HIStalk Interviews Brent Lang, CEO, Vocera
Brent Lang is president and CEO of Vocera of San Jose, CA.
Tell me about yourself and the company.
Vocera Communications makes clinical workflow solutions that simplify and improve the lives of healthcare professionals and patients. We’re focused on enabling hospitals to enhance both quality of care and operational efficiency. That has direct impact on patient satisfaction and caregiver resiliency as well.
The company has about 600 employees. We did roughly $160 million in revenue last year. I’ve been the president and CEO of Vocera since 2013 and I’ve worked with the company since 2001. I spent the first six years as the VP of marketing and then spent another six years as the president and chief operating officer before taking over as the CEO.
In terms of my personal background, I have an MBA from Stanford. I have an engineering degree from the University of Michigan. In 1988, I had the privilege of being part of the US Olympic Swimming Team and won a gold medal in the 4×100 freestyle relay in South Korea, which ironically is the location of this year’s Winter Olympics. Thirty years later, it’s returning back to Seoul, South Korea, and I’m really excited and interested to see that.
Vocera has been around since 2001, the company is publicly traded, and competitors have come and gone in those years. How would you characterize the market and Vocera’s position in it?
It is an interesting market. It has definitely evolved over time — our offering into the market, how we’ve broadened our solution, and the way the market perceives us. We were the creators of the category, and for a long time, had to educate the market about the value proposition.
What we’re seeing today is a recognition that clinical communications is a high priority. More and more customers are reaching out to us proactively to help them optimize their data and mobilize their data in the post-Meaningful Use era, where most hospitals have their electronic health record deployed. They’re looking for ways to empower the mobile workers inside their buildings. Getting the right information to the right worker is a real challenge for them.
We’ve evolved from being more of a pure communications company to being more of a clinical workflow company. Much more software-centric. The clinical relevance of our solution has definitely risen up. As a result of that, the competitive landscape has evolved over the years. Initially, we were replacing pagers and in-building wireless phones. We were replacing a lot of inefficient processes, where people were running the hallway looking for the right person.
Today, we’re much more focused around the idea of clinical workflow and how we can empower care providers to be more efficient. Also, how we can reduce the level of burnout or burden on those care providers by giving them the tools that allow them to do their job on a daily basis.
Have we figured out alarm and event notification?
It’s definitely still a work in process. Connectivity from all these clinical systems to mobile workers was a Phase I solution that created as many problems as it solved. All the research would indicate that the vast majority of those interruptions and alarms that caregivers are receiving don’t require immediate action.
A real focus for us is using intelligence, analytics, and rules engines to try to filter out only the most appropriate alarms, alerts, or messages. Then, delivering those only to the most appropriate person. This idea of the interruption fatigue or alarm fatigue that results from being bombarded by all these clinical alarms is a real concern. It has resulted in a high degree of burnout among clinicians.
For us, the key is pulling situational awareness from the environment. What’s going on with the patient? What’s going on with the care team and their care plan? What’s going on with the other data points that might be accessible from other systems in the hospital? Then, using that to filter out only the most relevant and most urgent messages to be delivered to a particular care provider.
Is it a market differentiator to offer an enterprise strategy instead of point solutions, multiple devices, or a lot of connectivity points?
Our approach has always been to try to listen to the pain points of our customers. You may not know this, but when Vocera was originally founded, we were not a healthcare company. We were a solution that could be used across a variety of vertical markets. It was a function of listening to specific pain points within our customer base that made us more and more focused on the healthcare space.
As we’ve evolved the product over time, it’s always been driven by, how do we not think of it as a particular technology or a particular point solution, but how do we think of it in terms of solving particular clinical problems or customer problems? Even our sales approach is one of a consultative inquiry, where we actually send out clinicians. These are people who have worked as nurses before they came to work at Vocera. They do a clinical assessment, where they interview people at a customer site to understand what problems are top-of-mind for them. Then we try to apply the solutions to that.
We’ve always had this solution mindset. I think the market is evolving in that direction. If you look at some of the more recent analyst reports, they’ve moved away from looking at it in terms of vendors that might only provide text messaging or might only provide integration. The landscape today is around who can deliver a unified platform that enables true collaboration and clinical communication across these different care providers.
I view that as validation of the strategy that we’ve been pursuing for the last several years. I think that the rest of the marketplace is recognizing that and realizing that they need to move more in that direction.
It must have been both a blessing and a curse to have been identified so strongly with the Star Trek Communicator thing early on, and people might still associate Vocera with that communications badge. How do your other services — such as patient experience tools, pre-arrival preparation, follow-up care, and PCP notification of patient hospitalization — fit in your business?
You’re absolutely right. The Star Trek connection, the uniqueness of the badge, and the iconic nature of the Vocera badge has been both a blessing and a curse over the years. It’s driven a tremendous amount of brand awareness for the company and a tremendous amount of differentiation and uniqueness in terms of our offering. But it does tend to limit people’s perspectives on the value proposition that we’re delivering to marketplace. We have had to invest time and energy over the last several years to educate the marketplace that there’s much, much more to the Vocera platform than just the badge or just voice communication.
Our goal is to deliver across the care continuum in interacting with patients and care providers. The products that you mentioned — pre-arrival, post-discharge communication, the rounding solution — these are all software solutions that we feel like fit into our vision around enabling the real-time health system. We have to do a better job of informing the marketplace that we have that breadth of solution.
For us, it’s all about how we can simplify the lives of these care providers and improve patient satisfaction, There’s a variety of ways we can do that, whether it’s clinical communication, secure text messaging, alarms and notifications, patient experience monitoring, or analytics. These are all areas that become part of a unified platform. By tying them together, we’re able to do some exciting things that you wouldn’t be able to do if they were simply just point product solutions.
Are caregivers changing their work communications expectations because of the apps they use at home?
It’s certainly raising the expectation, both in terms of their experience on consumer devices as well as their interaction with voice interactions. Things like the Amazon Echo, Siri, and Google Home. When we were first introducing our products 15 years ago, the idea of using speech recognition as a user interface was fairly new and took some getting used to. Today, consumers are very comfortable using speech as a user interface. That has generated a whole new level of interest in our products, because people are more comfortable with that in the rest of their daily lives. Mobile technology is another area that has become more prevalent for all of them.
Having said that, we still believe that there are some unique requirements for the healthcare environment. In general, it’s very difficult to bring a true consumer device or consumer experience into the healthcare environment. You’ve got issues associated with security and privacy of patient information. You’ve got cleaning and sterilization issues. You’ve got security on the wireless network standards. You’ve got breakage. Hostile environments are really tough on electronic devices, and most consumer-grade phones have a hard time surviving in the hostile environment.
Our purpose-built solution has created a large degree of differentiation for us because we’ve solved the problems of how you get a wireless device to roam inside a hospital. How you create the ability to block out background noise so that you can have a clear communication in a very noisy environment. How you can share a device across multiple users while having it be fully encrypted and logged into the highly secure wireless network environment that an enterprise customer has. Those are all examples where the expectations of their daily lives as a consumer influence their technology choices, but to bring it into the enterprise environment, you have to up the game one step further.
Another example has to do with text messaging itself. Several years ago, there was a feeling that text messaging by itself was going to be a communication solution for hospitals. Today, the market has spoken and made it very clear that while it’s an interesting feature, it is not a complete solution for mission-critical, real-time environments like hospitals delivering acute care. Secure text messaging combined with real-time voice communication, alerting and alarming, and clinical integration are all required to put together a complete solution.
The consumer offering tends to be the baseline. To be successful in the enterprise, you have to build upon that and solve for not only the environmental issues, but also the specific workflow challenges associated with a hospital.
I didn’t realize until recently how widely deployed Vocera is within the VA and DoD. Does their Cerner implementation present any new challenges or opportunities?
It really doesn’t affect our business directly. We love our federal customers, both in the VA and in the DoD with the military hospitals. They’re great customers for us. They have a tremendous level of loyalty. They’re great users of the product. They drive standardization across their facilities, something that the healthcare industry overall has not necessarily done a great job of and is moving more in that direction. People are recognizing that to drive greater efficiency and better quality outcomes, standardization is a key. The DoD and the VA are leading that effort and have done a great job of standardizing the product.
We integrate with Cerner. We have a lot of great Cerner customers that are able to send alerts and alarms from the Cerner EHR out to the Vocera clients. The DoD and the VA were very clear that it is important for Cerner and Vocera to work effectively together in that environment. To some extent, it’s another source of great data that can be delivered out to the mobile workers. In fact, the Cerner employees doing the deployment in that environment are going to be wearing Vocera badges during the deployment and rollout of the Cerner EHR.
What business lessons did you take away from your experience competing in the Olympics?
Swimming was a big part of my life growing up. Certainly the Olympics was a key accomplishment along that path. But one of the key lessons you learn as a competitive athlete that translates directly to the business world is that life is not a sprint. It’s a marathon.
I was a sprinter. I swam on the 400 freestyle relay. I swam the 50 and 100 freestyle. These are races that last less than a minute, but you train for them for 15 years. Even though the glory happens and the media focuses on the 20 seconds or the 50 seconds that you’re in the water, it’s the preparation that goes into that ahead of time.
The business world is very similar to that. People focus on an event. They focus on the IPO, the sale of the business, or a big customer win. But success in sports and success in business is about putting in the effort every day. Having the discipline. Having a clear vision of where you’re trying to go with your life or your company and focusing every day on making progress towards that and not letting the day-to-day highs and lows impact your progress towards that end goal.
Do you have any final thoughts?
I’m really excited about the market transition that we’re going through. I think in the post-Meaningful Use era, there is an opportunity to transition care delivery across the care continuum and to use technology to not only improve patient satisfaction and patient safety, but also improve the caregiver resiliency. We have a major problem with burnout among nurses and physicians. Technology has been a source of that problem, historically.
Vocera is committed to using technology to restore the human connection to healthcare and to enabling care providers to go back to doing what they went to nursing school for in the first place, which is to care for patients. Our employees and our customers are passionate about that. It drives us every day.
I think you're referring to this: https://www.wired.com/2015/03/how-technology-led-a-hospital-to-give-a-patient-38-times-his-dosage/ It's a fascinating example of the swiss cheese effect, and should be required…