What is Innovation?

Innovation is listening to people and designing for their needs :: Dr. Nupur Mehta

Episode Summary

Episode 41 of “What is Innovation?” is here! Jared talks with Dr. Nupur Mehta, co-founder of Heyday Health, shares how his company and the healthcare industry can do better in providing services for the 3Ps: Providers, Payers, and Patients. They also discuss how innovation works in the industry as response to COVID.

Episode Notes

Dr. Nupur Mehta, internal medicine physician, co-founder of Heyday Health, shares how his company and the healthcare industry can do better in providing services for the 3Ps:  Providers, Payers, and Patients.


More about our guest:

Dr. Nupur Mehta is an internal medicine physician dedicated to improving the quality of life and wellbeing of all patients but especially older adults. He has spent his career innovating within the healthcare industry to align incentives between patients, providers, and healthcare payors. Most recently, he co-founded Heyday Health, a virtual first primary care start-up practice dedicated to meeting the needs of older adults. The unique challenges identified during the COVID-19 pandemic have generated significant opportunities to improve patient outcomes and experience while reducing costs, and organizations like Heyday Health are innovating rapidly to shift the delivery model to refocus on the needs of patients. When he's not trying to fix healthcare, you can find him on the tennis court, in front of the stove/grill, or chasing after his two daughters.


Episode Guide:

1:44 - What Is Innovation

2:43 - Consumer back view of innovation  

3:02 - 3Ps: Providers, Payers, and Patients

5:21 - USA: Health care = Sick care

7:40 - 'External' light on the process: Innovation and Collaboration

10:38 - Opacity from providers and high healthcare costs

12:03 - Provider internal change: motivators beyond altruism

13:18 - 'Global' budget for proactive vs reactive response to healthcare

16:39 - Offsetting incentive to invest in 'sick care'

20:57 - Altruism in the current medical field

22:59 - 2 year difference in healthcare: COVID changes

24:25 - Reliance on face-to-face patient care

27:35 - New model on 'being able to do what's right for patients more often'

29:07 - 25 mins of conversation vs 5 mins of examination  

30:07 - Physical exam in practice

31:54 - Local service coverage

33:19 - Advice to Innovators


OUTLAST Consulting offers professional development and strategic advisory services in the areas of innovation and diversity management.

Episode Transcription

Jared Simmons  00:05

Hello and welcome to What Is Innovation. The podcast that explores the reality of a word that is in danger of losing its meaning altogether. This podcast is produced by OUTLAST Consulting, LLC, a boutique consultancy that helps companies use innovation principles to solve their toughest business problems. I'm your host, Jared Simmons, and I'm so excited to have Dr. Nupur Mehta.


Jared Simmons  00:29

Dr. Nupur Mehta is an internal medicine physician dedicated to improving the quality of life and well being of all patients, but especially older adults, he has spent his career innovating within the healthcare industry to align incentives between patients, providers and healthcare payers. Most recently, he co founded Heyday Health, a virtual first-primary care startup practice to meeting the needs of older adults. The unique challenges identified during the COVID 19 pandemic have generated significant opportunities to improve patient outcomes and experiences and organizations like Heyday Health are innovating rapidly to shift the delivery model, to refocus on the needs of the patients. Prior to Heyday, Dr. Mehta held leadership roles at Caremore Health, the George Washington University Hospital, the Advisory Board Company, Evolent Health, and McKinsey and Company. He is a graduate of Harvard Medical School and the Harvard School of Public Health and completed his residency training at Brigham and Women's Hospital. When he's not trying to fix healthcare, you can find him on the tennis court, in front of the stove or grill, or chasing after his two daughters. Nupur, welcome to the show.


Dr. Nupur Mehta  01:37

Thank you, Jared. 


Jared Simmons  01:38

Thanks for joining us today. I'm looking forward to a great conversation. So why don't we dive right in? Tell me what is innovation.


Dr. Nupur Mehta  01:47

Innovation is listening to what people are asking for, and designing solutions that meet those needs. When we think about healthcare, and the history of healthcare, so much of healthcare delivery has been based around what providers need, specifically physicians need, what healthcare insurers have needed. But I think where we have really let folks down is and not designing or building around the needs of patients. Very interestingly, not designing around the needs of their families or their caregivers, who we know, are very integral part are an important part of ensuring great health care outcomes.


Jared Simmons  02:37

I'm sure we can all think of so many examples of the of lack of attention to that. It's interesting that this industry, more than others, struggles with the consume. What I call the consumer back view of innovation. Why do you think that is?


Dr. Nupur Mehta  02:53

I think part of it, at least in the United States is just the way that health care is paid for. Your listeners and of course, you know, Jared, that we have this weird situation where there's a triangle between the providers, the payers, and the patients. Historically, the incentives on what each of those parties is trying to achieve are misaligned. Payers, of course, are trying to create margin, they are trying to reduce costs, they're trying to increase their revenue, because they are fiduciaries and have a responsibility to their shareholders, by large. Not true for all insurance companies but for the big ones, who drive a lot of the health care in our country, you know, that is true. 


Dr. Nupur Mehta  03:37

Patients, of course, they want to remain healthy and they want to pay the least amount for health care that they can, whilst also making sure that they stay healthy. Then of course, providers are part of that three legged stool and they are often for profit and gems. They're often part of large health systems, and even the "nonprofit health" systems are also really trying to generate margin and to gain market share. Interestingly, when you think about those three parties, the groups that are most closely aligned are actually the payers and the patients because they're both incentivized and very keen on keeping people healthy, out of the hospital, out of acute conditions, using less medicines, using less health care overall, whereas actually the providers meaning the doctors that are thought to be the allies of patients actually prefer when patients are sick. In our in our current world, doctors are paid and actually incentivized to treat people when they're sick, rather than keeping people healthy.


Jared Simmons  04:46

It would almost be like Apple being incentivized to keep people from coming to the Apple Store.


Dr. Nupur Mehta  04:51

Exactly, or selling crappy computers because they make money every time that computer breaks down.


Jared Simmons  04:59

I hadn't thought about it in terms of you want people to show up to spend money basically because that's what happens. Expecting them to operate from a wellness point of view, really, it doesn't make any sense based on the current structure in the current model, because they're revenue driven just the way any other financially supported organization would be.


Dr. Nupur Mehta  05:21

Exactly. That's why a lot of people, when they think about the US healthcare system, they don't call it health care, right? It's sick care, we're actually perhaps the best of the world in sick care. If you're sick and you have something going on, probably the US is the best place in the world to receive that level of "technology" to to receive your treatment. However, the US might be one of the worst places in the developed world, at least to receive welfare, or to receive preventative care, or to really focus on wellness that in a way gets to perhaps one of the things we'd want to talk about, which is, what has limited innovation and part of what's limited innovation in healthcare is actually this series of misaligned incentives. That physicians, especially unfortunately, in hospital systems, and doctors are actually not in the business of prevention. They're not in the business of maintaining wellness. I'm one of them. I'm a doctor, we get paid when people are sick. I think that's where I would really like to, if I had my daughters, where I'd love to be able to help change things is fixing those misaligned incentives to actually reward health, reward wellness, and reward that people who are putatively the advocates for patients, which is the clinicians, to reward them for keeping people healthy, rather than simply treating them when they're sick.


Jared Simmons  06:42

Yeah, the misalignment of value and of motivation and incentive, seems obvious, when we break it down that way. From a provider, payer, patient perspective, it feels like when there's a difference between the preservation of health and the alleviation of sick, of suffering or sickness. As long as the value creation for the provider is in alleviating sickness, in order to alleviate something it has to exist. So the preservation of health is almost runs counter to the fundamentals of innovation, which is; innovation requires, requires an incentive to change, right? That's very helpful variable explanation. Healthcare is such a, for me personally, and for, I'm sure, for a lot of folks that are outside of the system. It's such a black box in a lot of ways. Your simple model there with a three legged stool is helpful. But how much external light gets shined into these processes in terms of sort of innovation and collaboration or thinking about new ways of working or new models?


Dr. Nupur Mehta  07:51

Yeah, frankly, not enough. There are some health systems who have seen the light, to go with your analogy, and have realized that by reducing the opacity and making more clear, say what the costs of things are, or what ways to put, say, clinicians on the hook for outcomes, you'd have been able to ultimately, create that level of transparency but that's pretty few and far between. Unfortunately, coming out of, say the ACA or Obamacare is it's often thought of, there was a lot of hope, I think, even back in 2010, and 2012, that some of the things that were being put forward would actually fundamentally transform the way we think about healthcare delivery. While I think all of those things were well intentioned, unfortunately, providers specifically have held on with tooth and nail to keep the status quo the way it is, and have really resisted some of these efforts to build transparency. I actually got an email yesterday and I just want to read it to you because it I think it's it's very indicative of this lack of opacity, this lack of transparency. This is from a colleague of mine, who wrote to me, "I got a claim on my insurance, it says the service it paid for was called 'VN BLD VN XPR'. So there's no there's no vowels in that. Interestingly, they're sending that to the consumer. That's not like they're sending that to me, they're sending that to the consumer. It's absolutely, no wonder, that when someone receives that they'd be completely bewildered, of course. They also have no ability to question what the charge was there. How could you ever read that and know what it meant. Even I, as a physician, who can maybe even guess what that means? I don't know what most of it means. I know, maybe a couple things mean, I think of the word blood is there but that's all I can gather. Part of it is actually just get back to this transparency question, I think it's purposely okay. Because that prevents people from actually taking, having some agency and pushing back on what they're being charged for. 


Jared Simmons  10:35

That's a perfect example. In that example, I can imagine the tension between the providers, and the payers, and the patients, as you were saying, the payers and patients have similar interests, or similar incentives in this model, but that level of opacity, I can imagine that creating some tension between the payer and the patient


Dr. Nupur Mehta  10:57

This is the funniest thing. I totally agree with you. This is why when patients get upset about their health care costs, they actually blame the insurance company.


Jared Simmons  11:10



Dr. Nupur Mehta  11:11

Where did that come from? That actually came from the providers, interestingly. Yet, the patients never blamed the providers for generating this level of opacity or for charging for things that they didn't need. A lot of that is driven from the provider now, from this thing about the bill and how you get it and stuff. I'm not sure whether that came from the provider or payer, but everybody is on the game. It's a shell game and everyone's in on it, not enough has happened to change. That's where we really need to, as a healthcare community need to focus on on making change and innovating, I think it's making this work for people.


Jared Simmons  11:58

You see yourself as part of the solution, which is why I wanted to talk with you. But what would the motivator be for someone inside the system? We can talk about you specifically, but it feels like the solution is going to have to come from inside the provider community, and what would the motivators be beyond altruism? Like, how would a motivation be developed at a scalable level to initiate change?


Dr. Nupur Mehta  12:22

Perfect question. The good news here, at least, is that there are some now pretty tried and true models for how to actually make this work, haven't scaled. There's pockets of this all around the country but the good news is that I think we do know how to do this. The first thing and the thing that needs to really change and frankly, the way that most other developed countries are set up is like I was mentioning, incentivizing health. How do you do that? The best way, the easiest way to do that is to put providers on the hook for outcomes. So right now, if you think about it, the true person paying the bills, ultimately, at the very end of the day, is all of us. You, me, the patient's themselves so it's because it's a big loop. We pay premiums, the insurance companies pay the bills but we ultimately we pay the premiums that ultimately pay the bills, you see the result of that. To answer the question, what should happen is, in fact that providers get a global budget, a budget to manage a population of patients, all of whom receive care within a specific ecosystem, and the money to pay for all that care comes out of that big global budget. In the UK, famously, they have what are called Trust. Essentially, they're regions that have a budget and all of the care from that region gets paid out of that trust. 


Dr. Nupur Mehta  13:50

Similarly, imagine that you are in, I don't know, you're in Baltimore, and you are part of the Hopkins system. I'm just picking a random place here. Nothing about Hopkins or anything like that, I'm just choosing here. Such that instead of Hopkins charging for every individual that comes in, the individual person's insurance company, let's say are flipped around. Instead, Hopkins said to each of the insurance companies they work with, instead of us charging, every time we see a patient, give us a budget for managing the patients that we see on your behalf. Now, if we do a great job of providing them all the care that they need their wellcare plus their sick care, and we can do it for less than what they would have been predicted to cost, then we get to keep whatever is leftover. Maybe we'll even share it back with the patients themselves, right? They paid a premium, we'll give them a premium discount to incentivize them to stay within the Johns Hopkins sort of network, right? What does that do? That creates loyalty or fealty between the patients and Hopkins. That creates an incentive for Hopkins to keep people healthy rather than treating them when they get sick. It also gives Hopkins the flexibility to invest in the resources, and people, and processes, and technology systems, and even certain interventions. We could talk about what those interventions might be, but some of those interventions might be outside of the realm of what we think of as health. Imagine a world where Hopkins does have that big budget, why they could invest in healthy food, or grocery stores, or housing, or substance abuse treatment, all of the things that traditionally healthcare does not get reimbursed for, they could actually invest in because they know that for their population, it will ultimately reduce costs, and therefore they can devote resources to those those new interventions. That's really exciting, when we can make things like that work, it actually aligns payers, providers, and patients towards health.


Jared Simmons  15:57

That makes a lot of sense. I mean, it aligns the incentives, it also creates a scenario where you can create comps, for lack of a better term, you have peers, so Johns Hopkins has a peer. Right now, you're just treating whoever comes through the door but if every hospital is responsible for a region, that more aligns their care strategies, and more better aligns their approaches to things, which will make them more comparable, and give investors in those systems a way to drive expectations and set benchmarks and drive accountability.


Dr. Nupur Mehta  16:35

Exactly. Yeah, well said.


Jared Simmons  16:37

Now, in that structure, if you move to more of a P&L management model, and I'm oversimplifying, that your description of that system, but how do you offset the incentive to under invest in sick care?


Dr. Nupur Mehta  16:53

Yeah, great question. I think there's two parts to that. One is, the common complaint is well, what prevents Johns Hopkins from kicking out the really sick patients, because they know that they're gonna cost a lot of money and send them them across the street to University of Maryland. Also the other question about why not just withhold care, right? Like, that's an easy thing to do, just don't provide the cardiac bypass because it's $100,000, they don't need to spend on that. There's two big things, number one, these are very important. One is that you have to have quality gating. Essentially saying, let's say the payer is offering this global budget. The payer should write into that budget saying, look, if you don't meet a certain set of quality benchmarks, we call back a portion because we are not meeting the quality expectations, either from a patient experience perspective. Again, using this example, Hopkins starts to withhold care, well, then the patients are going to be upset. Their quality scores will go down or their experience scores will go down. Then as the payer, who's the ultimately accountable party here, queries their beneficiaries, they say, 'Hey, what did you know? you were part of Hopkins' group, did they do a good job?' They say, 'No, they were terrible.' Well, so that the payer can call back. It's not just experience, it could be from preventative care. What proportion of your patients got vaccinations? What proportion of your patients had appropriate screening tests done for cancer? what proportion of your patients had timely access to their doctors? You could create a scorecard or a way of sort of gating the funds flow such that you have to hit those gates, before you get any money, and the less quality care, you provide the lowest proportion of that 100% budget you get. The second big thing that's super critical to prevent cherry picking is to ensure that on an individual patient basis, you risk-adjust. There are actually some really good models to do the opposite of cherry picking. I don't know if there's another word for cherry picking. But whatever the opposite of cherry picking is, instead of taking the easiest patients or finding the the simplest ones, risk adjustment actually can create a scenario where hospitals, hospital systems, doctors actually go seek out the sickest patients, because on a per capita basis, they actually receive more reimbursement for those individuals.


Jared Simmons  19:18

I see some of these systems like these big hospitals that are always in the news like Mayo and other places, they would theoretically, for taking on the more complex cases, they would get a disproportionate risk adjusted, factored up reward for that. 


Dr. Nupur Mehta  19:34

Excatly, let's say an average person was $100 a month or something like that, in terms of how much that the system would receive. A really sick patient, who's twice as sick as the average we get 200 bucks. But if you can keep those folks healthy, you have more to work with. Some of these folks who have done this and have been successful have actually shown that focusing on the sick patients can result in better margins because they can actually improve their care such that they're receiving the higher revenue but they're reducing their costs even more. Whereas a healthy person like you or me, maybe Jared, that who is not using health care very much anyway. It's the low revenue, but it's also a low cost. So it's a wash. It creates good incentive, that's a good scenario to have, where you entice people to take on the sickest of the sick, because they have a chance to fix them.


Jared Simmons  20:29

I love that because it doesn't rely on altruism or a certain set of values or principles to overcome the natural momentum of the market, it sets the market in that direction, which will have its own momentum take you in that direction. That's really brilliant. This is a structure that countries already operating under this model is what you're saying.


Dr. Nupur Mehta  20:51

Countries, certainly. Many doctor groups around the country, many provider organizations are sort of doing this already. I should say one thing really quickly, which I'm making it sound like doctors and hospital groups and stuff are not altruistic or kind or they don't want to do the right thing. I don't think that that's the case. By the way, I think that people do want to do the right thing. However, I do also think that they also have to keep the lights on and some of these things become pervasive, even without people ever explicitly acknowledging that. They're still happening, the extent that we can couple altruism with the typical alignment, I think that that's where you find the the the real power. For the record, there's lots of good people out there doing the right thing, trying to do the right thing but unfortunately, some of these things do sneak their way into even the best intentions.


Jared Simmons  21:38

No, that's exactly right. That is great clarification, because when I think of and speak of altruism, I think of it in terms of, like you were saying, the system or the structure, the nonprofit world is built around an altruistic expectation being established within your operating model and your business model. I think that necessitates a certain way of operating and well intentioned people can operate in that system. People who aren't well-intentioned can operate in that system. It's the same, vice versa, where you have a profit motive and there can be wonderful human beings operating within that structure and doing the best they can to be as good as possible. But relying on systemic change to be driven by an altruistic sort of model is just not realistic in a broader sense. So yeah, thank you for clarifying that. That's a great point. As we talk about the way things currently are and the way things look, in the world, in various places, both here and abroad. I would imagine, both here and abroad, things look differently now than they did, as we're recording this in November of 2021, than they did say, a year and a half, two years ago.


Dr. Nupur Mehta  22:49

Yes. I mean, your listeners and I know, you've probably experienced this yourself, the world, that the health care universe has completely flipped on its head. Let's go back to March of 2020, where, seemingly within a month, what was a very bustling, face to face health care system in our country, almost overnight, flipped right to almost entirely virtual, or actually not even just entirely virtual, basically, people stopped seeking care altogether. Even for things that you would not have expected to be have anything to do with COVID. You probably read in the news. The heart attacks went down, strokes went down, cancer cases went down. It's probably not because those things went away. It's because people simply did not seek care. Those things, unfortunately, probably went on diagnosed, unaddressed. Over the course of the last, 18 months, I think the peak of the shift was back in the spring and summer of last year 2020. But things have gradually in fits and spurts started sort of going back to the way things were but I think we are never going to go back to the almost 100% face to face world and what's happening and what we're certainly seeing around the country is a proliferation of lots of different ways of engaging with patients that are far beyond the traditional face to face model. 


Dr. Nupur Mehta  24:25

To be very clear, why we've been so reliant on this face to face model was not necessarily because people didn't see a better way. It unfortunately, always comes back to the rules and the way that people get reimbursed. In the current, fee for service, getting paid for every time you perform a service, it had to be in-person, you had to do face to face in order to get paid. But the loosening of the situation around the pandemic and then of course, the changes of some of the rules has really enabled, I think, a significant opportunity to rethink how care is delivered. Because right now, we're in a moment where we can say are we going to go back to the way things work? are we going to take this as a learning opportunity to make things better? Some of these things that have taken hold during the pandemic, like virtual care, like remote patient monitoring, meaning be able to look at what's going on to patients, while they're at home, and you're in your office, or in your pajamas, at your own home office, whatever, not only should they continue, but I'm hoping that they will, because we've not seen, at least in my own clinical practice, a really significant drop off in outcomes. In fact, in some cases, we've seen that people have done better by not having to come into the clinic every month, or three months, or whatever. That they do better when they're at home around their loved ones in their familiar environment, especially people who are particularly vulnerable, people who are elderly, or have mental health issues, or who have significant physical limitations that don't allow them to easily come into a doctor's office.


Jared Simmons  26:14

I see. So in essence, maybe the pandemic either accelerated or introduced new models into the board of patient care.


Dr. Nupur Mehta  26:22

Yes, exactly. I would say that it's probably accelerated. None of these technologies are new. Zoom, email isn't new, and patient portals aren't new. Some of these, like vital signs, monitoring tools are not new but I think what has really changed is twofold. One is, to your point, a lot of people were forced to use it. I think, too, I think we have opened our minds up a little bit as to what the possibilities might be. My own organization, which is, Heyday health, we've really seen that even older adults, the group that people thought could not use technology, did not engage with a team of clinicians out, not in person or not, in the four walls of a clinic, have actually loved it. They've really embraced this. Maybe it was because they were zooming with their grandkids or wherever for all of 2020 and it felt like it wasn't a big deal. They got used to it. But folks have really taken to this and that's been very heartening from a care delivery perspective, that we can make change, and we can do things the right way and meet people where they are, and shift a little bit from this provider centric care model to one that actually does what's right for patients.


Jared Simmons  27:36

How does this new model enable that, to be able to do what's right for patients more often?


Dr. Nupur Mehta  27:42

In a nutshell, we think about the old way, if you're an older adult, you have to get up in the morning, make yourself breakfast, take your meds, get dressed, get in a car, drive in the rain, snow, whatever. We're entering winter now, Jared, it's gonna start getting cold, then you have to go sit in a waiting room with a bunch of other sick people, you have no idea when the doctor or nurse practitioner, whoever is going to come see you, then you have to go from the waiting room to the exam room, you wait again in the exam room, then you get seen for 10 minutes, and then you do the whole thing in reverse again, right? You're gonna imagine how difficult that is for older folks. But our motto; the team is there at the touch of a button. You be in your pajamas, you don't even have to take a shower. You can still see your team. Literally, the walking someone around the clinic is no longer there, we can actually spend more time with people because you click the button, where there we talk, we can review all your stuff, we can provide all the patient education and instead of spending five minutes, we can actually spend 25 minutes. That's been a real game changer for some individuals who we're used to being brushed through and you can really spend time here.


Jared Simmons  28:58

That spending time I can imagine, I'm just trying to make an oversimplified analogue to my consulting work. But I would imagine 25 minutes of conversation might also lead you to insights that you wouldn't have just with five minutes of examination.


Dr. Nupur Mehta  29:16

Absolutely! A joke that doctors talk about is if you have 15 minutes and a patient comes in with three problems, each of which take 15 minutes, what do you do? Well, you ask them to come back three times. You'll address each one of those problems in turn, right? Tell me what your most important problem is. We'll talk about the next to the next two visits and oh, by the way, I'm going to charge you for each of those visits. But in this world, God forbid something happens in between with problem number two or number three, it's no wonder why they might end up in the emergency room or in the hospital because you weren't able to address all their concerns within the allotted time. But because we can spend more time with individuals because we've made it so much more efficient. We can actually get to to your point a lot more of what the patient really needs and needs to talk about even though there's no more time in the day, we've simply just made practice more efficient.


Jared Simmons  30:08

There are some elements of things where you need to see something or touch something or bend something to get some understanding of what the challenge might be. How do you bring that into your practice?


Dr. Nupur Mehta  30:19

Great, that's very important and actually just be very clear that Heyday, it's a virtual first but it's not virtual only. All of our patients, their initial visits done in person. We come to the home, which I think is really, really powerful. Not only is it up to me, of course, to be seen face to face, and allow us to examine them and look at the patient over head to toe, but actually, we get to really understand the true lived experience of an individual and what their living circumstances are like, what their food situation is like, whether they have pets in the home or at work, if it's a fall risk situation, or whether if they have a good place to store their medicines, right? They need to refrigerate something. There's so many things you can learn about a patient and their life that you don't get by them coming to you, they're in your office. It's not just about convenience, but it's also about learning, we're learning a lot more about them. But then, subsequent to that, we want to make it as easy as possible to reach us and that could be through video or phone or email or chat or carrier pigeon, whatever works for people. But if they ever need us, if it ever comes to the point where they need to be seen again, we can always come back. It's not like you get that one time in the home and that's it, never again, because we are local to the patients that we serve, we can always come back, it's simply just a bit of a triage question about whether they do indeed need to be seen a person because frankly, we can do the vast majority of things from afar.


Jared Simmons  31:48

I would imagine the 80-20 principle shows up everywhere. I'd imagine it exists in medicine as well. You mentioned that your local, where are you local to?


Dr. Nupur Mehta  31:57

We launched Heyday health in Northeast Ohio, and a part of the country that is historically underserved and has low primary care utilization, but also has an aging population. We're really focused on older adults, Medicare beneficiaries. That's where we launched and we've been really amazed and pleased at how well this model has been adopted. It is, of course, new, and new things take some time to really be adopted. But all that being said, I think we've been really pleased at how quickly people have taken this, with new things, once the word gets around that it's good, that it's convenient, that it's legit, people then to take it on. We've been lucky to have a lot of word of mouth. Northeast Ohio. If your listeners are interested in learning more, we're always happy to talk to somebody you can check us out at hello@heyday.com.


Jared Simmons  32:52

You and I, we met, I don't know, 10 years ago?


Dr. Nupur Mehta  32:55

Yeah. Wow.


Jared Simmons  32:56

I wish I hadn't done that man. But we met at McKinsey and met a lot of amazing people and you're one of them through that experience. I just want to thank you for joining us. Before I let you go, I want to ask, I'm looking all the way across everything you've done as a physician, as a consultant in your entire career. What advice would you offer innovators?


Dr. Nupur Mehta  33:22

The honest to God truth is to move fast, break things, and fail early. I think the times I've sit around on a whiteboard and just tried to map something out that actually had what I mapped out, work out, I can count on zero hands. The number of times that's worth is zero. That never happened, at the end of the day, I really feel like you just have to go try something. Put yourself out there. Make mistakes, but be humble and willing to learn from those mistakes and then try again. Have the confidence that if you do the right thing for people, if you feel like you're operating in a way that is kind to the people you're trying to serve and to your team, at the very worst, even if you fail, at least you've done right by the people that you worked with, and hey, that's nothing to scoff at. 


Jared Simmons  34:17

Well said. I appreciate you making the time to join us and share those insights. Dr. Nupur Mehta of Heyday health. Thank you so much for your time and your friendship. I look forward to watching the great things you do with this organization and anything I can do to be helpful, let me know and I just have nothing but respect for the vision and the problem you're trying to solve and the population you're doing it for. Thank you for your your service to the community.


Dr. Nupur Mehta  34:51

Thank you, Jared. I really appreciate you having me. This  was a great. As always great fun to chat with you. I wish you all the best as well. 


Jared Simmons  35:04

All right. Take care. We'd love to hear your thoughts about this week's show. You can drop us a line on Twitter at OUTLAST LLC, or follow us on LinkedIn where we're OUTLAST Consulting. Until next time, keep innovating. Whatever that means.