Smriti Kirubanandan Spills the Tea on Health Equity

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[00:01:17] Welcome to the Hi Tea with Grace podcast where we spill the tea on HIT.

[00:01:22] I'm honored to welcome Smriti Kirubanandam to the pod.

[00:01:27] Thank you so much for joining us.

[00:01:29] Wonderful to be here, Grace.

[00:01:30] Thank you so much for having me here.

[00:01:32] So let's start by having you tell us a little bit about your career journey.

[00:01:36] A little bit nonlinear.

[00:01:38] Really my education is in robotics and engineering management and public health.

[00:01:43] I did go to culinary school in between, so I'm a raw vegan certified chef and a

[00:01:47] nutritionist.

[00:01:48] So really if I look back at it, it's really a bit of connecting those dots.

[00:01:52] My only career really started kind of in the startup environment.

[00:01:56] Business development, product development.

[00:01:58] I really love the creative angle of that.

[00:02:00] So really worked at the intersection of healthcare and technology for the first

[00:02:04] decade of my life.

[00:02:05] And then I spent the last almost five, six years in the consulting arm and now

[00:02:10] being with Accenture.

[00:02:11] So really bringing all our best services with its tech strategy consulting, but to

[00:02:17] really make healthcare more affordable, accessible and obviously innovative.

[00:02:22] So that's really the nonlinear journey.

[00:02:24] It's been quite exciting that I'm able to blend in different factors, hopefully

[00:02:28] to make healthcare just a little bit better.

[00:02:31] So interesting.

[00:02:32] So many different experiences you're bringing to the table now at Accenture.

[00:02:35] So, you know, I know you're a huge advocate for techquity and, you know,

[00:02:39] it's a big buzzword in the space.

[00:02:41] How do you define equity in the context of health care?

[00:02:45] What metrics like do you feel is crucial when you're assessing if

[00:02:49] something is equitable or not?

[00:02:51] A great way to start the session.

[00:02:53] Start with the quote, right?

[00:02:55] Of all the forms of inequality, injustice in healthcare is the most

[00:02:59] shocking and inhumane.

[00:03:01] An old quote by Martin Luther King Jr.

[00:03:04] You know, and here we are in 2024.

[00:03:06] We're still discussing this.

[00:03:07] I think it's a little bit sad, but here we are trying to make a change.

[00:03:11] So equity in a simple form is really the fair and just distribution of

[00:03:15] resources, access and opportunities to achieve optimal health outcomes.

[00:03:19] Right?

[00:03:20] So what do we mean by that?

[00:03:21] What metrics do we need to be looking at it?

[00:03:23] One is the accessibility to healthcare, which means the physical, the

[00:03:27] financial means, which is health outcomes, economic empowerment.

[00:03:31] Right?

[00:03:31] Some examples of that.

[00:03:33] The second one is health outcomes, literally examining disparities in

[00:03:38] health outcomes across different population groups is critical.

[00:03:42] Some of the examples are analyzing life expectancy, infant mortality

[00:03:47] rates and overall life indicators.

[00:03:50] The third one is really utilization and quality of care.

[00:03:54] We have to start understanding what the utilization patterns are and

[00:03:58] how are we creating and delivering the quality of care?

[00:04:01] The fourth one, which we really talk a lot about is social determinants

[00:04:06] of health, looking at a patient or a person as a whole person, the

[00:04:10] economic status, their food insecurity status, their home status.

[00:04:14] Right?

[00:04:15] I think those are all key components to really, you know, how a person

[00:04:18] shows up and how we need to be looking at care and delivering care.

[00:04:22] The last one is community representation, ensuring that diverse

[00:04:27] communities are actively engaged in the decision-making process related

[00:04:32] to healthcare policies, resource allocation and service delivery.

[00:04:36] I think is really crucial for the promoting equity as a whole.

[00:04:39] That's really interesting.

[00:04:40] So, you know, there's our different kinds of pieces in health equity

[00:04:43] that you feel, you know, are really kind of amplifying this, this issue.

[00:04:47] You know, what actions do you feel like the industry needs to take a

[00:04:49] stand on to address these disparities, you know, in terms of technology

[00:04:54] and education and more?

[00:04:55] Yeah.

[00:04:56] Great question.

[00:04:57] I think first at Essential, we've identified the five interconnected

[00:05:01] pieces that serve as obstacles.

[00:05:03] Right.

[00:05:04] I just want to break it down because I think it's critical before

[00:05:06] we go to the solutioning of this.

[00:05:08] The first one is implicit bias.

[00:05:11] Implicit racial ethnic biases are obviously unconscious attitudes and

[00:05:15] stereotypes that affect our understanding.

[00:05:18] And how do we respond to individuals and groups other than our own?

[00:05:22] These biases, you know, fundamentally, as you know, Grace, they erode

[00:05:26] the trust, the care, they create a lot of fear in the healthcare system.

[00:05:30] Right.

[00:05:31] So this leads to the second point.

[00:05:32] We have a lot of lack of trust and fear in the system by people.

[00:05:37] Some rightfully so.

[00:05:38] And we saw some of this during COVID, right?

[00:05:40] There was some, not some, a lot of hesitation in vaccination.

[00:05:44] One was really the misinformation, the lack of trust in the system,

[00:05:48] the lack of communication.

[00:05:50] So we really look at this in a competent kind of format.

[00:05:54] It really shows that we all need to show up equally hand in hand, right?

[00:05:58] To really build that trust constantly, not just when we have a pandemic.

[00:06:02] The third one really is access to barriers, which is, which is

[00:06:05] fundamental roadblocks, which is to prevent underrepresented groups

[00:06:09] from receiving equal access to care, such as affordability of care,

[00:06:13] medicines, the effects of implicit bias, health education, which is a huge part.

[00:06:18] You're now seeing a lot of other organizations focusing on information

[00:06:22] as a determinant of health, which is really key, right?

[00:06:25] Oh, yes, yes, it should be.

[00:06:27] That should be a determinant of health.

[00:06:29] Yes.

[00:06:30] You know, sometimes, you know, common sense is a privilege.

[00:06:33] I would like to say that not in a condescending way, but really

[00:06:36] is it really is a moment for us to say we always need to go back

[00:06:40] to the drawing board, understanding that we are always learning, you know,

[00:06:43] though as leaders in the health care industry, but also as a moment

[00:06:47] for us to do better for our community.

[00:06:49] Right.

[00:06:50] And the fourth one is uneven quality and experience.

[00:06:53] Like there are stark differences in the quality of care that exists

[00:06:56] between races, patients from racial ethnic minorities frequently

[00:07:01] receive subpar care and experience.

[00:07:03] And there is a worse outcomes, right?

[00:07:05] Our infant mortality rates in the U.S. is high.

[00:07:08] And, you know, we have also seen that how we assume

[00:07:11] that people from different races have different pain tolerance, right?

[00:07:15] Which really shows our lack of or I would say,

[00:07:19] really a narrow thinking.

[00:07:20] We just need to become more expansive and broad in our mindset.

[00:07:24] And the last one, grace is, you know, race, a seminar

[00:07:26] and the end clinical practices, right?

[00:07:28] We currently don't have all the parties in for clinical trials,

[00:07:32] for example.

[00:07:33] How do we bring them all in?

[00:07:35] Because when we're not doing that at that fundamental level,

[00:07:38] it really shows that we are not ready to give equitable care

[00:07:42] for everybody else. Right.

[00:07:43] So these are like the five components we think need to be moved

[00:07:47] to really create equity and care.

[00:07:49] Yeah, that is super comprehensive and makes a ton of sense.

[00:07:53] And so, like kind of knowing that then what actions do you feel

[00:07:56] we need to take to to act on this knowledge?

[00:07:59] You know, we are aware.

[00:08:01] It seems we're aware of the systems and the issues

[00:08:05] surrounding inequity generally.

[00:08:07] Like, how do we move forward with action

[00:08:09] and changing these things, you know, in technology, in education

[00:08:13] and whatever we decide is the next best step?

[00:08:16] Yeah, you know, great question and great point that we can just have ideas

[00:08:20] and thoughts like we need to be executing on them. Right.

[00:08:22] And so some of the actions we can take, I think,

[00:08:25] to address disparities and inequalities in care is the first one.

[00:08:30] You know, as we're talking, there is generative

[00:08:31] AI at the core of everything we're doing.

[00:08:34] So but before that, I think there has to be responsible data and then AI.

[00:08:38] Right. What I mean by that is we need to have our data foundation

[00:08:41] and governance in place first, which means that how we collect data,

[00:08:46] where we collect the data from really looking at each data point

[00:08:51] as a life as a person's life journey and history and not,

[00:08:55] you know, dismissing any of that, I think is critical.

[00:08:58] So really responsible data collection.

[00:09:01] The second one is, you know, unbiased AI.

[00:09:03] We have the power here to change lives, Grace, as you know.

[00:09:07] Recently, a colleague was sharing that, you know, the biomarkers

[00:09:11] created for heart health were mostly driven by men.

[00:09:14] So when we look at women who have heart diseases or,

[00:09:17] you know, having strokes, apparently we see that their biomarkers are accurate,

[00:09:22] but they have a heart disease, a heart stroke,

[00:09:24] which really brought them back to the drawing board, showing that women

[00:09:28] they're not really brought into the picture

[00:09:30] when these biomarkers were actually created.

[00:09:32] So that's where we are, right.

[00:09:34] Which is very shocking and disappointing.

[00:09:37] But that really shows to us that we really need to go back

[00:09:40] and have responsible data collection, unbiased AI

[00:09:44] while we're able to really move the needle to make health care truly equitable.

[00:09:49] The second one is design inclusive products and services, right?

[00:09:54] Placing equity and empathy at the center of technology,

[00:09:58] which means inclusive design methods, enabling and drawing

[00:10:02] on the full spectrum of human diversity and individual experiences

[00:10:06] to create solutions.

[00:10:07] We truly want to stop for a second because that was like a fire quote.

[00:10:10] We need to place empathy and equity at the center of technology.

[00:10:16] Ladies, we all know this is true, right?

[00:10:20] And you're spilling the tea right now.

[00:10:22] Like that should be at the center of all that we do.

[00:10:25] Every one of us is a link in the chain of this innovation process.

[00:10:28] Where can we be infusing that empathy?

[00:10:31] Where can we infuse that equity?

[00:10:32] Sorry, you keep going because you're on fire.

[00:10:34] I didn't mean to stop you.

[00:10:35] No, absolutely right.

[00:10:36] I mean, we can hold some space there because I think we

[00:10:40] we are in a moment in time where technology is really taking us

[00:10:45] by the horse, I would say.

[00:10:46] But we always have to come back and think end of the day,

[00:10:48] we are just humans, right?

[00:10:49] We are trying to give care human to human.

[00:10:51] But it really starts at the point at the place from equity and empathy

[00:10:55] and not forgetting that technology is a tool.

[00:10:58] But, you know, Grace, we belong to a diverse cultural world.

[00:11:01] We have to embrace that and bring everyone to the table.

[00:11:05] And we have to make decisions keeping everyone at the table.

[00:11:08] Healthcare is a fundamental right for all.

[00:11:10] And we have to design products and technology, keeping that in mind.

[00:11:14] That includes, you know, disability, cultural differences,

[00:11:17] different languages, economic status and so on and so forth.

[00:11:21] The last one is obviously creating sustainable structural changes.

[00:11:26] So this means policies, institutional policies, such as inclusive hiring practices,

[00:11:32] the types of partnerships that are created and how participants

[00:11:35] execute clinical treatment and tools will have far reaching effects

[00:11:40] on the sustainability of health care system.

[00:11:41] So I think it's not just important that we be the source of change,

[00:11:45] but we expect the same from all our partners.

[00:11:48] Yeah, that is a really good point, too.

[00:11:50] Everybody should be expected to be keeping this at the center.

[00:11:53] And it's not it's not enough for just one person or one part of the system to do that.

[00:11:59] So, you know, thinking about that, are there examples of successful

[00:12:03] initiatives or strategies that have worked in promoting,

[00:12:07] you know, health equity, tech equity within health care systems that you know of?

[00:12:12] Yeah, the first one that comes to my mind in a great question,

[00:12:15] I think we have miles to go.

[00:12:16] But, you know, the federal investments that has been

[00:12:20] $42 billion to improve Internet access.

[00:12:23] That's 14 billion dollars, which provides to extend

[00:12:26] the emergency broadband benefit program. Right.

[00:12:29] So these are, you know, gives us a sign of hope and shows that there is being

[00:12:33] importance placed in digital divide. Right.

[00:12:37] There is a call to action on creating responsible AI,

[00:12:40] responsible deployment of information, which goes hand in hand.

[00:12:44] I see councils and stakeholders across many organizations

[00:12:49] taking a stand on how AI has to be used.

[00:12:52] We also see large investments being deployed in research

[00:12:55] and innovation to women's health, which are all, you know, great,

[00:12:58] great starting points and great momentum.

[00:13:00] We're seeing ideally grace.

[00:13:02] I think the question is not how we use technology to create equity.

[00:13:06] It is equally critical.

[00:13:08] We use an equity lens while creating technology. Right.

[00:13:11] So this lies in the idea and the design, the MVP of a product

[00:13:16] execution and truly the scaling of it.

[00:13:18] That makes a ton of sense.

[00:13:19] You know, I think you're right.

[00:13:21] It's like there is so much we could do after the fact.

[00:13:24] And some of those initiatives, especially in telehealth have helped. Right.

[00:13:27] But it's unless we're developing it, keeping that lens while developing it,

[00:13:31] it's never going to be fully integrated.

[00:13:33] Part of the genome of the innovation will not be equity

[00:13:37] unless it's included. I love that genome of innovation.

[00:13:40] Right. It's by itself. Right.

[00:13:42] What it would take to innovate truly, you know, with equity,

[00:13:46] but with an all inclusive mindset, because I think, you know,

[00:13:49] big part of innovation is we cannot do it all right.

[00:13:52] We all come from different lifestyles and different parts of life,

[00:13:55] but having everyone else involved really opens up

[00:13:58] boundaryless innovation and creative as we can do.

[00:14:01] And I would love to, you know, share really about the awareness

[00:14:04] that's required. Right.

[00:14:05] And I think this may be something we'll be talking about is

[00:14:08] how does tech equity impact individual access?

[00:14:11] I think that's key. Right.

[00:14:12] Before we go into what's been happening. Yeah.

[00:14:15] So the first line of awareness and action for us

[00:14:18] is to look at a digital divide. Right.

[00:14:20] We're talking about technology, telehealth.

[00:14:22] But where are we right now, Grace?

[00:14:24] 82 million Americans don't have access to internet.

[00:14:27] I mean, this is 2024 and only 57 percent of us

[00:14:31] belong to the who belong to the low income have access to internet.

[00:14:34] Right. Then we have to look at our literacy in English and technology.

[00:14:38] 26 million Americans are not literate in English,

[00:14:43] which means that they don't have the access to the patient portals.

[00:14:46] Right. And now you can imagine these users lack awareness

[00:14:50] to benefits of digital, there's mistrust in tech

[00:14:53] and health care system resulting in low literacy overall.

[00:14:56] Right. Some rays of hope is obviously 5G innovation

[00:15:00] we think is going to really benefit and make this a little bit better.

[00:15:04] At Accenture, we did estimate about

[00:15:07] 8.4 million rural households

[00:15:11] could gain access to improved connectivity and speeds.

[00:15:13] Non-white. So it's possible it's just not being done

[00:15:16] because no one is finding the financial reason for it or why?

[00:15:21] I mean, you know, in a great question.

[00:15:23] I, you know, yes. And and also no. Right.

[00:15:26] Because I think there are organizations that are doing

[00:15:30] innovations to make internet available at every zip code globally.

[00:15:35] Right. So now it comes to us as health care systems,

[00:15:38] as policymakers, as leaders to partner with this organization to say, hey,

[00:15:43] if you're innovating and making sure internet is accessible everywhere,

[00:15:47] how do we know how do we now partner with you

[00:15:50] to make health care more accessible? Right.

[00:15:52] So I think it's so health care, I think, is everyone's business.

[00:15:55] We all need health care. Right.

[00:15:57] So that's when I think the part of cross industrial collaboration

[00:16:01] really starts playing a role here.

[00:16:03] Health care is really beyond the walls of clinical settings, as you know, Grace.

[00:16:07] So I think that's really some of it. Right.

[00:16:08] So 5G innovation is one really looking at telehealth,

[00:16:12] which really, you know, in 24 hours we had telehealth up and running during COVID.

[00:16:17] But you were not doing it before.

[00:16:18] So here, you know, moment of awakening is, you know,

[00:16:21] we are able to do these things, but we have to do it proactively,

[00:16:25] not just reactively. Right. Wow. You're so right.

[00:16:28] Kind of thinking about those that now, you know,

[00:16:31] what challenges are you foreseeing?

[00:16:33] You know, that and kind of some of these potential tech equity initiatives

[00:16:39] create changing this lens.

[00:16:41] And, you know, how can organizations overcome these obstacles,

[00:16:45] overcome these thought processes that they've had for so long?

[00:16:48] Yeah. First a sip of tea, because, you know, heavy question.

[00:16:51] Drink that tea, girl, then spill it.

[00:16:55] Spilling the tea is a good roast and black tea.

[00:16:57] I'll share about it as we wrap up. Right.

[00:17:00] But one of the primary obstacles really lies in the digital divide

[00:17:04] that presses across social, economic and demographic lines.

[00:17:08] Access to technology, digital literacy, reliable internet connectivity

[00:17:13] are significant barriers for many undeserved communities.

[00:17:17] And then we move on to the implementation of new technologies

[00:17:20] in health care settings.

[00:17:21] And this often requires significant capital investments,

[00:17:25] infrastructure upgrades, which can be really challenging

[00:17:29] for resource constrained health care organizations. Right.

[00:17:32] And then, Grace, we have financial barriers

[00:17:35] that can perpetuate a cycle of technological inequities,

[00:17:39] leaving really the undeserved communities behind

[00:17:43] advancements in digital health, the tools, the platforms that could be evolved.

[00:17:47] And another critical challenge really lies

[00:17:50] the need for culturally competent and inclusive design

[00:17:53] for digital health solutions.

[00:17:55] Yes. Yes.

[00:17:58] So again, we are, you know, it's clear that we're coming back

[00:18:02] at the same point, right, which is inclusiveness and creation in the design,

[00:18:07] which means that we do need to bring them in, which is cultural context,

[00:18:10] the languages, accessibility needs and all of these, you know,

[00:18:14] looking across different populations.

[00:18:16] I had a friend who was sharing with me that, Simi, you know,

[00:18:19] I'm in one zip code, how inequities show up in this zip code.

[00:18:24] And if you move five blocks down, it's completely different.

[00:18:27] So then I thought, you know, there are inequities within inequities.

[00:18:30] There's so many layers to this that needs to be unraveled.

[00:18:33] And that's when we need, you know, community influencers really doing this.

[00:18:38] Right. We have national strategies working on this, but that's not enough.

[00:18:42] We need to be doing this from our homes, from our streets, from our communities.

[00:18:45] And that's really what would make the change

[00:18:49] from a root level, not just us band-aiding a few of this. Right.

[00:18:53] Furthermore, I think the last one is really there are concerns

[00:18:56] about data privacy, security and the potential for algorithmic.

[00:19:02] Algorithmic, yes.

[00:19:04] Yeah. A little bit of tank west.

[00:19:06] So really, you know, us looking at AI biases, machine learning technologies,

[00:19:11] looking at Internet access, but really looking at it

[00:19:15] at a foundational level and doing the foundational work.

[00:19:18] And my favorite quote always is,

[00:19:21] we want the right things to work faster, not the crappier things. Right.

[00:19:24] So let's clean up the foundation and then talk about AI

[00:19:28] and automation than the other way around.

[00:19:30] I love that. It seems like in health care, just make the crummy things work

[00:19:35] faster and better and the crummy systems and the crime.

[00:19:38] It's like, no, it's not only crummy, but it's inequitable.

[00:19:42] So it's about more than just not working right.

[00:19:45] It's about, you know, it working well and correctly

[00:19:48] and within this lens of seeing people in an equitable way.

[00:19:53] Yeah, you know, and in a truly grace, this is actually also good business sense.

[00:19:57] Right. Because we always go back. Right.

[00:20:00] We do something then we're like, OK, it's not working

[00:20:03] because you have to make the small change and we go back and start from scratch.

[00:20:06] We are losing money doing that. Right.

[00:20:08] So the call really to action is let's do it right.

[00:20:11] Where are you going to start it? Right. Let's not repeat it.

[00:20:14] And that's really a good business sense.

[00:20:16] And also, you know, thinking, you know, as a business leader,

[00:20:19] we do want to be, you know, in every market segment. Right.

[00:20:23] So I think it's truly just good business sense to do it.

[00:20:26] But also, it's a responsible citizen to really for us to show up

[00:20:30] to be doing this right way. So two sides of the coin.

[00:20:33] So true. So true.

[00:20:35] So now I would love to learn more about you.

[00:20:37] You know, we talk business, we talk tech,

[00:20:40] but I would really want to know what drives you as an amazing leader

[00:20:44] that have worked in so many different parts of health care from different roles.

[00:20:47] You know, what drives you?

[00:20:49] So what are some habits or things that you have in your personal life

[00:20:54] that help you work your best and make a difference?

[00:20:56] Great question. Many things. Right.

[00:20:59] So when I was young, grace, you know, I come from a family of physicians

[00:21:03] and politicians and everything had a few losses. Right.

[00:21:06] But it made me really realize that we have to take care of our own health.

[00:21:10] Like no one else is responsible.

[00:21:12] It's not the policy. It's not everything else.

[00:21:15] If you can eat right and be physically active, right,

[00:21:18] most of the diseases are preventable.

[00:21:20] So that's one. Right.

[00:21:21] For me personally, I have a rule five days a week for the last 15 years.

[00:21:26] Two hours in the morning is physical physical activity time. Right.

[00:21:29] So I practice a stronger yoga every day, two hours in the morning.

[00:21:34] And then I can do whatever needs to be done. Right.

[00:21:36] So I prioritize my health because I truly believe that

[00:21:39] if you're selfish about your own health, you're actually

[00:21:42] selfless with your loved ones because you can think about it. Right.

[00:21:45] You worry about your parents, your loved ones, and you tell them how to eat right.

[00:21:49] And then I'm like, you know what? I don't want to be a burden. Right.

[00:21:51] If I'm taking care of my health, everyone can sleep in peace. Right.

[00:21:55] As a daughter, as a friend. Right.

[00:21:58] So I think that's that. And I spend a lot of time in nature.

[00:22:00] I love hiking. I'm out of the nature. That's key.

[00:22:03] I eat well. I'm a raw vegan chef.

[00:22:05] So most of my food is plant based.

[00:22:08] No red meat, no meat per se.

[00:22:10] No milk, no bread.

[00:22:12] And I've been that way for 15 years. Right.

[00:22:14] There's a lot of science behind that.

[00:22:16] And if you've seen Grace, the industry is moving towards a plant based diet,

[00:22:21] which is responsible for the earth, responsible for ourselves.

[00:22:24] And we have seen a lot of disease states go up,

[00:22:27] but you're not on a plant based diet. Right.

[00:22:29] So there's a lot of science, clinical trials behind that going on.

[00:22:33] So to me, it's eat right, be physically active.

[00:22:36] And the last one is being kind. I'm working on it. Right.

[00:22:40] Everything is a practice in life.

[00:22:41] So being kind to ourselves, being kind to everybody else

[00:22:44] and knowing that in our finite time,

[00:22:48] there's infinite opportunity to change lives.

[00:22:51] And that starts from us.

[00:22:53] So we have to take care of ourselves and then rest falls in place.

[00:22:57] I love that.

[00:22:57] And I love that your nutritionist, nutrition background

[00:23:01] kind of fuels a lot of the health choices that you're making in your life.

[00:23:04] Are there any great recipes that you're like, I just this is so easy

[00:23:08] and it's just filled with the right nutrients.

[00:23:11] And I love it that you'd be willing to share with us.

[00:23:13] Yeah. Good question.

[00:23:14] You know, busy person, right? I'm up and running.

[00:23:16] So my favorite thing and I've always loved is smoothies.

[00:23:19] Easy blended all in all nutrition one.

[00:23:22] My favorite recipe is a cup of coconut water.

[00:23:26] Some blueberries, right?

[00:23:27] Three fourth cup, I would say a couple of bananas.

[00:23:29] I don't believe in calorie intake.

[00:23:32] This is something I'll point out on everyone's metabolism is different.

[00:23:35] So I don't believe in calorie as long as it's natural.

[00:23:38] Obviously, pre-existing conditions, you know, check into that.

[00:23:41] So a couple of bananas dates for iron.

[00:23:44] I love using a scoop of vanilla protein powder.

[00:23:48] I use raw vegan ones, plant based, which is extracted from pea protein.

[00:23:53] So no way.

[00:23:54] And then what else do I add?

[00:23:55] I may add some chaga powder somewhere in there.

[00:23:58] I like the nuttiness, the flavor.

[00:23:59] I'm all about the aroma and the texture.

[00:24:02] And then just that's it.

[00:24:03] Then it up and that spinach cilantro.

[00:24:05] I'm a big thing about cilantro, right?

[00:24:06] Because we exposed a lot of metals nowadays, right?

[00:24:10] With the lifestyle we live.

[00:24:11] So cilantro, spinach is my go to.

[00:24:14] I could I drink this almost every day, like almost 20 ounce to 30 ounce.

[00:24:18] Yummy. Well, I think that we should do virtual breakfast one day and make your smoothie.

[00:24:23] So I'm going to be texting you after this

[00:24:26] and we're going to figure out a time to do that,

[00:24:27] because I know all of us would love to try it.

[00:24:30] Love it. Whenever you're ready.

[00:24:31] So, you know, kind of moving into more serious conversation.

[00:24:35] Obviously, huge obstacles come our way when we're women leaders,

[00:24:39] no matter who we are, where we are, when we are.

[00:24:42] What are some strategies you have in your personal life

[00:24:45] when those obstacles hit you and doors closed

[00:24:48] that help you just get through to the next thing?

[00:24:50] The first thing I'll say, Grace, and if you watch me on news,

[00:24:53] you'll know that I believe in when a woman steps into a room,

[00:24:57] it's not really a woman or a man, right?

[00:24:59] It's genderless. You're a human.

[00:25:01] That's where it starts. That's where it ends. Right.

[00:25:03] So we talk about obstacles.

[00:25:04] I'm just going to talk gender neutral, same obstacles for everybody else,

[00:25:08] maybe some different for us. Right.

[00:25:10] I think it's really if you're talking about business obstacles,

[00:25:14] leadership obstacles as a woman, then to me, it's a mindset change. Right.

[00:25:18] It's important how we think about ourselves and how we show up in the room.

[00:25:22] To me, I'm there for my talent, for my leadership, for my skills.

[00:25:26] That's about it. I'm not there as a woman.

[00:25:28] I'm not there as a man.

[00:25:29] None of that plays a role in my head. Right.

[00:25:31] So I think that mindset shift has to happen within us.

[00:25:34] And then that happens within us.

[00:25:36] It would automatically happen outside it.

[00:25:38] That's my mantra. I haven't ever I've been raised that way.

[00:25:41] I've been living that way.

[00:25:42] So that's one.

[00:25:43] But if people are not in that mindset yet,

[00:25:47] then my request would be to make that shift.

[00:25:48] But secondly, is also understanding that, you know, listen,

[00:25:52] I believe compassion, kindness can move mountains.

[00:25:55] Even in the toughest of the situations, be kind yourself,

[00:25:59] hold space for other people to show up, go through the ups and downs. Right.

[00:26:03] But also hold, hold your position.

[00:26:05] My dad often says, Simi, never forget your position.

[00:26:09] The longest time I thought, I don't know what it meant. Right.

[00:26:11] It always meant that being a place where you understand your value,

[00:26:15] being a place you're always humble and you're willing to learn.

[00:26:18] So it's always that equation creates curiosity,

[00:26:22] creates expansiveness, creates inclusiveness.

[00:26:25] But really change starts inside out and the outside end just happens.

[00:26:29] Hold your position.

[00:26:31] Now it's making me really think and I'm sure everyone else is feeling the same way.

[00:26:34] Like, what is my position that I need to hold here?

[00:26:37] It only took me 30 plus years.

[00:26:39] So, you know, still working on it, right?

[00:26:40] Changes, changes, context, changes per person.

[00:26:43] But it's more about understanding what it really means

[00:26:45] is understanding your values. Right.

[00:26:47] And now I've come to this value mapping exercise, understanding what

[00:26:50] what is my value, what is my essence,

[00:26:53] and then how do I match my essence with understanding who I am,

[00:26:57] what matters to me, and then using that for service to others. Right.

[00:27:01] So that equation of essence, how you show up, which is your energy

[00:27:05] and then eminence. Right.

[00:27:06] So the three E's is what, you know, kind of the value system.

[00:27:10] So inspiring, so inspiring.

[00:27:12] Definitely gives us food for thought today.

[00:27:14] So, you know, before we end out, I'm wondering,

[00:27:16] you know, what are some of your three top takeaways on the future of health?

[00:27:20] You know, we're all health care innovators here listening in.

[00:27:23] And what are you hoping to see?

[00:27:25] Yeah. So my three takeaways always has been for the future of health

[00:27:29] is the first one is empathy.

[00:27:31] I think empathy has to be at the core of everything we do

[00:27:35] from technology to patient care.

[00:27:37] There is no way we can make progress without having that as the core.

[00:27:40] The second one is placing equity at the center of our technology.

[00:27:44] This is important for the society we serve.

[00:27:46] And truly, it's just a good business model. Right.

[00:27:50] The third one, Grace, is we are only strong as our weakest links.

[00:27:54] And as a collective, we have to make sure that we lift others up.

[00:27:58] And that shows up in making sure everyone has equal access to internet,

[00:28:02] equal access to food, healthy food, the facilities and more.

[00:28:06] So I think, you know, really the three things are empathy, equity

[00:28:10] and collective ways of working.

[00:28:13] I love that.

[00:28:14] You know, so now for the folks that are listening in today,

[00:28:17] where can they find you online?

[00:28:19] Great question. They can find me on LinkedIn.

[00:28:21] That's Murthi Kaurav. Kirbanand that is my name.

[00:28:23] They can find me on my podcast, which is also called HLTH Forward.

[00:28:28] They can just Google. They will find me there.

[00:28:30] But if they need to reach out, LinkedIn is a great way.

[00:28:32] Essential emails are there. They could reach out there.

[00:28:35] But I'm here, as you know, as much as required.

[00:28:37] Awesome. Now, before I forget, did you happen to bring tea with you today?

[00:28:42] I did. Ah, now tell me about your tea or your mug.

[00:28:46] OK, so tea again, I'm going to start with a coat

[00:28:49] or maybe wrap it up with a coat.

[00:28:52] Tea, though ridiculed by those who are naturally coarse

[00:28:55] and their nervous sensibilities will always be the favorite

[00:28:58] beverage of the intellectual.

[00:29:00] It's a coat by Thomas De Quency.

[00:29:02] Thanks for sharing tea with me.

[00:29:04] My tea, I love the blend of black tea and rose petals.

[00:29:10] I think it's the most elegant blend.

[00:29:13] I love being in London.

[00:29:14] It's one of my favorite cities in the world.

[00:29:16] But this is from Fortnum and Mason.

[00:29:18] And if you've been that great, it's you go to the store.

[00:29:20] It's literally like my Disneyland, right?

[00:29:23] Three levels of tea and seasonal cookies.

[00:29:27] Yes, it's a trip for it.

[00:29:29] I'm going there this spring, so I'm going to have to go.

[00:29:32] Yes. I mean, you have to.

[00:29:33] And I mean, it's really one of my favorite spots.

[00:29:36] But this tea is really the blend of the rose petals,

[00:29:40] the elegance of it and the depth of the black tea.

[00:29:43] It's just the aroma.

[00:29:45] I just love the elegance and the smell of it.

[00:29:47] So that's my tea.

[00:29:49] And the cup is a Japanese, actually a teacup

[00:29:52] gifted by a friend from Canada.

[00:29:54] So it's really made of ceramic.

[00:29:57] But if everyone's looking at it, it's got the hues of blue,

[00:30:00] the dark purple, which is the central color,

[00:30:03] but really very soothing to the eye and the soul.

[00:30:06] So that's my tea. What about you?

[00:30:08] I love that. Well, I have my Blackberry Sage tea

[00:30:11] and I give this tea as a gift to like so many people

[00:30:15] anytime it's somebody's birthday.

[00:30:17] I haven't given them the tea before.

[00:30:18] I love to gift it to them.

[00:30:20] And I got this mug actually as a women in Health IT gift exchange.

[00:30:25] So you kind of join it and then women from across the world

[00:30:28] will send gifts depending on who is pulled.

[00:30:30] So it's kind of like a secret Santa,

[00:30:32] but it will happen randomly throughout the year.

[00:30:34] And so this was one of the mugs that I got from a wonderful woman in Arizona.

[00:30:39] Yeah, I love the copper color filled with blackberry and sage.

[00:30:44] Absolutely. It's my favorite right now.

[00:30:47] You know, I want my house to smell like that. That sounds great.

[00:30:50] I know the aroma is just fantastic.

[00:30:52] So it was so wonderful to have you here today, Simi.

[00:30:54] Thank you so much for joining us.

[00:30:56] Thank you so much for having me, Grace. Thank you.

[00:30:59] And thanks to you folks for joining us too.

[00:31:01] Check out the Hi Tea with Grace podcast website

[00:31:03] for more great interviews like Simi today. Cheers!

[00:31:14] And the voices of outstanding women innovating in health care.

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