On Rethinking Preventive Care Through AI - HIMSS Europe Series with Dr. Jérôme Bouaziz

AI can help to ask the best question at the best moment and the physician cannot know all the questions. Everybody uses AI to have the answer. I'm using AI to have the best question.Prevention is a part of the journey of the patient and this is what we do today. One question can save your life and if it's a good question, at the good moment.So I'm Jérôme Bouaziz, gynecologics and obstetrician specializing in fertility and I'm also an entrepreneur in healthcare.

Hello dear listeners. Welcome to a new episode of our HIMSS Europe special series on Narratives of Purpose.This week I bring you interviews with two speakers of the HIMSS Women's Health in Focus track from the session titled "10 Years Too Long: Prioritizing Endometriosis".These interviews were recorded in Paris back in June at the hims, the Healthcare Information and Management Systems Society European annual flagship event, also considered as Europe's number one digital health conference. For those of you listening to Narratives of Purpose for the first time, my name is Claire Murigande.I am your host on this podcast which is all about amplifying social impact by showcasing unique stories of global change makers who are contributing to make a difference in society society. My guest today is Dr. Jérôme Bouaziz. Dr. Bouaziz is an OBGYN specialized in fertility and endometriosis.He is also a health tech entrepreneur who sees women's health as the most powerful entry point to redesigning the entire healthcare system.Dr. Bouaziz is the co founder and CEO of One Clinic, a fast growing network of integrated care centers in France that combines multidisciplinary care, AI assisted workflows and data driven prevention.Remember to rate and review our show wherever you listen to your podcasts or simply share your thoughts and feedback on the Narratives of Purpose website using this short link bit ly narratives of Purpose, then select the review page. For now, get comfortable and let's jump into the fascinating conversation with Dr. Jérôme Bouaziz.

So I'm Jérôme Bouaziz. I'm a gynecologist and obstetrician specializing in fertility.This is my background and I'm also an entrepreneur in healthcare and I've been building few companies in healthcare to try to change how we can provide the care. I launched a new company about preventive medicine, but it was impossible for us to do it before AI.

Tell me about that and especially what are you trying to solve with your company.

The first point of this company was to realize that as a physician, sometimes you're not comfortable to ask questions even if there Are very good questions for prevention, either because it's a difficult question, either because you don't want to handle the answer about mental health. People are more coming to acute symptom or chronic symptom and you're not confident to ask the question.And it was one of my last conferences and I said, when you go to the physician, does he ask you when was the last time you took drugs? If you're coming for a urinary infection, does he ask you how many sexual partners you had in your life?And these two questions are usually sensitive questions, right? Sensitive. And imagine you come because you're having a fever.But we know that number of sexual partners is linked to hpv, is linked to cervical cancer. And just one question, change your monitor that you love drugs.We know that it's in Europe, the first cause of a heart attack for the people that are less than 50 years old. But we do not feel confident for that. So my point was like, physician cannot be expert in all the questions.When you talk to your gynecologist, he doesn't know about sleeping issues. He knows that it has an impact on the heart, on many things, but he's not an expert. He doesn't know the next question to ask you.And also the fact that patients do not feel necessarily confident. I was like, okay, AI can help to ask the best question at the best moment. And the physician cannot know all the questions.Everybody uses AI to have the answer. I'm using AI to have the best question relative to the patient. And for me, there is two ways to do prevention.Either you do the full, private, luxurious checkup and there still need to prove on the impact of that, but people are doing and it's something either you want to have a large scale impact and you have to decide that prevention is a part of the journey of the patient. And this is what we do today. We build a solution, believing that one question can save your life. And if it's a good question at the good moment.So when the patient book an appointment, we send him a personal link to have a question about his general health not related to the reason of the consultation. So we will explore his mental health, his cardiological risk, his cancer risk, but in an automatic and very personal way.Then we have the evaluation of all the risk factors and then we dig into personality, because prevention, you cannot provide to everybody the same motivational solution. Some people, they want to have data, some people, they want to have a friend who pushes them to prevention.So we dig into what makes you do sport, what Makes you not accomplish your goals.So we dig also into personality easily with AI and we build plan for your preventive, no matter what, are the reason that you are coming to see your health professional.

So it's individualized?

It's individualized and before the consultation. So you come because you're having a urinary infection.We'll be able to talk about your sleep issue and your mental health. And I don't think I'm the worst gynecologist, but usually I will not do it. When you come, I will pursue the antibiotics, the general recommendation.And now be able to see that your family have a heart problem, genetics that need to be focused, that your sleep issue can be related to that and also that you're a little bit overweight and that the moment to make it. So it really helps the physician to ask all the questions. And it's long.And I'm very surprised because even it's 10, 15 minutes to question the night before, the patient feels that, okay, I'm at home, I'm not in a rush, I can answer, I can be honest. The AI will not judge me if I'm using drugs or whatever. So we're having a rate of completion of the questionnaires that I was not expecting at all.

What is the rate?

More than 80% of the patients that fulfill 10 to 15 minutes of questionnaire because they do it to, to prepare their consultation. And that completely changed the mindset, changed the consultation itself.I mean, even if you have an acute problem, we will be able to change the prevention. I was giving a lecture about it in Africa, in Togo, and I was like, okay, maybe they're not going to be interested into that.It's not their daily project. And I was completely wrong. They came to me and they said, okay, there is something you don't understand about prevention in Europe.For you, it's almost marketing five fruits a day or do sport.And is it only if you give us a solution to avoid the diabetes of one patient, because we see his risk, because we push him to export or treat differently anyway, it will be too difficult for us to fund the insulin for this patient. So for us, it's a full part of the treatment. The prevention is a full part of the treatment.So now we're doing a collaboration and we try to implement because it's kind of cheap. I mean, my whole thing is to say you can do genetic, but you can also do the right question at the good timing. And this can change your life.

So this solution that you built out of France, you're trying to expand it in other places, right?

Yeah, because now it's easy. It's a multi language solution. It's not even a question. I mean, you can start to talk if you don't want to write and it's easy.So we call the solution by the name of the. The philosopher who changed the world by questioning. So it's Socrates with a K.

Socrates with a K. I wanted to ask you something perhaps more personal because you said you're a gynecologist and you're in the field of women's health. So what is the most challenging and perhaps also the most rewarding thing about trying to be this change agent within women's health as a male physician?

I don't think as a man, it's more or less difficult. There are lots of issues about the consultation. Does a patient feel confident?I mean, when you want to handle endometriosis, you just don't have to ask if it's painful during sex. I mean, you have to go really deep into the questions that you ask and you have to build trust.But I don't see it as a main difficulty that, you know, there is a lot of bad news that make it difficult to be a man gynecologist. For me, it doesn't change that much in the Delhi.What is challenging is to build the trust in general about what you want to do and how you want to change it as a group. In my group, so my group is called One Clinic. From day one, we were convinced that the care cannot be just a consultation.Let's have an example: infertility.Everybody agreed to say you need to have psychological support and you have also to have a dietitian support if you are about to have a treatment to improve your chance. Everybody, all the studies are doing that. But in France, no one is funding that. Okay, it will be you.It's not the private or the public insurance will not fund that. So we were like, okay, how does it work? The physicians say, okay, have a visit on that, see a psychologist.Usually the patient never go, you never have the feedback and he doesn't want to pay. So we said, okay, this will be our. And the patient will not pay for that.If we think that it's a medical recommendation, it's our team and that's the way we will create value. To build complete support and just to change its mentality was a lot of difficulties, a lot of mistakes.At the beginning I said, okay, it's our team, so it's open bar, you can have Every consultation it's free. I mean, it's our salary, so it's free. And it didn't work. I mean, the patient were not going even if it was free.We realized that it's not working like this if you do not have an evaluation, if you do not set up goals from day one with the patient as a contract, it does not work because it's free. It works because you have goals and we do the feedback for the physician. And that completely changed what we did.It's actually because one of my partner from day one, she was expert in value based health care and she really tried to make us understand what creates values. And we were like, okay, we're going to fund it. So everybody thought we were crazy to fund something and to have extra salaries.We're like, okay, but the normal consultation, a part of that will fund that. So when you accept that it's the best care you could give, also you have the best doctors that are coming and want to do more than the consultation.And that completely changed the experience for the physician and the patient. When the patient is coming, he will see one physician, many support healthcare provider and then the physician maybe one month later.But it will not be a laundering all this part.

So basically the care management is across different disciplines.

Exactly. And we have care managers now in the team because we realize that without care management, that does not work.So for me, the most challenging is building the trust on the visions of the things that you want to implement.

I was reading in your bio and there's a part that says "listening to and caring for women is not just a matter of equity, but a strategic lever to improve prevention, early detection and care coordination across all patient populations."

I wrote that?

I don't know if it's you or your team. It sounds good, right? I don't know if it's you or your team, but it's in your bio.And basically what I wanted to understand is that you're saying if you listen to and take care of women, you're basically going to include all populations. Why do you think that's the case?

So I'm kidding, but I know exactly what you're talking about.I started the company in primary care with women care, not because I'm a gynecologist, because I truly believe that women are handling the health of the family, of the children and of the husband. They do take the appointment. So that was the first step.And I was like, okay, if we want to change something the woman, it will be easy for her to implement it to her own family, more than children, more than men, to make it. She's the both of the health in the family. And that's true everywhere in the world.The second part, when you talk about prevention, women, they are doing checkup every year without any problem. I mean, they already have the mindset of prevention. Men are not going to the physician once a year.So they are really advanced in what is preventive care. I mean, doing a Pap test, I mean, you will not manage to convince men to today to have a physical exam that it's not easy to make every year.They're not ready for that. And so I was like, okay, women have more impact. So we have to focus on women.And as a gynecologist, we do 50% of our consultation, they are in preventive care. And it was fun because in France they launched a very nice program about preventive consultation, Social Security.And I was meeting the team and the minister that was doing that and they were telling me, oh, you're the first specialist to come, there's only GP and why are you coming? That's the main problem is because you don't understand why am I coming? Because we are used to that and we do more prevention than the other.So I really believe that women are the solution for prevention.There is many reasons for that, but the sense of responsibility is something that women will have because they feel the responsibility for the children, for the family, sometimes more than the men. That's one of the points.And there are many studies that show that the recommendations that are done by physicians are more respected by women than men.

My last question to you is, we'll be together on a panel on the last day of this Congress. It's about endometriosis and making sure that you don't have to wait up to 10 years to get a diagnosis.My question is, what do you want the audience to take away from this discussion that we'll have?

There are a few things. Endometriosis is really very common. One woman out of 10, it's more than diabetes. It's three times more than all the cancers in the world.So it's very, very common. We talk about genetic, micro RNA, MRI, but so far we know that expert question can make a high probability of diagnosis in many, many cases.And I don't think the solution will be to implement more MRI or more genetics. It will be to ask more easily the good question and not consider the woman hysterical when they say they have pain.For me, it's really about listening and asking the good question. And that's why I'm very excited about launching this new company, because this is what we try to do.There is one stat that I really like and that's my message. Even if there's lots of innovation in medicine, so far, 70% of the diagnosis, they are done just by the discussion.20% is done by examination and palpation, I mean looking and touching. And only 10% they are done by biology, MRI. If you ask the right question at the right moment, you can do 70% of the diagnosis.And it's not acceptable to have seven years such easy diagnosis to make. And one of the common mistakes in endometriosis, I mean, a young girl says that it's painful to have her period.She asked her mom that she also has a high probability to have endometriosis. And she told her it's normal. Me too, I had an issue, and that's the main problem. To ask the real question, when do you offend?So it's expert question to ask. I had this chance to work abroad. I work in London. I work in Israel also.And in Israel they did a very interesting study because they have access to the consummation of painkiller.They realize that women that are under 25 years old and are spending more than $200 a year, they have a 30% more chance to have endometriosis than the other without even seeing the patient. They say when we see how much she spent on painkiller, there is a higher chance. So she needs to have a consultation with the expert.And for me, it's just this is asking the good question, how often, how much? I mean, you don't always need the last innovation. And what I like about that is the impact. It's cheap to build an AI agent that asks a good question.I mean, I don't feel that I'm revolutionizing the AI with that. I'm just managing to implement it at the right position in the medical journey, not the patient on his side, without his physician.It's helping the patient and the physician. And because of that, we managed to implement it really fast.

Thank you. Thank you very much.

You're welcome. Pleasure.

If you wish to learn more about Dr. Jérôme Bouaziz's work and his group at One Clinic, have a look at their website, oneclinic.fr you can also follow Jérôme's activities by connecting with him on LinkedIn. All the links are available in the episode Show Notes. Thank you so much for tuning in today. I appreciate you taking the time. Join me again next week.For three new episodes of our HIMSS Europe Special series featuring speakers of the Women's Health Track session titled "It Starts with Data: Closing the Gap". Until then, take care of yourself, stay well, and stay inspired.