313: Boe Hartman, Co-Founder & CTO of Nomi Health, on Transforming U.S. Healthcare with Real-Time Data, Innovation and AI
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The employer said, I don't think we can afford that benefit for our employees that need it. What we found is when we did the data analytics against it to show the self-insured employers, yes, your pharmacy spend went up slightly, but your overall health costs went down for the employee because they lost weight, heart disease went down, high blood pressure went down, they got off of datins, they got off of high blood pressure medicine, type 2 diabetes went down. So the overall cost came down. So using that data to actually point out that, hey,

If you do these treatments, the overall health of the individual will go forward.

Good morning, good afternoon, or good evening, depending on where you're listening. Welcome to AI and the Future of Work, episode 314. I'm your host, Dan Turchin, CEO of PeopleRain, the AI platform for IT and HR employee service. Our community is growing. I get asked all the time how you can meet other listeners. To make that happen, we launched a newsletter where we share weekly insights and tips that don't make it into the podcast.

plus opportunities to engage with the community. It's free. It's not spammy. We'll never share your details without your permission. And of course, we will share a link in the show notes. If you like what we do, please tell a friend and give us a like and a rating on Apple Podcasts, Spotify, or wherever you listen. If you leave a comment, I may share it in an upcoming episode.

Like this one just in from Cindy in Billings, Montana, who is a financial analyst and listens while cleaning the barn. First time I've heard that one. Cindy's favorite episode is that great one with May Habib, CEO of Rider, about the future of AI co-pilots. Of course, we'll link to that episode in the show notes. Thank you, Cindy, for that feedback. We learn from AI thought leaders weekly on this show.

The added bonus, you get one AI fun fact each week. Today's AI fun fact comes from GZERO, the media outlet covering global politics. This week, they reported on the new United Nations plan for AI, which was unveiled at the recent UN General Assembly meetings in New York. It consists of seven recommendations. One, an international scientific panel on AI should exist.

that would issue an annual report on AI risks and opportunities. Number two, more policy dialogue on AI governance in the form of a twice yearly discussion on best practices. Number three, an AI standards exchange to develop common definitions and standards for evaluating AI systems. Number four,

capacity development network, which would provide researchers and social entrepreneurs with expertise, training data, and compute power,

Number 5, a global fund for AI that would collect donations from public and private groups and disperse money to countries with fewer resources to fund AI. Love that one. Number 6, a global AI data framework to set common standards for governing AI training data. Number 7, an AI office within the UN Secretariat to administer the above six recommendations.

My commentary, this is a really good policy framework, but it feels forced. By design, the United Nations is powerless unless member nations take action on its recommendations. The US is far behind the EU when it comes to AI governance. If collectively we make health and safety a priority, I believe we can institutionalize responsible AI in a way that doesn't constrain innovation.

Of course, more on that important topic in future episodes, perhaps starting with today's. Of course, we'll link to the full article in today's show notes. Now shifting to today's great conversation.

Bo Hartman is the co-founder and CTO of Nomi Health, a company on a mission to rebuild the US healthcare system. So it runs at half the cost. Bo brings nearly 30 years of global tech and banking experience from companies like Capital One, Barclays, and most recently at Goldman Sachs, Bo built their credit card offering from the ground up as the CTO of Consumer Technology.

He then moved to the role of integration lead where he focused on transitioning the firm's institutional businesses to being a premier digital experience. Bo served as a co-CIO of Goldman Sachs Bank USA, was co-head of the Technology Hiring Committee, and served as an advisor to the Disability Interest Forum. Prior to joining Goldman Sachs, Bo served as CIO at Barclaycard, where he developed the global tech responsible for managing billions of transactions across financial products.

Bo's a tech legend, but as you'll learn today, the biggest challenge of his career, I'm going to go out on a limb and say it's still ahead. Thanks to mutual friend, Sean Charlton, for the intro. Without further ado, Bo, it's my pleasure to welcome you to the podcast. Let's get started by having you share a bit more about that illustrious background and how you got into the space.

First off, Dan, great to talk to you again. And yeah, isn't Sean awesome? Sean's incredible. It's really interesting when folks look at my background, and as you're very kindly reciting my past experience, my degree from university is political science, international affairs. And they said, well, how did you get into a couple decades of banking technology? And it was funny. It was the 90s. I wanted to work internationally, so I went to school for international affairs.

But I had to take one coding class to code my statistical analysis from political science. When I graduated in 1993, so uni had collapsed, anybody wanting to work international was over. And so I was able to get a job based on the fact that I knew how to turn on a computer. I knew how to work with spreadsheets. And I knew how to do a little bit of coding using things like FoxPro and Access and other things like that.

And so that was in the 90s when technology was really becoming commoditized, landing into the general population. And I landed working for the U.S. Army, and it was a part of a modernization. So taking things from coax to fiber optic, taking things from mainframes to distributive services,

I just became hands-on and trained and went up through my years and lucky enough to meet the first CIO of Capital One, a guy named Jim Donahue, who I'll always be grateful for. Jim actually loved my combination of curiosity, my combination of wanting to see the world internationally, and my drive to learn as much as this technology that was being, for the first time, rolled out globally to all of the workforce and all of the industries.

And he gave me a shot at Cap One, and as they say, the rest of it's history. Most people looking at your resume would think that a shift from Goldman Sachs and digital banking is a pretty radical departure to then go into digitizing healthcare. I've gotten to know you, and I know that there's actually kind of a through line. Maybe tell us about that transition for you. Yeah, so in the United States, for those of your audience who's not in the United States,

We all have stories, healthcare stories in the United States. And we all can cite them where we have the best healthcare providers in the world because I've lived internationally. And I would tell you that we have the best doctors, nurses, clinicians. We have the best. The problem is access to that care. And there's multiple ways we can talk about getting access to that care or leveraging new technologies to get that care. But

But when I made partner at Goldman Sachs after building Marcus by Goldman Sachs and building Apple Card, a dear friend of mine named Mark Newman, who had founded a company called HireVue, who you got to meet, came to me and he said, hey, there's this thing in the United States where if you pay a doctor directly, it's 30% to 50% of the cost. The problem is that those payments aren't efficient. They're not digital. They're not straight through processing. There's a lot of calcification.

calcification around there. And I had heard about that. Couple that with the story, everyone has a healthcare story. I had to experience that through my life and my friends experienced that life. And so seeing those two problems of if it's a calcified industry that's not leveraging technology, but we have the best in the world,

How is this something I could pass up? And so the adventurer in me said, well, maybe I can make a difference because I understand payments. I know how to make markets efficient. I know how to leverage technology.

let me go take a shot at this. So at the ripe old age of 50, I decided that I want to go do a peer startup. And so that's what happened. I decided to turn my back on that seat at Goldman and put my lot in with trying to help the millions of Americans that can't get access to that care. Mark Newman, by the way, is an inspirational leader and a bit of a firebrand. I really enjoyed meeting him. Excellent CEO.

Now, you and Mark start Nomi, and along comes this thing called the pandemic. And all of a sudden, you are in the middle of a firestorm. It's so much chaos that nobody envisioned, but certainly not you and Mark and the team at Nomi Health. If you could just share with our listeners the background.

So this is Nomi Lohr, and this is, as you said, the insanity, and no one saw this coming, the Black Swan event that took place was incredible. And looking back on those days and some of the stories I'm going to share with you,

We still think it's surreal. So in November of 2019, Mark Newman and our other co-founder, Josh Walker, who's an industry expert, flew to New York to say, hey, let's take the conversation to the next level. Would you be willing to join us? And that's when they really caught my attention and saying, hey, we could actually help impact this $4.5 trillion market in the United States.

And so in that November, December timeframe, I had decided that, hey, I'm going to actually leave and go do Nomi. But I had to wait until January before I could actually make it official that I'd be leaving Goldman to join them.

And a couple of people who worked for me at Goldman at the time are of Chinese origin and went back home for Lunar New Year. And it was weird. During that time, I was getting weird text messages back from them where they were saying, hey, everything's great, but there's something going on here. People are not feeling well. And because I had worked in China at one point, I knew that was an indication of they were trying to tell me that something was taking place.

And so we started hearing about people being sick in China, and it was causing a little bit of concern. So towards the end of January, when I retired from Goldman to say I'm going to go join Nomi, Goldman put me on guard leave. And about that early February timeframe is when it really started getting out and people were getting concerned that the pandemic, that this thing called COVID was a thing of concern.

So I went on garden leave for a couple of months, and Mark and Josh wrote a white paper. And they wrote a white paper because when they started seeing the need for mass testing and looking at the existing healthcare industry of how we dealt with communicable diseases in the United States, it was not geared towards

to handle hundreds, if not thousands of people needing the test, all the way from where would the people go to get the test? How would the people find those locations? Where would the test come from? And how would you process the test? If you remember back to that time, the way that the first couple of weeks happened is you would have to go to your doctor if you're lucky enough for your doctor to even have something to test for COVID.

You would then get tested, and then what would happen is it would go away for 10 days. That would go to a traditional state lab or somewhere like that who could only handle a couple hundred a day. And maybe you might get a response in the form of a mailed letter, by the way, that you were positive or negative. And you'd already been past the cumulative disease phase, and you either ended up in the ER or not ended up in the ER.

So they wrote a white paper to say, look, you need mass digitization. You need mass logistics. You need better cost of materials. So, for example, if you remember in those days, some states were being charged $8,000 a test, $500 a test. And if you actually break down the pieces of the test –

It was literally, by our economics, all in, it was around $65 if you do all the logistics, the labs and all that sort of stuff. So they wrote this white paper saying, hey, you're going to need high-throughput labs. You're going to need large locations. You need digital engagement, not only for the individuals to get the test, but also for the nurses that were running the sites to do mass check-ins. And then you're going to need to actually have fast, straight-through processing and digital notification back.

So they wrote this paper and they gave it to the governor of Utah. The governor of Utah said, great, can you go do it for me? And they were like, no, no, no, no, no, no. See, we were just kind of giving you the framework of how to do it. And he said, look, we need innovators. We need people who are going to think outside of the box. So

They brought some entrepreneurs together. They were able to piece together tests like the swab, the swab that you actually use to go up someone's nose. States were being charged $25 for that swab. It actually cost three cents to make. So they were able to go get three cents for that. And so they pieced together an approach for Utah to get the digitization of all the things I talked about in processing. And eventually, it led to us actually building our own high-through-processing labs.

Well, what happens is, and it's funny, people don't know this, the governors of the states actually have text groups. They text each other because they're their peers. And so everyone's going, hey, what are you doing? What are you doing? And so the governor out of Utah went, well, I'm leveraging this company called Nomi who's helping bring together all these different aspects of it. And this is what they've done. And our phone started ringing off the hook.

all across the nation of come help us, you know, come do the same thing. And we're like, well, there is no Utah package, right? Like it was a one-off and they're like, no, no, no, you need to come do it. So what happened then is we actually got pulled into it where the eventually across 15 states, 15 governors, uh, caring for 15 million people during that timeframe and the platforms that we had to build, um,

We actually were getting real-time analytics because the world I came from in banking, everything is in real-time analytics. And so the governors were never exposed to being able to have the real-time analytics because their own data science team would take like three or four days or weeks to provide insights. And we were delivering to them every couple of hours, this is how many people you've tested today, this is how many positives you have. We actually even built a system in which we were able to turn around PCRs in 24 hours.

for anywhere in the United States. And the stories and the experiences of building upon that over the two and a half years, at one point at the peak of Omicron, that we were providing care to 170,000 people.

Funny side story, because of the analytics and because of what we were doing, I was able to predict the Omicron wave two weeks before it actually happened. One of our biggest clients in Southern Florida, the largest MSA down there, I got a hold of them and saying, I'm starting to see a pattern of people. Because we were testing in airports as well as we're testing employee populations that you had to take a test whether you wanted to or not. And so it was a controlled group.

And I said, the population isn't going positive, but the closed populations that are being forced to test are going parabolic. And I'm starting to see this thing take place. So I got a hold of a couple of these large MSAs and governors. I said, something is coming.

but I don't know what it is. And so we were able to position a couple of these states to prepare for this parabolic explosion of Omicron. And at that point, the improvements of the digital engagement we actually implemented was incredible. And we were working 17, 18 hours a day. I was in the field, so was my co-founders, helping to fix printers, but at the same token, helping to direct people of how to get on their airplanes,

We're helping the CDC identify travelers who are being tested positive in sites. And the one story that we have so many touching stories, but the one story I'll give to you that was mind-blowing to me is during one of our sites, there was a woman in line that was unconsolable, breaking down, crying.

And one of my team walked up to her and said, could we help you? And she said, my husband is in the hospital. He's on life support, and they're going to take him off. And I can't go and say goodbye to him unless I can prove I am negative for COVID, and I need a PCR test to do that. And they're going to do it in the next 24 to 32 hours. I don't know if I'm going to get my test back.

My team, as we did thousands of times, pulled her aside, got her swiped, hand-carried that sample through the process, and because we had digitized it, so that we could get her her response so she could be there with her family, her family member, her husband at that time, so she could say goodbye.

That story, I heard a thousand different ways and I witnessed that a thousand different ways in my timeframe. And so for me, that was a moment of why it was challenging. The pandemic brought out the best of humanity and it brought out the best of innovators and it taught the states and the federal government that you should not be scared of leveraging real-time throughput in a calcified industry. So many stories come out of there and I've

I was floored by the dedication, loyalty of the men and women who would sit out in freezing cold where diesel engines would freeze to burning up heat 18 hours a day, swabbing patients.

And in some cases, we're the first healthcare professional in rural and urban areas that people have seen in two or three years. And so we started giving blood pressure checks by the nurses. We started giving them blood pressure checks and asking them general health questions and helping them to understand there are programs you can do to go get care.

And so we became, as the people going into the locations that others wouldn't, to help answer some of those questions. So, so many stories and so inspiring to me that even to this day, I carry it forward. So we talk a lot on the show about technology and specifically AI for good and never a better example than that. But I know from getting to know you and Mark that it wasn't all...

puppy dogs and rainbows oh no it was uh it got very controversial and and uh and you're trying to do good for the world for the country for humans and uh and you get caught up in the middle of you know a bunch of ugliness maybe share that side of the story as well yeah so the thing that this actually stunned me like and I think you and I talked about it before but this absolutely stunned me so coming from banking and being you know International banker for as long as you know I I was

I am not spared from controversy. I am not spared from being cited as a horrible banker, Occupy Wall Street. I used to have to walk through groups of people to get into the building at Goldman Sachs.

And in some cases, banking got regulated because we did do things that, not intentionally, but we did do things that led to bad outcomes. And we needed to hold a mirror up to ourselves and say, we need to do better. Interest on interest on credit cards, things like that. And I lived through that, and I had regulators sit in front of me, and you have to own that. Even if it wasn't intentional, you have to own it.

I was complicit in that experience. Yes, as an industry, we need to be held to a higher standard. We need to do better. Coming into this industry, and to your point, this was a charitable move. If you talk to Mark, Josh, and myself, when we went into this,

We literally was, how do we help in a moment when the world needs help, right? And when you talk to these governors, and we had governors publicly come out and support us, saying, look, these are the only people who showed up, and they didn't shy away, or they didn't lead with, this is what it's going to cost you, or no, I need these guarantees. No, we're going to do our best, and we're going to try. The venom that came out of some of the established industry that

was stunning to me, just stunning. And some of the examples, some of the things that you would see that came out in the press, the way they portrayed Mark and Josh of tech pros, couldn't be further from the truth.

Did we get everything perfect? No, we did not get everything perfect. But we were the first ones to raise our hands and we did not do that perfect to our standard. And we always went back and we always remediated the situation. But I'll give you some prime examples that were stunning me is that people would cite the fact that we were granted these no-bid contracts. Not true.

Not true. I think the best, and I forgot which governor who said it is, no, Nomi is the last call that we ever made because we would call everyone else who were accountabilities and responsibility were to do these things. And they were either, the system was even getting broken, like it was just the back was being snapped, or people would say, I don't want to take on that risk. And the calls would come in and the calls weren't like, hey, I'm going to slide you over this contract. It's

We need your help and we need to come. And the answer from us would always be, we're on the planes now. We're sending the teams now. We will figure it out as we get there. And you're talking to very accomplished leaders, these governors, who were grateful for the fact that we were showing up. But then having established companies attack us, having the media attack us because it was good clicks, even to this day,

There is an outstanding number of payments that were owed by the insurance companies that they have just flat out refused to pay. By law, they were supposed to. And they have, two and a half years later, still are not paying, which is stunning to me. Because in banking, when you establish an agreement and you deliver on that agreement, then you, by contractual law, you have to pay it. And here,

Not such a case. So it was actually, even for a banker, it was eye-opening the venom in which some of the tractors came out. By the way, if you had a grounded criticism of us, we would take it every day of the week. Like, every day of the week. But the ungrounded assessments and the innuendos that were actually cited, I literally would sit and talk to Joshua Mark and go, I come from a world of rough and tumble and you take your punches.

Wow, this is amazing. It is absolutely amazing. And by the way, that is actually what has driven my passion to do the other things I'm doing on Capitol Hill about the way medical payments work in the United States, the work that Mark does being the passionate defender of we have to change the way that this happens, Josh being the architect of how the healthcare can change.

Because I saw that, and before I was driven into this mission because we all have that healthcare story, I'm now...

passionate about how calcified and how monopolistic this industry is and how it can be more efficient, it can be more fair, and it can be able to address everything by going through that experience. Because when you show up to say, I'm just here to try to do my best and do good and have people create flat-out false stories, I was stunned. I was absolutely stunned.

So you're talking to a community of technologists and entrepreneurs. And I know another perspective on this story is, as a technologist, how in the world you were able to build this system that scaled. There were massive PII, personally identifiable information, you had to store, and you're doing this in real time. And there was also the issue, I've heard a version of this from Mark, but of how you fund this business.

It's so important and everyone wants the service, but how do you get it funded? How do you convince investors that you're doing the right thing? It's a complete pivot. Talk us through that, Benning. So are you talking about during the COVID periods or as we're now pivoting into the stuff we've already built? During and post, but kind of how the business evolved and how the technology evolved.

Yeah, so it was insane. So I joined May 1st of 2020, right? Coming off garden leave, seeing the world burn. And it was really funny. I remember being on the phone with Mark, and Mark and Josh were busy implementing our first iterations of the COVID care. And about noon on May 1st, I called Mark and said,

Hey, how do I get access to my email? And he goes, Oh man, I totally forgot. Yeah, you're starting today. Because he was in the field. He goes, I am so sorry. He goes, by the way, once you get access, could you do me a favor? Could you set up email boxes for all these people? I'm like, yeah, I can go do that. So going from being a partner at Goldman Sachs to setting up email boxes. By the way,

I loved it. It felt like I was actually doing work. And so when I was leaving Goldman and people found out that I had left because I publicly really couldn't announce it as part of my agreement. But people were noticing I was not there and heading out. They were like, what are you going to go do?

And I said, hey, I'm going to go help to change healthcare in the United States. And so I had a bunch of people from Cap One, Barclays, and Goldman who said, I want to be a part of that journey. I want to go do that. And I had all these relationships with integrators that I'd worked with for 20 years that said, actually, we want to be a part of this as well. So what we did is when we had seen enough of the interactions of what was going on in the field in the pandemic, we

I brought together the philosophy that I used to build Marcus in 10 months, which had been influenced by decades of coaches, mentors, and hands-on in the world of banking to where, okay, what we're going to do is we're going to take some SaaS platforms. We're going to take some homegrown analytics and

and we're actually going to integrate them together to create the experience that we need for labs, for field staff, for nurses, and for patients. In fact, if you ever got tested at a Nomi test site, you would be used to the experience of you didn't have to download an app. You just went to a progressive web app. You'd schedule your appointment. You'd go do a check-in with the QR code by

By the way, talk about the rebirth of the phoenix of the QR codes during that period. You scan a QR code, check you in, and then you would get a secure text message back to click on that would challenge you with something only you knew to click through to get to your digital CLIA letter.

That was all influenced on my experience and learning of building markets. And so I just tested it in the field of markets as well. So bringing that architectural approach, bringing the seasoned vets from banking who are used to doing it in real time, then implementing those things in a fast-paced world. Analytics, I never thought not to do them in real time. So we were pulling it through.

But again, to your point, I was introduced to an industry that I had expectations that was much more advanced than it was. When I first was thinking about joining the industry, people talked about things like FHIR protocol, HL7 protocols, APIs. I show up going, hey, where's your API? And they're like, no, could you FTP a CSV to this location?

I was like, what? I was like, pardon me? So, for example, here's something about the industry that people didn't realize. So the communicable disease platforms for 48 of the 50 states in the United States was a mainframe-based system built by Accenture in the 90s called Merlin. Now, each state called it differently. Those platforms...

were destroyed and decimated in the first several months of the COVID pandemic because they were not ever designed to

to take millions or hundreds of thousands to millions of results. Because remember, you had to report to the states so that they report to the CDC every test ever taken, whether a person was positive or negative. And there were other criteria that you had to have in there. So what was happening is these systems were getting inundated with these files that had to get sucked up, and they just didn't have the processing power, they just didn't have the architecture, and they broke.

And so what was happening is, on the back end, a lot of these states, while they were trying to remediate those platforms, were also using Excel spreadsheets to actually do the reporting that had to go up every night. And so that's

What we did is we brought all the experience and background that we had in banking over the several decades, and we actually started building these processing. And we had to throttle a lot of our technology because we had built it in such a way that it was real time. We had to throttle that technology. And then to your point, private health information and private identifiable information, we literally brought all that banking experience of how do you secure it

How do you deliver it securely? In the early days, I know some competitors were sending information in the clear, and we'd actually get a hold of them and say, hey, look, let's us help you just a bit because we need to make sure that this is covered well. And so

all of that investment of of ip and experience of these experienced teams that were landing was brought in to evolve the the the covet uh platforms um and the real-time data that's why two different white houses would come to us and ask for our data our insights um the governors got used to getting things in real time which they'd never real time uh would get in real time before and so

Building all that up in that crucible, like you said, real-time development teams working literally seven days a week, literally 18 hours a day. I'd be working with the teams throughout the afternoon and evening. I would wake up, I'd make sure data was uploaded properly to the states, and then I'd go into the field and help the field teams because I had to see what was happening on the ground. So it could make improvements like QR codes on the vials so you could scan them in and didn't have to straight through processing. At the same time,

We were always true to where we wanted to go as a company and as our vision, our initial goal. So I had hived off teams and I said, you will still go build the medical bank. You will still go build the adjudication platforms. You'll still go build all those other things that we had cited about what our real mission was. And so what we did is we took the COVID investments that we got during that time period and

And we used that to actually invest in acquisitions like our data analytics organization that we acquired. There's a pharmaceutical management company that we acquired at that time. And the investment in the technologies for the payments and adjudication work that we did as well.

And so we used all that experience and we used all of that investment and all of that learning to build on top of it. And it's funny enough, I've probably re-architected some of our platforms now probably three times from the learning and the experience of coming out of that COVID and then into the world that is Nomi now, which is focusing on changing the economics of healthcare in the United States. - So let's talk about that new world of Nomi. We're taking this in 2024.

How does Nomi use AI today? Right. So it's really interesting. It's a lot like what you're really seeing in a bunch of other industries.

So as context coming into this conversation, I've actually been working with machine learning or what people sometimes just generally categorize as AI. Now, neural networks. I mean, banking has been using neural networks for a decade, right? So for fraud. So I've actually been in this world. I've also been exposed to a lot of people coming to me during that time period, selling me AI solutions, right? So I always tell people,

I've been exposed to what we now generally call AI out there for quite some time. And what I tell folks is a lot of stuff out there is just too early or we're still trying to learn about it. So bringing in chatbots in the banking, we learned about what's good and bad about those experiences as well. So inside the know-me side of the house,

I look at it in two areas that we're looking at. And I can't, in that intro that you're leading to, I am going to go back and listen to that co-pilot session because that, I think, is the big bang for the buck right now in the world that we call AI. So right now,

We leverage it around things around the co-pilots out there, using them as analysts to say, hey, tell me about this situation in the market. Analyze this bit of information. Another thing that we're doing internally, which is a lot of fun, is because we deal with banking regulations because we have our trust charter and we deal with health regulation...

We're actually creating a LLM right now that takes all the state regulation, all the federal regulation, both on health and on financial transactions.

that are related to that and putting it together so that we can actually have what we're referring to as our expert in that domain. So we can go ask questions and get a perspective from each state, from the federal level, from the banking laws, and all those perspectives so we can quickly identify areas that we need to think about or build towards. Our analysts use it a lot to make their day-to-day jobs easier.

My engineers use it to help with coding. We use it for our infrastructure and software development. We're experimenting it around customer experience. And as well as we also use it on the cybersecurity side of the house, right? So these are isolated tools that we use in those domains to make our day-to-day jobs easier as we build up the company.

longer term, we're actually looking at using AI around payment integrity in this industry. We have something called payment integrity. It's akin to banking fraud checks or credit checks in banking. So leveraging it in that domain, so we're actually experimenting with that now so that we can get better around payment integrity to help our customers like the self-insured employers and others going on

Are those dollars getting spent on the right things in the right places? And we have a broader vision of where we think that should go over time. So those are the two domains, which, by the way, is actually shadowing exactly how the banks are using them as well. Good insights.

we're almost out of time and we barely touched on any of the topics we had actually planned to discuss, which is just great. So that means I'm going to insist that you come back for another version and we'll continue this conversation. But I'm not letting you off the hot seat without answering one last very important question for me. The healthcare system in the United States has been broken for so long. And as humans, relying on the healthcare system, I think we could say it's getting more broken by the day. Some pretty bold questions

ambitions that you and Mark and the team at Nomi have. Let's say Nomi is ubiquitous. Maybe it's three, five, I don't know how many years down the road.

How is the world different for humans in that world where anomie is ubiquitous? From our perspective, we believe if this country fully adopted the anomie approach to paying in real time, paying for the real cost of healthcare, not the imaginary cost of healthcare, using data analytics to ground decisions in fact and truth,

And enabling providers to do what they went to school to do is practice healthcare and actually reduce the overall cost to the self-insured employers and the government to reduce that overall cost. This is what we believe will be the outcome. One, instead of the healthcare costs going from $4 trillion to $5 trillion to $6 trillion, as is projected, we will actually return a trillion dollars back.

back to the economy. That's one. Two, anybody will be able to shop for healthcare, meaning they can go to any doctor that they want to. The doctor will get the fair market price for their work, but you'll get to choose your provider and you won't be constrained in by these falsely developed contract networks, right? And the organizations that purchase that healthcare, right, will be able to provide, you know,

better, richer benefits so there won't be a deductible coming out of the employee's paycheck or there won't be a copay, because all that does is turn the doctor into a collections agency, right? That'll reduce the overall bankruptcy rate because of medical costs. People have access to that care, right? And you'll be going to the same doctor, same care, less price. The last big piece that I really can't wait to see that day is that, and at that point,

what will happen is because we're using data based on how these organizations provide the benefits to their employees. Things like GLP-1s. GLP-1s are becoming a miracle drug out there.

When they first rolled out, they're very expensive. And employers said, I don't think we can afford that benefit for our employees that need it. What we found is when we did the data analytics against it to show the self-insured employers, yes, your pharmacy spend went up slightly, but your overall health costs went down for the employee because they lost weight, heart disease went down, high blood pressure went down. They got off of batons. They got off of high blood pressure medicine. Type 2 diabetes went down. So the overall cost came down. So using that data to actually point out that, hey,

If you do these treatments, the overall health of the individual will go forward.

We believe those will be the outcomes. And we didn't even touch on the genetic solutions like the cure for sickle cell anemia coming out and being able to help organizations fund those treatments to get those cures. So those are the things that we believe we can drive in the United States that will get those results. And we actually are starting to get proof points in that domain as well. I mentioned in the intro that...

despite everything you've accomplished you're about to tackle or you're in the middle of tackling uh will be the biggest challenge of your career give us the uh get your crystal ball the over under on five years uh likelihood of this vision coming to fruition in that time frame

So I will tell you, I actually, I was bullish coming in, but that was pure passion and excitement and curiosity bullish. I actually am seeing the price points, and I am definitely on the over that this is going to come to fruition, that it's going to change. And let me give you the points why. The pandemic broke the back of the healthcare industry in the United States, and it just decimated it. We saw it. But more importantly-

It decimated in such a way that governors had to face their citizenry every day. CFOs of companies actually had to look at and saying, why are my people sick and why is it costing so much to get them back to work? And the care during that time period where people were going to the doctor less, the cost of healthcare went up 10%. And so both our policymakers and our industry leaders

are looking at this. And for the first time, it was no longer the benefits leader buried in an HR organization. It was these people I talked about had to deal with it on a day-to-day basis. That they now are looking for answers of why that has happened. How is this even possible? Because in the past, everyone went, well, healthcare's going up, and that's just what's happening. They're getting out of the emotional political conversation, and they're getting into what is the hard facts realities that are happening on the ground.

What is taking place? And what we're doing is we show up with the data. We show up with the experience. And because of our experience at COVID, we have credibility with these leaders. And they know that we're very transparent and very straightforward. And we're using the data to say, this is what's happening and this is why it's taking place.

And also there was a hack on Change Healthcare, which is the single medical exchange back in February that's still impacting today. All those things have just been a daisy chain of now policymakers and leaders going, I'm tired of us having the same rote conversation. We need to do something different. And so now these same people are willing and open to say, we have to make a change now.

And there's technologies that we're talking about that are coming to the forefront that are making it much easier to execute against. So those are the facts. We are seeing it. And so, in fact, I will be in D.C. again in a couple of weeks talking to more policymakers. Governors are constantly engaging with us. How do we bring what we did in the pandemic here? And so you have a broader base, more people engaged.

And they are seeing the outcomes that they desire. There you have it from the expert by 2029. The system's going to be fixed. And look, Bo, hey, you made miracles happen during the pandemic. So I don't think anyone should count you and the team out. And I think it's fair to say we're all rooting for you.

And we want everybody in the fight with us. And I just think it's a calling worthy of everyone's time, and we have the attention that we need now. Excellent. But where can the audience learn more about you and the work at Nomi?

You know, funny enough, LinkedIn. I've actually become very engaged on LinkedIn. I'm willing to engage with others on that. You can also go to my ex-handle. It's simple. It's Bo Hartman. It's at Bo Hartman, B-O-E Hartman. You can engage me there as well. And as always, you can always go to the nomihealth.com website. Also, if I could do a plug, I'm speaking at Money 2020 in a couple weeks. If any of you are going to be out at Money 2020 in Las Vegas, come by and see me.

I'll do another plug, Bo. Check out Bo's LinkedIn profile and you'll see a kind of cringy rap song written about Bo by AI. You can plug that too, Bo. Yeah, yeah. You know what? When 2020 sent me that from a famous poet in the UK, you said, I listened to it the first time. I'm like, okay, I'll post it. But wow, that was kind of weird. That was kind of weird.

A little cringy, but hey, I don't know. Source of pride. Yeah, I was going to say, sometimes AI wins, sometimes it kind of misses. All right. Well, that's the great Beau Hartman from Nomi Health. Excellent conversation. Thanks for hanging out, Beau. Always great, Dan. Always great. Good stuff. Well, gosh, that's a wrap for this week on AI and the future of work. As always, I'm your host, Dan Turchin from PeopleRain. And of course, we're back next week with another fascinating guest. ♪