Dan:
Paul, welcome to the show.

Paul:
Thanks so much for having me.

Dan:
All right, Paul, so we could probably tell your story in hours and hours, because it's fascinating, but we only got 30 minutes today, so we got a lot to cover. But I would love for you to just give a high level overview of your story and where you're at right now.

Paul:
Sure. So, I started my career Goldman Sachs. Like you mentioned, I was a derivatives trader on wall street, and suffered a stroke as a result of hypertrophic cardiomyopathy, which is heart disease. It makes the ventricles of the heart too thick, and so that caused a stroke. And I had to relearn how to walk and talk and a lot of my long term memories, but for some reason, the math part and the computer part was working fine. And so, I was able to successfully have that job on Wall Street for a few years. And then as my brain came back, I wanted to figure out just how smart it was, and also give purpose to what I went through, and most importantly help other people. And so, I went back to a lot of school in a condensed period of time, and got a few master's degrees, and then a doctorate in nursing.

Paul:
And went on into the workforce and became a nurse practitioner, palliative and end of life care NP. And then ended up fusing all of those skills into a role at New York Presbyterian, where I helped lead analytics, and then moved into a clinical operations role at Hospital for Special Surgery, ultimately becoming a vice president there, responsible for many departments. And along the way started a company called [Inspiren 00:01:19], which is a nurse-led healthcare technology company, which can talk a little bit more about. Invented a device, and it goes on the wall and does some neat things in healthcare. And got married, have a two year old son, and that's my life.

Dan:
Oh, my God. Well, on fast forward, you skipped all the commercials and went right to the live view. And if you haven't followed Paul, I mean, his story is awesome and he's done a lot of podcasts, a lot of speaking and talk about it, and it just, it's awesome. I mean, you and I think alike. I think that we have some awesome disrupt the industry kind of things. I want to dig in a little bit to your startup, Inspiren, and want to know, what was the problem that you experienced that you felt you were solving, and how did you choose this track to dive into with your tech?

Paul:
Yeah. So, another nurse, Michael Wang, the founder and CEO of Inspiren, we were Columbia classmates at Columbia Nursing School, second degree bachelor's program for both of us. And we both were becoming nurses. His first career was in the military, and we bonded in that program and became great friends. And after we were done, he went to the bedside at New York Presbyterian Hospital, and I went to work in analytics. And we quickly discovered, remaining friends working in the same large institution, that typically those two departments don't speak to each other at the level of bedside nurse and person leading analytics. And we can talk about this, I think that's a problem. And I think if more solutions, if that conversation happened more often in organizations, I think great innovation would come. But in our hospital, we frustrated and wanted to help the hospital solve that problem, but didn't really have a medium to do it, because hospitals aren't structured that way, that bedside nurses have allocated time to just hang out with the analytics team.

Paul:
And so, we did it on our own time, and we just discovered that everything that I was inventing and creating, and the analytics team and all the dashboards and things that I were making really didn't have direct, applicable benefit to him as a bedside nurse. And he was frustrated as a bedside nurse because his managers and his leaders were saying, "We need to stop falls. We need to stop pressure ulcers, and look at the data. Look at the data," and then not giving him a tool to really improve it. His analogy that he always uses is like a coach at halftime saying, "I know the way to win, guys. You just need to score more points." And so, we wanted to create a tool that would solve all those problems, and that's what we did.

Paul:
We partnered with some scientists from NASA and MIT, and raised funds, and went out and started a business on our own to create a device that would do that. And not only be a data generator, an aggregator, but one that would give real time feedback to nurses on the front lines, to help them be a force multiplier for them to do their jobs better.

Dan:
That's great. And I was in some conversations recently with some CIOs and things, and that problem, it seems like such an easy fix. Bring the user in, make the data and the insights relevant to their practice and their workflows, but it seems to be missed at almost every single organization there is. Why do you think that is?

Paul:
I think the skill sets, I mean, this might be the whole half hour, but I think the skill sets are vastly different, or we perceive them to be vastly different. I think that's perhaps a wrong perception often, but I think that if you look at other industries that aren't healthcare, and you look at those companies and whether they're an analytic company, or like an Amazon sells books, and then they become what they become, they're the same type of person throughout the company, whereas healthcare is great because we have all these diverse backgrounds. We have people in IT that know that. We have people in clinical practice who are brilliant clinicians. And then we have people in business. And then we have the whole complexity of the payer mix and all this. Add all that complexity, and I think it's just difficult to innovate in healthcare, but I still think you just put them in the room, and I mean, we proved that with Inspiren.

Paul:
We all got in the room. We went every night. we had a couple scientists. We had a couple data people. We had us as clinicians. We had some people like me that can bridge a little bit of both, and we created an award-winning product. So, it's not that it can't be done, I just think it requires a lot of dedicated time and focus. And there's not really a business model in healthcare that exists like that, or a staffing plan that allows that for an institution.

Dan:
Yeah. There's not a lot of flexibility and design thinking that's infused into legacy healthcare organizations, and it's just starting to come together. So, tell me about the product. Tell me about Inspiren and what the product actually does, and how it's adding value to the organization.

Paul:
Sure. So it's a hybrid sensing device. We use computer vision and Bluetooth low energy to basically fuse input from visual sensors, audio sensors, sound sensors, temperature sensors. But the main two components are computer vision and Bluetooth low energy that are being used, and it's really disrupting the RTLS market, or the realtime location service market, to track assets and people through space. And then the computer vision is disrupting the falls prevention market and pressure also prevention market, where we're able to detect people getting out of bed. But the fusion of those things, to say that this is Dr. Nurse Dan coming into the room, to use computer vision to do that, and then to use a BLE beacon to identify you and fuse those two data points together, is really what's driving a lot of it.

Paul:
And then we take those metrics. We aggregate them. We say how long nurses are spending with patients, which nurses are the most demanding of a nurse time from the shift before. And then we allocate staffing accordingly, so that a nurse doesn't get stuck with the five patients that take up the most time. The EHR only tells you so much. This tells you a lot more. And then we move into automated charting, where if a patient does need to be turned and positioned, the computer vision says, "Hey, it's been two hours since this patient hasn't been turned," without you needing to remember. It just says, "Hey, we don't see this skeleton really in the bed," which is how our pose estimation works. "We don't see it moving, so alert the nurse. Go turn the patient."

Paul:
So, those, using nudge theory, gamification, and really creating a team environment on the floor for things like hourly rounding. How long has it been since each bed's been seen? If it's more than an hour, then anyone, the manager, the CNO, it's creating a team where anyone can go make sure that that patient has been seen in less than an hour. And that entire product, none of that requires the nurse to do one extra thing.

Paul:
And I think that's where a lot of innovation stalls, because someone will come up with an idea, and it sounds good from a data perspective, but it still requires the nurse to manually fuel the data engine. And it'd be like, "Oh, it'd be really great if we had all this data. Oh, okay, let's collect it." Well, who collects it? Well, the nurse does. And then that's terrible, because it takes the nurse away from the patient. This product really, revolutionary, in the way that the tech's fused. I didn't invent a lot of that, so I don't deserve any credit for all those awards. Our tech team's phenomenal. But also revolutionary in the application of the technology, such that everything we made does not require the nurse to assign themselves. It doesn't require the nurse to do one extra thing. It just goes on the wall and helps you.

Dan:
I think you hit on a few key points there. One, it doesn't require additional workflow to work. And two, it enables the team to get alerts, not just the single person that's assigned to that room, and overload them. And those are the two breaking points, I noticed. I think the third piece is, the BLE is an awesome technology, which allows for 99% accuracy of the location, where the old RTLS systems, you had to have 15 different receivers in that room to get 89% accuracy. And for those that don't know, you think 90 and eight, 89 to 99 are aren't that far off, but if you're walking in a room and the thing thinks you're next door and it starts automating charting and stuff, there's a problem, so you have to have those accurate pieces so that you can make all these workflows work seamlessly.

Paul:
Absolutely.

Dan:
You've done a lot, a lot, a lot. And so, I'm sure you've had to go through times of burnout, and frustration, and all that stuff. How do you manage being a highly successful executive, as well as a business owner, and all the schooling and stuff? How did you manage all that and avoid burnout?

Paul:
Yeah. So, I think, I alluded to a little bit at the beginning. When I had a stroke, that academic period was a quest to just overcome a stroke, and that was a great driver. I don't know if it leads to the most fulfilling life, and so I'm using it as a contrast. Because in that period of my life, when I was getting all those degrees and overcoming as stroke, it was just a singular goal of, I'm going to overcome this stroke and it doesn't matter what else. I'm going to do it. And for whatever reason, I was able to do that. But during that time, I look back on it, I don't think I was a fulfilled human being, because it was a singular focus, and with a singular focus, I don't think people can be that fulfilled, is because life's not singular.

Paul:
And so, it set me up for great success, but I wouldn't wish those years on people. It was a quest, and in a quest, you miss a lot of the things that are in the periphery of your single vision. So, burnout there wasn't really an option because it's just, let's overcome and get through it. And I think that was just a long, extended period of my life that was like that. We all have days like that. I still have days like that. But when it's done for a long period of time, I think even when successful, it's probably not optimal. And then when I moved through that period and became more well-rounded, and I met my wife and started to have fun, and get married and fall in love, and have more things happen to me that are fulfilling things, like now being a father, it's a different challenge, because sometimes when there's multiple inputs and multiple things to do, almost sometimes that's more challenging than overcoming a stroke.

Paul:
Because people always say, "Oh, I can't believe you overcame a stroke and did all those things with the degrees." In some ways that's easier because it's a singular focus, and it's just one thing. Whereas if you have many things to do, even though you have a full brain and you're not overcoming a stroke, it's harder. So, it's just a different way of looking at burnout. And I think burnout can come in many ways, and I think it can come in those two ways. It can come from this endless tireless quest of feeling like you just need to keep going and not seeing an end in sight, like I had in my twenties. And then it can come from just burnout in terms of not knowing where to go or what the right thing to do is, because you have so many options and you have so much things that you want to do and feel like you can't do them all.

Paul:
So, that's a form of burnout too. I err more towards the second one now because I have my brain back, so I can do multiple things. But I think in terms of what helps me, I think trying to find ways that I'm not alone helps me. Personally, I like to talk to other people and like you, and [inaudible 00:11:14] podcast and meet other people that are going through the same things that I'm going through. That helps me feel not alone and then get through it. And then also remembering a difference that I'm making as a nurse, or someone who's creating products to try and save people's lives, or helping another nurse in terms of a form of mentorship, all of that adds great value to the world in ways that I probably don't even know the full impact of.

Paul:
And I always think about that. I watch It's a Wonderful Life a lot and think, "I would like to do this." Maybe my life mattered to some people that I don't know. Thinking that way opens up an infinite possibility of positive things, that perhaps you're not even fully realizing the extent of it, as opposed to the feeling of helplessness and not in control that leads to burnout. So, I think one, recognizing that you're in control, or I'm in control and that I have choices to make. And that each day I choose to do this, whatever it is that's difficult, I'm still choosing to do it, as opposed to it being forced upon me.

Paul:
And then two, recognizing the great impact that it would have, or potentially have. Even if I can't see it, I think of that movie and I'm like, "Well, maybe it's happening and I just don't see it today," and then that helps too. So, those are the two things, but it really comes from control and impact for me are the two things. And I know what it's like to not have control and have a stroke. That's the ultimate loss of control, but those are the two things for me that help with burnout.

Dan:
Yeah. You mentioned a couple things that I thought were interesting. One, you mentioned school sometimes, while it's definitely challenging, the steps are in front of you and you know what you have to do to complete them, in most programs. And you step your way through it, and it's not that it's not challenging. It's just, you know the path. And something that was interesting you said too, is around the stroke piece, recovering from the stroke. In some ways, there's also a pathway you have to take. You have to do some of the rehab, and you have places that you need to get to, and you know where you're headed. And then you enter into healthcare leadership and entrepreneurship, and you're like, "Well, I don't know what steps. There's no steps. There's no pathway. What are we doing here? I just have to make it up."

Dan:
And you have to let go of the steps as your control, and more of the, you have control over the choices and the information you use to make those choices, and that's where your steps are. And if you let all that go into chaos and look for those steps, then of course, you're going to be frustrated all the time, because they're not there. You're looking for something that doesn't exist, and so you have to reframe into this bigger picture of impact and outcomes, and really focusing on how do I adapt, rather than how do I solve or come up with a solution. So, I think those are great, and I often find nurses, they get stuck in the mundane routine of nursing, which can be repetitive over time, and they start to burn out, and they don't zoom out, and they don't take time for themselves.

Dan:
And they get excited about working six and seven shifts in a row, rather than taking time into those other things like family, or vacations, or whatever other stuff they can put their energy into. Instead, they're so hyper focused on the one work thing, and that definitely is going to lead to frustration over time, I think.

Paul:
Absolutely.

Dan:
So, you did mention a little bit the idea of that leadership or nursing is a lonely profession in many ways, and sometimes it's thankless. If we just focus on the interactions we have every day, it's very much thankless. And you send these people on their way and never hear for them again, and sometimes don't get thank yous and all that stuff. So, as a people manager and an executive, how do you make sure that you foster that sense of community within your team, so they don't have that sense of loneliness?

Paul:
One, people need to know that they're cared for by each other and the manager. So, Inspire n's product, like I said, we try to foster a team environment through changing the workflow, so that it's not an isolated workflow of, "Hey, these are your three patients and good luck," and maybe see each other for lunch, but more of really trying to foster a team environment on the floor. If there's not a solution like that, I think people can do that on their own, but it requires the individual to proactively create that outreach. I don't think it's naturally inherent in a lot of organizations, or on the floor, or even in the nurse single profession, or the inpatient setting. You have your patients and then you take care of them, and you maybe help somebody else if they need to move a patient together, or there's helping out your teamwork, but it is you and these are your patients today, and you do your job, and then you chart on them alone.

Paul:
So, there's some loneliness. And then there's also loneliness, I think, in terms of the more meaningful something is, or the more profound a situation that you go through in your life, the less people know about it, just by nature of it being that profound and special. And I think with the nursing profession, you witness people at their best and in their worst. And even though some of the day is thankless, there are those moments where you do have things to share in terms of sadness that you witnessed, or great happiness and joy that you witnessed, but a lot of the world doesn't know how that feels. So, you're lonely while you're doing it, and then you have no one to tell afterwards, and you're lonely afterwards. We don't devote enough time to recognizing that. There's well known things that people can do in organizations.

Paul:
We have a program at our organization, where it's a peer support program, where a stressful event happens and there's a number that people can call. And we try to do these timeouts after the stressful event and debrief. And there's things to do and ways to combat this, which are well documented. I just, they're not done as consistently, and I don't think they get the focus and effort that people deserve. It's not rocket science to pause for five seconds after something sad happens and ask each other how you're doing, or in the morning when you get your patients, ask somebody else how their night was. And as a manager, to take at least once a month, I would hope, and ask your direct reports about them, and know about their families, and care about them as human beings.

Paul:
This is not an invention. These are common sense things. I just don't think there's an intention or a focus on them. It's just harder in healthcare. Even on Wall Street, to be honest, when I was there, we all sat next to each other seven days. We were there all hours of the day and night, and perhaps it wasn't the most fun all the time, but we all knew each other, because we were all there working side-by-side. That's not nursing. There's people that are on your shift that you might not even see for months because they have different shifts or they have, they're on the night shift, you're on the day shift, or what have you. And I think it's just tough to foster a sense of community, truly foster a sense of true community. That's just within the nursing. And then if you extrapolate that to the broader hospital and other issues that you see facing with just different types of people that work there and how they all can work together, I think it compounds. But even just within nursing, I think, yeah, sometimes it's lonely.

Dan:
All those things you mentioned, in many places, they're extra. So, it's like, "Hey, get through your shift, then you can grieve," or "Get through your shift, then you can celebrate." It's never part of the shift. It's like, it's not part of the work. And so, you're forced to compartmentalize. And then I found this as an ER nurse was, I'd come home, and my wife's not going to understand what happened today. I can't talk about the trauma that was really nasty. And you go to dinner parties and friends are like, "Well, what's the worst thing you've ever seen," and you tell them sort of, and then they get grossed out and never want to talk to you about it again. You've got to find this community.

Dan:
And one of the things we did with Trusted Health was when New York was in the pandemic, we created a hotline that was staffed by mental health nurse practitioners, that nurses could call when they were feeling stressed, and that stuff. And we found that nurses didn't want to call it. They just wouldn't pick up the phone to even make that first step, even though it was a peer-to-peer thing. I think we have this coat of armor on that shuts out people. It's definitely a club. And I think healthcare in general is this special club, but we got to let down that armor sometimes, or it's not good for our mental health. We're starting to see that impact a lot now.

Paul:
Completely agree. I think what we just talked about is what helps burnout out the most. It's what helps people feel fulfilled the most, and then helps them to do their job better, and want to stay in the professional. We then try to say, "Okay, after your shift, here's the meditation room," but you're all alone in there meditating. I think it's great. I'm not, nothing against meditation rooms, but I don't know if that gets to the problem that we just spoke about. And I think we can have the meditation room and do what we just talked about.

Dan:
Yeah. I had a physician friend that, the docs were burning out from the workload and they were understaffed and stuff. I was like, "Oh, welcome to nursing." But he's like, "If my physician leader tells me to do yoga one more damn time," it's like, we got to default to, well, you got to meditate and be mindful and do yoga, which are all great tools. But at the same time, you got to address the underlying issue, and it could be loneliness. It could be lack of teamwork. It could be trauma from what you've seen that day. It could be lateral violence within your organization. We don't tend to address that. We just say, "Well, go have a beer with your buddy after work, or something."

Dan:
So, I think we can do better there. I think that leads into some of the mentoring stuff. I know you are a mentor. You mentor a lot of people. You've been an inspiration for a lot of people, as well. How do you think about mentoring the next generation of leaders, and what are some of the things that leaders coming into healthcare now, or emerging leaders, need to think about as they enter the leadership ranks?

Paul:
The opportunities that have been given to me, and they weren't intentional, like I said, they just happened by nature of me trying to get my brain back, but I think just a willingness to be open to not get put in a box, I guess is the best way to describe it. I see people in informatics and whatever organization they're at, they learn that EHR. And they ask me, "Okay, well I'm going to get certified in these 10 certifications, and whatever EHR is at my organization, and then that's what I should do, right, Paul?" And they call me up and that's how you were successful. And I'm like, I have a couple of those certifications, but I think it's wonderful to get, wonderful to do it and grow, but I think it should be that the people are thinking about how to really solve healthcare, and how can they use their skill to do so, rather than how they can fit into the box that healthcare thinks they're in currently, because the box changes.

Paul:
I mean, that EHR might change. That might not even be a company in five years. That's not the way to be fulfilled or grow optimally, unless it makes you extremely happy to get those, I'd say, go for it. But I guess when people ask me how to grow in terms of their career, or how they can help their organization and also themselves, I always try to broaden them to other things that they didn't even think of. And typically, my first answer is to ask them all the things they'd like to do. What are their hobbies? How do they have fun after work? What are their talents that have nothing to do with whatever their current career is? And then see if they can fuse those in, in a way that's creative and unique, that really makes a difference, because that's how they, themselves, as a person, will be most fulfilled.

Paul:
And then, by nature of them using their own unique talents, that's how they're out, able to help in a unique way and change things. So, I really struggle with, like I said, everyone in IT, healthcare, doing healthcare IT, and then everyone in nursing just doing nursing, and the business people just doing. I don't think it's good. And unfortunately, now analytics, it's almost its own thing separate from even IT, often. And we have the front end people and then the back end. It's just so much, and healthcare, it can't be that way. So, my advice to all these people is really to try and figure out how they can help solve that problem by learning more things, not contributing to that problem, by learning more things.

Dan:
Right. Yeah. I mean, it's definitely managing the complex network and de-fragmenting all these silos, because like we said earlier, that leads to poor solution's that doesn't end up being relevant to the people providing care, which ultimately healthcare is there to enable. I'm curious how you embed technology competency into your mentoring, too. That's something that nurse leaders tend to not have, or not know how to bring data into their decision makings, or evidence, or even how to even think about using all the data we have within our systems to get insights to help them move forward. I'm curious how you add that to your mentoring.

Paul:
Yeah. So, I mean, some people really can go get a degree in it. And I actually encourage people, if they're really passionate about that informatics field, I honestly tell them to go get a master's degree or certificates in completely not healthcare. Don't learn healthcare analytics, just go learn analytics. You already have the healthcare part. And then you put it together, or make sure you to a program that's really teaching you analytics. Because I find if you're just learning from people who don't have the other skill, then you're not really getting that skill. So, that's one way. And then for people that just want to learn it a little bit, then wherever they are, or however want to infuse that. And I think research, or nursing specifically, and some of the clinical practice, research is probably the way that people get first exposed to data, just thinking that way. And so, that's a great first step. And then the second step would be to learn how it is extracted from the EHR, and how you build databases and all that stuff.

Dan:
Yeah. And I think that evidence-based leadership is something that we need to double down on, because there is a lot of research out there on how you lead, how you create change, how you implement change. And I feel like many times, we just throw things at the wall and see what sticks, which is the opposite of evidence-based practice even as leaders. So, yeah, go out and learn it, or at least know enough to be dangerous. I mean, I'm an ER nurse. You know enough to do it, but you're not the ICU expert on it. But at least when to pull in the right people, and what they're talking about, and can have a general understanding, so that you can route the information or the people in the right way, or put the team around you. I think, we have to be more adaptable like that. I would think everyone should just think like an ER nurse, and we'd just be fine.

Paul:
Absolutely. No, that's such a great point because no ER nurse says, "Well, I could do the surgery myself after I send them off to the OR." You're triaging. And that's your role and you're proud of it, and that's what's needed. And we don't have many healthcare triages. We have healthcare specialists just everywhere, like I just said. And I think people say, "Oh, well, there's already an expert in that other thing, and I'm never going to be an expert in that, so let them do that." And if we're all doing that, then nobody's talking to each other.

Dan:
Right. Well, I know defaulting and not informing those people, because we assume they have some knowledge. And I've found nurses, especially, add a ton of value and insight to every part of the non-care delivery side of healthcare, IT, analytics, business, finance, staffing. All these things that are run by other people and non-clinicians, the nurse is like, "Well, they'll just do it." But I think the nurse insight has a ton of value there, and actually helps optimize our systems. So, what are some of the big takeaways that you've learned through your professional journey that you'd like to pass on to other nurses, or as we say in the Handoff podcast, what would you like to hand off to the nurse leaders out there? What can they take away from your journey?

Paul:
Anything's possible. I don't think there's a limit to what a nurse can do, if they want to do it, number one. I think you have to believe in yourself. And even if you don't, then try anyway, which I didn't believe in myself a lot of times in my twenties, and I just somehow tried anyway. So, try to believe in yourself. And if you can't, try anyway, is always my first advice. And then try to think bigger than your current role, and current knowledge base, and learning more, and doing that with the right intention to be genuine and to care for patients, which most nurses, pretty much all of them already do. So, it's not that much of a stretch.

Dan:
The big piece you said there was think beyond your role. I talk to nurses all over the place and they're saying, "Well, I'm just an the ER nurse, what can I do to change a system?" Or you look on social media right now, it's this frontline nurses, versus management, versus the world, and you're not going to be fulfilled just doing the role. You have to think about the bigger mission of how do you change the system, and where can you do that most effectively? And then that gives you freedom. It's like taking that pill in the matrix. You see the matrix, and you can go do the things to manipulate the matrix, and it's not tied to this one 12-hour shift you're going into it. It's bigger than that. I think that helps people have more purpose than the shift work that sometimes we fall into in our profession. So, Paul, just really appreciate the conversation today. If people want to get a hold of you, learn more about you and your company and your work, where's the best place to get in touch?

Paul:
Sure. Yes. I'm pretty active on LinkedIn, Paul Coyne. I try to respond to everyone that writes to me. I'm pretty active there. That's probably the best place to find me. And then in terms of the company, Inspiren.com is probably the best place to learn about that. But I'm on LinkedIn. If anyone reaches out, I'm happy to speak whenever.

Dan:
I love it. Thanks so much for being on the show, Paul. We'll put all those things in the show notes, and I just really appreciate your time.

Paul:
Thank you so much.