HIStalk Interviews Colin Konschak, CEO, Divurgent

Colin Konschak, RPh, MBA is CEO and managing partner of Divurgent of Virginia Beach, VA.

Tell me about yourself and the company.

I’m from south Jersey originally and I’m living in Virginia Beach currently. I went to school in Philly. I should have been an Eagles fan, but I ended up a Redskins fan, so I have some slight regret this year. My career started out as a pharmacist in retail, hospital, home health, and hospice. I moved on to some positions in pharma and biotech. My final pivot is where I am now in healthcare consulting, where we saw lots of things being done really well and lots of things that could be done better. That was the impetus for founding Divurgent.

Divurgent has been a pretty good story. We are in our 10th year and have had 10 straight years of revenue growth and profitability. I’m confident that if we talk next year, I can say that that number will be 11. I’m proud of the company. I think we’ve won “Best Places to Work” in Modern Healthcare five times and three times consecutively. Certainly performance aside, we appreciate culture.

What are the top three issues that health system CIOs are dealing with?

The top three are similar to what we’ve seen in the past — implementation and training, optimization, and activation. There seems to be a huge rush in ERP right now, so we’re building out capability in that area. Of course, security, and a lot of times, return-to-basics information technology infrastructure. Physician optimization, with a lot of requests around, “We have this system in place but physicians still aren’t as happy as we’d like them to be — can you come in and help us make that happen?”

You surprised me with ERP. What kind of activities are happening around that?

Now that folks have a lot of their EHR positions in place, they’re revisiting the other side of the house from a materials perspective and otherwise. The investment, it seems, is in the beginning stages of a move in that direction.

Are you seeing much activity with customer relationship management?

We are seeing a lot with customer relationship management, both from a “customer as the patient” perspective and a “customer as the physician or provider” perspective.

What gets CIOs fired most often?

Certainly it’s not like years past where you picked the wrong vendor. We’re past that. It’s around implementations. They get a little bit out of control still, even after as long as we’ve been doing this. They go over budget and people at the end of the day are surprised. Boards don’t like to be surprised. That’s the number one reason.

Do you believe that it’s not as much what a health system buys rather than what they do with it?

We believe that’s true. The systems are great now. The ones that are still left standing are great systems. Of course as consultants, we do our best to help however we can. Client culture is different. Everybody has different access to resources in different cultures that result in very different implementations. I couldn’t agree more. I don’t think it’s so much the technology now as about just getting it right.

Do health systems have the time and interest to pursue technology innovation?

We’re getting there. Those at the leading edge are thinking more about it. They’ve been implemented for many, many years and have moved past the optimization stage. It’s interesting to talk to our clients and especially interesting when they engage us to explore those innovation opportunities that they have. It’s a bell curve and not everybody is there.

Consolidation seems to be leading us to super-regional or national health systems. Will that change the picture of how healthcare technology is used?

I think it will and I couldn’t agree with you more. The merger and acquisition wave to super systems and super-regional systems is simply the future. There’s no way to avoid it. That’s going to provide a ton of business from a vendor perspective, which is great, but it’s going to give those health systems the scope that they need to do what they do. I hope with that scope comes tremendous amounts of data, tremendous amounts of resources, and hopefully at some point we don’t just implement technology, but we take that data and do really cool things with it. I don’t think we’re there yet.

Are you seeing more relationships between health systems and life sciences and an increasing interest in sharing data?

I do. Those that are there are at the forefront. It was interesting to see, as you reported, the Cerner-Surescripts opportunity. That’s something that I hadn’t really thought of, but what a great opportunity. Once we’re implemented a really good electronic health record, what a tremendous opportunity for the life sciences. I haven’t seen any good examples of it from a client perspective of Divurgent. Certainly I’ve read some of the things that you’ve read. There’s tremendous opportunity there, but we’re just at the implementation stage. I can’t wait to start pulling that data out and doing some of those very, very innovative and cool things with it.

People argue passionately both ways whether patients are true consumers as they are in all other industries. What do you think?

I couldn’t believe that premise any more than what you just said. I certainly believe there is, to a certain extent, an age gap. The younger you are, the more of a consumer you are in everything that you buy. That’s going to turn into healthcare. The move to consumerism, and the more that younger generation demands more from their healthcare providers, will will be one of the major things that push the industry further.

Have you seen anything promising on the technology horizon that would make insurers a more welcome participant in the provider-patient relationship?

We have. We’ve seen enough that we’ve launched, towards the end of last year, a payer division. We’ve seen so much interest, particularly from the payer side, in trying to align better with the provider side. At 10 years old, we have a good understanding and good subject matter experts on the provider side. We know what the payers are looking for.

I think it’s still about cost for them. Certainly I would hope that it’s about client satisfaction and pulling whatever data that they don’t have, which probably frankly isn’t a lot. I hope the goals are more than reducing costs and improving claims processing and those types of things. I think we can get way more out of it than that.

What kind of cybersecurity problems have you seen?

From our perspective, someone has done an audit previously of the client and they look to Divurgent to come in from a remediation and project plan perspective. That’s probably the number one source of security work for us. Then there are those clients that haven’t done that, realize they probably have weaknesses, and they want us to do the assessment. Those are the two biggest opportunities right now.

User management and patch management seem to be the items that get providers in trouble most often. Is there renewed interest in revisiting those practices?

It’s renewed interest in all of the above. The threat from within is still a major threat. The bad guys are getting sophisticated. It’s to the point where sometimes you have to double-check looking at an email — it just looks so good, so tempting to do what it’s asking you to do. The threat within is huge and I’ve seen renewed interest in trying to educate users.

What healthcare IT opportunities will be most significant over the next few years?

I think it’s still going to be driven by mergers and acquisitions. Some of the common theories around the constriction around implementations, optimization, all the work on the blocking and tackling that still needs to be done is missed on super systems and super-regional systems. That amount of merger and acquisition activity is going to generate a ton of business that is underestimated.

I don’t think it’s going to happen in the next three years or five years. It will will take a little bit longer. It’s going to be a lot more of the same. Unfortunately, one of the things you’ll see is that a Cerner-using system buys an Epic-using system or vice versa. Dollars that were spent are going to be reversed to get on that same platform.

What will be the biggest theme at HIMSS18?

Data analytics, artificial intelligence, cybersecurity. I think it’s still going around all of the data implications of what we can do with this. I predict this year maybe it’s around artificial intelligence. The HIMSS buzzwords and the HIMSS trends are usually a little bit ahead of the game.

Do you have any final thoughts?

First, kudos to you and your team. Your readers certainly realize that it’s not easy to do what you do, but what a valuable resource you’ve become.

As far as we’ve come, we feel in many ways that we’re at the starting line. We have highly capable systems implemented in most cases, but we’re taking very little advantage of them in the grand scheme of their abilities. We’re passionate, as are other firms, about taking advantage of those large investments and leveraging them into what they can inevitably do, whether it’s reduction in costs, improvements in patient care, and hopefully leapfrogging innovation with data, science, and technology. This is going to take many years. We’re in this for the long haul.