Why Patient Care Is Suffering (And How to Fix Your Workflow) | Ted Lindsley

Healthcare organizations continue to invest in data platforms, integration tools, and AI initiatives, yet many still cannot move trusted information across the enterprise or turn it into timely decisions. Ted Lindsley, CEO of CognomIQ, joins Chris Hutchins in Dallas to examine why healthcare data integration keeps breaking down — and what leaders should demand from the systems and vendors responsible for fixing it.

Chapters:

00:00 – The Signal Room opening and welcome from Dallas
01:06 – How Ted Lindsley arrived in healthcare
01:51 – Why he avoided healthcare for 30 years
03:49 – The payroll test for broken business processes
07:06 – EHR constraints, bolt-on tools, and vendor lock-in
08:49 – How organizations become accustomed to a broken system
11:44 – Predictive analytics before the AI conversation
13:48 – Buy results, not hopes and promises
14:31 – Guarantees, architecture, and vendor sprawl
19:58 – Relationships, trust, and long health-technology sales cycles
21:14 – What happens the first time a clinician touches a tool
22:42 – The standard for near-real-time healthcare data
27:37 – The cost and consequences of legacy decisions
31:11 – Why proofs of concept do not become operational capabilities
34:36 – Acquisitions, standardization, and governance
35:50 – Accountability when technology fails to deliver
37:56 – What finance teams can teach healthcare about standardization
40:59 – Dashboard sprawl and the burden placed on physicians
42:53 – The closing test: doing it because it is the right thing

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💼 Hutchins Data Strategy: hutchinsdatastrategyconsultants.com

Guest: Ted Lindsley — linkedin.com/in/tedlindsleydfw
Host: Christopher Hutchins — calendly.com/chris-hutchinsdatastrategy

Transcript

Chris Hutchins 0:00

Welcome back to the Signal Room. I'm Chris Hutchins. And I am excited to film on location in Dallas, Texas, where I've been really looking forward to having this conversation today. Joining me today is Ted Lindsley. I've got to know him a little bit over the last several months, and he's doing some really fascinating things for the benefit of people in healthcare that are still trying to figure out how to actually undo some things that have put themselves at a disadvantage when it comes to really operationalizing solutions and even just from a basic support mechanism in terms of how do you support your clinicians and the patient care. But even beyond that, there's just so many different layers that I know people are wrestling with today, trying to figure out where do I need to make the adjustments so that we can start getting past the pilot phase that everything seems to go great, guns up to, and then it falls apart. And that's what I think you're going to hear a little bit about today. But first I want to say, Ted, thanks for being here, and welcome to the Signal Room. Thank you.

Ted Lindsley 1:01

This is fun. Nice to get out. So uh let's jump right into this. Yes, let's do it. There's a lot to talk about in healthcare.

Chris Hutchins 1:08

So let's touch your background, it's not one that I think is typical. You've done a lot of other things besides healthcare, but I think the thing that has impressed me is there's always something that you're looking at that you're like, you know what, this needs a solution. And you're you excel in doing that. You've done a bunch of different things. Tell us a little bit about what's caused you to end up in a place where I'm gonna do something in healthcare. By the way, the company name is CognomIQ. If you haven't checked that out, check it out. But you're gonna learn today. But but tell me what really has led you to that point in your career at because it seems like you pick things that are really meaningful and important to you. All random, right?

Ted Lindsley 1:43

Yeah. They don't really connect, right? So three-time entrepreneur, I've founded three companies, I've exited twice. Uh I find myself through a series of events in healthcare. My entire career for 30 years, I've stayed away from healthcare. I knew that it was broken and had problems. I didn't realize how bad those were until I got in it. But a quirky series of events found me in healthcare, helping a consulting company, and we rocked it. Um, and they're just they're kicking butt right now. Uh but this opportunity came up and I said, I've got to do this. And uh so here we are. And uh the the technology itself is transformative, it is disruptive. There's no doubt about that. Healthcare is broken. We can fix it, not us alone, but together we can fix it. Right. I'm sorry, but there will be casualties. And it's the dead weight that's been hiding in the closets in the corners for years, suckling at the teat. You know, that's it's unpleasant, but it's not the popular guy in the room that always gets it done.

Chris Hutchins 2:38

I couldn't agree with you more. I think it's always been uh interesting to me. So when you're working inside of the health system, which is where I spent my career, there's always these expectations when there's technology being discussed and it's being introduced that it's going to do certain things. And one of the challenges that I've dealt with is when you're in an organization that's grown by uh acquisition in particular, there's just a lot of technologies, and it's basically a matrix and a whole bunch of spider webs that some are connected, some are not. And that happens every time you acquire a new company or a new hospital or health system.

Ted Lindsley 3:13

They got their own stack, their own way of doing things.

Chris Hutchins 3:15

Exactly. And the affordability, I think, comes from largely uh some aging infrastructure, uh some legacy things. They're they're getting tired, they're not doing well. Um, it could be contract issues, um variety of factors, but nonetheless you get to a point they're affordable until a certain point where you can actually make the acquisition, you might be able to standardize and put some structure around some things like payroll. You've got to be able to keep track of your your the teams, people that are applying to come to work for you, things like that.

Ted Lindsley 3:49

Isn't that an interesting angle, by the way? Uh payroll. Let's start there. Yeah. Does everybody get payroll okay? Do you get paid on a regular basis, or does payroll break down every every other month and you have to wait four or five weeks to get paid? I bet you get paid.

Chris Hutchins 4:03

Yeah, you do.

Ted Lindsley 4:04

Right? Strangely enough, yeah. Okay. Um do you pay your contractors on time? I'm betting probably more or less. It might be 30, 60, 90 days, but they don't go a year and a half before you pay your contractors because they're going to cut you off. That's right. It's interesting that the business parts of healthcare work. Yeah. All the things that are related to the patient or, you know, which is a business, but they don't work. They're broken.

Chris Hutchins 4:28

Yeah. That's true. I think that's one of the things that's always been, you know, nuts. Like when you think about the admissions processes and accepting transfers to an emergency room, organizations have struggled with some of those things for a long time still. And I heard someone say this, and I was like, ouch. He said, if healthcare was actually trying to run a hotel, it'd have been out of business a long time ago.

Ted Lindsley 4:52

And it is a hotel.

Chris Hutchins 4:54

Yeah.

Ted Lindsley 4:54

Ultimately. I know we like to say, oh no, it's about the patient, and we're doing this, and then we're different.

Chris Hutchins 4:59

It's still a business. Yeah. And I think the the funny thing, I've always heard this too. Uh, it's like when you're trying to get people on board with standardizing to do a migration to a new platform, it's always they want to talk about that 10% of nuance that no one can possibly solve for. And you spend all this time. And that's their argument. Yeah. And and and like I've seen this over and over again. And you know what's really crazy? They will sacrifice 90% and fight for the 10 when they could get 90% efficiency. If just look, look, suck it up, we'll deal with that later, but let's get the 90%.

Ted Lindsley 5:33

Like go to Vegas and play blackjack, right? You know, and you're you're hitting all your 18s because it's not 21. Yeah. Because it could be a 19 or a 20 or a 21. So you're hitting your 18s? Are you kidding me?

Chris Hutchins 5:43

You're not going to try because it's not perfect? Seriously? Exactly. I've seen that dynamic. And I mean it's funny, but it's really not. There's just a lot of reasons those things can happen. And you know, the business side of it is is difficult. I won't I don't mean to belittle it because it is hard. Um, but the things that we really have to start paying much more attention to now are some of the basics that we've not really been disciplined about in years past. Uh, data as an asset is something that organizations are starting to think differently about. Some of them are doing great, some of them are having some pain making through the transition to start to understand that better. Um, but it really is a significant problem. And when we talk about technical debt in inside of healthcare, I think people kind of have an understanding of what that means, to at least at a high level. But the underpinnings are where really where the problems tend to still hang out for a long time. And there's differentiators, and you know this from in the software industry, you might have three or four different solutions playing in the same space, but there's differentiators that everyone feels are really important in their product. And the same thing happens with any software in any healthcare.

Ted Lindsley 6:53

Like SaaS vendors?

Chris Hutchins 6:54

Uh yeah, or like your EHR vendors, you can pick there's a handful, there's a lot more than a handful. Um, but let's just take four or five of the big players. There's nuance to their product that they can actually speak to and they're very proud of it.

Ted Lindsley 7:06

Yeah, but those were never built to run a business. None of them. Because Epic's the monster, right? Let's just call them out. So that's uh that's a billing system built in an ancient language called MUMPS. And it's a billing system. Let's now that's fascinating. Um do you build PowerPoint presentations? Well, I used to. Okay, well, anybody who builds a PowerPoint presentation, I challenge you, next time you're gonna build one, don't use PowerPoint. Use Excel. And I want you to build that whole presentation in Excel with the pictures and all the text and stuff. You're gonna have to go to Canva and edit a picture and then copy paste it and put it over here, and you're gonna use another thing for the text, right? You're gonna have all these bolt-on things to make Excel work.

Chris Hutchins 7:52

Yeah, or you could actually call your grandkid and they'll do it in in collide in probably five minutes.

Ted Lindsley 7:58

That's the logical way to do it. But in healthcare, you're tied to one system, so you have to keep bolting on endless pieces to do what it won't and never was meant to do.

Chris Hutchins 8:08

No, you're you you're completely right about that. And I think that the pieces that were always problematic and in places that I've worked when there's migrations, like onboarding a new system, onboarding a new company, um, the pieces that tend to get the attention are the ones like to your point, payroll gets taken care of. Uh, because you're not gonna have anybody to man the stations if they're not being paid. Right. Everybody knows that. But the other pieces that are equally challenging are the ones that patients are actually gonna come face to face with. Um all the technology in the world, and you know, organizations still really struggle to understand the capacity and to have access when for patients that need to be seen when they need to be seen.

Ted Lindsley 8:49

Uh these are simple things to fix. You know, but then again, I get bashed sometimes for saying things like that because what do I know? I'm four years, five years in in the healthcare industry. It's an industry, it's business, right? So I can see it very clearly. If you were uh, and this is interesting too, because in healthcare, people traditionally were born into this industry. They graduated school and they started it, and this is the only thing they know. So they were indoctrinated into a broken system and eventually accepted that this is just how it is, and every generation continues to do that. This is the first time post-COVID where people from outside or from other industries are pouring in and looking around saying, This makes no sense. Let's fix this. And there's a lot of internal resistance in healthcare that we can't do that, we don't do it that way. You know, and well, that's the problem. Because actually, don't do it that way. So they're very uncomfortable with the change.

Chris Hutchins 9:41

Yeah, and I think probably one of the most illuminating moments for me was probably like five or six years ago. I was at an event in um in Chicago uh with the International Institute for Analytics. The fun part was there were three different research councils that we would just meet together in the same place at least twice a year. And so this particular one, there was banking, um retail, and uh and healthcare. And a guy that I had met from other meetings, um I'm not sure, it might have been even before both of us are involved in that company, but he was at a conference with me, and he actually had just been named the chief analytics officer for a major bank that he was working for. And he might actually have been the very first one I've ever heard of. I don't know for sure. He might have been, because I didn't really hear about anyone anyone being in that kind of capacity. But he decided he wanted to sit in the session with me, and we were gonna talk about population health analytics and things like that. And the conversations were just fascinating. We were having a lot of revelatory moments where people are sharing things that they're discovering. I mean, this one that was like you'll get a kick out of this. There's a chief analytics officer sitting next to me from for a really large health system. Um, and we were just talking about what analytics is now being able to show you. And she said something very profound. She was we are now starting to be able to see predictors of things like readmission, risk, and severity of illness. And it turns out it's something as simple as the volume of data that's in someone's record as a predictor. And I kind of paused and I thought back to the days I was working on the front desk in a radiology department and I would see a gurney being pulled up and a big like a three-volume stack of somebody's record put slapped up on that desk, probably 10 pounds worth of records. And my eyes told me this person's really sick. Because of the volume of paper? Exactly. Yeah. Because they have that many volumes, that means they're being seen a lot. Whatever the reasons are, they're sick.

Ted Lindsley 11:43

Isn't that logical deduction?

Chris Hutchins 11:44

You know, AI is not going to tell you that because they haven't taught AI to recognize things like that. Right, but this is even before we're talking about AI, just doing predictive analytics. I'm like, wow, we've come so far we we can now confirm with data what my eyes told me. Amazing. So this person is sick and this person is less sick. Let's say logical, yeah. But in terms of objectively trying to assess from a predictability standpoint, odds are we're gonna see this person again. Kind of thing.

Ted Lindsley 12:12

Yeah, you said something a minute ago about the data. Um I don't I I think very few facilities, uh people in healthcare understand how valuable their data is. It's not not by selling your data, that's not what's gonna make it uh valuable. I mean, pharma wants to buy it from healthcare, and uh healthcare wants data from the pharma people, and they think that it's a uh a commodity transaction. It's not. It's not how much data you got, it's not how it's what you can do with that. Yeah, and if you're lean and efficient and you're dialed in and tuned to uh uncover incredible uh insights, then that's the what gave and that's what attracted me to what I'm doing right now is that ability.

Chris Hutchins 12:52

Let's let's dig in on that a little bit because I think this is an area where I know people have aspirations, they want to do the right things. Um talk to the CEO that's got pressure coming from the board. Um they've tried a bunch of different things. They've got brilliant people around them that are trying to help them to solve some significant problems to help the population, the community that they're there to actually serve and support. But they're really having some difficulties because there's areas that I know that you're dealing with that they've not been able to get to before, and it's not any fault of theirs because they're trying to do the right thing. They're doing the best that they can. Doing the best they can with what they've had. Right. But we're at a point in time now where we have to make some significantly difficult choices, and some of it's gonna have to be along with you know what, I'm gonna raise my hand and tell you that I made the wrong decision. But we have to fix this in and whatever we need to do. I know we have to do it.

Ted Lindsley 13:48

That's sometimes the case, but that's okay. I mean, for what the options were at that time, you made the best decision, right? I think the bigger problem is uh that vendors overpromise and underdeliver. These uh providers are so desperate for any help, any solution, right? They hang their hopes on anything that sounds good. That's not a business decision. You don't buy hopes and dreams, you don't buy promises, buy results. And so demand every vendor from now on to put it in writing. You're gonna do this, you're gonna get this, and put an or else clause. I mean, that's what we did, and people are shocked that I'm saying you will get one, two, three, four, five, we'll put it in writing, and if you don't, and one year from now, a hundred percent money back guarantee. Not gee will make it better, oh we tried, a hundred percent money-back guarantee. Now I can do that with our platform because when we go in, we look at the architecture and see what they're doing, where they're wasting all this money, the vendor sprawl, the uh offshore contractors manually doing things. Right. Uh it's very easy to add up in a matter of a week or two, oh, there's millions of dollars right here. And when they're saying, Well, we haven't got any money in our budget, I was like, you got too much money in your budget. You're it is you're wasting seven million dollars a year right here alone. But you have to be able to see that.

Chris Hutchins 15:05

Let's talk about that for a second. One of the things that I've seen kind of blow up a few times. I imagine you've probably seen it too, probably even outside of healthcare. Um total cost of ownership kind of conversations happen. And when they do, there's usually some gaps that are glaring from a finance perspective that maybe not everyone's gonna see. What are some of the things that you've run into that you realize that folks aren't really getting an accurate cost? You know, they're not documenting the actual cost. So I think there's other elements besides just the direct spend on the licensing or the implementation resources.

Ted Lindsley 15:40

All those intangibles. Yeah. You want to name names? Well, I mean, I'm not sure I want to. A good example. A lot of the stuff we do, we can't talk about. We white label our product. Right. Uh, and a lot of systems are like, I don't want to say CognomIQ. Can it say so-and-so healthier? Sure. And we're we or you can build all this stuff on top of it and call it yours zero, right? Um University of Rochester, New York was using Databricks uh as a good example for their data platform. In that contract, 30 offshore contractors manually crunching data. That's a full time a full-time job to the tune of about two and a half million dollars a year, just that line item expense.

Chris Hutchins 16:17

Right.

Ted Lindsley 16:17

So they're looking at the cost of the software, but that was over here, not attached to it. That's an intangible, right? Right. Um now with our platform, one person spends about two hours a day looking at an anomaly report. That's the replacement to those 30 offshore contractors. Um, how about uh ad hoc reports? There's an interesting one. Everybody complains about ad hoc reports. They were running three, three and a half months because you've got all these people in the IT department or that are contractors that are helping to do that reporting in a manual fashion. Right. Uh our current time for ad hoc uh for reports is three hours, 24 minutes. I mean, you want to build a cohort, for example, or do something unusual, you'll have your data report done in just a couple hours. That's eliminating all those extra contractor things, the slow delay. Right. Grants, you want to write a grant proposal? Most people take three months. Yeah. They can knock it out, two people can knock it out in a week. Because the data is ready in a couple of hours. So, how fast can you write that proposal to get it out? How many grant proposals could you submit? And and get my and this is on and on and on.

Chris Hutchins 17:23

This is just one area. The processing piece of it, that I want to double-click on that one because from my own experiences, that's always an area that is always top of mind for me when someone's coming in and telling me, hey, look, I'm gonna get this done in X amount of weeks or whatever it is. Yeah, and when I say and I will ask the questions like, have you have you done anything with this particular vendor solution? Have you dealt with that data? Um, I've had more than one opportunity that was not fun. I call it an opportunity, but it was just painful. But going through an exercise because I was instructed to, discovering that these very well-meaning people, uh, good technology company, they asserted that they could do it. And when I asked them had they dealt with any of the systems that we were dealing with, the answer was no. And I I think one of the things that happens frequently, the there is a significant chunk of the US market that's using the same platform for better or worse. And so the ones that are coming in and usually telling you they can get it done at a period of time that you, as a person who's dealing with it day in and day out, you know it's nonsense. It's because they're not realizing what is going on inside of your organization, and they don't understand. You're not backing up the truck and plugging into one big platform, you got the whole system available to you. It's not that's what my point is. Yeah. And so the there's some confusion that usually is part of it. So it's I don't I wouldn't say it's deceitfulness or dishonesty in many cases. It's just how it operates. It's assumptions.

Ted Lindsley 18:56

Yeah.

Chris Hutchins 18:57

Because the process, uh this is one of the things that I will always have found really remarkable. I can count for you, on one hand, the conversations I've had with people who were approaching me because they wanted to do business with the company I was in, that they came an understanding that they needed to ask a lot of questions, they needed to understand the dynamics, they needed to understand what the real obstacles were. They made no assumptions. And some of these people I'm still connected to today. Some of them we've had phone calls and I've done referrals for them to get a new job. I mean these people are so unique because they that's a partner lifetime. That's exactly right. Right? That's right. But you you need to understand what you're up against, and I think that that's not what you're gonna get. Um you're not gonna get that in your training. If you're training to be a sales guy most often, you're just not. There's a special breed of people that do that, and their success comes from the patience of building relationships and delivering on it when they finally get that opportunity.

Ted Lindsley 19:58

And you know, it's funny, uh, because the consulting firm I came from uh here in Dallas, I would go to about 22 to 25 shows per year. Yeah. You know, HIMSS, ViVE, CHIME, F H L M L P, whatever, right? Endless, right? You'd see the same people over and over and again. And I I learned very quickly that healthcare is a relationship business. They do everything that way, to it to it to a fault. Yep. So uh when they get around to doing in the in the real world, in the real business world, when you want to tackle something, you're looking at I'm gonna I want to do this new thing. Yeah, the first thing you do, and you do this fast, who are the top three best of breed players that do that right now with credibility? And you go, great, let's talk to all three, let's get quotes, and let's pick one and go. And you can do that in two weeks. Right. In healthcare, they don't do that. They say we want to solve this problem. What is the problem? I don't know. So, well, what do you want to do? Call Bob. Yeah. Why? Well, I've known Bob for years. I like Bob, I trust Bob. You know, he's always at the shows, he takes me to dinner. Yeah. Okay. Does Bob know this stuff? I don't know, but Bob can figure it out. Right. And and then they hang their hopes and dreams on Bob. And they don't say, Bob, all right, you got 90 days. In 90 days, here's what we want, and there's the results we want. And if not, here are the consequences, Bob. Right.

Chris Hutchins 21:14

You brought up something that I think is really important to me. There's the experiential component of it. You know, in my case, I've only been in situations where I had to have people that were really, really skilled, that understood workflows from a clinical perspective, user interface workflows, data flows on the back end to actually get normalization done so that I could have relevant data structures for people that were dealing with endocrinology. They had an efficient way to access it and they wouldn't have to fish through everything else to get to it. But there were skill sets that were really required to be able to make sure that what you're building is complete, it's tested, and it's validated, and the very first time a clinician touches it, they're not like wigged out because it makes no sense and it's mess it's messed up. That's setting the basic foundation. Yes, but the difference though, what I've discovered in the last several years and the way I've learned about how different the technologies are now with AI, there is a reset that has not occurred because I think there's still an association with that legacy challenge that the technologies that you're using have solved that in a way that people do not understand and quite frankly probably won't believe it when they hear it the first time. About ours, you mean? Yeah, or anybody's, but specifically the things that you're doing, because what you've been describing to me in terms of the timing of what it takes to get somebody up and running with something they can trust, it is a very different ball game, and most people are gonna say, you know what, that's nonsense. Yeah. Because they've not seen it before.

Ted Lindsley 22:42

If it takes you in your facility, if you want an ad hoc, a brand new ad hoc report, you need to build one from scratch. Today, you go, we need to do this thing, let's build an ad hoc report. If it takes you longer than three days, you're failing. Period. Your people are failing, your technology is failing, you're doing something wrong. Uh if you're building a cohort, like in research, cancer research, this is a big thing in Rochester, right? If um you uh you're not getting uh building in real time in your catchment, you can't pull up those things on screen and see it in real time, uh that's a that's that's a fail. When you've got that cohort built and you want your data report, if you don't get that today, it's taking you weeks or months, fire everybody involved. I mean, this is ludicrous. These are the most elementary things that we do, right? So uh yeah, it's funny when I tell people what we do, I talk about this a lot, if I go to shows and I tell people what we do, the reaction most of the time is exactly like this. They're looking at me, they go, Yeah, sounds good if you can actually do it. And they look away. They won't even look me in the eye. I say, Yeah, yeah, it sounds good if you can actually do it. And and I'm thinking, why would I lie about this? Right. And then I realize, oh yeah, every vendor's been lying to you for 30 years and you've been hanging your hopes and dreams on it, so why am I any different? But when they see a demo, yeah, the jaws drop up and they look at me, how do you how do you doing this? Which is what happened at HIMSS and ViVE when we were at exhibits. Yeah. We had Databricks, Snowflake, uh, and a half a dozen other paradigm, half a dozen others in our booth looking over, like, how are they doing that? What's going on? Right. It's like just come on in, guys, it's okay, you don't have to hide.

Chris Hutchins 24:19

Right. But I think the piece that's um really stands out to me is that you've understood that yes, the technology can be applied anywhere. Healthcare needs some special attention for a variety of reasons. Um, but the problems are still the same kind of problems, no matter what kind of data or systems you're dealing with. But people have a hard time to wrap their heads around it because historically, it's just been healthcare's different and you don't understand.

Ted Lindsley 24:49

The data's different. You know, the processes are different. Hurdles and obstacles and how you go about things. I mean, no other industry would work like this. You wouldn't uh it wouldn't survive. You can't run a hotel the way you run a hospital. Uh I can't take credit for that. So this is not ours is not a new platform. This is a 10-year-old platform that originates from cybersecurity, was designed to handle trillions of threats simultaneously. So it's lean and efficient, but it was built by healthcare for healthcare from scratch. And that's interesting. Every other system I know in the industry was, you know, they come from credit cards or e-commerce or real estate or whatever, and then they're trying to jam that into healthcare like every other vendor. This one was built from scratch by healthcare for healthcare, right? And so it understands nuances that the other ones don't. And it is definitely a competitive advantage.

Chris Hutchins 25:37

Yeah, and I mean it just strikes me that I realized how much could be done in how the technology has advanced largely not in healthcare, because it's just we're we struggle to wrap our head around trying to figure out new ways to do it, just because it's really hard to find the resources that actually have an understanding from a clinical perspective to be eyeballs on it and help to validate what you're doing.

Ted Lindsley 25:58

Um understanding what the clinician does, right? Exactly. Yeah.

Chris Hutchins 26:02

I've been very fortunate. I had the chance to work with some extraordinary people that are really good in that space. Call them unicorns, frankly. Because they are they really are. They're a very unique um skill set. But there are some, and I have a good friend, I don't want to embarrass him by saying his name on here, but an extraordinary informaticist, PhD level, uh, has figured out how to clone himself. Not obviously not real clone, but I hear what you're saying. But he's been able to develop a mechanism and a way to educate people. And one of the things that's interesting is that just from an alignment standpoint, giving people who are technologically really, really savvy the opportunity to get into particular areas where there's a focus on winner disciplines from a clinical standpoint. And they're paired with people that are also in that same space for an expertise on the clinical side of it. And so they're not only learning how to support with the technology, they're learning the business part of it. And so now the way that they're approaching things, they're actually bringing value to the business much more so than they've ever done before. And they're able to start to think proactively based on what they're seeing and what they're hearing from the business. So it's an interesting dynamic that he's put in place. But it's just one of those things where if you do the things you've always done, we know what that's going to result in.

Ted Lindsley 27:25

That goes back to the 90s. My time in Silicon Valley. And I remember that. If you always do what you always did, you always get what you always got. Healthcare is just now learning that. That was the that was the mantra in the mid-90s.

Chris Hutchins 27:37

Well, it takes a takes a while, but I think some of the things are just misnomers and it's too expensive. That's one of the things that gets tossed out there pretty quickly because the things that you've done from a with a legacy in your background, you know what it cost you, you know what the promise of it was, and you know where it fell short. You know the pain points that you're still dealing with, you know the ones that got created because you didn't realize the side effects of what you're doing. All those things happen. And you've got this muscle memory that you just can't seem to get past. And you associate that and you assume that, well, he's saying all this. Well, I don't think it's true. He probably can't do what he says, but even if he can, it's gonna probably cost us a fortune. And that's an assumption that is completely backwards. Talk about that. Yeah, because there's the hidden cost that no one ever wants to talk about. Exactly. You make the decision to not do something because you think it's gonna be more expensive, and three years into it, you spent three times as much.

Ted Lindsley 28:30

Yeah, I can imagine. I mean, if you remember that movie with Ashton Kutcher uh playing Steve Jobs. Yes. And he's on the phone and he's he's trying to fly, yes, okay, yeah, it's yeah, okay, you have a typewriter. Okay, so yeah, it's like a typewriter, but it doesn't use paper, it doesn't use ribbons, and you can see what you're typing on a screen in real time and get it perfect, and then you just hit print and it's ready to go. Right. And the person says, But I already have a typewriter. That is basically what I hear all day, every day. I mean, I've spent the last three days meeting with 21 or 22 different health systems on Zoom calls. Um, and each one of them, they sound identical after a while. Yeah. They're they're fascinated by what we can do, and they feel the pain, and you and you can feel their pain. Yeah. You know, God, if I could just get these reports set, if I could just understand this visibility to blah, blah, blah. They mean well, but they're shackled to an endless vendor sprawl that's moving things around in circles and not getting it done. They're hanging their hopes and dreams on AI right now, because it sounds like a magic bullet solution. Right. It's nothing new. Um, 85%, I don't know if you knew this, 85% of all healthcare AI initiatives have failed. Some of them are suggesting up to 95%. Failed to uh meet expectations. Why? The data. Because you give it crappy data and garbage in, garbage out. So what we do is not sexy by any means. It's at the under-the-covers foundational level. Yeah. But when it's working properly, all your other stuff moves at light speed just magically. So it's in concept, it's so simple. But to do this, complex.

Chris Hutchins 30:12

So I I want to touch on something that's not directly from a technology standpoint, but I think it's something that the organizations are probably starting to realize they have to think differently about. Um we historically have, when we've gotten a new challenge, whether it's regulatory or it could be the new wave of technology that we really have to start to adopt. We try to look at the path of least resistance first. And there's one of the things that has always bugged me is from a contracting standpoint, those things kind of happen before there's a conversation around what the data dependency is. And what they're doing is they're committing on to do some things and the resources are not aligned. And what ends up happening is you're dumping a whole bunch more workload on people who are full-time already and they are supporting the lights on aspects of this. This is how they've always done it. Yeah. Yeah. So that's how we do it, right? Talk about that.

Ted Lindsley 31:12

Because I mean, I'm sure you see all kinds of things. Yeah, we get uh we get requests all the time for a proof of concept. Let's do a proof of concept, just a simple thing. And uh most startup companies would jump at that chance. Okay, let's do that. They're shocked when I say, no, we don't do proof of concept. And they're what? Like you okay, uh here's an all-star player that's been five years in the majors, has got a winning track record, and you want to send him down to the minors to try out for the minor league team. Yeah. Is he gonna say, okay, you know, give me a break. Come on. So but that we're in a rare situation because our platform is mature, it's fully baked, there's no technical debt. It's proofs won countless. I mean, it was it was a finalist, it was a runner-up for the Galien Award in the life sciences space. That's huge. Right. It was uh Viz, I think, that won first place, and this one came in second, uh, which is one of the reasons that we acquired the technology. Yeah, this got Rochester, New York, their NCI designation. Can you imagine that? They tried for years, couldn't get it. And in spring of 25, they get an NCI designation, and almost a quarter of the reasoning why was because of this platform. Yeah. You think there might be some weight to the credibility here?

Chris Hutchins 32:26

Well, I I I think I think that's exactly the things that people they just need to think differently. But when you're talking about resources and the teams that you have, the skill sets that you that you have built your capabilities around, and the resources you have access to, they're extraordinary people. They they really are. I mean, I've some of the most brilliant people I've ever known do that kind of stuff. They're creative. But the difference though is we're in a day and age now where things are moving at a clip where if you are not advancing and investing in training of your team and getting them new skills, you're at a significant disadvantage. And it's not because they're not motivated, because they are, and they're probably working their butts off now, probably too hard because they don't have all the tooling that they should. They are right. Um, but the the piece that's concerning to me is there's still this approach where, well, we can do it, we can do it ourselves. And I don't want to beat this to to death, but I do want to talk about it for a minute because it is really significantly hurting organizations and their ability to succeed to even get to a place where they can think about a pilot, let alone crash and burn. Yeah. Right? Because a hobbyist is not going to build something at scale for you. And I don't mean this to be disrespectful, but when you've got a full-time job and all you do is you support and maintain systems that have to have 100% uptime or as close to it as you can get, because it's really critical to the operations of a health system. These people are extraordinary at what they do. But if you need to pivot and you need to be able to process a lot of information and you're trying to get three new organizations onboarded to provide the care to the patients in these new areas that you're now off on the hook for, you the way that you've done it historically, you've struggled. Now you've got less time and less flexibility and less grace for it because the regulations are gonna start to push it even harder. Because the AI is now drawing attention. State legislators are starting to think about how they're gonna put standards and regulations in place. The federal government's trying to push back on it, and quite honestly, talk about hobbyists when you got people who aren't even full-time legislators, they're gonna try to put policy in place to help us govern AI off something. That scares me.

Ted Lindsley 34:36

But we that's not I don't think that's gonna happen. But you know what? I just remembered you started you started this conversation with you know uh acquisitions. Yeah. And I didn't even touch on that. That's just that's just a good example. Everybody's doing things different ways, right? Yeah. If you're a ph if you're an organization, you buy another one, now you've got to deal with that tech stack and the way they do things. No, you don't. That's one of the benefits of our system. So all you do is hook those data feeds. Well, we do it for you. We'll hook all their data stuff and their processes into your existing system that's on our platform. Yeah, take no time at all. Probably have it done in a day or two. My guys would probably say, give us a week. But uh, truth be told, it'll happen fast. And that'll just put it all together. So it uh that's one of the beautiful things, is it doesn't care where the data is, how it is, what format it is. That's another thing, is vendors will say, uh, oh, we can do anything you want. Just make sure you give us the data this way. Yeah. Okay? So now you're hiring 20 people to make the data that way so that the vendor can do half of what they're supposed to do. Come on.

Chris Hutchins 35:37

We take it just as is. Right. But that's actually the dilemma that I found myself in more than once. Contracts get signed, then all of a sudden they're like, hey, we need the data.

Ted Lindsley 35:44

Like what?

Chris Hutchins 35:46

Exactly. So where do volunteers at? I've got no budget to go get more people.

Ted Lindsley 35:50

Who's who didn't ask those questions? Who didn't know to ask those questions? Right. That's curious. At the executive level, the CEO, COO, CFO, the traditional business people, uh, they want default results, they demand them, and they put a contract in place that says get it done or else. And or else means or else. Right. It doesn't mean, oh well, you tried. Um I don't see that here. I don't see any accountability or uh consequences for failure. And that's that kills me. We're talking about lives here. Yeah, how are there no consequences for failure? I thought it was only in politics. Because you don't get elected or because you get you know run out of town.

Chris Hutchins 36:30

No, there's just no accountability sometimes. But you burn their career. You can write checks when you don't have any money. They do that all the time. Yeah, I don't know. You and I we're not gonna get away with that.

Ted Lindsley 36:39

I mean, I those things I can't fix. What uh all I can handle with is where I sit here. So I'm excited about what we're doing. Right. And it's it's grassroots, it's a one at a time kind of thing.

Chris Hutchins 36:49

Yeah. But the demand management stuff is really challenging because people are they still talk about governance from a legacy viewpoint. And what I mean by that is there's it's more academic in the minds of people who have been part of organizations that have put together some structure. And I've not seen too many who actually started building a foundation and just gradually built it up, and it's really it's firing on all cylinders. It usually fits and starts because they're trying to do something before they've got something for people to actually govern. And when you actually need the people to govern it, you've already alienated the decision makers and not even there, it's hard to get them in the room now. And you know, they're they're as siloed as the data is.

Ted Lindsley 37:29

Yeah. Uh uh, that's another thing I've noted uh in this time is that yeah, the these decisions are made by committee or made by every department, and a lot of times just they're doing their own things, they're not talking to each other. So there's there seems to be a missing level of leadership at the top that is truly leading, you know, rather than just holding meetings and being a figurehead, but the no one's waving the baton for the bit, the orchestra, to keep them all in time together.

Chris Hutchins 37:56

Well, you know, I had the most amazing experience. This is several years ago when I was working in Boston. There were, I think, four CFOs who came together and they brought some of their finance leaders together. And they got us all on a big conference room, and they said, guys, we have too many different cash reserve models. And uh we don't care what the result is, but your task is put your heads together and get us one model. And if you're up against something, you don't quite know what to do with it, call us, we'll come in and we'll we'll hand we'll answer your questions, or we'll you know, if you you want us to make a decision or something, you know, we'll wait, we'll do that. Okay, directive given, timeline, and then make it happen. And it was a by the way, uh I don't remember what the exact time frame was, but on such and such a date, we're gonna reconvene, and we will see a unified model that we can all accept. We're not all gonna be in love with it. Some of us are gonna love it more than others because it might be your methodology, but we don't care which methodology wins. We just need a common way to do it. So we're speaking the same language, we can answer the questions, we can defend.

Ted Lindsley 39:10

That's a great starting point, right?

Chris Hutchins 39:11

Yeah. It doesn't have to be perfect. But you know what? Those four CFOs were in that room. Every one of us reported at least one of them. And they were crystal clear. When we come back together, if we don't have one model, then we will bring in new people who will give us that model. Well, I would call that leadership. That was not confusing at all. It was not ambiguous. It's clear. Like, you know, I believe we should have a conversation, guys. What do we mean?

Ted Lindsley 39:38

But but that's and and the expectation has been set. When they come back, show us the result.

Chris Hutchins 39:43

Yes, and you want to know what was really interesting is that exercise was one of the first ones I got to be connected to, but it turned out to be very, very beneficial because it wasn't too long after that, within a year or two, decisions got made to do a major transformation, shifting from all the legacy EHRs and financial systems to platforms. Yeah. And that exercise prepared us for what the challenge was going to look like and even on a bigger scale. Because when you got organizations that function so independently, and when two of them are like constantly battling for the number one and number two spots, you know, globally and their specialties, uh, they you know, they're they're typically very, very solid reasons that they can defend for the difference in the way that they do things. It's a differentiator, that's why they're number one. You know, it's that competitive nature that they have, which was crazy.

Ted Lindsley 40:37

It's in their DNA, isn't it?

Chris Hutchins 40:39

It is. Yeah. But from an organizational standpoint, when you just start to figure out how do you support that in a way that doesn't counter it, you've got to make sure that you're still preserving that innovation and that drive that keeps them improving. They're just constantly improving the way they do things in delivering care. Sure. You can't fight that battle because when they're delivering outcomes, you're like, oh, uh, okay. Yeah, but give them the tools to do that.

Ted Lindsley 41:01

Yeah, right. Uh and automate things. This idea of all these dashboards, the sprawl of vendors and dashboards and and clicking here and there and logging in left and right. It's ludicrous. Oh, that's that's one of the things we did too. One of our clients uh it took an average two hours a night for the physicians to prepare for the next day in oncology. Our system now, it takes them 15 minutes. It's all right there. It knows everything, it knows what you need, where you want it, how. So they just look and go, Well, that looks great, and they're good to go. And everything is at their fingertips. Right. Uh another one uh in chemo. They manage their chemo chairs the way most hospitals manage their um their ER rooms. They squeeze every dollar out of every minute of those chairs because the system knows who's coming in, what the staffing looks like, um, how many minutes they're gonna need, what's the turnover look like. Yeah. On and on and on. So uh uh finding the people who can drive this change is the hard part in healthcare. There's a lot of bureaucrats and politicians that hide in the shadows in in healthcare.

Chris Hutchins 42:07

There are, but you know, one of the things that I keep coming back to because that's why I stayed in healthcare. It's that I think about the individuals that I've met over the course of my career. It's the clinicians and the nurses. And when I hear them and when I see what they're dealing with, that just renews my commitment to do whatever I can do to help to make things easier for them because they took their their their training and their education really seriously, and they the Hippocratic oath to them, it is gospel. You know, it's not negotiable. First, do no harm. It's funny you say that.

Ted Lindsley 42:45

Yeah, we we throw that around in terms of the Hippocratic Oath, do no harm. Right. Doesn't omission count also by not seeking action?

Chris Hutchins 42:53

Well, I I think that's the that's the thought I was trying to was gonna really get to is organizations. Um there's some that are extraordinary at this. Um, you know, I will say this. One of the things that I was taken back by, I never even knew what was going on until somebody uh mentioned that they were they're trying to get some more executives to get involved in this program. But the executives had a rotation in place where there was somebody helping the patients wayfind almost all the time. Somebody from the executive level was in the lobby, they were greeting patients, making sure they got where they needed to go. And it wasn't a big deal, it's just something that they did, it was just part of it. And that really struck me because the the more you're coming face to face with the people you're there to serve, the stronger your connection and your motivation is gonna be to get that stuff right. And I've never been in an organization where I saw something is like repeatedly over and over and over again. When you're deciding what you're gonna do, more often than not, the answer that I would get is because it's the right thing. That's it for this episode of the Signal Room. If today's conversation sparks something in you, an idea, a challenge, or a perspective worth amplifying, I'd love to hear from you. Message me on LinkedIn or visit signalroompodcast.com to explore being a guest on an upcoming episode.