Erick Herring, CTO at Vynyl, sits down with Dr. Rourke Yeakley, Chief Innovation Officer at Saltzer Health. They discuss topics like why it’s important to have a physician leading the digital transformation of the clinical staff as well as the non-clinical staff, clinician burnout/satisfaction, the value-based care model of the ER, and Rourke's latest project, Health Tech Idaho.
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Health Tech Idaho: www.healthtechidaho.com
For the full YouTube video: https://youtu.be/IBQRcMtTU_Q
Erick Herring 0:07
Welcome back to product and health tech, a community for health tech product leaders by product leaders. I'm EricK Herring Chief Technology Officer at Vynyl. Today I sat down with Rourke Yeakley, Chief Innovation Officer at Saltzer Health. Let's jump into the conversation.
Erick Herring 0:28
Hey, Rourke, thanks for joining me today.
Rourke Yeakley, MD 0:29
You're welcome, Erick. Good to be here.
Erick Herring 0:31
So you've had a really interesting professional journey, medical school working clinician primarily as an ER doc for over 20 years, and your copious spare time you were a medical educator, Chief Medical Officer for the air transport wing of a major hospital system and inventor and most recently, you created a groundbreaking approach to urgent care which you've implemented the Advanced Practice Urgent Care in Boise, Idaho. And now you're the chief clinical Innovation Officer for Salter Health and the founder of Health Tech Idaho. That's a lot.
Rourke Yeakley, MD 1:00
Yeah, it is. People ask me what my hobby is, and I think you just ran through.
Erick Herring 1:05
It is good, good to have work that matters and work that you enjoy doing. So the chief clinical information officer title is pretty new CIO was taken. So you can't just be the chief innovation officer. Although I've heard that too. I do think it's confusing. And the clinical part is really important, right? So why don't you talk a little bit about that role, and how you've settled into it and how you think about its place in the organization.
Rourke Yeakley, MD 1:32
I'd be happy to and it is a good topic of discussion of what that the name is, you know, you know what a CEO is a CFO, a CTO, kind of deciding on the CCIO is not only good to be different, but it's also emphasizes the importance of being a clinician, the importance of the Clinical Innovation Officer is critical to understanding how to move a health system or an organization towards innovation, you see a lot of health systems, it's kind of dipping their toes, and maybe having an innovation department or a part time director of innovation. And a lot of it ends up falling into the informatics department or the information department. But having a clinician that's at the C suite not only carries the weight of the C suite throughout the organization, it also demonstrates the commitment, any innovation in a health system is going to cross both clinical and non clinical departments. And in order to gain the trust on both sides, it's important I feel to have a physician in that role. And that's becoming more and more prevalent recently, there was a job posting, for example, and it was CCIO and it was the first time I'd actually seen that of a major health system. And a lot of it was leading the digital transformation of the clinical staff as well as the non clinical staff towards the ultimate goal of having data and informatics drive the change. And at the same time with a physician in that role, you really do help reduce the resistance on the clinical staff. You know, I grew up in medicine in the late 90s and early 2000s. And it was sort of the dawn of the digital revolution of medicine. You know, I started out with the handwritten charts and, and the old fashioned X ray films that you'd put up on a light I'd have as a medical student or resident, I'd come the basement looking for to wake up a radiologist to read an x ray as as a resident and now it's just it was amazing when that became digitized. And the same with information. I still have in fact, my first Palm Pilot, which was groundbreaking, I mean, clinicians loved it, we got to get rid of our white coats that carried all the books that we had to look up and now it was on there. Of course that's, you know, progress now to a smartphone and apps. But those were great things. But unfortunately, they're just after that probably mid 2000s. We see the EMR coming into play and you'll be hard pressed to find a clinician that's very happy about what EMR has done as far as workload. You know, there never used to be such a thing called a scribe. For example, we've created new roles in medicine in order to handle the EMR so there is hope with digital and information that will drive improved patient care and probably improve diagnosis precision, but there's also this natural resistance that needs to be overcome.
Erick Herring 4:47
It's exciting times I remember I worked with Next computers back in the same time you were starting your medical career and I remember how excited the medical staffs I talked to were when the color Next computer came out because it was the first time a computer screen was high enough resolution that they could actually look at radiology on a computer screen. And that was really eye opening for me. And it felt like it was coming both very early and very late at the same time. And that's how I feel I think about digital innovation and in healthcare, it always feels like it's, like, arriving very quickly. But also, why weren't we here 10 years ago, improving patient care.
Rourke Yeakley, MD 5:27
I agree.
Erick Herring 5:28
Computers are now writing text. They're making pictures. They're even making movies. They are, you know, that the audience, they don't know, you might be a deep fake, like, who knows? Right? Computers are doing amazing things AI and machine learning. I presume there's a lot of exciting stuff happening and stuff that you're focused on as an innovator in AI in healthcare. maybe you want to talk about that a little bit.
Rourke Yeakley, MD 5:57
Sure. So with artificial intelligence, there's a lot of hope. There's also some fears, as you mentioned, and I think it's incumbent upon clinicians and non clinicians and healthcare to make sure we're doing it right, to continually testing and make sure if we get there. When I look at artificial intelligence in medicine, I really break it down for me personally into three areas. One is imaging. The second is sort of population level, large groups of patients, and then the granular individual providers sitting across from their individual patient level. And if we go back and kind of mentioned those three, so imaging, the advancements in artificial intelligence, sometimes they're almost too good if you there's actually an article in Lancet Digital in 2020, that talks about how exact the or the sensitivity of digital artificial intelligence reads are on digital medicine to the point where incidental things, and we could talk about that as a clinician, but incidental things are being found beyond what a clinician would see. And then what is the significance or is it associated morbidity and mortality when you pursue anything? And is it too good? And how do we rein that in. And I think advances with imaging and imaging recognition will be there. And we'll get to that point. But that's just one example. And, and people oftentimes think of digital medicine as radiography, for example, but it goes beyond that, you know, ultrasounds, the cardiologist looking at an echocardiogram, or the mammograms being read. So that's one aspect of hope, for more sensitive but also specific diagnosis within medical imaging at a population level, I get real excited about artificial intelligence at a population level, I could give you a lot of anecdotal stories of patients already, in this early stage, large populations where individuals that would not have otherwise been recognized that might be at risk, say, for a genetic disorder. But through some AI techniques are being pulled out of populations, you know, even the clinician can't explain it. And then when you start working through those, you see these potential patterns that can be recognized for thing if there are clinicians listening to this, for example, Lynch syndrome, or Baraka gene defect, that the maybe there isn't a family history that they know of, or maybe they're a family member, that they inherited it from passed away from something else. But now all of a sudden, you're picking up a 35 year old with one of these disorders, and you can start screening or being or intervening and saving their lives, extending their lives. So that's a population level. And then at a individual patient level patient with provider level, the advancements are there for clinical decision support. There's a small AI group, brilliant data scientists that I that I advise right now that that's what they're looking at, they're looking at how we can make improve decisions based on large databases. You know, clinicians are really good. They're kind of like jugglers, right. You see a really good juggler can maybe juggle four or five things, clinicians are the same way in their brain, they can juggle four or five things. That's why there's always four risk factors or five risk factors and never more than that, because that's about what we can we can handle. But with artificial intelligence, you can pick up multiple variables that that wouldn't even be considered but you see these patterns. So it's really exciting - the potential. We got to use some caution, but it's incredible. It's sort of like going back to the medical tricorder of Star Trek, right? You're you get these tools that are going to help you ultimately you need that clinician, though, to make that call, to end to differentiate whether something's clinically significant.
Erick Herring 9:53
That's true. You certainly never see Captain Kirk using the tricorder. Actually, I think he did once and it was it was it was part of that part of the bit for that episode, I think I've had a bad outcome. I'm using the tricorder. So I'm excited about the, the the imaging and the decision support, you know, in particular, you know, my worries are always around over reliance and, and you know, especially in our health systems where insurance has an outsized role to play in the care of patients, I worry about them having requirements around using specific kinds of machine learning and artificial intelligence. But but many years ago, I went to a chiropractor, and this was a reputable one, she had a physician in her office, which is why I had elbow pain, I let her take an image of my elbow. And she on a Friday, she essentially diagnosed me with like, aggressive bone cancer. And so I spent a really long, tense weekend trying to figure out as a 32 year old if I needed to do get have a will, right. And, and I went to an orthopedist, the following Monday, like first thing got in, they were really good, great and see me. And he laughed at me, which I didn't think was very nice. But he was like, I cured your cancer. And it turned out, she just taken the image at the wrong angle, right. And a machine would have seen that immediately would have seen that it was taken at the wrong angle. And, you know, ask them to retake those images, it would have saved me a long week, I had Bursitis, by the way, that was that was the punch line is my cancer was Bursitis.
Rourke Yeakley, MD 11:23
I think it's interesting that you mentioned the over reliance. You know, when early days of medicine, there's a famous text for clinicians out there about diagnosing abdominal pain, an entire 300+ page book, about the nuances on a physical exam for abdominal pain. And clinicians just simply don't have that skill anymore, because they jump right to the imaging if they think it's needed, which is great. We have these images. But even in my career, I mean, I've been doing this a long time and not that long. It was pretty typical when I first started if you had a good story for appendicitis, and you coupled that with a good exam and a good and an elevated white blood cell count, you went to surgery, there was an acceptable rate of negative appendectomies, but that is just not tolerated anymore, everyone gets the CAT scanned, or maybe an ultrasound. So as we move more towards these digital tools, you can kind of see how maybe some of the exams will will be less than, you know, extensive, which may be good, but you know, who knows, like one of the complaint, you know, I oversee 30+ providers right now. And even the greatest providers get a few complaints here and there. And one of the ones we that I see is that the the provider did not spend enough time talking to me. They didn't put their stethoscope on me even if you got everything right, right? So there is that element that's always going to be there with one on one contact with the patient. So you don't want to lose those skills.
Erick Herring 12:56
AIML is a good a good touch point for the next topic. Doctors are not typically experts in machine learning. Some doctors have become experts in machine learning, I presume many fewer machine learning experts have become doctors, right. And so where does the innovation happen? You know, you've got internal innovation, I assume. And that's probably good for certain things. And then you got external innovation. And there's probably a whole process that you know, either exists or needs to be created around pulling that innovation in so it can turn into patient care. So how does all How do you balance all that? How do you talk to your startups about that on both sides of that coin? How do you think about them?
Rourke Yeakley, MD 13:37
Yeah, that's a big topic. I'll start internally at a health system, for example, is my this is my experience and my perception. First of all, there are some very good, very good machine learning physicians out there. But they are pretty rare. And and I'm not saying that we need to have more, right. I mean, it's a it's a team work. And at the very end, we'll talk a little bit about Health Tech Idaho and how that came together and why every person that did that is important. But and it's similar to this. But the internally, medicine, we've we've got a long ways to go you look at some of the, you know, the big tech companies, Google, Facebook, Amazon, and they're constantly internally innovating. But they're also at the same time looking externally for innovation. They know that they cannot do it on their own. And I feel sometimes not to be overly general. Sometimes health systems lose the perspective that there are maybe some things they can't do, and maybe someone else is doing it better. And so that's a really key point. I find with consulting innovation startups, and what maybe we'll talk in a few minutes about where the the physician or clinician comes in to those startups at what point but you know, you see these these rare opportunities for health startups to prove themselves. That's the biggest thing and you'll see either a pitch or an innovation competition. And it's great to have that gigantic check awarded you do at the end, especially if you're a company, it's still bootstrapping, you know. But more important than that is the opportunity to do projects with a health system, or with another healthcare entity. And those, there are so many startups and early stage companies that would love to have that opportunity more than money. And I think the health systems are not doing a good job at cultivating that environment to have that happen, where we're at potentially could be a win-win both for that startup and for the health system, even if they don't end up, you know, working together down the road, it will help the internal innovation of the health system. And obviously, it gives validation, or potentially gives validation to that startup company. So that's where I see that crossover. If you don't mind, we could talk a little bit about where the clinician and specifically maybe a physician comes in to a health startup, I oftentimes see whether it's tech or just health, innovation, startup, marching their way down without a lot of clinical guidance, either early on, or then just as important having either an advisor or maybe a member of the founding team, and they think about it late, they could have saved a lot of time, maybe their their innovation isn't even that innovative. I've mentioned this story before this has happened more than once a health tech company will approach me and say, Hey, how can we get to more health care? You know, how can we get into the healthcare space more, and then I'll start asking him about who the clinicians are on their team. And it's not, it's pretty common not to have a single clinician on their team. And then especially not to have a physician. So I think what I'm trying to say is, it's important to, at some, at some level, with a healthcare health tech startup company to have a clinician on board, as either a co founder as an adviser of something and really the way medicine is, it's very important to have that person or maybe two people, one of them being a physician,
Erick Herring 17:16
There's always a step with larger companies, especially where if we're going to provide services or build software, or help them realize their their vision, we there's a step in there where we meet the Chief Medical Officer. And, and so we're pretty used to that. Right. And then we have startups who are trying to do things. And and yes, first thing we asked them, because that's kind of how we've been trained by some of our bigger companies, you know, you know, what's your clinical validation? You know, who's advising you? Do you actually have a physician on staff and the ones that are most successful what our telehealth care client, was founded by a doctor. And so he brought those pieces together. And he makes sure that, that what we're doing has, you know, good clinical effect and all that good stuff. We've seen lots of bright young things, really smart people trying to solve problems that don't exist, just like you said, couldn't agree more.
Rourke Yeakley, MD 18:07
Yeah. And it's, the question is, when should you get someone on board, and I don't think there, you could do it early enough. To what extent they're involved. I mean, that depends on what the product is, and where they're where they're at. But certainly pre Series A, I mean, you've got to get that, first, I gotta admit that, you know, make sure it's, it's an actual, you know, this is going to succeed. But as far as advising them through the, through the pathway, and then again, going back to the ability to prove your product or prove your your idea, getting those connections into health systems into pharma, or whatever it is, it's pretty tough to do that without a clinician, especially a physician on board.
Erick Herring 18:48
Two topics that I want to want to get to before we run out of time here. Is there other advice, you give startups, you know, maybe looking to get into healthcare, you know, let's say we got some really smart people, they want to do a startup, they've got three or four ideas, they'd really like to do something to help the world, you know, want to do health care. So that's one question and you can answer these however and when and whatever Where do you want the other one is the topic we were just on is there's got to be a translation of all this digital goodness, all these toys that we build, you know, to make them into tools and make them into techniques and decision support systems and all the other stuff we've talked about. So they actually improve patient care. Because that's the ultimate goal in healthcare and health tech I hope I hope that's everyone's ultimate goal is to improve patient care. And so those are those are maybe a little bit hand in hand so how do you think about that?
Rourke Yeakley, MD 19:39
I'm glad you asked me that because I'm this is gonna get me excited here now because this is what this is my passion. I have two passions one I still work clinically and I always will and as long as I physically and mentally can. It grounds me and it reminds me of what healthcare is about. Sometimes I'll even if I feel like I haven't worked for a while I will even other show up at one of my urgent cares and start working with my partner. are just seeing patients it makes me human again, it's tough to do a health startup in certain areas, I think it's easier say in and I'm gonna give you a real world example of my first startup in my IP. But it's tough to do it in, in outside of certain core areas. It's a little easier now. But pretty tough. I mean, San Diego, Seattle, I mean, genomic medicine, San Diego, right. The but other places, Seattle, New York, Chicago, those have well established an environment ecosystem. And this actually would be a good segue into the Health Tech Idaho, but we can talk about that at the end. But I think taking the initiative to see what's out there, I think there are more and more incubators and accelerators that also are available as resources. Contacting maybe a clinician in the area that you've you've worked with, or another startup to get an idea. There, I will say there are more clinicians out there than you think that would love to balance their clinical life with something to do with innovation, again, going back to why they went into medicine, to improve it. So there's a lot of potential advisors out there bringing those together is key. And I think we're improving that some national organizations, whether it's HIMMS, or another one, is also a good resource. It's young, as far as is its development, but it is a good connection to national hands where there's a lot of resources. I'm going to kind of go over to your second question now. And this is what really excites me is is translating, that's my passion is translating what innovations are out there to actually clinical care. And at the same time improving clinician satisfaction, we hear a lot about clinician burnout. There was a recent study that half physicians in America are over the age of 55. And pretty much all of them want to quit. Nursing staffing shortages. It's just It's crazy. It's literally crazy right now, the nurses that have left the field. So if you can combine improvement of patient care, and at the same time, improve clinician satisfaction, you're doing an amazing thing, and it can be done. If you don't mind this to be a good time to talk about the advanced care center that we built here. A lot of things in life are about timing and the timing was perfect. Seltzer was a small, multi specialty group practice that was bought by a PE group. And that PE group were people that I knew one of them being a physician that I've known for over 25 years, who shared some similar ideas. And we brought some non clinicians with similar and built an amazing kind of hub and spoke model of healthcare where we have a central location where our specialists are, we have an ASC ambulatory surgery center. And then we have a 24 hour advanced imaging and then a 24 hour Advanced Practice urgent care. Back in 1997. I was I went to medical school in Boston and I at the time, Boston, like Minneapolis were kind of the centers of managed care that was sort of the pattern that the rest of the country everyone's getting a primary care we're going to solve all these problems, you know, the same problems we have now we're gonna solve them back then. Everyone's gonna get a primary care will reduce er admissions will reduce unnecessary specialty care to be coordinated. This is this is you know, this is it. And yet working in the ER as a medical student get ready for residency, I did not see a reduction in patient visits to the year in fact, I saw them increase. So I've made myself and two of my attending physicians, we did a simple study, we asked three we asked the top three reasons patients with primary cares were coming to the emergency room. And they're the same reasons people go to the emergency room now. Namely, they are time of day, okay, it's nine o'clock at night. It's Saturday at 10am. I've got this acute medical condition, there's really only one place to go and that's the ER. Number two I yeah, I've got a primary care, but I can't see them for three weeks, and I can't handle my abdominal pain that just started this morning. And then the third one, even if you were lucky enough to have your problem on a weekday say it's a Wednesday at 10am Perfect timing for whatever condition you have you call your provider, they've got an opening, then you tell them what you have. And they tell you I'm sorry, I don't have the tools to evaluate that condition or that chief complaint and maybe they could coordinate for you know getting an imaging at one place and some labs at another place and they might be able to see you. The ability to do that is difficult especially if that provider has a full schedule you know, so we took we looked at that and then couple that with 20 More 20 plus years of working in the emergency room. It was pretty consistent. I would say this is my my opinion. Three quarters of people that go to the emergency room do not need to be there they do not have an emergency or a life threatening event. And how do I know that one anecdotally every day I worked, but number two, my admission rate. So admitting to the hospital or to the O R, I averaged about 3000 patients a year I'd see. And of those, about 12 to 13% would be admitted. Okay, so that left, you know, 87% that weren't, there's probably another 10 12% that needed to go the ER to have something done but still went home, say, for example, a five year old with a arm fracture, that's angulated, you got to sedate reduce CAS and send them out. All right, that the appropriate that they went to the emergency room, they have the equipment to do that. But that still leaves, like I said, three quarters of the people there that didn't need to be there. So how can we solve that problem? And going back, you know that that little, you know, meaningless study, if you will, that I did as a medical student? How do we solve those three? How do we solve the access problems, the time problem, the resource problem, and so what we did is we built an imaging center that was open 24 hours a day. And with a handful of imaging studies, some 24, some less, that are needed for most evaluation, most evaluations as well as X ray, which we use a lot. We coupled that with the 24 hour Advanced Practice urgent care, that was open 24 hours, of course, it is a nurse practitioner, PA run. So those are the providers with physician oversight. 24/7. Going back, you originally introduced me talking about air medical, that's the pattern of air medical air medical is paramedic, nurse, paramedic EMT, as an extension of a physician, practicing medicine and bringing them to the hospitals, we use that same model. So our nurse practitioners and PAs are well seasoned nurse practitioners, PAs that have worked in ers, most of them 5 10 15 years or more experienced, so they know what they're doing. And but they always have that physician to be able to call and ask for advice. Now we have one of these 24 hour triggers, we have multiple other little ones that feed into it. So if a patient is at a office or gets a phone call or provider gets a phone call, or they show up the urgent care, they need more care, they just get directed to our urgent to our 24 hour advanced urgent care. So the patients only come in one way. So the front door we don't we don't have ambulances, at least right now community paramedicine is on the rise, maybe we could do another session on what that means. So they come through the door and the nurse practitioner or the PA along with the seasoned nurse, have the ability to write off say, Okay, you have a life threatening condition, we need to help you get to the ER. The next step would be bring them back. You know, if that's not the case, you bring them you start doing an evaluation, maybe you find something that they need to go to the ER for, because it's acute, but didn't show up acute initially. So for example, you do a CAT scan and you have free air in the abdomen, that's a medical emergency, you get them over the ER, then you have those that you work up and say an appendicitis we can easily do an appendicitis I haven't even mentioned costs, but we're about 20% of the cost of an ER or less for the same workup these workouts, you get a diagnosis of appendicitis, we do everything we can to contact a surgeon directly and bring them send them directly to a surgeon rather than going through in here.
Rourke Yeakley, MD 28:15
Our whole model was built on the push towards value based care, which I know is beyond this topic. But the culture we're building is a value based care model, keeping those resources in the patient's pocket, keeping the resources in the system to care for that patient rather than blowing the whole thing on one ER visit. So we have that if you look at many medical conditions in the ER you do that cannot be seen by the primary care provider, there's really a handful of tests that we do that most clinical offices don't have. And with, we're talking about advanced, you know, improved technology, there's a lot of bedside or point of care testing ability. So we do those for some of those tests. So couple all those together, we're able to provide, again, three quarters of what an ER does, we're not an emergency, that's why you don't have the name emergency in it. But the acute care conditions we can see. And then when we couple that with the digital medicine, which I've left out on this a little bit. What we do is we it's pretty simple. We have some Tableau chart data, real time data that we're continuously giving to their providers and if we we the family medicine pediatricians internal medicine, we, we tell them that three quarters of what's going to ER we can see so so we give the provider with individual level as well as, as a group level showing where are they with their patients even in acute care medicine beyond their clinic. What's their ratio, current ratio three quarters with a goal of being actually we're pretty liberal, we get two thirds 1/3 With the goal ultimately of one quarter of one quarter three quarters is going to the urgent care rather than the ER. And it's amazing when we show this data, the improvements that we're seeing the patients are coming to our center, we're very busy, we just added more staff, because we're so busy, we are reducing our ER visits within our system, we're keeping those resources within our system, and the providers are happy their patients are getting care that they need. And with their improved outcomes, you know, one of the things we had to overcome was, the payers don't really have this model in mind, right, you have to have pre approval for medical imaging. And unless you go to the ER, well, we're that whitespace, you know, that I've just described between an ER less than an ER but more than a traditional Urgent Care family practice. So we actually approached the payers, and we got pre approval for a CAT scan. So we can do those at the time of. And then we also offer ultrasound, 13 hours a day, things like that. So it's been a work to get this done. But it's exciting for clinicians, for patients to see innovation that's happening, and actually happening at the grassroots, not just reading about someone that did something, and then you never see it translated to actual practice.
Erick Herring 31:15
Personally, I think the most interesting thing about what you've accomplished there is, it's always fascinating to me how obvious the answer is, once you know it, you look at something and you're like, Oh, of course, of course, they did it that way. But that's not at all obvious at the start, you know, and so this is a lot of innovations you put together in order to get to this place. And you know, I know you can't say this, but I'll say it if I were, you know, having an urgent medical situation in Boise, and I wasn't like actively losing a lot of blood or in the middle of a coronary event, I'd come to you, you know, I'd walk through your door, because you've, you've got people who can, like see me right away pretty much and you've got a special. And I know you wouldn't characterize it this way, but a special side door into the emergency room. If it turns out, I really did need it. Right. And they don't have to redo all the work you've already done because of your relationships. I mean, it's really an amazing accomplishment. So congratulations on that.
Rourke Yeakley, MD 32:12
Yeah, yeah, patients are happy at the time. And they're really happy about three weeks later, when they open that bill, and that it's much less than than they would have got otherwise.
Erick Herring 32:21
I mean, we talked so much about the cost of health care and how it's rising and everything. And so I think it's important, I hope there are other people talking about about this model and about what you've accomplished, because it I think everybody knows it doesn't need to cost this much. But need is doing a lot of work in that sentence, right? There's a lot of systemic reasons why things cost, the what they cost. And, you know, at the same time, like you said, we have a, you know, a potential looming crisis of healthcare professionals leaving the profession or not entering the profession. And all of that's no bueno. And I'm getting to the age where I want to have doctors, you know, I want to have doctors on tap when I need them. So this has been fascinating. I think we could probably talk for another hour, but but we can't alas, but let's do talk about Health Tech Idaho, which you founded. As I understand it, you you met a met a bunch of people at a conference Product in Healthtech, and you all talked about maybe doing something to help all of this in Idaho, and then you went and did it.
Rourke Yeakley, MD 33:23
Yeah. So so a personal story. When I, when I finished my residency, heavily in debt, I was lucky that a bank gave me an 8020 loan at the time, right? I don't know where I would have lived and I was married with three kids because I went back to school after business degree. But I worked the swing shift and the night shift because I needed that pay differential, right that every little bit helped. And one of the things I ran into was that there was no ability even at a large tertiary hospital to give a pediatric patient a dose of oral liquid antibiotics. So I developed a two chamber, disposable one time point of care dispensing system to do that. The reason I bring it up is this is Boise, Idaho, you know, 20 ish, or 15 years ago, there, I didn't know where to turn with this, you know, I met with my IP attorney, because we needed to get a little bit of that he's what we're going to do. And he told me, you know, this is great. And it's going to cost a lot of money. And it's either going to work out fantastic, or it's going to be an expensive piece of paper to put on your wall. And I had an IP chair but I didn't really have much else. So I ended up traveling to New York City to Seattle to San Diego. I'm trying to find people to come on board with me and to bring this so fast forward a little bit with the way Boise is now there's a lot more resources, but even still, there isn't really a good there's no organized way to develop this ecosystem for future startups and for future innovators. So yeah, I met a member of Vynyl, Nick Crabbs, of course, as well as a couple other people, one from Salter, two from St. Luke's. And then another one that was an independent, who is basically an independent web designer. So we all have our, our talents that we bring into this, whether it's digital advertising, or it's just the ability to organize and have conferences, I have one of them's an RN with me, just all these individual talents that we came together on a project last fall, that had to do with Entrepreneur Week, and realized we had built this momentum and had all this positive feedback, and the turnout was amazing, and we didn't want it to just die. So we thought, and with my previous experience, that let's just keep this momentum going. And let's start this Health Tech Idaho. So what it is, is, it's kind of it's almost like a dating site, if you will, for four innovators, capital investors, and what we call partners, which are either private companies, educational institutions, to come together and support each other, whether it's recruiting nurses, for example, or it's using having a nurse that now wants to be part of a startup has her own his or her own, or maybe is the complement to a team that's already working on it. So we have a seed event every month, where we have a very small a short anchor speaker, then we give time to to startups to kind of basically pitch it's more of an explanation of their, what they're developing, then we often have a partner, give five minutes, so the whole run of that's about 30 minutes. And then we have an hour of just mixing and socializing and networking. So that's what we do a month. But that's not our goal. That's just basically a seed event, we want any event in the area in the state of Idaho, to or mountain west northwest, to use our calendar for to announce upcoming events, the School of Nursing at Boise State, or Icom, the College of Osteopathic Medicine here, whatever it is, or a private company that's hosting event or bringing in a guest speaker, a master calendar, just sort of again, cultivate this ecosystem. One of the problems also with with startups is getting your name out there. So we have free pages where we have startups in the area that can list for free, they can put their logo with the hyperlinks to their website, and then 25 words or less explain what they're doing. And we have a large number ever increasing number of startups that are on there. So if you're an investor, and you're looking or your physician or a nurse, and you want to, you know, maybe do some advising, you can go there, we also have, and that's totally free of charge. And it's advertising free page, we have a similar page for capital investors, whether it's an individual, an angel, or a true investment capital group that can do the same thing, logo, hyperlink 25 words or less what they're looking for. And then we have a third page, which is our partners page, again, logo 25 words the last hyperlink and it could be the nursing school or the medical school or, you know, Vynyl, which is a great company and supportive. There's some website, small little kind of local web developers that want to you know, put their name out there and maybe support or even jump onto a startup. So that's what we we've got it. And we have some other ideas going forward. This is nonprofit, we're not looking for a profit. But it just a great team just to cultivate the ecosystem here in Boise, which is, which is great, but we just need to bring it up to the surface.
Erick Herring 38:33
That's amazing. I think it's it's hard to overestimate the value. Yes, it's hard to overestimate the value of just being there and organizing and being a central hub. Maybe you guys should get your own part of the pitch competition next year at Boise Entrepreneur Week and get to health that health tech Idaho pitch and then all the other pitches for the for the, for all the other people.
Rourke Yeakley, MD 38:55
Yeah, I mean, that's a good idea because we had some healthcare intermixed with some non healthcare at the last pitch and I've seen that before I spoke at an entrepreneur week at a University back in New York. And watch the pitch competition they had there and first place was a I can't remember it was a consumer product. Second place was an AI company actually, I ended up connecting with him and I started doing some advising for him but yeah, mixing healthcare healthcare deserves its own health tech deserves its own its own avenue and pitch. So yeah, definitely. In fact, we're really thinking heavily of, of university level. You know, there's there is some stuff with high school and then of course, private but that university and maybe cross discipline, so maybe a business student, a medical student, a nursing student coming together to to do something. So yeah, a lot, a lot of potential a lot of work. But again, that's our hobbies, and we're trying to do both so,
Erick Herring 39:45
So I'm sure we'll also put up a card or put it in the notes or both, but why don't you tell people how to get in touch with where to find Health Tech Idaho, and see the calendar events and all that?
Rourke Yeakley, MD 39:55
Sure. It's pretty simple healthtechidaho.com and we're always updating that if you have a startup that you want to be listed, you may not have to be in Idaho even, or one of the other categories talked about it's on there. The calendar of the up and coming events are right there on the homepage. And then we have a master calendar too. So you look ahead, you know, months down the line, see what's coming up.
Erick Herring 40:16
I want to thank you. I've really enjoyed talking to you today. And I hope we get to do this again. Thank you for coming.
Rourke Yeakley, MD 40:22
Yeah, absolutely.
Erick Herring 40:24
Thanks so much for joining us today. You can also connect with us on LinkedIn, YouTube, and on our website, productinhealthtech.com. If you have ideas or suggestions on what you'd like to hear in the future episode, or if you'd like to be a guest, please shoot us an email to info@productinhealthtech.com