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 Welcome to this Week in Health, it influence where we discuss the influence of technology on health with the people who are making it happen. My name is Bill Russell, recovering healthcare, CIO, and creator of this week in Health. it a set of podcasts and videos dedicated to developing the next generation of health IT leaders.

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If you're interested in either of those services, check 'em out on the website. Today we're starting another of our interviews from the Health Analytics Summit in Salt Lake City, put on by Health Catalyst if you're trying to apply data as a transformative part of your healthcare strategy. This is a fantastic event.

I always appreciate being able to sit down with Dale Sanders, the Chief Technology Officer for Health Catalyst. Dale is, um, one of the leaders in the industry, not only in terms of technology and platforms and analytics, but also in really promoting, uh, empathy towards the clinicians who we are, uh, in some cases thrusting this technology on.

And I got the opportunity to sit down with him and get a few of his thoughts around that topic. Hope you enjoy. All right. Another session from HAS 19, the the Health Catalyst Conference. I'm here with, uh, Dale Sanders. Dale, what's your title? Official title is Chief Technology Officer. That's what I thought, but I've heard a lot of different titles.

Mm. Applied to you, so I don't Interesting. Um, what are the other title? But, but you're, you're the head, you're the head geek for Nerd for, uh, for Health, catalyst I, something like that. Something like that. . Um, uh, so somebody said this was the largest . Uh, conference dedicated to analytics? Is that, uh, I, you know, I, we think it is Bill, but honestly don't know that for sure.

Well, this is, this is my first one. I'm, I've been really, uh, I've been impressed by a handful of things. The, uh, um, . The, uh, the amount of sharing that's going on across your clients is, is really kind of amazing. I, I sat with, um, two of your clients, one that was very new and one that, uh, in fact, one that was sitting there going, we're gonna win the Flywheel award in three years.

That's awesome. And, uh, another one that, uh, was getting an award and, uh, and they were just sharing their stories, plus you had the talk a little bit about the analytics, uh, walkabout and, you know, what's the thought behind that and, and people sharing, uh, their story. Yeah. Uh, now let me back up to give some context.

You know, the, when we envisioned this conference. Several years ago. Um, kinda everything that we try to do is by the Golden Rule and as ACIO operationally, I didn't like going to events that were all about sales disguised as conferences, but really about selling vendors products. So we said this is gonna be, um, a conference for inspiration and education of the industry.

Not about selling Health Catalyst, of course, we wanna put on a good show and reflect well on the company, but it's not gonna be about selling Health Catalyst products, it's gonna be about the industry. And um, so in that context, the analytics walk about is our clients, but it's also anybody. Um, we don't care where the good news comes from.

And the role model and the inspiration. Um, if Health Catalyst is involved, that's great. If it's not, it's great too. So that's what it's all about. Just showcasing the use of data. To improve decision making, no matter where it comes from in the industry. I, I will say that you've done a good job of that, and as proof of that, I'm still not sure of all the products that you guys have.

Yeah. And I've been at the conference for a couple days now, including the user group meeting. Yeah. Um, and you know, just yesterday I talked to, uh, Rob dhe and he Oh, yeah. Uh, you know, gave me an education on chorus Yeah. And what's possible through it. Yeah. And I, I feel like every conversation I have, I, uh, talk to, uh, Alia.

About the life sciences Yeah. And what you guys are doing there. Yeah. And uh, yeah, we pushed all products. Were kind of pushed off in the corner. You can go see all the product stations and things like that, but they're definitely pushed to the back of the conference. So let's, let's start with, uh, your presentation.

I. Hmm. Um, you know, your, your presentation started with a pretty provocative, uh, uh, slide and it, you know, picture of, we're on a cliff and you had a, um, you, you had part of a quote on there that said, are we taking care of patients? Are we taking care of the emr? Yeah. Um, give us a little background. I mean, you've been, uh, in social media talking about empathy and those kind of things like that.

Um, yeah, and that was, that quote was from, uh, . Uh, an editorial in The Lancet from a physician at NYU and she was opining in that article that, uh, you know, EHRs are contributing to a lot of burnout and they, you know, docs are just spending too much time interacting with the EMR and not enough time with patients.

And we all know that, right? It's a problem. And, um, so the good news is with the deployment of EMRs, we have more data to analyze which . Helps Health Catalyst. You know, we're an analytics company, but if we're not careful as analytics professionals, we can propagate that burnout. You know, I feel a great deal of empathy and even sadness for physicians right now.

I. Because, uh, the interactions that they have with the EMRs burning 'em out, the social pressures they have to perform, um, and interact with very difficult cases now, um, very limited time with patients. Now, if we add on top of that analytics, that's measuring their performance quite oftentimes to clinically invalid, uh, measures.

Yeah, then it's gonna add to the burnout. Now, I don't want to be an analytics company that contributes to the burnout of physicians. I want to be part of an analytics company that relieves their burden and gives them more fulfilling life. And I absolutely firmly believe that we're standing at the edge of a cliff in the industry.

Um, we cannot become the data-driven industry that we're pursuing right now on the path that we're pursuing without high risk of further burning out our positions. And. As a company, we don't want anything to do with that. So the way we engage with our clients strategically with our analytics strategy has to be about minimizing the impact of these burdensome quality measures that are questionable in terms of their validity.

Make that as easy as possible, as less pressure as possible on the clinicians, and then give ourselves time to give the clinicians the data they need when they need it to make them more fulfilled. . So you're, you're taking that message out to the community. Um, 'cause we could do the same thing with analytics that we did with ER.

Absolute. We just keep, absolutely. Keep absolutely. Pushing it out there and, and increasing the burden. Yep. , I thought, I mean, that was a powerful message. I thought One of the more powerful, uh, pictures that you gave was you had a picture of your family and it was fuzzy. Mm-Hmm. . And you had a picture of your family and it was clear.

And you talked about the fact that, you know, patients expect us to be leveraging their data to their benefit. Yeah. Um, talk a little bit, a little bit about that whole patient view and getting more clear of, of what, what, what, what are we trying to get to? Well, you know, obviously we have to protect patient privacy and security and all that.

That's a no brainer, right? But the, but patients already think that we are leveraging their data to their benefit, both quality and cost. They, so a lot of times, um, they're surprised. Patients are quite surprised when they realize how little we actually leverage their data to their benefit. . And, uh, so, you know, at the, at the industry level, I think we're letting things like the IRB and HIPAA and things like that well intended to protect patients poorly applied to their benefit.

And they're being over applied, I think, in inappropriate ways. And, um, we just have to be more proactive about sharing data for the benefit of patients and, and, uh. Realize that they already think that we're doing it, but we're not for the most part. Yeah. The, uh, the last two keynotes were, were interesting, or two people who, who spoke, um, you know, one was from pharma and talked about, uh, pharma is, is really going directly to the patient for the data now.

Yeah. Which is, uh, an interesting turn. Um, and then the, the second was, um, gosh, I wanna say it's Justin. . Yeah. Mm-Hmm. , Justin shared a high school. Yeah. Young man. Young man doing just amazing stuff around data science and Yeah. And he just shared his journey of, you know, I, I thought this would be interesting.

So I, I learned these things and then I had to learn these things and, and he just, uh. Went through, but he talked about data altruism. He said, you know, for, for my generation, yeah. I want you to do more with my data. Yeah. So that interesting. Yeah. So that we could, you know, that we will be healthy. Yeah. And part of that is I think he was looking out to the audience and saying, you know, let's, let's get the data in a, in a place where it can do good.

Yeah. Well I've, you know, I've always said, um, sharing your data, be willing to share your data in an altruistic way. Is, is the digital equivalent of, of, uh, donating blood? You know, I, I think we all have to be more comfortable, of course, protect privacy and all that kind of thing. We can de-identify data.

Yeah. We can de-identify data. We can protect people's privacy, but share that for the benefit of science and share that for the benefit of the community and the population. We did a, I had the good fortune of sharing, um, uh, a project up in Alberta. Um, to create a provincial wide health related repository from a population health perspective.

So taking a very broad view of what population health is, but also using that same data content for precision medicine. Um, you know, it's just, it's the same data just tipped 180 degrees on its head. Right. Um. So as a part of that project, we put together seven different subcommittees and one of those subcommittees was the patient and Public Awareness Committee, and they actually co-chaired that that project with me.

Uh, we felt that was very important to have the non-healthcare community participating in the vision behind that repository. So a lot of what I did was educate the public about their data, the, the kind of data that we wanted for population health, the strategic acquisition of data for their benefit, and they were absolutely completely surprised that we didn't have all of this in place already in Alberta.

Um, so again, I, I just think that . Um, there's a lot of interesting dynamics around data right now. The healthcare systems still think that they own the data, they own the collection of the data for sure. But the data content belongs to us, to us as patients. And, um, so, uh, it's very interesting to see healthcare systems treating this data as their intellectual property, um, as opposed to thinking of it as.

Patience, intellectual property and what can we do as a healthcare system to return the value of that IP back to patients? And, you know, we certainly have to run a business. All of us have to run a business and make money off of it and make it sustainable. But it's not our data. It's, it's our data as patients, but it's not our data as an industry.

So, um, you know, there was nothing sustainable about what we were doing technically. Um, and we just said, Hey, if we're gonna be a real business, we've gotta re-platform this thing for scalability, and meet the investors' expectations and meet clients' expectations and, and position technology first. With professional services then as the wrapper of value around that.

So it was a shift, not just technically, but it was a shift in the way we engage with clients as well. I think that was one of the surprising things to me this week as I was having conversations is that, uh, a significant amount of your revenue is still services. Yeah, about half. We're about 50 50 right now.

50 50, yeah. So you, uh, and those services are primarily going in and helping systems to make the . Either make a transition or to improve or, or those kind of things, I would assume. Yeah. Yeah. Wow. Yeah, it's, uh, and you know, we're learning there too, that we need to broaden the way we engage with clients around data and the analytics, the, the platform.

And I say this with paranoid confidence that, uh, it's a great, it's an amazing platform now, I mean, I'm really comfortable as ACIO. Former CIO selling this back to my friends and colleagues in the business. I feel really comfortable that it's something we can be proud of and, uh, we need to adjust the way we engage with our clients around the platform.

'cause it's a lot more capable than what we typically, um, engage our clients around strategically. So we're gonna be making some adjustments to the way we strategize and engage our professional services around the tech going forward. So, um, . Two things. One, you know, we just came out of the UGM conference.

Yeah. So, yeah. Everyone's excited about, you know, the different things that you can do and, and they have made huge strides Yeah. Uh, in their, uh, analytics. Um, what distinguishes you guys as, uh, as a data platform over say, uh, say an epic or a Cerner strategy? Yeah, well, um, I think the big thing is we, you know, those of us involved in Health Catalyst have been in the middle of analytics for 25 years, so there's a level of expertise technically in just the knowledge of data.

The way to engage clients with data, behavioral change, process improvement with the, with data that I think EMR vendors just don't have, right? They, they didn't grow up in that space. They grew up on the front end of data, not on the back end of data. And it's a very different skill set technically as well as culturally.

So that's, I think, a big difference for us, you know, getting down to a, a very granular level. You know, we, um, we've essentially commoditized the ingestion of data no matter what kind, and not just the ingestion of data, but making sense of the data afterwards so we can pull in 350 different data sources off of our, in our existing library.

and we can have a very capable enterprise analytics platform up and running right away in a matter of weeks. Now, where something like that, earlier in my career was an 18 month affair. We can have that up in 18, 18 days now, 18 months. Millions of dollars. Absolutely. Right. You've been there. So that's a big deal.

And the the other thing too is that I, that we don't, um, advertise as well as . We've combined analytics and application development in the same platform. Now, you know, in the old days you had analytics over here in this infrastructure application development, in this infrastructure, and then interoperability over here in this infrastructure, right?

All should be using the same data, but they don't. So it's expensive to maintain those three architectures. Plus it creates all sorts of inconsistencies and problems with data. So as ACIO, I just said that's a complete violation of common sense. We can put all of that data in the same platform now technically, and we can build workflow applications on top of it.

At the same time, we're running analytics, so that's another thing that we, I would like to see our clients take greater advantage of, that we have workflow applications that sit on top of, uh, the data operating system. At the same time, it's running analytics now, like our care management system, our cost accounting system, our patient safety system.

those are all very real time workflow based. Um, data first applications. They're not, they're not a traditional, you know, bi analytic report. So that's a big deal. I mean, you can do app development and analytics now on the same platform. And then can I do consumer facing app development? Yeah, absolutely.

Positivity. Our, our care management roadmap includes a . consumer facing app development environment. Do you have, do you have your own set of APIs? That we have a whole set of APIs and we're gonna keep building those APIs out for our clients and for, uh, in fact, we wanna encourage, um, you know, creative software engineers and developers to take advantage of this infrastructure because we've got all the data now.

We've got the platform in place, and there's no need in the industry to keep recreating all these platforms of data. , uh, what we wanna leverage is all the smart ideas and, and the software engineers and data scientists to take advantage of this infrastructure now. Yeah. I thought, uh, actually we're coming up close to end of our time.

I, I, I, I, I really appreciate your time. The, uh, . , the exchange I think I appreciate the most, and I I mentioned it with Dan, was when you were in the front and you mentioned, oh, well we, we did this platform stuff and we have some critics, and you, you gave a platform to to the physician in the back of the room and

I, I think that speaks volumes to the culture of the company and just your ability to, to take feedback, to take criticism. The fact that you replatform the fact that you're . You know, you're looking at late stage binding, you're recognizing the, the, uh, limitations of it, and you're changing. I think all those things speak, uh, volumes to, uh, what health Callous is doing as a, as a platform for analytics for healthcare.

So, well, thanks, Phil. We we're trying to live the golden rule, right? And just be honest and truthful about, you know, my old saying is, find the truth, tell the truth. Face the truth. And it's not easy to face it. I mean, you're talking to some CIOs on the show now. It's not easy to face the truth sometimes.

You get beat up a lot. I, I'm gonna be 60 years old in a few weeks that it's easier for me to face the truth every day now . So it's a good place to be. Good place to be. Well thanks. Thanks for your time. I really appreciate it. Okay, thanks Bill. Appreciate it. Thanks for listening. We have several other great interviews from HAS 19.

Uh, please check them out on the website, iTunes or YouTube, and, uh, please come back every Friday for more great interviews with influencers. And don't forget, every Tuesday we take a look at the news that is impacting health. It This show is a production of this week in Health It. For more great content, you can check out our website at this week, health.com, or the YouTube channel this week, health.com.

Just go to the top, click on the YouTube link and it'll take you there. Thanks for listening. That's all for now.