Buckle up as we plunge into a riveting conversation with seasoned health tech entrepreneur, Dave Wattling. Strap in for a deep dive into the challenging yet exciting world of healthcare IT, spanning across Canada, Britain, and the U.S. Expect to uncover crucial insights into the ever-present issue of data interoperability and the untapped potential of data analytics and AI, waiting to revolutionize the healthcare sector. As we navigate this intricate landscape, we lay bare the critical need for trust – the cornerstone of a symbiotic relationship between providers and data systems.
The journey doesn't end there. We shift gears to explore the perilous yet exhilarating road of entrepreneurship. Dave, with his extensive experience, shares invaluable wisdom for entrepreneurs considering a transition into board work, offering a roadmap to navigate the complex and often ambiguous terrains of startups.
Thanks for listening! Like what you hear? Follow us on LinkedIn, Twitter, Instagram, Facebook and be sure to subscribe to The Vurge for the latest episodes and more!
Interested in being a guest on the show? Click here to learn more.
Buckle up as we plunge into a riveting conversation with seasoned health tech entrepreneur, Dave Wattling. Strap in for a deep dive into the challenging yet exciting world of healthcare IT, spanning across Canada, Britain, and the U.S. Expect to uncover crucial insights into the ever-present issue of data interoperability and the untapped potential of data analytics and AI, waiting to revolutionize the healthcare sector. As we navigate this intricate landscape, we lay bare the critical need for trust – the cornerstone of a symbiotic relationship between providers and data systems.
The journey doesn't end there. We shift gears to explore the perilous yet exhilarating road of entrepreneurship. Dave, with his extensive experience, shares invaluable wisdom for entrepreneurs considering a transition into board work, offering a roadmap to navigate the complex and often ambiguous terrains of startups.
Thanks for listening! Like what you hear? Follow us on LinkedIn, Twitter, Instagram, Facebook and be sure to subscribe to The Vurge for the latest episodes and more!
Interested in being a guest on the show? Click here to learn more.
Hi everyone and welcome to the Verge. Today we have David, one of our long-time health tech entrepreneurs, who has worked in Canada, the US and Britain. Welcome, david, how are you?
Speaker 2:I'm great. Thanks, rebecca. It's my pleasure to be here and speaking with you today.
Speaker 1:It's awesome to have you. I'm so excited you have such a wealth of knowledge and experience in healthcare IT. Can you tell us how you got started?
Speaker 2:Sure, it was completely by accident.
Speaker 2:I had been working in the tech space, so providing technology solutions and consulting services to a number of businesses back in the 80s and was asked to work with a health authority out in Western Canada to help them with a technology roadmap and an architecture, which I did. As was early 90s, I got completely infatuated with what I termed as the impossible problem in healthcare how to bring all the disparate parts of health delivery systems together into a common view of data. Remember this was 1991. A problem I still think we're trying to solve in 2023.
Speaker 2:We are right we are. I just became intrigued my brain became really exercised on how we could use technology to help bring disparate parts of a health system together around what we now call a common electronic health record.
Speaker 1:What was the biggest gap back then? There probably was not many people that had an EHR. A lot of it was on paper. How were you able to bridge the gap back then? How is it different now?
Speaker 2:So, yes, certainly. What was different is we were in an era of just implementing automated systems for hospitals. We had next to no automation in primary care, definitely nothing in public health and there was definitely no sharing of health information between those parties.
Speaker 2:So in many ways we were putting together the infrastructure, the basic building blocks, in each of the different aspects of the health system, while also trying to build data exchange concepts, which were really pedestrian back then. So, fortunately, time has moved on and we are seeing that the different providers in the health system are using electronic records. We are advancing towards interoperability and sharing of information. I say advancing because I don't certainly in Canada, we're not there, and we're not there in the States. One thing that hasn't changed we were using fax machines and we're still using fax machines.
Speaker 2:That bit has not advanced terribly.
Speaker 1:At least it's electronic faxing and not like you're printing out the paper anymore.
Speaker 2:I have still seen fax machines but, yes, at least we're advancing.
Speaker 1:Yeah, I went to HIMS a few years ago and there was a vendor that had a booth and you could pick what your background was Me and one of my employees. We took the background of please send the fax machine back to 1980, was like the background of us. It was a creative. I've flashed it up on LinkedIn before. It's like please, it's still out there, please send it back. Cheers. What are some opportunities that you still see now that you have such a long history and healthcare IT moving the needle in today's age and still the opportunity to bridge the gap between operations and technology, and where do you see that going and where do you see the biggest holes?
Speaker 2:I think at a foundational level, the biggest gap is still data interoperability, and that's not just moving piece of data A from point B to C, it's also the standard definition of said data element so it can be readily interpreted and, importantly, it can be trusted by care providers to be accurate and reliable information, adding in patient data or customer data into that mix on an equal, trusted basis as valid inputs into the health record. I think we still got a ways to go on that front. Certification of using data analytic tools. So there are a number of data analytic tools available, but I'm not sure the skills are there yet to fully utilize them or interpret what they're saying with reliability.
Speaker 2:I think there's a skill gap that we're still seeing around use of data and of course the great hope right now is what artificial intelligence can do, or augmented intelligence can do, on a predictive, generative basis. If you look at the adoption cycles, the adoption of things like chat, gdt and related products is, but it's just been immense in the last months, not even years. The acceleration cycles are unprecedented, more so than the iPhone or iPod was in its day. So I think there's a lot of potential there for that, if properly regulated, which I know is a huge debate right now about regulation and who should regulate and what should be regulated, appropriate application and back to my comment about skills, you know, meaningful interpretation and usage. I think there's still, there's lots of ways to go there, which I'm very excited about, I have to say.
Speaker 1:Yeah, I am too. I'm also excited I think you sort of touched on it about having the data, analytics and AI, you know information, but being able to utilize it in a meaningful way. So I feel 10 years ago we had all this data and we kind of pushed it on to the clinical leaders like here do something with it. They're really trying to do their day job and didn't really know how to consume that data and how to react to it. So I still see that there's a gap there. But how do we bridge that gap and how do we move forward? And some of it is happening with, you know, acos and moving the needle there, but I still think we have such a way to go.
Speaker 2:We do, and in our early days, as you reflect on pushing data to clinicians we were bombard them with data and I think about alerts Alerts in the old days, like everything's an alert, you've got to tap through it. Yes, no, yes, no. And especially drug-drug interaction stuff and so on.
Speaker 3:I think we've got to be a lot more intelligent.
Speaker 2:Our systems have to be more intelligent and the providers have to trust the way in which that data is being adjudicated for them, and until we get the intelligence and the trust, we won't advance meaningfully in the use of data and I think it's important to recognize there's two sides to that equation.
Speaker 1:And the trust is built on showing them that the data is correct. Right, it feels like years ago we would be like, oh, just make this decision and follow us, but we had no data to back it up, and so now I feel like the data is there. We need to show them that the data is correct. That is there, and I feel like it's a lot easier to bring change and bring them along as well. I would agree.
Speaker 1:Yeah, let's pivot over to all of your entrepreneurship. I'm an entrepreneur as well. I find it super fun and exciting to talk to other entrepreneurs. I follow lots of podcasts, hearing about what people are doing, and so what made you jump off that bridge and start flying with your companies and everything?
Speaker 3:and how did you?
Speaker 1:have that experience and the guts to do that, because not everybody is willing to become an entrepreneur.
Speaker 2:No, it's true, and I don't know what the formula is. Rebecca, I'll be honest, I think everyone's experience is just a wee bit different. For me, I was young. I had a sort of mindset of why not, not why?
Speaker 3:Yeah.
Speaker 2:Interesting to hear that I read about a story just three years prior to starting my first business. I'd moved from England to Canada.
Speaker 2:I'd never been to Canada before. I didn't know anyone in Canada. My then wife and I, we just picked up and moved and I had a job to come to who was the days of the brain drain, if you will? From Britain to Canada. She didn't have a job and we just we just hopped and left and moved over and she ended up walking into the bank to open a bank account and she got offered a job and I had a job to go to and that was great for a couple of years and I just saw opportunity that I didn't think I could have realized in England and so hence I thought what the heck, let's head out on my own as a solo prener, as I think they're called nowadays.
Speaker 2:Yeah, and did that for probably a year and I thought, oh wow, I wonder if I could bring on some staff and start helping me. And we gradually just evolved, yeah, and I think for me it was not knowing what I couldn't do, yeah, sort of blind ambition and trust. There was no great, you know, vision that I had that I had to do this. It was just that I thought, well, I couldn't tie.
Speaker 1:Figure it out on the way down.
Speaker 2:Hey, man, we kept going and growing and ended up someone decided we had something of value and wanted to buy the company and I thought, wow, that's cool. So, hey, maybe I can do it again. Yeah. So, we do it again.
Speaker 1:I wonder how often do you look back at the ideas and decisions that you made throughout your you know years of building the company, or is it something you don't think about that much? And it's more, you made the decision and we're going to go forward and figure out this path that we decided on and keep trudging forward.
Speaker 2:I actually reflect a fair amount, because part of what I do today is provide advice to entrepreneurs, so I do use my experience as part of that, and that causes me to reflect on different inflection points or decision points that I made during those journeys, and Were they the right? I mean, they were the decisions you made, so they were what they were.
Speaker 2:Yeah yeah, and typically you made the best decision with the information you had at the time and I do reflect on you know, was it right or wrong? So my first business we were doing sort of FIFA service consulting as a divergent would do. But we were also building a methodology for systems development, what ultimately became known as STLC system development, lifecycle or agile, is it? Hey, and we pivoted away from that, even though it was a great dream, because we didn't think we could realize it. So we went to consulting, which was kind of the easy answer. Do I regret making that shift?
Speaker 2:Absolutely, absolutely not, because on reflection, it was the right decision and we were able to business that way. But there's always nuggets in In your past to learn from what I have hired a certain person, certain type of person, at a certain point in the lifecycle of the business. Would I have opened the UK office at the time I did in my last business, or should we have waited and focus more on the US market, for example?
Speaker 2:Yeah so I mean, there are some things I probably would have Re-sequenced, honest. But yeah, I think it's always useful to reflect, not not to beat yourself up about what didn't work and not necessarily patch yourself on the back about what did work, but just to explore what learnings would come out of that.
Speaker 1:Yeah, do you find that you have that sort of? Are you or I guess are you the type of person that sort of just makes a decision and and go full force 180, or are you somebody that Will, you know, ponder for days and and think about the decision before you make it?
Speaker 2:Make it, make a mindful decision and just stick to it.
Speaker 1:Yeah.
Speaker 2:There's. There's an expression when you come to a fork in the road, take it Like it's just once you've decided go. If you continually revisiting your decision, then you won't give that decision the fullness of your attention or potential. Now, having said that, if you get new data along the way that causes you to rethink, that's fine right.
Speaker 1:But, but no, not, not not revisit unless there's something new that would change the decision right, yeah, yeah, and listening to some other podcasts, they, they say the same thing about entrepreneurs, and the most successful are the ones that just sort of Take that road and start running and and they might, you know, veer off another road, like you're saying. But you can't have that. Just sit and wait and and decide, you know, days later, what. What would be some advice that you would give to you know, a new entrepreneur in healthcare, it, that's, you know, looking to spin up an organization. Maybe it's around data, or maybe it's around AI and in all of the chat, gpt that's happening, what would be some little nugget you could give to the crowd?
Speaker 2:Oh, the little little nugget is a single word it's focused. Now, behind focus is a whole bunch of research and analytic analysis and understanding your market and having a product or having a solution that fits that market. All of that if you don't focus and you get distracted by every shiny object, every new application, every, what worse, everything a competitor is doing. Focusing on your competitors is death, yeah. Focusing on your own Proposition and what you believe in and taking that to the end of the road, that success, yeah in my opinion.
Speaker 1:Yeah, it doesn't that hold true to the healthcare organizations that we help today as well? Like, not even in an entrepreneur world. I see you know they're going to the next shiny object but not really vetting if it's appropriate or or need it, or or maybe they have the application or a piece of it Already there but it's not turned on. Are you seeing that as well?
Speaker 2:that's one of the biggest travesties I see in the health systems today is Things that people have bought and I just either sitting on a shelf or a 10% capacity, 20% capacity, and Then maybe this technology was bought a year ago. Well, of course technology moves quickly and you know, today's competitor is, you know, more efficient, fancier, slicker, sexier, whatever than the old one. But just shifting a horse, ignoring what you've already bought, and shifting to a new horse is going to give you a marginal benefit. The maximal benefit is actually running what you've already got to ground and fully implementing it, changing the organizational workflow, getting people to buy into to its use and and I do get maybe I get frustrated, if that's the right way of putting it, with organizations that just want to flip from sunny object to sunny object.
Speaker 3:Yeah they.
Speaker 2:They think they're advancing. I think they're getting the newer, called cooler stuff, but they're not Reaping the benefit of having fully implemented and extracted the full value from what they've already got. It is what you see it in your consulting as well.
Speaker 1:Yeah, yeah, no, absolutely your. Or go ahead and Tell us about the advisory boards and the other boards that you're on. I know there's lots of people that are interested in sitting on boards. How do you get on a board? How do you get involved to help advise Organizations and help them from not buying the shiny objects per se?
Speaker 2:so I being on a board of being a governor or in being an advisor on an advisory board is very different as a role than being in the operations of a business. The first trick is to understand that difference, to understand when you are there to advise Oversea direct versus do and the best way to understand that frankly is to take professional training. You're never too old to learn, so I took training many 10, 15 years ago I suppose on how to be a director, a board director and there are national pros and acd, I think is the US one.
Speaker 2:It's called ICD up here. These did copper directors. They run fantastic programs that really walk you through what it means to be on a board, what it means to be in a governance role and how that is different from being a manager.
Speaker 2:So I think, getting that education to understand what it means first, so that you can be clear that that is what you want to do. Right, you can only help people to a certain point, but they have to. They have to want to execute, yeah, and then how do you get on board? Networking is a big one.
Speaker 2:I mean these national associations actually have directors registers where people companies will post when they need a director. Yeah, you can apply Making relationships with recruiting firms, because recruiting firms will hire, will can be and are sometimes retained by companies to find directors. But but most of all, it's using, it is leveraging your network that you've built and and I would say to start thinking about board work before you give up your full-time job not after.
Speaker 2:So I started, I say about 15 years ago and I didn't retire from from full-time employment until five years ago. But during that sort of 10 year period I was able to To learn and leverage that experience and I started sitting on boards even when I had that full-time executive position and that builds great experience. An advisory board and the governance board are very different. The advisory board is typically made up of experts from the industry who have knowledge of market trends, of interests, of their connections, etc. Governance board is more functional.
Speaker 3:So do you know?
Speaker 2:about managing HR, managing, technology managing, risk managing finance. And so governance board will be made up of people with those functional expertise. We play a role in bringing together a whole picture of governance for the organization. Yeah, that's awesome Best expression I learned about being on a board is is nose in, fingers out. So you are there to look around, sniff around, feel, but you're not in the business. That's a really important concept. Concept.
Speaker 1:What would be advice that you would give to operational leaders. Where their board does have their fingers in, it can get messy. I've been on an organization where the board was you know when financially we were doing horrible and the board was all fingers in and it was hard.
Speaker 2:So boards can quite often go through a cycle of being more operational versus more strategic. So if your organization is in dire financial straits, you will see the board get their fingers more in. There's no question. That is natural, and they'll meet more frequently and they'll be quizzing the CFO and the CEO, and that's not uncommon. The important thing is to recognize when that's appropriate, when it's not and mostly it's not, but sometimes it is.
Speaker 2:So just to be in the right time that is necessary, the best way to build the relationship between board management and to establish the right role split Is to is to conduct joint workshops or joint sessions or have a governance expert come and talk to a combination of the board and management about their roles, and the most effective ones I've seen are where someone will come in from industry and tell real live stories, especially if there are publicly traded companies that we may be able to relate to. Just having rid of the newspaper and you say this is what happened in this scenario, this is why the board was too involved, this is why management wasn't giving the board in order to do it, and you use those stories because they've all progressed now to some sort of outcome, so you can then analyze that scenario and say what should have the board been doing?
Speaker 2:What should have management be?
Speaker 3:doing.
Speaker 2:And I find learning from those stories to be a lot more valuable than a textbook. So if you see an environment where the board management and I are not getting along one way, or if you see an environment where the board management and I are not getting along, one thinks the other is not doing the right job Bring someone in to work with the combination of the group Education, storytelling, workshopping and that will help the understanding.
Speaker 1:Yeah, board retreats right. I've been on a few of those Switching topics. Can you tell us about how you started the? Well, I apologize, I forget the name, but it's essentially the Chime Him version in Canada. What inspired you to do that? How is it going and when's the next conference so we can come over the border and participate?
Speaker 2:So yeah, I'll tell a pre-story first. So I've long believed that, certainly in Canada, I mean, industry was the health tech industry was just generally not cohesive little bits of spot pockets. It wasn't very mature as an industry. So the first thing I actually did is I created a trade association for health tech company Canadian health tech companies, so somewhat the equivalent of a hymn like organization.
Speaker 2:So we have a professional association which individuals are members of, and this was the trade association, and so I created that, co-opted a bunch of other fellow business leaders to join a board to put in some money and we gradually advanced that and it became part of our national tech association became the healthcare arm of our national tech association and through that I got I got a kind of inkling that maybe I had a purpose that was bigger than building my own business.
Speaker 2:But the mobilizing an industry or a community and make a movement, if you will, around strengthening our health and health tech community was, was a noble pursuit. So I was down at a hymn's, probably early 2000s in Scottsdale, and I was blown away by the openness and receptiveness of the individuals to sit at a table, not even look at your badge as to who you represented or who you worked for, but just have meaningful conversations about issues of the day, no, around tech and tech, enablement of healthcare and even health issues. So I love that. I love the fact that, yeah, I may work for a consulting firm, but nobody's treated me like a T to a CIO, like they were. Just we were just chatting about stuff.
Speaker 2:Yeah, I particularly found they loved hearing Canadian or British stories, as we like hearing American stories about differences in the health system and yet so much similarity in some of the challenges. And I just I came back up Canada and I thought, well, why don't we have one of these? We actually created a group. We call it chief Canadian Health Informatics Executive Forum and we tried to replicate the the chime model. So there's vendors and there's there's care providers. It's equal representation. Of vendors pay, and so it's a very similar model.
Speaker 2:The difference is we don't have the scale. We don't get 1500 people to a meeting, we get 150. So so there's a scale difference and in fact we've got an alliance with China so we can access some of the China programming and so on. But I just thought it was important that we created that sort of equal opportunity forum where no one's allowed to sell. In fact, we have one vendor that usually does a sales platform.
Speaker 2:We actually did them from the forum. We gave them money back. So you can't be part of this If all you got to do is this particular individual could not stop himself and I just thought it was important we create a forum and we meet in person. We've just just had an in person, so in the fall and spring one tends to be more virtual, and then on an ongoing basis, much like China's webinars, there's education sessions and we have an advisory board, guides the thing, and it's I'm not involved much anymore it's taken on its own life. So that's to me, that success.
Speaker 1:Yeah, absolutely so awesome that you're helping, you know, create a community so it's sounding board for everybody to to work, to work together. What, what type of differences do you see? And so you've worked in US, britain, canada. I've done US Canada, puerto Rico, which is a little bit different, but not and so what sort of differences do you see with the community? Where they are, maybe with interoperability, and are there other gaps? Are they similar across the pond or different?
Speaker 2:The there's depth. This interoperability is a similar refrain in all jurisdictions. It's a challenge. How it's been solved is based on the health system in these different forums. Like in Britain, there's a national health service. So they can edit certain data standards and certain data exchange protocols. In Canada we can't do that. We have a federal government that essentially provides 17% of the funding to health care systems run by each province Right.
Speaker 2:Each province is responsible for its interoperability. We have no national interoperability other than standards. We have standards, we have no, no, no force repository like the spine England, for example, and I think in the US. You're one step beyond that too.
Speaker 3:Yeah.
Speaker 2:So very fragmented as a system. So I see you know the UK system. It's fragmented in different ways. It's the health, pure health delivery is all integrated, but when you get into social services and so on, that's fragmented. In Canada we see different levels of integration depending which province you're in.
Speaker 2:There's a single health authority responsible for care delivery and there's a ministry, a government, that governs that In the area there's nearly a different health delivery organization. So it's quite, quite fragmented. So I see that the solution center operability depends on how integrated or fragmented the system is.
Speaker 3:That's what.
Speaker 2:I've observed, anyway, yeah, similar challenges in all. Interesting statistic Everyone thinks of Canada as a publicly funded health care system. Right yeah, we are 70% publicly funded.
Speaker 1:Okay.
Speaker 2:Everyone thinks of the US as a privately funded health system. You're only 70% privately funded, so we have the same 70 30 split, just in reverse.
Speaker 1:Yeah, yeah.
Speaker 2:Which is a little known fact.
Speaker 1:We all have our problems and our opportunities, though right Completely switching off of health care IT. When we talked and we've met in person multiple times now you talked to me about your love for hot sauce with your son. I would love to know what your favorite hot sauce is or what the hottest one is, and do you carry it around? You guys go out and eat hot sauce.
Speaker 2:To be clear, he's the one that has the hot sauce fetish. Okay, he's the one that we went to some sporting event and there were vendor booths set up and there's one booth set up with different grades of hot sauce from mild to wild and there were all these guys standing around tasting these different hot sauces and they kind of get to the two thirds of the way through and they're sweating and bugging out. My then 14 year old son started there and went all the way to the wild and asked for more. He is unbelievable in that respect and we actually search for when we go on vacation. We bring back hot sauces for them from different countries.
Speaker 2:He just loves them so much and he does as the old ad went he does put that on everything.
Speaker 1:Oh my goodness. Yeah, I'm very weak. I'm still like in the mild, even like buffalo sauce is hot to me, so I'm a wimp. My husband will go through a good portion and he'll be sweating and loves it, so it's fun. It's fun to have those things that you can do with your kids and bond, even if you're sweating bullets and exactly.
Speaker 1:We watch that show a lot on YouTube and I forget the actual name of it, but it's celebrities and they're really having like a podcast video and talking just in general topics and eating hot wings with different hot sauces along the way till they get to like really hot, where the celebrities are like trying to have a normal conversation but you can tell like it's so hot that they're about to like fall off their chair. Have you seen? This one yet.
Speaker 2:I have not seen that, but I will put Connor onto that because he would love that.
Speaker 1:Oh my God, it's hilarious. They're like trying to like talk and drink milk and like not like try to get through all of it, right? Not everybody does.
Speaker 2:Ghost peppers are his. What is so?
Speaker 3:one of his high bars yeah, they're nasty.
Speaker 2:Actually, my wife started growing them, growing some hot peppers here.
Speaker 1:They're cute little peppers, but man don't get all red.
Speaker 2:Oh, they're white.
Speaker 1:Oh, um, david was awesome to have you on today. I'd love to ask you one last question. And what is your superpower, or do you believe is your superpower that you're continuing to share with the world?
Speaker 2:Yeah, I was thinking about that question. I don't know if I have a superpower. I know I know certain things I do. I think I do. Well, I'm not sure I could put a superhero mantle on it, although I might try. I have an ability to join dots. I have ability, I think, to see how things conceive, how things that are looking desperate can be joined up into into a strategy, and see the potential and make the connections. Maybe that's the creative part of my brain that works, which is not always common in a health tech environment. I find that that piece of what I do and how I think is maybe a quote superpower in the context of health technology.
Speaker 1:Yeah. What I wish my super or superpower really was, is wonder why get people to tell me I think we need more people with your superpower and healthcare it to keep pushing it forward. I feel like we're still light years behind, although the Amazon and the Walmarts of the world are going to be disruptors. I think for sure, but having the entrepreneur mindset like you is helpful.
Speaker 2:They will push the system, and that's a good thing?
Speaker 1:Yeah, absolutely, Dave. Thank you so much for your time today. It's been a pleasure talking to you and I'll see you soon.
Speaker 2:Thanks, Rebecca. My backup pleasure is all mine.
Speaker 3:Thanks for tuning into the Verge podcast brought to you by Divergent, a leading healthcare IT consulting firm. We hope you enjoyed this episode. Be sure to hit the follow button to stay up to date with the latest IT developments and the exciting ways tech is transforming healthcare today.