Examining The Impact of Retail and Big Tech in Healthcare: Part 2 — Through the Vendor Lens

Transcript

Hello and welcome to part two of our webinar series examining the impact of retail and big tech in health care. This webinar will analyze the change in the health care landscape through multiple lenses from marketing to finance and operations and ultimately the consumers themselves. Health care has gone through tremendous shifts in the past two to three years, and patients have more choices than ever when it comes to obtaining care. Today, we will look through the lens of vendors who work alongside health care leaders to disrupt and transform the industry. Before we get started, I'd like to go over a few housekeeping items. All attendees will be enlisted only mode. If you're experiencing audio issues, please make sure your volume is turned up and speakers are not muted. Let's get started. I met Matt Dickson, senior vice president of product strategy and the general manager of Carenet Health, a 2022 gold globe disruptor recognized company. I have 20 plus years of experience in the health care industry working with both payers and health care systems. Today I'm joined by health care leader Carrie Liken. Carrie Would you like to tell us a little bit about yourself?

Hi yes, it's great to be here, Matt. I'm Carrie Liken. I am the head of industry for health care at Yext. I lead product strategy and go to market at Yext and I've been there for six years. Prior to that, I spent 8 and 1/2 years at Google and even focused my education, on health policy prior to Google. So I've been following the patient journey for many, many, many years and it's always exciting to see what's going on and how the industry is changing, and how that journey that the patient is taking and the consumer now, how that journey is really evolving. And I'm looking forward to our conversation today. What's interesting here is we were kind of leading up to this webinar. We had a couple delays and this, that and the other. And it turned out to be a little timely because a lot has changed in the last week or so here. I don't know if you heard this morning, our friends over at Walmart are partnering with UnitedHealthcare. They entered a 10 year partnership around value based care. And they also plan to launch a new Medicare Advantage plan. The other big news, of course, is signify health. Really, as I look at these, there's a couple of core central themes, right? When you look at how CVS is viewing the lens of this signify health acquisition, one of the things they said is they'll will play a critical role in their overall strategy, but also to accelerate their growth in value based care. So I think a lot of what we're seeing around these acquisitions is, again, a renewed focus on value based care. But also a lot of what's going on too is a lot of focus in aging population. Right so kind of two centimeters themes. You as a vendor, how do you think through how you approach helping with those themes, those central themes, both value based care and servicing an aging population? I would actually say that we probably don't think about that as much either one of those, because what I look at Yext and Yext is a search platform. So we're a cloud based platform. We help to organize information that then wherever somebody is looking for information, we're able to send that data to whatever that might be, Google or to an on site search experience or to an app. And so whether someone is looking for care, whether someone is looking for convenience, whatever that might be, we're powering it. So I'm not necessarily thinking about different segments as much as I'm thinking about just the convenience overall. So it's an interesting twist on your question because I believe and I think I try to convey to the team at Yext, I believe that everyone should be able to find the care that they need in the most convenient way possible when they need the care. There are so many stats out there that are talking about just how difficult it is for people to book an appointment or find the right provider or find care overall. And so organizations like CVS and Walmart and UnitedHealth and Optum and Amazon and Google, all of these other organizations are trying to chip away at that to make sure that it is actually easier for people to find care. So I don't actually even segment it in the way that you initially ask the question. I just think, how is it the easiest to find that and in what ways can people do that? I think that's an interesting take. More and more experience is becoming the leading influencer in health care decisions and choices. So if you look at it through that lens and again, I think the power of your platform, as you said, it is making it easy for people to get information right to know where to go, how to take that next step as you look at that from an experience standpoint. One of the things that I think is often missing when we evaluate experience in health care is instilling confidence in consumers. And that's something I've always liked about your platform. And some of the things you do is that you make it easy for people to get the information, for them to feel confident about that next step. So is that something you think about when you really look at health care systems, the way they communicate today and the way they design their digital front doors? Do you think they're doing a good job of instilling confidence or do you think they're doing a good job of just passing information? Or how do you look at it through that lens? Because I think that's what's really confusing to consumers now. You have to make too many choices, right? Where am I supposed to go? What should I do next? How are we giving them the information, the confidence to know what to do next. And to take that action? That's a really good point. I never really thought about the confidence piece, but I think that is accurately stated. And from my Google days, I remember when Marissa Mayer was leading the I think she was leading the interviews before she was leading maps and she was militant about not introducing anything to the Google Home page, which is one of the reasons why it has stayed as pristine and white, clear as possible where there's just a search bar. And there was this evolution of how people were searching for information and how then the results page was delivering that information in a way that could instill confidence that if somebody returned to Google, they could find the information they needed again and again. And you can see that the results page, has completely changed over the years. If you were to translate that over to finding care. It's I'd like to say that it's actually not confidence instilling in most cases. So a lot of organizations engage in projects. I have a website project. I'm launching a new CMS, I'm launching a new find a doctor or find a provider. And at the core of it, if somebody can't actually pull together the data that needs to surface in the right way so that when somebody is searching for that care on that new website or within that new experience, they can't find that information. What are they going to do? Well, they're certainly not going to be super confident about what they're finding because they're not. I was just literally doing this right now. I was looking for a dermatologist. I had received a referral. The referral was for a Brigham and Women's provider. Too far away. It's five miles away from me. I'd rather go to MGH, so I was starting the process over again. I went to MGH is website and when I went to go click on the Contact form like request an appointment form because of course they don't have online appointment scheduling it returned A 404 page not found. Is that confidence inducing for me? Absolutely not. So what am I going to do? I'm going to loop back to what I was talking about earlier with respect to Google. I'm going back to Google because Google has year over year over year instilled confidence in me that they can provide a better answer for me looking for a provider than actual websites can or health systems. So I would say at the end of the day, I don't think organizations are doing a really good job instilling confidence in their patients and consumers that they can actually deliver on what those expectations are. And then it goes back to why are these big tech and retail organizations getting into this space? Yes, there's a revenue component, but I think they're fundamentally trying to change the experience and to force the industry's hand to just make it better. This is a terrible experience and we are fundamentally dealing with. And it needs to get better. And if the industry isn't going to do it, then these other organizations outside of the industry will push them to do it. Now completely agree. I think I think what's interesting about the anecdote you just shared, you said you got a referral, right? This used to be the gold standard. Somebody would Yeah. Somebody would say to you, this is my guy, right? This is where you should go. They're awesome. And you've chose to say too far away, I want I'm convenience, right? This is important to me. I need something even closer, right? That's right. I'll give a little teaser. My marketing team loves when I do this, right? So we've got some data on how this gold standard is evolving, how people are making those choices that will be revealing as part of our survey results that we do every year. So tune back in for that when that time I can't wait to hear it. I want that data. But yeah, no data on that too. Yeah, people are opting to just search for something that is more convenient to them, despite the fact that they have a referral. I am I am not an anomaly. I would say no. I would say the data supports that. Absolutely So when you think about that convenience factor and this is something we think a lot about what we do today and the way we service our health care customers. Really, I think a big part of that convenience is making it easy to find what you're looking for. And then making it easy to take action. Right I think there's a potential danger, though, if you're not thoughtful about that. And you and I have talked about this before, but I'll reiterate it again. Frictionless is great once you they've made the proper decision. Right what you don't want to do is have people who are trying to show the app to get AI got a runny nose and I'm going to the ER. Right we want a certain kind of frictionless especially when we talk about value based care. So there are a way you think about getting people, especially since what you specializes in, surfacing the right information, right. As you pointed out, you don't want to surface, you don't want people going to Google even though that's what you had to do, because often Google results are skewed by inaccurate data sources. This fact, right, you want people at that digital front door getting that information, knowing it's accurate. How do you think about getting people to the right inflection point and making the right decision. And then making it easy for them to take action? How do you build that? Our house and health systems think about that. Right, because I think there's this obsession with frictionless, frictionless, frictionless. And if you're not mindful of it, you may end up exacerbating issues with people going to the wrong venue of care, picking the wrong provider, not showing up prepared for their appointment, etc., et cetera. So how do you better view that through your lens, or how do you think health systems should think about that? That's a great question. I don't know. Maybe we should talk a little bit about this because I don't think there is a true right answer to this. And it could probably be bucketed in lots of different ways. I think there's probably an educational component to this. So right now I get really frustrated when I see the US News and World Report rankings come out and all I see is I'm celebrating myself. Look at us. We're so amazing, we're so wonderful. We're the number one in this. But who cares? At the end of the day, who cares? I would rather see organizations understand what people are looking for and what decision points they have, and then educating, let's say, via marketing on what is the best what is the best thing for someone to actually do. If I have a runny nose, is there an urgent care educational campaign that I need to be doing to make sure people actually understand that? That doesn't mean you need to go to the er, but maybe you just need to go to an urgent care. Or maybe you could see a virtual doctor. Maybe you can have that. You know, there are so many different options that I think there's that educational component that needs to happen and that largely can be done through marketing, it can be done through provider education so that they're constantly mentioning it to the patients that they're seeing. There are a lot of different things that maybe could be happening instead of these big billboards about how wonderful we are. It's very system focused and not consumer focused. And what Amazon and others are doing is they're saying, we understand the consumer, we understand what the consumer is looking for and what the consumer wants. And so we are going to target that as opposed to talking about how wonderful we are. I think the other piece of it is probably along the lines of guiding someone. So Google doesn't really guide, but if you can get somebody, let's say to your website or to an app experience or to some sort of owned experience, there are then ways that you can guide someone. So we've built search experiences just as an example where it's just a. It's a. It's a question. So what are you looking for? Is it urgent care? Is it primary care? And you can actually click through. And if it's primary care, then it takes you through a different decision tree than if it was urgent care. Or if you put in the symptom, then maybe you can guide in that way. So other industries do this. Banking, financial services. Travel, hotels. What type of vacation are you looking for? How are you thinking about what you want to be doing for the next seven days off? Those are the types of things that we haven't really done as much of in health care that would require someone to actually get onto an owned experience, which, again, we know most people are going to search. Let's say we can pull them into an own experience. Maybe there's a guidance component to it that then can help almost triage. It's like a digital triage to make sure that people can actually go to the right place. I don't know if it's education plus the guide or what it might be, but I don't think there is one right answer, and I don't think that I can necessarily come up with that. Maybe there are some things within there that we could maybe help organizations better understand, because the way it's happening today or the way it's working today, it's not so great. And so I think there is a lot of waste in the system as a result of that. Yeah, I agree. Right, because I think to your point, the default becomes I go to that own experience, I don't get what I need and then I default back to Google. No, I'm going to have that kind of experience. Right so I think you made an interesting point there. You talked about how these new entrants into game here, the Amazons of the world, etc., etc., or people who are trying to expand the scope of their reach within to more traditional health care, much like CVS is doing, they're focusing consumer out. Yes, right. And as you said, health systems typically have focused from health system out. So as that shift occurs, how do health systems identify the right patterns are practices to follow, how do they have to shift maybe even their investments or their spend? What do they need to do to prepare for that shift? Because I agree with you, the experience is going to be King very, very shortly here. Experience is going to be right. How how do we have to think in the industry about as vendors ourselves? Right helping enable that shift to being more experienced consumer focused than what we've seen historically, which is more, I would say even to some degree, geographically bound, right where the health systems here, this is where you go to consume care because your point, we're the best, right? We have the best ranking. We have the best this. We have the best that. How how do you think about helping them along that journey to embrace that convenience factor, to compete on experience? Right so we know that health systems have a marked advantage when it comes to the complexity of issues they can deal with. That is their primary advantage, right? You're not going to see that replicated by Amazon. You're likely not going to see that replicated by CVS, right? Yeah how do we help them leverage that advantage and bring in a better consumer experience in a way that helps them double down on what they're best at? I think the largest thing, the biggest thing that organizations can do is just understand what Amazon and CVS, what are they doing now and how do you apply that to health care? So again. I was prepping for a presentation. And I was I'm a one medical member. I've been a one medical member for probably seven or eight years. So I've used one medical for a really long time. And I'm really happy with it. And so what I was going through was what is the process of using one medical to try to book an appointment and what was the process? If I wanted to do it outside of one medical and I just wanted to do it at MDA again, I always reference gh because it is my husband works there. It's literally 20 minutes from where I live walking. I mean, I'm very close to MGH, I'm affiliated with it, so I'm not trying to call him out necessarily, although I am trying to call it because I would love for them to get better. But I'm doing it more so because it's just this is my location. So I went through the one medical experience and that's not even a non health care experience that is full on health care. If you look at the one medical experience, everything is done through an app and when you log into the app, everything is right there in front of you. What are the three things that you can do? You can book an appointment, you can book a virtual visit, or you could get a COVID 19 consultation. That's it. So I wanted to book an appointment. I clicked on the book, an appointment, little button. It asked me what did and again, this is that guided triaging and asked why, why do I want to book an appointment? And I just typed in just as an example. Primary care in Boston clicked on the next button, and it took me up to primary care providers, including my own. It took me to other primary care providers in a mix. So those that were available today, those that were available via virtual and then my own doctor who wasn't actually available today, but she had availability a few days from now. And so then I went through that process. And I could I didn't do it because I was just trying to test it out, but I could click on that and literally receive an email confirmation with a calendar invite that is saying you are set and ready to go. OK that's a one medical example. Now, if it health system were to try to look at that, can they actually replicate that? That's that's a question. Can they replicate that immediately? That's where I would say an easy way of just trying to figure out how to improve the experience. You can improve the experience by just looking at what's going on outside in a better experience and trying to mimic that in any way possible. Another way of doing that is just to say, let me just go to Amazon. Let me shop for something on Amazon, let me shop for something on Google. What is that experience like? And I like to say is that you can search, you can review, you can compare, you can evaluate and you can convert on Amazon like that. Yep can you do the same thing with your health system? That's a question to ask. Can you do that? And if you can't do it for all providers, can you do it for some providers? If you can't do it for some providers, can you do it maybe for one or two just to elevate that experience? Maybe it's just for dermatologists try to mimic that experience. Let's say you're looking for a pot. I want to buy a certain type of pot because I want to replace the pot that I use in my kitchen. What is that process like now? Can you mimic that in health care, let's say for a dermatologist, if you can't, are there ways that you can actually move into that to provide a much better experience that way? And because people are so digital, I think it's super important to say, can you actually help in that transaction? And the transaction and the conversion piece is super important because if you're constantly just relying on someone calling in or like in my case filling out a request, an appointment form that actually took me to a 404 page not found, then you're constantly going to be losing people. So we're talking about revenue challenges that organizations are having right now, and we're talking about patient acquisition challenges or even filling panels because we don't have staff to work in. I mean, there are so many different challenges that are happening within health care right now. If you're just thinking about that and you can't actually even get somebody to pick up the phone or even click to fill out a form or even have somebody call back from that filled form and you're in trouble. There is no way that experience is ever going to be elevated because people are used to looking for that pot. They're used to converting, they're used to receiving it the next day. They're just so they have such high expectations outside of health care that they're bringing into health care. So I would say, long story short, take a look at what's going on outside of health care in these great experiences. And I say, look at Amazon, look at Google, even look at like Capital One. I always use Capital One and look at delta. Those are my high standard, great customer experience organizations that I would say try to mimic those journeys and bring those to health care and then see where you can actually implement them. You cannot do it entirely for every single. Provider for every single experience journey. But you definitely could do it for some smaller ones. Maybe it's primary care, maybe it's dermatology, maybe it's just mammography, whatever it might be. Try to start implementing because when you implement, you can learn. You can learn where those challenges actually do exist. You can also start to track conversions, and that's a huge opportunity to then start arguing for additional investment. And then at the end of the day, you're improving experience and then more people will be likely to say and talk about and to refer to you so that you can continue to drive some of that patient patient acquisition in the future. It's all about looking outside. You know, I think I think you raised an interesting point there. And one of the questions I had today is why is innovation so hard in traditional health care? And I think you hit on maybe a core reason why traditionally innovation has been hard. You said try to start with something small, right. Going with it. We used to say minimum viable product. Now we're saying minimum lovable product. This is our new thing. We say minimum level and I agree, right? It needs to be a little more than viable. It does have to be livable, it seems to me, or it strikes me that health systems take on a project and say we're going to transform everything to this new experience. Right as opposed to what you were saying there, which is let's take the parts of it that make the most sense to try to enable into a new journey our new experience. So certainly, as you think about why innovation is hard, I think you raised an interesting point there. What are some of the other reasons you think, though, that innovation has been so difficult for traditional health care? Because, guess what, these players come into the space, especially Amazon, that innovation is at their core. Right? so you're going to be forced to iterate more quickly to your point to move at their pace, because that's what consumers expect. So what are some of the other reasons you think innovation has been a little more difficult for traditional health care, traditional health care players? It might be controversial for me to say, but because I'm married to a doctor, I feel like I've seen it because I saw him go through his training and maybe I get a pass, but maybe not. You don't have to give me the pass. But I think that a lot of these health care organizations are run by MDS. They're they're trained doctors who then have also moved into administrative and/or leadership roles. This is not 100% the case everywhere, but I do feel that a lot of the leadership tends to be in sort of the M.D. role, in addition to the leadership role. And how have MDS been trained, sort of like the apprenticeship model, right? So why are doctors in residency. So that the older generations and those who are more experienced are training the newer, younger generations. So that then the younger generations move up and become the attendings who are doing the exact same thing. It's a cycle. What are they taught to do? They're taught to follow certain processes, and they're not necessarily taught to do anything outside of those processes, because if you innovate in a care setting, you actually could be doing more harm than good. And so it's a framework that I feel like a lot of these individuals have grown up through the system embracing. And so therefore you bring the collective together and then all of a sudden you're not necessarily saying, well, let's try this and let's try that, because that's not part of your operating cadence anymore. And so this apprenticeship model, I think, is great for care, but it's not necessarily awesome for thinking outside of the box when it comes to innovating on the experience side. I think the other piece, which also may be controversial, is that there's this great book that Dr. Topol Topol wrote that is called the Patient will see you now. It was published before the pandemic. I think it was published in 2015, maybe 2015 or 2016. And what he talks about in the beginning of the book is this whole concept of paternalism in health care and how the doctor has always been the authority and the voice. And similar to what we were talking about with the referrals, if I say, then you will do. And so now that the patient is a consumer and has so many new choices, I think these organizations and the leaders within the organizations don't necessarily know what to do, and they're playing catch up with respect to the experience piece and the fact that the patient actually has a lot of information that used to just be within the domain of the provider, literally within the provider's own head and education. Right and so there's this tension, I think, between the two. There's the doctor thinking, hey, I'm so amazing. And I know everything. And the patient's saying, well, I can find this information now, too, and I'm coming to you in a researched way. Maybe I have gone to Dr. Google and maybe I have this information, but it might not be the right information. I need confirmation from your doctor and doctors thinking, why in the world did you do this? You should have come to me. I'm not saying again, I'm not saying this is across the board, but I'm just saying that there are certain. Mindsets that need to shift in order to really, truly embrace understanding that the patient has a seat at the table. And what Dr. Topol wrote was that the patient will see you. Now, all of the choices that the patient is encountering across the board when looking for health care, it's really the patient's choice. So if organizations don't innovate, then the patients will force the innovation. The consumers were force the innovation. So I don't know I don't know what you think, Matt. I feel like there's a. No, no, I agree. I think you hit on an interesting point, and you have to be a little risk averse in medicine, to be perfectly honest. You have to. Right you have to know there's a clinical basis for what you're doing. It takes time to build that clinical basis. Right and you're right, that thought process maybe doesn't apply. So well to how we're evolving the customer experience or the consumer journey. Right so I certainly I think that's part of it. I think you raise another interesting point there. It's certainly in my lifetime and really has been probably accelerated. Maybe even the pandemic helped with some of this acceleration. But the power is with the patient now 100% The power is with the patient. Right for years, it was maybe questionable whether the insurance companies had the power or the health. The doctor had the power. But right now, I would say with certainty the patients have the power, right? They can choose where they want to go. They can go to a CVS, they can go to in my area, walgreens, the minuteclinics, all those fun kind of things they can to consume to your point, the concierge medical, the one medical's of the world, they can certainly have a plethora of choices when it comes to physicians. They want to see because that loyalty has been eroded by this process. Right it used to would wait to see your doctor now. Hey, whoever can see me today sign me up. Right how do I get in to see that person? Because I want to feel better today, right? We wait for anything anymore? I don't think we wait for anything. You're right. Absolutely no. Why would we expect to wait for health care? There's no need to. Absolutely here's what I think about from through my lens, at least as a vendor. And I wonder your thoughts about this as well. What I'm a little concerned about is the health care journey is becoming increasingly fragmented and interoperability is not good. Right so how do we everyone seems to think that they connect, but they really don't know. It's an unfortunate reality. So I think we need more standards based ways to share information I think is a big part of it. Hl 7 is woefully inadequate when it comes to sharing all the information we need to share, especially when it helps consumers navigate that journey. So how do you think about that fragmented journey where maybe my journey started at a CVS clinic, right? And I went there and what they told me to do. And I waited a few days and it didn't work out so great. Right? so now I'm presenting maybe in your urgent care or maybe I'm going to see a physician within your health system. How do you think about. Helping health systems navigate this very fragmented journey. And more importantly, how do health systems help consumers navigate a very fragmented journey? Here's the reality. They're going to be the end stop or the worse conditions, right? So they're going to be the ones that are, in essence, cleaning up the mess to some degree, right? Where it's like, hey, you did all this other stuff outside of our health system and it didn't work. Now you're very sick and you're sitting in front of me, right? How do I help you again? Feel confident that you're taking the next best steps, know what to do and take that action. Is there a way you think about helping patients navigate that journey, as well as health systems, preparing for a journey where somebody already spent a month trying to get treated and it's all been outside of your four walls, right? Yeah think about that. I mean, I think about it, but I don't know if there will be immediate impacts. So, for example. So my husband sees patients with Down syndrome. So he's the world's expert on down syndrome. He has a Down syndrome multidisciplinary clinic at Mass General Hospital. And if he sees a patient. Who sees a primary care provider at Tufts. He actually can't access the data about that patient because milligrams is an Epic shop and Tufts not so he. He does talk about how frustrating it is where he has to start over again with this patient these patients because he sees multiple ones from Tufts. But these patients because he can't access any of their historical visits or any of their diagnostic information, nothing, he can't access any of it. Now, I guess he can request it, but it doesn't always come in time for him to actually see it. So that's a challenge, I think, from a health system perspective, and I would say that's probably a challenge from a patient perspective. I could give my own example of I'm getting ready to go on vacation, I am going to turkey, which is really exciting. And my travel shots are out of date. So I want it and I'm going all over turkey. I'm not just staying in Istanbul and. The interesting thing was that even though one medical is affiliated with MGH here in Boston, for some reason my doctor at One Medical couldn't fully access my records from MGH to see what travel shots. I've already gotten through the MGH travel clinic over the years since 2006. So I keep it. I have to. So the patient has to do this. So the onus is on the patient, which is ridiculous. I have to keep track of all of my travel, immunizations and vaccinations on a Google document. And what she was trying to do is trying to access that information while we were sitting in the appointment together. And I was trying to access it through my app for patient gateway through MGH. I couldn't access it. So I went to my Google Doc and I just said, here are the. My typhoid is out of date, et cetera et cetera so that should not be the case. And this, I think, is what you're talking about. If we're going to deliver a better experience across the board, no matter whether big retail, big tech, like any of these organizations, whether they get into the industry or not, if we don't have communication standards. And we don't have that true sense of data flow in that interoperability and providers are not going to be able to successfully deliver the type and kind of care they need to provide. But the patients are also going to have to rely on themselves. I would like to say that I'm pretty organized, but I can guarantee you that not everyone is organized and keeps track of things on a Google Doc and then can deliver that during an in-person visit with a provider. So I think we need to take massive steps to figure out how to connect the dots. I don't know what that means. Does that mean that we need to have some sort of federal mandate? Does it mean that the big players like epic and Cerner need to get out of their own way and actually open fully open up their walls and pull down the curtains and basically say, yes, this is an opportunity to connect. And this will make it better for all. I don't know if it just means that we need to scrap everything and start over again, but I can tell you that the experience today on both sides is terrible and we should not have to take that on. I mean, my husband takes on the onus of trying to request the data, and that's time consuming. I have to take on the onus of storing the data and then delivering it to a doctor who should already have it. I mean, it's ridiculous. So I would say we need to figure out just a way of connecting those dots. And I just don't have an answer for what the best way of connecting the dots actually is. I'm with. Yeah, right. I think if we did have an answer, you and I would probably be serving in Congress or something. I don't know. We probably wouldn't be doing what we're doing. And I love what I said. You're right. And here's my concern and the reason I bring that up. Without better data sharing, I think all these things we view as more convenient today. In five years, we'll say wrecked health care. Because I went to CVS and I got this done and now I went to get additional care or follow up care, and I had to fill out 13 forms, which, by the way, I already told CVS this 10 times. Right now I'm telling you again. Right and to your point, what does this open the door for? You're having to document these things on a Google Doc. What happens if you transpose some numbers or get a date wrong? Now for you, the impact may not be big. You might get a vaccine you don't need, or more importantly, you might miss one. You did, right? So now because we're making the consumer b, the Nexus of all their medical information, to your point, storing it, accessing it, making sure it's accurate, it potentially opens the door for mistakes that could have a negative impact on your health. Right so that is my super primary concern as a vendor is how do we get because we're very agnostic here, right? I don't care what systems you have, we're going to try to intersect with those systems. We'll try to make that information leverage viable or try to work with whatever you have. Right I don't care whatever it is. Right but to your point, the onus can't be on the consumer. It just can't. Right? Yeah. So that's a big concern of mine as we look to this brave new world of more convenient access. Sometimes making things easier in the long run can have a detrimental impact. And that's my concern without better interoperability. So, Carrie, we're coming up on time. I do want to ask one final question, if I could. OK what do you think are some of your biggest challenges as a vendor that you'll face in the next three years? Oh, Wow. Good question. What are the challenges? I think a big challenge will be what I'm seeing right now is that a lot of organizations, so we primarily work with marketing and teams and I see a lot of organizations in this mode of they're coming out of the pandemic. And they're thinking, Oh my goodness, we have invested in hundreds of different platforms. It's time to consolidate. And I think that the consolidation is important, but I think that there will be a contraction. So far. The consolidation will happen that an organization will say, I'm just going to go. Five miles wide and an inch deep with one org and not realize that just like, Matt, what you were talking about, that really what an organization needs to think about investing in is what we would call sort of a headless piece of technology that you're able to connect to the best in class, where data can flow from one place to the next in a seamless manner. But you have a foundation of that data and then you can build on top of it. So I think we need to be able to say Yes. We need to be able to convince organizations that it's really important to invest in an open platform, in a platform that has connectivity and can do and be flexible for an organization to do whatever it is that they want to do. So we're going to I think we're going to have a lot of education around that. So that's a challenge because it's more of an evangelical. You have to make sure that organizations really fundamentally understand. I think the other is that we're going to see what's happening with retail and big tech. We're going to see all of these changes that are happening. We're going to see the changes with the experience piece. And I don't think organizations are going to move fast enough. So no matter what, we are able to deliver. As far as a better experience, let's say, for Yext on the search side, whether you're searching on Google or you're searching on a website or searching on something, I don't think organizations are going to be able to move fast enough to actually accommodate the changes and experience that these other orgs are doing. And so what we might end up seeing is that budgets are going to change, budgets are going to shift, and I think that's just going to be an interesting thing to watch because that could really change just investment, that could change experience. I think that will be a big issue. While organizations like health systems are trying to figure out what's going on outside of health care, I'd like to flip the question on you. What about you? What do you think? I think that I probably have the same concerns that I think people are my clients or customers do as well. I'm worried about the walled garden. I think in some ways the walls are getting higher, not lower. They are getting higher. Yes and that's a concern of mine. Right is how do we have a more open ecosystem that best services the patient or the consumer? Right I think that many players in the space are taking a protective stance. And to your point, the Amazons of the world are consumer oriented first. Right this is, I think, some of the. Competition they're bringing. I think the response has been from some traditional players to say shields up. Right, make the wall even higher, protect us. Right and I think that's problematic for the consumer. And it certainly is a vendor is problematic for us. Right it's making it harder for us to help patients navigate that journey when we have to navigate multiple walled gardens. Right the other thing, and I think to your point, you talked about budget shifting and things of that nature. I think the ROI picture is getting a little murkier. Yes and I think that's certainly a key component. Right at the end of the day, we run businesses, right? You help run a business. I help run a business. Certainly are people that we work with day to day in health systems. Their job is to help run a business. Right and as the ROI picture gets murkier and murkier and murkier, it's harder to know where to make investments. It's harder to know how those investments are paying off. The deluge of data is part of the reason that our ROI is getting murkier. But part of the reason it's getting murkier is because the walled gardens keep getting higher and higher, right? It's hard to prove the ROI when it's like, I need data from here to prove it, but it's hard for me to get it because I started something over here and this, that and the other, right? So those are my kind of primary concerns is how do I help them understand the value of the investment they're making with me as a vector? And how do I help them enable that next level experience when we have these challenges with data, the proliferation of that, and how siloed, it's becoming more siloed, in my opinion, not less. So those are my concerns. Yeah, I would definitely agree with those two. I would definitely share those ips, most especially. I think that's as the walls continue to get higher. I think the assumptions that you have to apply, if you even can calculate any type of ROI, the assumptions you have to apply then become more outrageous. And then I think that becomes more and more difficult to than argue for what's in the best interest of the consumer. And therefore then the same thing will happen. And the investments will maintain year after year, the same over and over again, and there will be no innovation. And that's going to be a problem. I certainly agree. Well, unfortunately, we are out of time. So thank you so much today. Too bad. I know. Maybe there'll be a part 7 at some point.

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