How AI Personalizes Patient Engagement w/ Robert Farrell, CEO, mPulse

AI, behavioral science and digital communications are transforming how patients interact with the healthcare system. But are they actually improving outcomes or just adding noise and costs?

In this episode of the Health Biz Podcast, host David Williams speaks with Robert Farrell, CEO of mPulse, about how AI-driven personalization is transforming patient engagement. They discuss how conversational AI, behavioral science, and predictive analytics are helping healthcare organizations improve outcomes, boost health literacy, and engage patients more effectively.

🎙️⚕️ABOUT HEALTHBIZ PODCAST
Healthbiz is a CareTalk podcast that delivers in-depth interviews on healthcare business, technology, and policy with entrepreneurs and CEOs. Host David E. Williams—president of the healthcare strategy consulting boutique Health Business Group is also a board member, investor in private healthcare companies, and author of the Health Business Blog. Known for his strategic insights and sharp humor, David offers a refreshing break from the usual healthcare industry BS.

🎙️⚕️ ABOUT ROBERT FARRELL
Bob Farrell is a 4-time CEO with a proven track record of building high growth, profitable software and technology-enabled service companies backed by private equity and public markets. Bob currently serves as an outside Member on the Board of Directors at Worldwide Express, Recycle Track Systems, Transportation Impact, Meal Ticket, and Tenstreet.

🎙️⚕️ ABOUT mPULSE
mPulse combines predictive analytics and advanced digital experience technology to deliver business efficiencies and more equitable health outcomes at scale. That’s why 400+ healthcare organizations trust them to orchestrate personalized health journeys for their populations.

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Transcript

David: 0:00

AI behavioral science and digital communications are transforming how patients interact with the system, but are they actually improving outcomes or just adding noise and costs? Hi everyone. I'm David Williams, president of strategy consulting firm, health business group, and host of the health biz podcast, where I interview top healthcare leaders about their lives and careers. My guest today is Bob Farrell, CEO of mPulse, a healthcare engagement company that leverages conversational AI, behavioral science, and multimodal communication to improve patient outcomes and health literacy. Do you like the show? If so, please subscribe and leave a review. Bob, welcome to the health biz podcast.

Bob: 0:47

Thank you, David. Good morning.

David: 0:49

We're going to talk all about what you're doing now, but I like to wind the clock back to the beginning and ask about, uh, the, the olden days. And ask about your, uh, your background, your upbringing, you know, what was your childhood, like any influences that have stuck with you throughout your career?

Bob: 1:04

Yeah, I, uh, I had a very interesting childhood in that, uh, early on I had the opportunity. My dad was an expatriate in Iran and we lived in Tehran for four years when I was in my formative middle school years. And, um, a lot of the things that I experienced during that time, um, I think made me very non ethnocentric and, um, Uh, aware of what's going on in the world. And that's kind of helped me help me in my career quite, quite often.

David: 1:32

And that's, that's an amazing background. I, uh, I grew up in Washington, DC, just outside in Bethesda. And so there were people from all over the place. And in, uh, 1979, I was. 12 years old. And there were a number of, uh, you know, Iranians that came in, uh, during that timeframe. Um, and just before that, uh, you know, Vietnam war ended and there were a lot of people that had come in as well. So you really got to see, uh, from a little bit different perspective, not as direct as what you saw, but, um, I can imagine that could be quite, uh, formative and open up your horizons.

Bob: 2:03

I think when you have, uh, a lot of diversity early on in your life, it, it, it makes you aware of the. Different constituencies that you need to deal with in a, in a, in a business life, which can be really helpful. So what did you do,

David: 2:16

uh, for education? Did you, did you move around when you were little or go through high school elsewhere? Were you in the States? No, I,

Bob: 2:23

I, after, after we returned from Iran, I, I went to high school on Long Island. I went to college, um, and in Stony Brook, which is also in Long Island. And, uh, I did have the opportunity in my career to travel quite extensively and early, early jobs had me spending extended time in Asia and in, in, in Europe. And, um, I think all of those things contributed to the experience that I was able to bring to the different CEO roles that I've had over, over the years. This is my, my fifth CEO, um, role. And with each of them, I've been able to sort of build on the last one and, and, uh, Hopefully forget about the things that didn't work well or, or take lessons from those and focus on the things that didn't work well and, and take those to the next level.

David: 3:09

That's good. Cause you know, sometimes I find that maybe the brain does this by itself, but someone will ask me about some previous unpleasant experience or something. I, I, I kind of repressed it somewhere. I can't remember the people or whatever, but hopefully I've, I've built on it as opposed to just being obsessed with it. Uh, all the time, but give us a quick, uh, sort of a quick run through of this career progression and various, uh, CEO roles that you had taken on. And I saw also, I think some, uh, some work in private equity, uh, both I think in the firms and as an operator.

Bob: 3:41

Yeah. So as I mentioned, I've been a CEO five times and my first CEO role was with a company called Metastorm, which was a. business process management, uh, software company. It was, it was a great opportunity for me to jump into something that was relatively small. We, we grew it fairly, fairly significantly to over a hundred million dollars in, in, in revenues. Um, The great company though, in that it, um, really automated manages and controlled mission critical processes with, uh, with software and really, um, took workflow type things to the, to, to the next level. And I've been able to parlay that into a bunch of other, other roles. Um, Most of my CEO experience has been, um, uh, with software and technology companies. And along the way I've worked with a number of private equity firms, as you mentioned, um, and have helped those firms, um, do some things with their portfolio companies, uh, uh, uh, along the way. And, you know, private equity often gets sort of a bad rap, um, particularly when you bring it up in customer settings. Private equity that I've worked for has been great. It really has provided the capital necessary for the companies that I've worked with to drive innovation, to drive growth, um, to help people's careers get progressed and to serve customers really well. Um, so I jumped into this role here at, in, in mPulse in August of 2022. And prior to that, I had worked. Around healthcare as a vertical in software businesses. This is my first time being squarely in the healthcare space. So it's been a little eyeopening in, in many ways. Uh, and, uh, exciting in many ways.

David: 5:21

Yeah. So with my first question related to mPulse, you kind of, uh, anticipated it is about why get into healthcare? Cause when you say, when some people say that, like they worked their way around healthcare, like I know some people that say, yeah, they worked their way, like everywhere, but healthcare to stay the heck away from it, cause it's not, uh, It's, it's, it has its own challenges. So why is it just that this seemed like a great company and a good spot to pull out your, you know, your CEO, uh, experience, or was there something about healthcare that made you interested in it?

Bob: 5:51

Well, as a business, there was definitely a clear opportunity. One of the things that really attracted me to the company for the first time in my career. It was an opportunity with a business where we're genuinely helping people every single day. And you know, you talk about different bottom lines here at mPulse. One of the key elements to our bottom line is what, what statistics do we have to prove that we're improving the healthcare outcomes of people on a daily basis? And we are doing that for millions of people. Um, so that was a big attraction for me. Independent of the technology, independent of the The domain expertise that we had in the company, which were all great, but this opportunity to, you know, to have some passion around actually helping people is, is, is really a, been an attraction for me.

David: 6:42

So I'm sure, you know, every industry has its own jargon and things that it, that it focuses on in healthcare. One of those is this concept of patient engagement. Well, first of all, the idea of a patient as opposed to, you know, customer, but patient engagement, what is that anyway? And why does it matter? I assume it does matter.

Bob: 7:01

Well, it does. And, and we, uh, we combine patient engagement and member engagement sort of into the, into the, into the same, uh, into the same genre. Um, and, you know, you mentioned the word customer, and one of the things that I learned when I got here was that, um, the healthcare industry does not often treat patients and members as customers. If you look at financial services, if you look at, uh, econ, you look at supply chain, a lot of other spaces have really engaged their customers digitally, um, using lots of modern techniques to, uh, create, um, detailed personalization and, and great experiences. Um, healthcare was a little behind in its adoption of those kinds of technologies and still is behind. And some of that has been driven by regulation, but some of it has also just been a slower technological adoption rate, uh, within, within the healthcare community. So, you know, we're focused on the health consumer journey and the different touch points along the way across different populations, uh, to really help consumers, uh, members, patients, uh, take charge of their health and do the things that they wouldn't otherwise do because they're not.

David: 8:29

So I always hear there's a lot of barriers to effective healthcare communication, and these have been, you know, going on for some time now, there's new technologies that are out there. So what kind of barriers do you see and how is technology helpful?

Bob: 8:45

Well, one of the barriers Unfortunately, it is a regulation, and when you look at the TCPA, the Telecommunications Protection Act, it, it is, um, been designed to protect the privacy of people, which, of course, we all agree with and understand, but when it comes to health care, it can limit it. What health plans in particular, uh, can do with, with texting and IVR and email outreaches, um, and, um, there is a carve out for that for health care, but there's some, you know, significant changes to that regulation coming and it puts some of these providers and. Health plans at a disadvantage and being able to use all the channels available to them to go, to go get, uh, to get access to their members. Now, listen, nobody wants unwanted text messages or unwanted phone calls and whatnot. Um, so you need to manage it in a, in an effective way. And, um, we can use technology to manage consents, manage opting out, uh, in a way that. The right messages get to the right people through the right channel for the right reasons. Um, and that's what we're, that's what we're trying to balance with, with, uh, the programs that we have.

David: 10:01

And so you think about, you know, AI, generative AI in particular, automation, things that are, that are all over the place. And are those having a big impact on your patient provider? interaction. And as we look at the potential of the technology and where it can go, are there, there's obviously some, some pluses. Are there any downsides?

Bob: 10:23

Yeah, so, uh, I would say that less than January of a I conversational a I has really played a role in in engagement and in particular, uh, the ability to have these two way communications where, um uh, A health plan or a provider reaches out to a member or a patient for something specific and through conversational AI, uh, and using NLU, you're able to help determine what the next best action is. So rather than leaving a member or patient hanging. You can continue the conversation in a way that ultimately leads to them doing something, whether that's arranging for breast cancer screening or getting a flu shot or, uh, making sure that they're adhering to their med programs, whatever the use case might be that that using AI in conjunction with NLU to really master the next, the next, uh, best action is important. And, you know, sometimes with certain populations, um, yeah. It's difficult because the, the, the simple reason they may not do something is because they don't have transportation or they don't understand it. And we can use. Um, AI then to help provide them with the right content to get them familiar with whatever the situation is that they're dealing with.

David: 11:46

And Bob, just to clarify, I'm guessing that NLU is Natural Language Understanding as opposed to NLP, Natural Language Processing. Is that fair? Is that right? And if so, what does that mean?

Bob: 11:56

Yes, that's right. And sorry for the, uh, I jumped into jargon there. That's all

David: 12:00

right. You got to get those TLAs, you know, three letter acronyms. So that's a good one. Um, good. So how about behavioral science? So I've seen you dealing with, uh, with people and, and when they're dealing with a health condition, you know, it's an area where it's not as so straightforward as, you know, buying something at a restaurant or something on the logistical side. What, what kind of impact is, does behavioral science play in terms of if you want to impact outcomes, which is what we talked about up front.

Bob: 12:29

Behavioral science plays a big role in helping improve outcomes, and it can be as simple as just, um, looking at the words that are used in a text message to make sure that you capture the person's attention and give them the right, uh, call to action. Um, without them Even realizing it, and that's not suggesting that it's done in an inappropriate way. Um, but the selection of the right words is really important. Understanding your population, uh, and using behavioral science to augment words with photo novellas, essentially comic strips, or video clips, or audio clips. Um, to help move people to the right action is really important. So we put together, uh, in our behavioral science practice. The use of all different forms of, of communication, uh, to help lead people the right way. And, um, if, if you don't stop and think about it and craft messages and craft interactions and build workflows with behavioral science in mind. The results just aren't going to be the same, and we've seen dramatic improvements in engagement results when behavioral science has been applied, uh, effectively.

David: 13:49

When we're talking about technology, we're talking a lot about information technology, we're talking about AI, automation, but there's another technology that's had a big impact in healthcare, and I think the, the impact is just starting to be seen, and that's a drug technology, I'm thinking about GLP 1s in particular. And I'm wondering, um, whether the, uh, you know, the blockbuster success that you've seen with the GLP ones, is that having an impact in your world?

Bob: 14:13

Yeah. So, you know, in, in our, in our business, um, one of the things that we've done is to, you know, work with, um, um, the RX side of health plans, as well as, um, drug manufacturers themselves. We have a number of, of large pharma customers to make sure that they are. Deploying messaging, uh, around whatever, uh, whatever their product is appropriately. And in a way that, um, helps people identify, um, interactions that could be dangerous. Or, uh, otherwise generating unintended outcomes, um, without allowing the engagement to be used for people to get access to things that they really shouldn't be getting access to. Got it.

David: 14:59

Now, one of the advantages of coming into healthcare after a career in technology elsewhere is as, as you said, uh, healthcare often lags in technology and there's some reasons for it. Some good reasons, some less good reasons. But are there things that healthcare can learn from some of the non healthcare businesses that you've been involved with and that you're able to bring to it now?

Bob: 15:21

Yeah, absolutely. I think, you know, when you think of digital engagement and advanced personalization, um, I think there's a lot that healthcare can learn from how, for example, financial services. have engaged with their customers in the case of health care members and patients. Um, and have really helped them orchestrate a journey. So if you think about, um, the journey that any health consumer is going through, there's a lot of stops along the way. There's a lot of different things that have to happen at different points in people's lives. You're going to engage with somebody who's Aging into Medicare differently than you're going to engage with a new mother. Um, and the same thing happened with financial services. When, when you were planning for retirement, it's, it's one set of interactions and engagement. When you get to retirement, it's another set. And so looking at how you can use technology to really manage the points along the journey the right way at the right time, I think is something that healthcare can pick up from how other industries have used technology.

David: 16:33

One of the challenges in digital health, and this is a longstanding challenge, has been about reimbursement. Um, and in fact, when, uh, digital health started and he had some things like, uh, doctor, patient, uh, emails and, uh, web based communications, one of the concerns was, hey, this is going to be like the phone, which was something that was theoretically reimbursable, but practically wasn't, wasn't actually going to be reimbursed in terms of reimbursement challenges. Have those been solved in digital health, or are there still challenges related to reimbursement?

Bob: 17:03

I think there's, uh, I mean, inherent in your question, part of the answer there, there's there, there continues to be, you know, a lot of challenges around how technology can be leveraged appropriately to, uh, improve reimbursement. Um, and I think, uh, I haven't been around. Detailed health care for as long as, as you and others in the number of years that I have been here, I've seen great improvements already happen, and I think that the great equalizer around all this is data and having the right. Um, data lake, if you will, and, um, opportunity to connect the dots between all the different, uh, pieces of what makes reimbursement work well and effectively and appropriately, um, great strides have been made there. And I think perhaps if we look at where AI could be deployed in the future. Um, once this data is there, once the LLMs are, are, uh, at a point where you can use them in a way to drive reimbursement appropriately, uh, we'll see some greater, uh, um, uh, leaps in, in, uh, progress.

David: 18:17

Now, when I first heard of mPulse, I, I remember, I think it was called mPulse mobile. And if that, is that right? And, and, uh, if so, why drop the mobile?

Bob: 18:26

Well, the short answer is I, I don't know why mobile was ever on that, uh, on that name and nameplate I, you know, when the company first got its start, uh, it was really focused on sort of this, you know, simple messaging around, uh, particular use cases on mobile devices. So it was kind of a part of a startup name and, and as the company has evolved, and today we have a value proposition that is focused on all things, health experiences, health experience and insights, um, and having mobile as part of the name doesn't really do justice to the breadth of our, of our overall value proposition.

David: 19:08

I guess if you ask somebody where it went, he could say, well, it's not, it's contained in the small M at the start of the name anyway. So, uh, yes, you could have it. So let's talk a little bit more about AI. I'm, I'm interested in about, you know, how AI, you mentioned conversational AI and kind of corrected me when I said generative, but the conversational AI, how, how using AI today, how are the clients using it and, and where is it going? Because I see you've set up, I think a kind of AI center. Of excellence. So how do you see it both today and where it's going? And to what extent can you actually anticipate? Where it's going or more just you want to be positioned so that you, you learn, uh, from it and incorporate the lessons that you do learn.

Bob: 19:49

So we're, we're using AI as, as I mentioned, conversational AI and the engagement side. We also use AI and machine learning, uh, on within our predictive analytics capabilities. And, and, um, uh, that both of those things have been part of our business for many, many years, really from inception. And, um, One of the things that has happened as, um, gender to the AI and, and the overall AI, um, excitement in the industry is, has, has gotten more significant. Um, a lot of our customers are re as soon as they hear AI, they throw us to a group that is focused on making sure that we're using AI appropriately, making sure that we're not making decisions around clinical care or anything like that. With it with A. I. Um, so the reason we created this A. I. Center of Excellence was really to make sure we had a governance vehicle in place to make sure that we were using it appropriately. And that we were driving innovation, but not letting innovation get, uh, ahead of regulation and ahead of where our customers felt comfortable deploying AI. Um, we recently introduced, uh, something called a trust portal where we've encapsulated all of our AI techniques. Um, Everything around what we would need to be compliant with a customer's, uh, views around AI into one place. Um, customers are excited by it and scared by it at the same time. And we're trying to, you know, bridge that gap for them and, uh, make sure that we continue to move AI forward. Um, but not in a way that, um, uh, gets in the way of, of, of, of companies desire to make sure they're governing it properly.

David: 21:43

I know we'll be talking about AI and healthcare and elsewhere for a long time. I'm wondering if we look just a little bit ahead and say, you know, what are some of the next frontiers in healthcare communication? Uh, voice AI, is it wearables? Is it, is it something else? But if we look a couple of years ahead, what will we be seeing that we don't currently see?

Bob: 22:02

Yeah. I mean, some of those things are here today and, and I think it's like how, how to, how to wearables, how does the data from wearables You know, find its way into, um, the ability for AI to leverage it to, um, provide prevention of, of at risk populations. I think we'll see a lot of, um, we're working very hard to, um, look at at risk populations. Use data, use AI to, to create engagement programs that engage those at risk populations earlier in the game. So we use our predictive analytics to determine who they are, we engage them, and then drive them to some certain actions. So I think we'll see, uh, technology more, uh, in a more streamlined way, helping patients and members. Take action long before they have a problem or in a way that allows them to deal more effectively with a problem in a more timely way. Um, help them become more educated about whatever it is they're dealing with. Um, so much of what we do is on the awareness front and having people aware of what they're dealing with and educated about it. whatever kind of population they're from, uh, whatever kind of language they speak, wherever they live, um, is really important.

David: 23:26

There's a new administration in town in Washington, D. C. and, uh, it's, you know, a lot of things have happened pretty quickly. Uh, as you look ahead, um, you know, what do you expect the impact to be of whatever may be happening in, you know, in, in D. C. and, and, and what's your plan to prepare for that and to react to it?

Bob: 23:48

Certainly, uh, the new administration has created a lot of uncertainty. Many of our customers are Medicare and Medicaid related customers. And, um, they're trying to navigate the landscape and determine how they can be as ready as possible for whatever may come down, whenever it may come down. Um, I've in the last two weeks in particular have been out on the road meeting a number of our customers, uh, for, uh, for a variety of reasons. Just make sure we understand what's going on in their businesses. And I think they're very, very focused on making sure that they can continue to serve their members, um, in the, in the best way possible, particularly health plans, um, and they're looking to us to make sure that we can get out ahead of the curve, um, And have the data necessary, uh, to, to make sure that they can continue to do that. Um, it's difficult to plan beyond that because of uncertainties. Um, and I think being in a state of readiness is, is crucial to, uh, what you can do right now.

David: 25:02

My last question for you, Bob, is if you've read any, uh, good books lately or at any point in time, anything you'd want to recommend for our audience.

Bob: 25:10

Well, there's a book that I read a long time ago. I keep it here, uh, in my office and, uh, refer to it often. Uh, and it's a book by Andrew Grove, who was the original CEO of Intel called Only the Paranoid Survive. And, um, I'm always looking behind me, always looking over my shoulder. Much of what we're talking about, you know, will be disruptive in certain ways. So how do we make sure as a business? We're a part of the disruption and helping our customers navigate that disruption. Um, how do we make sure that, uh, technology doesn't, uh, get the better of us and put us at a disadvantage. So all the principles in that book continue to be, um, continue to be applicable and, uh, um, if you haven't read that book, I suggest you go out and read it.

David: 26:05

Good. You know, it is, um, a well known book and I've done hundreds of podcast episodes and no one's ever recommended it before. Uh, so they should have, but I'm glad that you've, uh, that you put it out there. Well, Bob Farrell, CEO of mPulse. Thank you so much for joining me today on the health biz podcast. Thank you, David.

Bob: 26:23

Have a great day.