Elliot Moss
Welcome to the Jazz Shapers podcast from Mishcon de Reya. What you are about to hear was originally broadcast on Jazz FM however music has been cut or shortened due to rights issues.
Good morning, I am Elliot Moss and this is Jazz Shapers. It is where the Shapers of Business join the Shapers of Jazz, Soul and Blues. My guest today is Lydia Yarlott, Co-founder of Forward Health, one of the UK’s most exciting health-tech start-ups. Wanting to be a doctor from aged eleven, Lydia never saw herself in Health tech “I just didn’t believe things inside hospitals could be changed”, she said and certainly not by a junior doctor. The idea for Forward Health, an app that offers a secure communications platform for medical staff at work came to Lydia as she was frustrated by how much time she was wasting trying to navigate switchboards or respond to her pager. She was also shocked that medical staff were communicating via WhatsApp, putting patient data at risk. With her husband, Philip Mundy, a serial entrepreneur and friend, Dr Barney Gilbert, the trio founded Forward now used in over two hundred NHS Hospitals and savings doctors and nurses over thirty minutes each day. That of course frees up thousands of hours that are going back into patient care. We will be talking to Lydia in just a few minutes about embracing technology and listening to front-line staff. Also in Jazz Shapers today we have brilliant music from The RH Factor, Art Pepper and Rodney Franklin. Before all of that though, here is Jazz Shaper classic, Stan Getz with João Gilberto and Corcovado.
That was Stan Getz with João Gilberto and Corcovado and lovely it was too. As I said earlier, my Business Shaper today is Dr Lydia Yarlott; she is with me here in session until 10.00am and we are going to be talking about her wonderful business which she Co-founded called Forward Health. Hello.
Lydia Yarlott
Hello.
Elliot Moss
How are you?
Lydia Yarlott
Very good thank you, how are you?
Elliot Moss
I am good thank you. Quickly to say obviously you are a doctor but you are a part-time doctor which means you are allowed to be here because you are not doctoring at the moment evidently?
Lydia Yarlott
I am allowed to be here. I feel like it is very important that I am. There aren’t many doctors who work part-time on a business. I think it’s a beautiful combination actually. Medicine has many frustrations and it is one of the reasons why many of my peers have sadly left the profession but I think having an outlet for that, feeling like you are actually doing something to change things is amazingly galvanising for my clinical job as a doctor.
Elliot Moss
I mean what strikes me is obviously that, that medicine like other professions is one that most people are called into as it were and I know, and I said it earlier, you from a very young age wanted to be a doctor. First question, where did that calling come from do you think? Why? Why did you want to be a Doc?
Lydia Yarlott
That’s the really interesting question and I think it is one that scares everybody when they go for their Medical School interviews because honestly most people don’t have a good answer to that. It is a very instinctive thing being interested in the body, being fascinated by perhaps slightly morbid things like disease, ill-health, death. I remember reading a rather gruesome book when I was about six called Dr Dog, about this terrible family, they are called the Gumbo family and they’ve all got worms or head lice etcetera, finding it very exciting and it really was from there that my fascination with medicine grew. I feel very lucky to have that vocation. I think it’s a great advantage in life to know where you are headed and I just feel very privileged that despite the system providing a lot of difficulties for doctors, a lot of frustrations, I have a way of dealing with that myself and doing what I’ve always wanted to do.
Elliot Moss
Now the other thing of course is if you are a doctor or if you are any professional, it is quite hard to think outside of delivering that thing that you do. Most doctors as you started by saying, don’t do other things, most doctors are not part-time and they are good at medicinal things, they are good at looking after people hopefully and their bedside manner is I suppose, variable but they are at least expert in – we’ve all had different experiences of doctors over the years, we know they know their stuff but don’t always necessarily know how to deal with the human – but there you go, that’s the same for any profession. But for you, the entrepreneurial bit, it sounds to me like you saw a problem and you couldn’t believe no-one else had tried to fix it rather than you being kind of an out-and-out entrepreneur going ‘I know what I am going to do’. Is that fair?
Lydia Yarlott
Yes. I never expected to be doing this. I never expected to be doing something like talking to you today. But I am the sort of person that can’t ignore issues in front of my nose and the idea of not being able to get in contact with someone when you really need them, when there is an urgent clinical situation, someone is deteriorating in front of you and all you have is this bleep, a pager system, to get that help that you need is just mad. So I couldn’t ignore that and I was lucky enough to meet Philip and Barney who, we’ve executed this together and without them it would never have happened.
Elliot Moss
Tell me about, so this identification of the problem, tell me about what it took for someone who is at that point I imagine, in full-time medicine to then go ‘I want to set this thing up’ and ‘I’ve never done that before’ and now I need to know what the first, the second and third things are let alone the fifty eighth and the four thousandth. Where did you begin?
Lydia Yarlott
I think firstly with the conviction that this was a real problem so we talked to as many doctors and healthcare professionals as we can and this is, just to be clear, this is a problem for everybody in healthcare, it’s not just a problem for doctors and clinicians and we tried to work out, you know, what the extent and magnitude of that problem was and we found that it was pretty much everywhere. Everybody was resorting to using work around other instant messages, getting people’s phone numbers so they could call them on their private phones but essentially very inefficient means of communication. So we at that point understood that it wasn’t just my problem, that I was coming home to Philip with but Philip is an amazing person because he believes that something can go from a nought to a one and knows how to get it from a nought to a one. So we got Barney on board fairly quickly, we essentially tried to find out as much as we could about what was out there in the market at the moment and it turned out almost nothing and so we built something that we felt would really help us at work and we tested it in my hospital, we tested it with friends and colleagues and I think from that point onwards we couldn’t really stop because it was so clear that everybody wanted this. I think we almost felt like we had this obligation to continue and Philip and I always talk about Forward like as if we had a child, as actually a business is a responsibility just like having children is and I think we really felt that right from the beginning, that perhaps we were the people that could solve communication in healthcare and we had a duty to play that out to see if that was true.
Elliot Moss
And in terms of the actual product, how did you go about thinking - ‘well it’s going to look like this’, ‘it’s going to feel like that’, ‘this is the functionality’ - I mean you are not a techy though you are a consumer as are we all and we all know whether we like WhatsApp or whether we like instant Messenger or whether we like email or Slack or whatever it might be. Was that bit actually not that complicated? Or were there specific things that within the medical environment you just had to have in place?
Lydia Yarlott
I think the answer to that question is that it’s an ongoing process, right? You’ve never finished iterating your product. We are doing that constantly. But in those early stages it was about just keeping it as simple as we could and that’s the thing, we are really starting from scratch with communication. So people need to find each other, they need to be able to look each other up by job role, they need to know which hospital you are in and they need to be able to share information about the patients’ securely so that was it. It was an instant messenger with kind of a map of who you might need in that hospital and how to get in contact with them via instant messaging or via calling them and then ways of sharing information about a patient over that platform. It is a very simple concept and I think if you aren’t aware of what the situation is like currently, it might seem like, why would this ever take off? Why would we need it? It is because the current situation is so dysfunctional.
Elliot Moss
I do remember just as a quick anecdote when my wife had our child about six years ago there was a moment when we realised that the labour had moved along a little bit quicker than we thought and the nurse couldn’t locate the doctor.
Lydia Yarlott
Yeah.
Elliot Moss
There was that moment. It has now come flooding back to me and I was like ‘do you want me to go and find him?’, it literally got to that point and then she tootled off and he turned up but yes, I can see that we are in a pretty basic level or we were then and I suppose anything on top of that sounds like it would actually transform people’s lives.
Lydia Yarlott
And was your wife okay?
Elliot Moss
She’s fine.
Lydia Yarlott
Good.
Elliot Moss
And little Iris is six years old and is none the wiser. Stay with me for more from my guest, Dr Lydia Yarlott, she’ll be back in a couple of minutes here on Jazz Shapers. But first we are going to hear from of our partners at Mishcon de Reya and they’ve got some advice for your business.
There are many ways for you to enjoy all our former Jazz Shapers and indeed to hear this programme with the Doc again – I’m going to stop doing this I promise shortly - you can ask Alexa to play Jazz Shapers and there you can hear many of the recent programmes or if you pop Jazz Shapers into iTunes or Spotify or Deeza or whatever platform you like to use, you can enjoy the full archive but back to today’s guest, it’s Lydia Yarlott, the Doc, Co-founder of Forward Health; an app which helps medics easily and quickly contact each other – I said medics and you said before, this is not just between doctors, this is anyone in that profession and of course the reality is that hospitals are big, very big generally here in the UK, we are incredibly lucky to have a phenomenal NHS but obviously, as you alluded to, things have to change, transformation in medical equipment, transformation in technology that we use has yet to hit the most obvious place which is how we connect with each other?
Lydia Yarlott
Exactly. I mean I am imbedded in the NHS and I love it as an organisation. I feel it is an amazing privilege to treat anybody who walks in through the door, free at the point of care. That is so rare in the world and other systems actually really look up to our healthcare system but we would be astonished if we were still using the same medications, the same medical equipment as we used in the 1960’s but we are still using the same equipment to communicate, the pager, the landline, the bleep. It is extraordinary.
Elliot Moss
Now the business, and I am going to talk about it as a business, I know we are dealing with healthcare but in reality you are running a business now. The CEO roles as it were are done by I think, Philip and Barney and there is a team of people and you are funded to the tune of around I think, three million pounds or so. You were on the GovStart 2018 programme, I had Daniel Lanex the Founder of Public which was the creators of GovStart. You’ve done really well, people are noticing this and it’s a big, it’s a big area for Government and a big focus for them in terms of changing the way that, that medical services are delivered. What’s it like being part of a business as well as being a practising Paediatrician?
Lydia Yarlott
Exciting because on the shop floor technology has not reached me so I am still writing on paper, I am still logging into eight different, very clunky IT systems to do my clinical job but there is this eco system emerging of Health Tech which is so exciting. The things we could do with AI if we actually collected data in a sensible way, the things we could do with wearables are incredible but my belief is we won’t get there until we have the infrastructure right. The exciting thing as you alluded to, is that people are getting invested literally and metaphorically in Health Technology now so people will fund businesses like ours because they believe that we are solving an important problem and that that’s going to be valuable in the future and I think as a doctor that gives me so much, that’s so heart-warming for me because I know that the organisation is going to have to change to survive and I want to be part of that, I want to be on the crest of that wave, shaping it in the best interests of the patients that I look after genuinely.
Elliot Moss
And how many people are involved in the business now?
Lydia Yarlott
Yeah so we have fifteen in our office in London which is really exciting. We have a community team who look after our users, make sure that we are doing what they want with the product. We have a product team and we have an engineering team.
Elliot Moss
Wow, it’s all happening. And in terms of turning a profit, I am assuming that’s not happening just yet? How actually do you charge for this? How does it work? Do you charge the Local NHS Trust as it were?
Lydia Yarlott
So we don’t because we believe that healthcare professionals should have the tools that they need to do the job. So we operate a premium model, if Trusts or Hospitals want extra services that we offer then they can pay for those but the truth is, that we are not revenue generating at the moment and we are focussing entirely on learning from our users, on growing our network, on really embedding ourselves in healthcare within the UK and moving up from there. And that’s what’s exciting our investors at the same time.
Elliot Moss
They want to learn and they are going to have lots of data to do it and then hopefully one day you will work out the financials and we’ll come back to that in a moment. Stay with me for much more, I am with Lydia Yarlott and we are talking about healthcare and Forward Health specifically. Time for some more music right now, it’s Art Pepper with Mambo Koyama.
That was Art Pepper with Mambo Koyama. Dr Lydia Yarlott is my Business Shaper and we have been talking about how the transformation in the provision of medical services has to be important, is important because as you quite rightly said, you can’t expect if medications changed since the 60’s and if the equipment has changed since the 60’s then surely the way that people communicate in huge organisations like the NHS it is critical. We talked a little bit about your, your team. How involved are you in the management. Obviously you are not the Co-CEO’s and all that stuff but do you have some day-to-day involvement with the direction the team is taking and if so, how does that work when you’ve got Philip and Barney in the picture as well?
Lydia Yarlott
Yeah so it is a communication challenge.
Elliot Moss
I bet it is.
Lydia Yarlott
But one of our goals for the beginning of this year was actually to, to make communication within our organisation our main priority and I think if we are propagating that elsewhere we have to start from within and that applies to everything. So I try and keep the company very clinically focussed, very focussed on the problem and my role is really to advocate the patient and the healthcare professional within Forward Health. I’ve alluded to the fact that I believe that grass roots innovation by the people who actually understand the problem is the way for healthcare to really improve and I’d like to see more doctors and nurses and other healthcare professionals starting companies and solving problems and that’s beginning to happen actually which is really exciting.
Elliot Moss
And in terms of the, the profession itself which is you know, a rule bound profession, a process bound profession because it needs to be because we want our doctors to follow procedures and check-lists and things. We don’t want you know, scissors left in the wrong place, we don’t want the wrong bits chopped up and so on and so forth. How have they been with you? How have your management been with you, your line managers and the various powers that be, with this notion that you are there making change for the better and still holding down a job as a Paediatrician? Have they been encouraging? Is it patchy? Does it depend on the human being?
Lydia Yarlott
Well I work in a speciality that is very forward thinking so Paediatrics really looks towards the future and Great Ormond Street are doing some really interesting things with innovation, pushing technology in a way that it hasn’t been pushed before so I am lucky in that respect. As I said, there is a changing landscape in terms of how the NHS thinks about bringing in technology, bringing in small businesses to work with, working with start-ups. You know, when we started it was almost discouraged for a large organisation to work with a tiny organisation like ours, you know, they had no guarantee that we would exist in a few months’ time. But now there are incentives for hospitals to learn from the best, to bring in businesses to work with and to test whether they are effective or not and that’s really exciting.
Elliot Moss
Stay with me for my final chat with Lydia Yarlott, plus we will be playing a track from Rodney Franklin, that’s all coming up in just a moment here on Jazz FM.
That was Rodney Franklin with The Groove and you can’t not but like that and you kind of know where it’s going to go and it goes to a really good place, doesn’t it Lydia?
Lydia Yarlott
It does.
Elliot Moss
Lydia is with me for a little bit longer, we’ve been talking about transformation in the world of healthcare and the like and you have, as you’ve said yourself, you’ve managed to carry on practising, you want grass roots feedback into a product because otherwise you’ve got other people kind of coming in to this world without any sense of what it’s really like and what you need. It strikes me that when you’ve got this cracked and that may take a few more iterations and a few more years and financial, I mentioned the financial thing and in a way the finances I hope will work themselves out, there will be a way of doing this where it will be paid for and so on and so forth. There are going to be other things that you want to focus on and fix, I don’t believe this is going to be your only thing, not because you’re, you are a classic entrepreneur but because you are a problem solver and you love the medicine and the world of hospitals and patients. Am I right?
Lydia Yarlott
You are right but I love to do that in a…
Elliot Moss
I never hear that by the way, I never get ‘you are right’, we’ll stop there.
Lydia Yarlott
…no you’re right.
Elliot Moss
I already… I knew I liked you.
Lydia Yarlott
But I think I enjoy doing that in partnership with other people who really share that belief. If I were to do something different beyond this, it would have to be with the right partner and as I say, I am so grateful to have Philip and Barney for pushing this in ways that I am not capable of pushing it.
Elliot Moss
When you, when you did start doing this with Philip, were you already married or have you been married subsequently?
Lydia Yarlott
No, that’s sort of part of the love story really. We were dating. We’d only been dating for a few months and I just loved this attitude that I didn’t have to grit my teeth and bear this problem that we could do something about. It was very frustrating in some ways, you know you don’t necessarily want everything that you are complaining about to have a solution from your partner, that’s one of the real bug bears isn’t it? But…
Elliot Moss
As in you don’t want, sometimes you just want to tell them what the problem is.
Lydia Yarlott
…sometimes you just…
Elliot Moss
You don’t want an answer, yeah, yeah…
Lydia Yarlott
…want some sympathy.
Elliot Moss
…you just like ‘oh I understand’. I know it’s much easier, ‘no, no I don’t really want to talk about it’. Yeah.
Lydia Yarlott
Yeah and the honest truth is at the beginning I didn’t believe him when he said “I think we can do something about this” because I knew what the blockers would be in the NHS. I mean, it’s hard to convey what a novel concept it is to put patient data on your own device so that is utterly secure and nothing is ever stored there, it’s all in NHS approved cloud servers but it is still the concept that you are bringing your phone to work and you are using it for that purpose and to a lot of people when we started out that just seemed ridiculous.
Elliot Moss
But did they understand? Was it a highly intense period of education, so ‘no, no you can see it but it’s sitting over here and it’s safe and this is encrypted and this is compliant’ and so on and so forth. Was it literally just taking people through the steps? Because I imagine there is no other way of doing it?
Lydia Yarlott
Yes to some extent but I think…
Elliot Moss
What was the clincher though in terms of education because the point behind this is actually a big and serious one.
Lydia Yarlott
Mmmm it is.
Elliot Moss
Resistance in any conventional organisation whether its three people big or three hundred thousand people big, it’s typical, part 1 and part 2 is, how do you then educate people around something which really breaks boundaries? So what was the killer app as it were from your point of view to help educate people who were intrinsically resistant?
Lydia Yarlott
This is a really interesting question. There are many answers to this but I guess I would start with the fact that clinicians were already using WhatsApp so that isn’t safe, it’s not secure, there’s a real kind of misperception about whether it can or cannot be used for patient data in the NHS. The Guidelines are very fuzzy but it did present this immediate problem that that’s what clinicians were doing and therefore that really needed to be solved and I think in a way that went some way to educating their market that something was needed to replace that so WhatsApp helped, helped us start trying to change how people communicate.
Elliot Moss
So there was a kind of, there was a reference point with WhatsApp and that helped get over the barrier of ‘well we think this could work but it doesn’t so here’s something else that does’. Was there anything else you needed to do to clinch the deal so that if I was you and you were, you know, I’m talking to a doctor who is not going to buy me, was there something that you worked out that if you said or if you showed them and if you comforted them on their worry, then you could get over the hump? Was the main thing about privacy?
Lydia Yarlott
It’s different for everyone, so whether you are going to a hospital manager or a doctor or a nurse, they would have a different question before they decided to download and use Forward and that’s one of our major challenges but I suppose the underlying principle is trust. People in my clinical practice tell me their darkest secrets, their worst fears. Patient data is, is the most enormously serious topic and I think as an organisation its key, it’s crucial that we imbed trust in what we do so that involves working very closely with NHS organisations so that they are confident that what we are doing is correct. It involves working closely with patients so they understand the need for doctors to communicate amongst themselves and talk about them to get the information that different clinicians need for that purpose. It is more and more complex, you used to go into hospital and you would be treated by like one doctor in a Ward and now there might be ten doctors in a team and then there’s another team looking after you as well, could be a specialist, there’s nurses, there’s physio’s, there’s occupational therapists and then obviously it’s about approaching doctors and asking them what they are doing at the moment to communicate, you know re-educating them about how and when they should be using which technology because we are somewhat under educated as a profession in that respect.
Elliot Moss
So it sounds like it’s a combination of things but it also sounds like to me that if that’s the code then the answer to my question is yes you will be, you will be doing other things hopefully in the future and when you have obviously got this under control and it is growing fast and there will be other things looking forward into the, into the other areas that might need approaching and fixing.
Lydia Yarlott
Yes.
Elliot Moss
I am setting you up, go and fix the rest. But listen…
Lydia Yarlott
Well that’s very generous of you.
Elliot Moss
I feel like you can and we are, I am going to watch you, Lydia as you go forward you know, whether it’s with Philip and Barney, whether it’s with another group of people as well. We are going to have to wrap things up, it’s been fascinating talking to you, thank you.
Lydia Yarlott
Thank you so much.
Elliot Moss
And really, really good luck because there’s a social purpose in there as well as a business one but it is about applying great business principles isn’t it, into an environment which hasn’t probably seen before at least in this area. Just before I let you go though, what’s your song choice and why have you chosen it?
Lydia Yarlott
I chose Soweto Blues. It’s a song about a struggle really, it’s quite hard hitting. I really love African music, I’ve spent some time doing a small amount of medicine in Africa and that’s when I discovered this song.
Elliot Moss
And it is with Miriam Makeba, Hugh Masekela and Stanley Kwesi Todd.
That was Soweto Blues with Miriam Makeba, Hugh Masekela and Stanley Kwesi Todd, the song choice of my Business Shaper, Dr Lydia Yarlott. She was at heart a problem solver, someone who was identifying issues and wanting to fix them, someone who understood the power of transformation and how important it would be to an organisation and is important to an organisation like the NHS and really interesting though I thought, someone who was clear about the level of the task of getting over those barriers to finding out how people would actually buy in to the new way of communicating that she is advocating within the NHS and I am sure this isn’t the last we will hear of Dr Lydia Yarlott in terms of fixing other problems in the NHS. That’s it from me and Jazz Shapers, have a lovely weekend.
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