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Episode 5: Drex DeFord on An Amazon Hospital, SpaceX captures the imagination and Culture wins the Super Bowl

[00:00:32] This is episode number five, and my name is Bill Russell, recovering healthcare CIO, writer, and consultant. With the previously mentioned health Ericsson. Today I'm joined by Drex DeFord. Drex. Wow, this one, a longer bio. So I'll go ahead and read some of these things. Trex has a long career as a healthcare executive, including experience as a co-founder of next wave connect a CIO at Steward Healthcare in Boston, Seattle [00:01:00] children's in Seattle, obviously, and also scripts healthcare in San Diego.

[00:01:29] [00:01:30]Now a recovering CIO will have to argue who gets to hold that title. But Drex spends that he spends his time bringing together trusted health systems, payers, associations, vendors, and investors to solve healthcare's toughest problems as president of his home own healthcare practice, direct CEO, digital health. Good morning Drex and welcome to the show.

[00:01:58] Bill Russell: [00:01:58] I tried to pare it down [00:02:00] but it's all relevant. I mean, you've been a CIO at a bunch of very great systems. You've obviously done some great work with CHIME and and the stuff you're doing now of really networking and bringing these teams together is important to the industry.

[00:02:28] Drex DeFord: [00:02:28] Yeah. Thanks. I, I [00:02:30]I mean, I guess I would start off by saying yeah, it's a long intro and it probably tells you two things. I guess one of them is that I'm I'm old.

[00:03:19] And then I'm involved in in a bunch of different startups who are working kind of on their own ways to disrupt healthcare. And being from Seattle happy the [00:03:30] days are getting longer, which means that on the days that I'm home I get to spend more time in the cascades and the Olympic mountain ranges, hiking.

[00:03:50] Bill Russell: [00:03:50] Yeah. I'm, I'm looking forward to that event and It sounds like you have designed your work around your life now instead of your life [00:04:00] around work.

[00:04:04] Drex DeFord: [00:04:04] no, that's actually been a really huge, a huge part of, kind of how I've arrived to the point that I am in my life right now. A lot of it has been driven by. There's particular things, particular things that I want to do in my life. And I'm, I'm trying to arrange my work that in a way that allows that to happen.

[00:04:41] Cause a lot's happened this week. Not well, a lot's happened this week, period. So here's what happened, directs, and I each selected a sorority to discuss and I'll, I'll kick it off with with my story space X launch, the world's most powerful rocket. So what's next though, this is an article [00:05:00] from a space.com and I think we both shared just a love and a fascination for.

[00:05:30] And reduce the cost by a third from roughly 300 plus million to its nearest competitor to about a hundred million. So double the capacity, third of the costs they were able to to recover two of the the spent fuel cylinders. They had precision side-by-side landings. I had great photos of that.

[00:06:11] And what it shows is essentially without refueling or whatnot, they can, they can actually take these loads. Has Elon Musk is actually quoted as saying we can, without refueling, we can take something out to Pluto if we needed to. And you know, in true Elon Musk fashion, they did it in style. They [00:06:30] placed Musk's red Tesla roaster in the cargo with a mannequin named Sterman and a space X space suit that played the corresponding song by David Bowie, thus completing the world's most expensive car commercial.

[00:07:22] You, if you've ever heard Ray Kurzweil's speak about some of this stuff. He's talking about a future where. You know, precision medicine is, [00:07:30] is, is, is an amazing advancement for us where we are predicting things where we are doing pre preventative procedures, really with a nanotechnology and, and those kinds of things.

[00:08:15] Cause this, this will be over the next five years or so. I think it's universally. Accepted that this is going to be a fun time within healthcare to see some really great advancements, almost like we've seen in commercial spacecrafts over the last couple of years. I'm curious what your, [00:08:30] you know, as you see this, this does capture the imagination, but what, what are some of your thoughts as you sort of replay the events of the past week?

[00:08:59] And there are, [00:09:00] there are a ton of lessons. I think one, one of the real lessons, you know, he started this whole program with some really big ideas that I think even. Most avid space fans thought were on the verge of being ridiculous things like being able to land reusable rockets back at the launch side.

[00:09:35] And he started landing these rockets and doing recovering and turning them around and launching them again. And after a while I think any of the problems that they faced when they happen, they weren't really a disaster. They were viewed kind of as opportunities for success or lesson to learn and.

[00:10:12] We had low expectations. But we kind of all came into it in the context you have this thing doesn't work well, we know he's not going to quit and he's going to gather data and he's going to learn from the problem and he's going to continue to inspire everyone. So, so I mean, in some ways too, I would say not to get too political, but the government shutting down and all of [00:10:30] that, we used to look to kind of big, hairy, audacious goals.

[00:10:57] So it's, it's quite a story [00:11:00] and, and there are a lot of lessons in there. And. Leadership and management and innovation and all of that.

[00:11:20] And then really they had to, he had to leverage his future to to get that third one. And that's why we know space X today. If that third one had failed. [00:11:30] You know, he's on record as saying that we wouldn't be here talking about space X today, more than likely. The other thing you have to love love about him is the it, he really does lead with vision and it's not space X being the most profitable or the biggest or the best he's leading with.

[00:12:11] And when he speaks in those terms, I think those of us who who grew up, who grew up, you know, looking at the Apollo missions, wishing that we were still there while we were doing these you know, I, I don't know what to call them, but these shuttle missions that were just sorta looping around the earth instead of really activating our imagination, [00:12:30] this, this really has, has brought us back to.

[00:13:00] [00:12:59] That's also obviously moving us forward. So exciting time for the space program, extended time in healthcare. So I'm going to kick it to you and, and for, for you to, to give us context for your story.

[00:13:19] So probably a good place to start in. All of this is to say. Oh, and don't forget Bezos and Amazon have their own space program too. It's called blue origin. So [00:13:30] in a lot of ways dreamers like Musk and Bezos have have a lot in common. The story that's that's on the side is a pretty interesting, kind of a fun story.

[00:14:13] This, this article really sort of takes that to the next stage and talks about some interesting scenarios. So everything from supply chain, disruption to selling prescription drugs directly to consumers at a discount to opening drug stores in the whole food. [00:14:30]Chain it, it talks about drones and health care and surgical robots and 3d printing of medical devices and things like splints and casts, but even things like drugs and how you could use it, use that technology to make pills, for example, shaped like dinosaurs to make it easier to get kids, to take their medicines.

[00:15:12] And as a CIO, I think. We're all, probably a little jaded. We, we love the idea of someone getting in and really disrupting healthcare. But at the same time, Microsoft has been all in and then out of healthcare, seriously at least a couple of times, Google made a big push [00:15:30] with a personal health record and fizzled.

[00:15:49] And it is a really fun article to sort of think about how, how healthcare could change and how it could look different if somebody like Amazon really got it and to [00:16:00] the delivery business right flicking back on that, the space story I think most of the space industry, most of those big companies, general dynamics and the Russians and the French government and everyone else, I think they had to at least have been a little bit surprised at some point, the guy from South Africa came in and really has sort of changed how space may work.

[00:16:35] Bill Russell: [00:16:35] Yeah, that's a, I mean, that's an interesting point. Will, will disruption come from within or will it come from without I I've posted two stories about this and the responses are always interesting to me is it does range from, you know, welcome Amazon to, to the game, to some others that are essentially saying, yeah, we've heard all this before, as you said, you know, Microsoft was all in Google was all in now.

[00:17:21] Right? So Amazon has a way of. Making transactions easy to make them frictionless to make them [00:17:30]you know, something that is, is much more convenient to the, to the user. And we w we all, I mean, as, as health within the industry, that's what we're striving for. But you have to know also that, because if you've gone to any dinner parties, if you have any family conversations over Thanksgiving and you say I'm in healthcare, You invariably get the story where they go, Oh, let me tell you my, I saw a guy, you know, I had the same test three times and then this doctor and I got [00:18:00] passed over here.

[00:18:19] They do not try to. They're not gonna try to reinvent the hospital or not. Let me rephrase it. They're not going to try to run a hospital better. They are literally going to try to reinvent [00:18:30] healthcare. They're about establishing new ways of doing things, new ways of thinking about things. And so them actually buying a hospital and running a hospital.

[00:19:06] And, yeah. Yeah. And it's important to note this article doesn't make any case for. For Amazon being in there. In fact, I'll read this quote because I think it's interesting, but healthcare should not healthcare should not be pure business, medical evidence, empathy, and caregivers dedicated to their jobs make healthcare unique.

[00:19:40] And there's, there's the whole person that we have to really care for. I'll let you close this one up since it was your story.

[00:20:17] And and in some ways Amazon has sort of figured out not sort of figured out, they have really figured out how to do customer engagement and make, as you said about this, you said, make that experience really [00:20:30] frictionless and easy to do and easy to understand and not a problem and not something else and different that I have to do, but something that works with the way I work and live in my daily life.

[00:21:05] And, and. We need to leave the broken glass on the floor after that happens

[00:21:25] So in our second segment, we typically talk about leadership or an emerging technology. [00:21:30] This week. I want to talk about about culture. I you've written a couple of really good pieces. I re posted a piece from my executive coach on the Philadelphia Eagles win in the super bowl. And I'll just give you two quotes from that to try to shorten this up.

[00:22:08] That was not an anomaly. When the coach that he really believed in the team, he believes in the team, even on fourth down, even in the Superbowl. And those kinds of things really make a culture. And then the other quote, he throws out, which we all know, and we've all we've all been quoted many times, which is Peter Drucker's, quote, culture, eats strategy for breakfast every day.

[00:22:51] Drex DeFord: [00:22:51] Yeah. Well, first of all, I have to say, I watched some of the parade yesterday, and I don't know if you saw Brian, Kelsey, the center's speech yesterday during the [00:23:00] celebration, but he calls out virtually every person on the team and how the critics early in the season said. They weren't good enough. They weren't fast enough.

[00:23:36] They were starving for it, not just the team, but on behalf of the city. So it was a really good story. And I think that this idea that culture eats strategy, you know, continues to be really sound. It's not the easiest thing in the world to build or change culture. I'm in the process of writing a LinkedIn article series right now with a friend of mine.

[00:24:14] Ultimately you build trust and that's the kind of culture you want. Not really blind trust, although you may need that sometimes in emergencies, but the kind of trust that makes you vulnerable as a leader and also appreciated and respected. And, you know, I've worked with some [00:24:30] great folks. I came to Seattle children's because it was a, we you know, Wayne as a culture based organization and it had some, some great people here, Tom Hanson at the time was the CEO and Pat Hagan, who was the president.

[00:25:05] Excellence is kind of the motto of the air force is still a personal motto. It's the way I do business. It's kind of the way I live my life. And the last thing I would say about this is I think it's hard to be a different person at work than you are at home. It's simpler. If you kind of tell the truth and work hard and try to make everything that you do better.

[00:25:31] Bill Russell: [00:25:31] Yeah. And that's the role of the CIO within their department is to foster that culture, obviously within the context of a larger culture. And, you know, I'll just highlight a couple of things from this article that that I repost from Bob Perkins, you know, the, the, the, you mentioned this, you know, that the leader has to be consistent, you know, all the time, and it's consistent in their personal life, as well as their, their business life.

[00:26:18] You in fact, would like them to make mistakes. And as we've talked about earlier, in terms of innovation, I like the point he makes, in terms of the least of these, there's a great story of John. Darren boss, who was [00:26:30] traded before the season started traded from the Eagles to the saints. And he had to go through a physical and during the physical, I found he had a heart condition and couldn't play football and Jeffrey Lori, who's the owner for the Eagles.

[00:27:06] This is an organization that cares for everybody within the organization and you know, great cultures have a way of communicating that and reinforcing that over and over again. And you know, as a CIO, it's a lot easier to recruit when you have a great culture. But there's so many other side benefits to to spending the time doing it doing it right.

[00:27:36]Drex DeFord: [00:27:36] for sure that's a whole show by itself, right?

[00:27:47] And I'm going to switch it up on you in the last minute. I'm you know, I was going to highlight the Thurman posts that were out there, but I found an even better one. From Elon Musk, he in the [00:28:00] spacecraft that he shot up there, he has printed circuit boards on the car in deep space and printed on that circuit board.

[00:28:26] And what, what do you want to highlight?

[00:28:51] And by the way, somebody else has said something to me that I thought was funny the other day, after this launch with star man up there, I don't know if. If you needed to hide a [00:29:00] body, that would be a really fun and interesting way, right? Maybe there's actually somebody in that suit. I'm not sure

[00:29:11] Drex DeFord: [00:29:11] My tweet is from Andy Slavitt this week where he announces a new movement called U S of care. And it's, it's being lodged. There's a bunch of people involved. You can look it up@usfcare.org. It's a really interesting kind of approach kind of has three main tenants. Every American should have affordable [00:29:30] healthcare.

[00:29:51] And and I think if anybody can, can get a bunch of different people and they have a lot of different people on their board and their advisory group it's interesting to go [00:30:00] look at the site. So U S care lot or the U S of care.org. And and it's, it's certainly something that everybody in healthcare should at least be aware as it's happening right now.

[00:30:30] It is a it is a it project is it should be a white paper that we all read. It's, it's amazing what he did in a very short period of time to sort of turn that around. And the second thing I would say is we're just watching Andy Slavitt mature in front of us. I know that's kind of it, he went from being very partisan during the healthcare debate to really moving beyond that and saying, okay, what's it going to take for me?

[00:31:16] And this is a great move. So again, if you ever get a chance, ask him about healthcare.gov, I'm sure he's tired of telling the story, but it's, it's it's worth hearing. Drex thanks for being on. Well for now you can follow Drex at on Twitter [00:31:30]Drex DeFord, D R E X, D F R D, and me at the patient's CIO. And don't forget to follow the show on Twitter at this week and hit. And check out our new website at this week in health. It please come back every Friday for more news commentary from industry influencers. That's all.