Episode 47: Dr. Sarah Matt on Healthcare Data Gaps

Healthcare access isn’t just about availability, it’s about data. In this episode of The Informonster Podcast, Charlie Harp sits down with Sarah Matt, MD, MBA, Health Technology Strategist, and author of The Borderless Healthcare Revolution, to explore how gaps in healthcare data continue to create barriers for patients, providers, and caregivers alike.

Dr. Matt shares insights from her career spanning clinical practice, health tech startups, and large-scale healthcare transformation, unpacking how inconsistent, incomplete, and fragmented data undermines care delivery, limits the effectiveness of AI, and contributes to provider burnout. The conversation covers interoperability challenges, why “the average patient doesn’t exist,” and what it will really take to improve access without “burning down” the healthcare system.

If you’re interested in healthcare access, data quality, AI in medicine, and the future of patient-centered care, this episode offers a thoughtful and grounded perspective from someone who’s lived it from every angle.

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Transcript

00:01.53

Charlie Harp

Hi, I'm Charlie Harp and this is the Informonster Podcast. And today on the Informonster Podcast, I have the one and only Dr. Sarah Matt. Sarah, welcome to the podcast.

00:12.15

Sarah Matt

Thanks, Charlie. It's nice to be here.

00:14.49

Charlie Harp

Well, for people that may not know this or may not know you, why don't you start out with giving us a, just kind of a background on you and your journey in healthcare. care That's kind of the thing we do on the Informonster Podcast.

00:27.35

Sarah Matt

So I'm Dr. Sarah Matt, and I started off as a doctor. So I'm a surgeon by training, my fellowships in Burns, but I actually moved in the tech sector a long time ago, right from the beginning. And Charlie, we met each other a long time ago. We won't even mention how long ago that was. And so, you know, I actually cut my teeth in product management at NextGen Healthcare back in the day, taking care of clients that were critical access hospitals, no money, tons of regulations during the meaningful use days, and kind of worked through the ranks there, did a lot of great work in patient engagement. And then as Chief of Staff, the Chief Strategy Officer, where I definitely did some M&A I totally shouldn't have. but you know, it kind of set the stage for an entire career in product and strategy.

01:12.24

Sarah Matt

So I've done several startups, everything from ESO, so which is pre-hospital, firefighters, paramedics, EMTs, with some good exits. And then my last startup was Savato, focused on remote robotic surgery. And I'd say a big chunk of my career was at Oracle, doing everything from building out the OCI business for healthcare and life sciences, so cloud, all around the world, to being a big part of that Cerner acquisition, which was an absolutely amazing experience. So I've been here, there, and everywhere. I still practice medicine. I've been doing charity medicine for a long time, internal med. I go see patients here in upstate New York a couple times a month, and I do a lot of teaching too, so I teach med students here at SUNY Upstate.

01:53.11

Charlie Harp

So you keep yourself busy is what you're saying.

01:55.19

Sarah Matt

I thrive on a little bit of chaos.

01:58.97

Charlie Harp

So, one of the things that I want to talk to you about is you've recently written a book.

02:03.61

Sarah Matt

Absolutely. So, The Borderless Healthcare Revolution is my new book and it's out right now. Check it out if you haven't already. I know you have an advanced copy there, Charlie, so excited to hear your thoughts on the book. But it's all about healthcare access and how technology can decrease barriers to care. So, an important topic that I think everyone can come together on.

02:24.81

Charlie Harp

That's great. What inspired you to write the book?

02:27.51

Sarah Matt

Well, you know, at the end of 2024, the United States was a very polarized place. And I'd say that people were really separating each other in so many levels. And healthcare is an area where everyone's got big opinions. And I was trying to think about how can I make a big impact here? And how could I make things better? And healthcare access is a topic where it doesn't matter where you come from, how much money you make, what your situation is, we all struggle with healthcare care access in different ways. And so to me, this is a topic that we can all come back together on and work towards improving all around the world, but here in the United States in particular. And from any vantage point, whether you're in healthcare delivery, whether you're on the tech side like we are, or whether you're building other spaces. So I think healthcare care access is, again, one of those topics that's so rare in that everyone has a story where they've had access problems. Everyone can talk about that and come together in a topic where we can all make impact together.

03:28.86

Charlie Harp

That's great point. I think that especially when you think about the world in general, and I'm a salty dog and I have enough experience with healthcare and other countries to know that each region has its own unique set of challenges when it comes to access, when it comes to, you know, getting the right information to provide the best care for patients.

03:50.58

Sarah Matt

Absolutely.

03:50.87

Charlie Harp

When you think about care here in the U.S., what do you think is kind of the biggest issue we have around access?

03:58.90

Sarah Matt

Well, I know this podcast is not going to be long enough to talk about all the issues in health care in United States today, Charlie. But what I'd say is that we have lots of different barriers. To me, I break it down into financial, trusted knowledge, digital, cultural, and geographic. It's really easy to see the geographic barriers. Oh, we have people in rural environments. Oh, we have people unable to see specialists. But I think that one of the things that I know that you talk a lot about, Charlie, is data. And we think about the data that's really the heart and soul of health care, the ability to move it from place to place, the ability to have it be utilized properly with AI and the newest technologies, and the ability for that to actually improve patient outcomes. I think we don't recognize every day that sometimes that data is being collected, maybe not consistently for different groups of people. Maybe that data is historically not there. So we ultimately can't build great algos to help patients from certain groups. So what I'd say is that there's so many barriers, but one barrier that I know you and I have a lot we could chat on is really around the data. Movement, quality,

and who it's coming from. Because again, we have huge gaps in the ability for us to make that future work for everyone when we don't have the right data to start with.

05:20.02

Charlie Harp

And one of the things when I talk to folks, they kind of say, well, why is the data important? You know, the people that aren't deep in the trenches like we are. And what I what I try to remind them without scaring the crap out of them is saying, listen, you got to realize that in this country, at least, we have we don't have as many providers as we used to per person. We have an aging population. We have providers that are experiencing serious time famines. And we also have people that are on the front lines of providing care that don't have the same kind of training and experience as providers.

05:54.78

Sarah Matt

Agreed.

05:55.67

Charlie Harp

And the thing that can help us if we were able to get our arms around it is technology, because technology can kind of bring that artificial experience to the front. If we have a good picture of what's going on with the patient, we can augment the providers that maybe don't have the same experience. And also for the providers that do have the experience. We can automate a lot of those things that they really don't have the time to do. And so I'm always saying this is why the data is important is because we can't really make the most of our technology if we can't rely on the data. Trusting that data is a huge barrier to providing better care. Is that fair?

06:34.33

Sarah Matt

Well, I would say that's definitely fair. You know, when I was training, we were in the days of paper charts, homegrown systems, some crazy big systems, you name it. Every hospital you rotated at was different. You basically grab the other resident's password and username and looked at the screen for five, 10 minutes, and that was your training. And so probably not the best way to do things, but you know things have evolved. But if you didn't write it down, it didn't happen. And I think that's the trick is that when you think about data, whether it's structured, if unstructured, you name it, if it's not in there, did it happen? And so right now, there's so much question. As a patient myself, I go to appointments and I have to fill out the same gosh darn forms a gazillion times. And I'm a doctor. I'm in the system. I know how this works. I've done all this stuff. For anyone else, it must be absolutely impossible because it's next near impossible for me. And so to think about access and how we can make that better from a data perspective. Someone asked me this yesterday. They said how can you define the best state of access in one word? I said, simple, because right now everything is just way too complex. If we had the ability to just, I don't know, take that one intake form and use it a gazillion times, I promise you my birthday has not changed and it won't. And it'd be great if I didn't have to write it down again.

08:05.01

Charlie Harp

I was, you know, as you get older, you get to experience healthcare more and more. And I was in a in a radiologist's office and this gentleman who's probably 90 years old was standing at the counter. And he's like, you she said, go fill out the form. And he was like, I was here yesterday.

08:23.93

Sarah Matt

Sad but true, right?

08:24.30

Charlie Harp

You got to perform anyways. And I could feel, I could feel him like the the incredulity this poor guy, like I was here yesterday. Nothing has changed since yesterday. But so when you think about access, I mean, obviously access is kind of like interoperability, right? It's a multifaceted thing and there's you know being able to actually go see a doctor. There's being able to get access to your information. One of the things, and I have some more questions for you, but one of the things I'm curious about is there's a lot of folks out there right now that are that are you know basically pointing at artificial intelligence. You won't need doctors anymore because we'll have an artificial intelligence and we'll answer all your questions. And I know people that use ChatGPT, they feed their symptoms in, and I worked on a tool called QMR two decades, two and a half decades ago that did diagnostic decision support, ah deterministically, but it did it.

09:17.68

Sarah Matt

Don't date yourself, don't do it, don't do it.

09:22.81

Charlie Harp

So where do you think we are currently with AI as a way that people can get access to healthcare, and what do you think has to happen for it to be something that's realistic?

09:22.88

Sarah Matt

Yeah. I still see digital as a barrier. So, we just talked about all these issues with gaps in data. The best algorithm cannot diagnose me or take care of me if they don't have the full picture. And so unfortunately, and this is something we learned med school is that the average patient doesn 't exist. So if we're going to do some vanilla algo over the top of it, it's not going to be helpful for anybody. So if you want a great picture of a patient and what's going to help them most, you need to have their entire story. This is hard for doctors today because we're digging through charts. We're looking at, you know, scan faxes. We're trying to dig up records from a CD-ROM that shoves someplace else. We don't have a full picture today. There's lots of organizations working on that longitudinal record, if you must, but I can guarantee there's huge gaps. If someone asked me to get my entire record today, don't even know where I'd begin. I've lived in several states. I've seen lots of different doctors. It wouldn't happen. And so AI has great potential. No question there. Do I think AI is going to replace doctors? Not for a while, but I do think that doctors that know how to use AI well will replace those who don't.

10:54.48

Charlie Harp

No, I think it's a great point. I think that one of the things that I spend a lot of time in is kind of that interoperability space where we're sharing data. And I think the things that people don't always realize is that if we get to a point where we are sharing data at scale across the ecosystem, um we don't all we don't have all the controls in place to understand where everything actually came from. And we run the risk of creating this tsunami of data that's getting bounced back and forth and back and forth, this kind of conceptual echo. And you know physicians like you are already overwhelmed. Imagine that you've got 15 facilities sharing data with each other and then sharing the data from the other 15 facilities with each other. How do you filter through all that? How do you get it all to the point where it's normalizable and usable? I mean, we've been doing this work with the PIQI Framework to create kind of a store scorecard, and that's part of it. And I'm really excited about the momentum I'm seeing about having an ah an objective way of assessing quality. But we still haven't fixed things like provenance in a way where we know that I've already got this data about Sarah Matt, from this other place. I don't need it again. and I think that once we get fully interoperable and all the pipes are delivering information, I kind of worry about how we're going to wrangle all that data and not let it become, you know, landfill.

12:28.22

Sarah Matt

Well, unfortunately, I think we're going to continue to have an interoperability problem for a long time. And so the PIQI Framework, I am very excited about as well, because I think that quality has often been a a sticker or a stamp that people put on things, but don't actually have a real definition of or have had in a quantitative fashion. So I really appreciate what you folks are doing there with that. But when I think about interoperability, we're going to continue to have interop problems because we can't just burn down the existing system. And Charlie, if I decide to do that, I will call you. You'll be part of the team. But, you know, we can't start from scratch. Unfortunately, we are working with existing hospital systems. We're working with medical records that are decades and decades and decades. So when we think about this, People like you and I we've been around for a while. We've seen the tech, we've built the tech, and we've made some of the mistakes of the tech. Let's just be honest about it. And it's for lots of good reasons too. But we can't just start from scratch and patients need to be cared for today. So yes, it'd be great if in five years I could have a beautiful, clean X, Y, or Z. But until then, I still need to take patients today in the office, take great care of them and get as much information as I can to make those great decisions. And you can't get away from the reality of the current system. And I think some people will bring up their amazing, shiny AI. It's amazing. We should use this. And I'm not negating the fact that it's probably an amazing tool. But if it negates the fact that it needs to be used in real life now, that's where I have problems.

14:07.43

Charlie Harp

What I find about technology, it's an amazing new technology until it hurts somebody. And then it becomes this technological pariah and we say, oh, that technology doesn't work. When in reality, a lot of the times it's just, we didn't we didn't really use it right. We were riding high on the hype curve and we implemented something and we maybe forgot that there are real people there that that are impacted by this. One of the things I talked to my friends in Silicon Valley And they talk about disruption and we're going to disrupt health care. And I I've been doing this a long time. And I don't want to be the guy with the sandwich board on the corner. But I say, you know, health care is a disruption proof industry. There are things we can do, but it's so vital. There's so much momentum when you implement something in a hospital system. It's not like you could just turn it off. turn it off and things go berserk. So you have to respect the inertia of healthcare. And if you're going to try to transform or change healthcare, you have to do it in incremental, meaningful steps. You can't just come in and pull the tablecloth out from under it and expect that, oh, I'm going to fix healthcare. It's challenging.

15:20.15

Sarah Matt

You know, you use the word incremental people that are listening to podcast are going to just start clicking stop wherever they're listening when they hear that. But what I'd say is that I'd like to redefine that.

15:32.61

Charlie Harp

All right.

15:32.73

Sarah Matt

Yes, you can't go big bang because we can't burn it down. True. But I think when people decide we're going to implement this solution, they don't realize they're signing up for an entire transformation of their culture, their training, their workflows, et cetera. If you're not prepared for that, then are you really implementing it properly? I would say no. So oftentimes we don't even see incremental improvements because they haven't looked at the entire ecosystem and the programmatic issues that will be caused by not properly training, change management, you name it, to make something actually successful.

16:10.01

Charlie Harp

No, I think that's true. I think people underestimate the impact of process and human change when they do something like that. I also think that some of the approaches that worked in other industries just don't work in healthcare. I think that they're like, when I look at all these folks doing these ai AI startups, I think you really have to have a lot of respect for what's happening in healthcare and the significance of it. It's not like advertising. It's not like retail. It's a very entrenched industry. The trick is, how do we make progress without having to you know burn it all down? How do we make that incremental progress? My concern is some people come in, they do these grandiose things And then people start to move in that direction. I won't name names, Microsoft, Google, but they make these big moves and people start to invest and then they realize, oh my God, this is hard. I'm not gonna do this. And they ride off into the sunset and 10 years later, they go, oh, maybe we should try healthcare care again. And for me, it's like, for those of us that have been in it for 40 years, 30 years, 25 years, or a young person a young person like yourself, um the question is, you know, how can we make meaningful change in healthcare and get to the point where it is it is actually the data we produce as a byproduct of providing care is actually useful and not a distraction. In fact, the whole Informonster concept don't know if you know the origin story of the Informonster.

17:48.57

Charlie Harp

When my son was five years old, he's older than that now, but when he was five, he said, well, dad, what do you do? And I said, well, in healthcare, care people are, they feel like they're supposed to go out and get all the information for all the patients and bring it together in one place. And they do that. But when they do that, what they don't realize is they've created this Informonster. This information monster and becomes a big distraction instead of being what they want it to be, instead of being this useful asset, that's going to power all these things.

18:09.73

Sarah Matt

I like that.

18:17.59

Charlie Harp

They realize that it's just this, it's almost like a hallucination of an oasis where if I can just get there, everything will be great. But they they underestimate what it's going to take to get from pulling all the data together to actually turning the data into something that can drive your business. And it's still to this day, I mean, I've been doing this a long time. I don't think it's me, but it's been a challenge to get control of it. And I think AI can help a little bit. I think improving data quality and making people realize that the quality matters, I think, can help because people, there's a lot of quality deniers out there. So anyways, I'm very optimistic that we're getting to the point with AI as kind of a as the next OASIS driver. I think that people are starting to realize, well, maybe I do need to do something about data quality.

19:11.38

Charlie Harp

But let me let me change the topics. You ready?

19:14.46

Sarah Matt

Sure.

19:15.29

Charlie Harp

So when you were going through this journey of writing this book, was there anything when you were writing the book that really surprised you when you were doing the research and the work behind the book? Is there anything that you thought, well, I didn't really think about this when I was writing starting to write the book?

19:32.79

Sarah Matt

So for me, first of all, the most interesting part of writing the book were the interviews. And I met with patients, executives in tech, executives in healthcare care delivery, providers. And what I think I learned that was surprising to me didn't I didn't I hadn't heard all the stories. So you have your own expertise as a physician, as a technologist, you know from a real product management perspective, we talk to clients, we talk to patients, providers, you name it, whoever's gonna be using or buying this you know solution. But hearing folks that were many steps removed from that and their experiences, there's a ah great doc here at SUNY Upstate who is the first line of defense, if you will, for new refugees coming into United States. And I hadn't really recognized the refugee population and what that means in healthcare. care From a data perspective, you're starting from zero, to how they even get a prescription when they don't speak English, they don't understand the language, they don't understand the system, they've never even had healthcare care before. So I think some of those were interesting insights that I hadn't considered before. Because I know what it's like to be in a lot of different places in healthcare. care And I've talked to lots of people over my many decades. But at the same time, there's always these new groups, these new problems, and these new situations that I find are absolutely fascinating. Because if we could solve for the difficulties these people are having, it would help everybody.

21:07.31

Charlie Harp

Well, and I think that when you think about the concept of access, I mean, there's political, there's geographical, there's technological, there's data, there's financial. I mean, there's a lot of different there's a lot of different factors that could impact that. I'll share something. I mean, I have an adult son who is autistic and he's 30 and he he was on Medicaid for a long time. And I always felt guilty about him being on Medicaid because, you know, I make a decent living and we can afford health care. He can't be on my insurance anymore because he's aged out. But the reason he was on Medicaid is because there are all kinds of services for someone who has needs that you can't buy. If you're not in in the program, you don't get access. And so my wife was constantly you know battling to keep him on Medicaid so that he could have access to these services. And I mean, as of right now, earlier this year, he got bounced out again. so we're he's constantly getting bounced in and bounced out. And so now we're kind of going to the marketplace to try to find some kind of a program for him.

22:21.08

Charlie Harp

But, and honestly, a lot of the people that provide those types of services that you can't just buy are willing to do it for nothing if you can't get access. And so, you know, talking about access, there's so, there are these variables where I'm sitting here thinking, you know, I can afford to pay for his premiums for a healthcare plan. But even if I do that, he can't get access to these things. And so it is, it's a multi variable issue that I think a lot of people are impacted by.

22:52.63

Sarah Matt

I mean, the system is complex. And unfortunately, that means it's hard from all sides. It's hard from a patient perspective to get the care you need. It's hard from a provider perspective to help your patients get what they need. It's hard from a caregiver perspective to advocate, even in the best of situations. And, you know, ultimately it means everyone's suffering. So this is another reason why we're getting burnout for nurses, doctors, et cetera, because they can't take care of their patients the way they'd like to. And the patients are exhausted. It's just exhausting.

23:29.85

Charlie Harp

I agree. um So is there any low hanging fruit in all the research you did? Are there are there things that you think, hey, we should be able to accomplish these things? Not to not to give away any secrets in the book. Keep some secrets from the book for the readers. But um is there anything that kind of jumped out at you and said this is really something that we should be able to fix?

23:51.70

Sarah Matt

So for me, again, the five pillars I break it down into, geography, financial, digital, trust in knowledge, and cultural. I think the easiest one, the low-hanging fruit, if you will, is probably digital. You know, right now, when we think about getting quality internet services to rural environments, that seems like we can make a plan and have that happen.

When it comes to hey, what would be the minimum requirements for a cell phone or this or that so that a tele-visit could actually be produced on it? Okay, I thought we could do that. um I think that there's pieces in the digital space where we could educate people at whatever level they're at, in whatever language they need, in whatever case they're at, wherever they are, to be able to access some of the services that are now tried and true. Telehealth has been you know pumping like gangbusters since COVID and so since way be week before that as well. And when we think about the ability to make appointments, get prescriptions, et cetera, from your mobile device, that's a big deal. And so to me, that digital pillar, I think that's the easiest piece we have as a barrier to take care of in a short term.

25:07.08

Charlie Harp

Okay. Well, before we wrap up here today, first of all, thank you so much for your time. for the people that are listening. How can I get your book?

25:18.11

Sarah Matt

Oh, well, the Borderless Healthcare Revolution is available anywhere books are sold and you can check it out at drsarahmatt.com and it has all the information there.

25:27.43

Charlie Harp

Excellent. I'm going to read the book. You just gave it to me yesterday. I'm not that fast. And I was going to wait for the audio book. Is there going to be an audio book?

25:36.74

Sarah Matt

I'm working on it. I'm working on it.

25:39.18

Charlie Harp

I travel a lot. So I'll give it a read. And would you be willing to come back so we can talk more about the book itself at some point?

25:45.19

Sarah Matt

Oh, of course. I can't wait to hear what you think about it, Charlie.

25:48.86

Charlie Harp

All right. Well, hey, thank you so much for being on today. And thank you all for listening. I am Charlie Harp, and this has been the Infomonster Podcast. Thanks.