Miles David Romney: “Diplomacy”

Diplomacy. Being young and hot blooded it’s so easy to see passion as the cardinal virtue, to see the world in black and white, and be forever crusading. But in our world, in our time, far more gets done through diplomacy, collaboration, and compromise, than through revolution. As a part of my series about “Big […]

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Diplomacy. Being young and hot blooded it’s so easy to see passion as the cardinal virtue, to see the world in black and white, and be forever crusading. But in our world, in our time, far more gets done through diplomacy, collaboration, and compromise, than through revolution.


As a part of my series about “Big Ideas That Might Change The World In The Next Few Years” I had the pleasure of interviewing Miles David Romney.

Miles David Romney is Co-Founder, CTO and On-Staff Futurist of eVisit, the leading virtual care platform for large healthcare providers. He leads the team with a clear vision into the future — well beyond 2050 — and a detailed technology roadmap for the company and its customers and prospect organizations. He expertly leads the Product and Engineering teams to regularly deliver rich new functionality within the eVisit Enterprise SaaS platform in response to customer needs and roadmap vision infusing AI, AR and VR, among others. Romney did his undergraduate and graduate work at the University of Utah and has led several tech start-ups in the entertainment and healthcare spaces. He is also a classically trained singer and a Managing Director of the prolific, Tony Award-winning 42nd.club. Most recently, he played the role of “Sparky” in Forever Plaid (Jan. 2021).

He co-founded eVisit as a mission-driven company with a vision to simplify healthcare delivery to everyone, everywhere, enabling virtual care for hospitals and health systems so that they can deliver locally relevant patient care through telehealth. He is a published author, a frequent orator, and a healthtech visionary who has delivered his 2050 Vision (“Virtual Care IS Care”), which includes our home showers-of-the-future enabling proactive healthcare, at several high-profile events including the ATA2021 and the 2021 National Telehealth Summit. eVisit is the only Leader in The Forrester Wave™: Virtual Care Platforms for Digital Health, Q1 2021.


Thank you so much for doing this with us! Before we dig in, our readers would like to get to know you a bit. Can you please tell us a story about what brought you to this specific career path?

I started my career in healthtech. When I was 14, as a software engineer, I kicked-off the first in-clinic EHR for wireless mobile devices. Shortly after, I wrote secure data transmission and storage methodologies to satisfy what were in those days the new HIPAA requirements, then architected packet streaming encryption systems for video and audio over the web.

I moved into the entertainment industry for 15 years, built and sold a media company, ran an animation studio then a film distributor as CEO, and built out the consumer streaming experiences for EA, Blizzard, ESPN, and others. I love entertainment. Stories are what set us apart from all the other animals; they form the basis for our imagination, our aspiration, our ingenuity. But I didn’t feel I was solving the world’s biggest challenges. In entertainment, I came face-to-face with those challenges, and was supporting filmmakers and other storytellers who talked a lot about those challenges, but none of us was working directly to fix them.

So, I cut back over to healthtech and co-founded eVisit, where for the last seven years we’ve been addressing what is by my lights the world’s second biggest problem: the high cost and uneven availability of healthcare.

Can you please share with us the most interesting story that happened to you since you began your career?

I couldn’t possibly pinpoint a single experience as the very most interesting. But I’ve got a deep grab bag of candidates. I’ll admit that the most scintillating stories have happened while I’ve worked in entertainment: hurried calls with Michael Moore as I step out on stage; working with Jared Hess or Tim Blake Nelson; Kiefer Sutherland tripping over me at the Directors’ Guild awards and mistaking me for Sean Astin; moderating panels at Sundance; buying films at Cannes; walking off the Disney lot having sold a TV series… it’s all fodder for great stories.

And obstetrician and nephrology conferences are fun, too.

But you know what really matters? By year’s end, I’ll have been a big part of improving the health and wellness of over a million people. A million. That’s where the rubber really meets the road. It’s not as sexy, it’s not tuxedos and hors d’oeuvres — it’s much more. When a mom who doesn’t have insurance would be faced with a 3k dollars weekend ER bill but instead connects remotely to a pediatrician for 49 dollars, that’s me and everyone at eVisit. When medical practices may have faced closure in the face of COVID-19, but instead continued seeing patients remotely, maintaining a revenue stream, that’s me and everyone at eVisit. When a cancer patient can connect immediately to an urgent care physician who specializes in oncology complications — that’s me and everyone at eVisit!

So, while it may not make for the most exciting stories, the best thing I’ve ever done has been in these past 18 months, delivering healthcare over and over again, in many cases to those who need it the most.

Which principles or philosophies have guided your life? Your career?

I’m fascinated by the human mind’s capacity for cognitive dissonance, how we can hold to contradictory philosophies and all the while feel righteous and whole. I’m no exception. I hold Jesus Christ in one hand, and Ayn Rand in the other. I hold Christopher Hitchens and Teilhard de Chardin in equal regard. If you can find the Venn overlap in all that, tell me, will you?

On the main: I believe people are usually trying to do the right thing; I believe the world is getting better and better, and that now is the greatest time in history to be alive; I believe that humanity will last another million years, and that we’ll spread out across the galaxy; I believe that with work, passion, and discipline, most anyone can accomplish most anything.

Let’s now move to the main focus of our interview. Can you tell us about your “Big Idea That Might Change The World”?

The 2050 Vision for Healthcare:

Imagine waking gently at 6 am, not to the buzz of an alarm, but smoothly by a process that feels as natural as can be, steadily deployed by an app in your micro-implant. You stand and stretch, pass through the kitchen where you grab the cup of coffee that’s already waiting for you. You stare out at the sun rising over the city stretching at your feet while you peruse a few headlines, not on a mobile device or a hanging display, but rather, through your implant, and its ocular, or maybe neurological, interface.

Then you walk to the bathroom, slip out of your pajamas, and step into the shower. Before the water starts, though, you hear the hum of a full-body MRI scan, and feel the soft nipping (or maybe you feel nothing at all) of a half-dozen instruments collecting samples, and cataloguing vitals.

Results are analyzed real-time by AI, and sent to your care team for validation. A transdermal infuser pushes a cocktail into your blood: vitamins, relaxants, pain killers, beta blockers, anxiolytics, TNF inhibitors, even stimulants (your coffee is decaf). All synthesized in response to your current blood chemistry, and carefully balanced against one another.

When the steam roils up from beneath you and the hot water sprays down from above, you already feel like a new person.

Your doctors are still involved. And when it comes time for a conversation, you’ll have it — remotely, over video or VR. It’s all at your fingertips, but you’re only as aware of it as you want to be. Until a crisis hits, and when it does, the local infrastructure will exist to treat it, because your virtual care has largely been flowing through it, informing it, funding it.

There’s no taking time off of work to drive down to a medical center, no hassling with parking, no fighting to schedule with 5 different doctors, losing your lab orders and having to drive into the clinic to get a replacement, no accidental drug-on-drug interactions, or a drop in drug efficacy because of your own evolving chemistry.

No. Many of your vitals are collected and monitored continually through your implant. Others come daily, when you step into your shower. All of them flow in real time through AI and your flesh-and-blood care team at a frequency and with a granularity that would be the envy of any Ferrari mechanic. Your body will be, as it were, a well-oiled machine.

How do you think this will change the world?

With highly efficient mechanisms and democratized distribution, healthcare can become a right and not a privilege. When health, wellness, and longevity can be taken for granted, so much more becomes possible.

Keeping “Black Mirror” and the “Law of Unintended Consequences” in mind, can you see any potential drawbacks about this idea that people should think more deeply about?

Oh yes. There will always be unintended consequences. There are always risks. Progress is, almost by definition, messy. There are many ways this tech could go wrong, will go wrong. I’ve written all about that in my novel A Bloody Calculus (published under the pseudonym Milo Behr).

But the overwhelming skew is toward the good. And the thing about progress is: it’s both the solution to, and the cause of, all our problems. The only way forward, is through. We will never reach a state of equilibrium. We’re always either expanding or contracting, flourishing or decaying.

It’s exhilarating.

Was there a “tipping point” that led you to this idea? Can you tell us that story?

I’m hardly the first futurist to explore the idea of a “doc in a box”. I may be the first to have built a product roadmap around it. I start with social problems, with outcomes, and then work backwards. My inner dialog went something like this:

Sociopolitically, where is the world trending, regardless of how I may feel about it? Toward socialism, collectivism, or at least communitarianism. Increased population density favors collectivist approaches, while making self-sufficiency more difficult.

Again, setting qualitative judgment aside, what is preventing this approach from succeeding? Above all else, healthcare. Nothing can be a right, an expectation, while it remains so expensive to deliver, while it obligates so many others in its fulfillment.

How can healthcare be democratized? Through the same commoditization that has put a mobile phone — a device superior by orders of magnitude to the 1M dollars+ UNIVAC computer of the 1960s — in every hand.

What do you need to lead this idea to widespread adoption?

This is the beautiful part. All we need to make this a reality is what humanity has in spades: ambition. The pieces are already coming together. Technologies are emerging. Standards are gelling. Care strategies are evolving. Education and payment philosophies are morphing. Collaboration is happening — which is important because it will take a lot to make this a reality.

What are your “5 Things I Wish Someone Told Me Before I Started” and why.

To me this question reads as, “What are five skills you wish you’d mastered before you hit 20?” Because any number of people told me any number of valuable things that I simply didn’t take to heart, because I didn’t yet have the life skills that taught me their importance.

So here goes:

  1. Accounting, investment. What do all (persistently) financially successful people have in common? They’re good with money.
  2. Networking. Learn names. Learn names. Remember everyone you talk to, write them down, think about how you could accomplish more together than apart.
  3. Delegation. I developed this one in spades in my twenties. Even so, though, I kept too many “sacred” tasks to myself. Unless it’s a skill you want to develop, if you have access to someone else who can do any particular task better, faster, or cheaper than you, tap them.
  4. Diplomacy. Being young and hot blooded it’s so easy to see passion as the cardinal virtue, to see the world in black and white, and be forever crusading. But in our world, in our time, far more gets done through diplomacy, collaboration, and compromise, than through revolution.
  5. Parkour. I’m convinced that all Middle and High School PE programs should be replaced with parkour. (I’m particularly exuberant about it because I have a condition similar to rheumatoid arthritis and went through a period where I could barely walk. Wall-running, flipping, and rolling feel almost superhuman to me, now.) Simply put, it’s the physical discipline of moving through the world without breaking yourself, and the psychological discipline of seeing every obstacle as an opportunity.

Can you share with our readers what you think are the most important “success habits” or “success mindsets”?

Treat yourself as a whole person. We all know — most entrepreneurs do — the pressures that push us into working hundred-hour weeks. That’s healthily sustainable in short bursts. For a good while, I made the mistake of building a lifestyle around it. Sure, that can result in hyper-productivity for a while (years, even). But it eventually catches up with you, hits your health, and starts to limit productivity and creativity. I don’t like the phrase “work/life balance” because it implies that work is not life. It is, it’s a major part of life. But it’s not the only part of life. I prefer, simply, “life balance.” Knowledge workers, software engineers particularly, are often prone to obsession, to “life imbalance.” It’s part of what makes us effective. But it means we have to proactively build a discipline of balance into our lives — it will not happen by itself.

Exercise and physical activity are part of that. That has been martial arts and dance for me in the past (and then neglected completely for a decade); today it’s Parkour. It could be yoga, bodybuilding, running — take your pick. But something physical is non-negotiable, not only for maintaining balance, but also for spurring the mind. Tony Robbins talks about taking affirmations to the next level, to what he calls “incantations,” by adding “physiology.” That is, putting physical passion behind your thoughts; making them real by speaking them out into the world, and putting your body behind them. This concept is not new. It’s taken up in some way by nearly every major religion: the need to do something physical to symbolize an intellectual, emotional, or spiritual choice. When I take the time to nurture my body, my mind feels the benefit.

I always want to be evolving. To change any behavior, it must be measured, and it must be accountable. Otherwise, it will follow the path of least resistance. I keep a spreadsheet with a row for every day, and a column for every daily discipline I maintain. It includes physical exercise, incantations, right thinking, service, family. Then I choose a couple people (close friends or family) to be accountable to. There’s ruthless honesty between us — I literally have no secrets.

I find that knowing who I am, and who I want to be, then writing all that down and tracking it, understanding the delta: it makes my path forward clear.

Some very well known VCs read this column. If you had 60 seconds to make a pitch to a VC, what would you say? He or she might just see this if we tag them 🙂

The vision I’m painting is beyond the reach of any single VC — any dozen together. What’s more, it’s impossible at this point to game the outcome. We’re too early. All of us — operators and investors alike — need to nurture whatever promising building blocks we see. Something very much like what I’ve described will be the inevitable result of this successful execution.

How can our readers follow you on social media?

You can follow our progress at eVisit in simplifying healthcare delivery to everyone, everywhere.

LinkedIn: https://www.linkedin.com/company/evisit

Twitter:@evisit

Facebook: @evisitApp

Thank you so much for joining us. This was very inspirational.

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