How Can AI Improve Pediatric Care?

[00:00:00] Jared: Welcome to the med+Design Podcast where we delve into the fascinating intersection of healthcare, technology, and innovation. Today, we're honored to have a very special guest with us, Kate Groff, a visionary leader in the realm of pediatric health care and digital health innovation. As a dedicated nurse practitioner specializing in pediatrics, she has a track record and passion for improving patient care and outcomes. Her deep commitment to pediatrics led her to embrace the world of digital health where she's been making significant strides.

Currently, Kate serves as the chief nursing officer at First Hx, a pioneering digital health company that stands at the forefront of integrating AI technology with patient care. In this role, she's not just a leader, but a catalyst for change, driving forward the mission to transform how we approach pediatric health care. But Kate's influence extends beyond her role at first history. She's also a doctorate student at the prestigious Johns Hopkins School of Nursing, where she's expanding her expertise in nursing executive leadership. This pursuit reflects her unwavering commitment to advancing the field of nursing and health care as a whole.

Her work is a testament to how innovative thinking and compassionate care can come together to make a real difference in the lives of patients, especially the youngest ones. As we dive in, we're set to explore the depths of Kate's experience in pediatric healthcare, her insights in digital health innovation and her vision for the future of nursing and patient care. So I think let's just dive in. Welcome, Kate. We're really happy to have you today.

[00:01:18] Kate: Wow. Thank you so much for that introduction. I'm thrilled to be here with both of you today.

[00:01:23] Jared: Thank you. Thank you.

And I guess if you could just get started off telling us a little bit about your journey from being a nurse practitioner and then getting into the role that you have now at First HX. This first HX I always read it as first HX, and I think you guys may have a similar problem to us at med+Design where everyone sees us as med plus design, not med design. Mhmm. And I can imagine the First HX thing happens a lot too. And just also, as you talk about your journey, did you always see yourself being in the c suite as an executive leader?

[00:01:53] Kate: Sure. I'll start from the beginning. So I really came to nursing I think I have a second career. I didn't know I wanted to be a nurse. I explored lots of different career paths in college, switched my major, I think, a record 8 times exploring a multitude of interests.

I had a hard time just picking 1 thing that I was really about. I love design. I love science. I loved working with people. And so it really took meeting with different mentors to really land on nursing as a career.

And so I graduated with an undergraduate degree, not in nursing, but in international health, And then went on to get a second degree in nursing and then became a nurse in pediatric, focusing initially on pediatric stem cell transplant and oncology, and then went back to do more graduate work to become a nurse practitioner. Still focusing in pediatrics, but moving into more of pediatric critical care and pulmonology. And that's where I worked for a number of years In varying positions from clinical to operations, to teaching in nursing. Various leadership roles and really grew as a nursing leader within a health system. And it wasn't until the pandemic and my youngest son at the time was hospitalized in critical care during the height of the pandemic that I really made a big career transition. Going into the hospital with a child and experiencing that role reversal, from being a provider in the ICU to the parent of a child in the ICU had a really profound impact on my view of patient experience and patient engagement and access to care.

We were lucky enough to live down the road from a hospital that had a pediatric unit. When he needed critical care, there was no bed available because of the height of the pandemic. And so they had to transfer our bed into a critical care bed. And it was a very frightening, I'll say traumatic experience for our family going through that. And we had every advantage.

I'm a critical care nurse practitioner in pediatrics. We were close to home. We had access to pediatric specialists from pediatrician, pediatric respiratory therapist, pediatric nurses, child life specialist, all were able to come to our bedside and care for our son. But, Thankfully, he recovered.

We went home, but I felt this nagging feeling that not everyone has that experience. And so instead of feeling the joy and relief of being home, I felt this guilt and wanting to understand this problem more and what happened to us and make sense of what was really difficult to comprehend was at the time. And so I really kept having this nagging feeling every day, that this was something I really wanted to focus on and delve into. And so I initially just started volunteering with parent groups to understand their experiences coming out of the hospital. And then learned about start ups and different companies that were working in this space and came upon a start up in London named Little Journey that was getting off the ground focused on preparing children for being in the hospital, which made sense in the context of my experience. And so I jumped in not knowing anything about what it means to work in innovation or entrepreneurship and decided just to jump in and start helping out and see where I could contribute my nursing skills.

And that role grew and grew, and I really fell in love with the environment and the creativity and working with just incredibly inspiring people. And I last year, decided to really continue my education, focusing on patient engagement and digital health. And like you said, that's when I enrolled at Johns Hopkins, and that's been the focus of my project work there. And I joined the team at First HX, so you pronounced it correctly focusing on deploying their pediatric specific a solution to support children worldwide.

[00:06:04] Jared: First and foremost, just I'm so glad that, your child is okay now, and, that's an incredibly traumatic experience.

And if you could just tell us a little bit about First HX as a company and your role there in general. What's your day to day like and what impact do you have or do you hope to have on the company over time?

[00:06:22] Kate: Sure. So First HX is really a medical knowledge solution to capture the patient's history ahead of their visit with their health care provider and to use that data to really drive better outcomes for children. And so my role as the chief nursing officer at First HX is to really support that process in getting us out into the market and increasing awareness about how we can really for children and increased access to pediatric care.

Because what we know is that there are multiple pediatric health care deserts in the United States. There was a recent report from the American Academy of Pediatrics showing that 47 percent of US counties are pediatric health care deserts, meaning that they do not have access to a general pediatrician. And so what we can do is we work with pediatric specialists to write our questions, write our content so that we can really increase access to the best evidence based questions. No matter where you live. So if you live in a pediatric health care desert and you, say, go into an emergency room where there's not a pediatrician, you still get access to the most evidence based question.

So it's really about increasing access for all children no matter where they live.

[00:07:40] Jared: Oh, it's wonderful. And I guess just to role play a little bit, I know this is unscripted, but from the other side of the fence as a parent that's, gonna be using this technology, what's their experience in using this technology? What is their workflow like going through PED's history or HX, as people would read.

[00:07:57] Kate: Yep. So how it works is when the parents schedule or parents or guardian schedule an appointment with a health care provider.

They receive a text message that walks them through their history where each question is based on the previous answer. So it mimics the medical interview, which, is a complicated process. It's not a form. It's not something you can transfer onto a form.

It's the dialogue between the provider and the patient. And what we know is that 60 to 80 percent of the average patient encounter is spent collecting the history symptom data that we can collect ahead of the visit to really open up that time for patients and families to use it to meet their goals and their needs. Because most parents I know are rushed. We're running in. We have a sick child. We're trying to answer these questions in the middle of sort of chaos, and we often leave and think, I didn't even tell them that we went to the emergency room last week, I didn't tell them about that course of steroids. It's really hard to think clearly when you're inside that visit and use that time with the provider and really gain access to their expertise in that moment to make a plan for the future. And so it's about preparing the patients and families ahead of time, really priming them for that visit to collect the data that's gonna inform their care so that the provider on the other side doesn't have to focus on the documentation.

They can focus on what brings them joy because everyone that goes into pediatric love kids. They wanna interact with the kids. They wanna talk to the family. They wanna establish that connection.

And that's really difficult when you're having to chart and document everything that's going on. And so if you can walk into the visit understanding that child's story ahead of time, you go in with that base knowledge that you can really build off of so that visit is about that connection and that partnership with the family.

[00:09:49] Jared: That's wonderful. And would you also say that yeah. There's a sort of stigma also around people being fearful to tell their doctor the truth at all times and, maybe they flub the truth a little bit, but if they're, interacting with a device or talking to an AI or, something that's nonhuman, they feel like maybe the judgment side of things is taken out, and they are, more inclined to give a more truthful answer and more comprehensive answer or patient history, I guess you could say.

Is that something that maybe you've experienced as well through First HX?

[00:10:22] Kate: Absolutely. So as part of our evidence based question, we can incorporate screening items as well. So we can look at things that are very sensitive topics. Looking at adverse childhood events, depression screening, screening for sexual health for adolescent.

These are difficult topics, and we know that particularly adolescents prefer to interact with an AI based solution versus talking to the provider in person. And so we can gather that data from the comfort of their own home where they're gonna feel more comfortable with answering really sensitive topics so that the provider is better informed when they get the visit. That's a really great point and something that's particularly important in the adolescent population.

[00:11:02] Ty: Can you touch on the business model as far as the decision that's made on the provider side to incorporate your company's, digital health solution and then reimbursement. Do you mind just kinda give a I guess, a few bars are there?

[00:11:14] Kate: Yeah. Sure. So we work with everyone from small independent physician practices all the way up to large health enterprises as well as partner with other digital health companies and technology companies where we can really enhance their offerings.

And so we work with those providers to develop contracts to meet, whatever pricing needs best match their patient population. And, really, it goes across the ecosystem of digital health because we know that working collaboratively is really important. And so the more we can work with all of these different sized companies and other digital health companies, the more impact we can have as a company. And so we work in Canada, the US, and the Middle East.

[00:12:00] Jared: Wow.

And as far as adoption goes, where are you all on the adoption scale so far? And is there market share that you have to take from somebody else? Is there some sort of market leader that you're compared to, or are you just creating your own market share, in a way?

[00:12:15] Kate: Sure. So there's other, competitors, of course, in this space, but I think what makes us different, one of the big differences is that we're clinician led.

We are focused on the patient providing person centered care and really collaborating across all the different stakeholders that come into play. And in pediatrics, that's particularly important that the technology is created by experts in pediatrics. So our chief product officer is a physician. We have pediatricians on staff, myself specializing in pediatrics, it really shows the difference in the content and how tailored we can be to children's needs because there's so much that you can do by collecting that data. There's early symptom detected detection.

You can intervene earlier. Precision medicine and, even in just, for example, pediatric oncology, we can now match children with what intervention is gonna best meet their diagnosis. There's so much going on in this field, and the more that's driven by clinicians, I think the better you're gonna see outcome wide.

[00:13:20] Jared: I'm there with you. I maybe Ty had something to say too, but just I feel like from the clinician led companies that we've seen, there's always more of an aspect of empathy for the end user there.

Human centered design, I think, is more taken into account. I'm not sure if I interrupted you there, Ty. Oh, no. No.

[00:13:36] Ty: I wanted to come in with the observation that you're going through and being collaborative with the specific needs of the smaller, independent practice versus the larger system that both better serves the, the people you're trying to help, But it also adds some operational complexity.

Any software company would wanna just have one standard solution they can push out to the whole world and make everybody conform to that at the expense of maybe, say actually serving the patient needs, not to point fingers or anything, but that exists. Thank you. I'm curious from a the cost that you bear with that of that customization or, like, how has your team managed because it's a lot if you're trying to make a custom tailored solution for each customer of yours.

[00:14:22] Kate: It's a good question.

So I'll kinda walk you through how we develop the questions. I think that's what sets us apart as well. So it's a combination of going to the evidence, standard medical knowledge that's been documented, but also going to the experts that have experiential knowledge and really combining the two. Really, we sit at the intersection of evidence based practice and innovation. Right?

We sit at that intersection because we know that the medical knowledge is extremely important, but that experiential knowledge of working in pediatrics and working with patients is equally as important. And so we combine those two, which, you could argue is more labor intensive than just using the evidence, but we think it pays out in the outcome that we're gonna drive into the future. And so we're investing in creating that knowledge so that we can really see better

outcomes long term.

[00:15:13] Jared: Another topic I wanted to touch on as well is, obviously, you're in the c suite. You're a leader.

I wanted to talk a little bit about leadership in health care and your leadership style, does leadership have to change when you're in a hospital sort of setting versus the, start up environment, does that have to change a little bit over time? And also, just what would you say your leadership style is like? How did you develop it? And maybe what were some of the mentors you looked up to along the way?

[00:15:39] Kate: Great.

It sounds like you might have talked to my professor because I just wrote a paper on this ironically. But I talked about in the hospital, I would have described my leadership style as servant leadership, Really trying to serve my team and my patients often at the detriment of myself, putting their needs above my own. And so when I came into the start up environment, which, as can be much more chaotic than a hospital with all of its evidence based practice and guidelines and standards. You go to the start up environment and coming as a in as a clinician, I went back 0. I didn't have any background in this. I had to dive in and just learn and just see the potential and growth and accept that I'm not always gonna have the answer. But if I have a team behind me, and I do, that's amazing. Then I can really, thrive in that environment. And so I would say that my leadership style has changed into more of an authentic leadership style, really embracing my personal experiences as a mom, as a nurse, and really bringing those into my leadership experiences and combining the 2 to really help foster collaboration in my team and hopefully, encourage them to be authentic as well and to really embrace all the different sides of them.

I think and, one of the things you both touched on a lot is this aspect of Creativity. And I think in health care, we often neglect that side of ourselves. Growing up, you're often asked, what do you wanna be when you grow up? And to me, as a child, that was incredibly stressful. I don't think anyone spent more time in the career center than I did in high school just because I didn't have a single sentence answer to that question.

And so it wasn't until I discovered start ups that I realized you can wear multiple hats. You don't have to have one thing that you're good at and that you're committed to. You can be good at multiple different things. And so I think nurses are naturally positioned for that. And to be able to really embrace your creativity and let go of some of that perfectionism that I think is ingrained in us as we do our training to really be so driven for science that we neglect this other side of ourselves and to our own detriment.

I think we're seeing it play out, with increased physician burnout and nursing burnout. We're multidimensional people, and, really, we need to take a more holistic view of ourselves and accept that there's more to life than nursing and medicine. If we can embrace creativity and find ways to incorporate it into our work, whether that's in a hospital or outside of a hospital. I certainly struggled to incorporate it into my work inside of a hospital. But now I've seen so much change in that where I've seen so many more nursing leaders inside of health systems being innovative and creative.

And I think that's a really great change to see. And if we can find ways to work together and bridge that gap, I think that's where the magic's gonna happen, particularly for pediatrics.

[00:18:45] Ty: Yeah. Oftentimes, the solutions that I've seen nurses come up with are incredibly practical and novel in trying to address an immediate bedside challenge that would be counterintuitive to most people. There's enormous creativity that oftentimes, it's just then there's not a process to then pull it forward and know what to do with it after that first one off solution comes forward.

But love hearing that you've been, like, accessing that creative side of yourself and finding outlets for it and everything.

[00:19:15] Jared: That's awesome.

[00:19:16] Kate: So I think a lot of that has come from having children as well. I think I heard you I think it was you, Ty, that said the quote that 98 percent Of 5 year olds are creative geniuses. Mhmm.

And speaking from experience of having that age demographic in my home, I completely agree. I think we have a recycling bin on our front porch that is free game for engineering, robot, art project. And it's just amazing when you pull children at that age away from technology and TV, how innovative and creative they can be. They're not Impeded by this idea of failure and perfectionism that hasn't been built in them. And so I think it's inspiring to me to watch how creative they can be when you give them a problem. So I love that you describe that in children.

I think their natural curiosity really plays out, and they can be extremely creative, and we have a lot to learn as adults from them.

[00:20:12] Ty: We do. We do. And also to try to help nurture that as they can carry that forward into adulthood because there is a lot of pressure in middle school to stop being creative. And, you Yeah.

I think that's something to just touch on and make sure it's like going to the gym. It's a muscle that you have to exercise in order to main maintain it. Yeah.

[00:20:31] Kate: Absolutely.

I oh, go ahead.

[00:20:33] Jared: Oh, no. I was just curious if because you kinda talked about how your journey of creativity has been over time. And for a floor nurse, is there really a time in their day where they're able to be creative. Is that something that even comes into their life when they've got so many darn patients and they're overworked and short staffed?

And like, where are even the moments for creativity for nurses that are at that stage in their career versus, I guess it seems to be that a lot of people that have worked in the start up world and the digital health world when the nurses like yourself have moved on that direction, it seems to be that's where creativity finds you again.

[00:21:10] Kate: For me, that was certainly the case. I certainly didn't find creativity until I stepped away and took a moment, take a deep breath, and rest, And really find that's what I needed to recharge with creativity. And it was difficult at the bedside because you have so many competing demands and patients and working in critical care. There wasn't a lot of time for that.

And so I think it's creating space for that inside of health system dedicating time to nurses and physicians who wanna innovate, giving them dedicated office time to focus and work with their teams to really come up with creative solutions because it is really challenging when you're prioritizing patient care. But that being said, I've seen nurses come up with incredible solutions in that environment. In pediatrics, many different solutions come to mind. Color coded IV line. What a great idea for pediatrics.

A nurse that I worked with in my first nursing role created a line snugger device that holds the central line in place so that children can move about freely and not worry about tugging on their central line. Very practical application of creativity and innovation through the bedside. And so I certainly think it's possible for nurses to do that, but It's challenging. And so the more we can enable creativity in their life, whether that's at home or at work, I think the better. And the more we can work with, outside start up first history to help enable that, I'm more than happy to support that.

Because for me, It really made a huge difference in my life to circle back to creativity. I came back to it at several different points, but during your training, I know many physicians will say the same, that they're so focused on rigorous medical training that they have to abandon those aspects of themselves. And now when we're seeing the uptick in burnout, I think it's more important than ever to circle back to this conversation and say, how do we bring creativity back into the lives of health care providers to really give them relief and time to recharge and think about innovative solution because we're tackled with monumental issues in health care right now that, from fragmented health care to, burnout. We really need creative solutions. And so how do we grant health care professionals Time to focus on those solutions and think creatively.

[00:23:31] Jared: That was thank you for that answer. That was wonderful. Yeah, this we're actually working on a way to for health care providers to be able to just have more time to or just realize that creativity doesn't have to be this big lift to engage with, that there's these little activities that you can engage with throughout your day, whether you're going on a walk or whether it's something that like, you're listening to a podcast on your drive about, something new that you wanna learn about or things that you can do during your break. I've heard of nurses that mush their break breaks together so that they can be long their short breaks so they can have another long break. And, yeah, then you can have some time to mess around with that.

And so I think that is just about practicing this creative muscle over time. Anyways, I know that for anyone that's listening pay attention to us soon. We got some stuff coming up for you guys.

We're really excited to share but we're just not quite there yet. I

[00:24:22] Kate: can't wait to hear about it.

[00:24:23] Ty: Yeah. We're we've been working on it for a bit.

But, one of the comments you made, Kate, was just talking about how much urgent response And kind of short term in moment quick decision making to get to the right answer can you know there's lots of reason reasons for burnout, lack of autonomy, a system that's designed all stoplights and no roundabouts in terms of decision making control and taking away local decision making criteria. But, setting aside that time for daydreaming And intentional rest that allows for your kids or when my kids come to me and say they're bored great. What are you gonna do next?

Because

Yeah. Exactly.

I'm not gonna come up with it for you, but having that freedom to let your mind rest and be open to new possibilities is the only way I think some of the most critical problems we're facing in health care can start to be addressed because it's an accumulation of it's almost long term thinking debt. Because there's an accumulation of short term decisions, but then the long term picture seems to get lost in all maximizing the local optimizations that happen on such an urgent and short time scale. Definitely it definitely resonates.

[00:25:35] Kate: Yeah.

And I think you could draw a parallel to pediatrics in the sense that we focus so much on the pediatric age. Mhmm. Sometimes we fail to grasp the fact that we're really setting children up for a lifetime of health outcome. Positive or negative. If you take a wider view, It just shows the importance of this age group and the multiple different developmental phases involved in Pediatrics and taking more of a long view on investing in this age group because we see chronic underinvestment in pediatrics across the board. We see it. And so it's how do we collaborate to really work together to drive investment.

The World Health Organization released their digital strategy global digital health strategy really focusing on patient engagement in digital health and working across stakeholder groups to have real effect. And so a lot of projects have come out of those guidelines. One being our work most recently with the Digital Medicine Society creating a playbook on digital health for pediatrics, which is involving lots of different stakeholders, Boston Children, Stanford, multiple pharma companies, start up s really showcasing the power of working together and breaking down these silos because there's experts across these different groups. And the more we can collaborate, the more we can actually affect change. And, certainly, when it comes to national health policy and digital health.

We need to make sure we have a child health lens as part of that and make sure that children aren't left out of the equation as they often are. So I know recently the FDA announced a new digital health advisory committee, and so I've been rallying the troops trying to get people from the pediatric sphere to try to become a member of that committee so that we really get a voice on the national stage about the importance of engaging with pediatric and families and really trying to take a long view in driving positive health outcomes. It's a challenge, but we are more than willing to get involved and see what we can do.

[00:27:49] Ty: Wow. What a phenomenal just, just having that broader vision and trying to actively impact the change and kind of the point of view and make sure that the proper voices are heard at a in a forum like that.

[00:28:00] Jared: That's phenomenal. Yeah. And, my fiance, she also works in pediatrics and talks about how it is criminally underfunded at all levels. And you I guess you have talked about I've just seen it on your LinkedIn about bridging the gaps between in pediatric health care. And so for you, when you hear that statement what are some of the gaps that really stick out to you that kind of make you uncomfortable about the state of pediatrics as it is today.

[00:28:29] Kate: Yeah. When we got out of the hospital with my son, I really took a deep dive Into the data to really understand where we are right now and what's happening. And what we're seeing as a national trend is the centralization of Pediatrics. And so we're seeing these vast pediatric health care deserts mainly in rural areas where there's families that drive hours. Hours to see either a pediatrician and even worse to see a pediatric specialist.

They just don't have the access that they need. I think the most recent number I saw was 17000000 children live more than an hour drive from a regional children's hospital. And so you can imagine the impact of that. For me, on a personal level, that could have meant the difference between life and death for us, just having that access. We were 5 minutes down the street, so we could drive there in a matter of minutes and have access to the top pediatric specialists.

But for many people, that's just not, you know, what's going that's not the reality for them. And so how do we use digital health tool to help bridge that gap? And I've seen in the literature talk about how digital health is a new determinant of health. The organization for economic cooperation and development listed in the recent health report, digital health as an emerging determinant of health. And I think we've seen that bear out in the data that access to these technologies can mean a huge difference for pediatrics and gaining them access to pediatric expertise because they seeing a pediatric specialist bears out in the data that they will have better outcomes.

It can mean the difference between life and death, quality of care. This really matters. They're not small adult. They're unique Individuals with unique and real needs.

And so how do we increase access to pediatric expertise? And I think digital health tools like our solution, like other solutions in the industry, are looking at how to bridge that gap. So how do we bring technology into the home where the families are and meet them where they are and what they need. How do we bring technology into school? How do we bring it into the community to really meet the needs these families and make sure that everyone's getting the access that they need.

[00:30:49] Ty: And you mentioned, trying to be able to off have this kind of offering for rural communities, and that's usually where the gaps are from a broadband coverage. Curious how you've run into that, seen that, start tried to address that particular technology infrastructure challenge.

[00:31:04] Kate: Sure. So I think there's some encouraging news coming out on that. I saw recently in California Medicaid with giving out access to phones that were digitally enabled to give them access to digital health solutions, I think that's what we really are gonna need to focus on.

How do we get technology into the hands of these patients so that they can actually access the tools that they need. But, certainly, that's an ongoing conversation about how to address these inequities in health care across the lifespan, but even more particularly in the hands of families of children.

[00:31:39] Jared: Mhmm. Yeah. Your example really hits home for me.

Actually, my neighbors, they came here from Hawaii because their son had a very rare birth multiple rare birth defects. And he's just had a really he's I think he's only 4 years old, but he's just had a really tough go at it. And where they were in Hawaii, surprisingly, didn't have the sort of care that they needed. So they had to rely on a very generous family member that allowed them to stay in their home and raise their baby over here so that they can get access to the care that's It's not too far from us over here in LA. But yeah, it just makes me think about all of those people that have those situations.

And it's just these are real life people. These are real life people that are struggling every day, and families are coming together to try to help them. And sometimes, it's not enough. And anyways, sorry.

Just hit me in the Thank you. Appreciate it.

[00:32:30] Kate: A little bit. Yeah. And I think you make a great point.

The more complex cases, the more complex the history. Because they're coming from multiple different sites. They're having imaging done at multiple different places. And so that's where the real value in is what we do, we can really condense down that data and help tell that story so that patients that have these complex histories can then be funneled to the provider and they'll get the right care and really make sense of a complicated history.

When they're having so many different touch points, It's hard to rely on the families to keep track of all this and to really know how to share their story to their providers. And so that's what we really wanna help tackle are these patients with complex medical needs, whether it's, oncology or epilepsy or all these chronic health conditions in pediatrics that have complex history, we can really help ease out the information that's gonna help get them to the right health care that they need.

[00:33:32] Jared: And I kinda wanna go maybe from a maybe farther back view, a little bit farther back to just the broader health system as a whole in the US and how, outcomes health outcomes are getting worse over time in the US. It's scary to see and sad to see. And do you think that this is an effect of lack of effective leadership in health care, or is it more down to corporate greed, insurance companies with too much power or, I don't know, something else?

But I was just curious of do you think that it's leadership that's let us down to some degree in the US health system?

[00:34:09] Kate: I think it's challenging. I think a lot of it comes down to competition, like you said, where there's more focus on competition than collaboration. And so I think we need to take a different lens on how we can partner together instead of compete. How can we work across health systems?

How can health systems work with community centers and pediatric providers and rural communities? How can we all work together to make this more seamless. And help get patients through the system to get the care that they need. There's a lot of interesting projects looking at this, one of them is you may have heard of it, the pediatric moonshot out of CHLA looking at how do we drive better pediatric outcomes and make sure that no matter where a child gets, imaging done or testing done, that it can be accessed. So whether they sit inside of a pediatric hospital or an adult hospital, we can access their records.

We can see what's been done to them, and then we can increase access to pediatric expertise worldwide. There's no reason that we have to keep all of the knowledge here in our system. We can share it in other countries that are less fortunate and don't have access to all of the expertise that we have here. And so that's the real power of technology, I think, is expanding those borders and really looking to collaborate. But that's gonna take champions from within health systems, from within payers, within pharma to work together.

And so I'm a huge proponent of finding those champions and working together. I know they're there, but it can they have the space and the time to dedicate to this? And I think we're seeing more and more people step up for that challenge. And in pediatrics, we're fortunate because we tend to be very passionate and love what we do and want to help children. And so I think that we have a real shot at accomplishing this, and there's a lot of people that are much smarter than me that are working on this

to really tackle this challenge.

[00:36:08] Jared: It's honestly been very comforting the wonderful people we've been lucky enough to interview. It seems like a lot of people are pushing towards that. And it just takes time and people to get in the right positions and had the right opportunities in front of them.

And so I guess now going more towards the hospital level. And this is something that I was thinking about, which is the nursing shortage. And, the fact that bedside nursing is so difficult, I guess you could say.

It's brutal. You're dealing with, just some of the worst parts of the human experience, and and the worst parts of these people's lives, and that's your every single day. And so I can imagine the toll that would take on somebody throughout the course of their life. And so just thinking about their perspective, I can imagine a natural thing to do would be to say, what else can I do with my degree? Because I don't wanna have to cry after every shift because of all this craziness.

And so then from there, they're like, okay. What else can I do? I'll go work in startup world. Right?

Yeah, maybe a path similar to yours. And is it maybe that nurses have so many more opportunities than just having to be by the bedside that maybe is just the fact that we just need we need so many more nurses because there are so many more opportunities for nurses now. Is what is that an assumption to make. It's just been on my mind, and I've been curious of somebody that you've had just such a from leadership and working at, the bedside as well. So curious on your perspective on that.

[00:37:36] Kate: Yes. Certainly. When I was in nursing school, I never would have anticipated I'd be working at a start up. I didn't even know what a start up was or I never thought about being innovative and creative. That just never came up as part of our training and studies, and so I never pictured it for myself.

I always thought the only track was inside of a health system, and so it wasn't until a global pandemic and my son being hospitalized that I reevaluated that and took a deep dive to see what it was like and how nurses could contribute. And since that time, I've seen a lot more nurses come into the field. But I think what's interesting about the mixture of clinicians in my team is that many of them still practice. And so they have this gift of still seeing the issues right in their face. They're seeing the patients every day. They know the real challenges in tackling those challenges, but then they also sit inside of a digital health company trying to address those challenges. And so I think that's really special being able to have a foot in both and really, keep a pulse on what we can do to support providers, what we can support what we can do to support patients. And, for me, I'm sure I'll return to clinical care at some point when I complete my studies as well, because at the end of the day, I love patients, and I love taking care of patients. And so how do we marry these 2 worlds of evidence based practice and nursing, but also creativity and innovation.

And so I think clinicians sit at the center of that and can bridge that gap. And whether a nurse is innovating inside of a health system or outside of a health system we're well positioned to do that. I think we're natural MacGyvers of figuring out solutions. And to me, innovation is really just problem solving in the simplest terms. And so I think nurses have a long history of doing that from the very beginning.

Florence Nightingale in the nineteenth century, innovating with hygiene practices with soldiers and really showing better outcomes and less depth, to leading the way in innovation, from then on, all these different nurses have gotten involved. There's a great nursing society for those listening called SONSEIL that's dedicated to supporting this. And when I found that group of nurses, it really gave me the confidence to dive in because, when you feel like you're an expert in one thing. I felt like I was becoming an expert in pediatric critical care.

It's hard to leave that and go back to knowing nothing. And so you really have to develop your confidence and realize that as a nurse, you really do have a lot of value to give and bring that patient voice to the forefront. And I think we're seeing this transformation and digital health where more and more people are calling for that patient voice to become part of designing technologies and really engaging the patients that we're designing for and not assuming what their needs are, but really working with them from the beginning from designing all the way through commercialization to say, are we meeting your needs and your preferences to really drive better outcome? Because if we're not involving the patient, we're not gonna get the outcome. And so I think in the next few years, we're gonna see a big change when it comes to engaging patients in the design of new technologies, and certainly, nurses are gonna play a big part of that.

[00:41:02] Ty: The model you just described there of finding balance sense of balance and well-being by not being a hundred percent in, a full time, clinician role where you're, fully bedside, but rather have part of your time be at bedside, part of your time be in a build mode, creating, innovating something new. It seems like a solution for well-being. It could also be something that could set you up for, feeling too disparate or having worlds conflicting with each other.

And but, yeah, it seems like such a rewarding path to take too. Because you'd never wanna lose touch with, helping patients, being part of the that immersive environment of health care.

[00:41:42] Kate: Certainly. I think it helps deal with feelings of burnout or losing the joy in nursing or practicing medicine.

I think it can really rejuvenate you and allow you to use your skill set in a different, more creative way and, like you said, really flex that muscle and practice doing that. I think I'm really lucky because I found a team that's incredibly creative And innovative. And we really feed off each other. And every time we have, an ideation session, I just believe so rejuvenated and excited to work, and I think it's because we have a mixture of clinicians and nonclinicians. And at the end of the day, we're all dedicated to health care, but we have differing experiences.

I think that diverse team and our team culture really sets the stage for collaboration and this growth mindset that you don't have to know everything to start. You don't wanna let perfectionism get in the way of good. It's okay to just jump in and try and fail. And if you fail fast and then try again.

And if you can support that culture within the team, it really grants you freedom to be more creative and lean into things that you know, going back to the creative geniuses of children, going back to what you liked as a child. For me, it took self reflection to think what did I enjoy as a child. And I actually love graphic design, funny enough. My mom was a single working parent, and so I often went to work with her. And one of the things that I could do when I was there was to work with the advertising team using arts and letters on their computer back in the day.

And I would design different things, and I actually sold my first design when I was about 9 years old through the real estate company, and they used it on all of their branding. It said something cute, like calm is where the heart is. A little cartoon character that I drew. And it was my first taste of entrepreneurship and realizing that you could create something and love creating something, and you could profit from creating the thing that you love and designed. And I think reflecting on that, I realized I really do love the design process.

And so how do I, like you said, incorporate that more into my daily life Instead of siloing it to when I have time and when I can make moments for it. Because for me, it usually happens when I'm in motion of some sort. I'm walking. I'm running. I'm not thinking about, oh, this is my time to be creative.

I'm just thinking about, I'm gonna go for a walk and enjoy nature, and then, boom, the, inspiration strike. And I can't wait to write it down and record that idea. But I think what you are talking about and creating for health care providers and how to create those moments of creativity is gonna make a big impact because, certainly, I have a lot to learn on how to incorporate it into my life. And so I'm excited to delve into that more and really learn how to practice it more and make it part of my everyday life.

[00:44:48] Ty: You just touched on it there that let me like, when you're from a psychology standpoint or that when you are doing some level of movement, That's accessing one of the dopamine pathways that leads to divergent thought.

And Yeah. You just got a dedicated pathway in your brain already because it comes from opening yourself up to new experiences. You're seeing new things flash by you, and so your brain will make new connections through movement. And that could be like brushing your teeth as a movement and accesses that. But leaving your so if ever a team gets stuck and you're sitting down and hunched down and trying to cope with something and just go for a walk and talk will open yourself up, and you can do it in a team context, do it individually.

Certainly part of my daily practice to go for an early morning walk or run with the dog, and I usually come back with, solutions to whatever it is that's kinda facing this. And anyway, it's definitely a good daily discipline and something to unpack more. So yeah.

[00:45:42] Jared: And we don't have a lot of time left. Something I did wanna ask you as well, and maybe I think Ty could be have a good answer to this as well is just, for the nurses and for the physicians and nurses that listen to this podcast not everyone is already an innovator at this stage. There's a lot of people are earlier on.

And what is really the best way to just get started as an innovator? You have an idea. You have some pain point that you're experiencing in your clinical practice and you're maybe not feeling confident enough. You're like, oh, man. This idea is not worth anything or, whatever.

I don't believe in myself that I could be an innovator or anything like that. And what is that step that they or what are the steps they have to take yeah, just be become an innovator like yourself and the many others we've talked about today.

[00:46:25] Kate: I think the first step is really finding your community of other nurses innovating and working in that environment so that you can bounce ideas off of each other and really give each other or so like I said, there's and there's other nursing societies, the ANA that are working in innovation that you can connect with like minded people, and I for me, that was the most confidence building activity was to meet other people who were tackling these challenges and realizing that it was okay for me to be thinking that things could be better, but it was okay to challenge the notion of how things are done and think of a new way to do them. And so whether that's reaching out to internal innovation teams, certainly, many hospitals have them now. Or, you can do different nurse pitch a thons, where which are hosted about every quarter where you can actually pitch your own innovation.

There's lots of events like that you can get involved in, but I would just encourage people to create a network and look for mentorship. There's lots of nurses in this field that wanna support other nurses trying to break in. And so reach out and be bold, and don't be afraid. I have people reach out to me all the time, and I'm always happy to have a quick Zoom call to chat and try to give encouragement because the more we can encourage each other to really work on these projects and not give up, I think, the better.

[00:47:48] Ty: I don't have much to add to that.

That was an amazing answer other than just to highlight how much courage you have modeled, Kate, as you have shifted from the known and going into and the unknown in a place where you don't have expertise, but that courage that you've demonstrated for that. It doesn't just get handed to you. It does mean you take some risk if only you've just lost time. But I think you've found that it's an incredibly rewarding path on the other side of taking that leap.

[00:48:17] Kate: Absolutely. And I think a lot of it comes down to your team's culture and feeling that safety of not being confident and saying, I've never done this, but I'll try, and having the safety net to actually, go out and do it and, write a blog piece or, design a graphic for the website or, all these things that you're putting yourself on a out on a limb. Especially creatively. I feel like that's very vulnerable to put yourself out there.

When you don't have experience and you don't have a degree in something, for me, I felt if I was gonna do graphic design, I had to have a degree in graphic design. If I was gonna work in business, I had to have a degree in business, and I don't think that's the case. I think often it's a strength to not necessarily have the background because you can see things in a fresh perspective. And it's always it's great when you can work with people who do have the expertise and go collaborate so that you can bring in your ideas and work with someone who has the background and really create something special. So I think it's the team environment that really allows you to do that.

And so look for teams that are made up of supportive, encouraging people. Certainly, if they have clinicians on the team, I think that's a great sign that they're really committed to making a difference in health care. And so my recommendation would be to find the team that's gonna allow you that creative faith.

[00:49:39] Jared: And as we're really wrapping up I've done personally a lot of devil's advocate today of just saying all these negative things the health care system and, trying to pry this out of you. But I think at the same time, and you've done a good job of this, is talking about a lot of the positives that are out there.

And so when you think of pediatric digital health in general, and the future that's ahead of us next 5, 10 years, what really gets you excited about it?

[00:50:01] Kate: That's a great question. I think what gets me most excited is the potential, like we've talked about, to really democratize access to medical expertise across the lifespan, but particularly in pediatrics and really increase access to pediatric care and develop evidence based guidelines to support that care. I think seeing the collaboration across stakeholders in pediatrics, I think we're gonna see that come to fruition, and I'm excited to see the path forward.

[00:50:31] Jared: Yeah.

Excited as well. And I guess just what's coming up next for you? What's coming up next for First HX? And for everyone that's listening in today, how can they engage with you as well afterwards?

[00:50:41] Kate: Well for First HX, we're continuing to look for partnerships within health systems or independent physicians.

And so I would encourage anyone who's interested in working with us. So please reach out. Find me on LinkedIn or reach out on our website, and let us know if you want to partner with us because we're always excited to collaborate and work together all to benefit pediatric patient.

[00:51:06] Jared: Wonderful. Wonderful.

And I guess On that note, Kate Groff, thank you so much for joining us today. We really appreciate your time. Really appreciate the impact that you're having on the future of health care and patient care for especially for pediatrics. And yeah, we look forward to your future successes as well.

[00:51:21] Kate: Thank you so much.

Great to be here.

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