Bob Bailey is principal and founder of Healthcare IT Leaders of Alpharetta, GA.
Tell me about yourself and the company.
I’ve worked for 25 years in enterprise IT professional services firms that I have owned and operated. Our company is focused on enterprise applications, deployments, clinical information systems, business information systems, and a practice we’ve launched for COVID called Healthy Returns.
How has your business changed during the pandemic?
Our business changed dramatically as work-from-home became a strategy that we all had to get our arms around. Specific to our industry, a lot of our projects went offline by definition. We had to rethink who we are and what we do. Healthy Returns was a nice practice that we were able to establish in finding a way to be helpful to the communities we’ve served for the past 10 years. That has been a lot of fun and it has become a great success, so we are happy with that.
But it was clearly a time where we all had to sit back, reflect, and think about the business we have today and what might it look like tomorrow, then pivot in a number of directions to get it back on track. As the revenue came offline in the systems, a lot of these projects just started to disappear. It was a challenging time.
What changes are you seeing in the kinds of people who want to do consulting work?
I would say that we’re a work-from-home winner, our industry being professional services and software support. It has opened up wonderful opportunities for consultants, by and large, because they have so much more flexibility in their personal and work life. To us, it has been a tremendous uplift to employee morale internally and also externally for those that are working on behalf of our clients.
What services are health systems most commonly seeking?
We are a heavy Epic firm, as a good two-thirds of our revenue comes from the word Epic. There continues to be a dominant stance for that company, and therefore, a lot of work that we do on behalf of Epic-related clients and also due to continuing consolidation within the industry. We have also seen a tremendous uptick over the last two years in the business systems applications such as Workday, ServiceNow, Oracle, and Infor. Our business was built to support both the clinical systems and the business systems that an enterprise would have to implement and support. We are in the mid-innings, in a baseball analogy, of the overall business systems refresh that is going on in the health system.
Your mentioning Epic made me think of the consulting services arm it was launching a few years ago. To what extent do big software vendors support third-party consulting?
Epic and Epic Boost do a very good job inside of their customers, who then become our customers. Oftentimes we’re working side by side. We don’t see that as a threat to our business, but rather as complementary. If you look at Cerner, they traditionally have had a professional services organization on the ground implementing their software and we work very closely with them as well.
The key to working well with those two large vendors is understanding how they like to support their customers, what they want to do in addition to the software license sale itself, and then how we can cohabitate with them. We have found working with both firms to be a pleasure over the last 10 years. It’s a different set of challenges between those two organizations when you’re working with them, but once you understand what they’re looking to do and then how you can work with them, it becomes harmonious. Success for the client is what we’re both interested in. It has been good for us as a business.
What is the future of conferences such as HIMSS and Epic UGM?
In the healthcare enterprise, we talk about digitization. I think digitization of the conference world is a healthy thing, because we can get together more frequently and with less cost. It’s good for the customers. It’s good for the end clients of the software firms. It’s good for the vendors, in our case, the services firms. That’s healthy.
On the other hand, we are humans and we need to see each other and be around each other. The conference of old, let’s say HIMSS using that as the example, will never be as large as it once was. That’s actually a good thing. But we need to have a little bit of both.
How is the CIO role changing?
We were talking with a client recently who brought in a chief technology officer, who works for the CIO, from the retail industry. We have a number of those scenarios across the system now, where it used to be the CIO and his or her staff was always from the healthcare space, because it’s a unique space today. The good news is that we are starting to see that turnover and we’re starting to see a lot of the outside influences. When we talk about consumerism and healthcare, that’s an interesting thing to say. but does the CIO over the last 20 years really understand what to do about that? These outside influences that are coming in at leadership levels is helpful to that.
But clearly the CIO’s role was changing dramatically. The CIO has to think not only about traditional security, which is an incredibly complex topic, but now they have to think about the same thing for their at-home workforce. It’s a huge challenge. How do we secure Tim’s office, Bob’s office, and the devices they are working on? In addition to digitization, it’s the security piece, both inside the four walls and also now with the work-from-home piece of it.
A lot of the CIOs historically are clinically oriented, as they should be. They are driven to satisfy the chief medical officer and the clinicians with the applications that we bring to life. In today’s world, there’s this massive shift going on to large business systems implementations. They require a totally different set of personnel and leadership techniques. That’s the HR line of business or the finance line of business versus the clinical line of business that they are accustomed to supporting. That CIO seat is a challenging one these days.
How do you balance the value of bringing in outside experts in technology or consumerism who suddenly find themselves trying to understand the complexity of healthcare?
I’ll use as an example B.J. Moore, a friend at Providence who I’ve known going back to his Microsoft days, when he ran their finance division and we were helping them at the time with call center software called Siebel about 20 years ago. Since he came to Providence, you see them moving light years ahead of so many other organizations that are in healthcare. They are acting like a large enterprise, a large corporation, as relates to technology. Providence has been a long-time client of ours as well and they have tremendous healthcare domain expertise inside their IT organization. What they were missing was somebody with a vision to say, what do we do in this new world? How do we turn on the consumer? How do we interact with the patient? How do we treat the clinicians in a different way, to engage them and pull them into these systems that are so important for a place that large? How do we look at our EMR and how do we think about running that EMR as a mature client to reduce the cost of ownership? How does cloud impact our budgets and how can it help us scale our business and secure the business in ways that we’ve never thought about? Those influences are terrific and he has done a wonderful job.
My personal background is that I come from corporate business services for many years and started in healthcare when I created Healthcare IT Leaders 10 years ago. We are happily at our 10-year anniversary right now, so I have a perspective that is a little different than others that have been in the industry for 20 or 30 years. I think it’s wonderful. You need more of that kind of thinking, particularly now as we’re trying to get out to the consumer and make your life and my life that much easier before, during, and after our encounter with said health facility.
Providence has gone deep into providing commercial services as an IT vendor under the Tegria umbrella, while Ascension has decided that IT is not its core business and is outsourcing almost all of it. How are health systems defining IT as core competency?
Whatever industry you’re in, you’re going to have people that think about that question differently. You look at back to what Mercy was doing years ago and today, and look at what Providence is doing today. And then to your point, Ascension, with much different philosophies on core competencies. Providence and Rod Hochman and his team there are very much leaders and visionaries in how they are thinking about healthcare and healthcare IT services. They are looking at it as ways to increase revenue, being as important as it is when you’re an organization that large. Ascension is obviously an incredibly large place as well with a totally different viewpoint on this.
I’m not 100% sure what the right or wrong answer is, but I think you will see both of those models persist depending on the leadership in an organization. I like what Providence is doing. On one hand, it is competitive to what we do, but on the other hand, it’s collaborative. We work together to support Providence in partnership with Tegria. In my view, that’s all good.
Going back to Ascension, no question, that’s a great strategy. We know a lot of the people there and the leadership and they’re doing wonderful things on behalf of all their clinicians and the patients that they serve. That model is working very well for them as well.
What near-term changes do you expect that will affect healthcare and your business?
Our business was created to satisfy the most important element in the IT organization, which is the clinical information system. But then after Meaningful Use came and went, we turned the chapter on clinical systems in 2017. We will always be there to do the good work we do, but we put a lot of focus and investment in business systems because we knew there would be this natural refresh cycle. When I look out three to five years, from our company perspective, we want to be an organization that is understood by the CIOs to be able to handle the clinical systems and the business systems.
More and more, this Healthy Returns practice becomes important with President Biden’s recent mandate on how you test, trace, and maintain the credentials of employees, vendors, and patients. We start to get into consumerism and pulling all this data together to say, it’s safe for Tim to enter a building and it’s safe for Bob to enter a building based on our policies as a health system. That will persist long after COVID comes and goes because we will never, ever allow ourselves to come offline to the extent we have during COVID times.
Over these next three to five years, those three elements and cornerstones of our business will continue to be dominant trends in the eyes of the CIOs, CFOs, and CMOs that we support.