Philip Morisky — Adherence & the Missing Metric in Healthcare

Adam Walker:Welcome to Pharma Prescribed Podcast. I\'m Adam Walker, a biometrics consultant looking to uncover the real stories behind life science leaders in clinical research. Today\'s guest is Philip Morisky, who serves as chief optimist at adherence leading the company\'s mission to revolutionize. Global medication adherence under his leadership adherence is transforming from a clinical assessment developer into a global health technology company while maintaining the scientific integrity and validation that has made MMAS the gold standard in adherence measurement.

Adam Walker:Philip, welcome to the show.

Philip Morisky:~~Thank you Adam. Thank you, listeners and your entire audience for this platform.~~ I\'m very honored to be here today. ~~Adam, you and I go back quite a while and, just happy to reconnect.~~

Adam Walker:Great to see you today. And I thought maybe we could start by you telling us ~~a little bit of background to~~ how you came into the industry and how you find yourself here today.

Philip Morisky:Yeah, so adherence, it is. More than just ~~a,~~ a concept or a company. You know, healthcare doesn\'t work if people don\'t follow through, and what I\'ve seen is that healthcare is really focused on behavioral change over time. That\'s ~~the whole,~~ what adherence ~~is, is,~~ is maintaining your regimen, being, ~~you know,~~ consistent and sticking to it.

Philip Morisky:~~So take for our first question. So~~ the MMES is actually called the Morisky Medication Adherence Scale. It\'s a tool that was originally developed by my father, Dr. Donald Morisky. He is a behavioral scientist. ~~Graduated,~~ with his doctorate at Johns Hopkins andled a almost 40 year career at UCLA School of Public Health in Behavioral Sciences, community health sciences.

Adam Walker:Wow. So dare I say it, you are following very large footsteps of your father. ~~And, hopefully his shadow doesn\'t carry too far over you.~~ Does he still keep involved in day-to-day activity?

Philip Morisky:~~No, no.~~ He\'s happily retired. He has five grandchildren between my brother and I, two boys from myself and three girls from my brother.

Philip Morisky:~~And,~~ he\'s just enjoying life, ~~you know,~~ traveling and seeing what great things that I\'ve been doing.

Adam Walker:That\'s really amazing. So is it fair to say ~~that, if there were a question about who your hero might be~~ that he might fulfill that category in the fact that he\'s opened an avenue and a door into an industry that perhaps you might not have otherwise found yourself.

Philip Morisky:He is. ~~Yeah.~~ He is a real, mentor for me. ~~You know,~~ I really looked up to him for what he\'s done.

Philip Morisky:And, just to rewind a bit. Let me just go ahead and talk about, how I came to be here. ~~Yes, of course. So, you know,~~ when I was a little kid, I was always that one kid that always asked Why, you know what I\'m talking about?

Philip Morisky:~~Yep. You know,~~ when the teacher says, Hey, don\'t do that, or your mom says, okay, time to go to bed. I always ask why. Even if it made sense, I would be the one who says, why not? I wasn\'t trying to be difficult, but I really believe that every rule and every behavior, ~~I mean,~~ there had to be like a root cause there, or there had to be a reason for it.

Philip Morisky:And if there wasn\'t, we have a right to change it. ~~Some kids grew outta that phase. I just happened to build a career around~~

Adam Walker:That\'s really interesting that you say that. I think we probably have lots of listeners who are themselves very, obsessed about the details and certainly asked the questions why all the time.

Adam Walker:~~And I think we all come into this industry from different areas.~~ I\'ve spoken to many people over the years who. Identify their why as being something that connects \'em to helping other people. Something that really drive their passion every day. What is it the thing that gets you outta bed in the morning then?

Philip Morisky:~~So~~ I wasn\'t actually background in medicine or healthcare. It\'s actually in leadership and management. I went to my master\'s program, graduated a business degree, and I built two successful companies and I exited them. Successfully, even before I entered the health space, I\'ve always kind of followed and shadowed my dad and went to some of the conventions that he spoke at.

Philip Morisky:He was a professor, so I went to UCLA, hanging out with him and talking to his students and his, colleagues and what drew me to the science of medication, it was, the mystery of why people aren\'t adhering to their medication regimens. A hundred percent of the time, they\'re not consistent with it.

Philip Morisky:~~So,~~ that\'s what I was, really focused on.

Adam Walker:So what do you think is the reason why people don\'t adhere to their medications? ~~Because I\'m on a couple of medications and I make sure I take them at the same time every day, and that they become part of my routine.~~ What are some of the reasons why people don\'t,

Philip Morisky:It\'s not really the science of it.

Philip Morisky:It\'s more of like, it\'s the silence of it. So nobody\'s really asking the right questions about their behavior. I mean, we\'re pouring resources into these treatment plans, but we\'re not checking whether anyone actually is following them. So when we ask questions, sometimes we ask it the wrong way. ~~I mean,~~ if the doctor asks you, you take your medications, right?

Philip Morisky:What would be the first thing you say?

Adam Walker:The answer ~~I would say~~ is yes,

Philip Morisky:yeah, you probably have your fingers crossed behind your back and say, of course, doctor, you know, I always take my medications. So I think that\'s where, nobody wants to disappoint their doctor. And that\'s what my father actually kind of pointed out to me when we talked about how he developed this tool why don\'t we just rephrase that question.

Philip Morisky:If I asked you, do you sometimes forget to take your medication?

Adam Walker:I haven\'t forgotten to take my medication, but ~~perhaps~~ the timing of it might not be the same time every day.

Philip Morisky:Yeah. But the whole point is that it\'s not accusatory, it\'s just an honest question. You\'re saying sometimes. So the word sometimes really opens up. It turns the guilt into the truth, you know, it\'s more of a conversation and that\'s what builds the insight into it.

Adam Walker:It\'s really interesting because, you know, from this point of view and having an open conversation with you today, the whole point of having general conversations is to ask open questions, isn\'t it?

Adam Walker:Because the yes, no answers are the ones that don\'t get the answers that anyone wants to hear. ~~To be quite frank.~~

Philip Morisky:Yeah. I mean, people don\'t wanna fail their health. They want the health to stop failing them. That\'s how I really, that\'s like kind of a, a little, you know, pressure point that I\'ve always thought about.

Adam Walker:And I think ~~the other,~~ the other aspect of that is of course, if you\'re not. From a background of clinical research or life sciences, you don\'t necessarily connect action with outcome. And I think what we\'ve seen over the last few years, particularly thinking about the pandemic and COVID, has been action and outcome.

Adam Walker:In other words, did you take the vaccine or did you decline the vaccine? Did you get COVID? Were you very poorly as a result of it? ~~You know,~~ what was the outcome of that? And I think people have. Experience that firsthand over the last few years, but also there is an understanding of the language around clinical research, drug trials and pandemics more generally.

Philip Morisky:Yeah. ~~No, definitely.~~

Philip Morisky:I mean, we\'re really, ~~you know,~~ coming up with these new methods and, patient report, outcome measures, ~~which, you know, prompts,~~ it\'s really a tool that\'s getting that subjective validation into the system.

Philip Morisky:~~You know,~~ we still have the objective measures like, pharmacy refill data, but to introduce, the patient voice, let us listen to their story. They have a lot to say, let us bring that patient back into the mix and get their honest responses because obviously. If you ask the questions the wrong way, they\'re going to answer the wrong way.

Philip Morisky:They\'re not gonna give you the right response. So what the MMAS does it, it avoids that social desirability bias. It avoids time, recall bias. And those are the two of the biggest reasons why most adherence surveys, ~~you know,~~ actually fail. Yes. We\'re really getting those honest answers and the right timing as far as the responses.

Adam Walker:It,

Philip Morisky:it\'s a

Adam Walker:really interesting point you make there, because I remember historically. Working on many clinical trials where there were patient. Patient diaries and in the old days ~~mm-hmm. People,~~ people would complete them just outside the doctor\'s room, wouldn\'t they on paper bring them in ~~and,~~ and of course they\'d all be at, ~~you know,~~ collected ~~at,~~ at very similar time points when in fact the reality that we know now with patient recorded outcome devices and E pros is entirely different.

Adam Walker:And I think there was always a sense that people were embellishing or telling different stories to the reality, but now we can actually see that.

Adam Walker:Do you use, the MMAS score alongside E Pros ~~and,~~ and various other measures.

Philip Morisky:As far as what I do, I work with, CROs, I work directly with sponsors, big Pharma, and, help develop the protocol.

Philip Morisky:Typically, the PI or the principal investigator will already have an idea of how they want it structured. I would just steer them into what works. If it\'s an observational trial or if it\'s an interventional trial, we\'ll come up with the, subsets of questions and, how to use this tool to the best of its ability.

Philip Morisky:You know, really focus on driving those responses correctly. Making sure that the patients understand the questions in its entirety, especially when we translate it into different languages. We have a big library, a robust library of. Intricate, dialects from larger nations down to, just standard, east.

Adam Walker:Yeah.

Philip Morisky:So that

Adam Walker:It sounds very far reaching.

Adam Walker:And I remember when we previously spoke, you told me about. The extent of the countries that this covers, and it\'s into the hundreds, isn\'t it? The translations are into the hundreds of the world.

Philip Morisky:And some of the unique languages that we\'re actually working on, you know, it could really.

Philip Morisky:Tell how vast this tool is reaching. I mean, we\'re translating dialects in Ethiopia, even New Zealand in the Maori language. There is a population that could really benefit from this inexpensive, very useful and very easy to, decipher tool. So my goal is to get it into every, the smallest country or the smallest village.

Philip Morisky:To the largest, metropolitan area, everybody should be able to use this tool, properly and correctly and efficiently.

Adam Walker:That sounds amazing. ~~So presumably there is a licensing cost to doing that.~~ For any particular investigators that are running clinical trials that may be listening to our podcast, what kind of information can you share with them about how this would work for them?

Philip Morisky:I\'m always, up for collaborating, working with academic institutions. In fact, I have a memorandum of understanding, so essentially I have a collaboration with already over 300 universities and teaching hospitals around the world

Philip Morisky:we put academics first, non-funded, thesis and dissertations. I really emphasize that.

Philip Morisky:I have built a platform called Atlas, an acronym for adherence tools and location analytics system. What it does is it\'s taking all this empirical data, this structured, raw data from the MMA scores and it\'s populating it onto a visual map.

Philip Morisky:And eventually, ~~you know,~~ my goal is to provide, real time data on adherence levels, low, moderate, or high. And the WHO has always emphasized that nearly half the population or 50% is a threshold or benchmark of our non-adherence. Well, how do we justify that? And that\'s what the MMAS does.

Philip Morisky:It\'s a measurable tool, and it\'s a manageable outcome.

Adam Walker:That\'s, very impressive. And now I\'m remembering the demonstration that you gave me some time ago where you showed that real world platform where you can point across the globe to see adherence for particular therapeutic error.

Philip Morisky:day, I think May 27th, I did launch a landmark. Test, so to speak. And we\'ve received over, I believe, 1500 responses all around the world from different countries in real time, and it kind of gave us a bird\'s eye view of where adherence levels are and where the opportunity.

Philip Morisky:That we combine social determinants of health, age, sex, marital status, education, all those factors. And we can look at adherence levels. We can actually come up with ideas on how to, better manage these areas, if it\'s low adherence and the demographics point to, low income. We could have educational, trainings or educational outreaches to show people that, these tools or medication adherence is important.

Philip Morisky:If you want to manage your symptoms, if you want to, ~~you know,~~ quality of life, we have regimens built into the system that work for you.

Philip Morisky:Medication adherence ~~or,~~ or non-adherence, I should say. It\'s really broken up to intentional and unintentional behavior. Once we benchmark that and we know where our patients stand, then we could develop ~~the,~~ the resources and the solutions.

Philip Morisky:You can\'t just throw app reminders and pill boxes to a hundred percent of the population and say, now these patients are gonna, ~~you know,~~ stick to their regimen because some patients stop taking their medication because of side effects. Yes. And they don\'t tell their doctor. ~~And,~~ which is one of the questions in the MMAS tool, ~~you know,~~ thinking over the past two weeks, was there a time when you didn\'t tell your doctor that you stopped taking your medications?

Philip Morisky:That\'s a huge miss for, a lot of patients that, when they come into the doctor\'s office, the doctor thinks they\'re taking their medication, but they stopped three or four weeks ago.

Adam Walker:Yeah, and I think because of the nature of healthcare, both in the states and across the globe, it\'s not easy to access doctors more generally, general practitioners.

Adam Walker:I\'m fortunate, I can see through my window, I live next door to my, healthcare provider, so I\'m very fortunate. I can knock on their door and they know me on first name terms, but that\'s quite rare, certainly in the uk and I think across the globe and in the US it\'s a very different model, isn\'t it? So access to medication, access to care is very, very different.

Philip Morisky:Yeah, yeah.

Philip Morisky:So the MMAS was originally built into the clinical research, arena, researchers, students, clinical trials. Clinical trials is our main vertical right now. They would, sponsors or CROs would leverage it in as an outcome or endpoint measure.

Philip Morisky:But what I\'m really focused on is bringing this to standards of care. ~~You know,~~ what comes from clinical study could really lead to clinical practice. ~~You know,~~ it\'s been validated a hundred times over different languages, different medical conditions. It\'s a simple tool that if we could integrate this into an EHR system, so many physicians would definitely benefit from it.

Philip Morisky:And that\'s where I\'m, ~~you know,~~ I\'m really focusing my efforts on, to educate, companies remote patient monitoring platforms, to use this tool, to use these questions. Very simple, but very effective. And that\'s what, the goal is right now.

Adam Walker:So that sounds like a very heavy lift.

Philip Morisky:~~You\'d think so. AI is definitely a, really, really helping out.~~

Philip Morisky:So what I\'ve actually built, and I\'ve worked with, several partners on this, is an AI enhanced, agent. And as long as we have a structured protocol like the MMAS.

Philip Morisky:AI could really enhance that aspect of it, and you could really scale it up as far as. Getting pharmacists the data that they need. ~~You know,~~ rather than spend 10 minutes of a physician\'s time asking these questions, how simple would it be that that physician or pharmacist could get a care, a patient profile identified whether they\'re low adherent and the reasons behind it, their barriers to adherence, whether it\'s intentional behavior.

Philip Morisky:Like they\'re, they don\'t think the medication works, or they\'re, like I said, side effects or if it\'s unintentional behavior, like they just have problems remembering maybe an app reminder would be beneficial or maybe changes in the routine. There\'s also a difference between problems remembering and just simply forgetting, because when you have problems remembering you don\'t really have ~~that,~~ that cue to action ~~or, you know, real Yeah.~~

Philip Morisky:Similar to like brushing your teeth. You know, your focus, you say brushing your teeth is good for you, you know, it avoids a lot of, problems with your health. Sometimes you have to have that when you, in the same aspect of medication taking behavior. Yeah.

Philip Morisky:So one thing that adherence is really focused on, ~~and,~~ and I\'ve learned a lot, you know, even though I don\'t have a behavioral science background, I\'ve read so many research papers on this, adherence could be applied to so many other aspects.

Philip Morisky:And that\'s one thing I\'m working on right now is developing derivatives, enhanced, MMAS tools focused on smoking cessation, alcohol, exercise, and diet. These are all behaviors that you could apply the foundation of the MMAS and really go into that behavior aspect of why patients continue to smoke even though they want to stop.

Philip Morisky:I mean, that\'s huge right there.

Adam Walker:There, there\'s a lot to unpack there. I mean, you touched on, cessation of smoking, but also I think there are so many things that we\'re aware of these days with regards to the direct impact of those choices. I mean, smoking highly addictive nicotine products

Adam Walker:are everywhere. ~~Dare I say it. Yeah.~~ I mean, I\'m so aware of them these days. I was out the other night with my wife at a music concert and an advert for these pouches that go under your tongue Snus. Snus, I think they\'re called, they\'re from Sweden. And, I couldn\'t believe that they were allowed to be advertised on these big screens all over the place because.

Adam Walker:To me, that\'s the tobacco product. So I wasn\'t entirely clear how they managed to circumvent the rules, certainly in the UK about tobacco advertising. And it was a conversation that we had, and you just reminded me of it, because it\'s everywhere. And there are many different ways in which big companies get their products out there.

Adam Walker:Similarly, you know, ultra high processed foods, same thing, you know? Why do people go back to unhealthy choices? Because it\'s highly addictive, right? Because it\'s very difficult to break the cycle because it\'s actually now harder to cook food in its raw state than it is to take something out of a packet that\'s already pre-packed, pre-prepared, straight in, you know, ~~it\'s,~~ it\'s literally an instant fix, isn\'t it?

Adam Walker:Instant calories.

Philip Morisky:~~It is.~~ And that\'s why I built the library. And the library is a collaboration of all these derivatives in using the MMAS as a foundational structure. And going back to the AI aspect of it, we can actually really benchmark and that, and I think the term benchmark is used very, loosely nowadays,

Philip Morisky:pharmacy refill data has been in my opinion, a disservice to the actual medication taking behavior. Pharmacy refill data really focuses on access to medications, and that\'s completely not what medication adherence actually is. Now we\'re seeing 90 and a hundred day refills. That really skew the data.

Philip Morisky:I mean, it\'s a checkbox that, the patient got their medication, so we assume that, you know, they took it, the pharmacist or the payer gets paid and everybody\'s happy, or everybody\'s not really happy because we don\'t know if that patient stockpiles or doesn\'t even receive it. Especially with mail order pharmacy nowadays, you can, get your Amazon deliveries and pirate thieves or.

Philip Morisky:~~Yeah.~~ You throw it into your medicine cabinet and you just forget about it.

Adam Walker:It\'s absolutely true. I think delivery does not necessarily connect with uptake, does it? So what is the answer to that? ~~Is it about having these direct questions and how often do they need to be answered by~~

Philip Morisky:patients?

Philip Morisky:Yeah, it\'s, it\'s a hybrid approach. I think pharmacy refill data has its benefits. Especially from high level, oversight, but including or bringing the patient\'s voice into that definitely helps out. And that\'s why I built tools like Zoe Adherence, which is the AI agent. And it\'s not just a chat bot where you have to say yes and you have to say no.

Philip Morisky:You can just have a conversation like we are. ~~And~~ it captures all that data, all the nuances, and it provides it to that pharmacist or the physician.

Philip Morisky:They could really benefit, they could use it for a pharmacist LED intervention is another thing that I\'m really focusing on. ~~You know,~~ pharmacists, community pharmacy has really changed and morphed over the years.

Philip Morisky:In the United States. There\'s a lot of, retail pharmacies closing and now community pharmacy is really enhancing their capabilities, their expertise as far as how they could, work directly with the patient. With all their knowledge of motivational interviewing, medication therapy, management, even precision medicine.

Philip Morisky:Those are all, expertise, ideas that pharmacists have. So I\'m really focused on developing a, training program actually, and I call it expert. And it\'s also on my website. And it\'s three levels of training focusing on how to use the MMS as a foundational, interventional tool.

Adam Walker:So you touched on a couple of points there that I just wanted to ask you about. ~~So yes, with regards to ai, you\'ve made a couple of references to it.~~ Has the awareness of AI and the tools around it particularly changed for you recently? Because certainly in in many other conversations I\'m having.

Adam Walker:I\'m aware that the access to these very cost effective tools now can really transform the work that we\'re doing. How\'s that been for you?

Philip Morisky:Oh, yeah. ~~It\'s, it\'s~~ been phenomenal. I\'ve had so much interest and, I\'m already trying to put together some pilot programs just to prove the efficacy of it, because we know it\'s gonna work.

Philip Morisky:We know these tools are valuable and reliable, and it\'s just a matter of identifying how the system works, how the ecosystem who gets paid. Et cetera. ~~And, and~~ that\'s where the challenge is. But it\'s also an adventure as well, because I\'m learning so much in, the past couple months I\'ve been working with lots of big, companies who really see the value and the benefit of this.

Philip Morisky:~~So it\'s, it\'s~~ been an amazing journey.

Adam Walker:So presumably there\'s development alongside licensing costs and backroom tech. ~~How does that work?~~ How is that working in developing this platform and the tools as you go forward?

Philip Morisky:I\'ve built so many integral partners in, what I do.

Philip Morisky:What I\'ve learned is the MMAS is not a standalone tool. Partnerships are key. Working with people who are already specialized in certain. Aspects of the, entire ecosystem can really put a tool out there that\'s scalable, replicable and efficient.

Philip Morisky:And I think that\'s, where the magic really happens.

Adam Walker:And for potential clients of yours, are you talking about earliest intervention at the protocol development stage? Is that the kind of time when you would be involved in conversation?

Philip Morisky:At all times, ~~I\'m working with a large,~~ right now I\'m working with the Kingdom of Bhutan, which is a small kingdom ~~I believe~~ near Tibet, somewhere around East Asia.

Philip Morisky:They\'re on world adherence day. They actually really embraced. The MMAS as the pharmacist interventional tool. And so I\'m working with them now to see how we could integrate it into the hospitals that they run through the Ministry of Health. So that\'s an exciting development that I\'m working on.

Philip Morisky:I have so many collaborations with the universities using this tool, and validating it. ~~I\'ve have,~~ so many new, developments with these derivatives and even the MMAS as a standard scale I\'m working on. Realigning it to bring it to a more modern aspect and a higher sensitivity, higher specificity.

Philip Morisky:Really the psychometric properties could be enhanced, with very minor changes. ~~So those are the things that I\'m working on.~~

Adam Walker:That sounds amazing.

Adam Walker:Your father must be incredibly proud. I wonder if he ever dreamed that it would get to where it is now and perhaps where it might be in the future.

Philip Morisky:~~he is, you know, he, he,~~ he\'s always been a behavioral scientist, so he ~~is~~ never really had ~~the,~~ the business aspect to him. He was really, ~~you know,~~ focused on educating his students. And he really emphasized ~~the,~~ the concept of beneficence, ~~you know,~~ taking what we have and giving back, not just, giving away, but similar to the way those instructions ~~are, are the, the questions are,~~ are structured. It\'s not just taking in information we\'re giving back to the patient in the form of, Hey, you\'re not adherent because of this. And so it differs from just a standard survey where ~~the,~~ they ask questions and then ~~you, you know, the, the~~ company who asked the questions, ~~they, they~~ get all this data, but the patient is kind of left like, Hey, I just provide you all this valuable data.

Philip Morisky:What do I get out of it? So ~~I, I~~ think that\'s ~~where,~~ where his whole, ~~I guess,~~ mantra was when he thought about medication adherence.

Adam Walker:That\'s fascinating. Thank you for sharing that. So, presumably, ~~you know,~~ not having a background in behavioral science, you\'ve learned a lot in and around this space, but also you\'re coming into contact with people perhaps who have a very different background to you.

Adam Walker:How do you overcome that kind of credibility point? Do you ever come across people who say, well. You shouldn\'t be talking about this because it\'s not your thing. Show me all your qualifications because, academics can be quite, difficult to deal with at times, can\'t they?

Philip Morisky:Yeah, it is. ~~I mean,~~ I\'m smart in my own aspect, but I do surround myself with,

Philip Morisky:globally recognized pharmacists who do give me their background. In fact, this training and protocol that I\'m working on, that I\'m really pushing out there, working with big pharmacies who are interested in these patient support programs. ~~I\'m using their knowledge of the pharmacist led intervention.~~

Philip Morisky:~~So they\'ve already have a background in medication therapy management and motivational interviewing. They\'ve done the research, we\'re just integrating the MMAS and they have already understanding it. They use it in their daily practice.~~ So it only comes naturally that I work with them directly, leverage their expertise.

Adam Walker:~~with that, you kind of get experience as you go.~~ You come to a point of pattern recognition presumably as well, where you\'ve seen things in different settings and perhaps those translate in different countries and geographies, based upon requirements that you find in front of yourself.

Philip Morisky:Yeah. And everybody sees Exactly. What I\'m trying to do here and how. Motivated I am in improving the patient experience. Bringing this tool that it\'s highly recognizable and highly reliable out in the open. It\'s kind of like a hidden secret, but we don\'t want it to be a hidden secret.

Philip Morisky:I think people are embracing, my motivation in this, I would love that it could be the standard of care. Skin medication adherence all around the world. That\'s my biggest goal. Translating it into as many languages as there are. And, going forward, I think there\'s a lot of opportunity there.

Philip Morisky:Just to partner with this Atlas platform that I\'m developing. The library, which is a curated group of, behavioral science and, hypothesis generating tools that are ready for validation, ready for translation, and just ready for collaboration, and that\'s where I\'m at, at about this.

Adam Walker:It sounds absolutely awesome and really, kudos to you for taking it forward in the manner in which you have, and clearly the success that you\'re going to have will build on everything. And hopefully this will give you that platform to a wider audience as well. To really speak about the capabilities of your MMA scales and how that might develop, in the future.

Adam Walker:So do you have specific plans for the future? ~~I mean, presumably there is a roadmap of success.~~ What does that look like for you for the next few years ahead?

Philip Morisky:There is, ~~yeah,~~ definitely a roadmap to the future of success, ~~I mean,~~ monetarily ~~that, you know,~~ success is always good, but more importantly, it\'s bringing this tool, working with hospital systems, working with pharmacists.

Philip Morisky:Just meeting new people and being invited to travel all around the world is what I\'m really motivated for. I\'m still young enough to be able to make an impact. Yes, and I know there\'s a lot of challenges with value-based care and I\'m just taking the punches and rolling with them.

Adam Walker:That\'s really impressive. Dare I ask then, what is the thing ~~that gets you outta bed in the morning? I mean, before we came and hit record today, you were mentioning about your kids. I\'ve also got two kids of a similar sort of age. Is that what drives you? Is there more~~ that gets you outta bed in the morning?

Adam Walker:What? ~~What is your why?~~ What is your true why?

Philip Morisky:~~You know, yeah, they,~~ my kids, ~~my, my~~ boys, I have two boys. They\'re both in college now, so my youngest one just graduated high school and, now ~~I feel~~ my wife and I feel like we\'re empty nesters, but my youngest, chose the college close enough to home that we could, continue to watch \'em play water polo, which ~~is that~~ actually really good at.

Philip Morisky:He actually got recruited to this school for it, but also to be able to take them to dinner once in a while. ~~And,~~ and I\'m sure my wife wants to do his laundry as many times as possible. So they are my motivation. But I look at it that I have kids all around the world as well. ~~Hypothe, not, not seriously, but in the fact your wife might have a problem with that one~~ fact that I want be able to educate.

Philip Morisky:Everybody on this valuable tool that my father actually developed. And it\'s amazing how many people embrace it from the youngest scholars who are really interested in making a difference in their own community to seasoned veterans of healthcare that are very familiar with the tool.

Philip Morisky:They probably learned it when they were in their healthcare studies and now they\'rethe executives of these big corporations thatactually work with me directly to help leverage. This tool as an endpoint measure. So I\'m very grateful to all the connections that I\'ve made over the years.

Adam Walker:Talking about your kids, I\'m just wondering, have either of them intending to take this forward as you have from your father? ~~Have you talked about that as a possibility over the dinner table?~~

Philip Morisky:No. ~~That I, I wish, you know,~~ that\'s always a dream, but ~~I, I guess I, I, I~~ raised two black sheep. One wants to go.

Philip Morisky:Turn into a pirate. He wants to sail the seven Cs as ~~a,~~ a merchant Marine, and the other one wants to do cybersecurity andcomputer science. So I\'m very proud of both of them, and ~~I, and, you know,~~ I\'m always supportive ~~of,~~ of what they do. So my goal is to doto be the best at what I do.

Philip Morisky:And that\'s actually brings me into why, ~~you know,~~ I coined my title as Chief Optimist.

Philip Morisky:Optimist is Latin for the best, and I always strive to be the best. So I just, ~~kind of,~~ embraced it and say, Hey, CEO is a good title, butlet\'s think outside the box for a change. Let\'s stir things up andbe that cog in the system that reallymakes people,

Adam Walker:it\'s a standout title. It\'s not one I\'ve come across before. So, I think you deserve recognition for that particular point. ~~I also had to put my teeth back in when I tried to practice saying it in the introduction for you. So well done for choosing a very unusual title, and I think to Swim Against the Tide is really not a bad place to be in life, science and healthcare because.~~

Adam Walker:If we all were to follow the same path, many of the inventions that we now take for granted would not be around, be the change, be the difference. And by the sounds of it, in everything that you\'re doing, you\'re doing that with the best of intentions and also with that in mind, changing the status quo, not accepting what that status quo might look like.

Adam Walker:And indeed, you know, rewriting that narrative. Exactly. Yep. That\'s wonderful. Thank you so much for sharing so much around, your backstory, Philip. I think it\'s fascinating and I\'m sure our listeners will ~~really, really~~ have enjoyed listening to that. I think it strikes me as. A very interesting path that you\'ve taken and, no two careers are the same, but certainly I\'m sure when you finished high school and did your qualifications, you couldn\'t have anticipated the future that you were now looking at and that you\'re now experiencing.

Adam Walker:Is that fair comment?

Philip Morisky:Yeah. No, I was successful. As I mentioned earlier, I was successful in two. Other startup companies and it\'s given me the foothold to really, embrace what my father actually started and, just kind of continue, not necessarily his legacy, but his ideas and his beliefs there was one book that I do remember reading, it\'s called The Checklist Manifesto by ATO Gwane. Very exciting book. ~~It, it, I think it, it\'s really.~~ Basically define structured adherence. ~~And~~ and it\'s definitely a good book to read.

Adam Walker:You\'ve jumped ahead to my quickfire round.

Adam Walker:Going back, ~~dare I say it, we\'ll, we\'ll, we\'ll~~ go onto the quickfire round if now is a good time. ~~But, we,~~ we\'ve touched upon your younger self, but what is the one piece of advice ~~you would,~~ you would give to your younger self, do you think?

Philip Morisky:I would say mess up early and often. And I say that because, I\'ve messed up a lot, learning the ropes and stuff and now that I\'m older, I say, man, if I just, messed up earlier and I did it more often, I think I could have been slightly different, although I am happy where I am today.

Philip Morisky:So, ~~I like the word.~~ I like the way it sounds, mess up early and often that\'s something that you could see in your high school yearbook as far as your, personal quote.

Adam Walker:It\'s great. I love that one. It reminds me of one that I have, which is fail fast and fall forwards, which is not dissimilar, same sort of principle,

Adam Walker:don\'t sweat the small stuff, just keep moving forward. As long as you\'re moving forward, ~~it\'s gonna be okay. You know,~~ it\'s gonna be okay. So, what are the three top qualities that you look for most when you are building a team? Presumably you\'ve identified particular skill sets and likes around the people that you work with.

Adam Walker:What would they be?

Philip Morisky:I have a very small but enthusiastic group that\'s ~~really,~~ spearheading a lot of these initiatives that I\'m taking on and a little bit overwhelming. But the three qualities that I ~~really~~ look for is curiosity, imagining new care systems and ~~really~~ embracing this tool as their own ~~as well.~~

Philip Morisky:Resilience. We\'ve faced so many, fires and so many, barriers similar to medication adherence, we have barriers ~~as well,~~ that we just have to identify the right solutions. And then transparency, radical transparency. I think those three unique qualities ~~really,~~ make an overall person, valuable, as a core asset.

Adam Walker:That radical transparency.

Philip Morisky:That is always not just transparency, you ~~really~~ gotta be radical about it. You gotta, embrace it and ~~really,~~ take it to the next level.

Adam Walker:And presumably that that\'s personal, that\'s professional. It\'s both, isn\'t it? The two go hand in hand well, certainly ~~I find,~~ I find the two.

Adam Walker:Should connect. But if they don\'t, that\'s where I have a disconnect, ~~that mm-hmm.~~ Particularly around that radical transparency, because what you say and what you do should lead into all aspects of both ~~your, you know,~~ your daily work life, but also your daily personal life as well. So ~~if,~~ if you\'re not singing from the same hymn sheet, it certainly.

Adam Walker:Comes across very quickly, doesn\'t it?

Philip Morisky:~~Yeah. And I have that eye for true, patient behavior I guess.~~ So I could actually see, the true intentions of other people.

Adam Walker:Yes,

Philip Morisky:~~I hope so. And I hope that\'s why we\'re talking today. Oh yeah, for sure.~~

Philip Morisky:Definitely. There, there\'s so many people I meet on LinkedIn and all these other social medias, but there\'s only a very few selective people that I really embrace and want to take to that next step. Next conversation and life is about conversations. And, I could see how people see, ~~you know,~~ genuine and true intentions of people and they\'re always just encouraging them to move forward and they\'ll open the doors and, give me opportunities and give other people opportunities too.

Adam Walker:~~That\'s great.~~ What is your favorite thing outside of work? What is it that drives you?

Philip Morisky:~~Yeah, so, you know,~~ I mentioned that my son plays water polo.

Philip Morisky:He had a fruitful career in high school and club, and now he is at that collegiate level, ~~D three. Or~~ division three. So very, very excited to continue watching him play at the next level. Even, just sitting on the stands and making friends with a lot of the parents of his teammates really helps, ~~you know.~~

Philip Morisky:Gives us interesting, moments and networks. I used to run in high school, so I love running with my dog. I have a Husky who, is very active and keeps me on my feet. If I don\'t run her every day, she\'ll scratch the door and scratch furniture, that gives me my one hour, five mile run every morning.

Philip Morisky:And just living life and enjoying it. Those are the things that really drive me to do what I do and to do it as best as I can.

Adam Walker:That\'s wonderful. And finally, what is your number one golden rule in life and business? ~~Philip?~~

Philip Morisky:I didn\'t think about that one.

Adam Walker:~~I guess,~~

Adam Walker:Well, I think you\'ve probably touched on it, which is, consistency of behavior, those cu the trans and those things I.

Philip Morisky:Adherence is the ~~missing,~~ missing metric in healthcare. I want to fix that and I think we could fix that together.

Adam Walker:~~That\'s very, very strong and resounds very loudly.~~

Adam Walker:I like that.

Philip Morisky:I actually just made that up right off the top of my head. It really came across as something very poignant and impactful. ~~And, I like these impactful phrases and sayings and catchalls and~~ I think that that\'s what we need.

Adam Walker:It\'s been a wonderful conversation.

Adam Walker:I really appreciate you sharing, the detail and the background to the company adherence, the MMAS, and I think our listeners will have enjoyed learning and getting to know you a little bit more.

Adam Walker:I\'d like to just give you the opportunity to share how people can reach out to you, and make contact with you if they want to after listening to the podcast, Phillip?

Philip Morisky:Yeah. No, I\'m very reachable. ~~You know,~~ I\'m on LinkedIn. That\'s ~~my, I guess,~~ social media. My website is adherence cc, so just the word adherence. CC and you can just find me at many conventions. I like to travel around the world and, attend conventions. I\'ve always connected with people walking through the trade show halls and doing podcasts.

Philip Morisky:You\'re my third podcast. The time just went by so fast because of this basic conversations it\'s like these interventions that I like to emphasize with, ~~you know,~~ the pharmacist talks to the patient. The patient could really just tell their story how it is.

Philip Morisky:And that\'s one thing that I think it\'s critical in helping, not only clinical trials, be more efficient and effective, but also improving patient outcomes as a whole. ~~You know,~~ bringing, the uniqueness of what the patient says, but using a structured format so that we could actually, benchmark it and see improvement over time.

Adam Walker:I think it\'s a great summary and a really lovely place to end there. Philipp, thank you so much for taking the time today. It\'s been an absolute delight listening to you and talking to you and getting to know you a little bit better. I can\'t thank you enough and I hope you will share this far and wide.

Adam Walker:~~And thank you once again, Philipp, for your time. Oh,~~ thank you Adam. Very, very impressed.