healthcare capabilities, what does that look like? What’s happening in the world around us? And how do we need to rethink what is possible? It’s a great start that begins the journey of healthcare transformation, but we’re not done yet. The second step is now we need technical leadership. So what’s a technical leader? It’s someone that leads through vision, conviction, and technical mastery. It’s not how many people you manage, it’s about what you bring as an individual in terms of truly providing leadership for that transformational journey. So that was sort of the second semester, if you will, of our little learning journey. We’re into the third one, right now, we’re talking about innovation, but innovation in the day job. And it’s quite interesting because we use the word innovation, and we think we have the same definition. Having done this with 1300 people in the last two months, I’ll tell you, no, we don’t. We all use the word, but if we can actually sit down and spend meaningful time talking about what it means and how we bring our innovative selves to work, I believe that’s a massive accelerator on how you can drive the transformation journey. So the next one, which I already announced, is going to be storytelling, my favorite topic. And then the fifth one is going to be around networking, building coalitions, and there’ll be more after that. But it’s a choice you make to personally take an interest in doing something like that, and by being personal, I mean personal. I actually, every six months, travel to every one of our major sites, and I spend a day personally sitting down with the people at that site to have a structured conversation about the theme of the semester. And I don’t think very many senior executives make that choice.

‍Evan Reiser: That’s amazing, and your passion, your personal commitment to driving innovation really comes through. So I’m kind of jealous, like, I want to attend one of these semesters, I feel like I would learn a lot. So, Claus, when we first started talking, you said you wanted to find something where you would leave behind a better team, a better organization, ideally a better world. And so in one of your past roles, right, you were the Chief Technology Officer at CVS Health. And CVS Health is a pretty amazing organization. I don’t know the exact stats, but they’re probably like in the top ten biggest companies in the United States, like Fortune Four, that was a role in an organization that has a tremendous impact on health care in the United States and beyond. How has that experience affected your leadership, your motivations? I have to imagine that’s really influenced how you think about the world, right? And presumably your motivation to go leave that world in a better place.

‍Claus Torp Jensen: My first healthcare stint was really with Aetna, which was later acquired by CVS Health. So I started with Aetna. And I came from IBM. So I went from a technology company to, all of a sudden you work for a healthcare company. It gave me an opportunity to see healthcare not just from the outside, but from the inside. And where on the outside it’s all about, why isn’t it working better? This is just frustrating. How silly is it that we can’t figure it out. It just happens to be some problems that are sitting underneath it. And I think I got a healthy dose of respect for the complexity of healthcare, and it’s not actually, by the way, uniquely US. You will find some of the same complexities in other countries in the world. Carry on to the CVS experience, now we’re talking a bazillion people that the company is in touch with. We’re talking hundreds of thousands of employees and a massive footprint in US healthcare. So while Aetna was big, CVS Health is sort of super big. That gives you an impression of reach, but I think more importantly, it added some other dimensions. What is the retail angle on healthcare? And there is one. I mean, how do you actually reach people from a health consumer perspective? How do you help manage long term conditions, which can be medication, chronic conditions, et cetera? And you can say if you’re looking for a better team, better organization, better world, why would I ever leave? And look, I’ve been asked that question many times. It was a great place to work, but who hasn’t had cancer close to themselves and their family. And when Memorial Sloan Kettering reached out, it was like, here’s a unique opportunity to take a very specific disease and get an experience for how can you merge these five sciences and not just make care better in the here and now, but help drive a more accelerated research agenda for how you can find new treatments? So I made the jump and I learned a lot about what it feels like to be on the provider side through the pandemic and a few other bits and pieces. So then Teladoc Health comes about and it’s back to what is it that defines the biggest part of the healthcare impact? It really comes down to primary care, mental health, and chronic conditions. So if you get your arms around how you can deliver better holistic care, in just those three things, to a meaningful proportion of the population of any country, I think you can get to the point where when you get to retirement, you can truly say, yeah, I made a difference, together with whatever team it was you were leading, and it is a team sport. Nothing in healthcare happens to an individual. Everything happens to a team. So I don’t know that I have a better answer than what you take with you is a different appreciation for sophistication, for scale, for complexity, and for opportunity. And I’ve had the fortune, or misfortune, of seeing pretty much all parts of healthcare other than working for a pharmaceutical, but I worked with pharmaceuticals. I do think that’s a little bit unique.

‍Evan Reiser: Extremely unique, and we really appreciate your view, especially as it relates to how technology can be applied to further optimize and improve all those things. Can we do a quick lightning round before we sign off?

‍Claus Torp Jensen: We can do a lightning round.

‍Evan Reiser: Okay, so, Claus, what we try to do is just to go for, like, the one tweet answers, right? And Saam you want to kick it off?

‍Saam Motamedi: Yeah, absolutely. Maybe to start, Claus, how do you think companies should measure the success of a CIO?

‍Claus Torp Jensen: Through outcomes. It’s that simple.

‍Evan Reiser: And is there a common mistake you see maybe new CIOs or new technology leaders make?

‍Claus Torp Jensen: Not focusing on people.

‍Saam Motamedi: And maybe related to that, what part of the CIO’s responsibility do you think is most underestimated in its importance?

‍Claus Torp Jensen: I think it is a platform as a strategic driver. If you think about it, platforms have a massive impact on your ability to continue to innovate. We often focus on the first innovation and forget the next 17.

‍Evan Reiser: Maybe shifting a little more on the personal side, is there a book you’ve read recently that’s had a big impact on you? If so, which one and why?

‍Claus Torp Jensen: I don’t read very many professional books as a whole because I learn through snippets of information from different places. But if I were to pick one, and it’s not recent, I think there’s something you can learn from the book called “If Disney Ran Your Hospital”.

‍Evan Reiser: Can you give us the extra tweet version of what that’s about? Because I’m curious.

‍Claus Torp Jensen: It comes down to the experience. And if you look at a hospital or any part of healthcare through the lens of experience, there are certain things you would do differently.

‍Evan Reiser: Okay, I’m going to go look that up, because Disney is renowned for I mean, they don't even call their customers customers. They’re guests.

‍Claus Torp Jensen: No. And they don’t call their engineers engineers. They call them imagineers.

‍Evan Reiser: Exactly. It’s a much different mindset that’s kind of really affected their business.

‍Saam Motamedi: Claus, we’ve talked a lot about new technologies and technology transformation. I’m curious on a personal level, what’s an upcoming new technology, doesn’t need to be healthcare related, that you’re personally most excited about?

‍Claus Torp Jensen: Maybe the obvious answer would be ChatGPT because that’s what everyone is excited about. That’s not actually my answer. Now, I am excited about that, but the whole category of ambient technology. Our ability to embed technology solutions in the environment around us, which is not a single technology it’s a category, that’s actually what excites me most in terms of changing the world for the better.

‍Evan Reiser: Claus, what would be your advice to aspiring technical leaders?

‍Claus Torp Jensen: Own your vision, live your conviction, and learn how to embody your dreams through the technical mastery that gives you the gravitas and ability to actually execute.

‍Evan Reiser: That sounds so good. That’s a viral tweet right there. Claus, thank you so much for taking the time to chat with us. I really enjoyed the conversation. Looking forward to chatting again soon.

‍Claus Torp Jensen: My pleasure. Thanks for the invite.

‍Saam Motamedi: Thanks, Claus.

‍Evan Reiser: That was Claus Torp Jensen, Chief Innovation Officer and Executive Vice President of R&D at Teladoc Health.

‍Saam Motamedi: Thanks for listening to the Enterprise Software Innovators podcast. I’m Saam Motamedi, a General Partner at Greylock Partners.

‍Evan Reiser: And I’m Evan Reiser, the CEO and Founder of Abnormal Security. Please be sure to subscribe so you never miss an episode. You can find more great lessons from technology leaders and other enterprise software experts at enterprisesoftware.blog.

‍Saam Motamedi: This show is produced by Luke Reiser and Josh Meer. See you next time.