May 14, 2021: What happens if you can’t afford healthcare? If the pandemic did nothing else, it really uncovered the need for true empathy, to be present, to listen, to communicate and to understand what people’s individual circumstances are. It put a greater focus on the advocacy of helping people to truly be healthy. Sarah Richardson, CIO for Tivity Health talks about her new role and how she is transforming the organization from a healthcare services provider to a platform engagement and high-performing software development shop. There’s a TON of money flowing into health tech. 15.3 billion in 2020. Where is the potential for that money to have the greatest impact in healthcare? How will cybersecurity, analytics, AI and automation change over the next 12 months? And which area needs the most attention right now?
Embracing the Future of Healthcare with CIO Sarah Richardson
Episode 403: Transcript – May 14, 2021
This transcription is provided by artificial intelligence. We believe in technology but understand that even the smartest robots can sometimes get speech recognition wrong.
[00:00:00] Bill Russell: [00:00:00] Thanks for joining us on This Week in Health IT influence. My name is Bill Russell, former healthcare CIO for 16 hospital system and creator of This Week in Health IT, a channel dedicated to keeping health IT staff current and engaged.
[00:00:17]Today we’re joined by the incomparable Sarah Richardson, and we have a phenomenal conversation. She started a new role. We start there and how you transitioned to that role. What are the kinds of things you do? And Sarah is my hero at this [00:00:30] point. Instead of putting on the COVID 15, she lost the COVID 15. She’s an incredible leader, and I think you’re really going to enjoy this conversation.
[00:00:37] Special thanks to our influence show sponsors Sirius Healthcare and Health Lyrics for choosing to invest in our mission to develop the next generation of health IT leaders. If you want to be a part of our mission, you can become a show sponsor as well. The first step is to send an email to [email protected]
[00:00:52]Common question I get is how do we determine who comes on this week in health IT? To be honest, it started organically. It was just me inviting my peer network. [00:01:00] And after he show I’d asked them, is there anyone else I should talk to? And then the group, obviously the network group larger and larger, and it helped us to expand our community of thought leaders and practitioners who could just share their wisdom and expertise with the community.
[00:01:13] But another way is that we receive emails from you saying, Hey, cover this topic, have this person on the show. And we really appreciate those submissions as well. You can go ahead and shoot an email to [email protected] It will go to the entire team. We’ll take a look at it, reach out to these people [00:01:30] and see if there’s a good fit to, to bring their knowledge and wisdom to the community as well.
[00:01:35] Just a quick note, before we get to our show, we launched a new podcast Today in Health IT. We look at one story every weekday morning and we break it down from a health IT perspective. You can subscribe wherever you listen to podcasts. Apple, Google, Spotify, Stitcher, Overcast. You name it, we’re out there. You can also go to todayinhealthit.com. And now onto today’s show.
[00:01:58] Today, we are [00:02:00] joined by Sarah Richardson, CIO for well, I’m not going to say who she’s with. She’s going to get to do the announcement, Sarah welcome to the show.
[00:02:07] Sarah Richardson: [00:02:07] Thank you Bill. Nice to be back.
[00:02:09] Bill Russell: [00:02:09] So this is, this is your first time on the show under a new banner. So tell us, tell us about the new role and the new company you’re with.
[00:02:18] Sarah Richardson: [00:02:18] Yeah, absolutely. So I, this is like my third time, I believe on your show. And every time I have like a different role or different opportunity and a lot of times it’s in the same company but this time it is different. I am a senior vice president, CIO [00:02:30] Tivity Health. Tivity is best known for the silver sneakers brand.
[00:02:33] That’s our flagship flag ship brand. We also have prime fitness and we have wisely well and full health living. So we have a complete suite of products that allow us to really be the destination for healthy living. But most people know us for silver sneakers which is a fitness programs for seniors, 65 and older that they primarily get to their Medicare advantage plans.
[00:02:54] Bill Russell: [00:02:54] Wow. And you don’t, my parents do silver sneakers. So it’s a national program.
[00:02:59] Sarah Richardson: [00:02:59] It is. [00:03:00] Yes, very much. So it’s also a really emotional brand. Like our members love us. Like we have 17.5 million eligible members and people absolutely llove silver sneakers. The brand itself has been around for almost 30 years. It’s been, you know, it’s changed hands in terms of who owns it over a period of time.
[00:03:16] It’s now with Tivity where it will rmain and it’s fascinating to see how much our members love us. Like if I’m wearing my gear, even now out in public people will stop me and talk to me.
[00:03:28] Bill Russell: [00:03:28] Well, then it, then it’s a perfect hire [00:03:30] cause people love you. And they, they love that brand and they love silver sneakers. Cause I know my parents talk about it. It’s a real fascinating thing. And I thought it was a, to be honest with you, I thought it was a Geisinger thing cause they’re through a gust of your health plan and whatnot but they, they talk about silver sneakers and being a part of that. That’s fascinating.
[00:03:48] Tell me about the role. So it is the role different than other roles you’ve held in the past.
[00:03:54] Sarah Richardson: [00:03:54] It’s really different and here’s why I even took it. Because I wasn’t looking, I think that’s such an important [00:04:00] thing for people to understand, like, how did you choose Tivity? And I said, well, I was with Optum, you know, five years, really, exactly out at that five-year Mark doing a lot of really new and interesting and exciting things.
[00:04:10] And then Tivity comes along, you know, recruiters talk to us all the time. And I was like, hmm, let me look into this a bit more. Well, it’s the perfect culmination of my hospitality background. So I started in the casino hospitality business. Seven years in Vegas. Actually worked for an airline for a short period of time as well.
[00:04:28] And then [00:04:30] healthcare and I’m big into fitness. I think people that know me know that I have a Peloton stand. I’m standing on my walking treadmill right now. I sit on an exercise ball. Like you can always see me doing something healthy and related to fitness as well. And I’m a certified personal trainer.
[00:04:44] Bill Russell: [00:04:44] You’re on the treadmill going right now.
[00:04:47] Sarah Richardson: [00:04:47] Right now. I’ve actually shared with people, especially this whole COVID space, because fitness has been a big piece of staying healthy during COVID. It is very hard to walk and talk. I need to either on [00:05:00] camera type for other things, like the magic number is one mile an hour by the way to actually have a real conversation, potentially even take notes, but you can’t facilitate an outcome.
[00:05:11] You can’t, you can’t like lead a meeting and be on the treadmill. It’s distracting. It’s just, it doesn’t really work out. But if I’m in like, you know, a monthly performance review where I’m more of an attendee then I can cruise along on, at about a mile per hour and get some extra steps and everything. So, [00:05:30] yeah, so it is different.
[00:05:31] I mean, what I love about it is I get to be what I would call traditional CIO. Like I have my teams and we have the things we’re going after, but I get to work in verticals and with people I haven’t always worked with before, but it’s really about transforming the organization from what’s I guess been a healthcare services provider to a platform engagement company and a software company, because we’ve always offered fitness as an option for our members and some other add-ons from there. But now we’re creating these spaces it’s really about [00:06:00] how do we engage people at a new level? How do we build in community and volunteerism and tackle loneliness, and tackle the things that people want to come to a platform to be able to do? And that’s really where we’re headed.
[00:06:12] And so the CEO, Richard Ashworth from Walgreens joined June of last year. And he says, you know, I need a couple new roles or new or people in roles to make these things happen. And so one was the CIO with a background like mine and our chief experience and innovation officer Stacy Santo with a background like hers.
[00:06:30] [00:06:30] You know, she comes from Asics and global omni-channel Rue LA LA different experiences. And she and I got hired about three weeks apart. What’s so cool about Stacy and I joining at the same time Bill is that we didn’t know each other during the recruitment process but our boss. Richard knew that we would be complimentary for one another.
[00:06:51] And so every, so often in your career, you meet somebody that you’re going to be working really closely with and you’re immediately like able to accomplish things [00:07:00] together. So she and I just chat, she’s in Boston. I’m in LA. So we just chat and text and have a lot of great conversations about what to do.
[00:07:07] And we’re surrounded by amazing humans in the organization. So it’s like we have to do this by ourselves by any means. So we’re very grateful that our boss is very selective in choosing who he brought together and how he brought us together.
[00:07:17] Bill Russell: [00:07:17] Well, I mean, congratulations on the role. I want to go in a couple of different directions. One is, hey, I’ve always wanted to talk to you on the show about your career progression but before that to give a little more background [00:07:30] on, on Tivity. It’s not going to, you’re not going to be a traditional healthcare provider, so you don’t have any HR and those kinds of things you’ll have more more consumer-based types of applications. I would imagine some cloud applications, maybe even some development capabilities. Give us an idea of what the solution set looks like and what the activities look like.
[00:07:54] Sarah Richardson: [00:07:54] Sure. So we’re a big dev shop. I would say about 60% of our team is software development. And you [00:08:00] think about that being because when silver sneakers really became mainstream with its digital platforms, you know well more than a decade ago, those had to be custom built, those things didn’t exist off the shelf.
[00:08:13] And then all the tie ins that start to go into what it takes to run the organization around that and all these individual offerings and the ability to have customized programs for different products. Those all became homegrown applications and all the different backend that goes along with that.
[00:08:28] But as you know, technology [00:08:30] moves very quickly and the organization has been through pretty significant change over the last decade as well. Either mergers, acquisitions, divestitures, et cetera. So we are now that Tivity owning the silver sneakers and the prime and the whole health living and the wisely well brands.
[00:08:46] We are in the process of truly replatforming that. Not just all of our technology on the backend you know, going from having a couple of data centers and some cloud activity to guess what we’re going to have one data center we’re going to [00:09:00] do most of the things that we want to do in the cloud.
[00:09:02] We want to have a hybrid environment that really makes us able to have code based infrastructure. And then you put all of your development on top of that. And in a place like AWS using Kubernetes for containerization using low code environment, because that’s where most things are headed. So that like we used to talk about, even in the hospitals, you allow people to practice at their highest level of licensure.
[00:09:26] Well create an environment that allows your practitioners in your own environment to [00:09:30] practice at their highest level of capability as well. And nobody wants to be running around hard coding things and doing backup and recovery to two data centers anymore. And so you have to get there. So we are on a fast track to do those things.
[00:09:42] And when we can partner with a snowflake or a red point or a stitch or a stream to make these different things happen, we do. And if we have to go and build things still then we’re going to build them in the most optimized and agile environment, we possibly can. So no shortage of just things happening [00:10:00] everywhere and what most people don’t realize.
[00:10:02] So important is that our entire company has like 350 people in it. That’s it? Three, five, zero. It is about 68 of them with 30 contractors helping us to get us where we need to be. And so you think about the size of a company. It sounds this huge, amazing workforce to get these things done. You don’t need to have a whole lot of smart people working really hard to do very finite, very specific deliverables in a way that allows us to do that. That hasn’t been done before.
[00:10:29] Bill Russell: [00:10:29] That [00:10:30] is a, that’s pretty cool. I’m looking forward to future conversations as you start to progress into this. The architecture sounds awesome. And you know sponsor is VMware and we didn’t talk about the setup time, but they’re, they’re happy that you mentioned Kubernetes
[00:10:47] Sarah Richardson: [00:10:47] Well we use VMware. So we’re happy with them. It’s not a plug for our vendors. It’s our partners. It’s we use VMware, we’re happy with VMware and we’re going to move it to the next pace actually was joking with VMware. I’m like, they should change your name. [00:11:00] Like, you’re just do like everywhere because it’s not virtual machines anymore. You do all these other things now. I’m like, I’m not sure that would be a rebranding effort. I’m like, I’m not in the marketing department. I’m just offering suggestions.
[00:11:10]Bill Russell: [00:11:10] Frank Nydam came on the show a little while ago and I’m sure I’m sure you’d appreciate that because it’s one of those things that you get stuck.
[00:11:21] And they are no, I mean, they’ve changed the data center forever, or we view it, but they are so much more than that these days. [00:11:30] Let’s talk about your career progression. And I like the fact that you said, you know, you weren’t out there looking for something. It sort of sounds you. But let’s, let’s start all the way back, you know, how did you get into your first CIO role and then how did you progress from there?
[00:11:45] Sarah Richardson: [00:11:45] So that was, I want to say somewhat planned on my part. Like my career has not been by accident. There’s definitely been things when you say you weren’t looking at a new opportunity found you. It still had to be an opportunity you were prepared to take or to [00:12:00] handle. So I was incredibly fortunate that I worked for HCA for almost 10 years.
[00:12:06] And I had progressed from the casino business, airline into healthcare. I was working for the County hospital in Vegas. And then an opportunity came up with HCA. To be a hospital ICU director. So we did that. Then I went into security operations for them at the local division. And then I was able to move to Nashville to work at headquarters, which I was like to me, that was like, I’d made it in life.
[00:12:25] By the way, I was like 33 years old at headquarters, which is amazing. And I spent three, [00:12:30] about three years in a forward facing field operations role, essentially serving the CIO, helping them stand up their support models and really getting to know all of them. And then HC is very good about. Training their own leaders and investing in their team to have internal promotions and great succession plans.
[00:12:50] So when you’ve got 14 divisions at the time and a CIO opportunity pops up and you’ve been the field director supporting those opportunities, then you become a [00:13:00] candidate for that. Now we’ll tell you that the reason I was able to become a CIO when I did is I first opportunity was in Kansas City, Missouri.
[00:13:11] And no shade thrown at Kansas City, Missouri, but it was never a destination on my radar. Period. I’d never been to Missouri actually until I moved there. And what I’ve found was you might prepare for the job. You didn’t always prepare for the geography, [00:13:30] and if you’re willing to take that, then you get great opportunities.
[00:13:34] And so I think a lot of my careers has been based on taking roles and or geographies that weren’t necessarily the first choice of some people. And because it was excited about what those things meant and willing to do them, it worked out incredibly well. And I’ve never been disappointed in the choices I’ve made in doing that.
[00:13:54] I’ve moved around a lot. I’ll be honest. I mean, I’ve lived in a lot of States now with a few different companies. It’s always been [00:14:00] for the right reasons and have the right opportunities follow.
[00:14:02] Bill Russell: [00:14:02] Yeah. You know, what’s interesting about that is that’s one of the things, when I was CIO and people would ask me, how did you get that role?
[00:14:11] And one of the things I say is, you know, if, if you really want that role, you don’t get to live down the street for your parents. And what I meant by that was I moved several times and I moved for my career and that was one of the objectives was to get to certain roles and I was able to do that, but [00:14:30] they didn’t always pop up, you know, down the street from where we wanted to live.
[00:14:34] They popped up inPhoenix. They popped up in St. Louis. They popped up in Southern California and it’s hard, right? It’s hard to move depending on your family situation but you know, it’s a decision and hopefully you do it. So you get into that HCA role, you get into that, that first CIO role you know, how does it, how does it progress from there?
[00:14:56] I mean, is it a situation where you know, you [00:15:00] outgrew the Kansas city role and were looking for something a little bigger at that point?
[00:15:05] Sarah Richardson: [00:15:05] Yeah, it’s funny. I look back and say, I joke about, oh, I took a job or nobody wanted to live. The only thing about KC that wasn’t awesome was the geography. Like where it physically was in the us. But the people, the company, the experiences. I mean, I met my second husband there, like everything about that entire four and a half years was amazing. And we still have so many people we’re close to. So I love everything but the snow and being [00:15:30] three degrees in January kind of deal and I’m born and raised in California. I don’t do winter and now I’m back in LA.
[00:15:38] For the last five and a half years and I’m happy. I like the weather kind of thing. And now randomly, you know, you think about, you don’t have to necessarily move for your job anymore. You can live anywhere you want. So with that in mind, where do you choose to be? But it was really interesting about that role is that I could have happily stayed there.
[00:15:55] I mean HCA is a huge company and they’re, again, they’re very [00:16:00] supportive of moving people around into the right opportunities. But I was also somewhat, I don’t want to say impatient. But it’s probably the best way to describe it. I was ready for a bigger role and the next role was going to have to wait for something to open.
[00:16:14] And that’s okay if that’s on your radar, but I was like, I don’t want to wait. And so I took an opportunity to be a CIO with a much smaller organization, but to be the CIO of the hospital system. And so not a division CIO, I’m a CIO of a hospital system [00:16:30] that progressed into them going back into more of like a division type of role with well at the time was healthcare partners out in California. And I had personal reasons for needing to move back to California too. I mean, I was found myself in Florida, which was fantastic but I also had an aging parent who was starting to have some health problems in California. So I needed not down the street eight hours away, but I still needed to be closer to home.
[00:16:52] So I took an opportunity and that just progressed until it got bought by DaVita. It got bought by Optum and it kept going from there. So [00:17:00] there are experiences that I believe we curate or want to have in our careers. And sometimes we make them happen and sometimes they happen to us as you well know, I’m a big fan of create your own outcomes, create your own destiny like be prepared for whatever happens.
[00:17:16] But reinvention is something we are responsible for personally and where I am now as part of the things I want to accomplish in my career. So sometimes you find it, sometimes it finds you but either way you put it out there in the [00:17:30] universe for it to happen.
[00:17:31]Bill Russell: [00:17:31] You know what I find interesting. And we talk about this a lot. There’s seasons in life where, you know, you made that happen to be close to your parents and that’s phenomenal. I had a season in life where my daughter came to me and she was in middle school and she said, dad, I don’t want you to travel anymore. Well prior to that, I was traveling 40 weeks a year and doing consulting all over the place.
[00:17:51] So I started my own business and for the next three years, essentially hunkered down, you know, right around the location where we lived and [00:18:00] yeah, it’s just a season. Right. And then you get back on that of course your health care partnership was a pretty good job and you really thrived there. So you’ve found a pretty good location near your parents.
[00:18:14] Sarah Richardson: [00:18:14] I did. And, you know, I share this with people because it’s important for people to understand. And it also says a lot about the cultures and the structures and the key components about being a leader is, and that needed to happen because my mom died of cancer last year.
[00:18:28] I mean, and I was [00:18:30] able to be with her on that journey. I spent a lot of time up there. And then of course, end of life planning and all the things that go along with doing that with your parents. Which are not pleasant by any stretch of the means but when you get to actually be there and be part of that conversation and be their advocate and they don’t have to be alone that’s a big deal.
[00:18:51] So I’m very grateful that I was able to spend the time I was with my mom towards the end of her life.
[00:18:57] Bill Russell: [00:18:57] Yeah, absolutely. Sorry to hear about that. [00:19:00] Let me ask you this. And you know, I tend to ask this question of anyone who’s stepping into a new role only because it really helps. People that from time to time, they find themselves, you know, stepping into a CIO role for the first time or stepping into a new company for the first time. You know, what are the first days look like for you? What are you looking for? And what do you want to make sure that you accomplish in those first couple of weeks while you’re there, or even the weeks proceeding [00:19:30] you stepping into the role?
[00:19:32] Sarah Richardson: [00:19:32] Yeah, it’s interesting is that preparedness and or preparation are literally everything. So when you’re doing your due diligence and deciding if you’re going to join an organization, you learn a lot about what you read and what you hear in the interviews. And I’m hopeful that everybody has a list of questions that they’re asking that are very specific to, what am I stepping into? Like, how mature is this organization?
[00:19:57] How are decisions made? What, you know, what am I [00:20:00] overcoming when I walk in? What are the landmines, the sacred cows, all the different pieces, et cetera. When you ask those in your interview, you also start to get a sense of how transparent the organization is and what you would be finding on day one. When you walk in the door, though, you assume, you know, nothing
[00:20:20] Bill Russell: [00:20:20] Really, even after the interview, you just assume that you’re starting from scratch
[00:20:25] Sarah Richardson: [00:20:25] Start from scratch. You know have a list of questions it’s not, and it’s not a science. It is [00:20:30] research. I’m not gonna act like I don’t do my homework. You know, the joke I spend like four hours before our conversations, making sure that I sound relatively intelligent in what we share. But it’s about, and I’m glad I have a coaching background because you literally have like your five or six questions and you send them to everybody ahead of time.
[00:20:49] Cause I like to be prepared and you ask the open-ended questions. You listen, you’re fantastically curious to take notes. You listen some more. [00:21:00] You ask people, what do they need most from you? What are those expectations that they’re setting? And as you build those relationships, you create a couple of different things.
[00:21:10] You set and manage expectations, and then you create conscious working agreements. Like, how are you? And I built going to do business together. Like, what do you need from my team? What does it look like? How do we figure those things out? And then you share that with the team and say, Hey, I just got to meet with Bill Russell.
[00:21:25] And here’s what he’s saying to me about us. Tell me about what that means to you [00:21:30] as well. So it’s always this partnership and collaboration, but what really, I feel like is key is that in the first week I did a podcast with our CEO. I did an all IT meet and greet, and then I committed to meeting with every single member of IT one-on-one for 30 minutes in the first hundred days. And I’ll tell you 27 days in, on my fifth week, I’ve met with over 40% of the team. One-on-one and it [00:22:00] has been phenomenal in terms of being able to learn and grow and understand the organization. This is an addition to all the standing meetings and all the business partnerships as well, but people really appreciate when we take the time to get to know them.
[00:22:14] Bill Russell: [00:22:14] What my my scheduling person was saying, they’re like we can have Sarah for this one hour or we can talk to her in three months. I was like, really? She’s that busy? It sounds like you are that busy. I mean, you’ve made, that’s a big commitment. It’s talking to everybody for 30 minutes.
[00:22:30] [00:22:29] Sarah Richardson: [00:22:29] Yeah. And it’s not my favorite mentor friends to this day, talks to me, Joe Scarlet do not mistake activity with accomplishment.
[00:22:38] Cause he called me the other day and said, all right, so what are you learning? What are they telling you? What are you hearing? And notice how he says this, what are you hearing? Because he’s making sure that I’m listening. And like when you have people that keep you humble and honest, like that, it’s hard to make big mistakes.
[00:22:54] You’re gonna make mistakes and own them. And I do all the time and I share them. People laugh like, wow, you do a lot of self-deprecating humor. I’m like, [00:23:00] because I do something stupid everyday. Like you can’t lose a document in Teams but I can. And it was actually agenda for a big meeting that we had.
[00:23:08] And I totally, I totally like, it doesn’t even matter how it got lost, but the team thought it was pretty funny.
[00:23:13] Bill Russell: [00:23:13] That’s interesting. You know, one of the things that, cause I do coaching, you do coaching, we’ve talked about some of this stuff before. One of the things I do for my clients, especially if they’ve been in the role for two, you know, a year or two or so is I’ll go in and do the listening tour.
[00:23:28] So I have a [00:23:30] series of five or six questions I’ll go in and talk to some of the key leaders and some of the some of the peers within the organization. And it’s interesting. Because I just grab a ton of, you know, was quotes of anecdotes and that kind of stuff. And then we just sit through it and, you know, part of it is telling to say you know, have you heard this before?
[00:23:55] Are you aware of this? And you know, it’s sort of, [00:24:00] it’s sort of eye opening because sometimes they’ll tell a third party some things, knowing that it’s going to be anonymous and that, that doesn’t come out. And so it is interesting to continually get that feedback, not only in the first, you know, the first 30 days, but to keep going back and create new ways to keep engaging in listening to the to the group.
[00:24:26] Yeah, it’s just an interesting process. I want to shift gears [00:24:30] again on you. You know, I love having you on the show. You’re so insightful on so many different areas. And so I’m going to push you a little bit, but the first thing I want to ask you is what do you think the lasting impact of the pandemic is going to be on health IT?
[00:24:44] Sarah Richardson: [00:24:44] I love this question because I created like six questions from it. And that’s only because not to be annoying in to answer a question with a question but it really got me thinking about some of the things we need to be prepared for because you know how are we [00:25:00] actually accelerating digital engagement and digital health?
[00:25:03] And I’m not just talking about telemedicine. Like what are the things we’re actually doing that we’re seeing are stickiness and, you know lifetime value of some of the things we’re bringing forward. What’s really important is constantly planning for unknowns in that crisis management space and continued disruption.
[00:25:18] We weren’t very good about putting disruption in place, because you had to go through like 50 committees to do it. Some of the time you actually decided what you were going to do. It really wasn’t disruptive. It was just like a [00:25:30] relief to finally get it in place. You must’ve, weren’t even excited about some of the things that we’re putting in place.
[00:25:34] So you’ve got to create more of that startup kind of mindset and the ability for people to be like, good enough, gives us a minimum viable product to test out and try and either do it or not do it. We would talk about it, but we didn’t actually do it. And a lot of organizations. There’s always this hesitancy to disrupt things because disruption can actually lead to either it’s not gonna be profitable or you’re gonna make somebody mad or whatever reasons.
[00:25:58] But I feel like we were able to ditch [00:26:00] some of the bureaucracy around some of our decision making, but I think really it’s how you make investments and changes in your IT workforce. And what does it look like over the next 24 months? I’ve never met anybody in my company in person. Anybody. I interviewed on Zoom.
[00:26:19] I work on Zoom. I have literally not anyone face to face. And so how you can actually curate and build relationships. And how do you build trust when you’ve never [00:26:30] met somebody in person? Like you don’t get to break bread, you don’t get to have a beverage. You don’t get to go bowling yet. Do those things that you might do for team building.
[00:26:40] We’re getting there. I believe that if nothing else, that the lasting impact on health IT is our ability to be innovative and try things in a new and different way and not have to let bureaucracy and red tape be one of the dictations about how we are willing to try something. But also we have a truly [00:27:00] distributed workforce and I worked in that environment for a lot of years, so I was comfortable with it, but now we really can say, we actually need somebody for three months.
[00:27:09] Let’s contract out this one piece of the puzzle or let’s go pull this over here or hey, we can be in 23 different States and be on the same team and get things accomplished and done because you’re willing to go that extra mile sometimes because. Hey, so-and-so wants to go to their kid’s soccer game.
[00:27:28] No inFlorida that’s [00:27:30] 2:00pm for me, 5:00pm for them, but they’re willing to get back online at seven after the game was over before dinner. And it’s like, you start to like make these trade-offs because you’re all trying to achieve the same thing, but you’re getting to live your life at the same time.
[00:27:43] And that’s what I’ve loved about what’s happened is we all get to live our lives and do our jobs and create new opportunities to make things happen. We couldn’t do before.
[00:27:54] Bill Russell: [00:27:54] You don’t have Sarah. That is going to be one of the more interesting developments over the next. [00:28:00] Let’s say three to six months is the work from home. Whether it was an experiment or whether it is a new way of working.
[00:28:07] There’s you know, if you are running a hospital system, say in New York, well, LA. In LA. And a majority of your team is in that location and you require people to be there there’s a lot of interesting policies that needs still needs to be worked through. You know, do you allow people to live [00:28:30] in any state when you know, full well that you’re going to have to have them on site a certain amount of time?
[00:28:37] Are you going to start to build in travel budgets and those kinds of things? Or are you going to say, Hey, you know what, we want that kind of flexibility but look, it’s California, Arizona, Nevada. I mean that’s the geographies that you can live in. We don’t want you to living in Florida because quite frankly, now we’re dealing with three time zones or dealing with, you know, the travel budget where we’re looking at, you know, [00:29:00] $600 round trip flight plus hotel stays.
[00:29:02] Do you think, I mean, it, it is. I mean, the company you’re with now has that kind of working model, but a health system might still have some challenging decisions to make.
[00:29:13] Sarah Richardson: [00:29:13] It absolutely does. I mean, I have, I mean, several of my very close friends work in those environments and they’re like, hey, we have a tri-state region with which we can recruit because it’s hard to do business California, especially I laugh.
[00:29:25] I live here. You can make fun of California all day long. There are companies who are like, yeah, we’re good. We’re not doing business in [00:29:30] California. And I get it like California’s labor laws are intense and there’s a lot of nuances. You may find that there are geographical bubbles or timezone, bubbles, or different things you need to be able to do.
[00:29:41] That’s also where you’ve gotta be able to work, you know, with your human capital teams and say, yeah, but if I just need this one widget, this one type of work to be done, can that person be anywhere? And I’m grateful for anybody. Who has had to go into their hospitals or their offices, [00:30:00] or provide that frontline care in any given time throughout the pandemic, and really be working through a lot of those scenarios, because that’s a very real thing.
[00:30:09] But I bet you will start to see niche opportunities, especially as we’ve truly modernize our spaces in it that there will be a large component of the support that is not onsite from a technology perspective.
[00:30:26] Bill Russell: [00:30:26] All right. Let me throw out some different movements that are going on in [00:30:30] healthcare.
[00:30:31] And again, I just love your perspective on some of this stuff. So Amazon care concierge level service for Amazon employees today that really starts with telehealth progresses to a visit at a location of your choosing. So, you know, they’ll, they’ll come to you at your home, looks up to you at your at your place of work, whatever, a great digital interface to the whole experience.
[00:30:53] And I think I’m oversimplifying a little bit here, but that’s the core of it. What are your thoughts on this? Does this have the [00:31:00] potential? If it goes well for Amazon, so then to expand it and then you know, what’s the impact on the rest of healthcare?
[00:31:09] Sarah Richardson: [00:31:09] Here’s what I find fascinating about what Amazon Care is doing.
[00:31:11] If you go to their website, which of course you do. If you’re just saying, I’m gonna talk about Amazon Care they literally say your easy button for healthcare. And so often we talk about, is it easy to do business with our company? All companies have that conversation. How easy? Forbes publishes a list?
[00:31:28] Top hundred companies is [00:31:30] easiest to do business with. I talk about that in CHIME CIO bootcamp. I actually teach it. These companies are easy to do business with and guess what? None of them are healthcare companies. But one of them is Amazon. And so you think about the ability to create an experience with your employees first that gives you. Real-time feedback, the ability to pivot and changes the things you need to be able to do test out your, go to market strategy, understand what needs to be addressed in the moment. Is it sticky? Does it [00:32:00] create lifetime value? But I think about this way to bill, how many times in the last five to 10 years when describing what you would want an experience to be, have you literally said it’s like having an Amazon experience right.
[00:32:17] And now they’re just doing it in healthcare. And in order for someone to want to do business with a company, it comes down to the brand loyalty around trust. Why do you go to a certain [00:32:30] company? Why do you use their services? Because you trust it and because you have some kind of emotional attachment to it.
[00:32:37] Amazon shows up at my house every single day. Every day. Why not bring a doctor next time?
[00:32:44] Bill Russell: [00:32:44] Yeah. Yeah, we I think Drex and I talked about if Amazon were given the opportunity to do the mass vaccination of the entire country, how would it have been handled differently? And there was an interesting sort of thought exercise of what it might’ve looked like, but [00:33:00] I’ll tell you this.
[00:33:00] If they’d been given that it would have been very efficient. Whatever it was, whatever they did would have been very efficient. I know that. The pandemic changed behaviors iIn a lot of ways. Our our personal behaviors but specifically clinicians behaviors and patients’ behaviors.
[00:33:16] What do you think, you know, post pandemic, how much of that is going to swing back to previous behaviors? You know, clinicians got used to using telehealth, patients got used to using telehealth, clinicians got used to just a lot of different [00:33:30] ways of interacting. A lot of clinicians were remote.
[00:33:32] I heard of a clinician that spent, you know, three months literally in another country seeing patients back here in the States via telehealth. So behaviors changed significantly. When we see, you know, any of what happened during the pandemic stick, and I’m sure we’ll see some of it, but how much it’s going to swing back to previous behaviors.
[00:33:55] Sarah Richardson: [00:33:55] So here’s where you wouldn’t talk about behaviors makes me a little nervous. But I will say like telemedicine was [00:34:00] already a readily available form of care. There’s also the reimbursement models. Now CMS is extending, you know, the Medicare payments for 2021 and there’ll be all these different nuances that pop up. But people want it telemedicine a lot of times before they just wasn’t necessarily available.
[00:34:15] I traveled for work all the time before the pandemic and I would never probably pick up a bug on a plane in another city. And I had to use doctor on demand because at the time my provider didn’t have telemedicine. And so I think that convenience factor [00:34:30] is a component. It’s like the hybrid work environment.
[00:34:32] Do you want to go to the office a couple of days? Do you want to stay home a couple of days? Do you want to the doctor not go to the doctor, but if you didn’t want to go, you could go via telemedicine visits, especially in places that are harder to reach or some of the access issues we have. I’m hopeful that that continues to be a space that proliferates. But I think about talk about behavior. So New York times published an article that said the average American gained two pounds per month during the pandemic. [00:35:00] Well, last time I took the pandemic wasn’t over. So people were still gaining an average of two pounds per month. And so if you think the highest risk factor for getting COVID was obesity.
[00:35:11] And even before the pandemic, over 66% of Americans were, it had a BMI of over 25, which is overweight over 30 is considered obese. So if you have two thirds of Americans already a high risk factor, and now people have packed on an average of two pounds per month during the pandemic. What I’m worried about is that how do you [00:35:30] motivate people to want to go and get in shape or lose the weight that they gained or not develop new conditions and new co-morbidities simply because they were either home-bound because they couldn’t leave were in locked down different situations. But then you think about the people who did have to go out and work or do two or three jobs to maintain a certain level of status in the economy.
[00:35:55] And they don’t get to do the things that the rest of us did during a pandemic. [00:36:00] So I bought a Peloton, I lost 30 pounds during the pandemic. Wow. Literally but it’s the weight I’d gained from being on the road. So you think about the, like how some of these dynamics have shifted is people will only change if the pain of having to make the change is greater than actually doing. It has to be a reason to want to be able to change something.
[00:36:22] And you think even about like having choice and it was who was it? It was William Glasser suggested we behave and choose [00:36:30] things that are central to our existence. It was choice theory. And it’s driven by survival, love, belonging, freedom, fun and power. When you think about healthcare, survival, freedom and power are big components of choice in how we seek services every day. So I believe that it’s going to change behaviors but I’m not so certain that we are going to be, we’re not going to come out of this healthier and we’re not going to come out of this with less of an opportunity to not have it [00:37:00] be a risk factor for something else that may be coming down the pipe. There’s too much we don’t know about pandemics today, but I’ll tell you that if obesity is a key factor, we’re not addressing that issue very well in this country.
[00:37:14] Bill Russell: [00:37:14] How do we address that issue? I mean, so, you know, silver sneakers for 50 year olds. Do you have silver sneakers or 50 year olds?
[00:37:21] Sarah Richardson: [00:37:21] So we do. We have Prime fitness. Prime fitness also available through your insurance. So if your employer chooses to provide fitness as one of your options [00:37:30] and they would contract with us to provide prime fitness for you to stay healthy and motivated and make it part of your benefit plan. Absolutely.
[00:37:38]Bill Russell: [00:37:38] I want to keep marching through this cause we do have a hard stop with you cause you’re, cause you’re busy right now. Money flowing into health tech. Current numbers I’m looking at 15.3 billion in 2020, which is up from 10.6 billion in 2019. So a lot of money is flowing into health tech right now.
[00:37:56] Where do you expect that money to have the greatest impact in [00:38:00] healthcare? Is it on wellness? Is is it on addressing obesity? What area do you think it has the potential for the greatest impact?
[00:38:09] Sarah Richardson: [00:38:09] This is where you see me nerd out and look at my notes cause I was totally researching all this stuff, you know last night especially. Cyber security, got a bunch of big investments, 41 billion in the past decade. Digital health, 53 billion in the last decade with 2020 being the best funded years. But data intelligence 79 billion over the last [00:38:30] decade, 8.6 billion in 2020.
[00:38:32]Bill Russell: [00:38:32] Data intelligence, explain what data intelligence is.
[00:38:36] Sarah Richardson: [00:38:36] Analytical tools, methods for companies to employ a better understanding of information they collect for services and investments. Think about it like this industry applications for data intelligence where a vendor deeply understands an industry versus a one size fits all.
[00:38:52] Healthcare government and life science got the most funding, 23 billion last year. So it can accelerate drug discovery and it boosts client [00:39:00] engagement. So I looked at the company. I was curious about them called Karas. They provide AI tools for medical and industrial fields out of Japan.
[00:39:10] They extract features of small data for AI and they use what they call the sparse modeling technology. So it’s not just the data. They also pull in research. About opinions and social habits and create these algorithms to make better decisions. So they are considered a data intelligence [00:39:30] organization.
[00:39:30] They did series B last year and pulled in 12.4 million just for that. So now you don’t need these massive data lakes to start to nuance some of these decisions you pull in all these factors from all kinds of different activities and behaviors, and now you have a niche product that can help you. Use insights in a new and different way.
[00:39:50] Bill Russell: [00:39:50] Fantastic data intelligence. I feel like, you know, I joke about the fact that this show is sometimes the education of Bill Russell. And so I appreciate you [00:40:00] continuing that tradition of educating Bill Russell on this stuff. This is great. This one I’m gonna focus you in a little bit more. Area of most change in the next three years cybersecurity, AI or automation within healthcare?
[00:40:15] Sarah Richardson: [00:40:15] I love automation. So I want that to be my answer except for the fact that I can’t get away from being drawn to cybersecurity because I’m intrigued in what we’re seeing in both data discovery and classification. So if you think about what you can do to scan [00:40:30] your environment, to look for structured unstructured data to make sure it’s safe, because data is our biggest monetizeable asset as we continue to move forward. But then database activity monitor doesn’t sound like it’s very sexy, but you can find fraudulent, illegal undesirable behavior inside your databases. Because if somebody can get inside your information and mine it, and you don’t even know it, that’s insane. Think of the dollars that are there. Because if we’re using data to make and drive new and different [00:41:00] decisions all the time, way beyond what our own computing capabilities are personally. If someone’s in there taking that information and the aggregation of data is where some of these biggest fines are going to be, then you’ve got to make sure that you can protect your data.
[00:41:13] So I’m going to say cybersecurity, because if you don’t have that, then you’re not going to advantage that does the rest of it doesn’t matter. But I’ve had to say like, what am I most excited about? It’s the automation but. Like I can automate it if someone’s stole it or locked me [00:41:30] out of it.
[00:41:31] Bill Russell: [00:41:31] Yeah. The best advice on cybersecurity I ever got was assume they are already in your network.
[00:41:39] So now that you know that they’re already in in amongst your, they’re on your wire, they’re, they’re on your network now, how do you protect it? And that really changed my thinking. It was really kind of interesting to say, okay, if they’re already in. How do I make sure that they can’t get to the things that they want to get to?
[00:41:59] And once [00:42:00] they get there and start tooling around, how do I make sure that they don’t get out with it? And so we start spending an awful lot of time on excellent creatian an awful lot of time on identifying their anomalous activity on the wire and then what they were doing and those kinds of things, and putting the right tools in place.
[00:42:17] It was, again, it was awhile ago. It was 2013 that we had that conversation but it really changed how I was looking at cybersecurity. Three more questions for you. So [00:42:30] from a technology standpoint any specific technology that you’re you have your eye on right now?
[00:42:35] Sarah Richardson: [00:42:35] I would say that I am most curious about creating a code based infrastructure. Like having minimum necessary footprint from an infrastructure perspective so that I can really double down on what it means for us to be a high-performing software development shop and being able to do that in the most nuanced ways that are, that are new and exciting and allow people to keep growing and building and learning.
[00:43:00] [00:42:59] What’s really cool is that I don’t have to displace a bunch of people to do it. It’s about re-skilling re-tooling and creating new opportunities for the team. So any place where we can automate things and really take technology to remove tier one support or tier one activities on all fronts. Like no one should be, no one should be answering the phone to handle a help desk password reset anymore. And yet that’s pretty common. So how do you move all of the tier one activities to automation so that people can perform at tier two and tier three? Huge [00:43:30] job satisfaction there. But that doesn’t take just one product. It takes a philosophy across an organization. And it’s hard. Change is hard for people.
[00:43:38] You got to get people to want to go with you because it can’t happen to them to be successful in that endeavor.
[00:43:43] Bill Russell: [00:43:43] You and I have spoken about the patient experience. It’s a passion of yours and you know, how do you feel about our progress as an industry thus far? And what do you think the patient is going to be hopefully pleasantly surprised that the [00:44:00] patient experience has improved and in a certain way over the next year, what way would the patient experience improve over the next year that they would be really happy with it? You think it’s possible?
[00:44:11]Sarah Richardson: [00:44:11] What I find fascinating about the question is it’s not even different about how we lead teams or have conversations with anybody. It’s you have to meet people where they are and understand what they need because you can’t do a one size fits all. I think about the world that I live in every day 10,000 people age into [00:44:30] Medicare are 65 years old and that will double over the next few decades.
[00:44:37] 88 million people will represent 20% of the population over 65 in 2050. Which by the way, I will be 76 years old at that point. And I think about what does that mean for us as living longer, healthier, happier lives. People want to age in place. They want to be able to stay home [00:45:00] cause less extensive and it’s healthier and it’s safer and they have better routines.
[00:45:07] So sticking to medication adherence or following the protocols you need to have, because as you age, things just happen to your body, but just start to wear out. But I think about this, what options do you have if you can’t afford a caregiver?
[00:45:25]Bill Russell: [00:45:25] Yeah, that’s a good question. I’m not sure.
[00:45:27] Sarah Richardson: [00:45:27] And that’s not even just for the elderly [00:45:30] populations. What happens if you can’t afford healthcare? So I’m hopeful that, that patient experience is something we’re taking to heart based on what we’ve learned because if a pandemic did nothing else, it really uncovered the need for true empathy, to be present, to listen, to communicate, to understand what people’s individual circumstances are. That we put a greater focus on the advocacy of wellness and the advocacy of helping people truly be healthy because when you’re sick. It’s scary and [00:46:00] fear alone.
[00:46:00] Forget it. And I don’t want anybody to ever feel like they can’t get great care and feel like they matter individually because they’re either alone and they don’t have help or they can’t afford it. And I got to believe that we still are taking strides towards what that can mean for us, both as a country, but as we lead our own organizations.
[00:46:27] Bill Russell: [00:46:27] Well said. I have [00:46:30] started to close the interviews with a goofy question, but it’s led to some pretty interesting back and forth. So what’s the question or topic that I haven’t asked you that you think would be interesting for the community for us to discuss or for you to share with us?
[00:46:47] Sarah Richardson: [00:46:47] It parlays on our last topic. Health advocacy. If 88 million people are going to be over 65 by 2050, we’ve got to ensure they made smart choices in their life.
[00:46:58] And we can use technology [00:47:00] to not only augment those experiences but allow them to be independent. I don’t have kids and I don’t have nieces and nephews. So yeah, you can bet I’m all about like the robotics of what it means. I want a robot in 2050 to help take care of me because we can use all that intelligence.
[00:47:19] My mutated medicine helped me do things around the house. Like. Think of what that actually means for independent living and people being on their own and being healthier, they need support. How do we [00:47:30] use what we are building to create that? So health advocacy with the augmentation of technology because we’ve got a real problem solve coming up.
[00:47:41] Bill Russell: [00:47:41] Yeah, absolutely. Sarah always always great to catch up with you and we will have to do this again. I don’t know, in the fall, hopefully you’ll, you know, free up an hour or so in, in the fall and you and I can catch up again. That’d be great.
[00:47:58] Sarah Richardson: [00:47:58] Yes, we’ll be at CHIME fall [00:48:00] forum in person in San Diego as well. So those hallway conversations and all that fun stuff you set up for listeners and for people, I’m pretty sure you’re going to have a line out the door because we can.
[00:48:13]Bill Russell: [00:48:13] I’m looking forward to, it should be a great event down there.
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