The Desilu Effect


Editor's Note: Cambia Grove is proud to partner with the innovation community to amplify their perspectives on topics applicable to the larger health care ecosystem. This guest post from Neal Sofian, CEO tuzag Inc, dives into the paradigm shifts necessary to disrupt health care delivery in the employer space. 

The views expressed in this article are solely those of the author and do not necessarily reflect the opinions or positions of Cambia, Cambia Grove, or any other entity or organization.

I loved watching ‘I Love Lucy’ when I was a kid. But I had no idea it was the most important show in TV history.  It disrupted how TV was made, produced, and the basic value proposition of the medium itself. Early TV was done like a stage or radio show with a camera pointing at it. Desi Arnaz was the first television producer to film with three cameras instead of one, so he could shoot angles, reaction shots/other points of view, and close-ups simultaneously. Sitcoms are still shot this way to this day. Arnaz also initiated the industry practice of airing reruns, which made summer hiatuses possible and opened a new market for the sale of film rights. This has become the basis for syndication rights in TV, a totally new business model for the industry. Of course, without Desilu Productions there never would have been Star Trek or Mission Impossible.  

Health care needs its own Desilu Effect; great services and content delivered in a more contextually relevant way, using a better business model. The sector desperately needs disruption to its existing business models, delivery mechanisms and consumer engagement. This is why I have been a fan of worksite-based health care over the past thirty years. Why? 

Because to transform health care we need to reconceptualize the very nature of how it is delivered.

The worksite offered a great case of bringing both direct health care and occupational health management right to where people spent most of their waking time, using a different business model.

But just changing the physical venue has not been enough. Covid-19 has slammed that home. We face an inflexion point when it comes to the broader spectrum of care itself. 

Remote patient monitoring and telemedicine are still being done like early television; one camera with a provider-centric point of view.

The assumption is we can collect data through remote devices and then either deliver telemedicine with a ‘virtual doc in a box’ or just send information and assume this is going to drive effective care. This is wrong on two interrelated levels.  

Telemedicine really has limited ability to scale. A minute is still a minute to deliver care in real time. Though it is more convenient on the consumer side and generates some administrative and space saving on the delivery side, we bump up against its value limits quickly. We need to find how to create asynchronous forms of communication and intervention and massively extend the reach of care in a cost-effective way.

The fear has been that if we scale strictly through asynchronous technology, we will end up with highly impersonal, rigid, ineffective service delivery. That of course assumes that what we have been doing in the past is personal, flexible, and effective; not. When it comes to engagement; absolutely not. This is particularly true with chronic care management across whole populations. The healthcare world hasn’t   even tried impacting the entire population because we know what we do now doesn’t scale or work that well. And the only reason our technology based strategies are stiff, boring, and ineffective is because we are still using a one camera mentality when we actually have the ability to think about an unlimited number of cameras; capturing types of data while building consumer relationships that we simply didn’t understand were critical or available.  

The issue is NOT technology. It is our inability to transform our thinking... a way that integrates a deep understanding of what drives personal and group behavior through omni-channel communications, built on a model that pays for value rather than units of service. This is the discussion we need to have.


About Neal Sofian, CEO of tuzag, Inc.

Neal Sofian - Neal is recognized nationally for almost 40 years of innovation in population-based and corporate and payor health management/engagement. During his career, Neal commercialized the first and largest telephonic smoking cessation coaching program in the United States, Free & Clear (now called Quit for Life) while working within Group Health Cooperative. While the CEO of the NewSof Group he developed many of the early health related social networking platforms including the American Cancer Society's Cancer Survivors Network. Neal is currently the CEO of tuzag, Inc., a digital omni-channel conversational AI health concierge company that has built a tailored content & engagement platform for driving exponentially greater consumer behavior change. Previously Neal was the Director of Member Engagement at Premera Blue Cross where he is responsible for development strategies to engage the 2.2 million members of Premera in reaching their optimal health.  
Neal is a noted author and speaker and continues to be acknowledged as one of the true innovators in the world of health behavior change., and the role of personalization and social networking. Neal holds a master's degree in public health from the University of Missouri School of Medicine. He is also a working potter/sculpture and has done stand-up comedy in a vaudeville show.