In this insightful conversation, Shahid Shah interviews Holly Miller, CEO of Colette Health, about their award-winning virtual care platform. Miller discusses how Colette Health's virtual observation and nursing solutions help hospitals address critical staffing shortages while improving patient safety and clinical outcomes. As the inaugural winner of KLAS's "Best in Class for Virtual Sitting and Nursing," Colette Health demonstrates how technology can amplify rather than replace the human connection in healthcare delivery. It is followed by a thought-provoking conversation with Dr. Chris Gibbons, founder of Graystone Group, about meaningful healthcare innovation. Drawing from his 15 years leading digital health transformation initiatives, Dr. Gibbons shares insights on identifying authentic problems, developing transformative solutions, and addressing the emerging "caregiver cliff" crisis. As healthcare increasingly moves from hospitals to homes, Gibbons emphasizes the need for technology that serves real patient needs rather than solutions seeking problems.
Holly Miller, CEO, Collette Health
Chris Gibbons, MD, MPH, Founder & CEO, The Greystone Group, Inc
Shahid Shah, Chairman of the Board, Netspective Foundation
Welcome 0:01 Welcome to Digital Health talks. Each week we meet with healthcare leaders making an immeasurable difference in equity, access and quality. Hear about what tech is worth investing in and what isn't. As we focus on the innovations that deliver. Join Megan Antonelli, Janae sharp and Shahid Shah for a weekly no BS, deep dive on what's really making an impact in healthcare.
Shahid Shah 0:30 Welcome Holly to this very special episode. We're going to be doing two interviews. So first thing, tell us a little bit about what you're doing at hims here and what brings you to Las Vegas? Yeah,
Holly Miller 0:43 so I'm here with Colette health. I'm the CEO of Colette health, and we are a virtual care provider that focuses on patient safety, virtual observation, virtual care, virtual nursing. And really, specifically, we're here because we recently won Best in class for virtual sitting in nursing, and so we were here last night for our award ceremony. But more importantly, we really wanted to spend some time here with our peers, with other people in the industry, to understand what's going on, new entrants in the market, trends that we're seeing, how we can better support the healthcare industry, and how we can better support our patients and our hospitals and our caregivers.
Shahid Shah 1:24 Awesome. Yeah, that's such a great answer, because a lot of people just say, well, they come to him just to learn about what's going on. But really, if you can actually understand what companies are here, why they are here, then it can help you understand what do. What does the market really want? What I love is what you guys are doing on this area of virtual patient observation, and then we'll get to more of the specifics. What exactly does that mean? Virtual Patient observation seems like an oxymoron.
Holly Miller 1:48 I know it does. It takes on many meanings depending on who you're talking to. And so really, at Colette, we think about this under an umbrella, virtual care. And under virtual care, we really define this into three pillars. The first is virtual patient observation. And that's that's really looking at patient safety, fall avoidance, reducing incidents in your patient population, people that are at risk to either have a fall, pull a line or a tube, something that is, you know, a driver of cost for the hospital, but B leads to poor outcomes for the patient. So that's the first you know. Pillar is patient safety and making sure that your patient population is safe. And so for virtual observation, we have a turnkey solution that goes in and can provide the hardware, the software and the observers to observe those patients through proactive interventions to ensure that safety mechanism. The second pillar under there is virtual nursing. And we really think about that as transactional virtual nursing when you're working with a hospital on their journey. So you start out with admissions, discharges, transfers, so your ADT model. And the third pillar is really customized care brought to the bedside and program development. So it's virtual rounding, it's custom programs that you know, I think of one that we're working with pediatric hospital that has a high population of peds with eating disorders, so they need observers during eating time, meal time. So looking at that, custom program development is really the third pillar. But what we're really doing is helping to assist caregivers in providing care at the bedside and be a virtual conduit for that yeah, long winded answer for that question. Oh
Shahid Shah 3:27 no, it's a fantastic answer. And let's talk. Let's pull one thread on the observer part. And I'm glad you mentioned that last piece, which is normally when you think about virtual observers, you're thinking about patients sitting in a high acuity environment, you know, where you're sitting next to an ICU patient. But really, it's more than that. And so let's pull that thread a little bit and say, what are all the different kinds of things that people don't usually think about with observations that go beyond this ICU model?
Holly Miller 3:55 Yeah, there's a lot. I mean, you know, you think about your traditional high risk patients, right? It could be ICU, your med surg unit. And that's, you know, historically, if you were in the hospital and you at risk for a fall or an incident, they would bring in a live sitter and sit next to you one on one. It's costly. Don't know if anybody's gotten the memo. We have a labor shortage, right, especially in the healthcare industry. And so, you know, we set out to say, how can we make that more efficient, right? So with our technology, you can watch up to 16 patients at once. So one observer monitoring 16 patients effectively, because we've embodied in a built in AI and machine learning. So that's one standpoint for your high risk patients. The other area is, you know, things you don't think about the ED, right? So your emergency department looking at different ways that we can triage patients in the emergency department and help with that transition of care. The other would be a hot topic right now, which is clinician safety right in the hospital, and so we've had a lot of recent incidents. We've seen it on the news to where caregivers are being the targets for violence in the hospital. Biddle setting. So to have an extra set of eyes and ears in high risk areas to where there might be violence against a caregiver, that's another use case people aren't thinking about. I could go on and on. Our use cases are endless, but it's really anywhere that we can provide an extra set of eyes and ears on the patient and to help alleviate some of the burden that's on our clinical caregivers in the hospital, especially our nurses, right now, is really what we're focused on. You know, we talk a lot at collect health about being a virtual care provider, but we're adding the human connection. We strongly believe that everything that we're developing is to amplify the caregivers experience and the patient's experience, not to replace the caregiver, to really give them tools and technology that makes them superheroes so they can do what they love and what they do best, which is provide care at the bedside.
Shahid Shah 5:48 Yeah, that's so important, because there are a lot of people that will kind of like roll their eyes and say, Oh, another company trying to get rid of the people, but that's not what you're doing at all. So the extent expand on that a little bit is, why can you not do any of this without actually, really good humans that are watching these systems that you're putting into
Holly Miller 6:07 place? Yeah, no, listen, I mean, even as a, you know, consumer of healthcare, right? Like, I want to make sure I've got a caregiver, but I want to make sure they have time to spend time with me, right, that they have the tools so they can spend time with me. We already know that there's a caregiver shortage, right? I think they had said in 2025 here we are. There's a deficit of about 20% of caregivers that we need right now, because many have left their profession for burnout. Retirement Age, we've got an aging population, so there's a lot going on. I think it's by 2030 we're going to need another 1.2 million caregivers to meet this demand. So what can we do to make them more effective and efficient? And also, what can we do to make them not want to leave the profession early? Right? Can we give them tools and solutions to where they want to stay here? So if you have a nurse that's near retirement, she really loves what she does, or he loves what he does, can we give them the opportunity to not have to walk the floor every day, and put them in a virtual setting, and, number one, keep that institutional knowledge of that experienced nurse in the four walls of the hospital to help mentor the next generation of nurses. So it's really what we're doing is, how do we bridge the gap and close the gap on the demand of care caregivers that we need and the shortage that we have right now? What can we do to help close that
Shahid Shah 7:22 gap? Yeah, and when you think about that last group that you mentioned that the ones who don't want to leave the profession but are almost being forced out, right because of the burden and everything else, what might be an anecdote or two? Do you have a friendly story that you could tell about somebody who likes what you do so much they're like? Thank you so much for giving me something brand new.
Holly Miller 7:42 Yeah, we do, I mean, and I hear this all the time, right? So, you know, I can talk a lot about, you know, it used to be that that people would rotate through having to be an observer or do the virtual care. And it was almost like, oh, I pulled a straw. I'm going to do that today. A lot of our hospitals have made that an elevated role of, once you get to a point, you know, we're going to elevate you into this virtual care role, and it's something that people want to do and and really tap into that knowledge base that we have, and the tenure of the nurses that we have in the hospital so they don't leave, right? You know, you might have a nurse like, I'm tired of walking, you know, 30,000 steps a day, but I want to provide care, right? And I see these new nurses that are coming in, and it's not that people don't want to mentor them, it's just just time, right? So how can I tap into that? I love mentoring, so all of that's really important, but, you know, this is a mission driven, you know, journey that we're on, right? So it's a crisis that we're facing as an industry, and we've got to come together and figure out how to solve it and bring caregivers and technology together to close that gap
Shahid Shah 8:48 now. And you're so right? It's extremely important to realize that these technologies are not really to replace humans. It's to give them a new life, right? To give them something that they can do so and class recognizes. So tell us a little bit more. What is class and what is this best in class mean, and why
Holly Miller 9:06 did they give you guys the award? Yeah, so, I mean, classes is amazing, right? So they are kind of the gold standard of healthcare technology in this industry. And I think, as I mentioned earlier, to talk about how fast this market is moving, so virtual sitting in nursing. This is the first year that they had that category. You know, I like in class to people that aren't familiar with it, is kind of the Good Housekeeping of healthcare technology. And so for us to have the opportunity to be in there and to win that award, best in class for virtual sitting in nursing was pretty amazing for, you know, Colette health and the journey that we've been on, and what I love most about best in class, it's not how we talk about ourselves, it's not what we say about ourselves, it's what our customers say about us. So you know, we've you know, if you just look at the pure data, you know, on an annual basis, we prevent over 100,000 falls across 170 or. Organizations. And those organizations have been surveyed by class, and they give the feedback you know, we've got, you know, 100% of our customers said they'd buy from us again. 100% say we promise on what you know, deliver on what we promise. 100% say when we're making an impact, right to help them be more efficient and effective, reducing falls, improving outcomes, all of it. So it's a really, we're humbled and excited to have won this
Shahid Shah 10:26 award. No, that's fantastic that it was the first time that was done, and you guys literally are the inaugural winners of a new category. Yeah, two really, really important things for everybody to understand is that. One, it's not easy to win it, right? But more importantly, it's not something where a bunch of analysts are just looking at you guys and saying you have a good story, et cetera. They actually call up and talk to your patient, to your providers and to your customers. So what were some of the things that you heard from your customers when they were interviewed by class? Yeah,
Holly Miller 11:00 I mean, it goes back to what we say. It's like we, you know, we deliver on what we promise. We keep our promises, that we have a high engagement rate with our customers, and really, more importantly is that our whole product roadmap and everything that we're developing is really the brainchild of our customers on our hospital. So they tell us what we need. We spend a lot of time engaging with them. And, you know, I think the best comment is that we're a partner, not a vendor, right? That we are here to support their needs, and we're here with them on this journey, which is really critical. The other part of it is that we are making an impact on reducing nurse burnout. We are improving outcomes on fall reduction and adverse events that can happen in the hospital, and that we are willing to walk alongside them on this virtual nursing journey, which a lot of hospitals talk a lot about, but they're all on varying degrees, but we're there to hold their hand, take the journey with them, and really meet them where they are. Yeah,
Shahid Shah 11:58 so just the last couple of minutes that we have tell us a little bit about what do you feel like is the long term future of virtual nursing? Because you're currently doing patient you started with patient observations, moved to virtual nursing, and where you are today. You've described that really well. What do you see in the next two or three or four years that once your customers start to use you? What are the other things that
Holly Miller 12:20 they could do. Gosh. I mean, the options are endless. But what I will say is that, you know, we talk about virtual care right now and virtual nursing, and I think that as we fast forward and we look ahead, you know, two to three years from now, it's not going to be virtual nursing. It's just care or virtual care. It's just going to be a part of a care model, right? And, you know, the care teams, you're going to have some that are in person, some that are virtual, and it's going to be a hybrid approach. And so I think what's going to happen is the virtual component is going to be taken out, and it's just going to be care, and it's the best way for us to deliver care to our patients and meet them where they are, to improve outcomes, and really all come together as an industry to support these outcomes and to support our hospitals and our patients. And I think that you're going to see a lot of the organizations that you see here working together to come to figure out, what can we do right to improve outcomes, to really get our hands around this healthcare model and the crisis we're facing with labor and shortages and an aging population and all of that.
Shahid Shah 13:18 Well, we really appreciate Holly you coming out, and we hope that you'll come back and tell us more
Break 13:25 You're listening to digital health talks. When we return, we'll speak with Dr Chris Gibbons, founder of Greystone group. Stay with us to hear about meaningful healthcare innovation.
Shahid Shah 13:38 Welcome back to our live recording at hims 25 you're my second guest in this session, and Chris, welcome. Tell us what you've seen so far here at HIMSS, and what brings you out here? Well,
Chris Gibbons 13:51 thanks so much for having me. Hims is always a great event. I've been coming for years this year, obviously, a lot more AI, not surprisingly, a lot of EHRs, EMRs and EMRs with AI and a whole bunch of stuff. Lot of community based e I've seen some AI, some of that as well, just all kinds of things to make the providers work easier and more efficient and better all the
Shahid Shah 14:19 way around. Great. You've recently started Greystone group. That's right. Tell us a little bit about what that is, and why did you think you needed to start it?
Chris Gibbons 14:26 Yeah, so Greystone is actually a digital health innovation and healthcare transformation firm that I started, actually 15 years ago. So that's been going a little bit now, and I started it after I spent I trained in medicine at Johns Hopkins in surgery and preventive medicine, and was on the faculty there for many years, and also the associate director of the Johns Hopkins Urban Health Institute for about 15 years. And during that time, you know, I was charged with helping the institution learn how. To develop new models of care, particularly for inner city and underserved populations. And at the beginning of that time, I said, you know, I got to do something different, because this is not a new problem. Many people have tried to fix it and really haven't gone anywhere. And so to make a long story short, now this was 25 years ago. This was not yesterday. I heard about this newfangled thing. I'd never heard of it before, and that time, it was called E health, and I looked into it, I said, You know what? There's something here. You know, we need to try to see if digital technologies, they weren't called that back then, but could be brought to bear on these kinds of problems. Not that's not the only problems, but so we started that, and now the company that I run is really a for profit entity doing the same kinds of things across the country, right?
Shahid Shah 15:48 So let's start with that is, what are the most important things you're doing at the moment, and for who, which customers? Yeah.
Chris Gibbons 15:56 So we have had a variety of customers over the last 15 years, everything from public sector, federal agencies and smaller state agencies, public health departments, but also private sector. We've had big tech companies work with us in smaller tech companies, small hospital systems. So it's just a whole variety of types of clients and types of organizations, philanthropy, all kinds of things. And as you might imagine, the types of things that they need and they're interested in, in that is a broad range. You know, this is not just one thing. So it spans everything from doing some sophisticated analytics to developmental work to helping people, helping clients understand. One of our large clients is a federal agency. I won't name which one, but they're not a part of HHS. Actually, they're outside of HHS, but they are very involved in health and health care across the nation. But the agency is an agency that's about 80% lawyers, right? And so they don't have any bonafide, trained expertise in healthcare, and that's one of the reasons they brought our company on, been a long term client. And so with them, it's everything from really understanding not only what healthcare is today, but what it will be or likely to be in the future, and the different challenges and issues, and then helping them do their work in a way that supports that future. We all want to get to.
Shahid Shah 17:35 What I love about what you guys have is a bunch of people who are like, really, really good at what they do in there. They've done that. That's right. And so when you walk into customer customers often, they could tell you and pinpoint a problem or two, that's right. But how often do you get called in where they're like, I'm not sure what's wrong with Oh, my goodness.
Chris Gibbons 17:52 I mean, this same federal agencies. I was like, that's all it was. Is like, first of all, you know, you and I can talk. We've been in the healthcare space for a while, and even if you don't fully understand, you'll get some of the things and vice versa. But think about lawyers who are in a whole different sector. I'm not going to give away the sector, but things that are natural to you and I they just don't get so it really had to get very basic, but once they grasp them, then they're moved well, they move on. But you know, everything, I mean, it's explaining everything from you know, what, where patients are and how they receive care, because the way they operate, they have to operate based on laws or statute and some of those statutes, while they may have been written two years ago, laws are always based on previous laws. So in this particular case, some of the laws that were governing their actions in the healthcare space were written in 1964 and one in 1937 as I said to them, yeah, healthcare changed a little bit in that
Shahid Shah 18:56 time. So as you think about this, the term innovation is bandied about quite a bit. Absolutely, tell us what are some most, more, the most common kind of misconceptions, absolutely, when you're dealing with innovation,
Chris Gibbons 19:07 oh, my goodness, there are so many. I think the biggest one that we're focused on is, you know, they're all innovation is not the same, right? And I go back to the guy who originated these terms in the first Clayton Christensen, Harvard Business School professor recently passed away, but he wrote the book on this right, and he used the term disruptive innovation that a lot of people throw around. And at least by his definition, what they're saying is disruptive isn't disruptive. So a bottom line is a disruptive innovation is actually usually something that's really pretty small, right? It's not a huge, big thing, and the impact it has goes far beyond where the developers thought into other sectors so far that it couldn't been predicted. So right there all those people trying to tell you they have a disruptive innovation. And probably not, because you can't think of it that way, number one. And now this interesting thing about those they're usually not shiny things. They're usually infrastructure networks, kind of boring things that we don't even think as innovations or disruptive innovations. One quick example, think about the interstate railroad system. It did much, much more than allow people to travel faster than riding horses. It changed business commerce. It enabled coast to coast commerce in a way that simply wasn't possible, going far beyond transportation. That's the characteristic we focus on the disruptive side of things, and trying to enable that kind of transformative change, and not so much the incremental change, which is what many people are trained to do and see. So that's where we focus.
Shahid Shah 20:51 Yeah, so people today feel like if they were to just apply either old style AI or generative AI, that that itself is innovation, but not quite right? What are people thinking incorrectly
Chris Gibbons 21:04 about? Ai, right? So one of the biggest areas that we see is that people have a technology now they look for a problem. Yes, it can be done that way, but quite frankly, we believe that's not the best way to do it. The best way to do it is to start with a problem, a real problem that real people or real doctors or real patients have, and then design a solution that fixes that problem that may or may not involve technology. There's no value in applying technology to something that doesn't need technology, right? So that's the biggest overriding problem. Oh, we have AI, oh, we have EMRs, oh, we have this. Let's now apply it to everything we do. And sometimes that might be appropriate, but many times it's not. No, I love
Shahid Shah 21:49 the advice that you're giving to focus on problems. What's a good way to interview clients and understand their problems in a way that you can then use to describe that problem to, let's say, a technician like me, to say, Okay, go fix it. Yeah, problem definition is hard. Oh, it
Chris Gibbons 22:06 is. But you know what? It's amazing. I get asked this question a fair amount too. The best way ask them. It sounds trite, but many times they are not asked at the actual patient or person, somebody else the doctor is asking, I'm not downing doctors. I'm a doctor. But even as a physician, when I've pushed myself to ask patients about issues that I think I already know about, and I do, I inevitably learn something even myself. So it just proved to me that you got to ask the end user or the target population, and not always, you know, the proxy, the doctor or the insurance company or whoever else talk to that get what they're thinking. You might have to then reformat it a little bit, but once you start there, then at the end of the day, if your product solves that problem, you've got to market, because it's a real problem. You don't have to look for a market. It's there. That's the better way to do
Shahid Shah 23:09 it, we believe. Yeah. So, and if you think about that, you almost said about reformatting it, yeah. So, as you think about asking these kind of questions, there's a famous aphorism by I think it was Henry Ford who said, if he was going to ask what people wanted, they just say faster carriages, exactly as opposed to a car. That's exactly, right. What is that equivalent in modern day healthcare? Right?
Chris Gibbons 23:29 Yeah, another great question, because what I see an awful lot in healthcare is people, they may ask questions, right person, wrong person doesn't matter, but they ask, but then they try to come up with a solution that fits into a paradigm that we have, and sometimes that's appropriate, so I'm not even downing that, but if we're trying to make transformative change, that's not the way to get there. It will take 1000 lifetimes, incrementally changing, and you'll never get there. And so when, when you, when I talk about a problem, then you got to think about, okay, here's how it has been done, here's the challenges. But is there another way, totally different, maybe no blinders on another thing, and I get why they do it is, how do we build a solution that can be reimbursed by CMS or whoever. Again, I understand that, but you're locking yourself into a system that some people would say is failing already, right? So you're not going to get outside of that system with that solution. So we've got to think about that side of coin. I get it, it's hard. It's not easy, but, but it's also not possible to get outside of something if you're only thinking inside of it.
Shahid Shah 24:45 Yeah? So tell us now, as you, as you walk around the expo hall here at hims and what you're working on with your own customers, right? You most excited about over there the course of the next few months? Are you introducing something? Yeah? Talk about something new. Go ahead. Yeah,
Chris Gibbons 25:00 great question. So one of the biggest problems that we are focusing on is probably one of the biggest problems that's unrecognized or under recognized by the healthcare system. It's been called several things, but one way it's been called, it's called the caregiver cliff. I don't know if you've heard about that, and a specific portion of that's called the sandwich generation. So what does that mean the caregiver cliffs. Cliff is the millions of people in America who are now taking care of, usually senior parents or somebody else. Combine that with the reality in the healthcare system that care is moving out of hospitals. It's moving into homes. And it didn't just start with the pandemic. It was started before that, but the pandemic has accelerated. It Well, what's happening is now caregivers, family caregivers are being saddled with taking care of senior loved ones or children with chronic diseases, like I didn't go to medical school, I don't know what to do. And the worst part, or the most difficult part, is that many of them are still working. That's why they're called sandwich generation. They feel overwhelmed, stressed out. They feel like the traditional healthcare system is not supporting them, and it isn't, because that's not what it's for, focused on, and they don't have anything else. It's about 180 million people in 2022 in that caregiver cliff. So it's a huge population unsupported. We think it's an absolute huge opportunity for those who are willing to get in there, and that's what we're focused on. And we're building a solution that we that we believe will help this population not only learn what they need to do, but help them do it wherever they are, to manage, to improve, to maximize their help and and do it at a fraction of the cost, using technology, using AI, using IoT or an Internet of Things, to get things done in a way we've never done it before. And when you do this. You know, it's already happening. You're actually changing the definitions of what's healthcare, right? You know, one example I give is Apple a consumer electronics company, or are they a healthcare company? It's kind of hard to answer that today, right? Because they have a watch that will give you an FDA approved EKG, very similar to the ones I used to do in the hospital. So so this we the future health system is not going to be a health system where you go to some building to get it, you might do some of that, but it's also going to be in the homes and in the communities, and, quite frankly, wherever the patient is. So we need an ecosystem or a broader system that can move with that wherever the patient is. That's what we're trying to build to focus first on this caregiver Cliff problem.
Shahid Shah 27:50 That's fantastic advice, and I'm glad that you're out here working that problem, because you guys definitely have the personnel that can make it happen. So this is excellent. Thanks a lot, Chris for being here with us. We hope you'll come back and tell us more in the future. Absolutely.
Chris Gibbons 28:03 Thanks so much for having
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