Interview with Diana Nole, Microsoft Health & Life Sciences

Join me for a great discussion with Diana L. Nole, as she shares her progression from first-generation college graduate to Corporate Vice President of Microsoft Health & Life Sciences and General Manager of the Nuance Healthcare Division. The discussion outlines the pivotal moments and guiding principles of Diana's career, highlighting her evolution within the dynamic field of healthcare technology. From her pivotal role in Carestream's transition to advanced health solutions, to her leadership of Wolter Kluwer Health, Diana's journey illustrates a commitment to technological progress through dedication and innovation.

This episode provides a detailed examination of Nuance's strategic integration into Microsoft, emphasizing the profound effects on healthcare technology. Diana emphasizes the enhancement of scalability, security, and compliance in AI applications, positioning Nuance as a leader in shaping the future of healthcare.

The conversation concludes by addressing the revolutionary impact of AI in clinical documentation, particularly focusing on the Dragon Ambient Experience (DAX). This segment outlines how generative AI and DAX are transforming physician workflows and patient care by automating documentation and reducing administrative burdens. 

The episode considers the future of cloud-based solutions and AI integration in improving operational efficiency and security while revitalizing physicians' dedication to clinical practice. 

Host David E. Williams is president of healthcare strategy consulting firm Health Business Group. Produced by Dafna Williams.

Transcript

0:00:11 - David Williams
Clinical documentation is a major hassle for physicians, so it's no surprise that one of the first big use cases for generative AI in medicine is listening in on patient visits and automatically generating notes for the EHR. Microsoft's Nuance Healthcare Division recently rolled out Dragon Ambient Experience, or DAX, which combines conversational and ambient AI with chat GPT. Hi everyone, I'm David Williams, president of Strategy Consulting from Health Business Group and host of the Health Biz podcast, a weekly show where I interview top health care leaders about their lives and careers. My guest today is Diana Null, corporate VP of Microsoft Health and Life Sciences and General Manager of the Nuance Healthcare Division. If you like this show, please subscribe and leave a review. Diana, welcome to the Health Biz podcast. 

0:00:56 - Diana Nole
Hey, it's great to be here. 

0:00:59 - David Williams
So I want to talk about, obviously, DAX and all the exciting things you're doing now and into the future, but let's wind the clock back and talk a bit about your background, your upbringing. You know what was your childhood, like any particular influences that have stuck with you? 

0:01:13 - Diana Nole
Yeah. So I had a wonderful childhood, had a great growing up. I think one of the most impactful things is probably the fact that I am a first generation college family, so it was extremely important to my parents that myself and my three siblings we all had the option to attend college and they helped us. They helped us achieve that while also generating what I think are values that have continued to stay with us, and that is really around working hard, doing something that you're passionate about and really giving back. I would say. 

Growing up, one of the things that I clearly loved when I was going to school was math. I really love solving problems, and so at the time I was going to college, computer science seemed to be a natural selection along with it. I think that whole problem solving passion has stayed with me throughout my career. And then I think another strong influence was certainly my own father's career evolved. He did early days. He ran data centers in the telecommunications industry certainly an industry that's always been at the forefront of transformation and he ultimately did that and moved into more general business management as well. So a little bit about my early days. 

0:02:31 - David Williams
Now that sounds good and I think being interested in problem solving is good. There's a lot of people who are good at taking a problem and complaining about it. If you can actually solve it, that's likely to be a good key to advancement. We were talking before the show about Potsdam, New York, because I have a brother who lives there in SUNY Potsdam, which people know about, but I think you may be my first guest that I interviewed that went to not to a SUNY, but went to SUNY Potsdam. What was that like? 

0:02:57 - Diana Nole
So this was really interesting. So I went to high school in Iowa and I was all set to go to Iowa State and my father was offered the opportunity to transfer and he could either transfer to Minnesota or to the eastern part of New York State. And he ended up transferring to the eastern part of New York State and he and my mom sort of begged me to say, hey, wouldn't you come out here and consider it, the house that they bought, the people that were selling it, their daughter went to SUNY Potsdam and they indicated that it was a great school for computer science. For me it was a great college town because it's really it's very close to the Canadian border. It really is the North country. It is a college town. There is SUNY Potsdam, there is a great engineering school called Clarkson and once you get there I mean it's really about going to college. So it's a great environment. 

0:03:50 - David Williams
Nice and University of Rochester later on. Was that after you started working, or did you go straight? 

0:03:55 - Diana Nole
Yeah, that was. That was while I was working, so and I think for me that worked out Well because I had been working in various functional roles. Early in my career I worked at a large global company, kodak, and I had the opportunity to work in a variety of functional areas. That was a great thing about it. And then about ten years in, I decided to go back and get my MBA, which they supported, and one of the wonderful things out of the MBA was I met my husband, some schoolmates introduced us and I think for me going back to school and getting my MBA, I Really understood a lot about technology, but I did not understand anything about financial acumen. I didn't know how to read a P&L, I didn't know all of these business terms and so if I was in meetings I really felt a little lost with the terminology that was used to kind of run a business. So it really provided a great compliment to, I think, the ten years of work experience plus my undergraduate degree. 

0:04:57 - David Williams
Well, I met my wife in business school too. I was well. It was well worth it, just for that, you know, and it's interesting you know, rochester Kodak at that. In those days Kodak is making so much money. They, the people who are running Kodak, didn't need to know too much about finances either, and it actually come back to, you know, hurt them Eventually, that's it, that's it. 

0:05:15 - Diana Nole
There's a lot of learnings there, and so you know about, you know, 15, 16, 17 years ago I probably made one of the wisest choices I had made, also at the time, and I went to the Kodak health group, which ended up being sold. I was a wonderful business, but Kodak was going in a different direction and I had the opportunity to go through another career learning experience, which is the carve-out of an organization setting up everything you need to run it and being run by private equity Into the company that was called care stream, and that was my first really entry into healthcare. It was a very clear decision for me that I wanted to get into healthcare and that was really the pivotal, another pivotal moment in my career in terms of deciding which industry I wanted to be part of. 

0:06:06 - David Williams
Great, and then after that I saw your Walters-Clear, which is a real interesting business, and of course they have the real gem of up-to-date. I think it's part of the the group that you are running. 

0:06:15 - Diana Nole
That's right. So about eight years into care stream I said, you know I really would like to do something a little different again, wanting to grow, and I had the opportunity to work for Walters-Clear, work for a great leader in Nancy McKinstry, and their division had been going through again transformation from being sort of curated content to being much more a software Tool set. You mentioned one that's up-to-date. They have a lot of other iconic brands. These are all usually used either in educational opportunities for clinical people or Decision support. So they have, as you mentioned, up-to-date is one of their really premier, almost sort of cult following Solutions and I had the opportunity to run that business, which was which was really wonderful. 

0:07:03 - David Williams
And Walters-Clear is another place that doesn't have the most conventional way of doing their strategy and Find it. You know the way that they have their financial measures and things that are different, I think, from some at least software companies, and I'm wondering if that that's in fact the case and how, how that affected what you did there. 

0:07:19 - Diana Nole
Well, I think in Walters-Clear, what we really were focused on at the time that I was there was we had done a lot of Acquisitions to sort of transform and so we were integrating a lot of those. But it really was around how do people actually use, in particular in the health care division? How do people use these tools to ultimately change the decisions that they might have made to get better outcomes in terms of, you know, for patient care, and so you know the the. The real focus was obviously you need to grow and you need to grow the adoption and you need to grow the usage. So a lot of the metrics are around how many Encounters are we impacting, how much usage are we getting? Is it really valuable? And that kind of aspect around the ROI of the tool really has to be there. 

0:08:10 - David Williams
You know, one of the things that occurred, I think, during the time you were at wk is the real Adoption by everybody of electronic medical record and the EMR being really the key element to the workflow and then needing to make sure the tools which were previously used, maybe more on a standalone basis, really had to integrate. You know, with the workflow and a lot of tools I think got so just pushed aside because if it wasn't directly an epic, it, you know, it didn't really matter. But also, you know, I think, up to date in particular, managed to get integrated in a way that it stayed to be central. And I wonder if that's the case and we'll talk about how that relates to what you're doing now. 

0:08:46 - Diana Nole
Yeah, well, I think you've hit on one big important thing wherever the technology evolves to Everybody, all of our customers always say that the technology is is great, but it has to work within the workflow that I'm used to. And if you're going to have it sit over here on the side and not be Integrated and leverage all of the investment that I have in my electronic health record, it's not going to be as adopted, it's going to be extra clicks and it's just going to add more administrative burden versus taking administrative burden away. So as we've been thinking about and evolving our solutions and I think in particular the way that microsoft works, that's become even more important. And you mentioned, you know, certainly while I was at welter's clure, we were working heavily with the electronic health records to make that integration with the tool sets as seamless as possible. 

0:09:40 - David Williams
Great. So let's talk about Microsoft slash, nuance and interested. How did you get interested in the role? I mean, I can see that your background made you the perfect person for it, but how did you get interested in that role? 

0:09:55 - Diana Nole
Yeah, so I first knew about nuance when I was at CareStream, because we integrated their solution their speech solution on the radiology side into our solution, that we had our PAC solution, and it just happened to be that I actually reached out to at that time, the new CEO, mark Benjamin, who had come on in 2018 to talk to him and come over and see him in the Burlington office and talk to him about some other things more broadly in the industry, and this opportunity happened to be there, but I would say it was kind of at the right time with me also at Walter's score. 

I had been at Walter's score for five years. I've always had a great curiosity about technology, but really for the purpose of generating improvement in the business, and so early on I learned that technology can be used or leveraged everywhere, but it has to be in concert with change and change management, and I felt as though what the changes were that Mark was bringing, just from a cultural perspective, and the direction he was taking the company to really focus on this innovation and where can we go to really solve pain points. That was really attractive to me. So it was both the culture he was driving and the aspects of really trying to be just really forward thinking in terms of technology. 

0:11:17 - David Williams
We had done some work with Microsoft back in the day when they're getting into healthcare and they had purchased a Zixie, I think, at the time. And they're starting up HealthFault and they brought Peter Newpert back, who'd been running drugstorecom, because they figured he knew as much about healthcare as anybody and there was, I think, a lot of learning but also some false starts along the way. There has been quite a while. The Microsoft has matured a lot overall, but also in healthcare, so I'm curious about how Nuance integration with Microsoft has been working out. 

0:11:44 - Diana Nole
So it wasn't shortly after I started at Nuance that I started in June of 2020 and by April of 2021 we had announced this. 

There was a previous to the acquisition, a good, strong partnership, and I think that helps in terms of they knew us, we knew them, but the integration really started with a view into a shared vision. So after we closed last year, the joint teams across the Nuance Health and the broader, microsoft Health and Life Sciences came together to really talk about. You know, this is a large industry. It has very complex challenges. How are we going to use our assets to really solve the most important pain points? And so I think the good thing is is we have a very shared belief in, you know, really focusing on outcomes, and that has really driven a very strong integration. I think they're respectful of the fact that we have a at Nuance, a trusted brand in healthcare. You know we're deeply embedded into these clinical workflows, with hundreds of clinicians using it, but they also have just absolutely tremendous horizontal technology yeah, industry leading security compliance, so I think it's a really good horizontal breadth. We certainly have taken advantage of their capabilities as we've been building out, for example, dax copilot. 

0:13:10 - David Williams
Great, and how do you think about AI? Here Is AI is obviously totally essential to DAX, copilot and a lot of what you're doing. Is that a lot of the vision between Nuance and Microsoft to begin with? Is that a very central thing or is that just kind of the flavor of you know, 2023? 

0:13:26 - Diana Nole
I think that AI is apparent through all of it. I think sometimes people feel like AI is sort of at the very front and that's like what is it going to do? That actually interfaces directly with the end user. But if you look at the way we think about scalability of these solutions, it does include, like data and analytics, security and compliance, cloud infrastructure, and so you know, when we think about it, ai ripples through all of those. But it's not just at the forefront of okay, well, ai can give me data insights, it can give me content creation, it can give me user interactions, but it's building it in a stack such that you can scale it with the capabilities. That's also very responsible. Certainly, ai has evolved. I mean, it's much different, even in the last 12 months of the capabilities, than what we probably saw 10 years ago. Right, it was very simplistic in its sense 10 years ago. Now the things that we're starting to see is much more human-like, with very complex, you know, problems. 

0:14:33 - David Williams
I think Nuance is particularly. You know, there's a lot of companies that we work with that are saying, okay, AI is coming, Like what am I supposed to do about it? How does it affect what I'm doing? And I think about Nuance's business going from the traditional transcription and then kind of assisted transcription with some natural language processing, to really being much more you know, much more, taking the people out of it and bringing in the automation, probably ready for the next frontier as much as any company or maybe more than anybody else. 

0:15:02 - Diana Nole
Yeah, we see use cases. By the way, you know, we have been focused heavily on the content creation, the clinical document, as you mentioned at the beginning of our session here. But we also see use cases where, for example, in our radiology solutions, a lot of what the radiologist needs to perform their current report is to get information from the prior reports, to inform it, and that ability to easily get out data insights from the prior reports, that data insight piece of AI, is also very, you know, very beneficial to the space that we're in. 

0:15:38 - David Williams
Yeah, and radiology, of course, is a place where AI has been, you know, probably at the forefront, certainly within medicine, looking at images and being an assistant for the radiologist. 

0:15:47 - Diana Nole
Absolutely. 

And that's where it's been kind of it's been. I think there's been a lot of optimism around it, because in my career we obviously have had things where it's identified in the report, like what you would call hot spots, but the accuracy wasn't always great, so then people didn't really use it or look at it, and now we're getting much more sophisticated, much more accurate. I think when people ask what has changed with AI, it's the ability to get more accurate, get the scalability and really get it into spaces where it's kind of now it's more okay. I can see how it works, I understand it and I can see the applicability here. 

0:16:31 - David Williams
So DAX copilot, as I mentioned in the intro, is very exciting and I think is just a great use case and I'm wondering if you can just give just an overall explanation of what it is and then if you wouldn't mind breaking down some of the components of it so these words are not just thrown out there, I know, for marketing purposes, conversational, ambient, generative, those are all meaningful here and I wonder if you could just expand on what DAX copilot is overall and then how those different elements play in. 

0:17:01 - Diana Nole
Correct. Yeah, so we did announce the general availability of Dragon Ambient Experiencer DAX copilot on September 27. We have long times focused on the administrative burden of clinical documentation. So this isn't the first solution we've had. We've had Dragon Medical one out for many years and that was a tool that was used pre-visit with a patient and post-visit to efficiently be sort of a work assistant for the clinician to do their documentation. And that's what we refer to as kind of the early days of this. 

When you get into conversational and ambient, that's where you'd say here I am, I'm a patient with my doctor and I'm having a conversation and it's being done sort of in the background that the technology is capturing that and it understands that you're the physician and I'm the patient and it also understands when we're having this conversation, it understands what is applicable to the actual creation of the clinical documentation. 

So what happens is you as a patient just sit there, your physician talks to you, looks at you face to face that's great, because he's not, you know, the person is not looking at a computer and so you have this dialogue and within seconds, right after the visit, a draft of that note is ready for the physician to look through and sign off on. It's in a structured format that then is fed into the EHR and so that's at the simplicity of it. It's automatically creating this clinical document within seconds following this visit, and it's doing this in the usage of conversational ambient. And then where generative AI comes into is really around the accuracy levels. So in the background, the generative AI is really looking at how can we get more and more accurate based on when the physician goes in and potentially correct something that the note created. That is always fed back in terms of an ongoing loop of creating more and more accuracy. If that's helpful. 

0:19:16 - David Williams
Great. So it solves a lot of the problems of patient encounter and I think it's both from the patient perspective and from the physician or whoever is seeing them. Because with electronic medical record, great, now you can read the notes. But it's very much the conversations driven by. I have got this drop down, I have to put this in and it's not the conversational style that's going to be effective with the patient. The ambient nature of it is that it's just listening in. We don't have to go and dictate it later. What happened and the generative parts. Interesting because I saw and you've got a very good demo video which shows that output that they get initially and what's in the structured fields and then how the physician can drag and drop it, add to it and I guess what you're saying is that that then feeds back. So the next time or whenever they're in a next conversation with the patient, it's likely to be more accurate because they'll understand how the physician adjusted it based on what the DAX had told it. 

0:20:09 - Diana Nole
That's right. So it's kind of it's what we call supervised learning, because the physician is actually the human in the loop. That's continually providing feedback, that's training the models to get better and better. 

0:20:22 - David Williams
Can we talk now about the concept of the copilot. So I see this all that's not unique to DAX copilot, but it's a cool term. But I would love you to explain it a little bit and maybe contrast it to other things. Like, you know, a medical assistant, medical scribe, or just a peer that's there and you know, is it really comparable to the copilot of an airplane? Who I'd think about? Hey, the copilot can take off to and land, and if I had to step out of there and would be okay. I'm just trying to understand the copilot and how literally to take that and what it really means here with AI. 

0:20:54 - Diana Nole
Yeah, I think you, I think you, you are correct, you. Actually, when you do look up the definition of a co-pilot, it's always referred to as well Okay, that's the second pilot in an aircraft who actually helps the pilot who is in charge. So here what we're referring to is the co-pilot, is that the physician is the one in charge, but the co-pilot is doing something that to some degree, almost does and completes it automatically For the physician. Right, it can, it can do that in seconds, it can produce this clinical document. 

And I think what's different here is we're using co-pilot also as a technology driven Service. Right, it's not a human, because you could have a scribe that, in essence, is producing the same output, but it's a human in the loop and that's not easily scalable when you're talking about, you know, a co-pilot that needs to, you know kind of scale in terms of being able to be applicable and out there for all physicians. So in some regards they're similar in the fact that they are producing something that in the end, is very similar, but we're talking about co-pilot in this sense that actually Can do it in the purpose of technology and sort of at the at the direction of the of the physician who is the pilot. 

0:22:11 - David Williams
Got it, you know. So in the olden days, just to go back on the aviation side of it, a lot of the airplanes had Three-member crews. You'd have a navigator in addition to the pilot and the co-pilot. And now you know you don't have that anymore. It's it's helped to the technology self to reduce the number of people that are required, given all the workforce. You know strains and shortages. Do we foresee that? It's kind of co-pilot approach? Or you know the next evolution the DAX gets to the point where you can do more with fewer people in the loop. 

0:22:42 - Diana Nole
Yes, so one of the the things that we want to continue to do with sort of our dragon family and DAX, which kind of are a suite of offerings, is being able to provide things where you can do interfaces with the system to do ordering. It could also potentially check things in the background for more and more accuracy, with more embedded natures, with the EHR. So we released our initial view of DAX co-pilot Hanging off of our dragon medical one application, but we're also Releasing in the next few months a version of that that's embedded first in epic and we believe when it's embedded in epic Then there is more aspects of kind of you know, where does the note get utilized, how can you actually utilize the note within the HR to check more things for accuracy, and so I do think that the use cases will continue to expand in terms of Accuracy, other things that you could do with the system or interface with the system through, you know, speech technology. 

0:23:47 - David Williams
Great. So you mentioned before that AI isn't just kind of the front-end thing that people see. They're now familiar with ChatGPT and they say, okay, that's AI. There's more to it than that. And then there's other elements, too, that you talked about, as it relates to the synergy between nuance and Microsoft, and cloud is a big part of that, and I wonder how you know central cloud deployment is to DAX, is it just? Hey, cloud is important for Microsoft, let's put it in. Or how fundamental is cloud as you think about the DAX deployment? 

0:24:17 - Diana Nole
So cloud cloud is very central to the tool sets that we're talking about now and, for a variety of reasons, we want to have things in the cloud. So that is, we have new capabilities. It's very easy to get it out to the user. That's one thing, so that you're not constantly worrying about well, what version am I on, when am I going to shut the system down so I can do an upgrade. It's much easier to deploy new, innovative technology through a cloud. 

As we all know and we've gotten used to, I think we're in healthcare there's always been sensitivity, is it also has to be very good in terms of security compliance, and so the aspects of what cloud you select are extremely important. That's why, for the Microsoft cloud for healthcare, we really are doing that in a scalable, responsible way, and we also believe that there are going to be other integrated AI capabilities in that cloud, such as some of those things that have been recently introduced, like fabric for healthcare, where, once the data is out there and it's in the, it's in the healthcare cloud environment, actually having the end user be able to do different things that they would like to do with tool sets for around analytics or information, data, insights, extracts. It's all in a way that they can easily do that. 

0:25:37 - David Williams
Got it. So I'm very excited about you. Know, dax, copilot, I've been hearing about that also from you, know colleagues in the industry. I'm wondering what you're seeing in terms of how it's being received initially, you know, by different players hospitals, users, patients, regulators, anybody else and you mentioned different use cases. So what do you see is kind of the strongest use cases, the strongest feedback that you're getting? 

0:26:00 - Diana Nole
Well, clearly, on the last point that you made, family medicine is probably the specialty, the area that's the most overwhelmed. They have an extremely high volume of patients that they need to see and those patients that they see can have a very you know, very broad element of situations. It's not, you know, it could be from any kind of indication of just the you know, hey, you have a cold to you have something very serious and trying to get through that, the visit needs to be efficient. So we definitely are receiving very high feedback. We've had much higher adoption during our private preview than we've ever had with any solution that we've gone out with. And people we do surveys. Obviously, there's a lot of survey information that comes back that said they would be disappointed if it was taken away. They also agree that it's very easy to use. But we also have had, you know, specific customers on their own that have taken a look at what does that mean specifically in a quantitative fashion? What does that mean to them? 

And one of our first systems that has been using it atrium health. They deployed it to their primary care physicians and it created it, you know, automatically and securely, as we said, and they were indicating that it's saving them up to 40 minutes per day per physician, so you can imagine how impactful that can be. Right, they're almost saving an hour a day, five hours a week, and they think that that's actually going to be even more as they get more and more used to using it. I think the other thing that even when somebody doesn't completely accept the note, people are feeding back that it's a very good cognitive load burden relief, Like I can see in the note. Even if I decide I want to do the note differently, I see everything that was captured in that conversation and I didn't have to sit there and write all of it down. So that's just a bit of an interesting use case where some people are using it as a memory jogger in some cases even if they don't actually use the note that was created. 

0:28:11 - David Williams
Yeah, I've been working in the healthcare a long time and sometimes I get a little bit despondent that yeah, it's been great. There's always plenty of problems to solve going back to what you were saying but you know there's still going to be you know they still going to be more and more problems and not that many solutions. I feel like AI may actually be one of the approaches that allows us to actually get beyond that, and I'm really happy that you started off describing family medicine, because I know that's not where the big money is. You know that's they're not the big customers. 

But if you think about what vision would be about a better healthcare system, it is great if a person could go to a family physician and they've actually got the breadth of coverage of knowledge, because it's so hard for one person to catch up. You can imagine AI is helping with that and they're getting into the system with somebody that understands them holistically and then making an appropriate use of a more specialized treatment. I think it's actually would be good for the patient and also there's a lot of physicians that might like to practice that way, and so if you think about the next generation of people coming in, it's not going to be the Marcus Welby, you know single shingle. Hold it up and do whatever you learned in medical school. It really sounds like it has the potential to transform healthcare into kind of vision that we would like. Am I being too crazy with that? 

0:29:19 - Diana Nole
I did not think you're being too crazy. 

The feedback that we get is this is kind of put the joy back into the medicine, the way the physician has always envisioned their role. 

They wanted to really be in the room, present and focusing in on the patient, and have the system be able to create things that it needs, find things that it needs, help them with the decision making, and so the system is getting more and more intelligent and offering those capabilities. 

So I think the administrative burden coming down just makes their life go up. I think on the other side is what I saw too from the patient's perspective. The patients have a much higher level of satisfaction that they were heard during the visit. They can see words that they used actually in the clinical note. So that builds a higher level of trust. And you know, while I don't have hard factual data, when you have a higher level of trust between a patient and a physician, there's likelihood that you're going to have more compliance with the treatment. They understand what their role is in their own health care and they're not going to go down the street and get a second opinion if they really feel like everything they needed was accomplished in the room with that physician, which I think ultimately then can lower costs overall and increase quality. 

0:30:38 - David Williams
You know, adding another interesting piece, which is there was this concept of open notes that only started a few years ago. I started to think at the, at the BI with Tom Del Donco, where the patient, would you know, read the notes and that would be expected. And now, and sometimes I've done that, I read the notes and it's like that's not quite what I, you know, that's not quite what was what it's useful because you can, you can see and you Can correct, but it sounds like you're now gonna have probably a richer note and also More accurate, and that should lead to better engagement, at least among those that want to engage. 

0:31:08 - Diana Nole
I think so. I think you're pointing to a really Really pivotal item where we are trying to rebuild trust between the patient, the physician, and you know the physician has been Overwhelmed. They would like to get back to the joy of what they practice and the visit, and the patient wants to be listened to. 

0:31:23 - David Williams
Yeah, I've recently seen my father had hip replacement and they get things that I can tell it from like a patient engagement vendor. You know it says automatically sent out emails and then my mother gets it and she thinks you know the doctor said this and that I'm like mom, that's. They just wrote that script, you know, way ahead of time and they feed it to you day by day. If it's actually tied in to the specific case, specific notes and so on, I could see that being much more powerful and directly connected with what you're doing here with this product. Yeah, great. Well, last question, turning back more to the personal side, is If you've read any good books lately, anything that you would recommend or anything you would recommend to avoid. 

0:32:01 - Diana Nole
Yeah, so maybe it's a little overdue, but I actually actually I'm starting to read Satya Nadella's book hit refresh, and it's interesting to read, while I actually am integrating into the, the company and the culture that he has tried to do. 

I think another interesting book I've been reading is the autobiography of Reverend Billy Graham, called just as I am, and it's an interesting read for many reasons, but one that I like is to read about how he viewed his long, you know 95 year life and the nature of what was going on all around the world, as it is viewed through his specific role in the Learnings he had throughout it. I think both of these offer the reinforcement that we're all works in progress. We are all is leaders of various kinds or people in the globe. You know we're all trying to get better and learn and grow and that's a wonderful thing, I would probably say. You know, just in, I do have to admit that I do read people to stay up on all of the latest about Taylor Swift and travel, kelsey and stuff. So I you can obviously see that I have a variety of things that I read. 

0:33:08 - David Williams
Yeah, that's that. That sounds good. Well, diana Noel, corporate VP of Microsoft Health and Life Sciences and general manager of the nuance healthcare division, thank you so much for joining me today on the health biz podcast. 

0:33:18 - Diana Nole
Thank you. 

0:33:22 - David Williams
You've been listening to the health biz podcast with me, david Williams, president of health business group. I conduct in-depth interviews with leaders in healthcare, business and policy. If you like what you hear, go ahead and subscribe on your favorite service. While you're at it, go ahead and subscribe on your second and third favorite services as well. There's more good stuff to come and you won't want to miss an episode. If your organization is seeking strategy consulting services in healthcare, check out our website, healthbusinessgroupcom.