Month: March 2022

Digital health startups must pick a lane and stay with it

Season 4: Episode #115

Podcast with Matthew Warrens, Managing Director, UnityPoint Health Ventures

"Digital health startups must pick a lane and stay with it"

paddy Hosted by Paddy Padmanabhan
To receive regular updates 

In this episode, Matthew Warrens, Managing Director at UnityPoint Health Ventures, shares some of the learnings from their portfolio companies, and how UnityPoint Ventures approaches digital health investments.

UnityPoint Ventures invests in startups at various stages of their growth. Matt discusses their investment themes, what they look for in startups, and how they leverage the UnityPoint Health ecosystem to help their portfolio companies scale and grow – while clarifying that portfolio companies are not guaranteed a commercial contract with the health system.

Matt discusses the ongoing labor shortage and how that is reshaping priorities, the emerging competitive landscape for health systems, and the overall VC funding environment for digital health. Take a listen.

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Show Notes

00:42About UnityPoint Health and where UnityPoint Ventures sits within the overall organization?
02:12So what led UnityPoint Health to start a venture arm? What's your mandate and focus of the Venture?
05:33When you started out with the Venture, what kind of themes did you decide to focus on?
07:14 Do your portfolio companies automatically become enterprise technology partners to UnityPoint Health?
10:52Can you talk about a couple of the investments?
14:29 What themes excite you today when you look at the digital health startups landscape?
17:14 Do you think automation is what you're referring to when you mention some solutions to overcome the labor shortage issue?
18:55 What are you hearing from the digital health startups about their challenges? When you track their progress, what are the things that you see them struggling with the most?
22:36What’s your advice to new digital health startup founders who approach you?

About our guest

Matthew_Warrens-profile-pic1

Matt Warrens has over twenty years of experience in the health care industry. Currently, he is the Managing Director of Innovation for UnityPoint Health Ventures . An experienced innovation leader, he is driven to transform health care into a science of prevention culture to improve the quality of life. Matt has strong operations experience focusing on identifying, developing, and implementing new products and services for health systems. His ability to identify clinical and operational technologies will accelerate the transition to value-based care.

Prior to joining UnityPoint Health, Matt served OSF HealthCare System for nearly twenty years in various roles including its Vice President of Innovation Partnerships and Executive Director of Jump Trading Simulation and Education Center. He is a graduate of Bradley University’s Executive MBA program and Southern Illinois University’s Healthcare Administration Degree. 

Q. Could share a little bit about UnityPoint Health and where UnityPoint Ventures sits within the overall organization?  

Matt: UnityPoint Health is a health system primarily based in Iowa with regions across the state. We also have small footprints in Illinois and Wisconsin. It’s a 20+ hospital system, and while hospitals aren’t a great measuring stick for systems in the Midwest, typically because there are large quantum tertiary care centers with 700 beds and one can have critical access hospitals like we do with 20-some beds, we have over 1100 primary care providers in our network. We are very much a value-based care organization and have almost 40 percent of our patient population in some type of ACO or value-based model. We’re continuing to trend in that direction of adding even more.  

I joined the organization a little over three and a half years ago. Innovation was a complete white slate here and so it was somewhat attractive and somewhat challenging. Innovation and the venture fund itself report up through the Chief Strategy Officer which I think is similar across organizations. But I would tell you that the entire C-suite is involved with our investment decisions and our innovation program.  

Q. What led UnityPoint Health to start a venture arm? What’s your mandate and focus of the venture?  

Matt: In the organization I worked with previously for over 20 years, I’d been in a lot of operational roles. Later in my career, I was working with the C-suite on special projects and had the opportunity to help build a commercialization arm. Shortly after, there was an idea there, probably in 2015, around starting a venture fund.  

I worked with some individuals managing venture funds outside of healthcare and that was an interesting kind of a learning curve. I recruited a team there and ultimately ended up managing the pipeline for that fund. I spent a lot of time traveling the country, looking for these startup companies and having been an operator in healthcare for so long, I think I somewhat looked at things through the lens of understanding how hospital operations really worked. I was thus able to quickly sift through where the real value opportunity was going to be. When I started learning about the venture aspect, I decided that this was something I wanted to do full-time. I had a lot of other responsibilities in my former role. So, when this opportunity came up, I was really attracted. I talked to the leadership team.  

I get plenty of calls from health system leaders or CEOs who want to start a venture fund. To be quite honest, the first thing I tell them is “You shouldn’t start a fund. Here’s a list of three or four great institutional investors that have a great track record of returning great financial returns.” I tell them that because unless they recruit a team with experience in doing this and really understand how to evaluate opportunities and underwrite specific financial returns versus more like the scatter approach that one sees not just health systems, but across for-profit and not-for-profit organizations who have venture arms doing this sometimes, it’s hard.  

That scatter approach makes it tough to tell how you’re performing. What are you benchmarking against? When you have an actual fund with an actual financial thesis, you can benchmark it in time with other funds during that same time period and show success or failure. That’s why you see kind of a constant reevaluation of systems that may or may not be investing like this. I think that was what attracted me to coming here to UnityPoint. They understood that we needed to take that approach of sticking to a financial thesis, having a dedicated team, and really leveraging the strategic value that having a fund could bring.  

Q. While this is a relatively new initiative for UnityPoint Health, larger health systems have had innovation in venture funds for an extended period of time — UPMC Providence, Kaiser are a few of the names that come to mind — when you talk about those, what kind of themes did you decide to focus on? Was there a difference in your approach?  

Matt: I would say that early on in our approach or if you looked at the companies that were in our portfolio first or early on, they were primarily a lot of point solutions. That was really just bringing my experience from where I had been previously and recognizing that UnityPoint was somewhat behind in what I would call “digital table stakes.” We didn’t have remote monitoring or digital behavioral health. We weren’t doing shared decision-making, asynchronous visits, and there were some intriguing financial opportunities during that time to invest in those spaces, also knowing that strategically, we could then adopt and bring those solutions inside of UnityPoint.  

To your question — then, compared to now, where are we going? – I’d say, if you look at the last three or four investments in the portfolio that are much more enterprise type solutions, we have married our innovation strategy with the organization’s overall strategy, and that’s really allowing us to bring forward what we think are more impactful solutions that will impact the enterprise. You can imagine these are hot topics, especially the current one — recruiting retention. We’ve made some interesting investments in that space just recently.  

Q. How about some of your portfolio companies — do these companies automatically get to become enterprise technology partners to UnityPoint Health? Is that part of the attraction for these companies? Is that part of the intent of even investing in these companies?  

Matt: It’s a delicate balance and that’s the answer there. We’re primarily making our investments financial, first, so we’re looking to underwrite certain financial returns. That’s how we’re making our decision on investing in those companies. We don’t guarantee any commercial contract for any company that we invest in financially. However, we have a dedicated team in parallel to our venture team which starts work once we’ve made those investments. That organization and our leaders inside of UnityPoint do everything possible to see if we can help them get that commercial contract. So that starts with leadership alignment. One of the things that we often tell or ask leaders is, “Hey! What are you not doing today that you want to be doing? What do you think you’re going to be doing/You need to be doing tomorrow or the next day?”  

I often reference this industry agnostic concept, in my opinion of any highly functioning organization, of spinning a flywheel of innovate, operate, grow. So, whatever we’re innovating on today, we put into operations tomorrow to drive strategic growth.  

We’re looking to identify companies that we believe can help UnityPoint do that when we bring these opportunities and platforms forward to our leaders. We know that oftentimes these are early-stage companies and so, may be somewhat of a risk, especially when I describe going from originally point type solutions to now more enterprise type solutions. All we’re asking to do, is just give a fair comparison to anything else they’re looking in the market that might be doing similar things. If there are specific platform advantages, financial advantages, etc., that these long-standing organizations can do, we understand why you wouldn’t use the portfolio company that we brought in. But if you can’t find those differences, we have the support of the C-suite to take the risk on these early-stage companies.  

In addition, once we get to a commercial agreement with those companies, we also have a separate team — our internal accelerator team that doesn’t report to IT or marketing and doesn’t get sucked up into M&A activities or Epic upgrades. They come to work every day implementing those solutions and comprise Nurse Informatics, Product Managers, etc., and they really help accelerate the adoption of these things. There’s also some annual operating cash in those budgets to pay early-on SaaS-based software fees. Every startup has heard this story from a health system that says, “Oh hey! I love your solution. It’s February. We are two months into our fiscal year. We run on a 12 month budget cycle, so let’s talk next Spring.” What having that kind of a bucket of money does, is help us accelerate those things. So, I’m proud to say that of the 13 companies we have in our portfolio today, 12 of them have a commercial contract with UnityPoint.  

Q. You mentioned that you sometimes have to sell within the organization about making bets on these early-stage companies. How early is early? Can you talk about a couple of the investments — at what stage did you get in and how far have they come since?  

Matt: When you have these financial returns first alongside a strategic opportunity, you do have to be somewhat opportunistic. So, if you really buy it at our portfolio, you will see investments everywhere from Seed Stage to Series B and some things in between. You can kind of imagine what the revenue path of those companies are. A couple of great examples of companies in our portfolio are our CEOs that you’ve interviewed in your previous podcasts. 

The very first investment that we ever made was in a company called RxRevu, which is doing real-time benefits check. Our group has a motto of looking for solutions that make healthcare frictionless for consumers and make Providers’ jobs easier. And so RxRevu, when you think of it through the lens of those two things, every time a physician orders a new medication for a patient, he is automatically pinging the PBM and the insurance company and getting back in real-time what the co-pay for that patient is.  

You know, if you ask patients what the number one question they ask their provider, it is when they undertake an office visit, it is — how much is this medication going to cost? And prior to having a solution like RxReve, if a patient asked that, a physician would either say, “I don’t know,” or they would have to get up and leave the room and call an 1800 number, and it would be super painful, right? So, that really meets the standard there. And I would say that was more of a later stage company when we got involved from the investment side.  

An earlier stage company, one of our more recent investments, is TailorMed, which is helping payers. I know you recently interviewed the CEO from there. They’re helping patients with financial navigation. So, any health system of our size has what you call financial navigators who come to work every day and they’re working a list out of Epic of all the patients from that night, the day before that etc., who have been ordered to get these high-cost drugs, quite likely infusion drugs or Oncology drugs and whose insurance is not going to cover this. But the good news is there are Pharmacy Manufacturer Rebate programs out there, obviously federal and state programs and independent foundation programs, but those financial navigators must apply to all those different places where they might be able to find coverage for that drug for those patients. The TailorMed solution automates all that for those financial navigators. We’re back again then, to that mantra of frictionless experience for a consumer. So, I’m finding a way to pay for these medications

But, for us, we’re expecting on the financial navigation side that we’re going to increase our productivity from anywhere from 5-10X. And we’re not going to use that to get rid of FTEs. We’re going to use that to expand these programs to help more patients get this type of coverage.  

Q. USD 30 billion in VC money went into these digital health startups last year. The money’s going into various themes — there’s this whole patient engagement theme and it’s become like a catch-all term in many ways, there’s AI and clinical trials along with a variety of other themes. What themes excite you today when you look at the landscape?  

Matt: I mentioned recruiting and retention earlier, and this is a problem the pandemic has created with not just nursing travelers, but really all of the healthcare professionals that are doing traveling, or locums. It’s creating huge expense to the health systems. And it’s not going to just end when the pandemic ends, because we’ve created now somewhat of a bubble that’s going to go out for years. We’re going to be dealing with this and so, anything that we can bring to bear in that space is of high interest to us.  

You mentioned the AI space, and I’d say that personally I still don’t think we’re there. It’s still just a lot of machine learning. I would also tell you that every health system of our size has a team — ours is fairly small — but of people who are creating machine learning processes inside of the platforms that we already use. So, often, when we show that team and the stakeholders some of the start-up solutions in that space, they’re like “We’re already doing this; we’ve been doing this for a while.” So, we’re not really seeing anything that’s, you know, mind blowing in that space.  

To come back to your question about what else are we interested in? We’re no longer competing with the hospital across the street. I mean, watch the quarterly report of any for-profit health plan today, and the CEOs don’t even refer to themselves as Health Plans. They refer to themselves as Health Providers. These organizations are very well financially backed and we’re trying to bring to bear for the organization the types of tools and platforms that we believe we need to compete with them.  

Q. You alluded to the labor shortage a couple of different times. This is by far the number one issue on the minds of healthcare CEOs today, or for that matter for CEOs. There’s this statistic from Mercer, I think, a report last year which said some six million health care workers at the frontline — people who do the real work in many ways – will retire or leave the workforce, and only about a third of them will be back through organic processes. One of the terms I hear constantly is the role of automation in this. Do you think automation is what you’re referring to when you mention some of the solutions you’re looking at?  

Matt: So, this labor crisis is so big that it’s not going to be one single solution. And if there was, I’d tell you we should find that and put all our money there. So, it’s going to take several different approaches.  

One thing that I feel we must do is when we talk about the amount of people who are leaving the workforce is, we have one opportunity to create ways to bring those into a different environment, a more centralized environment, maybe not as high-paced or high-stress as what they have been working in and which is causing a lot of the reasons that they are leaving. On top of that, what technology can we bring to bear that enables those clinicians to provide value, valuable-based care and be a valuable-based portion of this care team that’s on the front lines? 

Q. You mentioned that some of your portfolio companies have been on the show. We invite a lot of innovative startup founders to talk about how they’re approaching health care and they have innovative, different ways of looking at problems. I always ask them about their single-biggest struggle when trying to make it in healthcare – a notoriously slow and conservative domain. What are you hearing from them about their challenges or when you track their progress? What are the one or two things that you see them struggling with the most? 

Matt: One of the things that we look for in our partners, our portfolio companies, is really strong CEOs and really strong founders. I’d say, even more than the financial or the market-size or the product because this is hard and you’re really, in a way, betting on them — Do you truly believe they can do this? Until our benchmarks review, you’ve got to meet two of probably the best CEOs that we have in the portfolio.  

Then, more specific to your question. Now, we take an active governance role with every company that we invest in, and sometimes it’s in our voting role, sometimes it’s just an advisory role. So, we’re listening to them on a quarterly basis of what those challenges are and then, weighing-in from a health system perspective. How can we be of help to them? So, if it’s a matter of understanding, just take market, for example. If they’ve got an understanding what they think the total market is, we can quickly figure out the market just for our system. And we can help with some math around that.  

When you think about product placement and how to pitch it and talk about it, we get into the board room with our leaders. We understand how they think, what’s motivating them and what will resonate with them. So, we can really do a lot to help and work with our portfolio CEOs on that pitch.  

The world does get really small relatively quickly when you bring together innovation leaders from across health systems and they tell you — we’re talking all the time with eight or nine other executives that are doing what I’m doing — “Hey, how are you doing this? Have you heard of this?” And there is a lot of inside baseball there.  

Lastly, I’d say about our portfolio CEOs that they do a lot for us too. They’re also a small world. You quickly know who the really good CEOs are, and they all talk to each other too. So, they’re saying, “Hey! We’re having great success with this health system here and this is why.” And they’re making intros as well. So, this network effect is really important.  

Q. The answer that I get from the CEOs, and founders I’ve spoken to has been that their biggest challenge is the sales cycle where the healthcare organizations, because eventually, it’s about surviving with the funding that you have on hand and marketplace traction on hand. The differential must be made up within the normal sales cycle because if you don’t make it then and you run out of money, you may not get another round of funding and you may have to either do a distress sale or go out of business or face any number of other undesirable outcomes. So, what’s your advice to new startup founders who approach you and say – Matt, I’ve got this great idea. I’ve got some early traction.  

Matt: I’d say the first thing is, it’s important that you somewhat pick a lane and I mean that in a couple of different aspects. There’re a lot of great startup companies out there that could sell into health systems, into payers and directly, into large employers. So, you must ask yourself — Should you?  

There’s also a lot of great startups out there that can do many different things based-off of the platform they built. But you really need to ask — should you? Maybe to get more specific, yes. If you have a great narrow product, maybe you can and should sell to all three of those markets that I described. But if you have a broader product trying to sell that to all three of those markets, I think, that becomes a big challenge early on. I’m not saying you can’t expand later, but trying to do that early to your point, could really break you because of the timing of things.  

You talked about the health system sales cycle, and that is a huge barrier. One way that we’re trying to break that is by having this annual operating budget to help with it. However, one thing I want to point out is, we don’t bend the security or the contracting processes. The only special treatment that our portfolio gets in those two buckets is, “Hey, will you please put our things on the top of the pile to be reviewed?” But other than that, they must pass and go through that same standard.  

I would tell you that I think I’m not an expert on the work on the payer side, but I think the some of the challenges that the startups see there is, whoever they’re working with initially in that industry, those people don’t stay in roles very long. They may be getting promoted or moving on to other things or typically, plans are growing fast, so, people are moving up. And they end up working with different stakeholders which is a barrier on that side. So, both present interesting challenges.  

We hope you enjoyed this podcast. Subscribe to our podcast series at  www.thebigunlock.com and write to us at  info@thebigunlock.com 

Disclaimer: This Q&A has been derived from the podcast transcript and has been edited for readability and clarity

About the host

Paddy is the co-author of Healthcare Digital Transformation – How Consumerism, Technology and Pandemic are Accelerating the Future (Taylor & Francis, Aug 2020), along with Edward W. Marx. Paddy is also the author of the best-selling book The Big Unlock – Harnessing Data and Growing Digital Health Businesses in a Value-based Care Era (Archway Publishing, 2017). He is the host of the highly subscribed The Big Unlock podcast on digital transformation in healthcare featuring C-level executives from the healthcare and technology sectors. He is widely published and has a by-lined column in CIO Magazine and other respected industry publications.

As an industry we should be implementing basic security controls a lot more

Season 4: Episode #114

Podcast with Lee Kim, Senior Principal, Cyber Security and Privacy, HIMSS

"As an industry we should be implementing basic security controls a lot more"

paddy Hosted by Paddy Padmanabhan
To receive regular updates 

In this episode, Lee Kim, Senior Principal, Cyber Security and Privacy at HIMSS, discusses the findings of their annual survey of cybersecurity. She talks about the emerging landscape of cyberthreats, the current state of security controls, and the heightened risks due to the interconnectedness of healthcare with other sectors. She also shares her thoughts and observations on the new threat that has emerged in the wake of the Ukraine crisis and what she is hearing from HIMSS members.

Lee discusses the onslaught of ransomware and phishing attacks from expanded networks of the nation-state and non-state actors and how a greater dependence on electronic information, forced by the circumstances of the pandemic has created a positive inflection point for improving our preparedness and responses to cyberthreats.

Lee talks about how HIMSS enables information sharing among “trusted circles” that include agencies and other non-provider organizations to help healthcare enterprises achieve greater maturity levels. Take a listen.

You can download the HIMSS healthcare cybersecurity survey report here.

Our Podcast Partners:

Show Notes

00:48The AHA recently issued an advisory for hospitals to be on high alert for possible cybersecurity incidents, including ransomware. What are you hearing from your membership at HHIMSS and what have you what have you learned so far?
03:39Is HIMSS planning to issue or has issued any kind of an advisory within its own membership?
04:56HIMSS recently published an annual report, based on your survey of the state of cyber security in healthcare. Can you walk us through the big highlights of the report?
07:11 Were there any big changes from the previous year's survey?
10:04Investment levels are going up in cybersecurity. Is it because cyber criminals are getting smarter and are becoming more sophisticated, and therefore you need to throw more money at the problem to stay one step ahead of them? Or is it because you are underinvested to begin with?
15:00 What are the cyber criminals fishing for?
19:36 Is there a pecking order in terms of where cyber cybercriminals like to target the attention? Is healthcare a preferred target for them?
22:32 What is the risk healthcare organizations are taking by choosing to partner with an increasing number of innovative startups? Is there something that we should be concerned about from a robustness of security protections and data productions in particular?
27:14 Is there a bigger shortage in cyber security workers relative to other parts of the tech sector? Or is it the same as everywhere else? If so, what's the solution here? What are what are organizations doing to overcome this?

About our guest

Lee Kim is the Senior Principal, Cybersecurity and Privacy at the Healthcare Information and Management Systems Society (HIMSS). Lee’s expertise includes cybersecurity, privacy, information technology, and law. Lee is a published author with numerous articles on data privacy, cybersecurity, and intellectual property. Lee’s publication credits include GCN, the American Bar Association, Digital Health Legal, Nursing Management, and the California Continuing Education of the Bar. Lee presents before a variety of audiences—technical, non-technical and legal for entities across the private and public sectors—and domestic as well as global.

Lee has served as a team leader of the US Department of Homeland Security Analytic Exchange Program and as a member of the National Cybersecurity Training and Education Center National Visiting Committee. Lee has also served with the (ISC)2 Government Advisory Council Executive Writers Bureau, National Cyber Incident Response Plan & NIST Cybersecurity Baldrige Excellence Builder working groups, and as a Vice Chair of the American Bar Association Health Law Section eHealth Privacy and Security Interest Group, eSource, and Emerging Issues in Healthcare Law.

Additionally, Lee is an AV Preeminent peer review rated attorney. Lee’s work experience includes incident response, system, database, and web administration, programming, and legal matters involving intellectual property, information technology, privacy, cybersecurity, healthcare, and EU GDPR.

Q. The AHA has recently issued an advisory for hospitals to be on high alert for possible cybersecurity incidents, including ransomware. What are you hearing from your membership at HIMSS and what have you learned so far in this context?

Lee: Our membership is obviously very concerned about what’s happening with the current geopolitical conflict. It’s safe to say that on any given day, there’s literally an onslaught of ransomware attempts and phishing attacks but what troubles our stakeholders is the great degree of sophistication seen when you’re dealing with the nation state actor or in some context, non-state actors as well. The time horizon in such cases, is much more compressed than regular actors, and there’s much more obfuscation in terms of detecting that intrusion into systems and networks. So, that’s a concern.

Many healthcare organizations and their IT Security departments run fairly lean. Consequently, they’re able to prioritize better and know what to focus on. For example, the Health Sector Cybersecurity Coordination Center (HC3) at the U.S. Department of Health and Human Services, the HSC and others share threat information, which may be of interest, especially regarding destructive malware and otherwise. Those indicators are good to have, however, there are so many threats and vulnerabilities that healthcare organizations have in terms of their IT systems and applications that, frankly, the best and most direct way for all healthcare organizations to be prepared is to prioritize and tackle their biggest weaknesses, first. Then address other things based upon priority. We always say the best kind of intelligence is direct intelligence-sharing with your peers and within your organization regarding cyber threat indicators and phishing.

Q. Is HIMSS planning to issue any kind of an advisory within its own membership?

Lee: Our efforts are not limited to information-sharing within trusted circles of stakeholders, which include providers. So, there are different units of HIMSS that are engaged in getting the word out, including a DHS, CSA and also the HHS and others. The key is to be a convener and be part of that pipeline in terms of information-sharing as it were, within our trusted circles of membership.

Q. HIMSS has just recently published your annual report, based on your survey of the state of cybersecurity in healthcare. Can you walk us through the big highlights of the report?

Lee: Absolutely. Some of the highlights of the survey include things that are already known, such as, the state of cybersecurity across healthcare organizations. We know from the headlines that phishing and ransomware are king in terms of incidents and intrusions that actually happen. But one of the ways in which our report takes it a little bit deeper, is that we test assumptions. We can glean from the report that there are some kinds of systemic weaknesses across healthcare organizations, and that the security controls perhaps, aren’t as robust. However, one of the key questions that emerged when we were developing the survey was — Is that true? If yes, how true? It’s one way to perpetuate assumptions without actual evidence but, in this case, we have actual evidence as to what Providers are doing at a granular level, such as, not including security controls. Working on the technical side for healthcare organizations, I’ve certainly seen many that are slow to patch, but we actually have discrete specific information in terms of how much time it takes to patch given certain perceived levels of vulnerabilities that healthcare organizations may have. So, I’d say that direct intelligence — the more specific and actionable it is, the better the steps healthcare organizations can take to reach higher levels of maturity in terms of their action plan or maturing their programs.

Q. Were there any big surprises from the previous year’s survey that caught your eye?

Lee: Yes, I’d say, the increased funding in terms of cybersecurity, especially during COVID-19, was definitely unexpected given various revenue sources were experiencing a shortfall. Now, COVID-19 isn’t yet over and just last year many healthcare organizations unfortunately had to cancel elective surgeries and turn patients away because of how severe the pandemic was. So yes, it was surprising and to be totally frank, that was very good news. That signaled, at least to me, that cybersecurity programs have become more of a business priority for many organizations.

In fact, if we look at what’s happening, globally, and not just with the U.S., cybersecurity is critical. Whether it’s smaller healthcare organizations in the U.S. or those in countries that perhaps don’t have the electronic health IT. infrastructure like we have, or countries that are less developed in terms of technology, they’ve been forced to adopt electronic health IT to track what’s happening in terms of COVID, healthcare, and treatments. So, it’s safe to say that cybersecurity has raised its profile as a result of a greater dependance on electronic information, which is forced by the circumstances of our pandemic. That’s certainly a positive inflection point for us in the industry.

Q. It’s certainly good news that investment levels are going up in cybersecurity. Is it because cyber criminals are getting smarter and therefore, you need to throw more money at the problem to stay one step ahead of them of is it because you are underinvested to begin with and this is just catch up?

Lee: I’d say both. Let’s look at your second point which is very well-informed and a great observation — the health IT sector. Our first publicized nation-state cyberattack was in 2013, almost 10 years ago, and now, it’s 2022. We’ve certainly had a “catch up” period for that time-period in the past decade. Whereas, if we look at the more mature sectors, as they’re perceived, such as, the chemical industry, critical manufacturing, electrical etc., they’ve had decades to bolster their security practices, turn to more electronic information, follow mature security protocols – In short, they’ve already had a playbook of sorts that’s been tested. They have disaster preparedness against natural and manmade disasters whereas we, have been playing catch-up in the last decade.

But, it’s safe to say that the pandemic among other things, has certainly accelerated our progress. Cyber-criminal activity absolutely cannot be ignored by any organization. We see the rising costs of cybercrime, and other things related to that, such as the cost of dealing with mitigation if you are breached and I’m sure many organizations have concluded that regardless of whether they’ve experienced an attack or feel one’s imminent, we must understand that it is inevitable. No one wants to be in the headlines anew so the focus will be a lot on proactive measures.

However, looking at the questions in-depth, for example, surrounding the degree to which basic security controls are implemented, we really should, as an industry, be implementing the most basic security controls a lot more, whether it’s encryption, identity and access management, or even the firewalls and antivirus. The internet has been booming for over 25 years, so shouldn’t we be on-board in terms of at least antivirus and firewalls if that technology has been around? And if the price point for that in the precedent for encryption solutions has lowered as a result of such innovation, development, and the multiplication of offerings out there, I think, the answer is, yes.

We are really reaching the point where we can’t afford to be unprotected because regardless of whether our sector is specifically targeted or there is a side-channel attack on another sector – water, electrical, manufacturing, telecom –on which we are dependent, we stand incredibly vulnerable in terms of critical infrastructure dependencies. Look at the National Infrastructure Protection Plan, the NIP, that clearly spells out all the sectors upon which we depend. I think, if people aren’t paying attention now, they will unfortunately experience the bite of a cyberattack and will have to unfortunately rethink their strategy.

Q. You make a really good point about the interconnectedness of infrastructure between healthcare and other parts of the economy. But I want to go back to one of the headlines of the report, which is that “phishing is still king.” What they are phishing for? Has anything changed about in terms of what they’re looking for or is it the same kind of data that remains vulnerable?

Lee: What needs to be traced is the motivation for the attack. For example, if I were a healthcare organization with a military base close by or some kind of defense operation in the vicinity, I may be, hypothetically, targeting people that have access to that information. That would be different from, for example, if a diplomat or someone of similar high status were treated at a hospital. Then their information would be targeted based on that. So, it truly depends upon the purpose of the attack. So often it’s assumed that the endgame for an attack is always the same, but we have to look at who’s attacking which entity and for what purpose, before we can make that determination and whether it’s because of the different geopolitical tensions currently happening or it’s because of who is being treated at your healthcare organization currently. It’s safe to say that organizations that are in those special situations are smart and layer their defenses and the strategy to account for that.

On the other hand, as we saw from the survey that money unfortunately tends to be the number one goal of attackers across nation state, non-state actors, cyber criminals, or the “kid next door.” Often, the purse strings that the accounts payable person may have is attacked or a highly compensated employee may be targeted through phishing websites that resemble a payment portal. Unwittingly, if they fall for such phishing attempts, their paycheck may be diverted. We’ve seen those attacks on providers in the past, and the way attackers work. Attackers employ efficient tactics that have worked before, whether for healthcare or another sector. They know time is money. So, the idea is highest efficiency for highest impact. That will achieve whatever their endgame is – money, stealing credentials, sensitive information – patient data, treatments, research on COVID-19, vaccines, or something more nefarious such as, disrupting business operations or even clinical operations etc. That attack is given that kind of purpose so phishing does carry with it many other things. 

Q. Is healthcare a preferred target simply because of the ease of attack and the potentially quick and high returns?

Lee: Well, certainly healthcare itself will be under attack if specific patients’ information is targeted. However, in terms of the sectors and the ease of attack, I think, it’s a bit of a myth that healthcare is easier to compromise than other sectors. Whether one is targeting government entities, other industries or critical infrastructure sectors, there are sectors that are easy to attack, such as, the financial sector. There are entities that do not fully share information within their organization, do not deploy security awareness across all personnel, so naturally, their rates for successful phishing attacks may be quite high.

I’ve heard that phrase before, and to some extent, it’s true, because many healthcare organizations have just hired their CISOs in the past five or 10 years. There are some cybersecurity professionals with really skilled backgrounds within healthcare that have been working at the helm of their organizations for 25 years. So, I can assure you that some of those organizations are very tough to break-in. But if you look at the symmetry of it all, the defense people or defenders on the provider’s side need to be right 100% the time; Someone on the offensive side needs to be right just once.

Q. We’re in an era of digital transformation. But what is the risk now that healthcare organizations are taking by choosing to partner with an increasing number of innovative startups? Is there something that we should be concerned about from the perspective of robustness of security protection and data protection, in particular?

Lee: That’s an interesting perspective. To give some context here, ever since at least January 2014 we’ve seen that the supply-chain style of attacks — whereby a vendor or a business associate has been compromised to essentially compromise the target whether it’s a big hospital or whomever is at the other end that’s receiving those services – are rampant. So, with that in mind, it’s fair to say that as a general rule, the small and medium companies and the startups may be weaker in terms of their security defenses compared with the larger organizations but that’s not always so given. You’re well aware, the asymmetric difference between the attacker’s perspective versus the person on the defense and how the person of the defense needs to always be right. Notwithstanding that, start-ups from what I’ve seen having worked with them over the years, I think, just like many other smaller organizations, they tend to outsource various tasks themselves — whether it’s development or cloud services or others.

If there’s one weakness that I’ve seen — and again, not all start-ups are the same – it’s that, often, smaller companies just assume that by partnering with another entity or individual that it’s the other person’s responsibility. So, they’re less vigilant. What’s more, the degree of vetting from a due diligence perspective isn’t given due weightage. As an attorney I always tell people to be careful about who they deal with from a business and technical perspective, otherwise, how does one know how secure an entity is, whether they’ll be around, or how robust their solution is? Being new, very innovative and perhaps very cutting-edge, doesn’t cut short the need for undertaking due diligence. One needs to see who their partners are, what information they’ll get access to – accounts, machines, systems — who else may be involved because there are various factors, including insider threat, that must be taken seriously.

Q. We’re right now in the midst of a big shortage of workers at all levels, including tech workers. On the one hand companies can spend enough money to get the talent but that talent may not be available. One Wall Street Journal article indicated around 300,000 tech jobs that are open as of January! And healthcare organizations, technology vendors or vendors to a vendor are all facing this same problem. The issue can’t be outsourced and is a bigger concern than cybersecurity. So, is there a bigger shortage in cybersecurity workers relative to other parts of the tech sector? What’s the solution — more automation? What are organizations doing to overcome this?

Lee: In terms of workforce development and having that pipeline, it’s safe to say that many healthcare organizations prefer hiring cybersecurity professionals with previous healthcare experience. Because, you can’t simply ping a medical device, for example, and expect for everything to be okay. If you see malware going into a H-back device or otherwise or some kind of potential trouble, for instance, you can’t necessarily close-off the ports to live devices that directly impact patient care. You need to be careful with that, especially where patient safety and the care of patients is directly connected. So, those are special reasons actually why healthcare cybersecurity pros do have interestingly, a specific body of knowledge that people from other sectors, such as, finance, manufacturing, chemical or even the government may not have. That’s because, if their emphasis is on confidentiality, locking up secrets so to speak, our emphasis above anything is ensuring that information is made available and has integrity so that we could rely upon that data. So that reality is quite different.

But in terms of some proactive measures being undertaken by some healthcare organizations there are things that are quite innovative. For example, some people in informatics may be trained up to assist with IT security duties. So, training from within is definitely a great thing because they’re familiar with the organization and committed to it. So, they find value in terms of what they’re doing.

Even with new individuals that are coming up from colleges and high schools and those that have certified cybersecurity credentials such as, certifications that we all know about or those that may graduate from a 2-4 year college with, you know, accreditation in terms of their cybersecurity degree — we know of some of these programs. I think that those things are prized. And once, a student with that potential, interns at a healthcare organization and is recognized by them to train, they are nurtured so they become familiar with the healthcare environment and continue to grow that way.

We may not be able to afford the salaries offered by more mature sectors in terms of cyber in healthcare but one way to combat that would be in terms of hiring students or people with less experience or training people from within, because, I think, there’s a renewed interest in terms of cyber. People are considering expanding their roles, responsibilities and wanting to delve into tech. Cyber is such a great field to be involved in. You’re always learning. We’re trained to think in ways that people generally don’t. We look at things from the reverse — how can something be attacked or breached? – And that’s like taking the glass half-full approach. We ask, “what’s not fine?” So, you know, it’s an interesting dynamic, but those are a few of the promising trends.

We hope you enjoyed this podcast. Subscribe to our podcast series at  www.thebigunlock.com and write to us at  info@thebigunlock.com

Disclaimer: This Q&A has been derived from the podcast transcript and has been edited for readability and clarity

About the host

Paddy is the co-author of Healthcare Digital Transformation – How Consumerism, Technology and Pandemic are Accelerating the Future (Taylor & Francis, Aug 2020), along with Edward W. Marx. Paddy is also the author of the best-selling book The Big Unlock – Harnessing Data and Growing Digital Health Businesses in a Value-based Care Era (Archway Publishing, 2017). He is the host of the highly subscribed The Big Unlock podcast on digital transformation in healthcare featuring C-level executives from the healthcare and technology sectors. He is widely published and has a by-lined column in CIO Magazine and other respected industry publications.

Our mission with digital health is to provide guidance and choice to consumers in an easy, frictionless way.

Season 4: Episode #113

Podcast with Ashis Barad, MD, Clinical Lead, Digital Health, Baylor Scott & White Health

"Our mission with digital health is to provide guidance and choice to consumers in an easy, frictionless way."

paddy Hosted by Paddy Padmanabhan
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In this episode, Dr. Ashis Barad, Clinical Lead, Digital Health at Baylor Scott & White Health, discusses their digital patient engagement journey, their highly rated best-in-class homegrown patient mobile app, and how they are creating a seamless digital experience for patients and consumers.

BS&W is the largest not-for-profit health system in Texas and is a pioneer in digital patient engagement. Dr. Barad discusses their focus on consumer expectations and consumer research at length and how that drives their digital investments. He discusses the challenges involved in gaining acceptance from clinicians for launching and implementing digital health, and the need to invest in ongoing research to understand consumer needs.

Dr. Barad talks about their digital investment priorities for 2022, their data and analytics partnership with the Truveta consortium, challenges with harnessing technology innovation, and how the talent shortage is impacting the pace of digital transformation. Take a listen.

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Show Notes

00:48The American Hospital Association has recently issued an advisory for hospitals to be on high alert for possible cybersecurity incidents, including ransomware. What are you hearing from your membership at HHIMSS and what have you what have you learned so far?
02:01Can you give us a broad overview of the digital health capabilities that you've implemented at Baylor Scott & White over the last couple of years?
06:46Tell us about the genesis of your mobile app and what does it do for your consumers?
10:40 What can you tell us about how consumer preferences have changed? What did the pandemic tell you and what changes have you made since then?
12:17 What are your big investment priorities and focus areas in 2022?
10:29 How long did it take you to figure out that providers are not going to be thrilled about this?
15:26 What are the tech, data, or integration challenges you've had to work through in the last couple of years?
18:45 How do you create a seamless experience for your clients?
22:05 Can you tell us about the data and analytics program being escorted at BS&W. You recently became members of the Truveta consortium. Can you talk about that too?
26:46 How have you gone about identifying digital health startups to work with? What is the message you have for startup founders listening to this podcast?
31:44 How do you keep score of how well you're doing with digital health? What are the one or two metrics that you track?
33:40 Can you share best practices / learnings for your peers?

About our guest

Dr. Ashis Barad is the Clinical Lead of Digital Health at Baylor Scott & White Health. He is a galvanizing physician leader with 16+ years’ experience in clinical medicine, informatics, digital health, and health equities. He is a proven leader that can communicate effectively with executives, data analysts, and clinicians and bring data insights into clinical workflow.

Dr. Barad leads one of the highest performing physician departments with great energy, attitude, and passion about data and advancing healthcare.

Dr. Barad graduated from the Texas Tech University Health Science Center School of Medicine in 2003.

Q. Ashis, can you tell us about BS&W and your role there? 

Ashis: We’re the largest not-for-profit healthcare system there, servicing 46 counties with 52 hospitals and a completely integrated delivery network — inpatient, outpatient, and all types of physicians. We have roughly 7300 physicians in our system and 49,000 employees. I have been with BS&W for 11 years now. I came in as and still practice as a Pediatric Gastroenterologist. I’ve had this role — Clinical Lead of Digital Health — for the last two years. 

Q. You’ve been with and seen the digital health program evolve over time, so, give us an overview of the digital health capabilities that you’ve implemented at BS&W over the last couple of years? 

Ashis: Baylor Scott & White Health were early in the digital health game for incumbents and so, we’ve had a digital front door – it’s an overused term today – since 2016-17. That’s separate from the one on MyChart and we are an Epic shop. Our digital studio envisions becoming the most desired consumer-centric partner for people’s well-being. So, that’s a critical vision we base our decisions and the products we roll-out, on. We want to think of ourselves as a very consumer-centric organization. The digital health office then, obviously plays a major role in that vision. Its features and capabilities are really focused on five strategies revolving around our digital front door to accord us unprecedented convenience, personalization, and accessibility. 

This also involves a big CRM tech stack that drives consumer engagement with the right message at the right time. 

We also look at innovative products that can get us closer to the consumer. We incumbents probably have something that the disruptors don’t necessarily do and that is brand permission that enables proximity with our consumers as of now. We need to capitalize on that. One line that we like to say internally, in that context is — we want to build Netflix here and don’t want to just make blockbuster lines faster. So, the key lies in not being iterative in what we’re building, but really thinking differently in our products. 

I’ll rattle off a few others here – creating systems of intelligence. We look at data and engagement and Epic, which is our EHR, a system of record. We look at other products and partners that can really envelop the EMR to enable us to get closer to the consumer automation. Lastly, we’ll call it a digital practice, which is building a platform to orchestrate care. We’re certainly providing care but in the new normal, because of all the partners in the ecosystem, the disruptors and, as seen in big tech, we are turning from providing everything to everyone to really orchestrating the journey. We want to put that together as a trusted partner. 

Q. Healthcare is not necessarily known as a consumer-focused industry so it’s refreshing to hear this. Now, you’re at the forefront also because your mobile app is rated very highly. Tell us about the genesis of the app and what it does for your consumers, today? 

Ashis: Thank you for calling that out since it’s really important to who we are. The consumerism aspect of things — and as a physician especially, I will just say — when I speak to physicians and we say “consumer,” there’s a little cringe or some kind of negativity. I just remind them that consumer or the definition I have around it, is actually the “patient,” plus the context of who that individual is outside of their healthcare. Once you really kind of level-set this, it seems to resonate. 

We’re very proud of our mobile app, which is very highly rated. Its genesis can be traced to another terms not usually seen in healthcare – Agile. We came together and made a decision to be more agile so, our app was based on a kind of agile methodology. It’s taken five versions, 40 sub-versions and considerable stakeholder involvement to really get to where it is, today. It was certainly a platform before platforms were cool. 

I’ll give credit to our Chief Digital Officer, Nick Reddy, who had this idea that, our brand is important, and we must unload our digital front door from our EMR. He had a bigger vision of being able to truly have a platform that could be customized to ensure a personal experience for all of our members. This was something we could use for our whole integrated delivery network, which includes a lot of joint ventures, specialists and hospitals that aren’t in our medical posse. So, they don’t have an Epic MyChart. Then, how could we take in full, consumer experiences, have every part of their journey — whether they’re in or out of our medical group — and really create an app while integrating it with the EMR? MyChart was really the only way to do that. So, it’s a fantastic app because it does let you sign-up without having ever walked into any of our clinics and to consume care. 

Q. Based on your experience with the app, what can you tell us about how consumer preferences have changed and how BS&W responded? What did the pandemic tell you and what changes have you made since? 

Ashis: That’s a great question. A couple of words come to mind. One, is guidance. Our users want to know if they need a doctor, when do they need them, where should they go and who should they see. These simple questions lead them to Google and other websites rather than their healthcare system. When we learned that consumers want their doctors and systems they know and trust to answer these, they’re looking for guidance, we saw it as our mission to provide that in a very easy, frictionless way. 

Once we’ve guided them, they’d also want choice, right? With price transparency and a lot more cost-sharing. This is a big reason why healthcare is beginning to look a little more like retail. So, our consumers get a choice same as they’re expecting in retail for where to go to consume care. 

Q. You have created a best-in-class mobile application and set the benchmark within healthcare enterprises. In 2022, what are your big investment priorities and where does your focus lie?

Ashis: I think that when moving into the orchestration of care space, scale matters. So, growth and using our digital and virtual tools to really grow as a system and move to markets that we may not have a physical footprint in, will be big priorities for us. You’re seeing that with a lot of large health care systems, today. 

Q. What would be an example of that — going beyond your current footprint, using your virtual means? Give us an example. 

Ashis: So, we see a lot of people moving into virtual primary care and so our virtual-first primary care product allows us to get into many markets and geographies that are not necessarily where we have a physical footprint. So that’s an example. 

I think other examples are around a lot of talk about home. We’re really leaning this year into home and hospital-at-home care. Home convenience, like vaccines-at-home labs, and some other home convenience products are what we will roll-out. 

The other thing is really creating a retail-like experience for all of our consumers, whether you’re in our physical geography or not, much like an ecosystem connector, right? So, if you’ve done genetics through 23andMe and if you are an avid Peloton rider, you know where you have these other retail-grade experiences that are part of your health or your wellness that we want to know about. People expect their health systems, their doctors to know them for who they are and again, other things that they’re doing regarding wellness. So, we’re working to connect to their whole world if they allow permission for us to do that. 

Q. What kind of challenges have you addressed along the way – tech, data, integration, internal culture-related? Talk to us about a couple of the big ones you’ve worked through in the last couple of years. 

Ashis: I’ve heard you say many times that, it’s 10% tech, 90% people, right? You’re absolutely right when you say that. The tech isn’t terribly hard now. The caveat to that is we’re short-staffed — on the nurses, tech, data people, engineers, designers’ sides – and talent is hard to find to really create this wonderful team. So that is a challenge today that we didn’t have as much, a few years ago. 

That being said, I’m a physician, so, we doctors don’t really move at speed with new technology. Working on the physician side of the house and getting things to really move at scale is why my position exists. I do think it’s important to find a physician champion that really understands both sides of the equation and moves a lot of these digital tools to help health systems become scalable and operationalized. 

Then, the other thing I’ll say is that a major challenge is, legacy healthcare systems have had this culture of a vote by veto. Typically, here, you have one stakeholder that just says “no, we can’t do that” and the whole thing falls through. That’s another challenge. We’re really working hard to change the culture as such to say “yes” versus “no” and then, really letting something fail. 

Q. In an abundant yet fragmented technology landscape you have to take a lot of different technology — Epic, which is your core system — and layer on other stuff including your homegrown mobile app. How do you make all that work together to create a seamless experience for your clients? 

Ashis: It’s what we wrestle with every day. It takes a large team and a lot of resources to really do it, especially since our app and video visits platform are homegrown. We’re quite blessed to have a very talented team — engineers and designers — as dedicated resources for digital health at Baylor Scott & White Health. They’re very passionate about healthcare.

I don’t think that in healthcare we always sell ourselves really well to the outside world as far as our mission is concerned. But if I talk to these teams every day, they have the same passion for healthcare that I do as a doctor taking care of my patients. Once they’re invested and in, we realize that the work they are doing is improving health care and health outcomes. They find a lot of value in being in health care versus other industries, so, the other aspect of that is that we really try to spend a lot of time on that internal culture within the digital health office to really be able to see the outcomes of other products. 

Q. You made such an important point – it isn’t the money but the sense of mission and purpose – that’s something I’ve observed across every health care organization I’ve worked with. You mentioned data and how you’re using it to drive experiences, understand your consumers etc. Talk to us about data and analytics and in that context, about you, as a member of the Truveta Consortium – a group of health systems coming together to pool data assets to drive insights that can collectively improve healthcare outcomes.

Ashis: Thank you for bringing up the Truveta Consortium. They’re adding health systems every month now, which has been wonderful because there’s a lot of data and there’s big data. They’re up to 16 percent of all U.S. healthcare data, which is certainly a large percentage. 

Talking about data, one term that gets thrown around a lot is personalized care. But to get to that end of the spectrum where we can predict people’s outcomes and be prescriptive in their care, we need data. I love to give the example of a particular patient I meet in office to who I say, “It looks like in a year’s time, you have a 40% chance of developing diabetes.” Now, if I left the conversation there, the person walking out of that door wouldn’t be happy. So, if I can then, take it a step further and say, “If you do these three things, then you can reduce that risk by 50%.” How do we get to that place in healthcare? 

I certainly don’t think Truveta alone will solve for everything but having that big data and being able to utilize 16% percent of the U.S. healthcare and leveraging the diversity of data that Truveta brings – that is important. 

We talk a lot about big data but data also needs to be diverse. One stat that appalled me when I saw it was — only less than three percent of research data is comprised of Hispanic and African American patients. We make so many decisions on incomplete data that does not represent the patient that’s sitting in front of us. To get to a point where you can actually personalize care to then say, for example to a Filipino, 50-year-old lady with breast cancer, “A thousand patients just like you underwent this therapy and had the best success and are now in remission.” I think that’s a lot more powerful than what any study that maybe had 95% Caucasian women in it. Truvada really does allow us to get to that level of care because of that diverse data. 

Q. It’s interesting you mention that. Two of my recent guests were the folk from Epic who’re on the Cosmos dataset which is similar to what Truveta is trying to build. But what’s always bothered me is the Balkanization of the data landscape in this country. The data’s sitting with different people, they’re all trying to do the same thing, but they’re not doing it at scale. For me, one vision of utopia, is where all this data gets consolidated with access granted in some way that allows everybody to do the kind of things that you talked about, because quite frankly, it’s not happening and it’s hurting caregivers, healthcare economy, and healthcare consumers. However, these initiatives are underway, involve innovative solutions that have been put together by startups. While the perspective is fresh, there are risks. How have you gone about identifying digital health startups to work with and what is the process you follow? What’s your message for startup founders listening in? 

Ashis: I get pinged a lot by start-ups looking for a door in and so, this is a wonderful call-out. I’ve heard this on your podcast as well that our systems are slow and the cycle at which we do things is slower. So, I’d imagine that’s very frustrating. 

One thing I was speaking about with a start-up CEO, recently, was, “How or what can we do better for you?” What he said was really enlightening for me. He said, “We spend a lot of time guessing what it is you want us to solve for. We spend money, resources and time but want more transparency to solve the pain point identified. Let us know we’re putting our time and resources in the right place.” If anyone’s listening on the incumbent healthcare side of this, I think that was a learning lesson for me. I’ve used that and it’s worked out quite well to make sure that end product we iterate and come together for, really solves the problem that we’ve both agreed upon. 

That being said, it is a tough atmosphere for start-ups because different healthcare systems of different countries have their own culture and things just run very differently. I don’t think anyone startup can go to Intermountain and say, “I’m going to use the same technique and same product to solve the same pain point for BS&W, and it’ll scale just the same as it may have done at say, Intermountain.” 

Taking some time to learn the strategy, the system KPIs of that particular health care system, looking at the ecosystem in which it lives — is it living a value-based care, is it living still in the fee-for-service role, is crucial. And because what we’re solving for is sometimes different as we really learn, so I’d say take the time to just learn and understand what the ecosystem of that system is, and go from there. 

Q. I had a startup founder who recently told me that the biggest challenge for them is surviving the sales cycles in healthcare. If a start-up has limited funding from venture capitalists, and run out of money pretty quickly, its shut down. In which case, where does that leave the health system that signed-up this innovative start-up? 

Ashis: I’m right there with you. And I think that for the startup, I would also suggest one tip — identify a business owner so when going into the healthcare system, you have an individual that you’re really talking to about trying the use case, doing a point solution. To scale, you need a business owner that’s truly passionate about the problem that you are solving for, because there is nothing more powerful in the health system than someone who’s going to take that, run with that torch, and really sell it for you. It’s such a large system that if you try to be that person within the system, often, it just doesn’t get the message across. 

Q. That is really valuable advice. How do you keep score of how well you’re doing with digital? What are the one or two metrics that you track? 

Ashis: Sure. We really believe the future is digital and we know where consumers are going. We certainly know that the digitally native consumers are going to be the largest part of the workforce going forward. And so, one metric, for example, is we’re tracking how many consumers are into interacting with us — more digitally than even in person — through phone calls or coming in, in person. So, virtual video visits, care journeys, and care navigation tools are what we use to track that.

I mentioned before, growth through digital channels is what we call digital-first growth. We ask, “did you actually interact with BS&W through a digital mechanism, first?” And then, on the back end, it’s our job to engage you in a personalized way, navigate you to the right care. We’re not just visually engaging with you once, but actually turning that into a sustained relationship.

Q. That’s good to hear. Are there one or two best practices or learnings that you would like to share with your peers who may be listening to this podcast? 

Ashis: At Baylor & Scott and White, one of the books that we have to read — this is our Chief Digital Officer who asks us to do so — before we sign on, is “Who says elephants can’t dance?” The IBM story, right? And so, yeah, Lou Gerstner. 

Q. Yeah, that’s right. I know Gerstner turned around IBM in the 90s. 

Ashis: Being agile and taking it the right way is important. We know that agile can be masquerading. But we’ve really changed our culture internally at all levels — all stakeholders — to really take on agile. 

My other advice would be to go from being a supply-driven company to demand-driven one. We need to spend time and resources on the voice of the consumer to learn what the demand is, where it lies and what consumers need and want. We think we know the pain points and that’s probably part of the paternalism in health care. So, that is not true. 

We have learned that as we go out, spend time and resources on the voice of the consumers, that often, what they want, need their pain points are very different from what we assume. 

So, my advice would be — really spend those resources, that time to truly learn the voice of the consumer because we’re never going to get to the retail level of care and experiences if we don’t spend that energy and time there. 

Q. That is so refreshing to hear again. Ashish, it’s been fantastic having you on this podcast. Thank you so much for setting aside a time when we look forward to following your progress and all the very best to you. 

We hope you enjoyed this podcast. Subscribe to our podcast series at  www.thebigunlock.com  and write to us at  info@thebigunlock.com

Disclaimer: This Q&A has been derived from the podcast transcript and has been edited for readability and clarity

About the host

Paddy is the co-author of Healthcare Digital Transformation – How Consumerism, Technology and Pandemic are Accelerating the Future (Taylor & Francis, Aug 2020), along with Edward W. Marx. Paddy is also the author of the best-selling book The Big Unlock – Harnessing Data and Growing Digital Health Businesses in a Value-based Care Era (Archway Publishing, 2017). He is the host of the highly subscribed The Big Unlock podcast on digital transformation in healthcare featuring C-level executives from the healthcare and technology sectors. He is widely published and has a by-lined column in CIO Magazine and other respected industry publications.

The Healthcare Digital Transformation Leader

Stay informed on the latest in digital health innovation and digital transformation.

The Healthcare Digital Transformation Leader

Stay informed on the latest in digital health innovation and digital transformation.

The Healthcare Digital Transformation Leader

Stay informed on the latest in digital health innovation and digital transformation.